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Adorni MP, Papotti B, Borghi MO, Raschi E, Zimetti F, Bernini F, Meroni PL, Ronda N. Effect of the JAK/STAT Inhibitor Tofacitinib on Macrophage Cholesterol Metabolism. Int J Mol Sci 2023; 24:12571. [PMID: 37628747 PMCID: PMC10454555 DOI: 10.3390/ijms241612571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
The impact of JAK/STAT inhibitors, which are used in various inflammatory diseases, on cardiovascular risk is controversial and has recently raised safety concerns. Our study investigates the direct effects of tofacitinib on macrophage cholesterol metabolism, which is crucial for atherosclerosis plaque development and stability. Cultured human macrophages THP-1 were used to assess the impact of tofacitinib on cell cholesterol efflux and synthesis via radioisotopic methods, and on cholesterol uptake by measuring the cell cholesterol content with a fluorometric assay. The cholesterol acceptors and donors were either standard lipoproteins or sera from patients with juvenile idiopathic arthritis (JIA) and from control subjects. Tofacitinib significantly increased the macrophage cholesterol efflux to all acceptors; it reduced cholesterol uptake from both the normal and hypercholesterolemic sera; and it reduced cholesterol synthesis. The treatment of macrophages with tofacitinib was able to increase the cholesterol efflux and decrease cholesterol uptake when using sera from untreated JIA patients with active disease as cholesterol acceptors and donors, respectively. In conclusion, our in vitro data support the concept that tofacitinib has a favorable impact on macrophage cholesterol metabolism, even in the presence of sera from rheumatologic patients, and suggest that other mechanisms may be responsible for the cardiovascular risk associated with tofacitinib use in selected patient populations.
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Affiliation(s)
- Maria Pia Adorni
- Unit of Neurosciences, Department of Medicine and Surgery, University of Parma, Via Volturno 39/F, 43125 Parma, Italy;
| | - Bianca Papotti
- Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy; (B.P.); (F.Z.); (F.B.)
| | - Maria Orietta Borghi
- Experimental Laboratory of Immuno-Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Cusano Milanino, Via Zucchi 18, 20095 Milan, Italy; (M.O.B.); (E.R.); (P.L.M.)
| | - Elena Raschi
- Experimental Laboratory of Immuno-Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Cusano Milanino, Via Zucchi 18, 20095 Milan, Italy; (M.O.B.); (E.R.); (P.L.M.)
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy; (B.P.); (F.Z.); (F.B.)
| | - Franco Bernini
- Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy; (B.P.); (F.Z.); (F.B.)
| | - Pier Luigi Meroni
- Experimental Laboratory of Immuno-Rheumatologic Researches, IRCCS Istituto Auxologico Italiano, Cusano Milanino, Via Zucchi 18, 20095 Milan, Italy; (M.O.B.); (E.R.); (P.L.M.)
| | - Nicoletta Ronda
- Department of Food and Drug, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy; (B.P.); (F.Z.); (F.B.)
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Piani F, Cicero AF, D'Addato S, Borghi C. From classical to innovative clinical epidemiology: the 50 years' experience of the Brisighella Heart Study. Panminerva Med 2021; 63:424-429. [PMID: 33878849 DOI: 10.23736/s0031-0808.21.04387-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The Brisighella Heart Study (BHS) is a long-term, prospective, population-based longitudinal study on 2939 randomly selected residents of the town of Brisighella, Emilia-Romagna, Italy. EVIDENCE ACQUISITION At the enrollment time in 1972 no participant had any cardiovascular disease, 1491 participants were men and 1448 women, and the age span was 14 to 84 years. EVIDENCE SYNTHESIS The observational phase of the study contributed to the evidence of a strong pathophysiological association between hypercholesterolemia and hypertension. The interventional phase was one of the first examples of successful cardiovascular risk reduction obtained through a population-based educational intervention. Currently, the BHS staff is planning its 11th four-yearly population survey in 2022. Today, the study is moving from an epidemiological perspective to a translational approach, involving advanced biomolecular analyses, genetic tests, and functional vascular investigations. CONCLUSIONS This review aims to summarize the main findings of the first 50 years of BHS research and spot the latest developments and future perspectives of this remarkable Italian cardiovascular study.
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Affiliation(s)
- Federica Piani
- IRCCS Policlinico S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Arrigo F Cicero
- IRCCS Policlinico S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Sergio D'Addato
- IRCCS Policlinico S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Claudio Borghi
- IRCCS Policlinico S. Orsola-Malpighi University Hospital, Bologna, Italy -
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Spigoni V, Aldigeri R, Picconi A, Derlindati E, Franzini L, Haddoub S, Prampolini G, Vigna GB, Zavaroni I, Bonadonna RC, Dei Cas A. Telomere length is independently associated with subclinical atherosclerosis in subjects with type 2 diabetes: a cross-sectional study. Acta Diabetol 2016; 53:661-7. [PMID: 27020053 DOI: 10.1007/s00592-016-0857-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/12/2016] [Indexed: 12/12/2022]
Abstract
AIMS Individuals with type 2 diabetes show shorter leukocyte telomere length (LTL) compared to people without diabetes. Reduced LTL is associated with increased carotid intima-media thickness (IMT) in healthy subjects. The aim of the study is to assess whether LTL also correlates with IMT in patients with diabetes. METHODS In a cohort of 104 subjects with type 2 diabetes and atherogenic dyslipidemia, we assessed anthropometric, hemodynamic and metabolic parameters. Common carotid IMT was expressed as the maximum IMT. LTL was assessed by a specific real-time PCR reaction. RESULTS At univariate analysis, IMT values were positively correlated with age (p < 0.001), previous history of cardiovascular events (p < 0.005), fasting plasma glucose (p < 0.01), HbA1c (p < 0.05) and negatively correlated with LTL (p < 0.05). In a multivariate model, age (p < 0.001) and LTL (p < 0.05) were the only independent predictors of maximum IMT, with an adjusted R (2) of 0.22. CONCLUSIONS LTL is an independent predictor of subclinical atherosclerosis pointing to a role of LTL as an early marker of vascular burden and cardiovascular disease also in type 2 diabetes.
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Affiliation(s)
- Valentina Spigoni
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Raffaella Aldigeri
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Angela Picconi
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Eleonora Derlindati
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Laura Franzini
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Silvia Haddoub
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Giorgia Prampolini
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Giovanni B Vigna
- Internal Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Ivana Zavaroni
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Riccardo C Bonadonna
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy
| | - Alessandra Dei Cas
- Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci, 14, 43126, Parma, Italy.
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Population health needs assessment and healthcare services use in a 3 years follow-up on administrative and clinical data: results from the Brisighella Heart Study. High Blood Press Cardiovasc Prev 2013; 21:45-51. [PMID: 24242956 DOI: 10.1007/s40292-013-0033-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 11/07/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION A large number of epidemiological trials clearly show the impact of the main cardiovascular disease risk factors in term of hospitalization and related cost, but relatively less frequently if this reflect the health needs of a given population. AIM To develop a model for the health needs-assessment that will be applied to verify if and how the prevalence of some classical risk factors for cardiovascular disease predicts mortality and hospitalisation episodes at 3 years, and if it could express the health need of that population. The long-life clinical record of 1,704 subjects, recruited during the 2004 Brisighella Heart Study survey, has been monitored. We defined the health profile of these subjects at 2004 (based on clinical history, smoking and dietary habits, physical activity, drug use, anthropometric data, blood pressure, and hematological data) and then sampled data relative to their hospitalisations, mortality, and general medical assistance. RESULTS Our results shows that age over 65 years (OR 4.08; 95 % CI 2.74-6.08), hypertension (OR 3.44; 95 % CI 2.36-5.01) and hypercholesterolemia (OR 1.33; 95 % CI 0.92-1.94) increase the probability to get hospitalised. Furthermore, the burden of care was defined and computed for our sample. Vascular and respiratory diseases [Burden of health care (Bc) = 24.5 and 36.5, respectively] are the most costly DRGs which means that the biggest part of our resources directed to cardiovascular patients were provided for these diagnoses. CONCLUSION The application of the proposed model could help policy makers and researchers in directing resources and workforce in the treatment of cardiovascular diseases.
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Cicero AFG, D'Addato S, Reggi A, Marchesini G, Borghi C. Gender difference in hepatic steatosis index and lipid accumulation product ability to predict incident metabolic syndrome in the historical cohort of the Brisighella Heart Study. Metab Syndr Relat Disord 2013; 11:412-6. [PMID: 23902132 DOI: 10.1089/met.2012.0147] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
UNLABELLED Abstract Background: Nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome are strongly related from both an epidemiological and a pathological point of view. The main aim of our study was to evaluate if two validated indexes of NAFLD are able to predict the 4-year metabolic syndrome incidence in a large population sample of pharmacologically untreated subjects without metabolic syndrome, type 2 diabetes, history of alcohol abuse, or known liver diseases at the baseline. METHODS From the database of the Brisighella Heart Study, we selected a subsample of 824 pharmacologically untreated subjects (male, 401; female, 423) without metabolic syndrome, type 2 diabetes, alcohol abuse, or known liver diseases at the 2004 survey and revisited in 2008. The Hepatic Steatosis Index (HSI) and Lipid Accumulation Product (LAP) values were calculated for everyone to evaluate their predictive role for metabolic syndrome through a Cox-regression analysis adjusted by metabolic syndrome components. RESULTS We observed 46 new cases of metabolic syndrome (male, 25; female, 21) with a cumulative incidence of 5.6% (1.4% per year): 6.2% in men (1.5% per year), 4.9% in women (1.2% per year). In women, the 4-year metabolic syndrome predictors (R(2)=0.680) were age [odds ratio (OR) 1.13, 95% confidence interval (CI) 1.12-1.15], HSI (OR 1.20, 95% CI 1.15-1.26), and lnLAP (OR 1.16, 95% CI 1.14-1.17), whereas in men they were (R(2)=0.554) age (OR 1.13, 95% CI 1.11-1.14) and lnLAP (OR 1.17, 95% CI 1.15-1.18). CONCLUSION HSI and LAP differently predict the 4-year incidence of metabolic syndrome. In women, both indexes can be considered significant predictors, whereas in men only LAP can be considered predictive.
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Affiliation(s)
- Arrigo F G Cicero
- 1 Department of Medical and Surgical Sciences, University of Bologna , Bologna, Italy
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Relationship between blood pressure, cholesterolemia and serum apolipoprotein B in a large population sample. J Hypertens 2012; 30:492-6. [DOI: 10.1097/hjh.0b013e32834f6b11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cicero AFG, Dormi A, D’Addato S, Borghi C. From risk factor assessment to cardiovascular disease risk and mortality modification: the first 40 years of the Brisighella Heart Study. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/clp.11.23] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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