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Rosina S, Rebollo-Gimenez AI, Tarantola L, Pistorio A, Vyzhga Y, El Miedany Y, Lotfy HM, Abu-Shady H, Eissa M, Osman NS, Hassan W, Mahgoub MY, Fouad NA, Mosa DM, Adel Y, Mohamed SEM, Radwan AR, Abu-Zaid MH, Tabra SAA, Shalaby RH, Nasef SI, Khubchandani R, Khan A, Maldar NP, Ozen S, Bayindir Y, Alsuweiti M, Alzyoud R, Almaaitah H, Vilaiyuk S, Lerkvaleekul B, Alexeeva E, Dvoryakovskaya T, Kriulin I, Bracaglia C, Pardeo M, De Benedetti F, Licciardi F, Montin D, Robasto F, Minoia F, Filocamo G, Rossano M, Simonini G, Marrani E, Abu-Rumeleih S, Kostik MM, Belozerov KE, Pal P, Bathia JN, Katsicas MM, Villarreal G, Marino A, Costi S, Sztajnbok F, Silva RM, Maggio MC, El-Ghoneimy DH, El Owaidy R, Civino A, Diomeda F, Al-Mayouf SM, Al-Sofyani F, Dāvidsone Z, Patrone E, Saad-Magalhães C, Consolaro A, Ravelli A. Defining criteria for disease activity states in systemic juvenile idiopathic arthritis based on the systemic Juvenile Arthritis Disease Activity Score. Arthritis Rheumatol 2024. [PMID: 38682570 DOI: 10.1002/art.42865] [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] [Received: 10/05/2023] [Revised: 02/06/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To develop and validate cutoff values in the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10) that distinguish the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with systemic juvenile idiopathic arthritis (sJIA), based on subjective disease state assessment by the treating pediatric rheumatologist. METHODS The cutoffs definition cohort was composed of 400 patients enrolled at 30 pediatric rheumatology centers in 11 countries. Using the subjective physician rating as an external criterion, 6 methods were applied to identify the cutoffs: mapping, calculation of percentiles of cumulative score distribution, Youden index, 90% specificity, maximum agreement, and ROC curve analysis. Sixty percent of the patients were assigned to the definition cohort and 40% to the validation cohort. Cutoff validation was conducted by assessing discriminative ability. RESULTS The sJADAS10 cutoffs that separated ID from MiDA, MiDA from MoDA, and MoDA from HDA were ≤ 2.9, ≤ 10, and > 20.6. The cutoffs discriminated strongly among different levels of pain, between patients with or without morning stiffness, and between patients whose parents judged their disease status as remission or persistent activity/flare or were satisfied or not satisfied with current illness outcome. CONCLUSION The sJADAS cutoffs revealed good metrologic properties in both definition and validation cohorts, and are therefore suitable for use in clinical trials and routine practice.
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Affiliation(s)
- Silvia Rosina
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Ana I Rebollo-Gimenez
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Letizia Tarantola
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angela Pistorio
- Direzione Scientifica - Unità di Biostatistica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Yulia Vyzhga
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Yasser El Miedany
- Canterbury Christ Church University, UK and Egyptian College of Pediatric Rheumatology, Egypt
| | - Hala M Lotfy
- Pediatric Rheumatology Department, Abu- el Reesh Hospital, Cairo University, Cairo, Egypt
| | - Hend Abu-Shady
- Pediatric Rheumatology Department, Abu- el Reesh Hospital, Cairo University, Cairo, Egypt
| | - Mervat Eissa
- Rheumatology, Kasr Elainy Cairo University, Cairo, Egypt
| | | | - Waleed Hassan
- Rheumatology, Rehabilitation and Physical Medicine, Benha University, Benha, Egypt
| | - Marwa Y Mahgoub
- Rheumatology, Rehabilitation and Physical Medicine, Benha University, Benha, Egypt
| | - Nermeen A Fouad
- Rheumatology and Rehabilitation, Fayoum University, Fayoum, Egypt
| | - Doaa M Mosa
- Rheumatology, Rehabilitation and Physical Medicine, Mansoura University, Mansoura, Egypt
| | - Yasmin Adel
- Rheumatology, Rehabilitation and Physical Medicine, Mansoura University, Mansoura, Egypt
| | | | - Ahmed R Radwan
- Rheumatology and Rehabilitation, Sohag University, Sohag, Egypt
| | | | - Samar A A Tabra
- Rheumatology and Rehabilitation Tanta University, Tanta, Egypt
| | - Radwa H Shalaby
- Rheumatology and Rehabilitation Tanta University, Tanta, Egypt
| | - Samah I Nasef
- Rheumatology & Rehabilitation, Faculty of Medicine Suez Canal University, Ismailia, Egypt
| | | | | | | | - Seza Ozen
- Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Yagmur Bayindir
- Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey
| | - Motasem Alsuweiti
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Raed Alzyoud
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Hiba Almaaitah
- Pediatric Immunology and Rheumatology division, Queen Rania Children's Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Soamarat Vilaiyuk
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Butsabong Lerkvaleekul
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ekaterina Alexeeva
- National Medical Research Center of Children's Health, Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Tatyana Dvoryakovskaya
- National Medical Research Center of Children's Health, Moscow, Russian Federation
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ivan Kriulin
- National Medical Research Center of Children's Health, Moscow, Russian Federation
| | - Claudia Bracaglia
- Division of Rheumatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Manuela Pardeo
- Division of Rheumatology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Francesco Licciardi
- Città della Salute e della Scienza, Pediatria specialistica Universitaria, Immunoreumatologia, Torino, Italy
| | - Davide Montin
- Città della Salute e della Scienza, Pediatria specialistica Universitaria, Immunoreumatologia, Torino, Italy
| | - Francesca Robasto
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli studi di Torino, Torino, Italy
| | - Francesca Minoia
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Filocamo
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Rossano
- SC Pediatria e Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriele Simonini
- Rheumatology Unit, IRCCS Meyer Children's Hospital, Florence, Italy
- NEUROFARBA Department, University of Florence, Florence, Italy
| | - Edoardo Marrani
- Rheumatology Unit, IRCCS Meyer Children's Hospital, Florence, Italy
| | | | - Mikhail M Kostik
- Department of Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Konstantin E Belozerov
- Department of Pediatrics, Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Priyankar Pal
- Pediatric Rheumatology Institute of Child Health, Kolkata, India
| | - Jigna N Bathia
- Pediatric Rheumatology Institute of Child Health, Kolkata, India
| | - María M Katsicas
- Service of Rheumatology. Hospital de Pediatría Prof Dr JP Garrahan, Buenos Aires, Argentina
| | - Giselle Villarreal
- Service of Rheumatology. Hospital de Pediatría Prof Dr JP Garrahan, Buenos Aires, Argentina
| | - Achille Marino
- Unit of Pediatric Rheumatology, ASST G.Pini-CTO, Milan, Italy
| | - Stefania Costi
- Unit of Pediatric Rheumatology, ASST G.Pini-CTO, Milan, Italy
| | - Flavio Sztajnbok
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Pediatric Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo M Silva
- Division of Pediatric Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria C Maggio
- Department PROMISE "G. D'Alessandro", University of Palermo, Italy
| | - Dalia H El-Ghoneimy
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Rasha El Owaidy
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Adele Civino
- Pediatric Rheumatology and Immunology Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | - Federico Diomeda
- Pediatric Rheumatology and Immunology Unit, "Vito Fazzi" Hospital, Lecce, Italy
| | - Sulaiman M Al-Mayouf
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fuad Al-Sofyani
- Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Zane Dāvidsone
- Department of Pediatrics, University Children Hospital, Riga, Latvia
| | - Elisa Patrone
- Servizio di Sperimentazioni Cliniche Pediatriche, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Alessandro Consolaro
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
| | - Angelo Ravelli
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno Infantili (DINOGMI), Università degli Studi di Genova, Genoa, Italy
- Direzione Scientifica, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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2
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Gazzin A, Pala F, Bosticardo M, Niemela J, Stoddard J, Biasin E, Quarello P, Carli D, Ferroni F, Delmonte OM, Montin D, Rosenzweig SD, Licciardi F, Notarangelo LD. Mulibrey nanism and immunological complications: a comprehensive case report and literature review. Front Immunol 2023; 14:1303251. [PMID: 38116000 PMCID: PMC10728670 DOI: 10.3389/fimmu.2023.1303251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Mulibrey nanism (MUL) is a rare disorder caused by TRIM37 gene variants characterized by growth failure, dysmorphic features, congestive heart failure (CHF), and an increased risk of Wilms' tumor. Although immune system impairment has been documented in MUL, the underlying mechanisms remain poorly understood. Methods We present a case of MUL with progressive lymphopenia and review similar cases from the literature. Results Our patient presented with prenatal onset growth restriction, characteristic dysmorphic features, and Wilms' tumor. She developed progressive lymphopenia starting at 10 years of age, leading to the initiation of intravenous immunoglobulin (IVIG) replacement therapy and infection prophylaxis. Genetic analysis detected a likely pathogenic variant on the maternal allele and copy number loss on the paternal allele in TRIM37. Subsequently a cardiac magnetic resonance imaging was conducted revealing signs of pericardial constriction raising concerns for intestinal lymphatic losses. The cessation of IVIG therapy did not coincide with any increase in the rate of infections. The patient exhibited a distinct immunological profile, characterized by hypogammaglobulinemia, impaired antibody responses, and skewed T-cell subsets with an altered CD4+/CD8+ ratio, consistent with previous reports. Normal thymocyte development assessed by artificial thymic organoid platform ruled out an early hematopoietic intrinsic defect of T-cell development. Discussion The immunological profile of MUL patients reported so far shares similarities with that described in protein-losing enteropathy secondary to CHF in Fontan circulation and primary intestinal lymphangiectasia. These similarities include hypogammaglobulinemia, significant T-cell deficiency with decreased CD4+ and CD8+ counts, altered CD4+/CD8+ ratios, and significantly modified CD4+ and CD8+ T-cell phenotypes toward effector and terminal differentiated T cells, accompanied by a loss of naïve CD45RA+ T lymphocytes. In MUL, CHF is a cardinal feature, occurring in a significant proportion of patients and influencing prognosis. Signs of CHF or constrictive pericarditis have been evident in the case reported here and in all cases of MUL with documented immune dysfunction reported so far. These observations raise intriguing connections between these conditions. However, further investigation is warranted to in-depth define the immunological defect, providing valuable insights into the pathophysiology and treatment strategies for this condition.
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Affiliation(s)
- Andrea Gazzin
- Laboratory of Clinical Immunology and Microbiology, Immune Deficiency Genetics Section, National Institutes of Health, Bethesda, MD, United States
- Postgraduate School of Pediatrics, University of Torino, Turin, Italy
| | - Francesca Pala
- Laboratory of Clinical Immunology and Microbiology, Immune Deficiency Genetics Section, National Institutes of Health, Bethesda, MD, United States
| | - Marita Bosticardo
- Laboratory of Clinical Immunology and Microbiology, Immune Deficiency Genetics Section, National Institutes of Health, Bethesda, MD, United States
| | - Julie Niemela
- Department of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Jennifer Stoddard
- Department of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Eleonora Biasin
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, Turin, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, Turin, Italy
| | - Diana Carli
- Immunogenetics and Transplant Biology Unit, Città della Salute e della Scienza University Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Ferroni
- Department of Pediatric Cardiology, City of Health and Science University Hospital, Turin, Italy
| | - Ottavia M. Delmonte
- Laboratory of Clinical Immunology and Microbiology, Immune Deficiency Genetics Section, National Institutes of Health, Bethesda, MD, United States
| | - Davide Montin
- Department of Public Health and Pediatrics, University of Turin, Pediatria Specialistica U, “Regina Margherita” Children Hospital, Turin, Italy
| | - Sergio D. Rosenzweig
- Department of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Francesco Licciardi
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Luigi D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, Immune Deficiency Genetics Section, National Institutes of Health, Bethesda, MD, United States
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3
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Le Voyer T, Parent AV, Liu X, Cederholm A, Gervais A, Rosain J, Nguyen T, Perez Lorenzo M, Rackaityte E, Rinchai D, Zhang P, Bizien L, Hancioglu G, Ghillani-Dalbin P, Charuel JL, Philippot Q, Gueye MS, Maglorius Renkilaraj MRL, Ogishi M, Soudée C, Migaud M, Rozenberg F, Momenilandi M, Riller Q, Imberti L, Delmonte OM, Müller G, Keller B, Orrego J, Franco Gallego WA, Rubin T, Emiroglu M, Parvaneh N, Eriksson D, Aranda-Guillen M, Berrios DI, Vong L, Katelaris CH, Mustillo P, Raedler J, Bohlen J, Bengi Celik J, Astudillo C, Winter S, McLean C, Guffroy A, DeRisi JL, Yu D, Miller C, Feng Y, Guichard A, Béziat V, Bustamante J, Pan-Hammarström Q, Zhang Y, Rosen LB, Holland SM, Bosticardo M, Kenney H, Castagnoli R, Slade CA, Boztuğ K, Mahlaoui N, Latour S, Abraham RS, Lougaris V, Hauck F, Sediva A, Atschekzei F, Sogkas G, Poli MC, Slatter MA, Palterer B, Keller MD, Pinzon-Charry A, Sullivan A, Droney L, Suan D, Wong M, Kane A, Hu H, Ma C, Grombiříková H, Ciznar P, Dalal I, Aladjidi N, Hie M, Lazaro E, Franco J, Keles S, Malphettes M, Pasquet M, Maccari ME, Meinhardt A, Ikinciogullari A, Shahrooei M, Celmeli F, Frosk P, Goodnow CC, Gray PE, Belot A, Kuehn HS, Rosenzweig SD, Miyara M, Licciardi F, Servettaz A, Barlogis V, Le Guenno G, Herrmann VM, Kuijpers T, Ducoux G, Sarrot-Reynauld F, Schuetz C, Cunningham-Rundles C, Rieux-Laucat F, Tangye SG, Sobacchi C, Doffinger R, Warnatz K, Grimbacher B, Fieschi C, Berteloot L, Bryant VL, Trouillet Assant S, Su H, Neven B, Abel L, Zhang Q, Boisson B, Cobat A, Jouanguy E, Kampe O, Bastard P, Roifman CM, Landegren N, Notarangelo LD, Anderson MS, Casanova JL, Puel A. Autoantibodies against type I IFNs in humans with alternative NF-κB pathway deficiency. Nature 2023; 623:803-813. [PMID: 37938781 PMCID: PMC10665196 DOI: 10.1038/s41586-023-06717-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/04/2023] [Indexed: 11/09/2023]
Abstract
Patients with autoimmune polyendocrinopathy syndrome type 1 (APS-1) caused by autosomal recessive AIRE deficiency produce autoantibodies that neutralize type I interferons (IFNs)1,2, conferring a predisposition to life-threatening COVID-19 pneumonia3. Here we report that patients with autosomal recessive NIK or RELB deficiency, or a specific type of autosomal-dominant NF-κB2 deficiency, also have neutralizing autoantibodies against type I IFNs and are at higher risk of getting life-threatening COVID-19 pneumonia. In patients with autosomal-dominant NF-κB2 deficiency, these autoantibodies are found only in individuals who are heterozygous for variants associated with both transcription (p52 activity) loss of function (LOF) due to impaired p100 processing to generate p52, and regulatory (IκBδ activity) gain of function (GOF) due to the accumulation of unprocessed p100, therefore increasing the inhibitory activity of IκBδ (hereafter, p52LOF/IκBδGOF). By contrast, neutralizing autoantibodies against type I IFNs are not found in individuals who are heterozygous for NFKB2 variants causing haploinsufficiency of p100 and p52 (hereafter, p52LOF/IκBδLOF) or gain-of-function of p52 (hereafter, p52GOF/IκBδLOF). In contrast to patients with APS-1, patients with disorders of NIK, RELB or NF-κB2 have very few tissue-specific autoantibodies. However, their thymuses have an abnormal structure, with few AIRE-expressing medullary thymic epithelial cells. Human inborn errors of the alternative NF-κB pathway impair the development of AIRE-expressing medullary thymic epithelial cells, thereby underlying the production of autoantibodies against type I IFNs and predisposition to viral diseases.
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Affiliation(s)
- Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.
- Paris Cité University, Imagine Institute, Paris, France.
| | - Audrey V Parent
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Xian Liu
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Axel Cederholm
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Adrian Gervais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- Study Center for Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
| | - Tina Nguyen
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Darlinghurst, New South Wales, Australia
| | - Malena Perez Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Elze Rackaityte
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Darawan Rinchai
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Peng Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Lucy Bizien
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Gonca Hancioglu
- Division of Pediatric Allergy and Immunology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | | | - Jean-Luc Charuel
- Department of Immunology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Mame Sokhna Gueye
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | | | - Masato Ogishi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Camille Soudée
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Mélanie Migaud
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Flore Rozenberg
- Virology, Cochin-Saint-Vincent de Paul Hospital, University of Paris, Paris, France
| | - Mana Momenilandi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Quentin Riller
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Paris Cité University, Imagine Institute, INSERM UMR1163, Paris, France
| | - Luisa Imberti
- Section of Microbiology, University of Brescia, Brescia, Italy
| | - Ottavia M Delmonte
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Gabriele Müller
- Institute for Immunodeficiency, Center for Chronic Immunodeficiencies, Medical Center-University Hospital Freiburg, and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Baerbel Keller
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Chronic Immunodeficiency (CCI), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julio Orrego
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - William Alexander Franco Gallego
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Tamar Rubin
- Division of Pediatric Clinical Immunology and Allergy, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melike Emiroglu
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Nima Parvaneh
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Daniel Eriksson
- Department of Clinical Genetics, Uppsala University Hospital, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Section of Clinical Genetics, Uppsala University and University Hospital, Uppsala, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
| | - Maribel Aranda-Guillen
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
| | - David I Berrios
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Linda Vong
- Division of Immunology and Allergy, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- The Canadian Centre for Primary Immunodeficiency and The Jeffrey Modell Research Laboratory for the Diagnosis of Primary Immunodeficiency, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Constance H Katelaris
- Immunology and Allergy, University of Western Sydney and Campbelltown Hospital, Campbelltown, New South Wales, Australia
| | - Peter Mustillo
- Division of Allergy and Immunology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Johannes Raedler
- Division of Pediatric Immunology and Rheumatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jonathan Bohlen
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
| | - Jale Bengi Celik
- Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Camila Astudillo
- Hospital de Niños Roberto del Río, Santiago, Chile
- Department of Pediatrics, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Sarah Winter
- Laboratory of Lymphocyte Activation and Susceptibility to EBV, Paris Cité University, Imagine Institute, Inserm UMR1163, Paris, France
| | - Catriona McLean
- Department of Anatomical Pathology, The Alfred Hospital, Prahran, Victoria, Australia
| | - Aurélien Guffroy
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg University Hospital, Strasbourg, France
| | - Joseph L DeRisi
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - David Yu
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Corey Miller
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
| | - Yi Feng
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | | | - Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- Study Center for Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Qiang Pan-Hammarström
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
- Division of Immunology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Yu Zhang
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- NIAID Clinical Genomics Program, NIH, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA
| | - Lindsey B Rosen
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Steve M Holland
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Marita Bosticardo
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Heather Kenney
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Riccardo Castagnoli
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Charlotte A Slade
- Immunology Division, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
- Dept Medical Biology, University of Melbourne, Victoria, Parkville, Australia
- Dept Clinical Immunology and Allergy, The Royal Melbourne Hospital, Parkville, Australia
| | - Kaan Boztuğ
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Anna Children's Cancer Research Institute, Vienna, Austria
- Anna Children's Hospital, Vienna, Austria
| | - Nizar Mahlaoui
- French National Reference Center for Primary Immunodeficiencies (CEREDIH), Necker-Enfants University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Sylvain Latour
- Laboratory of Lymphocyte Activation and Susceptibility to EBV, Paris Cité University, Imagine Institute, Inserm UMR1163, Paris, France
| | - Roshini S Abraham
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vassilios Lougaris
- Department of Clinical and Experimental Sciences, Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, University of Brescia ASST-Spedali Civili di Brescia, Brescia, Italy
| | - Fabian Hauck
- Division of Pediatric Immunology and Rheumatology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Anna Sediva
- Department of Immunology, Second Faculty of Medicine Charles University and Motol University Hospital, Prague, Czech Republic
| | - Faranaz Atschekzei
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Georgios Sogkas
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - M Cecilia Poli
- Hospital de Niños Roberto del Río, Santiago, Chile
- Department of Pediatrics, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Mary A Slatter
- Children's Haemopoietic Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle-upon-Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Boaz Palterer
- Allergy and Clinical Immunology, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michael D Keller
- Division of Allergy and Immunology, Children's National Medical Center, Washington, DC, USA
| | - Alberto Pinzon-Charry
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Immunology and Allergy, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Anna Sullivan
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Immunology and Allergy, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Luke Droney
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Immunology and Allergy, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Daniel Suan
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Wong
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Alisa Kane
- School of Clinical Medicine, UNSW Medicine & Health, Darlinghurst, New South Wales, Australia
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- South Western Sydney Clinical School, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Immunology, Allergy and HIV, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Hannah Hu
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- South Western Sydney Clinical School, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Immunology, Allergy and HIV, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Cindy Ma
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Darlinghurst, New South Wales, Australia
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
| | - Hana Grombiříková
- Centre for Cardiovascular Surgery and Transplantation, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Peter Ciznar
- Department of Paediatrics, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia
| | - Ilan Dalal
- Pediatric Department, E. Wolfson Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Nathalie Aladjidi
- Pediatric Oncology Hematology Unit, University Hospital, Plurithématique CIC (CICP), Centre d'Investigation Clinique (CIC) 1401, Bordeaux, France
| | - Miguel Hie
- Internal Medicine Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Estibaliz Lazaro
- Department of Internal Medicine & Infectious Diseases, Bordeaux Hospital University, Bordeaux, France
| | - Jose Franco
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Sevgi Keles
- Division of Pediatric Allergy and Immunology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | | | - Marlene Pasquet
- Department of Pediatric Hematology, Toulouse University Hospital, Toulouse, France
| | - Maria Elena Maccari
- Institute for Immunodeficiency, Center for Chronic Immunodeficiencies, Medical Center-University Hospital Freiburg, and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andrea Meinhardt
- Department of Pediatric Hematology, Oncology and Immunodeficiencies, University Children's Hospital Gießen, Giessen, Germany
| | - Aydan Ikinciogullari
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Mohammad Shahrooei
- Dr. Shahrooei Lab, Tehran, Iran
- Clinical and Diagnostic Immunology, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Fatih Celmeli
- Department of Allergy and Immunology, University of Medical Science, Antalya Education and Research Hospital, Antalya, Turkey
| | - Patrick Frosk
- Department of Biochemistry and Medical Genetics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christopher C Goodnow
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Darlinghurst, New South Wales, Australia
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
| | - Paul E Gray
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
- Immunology and Infectious Diseases, Sydney Children's Hospital Randwick, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Alexandre Belot
- CNRS UMR 5308, ENS, UCBL, Lyon, France
- National Reference Center for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE), Lyon, France
- Immunopathology Federation LIFE, Hospices Civils de Lyon, Lyon, France
| | - Hye Sun Kuehn
- Immunology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Sergio D Rosenzweig
- Immunology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Makoto Miyara
- Department of Immunology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Centre d'Immunologie et des Maladies Infectieuses (CIMI), Sorbonne Université, INSERM U1135, Paris, France
| | - Francesco Licciardi
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy
| | - Amélie Servettaz
- Internal Medicine, Clinical Immunology and Infectious Diseases Department, University Hospital Center, Reims, France
- IRMAIC EA 7509, URCA, Reims, France
| | - Vincent Barlogis
- CHU Marseille, Hôpital La Timone, Service d'Hémato-oncologie Pédiatrique, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | | | - Vera-Maria Herrmann
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
| | - Taco Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Grégoire Ducoux
- Department of Internal Medicine, Edouard Herriot Hospital, Lyon, France
| | | | - Catharina Schuetz
- Department of Pediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Frédéric Rieux-Laucat
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Paris Cité University, Imagine Institute, INSERM UMR1163, Paris, France
| | - Stuart G Tangye
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Darlinghurst, New South Wales, Australia
- Clinical Immunogenomics Research Consortium Australasia (CIRCA), Darlinghurst, New South Wales, Australia
| | - Cristina Sobacchi
- IRCCS Humanitas Research Hospital, Rozzano, Italy
- CNR-IRGB, Milan Unit, Milan, Italy
| | - Rainer Doffinger
- Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge, UK
| | - Klaus Warnatz
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Chronic Immunodeficiency (CCI), Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bodo Grimbacher
- Institute for Immunodeficiency, Center for Chronic Immunodeficiencies, Medical Center-University Hospital Freiburg, and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claire Fieschi
- Clinical Immunology Department, Saint Louis Hospital, Paris, France
- Paris Cité University, Paris, France
| | - Laureline Berteloot
- Pediatric Radiology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker Hospital for Sick Children, Paris, France
| | - Vanessa L Bryant
- Immunology Division, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
- Dept Medical Biology, University of Melbourne, Victoria, Parkville, Australia
- Dept Clinical Immunology and Allergy, The Royal Melbourne Hospital, Parkville, Australia
| | - Sophie Trouillet Assant
- Joint Unit Hospices Civils de Lyon-BioMérieux, Lyon, France
- CIRI (Centre International de Recherche en Infectiologie), Université de Lyon, Université Claude Bernard Lyon 1, INSERM U1111, CNRS, UMR5308, ENS Lyon, Université Jean Monnet de Saint-Etienne, Lyon, France
| | - Helen Su
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- NIAID Clinical Genomics Program, NIH, Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA
| | - Benedicte Neven
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Qian Zhang
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Bertrand Boisson
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Aurélie Cobat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Olle Kampe
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France
- Paris Cité University, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Chaim M Roifman
- Division of Immunology and Allergy, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- The Canadian Centre for Primary Immunodeficiency and The Jeffrey Modell Research Laboratory for the Diagnosis of Primary Immunodeficiency, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nils Landegren
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mark S Anderson
- Diabetes Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.
- Paris Cité University, Imagine Institute, Paris, France.
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
- Howard Hughes Medical Institute, New York, NY, USA.
- Department of Pediatrics, Necker Hospital for Sick Children, Paris, France.
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163, Paris, France.
- Paris Cité University, Imagine Institute, Paris, France.
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
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4
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Licciardi F, Covizzi C, Dellepiane M, Olivini N, Mastrolia MV, Lo Vecchio A, Monno V, Tardi M, Mauro A, Alessio M, Filocamo G, Cattalini M, Taddio A, Caorsi R, Marseglia GL, La Torre F, Campana A, Simonini G, Ravelli A, Montin D. Outcomes of MIS-C patients treated with anakinra: a retrospective multicenter national study. Front Pediatr 2023; 11:1137051. [PMID: 37675397 PMCID: PMC10478576 DOI: 10.3389/fped.2023.1137051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/27/2023] [Indexed: 09/08/2023] Open
Abstract
Background The treatment of multisystem inflammatory syndrome in children unresponsive to first-line therapies (IVIG and/or steroids) is challenging. The effectiveness of IL-1 receptor antagonist, anakinra, is debated. Patients and methods We conducted an anonymous retrospective multicenter study on MIS-C patients treated with anakinra in Italy from January 2020 to February 2021. Our study outcomes included the percentage of patients who required further therapeutic step-up, the percentage of patients who experienced fever resolution within 24 h and a reduction of CRP by half within 48 h, and the percentage of patients who developed Coronary Artery Anomalies (CAA) during follow-up. Results 35 cases of MIS-C were treated in 10 hospitals. Of these, 13 patients started anakinra while in the ICU, and 22 patients started anakinra in other wards. 25 patients (71.4%) were treated with corticosteroids at a starting dose 2-30 mg/Kg/day plus IVIG (2 g/Kg), 10 patients (28.6%) received only corticosteroids without IVIG. Anakinra was administered intravenously to all patients in Group A (mean dose 8 mg/Kg/day), and subcutaneously in Group B (mean dose 4 mg/Kg/day). Only two patients required further treatment step-up and no patients developed CAA after receiving anakinra. The most commonly observed side effect was an increase in ALT, occurring in 17.1% of patients. Conclusions In this retrospective cohort of severe MIS-C patients treated with anakinra we report favorable clinical outcomes with a low incidence of side effects. The simultaneous use of steroids ± IVIG in these patients hinders definitive conclusions regarding the need of IL-1 inhibition in MIS-C treatment.
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Affiliation(s)
- Francesco Licciardi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
| | - Carlotta Covizzi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
| | - Marta Dellepiane
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
| | - Nicole Olivini
- Pediatrics Unit, University Department of Pediatrics (DEAPG), Bambino Gesù Children’s Hospital—IRCCS, Rome, Italy
| | - Maria Vincenza Mastrolia
- Rheumatology Unit, Department of Paediatrics, Meyer Children’s Hospital, University of Florence, Florence, Italy
| | - Andrea Lo Vecchio
- Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Viviana Monno
- Pediatric Rheumatology Section, Department of Pediatrics, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | - Maria Tardi
- Rheumatology Unit, Department of Pediatrics, Santobono Pausilipon Children Hospital, Naples, Italy
| | - Angela Mauro
- COVID Unit, Emergency Department, Santobono-Pausilipon Children Hospital, Naples, Italy
| | - Maria Alessio
- Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni Filocamo
- Pediatric Rheumatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Marco Cattalini
- Spedali Civili, Unità di Immunologia e Reumatologia Pediatrica, Clinica Pediatrica dell’Università di Brescia, Brescia, Italy
| | - Andrea Taddio
- Institute for Maternal and Child Health “IRCCS Burlo Garofolo”, Trieste and University of Trieste, Trieste, Italy
| | - Roberta Caorsi
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic Foundation IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Francesco La Torre
- Pediatric Rheumatology Section, Department of Pediatrics, Giovanni XXIII Pediatric Hospital, Bari, Italy
| | - Andrea Campana
- Pediatrics Unit, University Department of Pediatrics (DEAPG), Bambino Gesù Children’s Hospital—IRCCS, Rome, Italy
| | - Gabriele Simonini
- Rheumatology Unit, Department of Paediatrics, Meyer Children’s Hospital, University of Florence, Florence, Italy
| | - Angelo Ravelli
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Davide Montin
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
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5
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Tovo PA, Galliano I, Parodi E, Calvi C, Gambarino S, Licciardi F, Dini M, Montanari P, Branca M, Ramenghi U, Bergallo M. Children with Chronic Immune Thrombocytopenia Exhibit High Expression of Human Endogenous Retroviruses TRIM28 and SETDB1. Genes (Basel) 2023; 14:1569. [PMID: 37628621 PMCID: PMC10454145 DOI: 10.3390/genes14081569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic immune thrombocytopenia (CITP) is an autoimmune disease whose underlying biologic mechanisms remain elusive. Human endogenous retroviruses (HERVs) derive from ancestral infections and constitute about 8% of our genome. A wealth of clinical and experimental studies highlights their pivotal pathogenetic role in autoimmune diseases. Epigenetic mechanisms, such as those modulated by TRIM28 and SETDB1, are involved in HERV activation and regulation of immune response. We assessed, through a polymerase chain reaction real-time Taqman amplification assay, the transcription levels of pol genes of HERV-H, HERV-K, and HERV-W; env genes of Syncytin (SYN)1, SYN2, and HERV-W; as well as TRIM28 and SETDB1 in whole blood from 34 children with CITP and age-matched healthy controls (HC). The transcriptional levels of all HERV sequences, with the exception of HERV-W-env, were significantly enhanced in children with CITP as compared to HC. Patients on eltrombopag treatment exhibited lower expression of SYN1, SYN2, and HERV-W-env as compared to untreated patients. The mRNA concentrations of TRIM28 and SETDB1 were significantly higher and were positively correlated with those of HERVs in CITP patients. The over-expressions of HERVs and TRIM28/SETDB1 and their positive correlations in patients with CITP are suggestive clues of their contribution to the pathogenesis of the disease and support innovative interventions to inhibit HERV and TRIM28/SETDB1 expressions in patients unresponsive to standard therapies.
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Affiliation(s)
- Pier-Angelo Tovo
- Department of Public Health and Pediatric Sciences, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (P.-A.T.); (U.R.)
| | - Ilaria Galliano
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
| | - Emilia Parodi
- Pediatric and Neonatology Unit, Ordine Mauriziano Hospital, Largo Filippo Turati 62, 10128 Turin, Italy;
| | - Cristina Calvi
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
| | - Stefano Gambarino
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
| | - Francesco Licciardi
- Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy;
| | - Maddalena Dini
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
| | - Paola Montanari
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
| | - Margherita Branca
- Postgraduate School of Pediatrics, University of Turin, Piazza Polonia 94, 10126 Turin, Italy;
| | - Ugo Ramenghi
- Department of Public Health and Pediatric Sciences, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (P.-A.T.); (U.R.)
- Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy;
- Postgraduate School of Pediatrics, University of Turin, Piazza Polonia 94, 10126 Turin, Italy;
| | - Massimiliano Bergallo
- Pediatric Laboratory, Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospitalno, Piazza Polonia 94, 10126 Turin, Italy; (I.G.); (C.C.); (S.G.); (M.D.); (P.M.)
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6
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Caorsi R, Insalaco A, Bovis F, Martini G, Cattalini M, Chinali M, Rimini A, Longo C, Federici S, Celani C, Filocamo G, Consolini R, Maggio MC, Fadanelli G, Licciardi F, Romano M, Teruzzi BL, Taddio A, Miniaci A, La Torre F, De Fanti A, Cavalli G, Bigucci B, Gallizzi R, Chinello M, Imazio M, Brucato A, Cimaz R, De Benedetti F, Gattorno M. Pediatric Recurrent Pericarditis: Appropriateness of the Standard of Care and Response to IL-1 Blockade. J Pediatr 2023; 256:18-26.e8. [PMID: 36470465 DOI: 10.1016/j.jpeds.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To analyze, in a cohort of pediatric patients with recurrent pericarditis undergoing anti-interleukin (IL)-1 treatment: the agent and dosing used as first-line treatment, the long-term efficacy of IL-1 blockers, the percentage of patients achieving a drug-free remission, and the presence of variables associated with drug-free remission. STUDY DESIGN Data were collected from patients' charts. The annualized relapse rate (ARR) was used for evaluation of treatment efficacy, and bivariate logistic regression analysis was used for variables associated with drug-free remission. RESULTS Fifty-eight patients, treated between 2008 and 2018, were included in the study (mean follow-up. 2.6 years). Of the 56 patients treated with first-line drugs, 14 not responsive patients were underdosed. Fifty-seven patients were treated with anakinra: the ARR before and during daily treatment was 3.05 and 0.28, respectively (P < .0001); an increase to 0.83 was observed after the reduction/withdrawal of treatment (P < .0001). The switch from anakinra to canakinumab (5 patients) was associated to an increase of the ARR (0.49 vs 1.46), but without statistical significance (P = .215). At last follow-up, only 9 of the 58 patients had withdrawn all treatments. With the limits of a retrospective study and the heterogeneity between the patients enrolled in the study, a shorter duration of treatment with anakinra was the only variable associated with drug-free remission. CONCLUSIONS This study shows that most pediatric patients with recurrent pericarditis needing IL-1 blockade received an inadequate treatment with first-line agents. The effectiveness of anakinra is supported by this study, but few patients achieved drug-free remission. The different rate of response to anakinra and canakinumab may suggest a possible role of IL-1α in the pathogenesis of recurrent pericarditis.
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Affiliation(s)
- Roberta Caorsi
- Center of Autoinflammatory Diseases and Immunodeficiencies, Department of Pediatrics and Rheumatology, IRCCS Istituto G. Gaslini, Genova, Italy.
| | - Antonella Insalaco
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Francesca Bovis
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - Giorgia Martini
- Pediatric Rheumatology Unit, University of Padua, Padova, Italy
| | - Marco Cattalini
- Pediatrics Clinic, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marcello Chinali
- Pediatric Cardiology e Cardio-Surgery, IRRCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | | | - Chiara Longo
- Department of Pediatrics, University of Genoa, Genova, Italy
| | - Silvia Federici
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Camilla Celani
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Giovanni Filocamo
- Division of Pediatric Immunology and Rheumatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Rita Consolini
- Department of Pediatrics, Università di Pisa, Pisa, Italy
| | | | | | - Francesco Licciardi
- Immuno-Rheumatology Unit, Ospedale Infantile Regina Margherita, Torino, Italy
| | | | - Barbara Lia Teruzzi
- Department of Pediatric Rheumatology, ASST GOM Niguarda Milano, Milan, Italy
| | - Andrea Taddio
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo" and Univeristy of Trieste, Trieste, Italy
| | - Angela Miniaci
- Pediatric Unit, Program of Pediatric Rheumatology, Immunology and Pneumo-Allergology, Policlinico S. Orsola-Malpighi Bologna, Bologna, Italy
| | - Francesco La Torre
- Department of Pediatrics, Pediatric Rheumatology Section, "Giovanni XXIII" Pediatric Hospital, Bari, Italy
| | | | - Giulio Cavalli
- Clinical Immunology and Rheumatology Unit, Ospedale San Raffaele, Milano, Italy
| | | | - Romina Gallizzi
- Pediatric Unit, Department of Medical of Health Sciencies Magna Grecia, University of Catanzaro, Catanzaro, Italy
| | - Matteo Chinello
- Pediatric Onco-Ematology Unit, Azienda Ospedaliera Universitaria Integrata di Verona Ospedale Donna Bambino, Verona, Italy
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Antonio Brucato
- L. Sacco Department of Clinical and Biomedical Science, Università degli studi di Milano, Milan, Italy
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health and RECAP-RD, University of Milan, Italy
| | | | - Marco Gattorno
- Center of Autoinflammatory Diseases and Immunodeficiencies, Department of Pediatrics and Rheumatology, IRCCS Istituto G. Gaslini, Genova, Italy
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7
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Redmond CJ, Kitakule MM, Son A, Sylvester M, Sacco K, Delmonte O, Licciardi F, Castagnoli R, Poli MC, Espinoza Y, Astudillo C, Weber SE, Montealegre Sanchez GA, Barron KS, Magliocco M, Dobbs K, Zhang Y, Matthews H, Oguz C, Su HC, Notarangelo LD, Frischmeyer-Guerrerio P, Schwartz DM. Deep immune profiling uncovers novel associations with clinical phenotypes of multisystem inflammatory syndrome in children (MIS-C). Ann Rheum Dis 2023; 82:442-445. [PMID: 36424123 PMCID: PMC10013176 DOI: 10.1136/ard-2022-223269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Christopher John Redmond
- Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland, USA
| | - Moses M Kitakule
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Aran Son
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - McKella Sylvester
- Vasculitis Translational Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland, USA
| | - Keith Sacco
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
- Department of Allergy and Immunology, University of Arizona, Phoenix, Arizona, USA
| | - Ottavia Delmonte
- Immune Deficiency and Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Francesco Licciardi
- Dipartimento di Scienze della Sanità Pubblica e Pediatrica, Università degli Studi di Torino, Torino, Italy
| | - Riccardo Castagnoli
- Immune Deficiency and Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - M Cecilia Poli
- Department of Pediatrics, Facultad de Medicina Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | | | - Sarah E Weber
- Molecular Development of the Immune System Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Gina A Montealegre Sanchez
- Translational Autoinflammatory Diseases Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Karyl S Barron
- Office of the Scientific Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Mary Magliocco
- Molecular Development of the Immune System Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kerry Dobbs
- Immune Deficiency and Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Yu Zhang
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Helen Matthews
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Cihan Oguz
- Research Technologies Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Helen C Su
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Luigi D Notarangelo
- Immune Deficiency and Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Daniella M Schwartz
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA
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8
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Redmond C, Kitakule MM, Son A, Sylvester M, Sacco K, Delmonte O, Licciardi F, Castagnoli R, Poli C, Espinoza Y, Astudillo C, Weber SE, Sanchez GAM, Barron K, Magliocco M, Dobbs K, Zhang Y, Matthews H, Oguz C, Su HC, Notarangelo LD, Frischmeyer-Guerrerio PA, Schwartz DM. Deep immune profiling uncovers novel associations with clinical phenotypes of Multisystem Inflammatory Syndrome in Children (MIS-C). medRxiv 2022:2022.08.31.22279265. [PMID: 36093351 PMCID: PMC9460975 DOI: 10.1101/2022.08.31.22279265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) is a systemic inflammatory condition that follows SARS-CoV2 infection or exposure in children. Clinical presentations are highly variable and include fever, gastrointestinal (GI) disease, shock, and Kawasaki Disease-like illness (MIS-C/KD). Compared to patients with acute COVID, patients with MIS-C have a distinct immune signature and expansion of TRVB11 expressing T cells. However, the relationship between immunological and clinical phenotypes of MIS-C is unknown. Here, we measured serum biomarkers, TCR repertoire, and SARS-CoV2-specific T cell responses in a cohort of 76 MIS-C patients. Serum biomarkers associated with macrophage and Th1 activation were elevated in patients with shock, consistent with previous reports. Significantly increased SARS-CoV-2-induced IFN-γ, IL-2, and TNF-α production were seen in CD4 + T cells from patients with neurologic involvement and respiratory failure. Diarrhea was associated with a significant reduction in shock-associated serum biomarkers, suggesting a protective effect. TRVB11 usage was highly associated with MIS-C/KD and coronary aneurysms, suggesting a potential biomarker for these manifestations in MIS-C patients. By identifying novel immunologic associations with the different clinical phenotypes of MIS-C, this study provides insights into the clinical heterogeneity of MIS-C. These unique immunophenotypic associations could provide biomarkers to identify patients at risk for severe complications of MIS-C, including shock and MIS-C/KD.
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Affiliation(s)
- Christopher Redmond
- Vasculitis Translational Research Section, National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health
| | | | - Aran Son
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - McKella Sylvester
- Vasculitis Translational Research Section, National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health
| | - Keith Sacco
- Phoenix Children’s Hospital
- University of Arizona
| | - Ottavia Delmonte
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Francesco Licciardi
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Riccardo Castagnoli
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Cecilia Poli
- Faculty of Medicine, Clinica Alemana Universidad del Desarrollo
- Division of Immunology and Rheumatology, Hospital Roberto del Rio
| | - Yasmin Espinoza
- Division of Immunology and Rheumatology, Hospital Roberto del Rio
| | - Camila Astudillo
- Division of Immunology and Rheumatology, Hospital Roberto del Rio
| | - Sarah E. Weber
- Molecular Development of the Immune System Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Gina A. Montealegre Sanchez
- Division of Clinical Medicine, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Karyl Barron
- Office of the Scientific Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Mary Magliocco
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Kerry Dobbs
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Yu Zhang
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Helen Matthews
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Cihan Oguz
- Research Technologies Branch, Collaborative Bioinformatics Resource, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Helen C. Su
- Human Immunological Diseases Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | - Luigi D. Notarangelo
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health
| | | | - Daniella M. Schwartz
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health
- University of Pittsburgh, Division of Rheumatology and Clinical Immunology
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9
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Carmona-Rivera C, Zhang Y, Dobbs K, Markowitz TE, Dalgard CL, Oler AJ, Claybaugh DR, Draper D, Truong M, Delmonte OM, Licciardi F, Ramenghi U, Crescenzio N, Imberti L, Sottini A, Quaresima V, Fiorini C, Discepolo V, Lo Vecchio A, Guarino A, Pierri L, Catzola A, Biondi A, Bonfanti P, Poli Harlowe MC, Espinosa Y, Astudillo C, Rey-Jurado E, Vial C, de la Cruz J, Gonzalez R, Pinera C, Mays JW, Ng A, Platt A, Drolet B, Moon J, Cowen EW, Kenney H, Weber SE, Castagnoli R, Magliocco M, Stack MA, Montealegre G, Barron K, Fink DL, Kuhns DB, Hewitt SM, Arkin LM, Chertow DS, Su HC, Notarangelo LD, Kaplan MJ. Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19. JCI Insight 2022; 7:160332. [PMID: 35852866 PMCID: PMC9534551 DOI: 10.1172/jci.insight.160332] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/14/2022] [Indexed: 12/02/2022] Open
Abstract
Dysregulation in neutrophil extracellular trap (NET) formation and degradation may play a role in the pathogenesis and severity of COVID-19; however, its role in the pediatric manifestations of this disease, including multisystem inflammatory syndrome in children (MIS-C) and chilblain-like lesions (CLLs), otherwise known as “COVID toes,” remains unclear. Studying multinational cohorts, we found that, in CLLs, NETs were significantly increased in serum and skin. There was geographic variability in the prevalence of increased NETs in MIS-C, in association with disease severity. MIS-C and CLL serum samples displayed decreased NET degradation ability, in association with C1q and G-actin or anti-NET antibodies, respectively, but not with genetic variants of DNases. In adult COVID-19, persistent elevations in NETs after disease diagnosis were detected but did not occur in asymptomatic infection. COVID-19–affected adults displayed significant prevalence of impaired NET degradation, in association with anti-DNase1L3, G-actin, and specific disease manifestations, but not with genetic variants of DNases. NETs were detected in many organs of adult patients who died from COVID-19 complications. Infection with the Omicron variant was associated with decreased NET levels when compared with other SARS-CoV-2 strains. These data support a role for NETs in the pathogenesis and severity of COVID-19 in pediatric and adult patients.
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Affiliation(s)
- Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
| | - Yu Zhang
- Human Immunological Diseases Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID); and
| | | | | | - Clifton L. Dalgard
- Department of Anatomy, Physiology & Genetics, School of Medicine, and the American Genome Center, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland, USA
| | - Andrew J. Oler
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, NIAID, NIH, Bethesda, Maryland, USA
| | - Dillon R. Claybaugh
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
| | | | | | | | | | - Ugo Ramenghi
- Department of Public Health and Pediatric Sciences and
| | - Nicoletta Crescenzio
- Pediatric Hematology, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
| | - Luisa Imberti
- Centro di Ricerca Emato-oncologica AIL, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Sottini
- Centro di Ricerca Emato-oncologica AIL, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Virginia Quaresima
- Centro di Ricerca Emato-oncologica AIL, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Fiorini
- Centro di Ricerca Emato-oncologica AIL, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Valentina Discepolo
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Luca Pierri
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Catzola
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Biondi
- Department of Pediatrics, University of Milano-Bicocca, European Reference Network (ERN) PaedCan, EuroBloodNet, MetabERN, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital–University of Milano-Bicocca, Monza, Italy
| | - Maria C. Poli Harlowe
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Hospital Roberto del Rio, Santiago, Chile
| | | | | | - Emma Rey-Jurado
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Vial
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Santiago, Chile
| | - Javiera de la Cruz
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ricardo Gonzalez
- Pediatric Intensive Care Unit, Hospital Exequiel Gonzalez Cortés, Santiago, Chile
| | - Cecilia Pinera
- Infectious Diseases Unit, Hospital Dr. Exequiel González Cortés, Región Metropolitana, Chile
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Jacqueline W. Mays
- National Institute of Dental and Craniofacial Research (NIDCR), NIH, Bethesda, Maryland, USA
| | - Ashley Ng
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Andrew Platt
- Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, and Laboratory of Immunoregulation, NIAID, NIH, Bethesda, Maryland, USA
| | | | | | - Beth Drolet
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - John Moon
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | | | | | | | - Mary Magliocco
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, NIAID; and
| | - Michael A. Stack
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, NIAID; and
| | - Gina Montealegre
- Division of Clinical Research, NIAID, NIH, Bethesda, Maryland, USA
| | - Karyl Barron
- Division of Clinical Research, NIAID, NIH, Bethesda, Maryland, USA
| | - Danielle L. Fink
- Applied/Developmental Research Directorate, Frederick and National Laboratory for Cancer Research, National Cancer Institute (NCI), NIH, Frederick, Maryland, USA
| | - Douglas B. Kuhns
- Applied/Developmental Research Directorate, Frederick and National Laboratory for Cancer Research, National Cancer Institute (NCI), NIH, Frederick, Maryland, USA
| | - Stephen M. Hewitt
- Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, Maryland, USA
| | - Lisa M. Arkin
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Daniel S. Chertow
- Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, and Laboratory of Immunoregulation, NIAID, NIH, Bethesda, Maryland, USA
| | - Helen C. Su
- Human Immunological Diseases Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID); and
| | | | - Mariana J. Kaplan
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
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10
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Sacco K, Castagnoli R, Vakkilainen S, Liu C, Delmonte OM, Oguz C, Kaplan IM, Alehashemi S, Burbelo PD, Bhuyan F, de Jesus AA, Dobbs K, Rosen LB, Cheng A, Shaw E, Vakkilainen MS, Pala F, Lack J, Zhang Y, Fink DL, Oikonomou V, Snow AL, Dalgard CL, Chen J, Sellers BA, Montealegre Sanchez GA, Barron K, Rey-Jurado E, Vial C, Poli MC, Licari A, Montagna D, Marseglia GL, Licciardi F, Ramenghi U, Discepolo V, Lo Vecchio A, Guarino A, Eisenstein EM, Imberti L, Sottini A, Biondi A, Mató S, Gerstbacher D, Truong M, Stack MA, Magliocco M, Bosticardo M, Kawai T, Danielson JJ, Hulett T, Askenazi M, Hu S, Cohen JI, Su HC, Kuhns DB, Lionakis MS, Snyder TM, Holland SM, Goldbach-Mansky R, Tsang JS, Notarangelo LD. Immunopathological signatures in multisystem inflammatory syndrome in children and pediatric COVID-19. Nat Med 2022; 28:1050-1062. [PMID: 35177862 PMCID: PMC9119950 DOI: 10.1038/s41591-022-01724-3] [Citation(s) in RCA: 121] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/31/2022] [Indexed: 12/22/2022]
Abstract
Pediatric Coronavirus Disease 2019 (pCOVID-19) is rarely severe; however, a minority of children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might develop multisystem inflammatory syndrome in children (MIS-C), with substantial morbidity. In this longitudinal multi-institutional study, we applied multi-omics (analysis of soluble biomarkers, proteomics, single-cell gene expression and immune repertoire analysis) to profile children with COVID-19 (n = 110) and MIS-C (n = 76), along with pediatric healthy controls (pHCs; n = 76). pCOVID-19 was characterized by robust type I interferon (IFN) responses, whereas prominent type II IFN-dependent and NF-κB-dependent signatures, matrisome activation and increased levels of circulating spike protein were detected in MIS-C, with no correlation with SARS-CoV-2 PCR status around the time of admission. Transient expansion of TRBV11-2 T cell clonotypes in MIS-C was associated with signatures of inflammation and T cell activation. The association of MIS-C with the combination of HLA A*02, B*35 and C*04 alleles suggests genetic susceptibility. MIS-C B cells showed higher mutation load than pCOVID-19 and pHC. These results identify distinct immunopathological signatures in pCOVID-19 and MIS-C that might help better define the pathophysiology of these disorders and guide therapy.
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Affiliation(s)
- Keith Sacco
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Riccardo Castagnoli
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Svetlana Vakkilainen
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Can Liu
- Multiscale Systems Biology Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Graduate Program in Biological Sciences, University of Maryland, College Park, MD, USA
| | - Ottavia M Delmonte
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cihan Oguz
- NIAID Collaborative Bioinformatics Resource (NCBR), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Advanced Biomedical Computational Science, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc, Frederick, MD, USA
| | | | - Sara Alehashemi
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter D Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Farzana Bhuyan
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adriana A de Jesus
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kerry Dobbs
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lindsey B Rosen
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Aristine Cheng
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Elana Shaw
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Francesca Pala
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Justin Lack
- Multiscale Systems Biology Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- NIAID Collaborative Bioinformatics Resource (NCBR), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Yu Zhang
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Danielle L Fink
- Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Vasileios Oikonomou
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Andrew L Snow
- Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Clifton L Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The American Genome Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jinguo Chen
- Trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation (CHI), National Institutes of Health, Bethesda, MD, USA
| | - Brian A Sellers
- Trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation (CHI), National Institutes of Health, Bethesda, MD, USA
| | - Gina A Montealegre Sanchez
- Intramural Clinical Management and Operation Branch (ICMOB), Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Karyl Barron
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emma Rey-Jurado
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Vial
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Maria Cecilia Poli
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Unidad de Inmunología y Reumatología, Hospital de niños Dr. Roberto del Río, Santiago, Chile
| | - Amelia Licari
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Daniela Montagna
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Laboratory of Immunology and Transplantation, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Francesco Licciardi
- Department of Pediatric and Public Health Sciences, Regina Margherita Children's Hospital, A.O.U. Città Della Salute E Della Scienza Di Torino, University of Turin, Turin, Italy
| | - Ugo Ramenghi
- Department of Pediatric and Public Health Sciences, Regina Margherita Children's Hospital, A.O.U. Città Della Salute E Della Scienza Di Torino, University of Turin, Turin, Italy
| | - Valentina Discepolo
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Napoli, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Napoli, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Napoli, Italy
| | - Eli M Eisenstein
- Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
| | - Luisa Imberti
- CREA Laboratory (AIL Center for Hemato-Oncologic Research), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Sottini
- CREA Laboratory (AIL Center for Hemato-Oncologic Research), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Biondi
- Pediatric Department and Centro Tettamanti-European Reference Network PaedCan, EuroBloodNet, MetabERN, University of Milano Bicocca, Fondazione MBBM, Ospedale San Gerardo, Monza, Italy
| | - Sayonara Mató
- Randall Children's Hospital at Legacy Emanuel, Portland, OR, USA
| | - Dana Gerstbacher
- Division of Pediatric Rheumatology, Stanford Children's Hospital, Stanford, CA, USA
| | - Meng Truong
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Michael A Stack
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mary Magliocco
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Marita Bosticardo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Tomoki Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey J Danielson
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Tyler Hulett
- CDI Laboratories, Antygen Division, Baltimore, MD, USA
| | | | - Shaohui Hu
- CDI Laboratories, Antygen Division, Baltimore, MD, USA
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Helen C Su
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Douglas B Kuhns
- Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Michail S Lionakis
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Raphaela Goldbach-Mansky
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John S Tsang
- Multiscale Systems Biology Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- NIH Center for Human Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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11
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Burbelo PD, Castagnoli R, Shimizu C, Delmonte OM, Dobbs K, Discepolo V, Lo Vecchio A, Guarino A, Licciardi F, Ramenghi U, Rey-Jurado E, Vial C, Marseglia GL, Licari A, Montagna D, Rossi C, Montealegre Sanchez GA, Barron K, Warner BM, Chiorini JA, Espinosa Y, Noguera L, Dropulic L, Truong M, Gerstbacher D, Mató S, Kanegaye J, Tremoulet AH, Eisenstein EM, Su HC, Imberti L, Poli MC, Burns JC, Notarangelo LD, Cohen JI. Autoantibodies Against Proteins Previously Associated With Autoimmunity in Adult and Pediatric Patients With COVID-19 and Children With MIS-C. Front Immunol 2022; 13:841126. [PMID: 35360001 PMCID: PMC8962198 DOI: 10.3389/fimmu.2022.841126] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 12/21/2021] [Accepted: 02/16/2022] [Indexed: 01/08/2023] Open
Abstract
The antibody profile against autoantigens previously associated with autoimmune diseases and other human proteins in patients with COVID-19 or multisystem inflammatory syndrome in children (MIS-C) remains poorly defined. Here we show that 30% of adults with COVID-19 had autoantibodies against the lung antigen KCNRG, and 34% had antibodies to the SLE-associated Smith-D3 protein. Children with COVID-19 rarely had autoantibodies; one of 59 children had GAD65 autoantibodies associated with acute onset of insulin-dependent diabetes. While autoantibodies associated with SLE/Sjögren's syndrome (Ro52, Ro60, and La) and/or autoimmune gastritis (gastric ATPase) were detected in 74% (40/54) of MIS-C patients, further analysis of these patients and of children with Kawasaki disease (KD), showed that the administration of intravenous immunoglobulin (IVIG) was largely responsible for detection of these autoantibodies in both groups of patients. Monitoring in vivo decay of the autoantibodies in MIS-C children showed that the IVIG-derived Ro52, Ro60, and La autoantibodies declined to undetectable levels by 45-60 days, but gastric ATPase autoantibodies declined more slowly requiring >100 days until undetectable. Further testing of IgG and/or IgA antibodies against a subset of potential targets identified by published autoantigen array studies of MIS-C failed to detect autoantibodies against most (16/18) of these proteins in patients with MIS-C who had not received IVIG. However, Troponin C2 and KLHL12 autoantibodies were detected in 2 of 20 and 1 of 20 patients with MIS-C, respectively. Overall, these results suggest that IVIG therapy may be a confounding factor in autoantibody measurements in MIS-C and that antibodies against antigens associated with autoimmune diseases or other human proteins are uncommon in MIS-C.
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Affiliation(s)
- Peter D Burbelo
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, United States
| | - Riccardo Castagnoli
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States.,Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Chisato Shimizu
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CA, United States
| | - Ottavia M Delmonte
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Kerry Dobbs
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Valentina Discepolo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Francesco Licciardi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatric Sciences, "Regina Margherita" Children's Hospital, University of Turin, Turin, Italy
| | - Ugo Ramenghi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatric Sciences, "Regina Margherita" Children's Hospital, University of Turin, Turin, Italy
| | - Emma Rey-Jurado
- Instituto de Ciencias e Innovación en Medicina (ICIM), Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Daniela Montagna
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Camillo Rossi
- Direzione Sanitaria, ASST Spedali Civili, Brescia, Italy
| | - Gina A Montealegre Sanchez
- Intramural Clinical Management and Operations Branch (ICMOB), Division of Clinical Research NIAID, NIH, Bethesda, MD, United States
| | - Karyl Barron
- Division of Intramural Research, National Institute of Allergy and Infectious Disease, NIH, Bethesda, MD, United States
| | - Blake M Warner
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, United States
| | - John A Chiorini
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, United States
| | | | - Loreani Noguera
- Instituto de Ciencias e Innovación en Medicina (ICIM), Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Lesia Dropulic
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Meng Truong
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Dana Gerstbacher
- Pediatric Rheumatology, Stanford Children's Hospital, Stanford, CA, United States
| | - Sayonara Mató
- Pediatric Infectious Diseases, Randall Children's Hospital at Legacy Emanuel, Portland, OR, United States
| | - John Kanegaye
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CA, United States
| | - Adriana H Tremoulet
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CA, United States
| | | | - Eli M Eisenstein
- Department of Pediatrics, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Helen C Su
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Luisa Imberti
- CREA Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Maria Cecilia Poli
- Instituto de Ciencias e Innovación en Medicina (ICIM), Clínica Alemana Universidad del Desarrollo, Santiago, Chile.,Hospital Roberto del Río, Santiago, Chile
| | - Jane C Burns
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CA, United States
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States
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12
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Carmona-Rivera C, Zhang Y, Dobbs K, Markowitz TE, Dalgard CL, Oler AJ, Claybaugh DR, Draper D, Truong M, Delmonte OM, Licciardi F, Ramenghi U, Crescenzio N, Imberti L, Sottini A, Quaresima V, Fiorini C, Discepolo V, Lo Vecchio A, Guarino A, Pierri L, Catzola A, Biondi A, Bonfanti P, Poli Harlowe MC, Espinosa Y, Astudillo C, Rey-Jurado E, Vial C, de la Cruz J, Gonzalez R, Pinera C, Mays JW, Ng A, Platt A, Drolet B, Moon J, Cowen EW, Kenney H, Weber SE, Castagnoli R, Magliocco M, Stack MA, Montealegre G, Barron K, Hewitt SM, Arkin LM, Chertow DS, Su HC, Notarangelo LD, Kaplan MJ. Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19. medRxiv 2022:2022.02.24.22271475. [PMID: 35262093 PMCID: PMC8902885 DOI: 10.1101/2022.02.24.22271475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dysregulation in neutrophil extracellular trap (NET) formation and degradation may play a role in the pathogenesis and severity of COVID-19; however, its role in the pediatric manifestations of this disease including MIS-C and chilblain-like lesions (CLL), otherwise known as "COVID toes", remains unclear. Studying multinational cohorts, we found that, in CLL, NETs were significantly increased in serum and skin. There was geographic variability in the prevalence of increased NETs in MIS-C, in association with disease severity. MIS-C and CLL serum samples displayed decreased NET degradation ability, in association with C1q and G-actin or anti-NET antibodies, respectively, but not with genetic variants of DNases. In adult COVID-19, persistent elevations in NETs post-disease diagnosis were detected but did not occur in asymptomatic infection. COVID-19-affected adults displayed significant prevalence of impaired NET degradation, in association with anti-DNase1L3, G-actin, and specific disease manifestations, but not with genetic variants of DNases. NETs were detected in many organs of adult patients who died from COVID-19 complications. Infection with the Omicron variant was associated with decreased levels of NETs when compared to other SARS-CoV-2 strains. These data support a role for NETs in the pathogenesis and severity of COVID-19 in pediatric and adult patients. Summary NET formation and degradation are dysregulated in pediatric and symptomatic adult patients with various complications of COVID-19, in association with disease severity. NET degradation impairments are multifactorial and associated with natural inhibitors of DNase 1, G-actin and anti-DNase1L3 and anti-NET antibodies. Infection with the Omicron variant is associated with decreased levels of NETs when compared to other SARS-CoV-2 strains.
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Affiliation(s)
- Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Yu Zhang
- Human Immunological Diseases Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | | | - Tovah E. Markowitz
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, NIAID, NIH, Bethesda, MD
- Axle Informatics, Bethesda, MD, USA
| | - Clifton L. Dalgard
- Department of Anatomy, Physiology & Genetics, School of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD and The American Genome Center, USUHS, Bethesda, MD, USA
| | - Andrew J. Oler
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, NIAID, NIH, Bethesda, MD
| | - Dillon R. Claybaugh
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
| | | | | | | | - Francesco Licciardi
- Department of Public Health and Pediatric Sciences, “Regina Margherita” Children’s Hospital, University of Turin, Turin, Italy
| | - Ugo Ramenghi
- Department of Public Health and Pediatric Sciences, “Regina Margherita” Children’s Hospital, University of Turin, Turin, Italy
| | - Nicoletta Crescenzio
- Pediatric Hematology, “Regina Margherita” Children Hospital, University of Turin, Turin, Italy
| | - Luisa Imberti
- Centro di Ricerca Emato-oncologica AIL (CREA), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Sottini
- Centro di Ricerca Emato-oncologica AIL (CREA), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Virginia Quaresima
- Centro di Ricerca Emato-oncologica AIL (CREA), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Fiorini
- Centro di Ricerca Emato-oncologica AIL (CREA), Diagnostic Department, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Valentina Discepolo
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Luca Pierri
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Catzola
- Department of Translational Medical Sciences, Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Andrea Biondi
- Department of Pediatrics, University of Milano-Bicocca, European Reference Network (ERN) PaedCan, EuroBloodNet, MetabERN, Fondazione MBBM/Ospedale San Gerardo, Monza, Italy
| | - Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital–University of Milano-Bicocca, Monza, Italy
| | - Maria Cecilia Poli Harlowe
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Hospital Roberto del Rio, Santiago, Chile
| | | | | | - Emma Rey-Jurado
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Vial
- Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina, Santiago, Chile
| | - Javiera de la Cruz
- Programa de Inmunogenética e Inmunología Traslacional, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ricardo Gonzalez
- Pediatric Intensive Care Unit, Hospital Exequiel Gonzalez Cortés, Santiago, Chile
| | - Cecilia Pinera
- Infectious Diseases Unit, Hospital Dr. Exequiel González Cortés, Región Metropolitana, Chile
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Jacqueline W. Mays
- National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD, USA
| | - Ashley Ng
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Andrew Platt
- Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, and Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD, USA
| | | | | | - Beth Drolet
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John Moon
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Edward W. Cowen
- Molecular Development of the Immune System Section, Laboratory of Immune System Biology, NIAID, NIH, Bethesda, MD
| | | | | | | | | | | | | | - Karyl Barron
- Division of Clinical Research, NIAID, NIH, Bethesda, MD
| | - Stephen M. Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Lisa M. Arkin
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Daniel S. Chertow
- Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, and Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD, USA
| | - Helen C. Su
- Human Immunological Diseases Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | | | - Mariana J. Kaplan
- Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, MD, USA
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13
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De Matteis A, Bracaglia C, Pires Marafon D, Piscitelli AL, Alessio M, Naddei R, Orlando F, Filocamo G, Minoia F, Ravelli A, Tibaldi J, Cimaz R, Marino A, Simonini G, Mastrolia MV, La Torre F, Tricarico I, Licciardi F, Montin D, Maggio MC, Alizzi C, Martini G, Civino A, Gallizzi R, Olivieri AN, Ardenti Morini F, Conti G, De Benedetti F, Pardeo M. CANAKINUMAB IN SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS: REAL-LIFE DATA FROM A RETROSPECTIVE ITALIAN COHORT. Rheumatology (Oxford) 2021; 61:1621-1629. [PMID: 34343275 DOI: 10.1093/rheumatology/keab619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/16/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate in real-life the effectiveness and safety of canakinumab in Italian patients with systemic juvenile idiopathic arthritis (sJIA). METHODS A retrospective multicentre study of children with sJIA was performed. Clinical features, laboratory parameters and adverse events were collected at baseline, after 6 and 12 months from starting canakinumab. The effectiveness primary outcome was clinical inactive disease (CID) off glucocorticoids (GCs) treatment at 6 months. RESULTS A total of 80 children were analyzed from 15 Italian centers. Of the 12 patients who started canakinumab in CID while receiving anakinra, all maintained CID. Of the 68 with active disease at baseline, 57.4% achieved CID off GCs at 6 months and 63.8% at 12 months. In univariate analysis, the variables significantly related with non-response were number of active joints (NAJ) ≥5, history of macrophage activation syndrome (MAS) and disease duration. Multivariate analysis confirmed the association with non-response of NAJ ≥5 (OR 6.37 (95%CI 1.69-24.02), p= 0.006) and history of MAS (OR 3.53 (95%CI 1.06-11.70), p= 0.039). No serious adverse events were recorded in this series. There were two cases of MAS during canakinumab, leading to a rate of 2.9 episodes per 100 patient year. CONCLUSION We confirm, in real-life, the efficacy of canakinumab in sJIA in a multicentric cohort. History of MAS and higher NAJ were associated with lower probability of achieving clinical inactive disease.
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Affiliation(s)
- Arianna De Matteis
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
| | - Claudia Bracaglia
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
| | - Denise Pires Marafon
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
| | - Anna Lucia Piscitelli
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
| | - Maria Alessio
- Department of Translational Medical Sciences, Pediatrics Section, University of Naples Federico II
| | - Roberta Naddei
- Department of Translational Medical Sciences, Pediatrics Section, University of Naples Federico II
| | - Francesca Orlando
- Unit of Pediatrics 2, Santobono-Pausilipon Children's Hospital, Napoli
| | - Giovanni Filocamo
- Pediatric Rheumatology, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano
| | - Francesca Minoia
- Pediatric Rheumatology, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milano
| | - Angelo Ravelli
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genova
| | - Jessica Tibaldi
- Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genova
| | | | | | - Gabriele Simonini
- Pediatric Rheumatology Unit, Meyer Children's University Hospital, Firenze
| | | | - Francesco La Torre
- Pediatric Rheumatology Center, Department of Pediatrics, Ospedale 'Giovanni XXIII', AOU Consorziale Policlinico, Bari
| | - Ilaria Tricarico
- Pediatric Rheumatology Center, Department of Pediatrics, Ospedale 'Giovanni XXIII', AOU Consorziale Policlinico, Bari
| | - Francesco Licciardi
- Department of Pediatrics and Infectious Diseases, School of Medicine, University of Turin, Regina Margherita Children's Hospital, Torino
| | - Davide Montin
- Department of Pediatrics and Infectious Diseases, School of Medicine, University of Turin, Regina Margherita Children's Hospital, Torino
| | | | - Clotilde Alizzi
- University Department Pro.Sa.M.I. 'G. D'Alessandro', University of Palermo, Palermo
| | - Giorgia Martini
- Department of Women's and Children's Health, University of Padua, Padova
| | - Adele Civino
- Department of Pediatrics, Division of Rheumatology and Immunology, Ospedale 'Vito Fazzi', Lecce
| | - Romina Gallizzi
- Unit of Pediatric Nephrology and Rheumatology, University of Messina, Messina
| | - Alma Nunzia Olivieri
- Department of General and Specialized Surgery for Women and Children, University 'Luigi Vanvitelli', Napoli
| | | | - Giovanni Conti
- Pediatric Nephrology and Rheumatology Unit, AOU Policlinico 'G. Martino', Messina, Italy
| | - Fabrizio De Benedetti
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
| | - Manuela Pardeo
- Division of Rheumatology, ERN RITA Center, IRCCS Ospedale Pediatrico Bambino Gesù, Roma
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14
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Tovo PA, Garazzino S, Daprà V, Pruccoli G, Calvi C, Mignone F, Alliaudi C, Denina M, Scolfaro C, Zoppo M, Licciardi F, Ramenghi U, Galliano I, Bergallo M. COVID-19 in Children: Expressions of Type I/II/III Interferons, TRIM28, SETDB1, and Endogenous Retroviruses in Mild and Severe Cases. Int J Mol Sci 2021; 22:7481. [PMID: 34299101 PMCID: PMC8303145 DOI: 10.3390/ijms22147481] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 05/28/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 02/07/2023] Open
Abstract
Children with the new coronavirus disease 2019 (COVID-19) have milder symptoms and a better prognosis than adult patients. Several investigations assessed type I, II, and III interferon (IFN) signatures in SARS-CoV-2 infected adults, however no data are available for pediatric patients. TRIM28 and SETDB1 regulate the transcription of multiple genes involved in the immune response as well as of human endogenous retroviruses (HERVs). Exogenous viral infections can trigger the activation of HERVs, which in turn can induce inflammatory and immune reactions. Despite the potential cross-talks between SARS-CoV-2 infection and TRIM28, SETDB1, and HERVs, information on their expressions in COVID-19 patients is lacking. We assessed, through a PCR real time Taqman amplification assay, the transcription levels of six IFN-I stimulated genes, IFN-II and three of its sensitive genes, three IFN-lIIs, as well as of TRIM28, SETDB1, pol genes of HERV-H, -K, and -W families, and of env genes of Syncytin (SYN)1, SYN2, and multiple sclerosis-associated retrovirus (MRSV) in peripheral blood from COVID-19 children and in control uninfected subjects. Higher expression levels of IFN-I and IFN-II inducible genes were observed in 36 COVID-19 children with mild or moderate disease as compared to uninfected controls, whereas their concentrations decreased in 17 children with severe disease and in 11 with multisystem inflammatory syndrome (MIS-C). Similar findings were found for the expression of TRIM-28, SETDB1, and every HERV gene. Positive correlations emerged between the transcriptional levels of type I and II IFNs, TRIM28, SETDB1, and HERVs in COVID-19 patients. IFN-III expressions were comparable in each group of subjects. This preserved induction of IFN-λs could contribute to the better control of the infection in children as compared to adults, in whom IFN-III deficiency has been reported. The upregulation of IFN-I, IFN-II, TRIM28, SETDB1, and HERVs in children with mild symptoms, their declines in severe cases or with MIS-C, and the positive correlations of their transcription in SARS-CoV-2-infected children suggest that they may play important roles in conditioning the evolution of the infection.
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Affiliation(s)
- Pier-Angelo Tovo
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
| | - Silvia Garazzino
- Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy; (S.G.); (F.M.); (C.S.); (M.Z.)
| | - Valentina Daprà
- Pediatric Laboratory, Department of Pediatric Sciences and Public Health, University of Turin, 10126 Turin, Italy;
| | - Giulia Pruccoli
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
| | - Cristina Calvi
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
- Pediatric Laboratory, Department of Pediatric Sciences and Public Health, University of Turin, 10126 Turin, Italy;
| | - Federica Mignone
- Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy; (S.G.); (F.M.); (C.S.); (M.Z.)
| | - Carla Alliaudi
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
- Pediatric Laboratory, Department of Pediatric Sciences and Public Health, University of Turin, 10126 Turin, Italy;
| | - Marco Denina
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
| | - Carlo Scolfaro
- Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy; (S.G.); (F.M.); (C.S.); (M.Z.)
| | - Marisa Zoppo
- Infectious Diseases Unit, Department of Pediatrics, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy; (S.G.); (F.M.); (C.S.); (M.Z.)
| | - Francesco Licciardi
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
| | - Ugo Ramenghi
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
| | - Ilaria Galliano
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
- Pediatric Laboratory, Department of Pediatric Sciences and Public Health, University of Turin, 10126 Turin, Italy;
| | - Massimiliano Bergallo
- Department of Pediatric Sciences and Public Health, University of Turin, Piazza Polonia 94, 10126 Turin, Italy; (G.P.); (C.C.); (C.A.); (M.D.); (F.L.); (U.R.); (I.G.)
- Pediatric Laboratory, Department of Pediatric Sciences and Public Health, University of Turin, 10126 Turin, Italy;
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15
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Baldini L, Di Sabatino F, Bodrero E, Dellepiane M, Covizzi C, La Selva R, Montin D, Licciardi F. NeMO mutations: a rare cause of monogenic Behçet-like disease. Rheumatology (Oxford) 2021; 60:e92-e94. [PMID: 32954429 DOI: 10.1093/rheumatology/keaa505] [Citation(s) in RCA: 1] [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: 11/14/2022] Open
Affiliation(s)
- Letizia Baldini
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Fabiana Di Sabatino
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Enrico Bodrero
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Marta Dellepiane
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Carlotta Covizzi
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Roberta La Selva
- Unit of Pediatric Plastic Surgery, Pediatric Dermatology, Città della Salute e della Scienza di Torino, Regina Margherita Children Hospital, Turin, Italy
| | - Davide Montin
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
| | - Francesco Licciardi
- Department of Pediatrics and Public Health, University of Turin, Turin, Italy
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16
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Magg T, Okano T, Koenig LM, Boehmer DFR, Schwartz SL, Inoue K, Heimall J, Licciardi F, Ley-Zaporozhan J, Ferdman RM, Caballero-Oteyza A, Park EN, Calderon BM, Dey D, Kanegane H, Cho K, Montin D, Reiter K, Griese M, Albert MH, Rohlfs M, Gray P, Walz C, Conn GL, Sullivan KE, Klein C, Morio T, Hauck F. Heterozygous OAS1 gain-of-function variants cause an autoinflammatory immunodeficiency. Sci Immunol 2021; 6:eabf9564. [PMID: 34145065 PMCID: PMC8392508 DOI: 10.1126/sciimmunol.abf9564] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/06/2021] [Indexed: 12/13/2022]
Abstract
Analysis of autoinflammatory and immunodeficiency disorders elucidates human immunity and fosters the development of targeted therapies. Oligoadenylate synthetase 1 is a type I interferon-induced, intracellular double-stranded RNA (dsRNA) sensor that generates 2'-5'-oligoadenylate to activate ribonuclease L (RNase L) as a means of antiviral defense. We identified four de novo heterozygous OAS1 gain-of-function variants in six patients with a polymorphic autoinflammatory immunodeficiency characterized by recurrent fever, dermatitis, inflammatory bowel disease, pulmonary alveolar proteinosis, and hypogammaglobulinemia. To establish causality, we applied genetic, molecular dynamics simulation, biochemical, and cellular functional analyses in heterologous, autologous, and inducible pluripotent stem cell-derived macrophages and/or monocytes and B cells. We found that upon interferon-induced expression, OAS1 variant proteins displayed dsRNA-independent activity, which resulted in RNase L-mediated RNA cleavage, transcriptomic alteration, translational arrest, and dysfunction and apoptosis of monocytes, macrophages, and B cells. RNase L inhibition with curcumin modulated and allogeneic hematopoietic cell transplantation cured the disorder. Together, these data suggest that human OAS1 is a regulator of interferon-induced hyperinflammatory monocyte, macrophage, and B cell pathophysiology.
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Affiliation(s)
- Thomas Magg
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tsubasa Okano
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Lars M Koenig
- Division of Clinical Pharmacology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Daniel F R Boehmer
- Division of Clinical Pharmacology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Samantha L Schwartz
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
- Graduate Program in Biochemistry, Cell and Developmental Biology, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
| | - Kento Inoue
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Jennifer Heimall
- Department of Allergy Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Francesco Licciardi
- Department of Pediatric and Public Health Sciences, University of Torino, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Julia Ley-Zaporozhan
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ronald M Ferdman
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Andrés Caballero-Oteyza
- Centre for Chronic Immunodeficiency (CCI) and Institute for Immunodeficiency (IFI), University Hospital Freiburg, Freiburg, Germany
| | - Esther N Park
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Brenda M Calderon
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
- Graduate Program in Biochemistry, Cell and Developmental Biology, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
| | - Debayan Dey
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Hirokazu Kanegane
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazutoshi Cho
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Hokkaido, Japan
| | - Davide Montin
- Department of Pediatric and Public Health Sciences, University of Torino, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Karl Reiter
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Matthias Griese
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Lung Research (DZL), Munich, Germany
| | - Michael H Albert
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Meino Rohlfs
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Paul Gray
- Department of Immunology and Infectious Disease, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Graeme L Conn
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
- Graduate Program in Biochemistry, Cell and Developmental Biology, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, USA
| | - Kathleen E Sullivan
- Department of Allergy Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Munich Centre for Rare Diseases (M-ZSE), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Centre for Infection Research (DZIF), Munich, Germany
- Munich Centre for Rare Diseases (M-ZSE), University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
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17
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Licciardi F, Baldini L, Denina M, Ricotti E, Covizzi C, Dellepiane M, Mignone F, Zoppo M, Felici E, Montin D. Peculiar immunophenotypic signature in MIS-C-affected children. Pediatr Allergy Immunol 2021; 32:801-804. [PMID: 33332663 DOI: 10.1111/pai.13434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Francesco Licciardi
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
| | - Letizia Baldini
- Department of Public Health and Pediatrics, Postgraduate School of Pediatrics, University of Turin, Turin, Italy
| | - Marco Denina
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
| | - Emanuela Ricotti
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carlotta Covizzi
- Department of Public Health and Pediatrics, Postgraduate School of Pediatrics, University of Turin, Turin, Italy
| | - Marta Dellepiane
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
| | - Federica Mignone
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
| | - Marisa Zoppo
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Davide Montin
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy
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18
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Silvestro E, Marino R, Cusenza F, Pruccoli G, Denina M, De Intinis G, Licciardi F, Garazzino S, Scolfaro C. Antimicrobial stewardship experience in paediatrics: first-year activity report. Eur J Clin Microbiol Infect Dis 2021; 40:1727-1735. [PMID: 33745086 DOI: 10.1007/s10096-021-04222-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/08/2021] [Indexed: 11/24/2022]
Abstract
Antimicrobial resistance is one of the most relevant threats in public health worldwide. Strategies as antimicrobial stewardship programs, aiming to preserve our antibiotic armamentarium, have been implemented since 2007 in adult and paediatric patients. We aim to describe the first experience of a paediatric antimicrobial stewardship program. We conducted a retrospective observational study in a tertiary care children's hospital. A team composed of a microbiologist, an infectious diseases physician, and a paediatrician led the project. All positive blood and cerebrospinal fluid cultures and other biological samples yielding multi-drug-resistant bacteria were collected and reviewed through a prospective-audit-with-feedback strategy. We recorded patient characteristics and worth monitoring prescribed antibiotics. The antimicrobial stewardship audit could end in intervention (step-up/step-down and broadening/narrowing) or recommendation(s). We then checked out wards staff compliance. The team performed 192 interventions out of 584 reviews, mostly suggesting discontinuation of antibiotics (in 76.0% of cases and 39.7% of running molecules). The antibiotic spectrum was more likely tapered than expanded (p < 0.0001), and we ordered more narrow-spectrum antibiotic molecules than local medical staff straightaway did (p = 0.0113). Interventions were most likely needed in case of documented infections (p < 0.0001) and in surgical patients (p = 0.0002). In 85.9% of interventions, ward teams fully agreed with our argument. This study demonstrated an antimicrobial stewardship program to be a suitable method for improving the appropriateness of antimicrobial use in hospitalized children.
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Affiliation(s)
- Erika Silvestro
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy.
| | - Raffaella Marino
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Francesca Cusenza
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Giulia Pruccoli
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Marco Denina
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Gianfranco De Intinis
- Microbiology and Virology Unit, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Francesco Licciardi
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Silvia Garazzino
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
| | - Carlo Scolfaro
- Department of Paediatrics, Infectious Diseases Unit, Regina Margherita Children's Hospital, University of Turin, Piazza Polonia, 94, 10126, Turin, TO, Italy
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19
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Carpino A, Buganza R, Matarazzo P, Tuli G, Pinon M, Calvo PL, Montin D, Licciardi F, De Sanctis L. Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy in Two Siblings: Same Mutations but Very Different Phenotypes. Genes (Basel) 2021; 12:genes12020169. [PMID: 33530632 PMCID: PMC7912139 DOI: 10.3390/genes12020169] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 01/31/2023] Open
Abstract
Autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED), caused by mutations in the AIRE gene, is mainly characterized by the triad of hypoparathyroidism, primary adrenocortical insufficiency and chronic mucocutaneous candidiasis, but can include many other manifestations, with no currently clear genotype–phenotype correlation. We present the clinical features of two siblings, a male and a female, with the same mutations in the AIRE gene associated with two very different phenotypes. Interestingly, the brother recently experienced COVID-19 infection with pneumonia, complicated by hypertension, hypokalemia and hypercalcemia. Although APECED is a monogenic disease, its expressiveness can be extremely different. In addition to the genetic basis, epigenetic and environmental factors might influence the phenotypic expression, although their exact role remains to be elucidated.
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Affiliation(s)
- Andrea Carpino
- Postgraduate School of Pediatrics, University of Turin, 10126 Turin, Italy
- Correspondence:
| | - Raffaele Buganza
- Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (R.B.); (G.T.); (P.M.); (L.D.S.)
| | - Patrizia Matarazzo
- Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (R.B.); (G.T.); (P.M.); (L.D.S.)
| | - Gerdi Tuli
- Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (R.B.); (G.T.); (P.M.); (L.D.S.)
| | - Michele Pinon
- Pediatric Gastroenterology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (P.L.C.); (M.P.)
| | - Pier Luigi Calvo
- Pediatric Gastroenterology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (P.L.C.); (M.P.)
| | - Davide Montin
- Pediatric Immunology and Rheumatology, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (F.L.); (D.M.)
| | - Francesco Licciardi
- Pediatric Immunology and Rheumatology, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (F.L.); (D.M.)
| | - Luisa De Sanctis
- Pediatric Endocrinology Unit, Regina Margherita Children’s Hospital, 10126 Turin, Italy; (R.B.); (G.T.); (P.M.); (L.D.S.)
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
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20
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Licciardi F, Baldini L, Dellepiane M, Covizzi C, Mogni R, Pruccoli G, Orsi C, Rabbone I, Parodi E, Mignone F, Montin D. MIS-C Treatment: Is IVIG Always Necessary? Front Pediatr 2021; 9:753123. [PMID: 34805048 PMCID: PMC8595395 DOI: 10.3389/fped.2021.753123] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/04/2021] [Accepted: 10/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background: MIS-C is a potentially severe inflammatory syndrome associated with SARS-CoV-2 exposure. Intravenous immunoglobulin (IVIG) is considered the first-tier therapy, but it implies infusion of large fluid volumes that may worsen cardiac function. Patients and Methods: Since April 2020, we have developed a treatment protocol that avoids the infusion of IVIG as first-line therapy in the early phase of MIS-C. In this study, we retrospectively analyzed a cohort of consecutive patients treated according to this protocol between 01/04/2020 and 01/04/2021. Results: In the last year, 31 patients have been treated according to the protocol: 25 with high-dose pulse MP (10 mg/kg) and 6 with 2 mg/kg. 67.7% of the patients responded to the initial treatment, while the others needed a step-up, either with Anakinra (25.8%) or with MP dose increase (6.5%). IVIG was administered in four patients. Overall, only one patient (3.2%) needed ICU admission and inotropic support; one patient developed a small coronary artery aneurysm. Conclusions: Timely start of MP therapy and careful fluid management might improve the outcomes of MIS-C patients.
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Affiliation(s)
- Francesco Licciardi
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Letizia Baldini
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Marta Dellepiane
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy
| | - Carlotta Covizzi
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Roberta Mogni
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Giulia Pruccoli
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy
| | - Cecilia Orsi
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Ivana Rabbone
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Emilia Parodi
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Federica Mignone
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Davide Montin
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
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Carli D, Moroni A, Eleonora DG, Zonta A, Montin D, Licciardi F, Aidala E, Bordese R, Carlo PN, Brusco A, Giovanni Battista F, Mussa A. Atypical microdeletion 22q11.2 in a patient with tetralogy of Fallot. J Genet 2021; 100:5. [PMID: 33707356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The 22q11.2 microdeletion syndrome (22q11.2 DGS) is characterized by an extreme intrafamilial and interfamilial variability. The main clinical features are congenital heart defects, palatal abnormalities, learning disability, facial dysmorphisms and immune deficiency. In 85-90% of cases, the 22q11.2 DGS is caused by a heterozygous ~3-Mb deletion, including the TBX1 gene, considered one of the major genes responsible for heart defects. Individuals with atypical deletions with at least one breakpoint outside low copy repeats have been reported. Our patient is a child presenting tetralogy of Fallot (TOF) with an atypical 22q11.2 deletion proximal to the critical DiGeorge region. The rearrangement was inherited from the healthy mother and spanned ~642-970 kb, encompassing DGCR6 and PRODH, two novel possible candidate genes for conotruncal heart defects.
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Affiliation(s)
- Diana Carli
- Clinical Pediatric Genetics, Department of Public Health Sciences and Pediatrics, University of Torino, 10126 Torino, Italy.
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22
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Licciardi F, Baldini L, Dellepiane M, Covizzi C, Mogni R, Pruccoli G, Orsi C, Rabbone I, Parodi E, Mignone F, Montin D. Corrigendum: MIS-C Treatment: Is IVIG Always Necessary? Front Pediatr 2021; 9:826518. [PMID: 35237545 PMCID: PMC8883580 DOI: 10.3389/fped.2021.826518] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2021.753123.].
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Affiliation(s)
- Francesco Licciardi
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Letizia Baldini
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Marta Dellepiane
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy
| | - Carlotta Covizzi
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Roberta Mogni
- Postgraduate School of Pediatrics, Università degli Studi di Torino, Turin, Italy
| | - Giulia Pruccoli
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy
| | - Cecilia Orsi
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Ivana Rabbone
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Emilia Parodi
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Federica Mignone
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - Davide Montin
- Department of Pediatrics and Public Health, Università degli Studi di Torino, Turin, Italy.,Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
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23
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Pelizzo G, Bagolan P, Morini F, Aceti M, Alberti D, Andermarcher M, Avolio L, Bartoli F, Briganti V, Cacciaguerra S, Camoglio FS, Ceccarelli P, Cheli M, Chiarenza F, Ciardini E, Cimador M, Clemente E, Cozzi DA, Dall' Oglio L, De Luca U, Del Rossi C, Esposito C, Falchetti D, Federici S, Gamba P, Gentilino V, Mattioli G, Martino A, Messina M, Noccioli B, Inserra A, Lelli Chiesa P, Leva E, Licciardi F, Midrio P, Nobili M, Papparella A, Paradies G, Piazza G, Pini Prato A, Rossi F, Riccipetitoni G, Romeo C, Salerno D, Settimi A, Schleef J, Milazzo M, Calcaterra V, Lima M. Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery. Ital J Pediatr 2020; 46:134. [PMID: 32938472 PMCID: PMC7493058 DOI: 10.1186/s13052-020-00889-2] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy. Methods A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units. Results The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern <Northern<Central, p < 0.03). The most frequent clinical characteristics of neonates was preterm neonates with birthweight < 1200 g, with cardiorespiratory instability and/or ventilatory dependence. The most frequently selected indications to surgery were pneumothorax, pleural effusion, pericardial effusion, central venous catheter (CVC) positioning, intestinal perforation, patent ductus arteriosus ligation and congenital diaphragmatic hernia. More than 60% of respondents report no institutional recommendations and dedicated informed consent on bedside surgical procedures. The lack of dedicated areas and infrastructures is considered a relative contraindication to the performance of bedside surgery. Conclusion Bedside surgery is performed in the majority of the Italian pediatric surgery centers included in this census. The introduction of a national set of surgery guidelines would be widely welcomed.
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Affiliation(s)
- Gloria Pelizzo
- Department of Paediatric Surgery, Ospedale dei Bambini "V. Buzzi" Children's Hospital, University of Milano, Milano, Italy.
| | - Pietro Bagolan
- Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Morini
- Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Daniele Alberti
- Department of Pediatric Surgery, Spedali Civili and University of Brescia, Brescia, Italy
| | | | - Luigi Avolio
- Pediatric Surgery Unit, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Fabio Bartoli
- Pediatric Surgery Unit, University of Foggia, Foggia, Italy
| | - Vito Briganti
- Department of Pediatric Surgery and Urology Unit, San Camillo Forlanini Hospital, Rome, Italy
| | | | | | | | - Maurizio Cheli
- Department of Pediatric Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fabio Chiarenza
- Department of Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy
| | - Enrico Ciardini
- Pediatric Surgery Unit, Ospedale Santa Chiara, Trento, Italy
| | - Marcello Cimador
- Pediatric Urology Unit, Department PRO.MI.SE, University of Palermo, Palermo, Italy
| | - Ennio Clemente
- Pediatric Surgery Unit, University of Salerno, Salerno, Italy
| | - Denis A Cozzi
- Department of Pediatrics, Sapienza University, Rome, Italy
| | - Luigi Dall' Oglio
- Digestive Endoscopy and Surgery Unit, Bambino Gesu Children's Hospital-IRCCS, Rome, Italy
| | - Ugo De Luca
- Day Surgery Unit, Santobono-Pausilipon Pediatric Hospital, Naples, Italy
| | - Carmine Del Rossi
- Pediatric Surgery Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Ciro Esposito
- Pediatric Surgery Unit, Federico II Hospital, University of Naples, Naples, Italy
| | - Diego Falchetti
- Pediatric Surgery Unit, Niguarda Ca' Granda Hospital, Milan, Italy
| | | | | | - Valerio Gentilino
- Unit of Pediatric Surgery, Woman and Child Department, Filippo Del Ponte Hospital - ASST Sette Laghi, Varese, Italy
| | - Girolamo Mattioli
- Department of Pediatric Surgery, G. Gaslini Children's Hospital, University of Genoa, Genoa, Italy
| | - Ascanio Martino
- Pediatric Surgery Unit, Salesi Children's Hospital, Politecnico delle Marche University, Ancona, Italy
| | - Mario Messina
- Division of Pediatric Surgery, Department of Medical Sciences, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Bruno Noccioli
- Department of Neonatal and Emergency Surgery, Meyer Children's Hospital, Florence, Italy
| | - Alessandro Inserra
- Surgical Oncology Unit, Department of Surgery, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Ernesto Leva
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Paola Midrio
- Pediatric Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Maria Nobili
- Pediatric Surgery Unit, University of Foggia, Foggia, Italy
| | - Alfonso Papparella
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Giuseppe Piazza
- Pediatric Surgery Unit, Sant'Antonio Abate Hospital, Trapani, Italy
| | - Alessio Pini Prato
- Unit of Pediatric Surgery, The Children Hospital, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Fabio Rossi
- Pediatric Surgery Unit, Azienda Ospedaliero-Universitaria Maggiore della Carità , Novara, Italy
| | - Giovanna Riccipetitoni
- Pediatric Surgery Unit, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
| | - Carmelo Romeo
- Department of Human Pathology of Adult and Childhood "Gaetano Barresi", Unit of Pediatric Surgery, University of Messina, Messina, Italy
| | - Domenico Salerno
- Pediatric Surgery Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
| | - Alessandro Settimi
- Pediatric Surgery Unit, Federico II Hospital, University of Naples , Naples, Italy
| | - Jurgen Schleef
- Department of Pediatric Surgery, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Mario Milazzo
- Pediatric Surgery Unit, Ospedale del Bambini "G. Di Cristina", ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia and Pediatric Unit V. Buzzi Children's Hospital, Milan, Italy
| | - Mario Lima
- Department of Pediatric Surgery, University of Bologna, Bologna, Italy
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Denina M, Pellegrino F, Morotti F, Coppo P, Bonsignori IM, Garazzino S, Ravanini P, Avolio M, Cavallo R, Bertolotti L, Felici E, Acucella G, Montin D, Rabbone I, Licciardi F. All that glisters is not COVID: Low prevalence of seroconversion against SARS-CoV-2 in a pediatric cohort of patients with chilblain-like lesions. J Am Acad Dermatol 2020; 83:1751-1753. [PMID: 32781180 PMCID: PMC7414307 DOI: 10.1016/j.jaad.2020.08.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Marco Denina
- Department of Pediatrics and Public Health, University of Turin, Turin (TO), Italy
| | - Francesco Pellegrino
- Department of Pediatrics and Public Health, University of Turin, Turin (TO), Italy
| | - Francesco Morotti
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara (NO), Italy
| | - Paola Coppo
- Unit of Chirurgia Plastica Pediatrica-Dermatologia, Città della salute e della Scienza, Regina Margherita, Children's Hospital, Turin (TO), Italy
| | - Ilaria Maria Bonsignori
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara (NO), Italy
| | - Silvia Garazzino
- Department of Pediatrics and Public Health, University of Turin, Turin (TO), Italy
| | - Paolo Ravanini
- Laboratorio di Microbiologia e virologia-AOU Maggiore della Carità di Novara, Novara (NO), Italy
| | - Maria Avolio
- Department of Public Health and Pediatrics, Microbiology and Virology Unit, Città della salute e della Scienza, Molinette Hospital, University of Turin, Turin (TO), Italy
| | - Rossana Cavallo
- Department of Public Health and Pediatrics, Microbiology and Virology Unit, Città della salute e della Scienza, Molinette Hospital, University of Turin, Turin (TO), Italy
| | - Luigi Bertolotti
- Department of Veterinary Science, University of Turin, Turin (TO), Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children's Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria (AL), Italy
| | | | - Davide Montin
- Department of Pediatrics and Public Health, University of Turin, Turin (TO), Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara (NO), Italy
| | - Francesco Licciardi
- Department of Pediatrics and Public Health, University of Turin, Turin (TO), Italy.
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25
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Licciardi F, Pruccoli G, Denina M, Parodi E, Taglietto M, Rosati S, Montin D. SARS-CoV-2-Induced Kawasaki-Like Hyperinflammatory Syndrome: A Novel COVID Phenotype in Children. Pediatrics 2020; 146:peds.2020-1711. [PMID: 32439816 DOI: 10.1542/peds.2020-1711] [Citation(s) in RCA: 154] [Impact Index Per Article: 38.5] [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] [Accepted: 05/18/2020] [Indexed: 12/13/2022] Open
Abstract
We describe 2 children with persistent fever and profuse diarrhea who developed signs of mucocutaneous involvement (conjunctivitis, fissured lips, skin rash, erythema, and edema of the hands and feet). Blood tests revealed elevated markers of inflammation, lymphopenia, thrombocytopenia, and complement consumption. Afterward, diffuse edema with hypoalbuminemia appeared in the context of a capillary leak syndrome. In both patients, repeated nasal swabs were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but each patient had high titers of immunoglobulin G and immunoglobulin M against the SARS-CoV-2 virus. The negative PCR results in the presence of immunoglobulin M and immunoglobulin G suggested that the inflammatory response developed in the late phase of viral infection, when SARS-CoV-2 was not detectable in the upper airway. In this report, we describe patients with what we propose to name as SARS-CoV-2-induced Kawasaki-like hyperinflammatory syndrome. SARS-CoV-2-induced Kawasaki-like hyperinflammatory syndrome seems to be caused by a delayed response to SARS-CoV-2. It resembles Kawasaki disease complicated by macrophage activation syndrome, although it has peculiar features, such as prodromal diarrhea, capillary leak syndrome, and myocardial dysfunction. Intravenous corticosteroid treatment appears to be helpful.
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Affiliation(s)
- Francesco Licciardi
- Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy.,Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giulia Pruccoli
- Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy;
| | - Marco Denina
- Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy.,Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Emilia Parodi
- Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy.,Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Manuela Taglietto
- Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sergio Rosati
- Department of Veterinary Sciences, University of Turin, Turin, Italy; and
| | - Davide Montin
- Department of Pediatric and Public Health Sciences, University of Torino, Turin, Italy.,Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
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Licciardi F, Dellepiane M, Covizzi C, Figus F, Azzolin I, Montin D, Iagnocco A. THU0505 MUSCULOSKELETAL ULTRASOUND MONITORING DURING MTX TAPERING IN JIA: A PROSPECTIVE BLINDED COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. Musculoskeletal ultrasound (MSUS) is a reliable tool in the assessment of chronic inflammatory arthropathies. MSUS in JIA has demonstrated a higher sensitivity for detecting synovitis and tenosynovitis as compared to physical examination. The occurrence of subclinical synovitis (Sub-S: MSUS+/ physical examination -) seems more frequent in wrist and foot joints; the clinical significance of Sub-S in real-life practice is still debated. Methotrexate (MTX) is the most widely used first-line DMARD in JIA therapy. Weekly treatment with MTX leads to clinical remission (CR) in 50-70% of patients. After a variable period of CR (usually 6-18 months), MTX is discontinued. Relapse rate after MTX suspension ranges between 40-50%; no predictors of disease flare have been identified so far.Objectives:We designed a cohort study in order to explore if MSUS monitoring during MTX tapering was able to predict disease flare.Methods:JIA patients in CR (as defined by the JADAS score) for at least 12 months were enrolled in the study. Patients at first attempt of suspension (G1) were tapered as follows: 1 week of suspension every 3 weeks for 3 months + 1 dose every 2 weeks for 3 months; if CR persisted, MTX was stopped. Patients who had a previous flare during/after MTX tapering (G2) had a similar tapering schedule but the step with 1 MTX dose every 2 weeks lasted 6 months. All patients underwent a complete MSUS of 48 joints every 3 months; clinicians who performed physical examinations and follow-up were blinded to US findings for the entire study period.Results:18 consecutive patients were enrolled between April 2018 and September 2019; patients had prevalently oligoJIA (55.5%) and RF- polyJIA (22.2%). Patients had been treated with MTX for 24.7 months (17.7–48.3), CR had been achieved 4.2 months after MTX start; 61.1% were at their first attempt of MTX tapering (G1).Baseline MSUS:at T0 MSUS detected 9/18 patients (50.0%) with Sub-S (MSUS+). Affected sites at T0 were distributed as follows: 4 MCP joints, 9 MTP joints, 1 f-IP joints, 11 knees. No significant differences resulted in comparing demographic and baseline disease features between MSUS- and MSUS+ patients at T0.Follow-up MSUS: 14 patients (77.8%) completed the entire study protocol, 4 patients are still ongoing. 7 patients relapsed: 42.9% during tapering, 1 of them relapsed during a VZV infection and was excluded from further analysis. We considered as Tlast-MSUS the last available MSUS before relapse or final MSUS (i.e. three months after MTX withdrawal) for not-relapsed subjects.At Tlast8 patients had at least 1 Sub-S. Sub-S per patient at Tlastwere more than Sub-S at T0 (2.85 vs 0.53 p=0.03) but the presence of Sub-S was not related with disease flare (50.0 vs 44.4% p=1). MSUS found 27 Sub-S of the small joints (sMSUS): 88.9% were in the feet, they had an OMERACT grading of 1. sMSUS+ patients were older (8.7 vs 3.9, p=0.002) therefore a weight-induced sub-S not related with JIA could be presumed.Kaplan-Meier curves were analyzed comparing MSUS results at T0 and Tlast, both considering all Sub-S and excluding small feet joints (pMSUS). The best performance was achieved with MSUS at Tlastand pMSUS (figure below, p=0.11).Conclusion:•Sub-S are present in 50% of patients in clinical remission >12 months.•Sub-S in older patients interest often feet small joints; these Sub-S may be of mechanical origin and are not associated with disease flare.•Sub-S increase during MTX tapering.Further patients must be enrolled to understand if Sub-S excluding feet small joints may predict disease flare.References:[1]Amendment of the OMERACT US definitions of joints’ features in healthy children using the DOPPLER technique. Collado P et al, Pediatr Rheumatol Online J. 2018.[2]Preliminary Definitions for the Sonographic Features of Synovitis in Children. Roth J, et al; Arthritis Care Res. 2017.Disclosure of Interests:Francesco Licciardi: None declared, Marta Dellepiane: None declared, Carlotta Covizzi: None declared, Fabiana Figus: None declared, Irene Azzolin: None declared, Davide Montin Speakers bureau: Not relevant for the topic, Annamaria Iagnocco Grant/research support from: Abbvie, MSD and Alfasigma, Consultant of: AbbVie, Abiogen, Alfasigma, Biogen, BMS, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Sanofi and Sanofi Genzyme, Speakers bureau: AbbVie, Alfasigma, BMS, Eli-Lilly, Janssen, MSD, Novartis, Sanofi
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Licciardi F, Giani T, Baldini L, Favalli EG, Caporali R, Cimaz R. COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country. Pediatr Rheumatol Online J 2020; 18:35. [PMID: 32321540 PMCID: PMC7175817 DOI: 10.1186/s12969-020-00422-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 01/08/2023] Open
Abstract
On March 11th, 2020 the World Health Organization declared COVID-19 a global pandemic. The infection, transmitted by 2019 novel coronavirus (2019-nCov), was first discovered in December 2019, in Wuhan, Hubei Province, and then rapidly spread worldwide. Italy was early and severely involved, with a critical spread of the infection and a very high number of victims. Person-to-person spread mainly occurs via respiratory droplets and contact. The median incubation period is 5 days. The spectrum of respiratory symptoms may range from mild to severe, strictly depending on the age of the patient and the underlying comorbidities.In children COVID-19 related disease is less frequent and less aggressive. In Italy 1% of positive cases are under 18 years of age, and no deaths have been recorded before 29 years of age. For patients affected by rheumatic disease, despite the concerns related to the imbalance of their immune response and the effect of immunosuppressive treatments, there are still few data to understand the real consequences of this infection. Major scientific societies have issued recommendations to help rheumatologists in caring their patients. Interestingly, some of the drugs mostly used by rheumatologists appear to be promising in critical COVID-19 infected patients, where the hyperinflammation and cytokine storm seem to drive to the multiorgan failure.Pediatric rheumatologists are expected to play a supporting role in this new front of COVID-19 pandemic, both as general pediatricians treating infected children, and as rheumatologists taking care of their rheumatic patients, as well as offering their experience in the possible alternative use of immunomodulatory drugs.
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Affiliation(s)
- Francesco Licciardi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, Turin, Italy
| | - Teresa Giani
- AOU Meyer, V.le Pieraccini 24, 50139, Florence, Italy.
- Department of Medical Biotechnology, University of Siena, Siena, Italy.
| | - Letizia Baldini
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, Regina Margherita Children Hospital, University of Turin, Turin, Italy
| | - Ennio Giulio Favalli
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
| | - Roberto Caporali
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
| | - Rolando Cimaz
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
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Ter Haar NM, Eijkelboom C, Cantarini L, Papa R, Brogan PA, Kone-Paut I, Modesto C, Hofer M, Iagaru N, Fingerhutová S, Insalaco A, Licciardi F, Uziel Y, Jelusic M, Nikishina I, Nielsen S, Papadopoulou-Alataki E, Olivieri AN, Cimaz R, Susic G, Stanevica V, van Gijn M, Vitale A, Ruperto N, Frenkel J, Gattorno M. Clinical characteristics and genetic analyses of 187 patients with undefined autoinflammatory diseases. Ann Rheum Dis 2019; 78:1405-1411. [PMID: 31278138 DOI: 10.1136/annrheumdis-2018-214472] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 09/21/2018] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To describe the clinical characteristics, treatment response and genetic findings in a large cohort of patients with undefined systemic autoinflammatory diseases (SAIDs). METHODS Clinical and genetic data from patients with undefined SAIDs were extracted from the Eurofever registry, an international web-based registry that retrospectively collects clinical information on patients with autoinflammatory diseases. RESULTS This study included 187 patients. Seven patients had a chronic disease course, 180 patients had a recurrent disease course. The median age at disease onset was 4.3 years. Patients had a median of 12 episodes per year, with a median duration of 4 days. Most commonly reported symptoms were arthralgia (n=113), myalgia (n=86), abdominal pain (n=89), fatigue (n=111), malaise (n=104) and mucocutaneous manifestations (n=128). In 24 patients, relatives were affected as well. In 15 patients, genetic variants were found in autoinflammatory genes. Patients with genetic variants more often had affected relatives compared with patients without genetic variants (p=0.005). Most patients responded well to non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, colchicine and anakinra. Complete remission was rarely achieved with NSAIDs alone. Notable patterns were found in patients with distinctive symptoms. Patients with pericarditis (n=11) were older at disease onset (33.8 years) and had fewer episodes per year (3.0/year) compared with other patients. Patients with an intellectual impairment (n=8) were younger at disease onset (2.2 years) and often had relatives affected (28.6%). CONCLUSION This study describes the clinical characteristics of a large cohort of patients with undefined SAIDs. Among these, patients with pericarditis and intellectual impairment appear to comprise distinct subsets.
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Affiliation(s)
- Nienke M Ter Haar
- Laboratory of Translational Immunology & Department of Paediatric Rheumatology and Immunology, University Medical Center Utrecht, Utrecht, Netherlands
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
| | - Charlotte Eijkelboom
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
- Department of Paediatrics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Luca Cantarini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Riccardo Papa
- Clinica Pediatrica e Reumatologia, Istituto Giannina Gaslini, Genova, Italy
| | - Paul A Brogan
- Institute of Child Health, University College London, London, UK
| | - Isabelle Kone-Paut
- Department of Paediatric Rheumatology and CEREMAI, Hôpital de Bicêtre, National Reference Centre for Auto-Inflammatory Diseases, le Kremlin-Bicêtre, Paris, France
| | - Consuelo Modesto
- Pediatric Rheumatology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Michael Hofer
- Unité Centre Multisite Romande d'Immuno-e Rhumatologie Pediatrique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nicolae Iagaru
- Pediatrie, Institutul pentru Ocrotirea Mamei și Copilului, București, Romania
| | - Sárka Fingerhutová
- Department of Pediatrics and Adolescent Medicine, Charles University in Prague and General University Hospital, Praha, Czech Republic
| | | | - Francesco Licciardi
- Dipartimento di Scienze della Sanità Pubblica e Pediatrica, Università degli Studi di Torino, Torino, Italy
| | - Yosef Uziel
- Pediatric Rheumatology Unit, Department of Pediatrics, Meir Medical Centre, Kfar Saba and Sackler School of Medicine, Kfar Saba, Israel
| | - Marija Jelusic
- Department of Paediatric Rheumatology and Immunology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Irina Nikishina
- Pediatric Department, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| | - Susan Nielsen
- Børnereumatologisk, Juliane Marie Centret, Rigshospitalet, København, Denmark
| | - Efimia Papadopoulou-Alataki
- Fourth Department of Pediatrics, Aristotle University of Thessaloniki Papageorgiou Hospital, Thessaloniki, Greece
| | - Alma Nunzia Olivieri
- Department of Woman and Child and General and Specialistic Surgery, University of the Study of Campania Luigi Vanvitelli, Napoli, Italy
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gordana Susic
- Department of Pediatric Rheumatology, Institute of Rheumatology, BelgradeInstitute of Rheumatology, Belgrade, Serbia
| | - Valda Stanevica
- Paediatric Department, Riga Stradins University, Children University Hospital, Rīga, Latvia
| | - Marielle van Gijn
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Antonio Vitale
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Nicolino Ruperto
- Center for Autoinflammatory Diseases and Immunodeficiency, IRCCS Instituto Giannina Gaslini, Genoa, Italy
| | - Joost Frenkel
- Department of Paediatrics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marco Gattorno
- Center for Autoinflammatory Diseases and Immunodeficiency, IRCCS Instituto Giannina Gaslini, Genoa, Italy
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Carli D, Giorgio E, Pantaleoni F, Bruselles A, Barresi S, Riberi E, Licciardi F, Gazzin A, Baldassarre G, Pizzi S, Niceta M, Radio FC, Molinatto C, Montin D, Calvo PL, Ciolfi A, Fleischer N, Ferrero GB, Brusco A, Tartaglia M. Front Cover, Volume 40, Issue 6. Hum Mutat 2019. [DOI: 10.1002/humu.23795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Diana Carli
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Elisa Giorgio
- Department of Medical SciencesUniversity of TorinoTorino Italy
| | - Francesca Pantaleoni
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Alessandro Bruselles
- Department of Oncology and Molecular MedicineIstituto Superiore di SanitàRome Italy
| | - Sabina Barresi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Evelise Riberi
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | | | - Andrea Gazzin
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | | | - Simone Pizzi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Marcello Niceta
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Francesca C. Radio
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Cristina Molinatto
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Davide Montin
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Pier L. Calvo
- Pediatric Gastroenterology UnitCittà della Salute e della Scienza University HospitalTorino Italy
| | - Andrea Ciolfi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | | | | | - Alfredo Brusco
- Department of Medical SciencesUniversity of TorinoTorino Italy
- Medical Genetics UnitCittà della Salute e della Scienza University HospitalTorino Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
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Cifaldi C, Brigida I, Barzaghi F, Zoccolillo M, Ferradini V, Petricone D, Cicalese MP, Lazarevic D, Cittaro D, Omrani M, Attardi E, Conti F, Scarselli A, Chiriaco M, Di Cesare S, Licciardi F, Davide M, Ferrua F, Canessa C, Pignata C, Giliani S, Ferrari S, Fousteri G, Barera G, Merli P, Palma P, Cesaro S, Gattorno M, Trizzino A, Moschese V, Chini L, Villa A, Azzari C, Finocchi A, Locatelli F, Rossi P, Sangiuolo F, Aiuti A, Cancrini C, Di Matteo G. Corrigendum: Targeted NGS Platforms for Genetic Screening and Gene Discovery in Primary Immunodeficiencies. Front Immunol 2019; 10:1184. [PMID: 31214169 PMCID: PMC6554535 DOI: 10.3389/fimmu.2019.01184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
- Cristina Cifaldi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Immacolata Brigida
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Barzaghi
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Matteo Zoccolillo
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Ferradini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Petricone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Pia Cicalese
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Dejan Lazarevic
- Center for Translational Genomics and BioInformatics, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Cittaro
- Center for Translational Genomics and BioInformatics, San Raffaele Scientific Institute, Milan, Italy
| | - Maryam Omrani
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Attardi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Francesca Conti
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Alessia Scarselli
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Maria Chiriaco
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Silvia Di Cesare
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Francesco Licciardi
- Division of Immunology and Rheumatology, Department of Paediatric Infectious Diseases, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Montin Davide
- Division of Immunology and Rheumatology, Department of Paediatric Infectious Diseases, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Francesca Ferrua
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Clementina Canessa
- Pediatric Immunology, Department of Health Sciences, University of Florence, Florence, Italy.,Meyer Children's Hospital, Florence, Italy
| | - Claudio Pignata
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Silvia Giliani
- Department of Molecular and Translational Medicine, A. Nocivelli Institute for Molecular Medicine, University of Brescia, Brescia, Italy
| | - Simona Ferrari
- Unit of Medical Genetics, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Georgia Fousteri
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI) IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Graziano Barera
- Pediatric Department, San Raffaele Scientific Institute, Milan, Italy
| | - Pietro Merli
- Department of Onco-Hematology and Cell and Gene Therapy, Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Paolo Palma
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Simone Cesaro
- Paediatric Hematology-Oncology, "Ospedale della Donna e del Bambino", Verona, Italy
| | - Marco Gattorno
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Giannina Gaslini, Genoa, Italy
| | - Antonio Trizzino
- Department of Pediatric Hematology and Oncology, "ARNAS Civico Di Cristina Benfratelli" Hospital, Palermo, Italy
| | - Viviana Moschese
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata Policlinico Tor Vergata, Rome, Italy
| | - Loredana Chini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata Policlinico Tor Vergata, Rome, Italy
| | - Anna Villa
- Milan Unit, National Research Council (CNR) Institute for Genetic and Biomedical Research (IRGB), Milan, Italy.,Humanitas Clinical and Research Institute, Rozzano, Italy
| | - Chiara Azzari
- Pediatric Immunology, Department of Health Sciences, University of Florence, Florence, Italy.,Meyer Children's Hospital, Florence, Italy
| | - Andrea Finocchi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, University of Rome La Sapienza, Rome, Italy
| | - Paolo Rossi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Sangiuolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Aiuti
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Caterina Cancrini
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gigliola Di Matteo
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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31
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Cifaldi C, Brigida I, Barzaghi F, Zoccolillo M, Ferradini V, Petricone D, Cicalese MP, Lazarevic D, Cittaro D, Omrani M, Attardi E, Conti F, Scarselli A, Chiriaco M, Di Cesare S, Licciardi F, Davide M, Ferrua F, Canessa C, Pignata C, Giliani S, Ferrari S, Fousteri G, Barera G, Merli P, Palma P, Cesaro S, Gattorno M, Trizzino A, Moschese V, Chini L, Villa A, Azzari C, Finocchi A, Locatelli F, Rossi P, Sangiuolo F, Aiuti A, Cancrini C, Di Matteo G. Targeted NGS Platforms for Genetic Screening and Gene Discovery in Primary Immunodeficiencies. Front Immunol 2019; 10:316. [PMID: 31031743 PMCID: PMC6470723 DOI: 10.3389/fimmu.2019.00316] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/06/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Primary Immunodeficiencies (PIDs) are a heterogeneous group of genetic immune disorders. While some PIDs can manifest with more than one phenotype, signs, and symptoms of various PIDs overlap considerably. Recently, novel defects in immune-related genes and additional variants in previously reported genes responsible for PIDs have been successfully identified by Next Generation Sequencing (NGS), allowing the recognition of a broad spectrum of disorders. Objective: To evaluate the strength and weakness of targeted NGS sequencing using custom-made Ion Torrent and Haloplex (Agilent) panels for diagnostics and research purposes. Methods: Five different panels including known and candidate genes were used to screen 105 patients with distinct PID features divided in three main PID categories: T cell defects, Humoral defects and Other PIDs. The Ion Torrent sequencing platform was used in 73 patients. Among these, 18 selected patients without a molecular diagnosis and 32 additional patients were analyzed by Haloplex enrichment technology. Results: The complementary use of the two custom-made targeted sequencing approaches allowed the identification of causative variants in 28.6% (n = 30) of patients. Twenty-two out of 73 (34.6%) patients were diagnosed by Ion Torrent. In this group 20 were included in the SCID/CID category. Eight out of 50 (16%) patients were diagnosed by Haloplex workflow. Ion Torrent method was highly successful for those cases with well-defined phenotypes for immunological and clinical presentation. The Haloplex approach was able to diagnose 4 SCID/CID patients and 4 additional patients with complex and extended phenotypes, embracing all three PID categories in which this approach was more efficient. Both technologies showed good gene coverage. Conclusions: NGS technology represents a powerful approach in the complex field of rare disorders but its different application should be weighted. A relatively small NGS target panel can be successfully applied for a robust diagnostic suspicion, while when the spectrum of clinical phenotypes overlaps more than one PID an in-depth NGS analysis is required, including also whole exome/genome sequencing to identify the causative gene.
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Affiliation(s)
- Cristina Cifaldi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Immacolata Brigida
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Barzaghi
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Matteo Zoccolillo
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Ferradini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Petricone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Pia Cicalese
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Vita Salute San Raffaele University, Milan, Italy
| | - Dejan Lazarevic
- Center for Translational Genomics and BioInformatics, San Raffaele Scientific Institute, Milan, Italy
| | - Davide Cittaro
- Center for Translational Genomics and BioInformatics, San Raffaele Scientific Institute, Milan, Italy
| | - Maryam Omrani
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Attardi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Francesca Conti
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Alessia Scarselli
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Maria Chiriaco
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Silvia Di Cesare
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Francesco Licciardi
- Division of Immunology and Rheumatology, Department of Paediatric Infectious Diseases, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Montin Davide
- Division of Immunology and Rheumatology, Department of Paediatric Infectious Diseases, Regina Margherita Children's Hospital, University of Turin, Turin, Italy
| | - Francesca Ferrua
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Vita Salute San Raffaele University, Milan, Italy
| | - Clementina Canessa
- Pediatric Immunology, Department of Health Sciences, University of Florence, Florence, Italy
- Meyer Children's Hospital, Florence, Italy
| | - Claudio Pignata
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Silvia Giliani
- Department of Molecular and Translational Medicine, A. Nocivelli Institute for Molecular Medicine, University of Brescia, Brescia, Italy
| | - Simona Ferrari
- Unit of Medical Genetics, St. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Georgia Fousteri
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI) IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Graziano Barera
- Pediatric Department, San Raffaele Scientific Institute, Milan, Italy
| | - Pietro Merli
- Department of Onco-Hematology and Cell and Gene Therapy, Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Paolo Palma
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
| | - Simone Cesaro
- Paediatric Hematology-Oncology, “Ospedale della Donna e del Bambino”, Verona, Italy
| | - Marco Gattorno
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Giannina Gaslini, Genoa, Italy
| | - Antonio Trizzino
- Department of Pediatric Hematology and Oncology, “ARNAS Civico Di Cristina Benfratelli” Hospital, Palermo, Italy
| | - Viviana Moschese
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata Policlinico Tor Vergata, Rome, Italy
| | - Loredana Chini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata Policlinico Tor Vergata, Rome, Italy
| | - Anna Villa
- Milan Unit, National Research Council (CNR) Institute for Genetic and Biomedical Research (IRGB), Milan, Italy
- Humanitas Clinical and Research Institute, Rozzano, Italy
| | - Chiara Azzari
- Pediatric Immunology, Department of Health Sciences, University of Florence, Florence, Italy
- Meyer Children's Hospital, Florence, Italy
| | - Andrea Finocchi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, University of Rome La Sapienza, Rome, Italy
| | - Paolo Rossi
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Sangiuolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Aiuti
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, Scientific Institute for Research and Healthcare (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Vita Salute San Raffaele University, Milan, Italy
| | - Caterina Cancrini
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gigliola Di Matteo
- Unit of Immune and Infectious Diseases, University Department of Pediatrics (DPUO), Scientific Institute for Research and Healthcare (IRCCS) Childrens' Hospital Bambino Gesù, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Montin D, Marolda A, Licciardi F, Robasto F, Di Cesare S, Ricotti E, Ferro F, Scaioli G, Giancotta C, Amodio D, Conti F, Giardino G, Leonardi L, Ricci S, Volpi S, Baselli LA, Azzari C, Bossi G, Consolini R, Dellepiane RM, Duse M, Gattorno M, Martire B, Putti MC, Soresina A, Plebani A, Ramenghi U, Martino S, Pignata C, Cancrini C. Immunophenotype Anomalies Predict the Development of Autoimmune Cytopenia in 22q11.2 Deletion Syndrome. J Allergy Clin Immunol Pract 2019; 7:2369-2376. [PMID: 30922987 DOI: 10.1016/j.jaip.2019.03.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patients with 22q11.2 deletion syndrome (22q11.2DS) may develop severe thrombocytopenic purpura and hemolytic anemia. There are no reliable predictors for the development of hematologic autoimmunity (HA) in these patients. OBJECTIVE To describe the peculiar B and T subpopulation defects in patients with 22q11DS who have developed HA and test if these defects precede the development of HA. METHODS We performed a case-control multicenter study. Patients with HA were compared with a control population of 22q11.2DS without HA (non-HA). A complete immunological evaluation was performed at diagnosis and at the last follow-up including extensive T and B phenotypes. RESULTS Immunophenotype at the last follow-up was available in 23 HA and 45 non-HA patients. HA patients had significantly decreased percentage of naïve CD4+ cells (26.8% vs 43.2%, P = .003) and recent thymic emigrants (48.6% vs 80.5%, P = .046); decreased class-switched B cells (2.0% vs 5.9%, P = .04) and increased naive B cells (83.5% vs 71.4%, P = .02); increased CD16+/56+ both in absolute number (312 vs 199, P = .009) and percentage (20.0% vs 13.0%, P = .03). Immunophenotype was performed in 36 patients (11 HA and 25 non-HA) at diagnosis. Odds ratio (OR) of immune cytopenia were estimated for both CD4 naïve ≤30% (OR 14.0, P = .002) and switched memory B cells ≤2% (OR 44.0, P = .01). The estimated survival curves reached statistical significance, respectively, P = .0001 and P = .002. CONCLUSIONS Among patients with 22q11.2DS, those with HA have characteristic lymphocyte anomalies that appear considerably before HA onset. Systematic immunophenotyping of patients with 22q11.2DS at diagnosis is advisable for early identification of patients at risk for this severe complication.
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Affiliation(s)
- Davide Montin
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy
| | - Agostina Marolda
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy; Department of Health Sciences, A. Avogadro University of Eastern Piedmont, Novara, Italy
| | - Francesco Licciardi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy.
| | - Francesca Robasto
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy
| | - Silvia Di Cesare
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emanuela Ricotti
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy
| | - Francesca Ferro
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy; Division of Microbiology and Virology, Maggiore della Carità Hospital, Novara, Italy
| | - Giacomo Scaioli
- Department of Public Health, University of Turin, Turin, Italy
| | - Carmela Giancotta
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Donato Amodio
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Conti
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Giuliana Giardino
- Department of Pediatrics, "Federico II" University of Naples, Naples, Italy
| | - Lucia Leonardi
- Department of Pediatrics, La Sapienza University of Rome, Rome, Italy
| | - Silvia Ricci
- Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Anna Meyer Children's Hospital, Florence, Italy
| | - Stefano Volpi
- Pediatric and Rheumatology Clinic, Center for Autoinflammatory Diseases and Immunodeficiencies, Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Lucia Augusta Baselli
- Department of Pediatrics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Chiara Azzari
- Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Anna Meyer Children's Hospital, Florence, Italy
| | - Grazia Bossi
- Department of Pediatrics, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Rita Consolini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rosa Maria Dellepiane
- Department of Pediatrics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marzia Duse
- Department of Pediatrics, La Sapienza University of Rome, Rome, Italy
| | - Marco Gattorno
- Pediatric and Rheumatology Clinic, Center for Autoinflammatory Diseases and Immunodeficiencies, Istituto Giannina Gaslini and University of Genoa, Genoa, Italy
| | - Baldassarre Martire
- Pediatric Hematology and Oncology Unit, "Policlinico-Giovanni XXIII" Hospital, University of Bari, Bari, Italy
| | - Maria Caterina Putti
- Pediatric Hematology-Oncology Unit, Department of Women's and Children's Health, Azienda Ospedaliera-University of Padova, Padua, Italy
| | - Annarosa Soresina
- Pediatrics Clinic and Institute of Molecular Medicine "A. Nocivelli," University and Spedali Civili, Brescia, Italy
| | - Alessandro Plebani
- Pediatrics Clinic and Institute of Molecular Medicine "A. Nocivelli," University and Spedali Civili, Brescia, Italy
| | - Ugo Ramenghi
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy
| | - Silvana Martino
- Division of Pediatric Immunology and Rheumatology, Department of Public Health and Pediatrics, "Regina Margherita" Children Hospital, University of Turin, Turin, Italy
| | - Claudio Pignata
- Department of Pediatrics, "Federico II" University of Naples, Naples, Italy
| | - Caterina Cancrini
- University Department of Pediatrics, Unit of Immune and Infectious Diseases, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Carli D, Giorgio E, Pantaleoni F, Bruselles A, Barresi S, Riberi E, Licciardi F, Gazzin A, Baldassarre G, Pizzi S, Niceta M, Radio FC, Molinatto C, Montin D, Calvo PL, Ciolfi A, Fleischer N, Ferrero GB, Brusco A, Tartaglia M. NBAS
pathogenic variants: Defining the associated clinical and facial phenotype and genotype–phenotype correlations. Hum Mutat 2019; 40:721-728. [DOI: 10.1002/humu.23734] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/05/2019] [Accepted: 02/28/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Diana Carli
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Elisa Giorgio
- Department of Medical SciencesUniversity of TorinoTorino Italy
| | - Francesca Pantaleoni
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Alessandro Bruselles
- Department of Oncology and Molecular MedicineIstituto Superiore di SanitàRome Italy
| | - Sabina Barresi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Evelise Riberi
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | | | - Andrea Gazzin
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | | | - Simone Pizzi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Marcello Niceta
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Francesca C. Radio
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | - Cristina Molinatto
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Davide Montin
- Department of Public Health and PediatricsUniversity of TorinoTorino Italy
| | - Pier L. Calvo
- Pediatric Gastroenterology UnitCittà della Salute e della Scienza University HospitalTorino Italy
| | - Andrea Ciolfi
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
| | | | | | - Alfredo Brusco
- Department of Medical SciencesUniversity of TorinoTorino Italy
- Medical Genetics UnitCittà della Salute e della Scienza University HospitalTorino Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research DivisionOspedale Pediatrico Bambino Gesù IRCSSRome Italy
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34
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Licciardi F, van den Boogaard M, Delle Piane M, Tovo PA, Montin D. EBV-Related Hodgkin Lymphoma in an ICF2 Patient: Is EBV Susceptibility a Hallmark of This ICF Subtype? J Clin Immunol 2019; 39:234-236. [DOI: 10.1007/s10875-019-00596-6] [Citation(s) in RCA: 4] [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] [Received: 12/11/2018] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
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35
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Lee S, Lee S, Schiffman M, Kramer Y, McCulloh D, Braverman A, Licciardi F. A prospective study comparing self-reported quality of life scales in women undergoing oocyte freezing versus in vitro fertilization. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.660] [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: 11/25/2022]
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36
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Babbar S, Blakemore J, Licciardi F. A comparison of intrauterine insemination (IUI) versus in vitro fertilization (IVF) in the era of pre-implantation genetic testing for aneuploidy (PGT-A): an analysis of efficacy and cost. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.591] [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]
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37
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Shaw J, Blakemore J, McCulloh D, Licciardi F. Can i take a break?: oocytes retrieved by time interval between in vitro fertilization (IVF) cycles. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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38
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Cicalese MP, Gerosa J, Baronio M, Montin D, Licciardi F, Soresina A, Dellepiane RM, Miano M, Baselli LA, Volpi S, Dufour C, Plebani A, Aiuti A, Lougaris V, Fousteri G. Circulating Follicular Helper and Follicular Regulatory T Cells Are Severely Compromised in Human CD40 Deficiency: A Case Report. Front Immunol 2018; 9:1761. [PMID: 30131802 PMCID: PMC6090258 DOI: 10.3389/fimmu.2018.01761] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 01/30/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022] Open
Abstract
Mutations in genes that control class switch recombination and somatic hypermutation during the germinal center (GC) response can cause diverse immune dysfunctions. In particular, mutations in CD40LG, CD40, AICDA, or UNG cause hyper-IgM (HIGM) syndrome, a heterogeneous group of primary immunodeficiencies. Follicular helper (Tfh) and follicular regulatory (Tfr) T cells play a key role in the formation and regulation of GCs, but their role in HIGM pathogenesis is still limited. Here, we found that compared to CD40 ligand (CD40L)- and activation-induced cytidine deaminase (AICDA)-deficient patients, circulating Tfh and Tfr cells were severely compromised in terms of frequency and activation phenotype in a child with CD40 deficiency. These findings offer useful insight for human Tfh biology, with potential implications for understanding the molecular basis of HIGM syndrome caused by mutations in CD40.
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Affiliation(s)
- Maria Pia Cicalese
- San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Jolanda Gerosa
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI) IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Manuela Baronio
- Department of Clinical and Experimental Sciences, Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Davide Montin
- Immuno-Rheumatology, Department of Paediatrics II, Regina Margherita Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesco Licciardi
- Immuno-Rheumatology, Department of Paediatrics II, Regina Margherita Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Rosa Maria Dellepiane
- Department of Pediatrics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Maurizio Miano
- Department of Emato-Oncology, IRCCS Instituto Giannina Gaslini, Genoa, Italy
| | - Lucia Augusta Baselli
- Department of Pediatrics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefano Volpi
- Department of Pediatrics, IRCCS Instituto Giannina Gaslini, Genoa, Italy
| | - Carlo Dufour
- Department of Emato-Oncology, IRCCS Instituto Giannina Gaslini, Genoa, Italy.,Department of Pediatrics, IRCCS Instituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Plebani
- Department of Clinical and Experimental Sciences, Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Alessandro Aiuti
- San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Vassilios Lougaris
- Department of Clinical and Experimental Sciences, Pediatrics Clinic and Institute of Molecular Medicine A. Novicelli, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Georgia Fousteri
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI) IRCCS San Raffaele Scientific Institute, Milan, Italy
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39
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Consolaro A, Bovis F, Pistorio A, Cimaz R, De Benedetti F, Miniaci A, Corona F, Gerloni V, Martino S, Pastore S, Barone P, Pieropan S, Cortis E, Podda RA, Gallizzi R, Civino A, Torre FL, Rigante D, Consolini R, Maggio MC, Magni-Manzoni S, Perfetti F, Filocamo G, Toppino C, Licciardi F, Garrone M, Scala S, Patrone E, Tonelli M, Tani D, Ravelli A, Martini A, Ruperto N. The Italian version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Rheumatol Int 2018; 38:251-258. [PMID: 29637324 PMCID: PMC5893696 DOI: 10.1007/s00296-018-3960-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Italian language.The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents.The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity).A total of 1296 JIA patients (7.2% systemic, 59.5% oligoarticular, 21.4% RF negative polyarthritis, 11.9% other categories) and 100 healthy children, were enrolled in 18 centres. The JAMAR components discriminated well healthy subjects from JIA patients except for the Health Related Quality of Life (HRQoL) Psychosocial Health (PsH) subscales. All JAMAR components revealed good psychometric performances.In conclusion, the Italian version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.
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Affiliation(s)
- Alessandro Consolaro
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy. .,Dipartimento di Pediatria, Università di Genova, Genoa, Italy.
| | - Francesca Bovis
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Angela Pistorio
- Servizio di Epidemiologia e Biostatistica, Istituto Giannina Gaslini, Genoa, Italy
| | - Rolando Cimaz
- Dipartimento di Pediatria, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy
| | | | - Angela Miniaci
- Salute della Donna, del Bambino e dell'Adolescente-Padiglione 16 Ambulatorio di reumatologia, Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Fabrizia Corona
- Clinica Pediatrica II De Marchi, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Gerloni
- Divisione di Reumatologia, Istituto Gaetano Pini, Milan, Italy
| | - Silvana Martino
- Clinica Pediatrica, Paediatrics Departments, Università di Torino, Turin, Italy
| | - Serena Pastore
- Scienze della Riproduzione e dello Sviluppo, IRCCS Burlo Garofolo, Trieste, Italy
| | - Patrizia Barone
- Clinica Pediatrica, Azienda Policlinico Università di Catania, Catania, Italy
| | | | - Elisabetta Cortis
- Struttura Complessa Pediatria, Ospedale Santa Maria Della Stella, Località Ciconia-Orvieto, Terni, Italy
| | - Rosa Anna Podda
- Clinica e Biologia dell'età evolutiva, Ospedale Regionale Microcitemia-II Clinica Pediatrica, Cagliari, Italy
| | - Romina Gallizzi
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, Italy
| | - Adele Civino
- Pediatria, Azienda Ospedaliera Cardinale G. Panico, Tricase, LE, Italy
| | - Francesco La Torre
- Centro Regionale-HUB-di Reumatologia Pediatrica, Ospedale Antonio Perrino, Brindisi, Italy
| | - Donato Rigante
- Pediatria, Università Cattolica Sacro Cuore, Roma, Italy
| | - Rita Consolini
- Pediatria, Ospedale Santa Chiara, Università di Pisa, Pisa, Italy
| | - Maria Cristina Maggio
- University Department Pro.Sa.M.I. "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Francesca Perfetti
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Giovanni Filocamo
- Clinica Pediatrica II De Marchi, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Toppino
- Clinica Pediatrica, Paediatrics Departments, Università di Torino, Turin, Italy
| | - Francesco Licciardi
- Clinica Pediatrica, Paediatrics Departments, Università di Torino, Turin, Italy
| | - Marco Garrone
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Silvia Scala
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Elisa Patrone
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Monica Tonelli
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Daniela Tani
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Angelo Ravelli
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.,Dipartimento di Pediatria, Università di Genova, Genoa, Italy
| | - Alberto Martini
- Direzione Scientifica, Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Nicolino Ruperto
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.
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40
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Montin D, Licciardi F, Giorgio E, Ciolfi A, Pizzi S, Mussa A, Meazza R, Tartaglia M, Brusco A, Pende D, Ferrero GB. Functional evaluation of natural killer cell cytotoxic activity in NFKB2-mutated patients. Immunol Lett 2017; 194:40-43. [PMID: 29278687 DOI: 10.1016/j.imlet.2017.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 02/06/2023]
Affiliation(s)
- Davide Montin
- University of Torino, Department of Public Health and Pediatrics, Piazza Polonia 64, Turin, 10126, Italy
| | - Francesco Licciardi
- University of Torino, Department of Public Health and Pediatrics, Piazza Polonia 64, Turin, 10126, Italy.
| | - Elisa Giorgio
- University of Torino, Department of Medical Sciences, Turin, 10126, Italy
| | - Andrea Ciolfi
- Division of Genetics and Rare Diseases, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Simone Pizzi
- Division of Genetics and Rare Diseases, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Alessandro Mussa
- University of Torino, Department of Public Health and Pediatrics, Turin, 10126, Italy
| | - Raffaella Meazza
- IRCCS AOU San Martino-IST, Immunology Laboratory, Genoa, 16132, Italy
| | - Marco Tartaglia
- Division of Genetics and Rare Diseases, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Alfredo Brusco
- University of Torino, Department of Medical Sciences, Turin, 10126, Italy
| | - Daniela Pende
- IRCCS AOU San Martino-IST, Immunology Laboratory, Genoa, 16132, Italy
| | - Giovanni Battista Ferrero
- University of Torino, Department of Public Health and Pediatrics, Piazza Polonia 94, Turin, 10126, Italy.
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41
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Licciardi F, Ceci M, Toppino C, Turco M, Martino S, Ricotti E, Ferro F, Montin D. Low synovial double negative T and γδ T cells predict longer free-disease survival in oligoarticular JIA. Cytometry B Clin Cytom 2017; 94:423-427. [PMID: 29059705 DOI: 10.1002/cyto.b.21597] [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] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/20/2017] [Accepted: 10/18/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Oligoarticular juvenile idiopathic arthritis (oJIA) is the most frequent form of chronic arthritis in children; the clinical course is extremely variable. In this study we have characterized by flow cytometry synovial B and T cells subsets in patients with oJIA in order to identify any parameters that could predict a more aggressive course of disease. METHODS B and T cells from synovial fluid (SF) of 39 patients with oJIA were characterized by flow cytometry. In 22 patients SF was analysed at the onset of the disease (GroupA), in 17 SF was analysed at articular relapse (Group B). All patients in Group A were followed up for at least for 2 years after SF analysis: 13 patients relapsed during the follow-up period. RESULTS Comparison of SF from Group A and Group B demonstrated an activated phenotype in relapsed patients, with higher Switched Memory B cells (58.53 vs 36.07% of CD19+, P-value 0.004) and lower Naïve B cells (8.53 vs 25.9 of CD19+, P-value 0.002) in Group B. Furthermore, patients from Group A who did not relapse showed lower percentages of synovial DNT (2.38 vs 1.50% of CD3 + TCRalpha/beta+, P-value 0.025) and γδ T cells (19.1 vs 15.0% of CD3+ cells, P-value 0.004) at the onset, if compared with other Group A patients. CONCLUSIONS In oJIA relapse SF present an activated B phenotype. Patients at disease onset with DNTs <1.8% and/or γδ T cells <16% of CD3+ in synovial fluid have longer free-disease survival. © 2017 International Clinical Cytometry Society.
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Affiliation(s)
- Francesco Licciardi
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Maria Ceci
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Claudia Toppino
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Marco Turco
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Silvana Martino
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Emanuela Ricotti
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
| | - Francesca Ferro
- Department of Immunohaematology, Cardinal Massaia Hospital, Asti, Italy
| | - Davide Montin
- Department of Pediatrics, Città della Salute e della Scienza, Regina Margherita Children Hospital, Turin, Italy
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van den Boogaard ML, Thijssen PE, Aytekin C, Licciardi F, Kıykım AA, Spossito L, Dalm VASH, Driessen GJ, Kersseboom R, de Vries F, van Ostaijen-Ten Dam MM, Ikinciogullari A, Dogu F, Oleastro M, Bailardo E, Daxinger L, Nain E, Baris S, van Tol MJD, Weemaes C, van der Maarel SM. Expanding the mutation spectrum in ICF syndrome: Evidence for a gender bias in ICF2. Clin Genet 2017; 92:380-387. [PMID: 28128455 DOI: 10.1111/cge.12979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/13/2017] [Accepted: 01/23/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Immunodeficiency, centromeric instability, and facial anomalies (ICF) syndrome is a rare, genetically heterogeneous, autosomal recessive disorder. Patients suffer from recurrent infections caused by reduced levels or absence of serum immunoglobulins. Genetically, 4 subtypes of ICF syndrome have been identified to date: ICF1 (DNMT3B mutations), ICF2 (ZBTB24 mutations), ICF3 (CDCA7 mutations), and ICF4 (HELLS mutations). AIM To study the mutation spectrum in ICF syndrome. MATERIALS AND METHODS Genetic studies were performed in peripheral blood lymphocyte DNA from suspected ICF patients and family members. RESULTS We describe 7 ICF1 patients and 6 novel missense mutations in DNMT3B, affecting highly conserved residues in the catalytic domain. We also describe 5 new ICF2 patients, one of them carrying a homozygous deletion of the complete ZBTB24 locus. In a meta-analysis of all published ICF cases, we observed a gender bias in ICF2 with 79% male patients. DISCUSSION The biallelic deletion of ZBTB24 provides strong support for the hypothesis that most ICF2 patients suffer from a ZBTB24 loss of function mechanism and confirms that complete absence of ZBTB24 is compatible with human life. This is in contrast to the observed early embryonic lethality in mice lacking functional Zbtb24. The observed gender bias seems to be restricted to ICF2 as it is not observed in the ICF1 cohort. CONCLUSION Our study expands the mutation spectrum in ICF syndrome and supports that DNMT3B and ZBTB24 are the most common disease genes.
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Affiliation(s)
- M L van den Boogaard
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - P E Thijssen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - C Aytekin
- Department of Pediatric Immunology, Dr Sami Ulus Maternity and Children's Research and Educational Hospital, Ankara, Turkey
| | - F Licciardi
- Department of Paediatrics II, Regina Margherita Hospital Città della Salute e della Scienza di Torino, Torino, Italy
| | - A A Kıykım
- Pediatric Allergy and Immunology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - L Spossito
- Department of Immunology and Rheumatology, Hospital "J.P Garrahan", Buenos Aires, Argentina
| | - V A S H Dalm
- Department of Immunology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - G J Driessen
- Department of Paediatric Infectious Diseases, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Department of Pediatrics, Juliana Children's Hospital, Haga Teaching Hospital, The Hague, The Netherlands
| | - R Kersseboom
- Department of Clinical Genetics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Medical service, Stichting Zuidwester, Middelharnis, The Netherlands
| | - F de Vries
- Department of Clinical Genetics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M M van Ostaijen-Ten Dam
- Department of Pediatrics, Laboratory Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - A Ikinciogullari
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - F Dogu
- Department of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - M Oleastro
- Department of Immunology and Rheumatology, Hospital "J.P Garrahan", Buenos Aires, Argentina
| | - E Bailardo
- Department of Genetics, Hospital "J.P. Garrahan", Buenos Aires, Argentina
| | - L Daxinger
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - E Nain
- Pediatric Allergy and Immunology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - S Baris
- Pediatric Allergy and Immunology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - M J D van Tol
- Department of Pediatrics, Laboratory Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - C Weemaes
- Department of Pediatric Infectious Diseases and Immunology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - S M van der Maarel
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
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Sachdev N, Maxwell S, Jordan A, Prates R, Konstantinidis M, Licciardi F. Determining the odds of pregnancy in brca positive women undergoing combined pre-implantation genetic diagnosis (PGD) and screening. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.796] [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: 11/24/2022]
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McCulloh D, Gonullu D, McCaffrey C, Grifo J, Noyes N, Licciardi F. Oocyte maturation in egg freeze cycles is significantly lower than in fresh ICSI cycles: contributing factors in over 5000 cases. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.679] [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: 11/16/2022]
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Licciardi F, Kramer Y, Lhakhang T, Zhang Y, Tsirigos A, Heguy A. Comprehensive transcriptome characterization of human blastocysts for normals and every known karyotype. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.326] [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: 11/28/2022]
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, Miettunen P, Lovell DJ, Giraldo AS, Lehmberg K, Kitoh T, Khubchandani R, Ilowite NT, Henter JI, Grom AA, De Benedetti F, Behrens EM, Avcin T, Aricò M, Gámir MG, Martini A, Ruperto N, Cron RQ, Ravelli A, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Mendoza AZ, Foster J, Sokolove J, Lahey L, Robinson W, Newson J, Stevens A, Shoop SJW, Hyrich KL, Verstappen SMM, Thomson W, Adrovic A, McDonagh JE, Beukelman T, Kimura Y, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dedeoglu R, Dennos A, Kaufmann R, Schanberg L, Parissenti I, Insalaco A, Taddio A, Mauro A, Pardeo M, Ricci F, Simonini G, Sahin S, Cattalini M, Montesano P, Parissenti I, Ricci F, Bonafini B, Medeghini V, Lancini F, Cattalini M, Gerbaux M, Lê PQ, Barut K, Goffin L, Badot V, La C, Caspers L, Willermain F, Ferster A, Ceci M, Licciardi F, Turco M, Santarelli F, Koka A, Montin D, Toppino C, Maggio MC, Alizzi C, Papia B, Vergara B, Corpora U, Messina L, Corsello G, Tsinti M, Oztunc F, Dermentzoglou V, Tziavas P, Tsitsami E, Perica M, Vidović M, Lamot L, Harjaček M, Bukovac LT, Çakan M, Ayaz NA, Kasapcopur O, Keskindemirci G, Miettunen P, Lang M, Laing C, Benseler S, Gerschman T, Luca N, Schmeling H, Dropol A, Taiani J, Rodriguez-Lozano AL, Johnson N, Rusted B, Nalbanti P, Trachana M, Pratsidou P, Pardalos G, Tzimouli V, Taparkou A, Stavrakidou M, Papachristou F, Rivas-Larrauri F, Kanakoudi-Tsakalidou F, Bale P, Robinson E, Palman J, Pilkington C, Ralph E, Gilmour K, Heard C, Wedderburn LR, Carlomagno R, de la Puente SG, Barrense-Dias Y, Gregory A, Amira D, Paolo S, Sylviane H, Michaël H, Panko N, Shokry S, Rakovska L, Pino S, Alves AGF, Diaz-Maldonado A, Guarnizo P, Torreggiani S, Cressoni P, Garagiola U, Di Landro G, Farronato G, Corona F, Filocamo G, Shenoi S, Giacomin MFDA, Bell S, Bhatti P, Nelson L, Mueller BA, Simon TA, Baheti A, Ray N, Guo Z, Ruperto N, Brunner HI, Farhat J, Hazra A, Stock T, Wang R, Mebus C, Alvey C, Lamba M, Krishnaswami S, Conte U, Wang M, Tzaribachev N, Braga ALF, Foeldvari I, Horneff G, Kingsbury D, Koskova E, Smolewska E, Vehe RK, Zuber Z, Martini A, Lovell D, Kubota T, Sallum AME, Shimizu M, Yasumura J, Nakagishi Y, Kizawa T, Yashiro M, Wakiguchi H, Yamatou T, Yamasaki Y, Takei S, Kawano Y, Campos LMDA, Nykvist UJ, Magnusson B, Wicksell R, Palmblad K, Olsson GL, Ziaee V, Modaressi M, Moradinejad MH, Seraya V, Zholobova E, Pereira LAA, Vitebskaya A, Moshe V, Amarilyo G, Harel L, Hashkes PJ, Mendelson A, Rabinowicz N, Reis Y, Uziel Y, Dāvidsone Z, Lichtenfels AJDFC, Lazareva A, Šantere R, Bērziņa D, Staņēviča V, Varnier GC, Consolaro A, Pilkington C, Maillard S, Ferrari C, Zaffarano S, Silva CA, Martini A, Ravelli A, Wienke J, Enders FB, van den Hoogen LL, Mertens JS, Radstake TR, Hotten HG, Fritsch R, de Jager W, Farhat SCL, Wedderburn L, Nistala K, Pilkington C, Prakken B, van Royen-Kerkhof A, van Wijk F, Alhemairi M, Muzaffer M, Van Dijkhuizen P, Deakin CT, Acar B, Simou S, Wedderburn LR, De Iorio M, Wu Q, Amin T, Simou S, Dossetter L, Wedderburn LR, Pilkington C, Campanilho-Marques R, Ozcakar ZB, Deakin C, Simou S, Wedderburn LR, Pilkington CA, Rosina S, Consolaro A, van Dijkhuizen P, Nistala K, Ruperto N, Pilkington C, Çakar N, Ravelli A, Soponkanaporn S, Simou S, Deakin CT, Wedderburn LR, Arıcı ZS, Tuğcu GD, Batu ED, Sönmez HE, Doğru-Ersöz D, Uncu N, Bilginer Y, Talim B, Kiper N, Özen S, Solyom A, Hügle B, Makay B, Magnusson B, Batu E, Mitchell J, Gür G, Kariminejad A, Hadipour F, Hadipour Z, Torcoletti M, Agostoni C, Di Rocco M, Tanpaiboon P, Superti-Furga A, Bonafé L, Arslan N, Özdel S, Guelbert N, Kostik M, Ehlert K, Grigelioniene G, Puri R, Ozen S, Schuchman E, Malagon C, Gomez P, Mosquera AC, Yalçınkaya F, Gonzalez T, Yepez R, Vargas C, Fernanda F, Lepri G, Ferrari A, Rigante D, Matucci-Cerinic M, Meini A, Moneta GM, Scott C, Caiello I, Marasco E, Nicolai R, Pardeo M, Bracaglia C, Insalaco A, Bracci-Laudiero L, De Benedetti F, Kopchak O, Kostik M, Brice N, Mushkin A, Maletin A, Makay B, Batu ED, Hügle B, Arslan N, Solyom A, Mitchell J, Schuchman E, Ozen S, Nourse P, Magnusson B, Malagon C, Gomez P, Mosquera C, Gonzalez T, Yepez R, Vargas C, Amorim RA, Len CA, Molina J, Lewandowski L, Moreira G, Santos FH, Fraga M, Keppeke L, Silva VM, Hirotsu C, Tufik S, Terreri MT, Braga VL, Fonseca MB, Arango C, Len CA, Fraga M, Schinzel V, Terreri MTR, Molina J, Len CA, Jorge L, Guerra L, Santos FH, Terreri MT, Mosquera AC, Junior EA, Fonseca MB, Braga VL, Len CA, Fraga M, Schinzel V, Terreri MTR, Alizzi C, Maggio MC, Castiglione MC, Malagon C, Tricarico A, Corsello G, Boulter E, Schultz A, Murray K, Falcini F, Lepri G, Stagi S, Bellucci E, Matucci-Cerinic M, Sakamoto AP, Grein IHR, Groot N, Pileggi G, Pinto NBF, de Oliveira AL, Wulffraat N, Chyzheuskaya I, Belyaeva L, Filonovich R, Khrustaleva H, Silva CA, Zajtseva L, Ilisson J, Pruunsild C, Kostik M, Kopchak O, Mushkin A, Maletin A, Gilliaux O, Corazza F, Lelubre C, Silva MFCD, Ferster A, Suárez RG, Morel Z, Espada G, Malagon C, C CSM, Lira L, Ladino M, Eraso R, Arroyo I, Lopes AS, Sztajnbok F, Silva C, Rose C, Russo GCS, Sallum AEM, Kozu K, Bonfá E, Saad-Magalhães C, Pereira RMR, Len CA, Terreri MT, Suri D, Didel S, Rawat A, Singh S, Maritsi D, Onoufriou MA, Vougiouka O, Tsolia M, Bosak EP, Vidović M, Lamot M, Lamot L, Harjaček M, Van Nieuwenhove E, Liston A, Wouters C, Tahghighi F, Ziaee V, Raeeskarami SR, Aguiar F, Pereira S, Rodrigues M, Moura C, Rocha G, Guimarães H, Brito I, Aguiar F, Fonseca R, Rodrigues M, Brito I, Horneff G, Klein A, Minden K, Huppertz HI, Weller-Heinemann F, Kuemmerle-Deschner J, Haas JP, Hospach A, Menendez-Castro R, Huegle B, Haas JP, Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, Marafon DP, Ailioaie C, Tsitsami E, Kamphuis S, Herlin T, Doležalová P, Susic G, Flatø B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N, Gattorno M, Brucato A, Finetti M, Lazaros G, Maestroni S, Carraro M, Cumetti D, Carobbio A, Lorini M, Rimini A, Marcolongo R, Valenti A, Erre GL, Belli R, Gaita F, Sormani MP, Ruperto N, Imazio M, Martini A, Abinun M, Smith N, Rapley T, McErlane F, Kearsley-Fleet L, Hyrich KL, Foster H, Ruperto N, Lovell DJ, Tzaribachev N, Zeft A, Cimaz R, Stanevicha V, Horneff G, Bohnsack J, Griffin T, Carrasco R, Trachana M, Dare J, Foeldvari I, Vehe R, Bovis F, Simon T, Martini A, Brunner H, Verazza S, Davì S, Consolaro A, Insalaco A, Gerloni V, Cimaz R, Zulian F, Pastore S, Corona F, Conti G, Barone P, Cattalini M, Cortis E, Breda L, Olivieri AN, Civino A, Podda R, Rigante D, La Torre F, D’Angelo G, Jorini M, Gallizzi R, Maggio MC, Consolini R, De Fanti A, Alpigiani MG, Martini A, Ravelli A, Sozeri B, Kısaarslan AP, Gunduz Z, Dusunsel R, Dursun I, Poyrazoglu H, Kuchinskaya E, Abduragimova F, Kostik M, Sundberg E, Omarsdottir S, Klevenvall L, Erlandsson-Harris H, Basbozkurt G, Erdemli O, Simsek D, Yazici F, Karsioglu Y, Tezcaner A, Keskin D, Ozkan H, Acikel C, Ozen S, Demirkaya E, Orbán I, Sevcic K, Brodszky V, Kiss E, Tekko IA, Rooney M, McElnay J, Taggart C, McCarthy H, Donnelly RF, Abinun M, Slatter M, Nademi Z, Friswell M, Foster H, Jandial S, McErlane F, Flood T, Hambleton S, Gennery A, Cant A, Finetti M, Bovis F, Swart J, Doležalová P, Tsitsami E, Trachana M, Demirkaya E, Duong PN, Koné-Paut I, Vougiouka O, Marafon DP, Cimaz R, Filocamo G, Gamir ML, Stanevicha V, Sanner H, Carenini L, Wulffraat N, Martini A, Ruperto N, Topdemir M, Basbozkurt G, Karslioglu Y, Ozkan H, Acikel C, Demirkaya E, Gok F, Zholobova E, Tsurikova N, Ligostaeva E, Ramchurn NR, Friswell M, Kostareva O, Nikishina I, Arsenyeva S, Rodionovskaya S, Kaleda M, Alexeev D, Dursun ID, Sozeri B, Kısaarslan AP, Dusunsel R, Poyrazoglu H, Poyrazoglu H, Murias S, Barral E, Alcobendas R, Enriquez E, Remesal A, de Inocencio J, Castro TM, Lotufo SA, Freye T, Carlomagno R, Zumbrunn T, Bonhoeffer J, Schneider EC, Kaiser D, Hofer M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Masbou A, Friedenthal J, McCulloh D, Fino M, Licciardi F. A comparative study of preimplantation genetic screening (PGS) vs no PGS in donor egg single embryo transfer cycles reveals limited benefit of biopsy on pregnancy rates. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.02.038] [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: 11/24/2022]
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Masbou A, McCulloh D, McCaffrey C, Fino M, Licciardi F. Using donors as their own controls in evaluating the effectiveness of fresh versus frozen oocytes. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.02.037] [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: 10/19/2022]
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Canessa C, Iacopelli J, Pecoraro A, Spadaro G, Matucci A, Milito C, Vultaggio A, Agostini C, Cinetto F, Danieli MG, Gambini S, Marasco C, Trizzino A, Vacca A, De Mattia D, Martire B, Plebani A, Di Gioacchino M, Gatta A, Finocchi A, Licciardi F, Martino S, De Carli M, Moschese V, Azzari C. Shift from intravenous or 16% subcutaneous replacement therapy to 20% subcutaneous immunoglobulin in patients with primary antibody deficiencies. Int J Immunopathol Pharmacol 2016; 30:73-82. [PMID: 27927705 PMCID: PMC5806788 DOI: 10.1177/0394632016681577] [Citation(s) in RCA: 19] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
In patients with primary antibody deficiencies, subcutaneous administration of IgG (SCIG) replacement is effective, safe, well-tolerated, and can be self-administered at home. A new SCIG replacement at 20% concentration (Hizentra®) has been developed and has replaced Vivaglobin® (SCIG 16%). An observational prospective multi-centric open-label study, with retrospective comparison was conducted in 15 Italian centers, in order to investigate whether and to what extent switching to Hizentra® would affect frequency of infusions, number of infusion sites, patients’ satisfaction, and tolerability in patients previously treated with Vivaglobin® or intravenous immunoglobulins (IVIG). Any variations of dosage, frequency and duration of the infusions, and of number of infusion sites induced by Hizentra® with respect to the former treatment were recorded. Practical advantages and disadvantages of Hizentra®, with respect to the medicinal product formerly used, and the variations in patients’ therapy-related satisfaction were monitored by means of the TSQM (Treatment Satisfaction Questionnaire for Medication); number, frequency, and duration of infectious events and adverse effects were recorded. Eighty-two patients switched to Hizentra®: 19 (23.2%) from IVIG and 63 (76.8%) from Vivaglobin®. The mean interval between infusions was not affected by the shift (7.0 ± 2.0 days with previous treatment versus 7.1 ± 1.2 during Hizentra®). A decrease in the number of infusion sites with Hizentra® was recorded in 12 out of 56 patients for whom these data were available. At 6 months, 89.7% of patients were satisfied with Hizentra®; no difference in terms of effectiveness, side effects, convenience, and global satisfaction was observed. No difference in the incidence of adverse events was reported.
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Affiliation(s)
- Clementina Canessa
- 1 Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Jessica Iacopelli
- 1 Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Antonio Pecoraro
- 2 Department of Translational Medical Sciences, Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Spadaro
- 2 Department of Translational Medical Sciences, Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | | | - Cinzia Milito
- 4 Molecular Medicine Department, Sapienza University of Rome, Rome, Italy
| | | | - Carlo Agostini
- 5 Department of Medicine DIMED, Clinical Immunology, Padova University, Padova, Italy
| | - Francesco Cinetto
- 5 Department of Medicine DIMED, Clinical Immunology, Padova University, Padova, Italy
| | | | | | - Carolina Marasco
- 7 Department of Biomedical Sciences and Human Oncology, Clinica Medica "G. Baccelli", University of Bari Medical School, Bari, Italy
| | - Antonino Trizzino
- 8 Department of Pediatric Hematology and Oncology, ARNAS Civico, Palermo, Italy
| | - Angelo Vacca
- 7 Department of Biomedical Sciences and Human Oncology, Clinica Medica "G. Baccelli", University of Bari Medical School, Bari, Italy
| | - Domenico De Mattia
- 9 Neonatology and NICU, Department of Biochemical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Baldassarre Martire
- 10 Department of Pediatric Science and Surgery, Pediatric Hospital "Policlinico-Giovanni XXIII", Bari, Italy
| | - Alessandro Plebani
- 11 Department of Clinical and Experimental Sciences, Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Mario Di Gioacchino
- 12 Department of Medicine and Science of Ageing, "G. d'Annunzio" University, Chieti, Italy
| | - Alessia Gatta
- 12 Department of Medicine and Science of Ageing, "G. d'Annunzio" University, Chieti, Italy
| | - Andrea Finocchi
- 13 Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, Rome, Italy.,14 Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Licciardi
- 15 SCDU Pediatria II, Immunoreumatologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvana Martino
- 15 SCDU Pediatria II, Immunoreumatologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco De Carli
- 16 Dipartimento di Medicina Interna, Azienda Ospedaliera Universitaria Santa Maria della Misericordia, Udine, Italy
| | - Viviana Moschese
- 17 Department of Pediatrics, "Tor Vergata" University, Policlinico "Tor Vergata", Rome, Italy
| | - Chiara Azzari
- 1 Anna Meyer Children's Hospital, University of Florence, Florence, Italy
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Licciardi F, Montin D, Versace A, Migliore G, Tzialla C, Fellay J, Borghesi A. Familial segregation of group B streptococcal infection in a consanguineous kindred. Int J Infect Dis 2016; 51:22-24. [DOI: 10.1016/j.ijid.2016.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/12/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022] Open
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