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Robotti C, Costantini G, Saggio G, Cesarini V, Calastri A, Maiorano E, Piloni D, Perrone T, Sabatini U, Ferretti VV, Cassaniti I, Baldanti F, Gravina A, Sakib A, Alessi E, Pietrantonio F, Pascucci M, Casali D, Zarezadeh Z, Zoppo VD, Pisani A, Benazzo M. Machine Learning-based Voice Assessment for the Detection of Positive and Recovered COVID-19 Patients. J Voice 2024; 38:796.e1-796.e13. [PMID: 34965907 PMCID: PMC8616736 DOI: 10.1016/j.jvoice.2021.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022]
Abstract
Many virological tests have been implemented during the Coronavirus Disease 2019 (COVID-19) pandemic for diagnostic purposes, but they appear unsuitable for screening purposes. Furthermore, current screening strategies are not accurate enough to effectively curb the spread of the disease. Therefore, the present study was conducted within a controlled clinical environment to determine eventual detectable variations in the voice of COVID-19 patients, recovered and healthy subjects, and also to determine whether machine learning-based voice assessment (MLVA) can accurately discriminate between them, thus potentially serving as a more effective mass-screening tool. Three different subpopulations were consecutively recruited: positive COVID-19 patients, recovered COVID-19 patients and healthy individuals as controls. Positive patients were recruited within 10 days from nasal swab positivity. Recovery from COVID-19 was established clinically, virologically and radiologically. Healthy individuals reported no COVID-19 symptoms and yielded negative results at serological testing. All study participants provided three trials for multiple vocal tasks (sustained vowel phonation, speech, cough). All recordings were initially divided into three different binary classifications with a feature selection, ranking and cross-validated RBF-SVM pipeline. This brough a mean accuracy of 90.24%, a mean sensitivity of 91.15%, a mean specificity of 89.13% and a mean AUC of 0.94 across all tasks and all comparisons, and outlined the sustained vowel as the most effective vocal task for COVID discrimination. Moreover, a three-way classification was carried out on an external test set comprised of 30 subjects, 10 per class, with a mean accuracy of 80% and an accuracy of 100% for the detection of positive subjects. Within this assessment, recovered individuals proved to be the most difficult class to identify, and all the misclassified subjects were declared positive; this might be related to mid and short-term vocal traces of COVID-19, even after the clinical resolution of the infection. In conclusion, MLVA may accurately discriminate between positive COVID-19 patients, recovered COVID-19 patients and healthy individuals. Further studies should test MLVA among larger populations and asymptomatic positive COVID-19 patients to validate this novel screening technology and test its potential application as a potentially more effective surveillance strategy for COVID-19.
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Affiliation(s)
- Carlo Robotti
- Department of Otolaryngology - Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
| | - Giovanni Costantini
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.
| | - Giovanni Saggio
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy.
| | - Valerio Cesarini
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Anna Calastri
- Department of Otolaryngology - Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Eugenia Maiorano
- Department of Otolaryngology - Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide Piloni
- Pneumology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Tiziano Perrone
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Umberto Sabatini
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Virginia Valeria Ferretti
- Clinical Epidemiology and Biometry Unit, Fondazione IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Irene Cassaniti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Gravina
- Otorhinolaryngology Department, University of Rome Tor Vergata, Rome, Italy
| | - Ahmed Sakib
- Otorhinolaryngology Department, University of Rome Tor Vergata, Rome, Italy
| | - Elena Alessi
- Internal Medicine Unit, Ospedale dei Castelli ASL Roma 6, Ariccia, Italy
| | | | - Matteo Pascucci
- Internal Medicine Unit, Ospedale dei Castelli ASL Roma 6, Ariccia, Italy
| | - Daniele Casali
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Zakarya Zarezadeh
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Vincenzo Del Zoppo
- Department of Electronic Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Marco Benazzo
- Department of Otolaryngology - Head and Neck Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Ghio S, Corsico A, Rapagnani A, Borrelli E, Alloni A, Valentini A, Piloni D, Scelsi L, Klersy C, D'Armini AM. Does pulmonary endarterectomy improve the clinical conditions of patients with chronic thromboembolic pulmonary disease without pulmonary hypertension? J Heart Lung Transplant 2024; 43:681-685. [PMID: 38184125 DOI: 10.1016/j.healun.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024] Open
Abstract
To verify whether the new hemodynamic definition of pulmonary hypertension (PH) has any implication in treatment of Chronic Thrombo-Embolic Pulmonary Disease (CTEPD) patients without PH, we retrospectively analysed the clinical and functional changes determined by pulmonary endarterectomy (PEA) in 63 CTEPD patients without PH who underwent surgery at our center, comparing those in whom the hemodynamic diagnosis of PH met recent guideline recommendations versus those in whom the diagnosis only met previous hemodynamic thresholds. The results show that the vast majority of CTEPD patients without PH operated at our center would now be defined as chronic thromboembolic pulmonary hypertension (CTEPH) patients. PEA did not result in any improvement in exercise capacity nor in right ventricular function or lung function test in patients with mean pulmonary artery pressure (mPAP) ≤ 20 mm Hg and pulmonary vascular resistance (PVR) ≤ 2 WU; on the contrary, hemodynamic parameters, exercise capacity, right ventricular function and lung function significantly improved in patients with mPAP between 21 and 24 mm Hg.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Foundation IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Andrea Rapagnani
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Ermelinda Borrelli
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy
| | - Alessia Alloni
- Division of Cardiac Surgery 2 and Pulmonary Hypertension Center, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Adele Valentini
- Institut of Radiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Catherine Klersy
- Service of Clinical Epidemiology and Biometry, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Maria D'Armini
- Department of Clinical, Surgical, Pediatric and Diagnostic Sciences, University of Pavia School of Medicine, Italy; Division of Cardiac Surgery 2 and Pulmonary Hypertension Center, Foundation IRCCS Policlinico San Matteo, Pavia, Italy.
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Della Zoppa M, Bertuccio FR, Campo I, Tousa F, Crescenzi M, Lettieri S, Mariani F, Corsico AG, Piloni D, Stella GM. Phenotypes and Serum Biomarkers in Sarcoidosis. Diagnostics (Basel) 2024; 14:709. [PMID: 38611622 PMCID: PMC11011731 DOI: 10.3390/diagnostics14070709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Sarcoidosis is a multisystem disease, which is diagnosed on a compatible clinical presentation, non-necrotizing granulomatous inflammation in one or more tissue samples, and exclusion of alternative causes of granulomatous disease. Considering its heterogeneity, numerous aspects of the disease remain to be elucidated. In this context, the identification and integration of biomarkers may hold significance in clinical practice, aiding in appropriate selection of patients for targeted clinical trials. This work aims to discuss and analyze how validated biomarkers are currently integrated in disease category definitions. Future studies are mandatory to unravel the diverse contributions of genetics, socioeconomic status, environmental exposures, and other sociodemographic variables to disease severity and phenotypic presentation. Furthermore, the implementation of transcriptomics, multidisciplinary approaches, and consideration of patients' perspectives, reporting innovative insights, could be pivotal for a better understanding of disease pathogenesis and the optimization of clinical assistance.
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Affiliation(s)
- Matteo Della Zoppa
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesco Rocco Bertuccio
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Ilaria Campo
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Fady Tousa
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Mariachiara Crescenzi
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Sara Lettieri
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesca Mariani
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Angelo Guido Corsico
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
| | - Davide Piloni
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
| | - Giulia Maria Stella
- Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy; (M.D.Z.); (F.R.B.); (F.T.); (M.C.); (S.L.); (F.M.); (A.G.C.); (D.P.); (G.M.S.)
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
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Balderacchi AM, Bignotti M, Ottaviani S, Denardo A, Barzon V, Ben Khlifa E, Vailati G, Piloni D, Benini F, Corda L, Corsico AG, Ferrarotti I, Fra A. Quantification of circulating alpha-1-antitrypsin polymers associated with different SERPINA1 genotypes. Clin Chem Lab Med 2024; 0:cclm-2023-1348. [PMID: 38407261 DOI: 10.1515/cclm-2023-1348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Alpha-1-antitrypsin deficiency is a genetic disorder caused by mutations in the SERPINA1 gene encoding alpha-1-antitrypsin (AAT), the major serine protease inhibitor in plasma. Reduced AAT levels are associated with elevated risk of developing emphysema mainly due to uncontrolled activity of neutrophil elastase in the lungs. The prevalent Z-AAT mutant and many rare pathogenic AAT variants also predispose to liver disease due to their accumulation as polymeric chains in hepatocytes. Part of these polymers are secreted into the bloodstream and could represent biomarkers of intra-hepatic accumulation. Moreover, being inactive, they further lower lung protection against proteases. Aim of our study is to accurately quantify the percentage of circulating polymers (CP) in a cohort of subjects with different SERPINA1 genotypes. METHODS CP concentration was measured in plasma or Dried Blood Spot (DBS) by a sensitive sandwich ELISA based on capture by the polymer-specific 2C1 monoclonal antibody. RESULTS CP were significantly elevated in patients with the prevalent PI*SZ and PI*ZZ genotypes, with considerable intra-genotype variability. Notably, higher percentage of polymers was observed in association with elevated C-reactive protein. CP levels were also increased in carriers of the Mmalton variant, and of Mprocida, I, Plowell and Mherleen in heterozygosity with Z-AAT. CONCLUSIONS These findings highlight the importance of implementing CP quantification in a clinical laboratory. Indeed, the variable amount of CP in patients with the same genotype may correlate with the variable severity of the associated lung and liver diseases. Moreover, CP can reveal the polymerogenic potential of newly discovered ultrarare AAT variants.
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Affiliation(s)
- Alice M Balderacchi
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, UOC Pulmonology, 18631Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mattia Bignotti
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, 9297University of Brescia, Brescia, Italy
| | - Stefania Ottaviani
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, UOC Pulmonology, 18631Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Denardo
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, 9297University of Brescia, Brescia, Italy
| | - Valentina Barzon
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, 19001University of Pavia, Pavia, Italy
| | - Emna Ben Khlifa
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, 9297University of Brescia, Brescia, Italy
| | - Guido Vailati
- Referral Centre for Alpha-1 Antitrypsin Deficiency, 18515 Spedali Civili , Brescia, Italy
| | - Davide Piloni
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, UOC Pulmonology, 18631Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Benini
- Referral Centre for Alpha-1 Antitrypsin Deficiency, 18515 Spedali Civili , Brescia, Italy
| | - Luciano Corda
- Referral Centre for Alpha-1 Antitrypsin Deficiency, 18515 Spedali Civili , Brescia, Italy
| | - Angelo G Corsico
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, UOC Pulmonology, 18631Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, 19001University of Pavia, Pavia, Italy
| | - Ilaria Ferrarotti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, UOC Pulmonology, 18631Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, 19001University of Pavia, Pavia, Italy
| | - Annamaria Fra
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, 9297University of Brescia, Brescia, Italy
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Piloni D, Ottaviani S, Saderi L, Corda L, Baderna P, Barzon V, Balderacchi AM, Seebacher C, Balbi B, Albicini F, Corino A, Mennitti MC, Tirelli C, Spreafico F, Bosio M, Mariani F, Sotgiu G, Corsico AG, Ferrarotti I. Comparison among populations with severe and intermediate alpha1-antitrypsin deficiency and chronic obstructive pulmonary disease. Minerva Med 2024; 115:23-31. [PMID: 37021471 DOI: 10.23736/s0026-4806.22.08266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/07/2023]
Abstract
BACKGROUND Severe alpha1-antitrypsin (AAT) deficiency (AATD) is associated with a high risk of airflow obstruction and emphysema. The risk of lung disease in those with intermediate AAT deficiency is unclear. Our aims were to compare pulmonary function, time of onset of symptoms, and indicators of quality of life among patients with severe AATD (PI*ZZ), patients with intermediate AATD (PI*MZ) from the Italian Registry of AATD with a chronic obstructive pulmonary disease (COPD) cohort of patients without AATD (PI*MM). METHODS We considered a total of 613 patients: 330 with the PI*ZZ genotype, 183 with the PI*MZ genotype and 100 with the PI*MM genotype. Radiological exams, pulmonary function test, and measurement of quality of life have been performed on all cohorts of patients. RESULTS The three populations differ significantly in terms of age at COPD/AATD diagnosis (P=0.00001), respiratory function (FEV1, FVC, DLCO P<0.001), quality of life (P=0.0001) and smoking history (P<0.0001). PI*ZZ genotype had 24.9 times a higher likelihood of developing airflow obstruction. The MZ genotype is not associated with a significant early risk of airflow obstruction. CONCLUSIONS The comparison of populations with PI*ZZ, MZ and MM genotypes allows to delineate the role of alpha1-antitrypsin deficiency on respiratory function and on the impact on quality of life, in relation to other risk factors. These results highlight the crucial role of primary and secondary prevention on smoking habits in PI*MZ subjects and the importance of an early diagnosis.
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Affiliation(s)
- Davide Piloni
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Stefania Ottaviani
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luciano Corda
- First Division of Medicine, ASST Spedali Civili, Brescia, Italy
| | | | - Valentina Barzon
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Alice M Balderacchi
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | | | - Bruno Balbi
- Division of Pneumology, IRCCS Maugeri Scientific Clinical Institutes, Veruno, Novara, Italy
| | - Federica Albicini
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
| | - Alessandra Corino
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
| | - Maria C Mennitti
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
| | - Claudio Tirelli
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
| | - Fabio Spreafico
- First Division of Medicine, ASST Spedali Civili, Brescia, Italy
| | - Matteo Bosio
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
| | - Francesca Mariani
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Angelo G Corsico
- Section of Pneumology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy
- AATD Core Network of European Reference Network LUNG, Frankfurt am Main, Germany
| | - Ilaria Ferrarotti
- Department of Internal Medicine, and Therapeutics, Center for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy -
- AATD Core Network of European Reference Network LUNG, Frankfurt am Main, Germany
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Bertuccio FR, Partenope V, Piloni D, Montini S, Baio N, Bortolotto C, Valentini A, Corsico AG, Stella GM. Predictive markers associated to fibrotic evolution in hypersensitivity pneumonitis: a single institution's analysis. Minerva Med 2023:S0026-4806.23.08823-7. [PMID: 37712941 DOI: 10.23736/s0026-4806.23.08823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Francesco R Bertuccio
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Valerio Partenope
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Davide Piloni
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Simone Montini
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Nicola Baio
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Chandra Bortolotto
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia Medical School, Pavia, Italy
- Unit of Radiology, Department of Diagnostic Services and Imaging, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Adele Valentini
- Unit of Radiology, Department of Diagnostic Services and Imaging, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Angelo G Corsico
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
| | - Giulia M Stella
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy -
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS San Matteo Polyclinic Hospital, Pavia, Italy
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Ottaviani S, Bartoli G, Carroll TP, Gangemi F, Balderacchi AM, Barzon V, Corino A, Piloni D, McElvaney NG, Corsico AG, Irving JA, Fra A, Ferrarotti I. Comprehensive Clinical Diagnostic Pipelines Reveal New Variants in Alpha-1 Antitrypsin Deficiency. Am J Respir Cell Mol Biol 2023; 69:355-366. [PMID: 37071847 DOI: 10.1165/rcmb.2022-0470oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/18/2023] [Indexed: 04/20/2023] Open
Abstract
Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed disorder associated with mutations in the SERPINA1 gene encoding alpha-1 antitrypsin (AAT). Severe AATD can manifest as pulmonary emphysema and progressive liver disease. Besides the most common pathogenic variants S (E264V) and Z (E342K), many rarer genetic variants of AAT have been found in patients and in the general population. Here we report a panel of new SERPINA1 variants, including 4 null and 16 missense alleles, identified among a cohort of individuals with suspected AATD whose phenotypic follow-up showed inconclusive or atypical results. Because the pathogenic significance of the missense variants was unclear purely on the basis of clinical data, the integration of computational, biochemical, and cellular studies was used to define the associated risk of disease. Established pathogenicity predictors and structural analysis identified a panel of candidate damaging mutations that were characterized by expression in mammalian cell models. Polymer formation, intracellular accumulation, and secretory efficiency were evaluated experimentally. Our results identified two AAT mutants with a Z-like polymerogenic severe deficiency profile (Smilano and Mcampolongo) and three milder variants (Xsarezzo, Pdublin, and Ctiberias). Overall, the experimentally determined behavior of the variants was in agreement with the pathogenicity scores of the REVEL (an ensemble method for predicting the pathogenicity of rare missense variants) predictor, supporting the utility of this bioinformatic tool in the initial assessment of newly identified amino acid substitutions of AAT. Our study, in addition to describing 20 new SERPINA1 variants, provides a model for a multidisciplinary approach to classification of rare AAT variants and their clinical impact on individuals with rare AATD genotypes.
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Affiliation(s)
- Stefania Ottaviani
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Giulia Bartoli
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Tomás P Carroll
- α-1 Foundation Ireland, Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Fabrizio Gangemi
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Alice M Balderacchi
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Valentina Barzon
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, University of Pavia, Pavia, Italy
| | - Alessandra Corino
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Davide Piloni
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Noel G McElvaney
- α-1 Foundation Ireland, Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Angelo G Corsico
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, University of Pavia, Pavia, Italy
- European Reference Network on Rare Respiratory Diseases (ERN-LUNG); and
| | - James A Irving
- University College London Respiratory, Rayne Institute and the Institute of Structural and Molecular Biology, University College London, London, United Kingdom
| | - Annamaria Fra
- Experimental Oncology and Immunology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ilaria Ferrarotti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Unità Operativa Complessa Pneumologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Therapeutics, Pulmonology Unit, University of Pavia, Pavia, Italy
- European Reference Network on Rare Respiratory Diseases (ERN-LUNG); and
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8
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Tirelli C, DE Amici M, Piloni D, Sacchi L, Mariani F, Testa G, Torre C, Ciprandi G, Centanni S, Marseglia G, Corsico AG. Serum Aspergillus-specific IgE, IgG and IgG4 immunoglobulins assessment in the work-up of invasive pulmonary aspergillosis: a prospective cohort study. Minerva Med 2023; 114:433-443. [PMID: 35904372 DOI: 10.23736/s0026-4806.22.08245-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
BACKGROUND Positive microbiological fungal culture from bronchoalveolar-lavage-fluid (BAL) for Aspergillus or tissue biopsy and the detection of high levels of Aspergillus Galactomannan (GM) are commonly considered standard for diagnosing Invasive Pulmonary Aspergillosis (IPA). However, Aspergillus infection induces both cellular and humoral immune responses, characterized by the production of specific immunoglobulins, which can be easily detected in serum and accurately measured. This study hypothesized that Aspergillus-specific IgE, IgG, including IgG<inf>4</inf>, assays could be adopted as a rapid preliminary screening tool in patients with suspected Aspergillus-related lung disease in order to help in the identification of patients who require more invasive procedures (bronchoscopy, biopsy). METHODS We prospectively stored 447 serum specimens of patients admitted for suspected IPA from 1 January 2010 to 31 July 2021. Serum total IgE and serum IgE, IgG and IgG<inf>4</inf> specific for Aspergillus fumigatus and Aspergillus niger were determined for each sample. In addition, bronchoscopy with BAL for microbiologic culture and Aspergillus Galactomannan (GM) antigen were performed in all patients. RESULTS Patients with IPA, diagnosed by detection of a positive BAL culture for Aspergillus and/or a positive GM, showed higher serum levels of specific Aspergillus fumigatus and Aspergillus niger immunoglobulins. Serum-specific Aspergillus fumigatus IgG at a cut-off of 22.6 mgA/L showed the highest sensitivity in predicting IPA, though quite moderate (AUC 0.62). Nonetheless, the simultaneous presence of values below the cut-off of Aspergillus IgE, IgG and IgG<inf>4</inf> showed a negative predictive value greater than 90% both towards positive BAL culture and positive GM. CONCLUSIONS In patients with suspected IPA, Aspergillus-specific immunoglobulins assay could be tested as a preliminary screening tool to support more invasive procedures, i.e. BAL.
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Affiliation(s)
- Claudio Tirelli
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy -
- Unit of Pulmonology, Department of Medical Sciences and Infectious Diseases, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy -
| | - Mara DE Amici
- Laboratory Immuno-Allergology of Clinical Chemistry, Department of Pediatrics, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | - Davide Piloni
- Unit of Pulmonology, Department of Medical Sciences and Infectious Diseases, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | - Lucia Sacchi
- Mario Stefanelli Laboratory for Biomedical Informatics, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Francesca Mariani
- Unit of Pulmonology, Department of Medical Sciences and Infectious Diseases, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | - Giorgia Testa
- Laboratory Immuno-Allergology of Clinical Chemistry, Department of Pediatrics, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | - Cristina Torre
- Laboratory Immuno-Allergology of Clinical Chemistry, Department of Pediatrics, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | | | - Stefano Centanni
- Respiratory Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Gianluigi Marseglia
- Laboratory Immuno-Allergology of Clinical Chemistry, Department of Pediatrics, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
- Pediatric Clinic, Department of Pediatrics, University of Pavia, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
| | - Angelo G Corsico
- Unit of Pulmonology, Department of Medical Sciences and Infectious Diseases, IRCCS Policlinico San Matteo University Hospital, Pavia, Italy
- Respiratory Diseases Clinic, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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9
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Stella GM, Lettieri S, Piloni D, Ferrarotti I, Perrotta F, Corsico AG, Bortolotto C. Smart Sensors and Microtechnologies in the Precision Medicine Approach against Lung Cancer. Pharmaceuticals (Basel) 2023; 16:1042. [PMID: 37513953 PMCID: PMC10385174 DOI: 10.3390/ph16071042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/23/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND AND RATIONALE The therapeutic interventions against lung cancer are currently based on a fully personalized approach to the disease with considerable improvement of patients' outcome. Alongside continuous scientific progresses and research investments, massive technologic efforts, innovative challenges, and consolidated achievements together with research investments are at the bases of the engineering and manufacturing revolution that allows a significant gain in clinical setting. AIM AND METHODS The scope of this review is thus to focus, rather than on the biologic traits, on the analysis of the precision sensors and novel generation materials, as semiconductors, which are below the clinical development of personalized diagnosis and treatment. In this perspective, a careful revision and analysis of the state of the art of the literature and experimental knowledge is presented. RESULTS Novel materials are being used in the development of personalized diagnosis and treatment for lung cancer. Among them, semiconductors are used to analyze volatile cancer compounds and allow early disease diagnosis. Moreover, they can be used to generate MEMS which have found an application in advanced imaging techniques as well as in drug delivery devices. CONCLUSIONS Overall, these issues represent critical issues only partially known and generally underestimated by the clinical community. These novel micro-technology-based biosensing devices, based on the use of molecules at atomic concentrations, are crucial for clinical innovation since they have allowed the recent significant advances in cancer biology deciphering as well as in disease detection and therapy. There is an urgent need to create a stronger dialogue between technologists, basic researchers, and clinicians to address all scientific and manufacturing efforts towards a real improvement in patients' outcome. Here, great attention is focused on their application against lung cancer, from their exploitations in translational research to their application in diagnosis and treatment development, to ensure early diagnosis and better clinical outcomes.
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Affiliation(s)
- Giulia Maria Stella
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Sara Lettieri
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Davide Piloni
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Ilaria Ferrarotti
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", 80131 Napoli, Italy
- U.O.C. Clinica Pneumologica "L. Vanvitelli", A.O. dei Colli, Ospedale Monaldi, 80131 Napoli, Italy
| | - Angelo Guido Corsico
- Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, 27100 Pavia, Italy
- Cardiothoracic and Vascular Department, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Chandra Bortolotto
- Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia Medical School, 27100 Pavia, Italy
- Department of Diagnostic Services and Imaging, Unit of Radiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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10
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Stella GM, Chino V, Putignano P, Bertuccio F, Agustoni F, Saracino L, Tomaselli S, Saddi J, Piloni D, Bortolotto C. CT Scan-Guided Fine Needle Aspiration Cytology for Lung Cancer Diagnosis through the COVID-19 Pandemic: What We Have Learned. Tomography 2023; 9:759-767. [PMID: 37104132 PMCID: PMC10143076 DOI: 10.3390/tomography9020061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Background and rationale. Novel coronavirus-related disease (COVID-19) has profoundly influenced hospital organization and structures worldwide. In Italy, the Lombardy Region, with almost 17% of the Italian population, rapidly became the most severely affected area since the pandemic beginning. The first and the following COVID-19 surges significantly affected lung cancer diagnosis and subsequent management. Much data have been already published regarding the therapeutic repercussions whereas very few reports have focused on the consequences of the pandemic on diagnostic procedures. Methods. We, here, would like to analyze data of novel lung cancer diagnosis performed in our Institution in Norther Italy where we faced the earliest and largest outbreaks of COVID-19 in Italy. Results. We discuss, in detail, the strategies developed to perform biopsies and the safe pathways created in emergency settings to protect lung cancer patients in subsequent therapeutic phases. Quite unexpectedly, no significant differences emerged between cases enrolled during the pandemic and those before, and the two populations were homogeneous considering the composition and diagnostic and complication rates. Conclusions. By pointing out the role of multidisciplinarity in emergency contexts, these data will be of help in the future for designing tailored strategies to manage lung cancer in a real-life setting.
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Affiliation(s)
- Giulia Maria Stella
- Department of Internal Medicine and Medical Therapeutics, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-0382-03369; Fax: +39-0382-502719
| | - Vittorio Chino
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- University of Pavia Medical School, 27100 Pavia, Italy
| | - Paola Putignano
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesco Bertuccio
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- University of Pavia Medical School, 27100 Pavia, Italy
| | - Francesco Agustoni
- Department of Internal Medicine and Medical Therapeutics, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- Unit of Oncology, Department of Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Laura Saracino
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Stefano Tomaselli
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Jessica Saddi
- Unit of Radiation Therapy, Department of Oncology, Clinical-Surgical, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- University of Milano-Bicocca, 20159 Milano, Italy
| | - Davide Piloni
- Unit of Respiratory Diseases, Cardio-Thoraco-Vascular Department, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Chandra Bortolotto
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Unit of Radiology, Department of Diagnostic and Imaging Services, University of Pavia Medical School, 27100 Pavia, Italy
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11
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Grosso A, Cerveri I, Cazzoletti L, Zanolin ME, Mattioli V, Piloni D, Gini E, Albicini F, Ronzoni V, Jarvis D, Janson C, Corsico AG. Inhaled corticosteroids and risk of osteoporosis in late-middle-aged subjects: a multicenter European cohort study. Minerva Med 2023; 114:15-21. [PMID: 34114441 DOI: 10.23736/s0026-4806.21.07431-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Inhaled corticosteroids have been widely used for the regular treatment of asthma and chronic obstructive pulmonary diseases (COPD) over the past few decades. To date, studies investigating the effects of inhaled corticosteroids (ICS) on bone in populations including asthma and COPD patients, show conflicting results. The skeletal effects of ICS remain poorly understood. We assessed the association between ICS exposure and self-reported osteoporosis diagnosis in a European cohort study. METHODS The analysis was carried out by using clinical and questionnaire data available for subjects participating in the ECRHS III (European Community Respiratory Health Survey) with age >55 years. RESULTS Among the 3004 enrolled subjects, 245 were ICS users with an exposure ≥12 months. Osteoporosis was reported by 16 subjects in the ICS group (6.5%) and by 167 in the not exposed group (6.1%). The adjusted risk of osteoporosis in ICS users (≥12 months) was not greater in exposed subjects when compared with the unexposed ones (OR=1.02, 95CI%: 0.51, 2.03). The same result was observed even when considering in the analysis a longer exposure to the ICS use (≥36.5 months, the median ICS exposure for all subjects). History of COPD, use of oral corticosteroids, Body Mass Index, smoking and physical activity did not show any evidence of an association with osteoporosis. CONCLUSIONS Our study did not show any significant association between long- term ICS use and self-reported diagnosis of osteoporosis in subjects aged >55 years. To explore the real effect of ICS on bone status, further studies are needed, especially in the long-term ICS exposure.
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Affiliation(s)
- Amelia Grosso
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy -
| | - Isa Cerveri
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Maria E Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Veronica Mattioli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Erica Gini
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Federica Albicini
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Vanessa Ronzoni
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Debbie Jarvis
- Department of Population Health and Occupational Diseases, National Heart and Lung Institute, Imperial College London, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Angelo G Corsico
- Division of Respiratory Diseases, Department of Internal Medicine, and Therapeutics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
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12
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Aiello M, Frizzelli A, Marchi L, Ferrarotti I, Piloni D, Pelà G, De Simoni A, D'Aloisio L, Calzetta L, Chetta A. Clinical manifestations of a new alpha‐1 antitrypsin genetic variant:
Q0parma
. Respirol Case Rep 2022; 10:e0936. [PMID: 35433011 PMCID: PMC9008433 DOI: 10.1002/rcr2.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/13/2022] [Indexed: 11/12/2022] Open
Abstract
Alpha‐1 antitrypsin deficiency is an autosomal, codominant disorder caused by mutations of the SERPINA1 gene. Several mutations of SERPINA1 have been described associated with the development of pulmonary emphysema and/or chronic liver disease and cirrhosis. Here, we report a very rare PI*Q0parma variant identified for the first time in an Italian family originally from the city of Parma in Northern Italy
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Affiliation(s)
- Marina Aiello
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
| | - Annalisa Frizzelli
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
| | - Laura Marchi
- Department of Food and Drug University of Parma Parma Italy
| | - Ilaria Ferrarotti
- Center for the Diagnosis of Inherited Alpha1‐Antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumology Unit University of Pavia Pavia Italy
| | - Davide Piloni
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases IRCCS Policlinico San Matteo Foundation Pavia Italy
| | - Giovanna Pelà
- Department of Medicine and Surgery University of Parma Parma Italy
- Department of General and Specialistic Medicine University‐Hospital of Parma Parma Italy
| | - Alessandro De Simoni
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
| | - Lorenzo D'Aloisio
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
| | - Luigino Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
| | - Alfredo Chetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit University of Parma Parma Italy
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13
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DE Amici M, Piloni D, Tirelli C, Mariani F, Accordino G, Sacchi L, Testa G, Licari A, Corsico AG. Eosinophilic cationic protein (ECP) in the clinical work-up of chronic cough. Minerva Med 2021; 114:148-151. [PMID: 34515456 DOI: 10.23736/s0026-4806.21.07679-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic cough is a common symptom, addressed in the clinical setting by empirical treatment together with some laboratory investigations. Purpose of the present study is to investigate the value of testing eosinophilic cationic protein (ECP) serum levels combined with other diagnostic procedures and empirical treatment in the diagnostic workup of chronic cough. METHODS In this study, we evaluated 194 patients with chronic cough. No subject had received any anti-inflammatory treatment before clinical evaluation, and none was an active smoker. ECP was measured with a commercially available fluoroenzyme immunoassay and results were expressed as µg/L. RESULTS The analysis of variance showed that mean ECP level differs among the various diagnosis categories (p < 0.001). Mean ECP level was significantly higher in asthmatic patients, particularly in the active disease. CONCLUSIONS Serum ECP concentration could represent a useful biomarker in the clinical work-up of chronic cough, managing to differentiate asthma from other chronic disorders.
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Affiliation(s)
- Mara DE Amici
- Laboratory Immuno-Allergology of Clinical Chemistry, Department of Pediatrics, Foundation IRCCS Policlinic San Matteo, Pavia, Italy.,Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.,Laboratory for Biomedical Informatics Mario Stefanelli, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.,Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy -
| | - Claudio Tirelli
- Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Francesca Mariani
- Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Giulia Accordino
- Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Lucia Sacchi
- Laboratory for Biomedical Informatics Mario Stefanelli, Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Giorgia Testa
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Amelia Licari
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Angelo G Corsico
- Respiratory Diseases Unit, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
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14
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Ottaviani S, Ferrarotti I, Balderacchi AM, Barzon V, Corino A, De Silvestri A, Piloni D, Mariani F, Corsico AG. COVID-19 infection in Severe Alpha 1-antitrypsin deficiency: looking for a rationale. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa918] [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: 11/05/2022]
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15
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Lisini D, Lettieri S, Nava S, Accordino G, Frigerio S, Bortolotto C, Lancia A, Filippi AR, Agustoni F, Pandolfi L, Piloni D, Comoli P, Corsico AG, Stella GM. Local Therapies and Modulation of Tumor Surrounding Stroma in Malignant Pleural Mesothelioma: A Translational Approach. Int J Mol Sci 2021; 22:9014. [PMID: 34445720 PMCID: PMC8396500 DOI: 10.3390/ijms22169014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022] Open
Abstract
Malignant Pleural Mesothelioma (MPM) is a rare and aggressive neoplasm of the pleural mesothelium, mainly associated with asbestos exposure and still lacking effective therapies. Modern targeted biological strategies that have revolutionized the therapy of other solid tumors have not had success so far in the MPM. Combination immunotherapy might achieve better results over chemotherapy alone, but there is still a need for more effective therapeutic approaches. Based on the peculiar disease features of MPM, several strategies for local therapeutic delivery have been developed over the past years. The common rationale of these approaches is: (i) to reduce the risk of drug inactivation before reaching the target tumor cells; (ii) to increase the concentration of active drugs in the tumor micro-environment and their bioavailability; (iii) to reduce toxic effects on normal, non-transformed cells, because of much lower drug doses than those used for systemic chemotherapy. The complex interactions between drugs and the local immune-inflammatory micro-environment modulate the subsequent clinical response. In this perspective, the main interest is currently addressed to the development of local drug delivery platforms, both cell therapy and engineered nanotools. We here propose a review aimed at deep investigation of the biologic effects of the current local therapies for MPM, including cell therapies, and the mechanisms of interaction with the tumor micro-environment.
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Affiliation(s)
- Daniela Lisini
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Sara Lettieri
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Sara Nava
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Giulia Accordino
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Simona Frigerio
- Cell Therapy Production Unit-UPTC and Cerebrovascular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (D.L.); (S.N.); (S.F.)
| | - Chandra Bortolotto
- Unit of Radiology, Department of Intensive Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Andrea Lancia
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Andrea Riccardo Filippi
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Francesco Agustoni
- Unit of Oncology, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Laura Pandolfi
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Davide Piloni
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Patrizia Comoli
- Cell Factory and Pediatric Hematology-Oncology Unit, IRCCS Fondazione Policlinico San Matteo, 27100 Pavia, Italy;
| | - Angelo Guido Corsico
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
| | - Giulia Maria Stella
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (S.L.); (G.A.); (L.P.); (D.P.); (A.G.C.)
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16
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Melazzini F, Colaneri M, Fumoso F, Freddi G, Lenti MV, Pieri TC, Piloni D, Noris P, Pieresca C, Preti PS, Russo M, Corsico A, Tavazzi G, Baldanti F, Triarico A, Mojoli F, Bruno R, Di Sabatino A. Correction to: Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy. Intern Emerg Med 2021; 16:1153. [PMID: 33400165 PMCID: PMC7782560 DOI: 10.1007/s11739-020-02613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Federica Melazzini
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marta Colaneri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Fumoso
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giulia Freddi
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Teresa Chiara Pieri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Patrizia Noris
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carla Pieresca
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paola Stefania Preti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Mariaconcetta Russo
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Guido Tavazzi
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Triarico
- Chief Medical Direction, San Matteo Hospital Foundation, Pavia, Italy
| | - Francesco Mojoli
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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17
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Melazzini F, Colaneri M, Fumoso F, Freddi G, Lenti MV, Pieri TC, Piloni D, Noris P, Pieresca C, Preti PS, Russo M, Corsico A, Tavazzi G, Baldanti F, Triarico A, Mojoli F, Bruno R, Di Sabatino A. Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy. Intern Emerg Med 2021; 16:1141-1152. [PMID: 33161478 PMCID: PMC7648897 DOI: 10.1007/s11739-020-02550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in D-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.
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Affiliation(s)
- Federica Melazzini
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marta Colaneri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Fumoso
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giulia Freddi
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Teresa Chiara Pieri
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Patrizia Noris
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Carla Pieresca
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Paola Stefania Preti
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Mariaconcetta Russo
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Department of Respiratory Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Guido Tavazzi
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Triarico
- Chief Medical Direction, San Matteo Hospital Foundation, Pavia, Italy
| | - Francesco Mojoli
- Department of Intensive Care, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Department of Infectious Disease, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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18
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Stella GM, Piloni D, Coretti M, Albicini F, Gini E, Grosso A, Corsico AG. Partition analysis of data of two waves of COVID-19 pandemic: is the landscape really evolving? A single institution experience. Minerva Med 2021; 114:244-247. [PMID: 33969963 DOI: 10.23736/s0026-4806.21.07547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giulia M Stella
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy -
| | - Davide Piloni
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Manuela Coretti
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Federica Albicini
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Erica Gini
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Amelia Grosso
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Angelo G Corsico
- Unit of Respiratory Diseases, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
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19
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Ferrarotti I, Ottaviani S, Balderacchi AM, Barzon V, De Silvestri A, Piloni D, Mariani F, Corsico AG. COVID-19 infection in severe Alpha 1-antitrypsin deficiency: Looking for a rationale. Respir Med 2021; 183:106440. [PMID: 33964815 PMCID: PMC8086383 DOI: 10.1016/j.rmed.2021.106440] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/08/2021] [Accepted: 04/27/2021] [Indexed: 12/29/2022]
Abstract
The clinical manifestations of COVID-19 are heterogeneous: 46.4% of patients admitted into hospital reported to have at least one comorbidity. Comorbidities such as COPD, diabetes, hypertension and malignancy predispose patients with Covid-19 to adverse clinical outcomes. Alpha 1-antitrypsin deficiency (AATD) is a genetic disorder caused by pathological mutation(s) in the SERPINA1 gene resulting in an imbalance in proteinase activity which may lead to premature emphysema and COPD. Our aim was to investigate whether people with severe AAT deficiency (AATD) have an increased risk of (severe) COVID-19 infection. We collected data on COVID-19 symptoms, laboratory-confirmed infection, hospitalization and treatment by means of a telephone survey, directly administered to Italian severe AATD subjects in May 2020. We then compared our findings with data collected by the Istituto Superiore di Sanità on the total population in Italy during the same period. We found an higher frequency of SARS-CoV-2 infection in our cohort (3.8%) compared to national data regarding infection, thus giving severe AATD a relative risk of 8. 8 (95%CI 5.1-20,0; p<0.0001) for symptomatic SARS-CoV-2 infection. Moreover, the relative risk (RR) was higher in AATD patients with pre-existing lung diseases (RR 13.9; 95%CI 8.0-33.6; p<0.001), but with a similar death rate (1 in 8, 12.5%) compared to the general population (13.9%; RR 0.9). These preliminary findings highlight the importance of close surveillance in the spread of COVID-19 in patients with severe AATD and underlines the need for further studies into the role of the antiprotease shield in preventing SARS-Cov-2 infection.
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Affiliation(s)
- I Ferrarotti
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - S Ottaviani
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A M Balderacchi
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - V Barzon
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A De Silvestri
- Statistics Dept, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - D Piloni
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Mariani
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A G Corsico
- Centre for Diagnosis of Inherited Alpha-1 Antitrypsin Deficiency, Laboratory of Biochemistry and Genetics, Institute for Respiratory Disease, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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20
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Ghio S, Klersy C, Corsico A, Gamba SL, Monterosso C, Masiglat J, Borrelli E, Scelsi L, Greco A, Piloni D, Visconti LO, D'Armini AM. Risk stratification in patients with residual pulmonary hypertension after pulmonary endarterectomy. Int J Cardiol 2021; 334:116-122. [PMID: 33823214 DOI: 10.1016/j.ijcard.2021.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/06/2021] [Accepted: 04/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Few studies addressed the issue of risk stratification in patients with residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA). This study tested the potential added value of parameters that have not been included in existing risk models. METHODS We evaluated 546 consecutive patients with chronic thromboembolic pulmonary hypertension who underwent PEA and were followed-up for a median period of 58 months. RESULTS Among the 242 with residual PH, 27 died and had 127 a clinical worsening event. At univariable analysis, the parameters associated with poor survival were pulmonary vascular resistance (PVR) ≥425 dyn·s·cm-5 (p ≤ 0.001), mean pulmonary artery pressure (mPAP) ≥38 mmHg (p = 0.003) and pulmonary artery compliance (CPA) ≤1.8 ml/mmHg (p = 0.014). In the bivariable models including either PVR or mPAP as first parameter, the addition of CPA was not statistically significant. The parameters associated with poor clinical worsening were CPA ≤1.8 ml/mmHg (p < 0.001), PVR ≥425 dyn·s·cm-5 (p = 0.002), arterial oxygen tension (PaO2) ≤ 75 mmHg (p = 0.003), mPAP ≥38 mmHg (p = 0.008). In a multivariable analysis which included PVR ≥425 as the first parameter, the addition of both CPA ≤1.8 ml/mmHg and of PaO2 ≤ 75 mmHg significantly improved prognostic stratification (Harrel's C of the model = 0.64, p < 0.001). Noticeably, the lower tertile of the model's predictor index identified a subgroup of 91 patients who had an event rate numerically similar to that of patients without residual PH. CONCLUSIONS Risk stratification in residual PH can be refined if CPA and PaO2 are considered in association with standard hemodynamic parameters.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy.
| | - Catherine Klersy
- Service of Clinical Epidemiology & Biometry, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Sofia Lucia Gamba
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Cristian Monterosso
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Joice Masiglat
- Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
| | - Ermelinda Borrelli
- Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Alessandra Greco
- Division of Cardiology, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy
| | | | - Andrea Maria D'Armini
- Division of Cardiac Surgery, Cardiopulmonary Surgery and Pulmonary Hypertension, Foundation "I.R.C.C.S. Policlinico San Matteo", Pavia, Italy; Department of Surgical, Clinical, Diagnostic and Pediatric Sciences, University of Pavia School of Medicine, Pavia, Italy
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21
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Stella GM, Piloni D, Accordino G, Grosso A, Albicini F, Gini E, Mancinelli S, Della Zoppa M, Marchelli APG, Bortolotto C, Corsico AG. COVID-19 epidemic in a Respiratory Diseases Unit: predictor ranking and mining. J Thorac Dis 2021; 13:2569-2574. [PMID: 34012603 PMCID: PMC8107544 DOI: 10.21037/jtd-20-2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Giulia M Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Davide Piloni
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Giulia Accordino
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Amelia Grosso
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Federica Albicini
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Erica Gini
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Silvia Mancinelli
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Matteo Della Zoppa
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Andrea P G Marchelli
- Analog and Power FMT and Smart Power Technology, ST Microelectronics, Agrate Brianza, Italy
| | - Chandra Bortolotto
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Angelo G Corsico
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
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22
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Piloni D, Gabanti E, Morosini M, Oggionni T, Saracino L, Conio V, Frangipane V, Cassinelli G, Lilleri D, Meloni F. Chronic Lung Allograft Dysfunction is Associated with Acute Rejection and High Levels of Cytomegalovirus Load in Blood (but Not in Lung). J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.948] [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: 11/29/2022] Open
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23
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Stella GM, D’Agnano V, Piloni D, Saracino L, Lettieri S, Mariani F, Lancia A, Bortolotto C, Rinaldi P, Falanga F, Primiceri C, Corsico AG, Bianco A. The oncogenic landscape of the idiopathic pulmonary fibrosis: a narrative review. Transl Lung Cancer Res 2021; 11:472-496. [PMID: 35399571 PMCID: PMC8988078 DOI: 10.21037/tlcr-21-880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/16/2022] [Indexed: 12/04/2022]
Abstract
Background and Objective Translational research is a source of continuous innovation in medicine, more particularly for clinical research on new treatment modalities in idiopathic pulmonary fibrosis (IPF) patients. However, the heterogeneity of the disease is well recognized, and different pathological and molecular settings have been identified. The molecular mechanisms by which IPF proceeds in time and space remains poorly understood. Although some IPF features are reminiscent of cancer, the dynamics of malignant divergent clonal selective pressure and heterogeneity clearly differ from those occurring in IPF. This is reflected in the absence of patient proper selection and stratification to biological agents (pirfenidone, nintedanib) which limit therapeutic efficacy. Consequently, increased costs are related to the clinical management of advanced IPF patients. Steady collaboration and fluid communication between pneumo-oncologists, radiologists and molecular biologists is a clear priority for the correct interpretation of tests and the definition of effective personalized strategies against this orphan disease. The present work aims at providing the most relevant hints shared by cancer and IPF. Methods A systematic literature review was performed to identify all relevant data. The examined databases were Scopus, Web of Science, Cochrane, Google Scholar, and PubMed. The last search was run on January 5, 2022. We have primarily conducted separated research for lung cancer, IPF, genetics, epigenetics, surgery in IPF and cancer. Key Content and Findings The data here presented mainly focus on gene mutations, epigenetics and novel therapeutic approaches. Moreover, epidemiology, prognostic variables and in new treatment strategies adopted in patients with IPF and lung cancer are discussed as well. Conclusions Overall, the findings of this narrative review will be of help in defining the key molecular features that could applied in IPF setting with promising rationale to improve therapy and to better manage those cases carrying IPF and cancer concomitantly.
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Affiliation(s)
- Giulia Maria Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Vito D’Agnano
- Department of Translational Medical Sciences, University of Campania “L. Vanvitelli”, Napoli, Italy
| | - Davide Piloni
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Laura Saracino
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Sara Lettieri
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Francesca Mariani
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Andrea Lancia
- Department of Medical Sciences and Infective Diseases, Unit of Radiation Therapy, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Chandra Bortolotto
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Pietro Rinaldi
- Department of Intensive Medicine, Unit of Thoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Francesco Falanga
- Department of Intensive Medicine, Unit of Thoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Cristiano Primiceri
- Department of Intensive Medicine, Unit of Thoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Angelo Guido Corsico
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania “L. Vanvitelli”, Napoli, Italy
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24
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Pandolfi L, Fusco R, Frangipane V, D'Amico R, Giustra M, Bozzini S, Morosini M, D'Amato M, Cova E, Ferrario G, Morbini P, Colombo M, Prosperi D, Viglio S, Piloni D, Di Paola R, Cuzzocrea S, Meloni F. Loading Imatinib inside targeted nanoparticles to prevent Bronchiolitis Obliterans Syndrome. Sci Rep 2020; 10:20726. [PMID: 33244143 PMCID: PMC7693282 DOI: 10.1038/s41598-020-77828-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/12/2020] [Indexed: 12/24/2022] Open
Abstract
Bronchiolitis Obliterans Syndrome seriously reduces long-term survival of lung transplanted patients. Up to now there is no effective therapy once BOS is established. Nanomedicine introduces the possibility to administer drugs locally into lungs increasing drug accumulation in alveola reducing side effects. Imatinib was loaded in gold nanoparticles (GNP) functionalized with antibody against CD44 (GNP-HCIm). Lung fibroblasts (LFs) were derived from bronchoalveolar lavage of BOS patients. GNP-HCIm cytotoxicity was evaluated by MTT assay, apoptosis/necrosis and phosphorylated-cAbl (cAbl-p). Heterotopic tracheal transplantation (HTT) mouse model was used to evaluate the effect of local GNP-HCIm administration by Alzet pump. GNP-HCIm decreased LFs viability compared to Imatinib (44.4 ± 1.8% vs. 91.8 ± 3.2%, p < 0.001), inducing higher apoptosis (22.68 ± 4.3% vs. 6.43 ± 0.29; p < 0.001) and necrosis (18.65 ± 5.19%; p < 0.01). GNP-HCIm reduced cAbl-p (0.41 GNP-HCIm, 0.24 Imatinib vs. to control; p < 0.001). GNP-HCIm in HTT mouse model by Alzet pump significantly reduced tracheal lumen obliteration (p < 0.05), decreasing apoptosis (p < 0.05) and TGF-β-positive signal (p < 0.05) in surrounding tissue. GNP-HCIm treatment significantly reduced lymphocytic and neutrophil infiltration and mast cells degranulation (p < 0.05). Encapsulation of Imatinib into targeted nanoparticles could be considered a new option to inhibit the onset of allograft rejection acting on BOS specific features.
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Affiliation(s)
- Laura Pandolfi
- Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy.
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 981000, Messina, Italy
| | - Vanessa Frangipane
- Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy
| | - Ramona D'Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 981000, Messina, Italy
| | - Marco Giustra
- NanoBioLab, Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20100, Milano, Italy
| | - Sara Bozzini
- Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy
| | - Monica Morosini
- Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy
| | - Maura D'Amato
- Research Laboratory of Lung Diseases, Section of Cell Biology, IRCCS Policlinico San Matteo Foundation, 27100, Pavia, Italy
| | - Emanuela Cova
- Department of Molecular Medicine, Pathology Unit, University of Pavia; IRCCS Foundation Policlinico San Matteo, 27100, Pavia, Italy
| | - Giuseppina Ferrario
- Department of Molecular Medicine, Pathology Unit, University of Pavia; IRCCS Foundation Policlinico San Matteo, 27100, Pavia, Italy
| | - Patrizia Morbini
- Department of Molecular Medicine, Pathology Unit, University of Pavia; IRCCS Foundation Policlinico San Matteo, 27100, Pavia, Italy
| | - Miriam Colombo
- NanoBioLab, Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20100, Milano, Italy
| | - Davide Prosperi
- NanoBioLab, Department of Biotechnology and Biosciences, University of Milano-Bicocca, 20100, Milano, Italy.,Nanomedicine Laboratory, ICS Maugeri S.P.A., 27100, Pavia, Italy
| | - Simona Viglio
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, 27100, Pavia, Italy
| | - Davide Piloni
- Department of Internal Medicine, Section of Pneumology, University of Pavia, Pavia, Italy.,Department of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 981000, Messina, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, 981000, Messina, Italy.,Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Federica Meloni
- Department of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Department of Internal Medicine, Section of Pneumology, University of Pavia, 27100, Pavia, Italy
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25
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Vicentini A, Masiello L, D’Amore S, Baldi E, Ghio S, Savastano S, Sanzo A, Di Matteo A, Seminari EM, Lenti MV, Bosio M, Petracci B, Frigerio L, Sabena A, Tavazzi G, Oltrona Visconti L, Rordorf R, Gnecchi M, Totaro R, Ferlini M, Greco A, Magrini G, Scelsi L, Acquaro M, Coccia M, Digiacomo S, Foglia D, Jeva F, Montalto C, Moschella M, Pezza L, Perlini S, Alfano C, Bonzano M, Briganti F, Crescenzi G, Falchi AG, Maggi E, Guarnone R, Guglielmana B, Martino IF, Pioli Di Marco MS, Pettenazza P, Quaglia F, Salinaro F, Speciale F, Zunino I, Sturniolo G, Bracchi F, Lago E, Corsico A, Piloni D, Accordino G, Burattini C, Di Sabatino A, Pellegrino I, Soriano S, Santacroce G, Parodi A, de Andreis FB, Bruno R, Zuccaro V, Moioli F, Dammassi V, Albertini R. QTc Interval and Mortality in a Population of SARS-2-CoV Infected Patients. Circ Arrhythm Electrophysiol 2020; 13:e008890. [DOI: 10.1161/circep.120.008890] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lucrezia Masiello
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Sabato D’Amore
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, Cardiology Unit (L.M., S.D., E.B.), University of Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology (S.G., S.S., L.O.V.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simone Savastano
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Sanzo
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Emergency Department (A.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine (A.S.), University of Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Maria Seminari
- Division of Infectious Disease (A.D.M., E.M.S.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine (M.V.L.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Bosio
- Division of Respiratory Diseases (M.B.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Barbara Petracci
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Frigerio
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Sabena
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guido Tavazzi
- Anaesthesia and Intensive Care (G.T.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of Anesthesia and Intensive Care (G.T.), University of Pavia, Italy
| | - Luigi Oltrona Visconti
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Laboratory of Clinical and Experimental Cardiology (A.V., L.M., S.D., E.B., A.S., B.P., L.F., R.R.), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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26
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Ghio S, Baldi E, Vicentini A, Lenti MV, Di Sabatino A, Di Matteo A, Zuccaro V, Piloni D, Corsico A, Gnecchi M, Speciale F, Sabena A, Oltrona Visconti L, Perlini S. Cardiac involvement at presentation in patients hospitalized with COVID-19 and their outcome in a tertiary referral hospital in Northern Italy. Intern Emerg Med 2020; 15:1457-1465. [PMID: 32960429 PMCID: PMC7505942 DOI: 10.1007/s11739-020-02493-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/04/2020] [Indexed: 12/15/2022]
Abstract
The correlation between myocardial injury and clinical outcome in COVID-19 patients is gaining attention in the literature. The aim of the present study was to evaluate the role of cardiac involvement and of respiratory failure in a cohort of COVID-19 patients hospitalized in an academic hospital in Lombardy, one of the most affected Italian (and worldwide) regions by the epidemic. The study included 405 consecutive patients with confirmed COVID-19 admitted to a medical ward from February 25th to March 31st, 2020. Follow-up of surviving patients ended either at hospital discharge or by July 30th, 2020. Myocardial injury was defined on the basis of the presence of blood levels of hs-TnI above the 99th percentile upper reference limit. Respiratory function was assessed as PaO2/FiO2 (P/F) ratio. The primary end-point was death for any cause. During hospitalization, 124 patients died. Death rate increased from 7.9% in patients with normal hs-TnI plasma levels and no cardiac comorbidity to 61.5% in patients with elevated hs-TnI and cardiac involvement (p < 0.001). At multivariable analysis, older age, P/F ratio < 200 (both p < 0.001) and hs-TnI plasma levels were independent predictors of death. However, it must be emphasized that the median values of hs-TnI were within normal range in non-survivors. Cardiac involvement at presentation was associated with poor prognosis in COVID-19 patients, but, even in a population of COVID-19 patients who did not require invasive ventilation at hospital admission, mortality was mainly driven by older age and respiratory failure.
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Affiliation(s)
- Stefano Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy.
| | - Enrico Baldi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alessandro Vicentini
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angela Di Matteo
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious Disease, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, University of Pavia, Pavia, Italy
| | - Massimiliano Gnecchi
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology, Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Cardiology Unit, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Francesco Speciale
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Anna Sabena
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Luigi Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100, Pavia, Italy
| | - Stefano Perlini
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Pavia, Italy
- Department of Internal Medicine, University of Pavia, Pavia, Italy
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27
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Grosso A, Piloni D, Zanolin ME, Cazzoletti L, Mattioli V, Gini E, Albicini F, Ronzoni V, Cerveri I, Corsico AG, Jarvis D, Janson C. Inhaled Corticosteroids and Risk of Osteoporosis in Late-Middle Age Subjects: A Multicenter European Cohort Study. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.1667] [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: 11/05/2022]
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28
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Ottaviani S, Fra AM, Balderacchi AM, Barzon V, Carroll TP, Piloni D, Mariani F, Mc Elvaney NG, Corsico AG, Ferrarotti I. Identification and characterisation of twenty-two novel SERPINA1 pathological mutations. Genes Environ 2020. [DOI: 10.1183/13993003.congress-2020.4922] [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: 11/05/2022] Open
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29
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Verleden SE, Vanstapel A, De Sadeleer L, Weynand B, Boone M, Verbeken E, Piloni D, Van Raemdonck D, Ackermann M, Jonigk DD, Verschakelen J, Wuyts WA. Quantitative analysis of airway obstruction in lymphangioleiomyomatosis. Eur Respir J 2020; 56:13993003.01965-2019. [PMID: 32108050 PMCID: PMC7330132 DOI: 10.1183/13993003.01965-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/03/2020] [Indexed: 02/02/2023]
Abstract
Lymphangioleiomyomatosis (LAM) is a rare, cystic lung disease with progressive pulmonary function loss caused by progressively proliferating LAM cells. The degree of airway obstruction has not been well investigated within the pathogenesis of LAM.Using a combination of ex vivo computed tomography (CT), microCT and histology, the site and nature of airway obstruction in LAM explant lungs was compared with matched control lungs (n=5 each). The total number of airways per generation, total airway counts, terminal bronchioles number and surface density were compared in LAM versus control.Ex vivo CT analysis demonstrated a reduced number of airways from generation 7 on (p<0.0001) in LAM compared with control, whereas whole-lung microCT analysis confirmed the three- to four-fold reduction in the number of airways. Specimen microCT analysis further demonstrated a four-fold decrease in the number of terminal bronchioles (p=0.0079) and a decreased surface density (p=0.0079). Serial microCT and histology images directly showed the loss of functional airways by collapse of airways on the cysts and filling of the airway by exudate.LAM lungs show a three- to four-fold decrease in the number of (small) airways, caused by cystic destruction which is the likely culprit for the progressive loss of pulmonary function.
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Affiliation(s)
- Stijn E Verleden
- Respiratory Diseases, Dept of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium .,Both authors contributed equally
| | - Arno Vanstapel
- Respiratory Diseases, Dept of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium.,Both authors contributed equally
| | - Laurens De Sadeleer
- Respiratory Diseases, Dept of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium
| | | | - Matthieu Boone
- Dept of Physics and Astronomy, Radiation Physics-Centre for X-ray Tomography, Ghent University, Ghent, Belgium
| | | | - Davide Piloni
- The Respiratory Disease Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Dirk Van Raemdonck
- Thoracic Surgery, Dept of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Institute of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Witten-Herdecke University, Wuppertal, Germany
| | - Danny D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | | | - Wim A Wuyts
- Respiratory Diseases, Dept of Chronic Diseases, Metabolism and Aging, KU Leuven, Leuven, Belgium
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30
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Benvenuto LJ, Costa J, Piloni D, Aversa M, Anderson MR, Shah L, Robbins HY, Stanifer B, Sonett JR, Arcasoy SM, D'Ovidio F. Right single lung transplantation or double lung transplantation compared with left single lung transplantation in chronic obstructive pulmonary disease. J Heart Lung Transplant 2020; 39:870-877. [PMID: 32693937 DOI: 10.1016/j.healun.2020.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/02/2020] [Accepted: 06/16/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Although single and double lung transplantation outcomes for chronic obstructive pulmonary disease (COPD) have been investigated, right and left single lung transplants have never been rigorously compared to evaluate disease-specific differences. Single lung transplants for COPD often have hyperinflation of the contralateral native lung, which may be more pronounced in left lung transplants. METHODS Using the United Network for Organ Sharing registry, we conducted a retrospective cohort study of 5,585 adults who underwent lung transplantation for COPD from May 4, 2005 to June 30, 2017. Subjects were followed until March 2019. Post-transplant survival was compared using Cox proportional hazards and Royston and Parmar's flexible parametric survival models. We adjusted for donor and recipient factors with known or plausible associations with survival. RESULTS Lung transplant recipients who received a left single lung transplant for COPD had an increased risk of post-transplant death when compared with those who received a right single lung transplant for COPD (hazard ratio [HR]: 1.24, 95% CI: 1.08-1.48, p = 0.002). Survival did not differ significantly between double lung transplant and right single lung transplant recipients (HR: 0.88, 95% CI: 0.77-1.02, p = 0.086). Adjusted 5-year survival was 57.8% (95% CI: 55.7-60.1) for double lung recipients, 56.7% (95% CI: 55.4-58.0) for right single lung recipients, and 50.9% (95% CI: 47.2-55.0) for left single lung recipients. CONCLUSIONS In COPD, right single lung transplantation was associated with improved post-transplant survival compared with left single lung transplantation, and no significant difference in post-transplant survival compared with double lung transplantation was found. In light of the ongoing donor lung shortage, preferential allocation of right single lungs to patients with COPD should be considered.
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Affiliation(s)
- Luke J Benvenuto
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Joseph Costa
- Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Davide Piloni
- Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Meghan Aversa
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | | | - Lori Shah
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Hilary Y Robbins
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Bryan Stanifer
- Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Joshua R Sonett
- Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Selim M Arcasoy
- Division of Pulmonary and Critical Care Medicine, Department of Medicine
| | - Frank D'Ovidio
- Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
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Verleden SE, Tanabe N, McDonough JE, Vasilescu DM, Xu F, Wuyts WA, Piloni D, De Sadeleer L, Willems S, Mai C, Hostens J, Cooper JD, Verbeken EK, Verschakelen J, Galban CJ, Van Raemdonck DE, Colby TV, Decramer M, Verleden GM, Kaminski N, Hackett TL, Vanaudenaerde BM, Hogg JC. Small airways pathology in idiopathic pulmonary fibrosis: a retrospective cohort study. Lancet Respir Med 2020; 8:573-584. [PMID: 32061334 DOI: 10.1016/s2213-2600(19)30356-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The observation that patients with idiopathic pulmonary fibrosis (IPF) can have higher than normal expiratory flow rates at low lung volumes led to the conclusion that the airways are spared in IPF. This study aimed to re-examine the hypothesis that airways are spared in IPF using a multiresolution imaging protocol that combines multidetector CT (MDCT), with micro-CT and histology. METHODS This was a retrospective cohort study comparing explanted lungs from patients with severe IPF treated by lung transplantation with a cohort of unused donor (control) lungs. The donor control lungs had no known lung disease, comorbidities, or structural lung injury, and were deemed appropriate for transplantation on review of the clinical files. The diagnosis of IPF in the lungs from patients was established by a multidisciplinary consensus committee according to existing guidelines, and was confirmed by video-assisted thoracic surgical biopsy or by pathological examination of the contralateral lung. The control and IPF groups were matched for age, sex, height, and bodyweight. Samples of lung tissue were compared using the multiresolution imaging approach: a cascade of clinical MDCT, micro-CT, and histological imaging. We did two experiments: in experiment 1, all the lungs were randomly sampled; in experiment 2, samples were selected from regions of minimal and established fibrosis. The patients and donors were recruited from the Katholieke Universiteit Leuven (Leuven, Belgium) and the University of Pennsylvania Hospital (Philadelphia, PA, USA). The study took place at the Katholieke Universiteit Leuven, and the University of British Columbia (Vancouver, BC, Canada). FINDINGS Between Oct 5, 2009, and July 22, 2016, explanted lungs from patients with severe IPF (n=11), were compared with a cohort of unused donor (control) lungs (n=10), providing 240 samples of lung tissue for comparison using the multiresolution imaging approach. The MDCT specimen scans show that the number of visible airways located between the ninth generation (control 69 [SD 22] versus patients with IPF 105 [33], p=0·0023) and 14th generation (control 9 [6] versus patients with IPF 49 [28], p<0·0001) of airway branching are increased in patients with IPF, which we show by micro-CT is due to thickening of their walls and distortion of their lumens. The micro-CT analysis showed that compared with healthy (control) lung anatomy (mean 5·6 terminal bronchioles per mL [SD 1·6]), minimal fibrosis in IPF tissue was associated with a 57% loss of the terminal bronchioles (mean 2·4 terminal bronchioles per mL [SD 1·0]; p<0·0001), the appearance of fibroblastic foci, and infiltration of the tissue by inflammatory immune cells capable of forming lymphoid follicles. Established fibrosis in IPF tissue had a similar reduction (66%) in the number of terminal bronchioles (mean 1·9 terminal bronchioles per mL [SD 1·4]; p<0·0001) and was dominated by increased airspace size, Ashcroft fibrosis score, and volume fractions of tissue and collagen. INTERPRETATION Small airways disease is a feature of IPF, with significant loss of terminal bronchioles occuring within regions of minimal fibrosis. On the basis of these findings, we postulate that the small airways could become a potential therapeutic target in IPF. FUNDING Katholieke Universiteit Leuven, US National Institutes of Health, BC Lung Association, and Genentech.
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Affiliation(s)
- Stijn E Verleden
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Naoya Tanabe
- University of British Columbia, Department of Pathology and Center for Heart and Lung Innovation at St Paul's Hospital, Vancouver, BC, Canada; Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - John E McDonough
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Dragoş M Vasilescu
- University of British Columbia, Department of Pathology and Center for Heart and Lung Innovation at St Paul's Hospital, Vancouver, BC, Canada
| | - Feng Xu
- University of British Columbia, Department of Pathology and Center for Heart and Lung Innovation at St Paul's Hospital, Vancouver, BC, Canada
| | - Wim A Wuyts
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Davide Piloni
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium; The Respiratory Disease Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Laurens De Sadeleer
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Stijn Willems
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Cindy Mai
- Department of Radiology, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | | | - Joel D Cooper
- Department of Thoracic Surgery University of Pennsylvania, Philadelphia, PA, USA
| | - Erik K Verbeken
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Johny Verschakelen
- Department of Radiology, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Craig J Galban
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Dirk E Van Raemdonck
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Thomas V Colby
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Marc Decramer
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Geert M Verleden
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Naftali Kaminski
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT, USA
| | - Tillie-Louise Hackett
- University of British Columbia, Department of Pathology and Center for Heart and Lung Innovation at St Paul's Hospital, Vancouver, BC, Canada
| | - Bart M Vanaudenaerde
- Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Katholieke Universiteit Leuven, University Hospitals Leuven, Leuven, Belgium
| | - James C Hogg
- University of British Columbia, Department of Pathology and Center for Heart and Lung Innovation at St Paul's Hospital, Vancouver, BC, Canada.
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Piloni D, Gabanti E, Morosini M, Oggionni T, Saracino L, Conio V, Lilleri D, Meloni F. Effective prevention of human cytomegalovirus (HCMV) disease in lung transplant recipients (LTR) by pre-emptive therapy based on HCMV monitoring in blood and lung. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa1102] [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: 11/05/2022]
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Grosso A, Pesce G, Marcon A, Piloni D, Albicini F, Gini E, Marchetti P, Battaglia S, Ferrari M, Fois A, Piccioni P, Antonicelli L, Verlato G, Corsico AG. Depression is associated with poor control of symptoms in asthma and rhinitis: A population-based study. Respir Med 2019; 155:6-12. [PMID: 31272012 DOI: 10.1016/j.rmed.2019.06.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although many studies have highlighted the link between asthma/rhinitis and depression, it is still unclear which characteristics of these diseases are associated with the risk of depression. We aimed to explore the relationship between depression and asthma or rhinitis in a representative sample of the Italian general population. METHODS The data were collected in GEIRD, an Italian multicenter, population-based, multicase-control study. 2227 participants (age 21-86 years, female 50%) underwent standardized interviews, skin prick and lung function tests, and were divided into cases of current asthma (n = 528), rhinitis without asthma (n = 972), and controls (n = 727). Two specific questions from the Patient Health Questionnaire (PHQ-2) were asked to identify symptoms of depressed mood and anhedonia, which were used as a proxy of major depression disorder. RESULTS The prevalence of depression was 16.7%, 11.9%, and 5.1% in subjects with asthma, rhinitis and controls, respectively. Both in asthma and rhinitis, subjects with depression had worse respiratory-health related quality of life and more frequent disease-related symptoms than their non-depressed counterparts. In asthma, depression was associated with poorer disease control. In rhinitis, depression was significantly associated with a disease-related limitations in daily activities and greater risk of symptom exacerbations and prescriptions of medicines for breathing. Cases of rhinitis with depression were less likely to be atopic. CONCLUSIONS Our results suggest that rhinitis exacerbations, particularly in non-atopic subjects, and low asthma control are strongly related to the presence of depressed mood in adults from the general population.
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Affiliation(s)
- Amelia Grosso
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy.
| | - Giancarlo Pesce
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Unit of Epidemiology of Allergic and Respiratory Diseases (EPAR), F75012, Paris, France
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Albicini
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Erica Gini
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Salvatore Battaglia
- Department of Science and Promotion of Health and Maternal Infancy "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Marcello Ferrari
- Department of Medicine, Section of Respiratory Medicine, University of Verona, Verona, Italy
| | - Alessandro Fois
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Pavilio Piccioni
- Unit of Respiratory Medicine, National Health Service, ASL TO2, Torino, Italy
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Angelo Guido Corsico
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
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Piloni D, Campo I. Current management strategies and the potential of inhaled GM-CSF for the treatment of autoimmune pulmonary alveolar proteinosis. Expert Opin Orphan Drugs 2019. [DOI: 10.1080/21678707.2019.1589450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Davide Piloni
- Pneumology Unit, IRCCS Policlinico San Matteo Hospital Foundation, Pavia, Italy
| | - Ilaria Campo
- Pneumology Unit, IRCCS Policlinico San Matteo Hospital Foundation, Pavia, Italy
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35
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Piloni D, Stella GM. Lymph-node mapping in lung cancer staging: accuracy and limits of the current approaches. Minerva Med 2019; 109:6-10. [PMID: 30642144 DOI: 10.23736/s0026-4806.18.05919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lung cancer is among the most important causes of death worldwide. The presence of tumor metastasis in the mediastinum is one of the most relevant elements in determining the optimal treatment strategy in lung cancer. Lymph node "maps" are used to describe the location of nodal metastases, the latest was proposed by the International Association for the Study of Lung Cancer (IASLC) in 2009. Here we present and analyze a recent paper by El-Sherief and collaborators aimed to verify if and how lung cancer specialists really apply the IALSC lymph node map when classifying thoracic lymph nodes documented on CT scans during lung cancer staging. In addition, we discuss the critical issues related to a correct N staging of lung cancer, mainly focusing on the limits of the present approaches and on how the increasing knowledge on the molecular basis on lung carcinogenesis can be exploited to properly dissect ambiguous and doubtful cases.
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Affiliation(s)
- Davide Piloni
- Department of Internal Medicine, University of Pavia, Pavia, Italy -
| | - Giulia M Stella
- Unit of Pulmonology, IRCCS Foundation, Policlinico San Matteo di Pavia, Pavia, Italy
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36
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Piloni D, Costa J, Urso A, Gomez AN, Shah L, Robbins HY, Benvenuto L, Sonett JR, Arcasoy S, D'Ovidio F. Donor lung pathological abnormalities and recipient outcomes. Transplantation 2018. [DOI: 10.1183/13993003.congress-2018.pa2592] [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: 11/05/2022]
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37
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Piloni D, Tirelli C, Di Domenica R, Conio V, Grosso A, Ronzoni V, Antonacci F, Totaro P, Corsico AG. Asthma-like symptoms: is it always a pulmonary issue? Multidiscip Respir Med 2018. [DOI: 10.4081/mrm.2018.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts. Case presentation: A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood. Since the beginning, an intrathoracic obstruction was suspected at pulmonary function tests. After 1 month of complete asthma treatment, the cough was unchanged and the spirometry confirmed the presence of an intrathoracic obstruction. Then, she underwent a chest CT with contrast medium, a contrast transthoracic echocardiography, a fiberbronchoscopy and an esophageal radiography with contrast medium. The final diagnosis was made and a double aortic arch was found. Conclusion: A careful observation of the flow/volume curve should always be guaranteed and the presence of congenital vascular anomalies should be suspected in case of difficult-to-treat asthma.
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38
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Piloni D, Tirelli C, Domenica RD, Conio V, Grosso A, Ronzoni V, Antonacci F, Totaro P, Corsico AG. Asthma-like symptoms: is it always a pulmonary issue? Multidiscip Respir Med 2018; 13:21. [PMID: 30123502 PMCID: PMC6091004 DOI: 10.1186/s40248-018-0136-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts. Case presentation A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood. Since the beginning, an intrathoracic obstruction was suspected at pulmonary function tests. After 1 month of complete asthma treatment, the cough was unchanged and the spirometry confirmed the presence of an intrathoracic obstruction. Then, she underwent a chest CT with contrast medium, a contrast transthoracic echocardiography, a fiberbronchoscopy and an esophageal radiography with contrast medium. The final diagnosis was made and a double aortic arch was found. Conclusion A careful observation of the flow/volume curve should always be guaranteed and the presence of congenital vascular anomalies should be suspected in case of difficult-to-treat asthma.
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Affiliation(s)
- Davide Piloni
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,2Thoracic surgery department, Columbia University, New York, USA
| | - Claudio Tirelli
- 3Department of Internal Medicine, Section of Pneumology, University of Pavia, Pavia, Italy
| | - Rita Di Domenica
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Valentina Conio
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Amelia Grosso
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Vanessa Ronzoni
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Filippo Antonacci
- 4Cardiothoracic and Vascular Department, Unit of Cardiothoracic Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pasquale Totaro
- 4Cardiothoracic and Vascular Department, Unit of Cardiothoracic Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Angelo G Corsico
- 1Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,3Department of Internal Medicine, Section of Pneumology, University of Pavia, Pavia, Italy
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Stella GM, Piloni D, Ciuffreda A, Spiaggi E, Marino E, Ilardi M, Cavalloro F. Prolonged-release oxycodone-naloxone for pain management in advanced EGFR wild-type lung cancer patients. Minerva Med 2018; 109:337-340. [PMID: 29458242 DOI: 10.23736/s0026-4806.18.05287-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giulia M Stella
- Section of Pneumology, Department of Cardiothoracic Surgery, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy -
| | - Davide Piloni
- Unit of Pneumology, Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Antonio Ciuffreda
- Section of Pneumology, Department of Cardiothoracic Surgery, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy
| | - Ernestina Spiaggi
- Section of Pneumology, Department of Cardiothoracic Surgery, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy
| | - Elisa Marino
- Section of Pneumology, Department of Cardiothoracic Surgery, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy
| | - Marcella Ilardi
- Pain Unit, Emergency Department, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy
| | - Fabrizio Cavalloro
- Pain Unit, Emergency Department, San Matteo Polyclinic and Institute for Research and Care, Pavia, Italy
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40
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Coiffard B, Piloni D, Boucekine M, Morosini M, Meloni F, Kessler R, Reynaud-Gaubert M. Effect of induction therapy on peripheral blood lymphocytes after lung transplantation: A multicenter international study. Transpl Immunol 2018; 48:47-54. [PMID: 29475091 DOI: 10.1016/j.trim.2018.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Benjamin Coiffard
- Department of Respiratory Medicine and Lung Transplantation, Hôpital Nord, Marseille, France.
| | - Davide Piloni
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Mohamed Boucekine
- Aix-Marseille Univ, EA 3279, Public Health, Chronic Diseases and Quality of Life Research Unit, 13005 Marseille, France
| | - Monica Morosini
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Federica Meloni
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Romain Kessler
- Department of Respiratory Medicine and Lung Transplantation, Nouvel Hôpital Civil, Strasbourg, France
| | - Martine Reynaud-Gaubert
- Department of Respiratory Medicine and Lung Transplantation, Hôpital Nord, Marseille, France
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Abstract
Lung cancer is among the most important causes of death worldwide. Despite the relevant progresses in the personalized approach to lung cancer, patients' survival is still poor. Only a minor fraction of patients can be addressed to surgery for radical tumor removal. Adjuvant chemotherapy is currently recommended for resected stages II and III patients although it is known that it can modestly contribute to survival prolongation. A better identification of molecular markers, predictive of adjuvant chemo response is now mandatory, in order to reduce useless toxicities and identify those patients who could really benefit. Here we present and analyze a recent paper by Huang et al. aimed at evaluating the prognostic role of epidermal growth factor receptor (EGFR) activation in adjuvant setting in order to determine whether the administration of EGFR tyrosine-kinase inhibitors could improve the outcomes of patients affected by NSCLC undergoing complete resection. Moreover we provide an exhaustive literature revision that could be helpful for a proper management of that small cohort of EGFR-mutated resected NSCLC.
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Affiliation(s)
- Giulia M Stella
- Unit of Pulmonology, Fondazione IRCCS, Policlinico San Matteo di Pavia, Pavia, Italy -
| | - Davide Piloni
- Department of Internal Medicine, University of Pavia, Pavia, Italy
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42
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Cova E, Inghilleri S, Piloni D, Morosini M, Pandolfi L, Colombo M, Mrakic-Sposta S, Moretti S, Magni S, Prosperi D, Meloni F. Bioengineered nanoparticles targeted to mesenchymal cells from patients with BOS exert anti-inflammatory activity. Transplantation 2017. [DOI: 10.1183/1393003.congress-2017.oa1994] [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: 11/05/2022]
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43
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Piloni D, Ferrarotti I, Viglio S, Cagnoni M, Gorrini M, Magni S, Di Venere M, Salvini R, Bardoni AM, Iadarola P, Meloni F. Role of Alpha 1-antitrypsin and Human Neutrophil Elastase in BALf of lung transplant recipients: preliminary data. Transplantation 2017. [DOI: 10.1183/1393003.congress-2017.pa1554] [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: 11/05/2022]
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Cova E, Inghilleri S, Pandolfi L, Morosini M, Magni S, Colombo M, Piloni D, Finetti C, Ceccarelli G, Benedetti L, Cusella MG, Agozzino M, Corsi F, Allevi R, Mrakic-Sposta S, Moretti S, De Gregori S, Prosperi D, Meloni F. Bioengineered gold nanoparticles targeted to mesenchymal cells from patients with bronchiolitis obliterans syndrome does not rise the inflammatory response and can be safely inhaled by rodents. Nanotoxicology 2017; 11:534-545. [PMID: 28415888 DOI: 10.1080/17435390.2017.1317862] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The use of gold nanoparticles (GNPs) as drug delivery system represents a promising issue for diseases without effective pharmacological treatment due to insufficient local drug accumulation and excessive systemic toxicity. Bronchiolitis obliterans syndrome (BOS) represents about 70% of cases of chronic lung allograft dysfunction, the main challenge to long-term lung transplantation. It is believed that due to repeated insults to epithelial bronchiolar cells local inflammatory response creates a milieu that favors epithelial-mesenchymal transition and activation of local mesenchymal cells (MCs) leading to airway fibro-obliteration. In a previous work, we engineered GNPs loaded with the mammalian target of rapamycin inhibitor everolimus, specifically decorated with an antibody against CD44, a surface receptor expressed by primary MCs isolated from bronchoalveolar lavage of BOS patients. We proved in vitro that these GNPs (GNP-HCe) were able to specifically inhibit primary MCs without affecting the bronchial epithelial cell. In the present work, we investigated the effect of these bioengineered nanoconstructs on inflammatory cells, given that a stimulating effect on macrophages, neutrophils or lymphocytes is strongly unwanted in graft airways since it would foster fibrogenesis. In addition, we administered GNP-HCe by the inhalatory route to normal mice for a preliminary assessment of their pulmonary and peripheral (liver, spleen and kidney) uptake. By these experiments, an evaluation of tissue toxicity was also performed. The present study proves that our bioengineered nanotools do not rise an inflammatory response and, under the tested inhalatory conditions that were used, are non-toxic.
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Affiliation(s)
- Emanuela Cova
- a Clinica di Malattie dell'Apparato Respiratorio , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Simona Inghilleri
- a Clinica di Malattie dell'Apparato Respiratorio , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Laura Pandolfi
- b Dipartimento di Biotecnologie e Bioscienze , Università di Milano-Bicocca , Milano , Italy
| | - Monica Morosini
- a Clinica di Malattie dell'Apparato Respiratorio , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Sara Magni
- a Clinica di Malattie dell'Apparato Respiratorio , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Miriam Colombo
- b Dipartimento di Biotecnologie e Bioscienze , Università di Milano-Bicocca , Milano , Italy
| | - Davide Piloni
- c Dipartimento di Medicina Interna, Unità di Pneumologia , Università degli Studi di Pavia , Pavia , Italy
| | - Chiara Finetti
- b Dipartimento di Biotecnologie e Bioscienze , Università di Milano-Bicocca , Milano , Italy
| | - Gabriele Ceccarelli
- d Istituto di Anatomia Umana, Dipartimento di Salute Pubblica, Medicina Sperimentale e Forense , Università degli Studi di Pavia , Pavia , Italy
| | - Laura Benedetti
- d Istituto di Anatomia Umana, Dipartimento di Salute Pubblica, Medicina Sperimentale e Forense , Università degli Studi di Pavia , Pavia , Italy
| | - Maria Gabriella Cusella
- d Istituto di Anatomia Umana, Dipartimento di Salute Pubblica, Medicina Sperimentale e Forense , Università degli Studi di Pavia , Pavia , Italy
| | - Manuela Agozzino
- e Centro per le Malattie Cardiovascolari Ereditarie , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Fabio Corsi
- f Dipartimento di Scienze Biomediche e Cliniche L. Sacco , Università degli Studi di Milano , Pavia , Italy.,g Chirurgia Senologica , ICS Maugeri S.p.A. SB , Pavia , Italy
| | - Raffaele Allevi
- f Dipartimento di Scienze Biomediche e Cliniche L. Sacco , Università degli Studi di Milano , Pavia , Italy
| | - Simona Mrakic-Sposta
- h Istituto di Bioimmagini e Fisiologia Molecolare , Consiglio Nazionale delle Ricerche (CNR) , Segrate , Milano , Italia
| | - Sarah Moretti
- h Istituto di Bioimmagini e Fisiologia Molecolare , Consiglio Nazionale delle Ricerche (CNR) , Segrate , Milano , Italia
| | - Simona De Gregori
- i S.S.di Farmacocinetica Clinica e Sperimentale , IRCCS Fondazione Policlinico San Matteo , Pavia , Italy
| | - Davide Prosperi
- b Dipartimento di Biotecnologie e Bioscienze , Università di Milano-Bicocca , Milano , Italy
| | - Federica Meloni
- c Dipartimento di Medicina Interna, Unità di Pneumologia , Università degli Studi di Pavia , Pavia , Italy
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45
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Campo I, Mariani F, Paracchini E, Piloni D, Kadija Z, Salvaterra E. Inhaled GM-CSF in a Pulmonary Alveolar Proteinosis Patient Refractory to Plasmapheresis Combined with Multiple Whole Lung Lavages. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/aprc.000018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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46
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Ciaramelli C, Fumagalli M, Viglio S, Bardoni AM, Piloni D, Meloni F, Iadarola P, Airoldi C. 1H NMR To Evaluate the Metabolome of Bronchoalveolar Lavage Fluid (BALf) in Bronchiolitis Obliterans Syndrome (BOS): Toward the Development of a New Approach for Biomarker Identification. J Proteome Res 2017; 16:1669-1682. [PMID: 28245130 DOI: 10.1021/acs.jproteome.6b01038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This report describes the application of NMR spectroscopy to the profiling of metabolites in bronchoalveolar lavage fluid (BALf) of lung transplant recipients without bronchiolitis obliterans syndrome (BOS) (stable, S, n = 10), and with BOS at different degrees of severity (BOS 0p, n = 10; BOS I, n = 10). Through the fine-tuning of a number of parameters concerning both sample preparation/processing and variations of spectra acquisition modes, an efficient and reproducible protocol was designed for the screening of metabolites in a pulmonary fluid that should reflect the status of airway inflammation/injury. Exploiting the combination of mono- and bidimensional NMR experiments, 38 polar metabolites, including amino acids, Krebs cycle intermediates, mono- and disaccharides, nucleotides, and phospholipid precursors, were unequivocally identified. To determine which signature could be correlated with the onset of BOS, the metabolites' content of the above recipients was analyzed by multivariate (PCA and OPLS-DA) statistical methods. PCA analysis (almost) totally differentiated S from BOS I, and this discrimination was significantly improved by the application of OPLS-DA, whose model was characterized by excellent fit and prediction values (R2 = 0.99 and Q2 = 0.88). The analysis of S vs BOS 0p and of BOS 0p vs BOS I samples showed a clear discrimination of considered cohorts, although with a poorer efficiency compared to those measured for S vs BOS I patients. The data shown in this work assess the suitability of the NMR approach in monitoring different pathological lung conditions.
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Affiliation(s)
- Carlotta Ciaramelli
- Department of Biotechnology and Biosciences, University of Milano-Bicocca , 20126 Milan, Italy
| | | | | | | | - Davide Piloni
- IRCCS Foundation Policlinico San Matteo , Department of Cardiothoracic and Vascular Department, Pneumology Unit, Pavia 27100, Italy
| | - Federica Meloni
- IRCCS Foundation Policlinico San Matteo , Department of Cardiothoracic and Vascular Department, Pneumology Unit, Pavia 27100, Italy
| | | | - Cristina Airoldi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca , 20126 Milan, Italy
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47
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Ruttens D, Verleden SE, Bijnens EM, Winckelmans E, Gottlieb J, Warnecke G, Meloni F, Morosini M, Van Der Bij W, Verschuuren EA, Sommerwerck U, Weinreich G, Kamler M, Roman A, Gomez-Olles S, Berastegui C, Benden C, Holm AM, Iversen M, Schultz HH, Luijk B, Oudijk EJ, Kwakkel-van Erp JM, Jaksch P, Klepetko W, Kneidinger N, Neurohr C, Corris P, Fisher AJ, Lordan J, Meachery G, Piloni D, Vandermeulen E, Bellon H, Hoffmann B, Vienneau D, Hoek G, de Hoogh K, Nemery B, Verleden GM, Vos R, Nawrot TS, Vanaudenaerde BM. An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe. Eur Respir J 2017; 49:13993003.00484-2016. [PMID: 27836956 DOI: 10.1183/13993003.00484-2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 09/19/2016] [Indexed: 11/05/2022]
Abstract
Air pollution from road traffic is a serious health risk, especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation, but there are no large studies.13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient, we quantified residential particulate matter with aerodynamic diameter ≤10 µm (PM10) by land use regression models, and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.After correction for macrolide use, we found associations between air pollution variables and CLAD/mortality. Given the important interaction with macrolides, we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However, in 3556 patients not taking macrolides, mortality was associated with PM10 (hazard ratio 1.081, 95% CI 1.000-1.167); similarly, CLAD and mortality were associated with road lengths in buffers of 200-1000 and 100-500 m, respectively (hazard ratio 1.085- 1.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation, but only in patients not taking macrolides.
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Affiliation(s)
- David Ruttens
- KU Leuven, Leuven, Belgium.,These authors contributed equally to this paper
| | - Stijn E Verleden
- KU Leuven, Leuven, Belgium.,These authors contributed equally to this paper
| | | | | | | | | | | | | | - Wim Van Der Bij
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik A Verschuuren
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Urte Sommerwerck
- Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Gerhard Weinreich
- Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Markus Kamler
- Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Antonio Roman
- Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Susana Gomez-Olles
- Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | | | - Are Martin Holm
- University of Oslo, Oslo, Norway.,Dept of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Martin Iversen
- Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Bart Luijk
- University Medical Center Utrecht/St Antonius Hospital Nieuwegein, Utrecht, The Netherlands
| | - Erik-Jan Oudijk
- University Medical Center Utrecht/St Antonius Hospital Nieuwegein, Utrecht, The Netherlands
| | | | | | | | | | | | | | | | | | | | - Davide Piloni
- KU Leuven, Leuven, Belgium.,Universita degli Studi di Pavia, Pavia, Italy
| | | | | | | | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Gerard Hoek
- University Medical Center Utrecht/St Antonius Hospital Nieuwegein, Utrecht, The Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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48
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Balestro E, Baraldo S, Piloni D, Stella GM. Lung tumors, COPD and immune response: is epigenetics the bottom line? Minerva Med 2016; 107:1-8. [PMID: 28009152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
NSCLC is a heterogeneous disorder consisting of distinct molecular subtypes which can be treated by using specific drugs targeted to distinct genetic lesions. It is well known that NSCLS incidence is higher in chronic obstructive pulmonary disease (COPD) patients because they share a common risk factor (cigarette smoking) and it is believed that the typical inflammatory microenvironment observed in COPD may influence the molecular mechanisms responsible of carcinogenesis. In the last years, the role of epigenetic processes in cell biology and tissue pathology has been extensively studied both in COPD and NSCLC. The recent paper by Wauters et al. showed a specific pattern of driver mutations and molecular features in NSCLC raising in the context of COPD. All these findings have shown for the first time that lung tumors found in COPD patients differ from those observed in patient without COPD due to the presence of a specific tumor microenvironment which is characterized by reduced CD4+ Treg cells. On this basis, the present work aims at discussing and analyzing the context-specific mechanisms of clonal selection and evolution mainly focusing on the epigenetic alterations and at pointing out the potential therapeutic implications.
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Affiliation(s)
- Elisabetta Balestro
- Pulmonology Unit, Department of Respiratory Diseases, University of Padua, Padua, Italy
| | - Simonetta Baraldo
- Department of Cardiac, Thoracic and Vascular Sciences, Respiratory Diseases Clinic, University of Padua, Padua, Italy
| | - Davide Piloni
- Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - Giulia M Stella
- Pulmonology Unit, San Matteo Polyclinic Foundation and Institute for Research and Care, Pavia, Italy -
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49
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Piloni D, Magni S, Oggionni T, Benazzo A, Stella G, Scudeller L, Morosini M, Cova E, Meloni F. Clinical utility of CD4+ function assessment (ViraCor-IBT ImmuKnow test) in lung recipients. Transpl Immunol 2016; 37:35-39. [PMID: 27095000 DOI: 10.1016/j.trim.2016.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 11/19/2022]
Abstract
The ImmuKnow assay measures cell-mediated immunity, quantifying ATP production from peripheral blood CD4+T-cells in solid-organ transplant patients who undergo immunosuppressive therapy. We aimed to measure functional immunity in lung transplant recipients and correlate Immuknow values with immunosuppression levels, presence of chronic lung allograft dysfunction (CLAD) and infections. We evaluated 61 lung recipients who underwent follow-up for lung transplantation between 2010 and 2014. Rejection and infection were retrospectively analyzed. The association between over-immunosuppression and a number of predictors was assessed by means of univariate and multivariate logistic regression models. 71 out of 127 samples (56%) showed an over-immunosuppression with an ImmuKnow assay mean level of 112.92ng/ml (SD±58.2), vs. 406.14ng/ml (SD±167.7) of the rest of our cohort. In the over-immunosuppression group we found 51 episodes of infection (71%) (OR 2.754, 95% CI 1.40-5.39; P-value 0.003). In the other group, only 25 samples (44%) were taken during an infectious episode. The mean absolute ATP level was significantly different between patients with or without infection (202.38±139.06ng/ml vs. 315.51±221.60ng/ml; P<0.001). RAS (Restrictive allograft syndrome) was associated to low ImmuKnow level (P<0.001). These results were confirmed by the multivariate analysis. The ImmuKnow assay levels were significantly lower in infected lung transplant recipients compared with non-infected recipients and in RAS patients.
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Affiliation(s)
- Davide Piloni
- Department of Internal Medicine, PhD in Experimental Medicine, University of Pavia, Pavia, Italy.
| | - Sara Magni
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Tiberio Oggionni
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alberto Benazzo
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Giulia Stella
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Luigia Scudeller
- Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Monica Morosini
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Emanuela Cova
- Cardiothoracic and Vascular Department, Pneumology Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Federica Meloni
- Department of Internal Medicine, University of Pavia, Pavia, Italy
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50
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Piloni D, Morosini M, Magni S, Balderacchi A, Scudeller L, Cova E, Oggionni T, Stella G, Tinelli C, Antonacci F, Meloni F. Role of CD4+CD25highCD127- Treg Cells in Long Term Outcome of Lung Recipients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.635] [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: 11/17/2022] Open
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