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Cavallo I, Sivori F, Mastrofrancesco A, Abril E, Pontone M, Di Domenico EG, Pimpinelli F. Bacterial Biofilm in Chronic Wounds and Possible Therapeutic Approaches. Biology (Basel) 2024; 13:109. [PMID: 38392327 PMCID: PMC10886835 DOI: 10.3390/biology13020109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Wound repair and skin regeneration is a very complex orchestrated process that is generally composed of four phases: hemostasis, inflammation, proliferation, and remodeling. Each phase involves the activation of different cells and the production of various cytokines, chemokines, and other inflammatory mediators affecting the immune response. The microbial skin composition plays an important role in wound healing. Indeed, skin commensals are essential in the maintenance of the epidermal barrier function, regulation of the host immune response, and protection from invading pathogenic microorganisms. Chronic wounds are common and are considered a major public health problem due to their difficult-to-treat features and their frequent association with challenging chronic infections. These infections can be very tough to manage due to the ability of some bacteria to produce multicellular structures encapsulated into a matrix called biofilms. The bacterial species contained in the biofilm are often different, as is their capability to influence the healing of chronic wounds. Biofilms are, in fact, often tolerant and resistant to antibiotics and antiseptics, leading to the failure of treatment. For these reasons, biofilms impede appropriate treatment and, consequently, prolong the wound healing period. Hence, there is an urgent necessity to deepen the knowledge of the pathophysiology of delayed wound healing and to develop more effective therapeutic approaches able to restore tissue damage. This work covers the wound-healing process and the pathogenesis of chronic wounds infected by biofilm-forming pathogens. An overview of the strategies to counteract biofilm formation or to destroy existing biofilms is also provided.
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Affiliation(s)
- Ilaria Cavallo
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
| | - Francesca Sivori
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
| | - Arianna Mastrofrancesco
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
| | - Elva Abril
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
| | - Enea Gino Di Domenico
- Department of Biology and Biotechnology "C. Darwin", Sapienza University of Rome, 00185 Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, San Gallicano Dermatological Institute IRCSS, 00144 Rome, Italy
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Truglio M, Sivori F, Cavallo I, Abril E, Licursi V, Fabrizio G, Cardinali G, Pignatti M, Toma L, Valensise F, Cristaudo A, Pimpinelli F, Di Domenico EG. Modulating the skin mycobiome-bacteriome and treating seborrheic dermatitis with a probiotic-enriched oily suspension. Sci Rep 2024; 14:2722. [PMID: 38302693 PMCID: PMC10834955 DOI: 10.1038/s41598-024-53016-0] [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: 10/19/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024] Open
Abstract
Seborrheic dermatitis (SD) affects 2-5% of the global population, with imbalances in the skin microbiome implicated in its development. This study assessed the impact of an oily suspension containing Lactobacillus crispatus P17631 and Lacticaseibacillus paracasei I1688 (termed EUTOPLAC) on SD symptoms and the skin mycobiome-bacteriome modulation. 25 SD patients were treated with EUTOPLAC for a week. Symptom severity and skin mycobiome-bacteriome changes were measured at the start of the treatment (T0), after seven days (T8), and three weeks post-treatment (T28). Results indicated symptom improvement post-EUTOPLAC, with notable reductions in the Malassezia genus. Concurrently, bacterial shifts were observed, including a decrease in Staphylococcus and an increase in Lactobacillus and Lacticaseibacillus. Network analysis highlighted post-EUTOPLAC instability in fungal and bacterial interactions, with increased negative correlations between Malassezia and Lactobacillus and Lacticaseibacillus genera. The study suggests EUTOPLAC's potential as a targeted SD treatment, reducing symptoms and modulating the mycobiome-bacteriome composition.
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Affiliation(s)
- Mauro Truglio
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Elva Abril
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Valerio Licursi
- Institute of Molecular Biology and Pathology, National Research Council of Italy, 00185, Rome, Italy
| | - Giorgia Fabrizio
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
- Department of Biology and Biotechnology C. Darwin, Sapienza University of Rome, 00185, Rome, Italy
| | - Giorgia Cardinali
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | | | - Luigi Toma
- Medical Directorate, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
| | - Floriana Valensise
- Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Antonio Cristaudo
- Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144, Rome, Italy.
| | - Enea Gino Di Domenico
- Department of Biology and Biotechnology C. Darwin, Sapienza University of Rome, 00185, Rome, Italy.
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Laquintana V, Mottini C, Marchesi F, Marcozzi B, Terrenato I, Sperandio E, de Latouliere L, Carrieri F, Pimpinelli F, Pontone M, Pellini R, Campo F, Conti L, Accetta C, Mandoj C, Petrone F, Di Bella O, Vujovic B, Morrone A, Compagnone M, Principato E, Pinto E, Papa E, Falcucci P, La Malfa A, Pallocca M, De Marco F, Piaggio G, Ciliberto G, Mengarelli A, di Martino S. Dynamics of humoral and cellular response to three doses of anti-SARS-CoV-2 BNT162b2 vaccine in patients with hematological malignancies and older subjects. Front Immunol 2024; 14:1221587. [PMID: 38343436 PMCID: PMC10853639 DOI: 10.3389/fimmu.2023.1221587] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Background Few data are available about the durability of the response, the induction of neutralizing antibodies, and the cellular response upon the third dose of the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in hemato-oncological patients. Objective To investigate the antibody and cellular response to the BNT162b2 vaccine in patients with hematological malignancy. Methods We measured SARS-CoV-2 anti-spike antibodies, anti-Omicron neutralizing antibodies, and T-cell responses 1 month after the third dose of vaccine in 93 fragile patients with hematological malignancy (FHM), 51 fragile not oncological subjects (FNO) aged 80-92, and 47 employees of the hospital (healthcare workers, (HW), aged 23-66 years. Blood samples were collected at day 0 (T0), 21 (T1), 35 (T2), 84 (T3), 168 (T4), 351 (T pre-3D), and 381 (T post-3D) after the first dose of vaccine. Serum IgG antibodies against S1/S2 antigens of SARS-CoV-2 spike protein were measured at every time point. Neutralizing antibodies were measured at T2, T3 (anti-Alpha), T4 (anti-Delta), and T post-3D (anti-Omicron). T cell response was assessed at T post-3D. Results An increase in anti-S1/S2 antigen antibodies compared to T0 was observed in the three groups at T post-3D. After the third vaccine dose, the median antibody level of FHM subjects was higher than after the second dose and above the putative protection threshold, although lower than in the other groups. The neutralizing activity of antibodies against the Omicron variant of the virus was tested at T2 and T post-3D. 42.3% of FHM, 80,0% of FNO, and 90,0% of HW had anti-Omicron neutralizing antibodies at T post-3D. To get more insight into the breadth of antibody responses, we analyzed neutralizing capacity against BA.4/BA.5, BF.7, BQ.1, XBB.1.5 since also for the Omicron variants, different mutations have been reported especially for the spike protein. The memory T-cell response was lower in FHM than in FNO and HW cohorts. Data on breakthrough infections and deaths suggested that the positivity threshold of the test is protective after the third dose of the vaccine in all cohorts. Conclusion FHM have a relevant response to the BNT162b2 vaccine, with increasing antibody levels after the third dose coupled with, although low, a T-cell response. FHM need repeated vaccine doses to attain a protective immunological response.
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Affiliation(s)
- Valentina Laquintana
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Carla Mottini
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Francesco Marchesi
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Benedetta Marcozzi
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Irene Terrenato
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Eleonora Sperandio
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Luisa de Latouliere
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Francesca Carrieri
- UOC D.I.T.R.A.R. IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fulvia Pimpinelli
- UOSD of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Martina Pontone
- UOSD of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Raul Pellini
- UOC Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Flaminia Campo
- UOC Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Laura Conti
- UOSD Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Celeste Accetta
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Chiara Mandoj
- UOSD Clinical Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fabrizio Petrone
- UOC D.I.T.R.A.R. IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Ornella Di Bella
- Medical Direction, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Branka Vujovic
- Medical Direction, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | | | | | | | - Elena Papa
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Paolo Falcucci
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Matteo Pallocca
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Federico De Marco
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Giulia Piaggio
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Andrea Mengarelli
- UOSD Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Simona di Martino
- UOC Anatomy Pathology, Biobank IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
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Donà MG, Giuliani E, Giglio A, Pimpinelli F, Stingone C, Giuliani M, Alei L, Cota C, Iacovelli P, Frascione P, Latini A. Increasing trend in confirmed scabies cases in the only public dermatological institute of scientific research and care in Italy. Eur J Dermatol 2023; 33:709-710. [PMID: 38465564 DOI: 10.1684/ejd.2023.4622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Eugenia Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Amalia Giglio
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Christof Stingone
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Lavinia Alei
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Carlo Cota
- Genetic Research Unit, Dermatological Molecular Biology and Dermatopathology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Paolo Iacovelli
- Clinical Dermatology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Pasquale Frascione
- Oncologic Dermatology, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
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Morrone A, Di Simone E, Buonomini AR, Panattoni N, Pimpinelli F, Pontone M, Saraceni P, Ercoli L, Ralli M, Petrone F, Cristaudo A. A report about the experience of COVID-19 active surveillance of homeless, undocumented people, and shelter staff in two cities of Lazio, Italy. Eur Rev Med Pharmacol Sci 2023; 27:10798-10805. [PMID: 37975404 DOI: 10.26355/eurrev_202311_34359] [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: 11/19/2023]
Abstract
OBJECTIVE This study aimed to investigate COVID-19 spread among people experiencing homelessness (PEH), undocumented migrants (UMs), and shelter staff of homeless service sites. Another aim has been to prevent an outbreak among these populations. A San Gallicano Institute's initiative to sustain the health system in helping hard-to-reach populations, very often with no community medical care coverage. SUBJECTS AND METHODS The San Gallicano Dermatological Institute performed active surveillance for COVID-19 on PEH and UMs living in Rome and Latina, Italy. The screening was performed with two swabs: real-time polymerase chain reaction (RT-PCR) and antigen rapid tests. RESULTS From June 2020 to January 2022, we performed 10,651 tests: 5,442 molecular swabs and 5,209 antigen rapid tests. A total of 3,503 individuals were screened. The prevalence of SARS-CoV-2 infection was 2.9% among the health and social workers and 5.7% among PEH and UMs. None of the people positive for COVID-19 had symptoms or signs of several illnesses. PEH and UMs who tested positive for COVID-19, asymptomatic or pauci-symptomatic, were transferred to a COVID Hotel or dedicated apartment for further clinical monitoring. CONCLUSIONS People experiencing homelessness and undocumented migrants are often not registered in the National Health Service and, therefore, difficult to trace. These data could aid in estimating the spread of SARS-CoV-2 among people experiencing homelessness, undocumented migrants, and shelter staff in two Italian cities.
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Affiliation(s)
- A Morrone
- Scientific Direction, San Gallicano Dermatology Institute for Research and Care, IFO, Rome, Italy.
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Paolini F, Campo F, Iocca O, Manciocco V, De Virgilio A, De Pascale V, Moretto S, Dalfino G, Vidiri A, Blandino G, Pimpinelli F, Venuti A, Pellini R. It is time to improve the diagnostic workup of oropharyngeal cancer with circulating tumor HPV DNA: Systematic review and meta-analysis. Head Neck 2023; 45:2945-2954. [PMID: 37715656 DOI: 10.1002/hed.27515] [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: 06/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Abstract
The possibility of detecting circulating tumor HPV DNA (ctHPVDNA) in plasma in patients with oropharyngeal cancer has been demonstrated in several reports. However, these data are from small cohorts and available tests for detection of ctHPVDNA are not fully validated. The aim is to evaluate sensitivity, specificity, and accuracy of ctHPVDNA by ddPCR to define its efficacy in the clinical setting for the diagnosis of HPV + OPSCC. A comprehensive search of three different databases: MEDLINE, Embase, and Cochrane Library databases. A total of 998 patients were evaluated from the 13 studies. OPSSC p16+ were 729, while controls p16- were 269. The meta-analytic study estimated the diagnostic performance of ctHPVDNA as follows: pooled sensitivity and specificity of 0.90 (95% CI: 0.82-0.94) and 0.94 (95% CI: 0.85-0.98), respectively; positive and negative likelihood ratios of 12.6 (95% CI: 4.9-32.1) and 0.05 (95% CI: 0.02-0.13), respectively. ddPCR for ctHPVDNA has good accuracy, sensitivity, and specificity for diagnosis of HPV + OPSCC. ctHPVDNA kinetic represents a great reliable opportunity to improve diagnostic and therapeutic management of cancer patients and could open new perspectives for understanding tumor biology.
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Affiliation(s)
- Francesca Paolini
- HPV-Unit, UOSD Tumor Immunology and Immunotherapy IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
- Department of Biochemical Sciences A. Rossi Fanelli, Sapienza University of Rome, Rome, Italy
| | - Flaminia Campo
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Oreste Iocca
- Division of Maxillofacial Surgery, Surgical Science Department, University of Torino, Torino, Italy
| | - Valentina Manciocco
- HPV-Unit, UOSD Tumor Immunology and Immunotherapy IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Valentina De Pascale
- Translational oncologic research, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Silvia Moretto
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Gianluca Dalfino
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fulvia Pimpinelli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Aldo Venuti
- HPV-Unit, UOSD Tumor Immunology and Immunotherapy IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
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Cavallo I, Oliva A, Pages R, Sivori F, Truglio M, Fabrizio G, Pasqua M, Pimpinelli F, Di Domenico EG. Acinetobacter baumannii in the critically ill: complex infections get complicated. Front Microbiol 2023; 14:1196774. [PMID: 37425994 PMCID: PMC10325864 DOI: 10.3389/fmicb.2023.1196774] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Acinetobacter baumannii is increasingly associated with various epidemics, representing a serious concern due to the broad level of antimicrobial resistance and clinical manifestations. During the last decades, A. baumannii has emerged as a major pathogen in vulnerable and critically ill patients. Bacteremia, pneumonia, urinary tract, and skin and soft tissue infections are the most common presentations of A. baumannii, with attributable mortality rates approaching 35%. Carbapenems have been considered the first choice to treat A. baumannii infections. However, due to the widespread prevalence of carbapenem-resistant A. baumannii (CRAB), colistin represents the main therapeutic option, while the role of the new siderophore cephalosporin cefiderocol still needs to be ascertained. Furthermore, high clinical failure rates have been reported for colistin monotherapy when used to treat CRAB infections. Thus, the most effective antibiotic combination remains disputed. In addition to its ability to develop antibiotic resistance, A. baumannii is also known to form biofilm on medical devices, including central venous catheters or endotracheal tubes. Thus, the worrisome spread of biofilm-producing strains in multidrug-resistant populations of A. baumannii poses a significant treatment challenge. This review provides an updated account of antimicrobial resistance patterns and biofilm-mediated tolerance in A. baumannii infections with a special focus on fragile and critically ill patients.
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Affiliation(s)
- Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Rebecca Pages
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Mauro Truglio
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Giorgia Fabrizio
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Martina Pasqua
- Department of Biology and Biotechnology "C. Darwin" Sapienza University of Rome, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Enea Gino Di Domenico
- Department of Biology and Biotechnology "C. Darwin" Sapienza University of Rome, Rome, Italy
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Di Noia V, Pimpinelli F, Renna D, Campo F, Cosimati A, Torchia A, Marcozzi B, Massacci A, Pallocca M, Pellini R, Morrone A, Cognetti F. Duration of humoral response to the third dose of BNT162b2 vaccine in patients with solid cancer: Is fourth dose urgently needed? Eur J Cancer 2022; 176:164-167. [PMID: 36223679 PMCID: PMC9548024 DOI: 10.1016/j.ejca.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Vincenzo Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Davide Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flaminia Campo
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonella Cosimati
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
| | - Andrea Torchia
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
| | - Benedetta Marcozzi
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alice Massacci
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Matteo Pallocca
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Raul Pellini
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Francesco Cognetti
- President of FOCE, ConFederazione Oncologi-Cardiologi-Ematologi, Rome, Italy
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9
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Cavallo I, Lesnoni La Parola I, Sivori F, Toma L, Koudriavtseva T, Sperduti I, Kovacs D, D’Agosto G, Trento E, Cameli N, Mussi A, Latini A, Morrone A, Pimpinelli F, Di Domenico EG. Homocysteine and Inflammatory Cytokines in the Clinical Assessment of Infection in Venous Leg Ulcers. Antibiotics (Basel) 2022; 11:antibiotics11091268. [PMID: 36140047 PMCID: PMC9495878 DOI: 10.3390/antibiotics11091268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/07/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Inflammation and biofilm-associated infection are common in chronic venous leg ulcers (VU), causing deep pain and delayed healing. Albeit important, clinical markers and laboratory parameters for identifying and monitoring persistent VU infections are limited. This study analyzed 101 patients with infected (IVU) and noninfected VUs (NVU). Clinical data were collected in both groups. The serum homocysteine (Hcys) and inflammatory cytokines from the wound fluid were measured. In addition, microbial identification, antibiotic susceptibility, and biofilm production were examined. IVU were 56 (55.4%) while NVU were 45 (44.5%). IVUs showed a significant increase in the wound's size and depth compared to NVUs. In addition, significantly higher levels of interleukin (IL)-6, IL-10, IL17A, and tumor necrosis factor-alpha (TNF-α) were found in patients with IVUs compared to those with NVUs. Notably, hyperhomocysteinemia (HHcy) was significantly more common in patients with IVUs than NVUs. A total of 89 different pathogens were identified from 56 IVUs. Gram-negative bacteria were 51.7%, while the Gram-positives were 48.3%. At the species level, Staphylococcus aureus was the most common isolate (43.8%), followed by Pseudomonas aeruginosa (18.0%). Multidrug-resistant organisms (MDROs) accounted for 25.8% of the total isolates. Strong biofilm producers (SBPs) (70.8%) were significantly more abundant than weak biofilm producers (WBP) (29.2%) in IVUs. SBPs were present in 97.7% of the IVUs as single or multispecies infections. Specifically, SBPs were 94.9% for S. aureus, 87.5% for P. aeruginosa, and 28.6% for Escherichia coli. In IVU, the tissue microenvironment and biofilm production can support chronic microbial persistence and a most severe clinical outcome even in the presence of an intense immune response, as shown by the high levels of inflammatory molecules. The measurement of local cytokines in combination with systemic homocysteine may offer a novel set of biomarkers for the clinical assessment of IVUs caused by biofilm-producing bacteria.
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Affiliation(s)
- Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | | | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | - Isabella Sperduti
- Biostatistics, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Daniela Kovacs
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Giovanna D’Agosto
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Elisabetta Trento
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Norma Cameli
- Department of Dermatology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Anna Mussi
- Department of Dermatology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Alessandra Latini
- Department of Dermatology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Institute, IRCCS, 00144 Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Enea Gino Di Domenico
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, 00185 Rome, Italy
- Correspondence:
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10
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Graceffa D, Sperati F, Bonifati C, Spoletini G, Lora V, Pimpinelli F, Pontone M, Pellini R, Di Bella O, Morrone A, Cristaudo A. Immunogenicity of three doses of anti-SARS-CoV-2 BNT162b2 vaccine in psoriasis patients treated with biologics. Front Med (Lausanne) 2022; 9:961904. [PMID: 36148445 PMCID: PMC9485492 DOI: 10.3389/fmed.2022.961904] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Psoriasis has not been directly linked to a poor prognosis for COVID-19, yet immunomodulatory agents used for its management may lead to increased vulnerability to the dangerous complications of SARS-CoV-2 infection, as well as impair the effectiveness of the recently introduced vaccines. The three-dose antibody response trend and the safety of BNT162b2 mRNA vaccine in psoriasis patients treated with biologic drugs have remained under-researched. Materials and methods Forty-five psoriatic patients on biologic treatment were enrolled to evaluate their humoral response to three doses of BNT162b2. IgG titers anti-SARS-CoV-2 spike protein were evaluated at baseline (day 0, first dose), after 3 weeks (second dose), four weeks post-second dose, at the time of the third dose administration and 4 weeks post-third dose. Seropositivity was defined as IgG ≥15 antibody-binding units (BAU)/mL. Data on vaccine safety were also collected by interview at each visit. Results A statistically significant increase in antibody titers was observed after each dose of vaccine compared with baseline, with no significant differences between patients and controls. Methotrexate used in combination with biologics has been shown to negatively influence the antibody response to the vaccine. On the contrary, increasing body mass index (BMI) positively influenced the antibody response. No adverse effects were reported, and no relapses of psoriasis were observed in the weeks following vaccine administration in our study population. Conclusions Our data are largely consistent with the recent literature on this topic confirming the substantial efficacy and safety of BNT162b2 mRNA vaccine on psoriatic patients treated with biologics of different types and support the recommendation to perform additional doses in this specific subgroup of patients.
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Affiliation(s)
- Dario Graceffa
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Francesca Sperati
- Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Claudio Bonifati
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Gabriele Spoletini
- General Surgery and Liver Transplantation, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Viviana Lora
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Antonio Cristaudo
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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11
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Silvestris N, Belleudi V, Addis A, Pimpinelli F, Morrone A, Sciacchitano S, Mancini R, Garrisi VM, Costantini M, Ciliberto G, Frisardi V, Piaggio G. Development of Approaches and Metrics to Measure the Impact and Improve the Clinical Outcomes of Patients With Frailty in the Era of COVID-19. The COMETA Italian Protocol. Front Oncol 2022; 12:828660. [PMID: 35756683 PMCID: PMC9215159 DOI: 10.3389/fonc.2022.828660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
The outbreak of the coronavirus 2 disease 2019 (COVID-19) puts an enormous burden on healthcare systems worldwide. This may worsen outcomes in patients with severe chronic diseases such as cancer, autoimmune diseases, and immune deficiencies. In this critical situation, only a few available data exist, which do not allow us to provide practical guides for the treatment of oncological or immunocompromised patients. Therefore, a further step forward is needed, addressing the specific needs and demands of frail patients in the pandemic era. Here we aim to present a protocol of a study approved by an ethical committee named "CO.M.E.TA". CO.M.E.TA protocol is a network project involving six Italian institutions and its goals are: i) to measure and compare the impact of the pandemic on the access of cancer and immunocompromised patients to therapies in three Italian regions; ii) to assess how reorganizational measures put in place in these different institutions have impacted specific metrics of performance; iii) to establish a COVID-19 Biobank of biological samples from SARS-CoV-2 infected patients to be used to study immunological alterations in patients with immune frailty.
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Affiliation(s)
- Nicola Silvestris
- Istituto Tumori "Giovanni Paolo II" of Bari, IRCCS, Bari, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
| | | | - Aldo Morrone
- San Gallicano Dermatological Institute, IRCCS, Roma, Italy
| | | | - Rita Mancini
- Azienda Ospedaliera Universitaria Sant'Andrea, Sapienza University, Roma, Italy
| | | | - Massimo Costantini
- Geriatric Unit, Azienda Unità Sanitaria Locale (AUSL), IRCCS, Reggio Emilia, Italy
| | | | - Vincenza Frisardi
- Geriatric Unit, Azienda Unità Sanitaria Locale (AUSL), IRCCS, Reggio Emilia, Italy
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12
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Morrone A, Buonomini AR, Sannella A, Pimpinelli F, Rotulo A. Unequal Access to Testing and Vaccination Services for the Homeless and Undocumented Population During COVID-19 Pandemic. Int J Public Health 2022; 67:1604851. [PMID: 35774355 PMCID: PMC9237209 DOI: 10.3389/ijph.2022.1604851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: To furnish a model to ensure access and use of healthcare services to the undocumented and homeless population. Methods: Between March 2020 and October 2021, public and third sector actors in Rome implemented an accessible COVID-19 screening service and vaccination program targeting the homeless and undocumented population. Results: 95.6% of the patients tested negative to both rapid and molecular tests. 0.9% tested positive to both. 0.7% were false negatives, while 2.8% were false positives. None of the participants refused the diagnostic treatment. From July to October 2021, 1384 people received a complete cycle of the COVID-19 vaccine through the program. 632 (45.6%) also agreed to perform the antibodies testing before inoculation. 318 (50.31%) of these were positive at the time of vaccination. Conclusion: We present a cost-effective model for reducing structural barriers to access diagnostic and preventive services for the homeless and undocumented population that can be applied to different public health settings.
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Affiliation(s)
- Aldo Morrone
- San Gallicano Dermatological Institute, Hospital Physiotherapy Institutes (IRCCS), Rome, Italy
| | - Anna Rita Buonomini
- San Gallicano Dermatological Institute, Hospital Physiotherapy Institutes (IRCCS), Rome, Italy
| | - Alessandra Sannella
- Human, Social, and Health Sciences Department, University of Cassino, Cassino, Italy
| | - Fulvia Pimpinelli
- San Gallicano Dermatological Institute, Hospital Physiotherapy Institutes (IRCCS), Rome, Italy
| | - Arianna Rotulo
- Wolfson Institute of Population Health, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Department of Sustainable Health, Campus Fryslan, University of Groningen, Groningen, Netherlands
- *Correspondence: Arianna Rotulo,
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13
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Sivori F, Cavallo I, Kovacs D, Guembe M, Sperduti I, Truglio M, Pasqua M, Prignano G, Mastrofrancesco A, Toma L, Pimpinelli F, Morrone A, Ensoli F, Di Domenico EG. Role of Extracellular DNA in Dalbavancin Activity against Methicillin-Resistant Staphylococcus aureus (MRSA) Biofilms in Patients with Skin and Soft Tissue Infections. Microbiol Spectr 2022; 10:e0035122. [PMID: 35416701 PMCID: PMC9045124 DOI: 10.1128/spectrum.00351-22] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 01/28/2022] [Accepted: 04/01/2022] [Indexed: 12/15/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has become the leading cause of skin and soft tissue infections (SSTIs). Biofilm production further complicates patient treatment, contributing to increased bacterial persistence and antibiotic tolerance. The study aimed to explore the efficacy of different antibiotics on biofilm-producing MRSA isolated from patients with SSTI. A total of 32 MRSA strains were collected from patients with SSTI. The MIC and minimal biofilm eradication concentration (MBEC) were measured in planktonic and biofilm growth. The study showed that dalbavancin, linezolid, and vancomycin all inhibited MRSA growth at their EUCAST susceptible breakpoint. Of the MRSA strains, 87.5% (n = 28) were strong biofilm producers (SBPs), while only 12.5% (n = 4) were weak biofilm producers (WBPs). The MBEC90 values for dalbavancin were significantly lower than those of linezolid and vancomycin in all tested strains. We also found that extracellular DNA (eDNA) contributes to the initial microbial attachment and biofilm formation. The amount of eDNA differed among MRSA strains and was significantly higher in those isolates with high dalbavancin and vancomycin tolerance. Exogenously added DNA increased the MBEC90 and protection of biofilm cells from dalbavancin activity. Of note, the relative abundance of eDNA was higher in MRSA biofilms exposed to MBEC90 dalbavancin than in untreated MRSA biofilms and those exposed to sub-MIC90. Overall, dalbavancin was the most active antibiotic against MRSA biofilms at concentrations achievable in the human serum. Moreover, the evidence of a drug-related increase of eDNA and its contribution to antimicrobial drug tolerance reveals novel potential targets for antibiofilm strategies against MRSA. IMPORTANCE Staphylococcus aureus is the most common cause of skin and soft tissue infections (SSTIs) worldwide. In addition, methicillin-resistant S. aureus (MRSA) is increasingly frequent in postoperative infections and responsible for a large number of hospital readmissions and deaths. Biofilm formation by S. aureus is a primary risk factor in SSTIs, due to a higher antibiotic tolerance. Our study showed that the biofilm-forming capacity varied among MRSA strains, although strong biofilm producers were significantly more abundant than weak biofilm producer strains. Notably, dalbavancin demonstrated a potent antibiofilm activity at concentrations achievable in human serum. Nevertheless, dalbavancin activity was affected by an increased concentration of extracellular DNA in the biofilm matrix. This study provides novel insight for designing more targeted therapeutic strategies against MRSA and to prevent or eradicate harmful biofilms.
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Affiliation(s)
- Francesca Sivori
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Ilaria Cavallo
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Daniela Kovacs
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Maria Guembe
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Isabella Sperduti
- Biostatistical Unit-Clinical Trials Center, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mauro Truglio
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Martina Pasqua
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, Rome, Italy
| | - Grazia Prignano
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | | | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - Enea Gino Di Domenico
- Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Rome, Italy
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, Rome, Italy
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14
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Sernicola A, Maddalena P, La Greca I, Donà MG, Salvi M, Garelli V, Stingone C, Gianserra L, Giuliani E, Pontone M, Pimpinelli F, Latini A. False negative RPR test with prozone phenomenon in an HIV-negative man with secondary syphilis. J Eur Acad Dermatol Venereol 2022; 36:e628-e629. [PMID: 35305047 DOI: 10.1111/jdv.18089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/15/2022] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- A Sernicola
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - P Maddalena
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - I La Greca
- Clinical Pathology and Microbiology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - M G Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - M Salvi
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - V Garelli
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - C Stingone
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - L Gianserra
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - E Giuliani
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - M Pontone
- Clinical Pathology and Microbiology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - F Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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15
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Di Noia V, Pimpinelli F, Renna D, Maccallini MT, Gariazzo L, Cosimati A, Campo F, Sperandio E, Pellini R, Giannarelli D, Cognetti F. Rapid decline of humoral response to two doses of BNT162b2 vaccine in patients with solid cancer after six months: The urgent need of the additional dose! Eur J Cancer 2022; 165:169-173. [PMID: 35245863 DOI: 10.1016/j.ejca.2022.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/26/2021] [Accepted: 01/07/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION We previously reported on the immunogenicity and safety of BNT162b2 in a large cohort of patients with cancer after the first and second doses (Di Noia et al., 2021) [1]. Herein, we present result after six months of follow-up. METHODS This prospective study included patients affected by solid tumors and afferent to our institution who received two doses of BNT162b2 vaccine. A cohort of vaccinated healthcare workers (HCW) was used as control-group. Both cohorts were evaluated for the titer of anti-Spike (S) IgG at prefixed time-points (TPs). Time-point 4 was scheduled at 24-26 weeks after the second dose. RESULTS In the current analysis, 400 patients and 232 healthcare workers were evaluated. Responders (IgG > 15 AU/mL) in patients group were 86.5% compared with 94.4% among healthcare workers. Also the IgG titer at TP4 was significantly inferior in patients than in healthcare workers (70.81 vs 134.64 AU/ml, p < 0.001). There was a more rapid decline of the antibody level from TP3 to TP4 in patients than in healthcare workers (1.78 vs 1.3 fold). The estimated IgG half-life was significantly shorter for patients (73 days) than in healthcare workers (118 days) as well as the time to reach negative serological status (340 vs 532 days). CONCLUSION The decline of humoral response to the vaccine observed in patients with solid cancer after six months from the first dose support the urgent need of an early additional dose.
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Affiliation(s)
- Vincenzo Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute, Italy
| | - Davide Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria T Maccallini
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
| | - Ludovica Gariazzo
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
| | - Antonella Cosimati
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
| | - Flaminia Campo
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Eleonora Sperandio
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Raul Pellini
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy; Department of Clinical and Molecular Medicine, Università La Sapienza di Roma, Italy
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16
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Di Noia V, Pimpinelli F, Renna D, Maccallini MT, Gariazzo L, Riva F, Sperandio E, Giannarelli D, Cognetti F. Potentiation of humoral response to BNT162b2 vaccine after the third dose in patients with solid cancer. Ann Oncol 2022; 33:563-565. [PMID: 35202794 PMCID: PMC8861182 DOI: 10.1016/j.annonc.2022.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/05/2022] [Accepted: 02/12/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- V Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - F Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute
| | - D Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M T Maccallini
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute
| | - L Gariazzo
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute
| | - F Riva
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute
| | - E Sperandio
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - D Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Cognetti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy; Department of Clinical and Molecular Medicine, Università La Sapienza di Roma
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17
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Muti GE, Muti-Schuenemann G, Pimpinelli F, Spataro A, Fiore A, Ciasullo F, Olivieri D, Rigoni M, Delbue S, Pariani E, Muzi F, Donzelli S, Strano S, Morrone A, Blandino G, Muti P. COVID-19 Test Before Tokyo2020 Paralympic Games: An Implemented Protocol to Protect Paralympic Athletes. Front Sports Act Living 2022; 4:834410. [PMID: 35252859 PMCID: PMC8888971 DOI: 10.3389/fspor.2022.834410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022] Open
Abstract
Objectives The COVID-19 pandemic represents a difficult challenge for the whole of humanity. Sports, in which contact between athletes is essential, became impossible to practice without the risk of viral spread. Athletes of the national teams are a particular subgroup of the population for whom there is an important need for protection and the implementation of targeted preventive measures. The present report describes the protocol that was developed to answer the urgent protection need for athletes during COVID-19 pandemic. The protocol aimed at demonstrating the feasibility of a rigid prevention intervention to prevent outbreaks and infections in terms of COVID-19 as well as in other potential future pandemics from pathogens with similar path of transmission. Methods The study was conducted in rowing para-thletes training of the Paralympic Games in Tokyo2020. It was designed to create an anti-COVID-19 “protection bubble” with the aim to isolate para-athletes and their technical support team during pre-Olympic retreats. The “bubble” development relied on a carefully conducted protocol of repeated antigen and molecular COVID-19 tests on nasal and oropharyngeal fluids among all participants carried out before, during and at the end of each retreat. Results During the 10 months of protocol implementation there were no COVID-19 outbreaks among the para-athletes and technical personnel during the retreats. In total, 552 PCR tests and 298 antigen-based tests were performed for an average number of 42 test per athlete. The number of retreat participants was larger (n = 23) in the beginning of the year due to the Paralympic selection rounds and smaller at the end of the study period (n = 12). Conclusion The protocol has indicated that it is possible to implement an anti-COVID-19 protection protocol where athletes and technical staff can train and compete in safe conditions. The study showed that it is feasible to implement a rigid prevention protocol for athletes and technical staff based on repeated COVID-19 antigenic and molecular tests for a long period of training with excellent participation and compliance.
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Affiliation(s)
- Greta E. Muti
- Medical Scholl, San Raffaele University, Milan, Italy
| | | | - Fulvia Pimpinelli
- Lazio Region COVID Center, San Gallicano Institute, Instituti Fisioterapici Ospedalieri (IFO), Rome, Italy
| | - Antonio Spataro
- Italian Rowing Federation Olympic Team, Comitato Olimpico Nazionale Italiano (CONI), Rome, Italy
| | - Antonio Fiore
- Italian Fencing Federation Olympic Team, Comitato Olimpico Nazionale Italiano (CONI), Rome, Italy
| | - Francesca Ciasullo
- Centro Italiano Studio Sviluppo Psicoterapie A Breve Termine (CISSPAT) Sport Psychology and Coaching Unit, Consultant Italian Fencing Olympic Federation, Rome, Italy
| | | | - Marta Rigoni
- Industrial Engineering Department, Trento University, Trento, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Elena Pariani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Muzi
- Sport Medicine Department, Regional Health System, Terni, Italy
| | - Sara Donzelli
- Oncogenomic and Epigenetic Unit, Italian National Cancer Center “Regina Elena”, Rome, Italy
| | - Sabrina Strano
- Oncogenomic and Epigenetic Unit, Italian National Cancer Center “Regina Elena”, Rome, Italy
- Scientific Director Office, San Gallicano Institute, IFO, Rome, Italy
| | - Aldo Morrone
- Scientific Director Office, San Gallicano Institute, IFO, Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, Italian National Cancer Center “Regina Elena”, Rome, Italy
| | - Paola Muti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- *Correspondence: Paola Muti
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18
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Marchesi F, Pimpinelli F, Giannarelli D, Ronchetti L, Papa E, Falcucci P, Pontone M, Di Domenico EG, di Martino S, Laquintana V, Mandoj C, Conti L, Cordone I, La Malfa A, Viggiani C, Renzi D, Palombi F, Romano A, Pisani F, Gumenyuk S, Di Bella O, Vujovic B, Morrone A, Ciliberto G, Ensoli F, Mengarelli A. Impact of anti-CD20 monoclonal antibodies on serologic response to BNT162b2 vaccine in B-cell Non-Hodgkin's lymphomas. Leukemia 2022; 36:588-590. [PMID: 34545184 PMCID: PMC8451738 DOI: 10.1038/s41375-021-01418-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Francesco Marchesi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Diana Giannarelli
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Livia Ronchetti
- SAFU Unit, Department of Research and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Papa
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Falcucci
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Enea Gino Di Domenico
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Simona di Martino
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Laquintana
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Mandoj
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Iole Cordone
- Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Caterina Viggiani
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Daniela Renzi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Palombi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Atelda Romano
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Pisani
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Svitlana Gumenyuk
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Andrea Mengarelli
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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19
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Donzelli S, Spinella F, di Domenico EG, Pontone M, Cavallo I, Orlandi G, Iannazzo S, Ricciuto GM, Team ISGVC, Pellini R, Muti P, Strano S, Ciliberto G, Ensoli F, Zapperi S, La Porta CA, Blandino G, Morrone A, Pimpinelli F. Evidence of a SARS-CoV-2 double Spike mutation D614G/S939F potentially affecting immune response of infected subjects. Comput Struct Biotechnol J 2022; 20:733-744. [PMID: 35096288 PMCID: PMC8780065 DOI: 10.1016/j.csbj.2022.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 12/16/2022] Open
Abstract
Objectives Despite extensive efforts to monitor the diffusion of COVID-19, the actual wave of infection is worldwide characterized by the presence of emerging SARS-CoV-2 variants. The present study aims to describe the presence of yet undiscovered SARS-CoV-2 variants in Italy. Methods Next Generation Sequencing was performed on 16 respiratory samples from occasionally employed within the Bangladeshi community present in Ostia and Fiumicino towns. Computational strategy was used to identify all potential epitopes for reference and mutated Spike proteins. A simulation of proteasome activity and the identification of possible cleavage sites along the protein guided to a combined score involving binding affinity, peptide stability and T-cell propensity. Results Retrospective sequencing analysis revealed a double Spike D614G/S939F mutation in COVID-19 positive subjects present in Ostia while D614G mutation was evidenced in those based in Fiumicino. Unlike D614G, S939F mutation affects immune response by the slight but significant modulation of T-cell propensity and the selective enrichment of potential binding epitopes for some HLA alleles. Conclusion Collectively, our findings mirror further the importance of deep sequencing of SARS-CoV-2 genome as a unique approach to monitor the appearance of specific mutations as for those herein reported for Spike protein. This might have implications on both the type of immune response triggered by the viral infection and the severity of the related illness.
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20
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Cristaudo A, Graceffa D, Pimpinelli F, Sperati F, Spoletini G, Bonifati C, Pellini R, Lora V, Pontone M, Di Bella O, Bracco D, Morrone A. Immunogenicity and safety of anti-SARS-CoV-2 BNT162b2 vaccine in psoriasis patients treated with biologic drugs. J Eur Acad Dermatol Venereol 2021; 36:e266-e268. [PMID: 34897821 DOI: 10.1111/jdv.17861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 02/02/2023]
Affiliation(s)
- A Cristaudo
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - D Graceffa
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - F Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - F Sperati
- Biostatistics Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - G Spoletini
- General Surgery and Liver Transplantation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Bonifati
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - R Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - V Lora
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - M Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - O Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - D Bracco
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Morrone
- Scientific Direction, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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21
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Di Noia V, Pimpinelli F, Renna D, Barberi V, Pellini R, Morrone A, Giannarelli D, Cognetti F. Clinical characteristics limiting the durability of humoral response to BNT162b2 in patients with solid cancer. Ann Oncol 2021; 33:350-352. [PMID: 34861377 DOI: 10.1016/j.annonc.2021.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/16/2021] [Accepted: 11/19/2021] [Indexed: 11/01/2022] Open
Affiliation(s)
- V Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - F Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Dermatological Institute
| | - D Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - V Barberi
- Department of Clinical and Molecular Medicine, Università La Sapienza di Roma
| | - R Pellini
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Rome, Italy
| | - D Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - F Cognetti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy; Department of Clinical and Molecular Medicine, Università La Sapienza di Roma
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22
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Ralli M, De-Giorgio F, Pimpinelli F, Cedola C, Shkodina N, Morrone A, Arcangeli A, Ercoli L. SARS-CoV-2 infection prevalence in people experiencing homelessness. Eur Rev Med Pharmacol Sci 2021; 25:6425-6430. [PMID: 34730224 DOI: 10.26355/eurrev_202110_27016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE People experiencing homelessness have peculiar characteristics that make them more vulnerable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission and to more serious forms of Coronavirus Disease 19 (COVID-19). The aim of this study was to evaluate the prevalence of SARS-CoV-2 infection in the homeless population assisted by the primary care services of the Eleemosynaria Apostolica, Vatican City. PATIENTS AND METHODS Persons experiencing homelessness and the volunteers assisting them were tested for COVID-19 through PCR and antigen rapid test between October 1st, 2020, and June 5th, 2021, in the clinical facilities of the Eleemosynaria Apostolica. RESULTS A total of 1665 subjects from 96 different countries in five continents were included in the study; age range was 1-90 years. Overall, 2315 COVID-19 tests through nasopharyngeal swab were performed; 1052 Polymerase Chain Reaction (PCR) tests and 1263 antigen rapid tests. Nearly 40% of the subjects underwent both tests (n=650, 39.04%), 402 were tested with PCR test only (24.14%) and 613 with antigen test only (36.8%). PCR tests were negative in 966 cases and positive in 86 (8.17%), while antigen tests were negative in 1205 cases and positive in 58 (4.59%). The number of positive cases varied over time, with a drastic increase during the winter months of 2020 and a progressive decrease over 2021. Among positive cases, 24.41% were symptomatic; symptoms included fever, breathing difficulties, anosmia/hyposmia, cough, headache, and diarrhea. CONCLUSIONS This study reported an overall prevalence of SARS-CoV-2 infection in our sample slightly above 8%. Additional data on viral genome through sequencing of SARS-CoV-2 in positive cases are of utmost importance to help identify variants and implement specific infection control measures.
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Affiliation(s)
- M Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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23
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Campo F, Venuti A, Pimpinelli F, Abril E, Blandino G, Conti L, De Virgilio A, De Marco F, Di Noia V, Di Domenico EG, Di Martino S, Ensoli F, Giannarelli D, Mandoj C, Mazzola F, Moretto S, Petruzzi G, Petrone F, Pichi B, Pontone M, Vidiri A, Vujovic B, Piaggio G, Sperandio E, Rosati V, Cognetti F, Morrone A, Ciliberto G, Pellini R. Antibody Persistence 6 Months Post-Vaccination with BNT162b2 among Health Care Workers. Vaccines (Basel) 2021; 9:vaccines9101125. [PMID: 34696233 PMCID: PMC8538824 DOI: 10.3390/vaccines9101125] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 08/17/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND We present immunogenicity data 6 months after the first dose of BNT162b2 in correlation with age, gender, BMI, comorbidities and previous SARS-CoV-2 infection. METHODS An immunogenicity evaluation was carried out among health care workers (HCW) vaccinated at the Istituti Fisioterapici Ospitalieri (IFO). All HCW were asked to be vaccine by the national vaccine campaign at the beginning of 2021. Serum samples were collected on day 1 just prior to the first dose of the vaccine and on day 21 just prior to the second vaccination dose. Thereafter sera samples were collected 28, 49, 84 and 168 days after the first dose of BNT162b2. Quantitative measurement of IgG antibodies against S1/S2 antigens of SARS-CoV-2 was performed with a commercial chemiluminescent immunoassay. RESULTS Two hundred seventy-four HWCs were analyzed, 175 women (63.9%) and 99 men (36.1%). The maximum antibody geometric mean concentration (AbGMC) was reached at T2 (299.89 AU/mL; 95% CI: 263.53-339.52) with a significant increase compared to baseline (p < 0.0001). Thereafter, a progressive decrease was observed. At T5, a median decrease of 59.6% in COVID-19 negative, and of 67.8% in COVID-19 positive individuals were identified with respect to the highest antibody response. At T1, age and previous COVID-19 were associated with differences in antibody response, while at T2 and T3 differences in immune response were associated with age, gender and previous COVID-19. At T4 and T5, only COVID-19 positive participants demonstrated a greater antibody response, whereas no other variables seemed to influence antibody levels. CONCLUSIONS Overall our study clearly shows antibody persistence at 6 months, albeit with a certain decline. Thus, the use of this vaccine in addressing the COVID-19 pandemic is supported by our results that in turn open debate about the need for further boosts.
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Affiliation(s)
- Flaminia Campo
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Aldo Venuti
- HPV Unit, UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy
- Correspondence:
| | - Fulvia Pimpinelli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Elva Abril
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Laura Conti
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (L.C.); (C.M.)
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy;
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Federico De Marco
- RIDAIT Department, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Vincenzo Di Noia
- Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.D.N.); (F.C.)
| | - Enea Gino Di Domenico
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Simona Di Martino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Fabrizio Ensoli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Diana Giannarelli
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Chiara Mandoj
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (L.C.); (C.M.)
| | - Francesco Mazzola
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Silvia Moretto
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Gerardo Petruzzi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Fabrizio Petrone
- U.O.C. DITRAR, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Barbara Pichi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Martina Pontone
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.P.); (E.A.); (E.G.D.D.); (F.E.); (M.P.)
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, 00144 Rome, Italy;
| | - Giulia Piaggio
- Department of Research, IRCSS Technological Innovation & Advanced Diagnostics, Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Eleonora Sperandio
- UOSD Clinical Trial Center, Biostatistic and Bionformatic, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Valentina Rosati
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
| | - Francesco Cognetti
- Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.D.N.); (F.C.)
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy;
| | - Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), 00144 Rome, Italy; (F.C.); (F.M.); (S.M.); (G.P.); (B.P.); (V.R.); (R.P.)
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24
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Di Noia V, Pimpinelli F, Renna D, Barberi V, Maccallini MT, Gariazzo L, Pontone M, Monti A, Campo F, Taraborelli E, Di Santo M, Petrone F, Mandoj C, Ferraresi V, Ferretti G, Carlini P, Di Bella O, Conti L, La Malfa AM, Pellini R, Bracco D, Giannarelli D, Morrone A, Cognetti F. Immunogenicity and Safety of COVID-19 Vaccine BNT162b2 for Patients with Solid Cancer: A Large Cohort Prospective Study from a Single Institution. Clin Cancer Res 2021; 27:6815-6823. [PMID: 34583970 DOI: 10.1158/1078-0432.ccr-21-2439] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/03/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE We assessed the immunogenicity and safety of the BNT162b2 vaccine in a large cohort of patients with cancer (CP). EXPERIMENTAL DESIGN From March 1, 2021 to March 20, 2021, this prospective cohort study included 816 CP afferent to our institution and eligible for the vaccination. A cohort of 274 health care workers (HCW) was used as age- and sex-matched control group. BNT162b2 was administered as a two-dose regimen given 21 days apart. Blood samples to analyze anti-Spike (S) IgG antibodies (Ab) were collected prevaccination [timepoint (TP) 0], and at 3 weeks (TP1) and 7 weeks (TP2) after the first dose. RESULTS Patients characteristics: median age 62 (range, 21-97); breast/lung cancer/others (31/21/48%); active treatment/follow-up (90/10%). In the whole CP cohort, the serologic response rate (RR) and the titre of anti-S IgG significantly increased across the TPs; at TP2, the responders (IgG >15 AU/mL) were 94.2%. Active chemotherapy and chronic use of steroids were independent predictors of lower RR. Adverse events (AE) after the booster predicted higher likelihood of response (OR, 4.04; 95% confidence interval, 1.63-9.99; P = 0.003). Comparing the matched cohorts, the responders were significantly lower in CP than in HCW at TP1 (61.2% vs. 93.2%) and TP2 (93.3% vs. 100%), while the geometric mean concentration of IgG did not significantly differ at TP2 being significantly lower in CP (23.3) than in HCW (52.1) at TP1. BNT162b2 was well tolerated in CP; severe-grade AEs were 3.5% and 1.3% after the first and second doses, respectively. CONCLUSIONS BNT162b2 assures serologic immunization without clinically significant toxicity in CP. The second dose is needed to reach a satisfactory humoral response.
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Affiliation(s)
- Vincenzo Di Noia
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Davide Renna
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Vittoria Barberi
- Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
| | | | - Ludovica Gariazzo
- Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Alessandro Monti
- Radiology and Diagnostic Imaging Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flaminia Campo
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Emanuela Taraborelli
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Di Santo
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Petrone
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Mandoj
- Department of Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Sarcomas and Rare Tumors Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gianluigi Ferretti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Carlini
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Department of Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia Marina La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Raul Pellini
- Otolaryngology Head and Neck Surgery Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Domenico Bracco
- Medical Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.,Department of Clinical and Molecular Medicine, Universita' La Sapienza di Roma, Rome, Italy
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Latini A, Magri F, Giuliani E, Giuliani M, Garelli V, Pontone M, Salvi M, Stingone C, Gianserra L, Pimpinelli F, Buonomini AR, Morrone A, Donà MG, Zaccarelli M. Continuing evidence that COVID-19 has influenced syphilis epidemiology in Rome. Sex Transm Infect 2021; 98:72. [PMID: 34544886 DOI: 10.1136/sextrans-2021-055250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesca Magri
- Department of Dermatology, University of Rome La Sapienza, Rome, Italy
| | - Eugenia Giuliani
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Valentina Garelli
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Martina Pontone
- Microbiology and Pathology Department, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Monica Salvi
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Christof Stingone
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Laura Gianserra
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Pathology Department, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Marchesi F, Pimpinelli F, Sperandio E, Papa E, Falcucci P, Pontone M, di Martino S, de Latouliere L, Orlandi G, Morrone A, Ciliberto G, Mengarelli A. The 12-week kinetics of anti-SARS-CoV-2 antibodies in different haematological cancers after vaccination with BNT162b2. Br J Haematol 2021; 196:362-367. [PMID: 34490627 PMCID: PMC8653015 DOI: 10.1111/bjh.17821] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Francesco Marchesi
- Haematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Eleonora Sperandio
- Biostatistics and Bioinformatics Unit, Scientific Direction, Clinical Trial Center, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Papa
- Haematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Falcucci
- Haematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Simona di Martino
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luisa de Latouliere
- SAFU Unit, Department of Research and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Orlandi
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Mengarelli
- Haematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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27
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Di Domenico EG, Marchesi F, Cavallo I, Toma L, Sivori F, Papa E, Spadea A, Cafarella G, Terrenato I, Prignano G, Pimpinelli F, Mastrofrancesco A, D’Agosto G, Trento E, Morrone A, Mengarelli A, Ensoli F. The Impact of Bacterial Biofilms on End-Organ Disease and Mortality in Patients with Hematologic Malignancies Developing a Bloodstream Infection. Microbiol Spectr 2021; 9:e0055021. [PMID: 34406812 PMCID: PMC8552682 DOI: 10.1128/spectrum.00550-21] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/22/2021] [Indexed: 11/20/2022] Open
Abstract
Bacterial bloodstream infection (BSI) represents a significant complication in hematologic patients. However, factors leading to BSI and progression to end-organ disease and death are understood only partially. The study analyzes host and microbial risk factors and assesses their impact on BSI development and mortality. A total of 96 patients with hematological malignancies and BSI were included in the study. Host-associated risk factors and all causes of mortality were analyzed by multivariable logistic regression at 30 days after BSI onset of the first neutropenic episode. The multidrug-resistant profile and biofilm production of bacterial isolates from primary BSI were included in the analysis. Median age was 60 years. The underlying diagnoses were acute leukemia (55%), lymphoma (31%), and myeloma (14%). A total of 96 bacterial isolates were isolated from BSIs. Escherichia coli was the most common isolate (29.2%). Multidrug-resistant bacteria caused 10.4% of bacteremia episodes. Weak biofilm producers (WBPs) were significantly (P < 0.0001) more abundant (72.2%) than strong biofilm producers (SBPs) (27.8%). Specifically, SBPs were 7.1% for E. coli, 93.7% for P. aeruginosa, 50% for K. pneumoniae, and 3.8% for coagulase-negative staphylococci. Mortality at day 30 was 8.3%, and all deaths were attributable to Gram-negative bacteria. About 22% of all BSIs were catheter-related BSIs (CRBSIs) and mostly caused by Gram-positive bacteria (79.0%). However, CRBSIs were not correlated with biofilm production levels (P = 0.75) and did not significantly impact the mortality rate (P = 0.62). Conversely, SBP bacteria were an independent risk factor (P = 0.018) for developing an end-organ disease. In addition, multivariate analysis indicated that SBPs (P = 0.013) and multidrug-resistant bacteria (P = 0.006) were independent risk factors associated with 30-day mortality. SBP and multidrug-resistant (MDR) bacteria caused a limited fraction of BSI in these patients. However, when present, SBPs raise the risk of end-organ disease and, together with an MDR phenotype, can independently and significantly concur at increasing the risk of death. IMPORTANCE Bacterial bloodstream infection (BSI) is a significant complication in hematologic patients and is associated with high mortality rates. Despite improvements in BSI management, factors leading to sepsis are understood only partially. This study analyzes the contribution of bacterial biofilm on BSI development and mortality in patients with hematological malignancies (HMs). In this work, weak biofilm producers (WBPs) were significantly more abundant than strong biofilm producers (SBPs). However, when present, SBP bacteria raised the risk of end-organ disease in HM patients developing a BSI. Besides, SBPs, together with a multidrug-resistant (MDR) phenotype, independently and significantly concur at increasing the risk of death in HM patients. The characterization of microbial biofilms may provide key information for the diagnosis and therapeutic management of BSI and may help develop novel strategies to either eradicate or control harmful microbial biofilms.
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Affiliation(s)
- Enea Gino Di Domenico
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Elena Papa
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonio Spadea
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppina Cafarella
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Biostatistics and Bioinformatic Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Grazia Prignano
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | | | - Giovanna D’Agosto
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Elisabetta Trento
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Andrea Mengarelli
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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28
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Pimpinelli F, Marchesi F, Piaggio G, Giannarelli D, Papa E, Falcucci P, Spadea A, Pontone M, Di Martino S, Laquintana V, La Malfa A, Di Domenico EG, Di Bella O, Falzone G, Ensoli F, Vujovic B, Morrone A, Ciliberto G, Mengarelli A. Lower response to BNT162b2 vaccine in patients with myelofibrosis compared to polycythemia vera and essential thrombocythemia. J Hematol Oncol 2021; 14:119. [PMID: 34325728 PMCID: PMC8319901 DOI: 10.1186/s13045-021-01130-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/16/2021] [Indexed: 12/16/2022] Open
Abstract
In a population of 42 Philadelphia negative myeloproliferative neoplasm patients, all on systemic active treatment, the likelihood of responding to anti-SARS-CoV-2 BNT162b2 vaccine at 2 weeks after the second dose was significantly lower in the ten patients with myelofibrosis compared to the 32 with essential thrombocythemia (n = 17) and polycythemia vera (n = 15) grouped together, both in terms of neutralizing anti-SARS-CoV-2 IgG titers and seroprotection rates (32.47 AU/mL vs 217.97 AU/mL, p = 0.003 and 60% vs 93.8%, p = 0.021, respectively). Ruxolitinib, which was the ongoing treatment in five patients with myelofibrosis and three with polycythemia vera, may be implicated in reducing vaccine immunogenicity (p = 0.076), though large prospective study is needed to address this issue.
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Affiliation(s)
- Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Francesco Marchesi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Giulia Piaggio
- SAFU Unit, Department of Research and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Papa
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Paolo Falcucci
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Antonio Spadea
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Simona Di Martino
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Laquintana
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Enea Gino Di Domenico
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Gianluca Falzone
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Mengarelli
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
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Koudriavtseva T, Villani V, Lorenzano S, Giannarelli D, Di Domenico EG, Stefanile A, Maschio M, D'Agosto G, Pimpinelli F, Tanzilli A, Galiè E, Pace A. Neutrophil-to-lymphocyte ratio, Factor VIII and Antithrombin III: inflammatory-clotting biomarkers in glioma. EXCLI J 2021; 20:1152-1169. [PMID: 34345234 PMCID: PMC8326499 DOI: 10.17179/excli2021-3831] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022]
Abstract
One of the key difficulties in glioma treatment is our limited ability to consistently assess cancer response or progression either by neuroimaging or specific blood biomarkers. An ideal biomarker could be measured through non-invasive methods such as blood-based biomarkers, aiding both early diagnosis and monitoring disease evolution. This is a single-center, case-control, 10-year retrospective, longitudinal study. We evaluated routine coagulation factors in 138 glioma patients (45 Females/93 Males; median [range] age, 56.4 [27-82] years; 64 non-recurrent/74 recurrent) and, for comparison, in 56 relapsing-remitting MS patients (41 Females/15 Males; 40.8 [25-62] years, 35 stable/21 active) and 23 controls (16 Females/7 Males; 41.7 [24-62] years) as well as Neutrophil-to-lymphocyte ratio (NLR) in subgroups of 127 glioma patients, 33 MS patients and 23 healthy controls. Secondly, we assessed whether these indicators could be predictive of overall (OS) and progression-free survival (PFS) in glioma patients. NLR, d-dimer, Antithrombin III and Factor VIII were significantly higher in glioma patients compared to both MS patients and controls (p<0.0001 for all). ROC curves confirmed that either NLR, Antithrombin III or Factor VIII were moderately accurate biomarkers (0.7<AUC<0.9) for glioma patients compared to other two groups whereas d-dimer was a moderately accurate marker for glioma only when compared to controls. In multivariable analysis, NLR ≥ 4.3 (median) (HR 1.53 [95 % CI 1.04-2.26], p=0.03) together with the Karnofsky Performance Status (KPS) ≥ 80 (median) (0.46 [0.31-0.69], p<0.0001) and use of steroids (1.75 [1.19-2.57], p=0.004) resulted independent predictors of OS while only KPS was independently associated with PFS. Our study showed increased levels of either NLR, Antithrombin III, Factor VIII, or d-dimer in glioma patients compared to MS patients and controls, where the first three represented moderately accurate biomarkers for this cancer. Among these markers, only NLR was found to be predictive for OS along with severe disability and steroid therapy.
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Affiliation(s)
- Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Veronica Villani
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Svetlana Lorenzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Diana Giannarelli
- Biostatistics, IRCCS Regina Elena National Cancer Institute, IFO, Rome, Italy
| | - Enea Gino Di Domenico
- Clinical Pathology and Microbiology Unit, IRCCS San Gallicano Institute, IFO, Rome, Italy
| | - Annunziata Stefanile
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Marta Maschio
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Giovanna D'Agosto
- Clinical Pathology and Microbiology Unit, IRCCS San Gallicano Institute, IFO, Rome, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology Unit, IRCCS San Gallicano Institute, IFO, Rome, Italy
| | - Antonio Tanzilli
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Edvina Galiè
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Andrea Pace
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, IFO, Via Elio Chianesi 53, 00144, Rome, Italy
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Magri F, Donà MG, Panetta C, Pontone M, Pimpinelli F, Cameli N, Cristaudo A, Zaccarelli M, Latini A. Unusual clinical manifestation and challenging serological interpretation of syphilis: insights from a case report. BMC Infect Dis 2021; 21:521. [PMID: 34078297 PMCID: PMC8173822 DOI: 10.1186/s12879-021-06199-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 05/17/2021] [Indexed: 01/23/2023] Open
Abstract
Background The clinical manifestations of recent syphilis can be variable, with typical and atypical patterns. Several conditions may cause atypical clinical aspects, including human immunodeficiency virus (HIV) co-infection. Besides the clinical features, co-infections may completely alter syphilis serological tests, causing interpretative difficulties and diagnostic delays. Aim of the work is to describe the difficulties encountered during the diagnostic evaluation of atypical skin manifestations and of the serology for syphilis of an HIV-infected patient who had contracted it several times. Case presentation In 2020, a 52-year old HIV-positive bisexual male patient was admitted to our department with a 4-month history of moderately itchy cutaneous lesions localized at his neck, trunk and arms. In 2013, the patient presented with a classic syphilitic roseola of the trunk and a secondary syphilis was diagnosed, with increased levels of rapid plasma reagin (RPR), Treponema pallidum hemagglutination assay (TPHA), anti-Treponema pallidum IgM and IgG Index. A second episode occurred in 2018, as a primary syphilis with multiple ulcerative lesions of the penis, and increased levels of RPR, IgG and IgM. In 2019, a further episode of secondary syphilis was treated with Doxycycline. In 2020, erythematous and papular lesions with vesicular components and urticarial erythema multiforme (EM)-like lesions were present at the neck, trunk and arms. Serological tests and Nucleic Acid Amplification Test (NAAT) for Treponema Pallidum were performed, as well as a cutaneous biopsy with histological and immunohistochemical evaluation of one lesion. NAAT was negative for T. pallidum. Serological test results were discordant with a new syphilis infection, showing only increased levels of RPR and anti-Treponema IgG. The cutaneous biopsy revealed a non specific histological pattern, while the immunohistochemical evaluation with anti-spirochetal antibodies was mandatory for the diagnosis of recent syphilis, showing clusters of rod-shaped elements, some of which with spiral form, focally present at the epidermis and adnexal structures. Conclusions Nowadays, syphilis may present with atypical clinical and serological features. Physicians should be aware of these possible alterations and consider syphilis even in case of uncommon clinical aspect and unclear serological tests. Cutaneous biopsy and immunohistochemical exam may be mandatory for the diagnosis.
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Affiliation(s)
- F Magri
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - M G Donà
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - C Panetta
- Laboratory of Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - M Pontone
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - F Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - N Cameli
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Cristaudo
- Department of Dermatology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - M Zaccarelli
- Clinical Department, National Institute for the Infectious Diseases Lazzaro Spallanzani, Rome, Italy.
| | - A Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Pellini R, Venuti A, Pimpinelli F, Abril E, Blandino G, Campo F, Conti L, De Virgilio A, De Marco F, Di Domenico EG, Di Bella O, Di Martino S, Ensoli F, Giannarelli D, Mandoj C, Manciocco V, Marchesi P, Mazzola F, Moretto S, Petruzzi G, Petrone F, Pichi B, Pontone M, Zocchi J, Vidiri A, Vujovic B, Piaggio G, Morrone A, Ciliberto G. Initial observations on age, gender, BMI and hypertension in antibody responses to SARS-CoV-2 BNT162b2 vaccine. EClinicalMedicine 2021; 36:100928. [PMID: 34109307 PMCID: PMC8177433 DOI: 10.1016/j.eclinm.2021.100928] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Literature data suggests that age, gender and body mass index (BMI) could be associated with difference in immune responses to vaccines. The first goal of the study was to analyze the antibody titre seven days after the second dose of BNT162b2 vaccine in a group of 248 healthcare workers (HCWs). The second goal was to analyze how antibody titre changes in correlation with age, gender, BMI and hypertension. METHODS An immunogenicity evaluation was carried out among HCWs vaccinated at the Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy. All HCWs were asked to be vaccinated by the Italian national vaccine campaign at the beginning of 2021. 260 vaccinated HCWs were enrolled in the study. All eligible participants were assigned to receive the priming dose in two weeks' time and the booster dose exactly 21 days thereafter. Blood and nasopharyngeal swabs were collected at baseline and 7 days after second dose of vaccine. Quantitative measurements of IgG antibodies against S1/S2 antigens of SARS-CoV-2 were performed with a commercial chemiluminescent immunoassay. Presence of SARS-Cov-2 in nasopharyngeal swab was determined by commercial RT-PCR testing. FINDINGS 248 HWCs were analyzed, 158 women (63.7%) and 90 men (36.3%). After the second dose of BNT162b2 vaccine, 99.5% of participants developed a humoral immune response. The geometric mean concentration of antibodies among the vaccinated subjects after booster dose (285.9 AU/mL 95% CI: 249.5-327.7) was higher than that of human convalescent sera (39.4 AU/mL, 95% CI: 33.1-46.9), with p<0.0001. Multivariate linear regression analysis of AU/mL by age, gender and BMI multivariate was performed by the inclusion of covariates. This analysis demonstrated that age (p<0.0001) and gender (p = 0.038) are statistically associated with differences in antibody response after vaccination, whereas BMI and hypertension have no statistically significant association (p = 0.078 and p = 0.52 respectively). INTERPRETATION 99.5% of HCW developed a humoral immune response and female and young participants seem to have an increased capacity to mount humoral immune responses. BMI and hypertension seem not associated with difference in immune response to the vaccine. FUNDING None.
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Affiliation(s)
- Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Aldo Venuti
- HPV Unit, UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
- Corresponding author: IRCCS “Regina Elena” National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Fulvia Pimpinelli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Elva Abril
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Flaminia Campo
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Laura Conti
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Federico De Marco
- Department of RiDAIT, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Enea Gino Di Domenico
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | | | - Simona Di Martino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fabrizio Ensoli
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Diana Giannarelli
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Chiara Mandoj
- Department Clinical Pathology and Cancer Biobank, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Valentina Manciocco
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Paolo Marchesi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Francesco Mazzola
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Silvia Moretto
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Gerardo Petruzzi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fabrizio Petrone
- U.O.C. D.I.T.R.A.R. IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Barbara Pichi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Martina Pontone
- Department of Microbiology and Virology, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Jacopo Zocchi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Antonello Vidiri
- Department of Radiology and Diagnostic Imaging, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | | | - Giulia Piaggio
- UOSD SAFU, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Dermatological Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
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Giuliani M, Donà MG, La Malfa A, Pasquantonio MS, Pimpinelli F, Cristaudo A, Latini A. Ensuring retention in care for people living with HIV during the COVID-19 pandemic in Rome, Italy. Sex Transm Infect 2021; 97:317. [PMID: 33046581 PMCID: PMC7551733 DOI: 10.1136/sextrans-2020-054650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/10/2020] [Accepted: 09/27/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Antonia La Malfa
- Hospital Pharmacy, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | | | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Pimpinelli F, Marchesi F, Piaggio G, Giannarelli D, Papa E, Falcucci P, Pontone M, Di Martino S, Laquintana V, La Malfa A, Di Domenico EG, Di Bella O, Falzone G, Ensoli F, Vujovic B, Morrone A, Ciliberto G, Mengarelli A. Fifth-week immunogenicity and safety of anti-SARS-CoV-2 BNT162b2 vaccine in patients with multiple myeloma and myeloproliferative malignancies on active treatment: preliminary data from a single institution. J Hematol Oncol 2021; 14:81. [PMID: 34001183 PMCID: PMC8128283 DOI: 10.1186/s13045-021-01090-6] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/06/2021] [Indexed: 12/27/2022] Open
Abstract
Background Safety and immunogenicity of BNT162b2 mRNA vaccine are unknown in hematological patients; both were evaluated prospectively in 42 patients with multiple myeloma (MM) and 50 with myeloproliferative malignancies (MPM) (20 chronic myeloid leukemias and 30 myeloproliferative neoplasms), all of them on active anti-cancer treatment, in comparison with 36 elderly controls not suffering from cancer. Subjects serologically and/or molecularly (by nasal/throat swab) positives at basal for SARS-CoV-2 were excluded. Primary endpoint was to compare titers of neutralizing anti-SARS-CoV-2 IgG and seroprotection rates among the cohorts at 3 and 5 weeks from first dose. Methods Titration was done using LIAISON® SARS-CoV-2 S1/S2 IgG test, a quantitative chemiluminescent immunoassay approved by FDA on the basis of robust evidences of concordance (94.4%) between the test at cutoff of 15 AU/mL and the Plaque Reduction Neutralization Test 90% at 1:40 ratio. Cutoff of 15 AU/mL was assumed to discriminate responders to vaccination with a protective titer. Cohorts were compared using Fisher’ exact test and the Mann–Whitney test as appropriated. Geometric mean concentrations (GMCs), geometric mean ratios and response rates after 1st and 2nd dose were compared in each cohort by Wilcoxon and McNemar tests, respectively. Results At 5 weeks, GMC of IgG in elderly controls was 353.3 AU/mL versus 106.7 in MM (p = 0.003) and 172.9 in MPM patients (p = 0.049). Seroprotection rate at cutoff of 15 AU/mL was 100% in controls compared to 78.6% in MM (p = 0.003) and 88% in MPM patients (p = 0.038). In terms of logarithm of IgG titer, in a generalized multivariate linear model, no gender effect was observed (p = 0.913), while there was a significant trend toward lower titers by increasing age (p < 0.001) and in disease cohorts with respect to controls (MM: p < 0.001 and MPM: p < 0.001). An ongoing treatment without daratumumab was associated with higher likelihood of response in MM patients (p = 0.003). No swabs resulted positive on each time point. No safety concerns were observed. Conclusions BNT162b2 has demonstrated to be immunogenic at different extent among the cohorts. Response was 88% and robust in MPM patients. MM patients responded significantly less, particularly those on anti-CD38-based treatment. These latter patients should be advised to maintain masks and social distancing regardless of vaccination status, and their cohabiting family members need to be vaccinated in order to reduce the risk of contagion from the family. Additional boosters and titer monitoring could be considered. Trial registration Study was formally approved by the IRCCS Central Ethical Committee of Regione Lazio in January 2021 (Prot. N-1463/21).
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Affiliation(s)
- Fulvia Pimpinelli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Francesco Marchesi
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Giulia Piaggio
- SAFU Unit, Department of Research and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Papa
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Paolo Falcucci
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Martina Pontone
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Simona Di Martino
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Laquintana
- Biological Tissue and Liquid Bank, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Antonia La Malfa
- Pharmacy Unit, Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Enea Gino Di Domenico
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Ornella Di Bella
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Gianluca Falzone
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology Unit, Dermatological Clinical and Research Department, IRCCS San Gallicano Institute, Rome, Italy
| | - Branka Vujovic
- Medical Direction, IRCCS Regina Elena National Cancer Institute and San Gallicano Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, IRCCS San Gallicano Institute, Rome, Italy
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Mengarelli
- Hematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
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Bognanni A, Schiaffino A, Pimpinelli F, Donzelli S, Celesti I, Strano S, Solari E, Schiaffino G, Solari G, Solari D, Delbue S, Rigoni M, Nollo G, Muti GE, Muti Schünemann GE, Schünemann HJ, Blandino G, Morrone A, Muti P. The Conundrum of Giglio Island: Unraveling the dynamics of an apparent resistance to COVID-19 - A descriptive study. Comput Struct Biotechnol J 2021; 19:1467-1471. [PMID: 33680349 PMCID: PMC7920805 DOI: 10.1016/j.csbj.2021.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Despite an extensive risk of exposure to COVID-19, the residents of Giglio Island, Italy, did not develop any symptom of SARS-CoV-2. The present study aims to characterize the nature of exposure and to describe the local population dynamics underlying its apparent resistance to COVID-19. METHODS Descriptive study of an islander partially-segregated population cohort based on a seroprevalence screening conducted from Aprile 29 to May 3, 2020 and including SARS-CoV-2 seroprevalence and viral prevalence in samples of saliva assessed through RT-qPCR. Serologic testing was performed using a COVID-19 IgG/IgM rapid test while molecular analyses were carried out by Allplex 2019-nCoV Assay (Seegene). RESULTS A total of 634 residents out of 748 (84.8%) present at the time, and 89 non-residents underwent serological testing. 364 males and 359 females with a median age of 58.5 years. The serological screening identified one positive, asymptomatic subject. The Nucleic Acid Amplification Tests (NAAT) did not yield any positive result. CONCLUSION Despite extensive exposure to SARS-CoV-2, possibly only one new asymptomatic infection occurred in this population, as documented by IgM positivity not confirmed by RT-qPCR. This may be due to unknown protective factors or chance. On the basis of this baseline study, using its population as a reference model, further investigations will be conducted to test the advanced hypotheses, focusing on the evaluation of a possible cross-reactivity to SARS-CoV-2 from exposure to endemic viruses.
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Affiliation(s)
- Antonio Bognanni
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical, Surgical and Dental Sciences, “Università degli Studi di Milano”, Milan, Italy
| | | | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - Sara Donzelli
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ilaria Celesti
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - Sabrina Strano
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Elena Solari
- Università di Pisa, Nursing School, Department of Clinical Health and Experimental Medicine, Pisa, Italy
| | | | - Gabriele Solari
- Independent Health Professionist, Isola del Giglio, Grosseto, Italy
| | - Domenico Solari
- Tuscany Regional Health System – South Eastern Area (retired), Italy
| | - Serena Delbue
- Department of Biomedical, Surgical and Dental Sciences, “Università degli Studi di Milano”, Milan, Italy
| | - Marta Rigoni
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Giandomenico Nollo
- Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Greta E. Muti
- Università “Vita Salute” San Raffaele – International MD Program, Milan, Italy
| | - Giovanna E.U. Muti Schünemann
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Paola Muti
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical, Surgical and Dental Sciences, “Università degli Studi di Milano”, Milan, Italy
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35
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Di Domenico EG, Cavallo I, Sivori F, Marchesi F, Prignano G, Pimpinelli F, Sperduti I, Pelagalli L, Di Salvo F, Celesti I, Paluzzi S, Pronesti C, Koudriavtseva T, Ascenzioni F, Toma L, De Luca A, Mengarelli A, Ensoli F. Biofilm Production by Carbapenem-Resistant Klebsiella pneumoniae Significantly Increases the Risk of Death in Oncological Patients. Front Cell Infect Microbiol 2020; 10:561741. [PMID: 33363047 PMCID: PMC7759150 DOI: 10.3389/fcimb.2020.561741] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 11/10/2020] [Indexed: 12/20/2022] Open
Abstract
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a prominent cause of nosocomial infections associated with high rates of morbidity and mortality, particularly in oncological patients. The hypermucoviscous (HMV) phenotype and biofilm production are key factors for CRKP colonization and persistence in the host. This study aims at exploring the impact of CRKP virulence factors on morbidity and mortality in oncological patients. A total of 86 CRKP were collected between January 2015 and December 2019. Carbapenem resistance-associated genes, antibiotic susceptibility, the HMV phenotype, and biofilm production were evaluated. The median age of the patients was 71 years (range 40–96 years). Clinically infected patients were 53 (61.6%), while CRKP colonized individuals were 33 (38.4%). The most common infectious manifestations were sepsis (43.4%) and pneumonia (18.9%), while rectal surveillance swabs were the most common site of CRKP isolation (81.8%) in colonized patients. The leading mechanism of carbapenem resistance was sustained by the KPC gene (96.5%), followed by OXA-48 (2.3%) and VIM (1.2%). Phenotypic CRKP characterization indicated that 55.8% of the isolates were strong biofilm-producers equally distributed between infected (54.2%) and colonized (45.8%) patients. The HMV phenotype was found in 22.1% of the isolates, which showed a significant (P<0.0001) decrease in biofilm production as compared to non-HMV strains. The overall mortality rate calculated on the group of infected patients was 35.8%. In univariate analysis, pneumoniae significantly correlated with death (OR 5.09; CI 95% 1.08–24.02; P=0.04). The non-HMV phenotype (OR 4.67; CI 95% 1.13–19.24; P=0.03) and strong biofilm-producing strains (OR 5.04; CI95% 1.39–18.25; P=0.01) were also associated with increased CRKP infection-related mortality. Notably, the multivariate analysis showed that infection with strong biofilm-producing CRKP was an independent predictor of mortality (OR 6.30; CI 95% 1.392–18.248; P=0.004). CRKP infection presents a high risk of death among oncological patients, particularly when pneumoniae and sepsis are present. In infected patients, the presence of strong biofilm-producing CRKP significantly increases the risk of death. Thus, the assessment of biofilm production may provide a key element in supporting the clinical management of high-risk oncological patients with CRKP infection.
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Affiliation(s)
- Enea Gino Di Domenico
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Grazia Prignano
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit-Clinical Trials Center, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lorella Pelagalli
- Anesthesiology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabiola Di Salvo
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Ilaria Celesti
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Silvia Paluzzi
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Carmelina Pronesti
- Hospital Infection Control Committee, Istituti Fisioterapici Ospitalieri-IFO, Rome, Italy
| | - Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fiorentina Ascenzioni
- Department of Biology and Biotechnology C. Darwin, Sapienza, University of Rome Sapienza, Rome, Italy
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Assunta De Luca
- Quality, Accreditation and Risk Management Unit, Istituti Fisioterapici Ospitalieri-IFO, Rome, Italy
| | - Andrea Mengarelli
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Fabrizio Ensoli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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36
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Di Domenico EG, De Angelis B, Cavallo I, Sivori F, Orlandi F, Fernandes Lopes Morais D’Autilio M, Di Segni C, Gentile P, Scioli MG, Orlandi A, D’Agosto G, Trento E, Kovacs D, Cardinali G, Stefanile A, Koudriavtseva T, Prignano G, Pimpinelli F, Lesnoni La Parola I, Toma L, Cervelli V, Ensoli F. Silver Sulfadiazine Eradicates Antibiotic-Tolerant Staphylococcus aureus and Pseudomonas aeruginosa Biofilms in Patients with Infected Diabetic Foot Ulcers. J Clin Med 2020; 9:jcm9123807. [PMID: 33255545 PMCID: PMC7760944 DOI: 10.3390/jcm9123807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 12/19/2022] Open
Abstract
Infections are among the most frequent and challenging events in diabetic foot ulcers (DFUs). Pathogenic bacteria growing in biofilms within host tissue are highly tolerant to environmental and chemical agents, including antibiotics. The present study was aimed at assessing the use of silver sulfadiazine (SSD) for wound healing and infection control in 16 patients with DFUs harboring biofilm-growing Staphylococcus aureus and Pseudomonas aeruginosa. All patients received a treatment based on a dressing protocol including disinfection, cleansing, application of SSD, and application of nonadherent gauze, followed by sterile gauze and tibio-breech bandage, in preparation for toilet surgery after 30 days of treatment. Clinical parameters were analyzed by the T.I.M.E. classification system. In addition, the activity of SSD against biofilm-growing S. aureus and P. aeruginosa isolates was assessed in vitro. A total of 16 patients with S. aureus and P. aeruginosa infected DFUs were included in the study. Clinical data showed a statistically significant (p < 0.002) improvement of patients’ DFUs after 30 days of treatment with SSD with significant amelioration of all the parameters analyzed. Notably, after 30 days of treatment, resolution of infection was observed in all DFUs. In vitro analysis showed that both S. aureus and P. aeruginosa isolates developed complex and highly structured biofilms. Antibiotic susceptibility profiles indicated that biofilm cultures were significantly (p ≤ 0.002) more tolerant to all tested antimicrobials than their planktonic counterparts. However, SSD was found to be effective against fully developed biofilms of both S. aureus and P. aeruginosa at concentrations below those normally used in clinical preparations (10 mg/mL). These results strongly suggest that the topical administration of SSD may represent an effective alternative to conventional antibiotics for the successful treatment of DFUs infected by biofilm-growing S. aureus and P. aeruginosa.
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Affiliation(s)
- Enea Gino Di Domenico
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
- Correspondence: ; Tel.: +39-06-5266-5564
| | - Barbara De Angelis
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00144 Rome, Italy; (B.D.A.); (F.O.); (M.F.L.M.D.); (C.D.S.); (P.G.); (V.C.)
| | - Ilaria Cavallo
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Francesca Sivori
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Fabrizio Orlandi
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00144 Rome, Italy; (B.D.A.); (F.O.); (M.F.L.M.D.); (C.D.S.); (P.G.); (V.C.)
| | | | - Chiara Di Segni
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00144 Rome, Italy; (B.D.A.); (F.O.); (M.F.L.M.D.); (C.D.S.); (P.G.); (V.C.)
| | - Pietro Gentile
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00144 Rome, Italy; (B.D.A.); (F.O.); (M.F.L.M.D.); (C.D.S.); (P.G.); (V.C.)
| | - Maria Giovanna Scioli
- Department of Anatomic Pathology, University of Rome Tor Vergata, 00144 Rome, Italy; (M.G.S.); (A.O.)
| | - Augusto Orlandi
- Department of Anatomic Pathology, University of Rome Tor Vergata, 00144 Rome, Italy; (M.G.S.); (A.O.)
| | - Giovanna D’Agosto
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Elisabetta Trento
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Daniela Kovacs
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (G.C.)
| | - Giorgia Cardinali
- Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (G.C.)
| | - Annunziata Stefanile
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.S.); (T.K.)
| | - Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.S.); (T.K.)
| | - Grazia Prignano
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Fulvia Pimpinelli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
| | - Ilaria Lesnoni La Parola
- Lichen Sclerosus Unit, Department of Dermatology, STI, Environmental Health, Tropical and Immigration, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy;
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Valerio Cervelli
- Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, 00144 Rome, Italy; (B.D.A.); (F.O.); (M.F.L.M.D.); (C.D.S.); (P.G.); (V.C.)
| | - Fabrizio Ensoli
- Microbiology and Virology, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy; (I.C.); (F.S.); (G.D.); (E.T.); (G.P.); (F.P.); (F.E.)
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Koudriavtseva T, Stefanile A, Fiorelli M, Lapucci C, Lorenzano S, Zannino S, Conti L, D'Agosto G, Pimpinelli F, Di Domenico EG, Mandoj C, Giannarelli D, Donzelli S, Blandino G, Salvetti M, Inglese M. Coagulation/Complement Activation and Cerebral Hypoperfusion in Relapsing-Remitting Multiple Sclerosis. Front Immunol 2020; 11:548604. [PMID: 33193314 PMCID: PMC7655134 DOI: 10.3389/fimmu.2020.548604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/03/2020] [Accepted: 08/25/2020] [Indexed: 01/08/2023] Open
Abstract
Introduction Multiple sclerosis (MS) is a demyelinating disease of the central nervous system with an underlying immune-mediated and inflammatory pathogenesis. Innate immunity, in addition to the adaptive immune system, plays a relevant role in MS pathogenesis. It represents the immediate non-specific defense against infections through the intrinsic effector mechanism “immunothrombosis” linking inflammation and coagulation. Moreover, decreased cerebral blood volume (CBV), cerebral blood flow (CBF), and prolonged mean transit time (MTT) have been widely demonstrated by MRI in MS patients. We hypothesized that coagulation/complement and platelet activation during MS relapse, likely during viral infections, could be related to CBF decrease. Our specific aims are to evaluate whether there are differences in serum/plasma levels of coagulation/complement factors between relapsing-remitting (RR) MS patients (RRMS) in relapse and those in remission and healthy controls as well as to assess whether brain hemodynamic changes detected by MRI occur in relapse compared with remission. This will allow us to correlate coagulation status with perfusion and demographic/clinical features in MS patients. Materials and Methods This is a multi-center, prospective, controlled study. RRMS patients (1° group: 30 patients in relapse; 2° group: 30 patients in remission) and age/sex-matched controls (3° group: 30 subjects) will be enrolled in the study. Patients and controls will be tested for either coagulation/complement (C3, C4, C4a, C9, PT, aPTT, fibrinogen, factor II, VIII, and X, D-dimer, antithrombin, protein C, protein S, von-Willebrand factor), soluble markers of endothelial damage (thrombomodulin, Endothelial Protein C Receptor), antiphospholipid antibodies, lupus anticoagulant, complete blood count, viral serological assays, or microRNA microarray. Patients will undergo dynamic susceptibility contrast-enhanced MRI using a 3.0-T scanner to evaluate CBF, CBV, MTT, lesion number, and volume. Statistical Analysis ANOVA and unpaired t-tests will be used. The level of significance was set at p ≤ 0.05. Discussion Identifying a link between activation of coagulation/complement system and cerebral hypoperfusion could improve the identification of novel molecular and/or imaging biomarkers and targets, leading to the development of new effective therapeutic strategies in MS. Clinical Trial Registration Clinicaltrials.gov, identifier NCT04380220.
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Affiliation(s)
- Tatiana Koudriavtseva
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Annunziata Stefanile
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Fiorelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Caterina Lapucci
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Svetlana Lorenzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Silvana Zannino
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Laura Conti
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanna D'Agosto
- Clinical Pathology and Microbiology Unit, IRCC San Gallicano Institute, Rome, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology Unit, IRCC San Gallicano Institute, Rome, Italy
| | | | - Chiara Mandoj
- Department of Clinical Experimental Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistics, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sara Donzelli
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Blandino
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Marco Salvetti
- Department of Neuroscience Mental Health and Sensory Organs (NEMOS), Sapienza University, Sant'Andrea Hospital, Rome, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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38
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Sacconi A, Donzelli S, Pulito C, Ferrero S, Spinella F, Morrone A, Rigoni M, Pimpinelli F, Ensoli F, Sanguineti G, Pellini R, Agrawal N, Izumchenko E, Ciliberto G, Giannì A, Muti P, Strano S, Blandino G. TMPRSS2, a SARS-CoV-2 internalization protease is downregulated in head and neck cancer patients. J Exp Clin Cancer Res 2020; 39:200. [PMID: 32967703 PMCID: PMC7510014 DOI: 10.1186/s13046-020-01708-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Abstract
Background SARS-coronavirus-2 enters host cells through binding of the Spike protein to ACE2 receptor and subsequent S priming by the TMPRSS2 protease. We aim to assess differences in both ACE2 and TMPRSS2 expression in normal tissues from oral cavity, pharynx, larynx and lung tissues as well as neoplastic tissues from the same areas. Methods The study has been conducted using the TCGA and the Regina Elena Institute databases and validated by experimental model in HNSCC cells. We also included data from one COVID19 patient who went under surgery for HNSCC. Results TMPRSS2 expression in HNSCC was significantly reduced compared to the normal tissues. It was more evident in women than in men, in TP53 mutated versus wild TP53 tumors, in HPV negative patients compared to HPV positive counterparts. Functionally, we modeled the multivariate effect of TP53, HPV, and other inherent variables on TMPRSS2. All variables had a statistically significant independent effect on TMPRSS2. In particular, in tumor tissues, HPV negative, TP53 mutated status and elevated TP53-dependent Myc-target genes were associated with low TMPRSS2 expression. The further analysis of both TCGA and our institutional HNSCC datasets identified a signature anti-correlated to TMPRSS2. As proof-of-principle we also validated the anti-correlation between microRNAs and TMPRSS2 expression in a SARS-CoV-2 positive HNSCC patient tissues Finally, we did not find TMPRSS2 promoter methylation. Conclusions Collectively, these findings suggest that tumoral tissues, herein exemplified by HNSCC and lung cancers might be more resistant to SARS-CoV-2 infection due to reduced expression of TMPRSS2. These observations may help to better assess the frailty of SARS-CoV-2 positive cancer patients.
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Affiliation(s)
- Andrea Sacconi
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sara Donzelli
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Claudio Pulito
- Oncogenomic and Epigenetic Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stefano Ferrero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | | | - Aldo Morrone
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy.,Department of Industrial Engineering, University of Trento, Trento, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute IRCCS, Rome, Italy
| | - Giuseppe Sanguineti
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Raul Pellini
- Otolaryngology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Nishant Agrawal
- Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Evgeny Izumchenko
- Department of Medicine, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Aldo Giannì
- Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Paola Muti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan La Statale, Milan, Italy
| | - Sabrina Strano
- SAFU Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanni Blandino
- UOSD Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
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39
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Di Domenico EG, Cavallo I, Capitanio B, Ascenzioni F, Pimpinelli F, Morrone A, Ensoli F. Staphylococcus aureus and the Cutaneous Microbiota Biofilms in the Pathogenesis of Atopic Dermatitis. Microorganisms 2019; 7:microorganisms7090301. [PMID: 31470558 PMCID: PMC6780378 DOI: 10.3390/microorganisms7090301] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/12/2019] [Accepted: 08/28/2019] [Indexed: 12/31/2022] Open
Abstract
Biofilm is the dominant mode of growth of the skin microbiota, which promotes adhesion and persistence in the cutaneous microenvironment, thus contributing to the epidermal barrier function and local immune modulation. In turn, the local immune microenvironment plays a part in shaping the skin microbiota composition. Atopic dermatitis (AD) is an immune disorder characterized by a marked dysbiosis, with a sharp decline of microbial diversity. During AD flares biofilm-growing Staphylococcus aureus emerges as the major colonizer in the skin lesions, in strict association with disease severity. The chronic production of inflammatory cytokines in the skin of AD individuals concurs at supporting S. aureus biofilm overgrowth at the expense of other microbial commensals, subverting the composition of the healthy skin microbiome. The close relationship between the host and microbial biofilm resident in the skin has profound implications on human health, making skin microbiota an attractive target for the therapeutic management of different skin disorders.
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Affiliation(s)
- Enea Gino Di Domenico
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute, IRCCS, 00144 Rome, Italy.
| | - Ilaria Cavallo
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute, IRCCS, 00144 Rome, Italy
| | - Bruno Capitanio
- Division of Dermatology, San Gallicano Dermatologic Institute, IRCCS, 00144 Rome, Italy
| | - Fiorentina Ascenzioni
- Department of Biology and Biotechnology C. Darwin, University of Rome Sapienza, 00161 Rome, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute, IRCCS, 00144 Rome, Italy
| | - Aldo Morrone
- Scientific Director San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology, San Gallicano Dermatologic Institute, IRCCS, 00144 Rome, Italy
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40
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Di Domenico EG, Cavallo I, Bordignon V, D'Agosto G, Pontone M, Trento E, Gallo MT, Prignano G, Pimpinelli F, Toma L, Ensoli F. The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis. Front Neurol 2018; 9:1048. [PMID: 30559713 PMCID: PMC6287027 DOI: 10.3389/fneur.2018.01048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 09/29/2018] [Accepted: 11/19/2018] [Indexed: 01/04/2023] Open
Abstract
Lyme borreliosis (LB) is the most common tick-borne disease caused by the spirochete Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia, respectively. The infection affects multiple organ systems, including the skin, joints, and the nervous system. Lyme neuroborreliosis (LNB) is the most dangerous manifestation of Lyme disease, occurring in 10-15% of infected individuals. During the course of the infection, bacteria migrate through the host tissues altering the coagulation and fibrinolysis pathways and the immune response, reaching the central nervous system (CNS) within 2 weeks after the bite of an infected tick. The early treatment with oral antimicrobials is effective in the majority of patients with LNB. Nevertheless, persistent forms of LNB are relatively common, despite targeted antibiotic therapy. It has been observed that the antibiotic resistance and the reoccurrence of Lyme disease are associated with biofilm-like aggregates in B. burgdorferi, B. afzelii, and B. garinii, both in vitro and in vivo, allowing Borrelia spp. to resist to adverse environmental conditions. Indeed, the increased tolerance to antibiotics described in the persisting forms of Borrelia spp., is strongly reminiscent of biofilm growing bacteria, suggesting a possible role of biofilm aggregates in the development of the different manifestations of Lyme disease including LNB.
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Affiliation(s)
- Enea Gino Di Domenico
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Ilaria Cavallo
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Valentina Bordignon
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Giovanna D'Agosto
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Martina Pontone
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Elisabetta Trento
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Teresa Gallo
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Grazia Prignano
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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Bordignon V, Di Domenico EG, Trento E, D'Agosto G, Cavallo I, Pontone M, Pimpinelli F, Mariani L, Ensoli F. How Human Papillomavirus Replication and Immune Evasion Strategies Take Advantage of the Host DNA Damage Repair Machinery. Viruses 2017; 9:v9120390. [PMID: 29257060 PMCID: PMC5744164 DOI: 10.3390/v9120390] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 11/13/2017] [Revised: 12/14/2017] [Accepted: 12/16/2017] [Indexed: 12/11/2022] Open
Abstract
The DNA damage response (DDR) is a complex signalling network activated when DNA is altered by intrinsic or extrinsic agents. DDR plays important roles in genome stability and cell cycle regulation, as well as in tumour transformation. Viruses have evolved successful life cycle strategies in order to ensure a chronic persistence in the host, virtually avoiding systemic sequelae and death. This process promotes the periodic shedding of large amounts of infectious particles to maintain a virus reservoir in individual hosts, while allowing virus spreading within the community. To achieve such a successful lifestyle, the human papilloma virus (HPV) needs to escape the host defence systems. The key to understanding how this is achieved is in the virus replication process that provides by itself an evasion mechanism by inhibiting and delaying the host immune response against the viral infection. Numerous studies have demonstrated that HPV exploits both the ataxia-telangiectasia mutated (ATM) and ataxia-telangiectasia and rad3-related (ATR) DDR pathways to replicate its genome and maintain a persistent infection by downregulating the innate and cell-mediated immunity. This review outlines how HPV interacts with the ATM- and ATR-dependent DDR machinery during the viral life cycle to create an environment favourable to viral replication, and how the interaction with the signal transducers and activators of transcription (STAT) protein family and the deregulation of the Janus kinase (JAK)-STAT pathways may impact the expression of interferon-inducible genes and the innate immune responses.
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Affiliation(s)
- Valentina Bordignon
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Enea Gino Di Domenico
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Elisabetta Trento
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Giovanna D'Agosto
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Ilaria Cavallo
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Martina Pontone
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Luciano Mariani
- HPV Unit, Department of Gynaecologic Oncology, National Cancer Institute Regina Elena, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology Unit, San Gallicano Dermatology Institute, IRCCS, IFO, Via Elio Chianesi 53, 00144 Rome, Italy.
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Marchesi F, Pimpinelli F, Ensoli F, Mengarelli A. Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant. Hematol Oncol 2017; 36:381-391. [DOI: 10.1002/hon.2453] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/28/2017] [Accepted: 06/05/2017] [Indexed: 12/13/2022]
Affiliation(s)
- F. Marchesi
- Hematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
| | - F. Pimpinelli
- Molecular Virology, Pathology and Microbiology Laboratory; San Gallicano Dermatological Institute; Rome Italy
| | - F. Ensoli
- Molecular Virology, Pathology and Microbiology Laboratory; San Gallicano Dermatological Institute; Rome Italy
| | - A. Mengarelli
- Hematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
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43
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Marchesi F, Spadea A, Pimpinelli F, Prignano G, Paglia MG, Forcella D, Gumenyuk S, Renzi D, Palombi F, Vulcano A, Pisani F, Romano A, Papa E, Facciolo F, Ensoli F, Girmenia C, Mengarelli A. The predictive value of Aspergillus PCR testing on bronchoalveolar lavage fluid for early diagnosis of invasive pulmonary aspergillosis in hematologic patients. Leuk Lymphoma 2017; 58:2943-2946. [PMID: 28482726 DOI: 10.1080/10428194.2017.1315116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Francesco Marchesi
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Antonio Spadea
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Fulvia Pimpinelli
- b Molecular Virology, Pathology and Microbiology Laboratory , San Gallicano Dermatological Institute , Italy
| | - Grazia Prignano
- b Molecular Virology, Pathology and Microbiology Laboratory , San Gallicano Dermatological Institute , Italy
| | - Maria Grazia Paglia
- c Microbiology and Infectious Diseases Biorepository Laboratory , National Institute of Infectious Diseases "L. Spallanzani" , Italy
| | - Daniele Forcella
- d Thoracic Surgery Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Svitlana Gumenyuk
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Daniela Renzi
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Francesca Palombi
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Antonella Vulcano
- c Microbiology and Infectious Diseases Biorepository Laboratory , National Institute of Infectious Diseases "L. Spallanzani" , Italy
| | - Francesco Pisani
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Atelda Romano
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Elena Papa
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Francesco Facciolo
- d Thoracic Surgery Unit , Regina Elena National Cancer Institute , Rome , Italy
| | - Fabrizio Ensoli
- b Molecular Virology, Pathology and Microbiology Laboratory , San Gallicano Dermatological Institute , Italy
| | | | - Andrea Mengarelli
- a Hematology and Stem Cell Transplant Unit , Regina Elena National Cancer Institute , Rome , Italy
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Paolini F, Curzio G, Cordeiro MN, Massa S, Mariani L, Pimpinelli F, de Freitas AC, Franconi R, Venuti A. HPV 16 E5 oncoprotein is expressed in early stage carcinogenesis and can be a target of immunotherapy. Hum Vaccin Immunother 2016; 13:291-297. [PMID: 27929754 DOI: 10.1080/21645515.2017.1264777] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
HPV16 persistent infection is a well-known condition that precedes human cancer development. High risk HPV E5 proteins cooperate with E6/E7 oncogenes to promote hyper-proliferation of infected cells leading to possible cancer progression. Thus, presence of E5 viral transcripts could be a key marker of active infection and, in turn, a target of immunotherapy. Purpose of the study is to detect E5 transcripts in clinical samples and to explore the activity of novel anti-HPV16 E5 DNA vaccines. HPV transcripts were detected by PCR with specific primers encompassing the splice-donor sites of E5 transcript. For E5-based immunotherapies, 2 E5-based versions of DNA vaccines carrying whole E5 gene or a synthetic multiepitope gene were improved by fusion to sequence of PVX coat protein. These vaccines were challenged with a new luminescent animal model based on C3-Luc cell line. E5 transcripts were detected in clinical samples of women with HPV positive low-grade SIL, demonstrating the validity of our test. In C3 pre-clinical mouse model, vaccine candidates were able to induce a strong cellular immunity as indicated by ELISPOT assays. In addition, E5-CP vaccines elicited strong anti-tumor effects as showed by decreased tumor growth monitored by animal imaging. The tumor growth inhibition was comparable to those obtained with anti-E7 DNA vaccines. In conclusion, detection of E5 transcripts in clinical samples indicates that E5 is a possible target of immunotherapy. Data from pre-clinical model demonstrate that E5 genetic immunization is feasible, efficacious and could be utilized in clinical trials.
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Affiliation(s)
| | | | | | - Silvia Massa
- c ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, C.R. Casaccia , Rome , Italy
| | - Luciano Mariani
- a Regina Elena National Cancer Institute, HPV Unit , Rome , Italy
| | | | | | - Rosella Franconi
- c ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, C.R. Casaccia , Rome , Italy
| | - Aldo Venuti
- a Regina Elena National Cancer Institute, HPV Unit , Rome , Italy
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Di Domenico EG, Toma L, Provot C, Ascenzioni F, Sperduti I, Prignano G, Gallo MT, Pimpinelli F, Bordignon V, Bernardi T, Ensoli F. Development of an in vitro Assay, Based on the BioFilm Ring Test ®, for Rapid Profiling of Biofilm-Growing Bacteria. Front Microbiol 2016; 7:1429. [PMID: 27708625 PMCID: PMC5030256 DOI: 10.3389/fmicb.2016.01429] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/29/2016] [Indexed: 01/05/2023] Open
Abstract
Microbial biofilm represents a major virulence factor associated with chronic and recurrent infections. Pathogenic bacteria embedded in biofilms are highly resistant to environmental and chemical agents, including antibiotics and therefore difficult to eradicate. Thus, reliable tests to assess biofilm formation by bacterial strains as well as the impact of chemicals or antibiotics on biofilm formation represent desirable tools for a most effective therapeutic management and microbiological risk control. Current methods to evaluate biofilm formation are usually time-consuming, costly, and hardly applicable in the clinical setting. The aim of the present study was to develop and assess a simple and reliable in vitro procedure for the characterization of biofilm-producing bacterial strains for future clinical applications based on the BioFilm Ring Test® (BRT) technology. The procedure developed for clinical testing (cBRT) can provide an accurate and timely (5 h) measurement of biofilm formation for the most common pathogenic bacteria seen in clinical practice. The results gathered by the cBRT assay were in agreement with the traditional crystal violet (CV) staining test, according to the κ coefficient test (κ = 0.623). However, the cBRT assay showed higher levels of specificity (92.2%) and accuracy (88.1%) as compared to CV. The results indicate that this procedure offers an easy, rapid and robust assay to test microbial biofilm and a promising tool for clinical microbiology.
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Affiliation(s)
- Enea G Di Domenico
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Luigi Toma
- Infectious Disease Consultant, San Gallicano Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Rome, Italy
| | - Christian Provot
- BioFilm Control, Biopole Clermont Limagne Saint Beauzire, France
| | - Fiorentina Ascenzioni
- Department of Biology and Biotechnology C. Darwin, Sapienza University of Rome Rome, Italy
| | - Isabella Sperduti
- Biostatistics, San Gallicano Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Rome, Italy
| | - Grazia Prignano
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Maria T Gallo
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Fulvia Pimpinelli
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Valentina Bordignon
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
| | - Thierry Bernardi
- BioFilm Control, Biopole Clermont Limagne Saint Beauzire, France
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology Department, San Gallicano Institute, Istituti di Ricovero e Cura a Carattere Scientifico Rome, Italy
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46
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Mengarelli A, Annibali O, Pimpinelli F, Riva E, Gumenyuk S, Renzi D, Cerchiara E, Piccioni L, Palombi F, Pisani F, Romano A, Spadea A, Papa E, Cordone I, Canfora M, Arcese W, Ensoli F, Marchesi F. Prospective surveillance vs clinically driven approach for CMV reactivation after autologous stem cell transplant. J Infect 2015; 72:265-8. [PMID: 26687516 DOI: 10.1016/j.jinf.2015.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 11/23/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Affiliation(s)
- A Mengarelli
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - O Annibali
- Unit of Hematology, Stem Cell Transplant, Transfusion Medicine and Cellular Therapy, University Campus Bio-Medico, Rome, Italy
| | - F Pimpinelli
- Molecular Virology, Pathology and Microbiology Laboratory, San Gallicano Dermatological Institute, Rome, Italy
| | - E Riva
- Virology Unit, Laboratory of Pathology and Microbiology, Campus Bio-Medico University, Rome, Italy
| | - S Gumenyuk
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - D Renzi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - E Cerchiara
- Unit of Hematology, Stem Cell Transplant, Transfusion Medicine and Cellular Therapy, University Campus Bio-Medico, Rome, Italy
| | - L Piccioni
- Virology Unit, Laboratory of Pathology and Microbiology, Campus Bio-Medico University, Rome, Italy
| | - F Palombi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - F Pisani
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - A Romano
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - A Spadea
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - E Papa
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - I Cordone
- Clinical Pathology, Regina Elena National Cancer Institute, Rome, Italy
| | - M Canfora
- Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
| | - W Arcese
- Rome Transplant Network, Rome, Italy
| | - F Ensoli
- Molecular Virology, Pathology and Microbiology Laboratory, San Gallicano Dermatological Institute, Rome, Italy
| | - F Marchesi
- Hematology and Stem Cell Transplant Unit, Regina Elena National Cancer Institute, Rome, Italy.
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47
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Marchesi F, Pimpinelli F, Gumenyuk S, Renzi D, Palombi F, Pisani F, Romano A, Spadea A, Papa E, Canfora M, Ensoli F, Mengarelli A. Cytomegalovirus reactivation after autologous stem cell transplantation in myeloma and lymphoma patients: A single-center study. World J Transplant 2015; 5:129-136. [PMID: 26421265 PMCID: PMC4580927 DOI: 10.5500/wjt.v5.i3.129] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/12/2015] [Accepted: 07/08/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the incidence of and the risk factors for cytomegalovirus (CMV) symptomatic infection and end-organ disease after autologous stem cell transplantation (ASCT).
METHODS: A total of 327 consecutive non CD34+ selected autografts performed from the Hematology and Stem Cell Transplantation Unit of Regina Elena National Cancer Institute of Rome (Italy) in the period comprised between January 2003 to January 2015, were reviewed. Over the 327 autografts, 201 were performed in patients with multiple myeloma, whereas the remaining 126 in patients affected by non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. The patients who underwent an ASCT for an acute leukemia (n = 20) in the same period were excluded from this analysis. CMV DNA load in the blood has been determined by polymerase-chain reaction in the case of a clinical suspicion of reactivation, therefore, no routine monitoring strategy was adopted. In the presence of signs and symptoms of CMV reactivation an antiviral treatment was performed.
RESULTS: Overall, 36 patients (11%) required a specific antiviral treatment for a symptomatic CMV reactivation (n = 32) or an end-organ disease (n = 4). We observed 20 and 16 cases of CMV reactivation among lymphoma (16%) and myeloma patients (8%), respectively. Among cases of end-organ disease, 3 were diagnosed as interstitial pneumonia and one remaining case as hemorrhagic enteritis. All cases of CMV reactivation were observed in IgG seropositive patients, with no documented cases of primary CMV infection. All patients were treated with a specific antiviral therapy, with a global rate of hospitalization of 55%; four patients received intravenous immunoglobulins. Transplant-related mortality was significantly higher in patients who experienced a CMV reactivation (8.4% ± 4.7% vs 1.7% ± 0.8%; P = 0.047). In univariate analysis, a pre-transplant HBcIgG seropositivity, a diagnosis of T-cell non-Hodgkin’s lymphoma and higher median age at transplant were significantly associated with the risk of developing a clinically relevant CMV infection requiring specific antiviral therapy (P < 0.001, P = 0.042 and P = 0.004, respectively). In multivariate analysis, only a pre-transplant HBcIgG seropositivity (OR = 8.928, 95%CI: 1.991-33.321; P = 0.023) and a diagnosis of T-cell non-Hodgkin’s lymphoma (OR = 4.739, 95%CI: 1.511-11.112; P = 0.042) proved to be independent predictors of a post-transplant clinically relevant CMV reactivation.
CONCLUSION: A symptomatic CMV infection can occur in about 11% of adult patients with lymphoma or myeloma undergoing ASCT. A pre-transplant HBcIgG seropositivity and a diagnosis of T-cell non-Hodgkin’s lymphoma should be considered as independent predictor factors of CMV reactivation.
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48
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Giuliani M, Vescio MF, Latini A, Palamara G, Pimpinelli F, Dona MG, Stivali F, Carduccelli F, Ensoli F, Di Carlo A, Rezza G. Continuous increase in HIV-1 incidence after the year 2000 among men who have sex with men in Rome: insights from a 25-year retrospective cohort study. ACTA ACUST UNITED AC 2014; 19:20969. [PMID: 25443035 DOI: 10.2807/1560-7917.es2014.19.47.20969] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To assess trends in HIV-1 incidence and risk factors for seroconversion among men who have sex with men (MSM) resident in Rome, Italy, a retrospective longitudinal cohort study was conducted over 25 years. Incidence rates and trends were modelled using Poisson regression and risk factors were assessed by multivariate Cox models. Of 1,862 HIV-1-negative individuals, 347 seroconverted during follow-up. HIV-1 incidence rates increased from 5.2/100 persons/year (p/y) in 1986 (95% confidence interval (CI): 2.3–11.5) to 9.2/00 p/y in 1992 (95% CI: 6.4–13.0), decreased to 1.3/100 p/y in 2001 and increased until 2009 (11.7/100 p/y; 95% CI: 7.4–18.6). The risk of HIV-1 seroconversion increased during the study period in younger MSM (incidence rate ratio (IRR) = 17.18; 95% CI: 9.74–30.32 in 16–32 year-olds and IRR = 5.09; 95% CI: 2.92–8.87 in 33–41 year-olds) and in those who acquired syphilis (IRR = 7.71; 95% CI: 5.00–11.88). In contrast, the risk of seroconversion decreased among highly educated MSM (IRR = 0.54; 95% CI: 0.35–0.82) and those without Italian citizenship (IRR = 0.45; 95% CI: 0.28–0.71). The HIV epidemic in MSM living in Rome continues to expand. Targeted prevention programmes against sexually transmitted infections to enhance knowledge transfer and behavioural skills are urgently required.
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Affiliation(s)
- M Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute, Rome, Italy
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49
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Marchesi F, Pimpinelli F, Dessanti ML, Gumenyuk S, Palombi F, Pisani F, Romano A, Spadea A, Maschio M, Ensoli F, Mengarelli A. Evaluation of risk of symptomatic cytomegalovirus reactivation in myeloma patients treated with tandem autologous stem cell transplantation and novel agents: a single-institution study. Transpl Infect Dis 2014; 16:1032-8. [PMID: 25369809 DOI: 10.1111/tid.12309] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 04/28/2014] [Revised: 08/18/2014] [Accepted: 08/23/2014] [Indexed: 01/12/2023]
Abstract
The introduction of proteasome inhibitors and/or immunomodulators in the treatment of myeloma has led to an increase in viral infections, particularly in the Herpesviridae family. Previous studies about the risk of cytomegalovirus (CMV) reactivation after autologous stem cell transplantation (ASCT) have examined the clinical outcome after the first ASCT; however, only 1 study to date has investigated the risk of CMV reactivation after a second transplantation. To address this issue, we performed a retrospective chart review on 78 consecutive myeloma patients (median age 56 years) who underwent a tandem non-CD34(+) selected ASCT after induction treatment with either conventional chemotherapy (n = 42) or with novel agents (n = 36), respectively. All subjects had been mobilized and conditioned with cyclophosphamide plus granulocyte colony-stimulating factor and melphalan alone, respectively. CMV DNA load in the blood has been determined by polymerase chain reaction in the case of a clinical suspicion of CMV reactivation; therefore, routine monitoring was not performed. Considering the outcome of both the first and the second transplantations, we observed a total of 13 episodes of symptomatic CMV reactivation (13/156, 8%), in 12 subjects (12/78, 15%), all successfully treated. Eight subjects experienced a CMV reactivation after the first ASCT (8/78, 10%); however, only 1 of them (1/8, 12%) experienced a CMV reactivation after the second transplantation. Conversely, 4 CMV reactivations (6%) were observed after the second transplantation in the group of 70 patients who did not experience a CMV reactivation after the first ASCT. No statistically significant difference was observed between first and second ASCT (8/78, 10% vs. 5/78, 6%; P = 0.767). Univariate analysis showed that a pre-transplant treatment with novel agents was the only baseline factor significantly associated with the occurrence of post-ASCT CMV symptomatic reactivation after the first transplant (odds ratio [OR]: 9.897; 95% confidence interval [CI]: 1.154-84.840; P = 0.021) but not after the second transplant (OR: 5.125; 95% CI: 0.546-48.119; P = 0.115). No end-organ disease or primary infection was documented. Our data suggest that second transplantation does not increase the risk of CMV reactivation in our patient population, when compared with the first one, and confirm the role of a pre-transplant treatment with novel agents as a risk factor for CMV symptomatic reactivation.
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Affiliation(s)
- F Marchesi
- Hematology and Stem Cell Transplantation Unit, Regina Elena National Cancer Institute, Rome, Italy
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50
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Pranteda G, Carlesimo M, Bottoni U, Di Napoli A, Muscianese M, Pimpinelli F, Cordiali P, Laganà B, Pranteda G, Di Carlo A. Pemphigus vulgaris in a patient with arthritis and uveitis: successful treatment with immunosuppressive therapy and acyclovir. Dermatol Ther 2014; 27:215-8. [PMID: 24548566 DOI: 10.1111/dth.12120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A case of pemphigus vulgaris in a 41-year-old man with undifferentiated arthritis and uveitis is described. Histology of labial mucosa showed acantholytic, necrotic, and multinucleated giant keratinocytes having some nuclear inclusions suggestive of a virus infection. Specific serological tests revealed IgG positivity for HSV-1, CMV, and EBV, while real-time polymerase chain reaction assay from a biopsy of the mucosal lesion showed the presence of HSV-1/2 DNA. Treatment with prednisone, methotrexate, and acyclovir induced the complete remission of mucosal and joint symptoms, which then relapsed after interruption of antiviral therapy or immunosuppressive therapy. Therefore, a combined treatment with low doses of prednisone, methotrexate, and acyclovir was restarted and during 18 months of follow-up no recurrence was registered. Correlations between pemphigus and the herpes virus infection and also between autoimmune arthritis and herpetic agents have been well documented, but the exact role of the herpes virus in these disorders still needs further discussion. Our case strongly suggests that when autoimmune disorders do not respond to immunosuppressive agents, a viral infection should be suspected, researched, and treated.
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Affiliation(s)
- G Pranteda
- Dermatology Unit, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza" University, Sant'Andrea Hospital, Rome, Italy
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