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Buonocore M, Grimaldi M, Santoro A, Covelli V, Marino C, Napolitano E, Novi S, Tecce MF, Ciaglia E, Montella F, Lopardo V, Perugini V, Santin M, D’Ursi AM. Exploiting the Features of Short Peptides to Recognize Specific Cell Surface Markers. Int J Mol Sci 2023; 24:15610. [PMID: 37958593 PMCID: PMC10650159 DOI: 10.3390/ijms242115610] [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: 09/27/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Antibodies are the macromolecules of choice to ensure specific recognition of biomarkers in biological assays. However, they present a range of shortfalls including a relatively high production cost and limited tissue penetration. Peptides are relatively small molecules able to reproduce sequences of highly specific paratopes and, although they have less biospecificity than antibodies, they offer advantages like ease of synthesis, modifications of their amino acid sequences and tagging with fluorophores and other molecules required for detection. This work presents a strategy to design peptide sequences able to recognize the CD44 hyaluronic acid receptor present in the plasmalemma of a range of cells including human bone marrow stromal mesenchymal cells. The protocol of identification of the optimal amino acid sequence was based on the combination of rational design and in silico methodologies. This protocol led to the identification of two peptide sequences which were synthesized and tested on human bone marrow mesenchymal stromal cells (hBM-MSCs) for their ability to ensure specific binding to the CD44 receptor. Of the two peptides, one binds CD44 with sensitivity and selectivity, thus proving its potential to be used as a suitable alternative to this antibody in conventional immunostaining. In the context of regenerative medicine, the availability of this peptide could be harnessed to functionalize tissue engineering scaffolds to anchor stem cells as well as to be integrated into systems such as cell sorters to efficiently isolate MSCs from biological samples including various cell subpopulations. The data here reported can represent a model for developing peptide sequences able to recognize hBM-MSCs and other types of cells and for their integration in a range of biomedical applications.
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Affiliation(s)
- Michela Buonocore
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- Department of Chemical Sciences, University of Naples Federico II, 80138 Naples, Italy
| | - Manuela Grimaldi
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
| | - Angelo Santoro
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- Scuola di Specializzazione in Farmacia Ospedaliera, University of Salerno, 84084 Fisciano, Italy
| | - Verdiana Covelli
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Carmen Marino
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- PhD Program in Drug Discovery and Development, Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
| | - Enza Napolitano
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- PhD Program in Drug Discovery and Development, Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
| | - Sara Novi
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
- PhD Program in Drug Discovery and Development, Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy
| | - Mario Felice Tecce
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (E.C.); (F.M.); (V.L.)
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (E.C.); (F.M.); (V.L.)
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (E.C.); (F.M.); (V.L.)
| | - Valeria Perugini
- Centre for Regenerative Medicine and Devices, School of Applied Sciences, University of Brighton, Brighton BN2 4AT, UK; (V.P.); (M.S.)
| | - Matteo Santin
- Centre for Regenerative Medicine and Devices, School of Applied Sciences, University of Brighton, Brighton BN2 4AT, UK; (V.P.); (M.S.)
| | - Anna Maria D’Ursi
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy or (M.B.); (M.G.); (A.S.); or (V.C.); (C.M.); (E.N.); (S.N.); (M.F.T.)
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Foglia F, Della Rocca M, Melardo C, Nastri B, Manfredini M, Montella F, De Filippis A, Finamore E, Galdiero M. Bloodstream infections and antibiotic resistance patterns: a six-year surveillance study from southern Italy. Pathog Glob Health 2023; 117:381-391. [PMID: 36190133 PMCID: PMC10177691 DOI: 10.1080/20477724.2022.2129161] [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] [Indexed: 10/10/2022] Open
Abstract
Bloodstream infections (BSI) are associated with high morbidity and mortality. This study aimed to describe the epidemiology of BSI and antimicrobial resistance patterns amongst its common bacterial causes. We conducted a retrospective record review of blood culture results of patients hospitalized with BSI at University Hospital 'L. Vanvitelli' from 2016 to 2021. For each patient records were obtained from the database using microbiological information. Gram-positive bacteria were the most predominant pathogens followed by Gram-negative bacteria. Among all isolates, bacterial pathogens most frequently identified included coagulase-negative Staphylococci (CoNS), Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and enterococci. We noted a general decrease in antimicrobial resistance amongst BSI pathogens in the latter years of the study. High levels of macrolide and aminoglycoside resistance amongst CoNS were reported. Carbapenem resistance amongst E. coli was barely reported, while resistance rates amongst K. pneumoniae declined considerably between 2018 and 2021. The prevalence of methicillin-resistant S. aureus decreased during the study period while that of methicillin-resistant CoNS remained relatively high throughout. The prevalence of extended spectrum ß-lactamase - producing E. coli increased considerably between 2016 and 2018 but showed a slight decrease thereafter. Conversely, there was a general decline in the resistant rates of extended spectrum ß-lactamase - producing K. pneumoniae between 2016 and 2018 with a similar trend being noted for carbapenem resistance in K. pneumoniae. Continuously monitoring the changes in the trends in BSI microbiological profiles, including pathogen profiles and the associated antibiotic resistance patterns, can help diagnostic approaches, treatment strategies and prevention programs.
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Affiliation(s)
- F. Foglia
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - M.T. Della Rocca
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - C. Melardo
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - B.M. Nastri
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - M. Manfredini
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - F. Montella
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - A. De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - E. Finamore
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Massimiliano Galdiero
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Lopardo V, Montella F, Esposito RM, Zannella C, Aliberti SM, Capunzo M, Franci G, Puca AA, Ciaglia E. SARS-CoV-2 Lysate Stimulation Impairs the Release of Platelet-like Particles and Megakaryopoiesis in the MEG-01 Cell Line. Int J Mol Sci 2023; 24:ijms24054723. [PMID: 36902151 PMCID: PMC10003077 DOI: 10.3390/ijms24054723] [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: 12/06/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
SARS-CoV-2 infection causes a considerable inflammatory response coupled with impaired platelet reactivity, which can lead to platelet disorders recognized as negative prognostic factors in COVID-19 patients. The virus may cause thrombocytopenia or thrombocytosis during the different disease stages by destroying or activating platelets and influencing platelet production. While it is known that several viruses can impair megakaryopoiesis by generating an improper production and activation of platelets, the potential involvement of SARS-CoV-2 in affecting megakaryopoiesis is poorly understood. To this purpose, we explored, in vitro, the impact of SARS-CoV-2 stimulation in the MEG-01 cell line, a human megakaryoblastic leukemia cell line, considering its spontaneous capacity of releasing platelet-like particles (PLPs). We interrogated the effect of heat-inactivated SARS-CoV-2 lysate in the release of PLPs and activation from MEG-01, the signaling pathway influenced by SARS-CoV-2, and the functional effect on macrophagic skewing. The results highlight the potential influence of SARS-CoV-2 in the early stages of megakaryopoiesis by enhancing the production and activation of platelets, very likely due to the impairment of STATs signaling and AMPK activity. Overall, these findings provide new insight into the role of SARS-CoV-2 in affecting megakaryocyte-platelet compartment, possibly unlocking another avenue by which SARS-CoV-2 moves.
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Affiliation(s)
- Valentina Lopardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
| | - Roberta Maria Esposito
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy
- Correspondence: (A.A.P.); (E.C.); Tel.: +39-089965235 (A.A.P.); +39-089965115 (E.C.); Fax: +39-089969602 (A.A.P. & E.C.)
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy
- Correspondence: (A.A.P.); (E.C.); Tel.: +39-089965235 (A.A.P.); +39-089965115 (E.C.); Fax: +39-089969602 (A.A.P. & E.C.)
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Ciaglia E, Montella F, Lopardo V, Esposito RM, Guarracino F, Spinetti G, Maciag AA, Ciccarelli M, Vitale C, Pellegrino SG, Polverino B, Izzo C, Vecchione C, Puca AA. Autoantibodies against the cardiovascular protective BPIFB4 in hospitalized patients with COVID-19. Eur Heart J 2022. [PMCID: PMC9619705 DOI: 10.1093/eurheartj/ehac544.2936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background/Introduction The bactericidal/permeability-increasing fold-containing family-B-member-4 (BPIFB4) serves as a biomarker of healthy aging [1,2] and displays prognostic relevance in vascular pathology [3–5]. We recently described a drop in plasma BPIFB4 level in patients with severe COVID-19 compared to low-grade disease patients [6]. Purpose As COVID-19 is associated with autoimmune features, we developed the methods for determination of Anti-BPIFB4 IgG (autoAbs) and then characterized their neutralizing activity in COVID-19 patients. Methods A sandwich ELISA-based colorimetric assay followed by immunoblot analysis detected the presence of autoAbs against BPIFB4 in 60 hospitalized COVID-19 patients and in 30 healthy volunteers. Compared to the healthy controls, the optical density (OD) level of autoAbs in COVID-19 showed considerable variability distributing over a range between 0.13 and 0.85. We thus divided the patients into two groups, one with OD >0,29 and the other one with a OD >0,29, where 0,29 represents the OD mean value of autoAbs against BPIFB4 in physiological conditions. Results Since patients with higher OD are mainly those who spend in average a higher number of days in hospital, we stratified the patients according to the Length of Stay (LoS) in hospital (Figure 1), and found a trend towards a positive correlation between AutoAbs OD level and length of hospitalization within COVID-19 patients. When present, autoAbs exclusively target the WT-BPIFB4 autoantigens and neglect the recognition of the Longevity-associated-variant-(LAV) of the BPIFB4 gene known for its therapeutic efficacy in cardiomyopathy, atherosclerosis (4), diabetes (6) and platelets' reactivity. As expected, the pre-treatment of human PrP with the recombinant rhLAV-BPIFB4 reduces platelets' aggregation in response to ADP and collagen in COVID-19 patients in vitro. On the other hand, at functional level, the well established LAV-BPIFB4-regulated M2 macrophage polarization (4,7), is neutralized in presence of anti-BPIFB4 autoAbs-enriched plasma. Conclusion We conclude that a significant proportion of hospitalized COVID-19 patients displays BPIFB4-AutoAbs which are positively correlated with the Length of Stay (LoS) in hospital. In future, it will be of utmost importance to clarify if the 4 missense SNPs which distinguish LAV-BPIFB4 gene from its WT-counterpart, are instrumental to prevent the self-tolerance brake-down and the potential development of specific antibodies against endogenous cardiovascular protectors. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Cariplo Foundation (n.2016-0874) to AAP and CV; Ministry of Health (RF-2016-02364864) to AAP and CV
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Affiliation(s)
- E Ciaglia
- University of Salerno School of Medicine , Salerno , Italy
| | - F Montella
- University of Salerno School of Medicine , Salerno , Italy
| | - V Lopardo
- University of Salerno School of Medicine , Salerno , Italy
| | - R M Esposito
- University of Salerno School of Medicine , Salerno , Italy
| | - F Guarracino
- University of Salerno School of Medicine , Salerno , Italy
| | | | | | - M Ciccarelli
- University of Salerno School of Medicine , Salerno , Italy
| | - C Vitale
- San Giovanni di Dio and Ruggi d'Aragona University Hospital , Salerno , Italy
| | - S G Pellegrino
- San Giovanni di Dio and Ruggi d'Aragona University Hospital , Salerno , Italy
| | - B Polverino
- San Giovanni di Dio and Ruggi d'Aragona University Hospital , Salerno , Italy
| | - C Izzo
- University of Salerno School of Medicine , Salerno , Italy
| | - C Vecchione
- University of Salerno School of Medicine , Salerno , Italy
| | - A A Puca
- University of Salerno School of Medicine , Salerno , Italy
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Montella F, Lopardo V, Cattaneo M, Carrizzo A, Vecchione C, Ciaglia E, Puca AA. Role of BPIFB4 in Immune System and Cardiovascular Disease: the Lesson from Centenarians. Transl Med UniSa 2022. [DOI: 10.37825/2239-9747.1024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Puca AA, Lopardo V, Montella F, Di Pietro P, Cesselli D, Rolle IG, Bulfoni M, Di Sarno V, Iaconetta G, Campiglia P, Vecchione C, Beltrami AP, Ciaglia E. The Longevity-Associated Variant of BPIFB4 Reduces Senescence in Glioma Cells and in Patients' Lymphocytes Favoring Chemotherapy Efficacy. Cells 2022; 11:294. [PMID: 35053408 PMCID: PMC8774353 DOI: 10.3390/cells11020294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/22/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
Glioblastoma (GBM) is the most common primary brain cancer with the median age at diagnosis around 64 years, thus pointing to aging as an important risk factor. Indeed, aging, by increasing the senescence burden, is configured as a negative prognostic factor for GBM stage. Furthermore, several anti-GBM therapies exist, such as temozolomide (TMZ) and etoposide (ETP), that unfortunately trigger senescence and the secretion of proinflammatory senescence-associated secretory phenotype (SASP) factors that are responsible for the improper burst of (i) tumorigenesis, (ii) cancer metastasis, (iii) immunosuppression, and (iv) tissue dysfunction. Thus, adjuvant therapies that limit senescence are urgently needed. The longevity-associated variant (LAV) of the bactericidal/permeability-increasing fold-containing family B member 4 (BPIFB4) gene previously demonstrated a modulatory activity in restoring age-related immune dysfunction and in balancing the low-grade inflammatory status of elderly people. Based on the above findings, we tested LAV-BPIFB4 senotherapeutic effects on senescent glioblastoma U87-MG cells and on T cells from GBM patients. We interrogated SA-β-gal and HLA-E senescence markers, SASP factors, and proliferation and apoptosis assays. The results highlighted a LAV-BPIFB4 remodeling of the senescent phenotype of GBM cells, enhancement of their sensitivity to temozolomide and a selective reduction of the T cells' senescence from GBM patients. Overall, these findings candidate LAV-BPIFB4 as an adjuvant therapy for GBM.
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Affiliation(s)
- Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
| | - Daniela Cesselli
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Irene Giulia Rolle
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Michela Bulfoni
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Veronica Di Sarno
- Department of Pharmacy, University of Salerno, Via G. Paolo II 132, Fisciano, 84084 Salerno, Italy; (V.D.S.); (P.C.)
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Department of Neurosurgery, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, Via G. Paolo II 132, Fisciano, 84084 Salerno, Italy; (V.D.S.); (P.C.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, 86077 Isernia, Italy
| | - Antonio Paolo Beltrami
- Department of Medicine, University of Udine, 33100 Udine, Italy; (D.C.); (I.G.R.); (M.B.); (A.P.B.)
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, Baronissi, 84081 Salerno, Italy; (V.L.); (F.M.); (P.D.P.); (G.I.); (C.V.)
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Montella F, Lopardo V, Cattaneo M, Carrizzo A, Vecchione C, Ciaglia E, Puca AA. The Role of BPIFB4 in Immune System and Cardiovascular Disease: The Lesson from Centenarians. Transl Med UniSa 2021; 24:1-12. [PMID: 36447743 PMCID: PMC9673912 DOI: 10.37825/2239-9754.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/16/2021] [Accepted: 12/28/2021] [Indexed: 06/16/2023] Open
Abstract
Recent discoveries have shed light on the participation of the immune system in the physio pathology of the cardiovascular system underpinning the importance of keeping the balance of the first to preserve the latter. Aging, along with other risk factors, can challenge such balance triggering the onset of cardiovascular diseases. Among several mediators ensuring the proper cross-talk between the two systems, bactericidal/permeability-increasing fold-containing family B member 4 (BPIFB4) has been shown to have a pivotal role, also by sustaining important signals such as eNOS and PKC-alpha. In addition, the Longevity-associated variant (LAV), which is an haplotype allele in BPIFB4 characterized by 4 missense polymorphisms, enriched in homozygosity in Long Living Individuals (LLIs), has been shown to be efficient, if administered systemically through gene therapy, in improving many aspects of cardiovascular diseases (CVDs). This occurs mainly through a fine immune system remodeling across: 1) a M2 macrophage polarizing effect, 2) a favorable redistribution of the circulating monocyte cell subsets and 3) the reduction of T-cell activation. Furthermore, LAV-BPIFB4 treatment induced a desirable recovery of the inflammatory balance by mitigating the pro-inflammatory factor levels and enhancing the anti-inflammatory boost through a mechanism that is partially dependent on SDF-1/CXCR4 axis. Importantly, the remarkable effects of LAV-BPIFB4 treatment, which translates in increased BPIFB4 circulating levels, mirror what occurs in long-living individuals (LLIs) in whom the high circulating levels of BPIFB4 are protective from age-related and CVDs and emphasize the reason why LLIs are considered a model of successful aging. Here, we review the mechanisms by which LAV-BPIFB4 exerts its immunomodulatory activity in improving the cardiovascular-immune system dialogue that might strengthen its role as a key mediator in CVDs.
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Affiliation(s)
- Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
| | - Monica Cattaneo
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138, Milan,
Italy
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
- Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, 86077, Isernia,
Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
- Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, 86077, Isernia,
Italy
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Salvatore Allende, 84081, Baronissi, Salerno,
Italy
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138, Milan,
Italy
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Ciaglia E, Lopardo V, Montella F, Sellitto C, Manzo V, De Bellis E, Iannaccone T, Franci G, Zannella C, Pagliano P, Di Pietro P, Carrizzo A, Vecchione C, Conti V, Filippelli A, Puca AA. BPIFB4 Circulating Levels and Its Prognostic Relevance in COVID-19. J Gerontol A Biol Sci Med Sci 2021; 76:1775-1783. [PMID: 34396395 PMCID: PMC8436991 DOI: 10.1093/gerona/glab208] [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] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Indexed: 02/06/2023] Open
Abstract
Aging and comorbidities make individuals at greatest risk of COVID-19 serious illness and mortality due to senescence-related events and deleterious inflammation. Long-living individuals (LLIs) are less susceptible to inflammation and develop more resiliency to COVID-19. As demonstrated, LLIs are characterized by high circulating levels of BPIFB4, a protein involved in homeostatic response to inflammatory stimuli. Also, LLIs show enrichment of homozygous genotype for the minor alleles of a 4 missense single-nucleotide polymorphism haplotype (longevity-associated variant [LAV]) in BPIFB4, able to counteract progression of diseases in animal models. Thus, the present study was designed to assess the presence and significance of BPIFB4 level in COVID-19 patients and the potential therapeutic use of LAV-BPIFB4 in fighting COVID-19. BPIFB4 plasma concentration was found significantly higher in LLIs compared to old healthy controls while it significantly decreased in 64 COVID-19 patients. Further, the drop in BPIFB4 values correlated with disease severity. Accordingly to the LAV-BPIFB4 immunomodulatory role, while lysates of SARS-CoV-2-infected cells induced an inflammatory response in healthy peripheral blood mononuclear cells in vitro, the co-treatment with recombinant protein (rh) LAV-BPIFB4 resulted in a protective and self-limiting reaction, culminating in the downregulation of CD69 activating-marker for T cells (both TCD4+ and TCD8+) and in MCP-1 reduction. On the contrary, rhLAV-BPIFB4 induced a rapid increase in IL-18 and IL-1b levels, shown largely protective during the early stages of the virus infection. This evidence, along with the ability of rhLAV-BPIFB4 to counteract the cytotoxicity induced by SARS-CoV-2 lysate in selected target cell lines, corroborates BPIFB4 prognostic value and open new therapeutic possibilities in more vulnerable people.
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Affiliation(s)
- Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Teresa Iannaccone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Infectious Diseases Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
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9
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Armenia D, Di Carlo D, Flandre P, Bouba Y, Borghi V, Forbici F, Bertoli A, Gori C, Fabeni L, Gennari W, Pinnetti C, Mondi A, Cicalini S, Gagliardini R, Vergori A, Bellagamba R, Malagnino V, Montella F, Colafigli M, Latini A, Marocco R, Licthner M, Andreoni M, Mussini C, Ceccherini-Silberstein F, Antinori A, Perno CF, Santoro MM. HIV MDR is still a relevant issue despite its dramatic drop over the years. J Antimicrob Chemother 2021; 75:1301-1310. [PMID: 31976521 DOI: 10.1093/jac/dkz554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/16/2019] [Accepted: 12/11/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To evaluate the prevalence and therapeutic relevance of drug resistance among isolates from ART-experienced HIV-1-infected patients over the past two decades in Italy. METHODS Dynamics of resistance to one, two and three or more antiretroviral classes were evaluated from 1999-2018. Virological success (VS) after the latest therapy switch was evaluated according to cumulative class resistance and cumulative genotypic susceptibility score (Stanford HIV_DB algorithm). RESULTS Among 13 663 isolates (from 6739 patients), resistance to at least one drug class decreased sharply from 1999 to 2010 (≤2001, 84.6%; 2010, 43.6%; P < 0.001), then remained relatively constant at ∼40% during 2010-18, with the proportion of resistance to three or more classes also stable (∼5%). After 2008, integrase inhibitor resistance slightly increased from 5.6% to 9.7% in 2018 and contributed to resistance, particularly in isolates with resistance to three or more classes (one class, 8.4%; two classes, 15.3%; three or more classes, 34.7%, P < 0.001). Among 1827 failing patients with an available follow-up, by 1 year after genotype-guided therapy start the probability of VS was 87.6%. Patients with cumulative resistance to three or more classes and receiving a poorly active regimen showed the lowest probability (62.6%) of VS (P < 0.001) compared with all other patients (≥81.8%). By Cox regression analysis, cumulative MDR and receiving poorly active antiretroviral regimens were associated with a lower hazard of VS compared with those without resistance. CONCLUSIONS A dramatic drop of HIV-1 drug resistance at failure has been achieved over the last two decades in Italy; resistance to three or more classes is low but present among currently failing patients. Its management still requires a rational and careful diagnostic and therapeutic approach.
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Affiliation(s)
- D Armenia
- UniCamillus International University of Health and Medical Sciences, Rome, Italy.,University of Rome 'Tor Vergata', Department of Experimental Medicine, Rome, Italy
| | - D Di Carlo
- University of Milan, Pediatric Clinical Research Center 'Romeo and Enrica Invernizzi', Milan, Italy
| | - P Flandre
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP) équipe Epidémiologie clinique des maladies virales chroniques, Paris, France
| | - Y Bouba
- University of Rome 'Tor Vergata', Department of Experimental Medicine, Rome, Italy.,Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management (CIRCB), Yaoundé, Cameroon
| | - V Borghi
- Clinic of Infectious Diseases, University Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | - F Forbici
- Laboratory of Virology, National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - A Bertoli
- University of Rome 'Tor Vergata', Department of Experimental Medicine, Rome, Italy
| | - C Gori
- Laboratory of Virology, National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - L Fabeni
- University of Rome 'Tor Vergata', Department of Experimental Medicine, Rome, Italy
| | - W Gennari
- Microbiology Unit, University Hospital of Modena, Modena, Italy
| | - C Pinnetti
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - A Mondi
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - S Cicalini
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - R Gagliardini
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - A Vergori
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - R Bellagamba
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - V Malagnino
- Clinical Infectious Diseases, University Hospital 'Tor Vergata', Rome, Italy
| | - F Montella
- Infectious disease Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - M Colafigli
- Unit of Dermatology and Sexually Transmitted Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Latini
- Unit of Dermatology and Sexually Transmitted Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - R Marocco
- Infectious Diseases Unit, 'Sapienza' University, Polo Pontino, Latina, Italy
| | - M Licthner
- Infectious Diseases Unit, 'Sapienza' University, Polo Pontino, Latina, Italy
| | - M Andreoni
- Clinical Infectious Diseases, University Hospital 'Tor Vergata', Rome, Italy
| | - C Mussini
- Clinic of Infectious Diseases, University Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | - A Antinori
- HIV/AIDS Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani' IRCCS, Rome, Italy
| | - C F Perno
- Laboratory of Virology, National Institute for Infectious Diseases 'Lazzaro Spallanzani', IRCCS, Rome, Italy
| | - M M Santoro
- University of Rome 'Tor Vergata', Department of Experimental Medicine, Rome, Italy
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10
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Puca AA, Carrizzo A, Spinelli C, Damato A, Ambrosio M, Villa F, Ferrario A, Maciag A, Fornai F, Lenzi P, Valenti V, di Nonno F, Accarino G, Madonna M, Forte M, Calì G, Baragetti A, Norata GD, Catapano AL, Cattaneo M, Izzo R, Trimarco V, Montella F, Versaci F, Auricchio A, Frati G, Sciarretta S, Madeddu P, Ciaglia E, Vecchione C. Single systemic transfer of a human gene associated with exceptional longevity halts the progression of atherosclerosis and inflammation in ApoE knockout mice through a CXCR4-mediated mechanism. Eur Heart J 2021; 41:2487-2497. [PMID: 31289820 PMCID: PMC7340354 DOI: 10.1093/eurheartj/ehz459] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 01/03/2019] [Revised: 04/13/2019] [Accepted: 06/22/2019] [Indexed: 12/22/2022] Open
Abstract
Aims Here, we aimed to determine the therapeutic effect of longevity-associated variant (LAV)-BPIFB4 gene therapy on atherosclerosis. Methods and results ApoE knockout mice (ApoE−/−) fed a high-fat diet were randomly allocated to receive LAV-BPIFB4, wild-type (WT)-BPIFB4, or empty vector via adeno-associated viral vector injection. The primary endpoints of the study were to assess (i) vascular reactivity and (ii) atherosclerotic disease severity, by Echo-Doppler imaging, histology and ultrastructural analysis. Moreover, we assessed the capacity of the LAV-BPIFB4 protein to shift monocyte-derived macrophages of atherosclerotic mice and patients towards an anti-inflammatory phenotype. LAV-BPIFB4 gene therapy rescued endothelial function of mesenteric and femoral arteries from ApoE−/− mice; this effect was blunted by AMD3100, a CXC chemokine receptor type 4 (CXCR4) inhibitor. LAV-BPIFB4-treated mice showed a CXCR4-mediated shift in the balance between Ly6Chigh/Ly6Clow monocytes and M2/M1 macrophages, along with decreased T cell proliferation and elevated circulating levels of interleukins IL-23 and IL-27. In vitro conditioning with LAV-BPIFB4 protein of macrophages from atherosclerotic patients resulted in a CXCR4-dependent M2 polarization phenotype. Furthermore, LAV-BPIFB4 treatment of arteries explanted from atherosclerotic patients increased the release of atheroprotective IL-33, while inhibiting the release of pro-inflammatory IL-1β, inducing endothelial nitric oxide synthase phosphorylation and restoring endothelial function. Finally, significantly lower plasma BPIFB4 was detected in patients with pathological carotid stenosis (>25%) and intima media thickness >2 mm. Conclusion Transfer of the LAV of BPIFB4 reduces the atherogenic process and skews macrophages towards an M2-resolving phenotype through modulation of CXCR4, thus opening up novel therapeutic possibilities in cardiovascular disease. ![]()
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Affiliation(s)
- Annibale Alessandro Puca
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy.,Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | | | - Chiara Spinelli
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy
| | - Antonio Damato
- IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy
| | | | - Francesco Villa
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy
| | - Anna Ferrario
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy
| | - Anna Maciag
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy
| | - Francesco Fornai
- IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Roma 55, 56126 Pisa, Italy
| | - Paola Lenzi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Roma 55, 56126 Pisa, Italy
| | | | | | - Giulio Accarino
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | | | - Maurizio Forte
- IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy
| | - Gaetano Calì
- Department of Endocrinology and Experimental Oncology Institute, CNR, Via Sergio Pansini, 80131 Naples, Italy
| | - Andrea Baragetti
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi di Milano, via Vanvitelli 32, 20129 Milan, Italy
| | - Giuseppe Danilo Norata
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi di Milano, via Vanvitelli 32, 20129 Milan, Italy.,Società Italiana per lo Studio della Arteriosclerosi (SISA) Centro Aterosclerosi, Bassini Hospital, Cinisello Balsamo, 20092 Milan, Italy
| | - Alberico Luigi Catapano
- Department of Pharmacological and Biomolecular Sciences, Università Degli Studi di Milano, via Vanvitelli 32, 20129 Milan, Italy.,IRCCS Multimedica Hospital, 20099 Sesto San Giovanni Milan, Italy
| | - Monica Cattaneo
- Ageing Unit, IRCCS MultiMedica, Via G. Fantoli 16/15, 20138 Milan, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, University Federico II of Naples, 80131 Naples, Italy
| | - Valentina Trimarco
- Department of Advanced Biomedical Sciences, University Federico II of Naples, 80131 Naples, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | - Francesco Versaci
- UOC Cardiologia Ospedale Santa Maria Goretti, 04100 Latina, Italy.,Department of Cardiovascular Disease, Tor Vergata University of Rome, 00133 Rome, Italy
| | - Alberto Auricchio
- Telethon Institute of Genetics and Medicine (TIGEM), 80078 Pozzuoli (Na), Italy.,Department of Advanced Biomedicine, Federico II University, 80131 Naples, Italy
| | - Giacomo Frati
- IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy.,Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, via Faggiana, 40100 Latina, Italy
| | - Sebastiano Sciarretta
- IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy.,Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, via Faggiana, 40100 Latina, Italy
| | - Paolo Madeddu
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Upper Maudlin Street, Bristol BS2 8HW, UK
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy.,IRCCS Neuromed, Loc. Camerelle, 86077 Pozzilli (IS), Italy
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11
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Paparo L, Nocerino R, Ciaglia E, Di Scala C, De Caro C, Russo R, Trinchese G, Aitoro R, Amoroso A, Bruno C, Di Costanzo M, Passariello A, Messina F, Agangi A, Napolitano M, Voto L, Gatta GD, Pisapia L, Montella F, Mollica MP, Calignano A, Puca A, Berni Canani R. Butyrate as a bioactive human milk protective component against food allergy. Allergy 2021; 76:1398-1415. [PMID: 33043467 PMCID: PMC8247419 DOI: 10.1111/all.14625] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Food allergy (FA) is a growing health problem worldwide. Effective strategies are advocated to limit the disease burden. Human milk (HM) could be considered as a protective factor against FA, but its mechanisms remain unclear. Butyrate is a gut microbiota-derived metabolite able to exert several immunomodulatory functions. We aimed to define the butyrate concentration in HM, and to see whether the butyrate concentration detected in HM is able to modulate the mechanisms of immune tolerance. METHODS HM butyrate concentration from 109 healthy women was assessed by GS-MS. The effect of HM butyrate on tolerogenic mechanisms was assessed in in vivo and in vitro models. RESULTS The median butyrate concentration in mature HM was 0.75 mM. This butyrate concentration was responsible for the maximum modulatory effects observed in all experimental models evaluated in this study. Data from mouse model show that in basal condition, butyrate up-regulated the expression of several biomarkers of gut barrier integrity, and of tolerogenic cytokines. Pretreatment with butyrate significantly reduced allergic response in three animal models of FA, with a stimulation of tolerogenic cytokines, inhibition of Th2 cytokines production and a modulation of oxidative stress. Data from human cell models show that butyrate stimulated human beta defensin-3, mucus components and tight junctions expression in human enterocytes, and IL-10, IFN-γ and FoxP3 expression through epigenetic mechanisms in PBMCs from FA children. Furthermore, it promoted the precursors of M2 macrophages, DCs and regulatory T cells. CONCLUSION The study's findings suggest the importance of butyrate as a pivotal HM compound able to protect against FA.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
- European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy
| | - Rita Nocerino
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Fisciano Italy
| | - Carmen Di Scala
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Carmen De Caro
- Department of Pharmacy University of Naples Federico II Naples Italy
| | - Roberto Russo
- Department of Pharmacy University of Naples Federico II Naples Italy
| | | | - Rosita Aitoro
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Antonio Amoroso
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Cristina Bruno
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Margherita Di Costanzo
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Annalisa Passariello
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- Department of Pediatric Cardiology Monaldi Hospital Naples Italy
| | - Francesco Messina
- Neonatal Intensive Care Unit "Betania" Evangelical Hospital Naples Italy
| | - Annalisa Agangi
- Neonatal Intensive Care Unit "Betania" Evangelical Hospital Naples Italy
| | | | - Luana Voto
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Giusy Della Gatta
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Laura Pisapia
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Fisciano Italy
| | | | - Antonio Calignano
- Department of Pharmacy University of Naples Federico II Naples Italy
| | - Annibale Puca
- European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy
- Cardiovascular Research Unit IRCCS MultiMedica Milan Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
- European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy
- Task Force for Microbiome Studies University of Naples Federico II Naples Italy
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12
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Abstract
BACKGROUND Seventy percent of patients affected by SARS-COV-2 disease are asymptomatic or with symptoms that not required Hospitalization. A prodromal period lasting about 5 days can be identified. In this phase a patient with a positive swab for viral RNA may or may not evolve towards the phase of symptomatic disease. METHODS In this paper we reviewed the literature related to COVID-19 therapy we propose a reasoned treatment protocols in outpatients according to the age and the comorbidity. RESULTS The aim of this study was to reduce the impact of the virus by reducing its ability to attack cells and the inflammatory burden and the prothrombotic effects proposing two therapeutic schemes of proven efficacy according to the age of the patients and the comorbidities. CONCLUSIONS We aimed to reduce worsening of clinical status and hospitalization while protecting patients at home.
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Affiliation(s)
- Claudio Allegra
- Department of Angiology, Union Internationale de Phlebologie (UIP), S.Giovanni Hospital, Rome, Italy
| | - Giacomo Failla
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy -
| | - Luca Costanzo
- Unit of Angiology, Department of Cardiovascular Disease, San Marco Hospital, Rodolico, S. Marco University Hospital, University of Catania, Catania, Italy
| | - Ferdinando Mannello
- Unit of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences, Carlo Bo University of Urbino, Urbino, Pesaro-Urbino, Italy
| | - Francesco Montella
- Department of Internal Medicine, San Giovanni-Addolorata Hospital, Rome, Italy
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13
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Ciaglia E, Montella F, Malavolta M, Carrizzo A, Lopardo V, Vecchione C, Puca A. Murine transfer of a human gene variant associated with exceptional longevity displays senolytic effects both in immune compartment and endothelium of aged mice. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3830] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The persistence and accumulation of senescent cells has been shown to potentially play a role in the pathophysiology of age-related cardiovascular diseases.
Indeed with time, a decline in immune efficacy, termed immunesenescence, and a deleterious secretory phenotype of senescent cells (SASP) generate that inflammatory background mainly mediating the elderly cardiovascular phenotype. Long Living Individuals (LLI) which delay aging, represent a model of positive biology and an exceptional resource to study and find a way to improve general public health. Previous studies from our group have shown that a human gene associated with exceptional longevity (LAV-BPIFB4) was able to block the atherosclerotic process in ApoE−/− mice by conferring the animals with a pro-resolving M2 macrophages profile. Furthermore, LAV-BPIFB4 promotes the recruitment of hematopoietic stem cells, reparative vascularization and frailty reduction.
Here we sought to underpinn the role of LAV-BPIFB4 in counteracting the age-related remodeling of the immune responses.
The effects of systemic adeno-associated viral vector-mediated LAV-BPIFB4 gene transfer on the immune dynamics in old mice have been investigated by an extensive flow cytometric approach in lymphoid tissues (bone marrow, spleen and peripheral blood). C57BL/6J mice were assigned to two age-matched experimental groups: a treatment group (AAV-LAV-BPIFB4; N=6 mice, aged 18–23 months and a control group (AAV-GFP; N=6 mice, aged 18–23 months. 30th and 60th day since the beginning of the infection, SA-beta Gal substrate has been used to identify CD45+ senescent cells in freshly isolated PBMC, splenocytes, bone marrow (BM)-derived cells.
As expected, we monitored an increase in SA-betaGal activity in blood. This increase is most significant in CD11b+ myeloid cells, whithout affecting neither CD3+T neither NK1.1+Natural Killer (NK) cell compartment. Notably 30 days AAV-LAV-BPIFB4 infection and to a more the 60 days-treatment, resulted in a significant decrease in senescent pool of peripheral immune cells and a concomitant enrichment of senescent cells in spleen. Concomitantly, aorta from AAV-LAV treated mice showed significant reduction in SA-beta Gal positive area. Furthermore a LAV-BPIFB4 induction of pro-resolving M2 macrophages compared to control group was documented in the main haemocateretic organ. As consequence the senolytic effect of LAV-BPIFB4 gene-therapy well correlated with the rescue of proliferative index of splenocytes upon PHA stimulation, and their functional protective response to lipopolysaccharide (LPS) in term of IL-6 and TNF-alpha secretion. The restoration of a protective and balanced immune response finally reflected the reduction of senescent phenopype acquired by mouse aortic endothelial cells during the aging process in vivo.
A better underpinning of the senolytic action of LAV-BPIFB4 may offer a valuable therapeutic tool to reverse aging phenotype causing most of cardiac diseases
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Cariplo Foundation (n.2016-0874) to AAP and CV
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Affiliation(s)
- E Ciaglia
- University of Salerno School of Medicine, Salerno, Italy
| | - F Montella
- University of Salerno School of Medicine, Salerno, Italy
| | - M Malavolta
- National Institute of Hospital and Care for Elderly (INRCA), Ancona, Italy
| | - A Carrizzo
- University of Salerno School of Medicine, Salerno, Italy
| | - V Lopardo
- University of Salerno School of Medicine, Salerno, Italy
| | - C Vecchione
- University of Salerno School of Medicine, Salerno, Italy
| | - A.A Puca
- IRCCS - MultiMedica, Milan, Italy
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14
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Ciaglia E, Montella F, Lopardo V, Scala P, Ferrario A, Cattaneo M, Carrizzo A, Malovini A, Madeddu P, Vecchione C, Puca AA. Circulating BPIFB4 Levels Associate With and Influence the Abundance of Reparative Monocytes and Macrophages in Long Living Individuals. Front Immunol 2020; 11:1034. [PMID: 32547549 PMCID: PMC7272600 DOI: 10.3389/fimmu.2020.01034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/25/2020] [Accepted: 04/29/2020] [Indexed: 12/31/2022] Open
Abstract
Long-Living Individuals (LLIs) delay aging and are less prone to chronic inflammatory reactions. Whether a distinct monocytes and macrophages repertoire is involved in such a characteristic remains unknown. Previous studies from our group have shown high levels of the host defense BPI Fold Containing Family B Member 4 (BPIFB4) protein in the peripheral blood of LLIs. Moreover, a polymorphic variant of the BPIFB4 gene associated with exceptional longevity (LAV-BPIFB4) confers protection from cardiovascular diseases underpinned by low-grade chronic inflammation, such as atherosclerosis. We hypothesize that BPIFB4 may influence monocytes pool and macrophages skewing, shifting the balance toward an anti-inflammatory phenotype. We profiled circulating monocytes in 52 LLIs (median-age 97) and 52 healthy volunteers (median-age 55) using flow cytometry. If the frequency of total monocyte did not change, the intermediate CD14++CD16+ monocytes counts were lower in LLIs compared to control adults. Conversely, non-classical CD14+CD16++ monocyte counts, which are M2 macrophage precursors with an immunomodulatory function, were found significantly associated with the LLIs' state. In a differentiation assay, supplementation of the LLIs' plasma enhanced the capacity of monocytes, either from LLIs or controls, to acquire a paracrine M2 phenotype. A neutralizing antibody against the phosphorylation site (ser 75) of BPIFB4 blunted the M2 skewing effect of the LLIs' plasma. These data indicate that LLIs carry a peculiar anti-inflammatory myeloid profile, which is associated with and possibly sustained by high circulating levels of BPIFB4. Supplementation of recombinant BPIFB4 may represent a novel means to attenuate inflammation-related conditions typical of unhealthy aging.
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Affiliation(s)
- Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Pasqualina Scala
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Anna Ferrario
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Monica Cattaneo
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Albino Carrizzo
- Vascular Pathophysiology Unit - IRCCS Neuromed, Pozzilli, Italy
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Paolo Madeddu
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy.,Bristol Medical School - Translational Health Sciences, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Vascular Pathophysiology Unit - IRCCS Neuromed, Pozzilli, Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
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15
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Salviati E, Ciaglia E, Sommella E, Montella F, Bertamino A, Ostacolo C, Parrino B, Rubino R, Vecchione C, Puca A, Novellino E, Campiglia P. Immunomodulatory activity of Humulus lupulus bitter acids fraction: Enhancement of natural killer cells function by NKp44 activating receptor stimulation. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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16
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Ciaglia E, Montella F, Trucillo P, Ciardulli M, Di Pietro P, Amodio G, Remondelli P, Vecchione C, Reverchon E, Maffulli N, Puca A, Della Porta G. A bioavailability study on microbeads and nanoliposomes fabricated by dense carbon dioxide technologies using human-primary monocytes and flow cytometry assay. Int J Pharm 2019; 570:118686. [DOI: 10.1016/j.ijpharm.2019.118686] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/06/2019] [Accepted: 09/07/2019] [Indexed: 12/19/2022]
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17
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Fabeni L, Alteri C, Berno G, Scutari R, Orchi N, De Carli G, Bertoli A, Carioti L, Gori C, Forbici F, Salpini R, Vergori A, Gagliardini R, Cicalini S, Mondi A, Pinnetti C, Mazzuti L, Turriziani O, Colafigli M, Borghi V, Montella F, Pennica A, Lichtner M, Girardi E, Andreoni M, Mussini C, Antinori A, Ceccherini-Silberstein F, Perno CF, Santoro MM. Characterisation of HIV-1 molecular transmission clusters among newly diagnosed individuals infected with non-B subtypes in Italy. Sex Transm Infect 2019; 95:619-625. [PMID: 31076456 DOI: 10.1136/sextrans-2019-054017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We evaluated the characteristics of HIV-1 molecular transmission clusters (MTCs) in 1890 newly diagnosed individuals infected with non-B subtypes between 2005 and 2017 in Italy. METHODS Phylogenetic analyses were performed on pol sequences to characterise subtypes/circulating recombinant forms and identify MTCs. MTCs were divided into small (SMTCs, 2-3 sequences), medium (MMTCs, 4-9 sequences) and large (LMTCs, ≥10 sequences). Factors associated with MTCs were evaluated using logistic regression analysis. RESULTS 145 MTCs were identified and involved 666 individuals (35.2%); 319 of them (16.9%) were included in 13 LMTCs, 111 (5.9%) in 20 MMTCs and 236 (12.5%) in 112 SMTCs. Compared with individuals out of MTCs, individuals involved in MTCs were prevalently Italian (72.7% vs 30.9%, p<0.001), male (82.9% vs 62.3%, p<0.001) and men who have sex with men (MSM) (43.5% vs 14.5%, p<0.001). Individuals in MTCs were also younger (median (IQR) years: 41 (35-49) vs 43 (36-51), p<0.001) and had higher CD4 cell count in comparison with individuals out of MTCs (median (IQR): 109/L: 0.4 (0.265-0.587) vs 0.246 (0.082-0.417), p<0.001). The viral load remained stable between the two groups (median (IQR) log10 copies/mL: 4.8 (4.2-5.5) vs 5.0 (4.3-5.5), p=0.87). Logistic regression confirmed that certain factors such as being MSM, of Italian origin, younger age and higher CD4 cell count were significantly associated with MTCs. CONCLUSIONS Our findings show that HIV-1 newly diagnosed individuals infected with non-B subtypes are involved in several MTCs in Italy. These MTCs include mainly Italians and MSM and highlight the complex phenomenon characterising the HIV-1 spread. This is important especially in view of monitoring the HIV epidemic and guiding the public health response.
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Affiliation(s)
- Lavinia Fabeni
- Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Claudia Alteri
- Oncology and Oncohematology, University of Milan, Milan, Italy
| | - Giulia Berno
- Laboratory of Virology, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Rossana Scutari
- Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicoletta Orchi
- AIDS Reference Center, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | | | - Ada Bertoli
- Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Carioti
- Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Caterina Gori
- Laboratory of Virology, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Federica Forbici
- Laboratory of Virology, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Romina Salpini
- Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | | | | | - Annalisa Mondi
- Clinical Department, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Carmela Pinnetti
- Clinical Department, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Laura Mazzuti
- Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | | | | | - Vanni Borghi
- Infectious Diseases, University Hospital of Modena, Modena, Italy
| | | | | | - Miriam Lichtner
- Infectious Diseases Unit, "Sapienza" University, Polo Pontino, Latina, Italy
| | - Enrico Girardi
- Clinical Epidemiology, INMI "Lazzaro Spallanzani" IRCCS, Rome, Lazio, Italy
| | - Massimo Andreoni
- Infectious Diseases, University Hospital "Tor Vergata", Rome, Italy
| | - Cristina Mussini
- Infectious Diseases, University Hospital of Modena, Modena, Italy
| | - Andrea Antinori
- Clinical Department, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | | | - Carlo Federico Perno
- Oncology and Oncohematology, University of Milan, Milan, Italy.,Laboratory of Virology, INMI "Lazzaro Spallanzani"-IRCCS, Rome, Italy
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18
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Ciaglia E, Montella F, Maciag A, Scala P, Ferrario A, Banco C, Carrizzo A, Spinelli CC, Cattaneo M, De Candia P, Vecchione C, Villa F, Puca AA. Longevity-Associated Variant of BPIFB4 Mitigates Monocyte-Mediated Acquired Immune Response. J Gerontol A Biol Sci Med Sci 2019; 74:S38-S44. [DOI: 10.1093/gerona/glz036] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 12/14/2022] Open
Abstract
Abstract
One of the basis of exceptional longevity is the maintaining of the balance between inflammatory and anti-inflammatory networks. The monocyte-macrophages activation plays a major role in tuning the immune responses, by oscillating between patrolling-protective to inflammatory status. Longevity-associated variant (LAV) of bactericidal/permeability-increasing fold-containing family B member 4 (BPIFB4) activates calcium, PKC-alpha, and eNOS, rescuing endothelial dysfunction in aged mice and inducing revascularization. The BPIFB4’s increment in serum of healthy long-living individuals (LLIs) compared to nonhealthy ones, its therapeutic potential in improving vascular homeostasis, which depends on immune system, together with its expression in bone marrow myeloid cells, suggests that LAV-BPIFB4 may improve immune regulation. Here we show that human monocytes exposed to LAV-BPIFB4 protein increased co-stimulatory molecules in resting state and reduced pro-inflammatory cytokine tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) after activating stimuli. Accordingly, a low percentage of CD69+ activated lymphocytes are found among LAV-BPIFB4-treated peripheral blood mononuclear cells (PBMCs). Moreover, human monocyte-derived dendritic cells (DCs) generated in presence of LAV-BPIFB4 secreted higher anti-(IL-10 and TGF-β) and lower pro-inflammatory (TNF-α and IL-1β) cytokines. Accordingly, LLIs’ plasma showed higher levels of circulating IL-10 and of neutralizing IL-1 receptor antagonist (IL-1RA) compared to controls. Thus, LAV-BPIFB4 effects on myeloid compartment could represent one example of a genetic predisposition carried by LLIs to protect from immunological dysfunctions.
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Affiliation(s)
- Elena Ciaglia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
| | - Anna Maciag
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Pasqualina Scala
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
| | - Anna Ferrario
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Carlotta Banco
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
| | - Albino Carrizzo
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | | | - Monica Cattaneo
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Paola De Candia
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Francesco Villa
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Salerno, Italy
- Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
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19
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Alteri C, Fabeni L, Scutari R, Berno G, Di Carlo D, Gori C, Bertoli A, Vergori A, Mastrorosa I, Bellagamba R, Mussini C, Colafigli M, Montella F, Pennica A, Mastroianni CM, Girardi E, Andreoni M, Antinori A, Svicher V, Ceccherini-Silberstein F, Perno CF, Santoro MM. Genetic divergence of HIV-1 B subtype in Italy over the years 2003-2016 and impact on CTL escape prevalence. Sci Rep 2018; 8:15739. [PMID: 30356083 PMCID: PMC6200748 DOI: 10.1038/s41598-018-34058-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/04/2018] [Indexed: 12/05/2022] Open
Abstract
HIV-1 is characterized by high genetic variability, with implications for spread, and immune-escape selection. Here, the genetic modification of HIV-1 B subtype over time was evaluated on 3,328 pol and 1,152 V3 sequences belonging to B subtype and collected from individuals diagnosed in Italy between 2003 and 2016. Sequences were analyzed for genetic-distance from consensus-B (Tajima-Nei), non-synonymous and synonymous rates (dN and dS), CTL escapes, and intra-host evolution over four time-spans (2003–2006, 2007–2009, 2010–2012, 2013–2016). Genetic-distance increased over time for both pol and V3 sequences (P < 0.0001 and 0.0003). Similar results were obtained for dN and dS. Entropy-value significantly increased at 16 pol and two V3 amino acid positions. Seven of them were CTL escape positions (protease: 71; reverse-transcriptase: 35, 162, 177, 202, 207, 211). Sequences with ≥3 CTL escapes increased from 36.1% in 2003–2006 to 54.0% in 2013–2016 (P < 0.0001), and showed better intra-host adaptation than those containing ≤2 CTL escapes (intra-host evolution: 3.0 × 10−3 [2.9 × 10−3–3.1 × 10−3] vs. 4.3 × 10−3 [4.0 × 10−3–5.0 × 10−3], P[LRT] < 0.0001[21.09]). These data provide evidence of still ongoing modifications, involving CTL escape mutations, in circulating HIV-1 B subtype in Italy. These modifications might affect the process of HIV-1 adaptation to the host, as suggested by the slow intra-host evolution characterizing viruses with a high number of CTL escapes.
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Affiliation(s)
- Claudia Alteri
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy.
| | - Lavinia Fabeni
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Rossana Scutari
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Giulia Berno
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | - Domenico Di Carlo
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Pediatric Clinical Research Center "Romeo and Enrica Invernizzi", Milan, 20133, Italy
| | - Caterina Gori
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | - Ada Bertoli
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy
| | - Alessandra Vergori
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | - Ilaria Mastrorosa
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | - Rita Bellagamba
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | | | | | | | | | | | - Enrico Girardi
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | | | - Andrea Antinori
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy
| | - Valentina Svicher
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy
| | | | - Carlo Federico Perno
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, 00161, Italy.,Department of Oncology, University of Milan, Milan, 20122, Italy
| | - Maria Mercedes Santoro
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, 00133, Italy
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20
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Villa F, Carrizzo A, Ferrario A, Maciag A, Cattaneo M, Spinelli CC, Montella F, Damato A, Ciaglia E, Puca AA. A Model of Evolutionary Selection: The Cardiovascular Protective Function of the Longevity Associated Variant of BPIFB4. Int J Mol Sci 2018; 19:ijms19103229. [PMID: 30347645 PMCID: PMC6214030 DOI: 10.3390/ijms19103229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 02/07/2023] Open
Abstract
Evolutionary forces select genetic variants that allow adaptation to environmental stresses. The genomes of centenarian populations could recapitulate the evolutionary adaptation model and reveal the secrets of disease resistance shown by these individuals. Indeed, longevity phenotype is supposed to have a genetic background able to survive or escape to age-related diseases. Among these, cardiovascular diseases (CVDs) are the most lethal and their major risk factor is aging and the associated frailty status. One example of genetic evolution revealed by the study of centenarians genome is the four missense Single Nucleotide Polymorphisms (SNPs) haplotype in bactericidal/permeability-increasing fold-containing family B, member 4 (BPIFB4) locus that is enriched in long living individuals: the longevity associated variant (LAV). Indeed, LAV-BPIFB4 is able to improve endothelial function and revascularization through the increase of endothelial nitric oxide synthase (eNOS) dependent nitric oxide production. This review recapitulates the beneficial effects of LAV-BPIFB4 and its therapeutic potential for the treatment of CVDs.
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Affiliation(s)
- Francesco Villa
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy.
| | | | - Anna Ferrario
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy.
| | - Anna Maciag
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy.
| | - Monica Cattaneo
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy.
| | | | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy.
| | | | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy.
| | - Annibale Alessandro Puca
- Cardiovascular Research Unit, IRCCS MultiMedica, 20138 Milan, Italy.
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081 Baronissi, Italy.
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21
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Fabeni L, Alteri C, Di Carlo D, Orchi N, Carioti L, Bertoli A, Gori C, Forbici F, Continenza F, Maffongelli G, Pinnetti C, Vergori A, Mondi A, Ammassari A, Borghi V, Giuliani M, De Carli G, Pittalis S, Grisetti S, Pennica A, Mastroianni CM, Montella F, Cristaudo A, Mussini C, Girardi E, Andreoni M, Antinori A, Ceccherini-Silberstein F, Perno CF, Santoro MM. Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14. J Antimicrob Chemother 2018; 72:2837-2845. [PMID: 29091206 DOI: 10.1093/jac/dkx231] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/09/2017] [Indexed: 11/14/2022] Open
Abstract
Background Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care. Methods In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters. Results Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30-45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005-14: 19.5%-38.5%, P < 0.0001), particularly among Italians (<2005-14: 6.5%-28.8%, P < 0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005-14: 2%-7.1%, P = 0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005-14: 12.9%-33.5%, P = 0.001) and non-B subtypes (<2005-14: 18.4%-41.9%, P = 0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005-14: 14.3%-35.5%, P = 0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters: 7 (IQR 6-19) versus 4 (3-4), P = 0.047]. Conclusions The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multi-transmitters is a major target for controlling HIV spread.
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Affiliation(s)
- L Fabeni
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - C Alteri
- University of Rome Tor Vergata, Rome, Italy
| | - D Di Carlo
- University of Rome Tor Vergata, Rome, Italy
| | - N Orchi
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - L Carioti
- University of Rome Tor Vergata, Rome, Italy
| | - A Bertoli
- University of Rome Tor Vergata, Rome, Italy
| | - C Gori
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - F Forbici
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - F Continenza
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | | | - C Pinnetti
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - A Vergori
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - A Mondi
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - A Ammassari
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - V Borghi
- Modena University Hospital, Modena, Italy
| | - M Giuliani
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - G De Carli
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - S Pittalis
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - S Grisetti
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | | | | | - F Montella
- S. Giovanni Addolorata Hospital, Rome, Italy
| | - A Cristaudo
- San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - C Mussini
- Modena University Hospital, Modena, Italy
| | - E Girardi
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | - M Andreoni
- University Hospital Tor Vergata, Rome, Italy
| | - A Antinori
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
| | | | - C F Perno
- National Institute for Infectious Diseases L Spallanzani, IRCCS, Rome, Italy
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22
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Abate M, Laezza C, Pisanti S, Torelli G, Seneca V, Catapano G, Montella F, Ranieri R, Notarnicola M, Gazzerro P, Bifulco M, Ciaglia E. Deregulated expression and activity of Farnesyl Diphosphate Synthase (FDPS) in Glioblastoma. Sci Rep 2017; 7:14123. [PMID: 29075041 PMCID: PMC5658376 DOI: 10.1038/s41598-017-14495-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/11/2017] [Indexed: 01/09/2023] Open
Abstract
Glioblastoma (GBM), the most aggressive brain cancer, is highly dependent on the mevalonate (MVA) pathway for the synthesis of lipid moieties critical for cell proliferation but the function and regulation of key intermediate enzymes like farnesyl-diphosphate synthase (FDPS), up to now, remained unknown. A deregulated expression and activity of FDPS was the central research idea of the present study. FDPS mRNA, protein and enzyme activity were analyzed in a cohort of stage III-IV glioma patients (N = 49) and primary derived cells. FDPS silencing helped to clarify its function in the maintenance of malignant phenotype. Interestingly, compared to tumor-free peripheral (TFB) brain and normal human astrocytes (NHA), FDPS protein expression and enzyme activity were detected at high degree in tumor mass where a correlation with canonical oncogenic signaling pathways such as STAT3, ERK and AKT was also documented. Further, FDPS knockdown in U87 and GBM primary cells but not in NHA, enhanced apoptosis. With the effort to develop a more refined map of the connectivity between signal transduction pathways and metabolic networks in cancer FDPS as a new candidate metabolic oncogene in glioblastoma, might suggest to further target MVA pathway as valid therapeutic tool.
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Affiliation(s)
- Mario Abate
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy
| | - Chiara Laezza
- Institute of Endocrinology and Experimental Oncology, IEOS CNR, Via Pansini 5, 80131, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Via Pansini, 80131, Naples, Italy
| | - Simona Pisanti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy
| | - Giovanni Torelli
- Neurosurgery Unit A.O. San Giovanni di Dio e Ruggi d' Aragona - Salerno's School of Medicine Largo Città di Ippocrate, 84131, Salerno, Italy
| | - Vincenzo Seneca
- "G.Rummo" Medical Hospital, Department of Neurosurgery, Benevento, Italy
| | - Giuseppe Catapano
- "G.Rummo" Medical Hospital, Department of Neurosurgery, Benevento, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy
| | - Roberta Ranieri
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy
| | - Maria Notarnicola
- National Institute of Gastroenterology "S. de Bellis", Research Hospital, Castellana Grotte, Bari, 70013, Italy
| | - Patrizia Gazzerro
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084, Fisciano Salerno, Italy
| | - Maurizio Bifulco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy. .,Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Via Pansini, 80131, Naples, Italy.
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Salvatore Allende, 84081, Baronissi Salerno, Italy.
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23
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Galli L, Spagnuolo V, Bigoloni A, D'Arminio Monforte A, Montella F, Antinori A, Di Biagio A, Rusconi S, Guaraldi G, Di Giambenedetto S, Borderi M, Gibellini D, Caramatti G, Lazzarin A, Castagna A. Atazanavir/ritonavir monotherapy: 96 week efficacy, safety and bone mineral density from the MODAt randomized trial. J Antimicrob Chemother 2016; 71:1637-42. [PMID: 26945711 DOI: 10.1093/jac/dkw031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/29/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To report the 96 week results on efficacy, safety and bone mineral density (BMD) in subjects with HIV-1 that were virologically suppressed and treated with atazanavir/ritonavir monotherapy versus atazanavir/ritonavir triple therapy. METHODS MODAt is a prospective, multicentre, open-label, non-inferiority, randomized, 96 week trial (NCT01511809) comparing efficacy of atazanavir/ritonavir monotherapy versus atazanavir/ritonavir triple therapy. Treatment success was defined as no occurrence of confirmed viral rebound (two consecutive HIV-RNA >50 copies/mL) or discontinuation for any cause of the ongoing regimen. RESULTS The 96 week treatment success was 64% in the atazanavir/ritonavir monotherapy arm and 63% in the triple-therapy arm (difference 1.3%, 95% CI: -17.5 to 20.1). In the atazanavir/ritonavir monotherapy arm, no PI- or NRTI-associated resistance mutations were observed at virological failure and all patients re-suppressed after re-intensification. In the monotherapy arm, treatment failure was more frequent in patients coinfected with hepatitis C virus [64% versus 28% (difference 35.4%, 95% CI: 3.7-67.2)]. Drug-related adverse events leading to discontinuation were 3 (6%) in the atazanavir/ritonavir monotherapy arm and 11 (21.5%) in the triple-therapy arm (P = 0.041). The 96 week adjusted mean percentage change in total proximal femur (not at lumbar spine) BMD was +1.16% and -1.64% in the atazanavir/ritonavir monotherapy arm and the triple-therapy arm, respectively (P = 0.012). CONCLUSIONS The 96 week analyses suggested that long-term efficacy of atazanavir/ritonavir monotherapy was inferior as compared with atazanavir/ritonavir triple therapy, particularly when administered in subjects coinfected with hepatitis C virus. In the atazanavir/ritonavir monotherapy arm, reintroduction of nucleosides, as needed, was always effective with no new resistance mutation; monotherapy was also associated with a lower incidence of adverse events and improvement in femur BMD.
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Affiliation(s)
- Laura Galli
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Spagnuolo
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Alba Bigoloni
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Antonella D'Arminio Monforte
- Clinic of Infectious and Tropical Diseases, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Francesco Montella
- Division of Infectious Diseases, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Andrea Antinori
- Clinical Department, National Institute for Infectious Diseases, IRCCS, Lazzaro Spallanzani, Rome, Italy
| | | | - Stefano Rusconi
- Division of Infectious and Tropical Diseases, DIBIC 'Luigi Sacco', University of Milan, Milan, Italy
| | - Giovanni Guaraldi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Di Giambenedetto
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - Marco Borderi
- Infectious Diseases Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Davide Gibellini
- Department of Pathology and Diagnostics, Microbiology Unit, University of Verona, Verona, Italy
| | - Giada Caramatti
- U.O. Riabilitazione Specialistica Disturbi Neurologici Cognitivo-Motori, Department of Clinical Neurosciences, IRCCS San Raffaele, Milan, Italy
| | - Adriano Lazzarin
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
| | - Antonella Castagna
- Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy Università Vita-Salute San Raffaele, Milan, Italy
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24
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Iebba F, Di Sora F, Leti W, Montella T, Corea F, Montella F. [Delay in diagnosis of common variable immunodeficiency: a paradigmatic case report]. Recenti Prog Med 2015; 106:576-579. [PMID: 26668044 DOI: 10.1701/2074.22498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This case report highlights the frequent delay in diagnosis of common variable immunodeficiency. The patient, 84 years old, had over 30 years of recurrent infections. At the first visit serum IgG were less than 134 mg/dl. From the review of previous examinations strong hypogammaglobulinemia was present for over 14 years.
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25
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Cascella R, Stocchi L, Strafella C, Mezzaroma I, Mannazzu M, Vullo V, Montella F, Parruti G, Borgiani P, Sangiuolo F, Novelli G, Pirazzoli A, Zampatti S, Giardina E. Comparative analysis between saliva and buccal swabs as source of DNA: lesson from HLA-B*57:01 testing. Pharmacogenomics 2015; 16:1039-46. [PMID: 26230858 DOI: 10.2217/pgs.15.59] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Our work aimed to designate the optimal DNA source for pharmacogenetic assays, such as the screening for HLA-B*57:01 allele. MATERIALS & METHODS A saliva and four buccal swab samples were taken from 104 patients. All the samples were stored at different time and temperature conditions and then genotyped for the HLA-B*57:01 allele by SSP-PCR and classical/capillary electrophoresis. RESULTS The genotyping analysis reported different performance rates depending on the storage conditions of the samples. Given our results, the buccal swab demonstrated to be more resistant and stable in time with respect to the saliva. CONCLUSION Our investigation designates the buccal swab as the optimal DNA source for pharmacogenetic assays in terms of resistance, low infectivity, low-invasiveness and easy sampling, and safe transport in centralized medical centers providing specialized pharmacogenetic tests.
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Affiliation(s)
- Raffaella Cascella
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Laura Stocchi
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Claudia Strafella
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Ivano Mezzaroma
- Department of Clinical Medicine, 'Sapienza' University of Rome, Rome, Italy
| | | | - Vincenzo Vullo
- Department of Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - Francesco Montella
- Internal Medicine & Clinical Immunology Unit, 'San Giovanni' Hospital, Rome, Italy
| | - Giustino Parruti
- Infectious Diseases Unit, Pescara General Hospital, Pescara, Italy
| | - Paola Borgiani
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Federica Sangiuolo
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | - Giuseppe Novelli
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy
| | | | - Stefania Zampatti
- Molecular Genetics Laboratory UILDM, Santa Lucia Foundation, Rome, Italy.,Neuromed IRCCS, Pozzilli, Italy
| | - Emiliano Giardina
- Department of Biomedicine & Prevention, School of Medicine, University of Rome 'Tor Vergata,' Rome, Italy.,Molecular Genetics Laboratory UILDM, Santa Lucia Foundation, Rome, Italy
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26
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Maggi P, Montinaro V, Rusconi S, Di Biagio A, Bellagamba R, Bonfanti P, Calza L, Corsi P, Montella F, Mussini C. The Problem of Renal Function Monitoring in Patients Treated With the Novel Antiretroviral Drugs. HIV Clinical Trials 2014; 15:87-91. [DOI: 10.1310/hct1503-87] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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27
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Maggi P, Montinaro V, Mussini C, Di Biagio A, Bellagamba R, Bonfanti P, Calza L, Cherubini C, Corsi P, Gargiulo M, Montella F, Rusconi S. Novel antiretroviral drugs and renal function monitoring of HIV patients. AIDS Rev 2014; 16:144-151. [PMID: 25102336] [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: 06/03/2023]
Abstract
Chronic kidney disease is a major comorbidity in patients affected by HIV infection. In addition, the introduction of new antiretroviral agents that interact with creatinine transporters is raising some concerns. In this review we analyze the currently available data about three new antiretroviral drugs and one new pharmacokinetic enhancer. Three of them (rilpivirine, cobicistat, dolutegravir) have shown some interactions with renal function, while tenofovir alafenamide fumarate reduces the plasmatic concentration of the parent drug. The future use of tenofovir alafenamide seems to be encouraging in order to reduce the renal interaction of tenofovir. Rilpivirine, cobicistat, and dolutegravir reduce the tubular secretion of creatinine, inducing a decrease of estimated glomerular filtration rate according to creatinine. Rilpivirine and dolutegravir block the uptake of creatinine from the blood, inhibiting organic cation transporter 2, and cobicistat interacts with the efflux inhibiting multidrug and toxin extrusion protein 1. This effect can then be considered a "reset" of the estimated glomerular filtration rate according to creatinine. However, clinicians should carefully monitor renal function in order to identify possible alterations suggestive of a true renal functional impairment. Owing to the interference of these drugs with creatinine secretion, an alternative way of estimation of glomerular filtration rate would be desirable. However, at the moment, other methods of direct glomerular filtration rate measurement have a high impact on the patient, are not readily available, or are not reliable in HIV patients. Consequently, use of classic formulas to estimate glomerular filtration rate is still recommended. Also, tubular function needs to be carefully monitored with simple tests such as proteinuria, phosphatemia, urinary excretion of phosphate, normoglycemic glycosuria, and excretion of uric acid.
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Affiliation(s)
- Paolo Maggi
- Clinic of Infectious Diseases, University Hospital "Policlinico", Bari, Italy
| | | | - Cristina Mussini
- Clinic of Infectious Disease, University Hospital, Modena, Italy
| | - Antonio Di Biagio
- Clinic of Infectious Disease, University Hospital "San Martino", Genoa, Italy
| | - Rita Bellagamba
- Infectious and Tropical Diseases Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy
| | - Paolo Bonfanti
- Infectious Diseases Unit, Hospital "A. Manzoni", Lecco, Italy
| | - Leonardo Calza
- Clinic of Infectious Disease, University Hospital "S. Orsola-Malpighi", Bologna, Italy
| | - Chiara Cherubini
- Nephrology and Dialysis Unit, Hospital " S. Camillo Forlanini", Rome, Italy
| | - Paola Corsi
- Infectious Disease Unit, University Hospital "Careggi", Florence, Italy
| | - Miriam Gargiulo
- Division of Infectious Diseases, Ospedale Cotugno, Naples, Italy
| | - Francesco Montella
- Internal Medicine and Clinical Immunology Unit, Hospital "San Giovanni", Rome, Italy
| | - Stefano Rusconi
- Infectious Disease and Immunopathology Unit, Department of Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
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28
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Iebba F, Di Sora F, Leti W, Montella T, Montella F. [Genetic and environmental contribution to rheumatoid arthritis: a family study]. Recenti Prog Med 2012; 103:279-283. [PMID: 22825383 DOI: 10.1701/1127.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report on the HLA typing of three brothers (A, B, C) with rheumatoid arthritis (RA) and their six sons. This family is interesting for the full concordance for RA between parents. The aim of this study was the discovery of genetic and/or enviromental cofactors determining this absolute concordance.
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Affiliation(s)
- Filippo Iebba
- Unità Operativa Complessa Medicina, Azienda ospedaliera San Giovanni Addolorata, Rome.
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29
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Maggi P, Bartolozzi D, Bonfanti P, Calza L, Cherubini C, Di Biagio A, Marcotullio S, Montella F, Montinaro V, Mussini C, Narciso P, Rusconi S, Vescini F. Renal complications in HIV disease: between present and future. AIDS Rev 2012; 14:37-53. [PMID: 22297503] [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: 05/31/2023]
Abstract
The recent introduction of new antiretroviral drugs, characterized by high efficiency and improved safety profiles, has not reduced the incidence of long-term adverse effects, in some cases manifested as selective organ damage. The presence of organ damage in patients receiving antiretroviral treatment is not only the expression of treatment toxicity, but also a complex interaction between individual risk factors, HIV-correlated effects, and antiretroviral drug toxicity. Kidney damage belongs to these adverse events. Renal function abnormalities are present in a large percentage of patients with HIV infection. Moreover, HIV-associated renal disease seems to be associated with progression to AIDS and death. In this review we address the various aspects of the epidemiology of renal damage, the interaction and the convergent effect of HIV and antiretroviral drugs in the onset of kidney injury, the interplay between kidney function and other organ systems, early clinical management, the monitoring of renal function, and a proposal of clinical approach to kidney disease in daily practice. Finally, we discuss future perspectives of renal damage in HIV patients and evaluate the patient's perspective.
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Affiliation(s)
- Paolo Maggi
- Clinic of Infectious Disease, University Hospital, Bari, Italy.
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30
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Iebba F, Di Sora F, Tarasi A, Leti W, Montella F. [Rheumatoid arthritis: a typical multifactorial genetic disease: review of the literature]. Recenti Prog Med 2011; 102:175-82. [PMID: 21572496 DOI: 10.1701/624.7291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Environmental factors can be triggers for the clinical appearance of rheumatoid arthritis in subjects with genetic susceptibility. Genetic factors account for 60% of disease susceptibility. This review is focused on the genetic and environmental basis of the susceptibility to arthritis.
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31
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Solano L, Costa M, Temoshok L, Salvati S, Coda R, Aiuti F, Di Sora F, D'Offizi G, Figa-Talamanca L, Mezzaroma I, Montella F, Bertini M. An Emotionally Inexpressive (Type C) Coping Style Influences HIV Disease Progression at Six and Twelve Month Follow-ups. Psychol Health 2010. [DOI: 10.1080/08870440290025830] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Grelli S, Balestrieri E, Matteucci C, Minutolo A, D'Ettorre G, Lauria F, Montella F, Vullo V, Vella S, Favalli C, Mastino A, Macchi B. Apoptotic cell signaling in lymphocytes from HIV+ patients during successful therapy. Ann N Y Acad Sci 2007; 1090:130-7. [PMID: 17384255 DOI: 10.1196/annals.1378.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The impact of antiretroviral therapy (ART) on immune-reconstitution and its relationship with the complex scenario of multiple cell signaling associated with apoptosis in HIV infection has not yet been fully elucidated. Here we report the results of the analysis of the expression of 13 genes involved in the apoptotic pathway, simultaneously detected by RNA-protection assay in peripheral blood mononuclear cells (PBMCs) of 12 HIV-1-infected responder patients before and during successful ART. In particular, we calculated the correlations among apoptosis and viral load (VL) levels versus the quantitative expression of genes associated with death receptors or to Bcl-2 pathways. Nonparametric bivariate Spearman's analysis of significant correlations showed that apoptosis was directly correlated with mRNA levels for caspase-8, FasL, and TRAIL. Conversely, apoptosis levels were inversely correlated with mRNA levels for Bcl-xl, Bcl-2, and Mcl-1, respectively. In addition, while VL was directly correlated with the expression of caspase 8, it was inversely correlated with mRNA levels for Bcl-2 and Mcl-1. These results, although worthy of further investigation, show that variations of apoptosis levels in PBMCs of HIV-1+ patients during ART are strictly related to the modulation of a complex network of signaling involving both death and survival of lymphocytes.
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Affiliation(s)
- Sandro Grelli
- Department of Experimental Medicine and Biochemical Science, University of Rome Tor Vergata, Via Montpellier 1, 00133 Roma, and Clinical Immunology Unit, S. Giovanni Hospital, Italy
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33
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Balestrieri E, Grelli S, Matteucci C, Minutolo A, d'Ettorre G, Di Sora F, Montella F, Vullo V, Vella S, Favalli C, Macchi B, Mastino A. Apoptosis-associated gene expression in HIV-infected patients in response to successful antiretroviral therapy. J Med Virol 2007; 79:111-7. [PMID: 17177302 DOI: 10.1002/jmv.20768] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The simultaneous expression of 19 apoptosis-related genes was analyzed by RNA-protection assay in peripheral blood mononuclear cells of HIV-infected patients before and during successful antiretroviral therapy (ART). After 12 months of therapy, the expression of the pro-apoptotic genes FAS, FAS-L, FAF-1, FADD, CASPASE-8, DR3, TRAIL, TNFR-1, TRADD, and BAX was significantly downregulated with respect to time 0, while that of BCL-2, BCL-XL, and MCL-1 was significantly upregulated. The data suggest that inhibition of cell death in HIV-positive patients under successful therapy is the result of a complex network of multifactor signaling, correlated with both death and survival of lymphocytes.
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Longo B, Pantosti A, Luzzi I, Tarasi A, Di Sora F, Gallo S, Placanica P, Monaco M, Dionisi AM, Volpe I, Montella F, Cassone A, Rezza G. Molecular findings and antibiotic-resistance in an outbreak of Acinetobacter baumannii in an intensive care unit. Ann Ist Super Sanita 2007; 43:83-8. [PMID: 17536158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We investigated an outbreak of Acinetobacter baumannii in the intensive care unit (ICU) of a hospital in Rome, Italy. The outbreak involved 14 patients whose isolates were most frequently recovered from bronchoalveolar lavage. All isolates were multidrug-resistant and showed diminished susceptibility or resistance to carbapenems. A. baumannii strains with a similar antibiotic susceptibility pattern were isolated from the environment. Pulsed-field gel electrophoresis identified a single clone from both the patients' and environmental isolates. Because of the lack of a single source of infection, the eradication of the epidemic required a broad approach, including contact isolation and cohorting, aggressive environmental disinfection, and close monitoring of the ward staff's performance. Infected patients were successfully treated with combined therapy. Although considered of low virulence, A. baumannii can be particularly aggressive and difficult to treat in ICU patients.
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Affiliation(s)
- Benedetta Longo
- Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate,Istituto Superiore di Sanità, Rome, Italy
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35
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Longo B, Pantosti A, Luzzi I, Placanica P, Gallo S, Tarasi A, Di Sora F, Monaco M, Dionisi AM, Volpe I, Montella F, Cassone A, Rezza G. An outbreak of Acinetobacter baumannii in an intensive care unit: epidemiological and molecular findings. J Hosp Infect 2006; 64:303-5. [PMID: 16978736 DOI: 10.1016/j.jhin.2006.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 07/21/2006] [Indexed: 11/18/2022]
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36
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Calugi G, Montella F, Favalli C, Benedetto A. Entire genome of a strain of human immunodeficiency virus type 1 with a deletion of nef that was recovered 20 years after primary infection: large pool of proviruses with deletions of env. J Virol 2006; 80:11892-6. [PMID: 16987968 PMCID: PMC1642615 DOI: 10.1128/jvi.00932-06] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report the complete sequence analysis of the provirus harbored in a long-term nonprogressor (patient SG1) 20 years after the first infection with a human immunodeficiency virus type 1 strain lacking nef. The sequencing showed large deletions in the nef-nef and nef-U3 regions. Except for vpu, all of the other accessory genes were intact. The gag and pol genes did not show significant alterations. We found large deletions in env, spanning the V1, V2, V3, V4, and V5 regions. We believe that, when down-regulation of the class 1 major histocompatibility complex molecules is inhibited by the lack of nef function, the cells containing Env-defective molecules evade cytotoxic T lymphocyte killing and accumulate progressively.
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Affiliation(s)
- Graziella Calugi
- Clinical Microbiology and Virology, University of Rome, Tor Vergata, Rome, Italy
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Cotticelli L, Borrelli M, D'Alessio AC, Menzione M, Villani A, Piccolo G, Montella F, Iovene MR, Romano M. Central serous chorioretinopathy and Helicobacter pylori. Eur J Ophthalmol 2006; 16:274-8. [PMID: 16703546 DOI: 10.1177/112067210601600213] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE This study was designed to evaluate the prevalence of Helicobacter pylori infection in patients with central serous chorioretinopathy (CSC). METHODS Retrospective observational case series. A group of 23 patients (22 men and 1 woman, age range 34-62 years, median age 47 years) with diagnosis of CSC, confirmed by fluorescein angiogram, and a control group of 23 consecutive patients (22 men and 1 woman, age range 41-69 years, median age 50 years) referred to our Department for retinal disease other than CSC were studied. Each patient provided peripheral venous blood samples and a stool specimen, which were analyzed at the Department of Gastroenterology and Microbiology at the same university. H. pylori infection was determined by measurement of IgG anti-bodies to H. pylori and by determination of H. pylori antigens in the stool specimens by enzyme-linked immunosorbent assay technique. Patients were defined as H. pylori infected if both tests were positive. RESULTS The prevalence of H. pylori infection was 78.2% (95% CI, 56%-92%) in CSC patients and 43.5% (95% CI, 23%-65%) in control subjects (p<0.03 by two-tail ed Fisher exact test). The odds ratio for CSC associated with H. pylori infection was 4.6 (95% CI 1.28-16.9). CONCLUSIONS The results of this study show that the prevalence of H. pylori infection seems to be significantly higher in patients with CSC than in control s. H. pylori infection may represent a risk factor in patients with CSC.
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Affiliation(s)
- L Cotticelli
- Department of Ophthalmology, II University of Napoli, Napoli, Italy.
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Kappelhoff BS, van Leth F, Robinson PA, MacGregor TR, Baraldi E, Montella F, Uip DE, Thompson MA, Russell DB, Lange JMA, Beijnen JH, Huitema ADR. Are Adverse Events of Nevirapine and Efavirenz Related to Plasma Concentrations? Antivir Ther 2005. [DOI: 10.1177/135965350501000404] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The relationships between adverse events (AEs) and plasma concentrations of nevirapine (NVP) and efavirenz (EFV) were investigated as part of the large, international, randomized 2NN study. Methods Treatment-naive, HIV-1-infected patients received NVP (once or twice daily), EFV or their combination, each in combination with lamivudine and stavudine. Blood samples were collected on day 3 and weeks 1, 2, 4, 24 and 48. Concentrations of NVP and EFV were quantitatively assessed by a validated HPLC assay. Individual Bayesian estimates of the area under the plasma concentration–time curve over 24 h (AUC24h), and minimum and maximum plasma concentrations (Cmin and Cmax) as measures for drug exposure of NVP and EFV, were generated using a previously developed population pharmacokinetic model. Pharmacokinetic parameters were compared for patients with and without central nervous system (CNS) and psychiatric AEs, hepatic events, liver enzyme elevations (LEEs) and rash. Furthermore, it was investigated whether a clear cut-off for a pharmacokinetic parameter could be identified above which the incidence of AEs was clearly increased. AEs were also related to demographic parameters and baseline characteristics. Results In total, from 1077 patients, NVP (3024 samples) and EFV (1694 samples) plasma concentrations and AE data (825 observations) were available. For all patients Cmin, Cmax and AUC24h were determined. When corrected for known covariates of gender, CD4 cell count at baseline, region, hepatitis coinfection and possible interactions between these factors, no significant associations between AEs and any tested exposure parameter of NVP was observed. Also, no target Cmin value, above which patients were at increased risk for AEs, could be established. On the other hand, geographical region, hepatitis coinfection, CD4 cell count and gender were found to be significantly related with the incidence of CNS and psychiatric AEs, hepatic events, LEEs and rash during the treatment with NVP. The occurrence of elevated liver enzymes during the first 6 weeks in the EFV-containing arm was significantly ( P=0.036) correlated to the exposure of EFV (Cmin). Only hepatitis coinfection impacted on LEEs during the first 6 weeks of treatment. With an EFV Cmin above 2.18 mg/l during the induction phase, patients were 4.4 (range 1.3–15.5) times more at risk for elevated liver enzymes. No other correlations between AEs and EFV pharmacokinetics or patient characteristics could be identified. Conclusions Pharmacokinetic parameters of NVP did not have a relationship to AEs in the 2NN trial when corrected for known covariates. The value of periodical drug monitoring of NVP as a way to prevent toxicity is therefore limited. Treating physicians should instead focus on factors that are more predictive of AEs (gender, CD4 count and hepatitis coinfection). High EFV Cmin levels resulted in elevated liver enzyme values during the first 6 weeks of treatment. Regular measurement of EFV levels and liver enzymes at the start of therapy may therefore be advised.
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Affiliation(s)
| | - Bregt S Kappelhoff
- Department of Pharmacy & Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Frank van Leth
- International Antiviral Therapy Evaluation Centre, Academic Medical Centre, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Ezio Baraldi
- Embassy Drive Medical Centre, Pretoria, South Africa
| | | | - David E Uip
- Clinical Hospital, University of Sao Paolo, Casa da AIDS, Sao Paolo, Brazil
| | | | | | - Joep MA Lange
- International Antiviral Therapy Evaluation Centre, Academic Medical Centre, Department of Internal Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands
- Faculty of Pharmaceutical Sciences, Department of Biomedical Analysis, Division of Drug Toxicology, Utrecht University, Utrecht, The Netherlands
| | - Alwin DR Huitema
- Department of Pharmacy & Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands
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Giana M, Montella F, Surico D, Vigone A, Bozzola C, Ruspa G. Large intramyometrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report. EUR J GYNAECOL ONCOL 2005; 26:462-3. [PMID: 16122206] [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: 05/04/2023]
Abstract
A case of an adenomyotic cyst in a 46-year-old woman was examined by means of transvaginal ultrasound, hysteroscopy and microscopy. The transvaginal ultrasound showed an anechoic area. Hysteroscopy revealed a cystic mass of the posterior wall and by means of a bipolar loop resectoscope the mass was removed. Histological examination of the lesion showed typical characteristics of an adenomyotic cyst. These results were consistent with those of previous reports and suggest that transvaginal ultrasound together with hysteroscopy is specific to diagnose and treat this kind of adenomyotic lesion.
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Affiliation(s)
- M Giana
- Department of Obstetrics and Gynaecology Piemonte Orientale University, Novara, Italy
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Kappelhoff BS, van Leth F, Robinson PA, MacGregor TR, Baraldi E, Montella F, Uip DE, Thompson MA, Russell DB, Lange JMA, Beijnen JH, Huitema ADR. Are adverse events of nevirapine and efavirenz related to plasma concentrations? Antivir Ther 2005; 10:489-98. [PMID: 16038474] [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: 05/03/2023]
Abstract
OBJECTIVE The relationships between adverse events (AEs) and plasma concentrations of nevirapine (NVP) and efavirenz (EFV) were investigated as part of the large, international, randomized 2NN study. METHODS Treatment-naive, HIV-1-infected patients received NVP (once or twice daily), EFV or their combination, each in combination with lamivudine and stavudine. Blood samples were collected on day 3 and weeks 1, 2, 4, 24 and 48. Concentrations of NVP and EFV were quantitatively assessed by a validated HPLC assay. Individual Bayesian estimates of the area under the plasma concentration-time curve over 24 h (AUC24h), and minimum and maximum plasma concentrations (Cmin and Cmax) as measures for drug exposure of NVP and EFV, were generated using a previously developed population pharmacokinetic model. Pharmacokinetic parameters were compared for patients with and without central nervous system (CNS) and psychiatric AEs, hepatic events, liver enzyme elevations (LEEs) and rash. Furthermore, it was investigated whether a clear cut-off for a pharmacokinetic parameter could be identified above which the incidence of AEs was clearly increased. AEs were also related to demographic parameters and baseline characteristics. RESULTS In total, from 1077 patients, NVP (3024 samples) and EFV (1694 samples) plasma concentrations and AE data (825 observations) were available. For all patients Cmin, Cmax and AUC24h were determined. When corrected for known covariates of gender, CD4 cell count at baseline, region, hepatitis coinfection and possible interactions between these factors, no significant associations between AEs and any tested exposure parameter of NVP was observed. Also, no target Cmin value, above which patients were at increased risk for AEs, could be established. On the other hand, geographical region, hepatitis coinfection, CD4 cell count and gender were found to be significantly related with the incidence of CNS and psychiatric AEs, hepatic events, LEEs and rash during the treatment with NVP. The occurrence of elevated liver enzymes during the first 6 weeks in the EFV-containing arm was significantly (P = 0.036) correlated to the exposure of EFV (Cmin). Only hepatitis coinfection impacted on LEEs during the first 6 weeks of treatment. With an EFV Cmin above 2.18 mg/l during the induction phase, patients were 4.4 (range 1.3-15.5) times more at risk for elevated liver enzymes. No other correlations between AEs and EFV pharmacokinetics or patient characteristics could be identified. CONCLUSIONS Pharmacokinetic parameters of NVP did not have a relationship to AEs in the 2NN trial when corrected for known covariates. The value of periodical drug monitoring of NVP as a way to prevent toxicity is therefore limited. Treating physicians should instead focus on factors that are more predictive of AEs (gender, CD4 count and hepatitis coinfection). High EFV Cmin levels resulted in elevated liver enzyme values during the first 6 weeks of treatment. Regular measurement of EFV levels and liver enzymes at the start of therapy may therefore be advised.
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Affiliation(s)
- Bregt S Kappelhoff
- Department of Pharmacy et Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands.
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van Leth F, Conway B, Laplumé H, Martin D, Fisher M, Jelaska A, Wit FW, Lange JMA, Laplumé H, Lasala MB, Losso MH, Bogdanowicz E, Lattes R, Krolewiecki A, Zala C, Orcese C, Terlizzi S, Duran A, Ebensrteijn J, Bloch M, Russell O, Russell DB, Roth NR, Eu B, Austin D, Gowers A, Quan D, Demonty J, Peleman R, Vandercam B, Vogelaers D, van der Gucht B, van Wanzeele F, Moutschen MM, Badaro R, Grinsztejn B, Schechter M, Uip D, Netto EN, Coelho SS, Badaró F, Pilotto JH, Schubach A, Barros ML, Leite OHM, Kiffer CRV, Wunsch CT, Nunes D, Catalani A, de Cassia Alves LR, Dossin TJ, D'Alló de Oliveira MT, Martini S, Conway B, de Wet JJ, Montaner JSG, Murphy C, Woodfall B, Sestak P, Phillips P, Montessori V, Harris M, Tesiorowski A, Willoughby B, Voigt R, Farley J, Reynolds R, Devlaming S, Livrozet JM, Rozenbaum W, Sereni D, Valantin MA, Lascoux C, Milpied B, Brunet C, Billaud E, Huart A, Reliquet V, Charonnat MF, Sicot M, Esnault JL, Slama L, Staszewski S, Bickel M, Lazanas MK, Stavrianeas N, Mangafas N, Zagoreos I, Kourkounti S, Paparizos V, Botsi C, Clarke S, Brannigan E, Boyle N, Chiriani A, Leoncini F, Montella F, Francesco L, Ambu S, Farese A, Gargiulo M, Di Sora F, Lavria F, Folgori F, Beniowski M, Boron Kaczmarska A, Halota W, Prokopowicz D, Bander DB, Leszuzyszyn-Pynka MLP, Wnuk AW, Bakowska E, Pulik P, Flisiak R, Wiercinska-Drapalo A, Mularska E, Witor A, Antunes F, Sarmento RSE, Doroana M, Horta AA, Vasconcelos O, Andrews SM, Huisamen CB, Johnson D, Martin O, Bekker LG, Maartens G, Wilson D, Visagie CJ, David NJ, Rattley M, Nettleship E, Martin DJ, Keyser V, Moraites TM, Moorhouse MA, Pitt JA, Orrell CJ, Bester C, Parboosing R, Moodley P, Gathiram V, Woolf D, Bernasconi E, Magenta L, Cardiello P, Kroon E, Ungsedhapand C, Fisher M, Wilkins EGL, Stockwell E, Day J, Daintith RS, Perry N, Timaeus C, Intosh-Roffet JM, Powell A, Youle M, Tyrer M, Madge S, Drinkwater A, Cuthbertson Z, Carroll A, Becker S, Katner H, Rimland D, Saag MS, Thompson M, Witt M, Aguilar MM, LaVoy A, Illeman M, Guerrero M, Gatell J, Belsey E, Hirschel B, Potarca A, Cronenberg M, Kreekel L, Meester R, Khodabaks J, Botma HJ, Esrhir N, Farida I, Feenstra M, Jansen K, Klotz A, Mulder M, Ruiter G, Bass CB, Pluymers E, de Vlegelaer E, Leeneman (VCL) R, Carlier H, van Steenberge E, Hall D. Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz. Antivir Ther 2004. [DOI: 10.1177/135965350400900512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL). Design A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine. Methods Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance. Results The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV ( P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively ( P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event. Conclusions First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.
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Affiliation(s)
| | - Frank van Leth
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Brian Conway
- University of British Columbia, Vancouver, BC, Canada
| | - Hector Laplumé
- Hospital Profesor Alejandro Posadas, Buenos Aires, Argentina
| | - Des Martin
- Toga Laboratories, Edenvale, South Africa
| | - Martin Fisher
- Brighton and Sussex University Hospitals, Brighton, UK
| | - Ante Jelaska
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Conn., USA
| | - Ferdinand W Wit
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Joep MA Lange
- International Antiviral Therapy Evaluation Center (IATEC); Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Grelli S, d'Ettorre G, Lauria F, Montella F, Di Traglia L, Lichtner M, Vullo V, Favalli C, Vella S, Macchi B, Mastino A. Inverse correlation between CD8+ lymphocyte apoptosis and CD4+ cell counts during potent antiretroviral therapy in HIV patients. J Antimicrob Chemother 2004; 53:494-500. [PMID: 14963063 DOI: 10.1093/jac/dkh105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES We have addressed the relationships between inhibition of CD4+ and CD8+ cell apoptosis and CD4+ cell recovery in HIV patients undergoing potent antiretroviral therapy (PART) by correlating apoptosis levels with virological and immunological parameters detected over a long-term period in HIV patients undergoing therapy. PATIENTS AND METHODS Twenty-two HIV-1-infected patients undergoing PART were enrolled in a long-term, open longitudinal study. Data derived from 17 patients with successful response to therapy (TS; median time of follow-up 36 months, range 24-36 months) were used for correlation studies. Apoptosis was evaluated after short-term culture of peripheral blood lymphocytes by flow cytometry analysis of isolated nuclei or of annexin V/CD4, annexin V/CD8 double-stained cells. RESULTS Sustained, noticeable levels of apoptosis inhibition in peripheral blood mononuclear cells were measured, in the long-term, in 16 of the 17 TS patients. Levels of total cell apoptosis correlated with levels of CD8+ apoptotic cells more significantly than with levels of CD4+ apoptotic cells. In addition, CD4+ cell counts were correlated inversely with levels of CD8+ apoptotic cells in a highly significant fashion, but not with levels of CD4+ apoptotic cells. CONCLUSIONS Our data indicate that the increase of CD4+ lymphocytes in HIV patients, as a consequence of successful response to PART, may be related to changes in apoptosis level occurring in the CD8+, and not in the CD4+, cell compartment.
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Affiliation(s)
- Sandro Grelli
- Department of Experimental Medicine and Biochemical Science, Tor Vergata University Hospital, 00133 Rome, Italy
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Montella F, Giana M, Vigone A, Surico D, Surico N. Angiomyofibroblastoma of the vulva: report of a case. EUR J GYNAECOL ONCOL 2004; 25:253-4. [PMID: 15032297] [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: 04/29/2023]
Abstract
A case of solitary angiomyofibroblastoma of the vulva in a 16-year-old woman was examined by histology and immunohistochemistry. Microscopic examination of the tumor revealed typical features of a mesenchymal neoplasm, composed of bundle spindle cells with low cellular density, rich in collagen fibers and thin-walled blood vessels. Immunohistochemistry revealed immunoreactivity for progesterone receptor, CD34, desmin and vimentin, tumor cells expressing positivity, but not for estrogen receptors. The stains for the muscle-specific actin and S-100 were negative. These results were mostly consistent with those of previous reports and suggest that the tumors cells were derived from primitive mesenchymal cells which occur normally in this region and show the potential for diverse lines of myoid differentiation.
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Affiliation(s)
- F Montella
- Department of Obstetrics and Gynaecology, Piemonte Orientale University, Novara, Italy
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Montella F, Di Salvo R, Picillo G, Iovene M. VALUTAZIONE DELLE RESISTENZE DI CEPPI DI ESCHERICHIA COLI ISOLATI DA URINOCOLTURE. Microbiol Med 2003. [DOI: 10.4081/mm.2003.4324] [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: 11/22/2022] Open
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Suligoi B, Massi M, Galli C, Sciandra M, Di Sora F, Pezzotti P, Recchia O, Montella F, Sinicco A, Rezza G. Identifying recent HIV infections using the avidity index and an automated enzyme immunoassay. J Acquir Immune Defic Syndr 2003; 32:424-8. [PMID: 12640201 DOI: 10.1097/00126334-200304010-00012] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We evaluated a procedure for identifying recent HIV infections, using sequential serum samples from 47 HIV-positive persons for whom the seroconversion date could be accurately estimated. Each serum sample was divided into two aliquots: one diluted with phosphate-buffered saline and the other diluted with 1 M guanidine. We assayed the aliquots with the automated AxSYM HIV1/2gO test (Abbott Diagnostics Division), without modifying the manufacturer's protocol. We then calculated the avidity index (AI): the ratio of the sample/cutoff value for the guanidine aliquot to that of the phosphate-buffered saline aliquot. We analyzed 216 serum samples: 34 samples were collected within 6 months of seroconversion (recent seroconversions), and 182 were collected after 6 months. The mean AIs, by time from seroconversion, were 0.68 +/- 0.16 (within 6 months) and 0.98 +/- 0.10 (after 6 months) (P < 0.0001). AI of <0.90 correctly identified 88.2% of recent infections but misclassified as recent infections 13.2% of serum samples collected afterward. The probability of an infection being classified as recent and having AI of > or = 0.90 would be 0.7% in a population with 5% recent infections. AI can identify with a certain degree of accuracy recent HIV infections, and being a quantitative index, it provides different levels of sensitivity and specificity, depending on the selected cutoff value. The standard assay procedure is not modified. This test is simple and inexpensive and could be used for surveillance, decision-making in treatment, and prevention.
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Affiliation(s)
- Barbara Suligoi
- Reparto AIDS e MSTl, Istituto Superiore di Sanità, Rome, Italy.
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Suligoi B, Galli C, Massi M, Di Sora F, Sciandra M, Pezzotti P, Recchia O, Montella F, Sinicco A, Rezza G. Precision and accuracy of a procedure for detecting recent human immunodeficiency virus infections by calculating the antibody avidity index by an automated immunoassay-based method. J Clin Microbiol 2002; 40:4015-20. [PMID: 12409368 PMCID: PMC139667 DOI: 10.1128/jcm.40.11.4015-4020.2002] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the precision and accuracy of a procedure for detecting recent human immunodeficiency virus (HIV) infections, specifically, the avidity index (AI) calculated using a method based on an automated AxSYM HIV 1/2gO assay (Abbott). To evaluate precision, we performed multiple replicates on eight HIV-positive serum samples. To evaluate the accuracy in identifying recent infections (i.e., within 6 months of seroconversion), we used 216 serum samples from 47 persons whose dates of seroconversion were known. To evaluate the sensitivity and specificity of the procedure for different AI cutoff values, we performed receiver operating characteristic (ROC) analysis. To determine the effects of antiretroviral treatment, advanced stage of the disease (i.e., low CD4-cell count), and low HIV viral load on the AI, we analyzed 15 serum samples from 15 persons whose dates of seroconversion were unknown. The precision study showed that the procedure was robust (i.e., the total variance of the AI was lower than 10%). Regarding accuracy, the mean AI was significantly lower for samples collected within 6 months of seroconversion, compared to those collected afterwards (0.68 +/- 0.16 versus 0.99 +/- 0.10; P < 0.0001), with no overlap of the 95% confidence intervals. The ROC analysis revealed that an AI lower than 0.6 had a sensitivity of 33.3% and a specificity of 98.4%, compared to 87.9 and 86.3%, respectively, for an AI lower than 0.9. Antiretroviral treatment, low CD4-cell count, and low viral load had no apparent effect on the AI. In conclusion, this procedure is reproducible and accurate in identifying recent infections; it is automated, inexpensive, and easy to perform, and it provides a quantitative result with different levels of sensitivity and specificity depending on the selected cutoff.
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Affiliation(s)
- Barbara Suligoi
- Reparto AIDS e MST, Istituto Superiore di Sanità, Ospedale S. Giovanni-Addolorata, Rome, Italy.
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Pilloni AP, Buttini G, Giannarelli D, Giordano B, Iovene MR, Montella F, di Salvo R, Colantuono R, Lalli G, Tufano MA. Antimicrobial action of Nitens mouthwash (cetyltrimethylammonium naproxenate) on multiple isolates of pharyngeal microbes: a controlled study against chlorhexidine, benzydamine, hexetidine, amoxicillin, amoxicillin-clavulanate, clarithromycin, and cefaclor. Chemotherapy 2002; 48:168-73. [PMID: 12218263 DOI: 10.1159/000063868] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Acute oropharyngeal and respiratory tract infections are due to a wide spectrum of microorganisms. The aim of this study was to compare and evaluate the in vitro activity of four antiseptics (cetyltrimethylammonium naproxenate, chlorhexidine, benzydamine, hexetidine) to four antibiotics (amoxicillin, amoxicillin-clavulanate, clarithromycin, cefaclor) on strains of Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Streptococcus pneumoniae. METHODS Susceptibility tests were performed on 90, aerobic and anaerobic, bacterial strains, isolated from nasopharyngeal swabs and sputum. Minimum inhibitory concentrations (by microdilution) and minimum bactericidal concentrations were determined and compared. RESULTS Our selected panel of bacteria was highly susceptible to the antiseptics, particularly to chlorhexidine and naproxenate, even more so than two of the most frequently used antibiotics. Data were statistically significant (p < 0.005). CONCLUSIONS In view of their bactericidal and anti-inflammatory properties, these antiseptics may be effective in controlling the transitory colonization of the oral cavity by microbes that cause or worsen disease in patients with mild infections.
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Affiliation(s)
- A P Pilloni
- III Divisione di Medicina Generale e Sistematica, II Università degli Studi di Napoli, Napoli, Italy
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Diotallevi P, Mazzetti Di Pietralata G, Montella F. Noncontrast CT assessment of early cerebral ischaemia. Radiol Med 2002; 103:84-90. [PMID: 11859304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
PURPOSE To assess the diagnostic value of early signs of ischaemic cerebral infarction detected by unenhanced CT in the first 6-10 hours. MATERIAL AND METHODS We reviewed the CT examinations of 42 patients (mean age: 61 years, range: 35-79) with suspected ischaemic stroke. We assessed CT findings at 6-10 hours of the onset of stroke for hemilateral evidence of main cerebral artery hyperdensity, sulcal effacement, liquoral space asymmetry, hypodensity of grey matter. The CT scans were performed without contrast medium. RESULTS The topographic pattern of cerebral infarctions was: middle cerebral artery territory in 25 patients, anterior cerebral in 9, striatal lacunar infarction in 2, posterior junctional infarction in 5, anterior junctional infarction in 1. Early signs of infarction were present in 24 patients (57%). CT scans showed early signs in 20 cases (80%) of middle cerebral infarctions; 8 (32%) had middle cerebral artery hyperdensity; 3 (12%) had middle cerebral artery hyperdensity and sulcal effacement; 4 (16%) had sulcal effacement; 2 (8%) had liquoral space asymmetry; 3 (12%) had hypodensity of grey matter and liquoral space asymmetry. CT scans showed early signs in 4/9 (44%) of anterior cerebral infarctions. Sensitivity and specificity of early CT to cerebral infarction was 57% and 100%. The three cases with both hyperdense middle cerebral artery and sulcal effacement died of transtentorial herniation within the 10th day. The seven other deaths occurred in patients without early signs or particular patterns appearing in subsequent CT. DISCUSSION In the management of ischaemic stroke the aim of neuroradiologic methods is to provide exact direction to immediate therapy by early diagnosis. In such cases the use of CT scanning aims at detecting signs of two main alterations of infarction: vascular occlusion and brain oedema. Middle cerebral artery hyperdensity, showing steady correspondence to infarction site and frequent disappearance on the follow-up CT, is indicative of embolic occlusion. Signs of "mass effect" are evident from the early stages in relation to the substantial concomitance of various types of brain oedema. The semeiology discussed in this study is more clearly detectable in middle cerebral artery infarction because this territory is the main site of embolic occlusion, and its larger size increases the "mass effect" due to oedema. The sensitivity obtained in this study is among the lowest values reported, which likely relates to our choice to use short scan times.
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Affiliation(s)
- Paolo Diotallevi
- UOD Radiodiagnostica I, Azienda Ospedaliera Complesso Ospedaliero S. Giovanni e Addolorata, Rome, Italy
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Solano L, Montella F, Salvati S, Disora F, Murgia F, Figà-Talamanca L, Zoppi LA, Lauria F, Coda R, Nicotra M. Expression and processing of emotions: Relationships with cd4+ levels in 42 hiv-positive asymptomatic individuals. Psychol Health 2001. [DOI: 10.1080/08870440108405867] [Citation(s) in RCA: 4] [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: 10/22/2022]
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Grelli S, Di Traglia L, Matteucci C, Lichtner M, Vullo V, Di Sora F, Lauria F, Montella F, Favalli C, Vella S, Macchi B, Mastino A. Changes in apoptosis after interruption of potent antiretroviral therapy in patients with maximal HIV-1-RNA suppression. AIDS 2001; 15:1178-81. [PMID: 11416721 DOI: 10.1097/00002030-200106150-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S Grelli
- Department of Experimental Medicine, University of Rome Tor Vergata, Italy
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