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Bartolini E, Baldini L, Casolaro F, Perruzza A, Pieri R, Ferrari AR. The photoparoxysmal response belongs to the spectrum of electroencephalographic findings in patients with triple X syndrome and epilepsy. Seizure 2023; 110:144-145. [PMID: 37385201 DOI: 10.1016/j.seizure.2023.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- E Bartolini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy; Tuscany PhD Programme in Neurosciences, Florence, Italy.
| | - L Baldini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - F Casolaro
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - A Perruzza
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - R Pieri
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - A R Ferrari
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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2
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Bartolini E, Cosottini M, Donatelli G, Tosetti M, Biagi L, Battini R, Guerrini R. Does 7T MRI reveal a neuronal bridge between periventricular heterotopia and overlying cortical malformations? Seizure 2022; 103:99-100. [DOI: 10.1016/j.seizure.2022.11.003] [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] [Received: 11/02/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
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Stinco M, Bartolini E, Veronese P, Rubino C, Moriondo M, Ricci S, Trapani S, Azzari C, Resti M, Indolfi G. Epidemiology and Natural History of Childhood-Acquired Chronic Hepatitis C: A Single-Center Long-Term Prospective Study. J Pediatr Gastroenterol Nutr 2022; 75:e2-e7. [PMID: 35653496 DOI: 10.1097/mpg.0000000000003481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To prospectively describe the epidemiology and long-term outcome of childhood-acquired hepatitis C virus (HCV) infection in a large cohort of children followed at a single center. METHODS All children with chronic HCV infection followed at the Liver Unit of our tertiary Hospital in Florence (Italy) from January 1, 1988, to September 30, 2021, were included in the analysis. RESULTS The final sample consisted of 163 children (median age at enrollment 4 years, interquartile range (IQR): 10; median age at last follow-up 14 years, IQR: 7). The median duration of follow-up was 86 months (IQR: 112). One hundred twenty-five children were vertically infected and 26 acquired the infection horizontally. Twenty-six of the 125 children who were vertically infected (20.8%) underwent spontaneous clearance of HCV RNA at a median age of 4 years (IQR: 2), whereas all the others remained persistently viremic. One patient was diagnosed with cirrhosis; 2 presented clinically detectable extrahepatic manifestations (chronic urticaria). Thirty-two children (19.6%) received antiviral therapy: 8 out of 32 (25%) were treated with pegylated-interferon alfa-2b [sustained virological response (SVR) 24 weeks after the end of treatment in 7/8]; 24 out of 32 (75%) were treated with direct-acting antivirals (SVR 12 weeks after the end of treatment in 23/24). CONCLUSIONS The present study describes the largest cohort of children with chronic HCV infection prospectively evaluated with a long follow-up at a single center. HCV infection in children is often a chronic infection that can be cured with modern antiviral therapy. Early treatment could prevent the development of advanced liver disease.
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Affiliation(s)
- Mariangela Stinco
- From the Liver Unit, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Elisa Bartolini
- From the Liver Unit, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Piero Veronese
- the Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Rubino
- From the Liver Unit, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Maria Moriondo
- the Immunology Laboratory, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Ricci
- the Immunology Laboratory, Meyer Children's University Hospital, Florence, Italy
- the Department of Health Sciences, Pediatric Section, University of Florence
| | - Sandra Trapani
- the Department of Health Sciences, Pediatric Section, University of Florence
| | - Chiara Azzari
- the Immunology Laboratory, Meyer Children's University Hospital, Florence, Italy
| | - Massimo Resti
- From the Liver Unit, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Giuseppe Indolfi
- From the Liver Unit, Meyer Children's University Hospital, University of Florence, Florence, Italy
- the Department NEUROFARBA, University of Florence
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4
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Mangone G, Serranti D, Bartolini E, Vigna V, Mastrangelo G, Ricci S, Trapani S, Azzari C, Resti M, Indolfi G. SNPs of the IFNL favour spontaneous clearance of HCV infection in children. Pediatr Res 2022; 91:1516-1521. [PMID: 33966053 DOI: 10.1038/s41390-021-01557-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Both spontaneous and treatment-induced clearance of hepatitis C virus (HCV) in adults have been associated with genetic polymorphisms in the interferon-λ genes. The aim of the present study was to confirm the association between the rs12979860 and evaluate the association between the rs368234815 and the rs4803217 single-nucleotide polymorphisms (SNPs) of the interferon-λ genes and the outcome of the infection in children. METHODS Alleles and genotypes frequencies of 32 children, who presented spontaneous clearance of the virus and 135 children, with viral persistence were compared with ethnically matched controls obtained from the 1000 Genomes Project and the International HapMap Project databases. RESULTS The frequencies of the C/C genotype of rs12979860, the TT/TT of the rs368234815 and the A/C of the rs4803217 were higher in the clearance group than in children with viral persistence (C/C versus T/T + C/T odds ratio (OR): 2.6; 90% confidence intervals (CI): 1.3-5; p = 0.01; TT/TT versus ΔG/TT + ΔG/ΔG OR: 2.8; 90% CI: 1.4-5.5; p = 0.01; and A/A versus A/C OR: 8.3; 90% CI: 1.5-45.9; p = 0.017, respectively) and with the ethnically matched controls. CONCLUSIONS The rs12979860, the rs368234815 and the rs4803217 SNPs are associated with spontaneous clearance of HCV in children. IMPACT Innate immune system response has a key role in the outcome of vertically acquired HCV infection in children. The rs12979860, the rs368234815 and the rs4803217 SNPs are associated with spontaneous clearance of HCV in children. Interferons-λ activate the Janus kinase-Stat pathway, which in turn induces several interferon-stimulated genes, leading to suppression of HCV replication both in vivo and in vitro.
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Affiliation(s)
- Giusi Mangone
- Immunology Unit, Meyer Children's University Hospital of Florence, Firenze, Italy
| | - Daniele Serranti
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy
| | - Elisa Bartolini
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy
| | - Veronica Vigna
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy
| | - Greta Mastrangelo
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy.,Department NEUROFARBA, University of Florence, Firenze, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence, Firenze, Italy
| | - Sandra Trapani
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy.,Department of Health Sciences, University of Florence, Firenze, Italy
| | - Chiara Azzari
- Immunology Unit, Meyer Children's University Hospital of Florence, Firenze, Italy.,Department of Health Sciences, University of Florence, Firenze, Italy
| | - Massimo Resti
- Department of Health Sciences, University of Florence, Firenze, Italy
| | - Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy. .,Department NEUROFARBA, University of Florence, Firenze, Italy.
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Rubino C, Mastrangelo G, Bartolini E, Indolfi G, Trapani S. The Pitfall in Differential Diagnosis of Musculoskeletal Symptoms in Children: A Case Series of Pediatric Scurvy. J Clin Rheumatol 2021; 27:S362-S367. [PMID: 32897996 DOI: 10.1097/rhu.0000000000001562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Di Giorgio A, Bartolini E, Calvo PL, Cananzi M, Cirillo F, Della Corte C, Dionisi-Vici C, Indolfi G, Iorio R, Maggiore G, Mandato C, Nebbia G, Nicastro E, Pinon M, Ranucci G, Sciveres M, Vajro P, D'Antiga L. Diagnostic Approach to Acute Liver Failure in Children: A Position Paper by the SIGENP Liver Disease Working Group. Dig Liver Dis 2021; 53:545-557. [PMID: 33775575 DOI: 10.1016/j.dld.2021.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023]
Abstract
Acute liver failure (ALF) is a clinical condition characterized by the abrupt onset of coagulopathy and biochemical evidence of hepatocellular injury, leading to rapid deterioration of liver cell function. In children, ALF has been characterized by raised transaminases, coagulopathy, and no known evidence of pre-existing chronic liver disease; unlike in adults, the presence of hepatic encephalopathy is not required to establish the diagnosis. Although rare, ALF has a high mortality rate without liver transplantation (LT). Etiology of ALF varies with age and geographical location, although it may remain indeterminate in a significant proportion of cases. However, identifying its etiology is crucial to undertake disease-specific management and evaluate indication to LT. In this position statement, the Liver Disease Working Group of the Italian Society of Gastroenterology, Hepatology and Nutrition (SIGENP) reviewed the most relevant studies on pediatric ALF to provide recommendations on etiology, clinical features and diagnostic work-up of neonates, infants and children presenting with ALF. Recommendations on medical management and transplant candidacy will be discussed in a following consensus conference.
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Affiliation(s)
- A Di Giorgio
- Paediatric Liver, GI and Transplantation, ASST-Hospital Papa Giovanni XXIII, Piazza OMS1, Bergamo 24127, Italy.
| | - E Bartolini
- Department Neurofarba, University of Florence and Liver Unit, Meyer Children's University Hospital, Florence, Italy
| | - P L Calvo
- Paediatric Gastroenterology Unit, Regina Margherita Children's Hospital Azienda Ospedaliera-Universitaria Citta della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - M Cananzi
- Unit of Pediatric Gastroenterology and Hepatology, Dpt. of Women's and Children's Health, University Hospital of Padova, Italy
| | - F Cirillo
- Paediatric Department and Transplantation, Ismett, Palermo, Italy
| | - C Della Corte
- Paediatric Gastroenterology, Hepatology, Nutrition and Liver Transplantation, IRCCS Bambino Gesù Paediatric Hospital, Rome, Italy
| | - C Dionisi-Vici
- Division of Metabolic Diseases, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - G Indolfi
- Department Neurofarba, University of Florence and Liver Unit, Meyer Children's University Hospital, Florence, Italy
| | - R Iorio
- Paediatric Liver Unit, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - G Maggiore
- Paediatric Gastroenterology, Hepatology, Nutrition and Liver Transplantation, IRCCS Bambino Gesù Paediatric Hospital, Rome, Italy
| | - C Mandato
- Department of Pediatrics, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - G Nebbia
- Pediatric Liver Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Nicastro
- Paediatric Liver, GI and Transplantation, ASST-Hospital Papa Giovanni XXIII, Piazza OMS1, Bergamo 24127, Italy
| | - M Pinon
- Paediatric Gastroenterology Unit, Regina Margherita Children's Hospital Azienda Ospedaliera-Universitaria Citta della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - G Ranucci
- Department of Pediatrics, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - M Sciveres
- Paediatric Department and Transplantation, Ismett, Palermo, Italy
| | - P Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Pediatrics, University of Salerno, Baronissi (Salerno), Italy
| | - L D'Antiga
- Paediatric Liver, GI and Transplantation, ASST-Hospital Papa Giovanni XXIII, Piazza OMS1, Bergamo 24127, Italy
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7
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Serranti D, Nebbia G, Cananzi M, Nicastro E, Di Dato F, Nuti F, Garazzino S, Silvestro E, Giacomet V, Forlanini F, Pinon M, Calvo PL, Riva S, Dodi I, Cangelosi AM, Antonucci R, Ricci S, Bartolini E, Mastrangelo G, Trapani S, Lenge M, Gaio P, Vajro P, Iorio R, D'Antiga L, Indolfi G. Efficacy of Sofosbuvir/Ledipasvir in Adolescents With Chronic Hepatitis C Genotypes 1, 3, and 4: A Real-world Study. J Pediatr Gastroenterol Nutr 2021; 72:95-100. [PMID: 32810039 DOI: 10.1097/mpg.0000000000002900] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Sofosbuvir/Ledipasvir (SOF/LDV) has been approved by the European Medicine Agency (EMA) for the treatment of children and adolescents (at least 3 years of age) with chronic hepatitis C (CHC) genotype 1, 3, and 4 infection. The aim of this study was to evaluate the efficacy and safety of SOF/LDV in adolescents (12 to <18 years old) with CHC in the real-world setting. METHODS Prospective, open-label, multicentre study involving 12 Italian centres. Patients received the fixed-dose combination of SOF/LDV (400/90 mg) once daily ± ribavirin as per EMA approval and recommendations. The key efficacy endpoint was sustained virological response 12 weeks after the end of treatment (SVR12) as per intention-to-treat analysis. Safety was assessed by adverse events and clinical/laboratory data. RESULTS Seventy-eight consecutive adolescents (median age 15.2 years, range 12-17.9; girls 53.8%) were enrolled and treated between June 2018 and December 2019. Genotype distribution was as follows: genotype 1 (82.1%), 3 (2.5%), and 4 (15.4%). Seventy-six (97.4%) patients completed treatment and follow-up. Overall, SVR12 was 98.7%. One patient was lost to follow-up after 4 weeks of treatment; 1 patient completed treatment and missed the follow-up visit. No virological breakthrough or relapse were observed. No patient experienced grade 3 to 4 adverse event or serious adverse event. CONCLUSIONS The results of this real-world study confirmed the high efficacy and the optimal safety profile of SOF/LDV for treatment of CHC in adolescents.
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Affiliation(s)
- Daniele Serranti
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze
| | - Gabriella Nebbia
- Pediatric Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Mara Cananzi
- Unit of Gastroenterology, Digestive Endoscopy, Hepatology and Care of Children with Liver Transplantation, University Hospital of Padova, Padova
| | - Emanuele Nicastro
- Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo
| | - Fabiola Di Dato
- Pediatric Liver Unit, University of Naples Federico II, Napoli
| | - Federica Nuti
- Pediatric Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | - Silvia Garazzino
- Ospedale Infantile Regina Margherita, Città della Salute e della Scienza della Città di Torino, Infectious Diseases Unit, University of Turin, Torino
| | - Erika Silvestro
- Ospedale Infantile Regina Margherita, Città della Salute e della Scienza della Città di Torino, Infectious Diseases Unit, University of Turin, Torino
| | - Vania Giacomet
- Unit of Paediatric Infectious Disease ASST FBF SACCO, University of Milan, Milan
| | - Federica Forlanini
- Unit of Paediatric Infectious Disease ASST FBF SACCO, University of Milan, Milan
| | - Michele Pinon
- Ospedale Infantile Regina Margherita, Città della Salute e della Scienza della Città di Torino, Pediatric Gastroenterology Unit, Torino
| | - Pier Luigi Calvo
- Ospedale Infantile Regina Margherita, Città della Salute e della Scienza della Città di Torino, Pediatric Gastroenterology Unit, Torino
| | - Silvia Riva
- Unità di Epatologia Pediatrica e Trapianto di Fegato ISMETT Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo
| | - Icilio Dodi
- U.O.C. Pediatria Generale e d'Urgenza, Ospedale dei Bambini "Pietro Barilla", Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Antonina Marta Cangelosi
- U.O.C. Pediatria Generale e d'Urgenza, Ospedale dei Bambini "Pietro Barilla", Azienda Ospedaliero-Universitaria di Parma, Parma
| | - Roberto Antonucci
- Pediatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari
| | - Silvia Ricci
- Immunology Division, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's University Hospital of Florence
| | - Elisa Bartolini
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze
| | - Greta Mastrangelo
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze
| | - Sandra Trapani
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze
| | - Matteo Lenge
- Clinical Trial Office, Meyer Children's University Hospital of Florence, Firenze
| | - Paola Gaio
- Unit of Gastroenterology, Digestive Endoscopy, Hepatology and Care of Children with Liver Transplantation, University Hospital of Padova, Padova
| | - Pietro Vajro
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Università di Salerno, Salerno
| | - Raffaele Iorio
- Pediatric Liver Unit, University of Naples Federico II, Napoli
| | - Lorenzo D'Antiga
- Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo
| | - Giuseppe Indolfi
- Department Neurofarba, University of Florence Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Firenze, Italy
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Arnone OC, Serranti D, Bartolini E, Mastrangelo G, Stinco M, Trapani S, Ricci S, Resti M, Indolfi G. Chronic hepatitis B in children, report of a single-centre longitudinal study on 152 children. J Viral Hepat 2020; 27:1344-1351. [PMID: 32853482 DOI: 10.1111/jvh.13382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/09/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
The aims of this prospective study were as follows: (1) to describe the natural history of chronic hepatitis B virus (HBV) infection in a large cohort of untreated children followed at a single centre and (2) to evaluate whether or not the new European Association for the Study of Liver (EASL) classification for the phases of HBV infection in adults can be used for children. All children who presented at the Liver Unit of our hospital from 1 January 1987 to 31 December 2019 and were diagnosed with chronic HBV infection were enrolled. The final sample consisted of 152 children. The median duration of the follow-up was 83 months (range 7-232). At baseline, 125 patients (82.2%) were HBeAg positive (85.3% abnormal alanine aminotransferase (ALT) levels), and 24 (15.8%) were HBeAg-negative (93.3% abnormal ALT). At the end of the observation period, 62 of the HBeAg-positive patients (40.7%) achieved HBeAg seroconversion (median age 9.45 years, range 0.8-19) and 2 (1.4%) achieved HBsAg seroconversion. Elevated ALT serum levels at baseline (P = .011), lower baseline HBV DNA levels (P < .001) and Asian ethnicity (P = .0001) were identified as predisposing factors towards HBeAg seroconversion. EASL criteria could not be applied to 43.3% and 43.5% of the children at baseline and at end of observation, respectively, that were grouped into an undetermined phenotype category. According to the results of the present study, the new EASL guidelines for adults with HBV infection cannot be applied in a satisfactory manner in children.
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Affiliation(s)
- Olivia C Arnone
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy
| | - Daniele Serranti
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy
| | - Elisa Bartolini
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy
| | | | - Mariangela Stinco
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy
| | - Sandra Trapani
- Department of Health Sciences, University of Florence, Firenze, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence, Firenze, Italy
| | - Massimo Resti
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy
| | - Giuseppe Indolfi
- Liver Unit, Meyer Children's University Hospital, University of Florence, Firenze, Italy.,Department NEUROFARBA, University of Florence, Firenze, Italy
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Bartolini E, Cosottini M, Costagli M, Barba C, Tassi L, Spreafico R, Garbelli R, Biagi L, Buccoliero A, Giordano F, Guerrini R. Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb. AJNR Am J Neuroradiol 2019; 40:2137-2142. [PMID: 31727747 DOI: 10.3174/ajnr.a6298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging. MATERIALS AND METHODS Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging-visible structural abnormality. RESULTS We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities (n = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa (n = 1/4) and in all those with focal cortical dysplasia IIb (n = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome (n = 4/5), while its incomplete removal yielded unsatisfactory results (n = 1/5). CONCLUSIONS The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.
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Affiliation(s)
- E Bartolini
- From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini).,Neurology Unit (E.B.), USL Centro Toscana, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - M Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy
| | - M Costagli
- IMAGO7 Research Foundation (M. Costagli), Pisa, Italy
| | - C Barba
- From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)
| | - L Tassi
- Epilepsy Surgery Centre C. Munari (L.T.), Ospedale Niguarda, Milano, Italy
| | - R Spreafico
- Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy
| | - R Garbelli
- Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy
| | - L Biagi
- Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris (L.B., R. Guerrini), Pisa, Italy
| | - A Buccoliero
- From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)
| | - F Giordano
- Neurogenetics and Neurobiology Unit and Laboratories, and Pediatric Neurosurgery Unit (F.G.), Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - R Guerrini
- From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini) .,Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris (L.B., R. Guerrini), Pisa, Italy
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Serranti D, Indolfi G, Caudai C, Bartolini E, Trapani S, Zazzi M, Resti M. Hepatitis C Genotype 4 Virus Nonstructural 3 and Nonstructural 5A Resistance-associated Substitutions in a 16-year-old Adolescent Failing Ombitasvir/Paritaprevir/Ritonavir Plus Ribavirin. Pediatr Infect Dis J 2019; 38:e72-e74. [PMID: 30882744 DOI: 10.1097/inf.0000000000002137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Preexistence and appearance of resistance-associated substitutions limit the efficacy of direct-acting antivirals in treatment of hepatitis C. This is the first case report of an adolescent with chronic hepatitis C virus genotype 4 infection and cirrhosis who failed treatment with ombitasvir/paritaprevir/ritonavir and ribavirin. Resistance analysis showed baseline resistance-associated substitutions M28V and Y93C and emergent D168H.
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Affiliation(s)
- Daniele Serranti
- From the Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Giuseppe Indolfi
- From the Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Cinzia Caudai
- Microbiology and Virology Unit, Siena University Hospital
| | - Elisa Bartolini
- From the Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Sandra Trapani
- From the Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Massimo Resti
- From the Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
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11
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Giuliani M, Bartolini E, Galli B, Santini L, Lo Surdo P, Buricchi F, Bruttini M, Benucci B, Pacchiani N, Alleri L, Donnarumma D, Pansegrau W, Peschiera I, Ferlenghi I, Cozzi R, Norais N, Giuliani MM, Maione D, Pizza M, Rappuoli R, Finco O, Masignani V. Human protective response induced by meningococcus B vaccine is mediated by the synergy of multiple bactericidal epitopes. Sci Rep 2018; 8:3700. [PMID: 29487324 PMCID: PMC5829249 DOI: 10.1038/s41598-018-22057-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 10/19/2017] [Accepted: 02/13/2018] [Indexed: 12/21/2022] Open
Abstract
4CMenB is the first broad coverage vaccine for the prevention of invasive meningococcal disease caused by serogroup B strains. To gain a comprehensive picture of the antibody response induced upon 4CMenB vaccination and to obtain relevant translational information directly from human studies, we have isolated a panel of human monoclonal antibodies from adult vaccinees. Based on the Ig-gene sequence of the variable region, 37 antigen-specific monoclonal antibodies were identified and produced as recombinant Fab fragments, and a subset also produced as full length recombinant IgG1 and functionally characterized. We found that the monoclonal antibodies were cross-reactive against different antigen variants and recognized multiple epitopes on each of the antigens. Interestingly, synergy between antibodies targeting different epitopes enhanced the potency of the bactericidal response. This work represents the first extensive characterization of monoclonal antibodies generated in humans upon 4CMenB immunization and contributes to further unraveling the immunological and functional properties of the vaccine antigens. Moreover, understanding the mechanistic nature of protection induced by vaccination paves the way to more rational vaccine design and implementation.
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Affiliation(s)
| | | | | | | | | | | | - M Bruttini
- GSK, Siena, Italy.,University of Siena, Siena, Italy
| | - B Benucci
- GSK, Siena, Italy.,University of Siena, Siena, Italy
| | | | | | | | | | - I Peschiera
- GSK, Siena, Italy.,University of Bologna, Bologna, Italy
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12
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Mascalchi M, Bianchi A, Basile M, Gulino P, Trifan MR, Difeo D, Bartolini E, Defilippi C, Diciotti S. Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children. AJNR Am J Neuroradiol 2016; 37:2376-2381. [PMID: 27585701 DOI: 10.3174/ajnr.a4915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/04/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE T2-weighted FLAIR can be combined with 3D-FSE sequences with isotropic voxels, yielding higher signal-to-noise ratio than 2D-FLAIR. Our aim was to explore whether a T2-weighted FLAIR-volume isotropic turbo spin-echo acquisition sequence (FLAIR-VISTA) with fat suppression shows areas of abnormal brain T2 hyperintensities with better conspicuity in children than a single 2D-FLAIR sequence. MATERIALS AND METHODS One week after a joint training session with 20 3T MR imaging examinations (8 under sedation), 3 radiologists independently evaluated the presence and conspicuity of abnormal areas of T2 hyperintensities of the brain in FLAIR-VISTA with fat suppression (sagittal source and axial and coronal reformatted images) and in axial 2D-FLAIR without fat suppression in a test set of 100 3T MR imaging examinations (34 under sedation) of patients 2-18 years of age performed for several clinical indications. Their agreement was measured with weighted κ statistics. RESULTS Agreement was "substantial" (mean, 0.61 for 3 observers; range, 0.49-0.69 for observer pairs) for the presence of abnormal T2 hyperintensities and "fair" (mean, 0.29; range, 0.23-0.38) for the comparative evaluation of lesion conspicuity. In 21 of 23 examinations in which the 3 radiologists agreed on the presence of abnormal T2 hyperintensities, FLAIR-VISTA with fat suppression images were judged to show hyperintensities with better conspicuity than 2D-FLAIR. In 2 cases, conspicuity was equal, and in no case was conspicuity better in 2D-FLAIR. CONCLUSIONS FLAIR-VISTA with fat suppression can replace the 2D-FLAIR sequence in brain MR imaging protocols for children.
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Affiliation(s)
- M Mascalchi
- From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy .,Structural and Functional Neuroradiology Research Unit (M.M.)
| | - A Bianchi
- From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy
| | - M Basile
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - P Gulino
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - M R Trifan
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - D Difeo
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - E Bartolini
- Neurology Unit and Laboratories (E.B.), Meyer Children's Hospital, Florence, Italy
| | - C Defilippi
- Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
| | - S Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (S.D.), University of Bologna, Cesena, Italy
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13
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Affiliation(s)
- Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Italy.
| | - Giusi Mangone
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Italy
| | - Elisa Bartolini
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Italy
| | - Maria Moriondo
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Chiara Azzari
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Massimo Resti
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Italy
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14
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Leoni S, Pilesi F, Bartolini E, Guglielmi S, Marinozzi A, Bufarini C. PP-019 Centralised iv compounding: A pre-feasibility study in clinical practice. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.458] [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: 11/03/2022] Open
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15
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Indolfi G, Mangone G, Moriondo M, Serranti D, Bartolini E, Azzari C, Resti M. Altered natural killer cells subsets distribution in children with hepatitis C following vertical transmission. Aliment Pharmacol Ther 2016; 43:125-33. [PMID: 26470759 DOI: 10.1111/apt.13430] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/14/2015] [Accepted: 09/25/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Natural killer (NK) cells number, phenotypes and function have been evaluated in many studies in adults with hepatitis C as compared with healthy controls or dynamically during interferon-based and interferon-free treatments. Overall, in adults with chronic infection number of circulating NK cells has been reported to be lower when compared to spontaneous resolvers and healthy subjects. Different studies yielded inconsistent findings due to patient and virus heterogeneity. AIM To evaluate NK cells in children according to the different outcomes of the infection. METHODS In this cross-sectional study, we examined numbers and phenotypes of circulating NK cells from a homogenous cohort of Italian children with vertically acquired hepatitis C. RESULTS We compared 31 children who developed chronic infection with nine who presented spontaneous clearance and 13 controls. CD56(+) CD3(-) NK cell numbers were consistently lower in the persistently infected group (P = 0.03 and 0.04). This decrease was due to depletions of CD56(dim) NK cells (P = 0.03 chronic infection vs. spontaneous clearance), while CD56(bright) NK cells were expanded (P = 0.03). No significant difference was found in the frequencies of CD56(+) CD16(+) and CD56(dim) CD16(-) cells. Perforin expression was higher in children with chronic infection (P = 0.03 vs. spontaneous clearance). CONCLUSIONS Altered NK cells number and phenotypes could impact the outcome of HCV infection in children following vertical transmission. This study suggests for the first time that NK cells cytolytic function, featured by CD56(dim) cells, contributes to the elimination of HCV in children presenting spontaneous clearance.
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Affiliation(s)
- G Indolfi
- Paediatric and Liver Unit, Meyer Children's University-Hospital of Florence, Florence, Italy
| | - G Mangone
- Immunology Lab, Meyer Children's University-Hospital of Florence, Florence, Italy
| | - M Moriondo
- Immunology Lab, Meyer Children's University-Hospital of Florence, Florence, Italy
| | - D Serranti
- Department of Health Sciences, University of Florence, Florence, Italy
| | - E Bartolini
- Paediatric and Liver Unit, Meyer Children's University-Hospital of Florence, Florence, Italy
| | - C Azzari
- Immunology Lab, Meyer Children's University-Hospital of Florence, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - M Resti
- Paediatric and Liver Unit, Meyer Children's University-Hospital of Florence, Florence, Italy
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16
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Pampaloni B, Cianferotti L, Gronchi G, Bartolini E, Fabbri S, Tanini A, Brandi ML. Growing Strong and Healthy with Mister Bone: An Educational Program to Have Strong Bones Later in Life. Nutrients 2015; 7:9985-98. [PMID: 26633485 PMCID: PMC4690062 DOI: 10.3390/nu7125510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 09/17/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 01/03/2023] Open
Abstract
Optimal peak bone mass and bone health later in life are favored by a sufficient calcium intake in infancy, childhood and adolescence. The purpose of this study was to test a new educational program created to monitor and to improve calcium and vitamin D intake in children. Nutritional habits in children were evaluated through a food frequency questionnaire (FFQ) to assess the intake of calcium, vitamin D, dairy products, and total caloric energy at baseline and after seven months of exposure to a unique educational program applied between November 2013 and May 2014 in 176 schoolchildren (48% male, 52% female) attending the fourth and fifth grades of two selected primary schools in Florence, Italy. A significant increase of calcium (from 870 ± 190 to 1100 ± 200 mg/day, p < 0.05), and vitamin D (from 3.6 ± 1.53 to 4.1 ± 2 µg/day) intake in children was documented after the educational program. The amount of specific foods important for bone health consumed, such as milk and vegetables, increased significantly, both in male and female children (p < 0.05). The proposed educational program appears to be effective in modifying calcium intake in children, with a significant increase in the consumption of dairy products and vegetables, but without a significant change in the total caloric intake.
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Affiliation(s)
- Barbara Pampaloni
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Luisella Cianferotti
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Giorgio Gronchi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Elisa Bartolini
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Sergio Fabbri
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Annalisa Tanini
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Maria Luisa Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
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17
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Indolfi G, Mangone G, Calvo PL, Bartolini E, Regoli M, Serranti D, Calitri C, Tovo PA, de Martino M, Azzari C, Resti M. Interleukin 28B rs12979860 single-nucleotide polymorphism predicts spontaneous clearance of hepatitis C virus in children. J Pediatr Gastroenterol Nutr 2014; 58:666-8. [PMID: 24792632 DOI: 10.1097/mpg.0000000000000275] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Recent genome-wide association studies performed in adults correlated single-nucleotide polymorphisms (SNPs rs12979860 and rs8099917) located on chromosome 19, upstream of the interleukin 28B gene, with spontaneous clearance of hepatitis C virus and with response to treatment with paginated interferon and ribavirin. The aim of the present collaborative study was to evaluate the rs12979860 SNP in a large cohort of Italian children with perinatal acquisition of hepatitis C. METHODS Children were prospectively enrolled in 2 Italian centers. The interleukin 28B rs12979860 SNP was studied according to the diagnosis of chronic infection or spontaneous clearance. RESULTS One hundred thirty children (86.7%) with chronic infection and 23 (13.3%) with spontaneous clearance of the virus were enrolled. Overall, the interleukin 28B C/C and C/T-T/T genotypes were found in 57 (37.3%) and 96 (62.7%) children, respectively. The proportion of C/C genotype was higher among children who cleared infection (14/23; 60.9%) compared with children with chronic infection (43/130; 33.1%; P = 0.01; odds ratio 3.15; 90% confidence intervals 1.34-7.53). CONCLUSIONS The present study showed that, as already demonstrated in adults, children with the rs12979860 C/C SNP of the interleukin 28B gene have a higher probability of spontaneous clearance of hepatitis C virus.
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Affiliation(s)
- Giuseppe Indolfi
- *Pediatric and Liver Unit †Immunology Unit and Laboratory at Meyer Children's University Hospital of Florence ‡Department of Pediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Turin §Department of Health Sciences, University of Florence, Firenze, Italy
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18
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Indolfi G, Mangone G, Bartolini E, Nebbia G, Calvo PL, Moriondo M, Tovo PA, de Martino M, Azzari C, Resti M. Comparative analysis of rs12979860 SNP of the IFNL3 gene in children with hepatitis C and ethnic matched controls using 1000 Genomes Project data. PLoS One 2014; 9:e85899. [PMID: 24465773 PMCID: PMC3895017 DOI: 10.1371/journal.pone.0085899] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/05/2013] [Indexed: 12/17/2022] Open
Abstract
The rs12979860 single nucleotide polymorphism located on chromosome 19q13.13 near the interferon L3 gene (formerly and commonly known as interleukin 28B gene) has been associated in adults with both spontaneous and treatment induced clearance of hepatitis C virus. Although the exact mechanism of these associations remains unclear, it suggests that variation in genes involved in the immune response against the virus favours viral clearance. Limited and preliminary data are available on this issue in children. The aim of the present study was to evaluate, in a representative cohort of children with perinatal infection, the potential association between rs12979860 single nucleotide polymorphism and the outcome of hepatitis C virus infection. Alleles and genotypes frequencies were evaluated in 30 children who spontaneously cleared the virus and in 147 children with persistent infection and were compared with a population sample of ethnically matched controls with unknown hepatitis C status obtained using the 1000 Genomes Project data. The C allele and the C/C genotype showed greater frequencies in the clearance group (76.7% and 56.7%, respectively) when compared with both children with viral persistence (C allele 56.5%, p = 0.004; C/C genotype 32.7%, p = 0.02) and with the ethnically matched individuals (C allele 59.7%, p = 0.02; C/C genotype 34.7%, p = 0.03). Children with the C/C genotype were 2 times more likely to clear hepatitis C virus relative to children with the C/T and T/T genotypes combined (odds ratio: 2.7; 90% confidence intervals: 1.3-5.8). The present study provides the evidence that the rs12979860 single nucleotide polymorphism influences the natural history of hepatitis C virus in children.
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Affiliation(s)
- Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Giusi Mangone
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Elisa Bartolini
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Gabriella Nebbia
- U.O. Pediatria 2, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Pier Luigi Calvo
- Department of Pediatrics, Infectious Diseases Unit, University of Turin, Italy Regina Margherita Children's Hospital, Turin, Italy
| | - Maria Moriondo
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Pier-Angelo Tovo
- Department of Pediatrics, Infectious Diseases Unit, University of Turin, Italy Regina Margherita Children's Hospital, Turin, Italy
| | | | - Chiara Azzari
- Immunology Unit and Laboratory, Meyer Children's University Hospital of Florence, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Massimo Resti
- Paediatric and Liver Unit, Meyer Children's University Hospital of Florence, Florence, Italy
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19
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Pampaloni B, Bartolini E, Barbieri M, Piscitelli P, Di Tanna GL, Giolli L, Brandi ML. Validation of a food-frequency questionnaire for the assessment of calcium intake in schoolchildren aged 9-10 years. Calcif Tissue Int 2013; 93:23-38. [PMID: 23543130 DOI: 10.1007/s00223-013-9721-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
Abstract
Bone mass increases steadily until age 20-30 years, when peak bone mass (PBM) is acquired. Nutrition plays a critical role in achievement of the optimal genetically programmed PBM, with reduction in the risk of osteoporosis later in life. Intake of nutrients can be estimated through the use of various tools; typically, food-frequency questionnaires (FFQs) are used in epidemiologic studies. The aim of this study was to validate a 21-item, semiquantitative FFQ to assess important nutrient intakes for bone health in Italian schoolchildren 9-10 years of age. Relative validation was accomplished through comparison of the 7-days weighed food record (7D records) with an FFQ developed ad hoc, completed by a group of 75 Italian schoolchildren (36 females, 39 males). Agreement between the two methods was evaluated by Spearman's correlation test and Bland-Altman analysis applied on the data on intake of energy, macronutrients, and micronutrients. Particular attention was devoted to nutrients relevant for bone health. Good correlations between the two methods (FFQ and 7D records) were observed for all nutrients. In particular, mean dietary calcium intakes were 725.6 mg/day (95 % CI 683.2-768.1) from 7D records and 892.4 mg/day (95 % CI 844.6-940.2) from the FFQ. These results indicate that our FFQ for schoolchildren aged 9-10 years is highly acceptable as it is an accurate method that can be used in large-scale or epidemiological studies for the evaluation of nutrient intakes important for the prevention of osteoporosis in a similar population.
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Affiliation(s)
- B Pampaloni
- Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy
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20
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Serranti D, Indolfi G, Bartolini E, Galli L, de Martino M, Resti M. Raised serum aminotransferase levels and muscle pseudohypertrophy caused by hypothyroidism. J Pediatr Gastroenterol Nutr 2013; 56:e48-9. [PMID: 22711002 DOI: 10.1097/mpg.0b013e3182645883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2022]
Affiliation(s)
- Daniele Serranti
- Department of Sciences for Woman and Child's Health, University of Florence, Florence, Italy.
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22
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Mula M, Iudice A, La Neve A, Mazza M, Bartolini E, De Caro MF, Mazza S, Kanner AM, Cantello R. Validation of the Italian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Epilepsy Behav 2012; 24:329-31. [PMID: 22652425 DOI: 10.1016/j.yebeh.2012.04.130] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 04/21/2012] [Indexed: 11/18/2022]
Abstract
The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed for the rapid detection of a major depressive episode in people with epilepsy. It has been proven to be a user-friendly screening instrument. This study describes the development, validation, and psychometric properties of the Italian version of the NDDI-E. A consecutive sample of 120 outpatients with epilepsy has been assessed using the M.I.N.I. Plus version 5.0.0 and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Italian version. Cronbach's alpha coefficient was 0.851. Receiver operating characteristic analysis showed an area under the curve of 0.943 (CI95%=0.902-0.985; SE 0.021; p<0.001), a cut off score of 13, a sensitivity of 86.2%, a specificity of 89%, a positive predictive value of 71.4%, and a negative predictive value of 95.3%.
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Affiliation(s)
- M Mula
- Division of Neurology, Amedeo Avogadro University, Novara, Italy.
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23
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Indolfi G, Bartolini E, Resti M. Spontaneous clearance of hepatitis C virus in vertically infected children: any clue for treatment? Eur J Pediatr 2011; 170:1621; author reply 1623. [PMID: 21932009 DOI: 10.1007/s00431-011-1582-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 09/09/2011] [Indexed: 02/02/2023]
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Pampaloni B, Bartolini E, Brandi ML. Parmigiano Reggiano cheese and bone health. Clin Cases Miner Bone Metab 2011; 8:33-6. [PMID: 22461827 PMCID: PMC3279064] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Osteoporosis is a multifactorial disease characterized by loss of bone mass and microarchitectural deterioration of bone tissue, which leads to a consequent increase in the risk of skeletal fractures. Diet awakes a critical interest in osteoporosis, because it is one of the few determinants that can be safely modified. A healthy well balanced nutrition can play an important role in prevention and pathogenesis of osteoporosis, but also in support of a pharmacological therapy. Numerous evidences have already established that dietary calcium, proteins and vitamin D are essential nutrients for achieved peak bone mass and maintaining skeletal health.Dairy products, by providing both calcium and proteins, represent the optimal source of highly bioavailable nutrients for bone health. Among dairy foods in particular cheese results one of the major source of calcium in the adults western diet and also in the Italian adults diet.Parmigiano Reggiano cheese is an homemade Italian food whose denomination "Protected Designation of Origin" is linked to an artisanal manufacturing process in limited geographic area of Northern Italy and is an optimal source of essential nutrients for acquisition and maintenance of bone health. Parmigiano Reggiano is a cheese easy digested, for the presence of ready to use proteins and lipids, lactose free, rich in calcium, with possible prebiotic and probiotic effect. On the basis of its nutritional characteristics and of its easy digestibility Parmigiano Reggiano cheese is recommended in all feeding age groups.
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Affiliation(s)
- Barbara Pampaloni
- Department of Internal Medicine, University of Florence, Florence, Italy
| | - Elisa Bartolini
- Department of Internal Medicine, University of Florence, Florence, Italy
| | - Maria Luisa Brandi
- Department of Internal Medicine, University of Florence, Florence, Italy
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Resti M, Moriondo M, Cortimiglia M, Indolfi G, Canessa C, Becciolini L, Bartolini E, de Benedictis FM, de Martino M, Azzari C. Community‐acquired bacteremic pneumococcal pneumonia in children: diagnosis and serotyping by real‐time polymerase chain reaction using blood samples. Clin Infect Dis 2011; 51:1042-9. [PMID: 20883110 DOI: 10.1086/656579] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The aim of this study was to use real-time polymerase chain reaction (RT-PCR) on blood samples to diagnose and serotype pneumococcal infection in a large cohort of Italian children hospitalized for community-acquired pneumonia. METHODS We conducted an observational study from April 2007 through June 2009 of children aged 0-16 years with a diagnosis of community-acquired pneumonia admitted to 83 pediatric hospitals in Italy. RESULTS Seven hundred fifty-three children were studied. RT-PCR found pneumococcal infection in 80 (10.6%) of 753 patients. In 292 patients, culture and RT-PCR were simultaneously performed. Streptococcus pneumoniae was identified in 47 of 292 patients; 45 (15.4%) tested positive by RT-PCR and 11 (3.8%) tested positive by culture. RT-PCR was significantly more sensitive than culture in revealing bacteremic pneumonia (odds ratio, 30.6; 95% confidence interval, 5.8-97.5; P<.001). Complicated pneumonia was found in 162 (21.5%) of 753 children; 152 (93.8%) of these 162 had parapneumonic effusion, and 51 (33.6%) had empyema. Children with complicated pneumonia were significantly older. Pneumococcal bacteremia was found by RT-PCR to occur significantly more frequently in children with complications (38 [23.5%] of 162) than in children with uncomplicated pneumonia (44 [7.4%] of 591; odds ratio, 3.8; 95% confidence interval, 2.30-6.30; P<.001). RT-PCR allowed serotyping from blood in 92.5% of patients. More than two-thirds of the pneumonia cases were due to nonpneumococcal conjugate vaccine 7 serotypes. Serotype 1 was the most frequent serotype (26 [32.5%] of 80) and was significantly associated with complications (50.0% in patients with complicated pneumonia vs 18.2% in patients with uncomplicated pneumonia; odds ratio, 4.5, 95% confidence interval, 1.48-14.03; P=.005) and older age. Serotype 19A was second in frequency (15.0%) and was significantly associated with younger age. CONCLUSIONS RT-PCR allows diagnosis and serotyping of pneumococcal bacteremic community-acquired pneumonia in children and is an important tool for evaluating serotype distribution in culture-negative samples.
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Affiliation(s)
- Massimo Resti
- Department of Pediatrics, University of Florence, and Anna Meyer Children's Hospital, Florence, Italy.
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Indolfi G, Bartolini E, Casavola D, Resti M. Chronic hepatitis C virus infection in children and adolescents: Epidemiology, natural history, and assessment of the safety and efficacy of combination therapy. Adolesc Health Med Ther 2010; 1:115-28. [PMID: 24600267 PMCID: PMC3915892 DOI: 10.2147/ahmt.s6750] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hepatitis C virus (HCV) is the most common cause of chronic liver disease of infectious etiology in children. Most of the children infected with HCV are asymptomatic, and only a few of them develop signs and symptoms of end-stage liver disease early in life. It is not possible to predict either in which patients HCV infection will have a bad outcome or the critical time in early adulthood when disease progression will accelerate. The experiences with therapy in children with chronic hepatitis C are based on earlier and continuing data from adult trials. The currently recommended treatment for chronic HCV infection in adults is the combination of peginterferon-á and ribavirin. The choice of this regimen is based on the results of randomized clinical trials that demonstrated the superiority of this combination treatment over standard interferon-á and ribavirin. Recently, results of pivotal, multicenter, interventional open-label studies on combined treatment with peginterferon-á and ribavirin in children have been published, and the US Food and Drug Administration and the European Medicines Agency have approved the combination therapy in those older than 3 years. The aim of this review is to evaluate critically the available data regarding the safety and efficacy of combination treatment with peginterferon-á and ribavirin in children.
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Affiliation(s)
- Giuseppe Indolfi
- Department of Sciences for Women and Child's Health, Liver and Pediatric Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Elisa Bartolini
- Department of Sciences for Women and Child's Health, Liver and Pediatric Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Davide Casavola
- Department of Sciences for Women and Child's Health, Liver and Pediatric Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Massimo Resti
- Department of Sciences for Women and Child's Health, Liver and Pediatric Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
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Indolfi G, Bartolini E, Resti M. Differential diagnosis between immune (idiopathic) thrombocytopenic purpura and portal vein thrombosis in children. Eur J Haematol 2009; 83:607-8. [PMID: 19682310 DOI: 10.1111/j.1600-0609.2009.01329.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Resti M, Micheli A, Moriondo M, Becciolini L, Cortimiglia M, Canessa C, Indolfi G, Bartolini E, de Martino M, Azzari C. Comparison of the effect of antibiotic treatment on the possibility of diagnosing invasive pneumococcal disease by culture or molecular methods: a prospective, observational study of children and adolescents with proven pneumococcal infection. Clin Ther 2009; 31:1266-73. [PMID: 19695393 DOI: 10.1016/j.clinthera.2009.06.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Detection of Streptococcus pneumoniae in culture specimens in invasive pneumococcal disease (IPD) may be hampered by antibiotic treatment administered before hospital admission. Realtime polymerase chain reaction (RT-PCR) assays do not require viable bacteria and are therefore less influenced by antimicrobial therapy. It is not known how long results of culture or molecular tests remain positive after antibiotic therapy is begun. OBJECTIVE The goal of the current study was to assess, in a pediatric population with a diagnosis of IPD confirmed by laboratory tests (culture and/or RT-PCR assay), the relationship between use of antibiotic therapy before hospital admission and the result of diagnostic methods (culture or molecular techniques) after admission. METHODS This prospective, observational study was conducted from April 2006 through March 2009. All children and adolescents aged 0 to 16 years, admitted to the hospital with a diagnosis of IPD confirmed by culture and/or molecular methods, were included in the study. Previous antibiotic treatment (drug, duration of therapy) was recorded. Primers and probes designed from the pneumococcal autolysin gene (lytA) were used in an RT-PCR assay for detection of S pneumoniae. Antibiotic tolerability, permanent sequelae (after a 6-month follow-up), and deaths were recorded. RESULTS Eighty-three patients (50 males, 33 females; 80 white, 3 Asian; mean age, 4.6 years; median age, 4.0 years; age range, 10 days-16 years) were included in the study. Fifty-four patients presented with pneumonia, 26 with meningitis/sepsis (meningitis, 19; sepsis, 7), and 3 with arthritis. Results of RT-PCR assays were positive in all 83 patients (100.0%), and 28 of the 83 patients (33.7%) also had culture-positive findings. Forty-two of the 83 patients (50.6%) had received antibiotic treatment before hospital admission, and 41 (49.4%) had not received antibiotics. Results of cultures were positive in 9 of the 42 patients with IPD (21.4%) who had received antibiotic treatment and in 19 of the 41 patients with IPD (46.3%) who had not received antibiotics (odds ratio, 3.2; 95% CI, 1.1-9.3; P = 0.03). Molecular methods appeared more sensitive than culture in any type of disease studied but particularly in patients with pneumonia, in whom the difference was statistically significant (P = 0.043). The mean length of antibiotic therapy was 1.4 days (median, 1 day; SD, 0.53 day; range, 1-2 days) for culture-confirmed cases and 4.5 days (median, 4 days; SD, 3.08 days; range, 1-15 days) for cases confirmed by RT-PCR assay (P = 0.002). No adverse reactions to the antibiotics used during home or hospital treatment were found. Two patients with meningitis suffered permanent, severe neurologic sequelae, and 1 girl died of sepsis 3 days after hospital admission. No permanent sequelae were recorded in patients with pneumonia or arthritis. CONCLUSION In these children and adolescents with IPD, the molecular methods used appeared to be more sensitive than culture in any IPD patient, with a higher statistical significance in patients previously treated with antibiotics and in patients with pneumonia.
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Affiliation(s)
- Massimo Resti
- Department of Pediatrics, University of Florence, and Anna Meyer Children's Hospital, Florence, Italy
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Pampaloni B, Bartolini S, Bartolini E, Ottanelli S, Masi L, Romani A, Tanini A, Vignolini P, Brandi ML. Absorption and bioeffects of an isoflavone-based supplementation in postmenopausal women. Clin Cases Miner Bone Metab 2009; 6:254-260. [PMID: 22461255 PMCID: PMC2811359] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Epidemiological studies suggest that consumption of isoflavones rich diets can improve several postmenopausal complications. The aim of this study was to investigate the absorption and the efficacy of isoflavonic supplementation in the treatment of menopausal symptoms.36 postmenopausal women received 75 mg/day of isoflavones in the form of tablets, for six months. 21 subjects concluded the treatment. Plasmatic and urinary samples were collected before and after the treatment, along with a dietary interview. Isoflavones were determined in biological samples and in commercial administered supplements by a HPLC/DAD system.Results showed the presence of genistein (from 0.043 to 1.820 micromol/L) in plasma samples, and of genistein (from 2.486 to 20.363 micromol/24h) and daidzein (from 11.106 to 98.091 micromol/24h) in the urines of the treated women. In the 21 completers the Greene Climateric scale value for hot flushes changed from 3 to 1 or 0. No changes of the endometrial thickness and of the breast tissue were detected. The analysis of the supplement content in the tablets was in agreement with what declared by the producer.Administration of isoflavone supplements produced a decrease of symptoms in this cohort of postmenopausal women monitored for isoflavone absorption.
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Affiliation(s)
| | | | | | | | | | - Annalisa Romani
- Departments of Internal Medicine and of Pharmacological Sciences
| | - Annalisa Tanini
- Departments of Internal Medicine and of DeGene Spin-off, University of Florence, Florence, Italy
| | - Pamela Vignolini
- Departments of Internal Medicine and of Pharmacological Sciences
| | - Maria Luisa Brandi
- Departments of Internal Medicine and of DeGene Spin-off, University of Florence, Florence, Italy
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Indolfi G, Catania P, Bartolini E, Azzari C, Massai C, Poggi GM, Martino MD, Resti M. Incidence and clinical significance of reactive thrombocytosis in children aged 1 to 24 months, hospitalized for community-acquired infections. Platelets 2009; 19:409-14. [DOI: 10.1080/09537100802233107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Indolfi G, Bartolini E, Azzari C, Becciolini L, Moriondo M, de Martino M, Resti M. Intrafamilial transmission of hepatitis C virus: Infection of the father predicts the risk of perinatal transmission. J Med Virol 2008; 80:1907-11. [DOI: 10.1002/jmv.21316] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
In children, clinical recognition of stroke and determination of its exact etiology are extremely difficult. The authors described a case of cryptogenic stroke in a 14-year-old-boy with asymptomatic atrial septal defect and hypercoagulable state. Paradoxical embolism was hypothesized as the responsible etiopathological mechanism. It is crucial to increase clinician awareness of stroke in children.
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Affiliation(s)
- Giuseppe Indolfi
- Department of Pediatrics, University of Florence, Anna Meyer Children's Hospital, Florence, Italy.
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Indolfi G, Stagi S, Bartolini E, Salti R, de Martino M, Azzari C, Resti M. Thyroid function and anti-thyroid autoantibodies in untreated children with vertically acquired chronic hepatitis C virus infection. Clin Endocrinol (Oxf) 2008; 68:117-21. [PMID: 17692107 DOI: 10.1111/j.1365-2265.2007.03009.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The reported data on thyroid function and anti-thyroid autoantibodies in adults with untreated hepatitis C virus (HCV) infection are controversial. Data are scarce for HCV-infected children, and only in those treated with interferon-alpha (IFN-alpha). We investigated thyroid function and anti-thyroid autoantibodies in a cohort of untreated children with vertically acquired, chronic, HCV infection. DESIGN AND PATIENTS FT4 and TSH serum levels (measured by immunometric assays) and anti-thyroglobulin (TgA) and anti-thyroperoxidase (TPOA) antibodies (evaluated by fluorescence enzymatic immunoassays) were studied in 36 consecutive HCV-infected children and 150 age- and sex-matched controls. The prevalence of thyroid involvement was also related to family history of autoimmune disease, distribution of HCV genotypes, and duration and activity of HCV infection. RESULTS Four out of 36 (11.1%) HCV-infected children and 4/150 controls (2.7%) showed subclinical hypothyroidism [P = 0.04; relative risk (RR) 4.56, 95% confidence interval (CI) 1.08-19.21]. None of these had anti-thyroid autoantibodies. Two out of 36 (5.6%) HCV-infected children and 1/150 (0.7%) controls had increased TgA values with normal levels of TSH (P > 0.05). Subclinical hypothyroidism and anti-thyroid autoantibodies were not related to family history of autoimmune disease, duration of infection, HCV viral load, liver function or different HCV genotype distribution, but seemed to be related to the presence of active HCV infection. CONCLUSIONS Our data suggest a role for HCV infection in the development of nonautoimmune thyroid disease in untreated HCV-infected children, confirming previous studies in adults. Clinicians should be aware of thyroid dysfunction even in untreated children.
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Affiliation(s)
- Giuseppe Indolfi
- Department of Paediatrics, University of Florence, Anna Meyer Children's Hospital, Florence, Italy.
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Bacciottini L, Falchetti A, Pampaloni B, Bartolini E, Carossino AM, Brandi ML. Phytoestrogens: food or drug? Clin Cases Miner Bone Metab 2007; 4:123-30. [PMID: 22461212 PMCID: PMC2781234] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Within the past several years, the relation between diet and health has been accepted by the mainstream nutrition community and in this connection interest in the physiological role of bioactive compounds present in plants has dramatically increased over the last decade.The phytoestrogens are bioactive molecules present as nutritional constituents of widely consumed vegetables. Their name derives from the fact that they are able to bind to estrogen receptors and to induce an estrogenic/antiestrogenic response in target tissues. Natural estrogens are involved in a multiplicity of programmed events in target tissues as uterus, breast, pituitary gland and hormone responsive tumors. Phytoestrogens are present in many human foodstuffs including fruits (plum, pear, apple grape berries, …), vegetables (beans, sprouts, cabbage, spinach, soybeans, grains, hops, garlic, onion,…), wine, tea, and they have been identified in a number of botanical dietary supplements. They include a wide variety of structurally different compounds such as isoflavones, mainly found in soy, lignans found in grains, stilbenes found in the skin of grapes. Other less investigated compounds include flavones, flavans, isoflavanes and coumestans. The estrogenic or antiestrogenic activity of any chemicals depends on the ability of the compound to interact with the ERs (ERα , ERβ ).This article reported the knowledge about the activity of phytoestrogens from a pharmacological point of view for their estrogenicity or antiestrogenicity.
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Affiliation(s)
- Lucia Bacciottini
- Department of Internal Medicine, University of Florence, Florence, Italy
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Grifantini R, Bartolini E, Muzzi A, Draghi M, Frigimelica E, Berger J, Randazzo F, Grandi G. Gene expression profile in Neisseria meningitidis and Neisseria lactamica upon host-cell contact: from basic research to vaccine development. Ann N Y Acad Sci 2002; 975:202-16. [PMID: 12538166 DOI: 10.1111/j.1749-6632.2002.tb05953.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Differential gene regulation in the human pathogen Neisseria meningitidis group B (MenB) and in Neisseria lactamica, a human commensal species, was studied by whole genome microarray after bacterial interaction with epithelial cells. Host-cell contact induced changes in the expression of 347 and 285 genes in MenB and N. lactamica, respectively. Of these, only 167 were common to MenB and N. lactamica, suggesting that a different subset of genes is activated by pathogens and commensals. Change in gene expression was stable over time in N. lactamica, but short-lived in MenB. A large part (greater than 30%) of the regulated genes encoded proteins with unknown function. Among the known genes, those coding for pili, capsule, protein synthesis, nucleotide synthesis, cell wall metabolism, ATP synthesis, and protein folding were down-regulated in MenB. Transporters for iron, chloride and sulfate, some known virulence factors, GAPDH and the entire pathway of selenocysteine biosynthesis were upregulated. Gene expression profiling indicates that approximately 40% of the regulated genes encode putative surface-associated proteins, suggesting that upon cell contact Neisseria undergoes substantial surface remodeling. This was confirmed by FACS analysis of adhering bacteria using mouse sera against a subset of recombinant proteins. Finally, a few surface-located, adhesion-activated antigens were capable of inducing bactericidal antibodies, indicating that microarray technology can be exploited for the identification of new vaccine candidates.
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Chiaramonte R, Bartolini E, Riso P, Calzavara E, Erba D, Testolin G, Comi P, Sherbet GV. Oxidative stress signalling in the apoptosis of Jurkat T-lymphocytes. J Cell Biochem 2001; 82:437-44. [PMID: 11500920 DOI: 10.1002/jcb.1158] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The pathways of transduction of oxidative stress signals have been studied using the Jurkat T cell model. The oxidative stress was induced by exposure of the cells to 100 microM H(2)O(2). DNA damage was detected within 15 min after commencement of treatment. DNA damage repair occurred within about 1 h in cells exposed to oxidative stress for 15 min. In continuous exposure to stress, DNA repair was slower and control levels of DNA integrity were not reached. DNA repair did not involve gene transcription. H(2)O(2) at 100 microM caused cell death by necrosis as well as by apoptosis. Both these processes were induced by 15 min exposure to the stress stimulus. However, some important differences were found between necrosis and apoptosis. Necrosis was more rapid, began within an hour of treatment and continued to increase during the full duration of the experiment. But apoptosis was seen after 4 h from treatment and was conspicuous between 6 and 20 h after the start of treatment. The necrotic phase preceded apoptosis, although these did show an overlap. In the necrotic phase, Bcl-2, Caspase 8 genes were down regulated. The 6-20 h phase characterised by a marked increase in apoptosis is accompanied by the up regulation of both Bcl-2 and Caspase genes. Expression of the Fas and p53 genes was not altered in either phase. We also analysed the levels of expression of the scavenging genes whose gene products are involved in detoxification. No modulation of the antioxidant enzymes, catalase, Cu/Zn superoxide dismutase and glutathione peroxidase was detectable.
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Affiliation(s)
- R Chiaramonte
- Department of Biomedical Sciences and Technologies, University of Milano, LITA-via Fratelli Cervi 93- 20090 Segrate (MI), Italy.
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Abstract
We tested if glut4, the gene for muscle-specific glucose transporter, underwent some variations of expression in neoplastic cells. Our model was a rhabdomyosarcoma cell line (RD18) which retains the ability to differentiate along the myogenic pathway. Any definable changes of expression of glut4 in normal and RD18 cells were revealed by Northern blot analysis. In order to identify the transcriptional regulatory regions of the glut4 gene we performed a deletion analysis of the 5' flanking region. The downregulation which we found in the expression of this gene in RD18 cells could be related with the activity of a negative regulatory element.
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Affiliation(s)
- R Chiaramonte
- Department of Biomedical Sciences and Technologies, University of Milan, Italy
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Pizza M, Scarlato V, Masignani V, Giuliani MM, Aricò B, Comanducci M, Jennings GT, Baldi L, Bartolini E, Capecchi B, Galeotti CL, Luzzi E, Manetti R, Marchetti E, Mora M, Nuti S, Ratti G, Santini L, Savino S, Scarselli M, Storni E, Zuo P, Broeker M, Hundt E, Knapp B, Blair E, Mason T, Tettelin H, Hood DW, Jeffries AC, Saunders NJ, Granoff DM, Venter JC, Moxon ER, Grandi G, Rappuoli R. Identification of vaccine candidates against serogroup B meningococcus by whole-genome sequencing. Science 2000; 287:1816-20. [PMID: 10710308 DOI: 10.1126/science.287.5459.1816] [Citation(s) in RCA: 914] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Neisseria meningitidis is a major cause of bacterial septicemia and meningitis. Sequence variation of surface-exposed proteins and cross-reactivity of the serogroup B capsular polysaccharide with human tissues have hampered efforts to develop a successful vaccine. To overcome these obstacles, the entire genome sequence of a virulent serogroup B strain (MC58) was used to identify vaccine candidates. A total of 350 candidate antigens were expressed in Escherichia coli, purified, and used to immunize mice. The sera allowed the identification of proteins that are surface exposed, that are conserved in sequence across a range of strains, and that induce a bactericidal antibody response, a property known to correlate with vaccine efficacy in humans.
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MESH Headings
- Amino Acid Sequence
- Animals
- Antibodies, Bacterial/biosynthesis
- Antibodies, Bacterial/blood
- Antigens, Bacterial/chemistry
- Antigens, Bacterial/genetics
- Antigens, Bacterial/immunology
- Antigens, Surface/chemistry
- Antigens, Surface/genetics
- Antigens, Surface/immunology
- Bacterial Capsules
- Bacterial Proteins/chemistry
- Bacterial Proteins/genetics
- Bacterial Proteins/immunology
- Bacterial Vaccines/genetics
- Bacterial Vaccines/immunology
- Conserved Sequence
- Escherichia coli/genetics
- Genome, Bacterial
- Humans
- Immune Sera/immunology
- Mice
- Neisseria meningitidis/classification
- Neisseria meningitidis/genetics
- Neisseria meningitidis/immunology
- Neisseria meningitidis/pathogenicity
- Open Reading Frames
- Recombinant Fusion Proteins/chemistry
- Recombinant Fusion Proteins/immunology
- Recombinant Fusion Proteins/isolation & purification
- Recombination, Genetic
- Sequence Analysis, DNA
- Serotyping
- Vaccination
- Virulence
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Affiliation(s)
- M Pizza
- IRIS, Chiron S.p.A., Via Fiorentina 1, 53100 Siena, Italy
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Petroni D, Bartolini E, Chiaramonte R, Ottolenghi S, Comi P. Computer sequence analysis of human highly conserved zinc finger modules. DNA Seq 1999; 9:163-9. [PMID: 10520746 DOI: 10.3109/10425179809072191] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We defined a sub-family of zinc finger proteins by computer analyses and comparisons of five new finger domains against protein databases. This subclass of the cysteine-cysteine/histidine-histidine motif shows additional well conserved amino acid patterns and belongs to the human kox and gli-Kruppel gene family, sharing also the same stretches of regulatory zinc finger-containing proteins of mouse and Xenopus. We particularly describe ZF6 cDNA which contains the most interesting sequence, encoding a putative multi-domain regulatory protein.
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Affiliation(s)
- D Petroni
- Dept. of Biomedical Sciences and Technologies, HSR, University of Milan, Italy
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Grifantini R, Finco O, Bartolini E, Draghi M, Del Giudice G, Kocken C, Thomas A, Abrignani S, Grandi G. Multi-plasmid DNA vaccination avoids antigenic competition and enhances immunogenicity of a poorly immunogenic plasmid. Eur J Immunol 1998; 28:1225-32. [PMID: 9565362 DOI: 10.1002/(sici)1521-4141(199804)28:04<1225::aid-immu1225>3.0.co;2-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
DNA immunization is a very promising approach to the formulation of multivalent vaccines. However, little information is currently available on the immunogenicity of multi-plasmid formulations. To address this issue, we immunized mice with a combination of four plasmids encoding malarial antigens and we compared antibody responses with those obtained with single-plasmid injections. We found that when four plasmids encoding Plasmodium falciparum circumsporozoite protein, thrombospondin-related anonymous protein, major merozoite surface protein (MSP)1 and Pfs25 are co-injected into mice, Ab responses against each antigen are elicited at levels at least as high as the level obtained with single-plasmid injection. The quality of antibody production, as determined by isotype analysis, was similar when single- and multi-plasmid administrations were compared, indicating the priming of the same cytokine profile for CD4+ T helper cells. The sera from mice immunized with the four-plasmid formulation specifically recognized sporozoites, blood stage schizonts and gametes, indicating that DNA immunization induced antibody responses relevant to the native conformation. Finally and of particular interest, in the case of MSP1, the antibody response appears to be strongly potentiated by the presence of additional plasmids, indicating an adjuvant effect of DNA.
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Chiaramonte R, Polizzi D, Bartolini E, Petroni D, Comi P. P1GF-saporin fusion protein: a potential anti-angiogenic agent. Anticancer Drug Des 1997; 12:649-57. [PMID: 9448704] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Vascularization is an important step in tumor growth and metastasis. Tumor neovascularization can be considered, therefore, as a good target for antineoplastic therapy. In order to target saporin, a powerful plant toxin, in proximity of the tumor we fused the saporin coding sequence to that for placental growth factor-2 (P1GF-2). P1GF is an angiogenic factor involved in tumor neovascularization. The fusion protein P1GF-2-saporin was obtained by transient transfection of mammalian cells and released in the culture medium as a 57.5 kDa polypeptide. Selectivity and cytotoxic activity are reported as a preliminary step towards the evaluation of its in vivo antitumor activity.
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Affiliation(s)
- R Chiaramonte
- Department of Biomedical Sciences and Technologies, University of Milan, Italy
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Mazza E, Collini G, Capaccioli L, Bartolini E, De Siena GM, Masini GC. [Ureteral obstruction. Urographic documentation of 5 cases of urate obstruction]. Radiol Med 1987; 74:464-7. [PMID: 3685473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- E Mazza
- Dipartimento di Fisiopatologia Clinica, Università Firenze
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Bo G, Bartolini E, Lalli P, Minelli L, Bicocchi R, Greco M, Ragni G. [Epidemiologic study on the spread of biliary calculi in the Umbria region. 1. Spread of the disease in the Province of Perugia in the period 1964-1977 through a study performed in hospitals]. Nuovi Ann Ig Microbiol 1981; 32:369-84. [PMID: 7348800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Galli P, Bartolini E, Franchi F, Kicovic PM, Luisi M. Treatment of cryptorchidism by intramuscular administration of LHRH. Reproduccion 1980; 4:247-54. [PMID: 6109680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Ten prepubertal boys, aged 6-12 years, presenting with unilateral or bilateral cryptorchidism were treated with a single i.m. injection of 100 micrograms of synthetic LHRH. In addition to the clinical effect, pituitary responsiveness was studied. Immunoreactive FSH and LH in serum were measured by radioimmunoassay. One week after the treatment a complete descent of testes occurred in the four oldest patients. In another four patients, a clear-cut improvement in their condition was seen, and, in two patients, no effect was observed. In nine patients, a significant (p less than 0.001) rise in serum FSH and LH levels was observed. In one patient, serum gonadotropin levels remained unchanged. There was no correlation between the clinical effect and pituitary responsiveness. It was concluded that i.m. administration of LHRH offers advantages over the paranasal route since the dose required for a good effect appears to be considerably lower.
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