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Annunziata A, Fiorentino G, Balestrino M, Rega R, Spinelli S, Atripaldi L, Sola A, Massaro F, Calabrese C. Alpha-1 Antitrypsin PI M Heterozygotes with Rare Variants: Do They Need a Clinical and Functional Follow-Up? J Clin Med 2024; 13:1084. [PMID: 38398397 PMCID: PMC10889345 DOI: 10.3390/jcm13041084] [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: 12/31/2023] [Revised: 01/31/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Few data are available on the risk of airway dysfunction in protease inhibitor (PI*) M heterozygotes carrying rare null or deficient allelic variants of the gene SERPINA-1 (PI*MR). (2) Methods: In this observational study, in a cohort of PI*MR heterozygotes, we evaluated respiratory functional parameters at baseline and at one-year follow-up. Moreover, we compared such parameters with those of the PI*MZ and PI*MS patients. (3) Results: A total of 60 patients were recruited; 35 PI*MR, 11 PI*MZ and 14 PI*MS. At the annual follow-up, the PI*MR and PI*MZ patients demonstrated a significantly higher FEV1 decline than the PI*MS group (p = 0.04 and p = 0.018, respectively). The PI*MR patients showed a significant increase in DLCO annual decline in comparison with the PI*MS group (p = 0.02). At baseline, the PI*MR smoking patients, compared with nonsmokers, showed statistically significant lower values of FEV1, FEV1/FVC and DLCO (p = 0.0004, p < 0.0001, p = 0.007, respectively) and, at the one-year follow-up, they displayed a significantly higher FEV1 and DLCO decline (p = 0.0022, p = 0.011, respectively). PI*MR heterozygotes with COPD showed a significantly higher FEV1, FEV1/FVC and DLCO annual decline in comparison with healthy PI*MR (p = 0.0083, p = 0.043, p = 0.041). (4) Conclusions: These results suggest that PI*MR heterozygotes, particularly smokers with COPD, have a greater annual decline in respiratory functional parameters and need to be monitored.
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Affiliation(s)
- Anna Annunziata
- Department of Intensive Care, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Giuseppe Fiorentino
- Department of Intensive Care, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Marco Balestrino
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Roberto Rega
- Department of Intensive Care, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Sara Spinelli
- Department of Intensive Care, Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Lidia Atripaldi
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Alessio Sola
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Federica Massaro
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
| | - Cecilia Calabrese
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Azienda Ospedaliera di Rilievo Nazionale dei Colli, 80131 Naples, Italy
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2
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Valentino MR, Annunziata A, Atripaldi L, Fiorentino G. An unusual way to improve lung function in congenital myopathies: the power of singing. Acta Myol 2023; 42:86-88. [PMID: 38090546 PMCID: PMC10712659 DOI: 10.36185/2532-1900-357] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023]
Abstract
Congenital myopathies (CMs) are a clinically and genetically heterogeneous group of disorders characterized by early onset weakness, hypotonia and characteristic structural abnormalities in muscle fibres. Hypotonia and weakness can be present at birth or appear in infancy, and a static or slowly progressive clinical course may present with muscle weakness, loss of spontaneous movement, involuntary muscle activity, and muscle atrophy. Often patients develop a restrictive syndrome and respiratory failure and require respiratory support In our case, we described lung improvement and respiratory muscle training due to singing in a young patient, affected by CMs with a poor adherence to non-invasive mechanical ventilation.
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Affiliation(s)
| | - Anna Annunziata
- UOC Malattie, Fisiopatologia e Riabilitazione dell’Apparato Respiratorio, Monaldi Hospital, Naples, Italy
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3
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Nardelli C, Scaglione GL, Testa D, Setaro M, Russo F, Di Domenico C, Atripaldi L, Zollo M, Corrado F, Salvatore P, Pinchera B, Gentile I, Capoluongo E. Nasal Microbiome in COVID-19: A Potential Role of Corynebacterium in Anosmia. Curr Microbiol 2023; 80:53. [PMID: 36583787 PMCID: PMC9802018 DOI: 10.1007/s00284-022-03106-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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/31/2022] [Indexed: 12/31/2022]
Abstract
The evolution and the development of the symptoms of Coronavirus disease 19 (COVID-19) are due to different factors, where the microbiome plays a relevant role. The possible relationships between the gut, lung, nasopharyngeal, and oral microbiome with COVID-19 have been investigated. We analyzed the nasal microbiome of both positive and negative SARS-CoV-2 individuals, showing differences in terms of bacterial composition in this niche of respiratory tract. The microbiota solution A (Arrow Diagnostics) was used to cover the hypervariable V1-V3 regions of the bacterial 16S rRNA gene. MicrobAT Suite and MicrobiomeAnalyst program were used to identify the operational taxonomic units (OTUs) and to perform the statistical analysis, respectively. The main taxa identified in nasal microbiome of COVID-19 patients and in Healthy Control subjects belonged to three distinct phyla: Proteobacteria (HC = 14%, Cov19 = 35.8%), Firmicutes (HC = 28.8%, Cov19 = 30.6%), and Actinobacteria (HC = 56.7%, Cov19 = 14.4%) with a relative abundance > 1% in all groups. A significant reduction of Actinobacteria in Cov19 group compared to controls (P < 0.001, FDR = 0.01) was found. The significant reduction of Actinobacteria was identified in all taxonomic levels down to the genus (P < 0.01) using the ANOVA test. Indeed, a significantly reduced relative abundance of Corynebacterium was found in the patients compared to healthy controls (P = 0.001). Reduced abundance of Corynebacterium has been widely associated with anosmia, a common symptom of COVID-19 as suffered from our patients. Contrastingly, the Corynebacterium genus was highly represented in the nasal mucosa of healthy subjects. Further investigations on larger cohorts are necessary to establish functional relationships between nasal microbiota content and clinical features of COVID-19.
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Affiliation(s)
- Carmela Nardelli
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
- Task Force On Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Giovanni Luca Scaglione
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
- Istituto Dermopatico Dell'Immacolata IDI-IRCSS, Rome, Italy
| | - Domenico Testa
- Department of Otorhinolaryngology, Luigi Vanvitelli University of Naples, Naples, Italy
| | - Mario Setaro
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
| | - Filippo Russo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
| | | | - Lidia Atripaldi
- Clinical Biochemistry Unit, AORN Ospedale Dei Colli, Naples, Italy
| | - Massimo Zollo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
| | - Federica Corrado
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
- CEINGE Biotecnologie Avanzate S.C.a R.L., Naples, Italy
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Ettore Capoluongo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.
- Department of Clinical Pathology and Genomics, Azienda Ospedaliera Per L'Emergenza Cannizzaro, Catania, Italy.
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Calabrese C, Annunziata A, Mariniello DF, Coppola A, Mirizzi AI, Simioli F, Pelaia C, Atripaldi L, Pugliese G, Guarino S, Fiorentino G. Evolution of the Clinical Profile and Outcomes of Unvaccinated Patients Affected by Critical COVID-19 Pneumonia from the Pre-Vaccination to the Post-Vaccination Waves in Italy. Pathogens 2022; 11:pathogens11070793. [PMID: 35890037 PMCID: PMC9323253 DOI: 10.3390/pathogens11070793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/04/2023] Open
Abstract
The vaccination campaign and the new SARS-CoV-2 variants may have changed the clinical profile and outcomes of patients admitted to sub-intensive unit care. We conducted a retrospective study aimed to compare the clinical and radiological features of unvaccinated critical COVID-19 patients hospitalized during the last pandemic wave (December 2021−February 2022, No-Vax group) and before starting the vaccination campaign (March−December 2020, Pre-Vax group). The No-Vax group was also compared with vaccinated patients of the same pandemic wave (Vax group). With respect to the Pre-Vax group, the No-Vax group contained a higher percentage of smokers (p = 0.0007) and a lower prevalence of males (p = 0.0003). At admission, the No-Vax patients showed both a higher CT score of pneumonia and a worse severe respiratory failure (p < 0.0001). In the No-Vax group, a higher percentage of deaths occurred, though this was not significant. In comparison with the No-Vax group, the Vax patients were older (p = 0.0097), with a higher Charlson comorbidity index (p < 0.0001) and a significantly lower HRCT score (p = 0.0015). The percentage of deaths was not different between the two groups. The No-Vax patients showed a more severe disease in comparison with the Pre-Vax patients, and were younger and had fewer comorbidities than the Vax patients.
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Affiliation(s)
- Cecilia Calabrese
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
- Correspondence:
| | - Anna Annunziata
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Domenica Francesca Mariniello
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Antonietta Coppola
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Angela Irene Mirizzi
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Francesca Simioli
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
| | - Corrado Pelaia
- Respiratory Medicine Unit, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy;
| | - Lidia Atripaldi
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Gaia Pugliese
- Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (D.F.M.); (L.A.); (G.P.)
| | - Salvatore Guarino
- Department of Radiology, Monaldi Hospital, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy;
| | - Giuseppe Fiorentino
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, 80131 Napoli, Italy; (A.A.); (A.C.); (A.I.M.); (F.S.); (G.F.)
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Fusco F, Scognamiglio G, Merola A, Roma AS, Nicastro C, Spatarella M, D'Abbraccio M, Di Mauro G, Atripaldi U, Atripaldi L, Correra A, Palma M, Barracano R, Borrelli N, Capuano A, Sarubbi B. COVID-19 vaccination in adults with congenital heart disease: Real-world data from an Italian tertiary centre. Int J Cardiol Congenit Heart Dis 2021; 6:100266. [PMID: 35360668 PMCID: PMC8552781 DOI: 10.1016/j.ijcchd.2021.100266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/25/2021] [Indexed: 11/01/2022] Open
Abstract
Background real-world data on COVID-19 vaccine safety, immunogenicity and acceptance in adults with congenital heart disease (ACHD) are lacking. Methods ACHD patients who were offered COVID-19 vaccination from January to June 2021 were included. Data on adverse events, on patients' attitude towards vaccination and antispike IgG titre were retrospectively collected. A group of healthy individuals with similar age and sex undergoing vaccination was included for comparison. Results 208 patients followed in a single ACHD tertiary centre (33.3 [26-45] years, 54% male) received COVID-19 vaccine, 65% vaccinated at our institution: 199 (96%) received Pfizer-BioNTech BNT162b2 vaccine, 4 (2%) Moderna-1273 and 5 (2%) AstraZeneca-ChAdOx1. Median follow-up after vaccination was 79 [57-96] days. No major adverse event was reported and the incidence of minor events was not different between ACHD patients and the control group. One patient was diagnosed with acute pericarditis. There were two deaths unrelated to the vaccine during follow-up. Three (1.5%) vaccinated patients tested positive for COVID-19. Antispike IgG titre, available in 159 (76%) patients, was 1334 [600-3401] BAU/ml, not significantly different from the control group (p=0.2). One patient with Fontan failure was seronegative. Advanced physiological stage was associated with lower antibody response, independently from previous viral exposure (p<0.0001). Fourteen percent refused COVID-19 vaccination at our institution. However, 50% of vaccinated patients declared to have been influenced by the discussion with the ACHD cardiologist and 66% of those vaccinated in situ reported that undergoing COVID-19 vaccination at the ACHD centre made them feel safer. Conclusion COVID-19 vaccines appear safe in ACHD with satisfactory immunogenicity. However, the most vulnerable patients showed lower antibody response. ACHD team may play a key role in vaccine acceptance.
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Affiliation(s)
- Flavia Fusco
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Assunta Merola
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Anna Selvaggia Roma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Carmine Nicastro
- Department for Laboratory Medicine, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Maurizio D'Abbraccio
- Vaccination Unit for Vulnerable Patients, AORN dei Colli - Cotugno Hospital, Naples, Italy
| | - Gabriella Di Mauro
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Umberto Atripaldi
- Department for Laboratory Medicine, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Lidia Atripaldi
- Department for Laboratory Medicine, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Anna Correra
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Michela Palma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Rosaria Barracano
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Nunzia Borrelli
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Annalisa Capuano
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Berardo Sarubbi
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Madonna G, Sale S, Capone M, De Falco C, Santocchio V, Di Matola T, Fiorentino G, Pirozzi C, D’Antonio A, Sabatino R, Atripaldi L, Atripaldi U, Raffone M, Curvietto M, Grimaldi AM, Vanella V, Festino L, Scarpato L, Palla M, Spatarella M, Perna F, Cerino P, Botti G, Parrella R, Montesarchio V, Ascierto PA, Atripaldi L. Clinical Outcome Prediction in COVID-19 Patients by Lymphocyte Subsets Analysis and Monocytes' iTNF-α Expression. Biology (Basel) 2021; 10:735. [PMID: 34439967 PMCID: PMC8389652 DOI: 10.3390/biology10080735] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 12/24/2022]
Abstract
In December 2019, a novel coronavirus, "SARS-CoV-2", was recognized as the cause of coronavirus disease 2019 (COVID-19). Several studies have explored the changes and the role of inflammatory cells and cytokines in the immunopathogenesis of the disease, but until today, the results have been controversial. Based on these premises, we conducted a retrospective assessment of monocyte intracellular TNF-α expression (iTNF-α) and on the frequencies of lymphocyte sub-populations in twenty-five patients with moderate/severe COVID-19. We found lymphopenia in all COVID-19 infected subjects compared to healthy subjects. On initial observation, in patients with favorable outcomes, we detected a high absolute eosinophil count and a high CD4+/CD8+ T lymphocytes ratio, while in the Exitus Group, we observed high neutrophil and CD8+ T lymphocyte counts. During infection, in patients with favorable outcomes, we observed a rise in the lymphocyte count, in the monocyte and in Treg lymphocyte counts, and in the CD4+ and in CD8+ T lymphocytes count but a reduction in the CD4+/CD8+ T lymphocyte ratio. Instead, in the Exitus Group, we observed a reduction in the Treg lymphocyte counts and a decrease in iTNF-α expression. Our preliminary findings point to a modulation of the different cellular mediators of the immune system, which probably play a key role in the outcomes of COVID-19.
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Affiliation(s)
- Gabriele Madonna
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Silvia Sale
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Mariaelena Capone
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Chiara De Falco
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Valentina Santocchio
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Tiziana Di Matola
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Giuseppe Fiorentino
- UOC Fisiopatologia e Riabilitazione Respiratoria, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy;
| | - Caterina Pirozzi
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Anna D’Antonio
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Rocco Sabatino
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
| | - Lidia Atripaldi
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.A.); (U.A.)
| | - Umberto Atripaldi
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.A.); (U.A.)
| | - Marcello Raffone
- UOC Microbiologia e Virologia, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy;
| | - Marcello Curvietto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Antonio Maria Grimaldi
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Vito Vanella
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Lucia Festino
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Luigi Scarpato
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Marco Palla
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Michela Spatarella
- UOSD di Farmacia, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy;
| | - Francesco Perna
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy;
| | - Pellegrino Cerino
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, 80055 Portici, Italy;
| | - Gerardo Botti
- Scientific Direction, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy;
| | - Roberto Parrella
- UOC Malattie Infettive ad Indirizzo Respiratorio, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy;
| | | | - Paolo Antonio Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy; (G.M.); (M.C.); (M.C.); (A.M.G.); (V.V.); (L.F.); (L.S.); (M.P.)
| | - Luigi Atripaldi
- UOC Biochimica Clinica, AORN Ospedali dei Colli—Monaldi—Cotugno—CTO, 80131 Napoli, Italy; (S.S.); (C.D.F.); (V.S.); (T.D.M.); (C.P.); (A.D.); (R.S.); (L.A.)
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Perna F, Bruzzaniti S, Piemonte E, Maddaloni V, Atripaldi L, Sale S, Sanduzzi A, Nicastro C, Pepe N, Bifulco M, Matarese G, Galgani M, Atripaldi L. Serum levels of SARS-CoV-2 nucleocapsid antigen associate with inflammatory status and disease severity in COVID-19 patients. Clin Immunol 2021; 226:108720. [PMID: 33819577 PMCID: PMC8017913 DOI: 10.1016/j.clim.2021.108720] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Francesco Perna
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Naples, Italy,Corresponding author
| | - Sara Bruzzaniti
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy,Dipartimento di Biologia, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Erica Piemonte
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Valeria Maddaloni
- UOC Biochimica Clinica, AORN Ospedale dei Colli, Ospedale Monaldi, Naples, Italy
| | - Lidia Atripaldi
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi della Campania “Vanvitelli”, Naples, Italy
| | - Silvia Sale
- UOC Biochimica Clinica, AORN Ospedale dei Colli, Ospedale Monaldi, Naples, Italy
| | - Alessandro Sanduzzi
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Carmine Nicastro
- UOC Biochimica Clinica, AORN Ospedale dei Colli, Ospedale Monaldi, Naples, Italy
| | - Nicola Pepe
- UOC Biochimica Clinica, AORN Ospedale dei Colli, Ospedale Monaldi, Naples, Italy
| | - Maurizio Bifulco
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Giuseppe Matarese
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, Naples, Italy
| | - Mario Galgani
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, Naples, Italy,Corresponding author at: Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy, Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli studi di Napoli Federico II, Italy
| | - Luigi Atripaldi
- UOC Biochimica Clinica, AORN Ospedale dei Colli, Ospedale Monaldi, Naples, Italy
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Scotto R, Pinchera B, Perna F, Atripaldi L, Giaccone A, Sequino D, Zappulo E, Sardanelli A, Schiano Moriello N, Stanziola A, Bocchino M, Gentile I, Sanduzzi A. Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia. Int J Environ Res Public Health 2021; 18:ijerph18042078. [PMID: 33672761 PMCID: PMC7924557 DOI: 10.3390/ijerph18042078] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 01/08/2023]
Abstract
KL-6 is a sialoglycoprotein antigen which proved elevated in the serum of patients with different interstitial lung diseases, especially in those with a poorer outcome. Given that interstitial pneumonia is the most common presentation of SARS-CoV2 infection, we evaluated the prognostic role of KL-6 in patients with COVID-19 pneumonia. Patients with COVID-19 pneumonia were prospectively enrolled. Blood samples were collected at the time of enrolment (TOE) and on day 7 (T1). Serum KL-6 concentrations were measured by chemiluminescence enzyme immunoassay using a KL-6 antibody kit (LUMIPULSE G1200, Fujirebio) and the cut-off value was set at >1000 U/mL. Fifteen out of 34 enrolled patients (44.1%) died. Patients with unfavourable outcome showed significantly lower P/F ratio and higher IL-6 values and plasmatic concentrations of KL-6 at TOE compared with those who survived (median KL-6: 1188 U/mL vs. 260 U/mL, p < 0.001). KL-6 > 1000 U/mL resulted independently associated with death (aOR: 11.29, p < 0.05) with a positive predictive value of 83.3%. Our results suggest that KL-6 is a reliable indicator of pulmonary function and unfavourable outcome in patients with COVID-19 pneumonia. A KL-6 value > 1000 U/mL resulted independently associated with death and showed good accuracy in predicting a poorer outcome. KL-6 may thus represent a quick, inexpensive, and sensitive parameter to stratify the risk of severe respiratory failure and death.
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Affiliation(s)
- Riccardo Scotto
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
| | - Biagio Pinchera
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
- Correspondence:
| | - Francesco Perna
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (D.S.); (A.S.); (M.B.); (A.S.)
| | - Lidia Atripaldi
- Laboratory of Clinical Biochemistry, Monaldi Hospital, 80131 Naples, Italy;
| | - Agnese Giaccone
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
| | - Davide Sequino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (D.S.); (A.S.); (M.B.); (A.S.)
| | - Emanuela Zappulo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
| | - Alessia Sardanelli
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
| | - Nicola Schiano Moriello
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
| | - Anna Stanziola
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (D.S.); (A.S.); (M.B.); (A.S.)
| | - Marialuisa Bocchino
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (D.S.); (A.S.); (M.B.); (A.S.)
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (R.S.); (A.G.); (E.Z.); (A.S.); (N.S.M.); (I.G.)
- Staff of United Nations Educational, Scientific and Cultural Organization (UNESCO), Health Education and Sustainable Development, University Federico II of Naples, 80131 Naples, Italy
| | - Alessandro Sanduzzi
- Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy; (F.P.); (D.S.); (A.S.); (M.B.); (A.S.)
- Staff of United Nations Educational, Scientific and Cultural Organization (UNESCO), Health Education and Sustainable Development, University Federico II of Naples, 80131 Naples, Italy
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9
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Cirillo M, Palladino R, Ciacci C, Atripaldi L, Fumo MG, Giordana R, Triassi M. Kidney Replacement Treatment in South-Western Italy (Campania): Population-Based Study on Gender and Residence Inequalities in Health Care Access. J Clin Med 2021; 10:jcm10030449. [PMID: 33498891 PMCID: PMC7865879 DOI: 10.3390/jcm10030449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to investigate the epidemiology of kidney replacement treatment (KRT) in Italy with a focus on gender and residence. As a population-based study using administrative databases from the Campania region of Italy between 2015 and 2018, the study outcomes included diagnoses of haemodialysis, peritoneal dialysis, kidney transplant, and mortality. A total of 11,713 residents in Campania were on KRT from 2015 to 2018. The annual prevalence ranged between 1000 and 1015 patients per million population (pmp) for haemodialysis, between 115 and 133 pmp for peritoneal dialysis, and between 2081 and 2245 pmp for kidney transplant. The annual incidence ranged between 160 and 185 pmp for de novo haemodialysis and between 59 and 191 pmp for kidney transplant. Annual mortality ranged between 12.8% and 14.2% in haemodialysis, between 5.2% and 13.8% in peritoneal dialysis, and between 2.4% and 3.3% in kidney transplant. In Cox regression targeting mortality, significant HRs were found for age (95%CI = 1.05/1.05), kidney transplant (compared to haemodialysis: 0.37/0.47), residence in suburban areas (1.03/1.24), and de novo dialysis incidence in years 2015–2018 (1.01/1.17). The annual rate of kidney transplant was 2.6%. In regression targeting kidney transplant rate, significant HRs were found for female gender (0.67/0.92), age (0.93/0.94), residence in suburban areas (0.65/0.98), and de novo incidence of dialysis in 2015–2018 (0.49/0.71). The existence of socioeconomic inequities in KRT is suggested by the evidence that gender and suburban residence predicted mortality and/or access to kidney transplant.
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Affiliation(s)
- Massimo Cirillo
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy; (M.C.); (M.T.)
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy; (M.C.); (M.T.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College of London, London W6 8RP, UK
- Correspondence:
| | - Carolina Ciacci
- Department ‘Scuola Medica Salernitana’, University of Salerno, 84081 Baronissi, Italy;
| | - Lidia Atripaldi
- Clinical Biochemistry Unit, AORN Ospedale dei Colli, 80131 Naples, Italy;
| | - Maria Grazia Fumo
- Regional Healthcare Society (So.Re.Sa), 80143 Naples, Italy; (M.G.F.); (R.G.)
| | - Roberta Giordana
- Regional Healthcare Society (So.Re.Sa), 80143 Naples, Italy; (M.G.F.); (R.G.)
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy; (M.C.); (M.T.)
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
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10
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Fusco FM, Pisaturo M, Iodice V, Bellopede R, Tambaro O, Parrella G, Di Flumeri G, Viglietti R, Pisapia R, Carleo MA, Boccardi M, Atripaldi L, Chignoli B, Maturo N, Rescigno C, Esposito V, Dell'Aversano R, Sangiovanni V, Punzi R. COVID-19 among healthcare workers in a specialist infectious diseases setting in Naples, Southern Italy: results of a cross-sectional surveillance study. J Hosp Infect 2020; 105:596-600. [PMID: 32565367 PMCID: PMC7301109 DOI: 10.1016/j.jhin.2020.06.021] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023]
Abstract
A coronavirus disease 2019 (COVID-19) surveillance study was performed in March–April 2020 among asymptomatic healthcare workers (HCWs) at a specialist infectious diseases hospital in Naples, Italy. All HCWs underwent two rounds of molecular and serological testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). One hundred and fifteen HCWs were tested; of these, two cases of infection were identified by reverse transcriptase polymerase chain reaction and two HCWs were SARS-CoV-2 immunoglobulin G seropositive. The overall prevalence of current or probable previous infection was 3.4%. The infection rate among HCWs was reasonably low. Most of the infected HCWs had been asymptomatic for the preceding 30 days, which supports the need for periodic screening of HCWs for COVID-19.
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Affiliation(s)
- F M Fusco
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy.
| | - M Pisaturo
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Iodice
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Bellopede
- UOC Pronto Soccorso Infettivologico ed Accettazione, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - O Tambaro
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - G Parrella
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - G Di Flumeri
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Viglietti
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Pisapia
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - M A Carleo
- UOC Immunodeficienze e Malattie Infettive di Genere, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - M Boccardi
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - L Atripaldi
- UOC Microbiologia e Virologia, AORN Ospedali dei Colli, P.O. Monaldi, Naples, Italy
| | - B Chignoli
- UOSD Medicina del Lavoro, AORN Ospedali dei Colli, Naples, Italy
| | - N Maturo
- UOC Pronto Soccorso Infettivologico ed Accettazione, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - C Rescigno
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Esposito
- UOC Immunodeficienze e Malattie Infettive di Genere, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Dell'Aversano
- UOC Direzione Medica di Ospedale, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Sangiovanni
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Punzi
- UOC Malattie Infettive ed Urgenze Infettivologiche, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
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Perrella A, Sbreglia C, D'Antonio A, Atripaldi L, Perrella O. Fosamprenavir treatment in a highly active antiretroviral therapy schedule induces a HCV-RNA decrease and a Th1 network boost in HIV/HCV-coinfected patients. Clin Microbiol Infect 2010; 16:676-8. [PMID: 19681945 DOI: 10.1111/j.1469-0691.2009.02897.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A Perrella
- Department of Infectious Disease and Immunology, Hospital D.Cotugno Naples, Naples, Italy.
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12
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Perrella A, Sbreglia C, Atripaldi L, Esposito C, D'Antonio A, Perrella O. Rapid virological response in peripheral blood mononuclear cells with an increase of hepatitis C virus-specific interferon-gamma production predisposes to sustained virological response in patients with chronic hepatitis C genotype 1 undergoing treatment with pegylated-interferon alpha 2a plus ribavirin. Scand J Gastroenterol 2010; 45:250-5. [PMID: 19968615 DOI: 10.3109/00365520903428614] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Viral load evaluation in plasma, after 1 month of treatment, represents one of the most important parameters to predict treatment response during interferon (IFN) treatment in chronic hepatitis C (CHC). It has been proven that hepatitis C virus (HCV) RNA may be present in peripheral blood mononuclear cells (PBMCs) but few studies have investigated the viral load in PBMCs during treatment. The aim of this study was to evaluate HCV RNA in PBMCs during therapy with pegylated-IFN-alpha2a plus ribavirin and whether its clearance in PBMCs may induce a treatment response. Furthermore, we also analyzed the IFN-gamma and interleukin (IL)-4 responses of PBMCs during therapy. MATERIAL AND METHODS We studied 35 patients with CHC genotype 1 undergoing antiviral treatment with pegylated IFN-alpha2a 180 microg weekly plus ribavirin 1000 mg/daily. In these patients we evaluated HCV-RNA in plasma and PBMCs, IFN-gamma and IL-4 before treatment, after 1, 3 and 12 months of treatment and 6 months after the end of treatment. RESULTS We found that rapid virological clearance of HCV-RNA in PBMCs with a restored and improved HCV-specific IFN-gamma response was statistically significantly higher in those with a sustained virological response (SVR). CONCLUSION Patients having a rapid virological response in PBMCs with an improved Th1 network achieve a complete SVR, whereas those having viral clearance only in plasma without a restored Th1 network have a relapse.
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Affiliation(s)
- A Perrella
- Department of Infectious Disease and Immunology, Hospital D Cotugno, Naples, Italy.
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Perrella A, Arenga G, Pisaniello D, Rampone B, Di Costanzo GG, Atripaldi L, Esposito C, Di Florio E, Perrella O, Cuomo O. Elevated CD4+/CD25+ T-cell frequency and function during hepatitis C virus recurrence after liver transplantation. Transplant Proc 2009; 41:1761-6. [PMID: 19545723 DOI: 10.1016/j.transproceed.2009.01.112] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Accepted: 01/08/2009] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIM Factors involved in hepatitis C virus (HCV) recurrence versus acute cellular rejection are not fully understood. The aim of the present study was to investigate whether patients with recurrence after liver transplantation (OLT) showed similar CD4(+)/CD25(+) cell frequency and function as those who became chronically infected. PATIENTS AND METHODS After written informed consent, we enrolled 20 patients (group A) who underwent OLT with HCV recurrence within 6 months. HCV-RNA and hypertransaminasemia were used to assess the reactivation of viral hepatitis. CD4(+)/CD25(+) T cells were enumerated using a flow cytometry assay, gated on CD3 cells, stained for FoxP3. After immunomagnetic sorting (Dynal, Oslo, NW), Treg suppressor activity was measured, as the ability to inhibit proliferation of autologous CD4(+)/CD25(-) T cells (anti-CD3/CD28 stimulation-1:2, 1:20 ratio). Eight patients with acute hepatitis C who evolved to a chronic infection after 6 months (group B) were used as positive controls, while 10 healthy individuals were negative controls (group C). RESULTS We did not observe any difference in CD4(+)/CD25(+) frequency or function among group A compared with group B (CD4(+)/CD25(+) = 14% +/- 2% versus CD4(+)/CD25(+) = 16% +/- 3%), although both groups were significantly increased with respect to group A (CD4(+)/CD25(+) = 6% +/- 3%; Mann-Whitney U test, P < .01). CONCLUSION Patients developing HCV recurrence after OLT have the same immunoregulatory network as patients with acute hepatitis C evolving to persistent infection, likely suggesting that CD4(+)/CD25(+) numbers may be a marker to predict recurrence of HCV after OLT.
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Affiliation(s)
- A Perrella
- Liver Transplant Unit Hospital A. Cardarelli, Naples, Italy
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14
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Perrella O, Sbreglia C, Arenga G, Perrella A, Ferrara A, D'Antonio A, Di Costanzo G, Atripaldi L, Alone C, Sciano D, Cuomo O. Acute rejection after liver transplantation: Is there a specific immunological pattern? Transplant Proc 2007; 38:3594-6. [PMID: 17175341 DOI: 10.1016/j.transproceed.2006.10.102] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Indexed: 02/08/2023]
Abstract
The aim of the study was to assess various T-cell subsets and cytokine secretion patterns both in liver tissue and in the peripheral blood of 24 liver transplant patients to assess possible specific immunological involvement in early acute rejection episodes after liver transplantation. Particularly, we studied CD4+ CD7+, CD8+ CD38+, and CD4+ CD25+ T cells by flow cytometry, as well as contemporaneously, interleukin (IL)-2 and IL-10 secretion by ELISpot to determine possible Th1-like immune responses and the immunomodulation expressed by Treg cells in acute liver rejection, respectively. As a control group we included patients transplanted without acute rejection. Early acute rejection within the first 4 weeks was proven histologically in 42% of patients. It was associated with a greater expression of CD4+ CD7+ and CD8+ CD38+ T cells in the liver than in the blood (P < .001). A contemporaneous reduced expansion of liver Treg cells was evident in patients with acute rejection (P < .001). Our data suggested that a preferential Th1-like immune mechanism operated in local fashion as characterized by a decreased presence in the liver and blood of Treg cells.
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Affiliation(s)
- O Perrella
- Department of Laparascopic, Hepatic Surgery and Liver Transplant Unit, AORN, A. Cardarelli Hospital, Naples, Italy
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Perrella A, Vitiello L, Atripaldi L, Conti P, Sbreglia C, Altamura S, Patarino T, Vela R, Morelli G, Bellopede P, Alone C, Racioppi L, Perrella O. Elevated CD4+/CD25+ T cell frequency and function during acute hepatitis C presage chronic evolution. Gut 2006; 55:1370-1. [PMID: 16905711 PMCID: PMC1860041 DOI: 10.1136/gut.2006.099887] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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16
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Cuomo O, Sbreglia C, Militerno G, Atripaldi L, Darretta G, Perrella A, Perrella O. T-lymphocyte kinetics in acute rejection after orthotopic liver transplantation. Transplant Proc 2001; 33:3303. [PMID: 11750414 DOI: 10.1016/s0041-1345(01)02403-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- O Cuomo
- Laparoscopic, Liver and Transplantation Surgery Unit, A. Cardarelli Hospital, Naples, Italy
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17
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Perrella O, Sanduzzi A, Perrella A, Ponticiello A, D'Antonio A, Guarnaccia D, Atripaldi L, Busto A, Tartaglia G. Immune Response in Bronchoalveolar Lavage Fluid of HIV-Infected Subjects with Pneumocystis Carinii Pneumonia. Int J Immunopathol Pharmacol 1997. [DOI: 10.1177/039463209701000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - A. Sanduzzi
- Institute of Respiratory Diseases, University Federico II, Naples, Italy
| | - A. Perrella
- Institute of Respiratory Diseases, University Federico II, Naples, Italy
| | - A. Ponticiello
- Institute of Respiratory Diseases, University Federico II, Naples, Italy
| | | | | | | | - A Busto
- III Department of Infectious Diseases, Hospital “D. Cotugno”, Naples, Italy
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18
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Paolillo G, Atripaldi L, Bassano U, Di Vincenzo A, Gaio M. Angiotensin converting enzyme determination in patients with chronic heart failure. J Mol Cell Cardiol 1990. [DOI: 10.1016/0022-2828(90)91815-o] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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