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Brenchley JM, Serrano-Villar S. From dysbiosis to defense: harnessing the gut microbiome in HIV/SIV therapy. MICROBIOME 2024; 12:113. [PMID: 38907315 PMCID: PMC11193286 DOI: 10.1186/s40168-024-01825-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/26/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Although the microbiota has been extensively associated with HIV pathogenesis, the majority of studies, particularly those using omics techniques, are largely correlative and serve primarily as a basis for hypothesis generation. Furthermore, most have focused on characterizing the taxonomic composition of the bacterial component, often overlooking other levels of the microbiome. The intricate mechanisms by which the microbiota influences immune responses to HIV are still poorly understood. Interventional studies on gut microbiota provide a powerful tool to test the hypothesis of whether we can harness the microbiota to improve health outcomes in people with HIV. RESULTS Here, we review the multifaceted role of the gut microbiome in HIV/SIV disease progression and its potential as a therapeutic target. We explore the complex interplay between gut microbial dysbiosis and systemic inflammation, highlighting the potential for microbiome-based therapeutics to open new avenues in HIV management. These include exploring the efficacy of probiotics, prebiotics, fecal microbiota transplantation, and targeted dietary modifications. We also address the challenges inherent in this research area, such as the difficulty in inducing long-lasting microbiome alterations and the complexities of study designs, including variations in probiotic strains, donor selection for FMT, antibiotic conditioning regimens, and the hurdles in translating findings into clinical practice. Finally, we speculate on future directions for this rapidly evolving field, emphasizing the need for a more granular understanding of microbiome-immune interactions, the development of personalized microbiome-based therapies, and the application of novel technologies to identify potential therapeutic agents. CONCLUSIONS Our review underscores the importance of the gut microbiome in HIV/SIV disease and its potential as a target for innovative therapeutic strategies.
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Affiliation(s)
- Jason M Brenchley
- Barrier Immunity Section, Lab of Viral Diseases, NIAID, NIH, Bethesda, MA, USA.
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, IRYCIS and CIBERInfec, Madrid, Spain.
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Kranyak A, Haran K, Smith P, Johnson C, Liao W, Bhutani T. The Mediterranean Diet as a Potential Solution to the Gut Microbiome Dysbiosis in Psoriasis Patients. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2024; 9:69-81. [PMID: 39156223 PMCID: PMC11329232 DOI: 10.1177/24755303241226626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
Background Adherence to a Mediterranean Diet (MeD) has been associated with lower disease severity in patients with psoriasis. However, the mechanism behind how this diet may lead to disease modification remain understudied. Recent studies have revealed dysbiosis of the gut microbiome in patients with psoriasis suggestive of inflammation and altered immune regulation. Diet affects the gut microbiome and this review aims to evaluate whether correcting this dysbiosis may be one theoretical mechanism by which the MeD may be associated with lower psoriasis severity. Methods A literature search of the PubMed database was conducted for the terms 1) 'psoriasis' and 'microbiome' or 'microbiota,' and 2) 'Mediterranean diet' and 'microbiome' or 'microbiota' with manual screening for relevant articles. In total, we identified 9 relevant primary research studies investigating the gut microbiome in patients with psoriasis and 16 relevant primary research studies investigating changes in the microbiota for those consuming a MeD. Results Though varying in exact levels of certain bacteria, studies analyzing the microbiome in psoriasis revealed dysbiosis. Those analyzing the effect of the Mediterranean diet on the microbiome revealed beneficial changes, including alleviating some of the same alterations seen in the microbiome of those with psoriasis. Conclusion Microbiota change is a possible mechanism why the MeD has previously been associated with lower psoriasis severity.
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Affiliation(s)
- Allison Kranyak
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn Haran
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Payton Smith
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Chandler Johnson
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
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Basta D, Latinovic OS, Tagaya Y, Silvestri G. Potential Advantages of a Well-balanced Nutrition Regimen for People Living with Human Immunodeficiency Virus Type -1. JOURNAL OF AIDS AND HIV TREATMENT 2024; 6:11-27. [PMID: 38845818 PMCID: PMC11155617 DOI: 10.33696/aids.6.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
This review underscores the important role of nutrition in enhancing the management of Human Immunodeficiency Virus type 1 (HIV-1). Highlighting the efficacy of dietary interventions, including, the importance of omega-3 fatty acids, vitamins D and B-12, and the Mediterranean diet, we delineate how these beneficial nutritional strategies can improve the effectiveness of combined antiretroviral therapy (cART), mitigate its side effects, and ameliorate metabolic disorders in people living with HIV-1 (PLWH). Our review advocates for the integration and implementation of personalized nutritional assessments into the care plan for PLWH, proposing actionable strategies for healthcare providers in HIV-1 field. Summarizing the current standing of the relevance of the nutritional and well-planned diet recommended for the PLWH and emphasizing on the future research directions, this review establishes a foundation for nutrition as a cornerstone in comprehensive HIV-1 management. Our review aims to improve patients' health outcomes and overall quality of life for PLWH.
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Affiliation(s)
- Daniele Basta
- Green Home scarl, Scientific Committee, Arcavacata di Rende (CS), Italy
| | - Olga S. Latinovic
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
| | - Yutaka Tagaya
- Division of Virology, Pathogenesis, and Cancer, Institute of Human Virology, University of Maryland School of Medicine, MD, 21201, USA
| | - Giovannino Silvestri
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 21201, USA
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Casas R. Dietary Pattern and Nutrients Intake on Chronic Diseases. Nutrients 2023; 15:3399. [PMID: 37571335 PMCID: PMC10420802 DOI: 10.3390/nu15153399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Non-communicable diseases (NCDs) are the leading causes of mortality and morbidity worldwide, primarily affecting middle-aged men, and imposing a significant global public health burden [...].
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Affiliation(s)
- Rosa Casas
- Centro de Investigación Biomédica en Red (CIBEROBN) de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Internal Medicine, Hospital Clinic, Institut d’Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036 Barcelona, Spain
- Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, 08007 Barcelona, Spain
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Abstract
PURPOSE OF REVIEW Weight gain has emerged as an important problem in people with HIV (PWH). When dealing with obesity, PWH face additional challenges to those without HIV. Understanding the nature of the problem and the modern evidence is essential to optimize management and identify knowledge gaps. RECENT FINDINGS Some PWH treated with antiretroviral therapy (ART) gain unhealthy amounts of weight and develop consequences of obesity. Newer agents have been consistently associated with excessive weight gain. Key studies are underway to inform the optimal use of specific ART in PWH dealing with obesity. For weight management, behavioral interventions fostering a healthier and active lifestyle, coupled with pharmacological therapies such as glucagon-like peptide 1 receptor agonists may be effective strategies in PWH, as recently demonstrated in those without HIV, although data in this regard is pending. SUMMARY A growing body of research has come to light in recent years regarding weight gain and obesity in PWH. However, much of the knowledge that inform current practices is extrapolated from studies in people without HIV. Modern ART regimens may promote excessive weight gain in some, and more research is needed to optimize ART selection and the use of weight loss medications.
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Affiliation(s)
- Luis Parra-Rodriguez
- Department of Medicine, Division of Infectious Diseases, Washington University in St. Louis, St. Louis, MO, USA
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Ellwanger JH, Kulmann-Leal B, Ziliotto M, Chies JAB. HIV Infection, Chromosome Instability, and Micronucleus Formation. Viruses 2023; 15:155. [PMID: 36680195 PMCID: PMC9867034 DOI: 10.3390/v15010155] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
Genome integrity is critical for proper cell functioning, and chromosome instability can lead to age-related diseases, including cancer and neurodegenerative disorders. Chromosome instability is caused by multiple factors, including replication stress, chromosome missegregation, exposure to pollutants, and viral infections. Although many studies have investigated the effects of environmental or lifestyle genotoxins on chromosomal integrity, information on the effects of viral infections on micronucleus formation and other chromosomal aberrations is still limited. Currently, HIV infection is considered a chronic disease treatable by antiretroviral therapy (ART). However, HIV-infected individuals still face important health problems, such as chronic inflammation and age-related diseases. In this context, this article reviews studies that have evaluated genomic instability using micronucleus assays in the context of HIV infection. In brief, HIV can induce chromosome instability directly through the interaction of HIV proteins with host DNA and indirectly through chronic inflammation or as a result of ART use. Connections between HIV infection, immunosenescence and age-related disease are discussed in this article. The monitoring of HIV-infected individuals should consider the increased risk of chromosome instability, and lifestyle interventions, such as reduced exposure to genotoxins and an antioxidant-rich diet, should be considered. Therapies to reduce chronic inflammation in HIV infection are needed.
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Affiliation(s)
- Joel Henrique Ellwanger
- Postgraduate Program in Genetics and Molecular Biology (PPGBM), Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91501-970, Brazil
| | | | | | - José Artur Bogo Chies
- Postgraduate Program in Genetics and Molecular Biology (PPGBM), Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 91501-970, Brazil
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Jaber M, Altamimi M, Altamimi A, Cavaliere S, De Filippis F. Mediterranean diet diminishes the effects of Crohn's disease and improves its parameters: A systematic review. Nutr Health 2022:2601060221102281. [PMID: 35611526 DOI: 10.1177/02601060221102281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The pathogenesis and clinical course of Crohn's disease (CD) is influenced by diet. Mediterranean Diet (MD) helps Crohn's patients through many mechanisms. AIMS This study aimed to evaluate the effect of the MD on CD patients and to evaluate such effect on body parameters. METHODS PubMed, Science Direct, Web of Science, MEDLINE and Cochrane central library were searched for MD and CD from 2010 to 2020. Included studies met the following criteria: (1) male and female adults (18-75 years) with a confirmed diagnosis of CD; (2) MD as an intervention; (3) original interventional Trial, Cross-Sectional Analysis, or Prospective Cohort Studies. RESULTS Five studies were included, involving 83,564 participants. A small number of patients with CD fulfilled the P-MDS criteria, the overall scores were low, 4.7 and 4.5 for females and males respectively. Patients with an inactive disease whose adherence to MD was greater, the MD score was negatively correlated with disease activity (p <0.001) and positively with IBDQ (p = 0.008). Twenty-seven percent had a prevalence of impaired adherence to a MD (mMED score = 0-2), giving such a population a risk attributed to 12% for the later CD. Seventy-point reduction in CDAI + decreased fecal CRP / calprotectin, calprotectin <250 mcg/gm or >50% decrease from baseline and hsCRP < 5 mg/L or >50% from baseline. CONCLUSIONS MD showed anti-inflammatory properties. Adherence to MD was associated with improvement in CD patients and negatively correlated with the disease activity, in addition to a lower risk of developing CD later in life.
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Affiliation(s)
- Mawada Jaber
- Department of Nutrition and food technology, An-Najah National University, Nablus, Palestine
| | - Mohammad Altamimi
- Department of Nutrition and food technology, An-Najah National University, Nablus, Palestine
| | - Almothana Altamimi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sara Cavaliere
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
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Ferrari B, Da Silva AC, Liu KH, Saidakova EV, Korolevskaya LB, Shmagel KV, Shive C, Pacheco Sanchez G, Retuerto M, Sharma AA, Ghneim K, Noel-Romas L, Rodriguez B, Ghannoum MA, Hunt PP, Deeks SG, Burgener AD, Jones DP, Dobre MA, Marconi VC, Sekaly RP, Younes SA. Gut-derived bacterial toxins impair memory CD4+ T cell mitochondrial function in HIV-1 infection. J Clin Invest 2022; 132:e149571. [PMID: 35316209 PMCID: PMC9057623 DOI: 10.1172/jci149571] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
People living with HIV (PLWH) who are immune nonresponders (INRs) are at greater risk of comorbidity and mortality than are immune responders (IRs) who restore their CD4+ T cell count after antiretroviral therapy (ART). INRs have low CD4+ T cell counts (<350 c/μL), heightened systemic inflammation, and increased CD4+ T cell cycling (Ki67+). Here, we report the findings that memory CD4+ T cells and plasma samples of INRs from several cohorts are enriched in gut-derived bacterial solutes p-cresol sulfate (PCS) and indoxyl sulfate (IS) that both negatively correlated with CD4+ T cell counts. In vitro PCS or IS blocked CD4+ T cell proliferation, induced apoptosis, and diminished the expression of mitochondrial proteins. Electron microscopy imaging revealed perturbations of mitochondrial networks similar to those found in INRs following incubation of healthy memory CD4+ T cells with PCS. Using bacterial 16S rDNA, INR stool samples were found enriched in proteolytic bacterial genera that metabolize tyrosine and phenylalanine to produce PCS. We propose that toxic solutes from the gut bacterial flora may impair CD4+ T cell recovery during ART and may contribute to CD4+ T cell lymphopenia characteristic of INRs.
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Affiliation(s)
- Brian Ferrari
- Department of Medicine, Division of Infectious Diseases and HIV Medicine, Center for AIDS Research, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Amanda Cabral Da Silva
- Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine and
| | - Ken H. Liu
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Evgeniya V. Saidakova
- Institute of Ecology and Genetics of Microorganisms, Perm Federal Research Center Ural Branch Russian Academy of Sciences, Perm, Russia
- Department of Microbiology and Immunology, Perm State University, Perm, Russia
| | - Larisa B. Korolevskaya
- Institute of Ecology and Genetics of Microorganisms, Perm Federal Research Center Ural Branch Russian Academy of Sciences, Perm, Russia
| | - Konstantin V. Shmagel
- Institute of Ecology and Genetics of Microorganisms, Perm Federal Research Center Ural Branch Russian Academy of Sciences, Perm, Russia
| | - Carey Shive
- Department of Medicine, Division of Infectious Diseases and HIV Medicine, Center for AIDS Research, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Cleveland VA Medical Center, Cleveland, Ohio, USA
| | - Gabriela Pacheco Sanchez
- Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine and
| | - Mauricio Retuerto
- Institute of Ecology and Genetics of Microorganisms, Perm Federal Research Center Ural Branch Russian Academy of Sciences, Perm, Russia
| | | | - Khader Ghneim
- Department of Microbiology and Immunology, Perm State University, Perm, Russia
| | - Laura Noel-Romas
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University/University Hospitals Case Medical Center, Cleveland, Ohio, USA
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
| | - Benigno Rodriguez
- Department of Medicine, Division of Infectious Diseases and HIV Medicine, Center for AIDS Research, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mahmoud A. Ghannoum
- Integrated Microbiome Core, Department of Dermatology, Case Western Reserve University/University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Peter P. Hunt
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Steven G. Deeks
- Department of Medicine, UCSF, San Francisco, California, USA
| | - Adam D. Burgener
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dean P. Jones
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Mirela A. Dobre
- Department of Medicine (Nephrology), Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Vincent C. Marconi
- Division of Infectious Diseases, Department of Global Health, and Department of Global Health, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Rafick-Pierre Sekaly
- Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine and
| | - Souheil-Antoine Younes
- Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine and
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Relationship of Diet to Gut Microbiota and Inflammatory Biomarkers in People with HIV. Nutrients 2022; 14:nu14061221. [PMID: 35334878 PMCID: PMC8954190 DOI: 10.3390/nu14061221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
While changes in microbiome composition have been associated with HIV, the effect of diet and its potential impact on inflammation remains unclear. Methods: Twenty-seven people living with HIV (PWH) on antiretroviral therapy (ART) were studied. A comprehensive dietary analysis was performed and two types of dietary patterns were determined. We explored the associations of each dietary pattern with gut microbiota and plasma inflammatory biomarkers. Results: We appreciated two dietary patterns, Mediterranean-like (MEL) and one Western-like (WEL). Compared to participants with the WEL pattern, participants with MEL pattern showed higher abundance of Lachnospira (p-value = 0.02) and lower levels of the inflammatory biomarkers D-dimer (p-value = 0.050) and soluble TNF-alpha receptor 2 (sTNFR2) (p-value = 0.049). Men who have sex with men (MSM) with MEL pattern had lower abundance of Erysipelotrichaceae (p-value < 0.001) and lower levels of D-dimer (p-value = 0.026) than MSM with WEL pattern. Conclusion: MEL pattern favours Lachnospira abundance, and protects against Erysipelotrichaceae abundance and higher levels of the inflammatory biomarkers D-dimer and sTNFR2, precursors of inflammatory processes in HIV-infected patients. Our study contributes to understanding the determinants of a healthier diet and its connections with gut microbiota and inflammation.
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Younes SA. Mitochondrial Exhaustion of Memory CD4 T-Cells in Treated HIV-1 Infection. IMMUNOMETABOLISM 2022; 4:e220013. [PMID: 35633761 PMCID: PMC9140223 DOI: 10.20900/immunometab20220013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
People living with HIV (PLWH) who are immune non-responders (INR) to therapy are unable to restore their CD4 T-cell count and remain at great risk of morbidity and mortality. Here the mitochondrial defects that characterize memory CD4 T-cells in INR and causes of this mitochondrial exhaustion are reviewed. This review also describes the various reagents used to induce the expression of the peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α), the master regulator of mitochondrial biogenesis, which can restore mitochondria fitness and CD4 T-cell proliferation in INR. Due to sustained heightened inflammation in INR, the mitochondrial network is unable to be rejuvenated and requires attenuation of mediators of inflammation to rescue mitochondria and CD4 T-cell counts in INR.
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Affiliation(s)
- Souheil-Antoine Younes
- Department of Pathology, Pathology Advanced Translational Research (PATRU), School of Medicine, Emory University, Atlanta 30322, USA
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Gervasi T, Barreca D, Laganà G, Mandalari G. Health Benefits Related to Tree Nut Consumption and Their Bioactive Compounds. Int J Mol Sci 2021; 22:ijms22115960. [PMID: 34073096 PMCID: PMC8198490 DOI: 10.3390/ijms22115960] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/1970] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 12/20/2022] Open
Abstract
Long-term studies with regular tree nut consumption have indicated positive outcomes for multiple health benefits. Here, we review the beneficial effects of tree nuts, highlighting the impact on glucose modulation, body weight management, cardiovascular risk, inflammation, oxidative stress, cognitive performance, and gut microbiota. Nuts are important sources of nutrients and phytochemicals, which, together with a healthy lipid profile, could help prevent certain chronic diseases, protect against oxidative stress and inflammation, and improve cognitive performance, thus reducing the impact of aging and neurodegeneration.
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Affiliation(s)
- Teresa Gervasi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98168 Messina, Italy;
| | - Davide Barreca
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (G.L.); (G.M.)
- Correspondence: ; Tel.: +39-(0)906765187
| | - Giuseppina Laganà
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (G.L.); (G.M.)
| | - Giuseppina Mandalari
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 98168 Messina, Italy; (G.L.); (G.M.)
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