1
|
Bizzarri C, Lonero A, Delvecchio M, Cavallo L, Faienza MF, Giordano M, Dello Strologo L, Cappa M. Growth hormone treatment improves final height and nutritional status of children with chronic kidney disease and growth deceleration. J Endocrinol Invest 2018; 41:325-331. [PMID: 28819753 DOI: 10.1007/s40618-017-0745-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/08/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Growth retardation is a common complication of chronic kidney disease (CKD) in children. Treatment with recombinant human growth hormone (rhGH) has been used to help short children with CKD to attain a height more in keeping with their age group, but the scientific evidence regarding the effect of rhGH on final height is scarce. METHODS Final heights of children with CKD receiving rhGH treatment (cases) were compared with final heights of a matched cohort of children with CKD that did not receive rhGH therapy (controls). RESULTS Sixty-eight rhGH-treated cases (44 boys) were compared with 92 untreated controls (60 boys). Mean duration of rhGH therapy was 4.2 ± 0.9 years; rhGH dose was 0.3 ± 0.07 mg/kg/week. Height SDS at baseline was lower in rhGH-treated patients than in controls (-2.00 ± 1.02 versus -0.96 ± 1.11, p < 0.001). Baseline height SDS was significantly lower than target height SDS in both groups. Height SDS significantly improved from baseline to final height attainment in rhGH-treated patients, while it slightly decreased in controls (mean SDS variation 0.69 ± 1.05 in rhGH-treated cases versus -0.15 ± 1.2 in controls). Final height SDS was -1.25 ± 1.06 in rhGH-treated cases and -1.06 ± 1.17 in controls (p = 0.29). Target adjusted final height SDS was -0.91 ± 1.03 in rhGH-treated cases and -0.61 ± 1.17 in controls (p = 0.1). CONCLUSIONS Long-term rhGH therapy is able to reduce the linear growth deceleration of children with CKD, and ultimately to improve their final height, reducing the difference with target height.
Collapse
Affiliation(s)
- C Bizzarri
- Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
| | - A Lonero
- Department of Biomedicine and Human Oncology/Pediatric Section, University A. Moro, Bari, Italy
| | - M Delvecchio
- Department of Biomedicine and Human Oncology/Pediatric Section, University A. Moro, Bari, Italy
| | - L Cavallo
- Department of Biomedicine and Human Oncology/Pediatric Section, University A. Moro, Bari, Italy
| | - M F Faienza
- Department of Biomedicine and Human Oncology/Pediatric Section, University A. Moro, Bari, Italy
| | - M Giordano
- Pediatric Nephrology and Dialysis Unit, Children's Hospital Giovanni XXIII, Bari, Italy
| | - L Dello Strologo
- Unit of Pediatric Nephrology and Renal Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Cappa
- Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| |
Collapse
|
2
|
Faienza MF, Brunetti G, Acquafredda A, Delvecchio M, Lonero A, Gaeta A, Suavo Bulzis P, Corica D, Velletri MR, De Luca F, Cavallo L, Wasniewska M. Metabolic Outcomes, Bone Health, and Risk of Polycystic Ovary Syndrome in Girls with Idiopathic Central Precocious Puberty Treated with Gonadotropin-Releasing Hormone Analogues. Horm Res Paediatr 2017; 87:162-169. [PMID: 28391271 DOI: 10.1159/000456546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/16/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Gonadotropin-releasing hormone analogues (GnRHa) represent the gold standard treatment for central precocious puberty (CPP). We aimed to assess the effects of GnRHa treatment on metabolic outcomes, bone status, and polycystic ovary syndrome (PCOS) prevalence in young girls with idiopathic CPP (ICPP). METHODS We enrolled 94 ICPP girls who were at least 2 years after menarche and had already attained adult height at the time of the study: 56 previously treated with depot triptorelin (3.4 ± 0.6 years) and 38 untreated. Auxological parameters, lipid profile, homeostatic model assessment of insulin resistance (HOMA-IR), bone state, and prevalence of PCOS were assessed. RESULTS The 2 groups were similar for body mass index (BMI) and waist circumference. HOMA-IR, dehydroepi-androsterone sulfate, and Δ4-androstenedione were higher in the treated than in the untreated subjects (p < 0.001). Significant differences were found for amplitude-dependent speed of sound (p < 0.03) and bone transmission time z-scores (p < 0.01). The prevalence of PCOS was higher in the treated than in the untreated subjects (p < 0.04). CONCLUSION GnRHa therapy is associated with hyperandrogenism and an increase in insulin resistance and PCOS prevalence, but not with increased BMI or lipid profile alterations. Long-term evaluations at the time of expected peak bone mass achievement are needed to understand the persistent or transient nature of subtle bone abnormalities.
Collapse
|
3
|
Faienza MF, Ventura A, Delvecchio M, Fusillo A, Piacente L, Aceto G, Colaianni G, Colucci S, Cavallo L, Grano M, Brunetti G. High Sclerostin and Dickkopf-1 (DKK-1) Serum Levels in Children and Adolescents With Type 1 Diabetes Mellitus. J Clin Endocrinol Metab 2017; 102:1174-1181. [PMID: 28388723 DOI: 10.1210/jc.2016-2371] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/07/2016] [Indexed: 12/28/2022]
Abstract
CONTEXT Childhood type 1 diabetes mellitus (T1DM) is associated with decreased bone mass. Sclerostin and dickkopf-1 (DKK-1) are Wnt inhibitors that regulate bone formation. OBJECTIVE To evaluate sclerostin and DKK-1 levels in T1DM children and to analyze the influence of glycemic control on bone health. DESIGN AND SETTING Cross-sectional study conducted at a clinical research center. PARTICIPANTS One hundred and six T1DM subjects (12.2 ± 4 years), 66 on multiple daily injections (MDIs) and 40 on continuous subcutaneous infusion of insulin (CSII), and 80 controls. RESULTS The average bone transmission time (BTT) and amplitude-dependent speed of sound (AD-SoS) z scores were lower in patients with diabetes than in controls. Significantly increased DKK-1 (3593 ± 1172 vs 2652 ± 689 pg/mL; P < 0.006) and sclerostin (29.45 ± 12.32 vs 22.53 ± 8.29; P < 0.001) levels were found in patients with diabetes with respect to controls, particularly in patients on MDI compared with ones on CSII. Glycemic control was improved in CSII patients compared with MDI ones (P < 0.001) and was also associated with significantly higher BMI-SDS (P < 0.002) and BTT z scores (P < 0.02). With adjustment for age, multiple linear regression analysis of DKK-1 and sclerostin as dependent variables showed that levels of glycated hemoglobin, glucose, 25(OH) vitamin D, osteocalcin, and parathyroid hormone; years of diabetes; and BMI-SDS and AD-SoS z score were the most important predictors (P < 0.0001). CONCLUSIONS Our study highlighted (1) the high serum levels of DKK-1 and sclerostin in T1DM children and their relationship with altered glycemic control and (2) the effect of CSII on improvement of glycemic control and bone health in T1DM children.
Collapse
Affiliation(s)
| | - Annamaria Ventura
- Departments of Biomedical Science and Human Oncology, Pediatric Unit, and
| | | | - Anna Fusillo
- Departments of Biomedical Science and Human Oncology, Pediatric Unit, and
| | - Laura Piacente
- Departments of Biomedical Science and Human Oncology, Pediatric Unit, and
| | - Gabriella Aceto
- Departments of Biomedical Science and Human Oncology, Pediatric Unit, and
| | - Graziana Colaianni
- Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari A. Moro, 70124 Bari, Italy
| | - Silvia Colucci
- Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari A. Moro, 70124 Bari, Italy
| | - Luciano Cavallo
- Departments of Biomedical Science and Human Oncology, Pediatric Unit, and
| | - Maria Grano
- Department of Emergency and Organ Transplantation, University of Bari A. Moro, 70121 Bari, Italy
| | - Giacomina Brunetti
- Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari A. Moro, 70124 Bari, Italy
| |
Collapse
|
4
|
Credendino R, Minenkov Y, Liguori D, Piemontesi F, Melchior A, Morini G, Tolazzi M, Cavallo L. Accurate experimental and theoretical enthalpies of association of TiCl4 with typical Lewis bases used in heterogeneous Ziegler–Natta catalysis. Phys Chem Chem Phys 2017; 19:26996-27006. [DOI: 10.1039/c7cp04047d] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The enthalpy of association of Lewis bases with TiCl4 is analyzed using experimental and computational techniques.
Collapse
Affiliation(s)
- R. Credendino
- King Abdullah University of Science and Technology (KAUST)
- Physical Sciences and Engineering Division (PSE)
- KAUST Catalysis Center (KCC)
- Thuwal
- Saudi Arabia
| | - Y. Minenkov
- King Abdullah University of Science and Technology (KAUST)
- Physical Sciences and Engineering Division (PSE)
- KAUST Catalysis Center (KCC)
- Thuwal
- Saudi Arabia
| | - D. Liguori
- Basell Italia Srl
- G. Natta Research Center
- 44100 Ferrara
- Italy
| | - F. Piemontesi
- Basell Italia Srl
- G. Natta Research Center
- 44100 Ferrara
- Italy
| | - A. Melchior
- Dipartimento Politecnico di Ingegneria e Architettura dell’Università di Udine
- Laboratori di Scienze e Tecnologie Chimiche
- 33100 Udine
- Italy
| | - G. Morini
- Basell Italia Srl
- G. Natta Research Center
- 44100 Ferrara
- Italy
| | - M. Tolazzi
- Dipartimento Politecnico di Ingegneria e Architettura dell’Università di Udine
- Laboratori di Scienze e Tecnologie Chimiche
- 33100 Udine
- Italy
| | - L. Cavallo
- King Abdullah University of Science and Technology (KAUST)
- Physical Sciences and Engineering Division (PSE)
- KAUST Catalysis Center (KCC)
- Thuwal
- Saudi Arabia
| |
Collapse
|
5
|
Brunetti G, Papadia F, Tummolo A, Fischetto R, Nicastro F, Piacente L, Ventura A, Mori G, Oranger A, Gigante I, Colucci S, Ciccarelli M, Grano M, Cavallo L, Delvecchio M, Faienza MF. Impaired bone remodeling in children with osteogenesis imperfecta treated and untreated with bisphosphonates: the role of DKK1, RANKL, and TNF-α. Osteoporos Int 2016; 27:2355-2365. [PMID: 26856585 DOI: 10.1007/s00198-016-3501-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 11/06/2015] [Accepted: 01/20/2016] [Indexed: 12/23/2022]
Abstract
UNLABELLED In this study, we investigated the bone cell activity in patients with osteogenesis imperfecta (OI) treated and untreated with neridronate. We demonstrated the key role of Dickkopf-1 (DKK1), receptor activator of nuclear factor-κB ligand (RANKL), and tumor necrosis factor alpha (TNF-α) in regulating bone cell of untreated and treated OI subjects. These cytokines could represent new pharmacological targets for OI. INTRODUCTION Bisphosphonates are widely used in the treatment of children with osteogenesis imperfecta (OI) with the objective of reducing the risk of fractures. Although bisphosphonates increase bone mineral density in OI subjects, the effects on fracture incidence are conflicting. The aim of this study was to investigate the mechanisms underlying bone cell activity in subjects with mild untreated forms of OI and in a group of subjects with severe OI treated with cycles of intravenous neridronate. METHODS Sclerostin, DKK1, TNF-α, RANKL, osteoprotegerin (OPG), and bone turnover markers were quantified in serum of 18 OI patients (12 females, mean age 8.86 ± 3.90), 8 of which were receiving cyclic intravenous neridronate, and 21 sex- and age-matched controls. The effects on osteoblastogenesis and OPG expression of media conditioned by the serum of OI patients and anti-DKK1 neutralizing antibody were evaluated. Osteoclastogenesis was assessed in cultures from patients and controls. RESULTS DKK1 and RANKL levels were significantly increased both in untreated and in treated OI subjects with respect to controls. The serum from patients with high DKK1 levels inhibited both osteoblast differentiation and OPG expression in vitro. High RANKL and low OPG messenger RNA (mRNA) levels were found in lymphomonocytes from patients. High amounts of TNF-α were expressed by monocytes, and an elevated percentage of circulating CD11b-CD51/CD61+ osteoclast precursors was observed in patients. CONCLUSIONS Our study demonstrated the key role of DKK1, RANKL, and TNF-α in regulating bone cell activity of subjects with OI untreated and treated with bisphosphonates. These cytokines could represent new pharmacological targets for OI patients.
Collapse
Affiliation(s)
- G Brunetti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
| | - F Papadia
- Department of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXIII Children's Hospital, Bari, Italy
| | - A Tummolo
- Department of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXIII Children's Hospital, Bari, Italy
| | - R Fischetto
- Department of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXIII Children's Hospital, Bari, Italy
| | - F Nicastro
- Department of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXIII Children's Hospital, Bari, Italy
| | - L Piacente
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - A Ventura
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - G Mori
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - A Oranger
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - I Gigante
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - S Colucci
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - M Ciccarelli
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - M Grano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy
| | - L Cavallo
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - M Delvecchio
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy
| | - M F Faienza
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Piazza G. Cesare, 11, 70124, Bari, Italy.
| |
Collapse
|
6
|
Lonero A, Delvecchio M, Primignani P, Caputo R, Bargiacchi S, Penco S, Mauri L, Andreucci E, Faienza MF, Cavallo L. A novel OTX2 gene frameshift mutation in a child with microphthalmia, ectopic pituitary and growth hormone deficiency. J Pediatr Endocrinol Metab 2016; 29:603-5. [PMID: 26974134 DOI: 10.1515/jpem-2015-0425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/22/2016] [Indexed: 11/15/2022]
Abstract
OTX2 mutations are reported in patients with eye maldevelopment and in some cases with brain or pituitary abnormalities. We describe a child carrying a novel OTX2 heterozygous mutation. She presented microphthalmia, absence of retinal vascularization, vitreal spots and optic nerve hypoplasia in the right eye and mild macular dystrophy in the left eye. Midline brain structures and cerebral parenchyma were normal, except for the ectopic posterior pituitary gland. OTX2 sequencing showed a heterozygous c.402del mutation. Most of OTX2 mutations are nonsense or frameshift introducing a premature termination codon and resulting in a truncated protein. More rarely missense mutations occur. Our novel OTX2 mutation (c.402del) is a frameshift mutation (p.S135Lfs*43), never reported before, causing a premature codon stop 43 amino-acids downstream, which is predicted to generate a premature truncation. The mutation was associated with microphthalmia and ectopic posterior pituitary.
Collapse
|
7
|
Indrio F, Di Mauro A, Di Mauro A, Riezzo G, Panza R, Cavallo L, Francavilla R. Prevention of functional gastrointestinal disorders in neonates: clinical and socioeconomic impact. Benef Microbes 2016; 6:195-8. [PMID: 25609653 DOI: 10.3920/bm2014.0078] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Infantile colic, gastro-oesophageal reflux and constipation are the most common functional gastrointestinal disorders (FGIDs) affecting infants during the first months of life. Despite infantile colic, functional constipation and regurgitation had a self-limited pattern, they are considered a risk factor for developing different disorders later in life. The pathophysiology of these functional diseases is still controversial but there is growing evidence that an abnormal gut microbiota colonisation may play a crucial role. An early probiotic supplementation could determine a change in colonisation and may represent a new strategy for preventing FGIDs.
Collapse
Affiliation(s)
- F Indrio
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| | - A Di Mauro
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| | - A Di Mauro
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| | - G Riezzo
- Laboratory of Experimental Physiopathology, IRCCS, Via F. Valente 4, 70013 Castellana Grotte, Italy
| | - R Panza
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| | - L Cavallo
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| | - R Francavilla
- Pediatric Unit, Department of Biomedical Science and Human Oncology, University of Bari 'Aldo Moro', Giovanni XXIII Hospital, Via Amendola 270, 70126 Bari, Italy
| |
Collapse
|
8
|
Faienza MF, Brunetti G, Delvecchio M, Zito A, De Palma F, Cortese F, Nitti A, Massari E, Gesualdo M, Ricci G, Carbonara S, Giordano P, Cavallo L, Scicchitano P, Ciccone MM. Vascular Function and Myocardial Performance Indices in Children Born Small for Gestational Age. Circ J 2016; 80:958-963. [PMID: 26861187 DOI: 10.1253/circj.cj-15-1038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University “A. Moro”
| | - Maurizio Delvecchio
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Annapaola Zito
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Fabrizia De Palma
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Francesca Cortese
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Adriana Nitti
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Elena Massari
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital
| | - Michele Gesualdo
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Gabriella Ricci
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Santa Carbonara
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Paola Giordano
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | | | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| |
Collapse
|
9
|
Faienza MF, Ventura A, Colucci S, Cavallo L, Grano M, Brunetti G. Bone Fragility in Turner Syndrome: Mechanisms and Prevention Strategies. Front Endocrinol (Lausanne) 2016; 7:34. [PMID: 27199891 PMCID: PMC4844601 DOI: 10.3389/fendo.2016.00034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/11/2016] [Indexed: 01/18/2023] Open
Abstract
Bone fragility is recognized as one of the major comorbidities in Turner syndrome (TS). The mechanisms underlying bone impairment in affected patients are not clearly elucidated, but estrogen deficiency and X-chromosomal abnormalities represent important factors. Moreover, although many girls with TS undergo recombinant growth hormone therapy to treat short stature, the efficacy of this treatment on bone mineral density is controversial. The present review will focus on bone fragility in subjects with TS, providing an overview on the pathogenic mechanisms and some prevention strategies.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Pediatrics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, Bari, Italy
| | - Annamaria Ventura
- Pediatrics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, Bari, Italy
| | - Silvia Colucci
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “A. Moro”, Bari, Italy
| | - Luciano Cavallo
- Pediatrics Unit, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, Bari, Italy
| | - Maria Grano
- Department of Emergency and Organ Transplantation (DETO), University of Bari “A. Moro”, Bari, Italy
| | - Giacomina Brunetti
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “A. Moro”, Bari, Italy
- *Correspondence: Giacomina Brunetti,
| |
Collapse
|
10
|
Faienza MF, Brunetti G, Ventura A, Piacente L, Messina MF, De Luca F, Ciccarelli M, Oranger A, Mori G, Natale MP, Gigante M, Ranieri E, Gesualdo L, Colucci S, Cavallo L, Grano M. Mechanisms of enhanced osteoclastogenesis in girls and young women with Turner's Syndrome. Bone 2015. [PMID: 26208797 DOI: 10.1016/j.bone.2015.07.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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] [Indexed: 02/02/2023]
Abstract
Subjects with hypergonadotropic hypogonadism due to Turner's syndrome show low cortical mineral density, osteoporosis and risk of fractures. It is not clear if this bone fragility derives from chromosomal abnormalities or is the result of inadequate bone formation due to estrogen deficiency. The aim of this study was to investigate the cellular mechanisms underlying bone fragility in subjects with Turner's syndrome before induction of puberty and after hormonal replacement therapy (HRT). For this purpose, we have evaluated the osteoclastogenic potential of non-fractioned and T-cell depleted cultures of peripheral blood mononuclear cells (PBMCs) belonging to girls with Turner's syndrome who had not been treated with HRT yet, girls and young women who were on HRT and age-matched controls. Untreated subjects showed high FSH serum levels, whereas the other subjects displayed normal FSH serum levels. T-cell immunophenotype was analyzed through flow cytometry. Biochemical and DXA analyses were performed. Spontaneous osteoclastogenesis in non-fractioned and T-cell depleted cultures of PBMC belonging to girls with high FSH levels was more evident than in cultures of subjects with normal FSH levels. In the former, osteoclastogenesis was sustained by monocytes expressing high levels of c-fms, TNF-α and RANK, and T-cells producing high RANKL and TNF-α; in the latter it was supported by T-cells expressing high RANKL levels. CD4(+)CD25(high) T-cells were reduced in all subjects, whereas CD3(+)/CD16(+)/CD56(+) NKT-cells were increased in those with high FSH levels. High RANKL and CTX levels were detected in the sera. Bone impairment was already detectable by DXA in subjects aged under 10, although it became more evident with aging. In conclusion, our results demonstrated that bone fragility in subjects with Turner's syndrome is associated to enhanced osteoclastogenesis. This process seems to be due to high FSH serum levels before HRT, whereas it is caused by high RANKL during HRT.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy.
| | - Giacomina Brunetti
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Bari, Italy.
| | - Annamaria Ventura
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy
| | - Laura Piacente
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy
| | - Maria Francesca Messina
- Department of Pediatric, Gynecologic, Microbiologic and Biomedical Sciences, University of Messina, Messina, Italy
| | - Filippo De Luca
- Department of Pediatric, Gynecologic, Microbiologic and Biomedical Sciences, University of Messina, Messina, Italy
| | - Maria Ciccarelli
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy
| | - Angela Oranger
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Bari, Italy
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Pia Natale
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy
| | - Margherita Gigante
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University "A. Moro" of Bari, Bari, Italy
| | - Elena Ranieri
- Clinical Pathology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University "A. Moro" of Bari, Bari, Italy
| | - Silvia Colucci
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Bari, Italy
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy
| | - Maria Grano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University "A. Moro" of Bari, Bari, Italy
| |
Collapse
|
11
|
Delvecchio M, Salerno M, Vigone MC, Wasniewska M, Popolo PP, Lapolla R, Mussa A, Tronconi GM, D'Acunzo I, Di Mase R, Falcone RM, Corrias A, De Luca F, Weber G, Cavallo L, Faienza MF. Levothyroxine requirement in congenital hypothyroidism: a 12-year longitudinal study. Endocrine 2015; 50:674-80. [PMID: 25762444 DOI: 10.1007/s12020-015-0574-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/28/2014] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
Abstract
The aim of the replacement therapy with levothyroxine in congenital hypothyroidism (CH) is to correct hypothyroidism and ensure normal growth and neuropsychological development. Few data are available about the appropriate dose during childhood and early adolescence; therefore, we performed a multicenter observational study in a large population of patients with CH to assess the required levothyroxine dose to obtain euthyroidism. We recruited 216 patients with permanent CH classified into three groups (agenesia, ectopia, and in situ gland) on the basis of the thyroid imaging. The levothyroxine dose was recorded at 6 and 12 months and then yearly until 12 years of age. The daily levothyroxine requirement progressively decreased during the follow-up, irrespective of etiology. It was significantly lower in patients with in situ gland than in patients with athyreosis during the entire study period and with ectopic gland from the age of 1 year. The levothyroxine requirement at 6 months of age was correlated with the requirement at each later time-point. The daily dose was modified less frequently in patients with in situ thyroid (36 %) than in patients with ectopic gland (41.4 %) or with athyreosis (43.6 %). Patients with in situ gland required a lower dose than the other two subgroups. The dose at 6 months seems predictive of the requirement until 12 years of age. Euthyroidism may be achieved in pre-school and in-school patients by 3-4 and 2-3 µg/kg/day (70-90 and 60-80 µg/m(2)/day) of levothyroxine, respectively.
Collapse
Affiliation(s)
- Maurizio Delvecchio
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy.
| | - Mariacarolina Salerno
- Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Cristina Vigone
- Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Rosa Lapolla
- Department of Pediatrics, University of Foggia, Foggia, Italy
| | - Alessandro Mussa
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Turin, Turin, Italy
| | - Giulia Maria Tronconi
- Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy
| | - Ida D'Acunzo
- Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Raffaella Di Mase
- Pediatric Section-Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Rosa Maria Falcone
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Corrias
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Turin, Turin, Italy
| | - Filippo De Luca
- Department of Pediatrics, University of Messina, Messina, Italy
| | - Giovanna Weber
- Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| |
Collapse
|
12
|
Marzano F, Ventura A, Caratozzolo MF, Aiello I, Mastropasqua F, Brunetti G, Cavallo L, Sbisà E, Faienza MF, Tullo A. The p53 family member p73 modulates the proproliferative role of IGFBP3 in short children born small for gestational age. Mol Biol Cell 2015; 26:2733-41. [PMID: 26063735 PMCID: PMC4571334 DOI: 10.1091/mbc.e15-02-0105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/05/2015] [Indexed: 12/23/2022] Open
Abstract
It is demonstrated that IGFBP3 is a direct p73 target gene and that mRNA expression levels of p73 and IGFBP3 are significantly lower in small for gestational age (SGA) children compared with controls; in particular, p73 mRNA expression is significantly lower in SGA children with respect to length, suggesting that p73 is a good biomarker of the clinical risk for SGA children to remain short into adulthood. The regulation of insulin-like growth factor–binding protein 3 (IGFBP3) gene expression is complex, because it can be induced by agents that both stimulate and inhibit the proliferation. The principal aim of this study was to investigate whether p73, a member of the p53 gene family, has a role in the regulation of the IGFBP3 expression and whether this regulation occurs in a context of cell survival or death. We demonstrate that IGFBP3 is a direct TAp73α (the p73 isoform that contains the trans-activation domain) target gene and activates the expression of IGFBP3 in actively proliferating cells. As IGFBP3 plays a key role in regulating the growth hormone/insulin-like growth factor type 1 (GH/IGF1) axis, whose alterations in gene expression appear to have a role in the growth failure of children born small for gestational age (SGA), we measured the mRNA expression levels of p73 and IGFBP3 in a group of SGA children. We found that mRNA expression levels of p73 and IGFBP3 are significantly lower in SGA children compared with controls and, in particular, p73 mRNA expression is significantly lower in SGA children with respect to height. Our results shed light on the intricate GH/IGF pathway, suggesting p73 as a good biomarker of the clinical risk for SGA children to remain short in adulthood.
Collapse
Affiliation(s)
- Flaviana Marzano
- Institute for Biomedical Technologies-ITB, National Research Council-Bari, 70126 Bari, Italy
| | - Annamaria Ventura
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro," 70124 Bari, Italy
| | | | - Italia Aiello
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari "A. Moro," 70126 Bari, Italy
| | - Francesca Mastropasqua
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari "A. Moro," 70126 Bari, Italy
| | - Giacomina Brunetti
- Section of Human Anatomy and Histology, Department of Basic and Medical Sciences, Neurosciences and Sense Organs, University of Bari "A. Moro," 70124 Bari, Italy
| | - Luciano Cavallo
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro," 70124 Bari, Italy
| | - Elisabetta Sbisà
- Institute for Biomedical Technologies-ITB, National Research Council-Bari, 70126 Bari, Italy
| | - Maria Felicia Faienza
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro," 70124 Bari, Italy
| | - Apollonia Tullo
- Institute for Biomedical Technologies-ITB, National Research Council-Bari, 70126 Bari, Italy
| |
Collapse
|
13
|
Faienza MF, Delvecchio M, Giordano P, Cavallo L, Grano M, Brunetti G, Ventura A. Metabolic syndrome in childhood leukemia survivors: a meta-analysis. Endocrine 2015; 49:353-60. [PMID: 25154516 DOI: 10.1007/s12020-014-0395-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/12/2014] [Indexed: 01/05/2023]
Abstract
A significant number of long-term complications have been described in childhood leukemia survivors. In particular, these patients may present features of metabolic syndrome (MetS), and therefore increased risk for cardiovascular diseases. The aim of this meta-analysis is to evaluate the prevalence and the risk of MetS in survivors of childhood leukemia. Two authors independently performed a systematic literature search in PubMed and EMBASE to March 2014, reviewed and selected articles, based on pre-determined selection criteria. Twelve articles, comprising 2,337 participants (1,462 cases and 875 controls), were included in the meta-analysis. Only three of them were case-control studies eligible for the meta-analysis. The childhood leukemia survivors showed an increased risk of MetS as compared to healthy controls (OR = 4.36; 95 % CI 1.19-16.22). The risk was significantly increased only in patients treated with chemotherapy and radiotherapy (OR = 7.79; 95 % CI 1.27-47.77), and not in patients treated with only chemotherapy (OR = 2.35; 95 % CI 0.40-13.78). Childhood leukemia survivors, in particular if treated also with radiotherapy, are prone to develop MetS more than healthy controls. Monitoring of MetS components in these patients is necessary to avoid cardiovascular consequences later in life.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Pediatrics Unit, University of Bari 'A. Moro', Piazza G. Cesare, 11, 70124, Bari, Italy,
| | | | | | | | | | | | | |
Collapse
|
14
|
Giordano P, Brunetti G, Lassandro G, Notarangelo LD, Luciani M, Mura RM, Lazzareschi I, Santagostino E, Piacente L, Ventura A, Cavallo L, Grano M, Faienza MF. High serum sclerostin levels in children with haemophilia A. Br J Haematol 2015; 172:293-5. [PMID: 25944671 DOI: 10.1111/bjh.13481] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Paola Giordano
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy
| | - Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari "A. Moro", Bari, Italy
| | - Giuseppe Lassandro
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy
| | - Lucia D Notarangelo
- Oncohaematology and Bone Marrow Transplantation Unit, Children's Hospital, Brescia, Italy
| | - Matteo Luciani
- Division of Paediatric Haematology, Bambino Gesù Children's and Research Hospital, Rome, Italy
| | - Rosa M Mura
- Paediatric Haematology-Oncology, Cagliari Hospital, Cagliari, Italy
| | - Ilaria Lazzareschi
- Division of Paediatric Oncology, A. Gemelli Hospital, Catholic University of Rome, Rome, Italy
| | - Elena Santagostino
- Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Maggiore Hospital, IRCCS Cà Granda Foundation, Milan, Italy
| | - Laura Piacente
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy
| | - Annamaria Ventura
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy
| | - Luciano Cavallo
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy
| | - Maria Grano
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari "A. Moro", Bari, Italy
| | - Maria F Faienza
- Department of Biomedical Science and Human Oncology, Paediatric Unit University of Bari "A. Moro", Bari, Italy.
| |
Collapse
|
15
|
Castellaneta S, Piccinno E, Oliva M, Cristofori F, Vendemiale M, Ortolani F, Papadia F, Catassi C, Cavallo L, Francavilla R. High rate of spontaneous normalization of celiac serology in a cohort of 446 children with type 1 diabetes: a prospective study. Diabetes Care 2015; 38:760-6. [PMID: 25784659 DOI: 10.2337/dc14-2890] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [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] [Received: 12/05/2014] [Accepted: 01/27/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In children with type 1 diabetes mellitus (T1DM), elevated levels of antitissue transglutaminase (anti-tTG) antibody may spontaneously normalize, despite continued consumption of gluten. We aimed to investigate the prevalence of spontaneous normalization of anti-tTG levels and the existence of factors predictive for this outcome. RESEARCH DESIGN AND METHODS All children referred from 2002 to 2012 were screened for celiac disease (CD) at diabetes onset and at specific intervals. In the presence of a high anti-tTG titer or clinical symptoms, children were offered endoscopy, and asymptomatic patients with a low anti-tTG titer were invited to a second serological test after 6 months of eating a gluten-containing diet. RESULTS The study included 446 children. Of these, 65 (14.5%) became positive for celiac serology: 38 (58%) had a persistently elevated anti-tTG titer and 27 (41%) fluctuating anti-tTG titer; 18 (28%) became negative. The prevalence of positive CD autoimmunity and overt CD was 14.3% (95% CI 11-17) and 8.5% (95% CI 5-10), 15- and 8-times higher than the general pediatric population, respectively. Asymptomatic children older than 9.1 years at T1DM onset had the lowest risk to develop CD. CONCLUSIONS Serum anti-tTG levels decreased spontaneously in 40% of children with T1DM and became negative in 20%, despite gluten consumption. This finding supports the hypothesis of a state of temporary positivity of celiac serology in children with diabetes. In absence of clinical symptoms or signs of CD, histological confirmation of the disease and the gluten-free diet should be postponed to avoid unnecessary procedures and reduce an additional psychological burden.
Collapse
Affiliation(s)
| | - Elvira Piccinno
- Unit of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXII Children's Hospital, Bari, Italy
| | - Marica Oliva
- Pediatric Gastroenterology and Hepatology Unit, Interdisciplinary Department of Medicine, Giovanni XXII Children's Hospital, University of Bari "A. Moro," Bari, Italy
| | - Fernanda Cristofori
- Pediatric Gastroenterology and Hepatology Unit, Interdisciplinary Department of Medicine, Giovanni XXII Children's Hospital, University of Bari "A. Moro," Bari, Italy
| | - Marcella Vendemiale
- Unit of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXII Children's Hospital, Bari, Italy
| | - Federica Ortolani
- Unit of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXII Children's Hospital, Bari, Italy
| | - Francesco Papadia
- Unit of Metabolic Diseases, Clinical Genetics and Diabetology, Giovanni XXII Children's Hospital, Bari, Italy
| | - Carlo Catassi
- Department of Paediatrics, University Politecnica delle Marche, Ancona, Italy
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro," Bari, Italy
| | - Ruggiero Francavilla
- Pediatric Gastroenterology and Hepatology Unit, Interdisciplinary Department of Medicine, Giovanni XXII Children's Hospital, University of Bari "A. Moro," Bari, Italy
| |
Collapse
|
16
|
Delvecchio M, Soldano L, Lonero A, Ventura A, Giordano P, Cavallo L, Grano M, Brunetti G, Faienza MF. Evaluation of impact of steroid replacement treatment on bone health in children with 21-hydroxylase deficiency. Endocrine 2015; 48:995-1000. [PMID: 24981037 DOI: 10.1007/s12020-014-0332-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/05/2014] [Indexed: 10/25/2022]
Abstract
There are conflicting data regarding the potential impact of chronic glucocorticoid (GC) therapy on the bone mineral density of patients with congenital adrenal hyperplasia (CAH). Previous studies performed by dual-energy X-ray absorptiometry reported conflicting results. The purpose of this study was to assess the impact of chronic GC replacement treatment in children with classical and non classical CAH due to 21-hydroxylase deficiency (21-OHD) by quantitative ultrasonometry (QUS), an easy, cheap, and radiation-free technique. The study population consisted of nineteen 21-OHD patients (nine males) on lifelong GC treatment. Anthropometric, hormonal, and treatment data were recorded for each patient, and bone quality was assessed by QUS measurements. QUS findings (amplitude-dependent speed of sound and bone transmission time) were normal in 21-OHD patients and did not correlate with duration of treatment, daily, total, and yearly hydrocortisone dose. Furthermore, no significant correlation was found between QUS findings and 17α-hydroxy progesterone, Δ4-androstenedione, and testosterone levels. In conclusion, our results provide reassurance that currently used replacement doses of GC do not have a major impact on bone in patients with CAH. QUS seems to be a reliable tool for screening of bone health in children with 21-OHD.
Collapse
Affiliation(s)
- M Delvecchio
- Department of Biomedical Sciences and Human Oncology, Pediatrics Unit, University of Bari 'A. Moro', Piazza G. Cesare, 11, 70124, Bari, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Delvecchio M, Faienza MF, Lonero A, Rutigliano V, Francavilla R, Cavallo L. Prolactin may be increased in newly diagnosed celiac children and adolescents and decreases after 6 months of gluten-free diet. Horm Res Paediatr 2015; 81:309-13. [PMID: 24603159 DOI: 10.1159/000357064] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/31/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/AIMS Prolactin (PRL) is produced by the anterior pituitary gland. It exerts its role on the breast gland but also plays a modulatory role in autoimmune mechanisms. Celiac disease (CD) is a gluten-sensitive autoimmune enteropathy sometimes associated with autoimmune endocrinopathies. No data on PRL levels in CD patients are available at diagnosis, and no conclusive data are reported. METHODS We aimed to evaluate PRL secretion in newly diagnosed CD pediatric patients and, in the case of hyperprolactinemia, any changes in its levels while the patients were on a gluten-free diet (GFD). We recruited 67 patients and 39 healthy controls. RESULTS PRL was statistically higher in the CD patients (13.5±9.2 ng/ml) than in the controls (8.5±5.0 ng/ml). In the CD group, PRL was inversely correlated with the age at diagnosis (r=-0.326; p=0.007). In patients with hyperprolactinemia at diagnosis, PRL decreased after 6 months of GFD. CONCLUSION This paper confirms that PRL may be increased at diagnosis of CD and shows, for the first time, that it decreases after a short course of GFD. Changes in the levels of inflammatory cytokines in CD may account for changes in PRL levels. Younger patients seem more prone to develop hyperprolactinemia than older ones.
Collapse
Affiliation(s)
- Maurizio Delvecchio
- Pediatrics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | | | | | | | | |
Collapse
|
18
|
Faienza MF, Luce V, Ventura A, Colaianni G, Colucci S, Cavallo L, Grano M, Brunetti G. Skeleton and glucose metabolism: a bone-pancreas loop. Int J Endocrinol 2015; 2015:758148. [PMID: 25873957 PMCID: PMC4383460 DOI: 10.1155/2015/758148] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 11/11/2014] [Accepted: 12/02/2014] [Indexed: 02/06/2023] Open
Abstract
Bone has been considered a structure essential for mobility, calcium homeostasis, and hematopoietic function. Recent advances in bone biology have highlighted the importance of skeleton as an endocrine organ which regulates some metabolic pathways, in particular, insulin signaling and glucose tolerance. This review will point out the role of bone as an endocrine "gland" and, specifically, of bone-specific proteins, as the osteocalcin (Ocn), and proteins involved in bone remodeling, as osteoprotegerin, in the regulation of insulin function and glucose metabolism.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Vincenza Luce
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Annamaria Ventura
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Graziana Colaianni
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Silvia Colucci
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Luciano Cavallo
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Maria Grano
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
| | - Giacomina Brunetti
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy
- *Giacomina Brunetti:
| |
Collapse
|
19
|
Aceto G, D'Addato O, Messina G, Carbone V, Cavallo L, Brunetti G, Faienza MF. Bone health in children and adolescents with steroid-sensitive nephrotic syndrome assessed by DXA and QUS. Pediatr Nephrol 2014; 29:2147-55. [PMID: 24902941 DOI: 10.1007/s00467-014-2834-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 04/14/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The management of steroid-sensitive nephrotic syndrome (SSNS) requires treatment with high-dose glucocorticoids (GCs), but GC usage causes the most frequent form of drug-induced osteoporosis. The aim of our study was to evaluate the impact of GCs on bone mineralization in patients with SSNS using two diagnostic tools, dual-energy X-ray densitometry (DXA) and quantitative ultrasound (QUS), and to compare the diagnostic efficacy of these two imaging tools. METHODS A total of 30 children with SSNS (age 5.20 ± 2.20 years) were evaluated at the start (T0) and after 1 (T1), 2.44 ± 0.75 (T2, 18 patients) and 5.96 ± 2.33 years (T4, 12 patients) of GC treatment. Patients who stopped at T2 were also evaluated at the 1-year timepoint after ceasing GC treatment (T3). RESULTS Of the patients assessed at T2, 11 had bone mineralization at the lower limit of normal versus those at T0 and T1, with bone mineralization rescue at the 1-year timepoint after GC discontinuation. At T4, 6/12 patients had densitometric parameters at the lower limit of normal values, and 3/12 patients showed reduced bone mineralization. The parameters derived from measurements of DXA and QUS were significantly related to each timepoint. CONCLUSIONS Patients with SSNS receiving GC therapy undergo bone status alteration related to the dosage and duration of the therapy. In terms of diagnostic efficacy, DXA and QUS were comparable, indicating that QUS is a reliable tool to evaluate bone health in children with SSNS.
Collapse
Affiliation(s)
- Gabriella Aceto
- Division of Pediatric Nephrology, Children's Hospital Giovanni XXIII, Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
20
|
Faienza MF, Luce V, Lonero A, Ventura A, Colaianni G, Colucci S, Cavallo L, Grano M, Brunetti G. Treatment of osteoporosis in children with glucocorticoid-treated diseases. Expert Rev Endocrinol Metab 2014; 9:525-534. [PMID: 30736214 DOI: 10.1586/17446651.2014.936384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Glucocorticoid induced osteoporosis (GIO) is the most frequent form of drug induced osteoporosis. Glucocorticoids affect osteoblastogenesis, osteoclastogenesis and promote the apoptosis of osteoblasts and osteocytes. A decrease of bone mineral density has been described in several pediatric diseases that require glucocorticoids, both as long-term replacement therapy, such as Congenital Adrenal Hyperplasia, and as treatment of acute phase or relapses, such as asthma, juvenile rheumatoid arthritis, inflammatory bowel diseases, systemic lupus erythematosus, organ transplantation and Steroid Sensitive Nephrotic Syndrome. The increasing number of children with GIO and at risk of fractures reflects the complex nature of this condition, and the need of development of anti-osteoporotic drugs. In this review, we focus on the mechanisms of GIO in some pediatric diseases and on treatment of osteoporosis. We also report data on new signaling pathways as potential targets for future anti-osteoporotic drugs.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- a Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University "A. Moro", Bari, Italy
| | - Vincenza Luce
- a Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University "A. Moro", Bari, Italy
| | - Antonella Lonero
- a Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University "A. Moro", Bari, Italy
| | - Annamaria Ventura
- a Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University "A. Moro", Bari, Italy
| | - Graziana Colaianni
- b Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Silvia Colucci
- b Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Luciano Cavallo
- a Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University "A. Moro", Bari, Italy
| | - Maria Grano
- b Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Giacomina Brunetti
- b Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| |
Collapse
|
21
|
Cristofori F, Fontana C, Magistà A, Capriati T, Indrio F, Castellaneta S, Cavallo L, Francavilla R. Increased prevalence of celiac disease among pediatric patients with irritable bowel syndrome: a 6-year prospective cohort study. JAMA Pediatr 2014; 168:555-60. [PMID: 24756157 DOI: 10.1001/jamapediatrics.2013.4984] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Recurrent abdominal pain is a prevalent health issue in childhood. Clinical criteria (ie, the Rome criteria) have been established to aid diagnosis. Studies of adults have shown an increased prevalence of celiac disease among patients with irritable bowel syndrome (IBS); few data are available with regard to children. OBJECTIVE To assess the prevalence of celiac disease among children with abdominal pain-related functional gastrointestinal disorders classified according to the Rome criteria. DESIGN, SETTING, PARTICIPANTS Six-year (2006-2012) prospective cohort study conducted in a tertiary referral center for the diagnosis and follow-up of gastrointestinal disorders in southern Italy (ie, Bari, Italy). A total of 992 children (42.8% male; median age, 6.8 years) consecutively referred for recurrent abdominal pain by their primary care physicians without previous investigation were evaluated. EXPOSURE Patients were classified according to Rome III criteria as having IBS, functional dyspepsia, functional abdominal pain, or abdominal migraine. MAIN OUTCOMES AND MEASURES Prevalence of celiac disease in each category of abdominal pain-related functional gastrointestinal disorder. Concentrations of IgA, IgA antitissue transglutaminase, and endomysial antibodies were measured, and a duodenal biopsy was performed in case of antibody positivity. RESULTS A total of 992 children were evaluated: 270 were classified as having IBS, 201 as having functional dyspepsia, and 311 as having functional abdominal pain, and 210 children were excluded from the study because they had an organic disorder or some other functional gastrointestinal disorder (not related to abdominal pain). Serologic testing was performed for all 782 children included in the study, and 15 patients tested positive for celiac disease (12 of 270 patients with IBS [4.4%], 2 of 201 patients with functional dyspepsia [1%], and 1 of 311 patients with functional abdominal pain [0.3%]). Children presenting with IBS have a 4 times higher risk of having celiac disease than children without IBS (odds ratio, 4.19 [95% CI, 2.03-8.49]; P < .001). CONCLUSIONS AND RELEVANCE The prevalence of celiac disease among children with IBS is 4 times higher than among the general pediatric population. Rome III classification of abdominal pain-related functional gastrointestinal disorders might help to select children who deserve screening for celiac disease.
Collapse
Affiliation(s)
- Fernanda Cristofori
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | - Claudia Fontana
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | | | - Teresa Capriati
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | - Flavia Indrio
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | | | - Luciano Cavallo
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | - Ruggiero Francavilla
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Giovanni XXIII Hospital, Bari, Italy
| |
Collapse
|
22
|
Fontsere N, Mestres G, Burrel M, Barrufet M, Montana X, Arias M, Ojeda R, Maduell F, Campistol JM, Nagaraja P, Rees D, Husein T, Chess J, Lin CC, Yang WC, Khosravi M, Kandil H, Cross J, Hopkins S, Collier S, Lopes D, Pereira S, Gomes AM, Ventura A, Martins V, Seabra J, Rothuizen TC, Damanik F, Visser MJT, Lavrijsen T, Cox MAJ, Moroni L, Rabelink TJ, Rotmans JI, Fontsere N, Cardozo C, Donate J, Soriano A, Muros M, Pons M, Mensa J, Campistol JM, Navarro-Gonzalez JF, Maduell F, Wijewardane A, Murley A, Powers S, Allen C, Baharani J, Wilmink T, Esenturk M, Zengin M, Dal M, Tahtal N, Shibata K, Shinzato T, Satta H, Nishihara M, Koguchi N, Kuji T, Kawata S, Kaneda T, Yasuda G, Scrivano J, Pettorini L, Rutigliano T, Ciavarella GM, De Biase L, Punzo G, Mene P, Pirozzi N, El Haggan W, Belazrague K, Ehoussou S, Foucher V, El Salhy M, Ouellet G, Davis J, Caron P, Leblanc M, Pettorini L, Romitelli F, Fazzari L, Scrivano J, Ortu G, Di Stasio E, Punzo G, Mene P, Pirozzi N, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Letachowicz K, Go biowski T, Kusztal M, Letachowicz W, Weyde W, Klinger M, Murley A, Wijewardane A, Powers S, Allen C, Hollingsworth L, Wilmink T, Baharani J, Roca-Tey R, Samon R, Ibrik O, Roda A, Gonzalez-Oliva JC, Martinez-Cercos R, Viladoms J, Renaud CJ, Lim EK, Seow TY, Teh HS, Tosic J, Jankovic A, Djuric P, Radovic Maslarevic V, Popovic J, Dimkovic N, Kazantzi A, Trigka K, Buono F, Laurino S, Toriello G, Di Luccio R, Galise A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Asano M, Oguchi K, Saito A, Onishi Y, Yamamoto Y, Fukuhara S, Akiba T, Akizawa T, Kurokawa K, Guedes Marques M, Ibeas J, Maia P, Ponce P, Chang KY, Park HS, Kim HW, Choi BS, Park CW, Yang CW, Jin DC, Likaj E, Seferi S, Caco G, Petrela E, Barbullushi M, Idrizi A, Thereska N, Lomonte C, Casucci F, Libutti P, Lisi P, Basile C, Ancarani P, Valsuani G, Cavallo L, Parodi D, Lorusso C, Renaud C, Lai BC, Tho S, Yeoh L, Guedes Marques M, Botelho C, Maia P, Ponce P, Yankovoy A, Alexandr S, Smoliacov A, Stepanov V, Rees D, Parker C, Davies P, Taylor S, Mikhail A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Gubensek J, Persic V, Vajdic B, Ponikvar R, Buturovic-Ponikvar J, Hadimeri U, Warme AV, Stegmayr B, Jankovic A, Suvakov S, Tosic J, Damjanovic T, Djuric P, Bajcetic S, Radovic-Maslarevic V, Popovic J, Simic T, Dimkovic N, Likaj E, Seferi S, Petrela E, Idrizi A, Rroji M, Barbullushi M, Thereska N, Chua HL, Kanda H, See SL, Liew NC, Tsuchida K, Tomo T, Fukasawa M, Kawashima S, Minakuchi J, Thanaraj V, Dhaygude A, Ikeda K, Forneris G, Cecere P, Pozzato M, Trogolo M, Vallero A, Mesiano P, Roccatello D, Esenturk M, Zengin M, Keskin L, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Casey JR, Hanson CS, Winkelmayer WC, Craig J, Palmer S, Strippoli G, Tong A, Ferrara D, Scamarda S, Bernardino L, Amico L, Lorito MC, Incalcaterra F, Visconti L, Visconti G, Valenza F, D'Amato F, Di Napoli A, Tazza L, Chicca S, Lapucci E, Silvestri P, Di Lallo D, Michelozzi P, Davoli M. DIALYSIS VASCULAR ACCESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
23
|
Faienza MF, Brunetti G, Monteduro M, Cavallo L. Best determinants of nonalcoholic fatty liver disease and intra-abdominal fat in prepubertal children born small for gestational age: ultrasound technique versus anthropometric data. Horm Res Paediatr 2014; 80:135-6. [PMID: 23797065 DOI: 10.1159/000351580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 04/21/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Maria Felicia Faienza
- Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy
| | | | | | | |
Collapse
|
24
|
Francavilla R, Cristofori F, Castellaneta S, Polloni C, Albano V, Dellatte S, Indrio F, Cavallo L, Catassi C. Clinical, serologic, and histologic features of gluten sensitivity in children. J Pediatr 2014; 164:463-7.e1. [PMID: 24252792 DOI: 10.1016/j.jpeds.2013.10.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [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] [Received: 06/21/2013] [Revised: 09/05/2013] [Accepted: 10/02/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To describe the clinical, serologic, and histologic characteristics of children with gluten sensitivity (GS). STUDY DESIGN We studied 15 children (10 males and 5 females; mean age, 9.6 ± 3.9 years) with GS who were diagnosed based on a clear-cut relationship between wheat consumption and development of symptoms, after excluding celiac disease (CD) and wheat allergy, along with 15 children with active CD (5 males and 10 females; mean age, 9.1 ± 3.1 years) and 15 controls with a functional gastrointestinal disorder (6 males and 9 females; mean age, 8.6 ± 2.7 years). All children underwent CD panel testing (native antigliadin antibodies IgG and IgA, anti-tissue transglutaminase antibody IgA and IgG, and anti-endomysial antibody IgA), hematologic assessment (hemoglobin, iron, ferritin, aspartate aminotransferase, erythrocyte sedimentation rate), HLA typing, and small intestinal biopsy (on a voluntary basis in the children with GS). RESULTS Abdominal pain was the most prevalent symptom in the children with GS (80%), followed by chronic diarrhea in (73%), tiredness (33%), bloating (26%), limb pain, vomiting, constipation, headache (20%), and failure to thrive (13%). Native antigliadin antibodies IgG was positive in 66% of the children with GS. No differences in nutritional, biochemical, or inflammatory markers were found between the children with GS and controls. HLA-DQ2 was found in 7 children with GS. Histology revealed normal to mildly inflamed mucosa (Marsh stage 0-1) in the children with GS. CONCLUSION Our findings support the existence of GS in children across all ages with clinical, serologic, genetic, and histologic features similar to those of adults.
Collapse
Affiliation(s)
- Ruggiero Francavilla
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy.
| | - Fernanda Cristofori
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy
| | | | - Carlo Polloni
- Department of Pediatrics, Rovereto Hospital, Rovereto, Italy
| | - Veronica Albano
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | | | - Flavia Indrio
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy
| | - Luciano Cavallo
- Interdisciplinary Department of Medicine, Pediatric Section, University of Bari, Bari, Italy
| | - Carlo Catassi
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| |
Collapse
|
25
|
Faienza MF, Ventura A, Piacente L, Ciccarelli M, Gigante M, Gesualdo L, Colucci S, Cavallo L, Grano M, Brunetti G. Osteoclastogenic potential of peripheral blood mononuclear cells in cleidocranial dysplasia. Int J Med Sci 2014; 11:356-64. [PMID: 24578613 PMCID: PMC3936030 DOI: 10.7150/ijms.7793] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/10/2014] [Indexed: 12/29/2022] Open
Abstract
Cleidocranial dysplasia (CCD) is an autosomal dominant skeletal dysplasia characterized by hypoplastic or aplastic clavicles, dental abnormalities, and delayed closure of the cranial sutures. In addition, mid-face hypoplasia, short stature, skeletal anomalies and osteoporosis are common. We aimed to evaluate osteoclastogenesis in a child (4 years old), who presented with clinical signs of CCD and who have been diagnosed as affected by deletion of RUNX2, master gene in osteoblast differentiation, but also affecting T cell development and indirectly osteoclastogenesis. The results of this study may help to understand whether in this disease is present an alteration in the bone-resorptive cells, the osteoclasts (OCs). Unfractionated and T cell-depleted Peripheral Blood Mononuclear Cells (PBMCs) from patient were cultured in presence/absence of recombinant human M-CSF and RANKL. At the end of the culture period, OCs only developed following the addition of M-CSF and RANKL. Moreover, real-time PCR experiment showed that freshly isolated T cells expressed the osteoclastogenic cytokines (RANKL and TNFα) at very low level, as in controls. This is in accordance with results arising from flow cytometry experiments demonstrating an high percentage of circulating CD4(+)CD28(+) and CD4(+)CD27(+) T cells, not able to produce osteoclastogenic cytokines. Also RANKL, OPG and CTX serum levels in CCD patient are similar to controls, whereas QUS measurements showed an osteoporotic status (BTT-Z score -3.09) in the patient. In conclusions, our findings suggest that the heterozygous deletion of RUNX2 in this CCD patient did not alter the osteoclastogenic potential of PBMCs in vitro.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- 1. Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari, Bari, Italy
| | - Annamaria Ventura
- 1. Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari, Bari, Italy
| | - Laura Piacente
- 1. Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari, Bari, Italy
| | - Maria Ciccarelli
- 1. Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari, Bari, Italy
| | - Margherita Gigante
- 2. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Loreto Gesualdo
- 2. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvia Colucci
- 3. Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Luciano Cavallo
- 1. Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University of Bari, Bari, Italy
| | - Maria Grano
- 3. Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | - Giacomina Brunetti
- 3. Department of Basic Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| |
Collapse
|
26
|
Macchiaroli A, Kelberman D, Auriemma RS, Drury S, Islam L, Giangiobbe S, Ironi G, Lench N, Sowden JC, Colao A, Pivonello R, Cavallo L, Gasperi M, Faienza MF. A novel heterozygous SOX2 mutation causing congenital bilateral anophthalmia, hypogonadotropic hypogonadism and growth hormone deficiency. Gene 2013; 534:282-5. [PMID: 24211324 DOI: 10.1016/j.gene.2013.10.043] [Citation(s) in RCA: 14] [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: 06/27/2013] [Revised: 10/16/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
Heterozygous de novo mutations in SOX2 have been reported in approximately 10-20% of patients with unilateral or bilateral anophthalmia or microphthalmia. An additional phenotype of hypopituitarism, with anterior pituitary hypoplasia and hypogonadotropic hypogonadism, has been reported in patients carrying SOX2 alterations. We report a novel heterozygous mutation in the SOX2 gene in a male affected with congenital bilateral anophthalmia, hypogonadotrophic hypogonadism and growth hormone deficiency. The mutation we describe is a cytosine deletion in position 905 (c905delC) which causes frameshift and an aberrant C-terminal domain. Our report highlights the fact that subjects affected with eye anomalies and harboring SOX2 mutations are at high risk for gonadotropin deficiency, which has important implications for their clinical management.
Collapse
Affiliation(s)
| | - Daniel Kelberman
- Ulverscroft Vision Research Group, Developmental Biology Unit, UCL Institute of Child Health, London, UK
| | - Renata Simona Auriemma
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Napoli, Italy
| | - Suzanne Drury
- NE Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Lily Islam
- Ulverscroft Vision Research Group, Developmental Biology Unit, UCL Institute of Child Health, London, UK
| | - Sara Giangiobbe
- Paediatric Endocrinology Unit, "Cardarelli" Hospital, Campobasso, Italy
| | - Gabriele Ironi
- Paediatric Endocrinology Unit, "Cardarelli" Hospital, Campobasso, Italy
| | - Nicholas Lench
- NE Thames Regional Genetics Service, Great Ormond Street Hospital for Children, London, UK
| | - Jane C Sowden
- Ulverscroft Vision Research Group, Developmental Biology Unit, UCL Institute of Child Health, London, UK
| | - Annamaria Colao
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Napoli, Italy
| | - Rosario Pivonello
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Napoli, Italy
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University "Aldo Moro", Bari, Italy
| | - Maurizio Gasperi
- Department of Medicine and Health Sciences, Section of Endocrinology, University of Molise, Campobasso, Italy
| | - Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University "Aldo Moro", Bari, Italy.
| |
Collapse
|
27
|
Faienza MF, Brunetti G, Ventura A, D'Aniello M, Pepe T, Giordano P, Monteduro M, Cavallo L. Nonalcoholic fatty liver disease in prepubertal children born small for gestational age: influence of rapid weight catch-up growth. Horm Res Paediatr 2013; 79:103-9. [PMID: 23466642 DOI: 10.1159/000347217] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [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] [Received: 10/08/2012] [Accepted: 01/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS We studied the association of low birth weight with ultrasound-assessed nonalcoholic fatty liver disease (NAFLD) to test the hypothesis that fetal growth retardation followed by a rapid weight catch-up growth might be an additional factor responsible for liver steatosis via insulin resistance (IR) and/or intra-abdominal fat. METHODS We enrolled 23 children born small for gestational age (SGA) with a rapid catch-up growth within the first 6-12 months, and 24 appropriate for gestational age (AGA) children as controls. All children underwent anthropometric, body composition measurements and evaluation of liver function tests, lipid profile, plasma glucose and insulin levels. Abdominal ultrasonography was performed in order to asses liver steatosis and thickness of subcutaneous and visceral adipose tissue. RESULTS NAFLD were observed in 8 out of the 23 SGA children (34.8%). IR and visceral fat were significantly increased in children with hepatic steatosis compared to those without. IR index was significantly related to liver steatosis, independently of body mass index standard deviation score and visceral fat. CONCLUSIONS NAFLD should be recognized as an emerging problem in SGA prepubertal children who presented a rapid weight gain in postnatal life, and IR plays the key role. An appropriate diet during pregnancy and in the first year of life might prevent metabolic syndrome and NAFLD in these subjects.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Faienza MF, Francavilla R, Goffredo R, Ventura A, Marzano F, Panzarino G, Marinelli G, Cavallo L, Di Bitonto G. Oxidative stress in obesity and metabolic syndrome in children and adolescents. Horm Res Paediatr 2013; 78:158-64. [PMID: 23052543 DOI: 10.1159/000342642] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [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] [Received: 03/26/2012] [Accepted: 08/11/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The aim of this study was to investigate the alterations in the oxidant/antioxidant status in obese children with and without metabolic syndrome (MetS). METHODS We recruited 25 Caucasian obese children with MetS, 30 Caucasian children with simple obesity and a control group of 30 Caucasian children. We performed diacron-reactive oxygen metabolites (d-ROMs) test and biological antioxidant potential (BAP) test in order to evaluate the oxidant-antioxidant status in recruited patients. RESULTS d-ROM level was significantly higher in obese children with and without MetS (p = 0.005). The total antioxidant capacity (BAP level) was reduced in MetS and noMetS children compared to controls (p = 0.009). The subjects without MetS had higher d-ROMs test and lower BAP/d-ROMs ratio than subjects with MetS (although not significant). The ratio BAP/d-ROMs was higher in controls than noMetS and MetS children (p < 0.0001). d-ROM level was higher in prepubertal subjects with MetS than pubertal ones (p = 0.03). A direct correlation was found between d-ROM levels and BMI SDS (p = 0.0005), while an inverse correlation was found between BAP and BMI SDS (p = 0.004) and BAP/d-ROMs and BMI SDS (p = 0.0001). CONCLUSIONS This result confirms that fat accumulation plays a key role in the pathogenesis of systemic oxidative stress already during pediatric age.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Brunetti G, Faienza MF, Piacente L, Ventura A, Oranger A, Carbone C, Benedetto AD, Colaianni G, Gigante M, Mori G, Gesualdo L, Colucci S, Cavallo L, Grano M. High dickkopf-1 levels in sera and leukocytes from children with 21-hydroxylase deficiency on chronic glucocorticoid treatment. Am J Physiol Endocrinol Metab 2013; 304:E546-54. [PMID: 23299503 DOI: 10.1152/ajpendo.00535.2012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Children with 21-hydroxylase deficiency (21-OHD) need chronic glucocorticoid (cGC) therapy to replace congenital deficit of cortisol synthesis, and this therapy is the most frequent and severe form of drug-induced osteoporosis. In this study, we enrolled 18 patients (9 females) and 18 sex- and age-matched controls. We found in 21-OHD patients high serum and leukocyte levels of dickkopf-1 (DKK1), a secreted antagonist of the Wnt/β-catenin signaling pathway known to be a key regulator of bone mass. In particular, we demonstrated by flow cytometry, confocal microscopy, and real-time PCR that monocytes, T lymphocytes, and neutrophils from patients expressed high levels of DKK1, which may be related to the cGC therapy. In fact, we showed that dexamethasone treatment markedly induced the expression of DKK1 in a dose- and time-dependent manner in leukocytes. The serum from patients containing elevated levels of DKK1 can directly inhibit in vitro osteoblast differentiation and receptor activator of NF-κB ligand (RANKL) expression. We also found a correlation between both DKK1 and RANKL or COOH-terminal telopeptides of type I collagen (CTX) serum levels in 21-OHD patients on cGC treatment. Our data indicated that DKK1, produced by leukocytes, may contribute to the alteration of bone remodeling in 21-OHD patients on cGC treatment.
Collapse
Affiliation(s)
- Giacomina Brunetti
- Dept. of Basic Medical Sciences, Neuroscience, and Sense Organs, Section of Human Anatomy and Histology, Univ. of Bari, Piazza Giulio Cesare, 11 70124 Bari, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Faienza MF, Acquafredda A, D'Aniello M, Soldano L, Marzano F, Ventura A, Cavallo L. Effect of recombinant insulin-like growth factor-1 treatment on short-term linear growth in a child with Majewski osteodysplastic primordial dwarfism type II and hepatic insufficiency. J Pediatr Endocrinol Metab 2013; 26:771-4. [PMID: 23612698 DOI: 10.1515/jpem-2012-0397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 02/18/2013] [Indexed: 11/15/2022]
Abstract
We report the case of a boy affected by severe intrauterine and postnatal growth retardation, microcephaly, facial dysmorphisms and postnecrotic cirrhosis, diagnosed at birth as having Seckel syndrome, and subsequently confirmed as Majewski osteodysplastic primordial dwarfism type II (MOPD II) on the basis of clinical and radiological features of skeletal dysplasia. At our observation (6 years 7 months) he presented height -10.3 standard deviation score (SDS), weight -22.1 SDS, head circumference -8 SDS, delayed bone age of 4 years with respect to chronological age. In consideration of the low levels of insulin-like growth factor-1 (IGF-1) as well as of hepatic insufficiency, we started the treatment with recombinant human IGF-1 (rhIGF-1) at the dose of 0.04 mg/kg in 2 doses/day, with an increase of 0.04 mg/kg after 1 week until the maximum dose of 0.12 mg/kg. We observed an early response to rhIGF-1 treatment, with a shift of height velocity from 1.8 cm/year (-4.6 SDS) at 4 cm/year (-1.9 SDS), and an increase in bone age of 1.5 years during the first 6 months. rhIGF-1 treatment does not seem to be able to replace the physiological action of IGF-1 in patients with MOPD II and hepatic insufficiency, however, it seems to preserve the typical growth pattern of MOPD II patients, avoiding a further widening of the growth deficiency in these subjects.
Collapse
|
31
|
Faienza MF, Acquafredda A, Tesse R, Luce V, Ventura A, Maggialetti N, Monteduro M, Giordano P, Cavallo L. Risk factors for subclinical atherosclerosis in diabetic and obese children. Int J Med Sci 2013; 10:338-43. [PMID: 23423872 PMCID: PMC3575630 DOI: 10.7150/ijms.5181] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 12/27/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Increased carotid intima-media thickness (cIMT) is considered a marker of early-onset atherosclerosis and it seems to predict cardiovascular events both in obese and diabetic subjects. We aimed to evaluate early signs of atherosclerosis and investigate for predisposing factors in children and adolescents affected by type 1 diabetes (T1DM) or obesity, comparing them with healthy controls. METHODS Out of 71 enrolled subjects (mean age 12.8 ± 2.3 years), 26 had T1DM and 24 were obese, while 21 age- and sex-matched subjects acted as controls. cIMT was measured using standardized methods. Serum glucose, insulin, cholesterol, triglycerides and C-reactive protein levels were evaluated. An oral glucose tolerance test (OGTT) was performed in obese subjects. RESULTS Diabetic and obese individuals showed higher cIMT mean values than healthy controls (p < 0.005). cIMT of the three examined segments correlated positively with fasting glucose levels and negatively with units of insulin/kg/day administered in T1DM individuals. A positive correlation between insulin levels (basal and after oral glucose load) and cIMT of common, internal and external carotid artery was found in obese subjects (p < 0.03). High density cholesterol levels represented a protective factor for cIMT in this latter group of the study population. CONCLUSIONS Our findings show that cIMT correlates with high insulin levels (a sign of insulin resistance) in obese patients and with high fasting glucose levels (a sign of relative insulin deficiency) in T1DM subjects, confirming the need of reducing hyperinsulinism and monitoring blood glucose levels in these subjects to prevent atherosclerosis.
Collapse
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro", Bari, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Tesse R, Spadavecchia L, Fanelli P, Paglialunga C, Capozza M, Favoino B, Armenio L, Cavallo L. New insights into childhood Vernal keratoconjunctivitis-associated factors. Pediatr Allergy Immunol 2012; 23:682-5. [PMID: 22963206 DOI: 10.1111/j.1399-3038.2012.01281.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to test for detectable serum levels of antibodies usually associated with immune-related diseases in children with Vernal keratoconjunctivitis (VKC) and seek for their family history of allergies and autoimmune disorders. The association of human leukocyte antigens (HLA) with VKC was also investigated. We enrolled 181 VKC children and assessed total and specific IgE, antithyroglobulin (AbTG), antithyroidperoxidase (AbTPO), antitransglutaminase (tTG), and antinuclear antibodies (ANA) by standard procedures. Class I and II HLA typing was also carried out following standard protocols, and it was compared with that of healthy subjects. Patients were positive for AbTG (22%), AbTPO (14.6%), and ANA (15.8%), and AbTG positivity was associated with VKC severity (mean ocular score ± SD positive vs. negative: 6.56 ± 2.1 vs. 4.82 ± 2.1; p = 0.03). We found that 12.2% of VKC cases had a positive family history for psoriasis, 6.4% for other cases of VKC, and 5.2% for thyroiditis, while 50.2% of them were atopic. The expression of HLA class I B37 was significantly higher in VKC patients than in controls (7.1% vs. 2.1%, p = 0.04), although not confirmed after multiple antigens testing analysis. Our study suggests a role of common components associated with immune-based diseases in the clinical expression of VKC.
Collapse
Affiliation(s)
- Riccardina Tesse
- Department of Biomedicine of the Developing Age, School of Medicine, University of Bari, Bari, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Urbano F, Acquafredda A, Aceto G, Penza R, Cavallo L. Unusual pediatric co-morbility: autoimmune thyroiditis and cortico-resistant nephrotic syndrome in a 6-month-old Italian patient. Ital J Pediatr 2012; 38:57. [PMID: 23092196 PMCID: PMC3502177 DOI: 10.1186/1824-7288-38-57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 10/11/2012] [Indexed: 11/29/2022] Open
Abstract
We report on a case of autoimmune thyroiditis in a 6-month-old patient with cortico-resistant nephrotic syndrome. Normal serum levels of thyroid hormons and thyroid-stimulating hormone were detected with high titers of circulant antithyroid antibodies and a dysomogeneous ultrasound appearance of the gland, typical of autoimmune thyroiditis. The research of maternal thyroid antibodies was negative. This is the first case of autoimmune thyroiditis found in such a young patient with pre-existing nephrotic syndrome ever described in literature. This association is random because nephrotic syndrome does not have an autoimmune pathogenesis and the genes involved in autoimmune thyroiditis are not related to those of nephrotic syndrome.
Collapse
Affiliation(s)
- Flavia Urbano
- Biomedicine Department of Development Age, University of Bari "Aldo Moro", Bari, Italy.
| | | | | | | | | |
Collapse
|
34
|
Poater A, Saliner A, Cavallo L, Poch M, Sola M, Worth A. Tuning the Electronic Properties by Width and Length Modifications of Narrow- Diameter Carbon Nanotubes for Nanomedicine. Curr Med Chem 2012; 19:5219-25. [DOI: 10.2174/092986712803530548] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 04/27/2012] [Accepted: 06/20/2012] [Indexed: 11/22/2022]
|
35
|
Brunetti G, Marzano F, Colucci S, Ventura A, Cavallo L, Grano M, Faienza MF. Genotype-phenotype correlation in juvenile Paget disease: role of molecular alterations of the TNFRSF11B gene. Endocrine 2012; 42:266-71. [PMID: 22638612 DOI: 10.1007/s12020-012-9705-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 05/11/2012] [Indexed: 12/23/2022]
Abstract
Juvenile Paget disease (JPD) {MIM 239000} is a rare inherited bone disease that affects children. The patients affected with JPD present an altered bone turnover, therefore, show a phenotype characterized by progressive bone deformities, fractures, and short stature. Deletions or missense mutations of the TNFRSN11B gene are common in these children. This gene encodes a soluble protein, the osteoprotegerin, which leads to uncontrolled osteoclastogenesis when mutated. JPD is characterized by a strong genotype-phenotype correlation, so depending on the alteration of the TNFRSN11B gene, the phenotype is variable. This review describes the different clinical features which are characteristic of JPD and the correspondence with the different molecular alterations of the TNFRSN11B gene.
Collapse
Affiliation(s)
- Giacomina Brunetti
- Department of Basic Medical Sciences, Section of Human Anatomy and Histology, University of Bari, Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
36
|
Faienza MF, Ventura A, Lauciello R, Crinò A, Ragusa L, Cavallo L, Spera S, Grugni G. Analysis of endothelial protein C receptor gene and metabolic profile in Prader-Willi syndrome and obese subjects. Obesity (Silver Spring) 2012; 20:1866-70. [PMID: 22193922 DOI: 10.1038/oby.2011.349] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The endothelial protein C receptor (EPCR) has a critical role in the regulation of anticoagulant and anti-inflammatory functions of activated protein C (APC). Abnormalities in EPCR might be associated with an increased risk of thrombosis. In this respect, a 23 bp insertion in the exon 3 of the EPCR gene predicts a truncated protein which cannot bind APC. High levels of C-reactive protein (CRP), a strong predictor of cardiovascular events, are found both in the obese and in subjects with Prader-Willi syndrome (PWS). Several cardiovascular risk factors are already present in prepubertal PWS children, but it is uncertain which mechanism contributes to the increased risk of cardiovascular disease in PWS. We analyzed the distribution of 23 bp insertion in the EPCR gene in 81 overweight and obese PWS subjects, 52 adults and 29 children, and in 58 overweight and obese children and adolescents (controls). We found that 1/58 (1.7%) of the controls was heterozygous for the 23 bp insertion, while this mutation was never found in PWS subjects. Furthermore, we evaluated CRP levels, glucose, insulin, and lipid profile, and we found higher CRP values in PWS adults with respect to children with PWS and controls, and a better insulin sensitivity in all PWS subjects than in the controls. This study suggests that in PWS subjects there is no predisposition to develop thrombotic events in association with EPCR gene alteration and demonstrates substantial differences regarding metabolic and inflammatory profile between PWS and non-PWS obese children, with further impairment in adults with PWS.
Collapse
Affiliation(s)
- Maria F Faienza
- Department of Biomedicine of Developmental Age, University of Bari, Bari, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Francavilla R, Lionetti E, Castellaneta S, Ciruzzi F, Indrio F, Masciale A, Fontana C, La Rosa MM, Cavallo L, Francavilla A. Randomised clinical trial: Lactobacillus reuteri DSM 17938 vs. placebo in children with acute diarrhoea--a double-blind study. Aliment Pharmacol Ther 2012; 36:363-9. [PMID: 22680836 DOI: 10.1111/j.1365-2036.2012.05180.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [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] [Received: 03/22/2012] [Revised: 04/08/2012] [Accepted: 05/21/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Probiotics may be of help for the management of acute diarrhoea, however, the effect is strain specific and efficacy needs to be proven. AIM To test the efficacy and safety of Lactobacillus reuteri DSM 17938 derived from L. reuteri ATCC 55730 in children with acute diarrhoea. Primary outcomes were the rate of unresolved diarrhoea after 3 days of treatment and duration of diarrhoea. METHODS Children (6-36 months), hospitalised in three paediatric hospitals in Southern Italy for acute diarrhoea with clinical signs of dehydration were randomised to receive in a double-blind fashion either L. reuteri (dose of 4 × 10(8) colony-forming units/die) or placebo. RESULTS Out of 96 eligible children, 74 were enrolled, five patients were withdrawn; 35 in the L. reuteri group and 34 in the placebo group. Lactobacillus reuteri significantly reduced the duration of watery diarrhoea as compared with placebo (2.1 ± 1.7 days vs. 3.3 ± 2.1 days; P < 0.03); on day two and three of treatment watery diarrhoea persisted in 82% and 74% of the placebo and 55% and 45% of the L. reuteri recipients respectively (P < 0.01; P < 0.03). Finally, children receiving L. reuteri had a significantly lower relapse rate of diarrhoea (15% vs. 42%; P < 0.03). There was not a significant difference in hospital stay between the groups. No adverse events were recorded. CONCLUSION Our study shows that L . reuteri DSM 17938 as an adjunct to rehydration therapy is efficacious in the treatment of acute diarrhoea reducing the frequency, duration and recrudescence rate of the disease.
Collapse
Affiliation(s)
- R Francavilla
- Department of Biomedicina dell'Età Evolutiva, University of Bari, Piazza Giulio Cesare 11, Bari, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Semeraro F, Giordano P, Faienza MF, Cavallo L, Semeraro N, Colucci M. Evidence that fibrinolytic changes in paediatric obesity translate into a hypofibrinolytic state: relative contribution of TAFI and PAI-1. Thromb Haemost 2012; 108:311-7. [PMID: 22740053 DOI: 10.1160/th11-12-0864] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 05/14/2012] [Indexed: 11/05/2022]
Abstract
Paediatric obesity, like adulthood obesity, is associated with an increase of fibrinolysis inhibitors. No study, however, has evaluated the impact of these changes on plasma fibrinolytic capacity. We investigated plasma fibrinolysis and the role therein of the fibrinolytic changes associated with obesity in 59 obese children (body mass index > 95th percentile) and 40 matched controls. Fibrinolysis was investigated by measuring 1) the plasma levels of relevant fibrinolytic factors; 2) the in vitro fibrinolytic capacity under different conditions, using a microplate plasma clot lysis assay; 3) the circulating levels of markers of clotting and fibrinolysis activation. Plasminogen activator inhibitor 1 (PAI-1), total thrombin activatable fibrinolysis inhibitor (TAFI) and fibrinogen levels were higher in obese children as compared to controls (p<0.01). Plasma clots from obese children lysed significantly slower than control clots when exposed to exogenous plasminogen activator, indicating a greater resistance to fibrinolysis. By the use of a selective inhibitor of activated TAFI and by regression analyses we found that fibrinolysis resistance in obese samples was attributable to PAI-1 increase and to enhanced TAFI activation. The ratio between the circulating levels of D-dimer and thrombin-antithrombin complex, a marker of in vivo fibrinolysis, was significantly lower in obese children, suggesting a reduced fibrinolytic efficiency. These data indicate that paediatric obesity is associated with a hypofibrinolytic state which might contribute to the increased thrombotic risk associated with this condition.
Collapse
Affiliation(s)
- Fabrizio Semeraro
- Dipartimento di Scienze Biomediche e Oncologia Umana, Sezione di Patologia Generale e Sperimentale, Bari, Italy
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
To provide an overview on the role of gut immunity, nervous system and motility patterns in the development of feeding intolerance in newborns. Maturation of the GI is important not only for digestion and absorption, but for endocrine and exocrine function as well. There is little data available about the development of the motility function and of the mucosal barrier of the human gut, and in particular about the motility patterns and mucosal changes in newborns during early days of life. It is known that functional maturation of the gastrointestinal tract is quite different over time with respect to its anatomical development. Besides, the gastrointestinal tract through innate and specific immunologic factors, acts as a defense against ingested antigens. In addition to the mucous membrane integrity and digestion, numerous specific immunologic cells and mediators orchestrate such defensive mechanisms. In case of food antigens, the outcome is usually in favor of tolerance. Defects in that barrier, however, can lead to the development of aberrant immunologic responses, including hypersensitivity reactions. It is obvious that an appropriate feeding regimen during early infancy is in favor of food tolerance. However, in addition to genetic predisposition, development of tolerance is facilitated by an adequate gut barrier (immune or nonimmune), well-coordinated GI motility and nervous network, and appropriate food regimen.
Collapse
Affiliation(s)
- Flavia Indrio
- Department of Pediatrics, University of Bari, Policlinico Piazza G.Cesare, Bari, Italy.
| | | | | | | | | |
Collapse
|
40
|
Tesse R, Manca A, Abrusci MR, Pinto S, Leonetti G, De Robertis S, Cavallo L, De Robertis F. The role of post-transplantation cyclosporine treatment in the course of cystic fibrosis pulmonary disease: a case report. Immunopharmacol Immunotoxicol 2012; 34:714-6. [DOI: 10.3109/08923973.2011.653492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
41
|
Diana A, Tesse R, Polizzi AM, Santostasi T, Manca A, Leonetti G, Seia M, Porcaro L, Cavallo L. A large deletion causes apparent homozygosity for the D1152H mutation in the cystic fibrosis transmembrane regulator (CFTR) gene. Gene 2012; 497:90-2. [PMID: 22310382 DOI: 10.1016/j.gene.2012.01.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 12/21/2011] [Accepted: 01/21/2012] [Indexed: 11/26/2022]
Abstract
We report the case of a patient with an apparent homozygosity for the D1152H mutation located in exon 18 of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The parents had no personal history of cystic fibrosis (CF) and referred to our laboratory after the diagnosis of fetal bowel hyperechogenicity. The proband presented with meconium ileus and normal sweat chloride test. Sequencing of the CFTR exon 18 together with quantitative genomic assays, such as real-time PCR and the multiplex ligation probe amplification (MLPA) techniques, were performed and revealed that the father was heterozygous for the D1152H mutation and the mother carried a large deletion of the CFTR gene encompassing the genomic sequence including the same mutation. The child inherited D1152H from his father and the large deletion of the CFTR gene from his mother. We suggest that D1152H likely acts as a mild mutation with a dominant effect on the severe deletion of exon 18, considering that after 3 years of clinical examinations the child shows no classical signs and symptoms of CF. Not testing for large deletions in subjects with apparent homozygosity for a mutated CFTR allele could lead to the misidentification of CFTR mutation carrier status.
Collapse
Affiliation(s)
- Anna Diana
- Department of Biomedicine of the Developing Age, Apulian Referral Center for Cystic Fibrosis, Policlinico, University of Bari, Bari, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Faienza MF, Marzano F, Ventura AM, Wasniewska M, Valenzise M, Valletti A, Caratozzolo MF, Cornacchia S, Sbisà E, Cavallo L, Tullo A. Regulation of IGFBP3 gene expression in short children born small for gestational age. Growth Horm IGF Res 2011; 21:349-355. [PMID: 22001433 DOI: 10.1016/j.ghir.2011.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 07/13/2011] [Accepted: 09/17/2011] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Approximately 6% of newborns at term are small for gestational age (SGA) and present a birth weight and/or length less than -2SD from the mean. SGA infants are at increased risk for perinatal morbidity, associated psychological and/or mental problems, persistent short stature (about 15% of subjects) and metabolic alterations. Insulin-like growth factors (IGFs), their common receptor (IGF1R) and their binding proteins (IGFBPs) play a critical role in fetal and postnatal growth. In these genes common polymorphisms, such as single nucleotide polymorphisms and variable number of tandem repeats, have been investigated with conflicting results with respect to SGA-related outcomes, and the functional role of these gene variants remains to be elucidated. DESIGN The study group consisted of 100 pre-pubertal short children born SGA and 94 healthy controls, matched for sex and age, recruited at the Department of Biomedicine of Development Age of the Bari University and at the Paediatric Department of the Messina Hospital. In the present study we analyzed the allelic frequency of the polymorphisms -795 G/A, -667 G/A, -396 C/T in the IGFBP3 in SGA children and their influence on the basal and insulin-stimulated transcriptional activity of the gene. RESULTS We found that the polymorphisms -667 G/A and -396 C/T in the IGFBP3 promoter region are capable of having an effect on the transcriptional activity of the gene, although with opposing effects. Interestingly, the -667 G/A polymorphism has a negative impact on the IGFBP3 transcription, while the -396 C/T polymorphism determines an increase of the transcriptional activity of the IGFBP3 gene promoter. Interestingly, we found that the -396 C/T polymorphism correlates with lower birth length in SGA children. Most importantly, while the diminished IGFBP3 transcriptional activity induced by the -667A polymorphism was significantly recovered after insulin administration (p-value<0.05), the increased transcriptional activity caused by the -396T polymorphism was not restored to baseline levels by insulin. CONCLUSIONS Altogether our results demonstrated that the -667 G/A and the -396 C/T polymorphisms in IGFBP3 promoter region influence the basal transcriptional activity of the gene.
Collapse
Affiliation(s)
- M F Faienza
- Department of Biomedicine of Developmental Age, University of Bari, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Giordano P, Del Vecchio GC, Cecinati V, Delvecchio M, Altomare M, De Palma F, De Mattia D, Cavallo L, Faienza MF. Metabolic, inflammatory, endothelial and haemostatic markers in a group of Italian obese children and adolescents. Eur J Pediatr 2011; 170:845-50. [PMID: 21210148 DOI: 10.1007/s00431-010-1356-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [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] [Received: 09/30/2010] [Accepted: 11/09/2010] [Indexed: 12/24/2022]
Abstract
Childhood obesity and its related comorbidities are increasingly recognised in children, predisposing them to early cardiovascular disease and metabolic syndrome. The objective of the study was to investigate markers of metabolism, inflammation and haemostasis in a group of Italian obese children and adolescents. Fifty-nine obese and 40 non-obese subjects were recruited. Fasting glucose and insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor alpha (TNF-α), and adiponectin were measured. Hypercoagulability was assessed by measuring the circulating levels of thrombin-antithrombin complex (TAT), D: -dimer, fibrinogen, plasminogen activator inhibitor 1 (PAI-1) and von Willebrand Factor (vWF). A significant degree of insulin resistance was present in obese subjects compared with controls (p < 0.0001). The obese showed higher levels of total cholesterol, LDL cholesterol and triglycerides, and lower levels of HDL cholesterol than controls (p < 0.0001). Circulating levels of hsCRP and TNF-α were significantly higher in obese than in controls while serum adiponectin levels were significantly lower in obese than non-obese subjects (p < 0.001; p = 0.031; p < 0.0001, respectively). vWF, TAT, D-dimer, fibrinogen and PAI-1 levels were significant higher in obese subjects compared with control group (p = 0.02; p < 0.0001; p = 0.0037; p < 0.0001; p = 0.017, respectively). In conclusion, our results suggest that childhood obesity per se is associated with a proinflammatory and prothrombotic state.
Collapse
Affiliation(s)
- Paola Giordano
- Department of Biomedicine of Developing Age, University of Bari, Piazza G. Cesare, 11, 70100, Bari, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Vivenza D, Godi M, Faienza MF, Mellone S, Moia S, Rapa A, Petri A, Bellone S, Riccomagno S, Cavallo L, Giordano M, Bona G. A novel HESX1 splice mutation causes isolated GH deficiency by interfering with mRNA processing. Eur J Endocrinol 2011; 164:705-13. [PMID: 21325470 DOI: 10.1530/eje-11-0047] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Mutations in HESX1 represent a rare cause of GH deficiency (GHD) associated with a broad spectrum of other anomalies. We searched for causative mutations in a cohort of 244 Italian patients affected by combined and isolated GHD (IGHD). METHODS The HESX1 gene-coding region and exon-intron boundaries were screened by denaturing HPLC scanning. RESULTS A novel mutation adjacent to the invariant donor splice site of intron 2 (c.357+3G>A) was identified at the heterozygous state in an IGHD patient. The in vitro and in vivo mRNA analysis of the wild-type HESX1 allele revealed the presence of the whole cDNA and two isoforms lacking exon 2 and exons 2-3 respectively. The mutant HESX1 allele yielded only two splicing products, the whole cDNA and the cDNA missing exons 2-3, whereas the mRNA lacking exon 2 was absent. An in vitro assay demonstrated that the exon 2-deleted mRNA, predicting a prematurely truncated protein, is subjected to nonsense-mediated mRNA decay (NMD). CONCLUSIONS The c.357+3G>A mutation prevents the generation of one of the alternative isoforms normally produced by the wild-type allele, predicting a truncated HESX1 protein. The mutation is likely to cause IGHD in the heterozygous patient by interfering with the downregulation of HESX1 expression mediated by alternative splicing and NMD. Our results open new insight into the mechanism of HESX1 regulation suggesting that the coupling of alternative splicing and NMD might play a fundamental role in directing the HESX1 expression, and that the alteration of this process might lead to severe consequences.
Collapse
Affiliation(s)
- Daniela Vivenza
- Laboratorio di Oncologia Ospedale Santa Croce e Carle, 12100 Cuneo, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Indrio F, Riezzo G, Raimondi F, Bisceglia M, Filannino A, Cavallo L, Francavilla R. Lactobacillus reuteri accelerates gastric emptying and improves regurgitation in infants. Eur J Clin Invest 2011; 41:417-22. [PMID: 21114493 DOI: 10.1111/j.1365-2362.2010.02425.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [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: 12/27/2022]
Abstract
BACKGROUND Young infants are frequently affected by uncomplicated regurgitation that may persist despite dietetic and conservative interventions. On this basis, we studied the putative effects of probiotics on the frequency of regurgitation and gastric emptying time in infants with functional gastroesophageal reflux (GER). PATIENTS AND METHODS Forty-two infants with regurgitation were randomized to assume Lactobacillus reuteri DSM 17938 at a dose of 1 × 10(8) CFU per day and placebo for 30 days. The episodes of regurgitation were recorded by the parents each day. Gastric emptying time was recorded using real-time ultrasound at baseline and at the end of the study. Twenty-one infants without regurgitation were enroled to compare anthropometric and physiological parameters before the intervention diet. RESULTS Thirty-four infants completed the study (19 infants receiving probiotics and 15 placebo).At baseline, the whole group of infants was similar to the control group as regards anthropometric and physiological data. The median fasting antral area was significantly reduced, (P = 0·01) the delta in gastric emptying rate was significantly increased (P = 0·01) and the median episodes per day of regurgitation was reduced (, P < 0·001) in the probiotic group compared to the placebo group. In the whole group, the frequency of regurgitation and the basal antral area showed a positive correlation (r = 0·53, P = 0·004). CONCLUSIONS In infants with functional GER, L. reuteri DSM 17938 reduce gastric distension and accelerate gastric emptying. In addition, this probiotic strain seems to diminish the frequency of regurgitation.
Collapse
Affiliation(s)
- Flavia Indrio
- Department of Pediatrics, University of Bari Policlinico Piazza G.Cesare, Bari, Italy.
| | | | | | | | | | | | | |
Collapse
|
46
|
|
47
|
Francavilla R, Miniello V, Magistà AM, De Canio A, Bucci N, Gagliardi F, Lionetti E, Castellaneta S, Polimeno L, Peccarisi L, Indrio F, Cavallo L. A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics 2010; 126:e1445-52. [PMID: 21078735 DOI: 10.1542/peds.2010-0467] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [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: 12/11/2022] Open
Abstract
OBJECTIVE Our aim was to determine whether Lactobacillus rhamnosus GG (LGG) relieves symptoms in children with recurrent abdominal pain. PATIENTS AND METHODS A total of 141 children with irritable bowel syndrome (IBS) or functional pain were enrolled in 9 primary care sites and a referral center. Children entered a randomized, double-blind, placebo-controlled trial and received LGG or placebo for 8 weeks and entered follow-up for 8 weeks. The primary outcome was overall pain at the end of the intervention period. At entry and at the end of the trial, children underwent a double-sugar intestinal permeability test. RESULTS Compared with baseline, LGG, but not placebo, caused a significant reduction of both frequency (P < .01) and severity (P < .01) of abdominal pain. These differences still were significant at the end of follow-up (P < .02 and P < .001, respectively). At week 12, treatment success was achieved in 48 children in the LGG group compared with 37 children in the placebo group (P < .03); this difference still was present at the end of follow-up (P < .03). At entry, 59% of the children had abnormal results from the intestinal permeability test; LGG, but not placebo, determined a significant decrease in the number of patients with abnormal results from the intestinal permeability testing (P < .03). These effects mainly were in children with IBS. CONCLUSIONS LGG significantly reduces the frequency and severity of abdominal pain in children with IBS; this effect is sustained and may be secondary to improvement of the gut barrier.
Collapse
Affiliation(s)
- Ruggiero Francavilla
- Department of Developmental Biomedicine, Gastroenterology Section, University of Bari, Bari, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Francavilla R, Lionetti E, Castellaneta S, Margiotta M, Piscitelli D, Lorenzo L, Cavallo L, Ierardi E, Russo F, Marangi S, Monno R, Stoppino V, Morini S, Panella C, Ierardi E. Clarithromycin-resistant genotypes and eradication of Helicobacter pylori. J Pediatr 2010; 157:228-32. [PMID: 20400110 DOI: 10.1016/j.jpeds.2010.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [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] [Received: 08/29/2009] [Revised: 11/24/2009] [Accepted: 02/04/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare the eradication rates among the different point mutations and the efficacy of triple therapy and a sequential regimen according to genotypic resistance. STUDY DESIGN Post hoc retrospective cohort study in a tertiary referral center for pediatric gastroenterology in southern Italy. All 168 children who were positive for Helicobacter pylori were enrolled. Patients had received clarithromycin-based 7-day triple therapy (73 children) or 10-day sequential therapy regimen (95 children). Real-time polymerase chain reaction for assessing clarithromycin resistance was performed on sections of paraffin-embedded gastric biopsy samples. RESULTS H pylori eradication was achieved in 16 of 32 (50%) children with the A2143G mutation, in 8 of 10 patients with either A2142G or A2142C strains (80%), and in 112 of 116 children with susceptible strains (88.9%). The presence of A2143G mutation was associated with a lower cure rate compared with the rate in the absence of this mutation (50% vs. 89%; P = .001). The sequential regimen achieved a higher cure rate than triple therapy in patients with A2143G mutant strains (80% vs nil; P < .001). CONCLUSIONS The A2143G mutation confers higher risk of treatment failure. Sequential regimen has higher efficacy than standard therapy, even in children with A2143G mutatant strains.
Collapse
|
49
|
Faienza MF, Santoro N, Lauciello R, Calabrò R, Giordani L, Di Salvo G, Ventura A, Delvecchio M, Perrone L, Del Giudice EM, Cavallo L. IGF2 gene variants and risk of hypertension in obese children and adolescents. Pediatr Res 2010; 67:340-4. [PMID: 20057340 DOI: 10.1203/pdr.0b013e3181d22757] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obese children have a great risk of hypertension and cardiovascular morbidity in adults. The insulin-like growth factor type II (IGF-II) regulates glucose homeostasis, cardiovascular functions, and lipid metabolism. IGF2 gene variants have shown a strong association with weight, body mass index (BMI), and metabolic profile in adults. We performed the molecular screening of two IGF2 polymorphisms (6815 A/T, 820 G/A), in 227 obese children to evaluate the potential association between IGF2 variants with either obesity or high blood pressure (assessed with a 24-h holter system) or both. A second cohort of age-, sex-, and BMI-matched children were enrolled to confirm any eventual association. We observed a significant association between the 6815 A/T IGF2 gene variant and high systolic blood pressure in obese children. Homozygote subjects for the T6815 allele showed, even in 24-h measurements, a higher risk to develop hypertension than those carrying the A6815 allele (OR = 3.7, 95% CI: 1.59-8.66). This result was confirmed in the second cohort (OR = 4.1, 95% CI: 1.41-6.50). Any statistically significant difference in terms of BMI between the genotype groups was observed. Our results suggest that IGF2 gene variants are involved in the blood pressure regulation in obese children.
Collapse
Affiliation(s)
- Maria F Faienza
- Department of Biomedicine of Developmental Age, University of Bari, Bari 70124, Italy.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Lionetti E, Indrio F, Pavone L, Borrelli G, Cavallo L, Francavilla R. Role of probiotics in pediatric patients with Helicobacter pylori infection: a comprehensive review of the literature. Helicobacter 2010; 15:79-87. [PMID: 20402810 DOI: 10.1111/j.1523-5378.2009.00743.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [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: 12/17/2022]
Abstract
BACKGROUND The current guidelines suggest the use of triple therapy as first choice treatment of Helicobacter pylori infection, although the eradication failure rate is more than 30%. Current interest in probiotics as therapeutic agents against H. pylori is stimulated not only by the clinical data showing efficacy of some probiotics in different gastrointestinal diseases but also by the increasing resistance of pathogenic bacteria to antibiotics, thus the interest for alternative therapies is a real actual topic. AIM To review in vitro and in vivo studies on the role of probiotics in H. pylori infection focusing on the paediatric literature. MATERIALS AND METHODS Pre-clinical and clinical paediatric studies in English assessing the role of probiotics in H. pylori infection identified by MEDLINE search (1950-2009) were reviewed. RESULTS In vitro studies demonstrated an inhibitory activity of probiotics on H. pylori growth and that this effect is extremely strain specific. Available data in children indicate that probiotics seems to be efficacious for the prevention of antibiotic associated side-effects, and might be of help for the prevention of H. pylori complications by decreasing H. pylori density and gastritis, and for the prevention of H. pylori colonization or re-infection by inhibiting adhesion to gastric epithelial cells. There is no clear evidence that probiotics may increase the H. pylori eradication rate. CONCLUSION Both in vitro and in vivo studies provide evidence that probiotics may represent a novel approach to the management of H. pylori infection.
Collapse
Affiliation(s)
- Elena Lionetti
- Department of Paediatrics, University of Catania, Catania, Italy.
| | | | | | | | | | | |
Collapse
|