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Bartold M, Ivanovski S. Biological processes and factors involved in soft and hard tissue healing. Periodontol 2000 2024. [PMID: 38243683 DOI: 10.1111/prd.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 01/21/2024]
Abstract
Wound healing is a complex and iterative process involving myriad cellular and biologic processes that are highly regulated to allow satisfactory repair and regeneration of damaged tissues. This review is intended to be an introductory chapter in a volume focusing on the use of platelet concentrates for tissue regeneration. In order to fully appreciate the clinical utility of these preparations, a sound understanding of the processes and factors involved in soft and hard tissue healing. This encompasses an appreciation of the cellular and biological mediators of both soft and hard tissues in general as well as specific consideration of the periodontal tissues. In light of good advances in this basic knowledge, there have been improvements in clinical strategies and therapeutic management of wound repair and regeneration. The use of platelet concentrates for tissue regeneration offers one such strategy and is based on the principles of cellular and biologic principles of wound repair discussed in this review.
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Affiliation(s)
- Mark Bartold
- University of Queensland, Brisbane, Queensland, Australia
| | - Saso Ivanovski
- University of Queensland, Brisbane, Queensland, Australia
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2
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Gliemann L, Rytter N, Jørgensen TS, Piil P, Carter H, Nyberg M, Grassi M, Daumer M, Hellsten Y. The Impact of Lower Limb Immobilization and Rehabilitation on Angiogenic Proteins and Capillarization in Skeletal Muscle. Med Sci Sports Exerc 2021; 53:1797-1806. [PMID: 33787530 DOI: 10.1249/mss.0000000000002665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Skeletal muscle vascularization is important for tissue regeneration after injury and immobilization. We examined whether complete immobilization influences capillarization and oxygen delivery to the muscle and assessed the efficacy of rehabilitation by aerobic exercise training. METHODS Young healthy males had one leg immobilized for 14 d and subsequently completed 4 wk of intense aerobic exercise training. Biopsies were obtained from musculus vastus lateralis, and arteriovenous blood sampling for assessment of oxygen extraction and leg blood flow during exercise was done before and after immobilization and training. Muscle capillarization, muscle and platelet content of vascular endothelial growth factor (VEGF), and muscle thrombospondin-1 were determined. RESULTS Immobilization did not have a significant impact on capillary per fiber ratio or capillary density. The content of VEGF protein in muscle samples was reduced by 36% (P = 0.024), and VEGF to thrombospondin-1 ratio was 94% lower (P = 0.046). The subsequent 4-wk training period increased the muscle VEGF content and normalized the muscle VEGF to thrombospondin-1 ratio but did not influence capillarization. Platelet VEGF content followed the trend of muscle VEGF. At the functional level, oxygen extraction, blood flow, and oxygen delivery at rest and during submaximal exercise were not affected by immobilization or training. CONCLUSIONS The results demonstrate that just 2 wk of leg immobilization leads to a strongly reduced angiogenic potential as evidenced by reduced muscle and platelet VEGF content and a reduced muscle VEGF to thrombospondin-1 ratio. Moreover, a subsequent period of intensive aerobic exercise training fails to increase capillarization in the previously immobilized leg, possibly because of the angiostatic condition caused by immobilization.
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Affiliation(s)
- Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Tue Smith Jørgensen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Peter Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Howard Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Marcello Grassi
- Technical University of Munich, Germany. Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, GERMANY
| | - Martin Daumer
- Technical University of Munich, Germany. Sylvia Lawry Centre for Multiple Sclerosis Research, Munich, GERMANY
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
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Phase I/II Clinical Trial of Autologous Activated Platelet-Rich Plasma (aaPRP) in the Treatment of Severe Coronavirus Disease 2019 (COVID-19) Patients. Int J Inflam 2021; 2021:5531873. [PMID: 34306612 PMCID: PMC8285191 DOI: 10.1155/2021/5531873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/07/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022] Open
Abstract
Background The outbreak of Coronavirus Disease 2019 (COVID-19) has been increasing rapidly. This disease causes an increase in proinflammatory cytokine production that leads to cytokine storm or cytokine release syndrome (CRS). Autologous activated platelet-rich plasma (aaPRP) contains various types of growth factors and anti-inflammatory cytokines that may have the potential to suppress CRS. This study of phase I/II trial was aimed to evaluate the safety and efficacy of aaPRP to treat severe COVID-19 patients. Methods A total of 10 severe COVID-19 patients from Koja Regional Public Hospital (Koja RPH) were admitted to the intensive care unit (ICU). All patients received aaPRP administration three times. Primary outcomes involving the duration of hospitalization, oxygen needs, time of recovery, and mortality were observed. Secondary outcomes involving C-reactive protein (CRP), neutrophil, lymphocyte, and lymphocyte-to-CRP (LCR) and neutrophil-lymphocyte ratio (NLR) were analyzed. Results All patients were transferred to the ICU with a median duration of 9 days. All patients received oxygen at enrollment and nine of ten patients recovered from the ICU and transferred to the ward room. There was one patient who passed away in the ICU due to heart failure. The results of secondary outcomes showed that CRP value and lymphocytes counts were significantly decreased while neutrophils, LCR, and NLR were slightly increased after aaPRP administration. Conclusions Our results of the phase I/II trial demonstrated that the use of aaPRP in severe COVID-19 patients was safe and not associated with serious adverse events, which showed that aaPRP was a promising adjunctive therapy for severe COVID-19 patients.
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Gliemann L, Rytter N, Yujia L, Tamariz-Ellemann A, Carter H, Hellsten Y. A High Activity Level Is Required for Augmented Muscle Capillarization in Older Women. Med Sci Sports Exerc 2021; 53:894-903. [PMID: 33844669 DOI: 10.1249/mss.0000000000002566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to evaluate the influence of lifelong regular physical activity on skeletal muscle capillarization in women. METHODS Postmenopausal women, 61±4 yr old, were divided according to self-reported physical activity level over the past 20 yrs: sedentary (SED; n = 14), moderately active (MOD; n = 12), and very active (VERY; n = 15). Leg blood flow (LBF) was determined by ultrasound Doppler, and blood samples were drawn from the femoral artery and vein for calculation of leg oxygen uptake (LVO2) at rest and during one-legged knee extensor exercise. A skeletal muscle biopsy was obtained from the vastus lateralis and analyzed for capillarization and vascular endothelial growth factor (VEGF) and mitochondrial OXPHOS proteins. Platelets were isolated from venous blood and analyzed for VEGF content and effect on endothelial cell proliferation. RESULTS The exercise-induced rise in LBF and LVO2 was faster (P = 0.008) in VERY compared with SED and MOD. Steady-state LBF and LVO2 were lower (P < 0.04) in MOD and VERY compared with SED. Capillary-fiber ratio and capillary density were greater (P < 0.03) in VERY (1.65 ± 0.48 and 409.3 ± 57.5) compared with MOD (1.30 ± 0.19 and 365.0 ± 40.2) and SED (1.30 ± 0.30 and 356.2 ± 66.3). Skeletal muscle VEGF and OXPHOS complexes I, II, and V were ~1.6-fold and ~1.25-fold (P < 0.01) higher, respectively, in VERY compared with SED. Platelets from all groups induced an approximately nine-fold (P < 0.001) increase in endothelial cell proliferation. CONCLUSION A very active lifestyle is associated with superior skeletal muscle exercise hemodynamics and greater potential for oxygen extraction concurrent with a higher skeletal muscle capillarization and mitochondrial capacity.
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Affiliation(s)
- Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Nicolai Rytter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | | | | | - Howard Carter
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, DENMARK
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Karina K, Christoffel LM, Novariani R, Rosadi I, Rosliana I, Rosidah S, Sobariah S, Fatkhurohman N, Puspitaningrum N, Hertati Y, Afini I, Ernanda D, Widyastuti T, Sulaeha AD, Zakiyah A, Aini N, Krisandi G, Andrew H. The Effect of Intravenous Autologous Activated Platelet-Rich Plasma Therapy on "Profibrotic Cytokine" IL-1 β Levels in Severe and Critical COVID-19 Patients: A Preliminary Study. SCIENTIFICA 2021; 2021:9427978. [PMID: 34306796 PMCID: PMC8266471 DOI: 10.1155/2021/9427978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/25/2021] [Accepted: 06/26/2021] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Elevated concentration of proinflammatory cytokines followed by hyperinflammation is one of the hallmarks of severe and critical COVID-19. In the short term, this may result in ARDS and lung injury; subsequently, this may cause pulmonary fibrosis-a disease with poor prognosis-in the long run. Among the cytokines, interleukin-1β (IL-1β) is one of the most overexpressed in COVID-19. We speculate that administration of intravenous activated autologous platelet-rich plasma (aaPRP), which contains interleukin-1 receptor antagonist (IL-1RA), would lower IL-1β levels and benefit the severe and critical COVID-19 patients. METHODS After acquiring ethical clearance, we recruited 12 adult COVID-19 patients of both sexes from the Koja Regional Hospital (Jakarta, Indonesia) ICU. After selection, seven patients were included and divided into two groups, severe and critical. In addition to three doses of aaPRP, both groups received the same treatment of antiviral, steroid, and antibiotics. Quantification of plasma IL-1β levels was performed by beads multiplex assay a day before the first aaPRP administration and a day after the second and third aaPRP administration. PaO2/FiO2 ratio and lung injury scores were evaluated a day before and a day after each aaPRP administration. RESULTS Severe and critical patients' initial plasma IL-1β concentration was 4.71 pg/mL and 3.095 pg/mL, respectively. After 2 treatments with aaPRP, severe patients' plasma IL-1β concentration decreased 12.48 pg/mL, while critical patients' plasma IL-1β concentration increased to 18.77 pg/mL. Furthermore, after 3 aaPRP treatments, significant amelioration of patients' PaO2/FiO2 ratio from 71.33 mmHg at baseline to 144.97 mmHg was observed (p < 0.05). However, no significant improvement in lung injury score was observed in severe and critical groups. All severe patients and one critical patient recovered. CONCLUSION The use of aaPRP may prevent pulmonary fibrosis in severe COVID-19 patients through the reduction of patients' plasma IL-1β concentration and the amelioration of PaO2/FiO2 ratio.
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Affiliation(s)
- Karina Karina
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
- Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia
- Pusat Kajian Stem Cell, Universitas Pembangunan Nasional Veteran Jakarta, Jakarta, Indonesia
| | | | - Rita Novariani
- Koja Regional Public Hospital, Jl. Deli No. 4, Jakarta, Indonesia
| | - Imam Rosadi
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
- Department of Biology, Faculty of Mathematics and Natural Sciences, Mulawarman University, Samarinda, Indonesia
| | - Iis Rosliana
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Siti Rosidah
- Koja Regional Public Hospital, Jl. Deli No. 4, Jakarta, Indonesia
| | - Siti Sobariah
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | | | | | - Yuli Hertati
- Koja Regional Public Hospital, Jl. Deli No. 4, Jakarta, Indonesia
| | - Irsyah Afini
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Difky Ernanda
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Tias Widyastuti
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - A. D. Sulaeha
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Alfida Zakiyah
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Noor Aini
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
| | - Grady Krisandi
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
- Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, Indonesia
| | - Hubert Andrew
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta, Indonesia
- Universitas Indonesia, Jl. Salemba Raya No. 6, Jakarta, Indonesia
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Chen J, Wan Y, Lin Y, Jiang H. The application of platelet-rich plasma for skin graft enrichment: A meta-analysis. Int Wound J 2020; 17:1650-1658. [PMID: 32633467 DOI: 10.1111/iwj.13445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
Existing evidence demonstrated that the role of platelet-rich plasma (PRP) in skin graft enrichment is uncertain. The aim of this study was to evaluate the efficacy and safety of PRP for skin graft. PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for randomised controlled trials that compared outcomes of skin graft treated with PRP versus those treated with blank controls. The outcomes mainly included the rate of skin graft take, number of skin graft loss and haematoma formation, and complications. There were 11 studies involving a total of 910 cases of skin grafts. Compared with the control group, PRP group had a significantly higher rate of skin graft take (mean difference = 5.47%; 95% confidence interval [CI], 2.80%-8.14%; P < .0001), fewer number of skin graft loss (risk ratio [RR] = 0.26; 95% CI, 0.13-0.55; P = .0004) and fewer cases of haematoma formation (RR = 0.24; 95% CI, 0.11-0.54; P = .0006). There was no significant difference in the incidence of complications between two groups. This meta-analysis summarises current evidence and indicates that PRP is a safe and effective adjuvant for skin graft enrichment.
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Affiliation(s)
- Jianguo Chen
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingying Wan
- Department of Internal Medicine, Xi Yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Lin
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyue Jiang
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Karina K, Rosliana I, Rosadi I, Schwartz R, Sobariah S, Afini I, Widyastuti T, Remelia M, Wahyuningsih KA, Pawitan JA. Safety of Technique and Procedure of Stromal Vascular Fraction Therapy: From Liposuction to Cell Administration. SCIENTIFICA 2020; 2020:2863624. [PMID: 32695550 PMCID: PMC7362293 DOI: 10.1155/2020/2863624] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/24/2020] [Accepted: 06/12/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Stromal vascular fraction (SVF) therapy has been performed over the past six years to treat 421 patients by our group in five clinical centers. Autologous SVF, which is a substance containing stem cells, was isolated from lipoaspirate, mixed with platelet-rich plasma (PRP), and administered to patients with degenerative diseases, autoimmune diseases, trauma, aging, and other diseases with unknown etiology. This study aimed to determine the safety of SVF and PRP that were given through infusion, spinal, and intra-articular injection. METHODS The lipoaspirate was treated with a tissue-dissociating enzyme, and then, through centrifugation, SVF was isolated. In addition, blood was drawn from each patient, and PRP was isolated. Autologous PRP and SVF were administered to all subjects by intravenous (IV) injection. A minority group within the population received an additional spinal or intra-articular injection. The type of intervention was determined by each disease evaluation. The cell doses and adverse events for each patient were documented and analyzed. RESULTS Cell dose that was considered to be safe was less than 10 billion SVF cells in 250 cc of normal saline, for IV injection, and less than 1 billion SVF, for intra-articular and spinal injection. Adverse events were not severe and were treated successfully. Any observed adverse events were identified as a result of spinal or intra-articular injections and were not related to SVF or PRP. CONCLUSIONS Our results showed that administration of high dose of SVF until 10 billion cells in a majority of 421 patients through infusion, spinal, and intra-articular injection was feasible without causing major adverse events and should be further investigated in well-designed phase I-II clinical trial to address the safety and efficacy of therapy.
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Affiliation(s)
- Karina Karina
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Iis Rosliana
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Imam Rosadi
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Rachel Schwartz
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
| | - Siti Sobariah
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Irsyah Afini
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Tias Widyastuti
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
| | - Melinda Remelia
- Department of Basic Biomedicine, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia
| | - Komang Ardi Wahyuningsih
- Klinik Hayandra, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
- HayandraLab, Yayasan Hayandra Peduli, Jl. Kramat VI No. 11, Jakarta Pusat, Indonesia
- Department of Histology, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
| | - Jeanne A. Pawitan
- Department of Histology, Faculty of Medicine, Universitas Indonesia, Jl. Salemba 6, Jakarta Pusat, Indonesia
- Stem Cell Medical Technology Integrated Service Unit, Dr. Cipto Mangunkusumo General Hospital/Faculty of Medicine, Universitas Indonesia, Jl. Diponegoro 71, Jakarta 10430, Indonesia
- Stem Cell and Tissue Engineering Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jl. Salemba 6, Jakarta 10430, Indonesia
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D'Esposito V, Lecce M, Marenzi G, Cabaro S, Ambrosio MR, Sammartino G, Misso S, Migliaccio T, Liguoro P, Oriente F, Fortunato L, Beguinot F, Sammartino JC, Formisano P, Gasparro R. Platelet-rich plasma counteracts detrimental effect of high-glucose concentrations on mesenchymal stem cells from Bichat fat pad. J Tissue Eng Regen Med 2020; 14:701-713. [PMID: 32174023 DOI: 10.1002/term.3032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/05/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022]
Abstract
Diabetic patients display increased risk of periodontitis and failure in bone augmentation procedures. Mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) represent a relevant advantage in tissue repair process and regenerative medicine. We isolated MSCs from Bichat's buccal fat pad (BFP) and measured the effects of glucose and PRP on cell number and osteogenic differentiation potential. Cells were cultured in the presence of 5.5-mM glucose (low glucose [LG]) or 25-mM glucose (high glucose [HG]). BFP-MSC number was significantly lower when cells were cultured in HG compared with those in LG. Following osteogenic differentiation procedures, calcium accumulation, alkaline phosphatase activity, and expression of osteogenic markers were significantly lower in HG compared with LG. Exposure of BFP-MSC to PRP significantly increased cell number and osteogenic differentiation potential, reaching comparable levels in LG and in HG. Thus, high-glucose concentrations impair BFP-MSC growth and osteogenic differentiation. However, these detrimental effects are largely counteracted by PRP.
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Affiliation(s)
- Vittoria D'Esposito
- URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy.,Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Manuela Lecce
- Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Gaetano Marenzi
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Naples, Italy
| | - Serena Cabaro
- URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy.,Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Maria Rosaria Ambrosio
- URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy.,Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Gilberto Sammartino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Naples, Italy
| | - Saverio Misso
- Unit of Transfusion Medicine, ASL-CE, Caserta, Italy
| | - Teresa Migliaccio
- Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Pasquale Liguoro
- Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Francesco Oriente
- Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Leonzio Fortunato
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Francesco Beguinot
- URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy.,Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | | | - Pietro Formisano
- URT "Genomics of Diabetes," Institute of Experimental Endocrinology and Oncology, National Research Council, Naples, Italy.,Department of Translational Medicine, "Federico II" University of Naples, Naples, Italy
| | - Roberta Gasparro
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Naples, Italy
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