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Kanwal H, Sangineto M, Ciarnelli M, Castaldo P, Villani R, Romano AD, Serviddio G, Cassano T. Potential Therapeutic Targets to Modulate the Endocannabinoid System in Alzheimer's Disease. Int J Mol Sci 2024; 25:4050. [PMID: 38612861 PMCID: PMC11012768 DOI: 10.3390/ijms25074050] [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: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Alzheimer's disease (AD), the most common neurodegenerative disease (NDD), is characterized by chronic neuronal cell death through progressive loss of cognitive function. Amyloid beta (Aβ) deposition, neuroinflammation, oxidative stress, and hyperphosphorylated tau proteins are considered the hallmarks of AD pathology. Different therapeutic approaches approved by the Food and Drug Administration can only target a single altered pathway instead of various mechanisms that are involved in AD pathology, resulting in limited symptomatic relief and almost no effect in slowing down the disease progression. Growing evidence on modulating the components of the endocannabinoid system (ECS) proclaimed their neuroprotective effects by reducing neurochemical alterations and preventing cellular dysfunction. Recent studies on AD mouse models have reported that the inhibitors of the fatty acid amide hydrolase (FAAH) and monoacylglycerol (MAGL), hydrolytic enzymes for N-arachidonoyl ethanolamine (AEA) and 2-arachidonoylglycerol (2-AG), respectively, might be promising candidates as therapeutical intervention. The FAAH and MAGL inhibitors alone or in combination seem to produce neuroprotection by reversing cognitive deficits along with Aβ-induced neuroinflammation, oxidative responses, and neuronal death, delaying AD progression. Their exact signaling mechanisms need to be elucidated for understanding the brain intrinsic repair mechanism. The aim of this review was to shed light on physiology and pathophysiology of AD and to summarize the experimental data on neuroprotective roles of FAAH and MAGL inhibitors. In this review, we have also included CB1R and CB2R modulators with their diverse roles to modulate ECS mediated responses such as anti-nociceptive, anxiolytic, and anti-inflammatory actions in AD. Future research would provide the directions in understanding the molecular mechanisms and development of new therapeutic interventions for the treatment of AD.
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Affiliation(s)
- Hina Kanwal
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Moris Sangineto
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Martina Ciarnelli
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Pasqualina Castaldo
- Department of Biomedical Sciences and Public Health, School of Medicine, University “Politecnica delle Marche”, 60126 Ancona, Italy;
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Antonino Davide Romano
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (M.S.); (M.C.); (R.V.); (A.D.R.); (G.S.); (T.C.)
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Lombardi R, Mantovani A, Cespiati A, Francione P, Maffi G, Del Zanna E, Maffeis C, Colecchia A, Passigato N, Ferrarese A, Cusumanu CD, Villani R, Orsi E, Grancini V, Airaghi L, Bignamini D, Serviddio G, Targher G, Dongiovanni P, Fargion S, Fracanzani AL. Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors. Dig Liver Dis 2024; 56:551-558. [PMID: 37845152 DOI: 10.1016/j.dld.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/29/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND AND AIMS Patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are at high risk of hepatic fibrosis. To prospectively evaluate changes in fibrosis in diabetic patients with NAFLD, predisposing factors and sodium glucose cotransporter 2 inhibitors (SGLT2i) influence. METHODS 237 T2DM outpatients (mean age 67 ± 9 years, 54% male) were enrolled and re-evaluated after 52 ± 10 months. At baseline and follow-up NAFLD and liver fibrosis (LSM) were detected by ultrasonography and Fibroscan®. RESULTS During follow-up an increase in LSM (6.0 ± 2.8 vs 5.8 ± 2.7 kPa, p = 0.02) and in the prescription of SGLT2i (20% vs 6%, p<0.001) was registered, despite stability of diabetic control. LSM worsened in 133(56%) subjects, 92 (39%) with worsening >10% from baseline. Patients with worsening versus non worsening of LSM had higher prevalence of increase in BMI during follow-up (45% vs 32%, p = 0.06) and lower SGLT2i prescription (15% vs 27%, p = 0.034). In multivariate analysis use of SGLT2-inhibitors at follow-up reduced the risk of LSM worsening (HR 0.34, 95% CI 0.13-0.88), even when considered>10% from baseline. CONCLUSIONS A high prevalence of fibrosis progression was observed in diabetic subjects with NAFLD over a nearly 5-years follow up and SGLT2-inhibitors seem to reduce the risk of worsening of liver stiffness.
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Affiliation(s)
- Rosa Lombardi
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Annalisa Cespiati
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Francione
- UO di Medicina, Azienda Ospedaliera "Card. G. Panico" di Tricase, Italy
| | - Gabriele Maffi
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elena Del Zanna
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, Dentistry, and Pediatrics, and Gynaecology, University Hospital of Verona, Verona, Italy
| | - Antonio Colecchia
- Gastroenterology Unit, Department of Medical Specialities, University Hospital of Modena, University of Modena & Reggio Emilia, Modena, Italy
| | - Nicola Passigato
- Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alberto Ferrarese
- Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Caterina Daniela Cusumanu
- Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Rosanna Villani
- Centro C.U.R.E, Dept. of Medical and Surgical Sciences, University of Foggia, Italy
| | - Emanuela Orsi
- Department of Medical Science, Endocrinology and Diabetes Unit, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan Italy
| | - Valeria Grancini
- Department of Medical Science, Endocrinology and Diabetes Unit, Ca' Granda IRCCS Foundation, Policlinico Hospital, University of Milan Italy
| | - Lorena Airaghi
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Daniela Bignamini
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Gaetano Serviddio
- Centro C.U.R.E, Dept. of Medical and Surgical Sciences, University of Foggia, Italy
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Paola Dongiovanni
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Silvia Fargion
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Anna Ludovica Fracanzani
- SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Ciccarese G, Broccolo F, Fidanzi C, Serviddio G, Drago F. Atypical hand foot and mouth disease related Coxsackievirus-A10 infection in an adult patient. Travel Med Infect Dis 2024; 59:102716. [PMID: 38537927 DOI: 10.1016/j.tmaid.2024.102716] [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: 12/23/2023] [Revised: 03/09/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Francesco Broccolo
- Department of Experimental Medicine, University of Salento, 73100, Lecce, Italy
| | - Cristian Fidanzi
- Unit of Dermatology, Department of Medical and Oncology Area, University of Pisa, Pisa, Italy
- Unit of Dermatology, Hospital of Carrara, Carrara, Italy.
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, Foggia, Italy
| | - Francesco Drago
- Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132, Genova, Italy
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La Marca A, Romano AD, Laonigro I, Villani R, Serviddio G. A rare case of cardiac metastasis of a small cell lung cancer by transvenous spread. Eur Heart J Cardiovasc Imaging 2024; 25:e113. [PMID: 37931126 DOI: 10.1093/ehjci/jead290] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023] Open
Affiliation(s)
- Antonella La Marca
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, 71122 Foggia, Italy
| | - Antonino Davide Romano
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, 71122 Foggia, Italy
| | - Irma Laonigro
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, 71122 Foggia, Italy
| | - Rosanna Villani
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, 71122 Foggia, Italy
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, 71122 Foggia, Italy
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Lo Buglio A, Bellanti F, Carmignano DFP, Serviddio G, Vendemiale G. Association between Controlling Nutritional Status (CONUT) Score and Body Composition, Inflammation and Frailty in Hospitalized Elderly Patients. Nutrients 2024; 16:576. [PMID: 38474705 DOI: 10.3390/nu16050576] [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] [Received: 01/25/2024] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
The Controlling Nutritional Status (CONUT) score has demonstrated its ability to identify patients with poor nutritional status and predict various clinical outcomes. Our objective was to assess the association between the CONUT score, inflammatory status, and body composition, as well as its ability to identify patients at risk of frailty in hospitalized elderly patients. METHODS a total of 361 patients were retrospectively recruited and divided into three groups based on the CONUT score. RESULTS patients with a score ≥5 exhibited significantly higher levels of inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Neutrophil/Lymphocytes ratio (NLR), main platelet volume (MPV), and ferritin, compared to those with a lower score. Furthermore, these patients showed unfavorable changes in body composition, including a lower percentage of skeletal muscle mass (MM) and fat-free mass (FFM) and a higher percentage of fatty mass (FM). A positive correlation was found between the CONUT score and inflammatory markers, Geriatric Depression Scale Short Form (GDS-SF), and FM. Conversely, the Mini Nutritional Assessment (MNA), Mini-Mental Status Examination, activity daily living (ADL), instrumental activity daily living (IADL), Barthel index, FFM, and MM showed a negative correlation. Frailty was highly prevalent among patients with a higher CONUT score. The receiver operating characteristic (ROC) curve demonstrated high accuracy in identifying frail patients (sensitivity). CONCLUSIONS a high CONUT score is associated with a pro-inflammatory status as well as with unfavorable body composition. Additionally, it is a good tool to identify frailty among hospitalized elderly patients.
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Affiliation(s)
- Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | | | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
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Vitello A, Maida M, Shahini E, Macaluso FS, Orlando A, Grova M, Ramai D, Serviddio G, Facciorusso A. Current Approaches for Monitoring of Patients with Inflammatory Bowel Diseases: A Narrative Review. J Clin Med 2024; 13:1008. [PMID: 38398321 PMCID: PMC10888591 DOI: 10.3390/jcm13041008] [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] [Received: 01/21/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Patients with inflammatory bowel diseases (IBD) require proactive monitoring both during the active phase to evaluate therapeutic response and during the remission phase to evaluate relapse or colorectal cancer surveillance. However, monitoring may vary between patients with ulcerative colitis (UC) and Crohn's disease (CD), with distinct tools and intervals. METHODS This narrative review aims to focus on modern approaches to IBD monitoring, considering international guidelines and expert consensus. RESULTS The most recent European diagnostic guidelines advocate a combination of clinical, laboratory, endoscopic, and radiological parameters to evaluate the disease course of patients with IBD. Unfortunately, the conventional symptom-based therapeutic approach does not improve long-term outcomes and there is no single ideal biomarker available. Endoscopy plays a key role in evaluating response to therapy as well as monitoring disease activity. Recently, bedside intestinal ultrasound (IUS) has gained increasing interest and diffusion as it appears to offer several advantages including the monitoring of therapeutic response. CONCLUSION In light of growing clinical advances, we present a schematic evidence-based monitoring algorithm that can be easily applied in clinical practice which combines all major monitoring modalities, including noninvasive tools such as IUS and video-capsule endoscopy.
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Affiliation(s)
- Alessandro Vitello
- Gastroenterology and Endoscopy Unit, S. Elia Hospital, 93100 Caltanissetta, Italy; (A.V.); (M.M.)
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia Hospital, 93100 Caltanissetta, Italy; (A.V.); (M.M.)
- Department of Medicine and Surgery, School of Medicine and Surgery, University of Enna ‘Kore’, 94100 Enna, Italy
| | - Endrit Shahini
- Gastroenterology Unit, National Institute of Gastroenterology-IRCCS “Saverio de Bellis”, 70013 Castellana Grotte, Italy;
| | - Fabio Salvatore Macaluso
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Mauro Grova
- Inflammatory Bowel Disease Unit, Department of Medicine, A.O.O.R. “Villa Sofia-Cervello” Hospital, 90146 Palermo, Italy; (F.S.M.); (A.O.); (M.G.)
| | - Daryl Ramai
- Division of Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 84132, USA;
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
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Ciccarese G, Serviddio G, Herzum A, Drago F. Antimicrobial resistance in genital Mycoplasmas infections. Indian J Med Microbiol 2024; 48:100533. [PMID: 38280552 DOI: 10.1016/j.ijmmb.2024.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Giulia Ciccarese
- Dermatology and Venereology, Section of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Gaetano Serviddio
- Internal Medicine, Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy.
| | - Astrid Herzum
- Dermatologist, Dermatology Unit, IRCCS Giannina Gaslini, Genoa, Italy.
| | - Francesco Drago
- Dermatologist, Section of Dermatology - Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy.
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Ciccarese G, Serviddio G, Drago F. Bartonella henselae Infection May Occasionally Distract Immune Control of Latent Human Herpesviruses. Cutis 2024; 113:E26-E27. [PMID: 38593094 DOI: 10.12788/cutis.0976] [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: 04/11/2024]
Affiliation(s)
- Giulia Ciccarese
- Drs. Ciccarese and Serviddio are from the Department of Medical and Surgical Sciences, University of Foggia, Italy. Dr. Ciccarese is from the Section of Dermatology, and Dr. Serviddio is from the Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment). Dr. Drago is from the Section of Dermatology, Department of Health Sciences, University of Genoa, Italy
| | - Gaetano Serviddio
- Drs. Ciccarese and Serviddio are from the Department of Medical and Surgical Sciences, University of Foggia, Italy. Dr. Ciccarese is from the Section of Dermatology, and Dr. Serviddio is from the Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment). Dr. Drago is from the Section of Dermatology, Department of Health Sciences, University of Genoa, Italy
| | - Francesco Drago
- Drs. Ciccarese and Serviddio are from the Department of Medical and Surgical Sciences, University of Foggia, Italy. Dr. Ciccarese is from the Section of Dermatology, and Dr. Serviddio is from the Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment). Dr. Drago is from the Section of Dermatology, Department of Health Sciences, University of Genoa, Italy
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Ciccarese G, Serviddio G, Drago F. Pityriasis rosea and pityriasis rosea-like eruption: The distinction is relevant for diagnostic and prognostic reasons. J Family Community Med 2024; 31:82-83. [PMID: 38406220 PMCID: PMC10883428 DOI: 10.4103/jfcm.jfcm_252_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 02/27/2024] Open
Affiliation(s)
- Giulia Ciccarese
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, University of Foggia, Foggia, Italy
| | - Francesco Drago
- Department of Health Sciences, University of Genoa, IRCCS-Ospedale Policlinico San Martino, Genoa, Italy
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Romano AD, La Marca A, Villani R, Sangineto M, Manuppelli V, Brunetti ND, Vendemiale G, Serviddio G. Exploring the Relationship between Epicardial Fat Thickness and Coronary Revascularization: Implications for Cardiovascular Health. J Clin Med 2023; 13:247. [PMID: 38202255 PMCID: PMC10779954 DOI: 10.3390/jcm13010247] [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] [Received: 11/29/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND this study aimed to assess the complex relationship between EAT thickness, as measured with echocardiography, and the severity of coronary artery disease (CAD). We investigated whether individuals with higher EAT thickness underwent coronary revascularization. Subsequently, we conducted a three-year follow-up to explore any potential modifications in EAT depots post-angioplasty. METHODS we conducted a prospective and retrospective cross-sectional observational study involving 150 patients consecutively referred for acute coronary syndrome, including ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina. Upon admission (T0), all patients underwent coronary angiography to assess the number of pathologic coronary vessels. Percutaneous transluminal coronary angioplasty (PTCA) was performed based on angiogram results if indicated. The sample was categorized into two groups: non-revascularized (no-PTCA) and revascularized (PTCA). Transthoracic echocardiograms to measure epicardial fat thickness were conducted at admission (T0) and after a 3-year follow-up (T1). RESULTS AND CONCLUSIONS findings revealed a positive correlation between EAT thickness and the severity of coronary artery disease (CAD), with patients undergoing PTCA showing decreased EAT thickness after three years. Echocardiography demonstrated reliability in assessing EAT, offering potential for risk stratification. The study introduces a cut-off value of 0.65 cm as a diagnostic tool for cardiovascular risk. Incorporating EAT measurements into clinical practice may lead to more precise risk stratification and tailored treatment strategies, ultimately reducing the burden of cardiovascular disease.
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Affiliation(s)
- Antonino Davide Romano
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Antonella La Marca
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Rosanna Villani
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Moris Sangineto
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Vincenzo Manuppelli
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti, 71122 Foggia, Italy
| | - Natale Daniele Brunetti
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti, 71122 Foggia, Italy
| | - Gianluigi Vendemiale
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
| | - Gaetano Serviddio
- Internal Medicine and Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico Riuniti 71122 Foggia, Italy; (A.L.M.); (R.V.); (M.S.); (G.S.)
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Villani R, Loizzi D, Sacco AF, Mirabella L, Santoliquido M, Mongiello D, Sollitto F, Serviddio G. Prevalence and clinical relevance of liver dysfunction after thoracic surgery: a retrospective study. Sci Rep 2023; 13:23045. [PMID: 38155193 PMCID: PMC10754851 DOI: 10.1038/s41598-023-49427-0] [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: 07/02/2023] [Accepted: 12/07/2023] [Indexed: 12/30/2023] Open
Abstract
Postoperative elevation of serum aminotransferase or alkaline phosphatase levels after liver and heart surgeries has been widely reported. The prevalence and clinical significance of hypertransaminasemia/liver dysfunction after thoracic surgery remains largely unknown. Significant differences in surgical procedures between thoracic and extra-thoracic surgeries may suggest different risks of liver dysfunction. We retrospectively analyzed data from 224 consecutive patients who underwent thoracic surgery. Liver function tests were recorded the day before surgery, 12 h, 1 day, 5, and 10 days after the surgical procedure. Patients were studied to identify the frequency of hypertransaminasemia and/or hyperbilirubinemia and/or increase of INR levels. 37,5% of patients showed an increase in serum alanine aminotransferase (ALT) level after thoracic surgery, whereas an increase in gamma glutamyl transferase (GGT) serum levels of any grade was observed in 53,6% of patients. Approximately 83% of patients who experienced an increase in the serum GGT or ALT levels showed a grade 1 or 2 change. Operative time was associated with hypertransaminasemia in the univariate and multivariate analyses, whereas the use of metformin was associated with a lower risk of ALT increase.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Domenico Loizzi
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonia Federica Sacco
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Lucia Mirabella
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mariateresa Santoliquido
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Diletta Mongiello
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Sollitto
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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12
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Marangi M, Boughattas S, De Nittis R, Pisanelli D, Delli Carri V, Lipsi MR, La Bella G, Serviddio G, Niglio M, Lo Caputo S, Margaglione M, Arena F. Prevalence and genetic diversity of Blastocystis sp. among autochthonous and immigrant patients in Italy. Microb Pathog 2023; 185:106377. [PMID: 37839760 DOI: 10.1016/j.micpath.2023.106377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
The prevalence of Blastocystis sp., its genetic diversity and the distribution of circulating subtypes (STs) were molecularly investigated in a cohort of autochthonous and immigrant patients with gastrointestinal symptoms hospitalized over the period February 2022-June 2023 at the Policlinico Ospedaliero-Universitario "Riuniti", Foggia, in Southern Italy. The population variables, including patient geographical origin, gender and age classes were reported. Out of the 927 investigated patients, 36 (3.9%) were positive for Blastocystis sp. A statistically significant association with African origin and age classes >18 years old was found. ST1 (allele 4), ST2 (alleles 9, 13), ST3 (alleles 34, 36) and ST4 (allele 92) were the subtypes detected with a different distribution between autochthonous and immigrant patients. Co-infections with enteric protozoa such as Giardia duodenalis and Dientamoeba fragilis, pathogenic bacteria as Clostridioides difficile, Campylobacter jejuni and Aeromonas sp. and viral infections such as Norovirus were found in 33% of cases. This is the first study of Blastocystis sp., its circulating subtypes and allele variability among patients with different geographical origin in an area of Southern Italy, in the Central Mediterranean, characterized by high immigrant pressure. These results provide baseline data to better investigate a potential interaction between Blastocystis sp. and other risk factors in patients with gastrointestinal symptoms.
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Affiliation(s)
- Marianna Marangi
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | | | - Rosella De Nittis
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Daniela Pisanelli
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Valeria Delli Carri
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Maria Rosaria Lipsi
- Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Gianfranco La Bella
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy; Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, Foggia, Italy.
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Mariangela Niglio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Sergio Lo Caputo
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Maurizio Margaglione
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy.
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Luigi Pinto, 71122, Foggia, Italy; Microbiology and Virology Unit, Ospedali Riuniti, Viale Luigi Pinto, 71122, Foggia, Italy.
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13
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Villani R, Serviddio G, Avolio C, Cassano T, D'Amico E. Autoimmune liver disease and multiple sclerosis: state of the art and future perspectives. Clin Exp Med 2023; 23:3321-3338. [PMID: 37421590 PMCID: PMC10618321 DOI: 10.1007/s10238-023-01128-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Clinical observations suggest that the prevalence of autoimmune diseases is changing over time. Both autoimmune liver diseases and multiple sclerosis have shown a significant increase in the last decades. Although the coexistence of autoimmune diseases within individuals and families is a common phenomenon, the extent to which liver disease and multiple sclerosis co-occur is not clear. Case reports and few studies have reported the possible coexistence of multiple sclerosis with thyroid diseases, inflammatory bowel disease, psoriasis, and rheumatoid arthritis. It is unknown whether there is a definite association between multiple sclerosis and autoimmune liver diseases. We reviewed the literature to summarize the available studies on the association between different autoimmune liver diseases (autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis) and treated or untreated multiple sclerosis.
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Affiliation(s)
- Rosanna Villani
- Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Carlo Avolio
- Department of Medical and Surgical Sciences, Multiple Sclerosis Center, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Emanuele D'Amico
- Department of Medical and Surgical Sciences, Multiple Sclerosis Center, University of Foggia, Foggia, Italy
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14
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Di Fazio N, Scopetti M, Delogu G, Morena D, Santurro A, Cipolloni L, Serviddio G, Papi L, Frati P, Turillazzi E, Fineschi V. Fourteen Deaths from Suspected Heparin Overdose in an Italian Primary-Level Hospital. Diagnostics (Basel) 2023; 13:3361. [PMID: 37958256 PMCID: PMC10650777 DOI: 10.3390/diagnostics13213361] [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] [Received: 09/11/2023] [Revised: 10/08/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Healthcare-related homicidal cases are not novel within the medical-legal landscape, but investigations are often made difficult with the scarcity of material evidence related to the crime. For this reason, it is necessary to carefully analyze the clinical documentation and employ ancillary forensic resources such as radiology, histopathology, and toxicology. In the presented scenario, the observation of 14 deaths from abnormal bleeding in a First-Level Italian Hospital revealed the administration of massive doses of heparin by a nurse. On behalf of the Judicial Authority, a multidisciplinary medical team investigated the case through the following steps: a thorough review of the clinical documentation, exhumation of the bodies belonging to the deceased patients, performing PMCT and autopsy, and collecting tissue samples for histopathological, immunohistochemical, and toxicological investigations. All the analyzed cases have been characterized by the observation of fatal hemorrhagic episodes not explained with the clinical conditions of the patients, confirmed using autopsy observations and the histological demonstration of the vitality of the lesions. However, due to the limited availability of biological material for the toxicological analysis, the indirect evidence from hematological analyses in hospitalized patients was crucial in demonstrating heparin overdose and its link to the recorded deaths. The present scenario demonstrates the fundamental importance of a multidisciplinary approach to cases of judicial interest related to the healthcare context. Therefore, the illustrated methodologies can be interpreted as an operational framework for similar future cases.
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Affiliation(s)
- Nicola Di Fazio
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Matteo Scopetti
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Giuseppe Delogu
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Donato Morena
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Alessandro Santurro
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy;
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy;
| | - Luigi Papi
- Department of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (E.T.)
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
| | - Emanuela Turillazzi
- Department of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (L.P.); (E.T.)
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, 00161 Rome, Italy; (N.D.F.); (M.S.); (G.D.); (D.M.); (A.S.); (P.F.)
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15
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Trave I, Ciccarese G, Gasparini G, Canta R, Serviddio G, Herzum A, Drago F, Parodi A. Skin cancers in solid organ transplant recipients: a retrospective study on 218 patients. Transpl Immunol 2023; 80:101896. [PMID: 37419374 DOI: 10.1016/j.trim.2023.101896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/01/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Ilaria Trave
- Section of Dermatology, Department of Health Sciences, University of Genoa, Policlinico San Martino, Via R. Benzi, 10, 16132 Genoa, Italy
| | - Giulia Ciccarese
- Section of Dermatology, Department of medical and surgical sciences, University of Foggia, Policlinico Riuniti, Viale Pinto 1, 71122 Foggia, Italy.
| | - Giulia Gasparini
- Section of Dermatology, Department of Health Sciences, University of Genoa, Policlinico San Martino, Via R. Benzi, 10, 16132 Genoa, Italy
| | - Riccardo Canta
- Physical medicine and rehabilitation, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), University of Genoa, Genoa, Largo P. Daneo 3, 16132 Genoa, Italy
| | - Gaetano Serviddio
- Liver Unit, C.U.R.E., Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Astrid Herzum
- Section of Dermatology, Department of Dermatology and Angioma Center, IRCCS Istituto Giannina Gaslini, Via G. Gaslini, 5, 16147 Genoa, Italy
| | - Francesco Drago
- Section of Dermatology, Department of Health Sciences, University of Genoa, Policlinico San Martino, Via R. Benzi, 10, 16132 Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences, University of Genoa, Policlinico San Martino, Via R. Benzi, 10, 16132 Genoa, Italy
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16
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Sangineto M, Ciarnelli M, Cassano T, Radesco A, Moola A, Bukke VN, Romano A, Villani R, Kanwal H, Capitanio N, Duda L, Avolio C, Serviddio G. Metabolic reprogramming in inflammatory microglia indicates a potential way of targeting inflammation in Alzheimer's disease. Redox Biol 2023; 66:102846. [PMID: 37586250 PMCID: PMC10457454 DOI: 10.1016/j.redox.2023.102846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023] Open
Abstract
Microglia activation drives the pro-inflammatory activity in the early stages of Alzheimer's disease (AD). However, the mechanistic basis is elusive, and the hypothesis of targeting microglia to prevent AD onset is little explored. Here, we demonstrated that upon LPS exposure, microglia shift towards an energetic phenotype characterised by high glycolysis and high mitochondrial respiration with dysfunction. Although the activity of electron transport chain (ETC) complexes is boosted by LPS, this is mostly devoted to the generation of reactive oxygen species. We showed that by inhibiting succinate dehydrogenase (SDH) with dimethyl malonate (DMM), it is possible to modulate the LPS-induced metabolic rewiring, facilitating an anti-inflammatory phenotype. DMM improves mitochondrial function in a direct way and by reducing LPS-induced mitochondrial biogenesis. Moreover, the block of SDH with DMM inhibits the recruitment of hypoxia inducible-factor 1 α (HIF-1α), which mediates the induction of glycolysis and cytokine expression. Similar bioenergetic alterations were observed in the microglia isolated from AD mice (3xTg-AD), which present high levels of circulating LPS and brain toll-like receptor4 (TLR4). Moreover, this well-established model of AD was used to show a potential effect of SDH inhibition in vivo as DMM administration abrogated brain inflammation and modulated the microglia metabolic alterations of 3xTg-AD mice. The RNA-sequencing analysis from a public dataset confirmed the consistent transcription of genes encoding for ETC subunits in the microglia of AD mice (5xFAD). In conclusion, TLR4 activation promotes metabolic changes and the pro-inflammatory activity in microglia, and SDH might represent a promising therapeutic target to prevent AD development.
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Affiliation(s)
- Moris Sangineto
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Martina Ciarnelli
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Radesco
- Istituto Oncologico "Giovanni Paolo II", I.R.C.S.S. of Bari, Laboratory of Haematological Diagnostics and Cellular Therapy, Bari, Italy
| | - Archana Moola
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vidyasagar Naik Bukke
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonino Romano
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Hina Kanwal
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Nazzareno Capitanio
- Biochemistry Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Loren Duda
- Pathology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carlo Avolio
- Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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17
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Ciccarese G, Mastrolonardo M, Serviddio G, Drago F. Maculopapular eruptions following COVID-19 vaccination: Pityriasis rosea or pityriasis rosea-like eruptions? J Cosmet Dermatol 2023; 22:2380-2381. [PMID: 37382032 DOI: 10.1111/jocd.15755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 03/11/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Giulia Ciccarese
- Section of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mario Mastrolonardo
- Section of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, C.U.R.E. (University Centre for Liver Disease Research and Treatment), University of Foggia, Foggia, Italy
| | - Francesco Drago
- Section of Dermatology, Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
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18
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Zanghì A, Manuti V, Serviddio G, D’Amico E, Avolio C. MiRNA 106a-5p in cerebrospinal fluid as signature of early relapsing remitting multiple sclerosis: a cross sectional study. Front Immunol 2023; 14:1226130. [PMID: 37711630 PMCID: PMC10499168 DOI: 10.3389/fimmu.2023.1226130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/29/2023] [Indexed: 09/16/2023] Open
Abstract
Background Circulating microRNAs (MiRNAs) have been investigated for their role in fine-tuning the adaptive immune response to inflammatory factors and in Multiple Sclerosis (MS). They have been investigated as possible biomarkers for the diagnosis and prognosis of the disease. Methods A cross sectional study conducted at the MS centre of Foggia, Italy. We enrolled patients with (1) an age between 18 and 55 years, (2) a definitive diagnosis of relapsing remitting MS (RRMS) as per the revised McDonald criteria, and (3) naïve to any disease modifying therapy (DMTs), as well as (4) patients with other neurological disorders (OND). The aim of the study was to compare the levels of expression of miRNA 21-5p, miRNA 106a-5p, miRNA 146a-5p, and miRNA223-3p in cell-free cerebrospinal fluid (CSF) in RRMS patients and OND. Investigated MiRNAs were extracted, retrotranscribed, and then assessed by real-time polymerase chain reaction assay (q-PCR). A receiver-operator characteristic (ROC) curve was used to test MiRNAs as a biomarker for diagnosing MS. A linear regression analysis was done to find any association with disease characteristics at the time of diagnosis. Results A total cohort of 70 subjects (70% women) was analyzed. Out of them, 35 had a RRMS diagnosis. MiRNA 106a-5p (7.8 ± 3.8 vs 1.3 ± 0.9, p=0.03) had higher levels in RRMS patients when compared to OND. The ROC curve indicated that MiRNA 106a-5p could be considered as a disease biomarker with an area under the curve of 0.812 (p<.001; 95% CI 0.686-0.937). Linear regression analysis showed an association between the number of oligoclonal bands and MiRNA 106a-5p levels (B-coeff 2.6, p<.001; 95% CI 1.3-4.9). Conclusion We described miRNA 106a-5p as a possible signature in the CSF of RRMS patients in early phases of the disease. Further studies are needed to characterize its role in early MS as a disease biomarker.
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Pedicillo MC, De Stefano IS, Zamparese R, Barile R, Meccariello M, Agostinone A, Villani G, Colangelo T, Serviddio G, Cassano T, Ronchi A, Franco R, Pannone P, Zito Marino F, Miele F, Municinò M, Pannone G. The Role of Toll-like Receptor-4 in Macrophage Imbalance in Lethal COVID-19 Lung Disease, and Its Correlation with Galectin-3. Int J Mol Sci 2023; 24:13259. [PMID: 37686069 PMCID: PMC10487501 DOI: 10.3390/ijms241713259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
To the current data, there have been 6,955,141 COVID-19-related deaths worldwide, reported to WHO. Toll-like receptors (TLRs) implicated in bacterial and virus sensing could be a crosstalk between activation of persistent innate-immune inflammation, and macrophage's sub-population alterations, implicated in cytokine storm, macrophage over-activation syndrome, unresolved Acute Respiratory Disease Syndrome (ARDS), and death. The aim of this study is to demonstrate the association between Toll-like-receptor-4 (TLR-4)-induced inflammation and macrophage imbalance in the lung inflammatory infiltrate of lethal COVID-19 disease. Twenty-five cases of autopsy lung tissues were studied by digital pathology-based immunohistochemistry to evaluate expression levels of TLR-4 (CD 284), pan-macrophage marker CD68 (clone KP1), sub-population marker related to alveolar macrophage Galectin-3 (GAL-3) (clone 9C4), and myeloid derived CD163 (clone MRQ-26), respectively. SARS-CoV-2 viral persistence has been evaluated by in situ hybridation (ISH) method. This study showed TLR-4 up-regulation in a subgroup of patients, increased macrophage infiltration in both Spike-1(+) and Spike-1(-) lungs (p < 0.0001), and a macrophage shift with important down-regulation of GAL-3(+) alveolar macrophages associated with Spike-1 persistence (p < 0.05), in favor of CD163(+) myeloid derived monocyte-macrophages. Data show that TLR-4 expression induces a persistent activation of the inflammation, with inefficient resolution, and pathological macrophage shift, thus explaining one of the mechanisms of lethal COVID-19.
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Affiliation(s)
- Maria Carmela Pedicillo
- Department of Clinical and Experimental Medicine, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (M.C.P.); (I.S.D.S.); (A.A.)
| | - Ilenia Sara De Stefano
- Department of Clinical and Experimental Medicine, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (M.C.P.); (I.S.D.S.); (A.A.)
| | - Rosanna Zamparese
- Legal Medicine Unit, Ascoli Piceno Hospital C-G. Mazzoni, Viale Degli Iris 13, 63100 Ascoli Piceno, Italy;
| | - Raffaele Barile
- Department of Medical and Surgical Sciences, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (R.B.); (M.M.); (T.C.); (G.S.); (T.C.)
| | - Mario Meccariello
- Department of Medical and Surgical Sciences, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (R.B.); (M.M.); (T.C.); (G.S.); (T.C.)
| | - Alessio Agostinone
- Department of Clinical and Experimental Medicine, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (M.C.P.); (I.S.D.S.); (A.A.)
| | - Giuliana Villani
- Policlinico Riuniti, University-Hospital, Viale L.Pinto 1, 71122 Foggia, Italy;
| | - Tommaso Colangelo
- Department of Medical and Surgical Sciences, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (R.B.); (M.M.); (T.C.); (G.S.); (T.C.)
- Cancer Cell Signalling Unit, Institute for Stem-Cell Biology, Regenerative Medicine and Innovative Therapies (ISBReMIT), IRCCS Fondazione Casa Sollievo della Sofferenza, Viale Cappuccini sc.c., San Giovanni Rotondo, 71013 Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (R.B.); (M.M.); (T.C.); (G.S.); (T.C.)
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (R.B.); (M.M.); (T.C.); (G.S.); (T.C.)
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “L Vanvitelli”, via Luciano Armanni, 80138 Naples, Italy; (A.R.); (R.F.); (F.Z.M.)
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “L Vanvitelli”, via Luciano Armanni, 80138 Naples, Italy; (A.R.); (R.F.); (F.Z.M.)
| | - Paola Pannone
- Federico II, Department of Clinical Medicine and Surgery, School of medicine and Surgery, University of Naples, via Sergio Pasini, 80131 Naples, Italy;
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “L Vanvitelli”, via Luciano Armanni, 80138 Naples, Italy; (A.R.); (R.F.); (F.Z.M.)
| | - Francesco Miele
- Department of Surgery, University of Campania “L Vanvitelli”, 80138 Naples, Italy;
| | - Maurizio Municinò
- Forensic Medicine Unit, “S. Giuliano” Hospital, via Giambattista Basile, 80014 Giugliano in Campania, Italy;
| | - Giuseppe Pannone
- Department of Clinical and Experimental Medicine, University of Foggia, Viale L.Pinto 1, 71122 Foggia, Italy; (M.C.P.); (I.S.D.S.); (A.A.)
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Villani R, Magnati GP, Tuccari G, Sangineto M, Romano AD, Cassano T, Serviddio G. Liver fat content assessed by conventional B-mode ultrasound and metabolic profile in non-diabetic patients: Implications for clinical practice. Ultrasound 2023; 31:177-185. [PMID: 37538971 PMCID: PMC10395382 DOI: 10.1177/1742271x221122585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 08/05/2023]
Abstract
Introduction Several studies have demonstrated a positive correlation between severe hepatic steatosis and metabolic alterations; however, few studies have addressed the potential association between different grades of steatosis and clinical patterns in a non-diabetic population. Methods We conducted a cross-sectional study of 223 non-diabetic individuals. The severity of steatosis was assessed using B-mode ultrasound. We analyzed lipid and glucose profiles according to the severity of hepatic steatosis. Estimated glomerular filtration rate (eGFR) values were also recorded to investigate the potential impact of steatosis on kidney function. Results Patients with steatosis were found to have higher insulinemia and mean values of fasting plasma glucose compared to patients without steatosis. A significant decrease in high-density lipoprotein level was observed only in patients with severe or moderate steatosis. All grades of steatosis were associated with increased triglyceride levels, which were more significant in severe steatosis. Subgroup analysis by body mass index demonstrated a significant difference between lean patients with steatosis and lean patients without steatosis for triglycerides (p = 0.002) and high-density lipoprotein levels (p = 0.019). Finally, patients diagnosed with steatosis demonstrated a higher prevalence of estimated glomerular filtration rate < 90 ml/min. Conclusion The degree of steatosis diagnosed at ultrasound may predict glucose or lipid metabolism disorders and a decline in kidney function in a non-diabetic population.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Grazia Pia Magnati
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giulia Tuccari
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonino Davide Romano
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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21
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Bellanti F, Kasperczyk S, Kasperczyk A, Dobrakowski M, Pacilli G, Vurchio G, Maddalena A, Quiete S, Lo Buglio A, Capurso C, Serviddio G, Vendemiale G. Alteration of circulating redox balance in coronavirus disease-19-induced acute respiratory distress syndrome. J Intensive Care 2023; 11:30. [PMID: 37408073 DOI: 10.1186/s40560-023-00679-y] [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] [Received: 04/17/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Mechanisms underpinning ARDS induced by COVID-19 are mostly immune-mediated, but need to be completely clarified. This study aimed to investigate redox balance in COVID-19 patients with ARDS, trying to recognize possible differences from typical ARDS related to the pathophysiology of severe disease. METHODS Patients affected by ARDS and positive for the SARS-CoV-2 virus (N = 40, COVID-19) were compared to ARDS patients negative to the molecular test (N = 42, No COVID-19). Circulating markers of redox balance were measured in serum and erythrocytes, and related to markers of inflammation and coagulability. RESULTS No differences in serum markers of oxidative damage were found between both groups, but a reduction in total antioxidant status and serum ceruloplasmin level was observed in COVID-19 rather than No COVID-19 patients. Redox balance alterations were described in erythrocytes from COVID-19 with respect to No COVID-19 group, characterized by increased lipofuscin and malondialdehyde concentration, and reduced glutathione S-transferase and glutathione reductase activity. These markers were associated with circulating indexes of respiratory disease severity (Horowitz index and alveolar-to-arterial oxygen gradient), inflammation (interleukin-6 and interleukin-10), and hypercoagulability (D-dimer) in COVID-19 patients with ARDS. CONCLUSIONS ARDS caused by COVID-19 is sustained by impairment of redox balance, particularly in erythrocytes. This alteration is associated with the pro-inflammatory and pro-coagulant status which characterizes severe COVID-19.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy.
| | - Sławomir Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Michał Dobrakowski
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Gabriella Pacilli
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Giuseppina Vurchio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Alessandro Maddalena
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Stefano Quiete
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Cristiano Capurso
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
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22
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Ciccarese G, Brucci G, Di Biagio A, Drago F, Ogliastro M, Caccianotti B, Lo Caputo S, Santantonio T, Serviddio G. Two cases of Monkeypox virus infection without detectable cutaneous/mucosal lesions. Travel Med Infect Dis 2023; 54:102605. [PMID: 37302775 PMCID: PMC10251729 DOI: 10.1016/j.tmaid.2023.102605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/19/2023] [Accepted: 06/03/2023] [Indexed: 06/13/2023]
Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Giorgia Brucci
- Infectious Diseases Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo R. Benzi, 10, 16132, Genoa, Italy; Department of Health Sciences (DiSSal), University of Genova, Via Pastore, 1, 16132, Genova, Italy
| | - Antonio Di Biagio
- Infectious Diseases Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo R. Benzi, 10, 16132, Genoa, Italy; Department of Health Sciences (DiSSal), University of Genova, Via Pastore, 1, 16132, Genova, Italy
| | - Francesco Drago
- Unit of Dermatology, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Largo R. Benzi, 10, 16132, Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DiSSal), University of Genova, Via Pastore, 1, 16132, Genova, Italy
| | - Bruno Caccianotti
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Sergio Lo Caputo
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Teresa Santantonio
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Viale Pinto, 1, 71122, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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23
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Villani R, Lupo P, Sangineto M, Romano AD, Serviddio G. Liver Ultrasound Elastography in Non-Alcoholic Fatty Liver Disease: A State-of-the-Art Summary. Diagnostics (Basel) 2023; 13:diagnostics13071236. [PMID: 37046454 PMCID: PMC10093430 DOI: 10.3390/diagnostics13071236] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a chronic disease which is currently the most common hepatic disorder affecting up to 38% of the general population with differences according to age, country, ethnicity and sex. Both genetic and acquired risk factors such as a high-calorie diet or high intake of saturated fats have been associated with obesity, diabetes and, finally, NAFLD. A liver biopsy has always been considered essential for the diagnosis of NAFLD; however, due to several limitations such as the potential occurrence of major complications, sampling variability and the poor repeatability in clinical practice, it is considered an imperfect option for the evaluation of liver fibrosis over time. For these reasons, a non-invasive assessment by serum biomarkers and the quantification of liver stiffness is becoming the new frontier in the management of patients with NAFLD and liver fibrosis. We present a state-of-the-art summary addressing the methods for the non-invasive evaluation of liver fibrosis in NAFLD patients, particularly the ultrasound-based techniques (transient elastography, ARFI techniques and strain elastography) and their optimal cut-off values for the staging of liver fibrosis.
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24
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D'Amico E, Zanghì A, Manuti V, Allegretta C, Amoruso A, Serviddio G, Avolio C. MicroRNAs 181a and 125a are highly expressed in naïve RRMS: a pilot case-control study. J Neurol 2023; 270:1150-1153. [PMID: 36239797 DOI: 10.1007/s00415-022-11391-6] [Citation(s) in RCA: 1] [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: 07/14/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Emanuele D'Amico
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy.
| | - Aurora Zanghì
- UOC Neurology, Sant'Elia Hospital, Caltanissetta, Italy
| | - Virginia Manuti
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy
| | - Caterina Allegretta
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy
| | - Antonella Amoruso
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy
| | - Carlo Avolio
- Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122, Foggia, FG, Italy
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25
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Villani R, Romano AD, Rinaldi R, Sangineto M, Santoliquido M, Cassano T, Serviddio G. Prevalence and risk factors for hospital-acquired anemia in internal medicine patients: learning from the "less is more" perspective. Intern Emerg Med 2023; 18:177-183. [PMID: 36346557 PMCID: PMC9883305 DOI: 10.1007/s11739-022-03147-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/27/2022] [Indexed: 11/10/2022]
Abstract
Hospital-acquired anemia is defined as a new-onset anemia in hospitalized patients who have a normal hemoglobin level at admission. Its prevalence is unknown and most studies published on this topic have been conducted in intensive care unit patients with limited applicability to less acute settings, such as internal medicine wards. We conducted a retrospective study and enrolled 129 patients who were admitted to an Internal Medicine Unit between October 2021 and February 2022. The median value of phlebotomy during hospitalization was 46 ml (IQR 30-72 ml), whereas the median length of hospital stay was 9 days (IQR 5-13 days). The median value of hemoglobin reduction was -0.63 g/dl (p < 0.001) and the maximum value of drop in hemoglobin value was -2.6 g/dl. All patients who experienced a phlebotomy > 85 ml had a hemoglobin reduction > 0.6 g/dl. 20.9% of patients developed anemia during the hospital stay (7% moderate and 13.9% mild). No cases of severe anemia were observed. The volume of blood drawn during the hospital stay and the Hb value on admission were the only two variables statistically associated with the development of anemia, whereas gender, age, and chronic diseases, such as diabetes, history of cancer, or heart failure, were not. Strategies, such as elimination of unnecessary laboratory tests and the use of smaller tubes for blood collection, are needed to reduce the volume of iatrogenic blood loss and avoid blood wastage occurring during hospitalization in internal medicine patients.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Antonino Davide Romano
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Roberta Rinaldi
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Mariateresa Santoliquido
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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26
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Ciccarese G, Broccolo F, Serviddio G, Drago F. Clinical, diagnostic features and complications of hand, foot, and mouth disease caused by coxsackievirus A6 in children and adults. J Med Virol 2023; 95:e28405. [PMID: 36515420 DOI: 10.1002/jmv.28405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Broccolo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Cerba HealthCare Italia, Milano, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Drago
- Section of Dermatology, Policlinic San Martino Hospital, Genova, Italy
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27
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Bukke VN, Moola A, Serviddio G, Vendemiale G, Bellanti F. Nuclear factor erythroid 2-related factor 2-mediated signaling and metabolic associated fatty liver disease. World J Gastroenterol 2022; 28:6909-6921. [PMID: 36632321 PMCID: PMC9827579 DOI: 10.3748/wjg.v28.i48.6909] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/05/2022] [Accepted: 11/23/2022] [Indexed: 12/26/2022] Open
Abstract
Oxidative stress is a key driver in the development and progression of several diseases, including metabolic associated fatty liver disease (MAFLD). This condition includes a wide spectrum of pathological injuries, extending from simple steatosis to inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma. Excessive buildup of lipids in the liver is strictly related to oxidative stress in MAFLD, progressing to liver fibrosis and cirrhosis. The nuclear factor erythroid 2-related factor 2 (NRF2) is a master regulator of redox homeostasis. NRF2 plays an important role for cellular protection by inducing the expression of genes related to antioxidant, anti-inflammatory, and cytoprotective response. Consistent evidence demonstrates that NRF2 is involved in every step of MAFLD deve-lopment, from simple steatosis to inflammation, advanced fibrosis, and ini-tiation/progression of hepatocellular carcinoma. NRF2 activators regulate lipid metabolism and oxidative stress alleviating the fatty liver disease by inducing the expression of cytoprotective genes. Thus, modulating NRF2 activation is crucial not only in understanding specific mechanisms underlying MAFLD progression but also to characterize effective therapeutic strategies. This review outlined the current knowledge on the effects of NRF2 pathway, modulators, and mechanisms involved in the therapeutic implications of liver steatosis, inflammation, and fibrosis in MAFLD.
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Affiliation(s)
- Vidyasagar Naik Bukke
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Archana Moola
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
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28
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Villani R, Sangineto M, Pontrelli P, Bellanti F, Bukke VN, Moola A, Gesualdo L, Vendemiale G, Grandaliano G, Stallone G, Serviddio G. Eradication of HCV by direct antiviral agents restores mitochondrial function and energy homeostasis in peripheral blood mononuclear cells. FASEB J 2022; 36:e22650. [PMID: 36394523 DOI: 10.1096/fj.202200629r] [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] [Received: 04/27/2022] [Revised: 09/30/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022]
Abstract
Hepatitis C virus (HCV) adopts several immune evasion mechanisms such as interfering with innate immunity or promoting T-cell exhaustion. However, the recent direct-antiviral agents (DAAs) rapidly eliminate the virus, and the repercussions in terms of immune system balance are unknown. Here we compared the PBMCs transcriptomic profile of patients with HCV chronic infection at baseline (T0) and 12 weeks after the end of the therapy (SVR12) with DAAs. 3862 genes were differently modulated, identifying oxidative phosphorylation as the top canonical pathway differentially activated. Therefore, we dissected PBMCs bioenergetic profile by analyzing mitochondrial respiration and glycolysis at 4 timepoints: T0, 4 weeks of therapy, end of therapy (EoT), and SVR12. Maximal and reserve respiratory capacity considerably increased at EoT, persisting until SVR12. Notably, over time a significant increase was observed in respiratory chain (RC) complexes protein levels and the enzymatic activity of complexes I, II, and IV. Mitochondrial-DNA integrity improved over time, and the expression of mitochondrial biogenesis key regulators such as TFAM, Nrf-1, and PPARGC1A significantly increased at SVR12; hence, RC complexes synthesis and mitochondrial respiration were supported after treatment. HCV clearance with DAAS profoundly changed PBMCs bioenergetic profile, suggesting the immunometabolism study as a new approach to the understanding of viral immune evasion mechanisms and host adaptations during infections and therapies.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Paola Pontrelli
- Experimental Biology, Department of Emergency and Organ Transplantation, Faculty of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Bellanti
- Internal Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vidyasagar N Bukke
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Archana Moola
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, 'Aldo Moro' University of Bari, Bari, Italy
| | - Gianluigi Vendemiale
- Internal Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe Grandaliano
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, 'Aldo Moro' University of Bari, Bari, Italy
| | - Giovanni Stallone
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Villani R, Di Cosimo F, Sangineto M, Romano AD, Serviddio G. Pseudocirrhosis and portal hypertension in patients with metastatic cancers: a systematic review and meta-analysis. Sci Rep 2022; 12:19865. [PMID: 36400809 PMCID: PMC9674682 DOI: 10.1038/s41598-022-24241-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
Pseudocirrhosis is a clinical and radiological entity mimicking liver cirrhosis in patients without a history of chronic liver disease. We performed a systematic review and meta-analysis of the current literature to evaluate the state-of-the-art and investigate the epidemiology and clinical features of pseudocirrhosis. We searched PubMed, Web of Science and Scopus for literature published until February 28, 2022. We included in the final analysis 62 articles (N = 389 patients): 51 case reports (N = 64 patients), 5 case series (N = 35 patients) and 6 observational studies (N = 290 patients). About 80% of patients included in the case reports and case series had breast cancer. Most patients had at least one clinical sign of portal hypertension and ascites was the most common clinical manifestation of portal hypertension. The median time from pseudocirrhosis to death was 2 months (IQR 1-7 months). Alkylating agents and antimitotics were the most common classes of anticancer drugs reported in our study population. Notably, about 70% of patients received three or more anticancer drugs. Finally, pseudocirrhosis is a condition that occurs in patients with hepatic metastases and may have a negative impact on survival and clinical management of patients because of the potential development of portal hypertension and its complications.
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Affiliation(s)
- Rosanna Villani
- grid.10796.390000000121049995Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Francesca Di Cosimo
- grid.10796.390000000121049995Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Moris Sangineto
- grid.10796.390000000121049995Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Antonino Davide Romano
- grid.10796.390000000121049995Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
| | - Gaetano Serviddio
- grid.10796.390000000121049995Liver Unit, C.U.R.E. (University Centre for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
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Bellanti F, Lo Buglio A, Dobrakowski M, Kasperczyk A, Kasperczyk S, Aich P, Singh SP, Serviddio G, Vendemiale G. Impact of sodium glucose cotransporter-2 inhibitors on liver steatosis/fibrosis/inflammation and redox balance in non-alcoholic fatty liver disease. World J Gastroenterol 2022; 28:3243-3257. [PMID: 36051336 PMCID: PMC9331534 DOI: 10.3748/wjg.v28.i26.3243] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/18/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sodium glucose cotransporter-2 inhibitors (SGLT2-I) are the most recently approved drugs for type 2 diabetes (T2D). Recent clinical trials of these compounds reported beneficial cardiovascular (CV) and renal outcomes. A major cause of vascular dysfunction and CV disease in diabetes is hyperglycemia associated with inflammation and oxidative stress. Pre-clinical studies demonstrated that SGLT2-I reduce glucotoxicity and promote anti-inflammatory effects by lowering oxidative stress.
AIM To investigate the effects of SGLT2-I on markers of oxidative stress, inflammation, liver steatosis, and fibrosis in patients of T2D with non-alcoholic fatty liver disease (NAFLD).
METHODS We referred fifty-two consecutive outpatients treated with metformin monotherapy and exhibiting poor glycemic control to our centre. We introduced the outpatients to an SGLT2-I (dapagliflozin, empagliflozin, or canagliflozin; n = 26) or a different hypoglycemic drug [other glucose-lowering drugs (OTHER), n = 26]. We evaluated circulating interleukins and serum hydroxynonenal (HNE)- or malondialdehyde (MDA)-protein adducts, fatty liver index (FLI), NAFLD fibrosis score, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST-to-platelet-ratio index (APRI), and fibrosis-4 on the day before (T0) and following treatment for six months (T1). We also performed transient elastography at T0 and T1.
RESULTS Add-on therapy resulted in improved glycemic control and reduced fasting blood glucose in both groups. Of note, following treatment for six months, a reduction of FLI and APRI, as well as of the FibroScan result, was reported in patients treated with SGLT2-I, but not in the OTHER group; furthermore, in the SGLT2-I group, we reported lower circulating levels of interleukin (IL)-1β, IL-6, tumor necrosis factor, vascular endothelial growth factor, and monocyte chemoattractant protein-1, and higher levels of IL-4 and IL-10. We did not observe any modification in circulating interleukins in the OTHER group. Finally, serum HNE- and MDA-protein adducts decreased significantly in SGLT2-I rather than OTHER patients and correlated with liver steatosis and fibrosis scores.
CONCLUSION The present data indicate that treatment with SGLT2-I in patients with T2D and NAFLD is associated with improvement of liver steatosis and fibrosis markers and circulating pro-inflammatory and redox status, more than optimizing glycemic control.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Michał Dobrakowski
- Department of Biochemistry, Medical University of Silesia in Katowice, Zabrze 41-808, Poland
| | - Aleksandra Kasperczyk
- Department of Biochemistry, Medical University of Silesia in Katowice, Zabrze 41-808, Poland
| | - Sławomir Kasperczyk
- Department of Biochemistry, Medical University of Silesia in Katowice, Zabrze 41-808, Poland
| | - Palok Aich
- School of Biological Sciences, National Institute of Science Education and Research, Khurdha 752050, India
| | - Shivaram P Singh
- Department of Gastroenterology, SCB Medical College, Cuttack 753007, India
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
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Bellanti F, Bukke VN, Moola A, Villani R, Scuderi C, Steardo L, Palombelli G, Canese R, Beggiato S, Altamura M, Vendemiale G, Serviddio G, Cassano T. Effects of Ultramicronized Palmitoylethanolamide on Mitochondrial Bioenergetics, Cerebral Metabolism, and Glutamatergic Transmission: An Integrated Approach in a Triple Transgenic Mouse Model of Alzheimer's Disease. Front Aging Neurosci 2022; 14:890855. [PMID: 35686025 PMCID: PMC9170916 DOI: 10.3389/fnagi.2022.890855] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/19/2022] [Indexed: 01/26/2023] Open
Abstract
The therapeutic potential of ultramicronized palmitoylethanolamide (um-PEA) was investigated in young (6-month-old) and adult (12-month-old) 3 × Tg-AD mice, which received um-PEA for 3 months via a subcutaneous delivery system. Mitochondrial bioenergetics, ATP homeostasis, and magnetic resonance imaging/magnetic resonance spectroscopy were evaluated in the frontal cortex (FC) and hippocampus (HIPP) at the end of um-PEA treatment. Glutamate release was investigated by in vivo microdialysis in the ventral HIPP (vHIPP). We demonstrated that chronic um-PEA treatment ameliorates the decrease in the complex-I respiration rate and the FoF1-ATPase (complex V) activity, as well as ATP content depletion in the cortical mitochondria. Otherwise, the impairment in mitochondrial bioenergetics and the release of glutamate after depolarization was not ameliorated by um-PEA treatment in the HIPP of both young and adult 3 × Tg-AD mice. Moreover, progressive age- and pathology-related changes were observed in the cortical and hippocampal metabolism that closely mimic the alterations observed in the human AD brain; these metabolic alterations were not affected by chronic um-PEA treatment. These findings confirm that the HIPP is the most affected area by AD-like pathology and demonstrate that um-PEA counteracts mitochondrial dysfunctions and helps rescue brain energy metabolism in the FC, but not in the HIPP.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Archana Moola
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Luca Steardo
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | | | - Rossella Canese
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Sarah Beggiato
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Tommaso Cassano
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Dalbeni A, Villani R, Bevilacqua M, Sacco F, Faccincani D, Cattazzo F, Cavallone F, Mantovani A, Ceruti V, Ieluzzi D, Paon V, Mantovani A, Serviddio G, Sacerdoti D. Effects of direct-acting antiviral agents on lipid and glucose profile in HCV patients with type 2 diabetes: A real-life Italian experience. J Dig Dis 2022; 23:324-330. [PMID: 35700113 DOI: 10.1111/1751-2980.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Hepatitis C virus (HCV) infection is associated with an increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The impact of HCV eradication on the metabolic profile in diabetic patients treated with direct-acting antiviral agents (DAAs) is not well defined. The aim of our study was to evaluate the effects of DAAs on a lipid and glucose profile in a cohort of diabetic patients with different liver fibrotic stages. METHODS T2DM patients with active HCV infection were consecutively enrolled in this prospective trial. Glycolipidic status was assessed, before starting DAA treatment (T0) and at 12 months after the beginning of treatment (T1). Liver fibrotic stage was assessed by FibroScan. RESULTS In all, 131 patients were enrolled and all of them achieved a sustained virologic response. At baseline, no significant differences were found in lipid and glucose profiles in subgroup analysis by liver fibrosis, HCV genotype, and cardiovascular risk factors. At T1, total cholesterol and low-density lipoprotein cholesterol, but not triglycerides, significantly increased irrespective of liver fibrotic stage and baseline anthropometric and clinical profiles, while glycated hemoglobin significantly decreased only in F4 patients. CONCLUSIONS HCV eradication in diabetic patients is associated with a worsening lipid profile that could impact future cardiovascular risk. A careful global monitoring of cardiovascular risk factors in all diabetic patients after HCV eradication is needed.
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Affiliation(s)
- Andrea Dalbeni
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Rosanna Villani
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Michele Bevilacqua
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Federica Sacco
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Diego Faccincani
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Filippo Cattazzo
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Francesco Cavallone
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Anna Mantovani
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Vittoria Ceruti
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Donatella Ieluzzi
- Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Veronica Paon
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alessandro Mantovani
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Gaetano Serviddio
- Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - David Sacerdoti
- Division of General Medicine C, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.,Liver Unit, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Romano AD, Villani R, Sangineto M, Cassano T, Serviddio G. The GLP-1 receptor agonist Exendin-4 modulates hippocampal NMDA-receptor signalling in aged rats and improves cognitive impairment in diabetic elderly patients. JGG 2022. [DOI: 10.36150/2499-6564-n474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sapena V, Enea M, Torres F, Celsa C, Rios J, Rizzo GEM, Nahon P, Mariño Z, Tateishi R, Minami T, Sangiovanni A, Forns X, Toyoda H, Brillanti S, Conti F, Degasperi E, Yu ML, Tsai PC, Jean K, El Kassas M, Shousha HI, Omar A, Zavaglia C, Nagata H, Nakagawa M, Asahina Y, Singal AG, Murphy C, Kohla M, Masetti C, Dufour JF, Merchante N, Cavalletto L, Chemello LL, Pol S, Crespo J, Calleja JL, Villani R, Serviddio G, Zanetto A, Shalaby S, Russo FP, Bielen R, Trevisani F, Cammà C, Bruix J, Cabibbo G, Reig M. Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis. Gut 2022; 71:593-604. [PMID: 33741640 DOI: 10.1136/gutjnl-2020-323663] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/12/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration. DESIGN We pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson. RESULTS Recurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p<0.001), performance status (2 vs 0, RR=4.35, 95% CI 1.54 to 11.11; 2 vs 1, RR=3.7, 95% CI 1.3 to 11.11; p=0.01) and tumour burden pre-HCC treatment (multifocal vs solitary nodule, RR=1.75, 95% CI 1.25 to 2.43; p<0.001). No significant difference was observed in RR between the DAA-exposed and DAA-unexposed groups in propensity score-matched patients (RR=0.64, 95% CI 0.37 to 1.1; p=0.1). CONCLUSION Effects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.
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Affiliation(s)
- Victor Sapena
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, CIBEREHD, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Marco Enea
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy
| | - Ferran Torres
- Biostatistics and Data Management Core Facility, IDIBAPS, Hospital Clinic Barcelona, Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Ciro Celsa
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy.,Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, Sicilia, Italy
| | - Jose Rios
- Biostatistics and Data Management Core Facility, IDIBAPS, Hospital Clinic Barcelona, Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Giacomo Emanuele Maria Rizzo
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy
| | - Pierre Nahon
- AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy; Université Paris 13, Sorbonne Paris Cité, "Equipe labellisée Ligue Contre le Cancer", F-93206 Saint-Denis; Inserm, UMR-1162, "Génomique fonctionnelle des tumeurs solides", F-75000, Bondy, France
| | - Zoe Mariño
- Liver Unit, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, CIBEREHD, Barcelona, Spain
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Minami
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Angelo Sangiovanni
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Maggiore Hospital, University of Milan, Milan, Italy.,CRC "A.M. and A. Migliavacca" Center for Liver Disease, Milan, Italy
| | - Xavier Forns
- Liver Unit, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, CIBEREHD, Barcelona, Spain
| | - Hidenori Toyoda
- Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
| | - Stefano Brillanti
- Department of Medical and Surgical Sciences (DIMEC), Research Centre for the Study of Hepatitis, University of Bologna, Bologna, Italy
| | - Fabio Conti
- Department of Medical and Surgical Sciences (DIMEC), Research Centre for the Study of Hepatitis, University of Bologna, Bologna, Italy
| | - Elisabetta Degasperi
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Maggiore Hospital, University of Milan, Milan, Italy.,CRC "A.M. and A. Migliavacca" Center for Liver Disease, Milan, Italy
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis, Center Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Chien Tsai
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis, Center Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kevin Jean
- Laboratoire MESuRS (EA 4628), Conservatoire National Des Arts et Métiers, Paris, France.,Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris, France
| | - Mohamed El Kassas
- Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Hend Ibrahim Shousha
- Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf Omar
- Endemic Medicine and Hepato-Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Claudio Zavaglia
- Department of Hepatology and Gastroenterology, Liver Unit, Niguarda Hospital, Milano, Lombardia, Italy
| | - Hiroko Nagata
- Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Mina Nakagawa
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Institute of Education, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yasuhiro Asahina
- Department of Gastroenterology and Hepatology, Liver Disease Control, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Amit G Singal
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Caitlin Murphy
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Mohamed Kohla
- Hepatology, National Liver Institute, Shebin El-Kom, Egypt
| | - Chiara Masetti
- Liver and Transplant Unit, Policlinico Tor Vergata, Rome, Italy
| | - Jean-François Dufour
- Hepatology, Department of Clinical Research, University Clinic for Visceral Surgery and Medicine Inselspital, Bern, Switzerland.,Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Nicolas Merchante
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Seville, Spain
| | - Luisa Cavalletto
- Department of Medicine-DIMED, Padua University, University Hospital, Clinica Medica 5, Refering Center for Liver Diseases, Padova, Italy
| | - Liliana Lc Chemello
- Department of Medicine-DIMED, Padua University, University Hospital, Clinica Medica 5, Refering Center for Liver Diseases, Padova, Italy
| | - Stanislas Pol
- l'Agence de recherche ANRS (France REcherche Nord&Sud Sida-HIV Hépatites), Paris, France
| | - Javier Crespo
- Gastroenterology and Hepatology Service, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain.,Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, Spain
| | - Jose Luis Calleja
- Gastroenterology and Hepatology, IDIPHIM, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain.,(CIBEREHD), Instituto de Salud Carlos III, Centro de Investigacion Biomedica en Red Enfermedades Hepaticas y Digestivas, Madrid, Spain
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Alberto Zanetto
- Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology Unit, University of Padova, Padova, Italy
| | - Sarah Shalaby
- Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology Unit, University of Padova, Padova, Italy
| | - Francesco Paolo Russo
- Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology Unit, University of Padova, Padova, Italy
| | - Rob Bielen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Limburg, Belgium.,Department of Gastro-Enterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Limburg, Belgium
| | - Franco Trevisani
- Department of Medical and Surgical Sciences, Semeiotics Unit, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Calogero Cammà
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy
| | - Jordi Bruix
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, CIBEREHD, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Giuseppe Cabibbo
- Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy
| | - Maria Reig
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, CIBEREHD, Hospital Clinic de Barcelona, Barcelona, Spain
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Sangineto M, Grander C, Grabherr F, Mayr L, Enrich B, Schwärzler J, Dallio M, Bukke VN, Moola A, Moschetta A, Adolph TE, Sabbà C, Serviddio G, Tilg H. Recovery of Bacteroides thetaiotaomicron ameliorates hepatic steatosis in experimental alcohol-related liver disease. Gut Microbes 2022; 14:2089006. [PMID: 35786161 PMCID: PMC9255095 DOI: 10.1080/19490976.2022.2089006] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
Alcohol-related liver disease (ALD) is a major cause of liver disease and represents a global burden, as treatment options are scarce. Whereas 90% of ethanol abusers develop alcoholic fatty liver disease (AFLD), only a minority evolves to steatohepatitis and cirrhosis. Alcohol increases lipogenesis and suppresses lipid-oxidation implying steatosis, although the key role of intestinal barrier integrity and microbiota in ALD has recently emerged. Bacteroides thetaiotaomicron (Bt) is a prominent member of human and murine intestinal microbiota, and plays important functions in metabolism, gut immunity, and mucosal barrier. We aimed to investigate the role of Bt in the genesis of ethanol-induced liver steatosis. Bt DNA was measured in feces of wild-type mice receiving a Lieber-DeCarli diet supplemented with an increase in alcohol concentration. In a second step, ethanol-fed mice were orally treated with living Bt, followed by analysis of intestinal homeostasis and histological and biochemical alterations in the liver. Alcohol feeding reduced Bt abundance, which was preserved by Bt oral supplementation. Bt-treated mice displayed lower hepatic steatosis and triglyceride content. Bt restored mucosal barrier and reduced LPS translocation by enhancing mucus thickness and production of Mucin2. Furthermore, Bt up-regulated Glucagon-like peptide-1 (GLP-1) expression and restored ethanol-induced Fibroblast growth factor 15 (FGF15) down-regulation. Lipid metabolism was consequently affected as Bt administration reduced fatty acid synthesis (FA) and improved FA oxidation and lipid exportation. Moreover, treatment with Bt preserved the mitochondrial fitness and redox state in alcohol-fed mice. In conclusion, recovery of ethanol-induced Bt depletion by oral supplementation was associated with restored intestinal homeostasis and ameliorated experimental ALD. Bt could serve as a novel probiotic to treat ALD in the future.
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Affiliation(s)
- Moris Sangineto
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Christoph Grander
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Felix Grabherr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Lisa Mayr
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Enrich
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Julian Schwärzler
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Marcello Dallio
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vidyasagar Naik Bukke
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Archana Moola
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Moschetta
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Timon E. Adolph
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Carlo Sabbà
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
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Ciccarese G, Di Biagio A, Drago F, Mastrolonardo M, Pipoli A, Lo Caputo S, Serviddio G, Santantonio T, Parodi A. Monkeypox virus infection mimicking primary syphilis. Infez Med 2022; 31:113-115. [PMID: 36908381 PMCID: PMC9994820 DOI: 10.53854/liim-3101-16] [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: 12/18/2022] [Accepted: 01/10/2023] [Indexed: 03/07/2023]
Abstract
In our case series of monkeypox (MPX) virus infected patients, one had a single genital ulcer as the only cutaneous manifestation of the infection. Physical examination revealed a single, rounded ulcer of the shaft penis characterized by pinkish raised, infiltrated borders and a crusty yellowish bottom associated with bilateral inguinal lymphadenopathies. Serology for Treponema pallidum infection and a complete screening for sexually transmitted infections (STIs) resulted negative except for the detection of Staphylococcus aureus at the cultural examination and MPX DNA at the ulcer bottom. The patient's general conditions were good therefore he remained isolated at home for 3 weeks after the diagnosis. At one month follow up, he presented only a depressed pinkish skin scars on the site of the previous ulcer. The clinical presentation of this patient could easily be misdiagnosed with other sexually transmitted infections (STIs), especially with primary syphilis. MPX infection should be considered in the differential diagnosis of STIs, also in patients with weak and localized manifestations.
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Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Di Biagio
- Infectious Diseases Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences, University of Genova, Genova, Italy
| | - Francesco Drago
- Unit of Dermatology, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Mario Mastrolonardo
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonietta Pipoli
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Sergio Lo Caputo
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Teresa Santantonio
- Clinic of Infectious Diseases, Department of Clinical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Aurora Parodi
- Unit of Dermatology, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
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Villani R, Magnati GP, De Girolamo G, Sangineto M, Romano AD, Cassano T, Serviddio G. Genetic Polymorphisms and Clinical Features in Diabetic Patients With Fatty Liver: Results From a Single-Center Experience in Southern Italy. Front Med (Lausanne) 2021; 8:737759. [PMID: 34746177 PMCID: PMC8566437 DOI: 10.3389/fmed.2021.737759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
Genetic background may be involved in the promotion and progression of non-alcoholic fatty liver disease (NAFLD). Previous studies have suggested that the single nucleotide polymorphisms (SNPs) may be associated with the specific clinical features in the patients with hepatic steatosis; however, data on the patients with diabetes from Southern Italy are lacking. We enrolled 454 patients and 260 of them had type 2 diabetes. We studied the PNPLA3 rs738409, LPIN1 rs13412852, KLF6 rs3750861, SOD2 rs4880, TM6SF2 rs58542926, and ZNF624 rs12603226 SNPs and their distribution in the study population. Lipid profile, liver stiffness, and kidney function were also studied to understand the potential role of the SNPs in the development of clinical phenotypes. No differences were observed in the distribution of polymorphisms between the diabetic and non-diabetic subjects. Carriers of risk allele G for PNPLA3 rs738409 SNP showed a lower mean value of serum triglycerides and a higher liver stiffness. Risk allele for KLF6 rs3750861 and SOD2 rs4880 polymorphism had a lower estimated glomerular filtration rate (eGFR) value, whereas no differences in the glucose and glycated hemoglobin level were observed in the subgroups by the different genotypes. Genetic polymorphisms are useful to identify the patients at higher risk of development of liver fibrosis and lower eGFR values in the patients with diabetes and NAFLD. Their use in clinical practice may help the clinicians to identify the patients who require a more strict follow-up program.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Grazia Pia Magnati
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe De Girolamo
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonino Davide Romano
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Bellanti F, di Bello G, Tamborra R, Amatruda M, Lo Buglio A, Dobrakowski M, Kasperczyk A, Kasperczyk S, Serviddio G, Vendemiale G. Impact of senescence on the transdifferentiation process of human hepatic progenitor-like cells. World J Stem Cells 2021; 13:1595-1609. [PMID: 34786160 PMCID: PMC8567448 DOI: 10.4252/wjsc.v13.i10.1595] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/14/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Senescence is characterized by a decline in hepatocyte function, with impairment of metabolism and regenerative capacity. Several models that duplicate liver functions in vitro are essential tools for studying drug metabolism, liver diseases, and organ regeneration. The human HepaRG cell line represents an effective model for the study of liver metabolism and hepatic progenitors. However, the impact of senescence on HepaRG cells is not yet known.
AIM To characterize the effects of senescence on the transdifferentiation capacity and mitochondrial metabolism of human HepaRG cells.
METHODS We compared the transdifferentiation capacity of cells over 10 (passage 10 [P10]) vs P20. Aging was evaluated by senescence-associated (SA) beta-galactosidase activity and the comet assay. HepaRG transdifferentiation was analyzed by confocal microscopy and flow cytometry (expression of cluster of differentiation 49a [CD49a], CD49f, CD184, epithelial cell adhesion molecule [EpCAM], and cytokeratin 19 [CK19]), quantitative PCR analysis (expression of albumin, cytochrome P450 3A4 [CYP3A4], γ-glutamyl transpeptidase [γ-GT], and carcinoembryonic antigen [CEA]), and functional analyses (albumin secretion, CYP3A4, and γ-GT). Mitochondrial respiration and the ATP and nicotinamide adenine dinucleotide (NAD+)/NAD with hydrogen (NADH) content were also measured.
RESULTS SA β-galactosidase staining was higher in P20 than P10 HepaRG cells; in parallel, the comet assay showed consistent DNA damage in P20 HepaRG cells. With respect to P10, P20 HepaRG cells exhibited a reduction of CD49a, CD49f, CD184, EpCAM, and CK19 after the induction of transdifferentiation. Furthermore, lower gene expression of albumin, CYP3A4, and γ-GT, as well as reduced albumin secretion capacity, CYP3A4, and γ-GT activity were reported in transdifferentiated P20 compared to P10 cells. By contrast, the gene expression level of CEA was not reduced by transdifferentiation in P20 cells. Of note, both cellular and mitochondrial oxygen consumption was lower in P20 than in P10 transdifferentiated cells. Finally, both ATP and NAD+/NADH were depleted in P20 cells with respect to P10 cells.
CONCLUSION SA mitochondrial dysfunction may limit the transdifferentiation potential of HepaRG cells, with consequent impairment of metabolic and regenerative properties, which may alter applications in basic studies.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Giorgia di Bello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Rosanna Tamborra
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Marco Amatruda
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Aurelio Lo Buglio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Michał Dobrakowski
- Department of Biochemistry, Medical University of Silesia, Zabrze 41-808, Poland
| | | | - Sławomir Kasperczyk
- Department of Biochemistry, Medical University of Silesia, Zabrze 41-808, Poland
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy
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Mirijello A, Santoliquido M, Piscitelli P, Borelli C, Serviddio G, Simeone A, Grandone E, De Cosmo S. Pulmonary Artery Stump Thrombosis: To Treat or Not to Treat? The Question Is Still Open. Description of a Case and Review of the Literature. Front Cardiovasc Med 2021; 8:714826. [PMID: 34671651 PMCID: PMC8520941 DOI: 10.3389/fcvm.2021.714826] [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: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
Pulmonary artery stump thrombosis (PAST) represents a possible complication after lung surgery. We report the case of a 59-year-old man who presented with dyspnoea about 4 years after right pneumonectomy due to squamous cell lung cancer. A CT-scan showed the presence of pulmonary artery stump thrombosis. Although there was no evidence of pulmonary embolism, given the clinical features and radiological shape of the thrombus, anticoagulation treatment with low-molecular-weight heparin was started with improvement of symptoms. The patient was discharged on anticoagulant treatment and a pulmonary CT-scan performed 4 months later showed an almost complete resolution of the PAST. Pathophysiological mechanisms of PAST are still unknown, although several hypotheses have been proposed. However, the decision to treat PAST with anticoagulants is still controversial. A review of literature will be provided in order to discuss risk factors, possible etiologies and to highlight clinical and radiological characteristics that could suggest to treat this condition, in particular when there is an increased risk of complications.
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Affiliation(s)
- Antonio Mirijello
- Internal Medicine Unit, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Mariateresa Santoliquido
- Internal Medicine Unit, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy.,Geriatrics Residency School, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pamela Piscitelli
- Internal Medicine Unit, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Cristina Borelli
- Radiology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Gaetano Serviddio
- Geriatrics Residency School, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Anna Simeone
- Radiology Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Elvira Grandone
- Thrombosis and Haemostasis Research Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Internal Medicine Unit, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
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40
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Bukke VN, Archana M, Villani R, Serviddio G, Cassano T. Pharmacological and Toxicological Effects of Phytocannabinoids and Recreational Synthetic Cannabinoids: Increasing Risk of Public Health. Pharmaceuticals (Basel) 2021; 14:ph14100965. [PMID: 34681189 PMCID: PMC8541640 DOI: 10.3390/ph14100965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023] Open
Abstract
Synthetic Cannabinoids (CBs) are a novel class of psychoactive substances that have rapidly evolved around the world with the addition of diverse structural modifications to existing molecules which produce new structural analogues that can be associated with serious adverse health effects. Synthetic CBs represent the largest class of drugs detected by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) with a total of 207 substances identified from 2008 to October 2020, and 9 compounds being reported for the first time. Synthetic CBs are sprayed on natural harmless herbs with an aim to mimic the euphoric effect of Cannabis. They are sold under different brand names including Black mamba, spice, K2, Bombay Blue, etc. As these synthetic CBs act as full agonists at the CB receptors, they are much more potent than natural Cannabis and have been increasingly associated with acute to chronic intoxications and death. Due to their potential toxicity and abuse, the US government has listed some synthetic CBs under schedule 1 classification. The present review aims to provide a focused overview of the literature concerning the development of synthetic CBs, their abuse, and potential toxicological effects including renal toxicity, respiratory depression, hyperemesis syndrome, cardiovascular effects, and a range of effects on brain function.
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Cornacchia MG, Sangineto M, Villani R, Cavallone F, Di Gioia G, Cicciomessere P, Serviddio G. High prevalence of false positive SARS-CoV2 serology in a cohort of patients with liver autoimmune diseases. Exploration of Medicine 2021. [DOI: 10.37349/emed.2021.00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aim
Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) immunization in patients with autoimmune diseases is of particular concern to understand their response to the infection and to the vaccine. In fact, the immunological disorder and the immunosuppressive therapies could affect the serological response. SARS-CoV2 serological tests potentially provide this information, although they were rapidly commercialized with internal verifications. Here, we analysed the seroprevalence to SARS-CoV2 in a cohort of patients with liver autoimmune diseases.
Methods
From May to December 2020, a cohort of patients affected by primary biliary cholangitis (PBC), autoimmune hepatitis (AIH) and PBC/AIH overlap syndrome were screened with (reverse transcription-polymerase chain reaction) RT-PCR of nasopharyngeal swabs, rapid antigenic test and chemiluminescent serological test during routine follow-up.
Results
The analysis of 42 patients was carried out: 18 (42.85%) PBC, 12 (28.57%) AIH and 12 (28.57%) PBC/AIH overlap syndromes. Only 2 patients (4.76%) resulted positive to the RNA, antigen and antibody detection tests, hence affected by SARS-CoV2 infection. 14 subjects out of 40 negative cases presented a positive serology for SARS-CoV2 antibodies, hence with a false positivity in the 35% of cases without infection. Among these, 6 (42.86%) patients presented only immunoglobulin (Ig)M positivity, 6 (42.86%) patients presented positivity for only IgG and 2 (14.28%) patients were positive to both IgM and IgG.
Notably, the presence of autoantibodies did not correlate with the serological false positivity, highlighting that there is no cross-reactivity with autoantibodies. The presence of polyclonal hypergammaglobulinemia did not interfere with the serological test as well.
Interestingly, the patients with false positive serology showed higher levels of gamma-glutamyltransferase (GGT) and C-reactive protein (CRP).
Conclusions
Patients with liver autoimmune diseases present a high rate of false positive SARS-CoV2 serology. Therefore, new strategies are needed to study the serological response in this patient category.
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Affiliation(s)
- Maria Giulia Cornacchia
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Moris Sangineto
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Rosanna Villani
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Francesco Cavallone
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Giuseppe Di Gioia
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Paola Cicciomessere
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
| | - Gaetano Serviddio
- University Center for Liver Disease Research and Treatment (C.U.R.E.), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71121 Foggia, Puglia, Italy
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Villani R, Romano AD, Sangineto M, Serviddio G. Direct-acting antivirals improve kidney function in diabetic patients with HCV infection and chronic kidney disease. Intern Emerg Med 2021; 16:1239-1245. [PMID: 33471254 DOI: 10.1007/s11739-020-02628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
After direct-acting antiviral (DAA) approval, a larger number of diabetic patients with chronic HCV infection have been treated. Cardiovascular risk and insulin resistance significantly change after successful clearance of HCV. Therefore, HCV therapy could potentially improve diabetes microvascular complications including nephropathy. We assessed kidney function after antiviral treatment completion in diabetic (N = 96) and non-diabetic patients (N = 187). Assessment of renal function was performed by serum creatinine and estimated glomerular filtration rate (eGFR) at baseline, at treatment completion and 12 weeks after treatment. Subgroup analysis by age, DAA regimen and eGFR stage at baseline was performed. Serum creatinine did not change significantly at any time whereas eGFR significantly improved during time in diabetic patients (baseline 83.7 ml/min/1.73 m2 vs 102.6 ml/min/1.73 m2 at 12 weeks after treatment completion; p = 0.028). Subgroup analysis showed that the improvement was observed particularly in old people with eGFR < 60 ml/min/1.73 m2. Antiviral regimens did not impact the eGFR values. Sixteen percent of diabetic patients improved their kidney function during treatment (vs 14.4% of non-diabetic patients) showing a one category change in eGFR. No acute kidney injury events were recorded in our cohort. Our study suggests that DAAs improve renal function in HCV diabetic patients with eGFR < 60 ml/min/1.73 m2 or aged ≥ 65 years independently from antiviral regimen.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Antonino Davide Romano
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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43
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Villani R, Di Cosimo F, Romano AD, Sangineto M, Serviddio G. Serum lipid profile in HCV patients treated with direct-acting antivirals: a systematic review and meta-analysis. Sci Rep 2021; 11:13944. [PMID: 34230541 PMCID: PMC8260657 DOI: 10.1038/s41598-021-93251-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022] Open
Abstract
Although direct-acting antivirals are very effective and safe drugs, several authors have reported the alteration of lipid profile during and after anti-HCV therapy suggesting a potential impact on the risk of cardiovascular events. We performed a systematic review and meta-analysis of observational studies to investigate the magnitude and temporal trend of lipid profile changes in DAA treated patients. All selected studies included data on lipid profile before starting therapy and at least one follow-up assessment during or after antiviral treatment. We identified 14 studies (N = 1537 patients) after removing duplicates. Pooled data showed an increase in total cholesterol 4 weeks after starting therapy (+ 15.86 mg/dl; 95% CI + 9.68 to 22.05; p < 0.001) and 12 weeks after treatment completion (+ 17.05 mg/dl; 95% CI + 11.24 to 22.85; p < 0.001). LDL trend was similar to the total cholesterol change in overall analysis. A mean increase in HDL-cholesterol of 3.36 mg/dl (95% CI + 0.92 to 5.79; p = 0.07) was observed after 12 weeks of treatment, whereas at SVR24 HDL difference was + 4.34 mg/dl (95% CI + 1.40 to 7.28; p = 0.004).Triglycerides did not show significant changes during treatment and after treatment completion. DAAs induce mild lipid changes in chronic hepatitis C patients treated with DAAs, which may persist after treatment completion.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Francesca Di Cosimo
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Antonino Davide Romano
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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44
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Corradini E, Ventura P, Ageno W, Cogliati CB, Muiesan ML, Girelli D, Pirisi M, Gasbarrini A, Angeli P, Querini PR, Bosi E, Tresoldi M, Vettor R, Cattaneo M, Piscaglia F, Brucato AL, Perlini S, Martelletti P, Pontremoli R, Porta M, Minuz P, Olivieri O, Sesti G, Biolo G, Rizzoni D, Serviddio G, Cipollone F, Grassi D, Manfredini R, Moreo GL, Pietrangelo A. Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI). Intern Emerg Med 2021; 16:1005-1015. [PMID: 33893976 PMCID: PMC8065333 DOI: 10.1007/s11739-021-02742-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022]
Abstract
During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO2/FiO2 ratio at admission was strongly inversely associated with survival. The use of conventional oxygen supplementation increased with the number of pre-existing comorbidities, but it did not associate with better survival in patients with PaO2/FiO2 ratio < 100. The latter, significantly benefited by the early use of non-invasive mechanical ventilation. Our study identified PaO2/FiO2 ratio at admission and comorbidity as the main alert signs to inform clinical decisions and resource allocation in non-critically ill COVID-19 patients admitted to IMU.
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Affiliation(s)
- Elena Corradini
- Unit of Internal Medicine, University Hospital Policlinico di Modena, Modena, Italy
| | - Paolo Ventura
- Unit of Internal Medicine, University Hospital Policlinico di Modena, Modena, Italy
| | - Walter Ageno
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia-Medicina 2, ASST Spedali Civili Brescia, Brescia, Italy
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine, University of Verona, Verona, Italy
| | - Mario Pirisi
- Internal Medicine Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Antonio Gasbarrini
- Department of Medical and Surgical Sciences, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del S. Cuore, Rome, Italy
| | - Paolo Angeli
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine-DIMED, University of Padova, Padua, Italy
| | - Patrizia Rovere Querini
- Unit of Internal Medicine, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Emanuele Bosi
- Unit of Internal Medicine, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Moreno Tresoldi
- Unit of Internal Medicine, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Vettor
- Department of Medicine, Università degli Studi di Padova, Padua, Italy
| | - Marco Cattaneo
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | | | - Stefano Perlini
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Roberto Pontremoli
- Department of Internal Medicine, University of Genoa and Policlinico San Martino, Genoa, Italy
| | - Massimo Porta
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Minuz
- Department of Internal Medicine, University of Verona, Verona, Italy
| | - Oliviero Olivieri
- Department of Medicine, Policlinico GB Rossi, University of Verona and AOUI Verona, Verona, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Gianni Biolo
- Department of Internal Medicine, Ospedale di Cattinara, University of Trieste, Trieste, Italy
| | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia, Brescia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Cipollone
- Department of Medicine and Aging, Clinica Medica, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Davide Grassi
- Department of Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Guido Luigi Moreo
- Internal Medicine Department, San Carlo Hospital, Paderno Dugnano, Milan, Italy
| | - Antonello Pietrangelo
- Unit of Internal Medicine, University Hospital Policlinico di Modena, Modena, Italy.
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Paglia A, Angeletti AG, Conte V, Serviddio G, Romano AD. Emphysematous cystitis in an elderly male diabetic patient: a case report. A complicated urinary tract infection. JGG 2021. [DOI: 10.36150/2499-6564-n341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bellanti F, di Bello G, Iannelli G, Pannone G, Pedicillo MC, Boulter L, Lu WY, Tamborra R, Villani R, Vendemiale G, Forbes SJ, Serviddio G. Inhibition of nuclear factor (erythroid-derived 2)-like 2 promotes hepatic progenitor cell activation and differentiation. NPJ Regen Med 2021; 6:28. [PMID: 34039998 PMCID: PMC8155039 DOI: 10.1038/s41536-021-00137-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 04/28/2021] [Indexed: 02/08/2023] Open
Abstract
The stem cell ability to self-renew and lead regeneration relies on the balance of complex signals in their microenvironment. The identification of modulators of hepatic progenitor cell (HPC) activation is determinant for liver regeneration and may improve cell transplantation for end-stage liver disease. This investigation used different models to point out the Nuclear factor (erythroid-derived 2)-like 2 (NRF2) as a key regulator of the HPC fate. We initially proved that in vivo models of biliary epithelial cells (BECs)/HPC activation show hepatic oxidative stress, which activates primary BECs/HPCs in vitro. NRF2 downregulation and silencing were associated with morphological, phenotypic, and functional modifications distinctive of differentiated cells. Furthermore, NRF2 activation in the biliary tract repressed the ductular reaction in injured liver. To definitely assess the importance of NRF2 in HPC biology, we applied a xenograft model by inhibiting NRF2 in the human derived HepaRG cell line and transplanting into SCID/beige mice administered with anti-Fas antibody to induce hepatocellular apoptosis; this resulted in effective human hepatocyte repopulation with reduced liver injury. To conclude, NRF2 inhibition leads to the activation and differentiation of liver progenitors. This redox-dependent transcription factor represents a potential target to regulate the commitment of undifferentiated hepatic progenitors into specific lineages.
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Affiliation(s)
- Francesco Bellanti
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Giorgia di Bello
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppina Iannelli
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe Pannone
- Anatomical Pathology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Carmela Pedicillo
- Anatomical Pathology Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luke Boulter
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Wei-Yu Lu
- Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston Birmingham, UK
| | - Rosanna Tamborra
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Villani
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gianluigi Vendemiale
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Stuart J Forbes
- MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh, UK
| | - Gaetano Serviddio
- Centre for Experimental and Regenerative Medicine, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Aghemo A, Alberti A, Andreone P, Angelico M, Brunetto MR, Chessa L, Ciancio A, Craxì A, Gaeta GB, Galli M, Gasbarrini A, Giorgini A, Grilli E, Lampertico P, Lichtner M, Milella M, Morisco F, Persico M, Pirisi M, Puoti M, Raimondo G, Romano A, Russello M, Sangiovanni V, Schiavini M, Serviddio G, Villa E, Vinci M, De Michina A, Gallinaro V, Gualberti G, Roscini AS, Zignego AL. Effectiveness and safety of glecaprevir/pibrentasvir in chronic hepatitis C patients: Results of the Italian cohort of a post-marketing observational study. Dig Liver Dis 2021; 53:612-619. [PMID: 32917546 DOI: 10.1016/j.dld.2020.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The MARS post-marketing, observational study evaluates glecaprevir/pibrentasvir in a large population of Italian patients who are infected with HCV. PATIENTS AND METHODS Achievement of SVR12 was the primary endpoint in the overall population and by subpopulations of interest (treatment-naïve and treatment-experienced patients, subjects infected with different HCV genotype/sub-genotype, cirrhotic and non-cirrhotic patients, patients with different severity of fibrosis, patients with an APRI score ≥1, subjects with comorbidities, HIV-coinfected patients, elderly patients and people who use drugs). Safety and quality of life (assessed by SF-36 and Work Productivity and Activity Impairment) were also evaluated. RESULTS The SVR12 rate was 99.4% (319/321; 95% CI: 97.8-99.8%) in the core population with sufficient follow-up (n = 321), 99.7% (289/290) in 8-week treated patients, and high (>96%) across subgroups. Only three patients (0.9%) had treatment-related adverse events that led to treatment discontinuation. In total, 30.1% of patients showed an improvement of ≥2.5 points in the Physical Component Summary of the SF-36 from baseline to the end of treatment, and this figure raised to 37.5% with the achievement of SVR12. Corresponding values for MCS were 42.2% and 42.8%, respectively. CONCLUSION Glecaprevir/pibrentasvir is safe and effective across subpopulations who are underserved in clinical trials.
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Affiliation(s)
- Alessio Aghemo
- Humanitas Clinical and Research Center IRCCS and Humanitas University
| | - Alfredo Alberti
- Dipartimento di Medicina Molecolare Università di Padova, 35122 Padova, Italy
| | - Pietro Andreone
- Dipartimento di Scienze Mediche, Materno Infantili e dell'Adulto, Università di Modena e Reggio Emilia, 41125 Modena, Italy
| | - Mario Angelico
- Dipartimento di Medicina - UOC di Epatologia, Fondazione PTV - Policlinico Tor Vergata, 00133 Roma, Italy
| | - Maurizia Rossana Brunetto
- Dipartimento di Medicina clinica e sperimentale Università di Pisa - UO Epatologia, Azienda Ospedaliero - Universitaria Pisana, 56126 Pisa, Italy
| | - Luchino Chessa
- Liver Unit, University Hospital, Monserrato, 09042 Cagliari, Italy
| | - Alessia Ciancio
- Dipartimento di Scienze Mediche, SC GastroEpatologia U, A.O.U. Città della Salute e della Scienza di Torino, Università di Medicina, 10126 Torino, Italy
| | - Antonio Craxì
- Dipartimento Biomedico di Medicina Interna e Specialistica - Reparto di Gastroenterologia, Azienda Ospedaliera Universitaria Policlinico P. Giaccone, 90127 Palermo, Italy
| | - Giovanni Battista Gaeta
- Dipartimento Salute Mentale e Fisica, UOC Malattie Infettive, Università degli Studi della Campania "Luigi Vanvitelli", 80138 Napoli, Italy
| | - Massimo Galli
- Dip. Scienze Biomediche e Cliniche L. Sacco - UNIMI, III Divisione Malattie Infettive, ASST Fatebenefratelli Sacco, 20131 Milano, Italy
| | - Antonio Gasbarrini
- UOC Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Roma, Italy
| | - Alessia Giorgini
- Dipartimento di Malattie Epatologiche, Gastroenterologiche e Metaboliche, Reparto U.O di Epatologia e Gastroenterologia, ASST Santi Paolo e Carlo, 20142 Milano, Italy
| | - Elisabetta Grilli
- Dipartimento Clinico UOC Immunodeficienze Virali, INMI Lazzaro Spallanzani IRCCS, 00149 Roma, Italy
| | - Pietro Lampertico
- CRC "A. M. and A. Migliavacca" Center for the Study of Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Disease, Sapienza University of Rome, Polo Pontino, SM Goretti Hospital, 04100 Latina, Italy
| | - Michele Milella
- DIMO - U.O.C. di Malattie Infettive, Azienda Universitaria Ospedaliera Consorziale-Policlinico Bari, 70124 Bari, Italy
| | - Filomena Morisco
- Dipartimento di Medicina Clinica e Chirurgica, UOC di Gastroenterologia ed Epatologia, Università Federico II, 80138 Napoli, Italy
| | - Marcello Persico
- Dipartimento di Medicina Clinica Medica, Epatologica e Lungodegenza, AOU OO. RR. San Giovanni di Dio Ruggi e D'Aragona, 84131 Salerno, Italy
| | - Mario Pirisi
- Università del Piemonte Orientale, Dipartimento di Medicina Traslazionale, 28100 Novara, Italy
| | - Massimo Puoti
- Dipartimento Medico Polispecialistico - SC Malattie Infettive - ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
| | - Giovanni Raimondo
- Dipartimento di Medicina Clinica e Sperimentale, UOC di Epatologia Clinica e Biomolecolare, Università ed AOU di Messina, 98125 Messina, Italy
| | - Antonietta Romano
- Dipartimento di Medicina (DIMED) UOC Clinica Medica 5, A. O. Di Padova, 35128 Padova, Italy
| | - Maurizio Russello
- Dipartimento Medicina Interna, UOSD Epatologia, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi - Presidio Ospedaliero Garibaldi-Nesima, 95122 Catania, Italy
| | | | - Monica Schiavini
- 1° Divisione di Malattie Infettive, ASST-FBF- Sacco, 20131 Milano, Italy
| | - Gaetano Serviddio
- Unità Universitaria di Epatologia, OORR Ospedali Riuniti - Università degli Studi di Foggia, 71122 Foggia, Italy
| | - Erica Villa
- UC Gastroenterologia, Dipartimento di Specialità Mediche, Azienda Ospedaliera Universitaria di Modena, 41125 Modena, Italy
| | - Maria Vinci
- Dipartimento Medico Polispecialistico, S.C. Epatologia e Gastroenterologia, ASST Grande Ospadale Metropolitano Niguarda, 20162 Milano, Italy
| | | | | | | | | | - Anna Linda Zignego
- Dipartimento di Medicina Sperimentale e Clinica, Centro Interdipartimentale di Epatologia Università di Firenze e C.R.I.A. MASVE AOU Careggi, Firenze, Italy.
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Ramai D, Singh J, Lester J, Khan SR, Chandan S, Tartaglia N, Ambrosi A, Serviddio G, Facciorusso A. Systematic review with meta-analysis: bariatric surgery reduces the incidence of hepatocellular carcinoma. Aliment Pharmacol Ther 2021; 53:977-984. [PMID: 33721336 DOI: 10.1111/apt.16335] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Obesity is a risk factor for non-alcoholic steatohepatitis (NASH) and increases the risk of several cancer types including cancers of the liver. Bariatric surgery can provide durable weight loss, but little is known about the later development of hepatocellular carcinoma (HCC) after surgery. AIM To determine whether bariatric surgery reduces the risk of HCC. METHODS We performed a comprehensive literature search of major databases (from inception to November 2020) to identify studies which assess the incidence and risk of HCC following bariatric surgery. Pooled data were assessed using a random-effects model expressed in terms of odds ratio (OR), incidence rate ratio and 95% confidence interval (CI). RESULTS Nine studies (two abstracts and seven full texts) were included for meta-analysis which involved 19 514 750 patients (18 423 546 controls and 1 091 204 bariatric patients). Pooled unadjusted odds ratio (OR) was 0.40 (95% CI: 0.28-0.57) which favoured bariatric surgery, though with high heterogeneity (I2 : 79%). Using an adjusted model derived from matched cohorts (five studies) yielded an OR of 0.63 (95% CI: 0.53-0.75) with moderate heterogeneity (I2 : 38%). The pooled rate/1000 person-years was 0.05 (95% CI: 0.02-0.07) in bariatric surgery patients and 0.34 (95% CI: 0.20-0.49) in the control group with an incidence rate ratio of 0.28 (95% CI: 0.18-0.42). CONCLUSION Bariatric surgery is associated with a decreased risk of HCC.
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Affiliation(s)
- Daryl Ramai
- Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA
| | - Jameel Singh
- Department of Internal Medicine, Mather Hospital, Northwell Health, Port Jefferson, NY, USA
| | - Janice Lester
- Health Science Library, Long Island Jewish Medical Center, Northwell Health, New Hyde Park, NY, USA
| | - Shahab R Khan
- Division of Gastroenterology, Rush University Medical Center, Chicago, IL, USA
| | - Saurabh Chandan
- Division of Gastroenterology & Hepatology, CHI Health Creighton University Medical Center, Omaha, NE, USA
| | - Nicola Tartaglia
- General Surgery Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Ambrosi
- General Surgery Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Hepatology Unit, Centro C.U.R.E., Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Facciorusso
- Section of Gastroenterology, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy
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Facciorusso A, Tartaglia N, Villani R, Serviddio G, Ramai D, Mohan BP, Chandan S, Abd El Aziz MA, Evangelista J, Cotsoglou C, Ambrosi A. Lenvatinib versus sorafenib as first-line therapy of advanced hepatocellular carcinoma: a systematic review and meta-analysis. Am J Transl Res 2021; 13:2379-2387. [PMID: 34017396 PMCID: PMC8129234] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
There is limited evidence on the efficacy of lenvatinib in advanced hepatocellular carcinoma (HCC) patients. Aim of this meta-analysis was to compare lenvatinib and sorafenib as first-line treatment. Computerized bibliographic search was performed on main databases through November 2020. The primary outcome was overall survival, whereas survival rate (at 1-, and 2-year), progression-free survival (PFS), tumor response, and severe adverse event rate were the secondary outcomes. Results were expressed in terms of odds ratio (OR) or hazard ratio (HR) and 95% confidence interval (CI). Five studies enrolling 1481 patients were included. No difference in terms of overall survival was detected (HR 0.81, 0.58-1.11) and median survival was 13.4 months (9.38-17.48) in lenvatinib and 11.4 months (8.46-14.47) in sorafenib patients. Lenvatinib led to a significant improvement of PFS (HR 0.67, 0.48-0.94) and median PFS was 5.88 months (3.68-8) in lenvatinib and 4.17 months (3.08-5.25) in sorafenib patients. Lenvatinib determined a considerably higher rate of objective response (33.3%, 23.6%-43% versus 6.5%, 3.5%-9.5%; OR 7.70, 2.99-19.82), and of disease control rate (76.9%, 70.4%-83.5% versus 52.7%, 40.7%-64.6%; OR 2.41, 1.55-3.77). No difference between lenvatinib and sorafenib in terms of severe adverse event rate was observed (OR 1.31, 0.82-2.09). Lenvatinib prolongs progression-free survival as compared to sorafenib in HCC patients, although this result does not translate to a significant survival benefit.
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Affiliation(s)
- Antonio Facciorusso
- Department of Surgical and Medical Sciences, Gastroenterology Unit, University of FoggiaFoggia 71122, Italy
| | - Nicola Tartaglia
- Department of Surgical and Medical Sciences, General Surgery Unit, University of FoggiaFoggia 71122, Italy
| | - Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of FoggiaFoggia 71122, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Department of Medical and Surgical Sciences, University of FoggiaFoggia 71122, Italy
| | - Daryl Ramai
- Gastroenterology and Hepatology, Brooklyn Hospital Medical CenterBrooklyn, NY, USA
| | - Babu P Mohan
- Gastroenterology & Hepatology, University of Utah HealthSalt Lake City, Utah, USA
| | - Saurabh Chandan
- Gastroenterology Unit, CHI Health Creighton University Medical CenterOmaha, NE, USA
| | | | - Jessica Evangelista
- Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCSRome 00168, Italy
| | | | - Antonio Ambrosi
- Department of Surgical and Medical Sciences, General Surgery Unit, University of FoggiaFoggia 71122, Italy
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50
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Villani R, Cavallone F, Sangineto M, Fioravanti G, Romano AD, Serviddio G. Management of intermediate-stage hepatocellular carcinoma in the elderly with transcatheter arterial chemoembolization failure: Retreatment or switching to systemic therapy? Int J Clin Pract 2021; 75:e13733. [PMID: 32981175 DOI: 10.1111/ijcp.13733] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/18/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Transcatheter Arterial chemoembolization (TACE) is the first-line option for the intermediate-stage hepatocellular carcinoma. Guidelines do not define the number of TACE sessions to be repeated before stopping treatment and switching to sorafenib. METHODS We retrospectively analysed 76 patients aged ≥65 years who were treated by multiple TACE sessions (re-TACE group; N = 36 patients) or one TACE session followed by sorafenib (TACE/Sorafenib group; N = 40 patients). The primary outcome was the overall survival (Kaplan-Meier analysis and log-rank test). RESULTS Median overall survival was 320 days (range: 70-420 days) in re-TACE subgroup and 285 days (range: 50-368 days) in TACE/Sorafenib subgroup without significant differences between the two groups (log-rank test P = .72; HR = 0.87; 95% IC 0.41-1.87). The survival rate at one year was 43.6% and 32% in the re-TACE and in the TACE/sorafenib groups (P = .12), respectively. Subgroup analysis by gender, number of nodules at baseline and etiology of liver cirrhosis was performed but no differences were found. No statistical difference was observed in the frequency of side effects, but sorafenib was associated with severe diarrhoea in most patients requiring dose reduction. CONCLUSION In our study including HCC patients aged ≥65 years, no differences in survival rate and side effects were found between patients Retreated with further TACE sessions and patients with treatment stage migration to sorafenib after first TACE failure. We included in our analysis a small study population; therefore, larger prospective studies are needed to confirm these findings.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Cavallone
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Moris Sangineto
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gilda Fioravanti
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonino Davide Romano
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Centre for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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