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Biglia A, Dourado E, Palterer B, Parronchi P, Pellico MR, Zanframundo G, Rivera Matias PA, Martins P, Miranda A, Cabral Da Fonseca JE, DI Agosta E, Cammelli D, Emmi G, Rosi E, Bixio R, Conticini E, Bellis E, Bruni C, Montecucco C, Matucci-Cerinic M, Rojas-Serrano J, Cavagna L. POS0863 ANTI-NOR90 ANTIBODIES IN THE SETTING OF CONNECTIVE TISSUE DISEASE: CLINICAL SIGNIFICANCE AND COMPARISON WITH A COHORT OF PATIENTS WITH SYSTEMIC SCLEROSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAnti-NOR90 antibodies are directed against a 90-kD nucleolar protein located in the nucleolus organizing regions (NORs), mainly described in systemic sclerosis (SSc) [1, 2, 3] but reported also in other rheumatologic and oncologic diseases [4, 5, 6]. The clinical correlates of anti-NOR90 antibodies are still to be defined because the cohorts described thus far include a low number of patients.ObjectivesTo describe the characteristics of a large cohort of anti-NOR90 antibodies positive patients and compare them with a matched cohort of SSc patients negative for anti-NOR90 antibodies.MethodsA retrospective analysis was performed on patients positive for anti-NOR90 antibodies referring to participating centres. The concomitant positivity for anti-RNA polymerase III, Th/To, PM-Scl, Ku, and PDGFR antibodies was an exclusion criterion. In all cases the diagnoses, the different organ involvement and related clinical, instrumental and laboratory characteristics were evaluated. The EUROLINE SystemicSclerosisProfile kit from Euroimmun (Lübeck, Germany) was used to detect anti-NOR90 antibodies.ResultsWe included 101 patients positive for anti-NOR90 (M/F=13/88, mean age 52.5 years). They were mainly classified as SSc (n=38), undifferentiated connective tissue disease (UCTD) (n=21), interstitial pneumonia with autoimmune features (IPAF) (n=11) (graph 1). The most frequent clinical manifestations were arthralgias (n=72), Raynaud’s phenomenon (RP) (n=58), sicca syndrome (n=49), ILD (n=40), puffy fingers (n=32), arthritis (n=30), and limited skin sclerosis (n=24). Anti-NOR90 antibodies were associated with anti-Ro52 antibodies in the 16% of cases, with anticentromere antibodies in the 7% of cases, and with anti-Scl70 in the 5% of cases. After excluding these patients, and considering the isolated anti-NOR90 positivity, 12 patients had SSc, 35 UCTD, and 11 IPAF. The most frequent clinical manifestations were arthralgias (n=40), RP (n=37), and sicca syndrome (n=21). Compared to 242 matched SSc without anti-NOR90 antibodies, patients with anti-NOR90 had more frequently joint manifestations and sicca syndrome and less frequently all vasculopathic manifestations (RP, telangiectasias, pitting scars, acral ulcers), dysphagia and fibromyalgia.ConclusionOur study shows that anti-NOR90 antibodies are more commonly observed in females, and clinically associated with the occurrence of arthritis/arthralgias, sicca syndrome and RP. In more than the 50% of cases they may be found with other autoantibodies, such as the anti-Ro52, the anticentromere, and the anti-Scl70 antibodies. Anti-NOR90 seems to play an accompanying role in the context of CTDs, without strong influence on the clinical phenotype expression of the underlying CTD.References[1]Rodriguez-Sanchez et al., Anti-NOR 90. A new autoantibody in scleroderma that recognizes a 90-kDa component of the nucleolus-organizing region of chromatin, 1987.[2]Hamaguchi et al., Clinical and immunologic predictors of scleroderma renal crisis in Japanese systemic sclerosis patients with anti-RNA polymerase III autoantibodies, 2015.[3]Liaskos et al., Disease-related autoantibody profile in patients with systemic sclerosis, 2017.[4]Imai et al., Immunocytochemical characterization of human NOR-90 (upstream binding factor) and associated antigens reactive with autoimmune sera. Two MR forms of NOR-90/hUBF autoantigens, 1994.[5]Fujii et al., Detection of autoantibodies to nucleolar transcription factor NOR 90/hUBF in sera of patients with rheumatic diseases, by recombinant autoantigen-based assays, 1996.[6]Yamashita et al., Clinical significance of anti-NOR90 antibodies in systemic sclerosis and idiopathic interstitial pneumonia, 2021.Figure 1.Disclosure of InterestsNone declared
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Treppo E, Infantino M, Benucci M, Ravagnani V, Palterer B, Grandis M, Fabris M, Tomietto P, Manfredi M, Sonaglia A, Giudizi MG, Ligobbi F, Cammelli D, Parronchi P, De Vita S, Quartuccio L. AB0601 RAPID AND SUSTAINED EFFICACY OF AN INDUCTION TREATMENT WITH A TRIPLE THERAPY INCLUDING HIGH-DOSE INTRAVENOUS IMMUNOGLOBULINS, METHOTREXATE AND GLUCOCORTICOIDS IN ANTI-3-HYDROXY-3-METHYLGLUTARYL-COENZYME A REDUCTASE MYOPATHY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Anti-3-hydroxy-3-methylglutaryl-coenzime A reductase (HMGCR) myopathy is a new entity, which has been clearly associated to statin use, even if it can be diagnosed in patients without a history of exposure to statin or even in the childhood (1).Objectives:The aim of the study is to describe the efficacy of a triple therapy regimen consisting in high-doses of intravenous immunoglobulins (IVIG), methotrexate (MTX), and glucocorticoids (GC) in 16 patients with Anti-HMGCR myopathy enrolled in 6 specialized centres.Methods:A total of 16 patients with anti-HMGCR myopathy (7 females; 9 males) were collected. Mean (±standard deviation) age at the onset of disease was 72.4±10.3 years old. All patients were diagnosed having anti-HMGCR myopathy [anti-HMGCR antibodies were measured by chemiluminescence assay (BioFlash, Inova, CA)] (2). Median follow-up was 29.5 months (interquartile range: 15.75-60 months). Anti-HMGCR antibodies were available in the follow-up in 8/16 patients.Results:Thirteen out of 16 patients (81.3%) had been exposed to statin (1/13 to red rice), 3/16 (18.7%) were not exposed. As induction therapy, 11/16 patients have been treated with triple therapy (high-dose IVIG, MTX and GC), 2/16 with double therapy (high-dose IVIG and GC), 2/16 have been treated with GC alone, the patient exposed to red rice resolved only with red rice suspension. Clinical remission and normalization of CPK values within month +24 were obtained in all the patients. All the patients were in remission at the last follow-up. Gradual improvement started soon from the first month, and among the 13 patients treated with an aggressive immunosuppresssive therapy including IVIG (13/13), GC (13/13) and methotrexate (11/13), 9/13 normalized the CPK value within 6 months. Clinical and laboratory response was accompanied by significant decrease or normalization of the anti-HMGCR antibody titer. All the patients were either not taking GC (56.3%), or were taking low doses of GC (43.7%) at the last follow-up. Four patients had stopped GC within 6 months. No serious side effects were recorded. After persistent remission, a maintenance immunosuppressive therapy was then administered. Only 3 relapses in 3 different cases were recorded, all of them during drug-free remission in long-term follow-up. Reinduction was again effective in all.Conclusion:Anti-HMGCR myopathy is a rare and serious myopathy which usually affects older people during statin treatment. After statin suspension, a rapid and sustained remission can be achieved by induction with a triple aggressive therapy consisting in medium-to high doses of GC, high-dose IVIG, and MTX (3). GC should be tapered as soon as possible. Relapse appears infrequent during maintenance treatment. Monitoring anti-HMGCR antibody titer may be clinically relevant.References:[1]AL Mammen et al. N Engl J Med. 2016;374:664-9[2]Musset L et al. Autoimmun Rev. 2016;15:983-93.[3]Aggarwal A et al. Scand J Rheumatol. 2019; 1-7.Acknowledgments:We thank MD Francesca Grosso and MD Valentina Mecheri from the University of Florence, MD Angela Zuppa and MD Chiara De Michelis, from San Martino Hospital, Genova, for their valued collaboration in data collectionDisclosure of Interests:Elena Treppo: None declared, Maria Infantino: None declared, Maurizio Benucci: None declared, Viviana Ravagnani: None declared, Boaz Palterer: None declared, Marina Grandis: None declared, Martina Fabris: None declared, Paola Tomietto: None declared, Mariangela Manfredi: None declared, Arianna Sonaglia: None declared, Maria Grazia Giudizi: None declared, Francesca Ligobbi: None declared, Daniele Cammelli: None declared, Paola Parronchi: None declared, Salvatore De Vita Consultant of: Roche, GSK, Speakers bureau: Roche, GSK, Novartis, Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer
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Quartuccio L, Isola M, Bruno D, Treppo E, Gigante L, Angelotti F, Capecchi R, Vitiello G, Cavallaro E, Tavoni A, Bosello SL, Cammelli D, De Vita S, Gremese E. FRI0216 STEROID SPARING EFFECT, LOWER INCIDENCE OF DISEASE RELAPSE AND DIABETES IN GIANT CELL ARTERITIS TREATED WITH IMMUNOSUPPRESSORS AB INITIO OR VERY EARLY: A MULTICENTER RETROSPECTIVE CASE-CONTROL STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Glucocorticoids (GC) are associated with serious side effects in giant cell arteritis (GCA). Immunosuppressive therapies (IT) gave conflicting results in GCA, regarding GC sparing effect. Recently, tocilizumab by blocking IL-6, has been licensed as first biologic treatment for GCA, being clinically effective and saving GC (1).Objectives:To evaluate the usefulness of IT for GCA in: 1) minimizing the rate of GC-induced adverse events (AEs) and 2) reducing the risk of relapse.Methods:A multicenter retrospective case-control study included 165 GCA was performed. The first group of patients (GCA-IT) included 114 patients who were treated with at least one IT given ab initio or within 3 months from the start of GC. The control group included 51 GCA who received only GC or an IT later than 3 months (GCA-steroid). The primary endpoints were the rate of GC-related side effects: infections, hospitalized infections, new onset systemic arterial hypertension, GC-induced diabetes and osteoporotic fractures.Results:Methotrexate up to 20 mg/week (138 patients), followed by cyclophosphamide (48 patients) and tocilizumab (27 patients) were the most frequently used IT. No difference was observed as concerns the follow-up time between the two groups [48.5 (IQR 26-72) vs 40 (IQR 24-69), p=0,3, rank-sum test)]. The two groups were similar as concerns sex (p=0,13), while the first group (69±8 yrs) was slightly younger than the second one (72±7 yrs) (p=0,005). Comorbidity was similar between groups. Patients in the GCA-IT group showed a significant lower incidence of GC-induced diabetes (8/114, 7% vs 12/51, 23,5%; p=0,003, chi-square test), while no differences were documented for rate of infections (p=0,64), including hospitalized infections (p=0,44), new onset systemic arterial hypertension (p=0,68), or osteoporotic fractures (p=0,32). Forty-four patients in the GCA-IT group (38,6%), while 34 patients in the GCA-steroid group (66,7%) experienced at least one relapse (p=0,001, chi square test). There was no difference in terms of time to first relapse between the two groups (p=0,53, log-rank test). GCA-IT group was exposed to lower dose of GC at first (p<0,0001, rank-sum test) and third (p<0,0001, rank-sum test) month, while no differences were recorded at the other time points. Clinical outcomes were similar between the two groups.Conclusion:Very early introduction of IT in GCA provided a greater steroid sparing in the first 3 months of treatment, leading to a lower incidence of diabetes. Relapse rate was even lower. IT was usually well tolerated without an increase incidence of infections. A randomized prospective trial is required to support this strategy in the management of GCA.References:[1]Hellmich B, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020;79:19-30.Disclosure of Interests:Luca Quartuccio Consultant of: Abbvie, Bristol, Speakers bureau: Abbvie, Pfizer, Miriam Isola: None declared, Dario Bruno: None declared, Elena Treppo: None declared, Laura Gigante: None declared, Francesca Angelotti: None declared, Riccardo Capecchi: None declared, Gianfranco Vitiello: None declared, Elena Cavallaro: None declared, Antonio Tavoni: None declared, Silvia Laura Bosello: None declared, Daniele Cammelli: None declared, Salvatore De Vita Consultant of: Roche, GSK, Speakers bureau: Roche, GSK, Novartis, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB
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Palterer B, Vitiello G, Cammelli D. First report of anti-TIF1γ dermatomyositis in a patient with myelodysplastic syndrome. Reumatismo 2017; 69:75-77. [PMID: 28776361 DOI: 10.4081/reumatismo.2017.923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 02/18/2017] [Accepted: 04/27/2017] [Indexed: 11/23/2022] Open
Abstract
Inflammatory myopathies as para-neoplastic phenomena were first described by Sterz in 1916. Recently, myositis specific autoantibodies were described in cancer-associated myositis. Anti-transcription intermediary factor 1 gamma (anti-TIF1γ) antibodies have been found in both young adults affected by juvenile dermatomyositis and in elderly patients with cancer-associated myositis. In this regard, we report herein the first case of anti-TIF1γ dermatomyositis secondary to a myelodysplastic syndrome.
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Affiliation(s)
- B Palterer
- Experimental and Clinical Medicine Dept., University of Florence, Florence.
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Castellani S, Vitiello G, Selvaggio S, Cammelli D, Maggi E, Di Mario C. P5201Diagnostic yield of color doppler ultrasonography in suspected giant cell arteritis: a clinical, sonographic and positron emission tomography retrospective analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jung IH, Kurnicka K, Enache R, Nagy AI, Martins E, Cereda A, Vitiello G, Magda SL, Styczynski G, Lo Iudice F, De Barros Viegas H, Shahab F, Trunina I, Mata Caballero R, De Barros Viegas H, Marques A, Shimoni S, Generati G, Generati G, Bendix Salkvist Jorgensen T, Chen TE, Andrianova A, Fernandez-Golfin C, Corneli MC, Ali M, Seo HS, Kim MJ, Lichodziejewska B, Goliszek S, Dzikowska-Diduch O, Zdonczyk O, Kozlowska M, Kostrubiec M, Ciurzynski M, Palczewski P, Pruszczyk P, Popa E, Coman IM, Badea R, Platon P, Calin A, Beladan CC, Rosca M, Ginghina C, Popescu BA, Jurcut R, Venkateshvaran AI, Sola SC, Govind SC, Dash PK, Lund L, Manouras AI, Merkely B, Magne J, Aboyans V, Boulogne C, Lavergne D, Jaccard A, Mohty D, Casadei F, Spano F, Santambrogio G, Musca F, Belli O, De Chiara B, Bokor D, Giannattasio C, Corradi E, Colombo CA, Moreo A, Vicario ML, Castellani S, Cammelli D, Gallini C, Needleman L, Cruz BK, Maggi E, Marchionni N, Bratu VD, Mincu RI, Mihai CM, Gherghe AM, Florescu M, Cinteza M, Vinereanu D, Sobieraj P, Bielicki P, Krenke R, Szmigielski CA, Petitto M, Ferrone M, Esposito R, Vaccaro A, Buonauro A, Trimarco B, Galderisi M, Mendes L, Dores H, Melo I, Madeira V, Patinha J, Encarnacao C, Ferreia Santos J, Habib F, Soesanto AM, Sedyawan J, Abdurrazak G, Sharykin A, Popova NE, Karelina EV, Telezhnikova ND, Hernandez Jimenez V, Saavedra J, Molina L, Alberca MT, Gorriz J, L Pais J, Pavon I, Navea C, Alonso JJ, Mendes L, Sonia S, Madeira V, Encarnacao C, Patinha J, Melo I, Ferreia Santos J, Cruz I, Joao I, Gomes AC, Caldeira D, Lopes L, Fazendas P, Pereira H, Edri O, Edri O, Schneider N, Schneider N, Abaye N, Abaye N, Goerge J, Goerge J, Gandelman G, Gandelman G, Bandera F, Alfonzetti E, Guazzi M, Bandera F, Villani S, Ferraro O, Alfonzetti E, Guazzi M, Ramberg E, Bhardwaj P, Nepper ML, Binko TS, Olausson M, Fink-Jensen T, Andersen AM, Roland J, Gleerup Fornitz G, Ong K, Suri RM, Enrique-Sarano M, Michelena HI, Burkhart HM, Gillespie SM, Cha S, Mankad SV, Saidova MA, Bolotova MN, Salido Tahoces L, Izurieta C, Villareal G, Esteban A, Urena Vacas A, Ayala A, Jimenez Nacher JJ, Hinojar Baydes R, Gonzalez Gomez A, Garcia A, Mestre JL, Hernandez Antolin R, Zamorano Gomez JJ, Perea G, Covelli Y, Henquin R, Ronderos R, Hepinstall MJ, Cassidy CS, Pellikka PA, Pislaru SV, Kane G. P569Diastolic dyssynchrony is associated with exercise intolerance in hypertensive patients with left ventricular hypertrophyP570Echocardiographic pattern of acute pulmonary embolism, analysis of consecutive 511 patientsP571Clinical significance of ventricular interdependence and left ventricular function in patients with pulmonary hypertension receiving specific vasodilator therapyP572Haemodynamic characteristics and ventricular mechanics in post-capillary and combined pre- and post-capillary pulmonary hypertensionP573Relationship between hematological response and echocardiographic features in patients with light chains systemic amyloidosisP574Myocardial changes in patients with anorexia nervosaP575Giant cell arteritis presenting as fever of unknown origin: role of clinical history, early positron emission tomography and ultrasound screeningP576Subclinical systolic dysfunction in systemic sclerosis is not influenced by standard rheumatologic therapy - a 4D echocardiographic studyP577Cardiac index correlates with the degree of hepatic steathosis in obese patients with obstructive sleep apneaP578Myocardial mechanics in top-level endurance athletes: a three-dimensional speckle tracking studyP579The athlete heart: what happens to myocardial deformation in physiological adaptation to sportsP580Association between left ventricle intrinsic function and urine protein-creatinine ratio in preeclampsia before and after deliveryP581Dilatation of the aorta in children with bicuspid aortic valveP582Cardiovascular functional abnormalities in patients with osteogenesis imperfectaP583Dobutamine stress test fast protocol: diagnostic accuracy and securityP584Prognostic value of non-positive exercise echocardiography in the patients submitted to percutaneous coronary interventionP585The use of myocardial strain imaging in the detection of coronary artery disease during stress echocardiographyP586Preserved O2 extraction exercise response in heart failure patients with chronotropic insufficiency: evidence for a central cardiac rather than peripheral oxygen uptake limitationP587Major determinant of O2 artero-venous difference at peak exercise in heart failure and healthy subjectsP588Stress echocardiography with contrast perfusion analysis for a more sensitive test for ischemic heart diseaseP589Assessment of mitral annular physiology in myxomatous mitral disease with 3D transesophageal echocardiography: comparison between early severe mitral regurgitation and decompensated groupP590Three-dimensional transesophageal echocardiographic assessment of the mitral valve geometry in patients with mild, moderate and severe chronic ischemic mitral regurgitationP591Left atrial appendage closure. Multimodality imaging in device size selectionP592Contributions of three-dimensional transesophageal echocardiography in the evaluation of aortic atherosclerotic plaquesP593Agitated blood-saline is superior to agitated air-saline for echocardiographic shunt studies. Eur Heart J Cardiovasc Imaging 2016; 17:ii102-ii109. [DOI: 10.1093/ehjci/jew248.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vultaggio A, Petroni G, Pratesi S, Nencini F, Cammelli D, Milla M, Prignano F, Annese V, Romagnani S, Maggi E, Matucci A. Circulating T cells to infliximab are detectable mainly in treated patients developing anti-drug antibodies and hypersensitivity reactions. Clin Exp Immunol 2016; 186:364-372. [PMID: 27569750 PMCID: PMC5108070 DOI: 10.1111/cei.12858] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 01/28/2023] Open
Abstract
Antibodies recognizing infliximab (IFX) may develop in a proportion of treated patients, leading to loss of response or hypersensitivity reactions (HRs). T cell response to IFX has been poorly investigated. This paper was addressed to detect IFX‐specific T cells in treated patients with inflammatory diseases developing, or not, anti‐drug antibodies (ADA) and to correlate the presence of specific T cells with the clinical outcomes of the treatment. A co‐culture system of IFX‐loaded dendritic cells and purified autologous CD4+ T cells was used to detect memory T cells in 32 ADA+ and 39 ADA– IFX‐treated patients and control groups. The cytokine profile of IFX‐specific T cells was also studied in culture supernatants. IFX‐specific cell proliferation was detected mainly in cells from ADA+ patients, irrespective of their different diseases. HR patients displayed higher T cell proliferation than non‐responder and tolerant patients. A mixed [interferon (IFN)‐γ, interleukin (IL)‐13, IL‐10] cytokine profile was shown in cells from ADA+ patients, while IL‐10 was the most frequently detected cytokine in the supernatants of cultures from ADA‐ patients. Immunoglobulin (Ig)E+ADA+ patients with previous HRs exhibited a more pronounced type 2 profile than IgE–ADA+ patients. This work provides evidence that IFX‐specific circulating T cells are detectable mainly in ADA+ patients with HRs, regardless of their disease. The IFX‐induced cytokine pattern partially correlates with the ADA isotype.
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Affiliation(s)
- A Vultaggio
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy.,Immunoallergology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - G Petroni
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - S Pratesi
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - F Nencini
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - D Cammelli
- Immunoallergology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - M Milla
- Gastroenterology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - F Prignano
- Dermatology Clinic, Azienda Sanitaria Firenze, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - V Annese
- Gastroenterology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - S Romagnani
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - E Maggi
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - A Matucci
- Centre of Research DENOTHE and Department of Experimental and Clinical Medicine, University of Florence, Italy.,Immunoallergology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Giudizi MG, Cammelli D, Vivarelli E, Biagiotti R, Ferraro A, Bentow C, Almerigogna F, Albesa R, Mahler M. Anti-HMGCR antibody-associated necrotizing myopathy: diagnosis and treatment illustrated using a case report. Scand J Rheumatol 2016; 45:427-9. [DOI: 10.3109/03009742.2015.1132761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- MG Giudizi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - D Cammelli
- SOD Immunoallergology, DAI, Medico-Geriatrico, AOU Careggi, Florence, Italy
| | - E Vivarelli
- School of Allergy and Clinical Immunology, University of Florence, Florence, Italy
| | - R Biagiotti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A Ferraro
- School of Allergy and Clinical Immunology, University of Florence, Florence, Italy
| | - C Bentow
- Inova Diagnostics, Inc, San Diego, CA, USA
| | - F Almerigogna
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - R Albesa
- Inova Diagnostics, Inc, San Diego, CA, USA
| | - M Mahler
- Inova Diagnostics, Inc, San Diego, CA, USA
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Cammelli D, Rosselli M. AB0747 Churg-strauss syndrome complicated by heart inflammatory pseudotumor. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Romagnoli I, Gigliotti F, Galarducci A, Lanini B, Bianchi R, Cammelli D, Scano G. Chest wall kinematics and respiratory muscle action in ankylosing spondylitis patients. Eur Respir J 2004; 24:453-60. [PMID: 15358706 DOI: 10.1183/09031936.04.00123903] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
No direct measurements of the pressures produced by the ribcage muscles, the diaphragm and the abdominal muscles during hyperventilation have been reported in patients with ankylosing spondylitis. Based on recent evidence indicating that abdominal muscles are important contributors to stimulation of ventilation, it was hypothesised that, in ankylosing spondylitis patients with limited ribcage expansion, a respiratory centre strategy to help the diaphragm function may involve coordinated action of this muscle with abdominal muscles. In order to validate this hypothesis, the chest wall response to a hypercapnic/hyperoxic rebreathing test was assessed in six ankylosing spondylitis patients and seven controls by combined analysis of: 1) chest wall kinematics, using optoelectronic plethysmography, this system is accurate in partitioning chest wall expansion into the contributions of the ribcage and the abdomen; and 2) respiratory muscle pressures, oesophageal, gastric and transdiaphragmatic (Pdi); the pressure/volume relaxation characteristics of both the ribcage and the abdomen allowed assessment of the peak pressure of both inspiratory and expiratory ribcage muscles, and of the abdominal muscles. During rebreathing, chest wall expansion increased to a similar extent in patients to that in controls; however, the abdominal component increased more and the ribcage component less in patients. Peak inspiratory ribcage, but not abdominal, muscle pressure was significantly lower in patients than in controls. End-inspiratory Pdi increased similarly in both groups, whereas inspiratory swings in Pdi increased significantly only in patients. No pressure or volume signals correlated with disease severity. The diaphragm and abdominal muscles help to expand the chest wall in ankylosing spondylitis patients, regardless of the severity of their disease. This finding supports the starting hypothesis that a coordinated response of respiratory muscle activity optimises the efficiency of the thoracoabdominal compartment in conditions of limited ribcage expansion.
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Affiliation(s)
- I Romagnoli
- Don C. Gnocchi Foundation, Section of Respiratory Rehabilitation, Pozzolatico, Florence, Italy
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Abstract
We report the clinical and neuroradiological features of cerebral rheumatoid pachymeningitis with 1 year follow-up in two patients. MRI of the head enabled noninvasive diagnosis of both the meningeal abnormality and its complications, consisting of hypertensive hydrocephalus and superior sagittal sinus thrombosis, respectively. Dural sinus thrombosis, very uncommon in rheumatoid arthritis, was confirmed by phase-contrast MRA. Worsening of the pachymeningitis at follow-up was observed in both patients despite regression or stability of the clinical picture and long-term therapy.
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Affiliation(s)
- M Cellerini
- Section of Radiology, Department of Clinical Pathophysiology, School of Medicine, University of Florence, Italy
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Mazza E, Lazzeri S, Innocenti P, Fargnoli R, Cammelli D, Andreotti L. [Sternocostoclavicular hyperostosis. The clinico-radiological aspects of 3 cases]. Radiol Med 1991; 82:854-8. [PMID: 1788445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E Mazza
- Sezione di Radiodiagnostica, Università, Firenze
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Andreotti L, Bussotti A, Cammelli D, di Giovine F, Sterrantino G, Varcasia G, Arcangeli P. Aortic connective tissue in atherosclerotic aorta--a biochemical study. Angiology 1986; 37:735-43. [PMID: 3767064 DOI: 10.1177/000331978603701007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Biochemical analysis of the extracellular matrix of human aortas was performed on samples of ascending and descending aortas affected by atherosclerosis in comparison with a control group of nonatherosclerotic aortas. Ulcerated or heavily calcified atheromas were excised and excluded from the analysis in order to differentiate biochemical alterations leading to the formation of atheromas from those due to complications of already formed atheromas. Our results show that the development of atheromas brings about an extensive destruction of elastic fibers and muscular cells, and their place is occupied by other components of the extracellular matrix, most notably, collagen, non-uronic sugars, water, and lipids, which were found significantly increased.
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Andreotti L, Bussotti A, Cammelli D, di Giovine F, Sampognaro S, Sterrantino G, Varcasia G, Arcangeli P. Aortic connective tissue in ageing--a biochemical study. Angiology 1985; 36:872-9. [PMID: 4083569 DOI: 10.1177/000331978503601206] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The biochemical analysis of samples of aortic connective tissue was carried out in 22 subjects from 9 to 84 years old. Aortic samples were taken at necropsy performed after sudden or, more often, traumatic death. The results suggest that aging of the aorta is accompanied by an increase both in collagen content and in total sugar content when expressed as mg/cm2 while the elastin content, when expressed in the same way, does not undergo any variation.
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Andreotti L, Cammelli D, Sampognaro S, Allori A, Baldoni D, Bussotti A, Cortini P, Di Giovine F, Sterrantino G. Biochemical analysis of dermal connective tissue in subjects affected by primary uncomplicated varicose veins. Angiology 1985; 36:265-70. [PMID: 4025937 DOI: 10.1177/000331978503600501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Biochemical analysis of dermal connective tissue was carried out in 14 subjects affected by primary uncomplicated varicose veins and 14 controls. Skin samples were taken, according to fixed criteria, from operation pieces of total mastectomy for breast cancer. The results suggest that the dermal tissue in these subjects is just thinner than that of controls, confirming previous similar clinical findings. The elective reduction of the collagen content observed, unassociated with changes of other components of the dermal connective tissue, brings evidence for a systemic biochemical defect of the extracellular matrix i.e. a collagen defect affecting the entire body structure and not only the varicose or pre-varicose veins of the lower limbs.
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Abstract
Collagen, elastin and structural glycoproteins were measured in 21 intact lungs taken at postmortem examination after sudden death from subjects aged from 15 to 83. The data were expressed as milligrams per cubic centimeter of lung peripheral parenchyma inflated and fixed at the standard pressure of 25 cm H2O to exclude the pitfall of referring to dried tissue weight. The volume/weight ratio of inflated dried lung parenchyma increased significantly with aging; likewise the collagen content decreased and so did the collagen/elastin ratio, while the elastin content did not show any significant correlation with age. The present findings indicate that biochemical, morphological and functional data on the senile lung agree well.
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Andreotti L, Cammelli D, Banchi G, Allori A, Guarnieri M, Bussotti A. [Incidence of the manifestations of the so-called status varicosus of Curtius in subjects with idiopathic varices of the lower extremities]. Minerva Med 1980; 71:2729-38. [PMID: 7432683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Two groups of subjects have been studied: the first one affected by varicose veins in lower legs, the second one as control (both groups include 138 subjects, mostly corresponding about age, sex and general health conditions). Acrocyanosis, blue sclerae, juvenile spontaneous epistaxis, hand's primary osteoarthrosis, articular hypermobility, thin skin and hernia were present more frequently in the group affected by varicose veins, the difference being statistically very significant. We suggest that mechanical revealing factors lead to the development of varicose veins in subjects who have a constitutional and probably hereditary systemic weakness of connective tissue network.
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Abstract
The collagen, elastin, total sugar, and nonscleroprotein content was evaluated in 32 samples of saphenous varicose vein and in 34 controls. A significantly lower collagen and elastin content was found in the varicose samples without correlation with the degree of pathologic broadening. Otherwise the total sugars and the soluble nonscleroproteins were found to be increased in varicose samples. The results are more significant when expressed as milligrams per surface unit of endothelium. Our data support the hypothesis that the decrease in collagen and elastin content is a primary rather than secondary change.
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