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Bossa F, Valvano MR, Vetrone LM, Guerra M, Lopetuso LR, Carparelli S, Mignini I, Cocomazzi F, Napolitano D, Costantino A, Caprioli F, Gasbarrini A, Perri F, Papa A. Evaluation of factors associated with trust in telemedicine in patients with inflammatory bowel disease during COVID-19 pandemic: a multicenter cross-sectional survey. Eur Rev Med Pharmacol Sci 2022; 26:7277-7284. [PMID: 36263539 DOI: 10.26355/eurrev_202210_29921] [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: 06/16/2023]
Abstract
OBJECTIVE Telemedicine (TM) has had a powerful impact in recent years, particularly on managing chronic diseases such as inflammatory bowel disease (IBD). Knowing patients' expectations and concerns is essential to increase their confidence in this mode of medical care. PATIENTS AND METHODS We interviewed a large cohort of IBD patients enrolled at two Italian tertiary referral centers to investigate their trust in TM. RESULTS A total of 376 patients completed the survey and were included in the study: 293 (77.9%) considered TM valuable for managing their disease, and 307 (85%) wanted to have TM service at their center. However, only 99 patients (26.3%) believed that TM guarantees the same level of care as the in-person visit. Among the socio-demographic variables, those independently associated with trust in TM were the higher education qualification (p=0.02) and the level of competence in information and communication technologies (ICT) (p=0.03). CONCLUSIONS Our findings highlighted the importance of equipping IBD patients with basic ICT skills to utilize TM services and increase their confidence in ICT with the help of caregivers. Additionally, to improve the perceived value of TM, it will be helpful to use additional tools such as telemonitoring of disease activity using patients' reported outcomes or remote measurement of fecal calprotectin.
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Affiliation(s)
- F Bossa
- Gastroenterology Department, Quality and Accreditation Unit, Casa Sollievo Della Sofferenza Hospital, IRCCS, Foggia, Italy.
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Filosto M, Cotti Piccinelli S, Gazzina S, Foresti C, Frigeni B, Servalli MC, Sessa M, Cosentino G, Marchioni E, Ravaglia S, Briani C, Castellani F, Zara G, Bianchi F, Del Carro U, Fazio R, Filippi M, Magni E, Natalini G, Palmerini F, Perotti AM, Bellomo A, Osio M, Nascimbene C, Carpo M, Rasera A, Squintani G, Doneddu PE, Bertasi V, Cotelli MS, Bertolasi L, Fabrizi GM, Ferrari S, Ranieri F, Caprioli F, Grappa E, Manganotti P, Bellavita G, Furlanis G, De Maria G, Leggio U, Poli L, Rasulo F, Latronico N, Nobile-Orazio E, Beghi E, Padovani A, Uncini A. Guillain-Barré Syndrome and COVID-19: a one-year observational multicenter study. Eur J Neurol 2022; 29:3358-3367. [PMID: 35837806 PMCID: PMC9349567 DOI: 10.1111/ene.15497] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/04/2022] [Accepted: 07/07/2022] [Indexed: 01/08/2023]
Abstract
Background and purpose Many single cases and small series of Guillain–Barré syndrome (GBS) associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection were reported during the coronavirus disease 19 (COVID‐19) outbreak worldwide. However, the debate regarding the possible role of infection in causing GBS is still ongoing. This multicenter study aimed to evaluate epidemiological and clinical findings of GBS diagnosed during the COVID‐19 pandemic in northeastern Italy in order to further investigate the possible association between GBS and COVID‐19. Methods Guillain–Barré syndrome cases diagnosed in 14 referral hospitals from northern Italy between March 2020 and March 2021 were collected and divided into COVID‐19‐positive and COVID‐19‐negative. As a control population, GBS patients diagnosed in the same hospitals from January 2019 to February 2020 were considered. Results The estimated incidence of GBS in 2020 was 1.41 cases per 100,000 persons/year (95% confidence interval 1.18–1.68) versus 0.89 cases per 100,000 persons/year (95% confidence interval 0.71–1.11) in 2019. The cumulative incidence of GBS increased by 59% in the period March 2020–March 2021 and, most importantly, COVID‐19‐positive GBS patients represented about 50% of the total GBS cases with most of them occurring during the two first pandemic waves in spring and autumn 2020. COVID‐19‐negative GBS cases from March 2020 to March 2021 declined by 22% compared to February 2019–February 2020. Conclusions Other than showing an increase of GBS in northern Italy in the “COVID‐19 era” compared to the previous year, this study emphasizes how GBS cases related to COVID‐19 represent a significant part of the total, thus suggesting a relation between COVID‐19 and GBS.
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Affiliation(s)
- Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Stefano Gazzina
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Camillo Foresti
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Barbara Frigeni
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | | | - Maria Sessa
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Enrico Marchioni
- IRCCS Mondino Foundation, Neurooncology and Neuroinflammation Unit, Pavia, Italy
| | - Sabrina Ravaglia
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Chiara Briani
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | | | - Gabriella Zara
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Francesca Bianchi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Ubaldo Del Carro
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Raffaella Fazio
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Massimo Filippi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Eugenio Magni
- Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy
| | - Giuseppe Natalini
- Unit of Intensive Care and Anesthesiology, Fondazione Poliambulanza, Brescia, Italy
| | | | | | - Andrea Bellomo
- "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milano, Italy
| | - Maurizio Osio
- Unit of Neurology, ASST Fatebenefratelli Sacco, Milano
| | | | | | | | | | - Pietro Emiliano Doneddu
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | | | | | - Laura Bertolasi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gian Maria Fabrizi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Ranieri
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Elena Grappa
- Intensive Care Unit, ASST Cremona, Cremona, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Giulia Bellavita
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | | | - Ugo Leggio
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Loris Poli
- Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Frank Rasulo
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili, Brescia; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Nicola Latronico
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili, Brescia; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Eduardo Nobile-Orazio
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Ettore Beghi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Antonino Uncini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy
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3
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Filosto M, Cotti Piccinelli S, Gazzina S, Foresti C, Frigeni B, Servalli MC, Sessa M, Cosentino G, Marchioni E, Ravaglia S, Briani C, Castellani F, Zara G, Bianchi F, Del Carro U, Fazio R, Filippi M, Magni E, Natalini G, Palmerini F, Perotti AM, Bellomo A, Osio M, Scopelliti G, Carpo M, Rasera A, Squintani G, Doneddu PE, Bertasi V, Cotelli MS, Bertolasi L, Fabrizi GM, Ferrari S, Ranieri F, Caprioli F, Grappa E, Broglio L, De Maria G, Leggio U, Poli L, Rasulo F, Latronico N, Nobile-Orazio E, Padovani A, Uncini A. Guillain-Barré syndrome and COVID-19: an observational multicentre study from two Italian hotspot regions. J Neurol Neurosurg Psychiatry 2021; 92:751-756. [PMID: 33158914 PMCID: PMC7650204 DOI: 10.1136/jnnp-2020-324837] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/17/2020] [Accepted: 10/17/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Single cases and small series of Guillain-Barré syndrome (GBS) have been reported during the SARS-CoV-2 outbreak worldwide. We evaluated incidence and clinical features of GBS in a cohort of patients from two regions of northern Italy with the highest number of patients with COVID-19. METHODS GBS cases diagnosed in 12 referral hospitals from Lombardy and Veneto in March and April 2020 were retrospectively collected. As a control population, GBS diagnosed in March and April 2019 in the same hospitals were considered. RESULTS Incidence of GBS in March and April 2020 was 0.202/100 000/month (estimated rate 2.43/100 000/year) vs 0.077/100 000/month (estimated rate 0.93/100 000/year) in the same months of 2019 with a 2.6-fold increase. Estimated incidence of GBS in COVID-19-positive patients was 47.9/100 000 and in the COVID-19-positive hospitalised patients was 236/100 000. COVID-19-positive patients with GBS, when compared with COVID-19-negative subjects, showed lower MRC sum score (26.3±18.3 vs 41.4±14.8, p=0.006), higher frequency of demyelinating subtype (76.6% vs 35.3%, p=0.011), more frequent low blood pressure (50% vs 11.8%, p=0.017) and higher rate of admission to intensive care unit (66.6% vs 17.6%, p=0.002). CONCLUSIONS This study shows an increased incidence of GBS during the COVID-19 outbreak in northern Italy, supporting a pathogenic link. COVID-19-associated GBS is predominantly demyelinating and seems to be more severe than non-COVID-19 GBS, although it is likely that in some patients the systemic impairment due to COVID-19 might have contributed to the severity of the whole clinical picture.
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Affiliation(s)
- Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili; NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Stefano Gazzina
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Camillo Foresti
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Barbara Frigeni
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | | | - Maria Sessa
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Enrico Marchioni
- IRCCS Mondino Foundation, Neurooncology and Neuroinflammation Unit, Pavia, Italy
| | - Sabrina Ravaglia
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Chiara Briani
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | | | - Gabriella Zara
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Francesca Bianchi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy
| | - Ubaldo Del Carro
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy
| | - Raffaella Fazio
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy
| | - Massimo Filippi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy
| | - Eugenio Magni
- Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy
| | - Giuseppe Natalini
- Unit of Intensive Care and Anesthesiology, Fondazione Poliambulanza, Brescia, Italy
| | | | | | - Andrea Bellomo
- ''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy
| | - Maurizio Osio
- Unit of Neurology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Giuseppe Scopelliti
- ''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy
| | | | | | | | - Pietro Emiliano Doneddu
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine,Milan University, Milano, Italy
| | | | | | - Laura Bertolasi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gian Maria Fabrizi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Ranieri
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Elena Grappa
- Intensive Care Unit, ASST Cremona, Cremona, Italy
| | - Laura Broglio
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | | | - Ugo Leggio
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Loris Poli
- Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Frank Rasulo
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili;Department of Medical and Surgical Specialties, Radiological Sciences and Public Health,University of Brescia, Brescia, Italy
| | - Nicola Latronico
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili;Department of Medical and Surgical Specialties, Radiological Sciences and Public Health,University of Brescia, Brescia, Italy
| | - Eduardo Nobile-Orazio
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine,Milan University, Milano, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Antonino Uncini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy
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Pilotto A, Masciocchi S, Volonghi I, Crabbio M, Magni E, De Giuli V, Caprioli F, Rifino N, Sessa M, Gennuso M, Cotelli MS, Turla M, Balducci U, Mariotto S, Ferrari S, Ciccone A, Fiacco F, Imarisio A, Risi B, Benussi A, Premi E, Focà E, Caccuri F, Leonardi M, Gasparotti R, Castelli F, Zanusso G, Pezzini A, Padovani A. Clinical Presentation and Outcomes of Severe Acute Respiratory Syndrome Coronavirus 2-Related Encephalitis: The ENCOVID Multicenter Study. J Infect Dis 2021; 223:28-37. [PMID: 32986824 PMCID: PMC7543535 DOI: 10.1093/infdis/jiaa609] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/26/2020] [Indexed: 01/01/2023] Open
Abstract
Background Several preclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection. Some sparse case reports have described various forms of encephalitis in COVID-19 disease, but very few data have focused on clinical presentations, clinical course, response to treatment and outcomes. Methods The ENCOVID multicentre study included patients with encephalitis with full infectious screening, CSF, EEG, MRI data and confirmed SARS-CoV-2 infection recruited from 13 centres in northern Italy. Clinical presentation and laboratory markers, severity of COVID-19 disease, response to treatment and outcomes were recorded. Results twenty-five cases of encephalitis positive for SARS-CoV-2 infection were included. CSF showed hyperproteinorrachia and/or pleocytosis in 68% of cases whereas SARS-CoV-2 RNA by RT-PCR resulted negative. Based on MRI, cases were classified as ADEM (n=3), limbic encephalitis (LE, n=2), encephalitis with normal imaging (n=13) and encephalitis with MRI alterations (n=7). ADEM and LE cases showed a delayed onset compared to the other encephalitis (p=0.001) and were associated with previous more severe COVID-19 respiratory involvement. Patients with MRI alterations exhibited worse response to treatment and final outcomes compared to other encephalitis. Conclusions SARS-CoV-2 infection is associated with a wide spectrum of encephalitis characterized by different clinical presentation, response to treatment and outcomes.
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Affiliation(s)
- Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Parkinson's Disease Rehabilitation Centre, Fondazione Europea Ricerca Biomedica ONLUS, S. Isidoro Hospital, Trescore Balneario, Italy
| | - Stefano Masciocchi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Irene Volonghi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Eugenio Magni
- Neurology Unit, Poliambulanza Hospital, Brescia, Italy
| | - Valeria De Giuli
- Neurology Unit, Istituti Ospedalieri, Azienda Socio Sanitaria Teritoriale di Cremona, Cremona, Italy
| | - Francesca Caprioli
- Neurology Unit, Istituti Ospedalieri, Azienda Socio Sanitaria Teritoriale di Cremona, Cremona, Italy
| | - Nicola Rifino
- Department of Neurology, Azienda Socio Sanitaria Teritoriale di Papa Giovanni XXII, Bergamo, Italy
| | - Maria Sessa
- Department of Neurology, Azienda Socio Sanitaria Teritoriale di Papa Giovanni XXII, Bergamo, Italy
| | | | - Maria Sofia Cotelli
- Neurology Unit, Azienda Socio Sanitaria Teritoriale della Valcamonica, Esine, Brescia, Italy
| | - Marinella Turla
- Neurology Unit, Azienda Socio Sanitaria Teritoriale della Valcamonica, Esine, Brescia, Italy
| | - Ubaldo Balducci
- Neurology Unit, Azienda Socio Sanitaria Teritoriale di Chiari, Chiari, Italy
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alfonso Ciccone
- Department of Neurology and Stroke Unit, Carlo Poma Hospital, Azienda Socio Sanitaria Teritoriale di Mantova, Mantova, Italy
| | - Fabrizio Fiacco
- Neurology Unit, Azienda Socio Sanitaria Teritoriale di Bergamo Est, Seriate, Italy
| | - Alberto Imarisio
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Risi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Enrico Premi
- Stroke Unit, Azienda Socio Sanitaria Teritoriale Spedali Civili di Brescia, Rescia, Italy
| | - Emanuele Focà
- University Division of Infectious and Tropical Diseases, University of Brescia and Azienda Socio Sanitaria Teritoriale di Spedali Civili Hospital, Brescia, Italy
| | - Francesca Caccuri
- Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and Azienda Socio Sanitaria Teritoriale di Spedali Civili Hospital, Brescia, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Istituto di Ricerca e Cura a Carattere Scientifico Neurology Institute Besta, Milan, Italy
| | - Roberto Gasparotti
- Neuroradiology Unit, Department of Medical and Surgical Specialties, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Francesco Castelli
- University Division of Infectious and Tropical Diseases, University of Brescia and Azienda Socio Sanitaria Teritoriale di Spedali Civili Hospital, Brescia, Italy
| | - Gianluigi Zanusso
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Pezzini
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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5
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Pilotto A, Masciocchi S, Volonghi I, De Giuli V, Caprioli F, Mariotto S, Ferrari S, Bozzetti S, Imarisio A, Risi B, Premi E, Benussi A, Focà E, Castelli F, Zanusso G, Monaco S, Stefanelli P, Gasparotti R, Zekeridou A, McKeon A, Ashton NJ, Blennov K, Zetterberg H, Padovani A. SARS-CoV-2 encephalitis is a cytokine release syndrome: evidences from cerebrospinal fluid analyses. Clin Infect Dis 2021; 73:e3019-e3026. [PMID: 33395482 PMCID: PMC7799260 DOI: 10.1093/cid/ciaa1933] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Indexed: 01/01/2023] Open
Abstract
Background Recent findings indicated that SARS-CoV-2 related neurological manifestations involve cytokine release syndrome along with endothelial activation, blood brain barrier dysfunction, and immune‐mediated mechanisms. Very few studies have fully investigated the CSF correlates of SARS-CoV-2 encephalitis. Methods Patients with PCR-confirmed SARS-CoV-2 infection and encephalitis (COV-Enc), encephalitis without SARS-CoV-2 infection (ENC) and healthy controls (HC) underwent an extended panel of CSF neuronal (NfL, T-tau), glial (GFAP, TREM2, YKL-40) and inflammatory biomarkers (IL-1β, IL-6, Il-8, TNF- α, CXCL-13 and β2-microglobulin). Results Thirteen COV-Enc, 21 ENC and 18 HC entered the study. In COV-Enc cases, CSF was negative for SARS-CoV-2 real-time PCR but exhibited increased IL-8 levels independently from presence of pleocytosis/hyperproteinorracchia. COV-Enc patients showed increased IL-6, TNF- α, and β2-microglobulin and glial markers (GFAP, sTREM-2, YKL-40) levels similar to ENC but normal CXCL13 levels. Neuronal markers NfL and T-Tau were abnormal only in severe cases. Conclusions SARS-CoV-2-related encephalitis were associated with prominent glial activation and neuroinflammatory markers, whereas neuronal markers were increased in severe cases only. The pattern of CSF alterations suggested a cytokine-release syndrome as the main inflammatory mechanism of SARS-CoV-2 related encephalitis.
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Affiliation(s)
- Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.,Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario (BG), Italy
| | - Stefano Masciocchi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Irene Volonghi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Valeria De Giuli
- Neurology Unit, Istituti Ospedalieri, ASST Cremona, Cremona, Italy
| | | | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Silvia Bozzetti
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alberto Imarisio
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Barbara Risi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Enrico Premi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Emanuele Focà
- University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Francesco Castelli
- University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Gianluigi Zanusso
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Salvatore Monaco
- Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Italian National Public Health Institute, Rome, Italy
| | - Roberto Gasparotti
- Neuroradiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Anastasia Zekeridou
- Departments of Laboratory Medicine and Pathology, and Neurology, Mayo Clinic, Rochester, MN 55906, USA
| | - Andrew McKeon
- Departments of Laboratory Medicine and Pathology, and Neurology, Mayo Clinic, Rochester, MN 55906, USA
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
| | - Kaj Blennov
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
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6
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Leoncini G, Donato F, Reggiani-Bonetti L, Salviato T, Cadei M, Daperno M, Principi MB, Armuzzi A, Caprioli F, Canavese G, Villanacci V. Diagnostic interobserver variability in Crohn's disease- and ulcerative colitis-associated dysplasia: a multicenter digital survey from the IG-IBD Pathologists Group. Tech Coloproctol 2020; 25:101-108. [PMID: 33025294 DOI: 10.1007/s10151-020-02349-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Crohn's disease (CD) and ulcerative colitis, two forms of inflammatory bowel disease (IBD), are chronic and relapsing conditions of the gastrointestinal tract both characterized by long lasting chronic inflammation and increased risk of dysplasia and colorectal cancer (CRC). The aim of our study was to evaluate the interobserver agreement about IBD-associated dysplasia among pathologists belonging to the Italian Group for Inflammatory Bowel Diseases (IG-IBD P). METHODS The present multicenter survey was performed using telepathology, supported by an open source E-learning platform. Biopsy specimens from 30 colonoscopies and from 20 patients were included. The glass slides of any case, including clinical and endoscopic data, were digitalized and uploaded on the E-learning platform. All the digital slides were grouped in 54 diagnostic "blocks". Blinded histopathological evaluation on all the digital slides was performed by 20 gastrointestinal pathologists. Closed-ended questions about (1) the occurrence of IBD; (2) the classification of IBD (as UC or CD); (3) the presence of active versus quiescent disease; (4) the presence of dysplasia; (5) the possible association of dysplasia with the sites of disease (dysplasia-associated lesion or mass-DALM vs adenoma-like mass-ALM); (6) the grading of dysplasia according to the ECCO guidelines (negative, indefinite, low grade, high grade categories) and (7) the presence of associated serrated features, were proposed in each case. Inter-observer agreement was evaluated by mean agreement percentage and kappa statistic, when suitable. RESULTS The diagnosis of IBD was confirmed in 19 of 20 patients, 17 of 19 being classified as UC, 2 as CD. The mean interobserver agreement percentages about (1) the evidence of IBD, (2) the presence of either UC or CD and (3) the activity grading resulted to be 80%, 69% and 86%, respectively. Dysplasia was detected in 8/20 patients, with moderate agreement between pathologists (mean 72%, k 0.48). Particularly, low grade dysplasia was found in 13 biopsies (combined k 0.38), whereas high grade dysplasia in 8 (combined k 0.47). When the endoscopic and histopathological data were combined, features consistent with DALM were found in 6 of 20 patients with low grade dysplasia and those consistent with ALM in 2 patients with low grade dysplasia in a single biopsy (mean agreement: 86%). An associated serrated pattern was discovered in 4 patients (7 biopsies). CONCLUSIONS Our study showed moderate interobserver agreement about the histopathological detection and classification of IBD-associated dysplasia. Further efforts should be undertaken to integrate the histopathological data with both the ancillary tests and molecular investigations.
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Affiliation(s)
- G Leoncini
- Pathology Unit, ASST del Garda, Desenzano del Garda (BS), Brescia, Italy.
| | - F Donato
- Unit of Hygiene, Epidemiology and Public Health, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - L Reggiani-Bonetti
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - T Salviato
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Cadei
- Institute of Pathology, ASST Spedali Civili, Brescia, Italy
| | - M Daperno
- Gastroenterology Unit, Mauriziano Hospital, Turin, Italy
| | - M B Principi
- Emergency and Organ Transplantation Department, Section of Gastroenterology, AOU Policlinico, Bari, Italy
| | - A Armuzzi
- IBD Unit, Presidio Columbus Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Policlinico di Milano, Milan, Italy
- Department of Pathophysiology, University of Milan, Milan, Italy
- Department of Transplantation, University of Milan, Milan, Italy
| | - G Canavese
- Pathology Department, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - V Villanacci
- Institute of Pathology, ASST Spedali Civili, Brescia, Italy
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7
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Chaparro M, Verreth A, Lobaton T, Gravito-Soares E, Julsgaard M, Savarino E, Magro F, Biron AI, Lopez-Serrano P, Casanova MJ, Gompertz M, Vitor S, Arroyo M, Pugliese D, Zabana Y, Vicente R, Aguas M, Shitrit BGA, Gutierrez A, Doherty GA, Fernandez-Salazar L, Cadilla MJ, Huguet JM, OʼToole A, Stasi E, Marcos MN, Villoria A, Karmiris K, Rahier JF, Rodriguez C, Palomares DLM, Fiorino G, Benitez JM, Principi M, Naftali T, Taxonera C, Mantzaris G, Sebkova L, Iade B, Lissner D, Bradley FI, Roman LSA, Marin-Jimenez I, Merino O, Sierra M, Van Domselaar M, Caprioli F, Guerra I, Peixe P, Piqueras M, Rodriguez-Lago I, Ber Y, van Hoeve K, Torres P, Gravito-Soares M, Rudbeck-Resdal D, Bartolo O, Peixoto A, Martin G, Armuzzi A, Garre A, Donday MG, de Carpi MFJ, Gisbert JP. Long-Term Safety of In Utero Exposure to Anti-TNFα Drugs for the Treatment of Inflammatory Bowel Disease: Results from the Multicenter European TEDDY Study. Am J Gastroenterol 2018; 113:396-403. [PMID: 29460920 DOI: 10.1038/ajg.2017.501] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 11/26/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The long-term safety of exposure to anti-tumor necrosis factor (anti-TNFα) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with inflammatory bowel disease (IBD) who were exposed to anti-TNFα drugs in utero with that of children who were not exposed to the drugs. METHODS Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNFα medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception. Non-exposed cohort: children from mothers with IBD not treated with anti-TNFα agents or thiopurines at any time during pregnancy or the 3 months before conception. The cumulative incidence of severe infections after birth was estimated using Kaplan-Meier curves, which were compared using the log-rank test. Cox-regression analysis was performed to identify potential predictive factors for severe infections in the offspring. RESULTS The study population comprised 841 children, of whom 388 (46%) had been exposed to anti-TNFα agents. Median follow-up after delivery was 47 months in the exposed group and 68 months in the non-exposed group. Both univariate and multivariate analysis showed the incidence rate of severe infections to be similar in non-exposed and exposed children (1.6% vs. 2.8% per person-year, hazard ratio 1.2 (95% confidence interval 0.8-1.8)). In the multivariate analysis, preterm delivery was the only variable associated with a higher risk of severe infection (2.5% (1.5-4.3)). CONCLUSIONS In utero exposure to anti-TNFα drugs does not seem to be associated with increased short-term or long-term risk of severe infections in children.
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Affiliation(s)
- M Chaparro
- Gastroenterology Units Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - A Verreth
- Department of Gastroenterology and Department of Pediatric Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - T Lobaton
- Hospital Universitari Germans Trias i Pujol and CIBEREHD, Badalona, Spain
| | | | - M Julsgaard
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | | | - F Magro
- Centro Hospitalar São João, Porto, Portugal
| | - Avni I Biron
- Gastroenterology Devision, Rabin Medical Center, Petach Tikva, Israel
| | | | - M J Casanova
- Gastroenterology Units Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - M Gompertz
- Hospital Clinic and CIBEREHD, Barcelona, Spain
| | - S Vitor
- Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - M Arroyo
- Hospital Clinico Universitario Lozano Blesa, IIS Aragon, CIBEREHD, Zaragoza, Spain
| | - D Pugliese
- IBD Unit, Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Roma, Italy
| | - Y Zabana
- Hospital Universitari Mutua de Terrassa and CIBEREHD, Terrassa, Spain
| | - R Vicente
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - M Aguas
- Hospital Universitario La Fe and CIBEREHD, Valencia, Spain
| | | | - A Gutierrez
- Hospital General Universitario de Alicante and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Alicante, Spain
| | - G A Doherty
- St. Vincents University Hospital, Dublin, Ireland
| | | | | | - J M Huguet
- Hospital General Universitario de Valencia, Valencia, Spain
| | | | - E Stasi
- IRCCS Saverio de Bellis, Castellana Grotte, Italy
| | | | - A Villoria
- Hospital Universitari Parc Taulí.Institut d'Investigació i Innovació Parc Taulí. Departament de Medicina, Universitat Autònoma de Barcelona.CIBERehd, Instituto de Salud Carlos III, Sabadell, Spain
| | - K Karmiris
- Venizeleio General Hospital, Heraklion, Greece
| | | | - C Rodriguez
- Complejo Universitario de Navarra, Pamplona, Spain
| | | | - G Fiorino
- IBD Center, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy and Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - J M Benitez
- Hospital Universitario Reina Sofia and IMIBIC, Córdoba, Spain
| | - M Principi
- Azienda Policlinico Ospedaliero-Universitaria di Bari, Bari, Italy
| | - T Naftali
- Meir Hospital Kfar saba Tel Aviv University, Tel Aviv, Israel
| | - C Taxonera
- Hospital Clínico San Carlos and IdISSC, Madrid, Spain
| | - G Mantzaris
- Evangelismos, Ophthalmiatreion Athinon and Polyclinic Hospitals, Athens, Greece
| | - L Sebkova
- Azienda Ospedaliera "Pugliese-Ciaccio", Catanzaro, Italy
| | - B Iade
- Hospital de Clinicas, Montevideo, Uruguay
| | - D Lissner
- Universitatsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | | | - I Marin-Jimenez
- Hospital General Universitario Gregorio Marañón and IiSGM, Madrid, Spain
| | - O Merino
- Hospital Universitario de Cruces, Baracaldo, Spain
| | - M Sierra
- Complejo Universitario de León, León, Spain
| | | | - F Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Policlinico di Milano AND Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - I Guerra
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - P Peixe
- Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - M Piqueras
- Consorci Sanitari de Terrasa, Terrasa, Spain
| | | | - Y Ber
- Hospital San Jorge, Huesca, Spain
| | - K van Hoeve
- Department of Paediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - P Torres
- Hospital Universitari Germans Trias i Pujol and CIBEREHD, Badalona, Spain
| | | | - D Rudbeck-Resdal
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | | | - A Peixoto
- Centro Hospitalar São João, Porto, Portugal
| | - G Martin
- Gastroenterology Devision, Rabin Medical Center, Petach Tikva, Israel
| | - A Armuzzi
- IBD Unit, Presidio Columbus, Fondazione Policlinico Gemelli Università Cattolica, Roma, Italy
| | - A Garre
- Gastroenterology Units Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - M G Donday
- Gastroenterology Units Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | | | - J P Gisbert
- Gastroenterology Units Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
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8
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Coletta M, Paroni M, Caprioli F. Successful Treatment With Vedolizumab in a Patient With Chronic Refractory Pouchitis and Primary Sclerosing Cholangitis. J Crohns Colitis 2017; 11:1507-1508. [PMID: 29106505 DOI: 10.1093/ecco-jcc/jjx090] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 12/29/2022]
Affiliation(s)
- M Coletta
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy
| | - M Paroni
- Istituto Nazionale di Genetica Molecolare, Italy.,Dipartimento di Bioscienze, Università degli Studi di Milano, Italy
| | - F Caprioli
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy.,Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda, Ospedale Policlinico di Milano, Italy
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9
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Caruso R, Marafini I, Franzè E, Stolfi C, Zorzi F, Monteleone I, Caprioli F, Colantoni A, Sarra M, Sedda S, Biancone L, Sileri P, Sica GS, MacDonald TT, Pallone F, Monteleone G. Defective expression of SIRT1 contributes to sustain inflammatory pathways in the gut. Mucosal Immunol 2014; 7:1467-79. [PMID: 24850427 DOI: 10.1038/mi.2014.35] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 04/15/2014] [Indexed: 02/04/2023]
Abstract
In inflammatory bowel disease (IBD), tissue damage is driven by an excessive immune response, poorly controlled by counter-regulatory mechanisms. SIRT1, a class III NAD+-dependent deacetylase, regulates negatively the expression of various proteins involved in the control of immune-inflammatory pathways, such as Stat3, Smad7, and NF-κB. Here we examined the expression, regulation, and function of SIRT1 in IBD. SIRT1 RNA and protein expression was less pronounced in whole biopsies and lamina propria mononuclear cells (LPMCs) of IBD patients in comparison with normal controls. SIRT1 expression was downregulated in control LPMC by tumor necrosis factor (TNF)-α and interleukin (IL)-21, and upregulated in IBD LPMC by neutralizing TNF-α and IL-21antibodies. Consistently, SIRT1 expression was increased in mucosal samples taken from IBD patients successfully treated with Infliximab. Treatment of IBD LPMC with Cay10591, a specific SIRT1 activator, reduced NF-κB activation and inhibited inflammatory cytokine synthesis, whereas Ex527, an inhibitor of SIRT1, increased interferon (IFN)-γ in control LPMC. SIRT1 was also reduced in mice with colitis induced by 2,4,6-trinitrobenzenesulphonic acid or oxazolone. Cay10591 prevented and cured experimental colitis whereas Ex527 exacerbated disease by modulating T cell-derived cytokine response. Data indicate that SIRT1 is downregulated in IBD patients and colitic mice and suggest that SIRT1 activation can help attenuate inflammatory signals in the gut.
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Affiliation(s)
- R Caruso
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - I Marafini
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - E Franzè
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - C Stolfi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Zorzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - I Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Caprioli
- Unit of Gastroenterology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Colantoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - M Sarra
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - S Sedda
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - L Biancone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - P Sileri
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - G S Sica
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - T T MacDonald
- Barts and the London School of Medicine and Dentistry, London, UK
| | - F Pallone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - G Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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10
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Lazzaro C, Cappello M, Cortelezzi C, Costantino G, Fiorino G, Mastronardi M, Giannotta M, Galletti B, Cicala M, Vadalà di Prampero S, Gualberti G, Caprioli F, Gasbarrini A, Fattore G. A Health Technology-Related Cost Description Concerning Italian Ibd Centres Dealing With Crohn's Disease Results From Sole Study. Value Health 2014; 17:A370. [PMID: 27200785 DOI: 10.1016/j.jval.2014.08.841] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Lazzaro
- Studio di Economia Sanitaria, Milan, Italy
| | | | - C Cortelezzi
- AOU di Circolo - Fondazione Macchi, Varese, Italy
| | | | - G Fiorino
- Istituto Clinico Humanitas, Rozzano (MI), Italy
| | | | - M Giannotta
- Azienda Ospedaliero Universitaria di Careggi, Firenze, Italy
| | | | - M Cicala
- Università Campus Bio Medico, Roma, Italy
| | - S Vadalà di Prampero
- Azienda Ospedaliero-Universitaria S. Maria della Misericordia di Udine, Udine, Italy
| | | | - F Caprioli
- Università degli Studi di Milano, Milano, Italy
| | - A Gasbarrini
- Università Cattolica del Sacro Cuore, Rome, Italy
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11
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Lazzaro C, Cappello M, Cortelezzi C, Costantino G, Fiorino G, Mastronardi M, Giannotta M, Galletti B, Cicala M, Vadalà di Prampero S, Gualberti G, Caprioli F, Gasbarrini A, Meregaglia M. Health-Related Quality of Life in Italian Patients With Moderate and Severe Crohn's Disease: Interim Results from the Sole Study. Value Health 2014; 17:A570-A571. [PMID: 27201899 DOI: 10.1016/j.jval.2014.08.1908] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C Lazzaro
- Studio di Economia Sanitaria, Milan, Italy
| | | | - C Cortelezzi
- AOU di Circolo - Fondazione Macchi, Varese, Italy
| | | | - G Fiorino
- Istituto Clinico Humanitas, Rozzano (MI), Italy
| | | | - M Giannotta
- Azienda Ospedaliero Universitaria di Careggi, Firenze, Italy
| | | | - M Cicala
- Università Campus Bio Medico, Roma, Italy
| | - S Vadalà di Prampero
- Azienda Ospedaliero-Universitaria S. Maria della Misericordia di Udine, Udine, Italy
| | | | - F Caprioli
- Università degli Studi di Milano, Milano, Italy
| | - A Gasbarrini
- Università Cattolica del Sacro Cuore, Rome, Italy
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12
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Caprioli F. Le bas du visage : importance du morphotype. Anatomie du tiers inférieur du visage et vieillissement facial : importance du morphotype. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.04.050] [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: 10/25/2022]
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13
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Scafato P, Caprioli F, Pisani L, Padula D, Santoro F, Mazzeo G, Abbate S, Lebon F, Longhi G. Combined use of three forms of chiroptical spectroscopies in the study of the absolute configuration and conformational properties of 3-phenylcyclopentanone, 3-phenylcyclohexanone, and 3-phenylcycloheptanone. Tetrahedron 2013. [DOI: 10.1016/j.tet.2013.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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14
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Geginat J, Paroni M, Facciotti F, Gruarin P, Kastirr I, Caprioli F, Pagani M, Abrignani. S. The CD4-centered universe of human T cell subsets. Semin Immunol 2013; 25:252-62. [DOI: 10.1016/j.smim.2013.10.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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15
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Harutyunyan S, Caprioli F, Lutz M, Meetsma A, Minnaard A. Structural Characterisation of Cu Complexes of Chiral Ferrocenyl Diphosphine Ligands. Synlett 2013. [DOI: 10.1055/s-0033-1339851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Martin Lutz
- Bijvoet Center for Biomolecular Research, Utrecht University
| | - Auke Meetsma
- Stratingh Institute for Chemistry, University of Groningen
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16
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Caprioli F, Madduri AVR, Minnaard AJ, Harutyunyan SR. Asymmetric amplification in the catalytic enantioselective 1,2-addition of Grignard reagents to enones. Chem Commun (Camb) 2013; 49:5450-2. [DOI: 10.1039/c3cc41892h] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Bose F, Caprioli F, Rossi R, Palazzo M, Viganò C, Raeli L, Moro M, Basilisco G, Ferrero S, Pagani M, Altomare G, Abrignani S, Reali E. CS15-7. Decrease of IL-17 and Gm-Csf in Intestinal Mucosa of Ibd Patients is Associated With Reduction of CD68+ Macrophages and Clinical Remission in Response to Anti-TNF Therapy. Cytokine 2011. [DOI: 10.1016/j.cyto.2011.07.405] [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: 10/17/2022]
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18
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Scafato P, Caprioli F, Rosini C. Asymmetric addition of phenylboronic acid to cycloalkanones mediated by a Rh/phosphoramidite complex: a comparison between tropos versus nontropos behavior. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.tetasy.2011.02.030] [Citation(s) in RCA: 9] [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: 11/29/2022]
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19
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Di Castro V, Beccari M, Bruni F, Caprioli F, Decker F. Comparison of the protective effect of aromatic thiols adsorbed on copper. SURF INTERFACE ANAL 2010. [DOI: 10.1002/sia.3280] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Iliev ID, Spadoni I, Mileti E, Matteoli G, Sonzogni A, Sampietro GM, Foschi D, Caprioli F, Viale G, Rescigno M. Human intestinal epithelial cells promote the differentiation of tolerogenic dendritic cells. Gut 2009; 58:1481-9. [PMID: 19570762 DOI: 10.1136/gut.2008.175166] [Citation(s) in RCA: 307] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE In mice, a subpopulation of gut dendritic cells (DCs) expressing CD103 drives the development of regulatory T (T(reg)) cells. Further, it was recently described that the cross-talk between human intestinal epithelial cells (IECs) and DCs helps in maintaining gut immune homeostasis via the induction of non-inflammatory DCs. In this study, an analysis was carried out to determine whether IECs could promote the differentiation of CD103+ tolerogenic DCs, and the function of primary CD103+ DCs isolated from human mesenteric lymph nodes (MLNs) was evaluated. METHODS Monocyte-derived DCs (MoDCs) and circulating CD1c+ DCs were conditioned or not with supernatants from Caco-2 cells or IECs isolated from healthy donors or donors with Crohn's disease and analysed for their ability to induce T(reg) cell differentiation. In some cases, transforming growth factor beta (TGFbeta), retinoic acid (RA) or thymic stromal lymphopoietin (TSLP) were neutralised before conditioning. CD103+ and CD103- DCs were sorted by fluorescence-activated cell sorting (FACS) from MLNs and used in T(reg) cell differentiation experiments. RESULTS It was found that human IECs promoted the differentiation of tolerogenic DCs able to drive the development of adaptive Foxp3+ T(reg) cells. This control was lost in patients with Crohn's disease and paralleled a reduced expression of tolerogenic factors by primary IECs. MoDCs differentiated with RA or IEC supernatant upregulated the expression of CD103. Consistently, human primary CD103+ DCs isolated from MLNs were endowed with the ability to drive T(reg) cell differentiation. This subset of DCs expressed CCR7 and probably represents a lamina propria-derived migratory population. CONCLUSIONS A population of tolerogenic CD103+ DCs was identified in the human gut that probably differentiate in response to IEC-derived factors and drive T(reg) cell development.
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Affiliation(s)
- I D Iliev
- Department of Experimental Oncology, European Institute of Oncology, 20141 Milan, Italy
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21
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Caprioli F, Stolfi C, Caruso R, Fina D, Sica G, Biancone L, Pallone F, Monteleone G. Transcriptional and post-translational regulation of Flip, an inhibitor of Fas-mediated apoptosis, in human gut inflammation. Gut 2008; 57:1674-80. [PMID: 18625693 DOI: 10.1136/gut.2008.149286] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Defects in Fas-mediated apoptosis are supposed to contribute to the accumulation of T lymphocytes in the gut of patients with Crohn's disease (CD). This phenomenon has been functionally linked with the elevated expression of Flip, an inhibitor of Fas-mediated apoptosis. In this study, the molecular mechanisms that control Flip in CD were examined. METHODS Paired colonic biopsies of patients with CD, patients with ulcerative colitis (UC) and normal controls were analysed for Flip by real-time PCR and western blotting. Flip was also evaluated in CD3(+) lamina propria lymphocytes (T-LPLs) cultured with tosyl phenylalanyl chloromethyl ketone (TPCK; a nuclear factor-kappaB (NF-kappaB) inhibitor), AG490 (a Janus kinase 2 (Jak2)/signal transducer and activator of transcription (Stat) inhibitor) or 17-desmethoxy-17-N,N-dimethylamino-geldanamycin (DMAG; an inhibitor of heat shock protein 90). The rate of apoptosis was examined by flow cytometry. RESULTS In CD, upregulation of Flip occurred at both the RNA and protein level. Treatment of CD CD3(+) T-LPLs with TPCK or AG490 markedly reduced Flip RNA, suggesting a role for NF-kappaB and Jak/Stat pathways in the transcriptional control of Flip in this condition. Consistently, both TPCK and AG490 sensitised CD T-LPLs to Fas-mediated apoptosis. Flip protein in cells from normal gut was rapidly degraded by the proteasome pathway. In contrast, in inflamed gut of both CD and UC patients, there was a reduced degradation of Flip via the ubiquitin-proteasome-dependent pathway, but Flip expression can be decreased by DMAG. CONCLUSIONS The data demonstrate that Flip is regulated at both the transcriptional and post-translational level in CD, and indicate that in the normal but not inflamed gut Flip is degraded via the ubiquitin-proteasome-dependent pathway.
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Affiliation(s)
- F Caprioli
- Department of Internal Medicine, University Tor Vergata of Rome, Rome, Italy
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22
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Stolfi C, Fina D, Caruso R, Caprioli F, Fantini MC, Rizzo A, Sarra M, Pallone F, Monteleone G. Mesalazine negatively regulates CDC25A protein expression and promotes accumulation of colon cancer cells in S phase. Carcinogenesis 2008; 29:1258-66. [DOI: 10.1093/carcin/bgn122] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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23
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Monteleone G, Caruso R, Fina D, Peluso I, Gioia V, Stolfi C, Fantini MC, Caprioli F, Tersigni R, Alessandroni L, MacDonald TT, Pallone F. Control of matrix metalloproteinase production in human intestinal fibroblasts by interleukin 21. Gut 2006; 55:1774-80. [PMID: 16682426 PMCID: PMC1856468 DOI: 10.1136/gut.2006.093187] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND T cell-mediated immunity plays a central part in the pathogenesis of tissue damage in inflammatory bowel disease (IBD). The mechanism by which T cells mediate tissue damage during IBD remains unclear, but evidence indicates that T cell-derived cytokines stimulate fibroblasts to synthesise matrix metalloproteinases (MMPs), which then mediate mucosal degradation. We have previously shown that, in IBD, there is high production of interleukin (IL) 21, a T cell-derived cytokine, which enhances Th1 activity. AIM To investigate whether IL21 controls MMP production by intestinal fibroblasts. METHODS IL21 receptor (IL21R) was evaluated in intestinal fibroblasts by reverse transcriptase-polymerase chain reaction (RT-PCR) and western blotting. Fibroblasts were stimulated with IL21 and MMPs were evaluated by RT-PCR and western blotting. The effect of a neutralising IL21R fusion protein (IL21R/Fc) on the induction of MMPs in fibroblasts stimulated with IBD lamina propria mononuclear cell (LPMC) supernatants was also evaluated. RESULTS Intestinal fibroblasts constitutively express both IL21R and the common gamma chain receptor, which are necessary for IL21-driven signalling. IL21 enhances fibroblast production of MMP-1, MMP-2, MMP-3 and MMP-9, but not tissue inhibitors of MMP-1 and MMP-2. Moreover, IL21 synergises with tumour necrosis factor alpha to increase synthesis of MMP synthesis. IL21 enhances MMP secretion without affecting gene transcription and protein synthesis. IBD LPMC supernatants stimulate MMP secretion by intestinal fibroblasts, and this effect is partly inhibited by IL21R/Fc. CONCLUSIONS These results suggest that fibroblasts are a potential target of IL21 in the gut and that IL21 controls MMP secretion by fibroblasts.
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Affiliation(s)
- G Monteleone
- Dipartimento di Medicina Interna, Università Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
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24
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Peracchi M, Bardella MT, Caprioli F, Massironi S, Conte D, Valenti L, Ronchi C, Beck-Peccoz P, Arosio M, Piodi L. Circulating ghrelin levels in patients with inflammatory bowel disease. Gut 2006; 55:432-3. [PMID: 16474110 PMCID: PMC1856072 DOI: 10.1136/gut.2005.079483] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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25
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Sebille S, Caprioli F, Bennani K, Baralle MM, Mallart A, Ferri J. [Radiographic anomalies and obstructive sleep apnea syndrome]. Rev Stomatol Chir Maxillofac 2003; 104:133-8. [PMID: 12931063] [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: 03/04/2023]
Abstract
BACKGROUND The purpose of this study was to identify the particular cranio-facial pattern observed in patients with obstructive sleep apnea syndrome and to search for possible correlations between morphological anomalies and disease severity. MATERIAL AND METHODS The study group included 49 dentate patients, mean age 47.7 years suffering from obstructive sleep apnea syndrome. Most of the patients were overweight. RESULTS Typical features observed in these patients were a short craniospinal field, a retro-maxillary, a retro-mandibula, antero-inferior vertical excess of the face, and class II malocclusion. No correlation between severity of obstructive sleep apnea syndrome and craniofacial morphology could be identified. DISCUSSION These results are in agreement with data in the literature. The absence of a morphological correlation appears to be related to the type of patients studied (overweight). Indeed, two categories of sleep apnea patients have been identified: obese patients who have few or no anomalies of the facial skeleton and thin patients with characteristic open bite class II malocclusion.
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Affiliation(s)
- S Sebille
- Service de Chirurgie Maxillo-Faciale et de Stomatologie, Hôpital Roger Salengro, CHRU de Lille, 59037 Lille cedex
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26
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Vereecke F, Caprioli F, Raoul G, Bennani K, Ferri J. [The management of anterior transversal mandibular deficiencies by distraction osteogenesis. Preliminary results and report of 3 cases]. ANN CHIR PLAST ESTH 2001; 46:304-15. [PMID: 11534442 DOI: 10.1016/s0294-1260(01)00033-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/17/2022]
Abstract
During the last ten years, osteodistraction genesis appeared as being a treatment of some maxillo-facial transversal deficiencies. A new technique have been develop in Lille Maxillo-Facial Department (Pr Ferri, France). This new technique is used in cases of mandibular hyposymphysis, which induce most of the time a mandibular incisor crowding. This distraction osteogenesis performed after sagittal osteotomy of the mandibular symphysis and associated with orthodontic treatment is a solution to avoid teeth extractions. Other treatments could be used to solve anterior mandibular teeth crowding but they have disadvantages: teeth slicing, teeth extraction or orthodontic teeth tilting. This new technique is performed with intra oral-device, small enough to be placed under mandibular periosteum. Three patients have been treated by this technique, they got a stable result. In these three cases, alveolar and basal bone is present. So for us, symphysis osteogenesis distraction appears to be an alternative treatments to mandibular incisor crowding.
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Affiliation(s)
- F Vereecke
- Service de chirurgie maxillofaciale et stomatologie, CHRU Lille, hôpital Roger Salengro, avenue du professeur Leclerc, 59037 Lille, France
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27
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Caprioli F, Pometta R, Visentin S, Massironi S, Conte D. "Hepatitic flare", asthenia, peripheral polyneuropathy and diffuse liver steatosis in a hepatitis C virus asymptomatic chronic carrier. Dig Liver Dis 2001; 33:359-62. [PMID: 11432516 DOI: 10.1016/s1590-8658(01)80092-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In July 2000, a 62-year-old female, with a ten-year history of chronic hepatitis C virus infection and persistently normal aspartate amino-transferase and alanine aminotransferase levels, presented with asthenia, weight loss, peripheral polyneuropathy and increased levels of aspartate aminotransferase (8 times upper normal limit), alanine aminotransferase (10 times upper normal limit) and gamma glutamyl-transferase (6 times upper normal limit). The ultrasound findings were consistent with massive liver steatosis. The patient had been previously diagnosed elsewhere as having hepatitis C virus-related "hepatitic flare" with neurological involvement related to concomitant mixed type-III cryoglobulinaemia. However intense exposure to trichloroethylene since April 2000 was revealed and liver histology was fully consistent with non-alcoholic steatohepatitis. The pathogenetic role of the solvent was definitely supported by the complete clinical and biochemical remission within six months of trichloroethylene withdrawal.
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Affiliation(s)
- F Caprioli
- Cattedra di Gastroenterologia, IRCCS Ospedale Maggiore, Milan, Italy
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28
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Lemière E, Maes JM, Raoul G, Caprioli F, Ruhin B, Ferri J. [Chronic diffuse osteomyelitis of the mandible. Apropos of a case]. Rev Stomatol Chir Maxillofac 2000; 101:330-5. [PMID: 11242773] [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: 02/19/2023]
Abstract
The incidence of osteomyelitis of the jaw has declined. Outcome is favorable with antibiotic therapy and surgery. We report a case in a women who experienced an unfavorable course with massive progressive diffusion, complicated by neoplastic conversion.
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Affiliation(s)
- E Lemière
- Service de Chirurgie Maxillo-Faciale et Stomatologie, Hopital Roger Salengro, CHRU de Lille, 59037 Lille
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29
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Ferri J, Bennani K, Sebille S, Caprioli F. [Growth: responses to pathology. Preliminary study]. Orthod Fr 2000; 71:241-8. [PMID: 11039277] [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: 02/18/2023]
Abstract
Many pathologies involve face. Among them, many have craniofacial growth consequences. The authors' aims are to analyze some of these pathologies, where clinical observations emphasize the role of the different craniofacial growth patterns. Despite a complex relation between the malformative part and the deformative one, untreated observations provide a better understanding of some craniofacial growth defects. Syndromes can be classified in 4 categories, involving the primitive causes of the clinical finding: 1. organic abnormalities of one or many functional matrix, 2. localized abnormalities of the anatomical structures, 3. general abnormalities of the conjunctive tissue, 4. mixed syndromes. Many observations will presented.
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Affiliation(s)
- J Ferri
- Hôpital Roger Salengro, Service de stomatologie et chirurgie maxillo-faciale, C.H.R.U. de Lille
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30
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Ruhin B, Maes JM, Caprioli F, Ferri J. [Fibrous dysplasia: management of a severe case of pseudo-leontiasis ossea]. Rev Stomatol Chir Maxillofac 1998; 99:250-7. [PMID: 10343997] [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: 02/12/2023]
Abstract
We report the case of a 75-year-old woman who consulted for suppurative gingivitis and maxillary deformation with slow progression and associated severe joint disorder. The patient suffered both esthetic prejudice and functional impairment. Clinical signs and radiographic findings suggested the diagnosis of fibrous dysplasia, in its leontiasis ossea form, rarely reported in the literature. Primum non nocere guided our management. Abstention, a simple remodeling resection, or extensive resection and reconstruction would have been inappropriate in this elderly patient. We opted for an orthognatic attitude in spite of the vascular risk inherent in the orthodontic preparation and the osteotomy on an abnormal dystrophic bone. Outcome was satisfactory.
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Affiliation(s)
- B Ruhin
- Service de Stomatologie et Chirurgie Maxillo-Faciale, CHRU de Lille, Hôpital Roger Salengro, Lille
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31
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Moscatelli P, Bartolini M, Caprioli F, Casini-Lemmi M, Cavanna E, Cosso D, Piccinini A, Zucchinetti P, Centa A. [Early neonatal manifestations of group B Streptococcus infection: case series and preventive strategy]. Pediatr Med Chir 1995; 17:427-9. [PMID: 8684998] [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: 02/01/2023] Open
Abstract
Group B Streptococcus (GBS) is, so far, one of the most important causes of neonatal morbidity and mortality. In order to elucidate the extent of this problem a screening for GBS has been performed on a group of pregnant women and their neonates. Maternal vaginal and rectal swabs were obtained on admission to the labor area. In these infants throat swabs at birth and throat and rectal swabs on day 4th and 6th were obtained. In the 14,248 pairs mother/infant examined, the rate of colonization was, respectively, 9 (7%) and 4 (1%). 6 among 569 colonized newborn show evidence of the early onset type infection (respiratory form: 2 cases; meningitic form: 4 cases). Fatal outcome and severe neurologic impairment were observed respectively in 3 and 1 patient. Risk factors (prematurity) were present only in two patients. In all cases clinic evidence was observed before that laboratory findings were disposable. The Authors remark the importance of the bacteriological screening in pregnancy, and of antibiotic therapy intrapartum in women with risk factors and in colonized newborn in the first hour of life when acute phase reactants are positive.
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Affiliation(s)
- P Moscatelli
- Divisione di Neonatologia, E.O. Ospedali Galliera, Genova, Italia
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32
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Battistoni MG, Faccincani L, De Vita F, Geremia U, Caprioli F. [Epithelioid hemangioendothelioma of the liver. A case report]. MINERVA CHIR 1994; 49:723-7. [PMID: 7991182] [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: 01/28/2023]
Abstract
One case of epithelioid hemangioendothelioma (EHE) of the liver is reported. The problems of a correct diagnosis of this unusual type of vascular tumor are discussed. A final diagnosis can be established only by histologic examination of appropriate material and may be helped by immunohistochemistry and ultrastructural examination. Tumor cells are vasoformative and synthesized Factor VIII-related antigen. The accurate diagnosis of EHE of the liver is of clinical and therapeutic relevance, for the favourable prognosis, also without therapy, nevertheless liver transplantation represents in selected cases (patients exhibiting a rapidly progressive liver failure) the only possible treatment. The case studied in our Department is very interesting, because it represents a summary of knowledge regarding this type of neoplasm in a 20-year period.
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Affiliation(s)
- M G Battistoni
- II Divisione di Chirurgia Generale, Ospedale Civile Maggiore di Verona
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33
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Pietrarota P, Battistoni MG, Furlan F, Caprioli F. [Hepatic abscess]. MINERVA GASTROENTERO 1992; 38:131-5. [PMID: 1299335] [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: 12/26/2022]
Abstract
The Authors review the medical records of 9 patients with liver abscess over a 15-year period from 1975 to 1989. They report on 5 pyogenic abscess, 3 amebic abscess and one case of tuberculosis of the liver. The most common initial diagnosis was fever of unknown origin, abdominal pain and hepatomegaly. The treatment consisted of 6 percutaneous transhepatic drainage, 2 open surgical drainage, and one explorative laparotomy (tbc infection). The Authors had no mortality and recommend the percutaneous transhepatic drainage as first-choice treatment.
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Affiliation(s)
- P Pietrarota
- II Divisione di Chirurgia Generale, Ospedale Civile Maggiore di Verona
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34
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Sbolgi P, Mangiante G, Ruffa G, Caprioli F, Bartolozzi G, Cingolani M, Gemme G. [Anti-gliadin antibodies in the diagnosis and follow-up of celiac disease]. Minerva Pediatr 1991; 43:783-8. [PMID: 1798403] [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: 12/28/2022]
Abstract
The study assessed the value of anti-gliadin antibodies (AGA) as a diagnostic test for celiac disease (CD) by examining 219 children: 57 were affected by malabsorption syndrome and underwent the first duodenojejunal biopsy; 83 underwent a secondary diagnostic phase for CD; 44 underwent a challenge test; 35 controls. Duodenojejunal biopsy was performed in all subjects in the three stages of diagnosis for CD. By comparing AGA levels and on the basis of histological tests of duodenojejunal mucosa it is possible to confirm the reliability of the method as a screening test for use in subjects whose clinical symptoms suggest CD. AGA are however less reliable in the second and third stages, that is to say in the follow-up of CD, since they do not always reflect the conditions of intestinal mucosa.
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Affiliation(s)
- P Sbolgi
- II Clinica Pediatrica G. Gaslin, Università degli Studi di Genova
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35
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Pelosi G, Zannoni M, Caprioli F, Faccincani L, Battistoni MG, Balercia G, Bontempini L. Benign multicystic mesothelial proliferation of the peritoneum: immunohistochemical and electron microscopical study of a case and review of the literature. Histol Histopathol 1991; 6:575-83. [PMID: 1725139] [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: 12/28/2022]
Abstract
We report a case of benign multicystic mesothelial proliferation (the so-called multicystic peritoneal mesothelioma) arising multifocally in the abdomen of a 46-year-old white man. His anamnesis showed an 8-year history of intermittent pain in the right lower abdominal quadrant. Mucin stains, immunohistochemistry, and electron microscopy confirmed the mesothelial origin of the lesion. Review of the available literature allowed us to find another 85 reported cases of benign multicystic mesothelial proliferations of the peritoneum. Out of these cases, eighteen only occurred in men, the majority being reported in middle-aged women mostly with complaints of abdominal pain. Electron microscopy or immunohistochemistry are needed to make a differential diagnosis towards other multicystic lesions, such as peritoneal cystic lymphangioma. Although multicystic mesothelial proliferations of the peritoneum have often been regarded as benign neoplasms, the true nature--neoplastic or hyperplastic--of these lesions still remains greatly elusive. Therefore, we believe that the unbinding term benign multicystic mesothelial proliferation (first used with regard to the unique hitherto reported case arisen in the pleural cavity) should be considered at present more appropriate to indicate even these peritoneal lesions.
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Affiliation(s)
- G Pelosi
- Institute of Surgical Pathology, Hospital Civile Maggiore, Verona, Italy
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36
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Gemme G, Lagorio V, Ruffa G, Bonioli E, Caprioli F. [Iconographic rubric. Fibrodysplasia ossificans progressiva (myositis ossificans progressiva)]. Arch Fr Pediatr 1988; 45:133-4. [PMID: 3389976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- G Gemme
- Première Clinique Pédiatrique de Gênes, Clinica Pediatrica G. Gaslini, Genova, Italie
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37
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Pietrarota P, Battistoni MG, Caprioli F. [7 years' experience in the determination of hormone receptors in cancer of the breast. Current status and prospectives for the surgeon]. Pathologica 1987; 79:105-8. [PMID: 3441400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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38
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Geremia U, Nicodemo P, Grazia M, Caprioli F. [Iatrogenic celiac-mesenteric arteriovenous fistulae; with reference to a new case of postgastrectomy arteriovenous fistula]. Chir Ital 1985; 37:57-71. [PMID: 3995665] [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: 01/08/2023]
Abstract
The authors report a rare case of iatrogenous arteriovenous fistula between left gastric artery and vein, arising after gastric resection. The observation caused a reviewing of the literature (19 cases published, of which only one between left gastric artery and vein) and some remarks about the physiopathology, pathological anatomy, clinics and treatment of such rare diseases. The authors, in their conclusions, emphasize that such arteriovenous fistulas can remain asymptomatic for a long time; they, moreover, with evident effects on the liver physiology, can progressively cause a serious state of portal hypertension, in the genesis of which the time-factor plays a primary role.
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39
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Frascaria F, Caprioli F. [Clinical considerations on biliary ielus]. Chir Ital 1965; 17:241-72. [PMID: 5178307] [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: 01/14/2023]
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