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Soraci L, Cherubini A, Paoletti L, Filippelli G, Luciani F, Laganà P, Gambuzza ME, Filicetti E, Corsonello A, Lattanzio F. Safety and Tolerability of Antimicrobial Agents in the Older Patient. Drugs Aging 2023; 40:499-526. [PMID: 36976501 PMCID: PMC10043546 DOI: 10.1007/s40266-023-01019-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/29/2023]
Abstract
Older patients are at high risk of infections, which often present atypically and are associated with high morbidity and mortality. Antimicrobial treatment in older individuals with infectious diseases represents a clinical challenge, causing an increasing burden on worldwide healthcare systems; immunosenescence and the coexistence of multiple comorbidities determine complex polypharmacy regimens with an increase in drug-drug interactions and spread of multidrug-resistance infections. Aging-induced pharmacokinetic and pharmacodynamic changes can additionally increase the risk of inappropriate drug dosing, with underexposure that is associated with antimicrobial resistance and overexposure that may lead to adverse effects and poor adherence because of low tolerability. These issues need to be considered when starting antimicrobial prescriptions. National and international efforts have been made towards the implementation of antimicrobial stewardship (AMS) interventions to help clinicians improve the appropriateness and safety of antimicrobial prescriptions in both acute and long-term care settings. AMS programs were shown to decrease consumption of antimicrobials and to improve safety in hospitalized patients and older nursing home residents. With the abundance of antimicrobial prescriptions and the recent emergence of multidrug resistant pathogens, an in-depth review of antimicrobial prescriptions in geriatric clinical practice is needed. This review will discuss the special considerations for older individuals needing antimicrobials, including risk factors that shape risk profiles in geriatric populations as well as an evidence-based description of antimicrobial-induced adverse events in this patient population. It will highlight agents of concern for this age group and discuss interventions to mitigate the effects of inappropriate antimicrobial prescribing.
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Affiliation(s)
- Luca Soraci
- Unit of Geriatric Medicine, IRCCS INRCA, 87100, Cosenza, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Luca Paoletti
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Filippo Luciani
- Infectious Diseases Unit of Annunziata Hospital, Cosenza, Italy
| | - Pasqualina Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Esposito V, Carocci A, Luciani F, Battistone A, Gaggioli A, Esposito F. Validation and application of a SEC-HPLC method for the determination of total protein in therapeutic immunoglobulins as an alternative to the European Pharmacopoeia methods. Pharmeur Bio Sci Notes 2023; 2023:69-81. [PMID: 37961820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Several analytical procedures are described in the European Pharmacopoeia (Ph. Eur.) to determine total protein content. However, the method for the determination of protein content in therapeutic immunoglobulins prescribed in the Ph. Eur. monographs is the Kjeldahl method. The Kjeldahl method is time-consuming and requires the use of large amounts of hazardous reagents, which also results in the production of a large amount of hazardous chemical waste. The purpose of this work was to validate an alternative chromatographic method that requires no hazardous reagents and saves time, using the same instrumental conditions specified in the Ph. Eur. for the human immunoglobulin size-exclusion high-performance liquid chromatography (SEC-HPLC) molecular-size distribution assay. The chromatographic separation was achieved with a TSKgel G3000SW (600 × 7.5 mm, 10 µm) column, using an isocratic elution, with detection at 280 nm wavelength. The mobile phase consisted of an aqueous solution of 0.03 M disodium hydrogen phosphate dehydrate, 0.01 M sodium dihydrogen phosphate monohydrate, 0.2 M sodium chloride and 1 mM sodium azide. The protein content of the test samples was determined referring to a standard with a known protein concentration (i.e. Human immunoglobulin (molecular size) Biological Reference Preparation). The method was validated evaluating the characteristics precision and trueness according to the ICH Q2 guideline, and the goodness of linear fit for the signal response was assessed (given for information only). In addition, the equivalence of methods was evaluated with two one-sided t-tests (TOST) analysis with the Kjeldahl method mentioned in Ph. Eur. monographs on therapeutic immunoglobulins, and with Bland-Altman analysis of SEC-HPLC and manufacturers' data (Kjeldahl and biuret methods). The uncertainty of measurement was also calculated in order to evaluate the accuracy and quality of the results, thus facilitating a reliable compliance/non-compliance decision. Based on the outcome, the method is proposed as a suitable and convenient alternative for the determination of protein content in human immunoglobulins.
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Affiliation(s)
- V Esposito
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
| | - A Carocci
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
| | - F Luciani
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
| | - A Battistone
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
| | - A Gaggioli
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
| | - F Esposito
- National Centre for the Control and Evaluation of Medicines, Istituto Superiore di Sanità, viale Regina Elena, 00161, Rome, Italy
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Manava P, Eckrich C, Luciani F, Schmidbauer J, Lell MM, Detmar K. Glymphatic System in Ocular Diseases: Evaluation of MRI Findings. AJNR Am J Neuroradiol 2022; 43:1012-1017. [PMID: 35772805 DOI: 10.3174/ajnr.a7552] [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] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/03/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is growing evidence of leakage of gadolinium in an impaired blood-retina barrier. We investigated gadolinium enhancement in different eye compartments and correlated the enhancement with specific ophthalmologic diseases. MATERIALS AND METHODS In a prospective clinical study (ClinicalTrials.gov Identifier: NCT05035251), 95 patients (63 with and 32 without ophthalmologic disease) were examined before and after gadolinium administration (20 and 120 minutes) with heavily T2-weighted FLAIR. The cohort was divided according to the location of pathology into anterior and posterior eye compartment groups. Relative signal intensity increase in the anterior eye chamber, vitreous body with retina, optic nerve sheath, and the Meckel cave was analyzed and correlated with the final clinical diagnosis. RESULTS In patients with a disorder in the anterior eye compartment, significant signal intensity increases were found in the central anterior eye chamber (P 20 minutes = .000, P 120 minutes = .000), lateral anterior eye chamber (P 20 minutes = .001, P 120 minutes = .005), and vitreous body with retina (P 20 minutes = .02) compared with the control group. Patients with pathologies in the posterior eye compartment showed higher signal intensity levels in the central anterior eye compartment (P 20 minutes = .041) and vitreous body with retina (P 120 minutes = .006). CONCLUSIONS Increased gadolinium enhancement was found in the central and lateral anterior eye compartments and the vitreous body with retina in patients with anterior eye compartment disorders 20 and 120 minutes after contrast application, suggesting impairment of the blood-aqueous barrier. In patients with a disorder in the posterior eye compartment, pathologic enhancement indicated disruption of the blood-retinal barrier that allows gadolinium to diffuse into the vitreous body with retina from posterior to anterior, opposite to the known physiologic glymphatic pathway.
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Affiliation(s)
- P Manava
- From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.) .,Institute of Radiology (P.M., M.M.L.), Friedrich-Alexander University, University of Erlangen-Nuremberg, Erlangen, Germany
| | - C Eckrich
- From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)
| | - F Luciani
- Ophthalmology and Visual Science (F.L., J.S.), Klinikum Nuernberg, Paracelsus Medical University, Nuernberg, Germany
| | - J Schmidbauer
- Ophthalmology and Visual Science (F.L., J.S.), Klinikum Nuernberg, Paracelsus Medical University, Nuernberg, Germany
| | - M M Lell
- From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.).,Institute of Radiology (P.M., M.M.L.), Friedrich-Alexander University, University of Erlangen-Nuremberg, Erlangen, Germany
| | - K Detmar
- From the Departments of Radiology and Nuclear Medicine (P.M., C.E., M.M.L., K.D.)
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Colosimo M, Caruso A, Nisticò S, Minchella P, Cutruzzolà A, Tiburzi SP, Vescio V, Luciani F, Marcianò G, Gallelli L. A Fatal Case of Tuberculosis Meningitis in Previously Health Children. Pediatr Rep 2022; 14:175-180. [PMID: 35466203 PMCID: PMC9036219 DOI: 10.3390/pediatric14020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 02/05/2023] Open
Abstract
Tuberculous meningitis (TBM) is a severe form of tuberculosis. We report the development of fatal TBM in a 2-year-old previously healthy child, suggesting that TBM must be evaluated in children of all ages with non-specific symptoms of central nervous involvement because a diagnostic delay induces a negative prognosis.
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Affiliation(s)
- Manuela Colosimo
- Operative Unit of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (M.C.); (A.C.); (S.N.); (P.M.)
| | - Antonella Caruso
- Operative Unit of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (M.C.); (A.C.); (S.N.); (P.M.)
| | - Salvatore Nisticò
- Operative Unit of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (M.C.); (A.C.); (S.N.); (P.M.)
| | - Pasquale Minchella
- Operative Unit of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (M.C.); (A.C.); (S.N.); (P.M.)
| | - Antonio Cutruzzolà
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Simona Paola Tiburzi
- Operative Unit of Anaesthesiology and Intensive Care, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Virginia Vescio
- Operative Unit of Neurology, “Pugliese Ciaccio” Hospital, 88100 Catanzaro, Italy;
| | - Filippo Luciani
- Infectious Diseases Unit of Annunziata Hospital, 87100 Cosenza, Italy;
| | - Gianmarco Marcianò
- Clinical Pharmacology and Pharmacovigilance Unit Mater Domini Hospital, 88100 Catanzaro, Italy;
| | - Luca Gallelli
- Clinical Pharmacology and Pharmacovigilance Unit Mater Domini Hospital, 88100 Catanzaro, Italy;
- Medifarmagen SRL, Mater Domini Hospital, 88100 Catanzaro, Italy
- Research Centre FAS@UMG, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-0961712322
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Gallelli L, Cione E, Siniscalchi A, Vasta G, Guerra A, Scaramuzzino A, Longo L, Muraca L, De Sarro G, Leuzzi G, Gerace A, Scuteri A, Vasapollo P, Natale V, Zampogna S, Luciani F. Is there a link between Non melanoma skin cancer and hydrochlorothiazide? Curr Drug Saf 2021; 17:211-216. [PMID: 34732119 DOI: 10.2174/1574886316666211103164412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022]
Abstract
AIMS Herein we evaluated the association between the use of Hydrochlorothiazide (HCTZ) and the risk of NMSC both, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). BACKGROUND Even if the use of HCTZ is not related with the development of serious adverse drug reactions, in the last years, has been recorded the development of non-melanoma skin cancer (NMSC) in patients treated HCTZ, probably due to its photosensitizing capability. OBJECTIVE To evaluate the statistically significant difference (P<0.05) in the development of NMSC between HCTZ users and non-users, and the correlation (P<0.05) between HCTZ use and NMSC. METHODS We performed a retrospective study, in patients referred to general practitioners that, treated or not with antihypertensive drugs, developed or not skin cancer or NMSC. Controls were matched with test by age and sex. Using conditional logistic regression, we calculated odds ratios (ORs) for both skin cancer and NMSC associated with hydrochlorothiazide use. RESULTS In the present study, we enrolled 19,320 patients of these 10,110 (52.3%) received treatment with antihypertensive drugs. Of 10,110 patients, 3,870 were treated with HCTZ (38.3%). During the study, we failed to report an increased risk of NMSC in HCTZ-treated vs untreated patients. Gender stratification revealed an OR for NMSC of 1.36 for men and 0.56 for women. We did not find a dose-response relationship between HCTZ use and NMSC. CONCLUSIONS In the present study we failed to report an association between the use of HCTZ and the development of NMSC.
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Affiliation(s)
- Luca Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro. Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences-Department of Excellence 2018-2020, University of Calabria, 87036 Rende (CS). Italy
| | - Antonio Siniscalchi
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza. Italy
| | | | | | - Andrea Scaramuzzino
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro. Italy
| | - Lucia Longo
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro. Italy
| | - Lucia Muraca
- Department of General Medicine, ASP 7, Catanzaro. Italy
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini University Hospital, Catanzaro. Italy
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Gallelli L, Mannino GC, Luciani F, de Sire A, Mancuso E, Gangemi P, Cosco L, Monea G, Averta C, Minchella P, Colosimo M, Muraca L, Longhini F, Ammendolia A, Andreozzi F, De Sarro G, Cione E. Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study. Nutrients 2021; 13:nu13113932. [PMID: 34836187 PMCID: PMC8625490 DOI: 10.3390/nu13113932] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 10/07/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D might play a role in counteracting COVID-19, albeit strong evidence is still lacking in the literature. The present multicenter real-practice study aimed to evaluate the differences of 25(OH)D3 serum levels in adults tested for SARS-CoV-2 (acute COVID-19 patients, subjects healed from COVID-19, and non-infected ones) recruited over a 6-month period (March-September 2021). In a sample of 117 subjects, a statistically significant difference was found, with acute COVID-19 patients demonstrating the lowest levels of serum 25(OH)D3 (9.63 ± 8.70 ng/mL), significantly lower than values reported by no-COVID-19 patients (15.96 ± 5.99 ng/mL, p = 0.0091) and healed COVID-19 patients (11.52 ± 4.90 ng/mL, p > 0.05). Male gender across the three groups displayed unfluctuating 25(OH)D3 levels, hinting at an inability to ensure adequate levels of the active vitamin D3 form (1α,25(OH)2D3). As a secondary endpoint, we assessed the correlation between serum 25(OH)D3 levels and pro-inflammatory cytokine interleukin-6 (IL-6) in patients with extremely low serum 25(OH)D3 levels (<1 ng/mL) and in a subset supplemented with 1α,25(OH)2D3. Although patients with severe hypovitaminosis-D showed no significant increase in IL-6 levels, acute COVID-19 patients manifested high circulating IL-6 at admission (females = 127.64 ± 22.24 pg/mL, males = 139.28 ± 48.95 ng/mL) which dropped drastically after the administration of 1α,25(OH)2D3 (1.84 ± 0.77 pg/mL and 2.65 ± 0.92 ng/mL, respectively). Taken together, these findings suggest that an administration of 1α,25(OH)2D3 might be helpful for treating male patients with an acute COVID-19 infection. Further studies on rapid correction of vitamin D deficiency with fast acting metabolites are warranted in COVID-19 patients.
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Affiliation(s)
- Luca Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, 88100 Catanzaro, Italy; (L.G.); (G.D.S.)
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Filippo Luciani
- Infectious Diseases Unit of Annunziata Hospital, 87100 Cosenza, Italy;
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Correspondence: (A.d.S.); (F.A.); Tel.: +39-0961-7128-19 (A.d.S.); +39-0961-36471-20 (F.A.)
| | - Elettra Mancuso
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Pietro Gangemi
- Operative Unit of Clinical Chemistry Laboratory, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Lucio Cosco
- Department of Infectious Disease, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Giuseppe Monea
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Carolina Averta
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Pasquale Minchella
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (P.M.); (M.C.)
| | - Manuela Colosimo
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (P.M.); (M.C.)
| | - Lucia Muraca
- Department of General Medicine, ASP 7, 88100 Catanzaro, Italy;
| | - Federico Longhini
- Department of Anesthesiology and Reanimation, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
- Correspondence: (A.d.S.); (F.A.); Tel.: +39-0961-7128-19 (A.d.S.); +39-0961-36471-20 (F.A.)
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, University of Catanzaro, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, 88100 Catanzaro, Italy; (L.G.); (G.D.S.)
| | | | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018–2022, University of Calabria, 87036 Cosenza, Italy;
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Greco S, Zenunaj G, Bonsi B, Bella A, Lopreiato M, Luciani F. SARS-CoV-2 and Finding of Vein Thrombosis: Can IMPROVE and IMPROVEDD Scores Predict COVID-19 Outcomes? J Vasc Surg Venous Lymphat Disord 2021. [PMCID: PMC8360978 DOI: 10.1016/j.jvsv.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Cione E, Siniscalchi A, Gangemi P, Cosco L, Colosimo M, Longhini F, Luciani F, De Sarro G, Berrino L, D’Agostino B, Gallelli L. Neuron-specific enolase serum levels in COVID-19 are related to the severity of lung injury. PLoS One 2021; 16:e0251819. [PMID: 34010310 PMCID: PMC8133450 DOI: 10.1371/journal.pone.0251819] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/18/2020] [Accepted: 05/03/2021] [Indexed: 12/29/2022] Open
Abstract
The multifunctional role of neuron-specific enolase (NSE) in lung diseases is well established. As the lungs are greatly affected in COVID-19, we evaluated serum NSE levels in COVID-19 patients with and without dyspnea. In this study, we evaluated both SARS-CoV-2-infected and uninfected patients aged >18 years who were referred to hospitals in Catanzaro, Italy from March 30 to July 30, 2020. Epidemiological, clinical, and radiological characteristics, treatment, and outcome data were recorded and reviewed by a trained team of physicians. In total, 323 patients (178 men, 55.1% and 145 women, 44.9%) were enrolled; of these, 128 were COVID-19 patients (39.6%) and 195 were control patients (60.4%). Westergren’s method was used to determine erythroid sedimentation rate. A chemiluminescence assay was used for measurement of interleukin-6, procalcitonin, C-reactive protein, and NSE. We detected significantly higher NSE values (P<0.05) in COVID-19 patients than in controls. Interestingly, within the COVID-19 group, we also observed a further significant increase in dyspnea (Dyspnea Scale and Exercise score: 8.2 ± 0.8; scores ranging from 0 to 10, with higher numbers indicating very severe shortness of breath). These data provide the background for further investigations into the potential role of NSE as a clinical marker of COVID-19 progression.
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Affiliation(s)
- Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences-Department of Excellence 2018-2020, University of Calabria, Rende, Cosenza, Italy
| | | | - Pietro Gangemi
- Operative Unit of Clinical Chemistry Laboratory, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Lucio Cosco
- Department of Infectious Disease, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Manuela Colosimo
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Federico Longhini
- Department of Medical and Surgical Science, Operative Unit of Anesthesiology and Reanimation, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Filippo Luciani
- Department of Infectious Disease, Annunziata Hospital, Cosenza, Italy
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, University of Catanzaro, Catanzaro, Italy
- Department of Health Science, School of Medicine, Research Center FA@UNICZ, University of Catanzaro, Catanzaro, Italy
| | | | - Liberato Berrino
- Department of Experimental Medicine L. Donatelli, Section of Pharmacology, School of Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Bruno D’Agostino
- Department of Experimental Medicine L. Donatelli, Section of Pharmacology, School of Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- * E-mail:
| | - Luca Gallelli
- Department of Health Science, School of Medicine, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, University of Catanzaro, Catanzaro, Italy
- Department of Health Science, School of Medicine, Research Center FA@UNICZ, University of Catanzaro, Catanzaro, Italy
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Menga LS, Cese LD, Bongiovanni F, Lombardi G, Michi T, Luciani F, Cicetti M, Timpano J, Ferrante MC, Cesarano M, Anzellotti GM, Rosà T, Natalini D, Tanzarella ES, Cutuli SL, Pintaudi G, De Pascale G, Dell'Anna AM, Bello G, Pennisi MA, Maggiore SM, Maviglia R, Grieco DL, Antonelli M. High Failure Rate of Noninvasive Oxygenation Strategies in Critically Ill Subjects With Acute Hypoxemic Respiratory Failure Due to COVID-19. Respir Care 2021; 66:705-714. [PMID: 33653913 PMCID: PMC9994130 DOI: 10.4187/respcare.08622] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The efficacy of noninvasive oxygenation strategies (NIOS) in treating COVID-19 disease is unknown. We conducted a prospective observational study to assess the rate of NIOS failure in subjects treated in the ICU for hypoxemic respiratory failure due to COVID-19. METHODS Patients receiving first-line treatment NIOS for hypoxemic respiratory failure due to COVID-19 in the ICU of a university hospital were included in this study; laboratory data were collected upon arrival, and 28-d outcome was recorded. After propensity score matching based on Simplified Acute Physiology (SAPS) II score, age, [Formula: see text] and [Formula: see text] at arrival, the NIOS failure rate in subjects with COVID-19 was compared to a previously published cohort who received NIOS during hypoxemic respiratory failure due to other causes. RESULTS A total of 85 subjects received first-line treatment with NIOS. The most frequently used methods were helmet noninvasive ventilation and high-flow nasal cannula; of these, 52 subjects (61%) required endotracheal intubation. Independent factors associated with NIOS failure were SAPS II score (P = .009) and serum lactate dehydrogenase at enrollment (P = .02); the combination of SAPS II score ≥ 33 with serum lactate dehydrogenase ≥ 405 units/L at ICU admission had 91% specificity in predicting the need for endotracheal intubation. In the propensity-matched cohorts (54 pairs), subjects with COVID-19 showed higher risk of NIOS failure than those with other causes of hypoxemic respiratory failure (59% vs 35%, P = .02), with an adjusted hazard ratio of 2 (95% CI 1.1-3.6, P = .01). CONCLUSIONS As compared to hypoxemic respiratory failure due to other etiologies, subjects with COVID-19 who were treated with NIOS in the ICU were burdened by a 2-fold higher risk of failure. Subjects with a SAPS II score ≥ 33 and serum lactate dehydrogenase ≥ 405 units/L represent the population with the greatest risk.
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Affiliation(s)
- Luca Salvatore Menga
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Luca Delle Cese
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Filippo Bongiovanni
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Gianmarco Lombardi
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Teresa Michi
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Filippo Luciani
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Marta Cicetti
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Jacopo Timpano
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Maria Cristina Ferrante
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Melania Cesarano
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Gian Marco Anzellotti
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Tommaso Rosà
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Daniele Natalini
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Eloisa S Tanzarella
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Salvatore Lucio Cutuli
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Gabriele Pintaudi
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Gennaro De Pascale
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Antonio M Dell'Anna
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Giuseppe Bello
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Mariano Alberto Pennisi
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Salvatore Maurizio Maggiore
- Department of Medical, Oral and Biotechnological Sciences, School of Medicine and Health Sciences, Section of Anesthesia, Analgesia, Perioperative and Intensive Care, SS. Annunziata Hospital, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Riccardo Maviglia
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Domenico Luca Grieco
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy.
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
| | - Massimo Antonelli
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS; Rome, Italy
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart; Rome, Italy
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Greco S, Zenunaj G, Bonsi B, Bella A, Lopreiato M, Luciani F, Pedrini D, Vestita G, Dalla Nora E, Passaro A. SARS-CoV-2 and finding of vein thrombosis: can IMPROVE and IMPROVEDD scores predict COVID-19 outcomes? Eur Rev Med Pharmacol Sci 2021; 25:2123-2130. [PMID: 33660832 DOI: 10.26355/eurrev_202102_25118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diffuse thrombosis represents one of the most predominant causes of death by COVID-19 and SARS-CoV-2 infection seems to increase the risk of developing venous thromboembolic diseases (VTE). Aim of this study is to analyze the relationship between validated predictive scores for VTE such as IMPROVE and IMPROVEDD and: (1) Intensification of Care (IoC, admission to Pulmonology Department or Intensive Care Unit) (2) in-hospital mortality rate 3) 30-days mortality rate. PATIENTS AND METHODS We retrospectively evaluated 51 adult patients with laboratory diagnosis of SARS-CoV-2 infection and calculated IMPROVE and IMPROVEDD scores. All patients underwent venous color-Doppler ultrasound of the lower limbs to assess the presence of superficial vein thrombosis (SVT) and/or deep vein thrombosis (DVT). Patients with normal values of D-dimer did not receive heparin therapy (LMWH); patients with ≥ 4 ULN values of D-dimer or with a diagnosis of DVT were treated with therapeutic LMWH dosage, while the remaining patients were treated with prophylactic LMWH dosages. RESULTS We found strong relations between IMPROVE score and the need for IoC and with the in-hospital mortality rate and between the IMPROVEDD score and the need for IoC. We defined that an IMPROVE score greater than 4 points was significantly associated to in-hospital mortality rate (p = 0.05), while an IMPROVEDD score greater than 3 points was associated with the need for IoC (p = 0.04). Multivariate logistic analysis showed how IMPROVE score was significantly associated to in-hospital and 30-days mortality rates. CONCLUSIONS IMPROVE score can be considered an independent predictor of in-hospital and 30-days mortality.
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Affiliation(s)
- S Greco
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
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11
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Lo Coco G, Molina JS, Luciani F, Semprini C, Nora ED, Zuliani G, Vigna G, Passaro A. Association between size of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol particles and cardiovascular events in type 2 diabetes subjects. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Luciani F, Molina JS, Lo Coco G, Nora ED, Bosi C, Semprini C, Dall'Agata M, Colangiulo A, Passaro A, Vigna G. Cardiovascular events, LDL and HDL subfraction size in a cohort of FH patients. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Corsonello A, Lattanzio F, Bustacchini S, Garasto S, Cozza A, Schepisi R, Lenci F, Luciani F, Maggio MG, Ticinesi A, Butto V, Tagliaferri S, Corica F. Adverse Events of Proton Pump Inhibitors: Potential Mechanisms. Curr Drug Metab 2018; 19:142-154. [PMID: 29219052 DOI: 10.2174/1389200219666171207125351] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/15/2017] [Accepted: 11/11/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We aimed at summarizing current evidence about mechanisms for potentially harmful effects of Proton Pump Inhibitors (PPIs). METHODS A Pubmed search was performed, and 207 studies concerning the relationship between use of PPIs and cardiovascular diseases, kidney impairment, nutritional disorders, fractures, infections, functional decline, and mortality were selected and reviewed. RESULTS PPIs may cause potentially harmful effects by several mechanisms, including endothelial dysfunction, hypomagnesemia, drug interactions, reduced absorption of selected nutrients, increased gastric microbiota and small intestine bacterial overgrowth, reduced immune response, tubular-interstitial inflammation, increased bone turnover, accumulation of amyloid in the brain. Clinical and epidemiologic evidence is not consistent in regard to some negative outcomes during PPI treatment. Data from randomized clinical trials seem to deny most of them, but they are usually designed to investigate efficacy of drugs in ideal conditions and are not powered enough to detect adverse events. Besides being at special risk of experiencing negative outcomes during long-term treatment with PPIs, older and complex patients treated with polypharmacy regimens are persistently excluded from randomized clinical trials. Thus, large observational studies involving real-world patients should be considered as an important informative source about potential risks related to PPIs. CONCLUSIONS Current evidence suggests that use of PPIs may be associated with negative outcomes by eliciting several different pathophysiologic mechanisms. While short-term PPIs could be considered effective and safe in adult patients with acid-related disorders, their long-term and often inappropriate use in patients carrying vulnerability to adverse events and/or high risk of drug-interactions should be avoided.
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Affiliation(s)
- Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy
| | - Fabrizia Lattanzio
- Scientific Direction, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Silvia Bustacchini
- Scientific Direction, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Sabrina Garasto
- Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy
| | - Annalisa Cozza
- Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy
| | - Roberto Schepisi
- Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy
| | - Federica Lenci
- Unit of Nephrology, Italian National Research Center on Aging (INRCA), Ancona, Italy
| | - Filippo Luciani
- Unit of Infectious Diseases, Annunziata Hospital, Cosenza, Italy
| | - Marcello Giuseppe Maggio
- Department of Clinical and Experimental Medicine, Unit of Geriatrics, University of Parma, Parma, Italy
| | - Andrea Ticinesi
- Department of Clinical and Experimental Medicine, Unit of Geriatrics, University of Parma, Parma, Italy
| | - Valeria Butto
- Department of Clinical and Experimental Medicine, Unit of Geriatrics, University of Parma, Parma, Italy
| | - Sara Tagliaferri
- Department of Clinical and Experimental Medicine, Unit of Geriatrics, University of Parma, Parma, Italy
| | - Francesco Corica
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Vasapollo P, Cione E, Luciani F, Gallelli L. Generalized Intense Pruritus During Canagliflozin Treatment: Is it an Adverse Drug Reaction? Curr Drug Saf 2018; 13:38-40. [PMID: 27048192 DOI: 10.2174/1574886311666160405110515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/16/2016] [Accepted: 04/01/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Selective agents able to locate and identify unique targets represent a crucial aspect of modern pharmacology. The exclusive location of Sodium-Glucose co-Transporter-2 (SGLUT2) on kidneys prompt companies to develop SGLT2 inhibitors that today are the latest class of drugs for diabetes treatment. In particular, canagliflozin blocks the re-absorption of glucose in the kidney lowering blood glucose levels by increasing glucose excretion. CASE DESCRIPTION We report a 61-year old woman who developed an intense and severe pruritus during the treatment with canagliflozin. Clinical and laboratory findings excluded the presence of systemic or skin diseases able to induce pruritus. The discontinuation of canagliflozin and the treatment with pioglitazone/metformin fixed combination induced a remission of pruritus. CONCLUSION This case emphasizes the need to consider pruritus as a differential diagnosis during the treatment with canagliflozin.
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Affiliation(s)
- Piero Vasapollo
- Department of General and Territorial Medicine, Azienda Sanitaria Provinciale, Crotone, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Catanzaro, Italy
| | - Filippo Luciani
- Infectious Disease Unit, Annunziata Hospital, Cosenza, Italy
| | - Luca Gallelli
- Department of Health Science, University of Catanzaro and Operative Unit of Clinical Pharmacology and Pharmacovigilance, Mater Domini Hospital, Catanzaro, Italy
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Cunningham EB, Hajarizadeh B, Amin J, Betz-Stablein B, Dore GJ, Luciani F, Teutsch S, Bretana NA, Dolan K, Lloyd AR, Grebely J. A161 ONGOING INCIDENT HEPATITIC C VIRUS INFECTION AMONG PEOPLE WITH A HISTORY OF INJECTING DRUG USE IN AN AUSTRALIAN PRISON SETTING. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E B Cunningham
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - B Hajarizadeh
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - J Amin
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - B Betz-Stablein
- Inflammation and Infection Research Centre, UNSW Australia, Sydney, New South Wales, Australia
| | - G J Dore
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - F Luciani
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - S Teutsch
- Inflammation and Infection Research Centre, UNSW Australia, Sydney, New South Wales, Australia
| | - N A Bretana
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - K Dolan
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia
| | - A R Lloyd
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
| | - J Grebely
- The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
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Ottria L, Luciani F, Piva P, Alagna AM, Arcuri C, Bartuli FN. The flap recovery on the impacted lower third molar surgery comparing 3 different flap designs: a clinical study. ACTA ACUST UNITED AC 2017; 10:270-275. [PMID: 29285329 DOI: 10.11138/orl/2017.10.3.270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim The purpose of the study was to analyze the healing of the deep and superficial lower first and second molars periodontium, after the surgical extraction of the contiguous impacted third molar, comparing 3 mucoperiosteal flap designs. Materials and methods 150 patients which had to undergo a impacted lower third molar surgery were enrolled in this study. They were checked from day 0 to day 90, in order to focus on the recovery quality of the soft tissues around the lower second molar, comparing 3 different flap designs. Results No intraoperatory incident happened. The complete recovery of the periodontium around the second molar has been shown in each patient after 90 days from surgery and each adverse reaction happened within the sixth week after surgery. Only 2 slight gengival recessions 0,5 mm have been find out. Conclusions The impacted third molar surgery is an operation that, if rightly programmed and performed, is relatively safe. Besides, the correct handling and management of periodontium around the second molar and the choice of the flap type to be used support a correct recovery on the second molar periodontium, avoiding any long-term damage. Clinical significance This study wanted to analyze the healing of the deep and superficial lower second molar periodontium, after the impacted lower third molar surgery. In order to improve the surgical technique used for lower third molar germectomies, we wanted to compare 3 different kind of flap designs.
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Affiliation(s)
- L Ottria
- MD, DDS, MSc University of Rome "Tor Vergata", Department of Clinical Science and Translational Medicine, Rome, Italy
| | - F Luciani
- DDS, PhD University of Rome "Tor Vergata", Rome, Italy
| | - P Piva
- DDS, PhD University of Rome "Tor Vergata", Rome, Italy
| | - A M Alagna
- DDS, University of Rome "Tor Vergata", Rome, Italy
| | - C Arcuri
- MD, DDS, Resident Professor in Periodontics. Director and Chief UOCC Odontostomatology "S. Giovanni Calibita-Fatebenefratelli" Hospital. Co-Director PhD Programm in "Material for Health, Environment and Energy" University of Rome "Tor Vergata", Rome, Italy
| | - F N Bartuli
- DDS, PhD, UOCC Odontostomatology "S. Giovanni Calibita-Fatebenefratelli", University of Rome "Tor Vergata", Rome, Italy
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Abstract
Introduction Gingival hypertrophy is a frequent condition associated to the increased number of patients taking some categories of drugs. The goal of this work is to emphasize the importance of diagnosis to set a proper therapy. Material and methods The plaque accumulation in patients having a poor oral hygiene damages the periodontium and requires the application of strict professional and home hygiene protocols. Results and conclusion The drug-induced gingival proliferation knowledge is essential in order to succeed in working with the internist and in planning a precise therapy, without interfering with the metabolism of drugs, often necessary and irreplaceable for patients' health.
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Affiliation(s)
- F Luciani
- Catholic University "Our Lady of Good Counsel", Tirana, Albania
| | - G Paolantonio
- Catholic University "Our Lady of Good Counsel", Tirana, Albania
| | - C Calabrese
- Department Odontostomatology ASL RM/B, Rome, Italy
| | - L Calabrese
- University of Rome "Tor Vergata", Director and Chief U.O.C. MaxilloFacial Surgery, Department of Clinical Science and Translational Medicine, PTV Foundation Rome, Rome, Italy
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Cunningham EB, Hajarizadeh B, Bretana NA, Amin J, Betz-Stablein B, Dore GJ, Luciani F, Teutsch S, Dolan K, Lloyd AR, Grebely J. Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005-2014: The HITS-p study. J Viral Hepat 2017; 24:733-741. [PMID: 28256027 DOI: 10.1111/jvh.12701] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 10/30/2016] [Accepted: 01/30/2017] [Indexed: 12/12/2022]
Abstract
Hepatitis C virus (HCV) transmission is high in prisons. This study investigated trends in HCV incidence and associated factors among a cohort of prisoners with a history of injecting drug use in New South Wales, Australia. Data were available from the Hepatitis C Incidence and Transmission Study-prisons (HITS-p) from 2005 to 2014. Temporal trends in HCV incidence were evaluated. Factors associated with time to HCV seroconversion among people with ongoing injecting was assessed using Cox proportional hazards. Among 320 antibody-negative participants with a history of injecting drug use (mean age 26; 72% male), 62% (n=197) reported injecting drug use during follow-up. Overall, 93 infections were observed. HCV incidence was 11.4/100 person-years in the overall population and 6.3/100 person-years among the continually imprisoned population. A stable trend in HCV incidence was observed. Among the overall population with ongoing injecting during follow-up, ≥weekly injecting drug use frequency was independently associated with time to HCV seroconversion. Among continuously imprisoned injectors with ongoing injecting during follow-up, needle/syringe sharing was independently associated with time to HCV seroconversion. This study demonstrates that prison is a high-risk environment for acquisition of HCV infection. Needle and syringe sharing was associated with HCV infection among continually imprisoned participants, irrespective of frequency of injecting or the type of drug injected. These findings highlight the need for the evaluation of improved HCV prevention strategies in prison, including needle/syringe programmes and HCV treatment.
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Affiliation(s)
- E B Cunningham
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - B Hajarizadeh
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - N A Bretana
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - J Amin
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - B Betz-Stablein
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - G J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - F Luciani
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - S Teutsch
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - K Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - A R Lloyd
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - J Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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Cunningham E, Amin J, Bretana N, Luciani F, Degenhardt L, Larney S, Hajarizadeh B, Dore G, Lloyd A, Grebely J. P10 Injecting risk behaviours among people who inject drugs in an Australian prison setting, 2005–2014: the HITS-p study. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30751-2] [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: 11/27/2022] Open
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20
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Fusco S, Garasto S, Corsonello A, Vena S, Mari V, Gareri P, Ruotolo G, Luciani F, Roncone A, Maggio M, Lattanzio F. Medication-Induced Nephrotoxicity in Older Patients. Curr Drug Metab 2017; 17:608-25. [PMID: 27048182 DOI: 10.2174/1389200217666160406115959] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To summarize current evidence about mechanisms, clinical features, diagnostic issues, and strategies for prevention of medication-induced nephrotoxicity among older people. METHODS A Pubmed search was performed, and studies concerning age-related changes in kidney structure and function predisposing to nephrotoxicity, pathophysiological mechanisms, kidney drug metabolism enzymes, clinical epidemiology of medication-induced kidney damage, biomarkers for early identification of nephrotoxicity and strategies for prevention of medication-induced nephrotoxicity among older people were selected. Finally, 245 papers were included in the review. RESULTS Medications may induce nephrotoxicity through several pathophysiological mechanisms. People aged 75 or more are especially exposed to potential nephrotoxic medications or combinations of medications in the context of complex polypharmacy regimens. Estimated glomerular filtration rate (eGFR) may be useful to identify medication-induced alterations in kidney function, but creatinine-based methods have important limitation in older patients. Several innovative biomarkers have been proposed to identify AKI but these methodologies are not standardized and older people have not been evaluated systematically. Factors related to patient, medication, and interactions should be taken into account for effective prevention. CONCLUSIONS Medication-induced nephrotoxicity is a relevant problem in older populations. Nevertheless, several areas of uncertainty remain to be explored, including the impact of nephrotoxicity on functional outcomes relevant to older patients, the reliability of currently recommended methods for diagnosing and staging AKI, the use of innovative biomarkers in such a heterogeneous population, the effectiveness of preventing strategies and treatments and their impact on functional outcomes.
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Affiliation(s)
| | | | - Andrea Corsonello
- Unit of Geriatric Pharmacopidemiology, Italian National Research Centre on Aging, C. da Muoio Piccolo, 87100 Cosenza, Italy.
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Abstract
Next-generation sequencing (NGS) technologies have reshaped genome research. The resulting increase in sequencing depth and resolution has led to an unprecedented level of genomic detail and thus an increasing awareness of the complexity of animal, human and pathogen genomes. This has resulted in new approaches to vaccine research. On the one hand, the increase in genome complexity challenges our ability to study and understand pathogen biology and pathogen-host interactions. On the other hand, the increase in genomic data also provides key information for developing and designing improved vaccines against pathogens that were previously extremely difficult to deal with, such as rapidly mutating RNA viruses or bacteria that have complex interactions with the host immune system. This review describes how the broad application of NGS technologies to genome research is affecting vaccine research. It focuses on implications for the field of viral genomics, and includes recent animal and human studies.
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Olvedy M, Tisserand J, Luciani F, Boeckx B, Rambow F, Wouters J, Van den Oord J, Lambrechts D, De Sepulveda P, Marine J. An oncogenomics-based in vivo screen identifies novel melanoma tumor-suppressors. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61095-x] [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: 10/21/2022]
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Mina MM, Cameron B, Luciani F, Vollmer-Conna U, Lloyd AR. Natural killer cells in highly exposed hepatitis C-seronegative injecting drug users. J Viral Hepat 2016; 23:464-72. [PMID: 26833632 DOI: 10.1111/jvh.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/06/2015] [Accepted: 12/12/2015] [Indexed: 12/22/2022]
Abstract
Injecting drug use remains the major risk factor for hepatitis C (HCV) transmission. A minority of long-term injecting drug users remain seronegative and aviraemic, despite prolonged exposure to HCV - termed highly exposed seronegative subjects. Natural killer (NK) cells have been implicated in this apparent protection. A longitudinal nested, three group case-control series of subjects was selected from a prospective cohort of seronegative injecting drug users who became incident cases (n = 11), remained seronegative (n = 11) or reported transient high-risk behaviour and remained uninfected (n = 11). The groups were matched by age, sex and initial risk behaviour characteristics. Stored peripheral blood mononuclear cells were assayed in multicolour flow cytometry to enumerate natural killer cell subpopulations and to assess functional activity using Toll-like receptor ligands before measurement of activation, cytokine production and natural cytotoxicity receptor expression. Principal components were derived to describe the detailed phenotypic characteristics of the major NK subpopulations (based on CD56 and CD16 co-expression), before logistic regression analysis to identify associations with exposed, seronegative individuals. The CD56(dim) CD16(+) (P = 0.05, OR 6.92) and CD56(dim) CD16(-) (P = 0.05, OR 6.07) principal components differed between exposed, seronegative individuals and pre-infection samples of the other two groups. These included CD56(dim) CD16(+) and CD56(dim) CD16(-) subsets with CD56(dim) CD16(+) IFN-γ and TNF-α on unstimulated cells, and CD56(dim) CD16(-) CD69(+) , CD107a(+) , IFN-γ and TNF-α following TLR stimulation. The cytotoxic CD56(dim) NK subset thus distinguished highly exposed, seronegative subjects, suggesting NK cytotoxicity may contribute to protection from HCV acquisition. Further investigation of the determinants of this association and prospective assessment of protection against HCV infection are warranted.
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Affiliation(s)
- M M Mina
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - B Cameron
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - F Luciani
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - U Vollmer-Conna
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - A R Lloyd
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
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Papadopoulou C, Solbach MC, Lorenz B, Luciani F. [Treatment Options for Basal Cell Carcinomas of the Medial Canthus]. Klin Monbl Augenheilkd 2016; 233:38-43. [PMID: 26797885 DOI: 10.1055/s-0041-110134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Basal cell carcinoma is the most common skin cancer of the eyelid. It most frequently occurs on the lower eyelid and the medial canthus. Although metastases appear only very rarely, basal cell carcinoma is locally destructive if left untreated. Nowadays several surgical and nonsurgical treatments can be used to remove or destroy basal cell carcinomas. The selection of optimal treatment depends on the initial individual situation as well as the age and the general condition of the patient. The "gold standard" method for the treatment of basal cell carcinomas is surgical removal with subsequent histological examination. Because of the complex anatomical characteristics of the medial canthus and the lateral nasal root region, basal cell carcinomas of this area present great challenges for any treatment method. These characteristics also explain the higher rates of incomplete removal and greater risk of recurrence, with in depth extension of the tumor. Additionally, surgical removal of the tumor from the medial canthus area often results in extended tissue defects. The plastic covering of these defects can be achieved by various reconstruction procedures.
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Affiliation(s)
- C Papadopoulou
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
| | - M C Solbach
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
| | - B Lorenz
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
| | - F Luciani
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen
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Giannitelli S, Basoli F, Mozetic P, Piva P, Bartuli F, Luciani F, Arcuri C, Trombetta M, Rainer A, Licoccia S. Graded porous polyurethane foam: A potential scaffold for oro-maxillary bone regeneration. Materials Science and Engineering: C 2015; 51:329-35. [DOI: 10.1016/j.msec.2015.03.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 02/01/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
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Luciani F, Fedele F, Corsonello A, Florio M, De Santis S, Guzzo E, Perri M, Caroleo MC, Cannataro R, Cione E. Pneumonia, lung cancer or Medlar's core? Respir Med Case Rep 2015; 16:92-4. [PMID: 26744666 PMCID: PMC4681963 DOI: 10.1016/j.rmcr.2015.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 08/20/2015] [Accepted: 08/30/2015] [Indexed: 02/08/2023] Open
Abstract
Here, we report a case of 57-year-old previously healthy man with six-months medical history of significant chronic cough and recurring episodes of fever. Cytology, bacteria, fungi and acid fast bacilli in the sputum were negative. CT scan, initially interpreted as suspected lung cancer, detected by chest x-ray, revealed pneumonia. Bronchoscopy is frequently necessary for the diagnosis as well as the treatment as a routine practice and in this case was applied. Our patient underwent to fiberoptic rigid bronchoscopy in the right upper lobe in general anaesthesia. Unexpectedly, a vegetal FB, Medlar's core instead a tumor, was removed. After two-months follow-up the patient was found healthy without any old or other symptoms.
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Affiliation(s)
- Filippo Luciani
- Infectious Diseases Unit of Annunziata Hospital, Cosenza, Italy
| | - Flavio Fedele
- Bronchology Service Mariano Santo Hospital, Cosenza, Italy
| | | | | | | | - Elena Guzzo
- Otorhinolaryngology Unit of Annunziata Hospital, Cosenza, Italy
| | - Mariarita Perri
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Italy
| | - Maria Cristina Caroleo
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Italy
| | - Roberto Cannataro
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Italy
| | - Erika Cione
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Italy
- Corresponding author.
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Ayres A, Yuen L, Jackson KM, Manoharan S, Glass A, Maley M, Yoo W, Hong SP, Kim SO, Luciani F, Bowden DS, Bayliss J, Levy MT, Locarnini SA. Short duration of lamivudine for the prevention of hepatitis B virus transmission in pregnancy: lack of potency and selection of resistance mutations. J Viral Hepat 2014; 21:809-17. [PMID: 24329944 DOI: 10.1111/jvh.12212] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [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: 07/14/2013] [Accepted: 10/01/2013] [Indexed: 12/13/2022]
Abstract
This study sought to assess the antiviral efficacy of lamivudine (LMV) administered during third trimester to reduce maternal viraemia and to identify the emergence of LMV resistance. A prospective observational analysis was performed on 26 mothers with high viral load (>10⁷ IU/mL). Twenty-one women received LMV (treated group) for an average of 53 days (range 22-88 days), and the remaining five formed the untreated control group. Serum samples from two time points were used to measure HBV DNA levels and antiviral drug resistance. The LMV-treated women achieved a median HBV DNA reduction of 2.6-log10 IU/mL. Although end-of-treatment (EOT) HBV DNA in four (18%) LMV-treated women remained at >10(7) IU/mL (± 0.5 log IU/mL), no mother-to-baby transmission was observed. In contrast, a baby from the untreated mother was HBsAg positive at 9 months postpartum. Four technologies were used for drug resistance testing. Only ultra-deep pyrosequencing (UDPS) was sufficiently sensitive to detect minor viral variants down to <1%. UDPS showed that LMV therapy resulted in increased viral quasispecies diversity and positive selection of HBV variants with reverse transcriptase amino acid substitutions at sites associated with primary LMV resistance (rtM204I/V and rtA181T) in four (19%) women. These viral variants were detected mostly at low frequencies (0.63-5.92%) at EOT, but one LMV-treated mother had an rtA181T variant that increased from 2.2% pretherapy to 25.59% at EOT. This mother was also infected with the vaccine escape variant (sG145R), which was inhibited by LMV treatment. LMV therapy during late pregnancy only reduced maternal viraemia moderately, and drug-resistant viral variants emerged.
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Affiliation(s)
- A Ayres
- Research & Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, Vic., Australia
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Corsonello A, Abbatecola AM, Fusco S, Luciani F, Marino A, Catalano S, Maggio MG, Lattanzio F. The impact of drug interactions and polypharmacy on antimicrobial therapy in the elderly. Clin Microbiol Infect 2014; 21:20-6. [PMID: 25636922 DOI: 10.1016/j.cmi.2014.09.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
Infectious diseases are more prevalent in older people than in younger adults, and represent a major healthcare issue in older populations. Indeed, infections in the elderly are often associated with higher morbidity and mortality, and may present atypically. Additionally, older patients are generally treated with polypharmacy regimens, which increase the likelihood of drug-drug interactions when the prescription of an antimicrobial agent is needed. A progressive impairment in the functional reserve of multiple organs may affect either pharmacokinetics or pharmacodynamics during aging. Changes in body composition occurring with advancing age, reduced liver mass and perfusion, and reduced renal excretion may affect either pharmacokinetics or pharmacodynamics. These issues need to be taken into account when prescribing antimicrobial agents to older complex patients taking multiple drugs. Interventions aimed at improving the appropriateness and safety of antimicrobial prescriptions have been proposed. Educational interventions targeting physicians may improve antimicrobial prescriptions. Antimicrobial stewardship programmes have been found to reduce the length of hospital stay and improve safety in hospitalized patients, and their use in long-term care facilities is worth testing. Computerized prescription and decision support systems, as well as interventions aimed at improving antimicrobial agents dosage in relation to kidney function, may also help to reduce the burden of interactions and inherent costs.
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Affiliation(s)
- A Corsonello
- Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Centre on Aging (INRCA), Cosenza, Italy.
| | - A M Abbatecola
- Scientific Direction, Italian National Research Centre on Aging (INRCA), Ancona, Italy
| | - S Fusco
- Department of Internal Medicine, University of Messina, Messina, Italy
| | - F Luciani
- Infectious Diseases Unit, "Annunziata" Hospital, Cosenza, Italy
| | - A Marino
- Department of Pharmacy, Health and Nutritional Sciences, Italy
| | - S Catalano
- Department of Pharmacy, Health and Nutritional Sciences, Italy
| | - M G Maggio
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, Parma, Italy
| | - F Lattanzio
- Scientific Direction, Italian National Research Centre on Aging (INRCA), Ancona, Italy
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Luciani F, Cione E, Corsonello A, Guido F, De Santis S, Cannataro R, Perri M, Caroleo MC, Cannataro AM. Spotted fever from Rickettsia typhi in an older woman: a case report from a geographic area where it would not be expected. Int J Infect Dis 2014; 27:10-2. [PMID: 25111740 DOI: 10.1016/j.ijid.2014.05.027] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/26/2014] [Accepted: 05/27/2014] [Indexed: 02/05/2023] Open
Abstract
We describe the case of a 75-year-old woman presenting with spotted fever followed by acute renal failure and septic shock. The infection was caused by Rickettsia typhi, not reported in Calabria district (southern Italy) since World War II. The diagnosis of murine typhus was made 3 days after admission and was based solely on clinical criteria when her worsening condition required a prompt move to the intensive care unit. Therapy with tigecycline was then started immediately and the patient improved dramatically. The diagnosis of murine typhus was confirmed 10 days after admission by immunofluorescence assay. Our case is an example of how the diagnosis of murine typhus is challenging. However, in the case of a disease lacking specific symptoms, clinicians should never forget that, even in geographic areas considered free of flea-borne diseases, the components of the enzootic cycle are present and the diagnosis should never be underestimated.
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Affiliation(s)
- Filippo Luciani
- Infectious Diseases Unit, Annunziata Hospital, Via F. Migliori, 87100 Cosenza, Italy.
| | - Erika Cione
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Andrea Corsonello
- Unit of Geriatric Pharmaco-epidemiology, IRCCS - Italian National Research on Aging, Cosenza, Italy
| | | | - Salvatore De Santis
- Infectious Diseases Unit, Annunziata Hospital, Via F. Migliori, 87100 Cosenza, Italy
| | - Roberto Cannataro
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Mariarita Perri
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Maria Cristina Caroleo
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Anna Maria Cannataro
- Virology and Microbiology Laboratories Unit, Annunziata Hospital, Cosenza, Italy
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Sugden PB, Cameron B, Luciani F, Lloyd AR. Exploration of genetically determined resistance against hepatitis C infection in high-risk injecting drug users. J Viral Hepat 2014; 21:e65-73. [PMID: 24612442 DOI: 10.1111/jvh.12232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 09/18/2013] [Accepted: 01/12/2014] [Indexed: 01/08/2023]
Abstract
Genetic resistance to specific infections is well recognized. In hepatitis C virus (HCV) infection, genetic polymorphisms in IL-28B and the killer cell immunoglobulin-like receptors (KIR) and their HLA class I ligands have been shown to affect clearance of the virus following infection. There are limited data regarding resistance to established HCV infection. Reliable quantification of repeated exposure in high-risk populations, such as injecting drug users (IDU), is a key limitation of previous studies of resistance. Behavioural data and DNA from IDU (n = 210) in the Hepatitis C Incidence and Transmission Study in prisons (HITS-p) cohort were genotyped for polymorphisms in: IL-28B, peptidyl-prolyl isomerase A (PPIA), HLA-C and KIR2. To quantify risk, a composite risk index based on factors predictive of incident HCV infection was derived. Logistic regression analysis revealed the risk index was strongly associated with incident HCV infection (P < 0.0001). The upper tertile of the uninfected individuals had risk indices comparable to the incident cases, but remained uninfected. There were no significant differences in the frequencies of IL-28B or PPIA polymorphisms between these exposed-uninfected cases, or in the frequencies of KIR2-DL3, HLA-C1, or their combination. A framework for the investigation of genetic determinants of resistance to HCV infection has been developed. Several candidate gene associations were investigated and excluded. Further investigation of genetic determinants of resistance to HCV infection is warranted.
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Affiliation(s)
- P B Sugden
- Inflammation and Infection Research Centre, School of Medical Sciences University of New South Wales, Sydney, NSW, Australia
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d'Arminio Monforte A, Gianotti N, Cozzi-Lepri A, Pinnetti C, Andreoni M, di Perri G, Galli M, Poli A, Costantini A, Orofino G, Maggiolo F, Mazzarello G, Celesia BM, Luciani F, Lazzarin A, Sighinolfi L, Rizzardini G, Bonfanti P, Perno CF, Antinori A. Durability of lopinavir/ritonavir monotherapy in individuals with viral load ≤50 copies/ml in an observational setting. Antivir Ther 2013; 19:319-24. [PMID: 24036891 DOI: 10.3851/imp2687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND The main objective is to evaluate the efficacy and durability of lopinavir-ritonavir monotherapy (LPV/r-MT) in virologically controlled HIV-positive individuals switching from combination antiretroviral therapy (cART). METHODS Criteria to be included in this observational study were to have initiated for the first time LPV/r-MT after ≥2 consecutive HIV RNA≤50 copies/ml achieved on a ≥3-drug-including regimen. The main end points were time to virological rebound (VR; defined in two ways: time of first of two consecutive viral load [VL]>50 and >200 copies/ml), time to discontinuation/intensification and time to experience either a single VL>200 copies/ml or discontinuation/intensification (treatment failure [TF]). Individuals' follow-up accrued from the date of starting LPV/r-MT to event or last available VL. Kaplan-Meier curves and Cox regression analyses were used. RESULTS A total of 228 individuals were included: median age 46 years (IQR 40-50), 36% females, 36% intravenous drug users and 25% HCV-coinfected. Median CD4(+) T-cell count at nadir was 215 cell/mm(3) (IQR 116-336) and at baseline was 615 cell/mm(3) (IQR 436-768). By 36 months after switching to LPV/r-MT, the proportion of individuals with VR (confirmed VL>200 copies/ml) was 11% and with TF was 35%. In the multivariable Cox model the factors associated with a lower risk of TF was the duration of viral suppression <50 copies/ml prior to baseline (ARH=0.92; 95% CI 0.85, 0.99; P=0.024, per 6 months longer) and having LPV/r as part of last cART (ARH=0.45; 95% CI 0.21, 0.95; P=0.037). CONCLUSIONS In daily clinical practice, we confirm a relatively safe approach of treatment simplification to LPV-MT in a selected population with long-lasting virological control.
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Corsonello A, Luciani F, Incalzi RA. Biomarkers in community-acquired pneumonia: does chronic kidney disease matter? Am J Respir Crit Care Med 2011; 183:1734; author response 1734-5. [PMID: 21693721 DOI: 10.1164/ajrccm.183.12.1734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pisani G, Cristiano K, Marino F, Luciani F, Bisso GM, Gaggioli A, Mele C, Pupella S, Grazzini G, Wirz M. External quality assessment programmes for detection of HCV RNA, HIV RNA and HBV DNA in plasma: improved proficiency of the participants observed over a 2-year period. Vox Sang 2011; 99:319-24. [PMID: 20609209 DOI: 10.1111/j.1423-0410.2010.01370.x] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Two External Quality Assessment Programmes (EQAPs) were run in 2008 and 2009 to evaluate the proficiency of blood centres in detecting, by nucleic acid amplification techniques (NAT), the possible contamination of plasma with hepatitis C virus (HCV), human immunodeficiency virus (HIV) and hepatitis B virus (HBV). MATERIALS AND METHODS In the EQAP-2008, three customized panels were designed; each containing positive samples with a viral nominal concentration for the three viruses of about three times the 95% DL of the respective commercial NAT assay. In the EQAP-2009, the proficiency of the participants was evaluated with a single panel, independently on the NAT method used. RESULTS While 84% (102/122) of the participants in the EQAP-2008 correctly identified the positive and negative samples of the panels, in the EQAP-2009 the percentage of proficient laboratories increased to 97% (118/122). Most importantly, in this 2-year experience, we observed a decrease in the number of pre-/postanalytical errors, from 14 in 2008 to two in 2009. CONCLUSIONS The design of these two EQAPs allowed participants to assess the performance of the NAT methods applied in their routine screening of blood donations, not only with respect to analytical errors but also to human errors that, despite the high level of automation reached by NAT methods, can still occur.
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Affiliation(s)
- G Pisani
- Biologicals Unit, National Center for Immunobiologicals Research and Evaluation, Istituto Superiore di Sanità, Viale Regina Elena, Rome, Italy.
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Ferrari S, Toniolo A, Monaco S, Luciani F, Cainelli F, Baj A, Temesgen Z, Vento S. Viral Encephalitis: Etiology, Clinical Features, Diagnosis and Management. ACTA ACUST UNITED AC 2009. [DOI: 10.2174/1874279300903010001] [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: 11/22/2022]
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Larue L, Luciani F, Kumasaka M, Champeval D, Demirkan N, Bonaventure J, Delmas V. Bypassing melanocyte senescence by beta-catenin: a novel way to promote melanoma. ACTA ACUST UNITED AC 2009; 57:543-7. [PMID: 19201106 DOI: 10.1016/j.patbio.2008.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 11/28/2008] [Indexed: 12/15/2022]
Abstract
The Wnt/beta-catenin signaling pathway plays a key role in several cellular functions during embryonic development and adult homeostasis. The deregulation of this pathway may lead to the development of cancer, including melanoma. Deregulation of the Wnt/beta-catenin pathway occurs through either the induction/repression of, or specific mutations in, various members of this signaling pathway; this results in the stabilization of beta-catenin and its translocation from the cytoplasm to the nucleus, where it regulates transcription. Although nuclear beta-catenin is clearly involved in malignant transformation, the mechanism by which it exerts its effects remains elusive. This review focuses on the molecular and cellular mechanisms that are driven by beta-catenin and lead to melanocyte transformation. In particular, we describe how beta-catenin induces melanocyte immortalization, a novel activity of this multifunction protein. Finally, we discuss how beta-catenin-induced immortalization can cooperate with MAPKinase pathways to produce melanoma.
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Affiliation(s)
- L Larue
- Institut Curie, Developmental Genetics of Melanocytes, bâtiment 110, 91405 Orsay cedex, France.
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Dupont C, Gonnaud F, Touzet S, Luciani F, Perié MA, Molenat F, Evrard A, Fernandez MP, Roy J, Rudigoz RC. [Early prenatal interview: implementation of a sheet link "carried" by patient. The Aurore perinatal network experience]. ACTA ACUST UNITED AC 2008; 37:685-90. [PMID: 18755561 DOI: 10.1016/j.jgyn.2008.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 07/08/2008] [Accepted: 07/09/2008] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Early prenatal interview has needed the implementation of a new communication tool between follow-up pregnancy professionals: a link sheet filled and carried by patients. OBJECTIVE To assess the utilization of link sheet by trained professionals, the contribution of the interview and the patient acceptation of the link sheet. MATERIALS AND METHOD Descriptive survey from the database of link sheets returned by professionals to Aurore perinatal network and semi-guided interviews with 100 randomized patients. RESULT One thousand one hundred and nineteen link sheets were sent to Aurore perinatal network by 55 professionals out of 78 trained. For primipare, precocious prenatal interview contribution has concerned health care security (60%) and emotional security (56%). For multipare, this contribution has concerned mainly emotional security (80%). No interviewed patient has refused link sheet principle. CONCLUSION Link sheet principle, like implemented by Aurore perinatal network, seems pertinent to professionals and patients but it constitutes only one of the elements of network elaboration of personalized care.
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Affiliation(s)
- C Dupont
- Coordination du réseau Aurore, DIM des HCL, hôpital de la Croix-Rousse, hospices Civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France.
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Tang C, Reyes JF, Luciani F, Francis AR, Tanaka MM. spolTools: online utilities for analyzing spoligotypes of the Mycobacterium tuberculosis complex. Bioinformatics 2008; 24:2414-5. [DOI: 10.1093/bioinformatics/btn434] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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38
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Pisani G, Marino F, Cristiano K, Bisso GM, Mele C, Luciani F, Wirz M, Gentili G. External quality assessment for the detection of HCV RNA, HIV RNA and HBV DNA in plasma by nucleic acid amplification technology: a novel approach. Vox Sang 2008; 95:8-12. [DOI: 10.1111/j.1423-0410.2008.01047.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Luciani F, Matarrese P, Giammarioli AM, Lugini L, Lozupone F, Federici C, Iessi E, Malorni W, Fais S. CD95/phosphorylated ezrin association underlies HIV-1 GP120/IL-2-induced susceptibility to CD95(APO-1/Fas)-mediated apoptosis of human resting CD4+T lymphocytes. Cell Death Differ 2004; 11:574-82. [PMID: 14739941 DOI: 10.1038/sj.cdd.4401374] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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: 11/09/2022] Open
Abstract
CD95(APO-1/Fas)-mediated apoptosis of bystander uninfected T cells exerts a major role in the HIV-1-mediated CD4+ T-cell depletion. HIV-1 gp120 has a key role in the induction of sensitivity of human lymphocytes to CD95-mediated apoptosis through its interaction with the CD4 receptor. Recently, we have shown the importance of CD95/ezrin/actin association in CD95-mediated apoptosis. In this study, we explored the hypothesis that the gp120-mediated CD4 engagement could be involved in the induction of susceptibility of primary human T lymphocytes to CD95-mediated apoptosis through ezrin phosphorylation and ezrin-to-CD95 association. Here, we show that gp120/IL-2 combined stimuli, as well as the direct CD4 triggering, on human primary CD4(+)T lymphocytes induced an early and stable ezrin activation through phosphorylation, consistent with the induction of ezrin/CD95 association and susceptibility to CD95-mediated apoptosis. Our results provide a new mechanism through which HIV-1-gp120 may predispose resting CD4(+)T cell to bystander CD95-mediated apoptosis and support the key role of ezrin/CD95 linkage in regulating susceptibility to CD95-mediated apoptosis.
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Affiliation(s)
- F Luciani
- Laboratories of Immunology, Istituto Superiore di Sanità, 00161 Rome, Italy
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Luciani F, Valensin S, Vescovini R, Sansoni P, Fagnoni F, Franceschi C, Bonafè M, Turchetti G. A stochastic model for CD8(+)T cell dynamics in human immunosenescence: implications for survival and longevity. J Theor Biol 2001; 213:587-97. [PMID: 11742527 DOI: 10.1006/jtbi.2001.2433] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 11/22/2022]
Abstract
We propose here a stochastic model for the CD 8(+)T lymphocyte dynamics on the long time-scale of the human lifespan. Our purpose has been to test the hypothesis, recently proposed on the basis of our experimental data (Fagnoni et al., 2000), that the depletion of virgin CD8(+)T lymphocytes can be considered a reliable biomarker related to the risk of death. This hypothesis is embedded in a more general theory of immunosenescence according to which the accumulation of antigen experienced (AE) T cells and the concomitant exhaustion of antigen non-experienced (ANE) T cells with age, mostly due to the chronic lifelong exposure to antigens, is a major characteristic of the remodeling of the human immune system with age. In our model we considered a deterministic balance of ANE and AE T cell concentrations plus a stochastic forcing, which describes the chronic antigenic stress fluctuations, assuming a mean genetically determined capability of individuals to respond to antigens. The major results of our model is the validation of the above-mentioned hypothesis, since the model is capable of fitting the experimental data concerning the changes of ANE T cell concentration over age, and at the same time to reproduce survival curves similar to the demographic ones. Furthermore, the stochastic process results in being responsible for the peculiar shape of the survival curves.
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Affiliation(s)
- F Luciani
- Department of Physics, University of Bologna, Bologna, Italy
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41
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Luciani F, Turchetti G, Franceschi C, Valensin S. A mathematical model for the immunosenescence. Riv Biol 2001; 94:305-18. [PMID: 11702654] [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: 02/22/2023]
Abstract
We propose a model for the dynamics of the immune system by considering the subpopulations of virgin and memory T lymphocytes on a time scale corresponding to the human life span. In the deterministic balance equation we introduce a fluctuating term in order to take into account the chronic antigenic stress. Starting from the hypothesis that the depletion of virgin cells with cytotoxic properties (CD8+) is a mortality marker, the model provides survival curves quite similar to the demographic curves.
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Affiliation(s)
- F Luciani
- Dipartimento di Fisica, Università di Bologna, Via Irnerio 46, 40126 Bologna
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Parlato S, Giammarioli AM, Logozzi M, Lozupone F, Matarrese P, Luciani F, Falchi M, Malorni W, Fais S. CD95 (APO-1/Fas) linkage to the actin cytoskeleton through ezrin in human T lymphocytes: a novel regulatory mechanism of the CD95 apoptotic pathway. EMBO J 2000; 19:5123-34. [PMID: 11013215 PMCID: PMC302100 DOI: 10.1093/emboj/19.19.5123] [Citation(s) in RCA: 175] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CD95 (APO-1/Fas) is a member of the tumor necrosis factor receptor family, which can trigger apoptosis in a variety of cell types. However, little is known of the mechanisms underlying cell susceptibility to CD95-mediated apoptosis. Here we show that human T cells that are susceptible to CD95-mediated apoptosis, exhibit a constitutive polarized morphology, and that CD95 colocalizes with ezrin at the site of cellular polarization. In fact, CD95 co-immunoprecipitates with ezrin exclusively in lymphoblastoid CD4(+) T cells and primary long-term activated T lymphocytes, which are prone to CD95-mediated apoptosis, but not in short-term activated T lymphocytes, which are refractory to the same stimuli, even expressing equal levels of CD95 on the cell membrane. Pre-treatment with ezrin antisense oligonucleotides specifically protected from the CD95-mediated apoptosis. Moreover, we show that the actin cytoskeleton integrity is essential for this function. These findings strongly suggest that the CD95 cell membrane polarization, through an ezrin-mediated association with the actin cytoskeleton, is a key intracellular mechanism in rendering human T lymphocytes susceptible to the CD95-mediated apoptosis.
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Affiliation(s)
- S Parlato
- Laboratories of Virology, Istituto Superiore di Sanità Viale Regina Elena 299, 00161 Rome, Italy
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Abstract
Severe combined immunodeficient (SCID) mice generally do not reject allogeneic or xenogeneic organ grafts and represent a unique model for investigating in vivo the behaviour of both normal and neoplastic human cells. However, cells from human primary tumors often do not grow in SCID mice. We have previously shown that the major reaction of SCID mice to the engraftment of human peripheral blood leukocytes is a massive granulocyte recruitment into the site of transplantation. In this study, we have investigated the role of murine granulocytes in the control of human tumor cell growth in SCID mice. We report here that murine granulocytes infiltrate and delimit the human tumor mass and that treatment of SCID mice with anti-murine granulocyte antibody markedly improves the growth of human tumor cell lines of different origin through suppression of the host granulocyte reaction. This finding provides a new tool for improving the human tumor take in SCID mice, thus opening new perspectives for a practical in vivo preclinical test of anti-tumor strategies. Moreover, this study, even with the limits of the known natural reaction against xenotransplants, further supports the importance of granulocytes in the control of tumor take and growth.
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Affiliation(s)
- F Lozupone
- Laboratories of Immunology and Virology, Istituto Superiore di Sanità, Rome, Italy
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Fais S, Luciani F, Logozzi M, Parlato S, Lozupone F. Linkage between cell membrane proteins and actin-based cytoskeleton: the cytoskeletal-driven cellular functions. Histol Histopathol 2000; 15:539-49. [PMID: 10809375 DOI: 10.14670/hh-15.539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Asymmetric organization of the plasma membrane and cytosolic organelles is fundamental for a variety of cells, including bacteria, yeast and eukaryotic cells (Nelson, 1992). The degree into which cells polarize is characterized by their ability to create and maintain morphologically and biochemically distinct plasma membrane domains. The generation and maintenance of polarized distribution of membrane components (proteins and lipids) is thus critical to the ability of cells to perform complex activities such as cell-to-cell interactions, vectorial transport and secretion, cellular immunity, development and morphogenesis. Modification of cellular polarity may potentially lead to abnormal cellular activities and various pathological disorders (Molitoris, 1991; Carone et al., 1994; Chen et al., 1995). Our review shows the complex interplay between membrane proteins and the cytoskeletal network in determining the "polarized phenotype" in the cell. We provide evidence that membrane/cytoskeleton interaction is the key to regulation of the vast majority of cellular functions.
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Affiliation(s)
- S Fais
- Laboratory of Immunology, Istituto Superiore di Sanità, Rome, Italy.
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Puddu P, Fais S, Luciani F, Gherardi G, Dupuis ML, Romagnoli G, Ramoni C, Cianfriglia M, Gessani S. Interferon-gamma up-regulates expression and activity of P-glycoprotein in human peripheral blood monocyte-derived macrophages. J Transl Med 1999; 79:1299-309. [PMID: 10532592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
P-glycoprotein (Pgp), the product of the multidrug resistance (MDR1) gene, is expressed in a variety of normal tissues but very little is known about its expression and function in cells of the immune system. In this study, we investigated the effect of interferon-gamma (IFN-gamma) on the expression and activity of Pgp in human peripheral blood monocyte-derived macrophages (MDM). We report that IFN-gamma up-regulated Pgp expression in a dose- and time-dependent manner. We show that IFN-gamma slightly increased the accumulation of MDR1 mRNA and induced a polarized redistribution of Pgp, as well as of some cytoskeletal proteins (ie, ezrin, actin, and alpha-actinin) on cell pseudopodia. Notably, confocal microscopy studies showed that Pgp and ezrin colocalized in these cellular structures. The IFN-gamma-induced Pgp up-modulation was a specific response of primary macrophages, as IFN-gamma treatment of primary lymphocytes and monocytic cell lines did not result in any increase of Pgp expression. Finally, IFN-gamma stimulated the Pgp transport activity in MDM, as rhodamine 123-efflux increased in treated cells as compared with control cultures. These results indicate that Pgp expression and activity can be up-regulated in human MDM in response to IFN-gamma. We suggest that IFN-gamma may be involved in the induction of multidrug resistance in macrophages.
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Affiliation(s)
- P Puddu
- Laboratory of Immunology, Istituto Superiore di Sanità, Rome, Italy.
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Cadranel JF, Benhamou Y, Zylberberg P, Novello P, Luciani F, Valla D, Opolon P. Hypnotic relaxation: a new sedative tool for colonoscopy? J Clin Gastroenterol 1994; 18:127-9. [PMID: 8189006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Sedation is often justified in patients requiring colonoscopy. We investigated the potential usefulness of hypnotic relaxation in 13 women and 11 men (median age, 43 years; range, 22-67) for whom other forms of anesthesia were not available. Hypnotic relaxation resulted in moderate or deep sedation in 12 patients (nine women; p < 0.05). In the patients in whom hypnosis was successful, pain was less intense than in patients in whom hypnosis was unsuccessful (p < 0.001). In addition, all colonoscopies were completed in the successful group, versus 50% in the unsuccessful group (p < 0.05). The patients in the successful group all agreed to another examination under the same conditions, whereas only 2% in the unsuccessful group agreed (p < 0.001). Our study suggests that, in a subgroup of hypnotizable patients, hypnotic relaxation may be a safe alternative to drug sedation and merits further study.
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Affiliation(s)
- J F Cadranel
- Service d'Hepato-Gastroenterologie, Groupe Hospitalier, Pitié-Salpêtrière, Paris, France
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Luciani F, Capront P. [Vertebral osteoporosis manifesting systemic mastocytosis]. J Belge Radiol 1992; 75:87-9. [PMID: 1618726] [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: 12/27/2022]
Abstract
A case of systemic mastocytosis in a 33-year-old man, with multiple spine fractures caused by severe osteoporosis, is presented. The diagnosis could only be established three years after the initial symptoms, when the patient developed skin eruption. Skin and bone biopsy, as well as histamine dosage, confirmed the diagnosis.
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Affiliation(s)
- F Luciani
- Service de Radiologie, Hôpital Universitaire Saint-Pierre, Bruxelles, Belgique
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Cadranel JF, Grippon P, Pariente D, Hagiage M, Luciani F, Saigot T, Bousquet O, Opolon P. [Spontaneous esophageal perforation. Radiological diagnosis]. J Radiol 1988; 69:45-7. [PMID: 3361467] [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: 01/05/2023]
Abstract
Esophageal perforations are rare and usually occur after instrumentation. We relate here a case unsuspected spontaneous esophageal perforation. Computed chest tomography firstly showed signs of mediastinal abscess. Secondary barium meal confirmed the diagnosis.
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Affiliation(s)
- J F Cadranel
- Service d'Hépato-gastroentérologie, Hôpital de la Salpêtrière, Paris
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Rudigoz RC, Revillard JP, Audra P, Luciani F, Malvolti B, Griot JP, Frappart L, Lafont S. [Fetal death in utero]. Rev Fr Gynecol Obstet 1986; 81:613-26. [PMID: 3797943] [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: 01/07/2023]
Abstract
152 cases of fetal death in utero are reported. The most frequent etiologies were: vasculorenal syndromes: 28.3 p. cent, idiopathic DPPNIs and RCIUs: 28 p. cent, accidental causes (trauma, funicular syndromes): 19.5 p. cent. Cause of death was unknown or imprecise in 18.4 p. cent of cases. Repeated fetal deaths in utero were rare: 5 observations. The authors consider the management of fetal death in utero, associated immunological problems and how to deal with subsequent pregnancies.
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Bouygues M, Danne O, Bouvry M, Luciani F, Rabreau D. [Trichloroethylene hepatitis. Synergistic effect of carbon tetrachloride?]. Nouv Presse Med 1980; 9:3277. [PMID: 7454577] [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: 01/25/2023]
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