1
|
D'Alessandro M, Bergantini L, Perrone A, Beltrami V, Cameli P, Flori L, Saletti M, Vietri L, Sestini P, Bargagli E. A real-life experience with ImmunoCAP ISAC: the advantages of a new diagnostic method. Minerva Med 2023; 114:94-96. [PMID: 32108456 DOI: 10.23736/s0026-4806.19.06408-5] [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] [Indexed: 11/08/2022]
Affiliation(s)
- Miriana D'Alessandro
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy -
| | - Laura Bergantini
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Anna Perrone
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Valerio Beltrami
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Paolo Cameli
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Laura Flori
- Unit of Dermatology, University Hospital of Siena, Siena, Italy
| | - Marco Saletti
- Unit of Physiopathology and Respiratory Rehabilitation, Allergy Service for Drug and Food Reactions, University Hospital of Siena, Siena, Italy
| | - Lucia Vietri
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Piersante Sestini
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| | - Elena Bargagli
- Unit of Respiratory Diseases and Lung Transplant, Department of Medical and Surgical Sciences and Neurosciences, University Hospital of Siena, Siena, Italy
| |
Collapse
|
2
|
d'Alessandro M, Vietri L, Bergantini L, Bargagli E. Author reply. Intern Med J 2021; 51:1197. [PMID: 34278697 DOI: 10.1111/imj.15406] [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: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Miriana d'Alessandro
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Lucia Vietri
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| |
Collapse
|
3
|
Bergantini L, d'Alessandro M, Cameli P, Carleo A, Landi C, Vietri L, Lanzarone N, Pieroni M, Sestini P, Bargagli E. Antithrombin III as predictive indicator of survival in idiopathic pulmonary fibrosis (IPF) patients treated with nintedanib: a preliminary study. Intern Med J 2021; 51:705-711. [PMID: 32040256 DOI: 10.1111/imj.14768] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/20/2020] [Accepted: 02/03/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease often managed with nintedanib, a tyrosine kinase inhibitor targeting several profibrotic pathways. Although clotting processes are involved in wound healing and repair in the lung, there are no data on the role of antithrombin III (ATIII) in IPF patients treated with nintedanib. A previous proteomic analysis of serum of IPF patients before and after 1 year of nintedanib treatment showed differential protein expression of ATIII. AIMS Here we used quantitative methods to evaluate differential ATIII concentrations in IPF patients before and after 1 year of nintedanib treatment and to assess the potential of ATIII as a prognostic biomarker in IPF patients. METHODS Serum levels of ATIII were measured by enzyme-linked immunosorbent assay in 14 IPF patients before and after 1 year of nintedanib treatment. RESULTS A statistically significant inverse correlation was found between serum ATIII concentrations and pulmonary function test parameters in all patients at baseline and follow up. Baseline serum ATIII and bronchoalveolar lavage (BAL) neutrophils proved to be reliable predictors of poor prognosis. A baseline ATIII threshold of 126.5 μg/mL discriminated survivors from non-survivors. CONCLUSIONS After 12 months of antifibrotic treatment, IPF patients with high serum ATIII concentrations and high BAL neutrophil percentages had a poor prognosis and increased survival risk. The results of this preliminary study suggest that ATIII has potential as a biomarker of IPF severity and in predicting response to nintedanib therapy. As a marker, ATIII showed several advantages over BAL neutrophil percentage.
Collapse
Affiliation(s)
- Laura Bergantini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Miriana d'Alessandro
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Paolo Cameli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Alfonso Carleo
- Department of Pulmonology, Hannover Medical School, Hannover, Germany
| | - Claudia Landi
- Department of Life Science, University of Siena, Siena, Italy
| | - Lucia Vietri
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Nicola Lanzarone
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Maria Pieroni
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Piersante Sestini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Elena Bargagli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| |
Collapse
|
4
|
Vietri L, Cameli P, Perruzza M, Cekorja B, Bergantini L, d'Alessandro M, Refini RM, Pieroni M, Fossi A, Bennett D, Spalletti M, Mazzei MA, Sestini P, Rottoli P, Bargagli E. Pirfenidone in idiopathic pulmonary fibrosis: real-life experience in the referral centre of Siena. Ther Adv Respir Dis 2021; 14:1753466620906326. [PMID: 32066332 PMCID: PMC7029533 DOI: 10.1177/1753466620906326] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Indexed: 11/19/2022] Open
Abstract
Background: Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonia and has a median survival after diagnosis of 2–5 years. Pirfenidone is the first approved antifibrotic drug for the treatment of IPF. Here we report the functional progress, side effects and survival data of a population of patients with IPF, diagnosed at our centre and treated with pirfenidone. Methods: We enrolled 91 patients with IPF (71 males) treated with pirfenidone. Clinical, survival and functional details were collected retrospectively at start of therapy and after 12, 24, 36 and 48 months of treatment. Lung function tests at least 12 months before starting therapy were available for 40 patients and were entered in the database, as well as side effects. Results: During the observation period (922 ± 529 days), 27 patients died, 5 patients underwent lung transplant and 10 patients interrupted therapy due to adverse events or IPF progression. The median survival was 1606 days. There was a significant reduction in disease progression rate, as measured by trend of forced vital capacity, after 1 year of therapy with respect to before treatment (p = 0.0085). Forced vital capacity reduction rate was progressively higher in the subsequent years of treatment. Treatment-related side effects were reported in 25 patients and were predominantly mild. Overall, four patients discontinued therapy due to severe photosensitivity. Conclusions: Our findings confirm the efficacy of pirfenidone in reducing functional progression of IPF and its excellent safety profile in a real-life setting. This study, designed on a long-term follow up, contributes to the growing evidence on safety, tolerability and efficacy of pirfenidone in IPF. The reviews of this paper are available via the supplemental material section.
Collapse
Affiliation(s)
- Lucia Vietri
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Paolo Cameli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, Siena, 53100, Italy
| | - Marco Perruzza
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Behar Cekorja
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Laura Bergantini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Miriana d'Alessandro
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Rosa Metella Refini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Maria Pieroni
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Antonella Fossi
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - David Bennett
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Marco Spalletti
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Maria Antonietta Mazzei
- Department of Medical and Surgical Sciences and Neurosciences, Diagnostic Imaging Unit, University of Siena, AOUS, Siena, Italy
| | - Piersante Sestini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Paola Rottoli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Elena Bargagli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| |
Collapse
|
5
|
Vietri L, d'Alessandro M, Bergantini L, Carleo A, Cameli P, Mazzei MA, Sestini P, Bargagli E. Specificity of serum amyloid A as a biomarker of idiopathic pulmonary fibrosis. Intern Med J 2021; 50:1571-1574. [PMID: 33354874 DOI: 10.1111/imj.15113] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 12/16/2022]
Abstract
Serum amyloid A (SAA) is an apo-lipoprotein produced by the liver in response to proinflammatory cytokines. Few data are available on SAA levels in patients with idiopathic pulmonary fibrosis (IPF), the most common idiopathic form of interstitial pneumonitis (ILD). This study compared SAA concentration in IPF patients to other ILD groups to explore its potential use as a clinical biomarker.
Collapse
Affiliation(s)
- Lucia Vietri
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Miriana d'Alessandro
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Alfonso Carleo
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Maria Antonietta Mazzei
- Imaging Unit, Department of Medical and Surgical Science and Neurosciences, Siena University Hospital, Siena, Italy
| | - Piersante Sestini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| |
Collapse
|
6
|
Bergantini L, Cameli P, d'Alessandro M, Vietri L, Perruzza M, Pieroni M, Lanzarone N, Refini RM, Fossi A, Bargagli E. Regulatory T Cells in Severe Persistent Asthma in the Era of Monoclonal Antibodies Target Therapies. Inflammation 2021; 43:393-400. [PMID: 31853715 DOI: 10.1007/s10753-019-01157-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Asthma is an immunoinflammatory disease characterized by bronchial hyper-reactivity to different external stimuli. New monoclonal target treatments have been developed, but few studies have investigated the role of regulatory T cells in severe asthma and the modulatory effect of biological therapy on regulatory T cell functions. Their dysfunction may contribute to the development and exacerbation of asthma. Here we review the recent literature on the potential immunological role of regulatory T cells in the pathogenesis of severe asthma. The analysis of the role of regulatory T cells was performed in terms of functions and their possible interactions with mechanisms of action of the novel treatment for severe asthma. In an era of biological therapies for severe asthma, little data is available on the potential effects of what could be a new therapy: monoclonal antibody targeting of regulatory T cell numbers and functions.
Collapse
Affiliation(s)
- L Bergantini
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy.
| | - P Cameli
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - M d'Alessandro
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - L Vietri
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - M Perruzza
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - M Pieroni
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - N Lanzarone
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - R M Refini
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - A Fossi
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| | - E Bargagli
- Department of Medicine, Surgery and Neurosciences, Respiratory Diseases and Lung Transplantation Section, University of Siena, Viale Bracci, 1, 53100, Siena, Italy
| |
Collapse
|
7
|
Bergantini L, d'Alessandro M, Vietri L, Rana GD, Cameli P, Acerra S, Sestini P, Bargagli E. Utility of serological biomarker' panels for diagnostic accuracy of interstitial lung diseases. Immunol Res 2020; 68:414-421. [PMID: 33089426 PMCID: PMC7674352 DOI: 10.1007/s12026-020-09158-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
Interstitial lung diseases (ILD) are a heterogeneous group of illnesses of known and unknown aetiology. Differential diagnosis among the three disorders is often challenging. Specific biomarkers with good sensitivity and specificity are therefore needed to predict clinical outcome and guide clinical decisions. The aim of this study was to investigate inflammatory/fibrotic biomarkers, to determine whether single mediators or panels of mediators could be useful to stratify patients into three distinct domains: sarcoidosis, idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (cHP). A total of 163 ILD patients monitored at Siena Referral Centre for Sarcoidosis and other Interstitial Lung Diseases were enrolled in the study. Clinical data, pulmonary function tests and biochemical analytes were retrospectively collected. SAA levels were detected by ELISA kit and Krebs von den Lungen 6 (KL-6) were measured by CLEIA method, for sarcoidosis, cHP and IPF patients. Multiple comparison analysis showed significant differences in C reactive protein (CRP), white blood cell count (WBC) and creatinine levels between the three groups. In the logistic regression model, KL-6, CRP and WBC showed areas under curves (AUC) 0.86, for sarcoidosis diagnosis. The logistic regression model KL-6 and SAA showed the best performance with an AUC 0.81 for discriminating IPF than cHP and sarcoidosis. For differential diagnosis of IPF and cHP, KL-6 and SAA were considered in the logistic regression model, showed an AUC 0.79. The combination of serum biomarkers proposed here offers insights into the pathobiology of ILDs. These panels of bioindicators will improve diagnostic accuracy and will be useful in the clinical management of ILDs.
Collapse
Affiliation(s)
- Laura Bergantini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Miriana d'Alessandro
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Lucia Vietri
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Giuseppe Domenico Rana
- Internal Medicine Unit, Department of Internal Medicine, Geriatrics and Rare Diseases Unit, Bari University, Bari, Italy
| | - Paolo Cameli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Silvia Acerra
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Piersante Sestini
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| | - Elena Bargagli
- Department of Medical Sciences, Surgery and Neuroscience, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy
| |
Collapse
|
8
|
Lanzarone N, Gentili F, Alonzi V, Bergantini L, d'Alessandro M, Rottoli P, Refini RM, Pieroni M, Vietri L, Bianchi F, Mazzei MA, Volterrani L, Perrone A, Cameli P, Bargagli E, Sestini P. Bronchoalveolar lavage and serum KL-6 concentrations in chronic hypersensitivity pneumonitis: correlations with radiological and immunological features. Intern Emerg Med 2020; 15:1247-1254. [PMID: 32078140 DOI: 10.1007/s11739-020-02281-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 10/24/2019] [Accepted: 01/19/2020] [Indexed: 11/29/2022]
Abstract
Chronic hypersensitivity pneumonitis (cHP) is a fibrotic interstitial lung disease (ILD) resulting from inhalation of different organic substances and chemical compounds determining an inflammatory and immunological response in sensitized individuals. KL-6, a human mucin protein expressed by type 2 pneumocytes, has been proposed as a prognostic biomarker of cHP. Assessment of usefulness KL-6 in ILD has been investigated primarily in Asiatic population. The aim of this study was to evaluate clinical utility of KL-6 in serum and bronchoalveolar lavage (BAL). In this study, we retrospectively analysed clinical, radiological and immunological data of a cohort of 42 patients affected by cHP: KL-6 concentrations were collected from serum and BAL. KL-6 clinical value was assessed through the analysis of association between KL-6 concentrations and clinical, functional, immunological and radiological features. KL-6 serum concentration results increased in 28/34 patients (82%). A positive direct correlation was observed between KL-6 concentrations in BAL and serum (r = 0.62, p < 0.05). In our study population we found that patients with extensive presence of ground glass opacities and centrilobular nodules at high-resolution computed tomography (HRCT) showed the highest concentrations of KL-6 in BAL and a predominantly CD3+ CD8+ BAL lymphocytosis. BAL lymphocytosis and KL-6 concentrations showed a direct correlation. BAL KL-6, a result of alveolar damage, caused in cHP by CD3+ CD8+ mediated flogosis and suggested by radiological evidence of ground-glass opacities and centrilobular nodules, can be considered a useful biomarker to assess, along with BAL cellular analysis and HRCT findings, disease activity.
Collapse
Affiliation(s)
- Nicola Lanzarone
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Valerio Alonzi
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Miriana d'Alessandro
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Paola Rottoli
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Rosa Metella Refini
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Maria Pieroni
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Lucia Vietri
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Francesco Bianchi
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Maria Antonietta Mazzei
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Siena, Italy
| | | | - Anna Perrone
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy.
| | - Piersante Sestini
- Respiratory Diseases and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, 53100, Siena, Italy
| |
Collapse
|
9
|
Cameli P, Bergantini L, D'alessandro M, Vietri L, Refini RM, Pieroni M, Sestini P, Bargagli E. Alveolar nitric oxide is related to periostin levels in idiopathic pulmonary fibrosis. Minerva Med 2020; 111:324-329. [DOI: 10.23736/s0026-4806.19.06321-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
10
|
Tamburrini M, Thakare P, Zampieri F, Scarda A, Di Paolo A, De Leo G, Gianfagna E, Vietri L, Zuccon U. A case report on expanding horizon of endobronchial ultrasound through esophagus. Monaldi Arch Chest Dis 2020; 90. [PMID: 32696627 DOI: 10.4081/monaldi.2020.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/22/2020] [Indexed: 11/23/2022] Open
Abstract
Endobronchial ultrasound has revolutionized the field of bronchoscopy and has become one of the most important tools for the diagnosis of intrathoracic lymphadenopathy and para-bronchial structures. The reach of this technique has not been limited to these structures and pleural lesions have been at times accessible. To our knowledge, pleural fluid collections have not been accessed with endobronchial ultrasound (EBUS) through oesophageal approach and rationale behind using this approach. We report a case of 70 years old man who has been referred from physician for the EBUS in view of hilar mass with mediastinal lymphadenopathy with pleural effusion. The endobronchial ultrasound through oesophagus (EUS-B) was done for thoracocentesis and lymph node cytology evaluation and ultimately endobronchial biopsy of hilar mass was done as rapid on-site (ROSE) analysis of lymph node was suggestive of necrotic tissue. The cytology report of lymph node and pleural effusion was positive for malignant cells. The final diagnosis was metastatic poorly differentiating adeno-squamous carcinoma.
Collapse
Affiliation(s)
- Mario Tamburrini
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Parikshit Thakare
- Department of Pulmonary Medicine, TNMC and BYL Nair Ch Hospital, Mumbai.
| | - Francesca Zampieri
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Angelo Scarda
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Alessandra Di Paolo
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Giancarlo De Leo
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Enrico Gianfagna
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Lucia Vietri
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| | - Umberto Zuccon
- Department of Internal and Specialist Medicine, Pneumology Unit, Friuli Venezia Giulia Health Authority Hospital of Pordenone.
| |
Collapse
|
11
|
d’Alessandro M, Bergantini L, Cameli P, Vietri L, Lanzarone N, Alonzi V, Pieroni M, M Refini R, Sestini P, Bonella F, Bargagli E. Krebs von den Lungen-6 as a biomarker for disease severity assessment in interstitial lung disease: a comprehensive review. Biomark Med 2020; 14:665-674. [DOI: 10.2217/bmm-2019-0545] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Interstitial lung diseases (ILD) are a group of lung disorders characterized by interstitial lung thickening. Krebs von den Lungen-6 (KL-6) is a molecule that is predominantly expressed by damaged alveolar type II cells and it has been proposed as a potential biomarker of different ILD. Materials & methods: A growing literature about KL-6 has been reviewed and selected to evaluate its role in the clinical management of ILD to predict disease diagnosis, activity, prognosis and treatment response. Results: KL-6 concentrations have been evaluated in fibrotic and granulomatous lung diseases and it was demonstrated to be a biomarker of disease severity useful for clinical follow-up of ILD patients. KL-6 levels differentiated between fibrotic ILD, such as idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis, and nonfibrotic lung disorders, including sarcoidosis and pulmonary alveolar proteinosis. Conclusion: KL-6 is predictive biomarker useful in the clinical management of ILD patients, in particular in patients with severe fibrotic lung disorders.
Collapse
Affiliation(s)
- Miriana d’Alessandro
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Paolo Cameli
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Lucia Vietri
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Nicola Lanzarone
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Valerio Alonzi
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Maria Pieroni
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Rosa M Refini
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Piersante Sestini
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Francesco Bonella
- Center for Interstitial & Rare Lung Disease, Department of Pulmonology, Ruhrlandklinik University Hospital, Essen, Germany
| | - Elena Bargagli
- Respiratory Diseases & Lung Transplantation, Department of Medical & Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| |
Collapse
|
12
|
Bargagli E, Cameli P, Carleo A, Refini RM, Bergantini L, D'alessandro M, Vietri L, Perillo F, Volterrani L, Rottoli P, Bini L, Landi C. The effect of cigarette smoking on bronchoalveolar lavage protein profiles from patients with different interstitial lung diseases. Panminerva Med 2020; 62:109-115. [DOI: 10.23736/s0031-0808.19.03754-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
13
|
Cameli P, Bergantini L, D'Alessandro M, Vietri L, Cameli M, Sestini P, Bargagli E. Serum CD59: a novel biomarker of idiopathic pulmonary fibrosis? Panminerva Med 2020; 63:201-205. [PMID: 32290641 DOI: 10.23736/s0031-0808.20.03893-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is the most common among idiopathic interstitial pneumonia. Life expectancy is estimated around 3-5 years at diagnosis. No reliable prognostic biomarker has been approved for routinary clinical practice of IPF. The aim of this study is to investigate the potential prognostic value of serum CD59 in a cohort of IPF patients. METHODS Fifty-seven patients (45 males, 66.1±10 years old) were recruited in Siena Regional Referral Center for Interstitial Lung Disease and underwent serum sampling for CD59 detection during diagnostic pathway. Clinical, functional, radiological and survival data were retrospectively collected. As control group for CD59 values, we recruited eight healthy volunteers (five males, 59.2±18 years old). RESULTS CD59 levels were significantly higher in IPF patients in respect with healthy controls (P=0.0238). Patients with CD59 concentrations lower than 15 ng/mL reported a significant reduction of survival time (P=0.009); current or former smokers with CD59 <15 ng/mL showed the worst prognosis (P=0.014). CONCLUSIONS CD59 levels were significantly increased in IPF patients, supporting the existence of epithelial damage in the pathogenesis of disease. Lower values of CD59 were associated with a significantly worse prognosis, suggesting a potential role of CD59 in the prognostic estimation of IPF patients.
Collapse
Affiliation(s)
- Paolo Cameli
- Respiratory Disease and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy: 2 Department of Cardiovascular Diseases, University of Siena, Siena, Italy -
| | - Laura Bergantini
- Respiratory Disease and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy: 2 Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | | | - Lucia Vietri
- Respiratory Disease and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy: 2 Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | | | - Piersante Sestini
- Respiratory Disease and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy: 2 Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Elena Bargagli
- Respiratory Disease and Lung Transplant Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy: 2 Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| |
Collapse
|
14
|
Vietri L, Bargagli E, Bennett D, Fossi A, Cameli P, Bergantini L, d'Alessandro M, Paladini P, Luzzi L, Gentili F, Mazzei MA, Spina D, Sestini P, Rottoli P. Serum Amyloid A in lung transplantation. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37:2-7. [PMID: 33093763 PMCID: PMC7569538 DOI: 10.36141/svdld.v37i1.8775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/10/2019] [Indexed: 12/01/2022]
Abstract
Background: Serum Amyloid A (SAA) is an acute phase protein and we analyzed its concentrations in lung transplantated patients (LTX). Methods: 26 LTX patients (58.6 ± 11 years) and 11 healthy controls (55 ± 11.3 years). Three groups of LTX patients: acute rejection (AR, 7) bronchiolitis obliterans syndrome (BOS, 3), acute infection (INF, 9) and stable patients (NEG, 7). Results: In LTX patients SAA concentrations were significantly increased, particularly in AR and INF. In LTX-AR patients were observed a correlation between SAA levels and peripheral CD4+ lymphocyte percentage (r=0.9, p<0.01) and a reverse correlation with FVC percentages (r -0.94, p=0.01). Conclusions: SAA may represent a potential biomarker of LTX acute complications, with a prognostic value in AR. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (1): 2-7)
Collapse
Affiliation(s)
- Lucia Vietri
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Elena Bargagli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - David Bennett
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Antonella Fossi
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Paolo Cameli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Laura Bergantini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Miriana d'Alessandro
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Piero Paladini
- Thoracic Surgery Unit, Department of Medicine, Surgery and Neuroscences, Siena University Hospital Siena, Italy
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medicine, Surgery and Neuroscences, Siena University Hospital Siena, Italy
| | - Francesco Gentili
- Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Maria Antonietta Mazzei
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy.,Thoracic Surgery Unit, Department of Medicine, Surgery and Neuroscences, Siena University Hospital Siena, Italy.,Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy.,Pathology Unit, Siena University Hospital Siena, Italy
| | | | - Piersante Sestini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| | - Paola Rottoli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, AOUS, Siena, Italy
| |
Collapse
|
15
|
d'Alessandro M, Carleo A, Cameli P, Bergantini L, Perrone A, Vietri L, Lanzarone N, Vagaggini C, Sestini P, Bargagli E. Correction to: BAL biomarkers' panel for differential diagnosis of interstitial lung diseases. Clin Exp Med 2020; 20:217. [PMID: 32036463 DOI: 10.1007/s10238-020-00613-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The original version of this article unfortunately contained a mistake. First and last names of the authors were interchanged.
Collapse
Affiliation(s)
- Miriana d'Alessandro
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy.
| | - Alfonso Carleo
- Department of Pulmonology, Hannover Medical School, Hannover, Germany
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Anna Perrone
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Lucia Vietri
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Nicola Lanzarone
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Cecilia Vagaggini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Piersante Sestini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| |
Collapse
|
16
|
d'Alessandro M, Carleo A, Cameli P, Bergantini L, Perrone A, Vietri L, Lanzarone N, Vagaggini C, Sestini P, Bargagli E. BAL biomarkers' panel for differential diagnosis of interstitial lung diseases. Clin Exp Med 2020; 20:207-216. [PMID: 31970550 DOI: 10.1007/s10238-020-00608-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 10/08/2019] [Accepted: 01/18/2020] [Indexed: 12/17/2022]
Abstract
Bronchoalveolar lavage (BAL) is a useful procedure for differential diagnosis of interstitial lung diseases (ILDs) and for identification of granulomatous lung diseases. We investigated a panel of biomarkers from BAL fluid of ILD patients to evaluate their utility in differentiating ILDs. Bronchoscopy with BAL was performed in 100 consecutive patients with suspected ILD (41 sarcoidosis, 11 cHP and 24 other ILDs); the 24 patients negative for ILD diagnosis were included as control group. BAL phenotypes and cell profiles (CD4+/CD8+ ratio, NK and CD103+ cell counts, chitotriosidase and KL-6 levels in BAL) were determined by flow cytometry. A decision-tree statistical algorithm was applied. Sarcoidosis was discriminated by a higher BAL CD4+/CD8+ ratio (p = 5.8E-05), a lower BAL CD103+CD4+ count (p = 5.0E-02) and lower BAL NK percentages (p = 8.8E-03) than the other groups. BAL KL-6 concentrations were higher in sarcoidosis than in other ILDs (p = 1.5E-02) and were directly correlated with CD4+/CD8+ ratio. We used decision-tree statistical analysis to combine our biomarkers into two diagnostic algorithms for differential diagnosis of ILDs. A panel of BAL biomarkers for diagnosis of ILDs is proposed; CD4+/CD8+ ratio, KL-6 concentrations, and NK and CD103+CD4+ cell percentages in BAL could improve the identification and differential diagnosis of sarcoidosis.
Collapse
Affiliation(s)
- Miriana d'Alessandro
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy.
| | - Alfonso Carleo
- Department of Pulmonology, Hannover Medical School, Hannover, Germany
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Anna Perrone
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Lucia Vietri
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Nicola Lanzarone
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Cecilia Vagaggini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Piersante Sestini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, University of Siena, Viale Bracci 1, 53100, Siena, Italy
| |
Collapse
|
17
|
Vietri L, Fui A, Bergantini L, d'Alessandro M, Cameli P, Sestini P, Rottoli P, Bargagli E. Serum amyloid A: A potential biomarker of lung disorders. Respir Investig 2019; 58:21-27. [PMID: 31708467 DOI: 10.1016/j.resinv.2019.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/29/2019] [Accepted: 09/20/2019] [Indexed: 12/27/2022]
Abstract
Serum amyloid A is an acute-phase protein with multiple immunological functions. Serum amyloid A is involved in lipid metabolism, inflammatory reactions, granuloma formation, and cancerogenesis. Additionally, serum amyloid A is involved in the pathogenesis of different autoimmune lung diseases. The levels of serum amyloid A has been evaluated in biological fluids of patients with different lung diseases, including autoimmune disorders, chronic obstructive pulmonary diseases, obstructive sleep apnea syndrome, sarcoidosis, asthma, lung cancer, and other lung disorders, such as idiopathic pulmonary fibrosis, tuberculosis, radiation pneumonitis, and cystic fibrosis. This review focuses on the cellular and molecular interactions of serum amyloid A in different lung diseases and suggests this acute-phase protein as a prognostic marker.
Collapse
Affiliation(s)
- Lucia Vietri
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Annalisa Fui
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Laura Bergantini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Miriana d'Alessandro
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Paolo Cameli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Piersante Sestini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Paola Rottoli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| | - Elena Bargagli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, Siena, Italy.
| |
Collapse
|
18
|
Vietri L, Bennett D, Cameli P, Bergantini L, Cillis G, Sestini P, Bargagli E, Rottoli P. Serum amyloid A in patients with idiopathic pulmonary fibrosis. Respir Investig 2019; 57:430-434. [PMID: 31031123 DOI: 10.1016/j.resinv.2019.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/20/2019] [Accepted: 03/28/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Serum amyloid A (SAA) is an apo-lipoprotein (12-14 kDa) produced by the liver in response to proinflammatory cytokines from activated monocytes. The precursor of SAA is an acute-phase protein involved in the pathogenesis of sarcoidosis and has been found to be increased during exacerbation of chronic obstructive pulmonary disease and lung cancer. However, no data are available on SAA levels in patients with idiopathic pulmonary fibrosis (IPF), the most common and severe idiopathic form of interstitial pneumonitis associated with a usual interstitial histological and radiological pattern. The aim of this preliminary study was to evaluate SAA concentration in patients with IPF and to explore its potential use as a clinical biomarker. METHODS SAA levels were determined by enzyme-linked immunosorbent assay in a population of 21 patients with IPF (14 male, aged 64.8 ± 8.1 years) and compared with those in 11 healthy controls (3 male, aged 55 ± 11.3 years). Clinical, functional, and immunological data were collected in a database. RESULTS SAA levels were significantly higher in patients with IPF than in controls (p = 0.03). In patients with IPF, statistically significant correlations were found between SAA and HDL cholesterol levels (r = -0.62, p = 0.05) and FVC % predicted value (r = -0.52, p = 0.01). CONCLUSIONS SAA is a promising marker of disease severity in patients with IPF. Our preliminary data suggest a potential pathogenetic role of alteration in lipid metabolism in this rare disease.
Collapse
Affiliation(s)
- Lucia Vietri
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - David Bennett
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Paolo Cameli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Laura Bergantini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Giuseppe Cillis
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Piersante Sestini
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Elena Bargagli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| | - Paola Rottoli
- Department of Medical and Surgical Sciences and Neurosciences, Respiratory Disease and Lung Transplant Unit, University of Siena, Viale Bracci, 53100 Siena, Italy.
| |
Collapse
|
19
|
Bergantini L, Bargagli E, Cameli P, Cekorja B, Lanzarone N, Pianigiani L, Vietri L, Bennett D, Sestini P, Rottoli P. Serial KL-6 analysis in patients with idiopathic pulmonary fibrosis treated with nintedanib. Respir Investig 2019; 57:290-291. [PMID: 30799155 DOI: 10.1016/j.resinv.2019.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Laura Bergantini
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy.
| | - Elena Bargagli
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Paolo Cameli
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Behar Cekorja
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Nicola Lanzarone
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Lucrezia Pianigiani
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Lucia Vietri
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - David Bennett
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Piersante Sestini
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| | - Paola Rottoli
- Department of Clinical Medical and Neurosciences, Respiratory Disease and Lung Transplantation Section, Le Scotte Hospital, University of Siena, Siena, Italy
| |
Collapse
|
20
|
Bargagli E, Di Masi M, Perruzza M, Vietri L, Bergantini L, Torricelli E, Biadene G, Fontana G, Lavorini F. The pathogenetic mechanisms of cough in idiopathic pulmonary fibrosis. Intern Emerg Med 2019; 14:39-43. [PMID: 30269188 DOI: 10.1007/s11739-018-1960-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 09/24/2018] [Indexed: 01/07/2023]
Abstract
Idiopathic pulmonary fibrosis is a peripheral subpleural interstitial lung disorder limited to the lung not involving the airways. It has a poor prognosis (survival less than 5 years) and commonly an interstitial pneumonia radiological pattern. Patients complain of a chronic dry cough in 80% of cases. A cough is often the first symptom of this rare disease, preceding dyspnea by years, and is associated with a poor prognosis, high dyspnea scores and low FVC percentages. The pathogenetic mechanisms leading to coughing in IPF are unclear. This review focuses on recent evidence of cough pathophysiology in this disease. Gastroesophageal reflux may promote coughing in IPF patients; bile salts and pepsin may be abundant in BAL of these patients, inducing overproduction of TGF-β by airway epithelial cells and mesenchymal transition with fibroblast recruitment/activation and extracellular matrix deposition. Patients have an enhanced cough reflex to capsaicin and substance P with respect to control subjects. Moreover, patients with the MUC5B polymorphism show more severe coughing as MUC5B encodes for the dominant mucin in the honeycomb cysts of IPF patients. Comorbidities, including asthma, gastroesophageal reflux, hypersensitivity pneumonitis, bronchiectasis, chronic obstructive pulmonary disease and emphysema, can induce coughing in IPF patients. There is no clear explanation of the causes of coughing in IPF. Further research into the pathophysiology of IPF and the pathogenetic mechanisms of coughing is necessary to improve survival and quality of life.
Collapse
Affiliation(s)
- Elena Bargagli
- Section of Respiratory Diseases and Lung Transplantation, Department of Clinical Medicine and Neurosciences, Siena University Hospital, Siena, Italy.
| | - Maria Di Masi
- Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Marco Perruzza
- Section of Respiratory Diseases and Lung Transplantation, Department of Clinical Medicine and Neurosciences, Siena University Hospital, Siena, Italy
| | - Lucia Vietri
- Section of Respiratory Diseases and Lung Transplantation, Department of Clinical Medicine and Neurosciences, Siena University Hospital, Siena, Italy
| | - Laura Bergantini
- Section of Respiratory Diseases and Lung Transplantation, Department of Clinical Medicine and Neurosciences, Siena University Hospital, Siena, Italy
| | - Elena Torricelli
- Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Giulia Biadene
- Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Giovanni Fontana
- Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Federico Lavorini
- Section of Respiratory Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| |
Collapse
|