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Bozzini S, Bozza E, Bagnera C, Del Fante C, Barone E, De Vitis S, De Amici M, Testa G, Croce S, Valsecchi C, Avanzini MA, Cacciatore R, Mortellaro C, Viarengo G, Perotti C, Meloni F. Exosomal-miRNas expression and growth factors released by mononuclear cells of CLAD patients in response to extracorporeal photopheresis. J Transl Med 2024; 22:276. [PMID: 38486224 PMCID: PMC10938790 DOI: 10.1186/s12967-024-05045-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND CLAD (Chronic Lung Allograft Dysfunction) remains a serious complication following lung transplantation. Some evidence shows that portions of Extracorporeal Photopheresis (ECP)-treated patients improve/stabilize their graft function. In spite of that, data concerning molecular mechanisms are still lacking. Aims of our study were to assess whether ECP effects are mediated by Mononuclear Cells (MNCs) modulation in term of microRNAs (miRNAs) expression and growth factors release. METHODS Cells from leukapheresis of 16 CLAD patients, at time 0 and 6-months (10 cycles), were cultured for 48h ± PHA (10 ug/ml) or LPS (2 ug/ml). Expression levels of miR-146a-5p, miR-155-5p, miR-31-5p, miR181a-5p, miR-142-3p, miR-16-5p and miR-23b-5p in MNCs-exosomes were evaluated by qRT-PCR, while ELISA assessed different growth factors levels on culture supernatants. RESULTS Our result showed miR-142-3p down-regulation (p = 0.02) in MNCs of ECP-patients after the 10 cycles and after LPS stimulation (p = 0.005). We also find miR-146a-5p up-regulation in cells after the 10 cycles stimulated with LPS (p = 0.03). Connective tissue growth factor (CTGF) levels significantly decreased in MNCs supernatant (p = 0.04). The effect of ECP is translated into frequency changes of Dendritic Cell (DC) subpopulations and a slight increase in T regulatory cells (Treg) number and a significant decrease in CTGF release. CONCLUSIONS ECP might affect regulatory T cell functions, since both miR-142 and miR-146a have been shown to be involved in the regulation of suppressor regulatory T cell functions and DCs. On the other side ECP, possibly by regulating macrophage activation, is able to significantly down modulate CTGF release.
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Affiliation(s)
- Sara Bozzini
- Department of Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Eleonora Bozza
- Department of Paediatric Oncoaematology/Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cecilia Bagnera
- Department of Paediatric Oncoaematology/Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudia Del Fante
- Immunohaematology and Transfusion Service, Cell Manipulation Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Eugenio Barone
- Immunohaematology and Transfusion Service, Cell Manipulation Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simona De Vitis
- Immunohaematology and Transfusion Service, Cell Manipulation Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mara De Amici
- Immuno-Allergology Laboratory of the Clinical Chemistry Unit and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giorgia Testa
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefania Croce
- Department of Paediatric Oncoaematology/Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Valsecchi
- Department of Paediatric Oncoaematology/Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maria A Avanzini
- Department of Paediatric Oncoaematology/Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosalia Cacciatore
- Immunohaematology and Transfusion Service, Cell Manipulation Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cristina Mortellaro
- Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianluca Viarengo
- Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Cesare Perotti
- Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Federica Meloni
- Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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2
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Abbà C, Croce S, Valsecchi C, Lenta E, Campanelli R, Codazzi AC, Brazzelli V, Carolei A, Catarsi P, Acquafredda G, Apicella A, Caliogna L, Berni M, Mannarino S, Avanzini MA, Rosti V, Massa M. Circulating Mesenchymal Stromal Cells in Patients with Infantile Hemangioma: Evaluation of Their Functional Capacity and Gene Expression Profile. Cells 2024; 13:254. [PMID: 38334645 PMCID: PMC10854919 DOI: 10.3390/cells13030254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/10/2024] Open
Abstract
We previously published that in patients with infantile hemangioma (IH) at the onset (T0) colony forming unit-fibroblasts (CFU-Fs) are present in in vitro cultures from PB. Herein, we characterize these CFU-Fs and investigate their potential role in IH pathogenesis, before and after propranolol therapy. The CFU-F phenotype (by flow cytometry), their differentiation capacity and ability to support angiogenesis (by in vitro cultures) and their gene expression (by RT-PCR) were evaluated. We found that CFU-Fs are actual circulating MSCs (cMSCs). In patients at T0, cMSCs had reduced adipogenic potential, supported the formation of tube-like structures in vitro and showed either inflammatory (IL1β and ESM1) or angiogenic (F3) gene expression higher than that of cMSCs from CTRLs. In patients receiving one-year propranolol therapy, the cMSC differentiation in adipocytes improved, while their support in in vitro tube-like formation was lost; no difference was found between patient and CTRL cMSC gene expressions. In conclusion, in patients with IH at T0 the cMSC reduced adipogenic potential, their support in angiogenic activity and the inflammatory/angiogenic gene expression may fuel the tumor growth. One-year propranolol therapy modifies this picture, suggesting cMSCs as one of the drug targets.
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Affiliation(s)
- Carlotta Abbà
- General Medicine 2—Center for Systemic Amyloidosis and High-Complexity Diseases, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy;
| | - Stefania Croce
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Haematology Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (S.C.); (C.V.); (E.L.); (G.A.); (M.A.A.)
| | - Chiara Valsecchi
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Haematology Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (S.C.); (C.V.); (E.L.); (G.A.); (M.A.A.)
| | - Elisa Lenta
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Haematology Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (S.C.); (C.V.); (E.L.); (G.A.); (M.A.A.)
| | - Rita Campanelli
- Center for the Study of Myelofibrosis, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (R.C.); (A.C.); (P.C.); (V.R.)
| | - Alessia C. Codazzi
- Pediatric Cardiology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (A.C.C.); (A.A.)
| | - Valeria Brazzelli
- Institute of Dermatology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy;
| | - Adriana Carolei
- Center for the Study of Myelofibrosis, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (R.C.); (A.C.); (P.C.); (V.R.)
| | - Paolo Catarsi
- Center for the Study of Myelofibrosis, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (R.C.); (A.C.); (P.C.); (V.R.)
| | - Gloria Acquafredda
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Haematology Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (S.C.); (C.V.); (E.L.); (G.A.); (M.A.A.)
| | - Antonia Apicella
- Pediatric Cardiology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (A.C.C.); (A.A.)
| | - Laura Caliogna
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (L.C.); (M.B.)
| | - Micaela Berni
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (L.C.); (M.B.)
| | - Savina Mannarino
- Pediatric Cardiology Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy;
| | - Maria A. Avanzini
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Haematology Oncology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (S.C.); (C.V.); (E.L.); (G.A.); (M.A.A.)
| | - Vittorio Rosti
- Center for the Study of Myelofibrosis, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy; (R.C.); (A.C.); (P.C.); (V.R.)
| | - Margherita Massa
- General Medicine 2—Center for Systemic Amyloidosis and High-Complexity Diseases, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy;
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3
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Di Gravina GM, Bari E, Croce S, Scocozza F, Pisani S, Conti B, Avanzini MA, Auricchio F, Cobianchi L, Torre ML, Conti M. Design and development of a hepatic lyo-dECM powder as a biomimetic component for 3D-printable hybrid hydrogels. Biomed Mater 2023; 19:015005. [PMID: 37992318 DOI: 10.1088/1748-605x/ad0ee2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/22/2023] [Indexed: 11/24/2023]
Abstract
Bioprinting offers new opportunities to obtain reliable 3Din vitromodels of the liver for testing new drugs and studying pathophysiological mechanisms, thanks to its main feature in controlling the spatial deposition of cell-laden hydrogels. In this context, decellularized extracellular matrix (dECM)-based hydrogels have caught more and more attention over the last years because of their characteristic to closely mimic the tissue-specific microenvironment from a biological point of view. In this work, we describe a new concept of designing dECM-based hydrogels; in particular, we set up an alternative and more practical protocol to develop a hepatic lyophilized dECM (lyo-dECM) powder as an 'off-the-shelf' and free soluble product to be incorporated as a biomimetic component in the design of 3D-printable hybrid hydrogels. To this aim, the powder was first characterized in terms of cytocompatibility on human and porcine mesenchymal stem cells (MSCs), and the optimal powder concentration (i.e. 3.75 mg ml-1) to use in the hydrogel formulation was identified. Moreover, its non-immunogenicity and capacity to reactivate the elastase enzyme potency was proved. Afterward, as a proof-of-concept, the powder was added to a sodium alginate/gelatin blend, and the so-defined multi-component hydrogel was studied from a rheological point of view, demonstrating that adding the lyo-dECM powder at the selected concentration did not alter the viscoelastic properties of the original material. Then, a printing assessment was performed with the support of computational simulations, which were useful to definea priorithe hydrogel printing parameters as window of printability and its post-printing mechanical collapse. Finally, the proposed multi-component hydrogel was bioprinted with cells inside, and its post-printing cell viability for up to 7 d was successfully demonstrated.
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Affiliation(s)
- Giulia M Di Gravina
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
- Department of Industrial and Information Engineering, University of Pavia, Pavia, Italy
| | - Elia Bari
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Stefania Croce
- Department of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Franca Scocozza
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
| | - Silvia Pisani
- Department of Drug Science, University of Pavia, Pavia, Italy
| | - Bice Conti
- Department of Drug Science, University of Pavia, Pavia, Italy
| | - Maria A Avanzini
- Pediatric Hematology Oncology Unit and Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ferdinando Auricchio
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
| | - Lorenzo Cobianchi
- Department of General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maria Luisa Torre
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
- PharmaExceed s.r.l., Pavia, Italy
| | - Michele Conti
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
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Avanzini MA, Mura M, Percivalle E, Bastaroli F, Croce S, Valsecchi C, Lenta E, Nykjaer G, Cassaniti I, Bagnarino J, Baldanti F, Zecca M, Comoli P, Gnecchi M. Human mesenchymal stromal cells do not express ACE2 and TMPRSS2 and are not permissive to SARS-CoV-2 infection. Stem Cells Transl Med 2021; 10:636-642. [PMID: 33188579 PMCID: PMC7753681 DOI: 10.1002/sctm.20-0385] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/02/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022] Open
Abstract
Anti‐inflammatory and immune‐modulatory therapies have been proposed for the treatment of COVID‐19 and its most serious complications. Among others, the use of mesenchymal stromal cells (MSCs) is under investigation given their well‐documented anti‐inflammatory and immunomodulatory properties. However, some critical issues regarding the possibility that MSCs could be infected by the virus have been raised. Angiotensin‐converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2) are the main host cell factors for the severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2), entry, but so far it is unclear if human MSCs do or do not express these two proteins. To elucidate these important aspects, we evaluated if human MSCs from both fetal and adult tissues constitutively express ACE2 and TMPRSS2 and, most importantly, if they can be infected by SARS‐CoV‐2. We evaluated human MSCs derived from amnios, cord blood, cord tissue, adipose tissue, and bone marrow. ACE2 and TMPRSS2 were expressed by the SARS‐CoV‐2‐permissive human pulmonary Calu‐3 cell line but not by all the MSCs tested. MSCs were then exposed to SARS‐CoV‐2 wild strain without evidence of cytopathic effect. Moreover, we also excluded that the MSCs could be infected without showing lytic effects since their conditioned medium after SARS‐CoV‐2 exposure did not contain viral particles. Our data, demonstrating that MSCs derived from different human tissues are not permissive to SARS‐CoV‐2 infection, support the safety of MSCs as potential therapy for COVID‐19.
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Affiliation(s)
- Maria A Avanzini
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Manuela Mura
- Intensive Cardiac Care Unit and Laboratory of Experimental Cardiology for Cell and Molecular Therapy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elena Percivalle
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Bastaroli
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Stefania Croce
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,General Surgery I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Valsecchi
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elisa Lenta
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giulia Nykjaer
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Irene Cassaniti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jessica Bagnarino
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Zecca
- Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Comoli
- Cell Factory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Pediatric Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimiliano Gnecchi
- Intensive Cardiac Care Unit and Laboratory of Experimental Cardiology for Cell and Molecular Therapy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy.,Department of Medicine, University of Cape Town, Cape Town, South Africa
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5
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Pelizzo G, Avanzini MA, Lenta E, Mantelli M, Croce S, Catenacci L, Acquafredda G, Ferraro AL, Giambanco C, D'Amelio L, Giordano S, Re G, Zennaro F, Calcaterra V. Allogeneic mesenchymal stromal cells: Novel therapeutic option for mutated FLNA-associated respiratory failure in the pediatric setting. Pediatr Pulmonol 2020; 55:190-197. [PMID: 31468740 DOI: 10.1002/ppul.24497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mesenchymal stromal cell (MSC)-mediated therapeutic effects have been observed in the treatment of lung diseases. For the first time, this treatment was used as rescue therapy in a pediatric patient with a life-threatening respiratory syndrome associated with the filamin A (FLNA) gene mutation. METHODS A child with a new pathogenic variant of the FLNA gene c.7391_7403del (p.Val2464AlafsTer5), at the age of 18 months, due to serious and irreversible chronic respiratory failure, was treated with repeated intravenous infusions of allogeneic bone marrow (BM)-MSCs. The child's respiratory condition was monitored. Immunologic studies before each MSC treatment were performed. RESULTS No acute adverse events related to the MSC infusions were observed. After the second infusion, the child's respiratory condition progressively improved, with reduced necessity for mechanical ventilation support. A thorax computed tomography (CT) scan showed bilateral recovery of the basal parenchyma, anatomical-functional alignment and aerial penetration improvement. After the first MSC administration, an increase in Th17 and FoxP3+ T percentages in the peripheral blood was observed. After the second MSC infusion, a significant rise in the Treg/Th17 ratio was noted, as well as an increased percentage of CD20+ /CD19+ B lymphocytes and augmented PHA-induced proliferation. DISCUSSION MSC infusions are a promising therapeutic modality for patients in respiratory failure, as observed in this pediatric patient with an FLNA mutation. MSCs may have an immunomodulatory effect and thus mitigate lung injury; although in this case, MSC antimicrobial effects may have synergistically impacted the clinical improvements. Further investigations are planned to establish the safety and efficacy of this treatment option for interstitial lung diseases in children.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, Children's Hospital G. di Cristina, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Maria A Avanzini
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Elisa Lenta
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Melissa Mantelli
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Stefania Croce
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Laura Catenacci
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Gloria Acquafredda
- Immunology and Transplantation Laboratory, Cell Factory, Pediatric Hematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Aurelio L Ferraro
- Specialized Oncology Laboratory, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Caterina Giambanco
- Specialized Oncology Laboratory, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Lucia D'Amelio
- Specialized Oncology Laboratory, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Salvatore Giordano
- Biology Unit, Children's Hospital, ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy
| | - Giuseppe Re
- Pediatric Anesthesiology and Intensive Care Unit, Children's Hospital, Mediterranean Institute for Pediatric Excellence, Palermo, Italy
| | - Floriana Zennaro
- Radiologie Pédiatrique, Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Bari E, Perteghella S, Catenacci L, Sorlini M, Croce S, Mantelli M, Avanzini MA, Sorrenti M, Torre ML. Freeze-dried and GMP-compliant pharmaceuticals containing exosomes for acellular mesenchymal stromal cell immunomodulant therapy. Nanomedicine (Lond) 2019; 14:753-765. [DOI: 10.2217/nnm-2018-0240] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: To validate the use of ultrafiltration (UF) as an alternative applicable industrial method to replace ultracentrifugation (UC) in the purification of mesenchymal stromal cell (MSC)-secretome. Materials & methods: Pharmaceutical formulations containing secretome and/or extracellular vesicles were extracted from adipose-MSCs and bone marrow-MSCs by combining UF or UC with lyophilization. Results & conclusion: UF led to higher protein, lipid, cytokine and exosomes yields compared with UC. The isolation procedure and cell source influenced immunomodulatory activity, which was in vitro evaluated by inhibition of phytohemagglutinin-activated peripheral blood mononuclear cell proliferation, and by modulation of IL-10, IFN-γ and IL-6. A secretome dosage was identified to obtain the same immunomodulatory activity of MSCs, paving the way for cell-free therapy.
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Affiliation(s)
- Elia Bari
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Sara Perteghella
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
- PharmaExceed srl, 27100 Pavia, Italy
| | - Laura Catenacci
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Marzio Sorlini
- PharmaExceed srl, 27100 Pavia, Italy
- SUPSI, Department of Innovative Technologies, University of Applied Sciences & Arts of Southern Switzerland, Via Pobiette 11, 6928 Manno, Switzerland
| | - Stefania Croce
- Department of Clinical, Surgical, Diagnostic & Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Melissa Mantelli
- Fondazione IRCCS Policlinico S. Matteo, Immunology & Transplantation Laboratory/Pediatric Surgery, Cell Factory & Regenerative Medicine Research Center, 27100 Pavia, Italy
| | - Maria A Avanzini
- Fondazione IRCCS Policlinico S. Matteo, Immunology & Transplantation Laboratory/Pediatric Surgery, Cell Factory & Regenerative Medicine Research Center, 27100 Pavia, Italy
| | - Milena Sorrenti
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
| | - Maria L Torre
- Department of Drug Sciences, University of Pavia, Viale Taramelli 12, 27100 Pavia, Italy
- PharmaExceed srl, 27100 Pavia, Italy
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7
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Allegri M, Bugada D, De Gregori M, Avanzini MA, De Silvestri A, Petroni A, Sala A, Filisetti C, Icaro Cornaglia A, Cobianchi L. Continuous wound infusion with chloroprocaine in a pig model of surgical lesion: drug absorption and effects on inflammatory response. J Pain Res 2017; 10:2515-2524. [PMID: 29184436 PMCID: PMC5673045 DOI: 10.2147/jpr.s139856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Continuous wound infusion (CWI) may protect from inflammation, hyperalgesia and persistent pain. Current local anesthetics display suboptimal pharmacokinetic profile during CWI; chloroprocaine (CP) has ideal characteristics, but has never been tested for CWI. We performed an animal study to investigate the pharmacokinetic profile and anti-inflammatory effect of CP during CWI. A total of 14 piglets received an infusion catheter after pararectal laparotomy and were randomly allocated to one of three groups: 5 mL/h infusion of saline (group A), CP 1.5% (group B) and CP 0.5% (group C). Blood sampling was performed to assess absorption and systemic inflammation at 0, 3, 6, 12, 24, 48, 72, 96, 102 and 108 hours. The wound and contralateral healthy abdominal wall were sampled for histological analyses. Absorption of CP from the site of infusion, evaluated as the plasmatic concentrations of CP and its metabolite, 4-amino-2-chlorobenzoic acid (CABA), showed a peak during the first 6 hours, but both CP and its metabolite rapidly disappeared after stopping CP infusion. Local inflammation was reduced in groups B and C (CP-treated p < 0.001), in a CP dose-dependent fashion. While CP inhibited in a dose-dependent manner pig mononuclear cells (MNCs) in vitro proliferation to a polyclonal activator, no effect on systemic cytokines’ concentrations or on ex vivo monocytes’ responsiveness was observed, suggesting the lack of systemic effects, in line with the very short half-life of CP in plasma. CP showed a very good profile for use in CWI, with dose-dependent local anti-inflammatory effects, limited absorption and rapid clearance from the bloodstream upon discontinuation. No cytotoxicity or side effects were observed. CP, therefore, may represent an optimal choice for clinical CWI, adaptable to each patient’s need, and protective on wound inflammatory response (and hyperalgesia) after surgery.
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Affiliation(s)
- Massimo Allegri
- Department of Medicine and Surgery, University of Parma, Parma.,SIMPAR Group (Study in Multidisciplinary PAin Research)
| | - Dario Bugada
- Department of Medicine and Surgery, University of Parma, Parma.,SIMPAR Group (Study in Multidisciplinary PAin Research).,Department of Anaesthesia and ICU, ASST Papa Giovanni XXIII, Bergamo
| | - Manuela De Gregori
- SIMPAR Group (Study in Multidisciplinary PAin Research).,Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo
| | - Maria A Avanzini
- Laboratory of Transplant Immunology/Cell Factory, IRCCS Foundation Policlinico San Matteo
| | - Annalisa De Silvestri
- Clinical epidemiology and Biometrics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Anna Petroni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan
| | - Angelo Sala
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan.,I.B.I.M., C.N.R., Palermo
| | - Claudia Filisetti
- PhD School, University of Pavia.,Department of Pediatric Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia.,Department of Pediatric Surgery, "V. Buzzi" Children's Hospital, Milan
| | | | - Lorenzo Cobianchi
- Department of Surgical, Clinical, Paediatric and Diagnostic Science, University of Pavia.,General Surgery 1, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
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8
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Pelizzo G, Avanzini MA, Folini M, Bussani R, Mantelli M, Croce S, Acquafredda G, Travaglino P, Cimino-Reale G, Boni M, Dambruoso I, Calcaterra V. CPAM type 2-derived mesenchymal stem cells: Malignancy risk study in a 14-month-old boy. Pediatr Pulmonol 2017; 52:990-999. [PMID: 28493304 DOI: 10.1002/ppul.23734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/20/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The association between congenital pulmonary airway malformations (CPAM) and malignancy is reported in the literature. Interactions between the tumor, immune, and mesenchymal stromal/stem cells (MSCs) have been recognized as crucial for understanding tumorigenesis. We characterized MSCs isolated from CPAM lesions in order to define potential malignancy risks. METHODS CPAM II pulmonary tissue was used for MSC expansion; a "healthy" lung section from the same child was used as a comparator. Morphology, immunophenotype, differentiation and immunological capacity, proliferative growth, gene signature telomerase activity, and in vivo tumorigenicity in nude mice were evaluated. RESULTS MSCs were successfully isolated and propagated from CPAM tissue. CPAM-MSCs presented the typical MSC morphology and phenotype, while exhibiting high proliferative capacity, reaching confluence at a median time of 5 days as well as differentiation capabilities. CPAM-MSCs at early passages were not neoplastic and chromosomally normal, even though unbalanced chromosomal rearrangements were noted by molecular karyotype. CONCLUSIONS CPAM-MSCs exhibited specific features similar to tumor derived MSCs. Whilst there was no evidence of malignant transformation in the cystic tissue, our results provide evidence that this abnormal tissue has malignant potential. MSCs are considered important players in the tumor microenvironment and they have been closely linked to regulation of tumor survival, growth, and progression. Thus, early lesion resection also in asymptomatic patients might be indicated to exclude that the microenvironment may be potentially permissive to cancer development.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Unit, Children's Hospital, Istituto Mediterraneo di Eccellenza Pediatrica, Palermo, Italy
| | - Maria A Avanzini
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Marco Folini
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Rossana Bussani
- Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy
| | - Melissa Mantelli
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Stefania Croce
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Gloria Acquafredda
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Paola Travaglino
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Graziella Cimino-Reale
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marina Boni
- Hematology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Irene Dambruoso
- Hematology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Valeria Calcaterra
- Pediatric Unit, Department of Internal Medicine, University of Pavia and Department of Maternal and Children's Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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9
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Ruberti S, Bianchi E, Guglielmelli P, Rontauroli S, Barbieri G, Tavernari L, Fanelli T, Norfo R, Pennucci V, Fattori GC, Mannarelli C, Bartalucci N, Mora B, Elli L, Avanzini MA, Rossi C, Salmoiraghi S, Zini R, Salati S, Prudente Z, Rosti V, Passamonti F, Rambaldi A, Ferrari S, Tagliafico E, Vannucchi AM, Manfredini R. Involvement of MAF/SPP1 axis in the development of bone marrow fibrosis in PMF patients. Leukemia 2017; 32:438-449. [PMID: 28745329 PMCID: PMC5808097 DOI: 10.1038/leu.2017.220] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 09/28/2016] [Revised: 06/16/2017] [Accepted: 06/26/2017] [Indexed: 01/13/2023]
Abstract
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm characterized by hyperplastic megakaryopoiesis and myelofibrosis. We recently described the upregulation of MAF (v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog) in PMF CD34+ hematopoietic progenitor cells (HPCs) compared to healthy donor. Here we demonstrated that MAF is also upregulated in PMF compared with the essential thrombocytemia (ET) and polycytemia vera (PV) HPCs. MAF overexpression and knockdown experiments shed some light into the role of MAF in PMF pathogenesis, by demonstrating that MAF favors the megakaryocyte and monocyte/macrophage commitment of HPCs and leads to the increased expression of proinflammatory and profibrotic mediators. Among them, we focused our further studies on SPP1 and LGALS3. We assessed SPP1 and LGALS3 protein levels in 115 PMF, 47 ET and 24 PV patients plasma samples and we found that SPP1 plasma levels are significantly higher in PMF compared with ET and PV patients. Furthermore, in vitro assays demonstrated that SPP1 promotes fibroblasts and mesenchymal stromal cells proliferation and collagen production. Strikingly, clinical correlation analyses uncovered that higher SPP1 plasma levels in PMF patients correlate with a more severe fibrosis degree and a shorter overall survival. Collectively our data unveil that MAF overexpression contributes to PMF pathogenesis by driving the deranged production of the profibrotic mediator SPP1.
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Affiliation(s)
- S Ruberti
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - E Bianchi
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - P Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - S Rontauroli
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - G Barbieri
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - L Tavernari
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - T Fanelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - R Norfo
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy.,Haematopoietic Stem Cell Biology Laboratory, MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - V Pennucci
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - G Corbizi Fattori
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy.,GenOMec, University of Siena, Siena, Italy
| | - C Mannarelli
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy.,GenOMec, University of Siena, Siena, Italy
| | - N Bartalucci
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - B Mora
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - L Elli
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - M A Avanzini
- Department of Pediatric Onco-Hematology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - C Rossi
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - S Salmoiraghi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - R Zini
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - S Salati
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Z Prudente
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - V Rosti
- Center for the Study of Myelofibrosis, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Passamonti
- Division of Hematology, Ospedale ASST Sette Laghi, Universita degli Studi dell'Insubria, Varese, Italy
| | - A Rambaldi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - S Ferrari
- Department of Life Sciences, Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - E Tagliafico
- Department of Life Sciences, Center for Genome Research, University of Modena and Reggio Emilia, Modena, Italy
| | - A M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center for Research and Innovation for Myeloproliferative Neoplasms, AOU Careggi, University of Florence, Florence, Italy
| | - R Manfredini
- Department of Life Sciences, Centre for Regenerative Medicine 'Stefano Ferrari', University of Modena and Reggio Emilia, Modena, Italy
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10
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Ciardelli L, Garofoli F, Avanzini MA, De Silvestri A, Gasparoni A, Sabatino G, Stronati M. Escherichia Coli Specific Secretory IgA and Cytokines in Human Milk from Mothers of Different Ethnic Groups Resident in Northern Italy. Int J Immunopathol Pharmacol 2016; 20:335-40. [PMID: 17624245 DOI: 10.1177/039463200702000213] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Breast milk supplies many bioactive components. Neonates protection from pathogenic bacteria is mainly attributable to secretory IgA antibodies present in human milk in an amount depending on previous antigenic exposure. To bring new details into the field of immunological memory in secretory immunity, we evaluated the production of s-IgA specific for E. coli (E. coli s-IgA), and of proinflammatory (IL-6 and IL-8) or anti-inflammatory (IL-10) cytokines in the milk of mothers of different ethnic groups exposed in the past to poor conditions, but nowadays living in Italy in adequate conditions. Mothers from Italy, Africa, Asia and Eastern European Countries were included in the study. Anti- E. coli s-IgA, IL-6, IL-8 and IL-10 were determined by ELISA. Breast milk of all the foreign mothers presented higher levels of E. coli s-IgA than Italians, and for Asian and African mothers were significative (p=0.031 and p=0.015, respectively). Milk from women of Eastern European Countries revealed the highest IL-8 levels (p=0.026), while milk from Asian women presented the greatest concentration of IL-6 (p=0.04); however, the Africans reported the lowest concentrations of IL-10 (p=0.045). Since all the mothers had been living in Italy for some time, we believe that the presence of high levels of E. coli s-IgA, supported by high levels of pro-inflammatory cytokine, is part of a persisting immunological secretory memory.
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Affiliation(s)
- L Ciardelli
- Research Laboratories (Neonatal Immunology and Paediatric Oncohematology), IRCCS Policlinico San Matteo, Pavia, Italy.
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11
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Ciccocioppo R, Gallia A, Avanzini MA, Betti E, Picone C, Vanoli A, Paganini C, Biagi F, Maccario R, Corazza GR. A Refractory Celiac Patient Successfully Treated With Mesenchymal Stem Cell Infusions. Mayo Clin Proc 2016; 91:812-9. [PMID: 27087453 DOI: 10.1016/j.mayocp.2016.03.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Received: 11/15/2015] [Revised: 02/20/2016] [Accepted: 03/01/2016] [Indexed: 02/07/2023]
Abstract
Type II refractory celiac disease (RCD), as defined according to the amount of aberrant intraepithelial lymphocytes, is a condition characterized by severe malabsorption syndrome and poor prognosis, with no effective treatment. Based on the regenerative and immunomodulatory properties of mesenchymal stem cells (MSCs), we investigated the feasibility, safety, and efficacy of serial infusions of autologous bone marrow-derived MSCs in a 51-year-old woman with type II RCD. Mesenchymal stem cells were isolated, expanded, and characterized following standard protocols. Monitoring of the patient's malabsorption indexes, mucosal architecture, and percentage of aberrant intraepithelial lymphocytes was scheduled for the time of enrollment, at each infusion, and after 6 months. Determination of mucosal expression of interleukin (IL)-15 and its receptor was also performed. Expansion of MSCs was feasible, and the patient underwent 4 systemic infusions of 2 × 10(6) MSCs/kg body weight 4 months apart, without adverse effects. During the treatment period, she experienced gradual and durable amelioration of her general condition, with normalization of stool frequency, body mass index, laboratory test results, and mucosal architecture. Remarkably, the expression of IL-15 and its receptor almost completely disappeared. Thus, treatment of RCD with serial MSC infusions seems promising, leading to recovery from the life-threatening condition while blocking the IL-15 pathogenic pathway.
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Affiliation(s)
- Rachele Ciccocioppo
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy.
| | - Alessandra Gallia
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Maria A Avanzini
- Cell Factory and Research Laboratory-Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Elena Betti
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Cristina Picone
- Clinic Cytometry Laboratory-Department of Hematology, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Alessandro Vanoli
- Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Chiara Paganini
- Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Federico Biagi
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Rita Maccario
- Cell Factory and Research Laboratory-Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Gino R Corazza
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
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12
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Abbonante V, Gruppi C, Catarsi P, Avanzini MA, Tira ME, Barosi G, Rosti V, Balduini A. Altered fibronectin expression and deposition by myeloproliferative neoplasm-derived mesenchymal stromal cells. Br J Haematol 2015; 172:140-4. [PMID: 25940987 DOI: 10.1111/bjh.13471] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Vittorio Abbonante
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Laboratory of Biotechnology, IRCCS San Matteo Foundation, Pavia, Italy
| | - Cristian Gruppi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Laboratory of Biotechnology, IRCCS San Matteo Foundation, Pavia, Italy
| | - Paolo Catarsi
- Centre for the Study and Treatment of Myelofibrosis, Research Laboratories of Biotechnology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Maria A Avanzini
- Immunology and Transplantation Laboratory/Cell Factory/Paediatric Haematology/Oncology Department, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Maria E Tira
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Giovanni Barosi
- Centre for the Study and Treatment of Myelofibrosis, Research Laboratories of Biotechnology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Vittorio Rosti
- Centre for the Study and Treatment of Myelofibrosis, Research Laboratories of Biotechnology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessandra Balduini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy. .,Laboratory of Biotechnology, IRCCS San Matteo Foundation, Pavia, Italy.
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13
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Ciccocioppo R, Russo ML, Bernardo ME, Biagi F, Catenacci L, Avanzini MA, Alvisi C, Vanoli A, Manca R, Luinetti O, Locatelli F, Corazza GR. Mesenchymal stromal cell infusions as rescue therapy for corticosteroid-refractory adult autoimmune enteropathy. Mayo Clin Proc 2012; 87:909-14. [PMID: 22958995 PMCID: PMC3498138 DOI: 10.1016/j.mayocp.2012.04.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [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: 02/18/2012] [Revised: 04/08/2012] [Accepted: 04/19/2012] [Indexed: 01/05/2023]
Abstract
Adult autoimmune enteropathy (AIE) is a rare cause of malabsorption syndrome unresponsive to dietary restriction. Its diagnostic hallmarks are small-bowel villous atrophy and antienterocyte autoantibodies. Therapy is based mainly on nutritional support and immunosuppression. We treated a 61-year-old woman with corticosteroid-refractory AIE and life-threatening malabsorption syndrome with systemic infusions of autologous, bone marrow-derived, mesenchymal stromal cells (MSCs) as rescue therapy. The MSCs were expanded ex vivo following a previously used Good Manufacturing Practice procedure, and 2 intravenous infusions of 1.8 × 10(6) MSCs/kg body weight were administered 2 weeks apart. Analysis of circulating and mucosal regulatory T-and B-cell numbers, and of serum and secretory immunoglobulin levels, was performed before and after treatment. The MSC infusions were safe and effective, leading to disappearance of disease hallmarks and recovery from the life-threatening condition. Increases in mucosal regulatory T-cell numbers and secretory immunoglobulin levels were also observed. The benefit, however, was transient, and a further MSC infusion resulted in the same short efficacy. This case encourages the use of MSCs to treat patients with life-threatening, corticosteroid-refractory AIE and suggests that MSC infusion can attenuate, albeit transiently, the autoimmune attack.
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Affiliation(s)
- Rachele Ciccocioppo
- Clinica Medica I, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Università degli Studi di Pavia, Italy.
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14
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Comite P, Cobianchi L, Avanzini MA, Mantelli M, Achille V, Zonta S, Ferrari C, Alessiani M, De Silvestri A, Gandolfo GM, Inverardi L, Brescia L, Pietrabissa A, Dionigi P, Locatelli F, Bernardo ME. Immunomodulatory properties of porcine, bone marrow-derived multipotent mesenchymal stromal cells and comparison with their human counterpart. Cell Mol Biol (Noisy-le-grand) 2011; 57 Suppl:OL1600-OL1605. [PMID: 22000490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 09/30/2011] [Indexed: 05/31/2023]
Abstract
Thanks to their immunonodulatory properties, multipotent mesenchymal stromal cells (MSCs) are a promising strategy for preventing/reducing the risk of graft rejection after hematopoietic cell and solid organ transplantation. We have previously demonstrated that porcine MSCs (pMSCs) can be isolated from bone marrow and display similar morphology and differentiative capacity as compared to human MSC (hMSCs). In this study, we investigated the in vitro immunomodulatory properties (namely the ability to suppress lymphocyte proliferation in response to phytohemagglutinin and the cytokine production in the culture supernatants) of pMSCs from six Large White 6-month old piglets. Similarly to hMSCs, pMSCs reduced the phytohemagglutinin-induced lymphocyte proliferation. High levels of IL-6 were found in culture supernatants, whereas IL-10 and TGF-β were not detectable. In conclusion, ex vivo expanded pMSCs share selected biological/functional properties with hMSCs. pMSCs may be used in in vivo models to investigate novel approaches of prevention of graft rejection in solid organ transplantation.
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Affiliation(s)
- P Comite
- Università degli Studi di Roma, Dipartimento di Medicina Sperimentale, Sapienza, Italy
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15
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Montagna M, Montillo M, Avanzini MA, Tinelli C, Tedeschi A, Visai L, Ricci F, Vismara E, Morra E, Regazzi M. Relationship between pharmacokinetic profile of subcutaneously administered alemtuzumab and clinical response in patients with chronic lymphocytic leukemia. Haematologica 2011; 96:932-6. [PMID: 21330330 DOI: 10.3324/haematol.2010.033159] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Alemtuzumab serum levels and clinical response after subcutaneous administration (10 mg 3 times/week for six weeks) have been explored in 29 chronic lymphocytic leukemia patients receiving the monoclonal antibody as consolidation. Serum concentrations after each administration gradually increased during the first week and more markedly during weeks 2 and 3, approaching the steady-state at week 6. Absorption continued slowly through the tissues for about 2-3 weeks after the last administration, starting to decrease thereafter. Difference between Responders and Non-responders was statistically significant: maximal concentration (Cmax) was 1.69 μg/mL vs. 0.44 μg/mL; concentration before subcutaneous administration (Cpre-dose) on day 15 was 0.7 vs. 0.21 μg/mL, area under curve (AUC0-12h) was 11.09 vs. 2.26 μgxh/mL for Responders and Non-responders, respectively. Higher systemic exposure to alemtuzumab correlated with a better clinical response and minimal residual disease. Results suggest that an adjusted schedule according to serum level could improve clinical outcome of patients receiving subcutaneous alemtuzumab.
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Affiliation(s)
- Michela Montagna
- Foundation IRCCS Policlinico San Matteo, Laboratory of Clinical Pharmacokinetics, P.le Golgi 2, 27100 Pavia, Italy.
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16
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Comite P, Cobianchi L, Avanzini MA, Zonta S, Mantelli M, Achille V, De Martino M, Cansolino L, Ferrari C, Alessiani M, Maccario R, Gandolfo GM, Dionigi P, Locatelli F, Bernardo ME. Isolation and ex vivo expansion of bone marrow-derived porcine mesenchymal stromal cells: potential for application in an experimental model of solid organ transplantation in large animals. Transplant Proc 2010; 42:1341-3. [PMID: 20534296 DOI: 10.1016/j.transproceed.2010.03.080] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pharmacological aspecific immunosuppression, despite being widely used in solid organ transplantation recipients, is unable to completely prevent allograft rejection. It promotes the occurrence of sometimes life-threatening infections. Due to their immunosuppressive and anti- inflammatory properties, there is great interest in the therapeutic use of bone marrow (BM)-derived mesenchymal stromal cells (MSC). Large animal models play a crucial role to investigate the biological and functional properties of MSCs as novel cellular therapy. In the current study we sought to isolate expand ex vivo, and phenotypically characterize MSC derived from BM of 4 Large White 6-month-old piglets. Porcine MSC (pMSC) were characterized for their in vitro differentiation capacity. pMSC were successfully isolated from all BM samples. They showed spindle-shaped morphology and a stable doubling time on culture. They were positive for CD90, CD29, CD105, and negative for CD45 and CD11b. Furthermore, they differentiated, upon specific in vitro conditions toward adipogenic and osteogenic lineages. The optimization of methods for the isolation and characterization of pMSC may be useful to elucidate their biological and functional properties. The anatomy and physiology of the pig, which is similar to humans, make this animal model more attractive than small animals to test the safety and efficacy of MSC in the context of solid organ transplantation.
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Affiliation(s)
- P Comite
- Dipartimento di Medicina Sperimentale, Sapienza, Università degli Studi di Roma, Italy
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17
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Avanzini MA, Maccario R, Belloni C, Carrera G, Bertaina A, Cagliuso M, La Rocca M, Valsecchi C, Mantelli M, Castellazzi AM, Quinti I, De Silvestri A, Marconi M. B lymphocyte subsets and their functional activity in the early months of life. Int J Immunopathol Pharmacol 2010; 23:247-54. [PMID: 20378010 DOI: 10.1177/039463201002300122] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the present study we evaluated B-cell subsets and their functional development in 74 newborns from birth to 6 months of life. Moreover, we evaluated natural antibody production in vitro. The results documented a predominance of naive B-lymphocytes at all time-points evaluated, decreasing from birth to 6 months (p=0.009). The percentages of CD27+IgD+ and CD27+IgDneg memory B-cells were very low at birth and significantly increased only at 6 months (p=0.02 and p less than 0.001, respectively). We found a significant increase only in in vitro stimulated IgG production at 6 months as compared to birth (p less than 0.001). Moreover, a lower secretion of anti-Pn IgM antibodies up to 6 months of age, as compared to controls was observed. Our results underline that the susceptibility and severe course of infection in the neonate can be attributed, at least in part, to the lack of pre-existing immunological memory and competent adaptive immunity.
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Affiliation(s)
- M A Avanzini
- Laboratorio Sperimentale Oncoematologia Pediatrica, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
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18
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Bernardo ME, Ball LM, Cometa AM, Roelofs H, Zecca M, Avanzini MA, Bertaina A, Vinti L, Lankester A, Maccario R, Ringden O, Le Blanc K, Egeler RM, Fibbe WE, Locatelli F. Co-infusion of ex vivo-expanded, parental MSCs prevents life-threatening acute GVHD, but does not reduce the risk of graft failure in pediatric patients undergoing allogeneic umbilical cord blood transplantation. Bone Marrow Transplant 2010; 46:200-7. [DOI: 10.1038/bmt.2010.87] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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19
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Derosa G, Cicero AFG, Scalise F, Avanzini MA, Tinelli C, Peros E, Fogari E, D'Angelo A. Metalloproteinases in Diabetics and Nondiabetics during Acute Coronary Syndromes and after 3 Months. ACTA ACUST UNITED AC 2009; 14:175-83. [DOI: 10.1080/10623320701606475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Castellazzi AM, Valsecchi C, Montagna L, Malfa P, Ciprandi G, Avanzini MA, Marseglia GL. In vitroActivation of Mononuclear Cells by Two Probiotics:Lactobacillus paracaseiI 1688,Lactobacillus salivariusI 1794, and their Mixture (PSMIX). Immunol Invest 2009; 36:413-21. [PMID: 17691023 DOI: 10.1080/08820130701361160] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Most studies on probiotics have described their effects on the human immune system after ingestion of LAB, but little is known about their effect on in vitro stimulation of human immune cells. AIM OF THE STUDY Evaluate the "in vitro" activity of Lactobacillus paracasei (I 1688), Lactobacillus salivarius (I 1794), and a commercial mix of the two (PSMIX, Proge Farm), on immune cells from healthy individuals. MATERIALS Two probiotic strains, Lactobacillus salivarius (I 1794; Proge Farm, Italy) and Lactobacillus paracasei (I 1688; Proge Farm, Italy), which are contained in the functional food ENTEROBACILLI, were evaluated for their ability to stimulate peripheral blood mononuclear cells and modulate surface phenotype and cytokine production. RESULTS All subjects responded to the bacteria, with different levels of response. The cell populations that showed a significant percent increase were CD4+/CD25+ cells (T-helper activated regulatory cells), CD8+/CD25+ (T-suppressor/cytotoxic activated cells), and CD16+/CD56+ (NK cells) (p<0.05). IL-12 and IFN-gamma in vitro production significantly increased with exposure to probiotics (p<0.05 for both). CONCLUSIONS This study provides the first evidence that Lactobacillus paracasei and Lactobacillus salivarius are capable of inducing a specific immune response that may be useful in the clinical setting for improving innate and adaptive immune responses.
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Affiliation(s)
- A M Castellazzi
- Department of Pediatric Sciences, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy.
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21
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Ciardelli L, Garofoli F, Stronati M, Mazzucchelli I, Avanzini MA, Figar T, Gasparoni A, De Silvestri A, Sabatino G, Chirico G. Human colostrum T lymphocytes and their effector cytokines actively aid the development of the newborn immune system. Int J Immunopathol Pharmacol 2009; 21:781-6. [PMID: 19144263 DOI: 10.1177/039463200802100402] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Colostrum contains soluble and cellular components, the latter mainly T lymphocytes. We expanded in vitro colostrum T lymphocytes (CoTL) to evaluate phenotype and capability of cytokine production. We also considered paired cord blood T-lymphocytes (CBTL) representing the newborn "virgin" immune system. CoTL showed memory phenotype while CBTL expressed mainly naïve phenotype. CoTL included a balanced percentage of helper and cytotoxic subsets. We observed higher percentages of IL-2 (p=0.003) and IL-4 (p=0.027) producing cells by helper rather than by cytotoxic T lymphocytes. The greatest percentage of IFN-gamma producing cells was in cytotoxic cells (p=0.0048), while no difference was found for IL-10. Cord blood samples consisted of a statistically significant greater percentage of helper than cytotoxic cells (p<0.001), with a low percentage of cytokine producing cells, confirming the immaturity of the newborns immune system. CBTL percentage of IL-2 producing cells was higher for helper than cytotoxic subset (p<0.001). We observed a greater percentage of IFN-gamma (p=0.001), IL-4 (p=0.003) and IL-10 (p<0.001) producing cells by cytotoxic than helper T lymphocytes. CoTL demonstrated to protect the newborn through the mothers previous immune experience and to supply active cytokines, which can help the postnatal development of both T type 1/T type 2 response.
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Affiliation(s)
- L Ciardelli
- Neonatal Immunology Research Laboratories, Neonatology and Neonatal Intensive Care Unit Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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22
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Derosa G, D'Angelo A, Scalise F, Avanzini MA, Tinelli C, Peros E, Fogari E, Cicero AF. Comparison between metalloproteinases-2 and -9 in healthy subjects, diabetics, and subjects with acute coronary syndrome. Heart Vessels 2007; 22:361-70. [DOI: 10.1007/s00380-007-0989-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 04/13/2007] [Indexed: 11/29/2022]
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23
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Montagna M, Avanzini MA, Visai L, Locatelli F, Montillo M, Morra E, Regazzi MB. A new sensitive enzyme-linked immunosorbent assay (ELISA) for Alemtuzumab determination: development, validation and application. Int J Immunopathol Pharmacol 2007; 20:363-71. [PMID: 17624249 DOI: 10.1177/039463200702000217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Alemtuzumab is a humanized (IgG(1)) rat monoclonal antibody to CD52 antigen and is currently used in the treatment of chronic lymphocytic leukemia (CLL) and other CD52-positive lymphoproliferative disorders. Various techniques have been developed to measure Alemtuzumab levels in human serum/plasma. The authors report on the validation of a very sensitive enzyme-linked immunosorbent assay (ELISA) to measure serum concentrations of the humanized IgG(1) using a rabbit polyclonal antibody specifically produced against the rat sequence of Alemtuzumab after papain digestion. The assay was successfully applied to test the serum samples of patients with B-lymphocyte CLL who received Alemtuzumab subcutaneously. This ELISA assay could be easily used to determine human serum levels of Alemtuzumab pre- and post-treatment to optimize dosing and scheduling and to study the relationship between dose and clinical response.
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MESH Headings
- Alemtuzumab
- Animals
- Antibodies, Monoclonal/analysis
- Antibodies, Monoclonal/blood
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/analysis
- Antibodies, Neoplasm/blood
- Antineoplastic Agents/analysis
- Antineoplastic Agents/blood
- Dose-Response Relationship, Drug
- Enzyme-Linked Immunosorbent Assay
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Rabbits
- Rats
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Affiliation(s)
- M Montagna
- Clinical Pharmacokinetics Unit, IRCCS-Fondazione Policlinico S. Matteo, Pavia, Italy
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24
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Derosa G, Cicero AFG, Scalise F, Avanzini MA, Tinelli C, Piccinni MN, Peros E, Geroldi D, Fogari E, D'Angelo A. Metalloproteinase-2 and -9 in diabetic and nondiabetic subjects during acute coronary syndromes. ACTA ACUST UNITED AC 2007; 14:45-51. [PMID: 17364896 DOI: 10.1080/10623320601177064] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The authors hypothesized that matrix metalloproteinase (MMP)-2, -9, and tissue inhibitor metalloproteinase (TIMP)-1, -2 would be abnormal in acute coronary syndromes (ACSs). MMP-2, -9, and TIMP-1, -2 plasma levels were measured in diabetic patients with ACSs compared to nondiabetic patients with ACSs. A total of 46 diabetic and 78 nondiabetic patients with ACSs were enrolled. The following parameters were measured: body mass index (BMI), glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), fasting plasma insulin (FPI), homeostasis model assessment index (HOMA index), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (Tg), lipoprotein(a) [Lp(a)], plasminogen activator inhibitor-1 (PAI-1), homocysteine (Hct), fibrinogen (Fg), high-sensitivity C-reactive protein (hs-CRP), and plasma levels of MMP-2, MMP-9, TIMP-1, and TIMP-2. Significant HbA1c, FPG, FPI, HOMA index, DBP, Tg, Hct, and Fg increases were present in the diabetic group with ACSs, whereas hs-CRP was lower in these patients compared to nondiabetic patients with ACSs. MMP-9, TIMP-1, and TIMP-2 plasma levels were higher in diabetic patients with ACSs compared to nondiabetic patients with ACSs. MMP-9, TIMP-1, and TIMP-2 plasma levels were increased in diabetic patients with ACSs, which may reflect abnormal extracellular matrix metabolism in diabetes during acute event.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
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25
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Bernardo ME, Avanzini MA, Perotti C, Cometa AM, Moretta A, Lenta E, Del Fante C, Novara F, de Silvestri A, Amendola G, Zuffardi O, Maccario R, Locatelli F. Optimization of in vitro expansion of human multipotent mesenchymal stromal cells for cell-therapy approaches: further insights in the search for a fetal calf serum substitute. J Cell Physiol 2007; 211:121-30. [PMID: 17187344 DOI: 10.1002/jcp.20911] [Citation(s) in RCA: 218] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
There is great interest in mesenchymal stromal cells (MSCs) for cell-therapy and tissue engineering approaches. MSCs are currently expanded in vitro in the presence of fetal calf serum (FCS); however, FCS raises concerns when used in clinical grade preparations. The aim of this study was to evaluate whether MSCs expanded in medium supplemented with platelet-lysate (PL), already shown to promote MSC growth, are endowed with biological properties appropriate for cell-therapy approaches. We confirm previously published data showing that MSCs expanded in either FCS or PL display comparable morphology, phenotype, and differentiation capacity, while PL-MSCs were superior in terms of clonogenic efficiency and proliferative capacity. We further extended these data by investigating the immune-regulatory effect of MSCs on the alloantigen-specific immune response in mixed lymphocyte culture (MLC). We found that MSCs-PL are comparable to MSCs-FCS in their capacity to: (i) decrease alloantigen-induced cytotoxic activity; (ii) favor differentiation of CD4+ T-cell subsets expressing a Treg phenotype; (iii) increase early secretion of IL-10 in MLC supernatant, as well as induce a striking augmentation of IL-6 production. As compared with MSCs-PL, MSCs-FCS were more efficient in suppressing alloantigen-induced lymphocyte subset proliferation and reducing early IFNgamma-secretion. Resistance to spontaneous transformation into tumor cells of expanded MSCs was demonstrated by molecular karyotyping and maintenance of normal morphology/phenotype after prolonged in vitro culture. Our data support the immunological functional plasticity of MSCs and suggest that MSCs-PL can be used as an alternative to MSCs-FCS, although these latter cells might be more suitable for preventing/treating alloreactivity-related immune complications.
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Affiliation(s)
- M E Bernardo
- Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy.
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26
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Avanzini MA, Ricci A, Scaramuzza C, Semino L, Pagella F, Castellazzi AM, Marconi M, Klersy C, Pistorio A, Boner AL, Marseglia GL. Deficiency of INFgamma producing cells in adenoids of children exposed to passive smoke. Int J Immunopathol Pharmacol 2006; 19:609-16. [PMID: 17026846 DOI: 10.1177/039463200601900317] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Exposure to passive smoke is a very common event associated with increased susceptibility to respiratory tract infections. Many related adverse effects result from the ability of cigarette smoke extracts to interfere with the immune system, but the mechanism is not yet completely understood. The aim of the present study is to evaluate the intracellular cytokine profile in adenoids and peripheral blood cells of children exposed to passive smoke. Children undergoing adenoidectomy exposed or not exposed to passive smoke were studied. The intracellular cytokine profile of lymphocyte subsets in adenoids and in peripheral blood were evaluated by flow cytometry analysis. Children exposed to tobacco smoke showed a significantly lower percentage of INF-gamma producing CD4+ and CD8+ cells in adenoids. Moreover a significant correlation was observed between the quantity of exposure and reduction in Th1 (CD4+INFgamma+ and CD8+INFgamma+) cells in adenoids. This reduction may be a contributing factor in the increasing susceptibility to respiratory tract infection in children exposed to tobacco smoke.
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Affiliation(s)
- M A Avanzini
- Research Laboratories, Transplantation Area, IRCCS Policlinico S. Matteo, Pavia, Italy.
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27
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Carlo-Stella C, Di Nicola M, Longoni P, Cleris L, Lavazza C, Milani R, Milanesi M, Magni M, Pace V, Colotta F, Avanzini MA, Formelli F, Gianni AM. Placental Growth Factor-1 Potentiates Hematopoietic Progenitor Cell Mobilization Induced by Granulocyte Colony-Stimulating Factor in Mice and Nonhuman Primates. Stem Cells 2006; 25:252-61. [PMID: 17008429 DOI: 10.1634/stemcells.2006-0020] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The complex hematopoietic effects of placental growth factor (PlGF) prompted us to test in mice and nonhuman primates the mobilization of peripheral blood progenitor cells (PBPCs) elicited by recombinant mouse PlGF-2 (rmPlGF-2) and recombinant human PlGF-1 (rhPlGF-1). PBPC mobilization was evaluated by assaying colony-forming cells (CFCs), high-proliferative potential-CFCs (HPP-CFCs), and long-term culture-initiating cells (LTC-ICs). In mice, both rmPlGF-2 and rhPlGF-1 used as single agents failed to mobilize PBPCs, whereas the combination of rhPlGF-1 and granulocyte colony-stimulating factor (rhG-CSF) increased CFCs and LTC-ICs per milliliter of blood by four- and eightfold, respectively, as compared with rhG-CSF alone. rhPlGF-1 plus rhG-CSF significantly increased matrix metalloproteinase-9 plasma levels over rhG-CSF alone, suggesting a mechanistic explanation for rhPlGF-1/rhG-CSF synergism. In rhesus monkeys, rhPlGF-1 alone had no mobilization effect, whereas rhPlGF-1 (260 microg/kg per day) plus rhG-CSF (100 microg/kg per day) increased rhG-CSF-elicited mobilization of CFCs, HPP-CFCs, and LTC-ICs per milliliter of blood by 5-, 7-, and 15-fold, respectively. No specific toxicity was associated with the administration of rhPlGF-1 alone or in combination. In conclusion, our data demonstrate that rhPlGF-1 significantly increases rhG-CSF-elicited hematopoietic mobilization and provide a preclinical rationale for evaluating rhPlGF-1 in the clinical setting.
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Affiliation(s)
- Carmelo Carlo-Stella
- C. Gandini Bone Marrow Transplantation Unit, Istituto Nazionale Tumori, Via Venezian, 1, 20133 Milano, Italy.
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28
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Derosa G, Avanzini MA, Geroldi D, Fogari R, Lorini R, De Silvestri A, Tinelli C, Rondini G, d'Annunzio G. Matrix metalloproteinase 2 may be a marker of microangiopathy in children and adolescents with type 1 diabetes mellitus. Diabetes Res Clin Pract 2005; 70:119-25. [PMID: 16188574 DOI: 10.1016/j.diabres.2005.03.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [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: 08/24/2004] [Revised: 02/14/2005] [Accepted: 03/04/2005] [Indexed: 11/22/2022]
Abstract
Matrix metalloproteinases (MMPs) 2 and 9 are responsible for extracellular matrix breakdown and their abnormal circulating levels may pre-date clinical evidence of diabetic angiopathy. We detected by ELISA, plasma MMP-2 and MMP-9 levels and associated activity in 25 children and adolescents with T1DM. Thirteen male and 12 female patients were evaluated at the clinical diagnosis and onset of T1DM and again at a 5-year follow-up. Twelve patients had developed microangiopathic complications at the follow-up evaluation. MMP-2 and MMP-9 levels and activity were detected in samples obtained at T1DM diagnosis and at the 5-year follow-up. As controls, 19 healthy subjects who were the same age as the patients were also evaluated at baseline and again after 5 years. MMP-2 levels and activity were significantly higher in the patients than in the controls at disease onset. This was particularly evident when patients who developed microangiopathic complications were compared to controls and patients without complications. At the 5-year follow-up, a significant increase in MMP-2 levels and a significant decrease in MMP-2 activity were found only in the control group compared to the baseline levels. MMP-2 levels and activity were higher in patients with microangiopathy. MMP-9 levels and activity were increased in all groups compared to baseline levels. MMP-9 levels were lower in patients with microangiopathy compared to controls, but no difference was found between the two patient groups. It is well known that MMP-9 is an index of the severity and stability of macroangiopathy while our results allow us to postulate that MMP-2 may be a marker of microangiopathy.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, P. le C. Golgi 2, 27100 Pavia, Italy.
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29
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Giebel S, Maccario R, Lilleri D, Zecca M, Avanzini MA, Marconi M, Di Cesare Merlone A, Campanini G, Montagna D, Travaglino P, Gentile R, Telli S, Pagliara D, Holowiecki J, Locatelli F. The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 36:503-9. [PMID: 16007103 DOI: 10.1038/sj.bmt.1705094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In immune-competent individuals, human cytomegalovirus (HCMV) infection is associated with impairment of T-cell function. Our goal was to evaluate prospectively whether clinically asymptomatic HCMV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, treated pre emptively with ganciclovir, influences T-cell function as well. Mitogen-stimulated T-cell proliferative activity, together with cell surface markers, was tested in 49 patients on days + 30, + 45, + 60, and + 90 after alloHSCT and, additionally, in cases of positive HCMV pp65-antigenemia. HCMV infection was diagnosed in 19 patients. None of them developed HCMV disease. T-cell proliferative activity was significantly decreased on days when HCMV antigenemia was positive as compared to days without antigenemia. The number of pp65-positive cells negatively correlated with proliferative response. Comparison of patients who did experience HCMV infection with those who did not reveals significant decrease of T-cell proliferative activity observed on days + 30 and + 45, a time period when antigenemia was most frequently found to be positive, whereas no difference was detected on days + 60 and + 90. We conclude that, even clinically asymptomatic, HCMV infection has negative impact on T-cell proliferation capacity in alloHSCT recipients. However, pre emptive therapy with ganciclovir makes this immunosuppressive effect transient and restricted to the time of infection duration.
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Affiliation(s)
- S Giebel
- Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy.
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30
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Avanzini MA, Ciardelli L, Lenta E, Castellazzi AM, Marconi M, Derosa G, Dos Santos C, Oliveri M, Pistorio A, Lorini R, d'Annunzio G. IFN-γ Low Production Capacity in Type 1 Diabetes Mellitus Patients at Onset of Disease. Exp Clin Endocrinol Diabetes 2005; 113:313-7. [PMID: 15977097 DOI: 10.1055/s-2005-865643] [Citation(s) in RCA: 14] [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] [Indexed: 10/25/2022]
Abstract
In type 1 diabetes mellitus (T1DM), cytokines can be directly cytotoxic to beta-cells, and/or play an indirect role influencing some cells of the immune system. Since several factors could impair cytokine serum levels, the purpose of our study was to longitudinally evaluate intracellular cytokines, in T1DM patients, and in subject at risk, by flow cytometry analysis. At T1DM onset we observed significantly lower percentage of peripheral CD4 + and CD8 + cells producing IFN-gamma in patients compared to controls and subjects at risk. The 15-month follow-up patients showed significantly lower percentage of CD4 + and CD8 + cells producing IFN-gamma compared to the other groups. At 8-year follow-up no significant differences were observed among the groups in the percentage of cells producing cytokines. We could have considered "exhausted cells" or these T cell subsets may be migrated from peripheral blood to pancreas. On the other hand, our results are in agreement with those reported in literature: in animal model the absence of IFN-gamma production makes beta-cells highly susceptible to viral infection and subsequent attack by natural killer cells, which lead to hyperglycaemia and diabetes mellitus.
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Affiliation(s)
- M A Avanzini
- Research Laboratories for Pediatric Oncohematology and Immunology, IRCCS Policlinico S. Matteo, Pavia, Italy.
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31
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Avanzini MA, Monafo V, De Amici M, Maccario R, Burgio GR, Plebani A, Ugazio AG, Hanson LA. Humoral immunodeficiencies in Down syndrome: serum IgG subclass and antibody response to hepatitis B vaccine. Am J Med Genet Suppl 2005; 7:231-3. [PMID: 2149953 DOI: 10.1002/ajmg.1320370746] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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32
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Belloni C, De Silvestri A, Tinelli C, Avanzini MA, Marconi M, Strano F, Rondini G, Chirico G. Immunogenicity of a three-component acellular pertussis vaccine administered at birth. Pediatrics 2003; 111:1042-5. [PMID: 12728086 DOI: 10.1542/peds.111.5.1042] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [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: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate within the first 6 months of birth the immunogenicity of a 3-component acellular pertussis (aP) vaccine containing filamentous hemagglutinin (FHA), pertactine (PRN), and genetically detoxified pertussis toxin (PT) in infants who received a dose of vaccine at birth, in addition to the recommended schedule administered at 3, 5, and 11 months. Furthermore, we investigated the influence of maternal antibodies on aP vaccine response. METHODS We used enzyme-linked immunosorbent assay to evaluate immunoglobulin G antibody levels in 45 infants immunized at birth and at 3, 5, and 11 months (group 1) and in 46 infants immunized at the ages of 3, 5, and 11 months (group 2). All mothers were also tested at delivery. RESULTS At the age of 5 months the geometric mean titer of anti-PT, anti-FHA, and anti-PRN was significantly greater in group 1 (who had received 2 doses) than in group 2 (1 dose). At 6 months geometric mean titers were significantly higher in group 1 than in group 2 for anti-PRN and anti-FHA, whereas no significant differences were observed for anti-PT. CONCLUSIONS Immunization at birth may be important for an earlier prevention of the pertussis disease in infants under 6 months, especially in Italy, where the recommended ages for aP vaccine administration are 3, 5, and 11 months.
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MESH Headings
- Adhesins, Bacterial/administration & dosage
- Adhesins, Bacterial/immunology
- Adhesins, Bacterial/therapeutic use
- Adolescent
- Adult
- Antibodies, Bacterial/biosynthesis
- Antibodies, Bacterial/blood
- Antigens, Bacterial/administration & dosage
- Antigens, Bacterial/immunology
- Antigens, Bacterial/therapeutic use
- Bacterial Outer Membrane Proteins/administration & dosage
- Bacterial Outer Membrane Proteins/immunology
- Bacterial Outer Membrane Proteins/therapeutic use
- Bordetella pertussis/immunology
- Female
- Hemagglutinins/administration & dosage
- Hemagglutinins/immunology
- Hemagglutinins/therapeutic use
- Humans
- Immunization Schedule
- Immunoglobulin G/biosynthesis
- Immunoglobulin G/blood
- Infant
- Infant, Newborn
- Injections, Intramuscular
- Italy
- Male
- Mothers
- Pertussis Toxin/administration & dosage
- Pertussis Toxin/immunology
- Pertussis Toxin/therapeutic use
- Pertussis Vaccine/administration & dosage
- Pertussis Vaccine/immunology
- Pertussis Vaccine/therapeutic use
- Virulence Factors, Bordetella/administration & dosage
- Virulence Factors, Bordetella/immunology
- Virulence Factors, Bordetella/therapeutic use
- Whooping Cough/prevention & control
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Affiliation(s)
- Cesare Belloni
- Division of Neonatology and Neonatal Intensive Care, IRCCS Policlinico San Matteo Pavia, Italy.
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Abstract
UNLABELLED Hepatitis A is a common viral infection causing substantial morbidity and mortality. The anti-hepatitis A virus (HAV) vaccination in infants would guarantee control of the infection. However, the immunogenicity of the HAV vaccine in infants could be impaired by the presence of passively acquired maternal HAV antibodies. This study evaluated the prevalence of HAV antibodies in 103 women at delivery and in their babies in the first year of life. Eighteen mothers (17.5%) had anti-HAV serum level >10 mIU ml(-1). In their infants the anti-HAV level was still positive in 11 out of 18 (61.1%) at 12 mo. Two out of 85 infants born to anti-HAV-negative mothers and anti-HAV negative at birth were found to be positive at 5 mo of age. CONCLUSION It is proposed that all women be screened at delivery for anti-HAV antibodies. Children born to anti-HAV-negative mothers could be vaccinated early during the first year of life, whereas vaccination could be postponed in children born to anti-HAV-positive mothers, if necessary.
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Affiliation(s)
- A De Silvestri
- Divisione Neonatologia-Patologia Neonatale, IRCCS Policlinico S. Matteo Pavia, Italy
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34
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Belloni C, Avanzini MA, De Silvestri A, Martinetti M, Pasi A, Coslovich E, Autelli M, Masanti ML, Cuccia M, Tinelli C, Rondini G, Lorini R. No evidence of autoimmunity in 6-year-old children immunized at birth with recombinant hepatitis B vaccine. Pediatrics 2002; 110:e4. [PMID: 12093985 DOI: 10.1542/peds.110.1.e4] [Citation(s) in RCA: 17] [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: 11/24/2022] Open
Abstract
OBJECTIVES Taking into account that genetic predisposition, marked by human leukocyte antigen (HLA) class I and II genes, augments the probability of developing an autoimmune disorder after a triggering vaccination, as largely debated, we investigated the frequency of autoantibody production after recombinant hepatitis B vaccine (rHBv) in 6-year-old children immunized at birth to evaluate an association between autoimmune disorders and hepatitis B virus vaccination. METHODS We investigated the presence of autoantibodies in 210 6-year-old children who were immunized at birth with rHBv: 200 showed anti-hepatitis B surface antigen concentrations > or =10 mUI/mL at seroconversion (responders), and 10 were nonresponders. Data were compared with those obtained in 109 unvaccinated children. All participants were screened for the presence of antinuclear antibodies (ANAs), anti-DNA, antimitochondrial, anti-liver/kidney microsomal, antireticulin, anti-smooth muscle (SMA), and antiribosomal antibodies. All participants were also screened for the presence of antithyroid antibodies, such as antithyroglobulin and antiperoxidase, and for antibodies found in type 1 diabetes, such as tyrosine phosphatase (IA-2A) and glutamic acid decarboxylase (GADA). HLA typing was extended to all 10 nonresponders. RESULTS Autoantibodies were found in 16 of the 200 responders: ANAs were found in 12 (6%), smooth muscle antibodies were found in 4 (2.0%), and antireticulin antibodies and endomysial antibodies were found in 1 girl with ANAs. Antithyroid antibodies, IA-2A, and GADA were not present in any of the participants. No significant difference was found in the frequency of autoantibodies between vaccinated and control children. Three of the 10 nonresponder children were SMA-positive (30% vs 2% of responders); they also carried the supratype HLA-C4AQ0,DRB1*0301,DQB1*02. A family history for autoimmune disorders was present in 3 (18%; 95% confidence interval [CI]: 4.0%-45.6%) of the 16 responder infants with autoantibodies, in 15 (8.4%; 95% CI: 4.6%-13.1%) of responder children without autoantibodies, and in 1 (10%) of the 10 nonsreponder children. CONCLUSIONS From our data, vaccination with rHBv given during the neonatal period does not seem to increase autoantibody production in a 6-year-old children. Autoantibodies, referred to as natural autoantibodies, can be found in healthy participants, but their significance is unclear. These autoantibodies often cross-react with bacteria or tumor antigens, suggesting their importance in innate immunity. It has been demonstrated in an animal model that self-antigen can promote B-cell accumulation, and that a significant proportion of natural autoantibodies is the product of this self-antigen- dependent process. Consequently, it has been speculated that self-antigens play a positive role in recruiting B cells as a part of innate immunity, but this process carries a potential risk for unregulated growth. Spreading of the immune response is a common theme in organ-specific and systemis autoimmune diseases, and this could be initiated by exogenous agents, in genetically susceptible hosts, owing to molecular mimicry of natural antigen. Moreover, 3 (18%) of the 16 children who had autoantibodies had a family history of autoimmume diseases. Thus, it is apparent that susceptibility to autoimmunity is determined by genetic factors rather than by vaccine challenge. Among all the children considered, only 1 girl (0.5%) developed celiac disease, reflecting the prevalence described in the literature. GADA and IA-2A were not found in our children; this observation is in agreement with data showing that type 1 diabetes risk may not be altered by vaccinations administered during childhood. On the contrary, a high frequency (30%) of autoantibodies, in particular SMA, was observed in the nonresponder children. The 3 SMA-positive children carried the HLA-C4Q0,DRB1*0301,DQB1*02 haplotype, a well-known predisposing factor for autoimmune disorders. On the other hand, the presence of autoantibodies to smooth muscle is known to be common in hepatitis B infection, and, it has been shown that cross-reactive immunity targeting homologous self-protein may partly account for autoantibody production. Although hepatitis B vaccination given during the neonatal period does not increase autoantibody production in 6-year-old immunized children, we deem useful a more prolonged follow-up for these nonresponder children carrying certain HLA haplotypes (such as C4AQ0,DRB1*0301,DQB1*02), particularly because most autoimmune diseases do not develop until later in life.
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Affiliation(s)
- Cesare Belloni
- Division of Neonatal Intensive Care, IRCCS Policlinico San Matteo, Pavia, Italy.
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35
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Ferrari S, Giliani S, Insalaco A, Al-Ghonaium A, Soresina AR, Loubser M, Avanzini MA, Marconi M, Badolato R, Ugazio AG, Levy Y, Catalan N, Durandy A, Tbakhi A, Notarangelo LD, Plebani A. Mutations of CD40 gene cause an autosomal recessive form of immunodeficiency with hyper IgM. Proc Natl Acad Sci U S A 2001; 98:12614-9. [PMID: 11675497 PMCID: PMC60102 DOI: 10.1073/pnas.221456898] [Citation(s) in RCA: 253] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
CD40 is a member of the tumor necrosis factor receptor superfamily, expressed on a wide range of cell types including B cells, macrophages, and dendritic cells. CD40 is the receptor for CD40 ligand (CD40L), a molecule predominantly expressed by activated CD4(+) T cells. CD40/CD40L interaction induces the formation of memory B lymphocytes and promotes Ig isotype switching, as demonstrated in mice knocked-out for either CD40L or CD40 gene, and in patients with X-linked hyper IgM syndrome, a disease caused by CD40L/TNFSF5 gene mutations. In the present study, we have identified three patients with an autosomal recessive form of hyper IgM who fail to express CD40 on the cell surface. Sequence analysis of CD40 genomic DNA showed that one patient carried a homozygous silent mutation at the fifth base pair position of exon 5, involving an exonic splicing enhancer and leading to exon skipping and premature termination; the other two patients showed a homozygous point mutation in exon 3, resulting in a cysteine to arginine substitution. These findings show that mutations of the CD40 gene cause an autosomal recessive form of hyper IgM, which is immunologically and clinically undistinguishable from the X-linked form.
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Affiliation(s)
- S Ferrari
- Istituto di Medicina Molecolare "Angelo Nocivelli," Clinica Pediatrica, Università di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
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36
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Avanzini MA, Belloni C, Soncini R, Ciardelli L, de Silvestri A, Pistorio A, Tinelli C, Maccario R, Rondini G. Increment of recombinant hepatitis B surface antigen-specific T-cell precursors after revaccination of slow responder children. Vaccine 2001; 19:2819-24. [PMID: 11282192 DOI: 10.1016/s0264-410x(01)00007-x] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The aim of the study was to investigate the in vitro T-cell response to recombinant hepatitis B (rHBsAg) in a group of children (defined as "slow responders") vaccinated at birth, presenting antibody levels < 10 mIU/ml after the vaccination schedule, and developing anti-rHBs antibodies after revaccination. T-cell mediated immune response towards rHBsAg was evaluated in 35 healthy children in "bulk" culture experiments (19 responders and 16 slow responders) and by limiting dilution analysis (nine responders and five slow responders) to quantify the frequency of proliferating T lymphocyte-precursors (PTL-p). Before the booster dose, lymphocytes from slow responder children failed to proliferate to rHBsAg, while a normal proliferation was observed in all responders. A statistically significant difference in rHBsAg-specific PTLp frequencies was observed between the two groups. Among the slow responder group, a significant increase of PTLp was observed after the supplementary vaccine dose.Nevertheless, PTLp frequencies remained significantly lower than those measured in responders. These results suggest a role for follow-up of slow responder children over time, in order to perform booster vaccination when inadequate anti-HBs titre is present.
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Affiliation(s)
- M A Avanzini
- Laboratori Sperimentali di ricerca -- Area trapiantologica -- Trapianto midollo osseo ed oncoematologia pediatrica, IRCCS Policlinico S. Matteo, 27100 Pavia, Italy.
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37
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Martinetti M, De Silvestri A, Belloni C, Pasi A, Tinelli C, Pistorio A, Salvaneschi L, Rondini G, Avanzini MA, Cuccia M. Humoral response to recombinant hepatitis B virus vaccine at birth: role of HLA and beyond. Clin Immunol 2000; 97:234-40. [PMID: 11112362 DOI: 10.1006/clim.2000.4933] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
From 1991 to 1998 we vaccinated 4835 neonates against hepatitis B virus (HBV) and monitored their humoral response to the recombinant vaccine. In a sample of 184 of these babies we studied the association between HLA class I and II genomic polymorphisms and humoral response to the vaccine and the association between the response and immune-mediated diseases. A subgroup of 96 babies also underwent HLA class III (C4A and C4B) typing. Four levels of humoral response were identified, each with a peculiar MHC restriction. Different HLA products seem to act as agonists (C4AQ0 and HLA-DQB1(*)02) or antagonists (C4AQ0, HLA-DQB1(*)02, and HLA-DRB1(*)11, DQB1(*)0301) in lowering humoral response to HBV vaccine. The group of responders was characterized more for lacking "nonresponder" alleles than for having specific "responder" ones. Tolerance to HBV peptides may have clinical implications, possibly being a marker for babies with a genetic risk of immunopathologies. In fact, many of the poor responders carried from two to four HLA-DQ alpha beta heterodimers predisposing to insulin-dependent diabetes mellitus and celiac disease. Two true nonresponders suffered from allergies and two slow responders had transient episodes of hyperglycemia.
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Affiliation(s)
- M Martinetti
- Servizio di Immunoematologia, Transfusione e Centro di Immunologia dei Trapianti, IRCCS Policlinico S. Matteo, Pavia, Italy
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38
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Marseglia G, Alibrandi A, d'Annunzio G, Gulminetti R, Avanzini MA, Marconi M, Tinelli C, Lorini R. Long term persistence of anti-HBs protective levels in young patients with type 1 diabetes after recombinant hepatitis B vaccine. Vaccine 2000; 19:680-3. [PMID: 11115688 DOI: 10.1016/s0264-410x(00)00268-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to evaluate the persistence of anti-hepatitis B protective levels in young patients with type 1 diabetes, successfully immunised with a recombinant hepatitis B vaccine. We re-evaluated, after a 4 year follow-up, 54 patients and 70 age and sex-matched healthy subjects. Protective antibodies levels were found in 50/54 (92%) patients and in 67/70 (96%) controls. Moreover, anti-HBs levels were similar in diabetic patients and controls (means of log-titre and (sd); 1.95 (0.88) and 2.18 (0.64) patients and controls, respectively; P=0.11). No cases of clinical hepatitis were reported and all patients and controls remained HBc negative. These data demonstrate the persistence of anti-HBs levels in children, adolescents and young patients with type 1 diabetes after recombinant hepatitis B vaccine showing evidence of longterm immunogenity and protective effect.
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Affiliation(s)
- G Marseglia
- Department of Pediatrics, University of Pavia, IRCCS Policlinico S. Matteo, P.le Golgi 2, 27100, Pavia, Italy.
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39
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Abstract
Among the molecular variants of human GH, the monomeric 22-kD is the predominant isoform, whereas the 20-kD is the second most abundant isoform. Because little is known on the pattern of human GH isoforms in the early postnatal period, we evaluated serum levels of 22-kD GH by an immunofluorometric assay and of 20-kD GH by an ELISA using an anti-20-kD antibody, and measured GH bioactivity with the Nb2 cell bioassay in 19 preterm neonates (gestational age, 32 +/- 0.5 wk; mean +/- SEM) on the fourth and 15th days of life. As control subjects, we studied 19 full-term neonates (gestational age, 39 +/- 0.3 wk) on the fourth day of life and 20 healthy adults, aged 20 +/- 0.3 y. Four-day-old preterm neonates showed significantly higher serum values of 20-kD GH (0.99 - 0.14 ng/mL) than full-term neonates (0.33 +/- 0.07 ng/mL; p < 0.001) and adults (0.09 +/- 0.02; p < 0.0001). Likewise, 22-kD GH and GH levels by Nb2 cell bioassay were also significantly higher (p < 0.001) in preterm than in full-term neonates and young adults. A significant decrease (p < 0.01) in 20-kD, 22-kD, and Nb2-determined GH was observed in preterm neonates on the 15th day of life The percentage of the 20-kD isoform was similar in the preterm infants at the fourth and 15th day, in full-term-infants, and in adults (2.7%, 2.7%, 2.8%, and 3.16%, respectively). Our results indicate that 20-kD GH serum levels change throughout life as regards total amount, but not as regards percentage.
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Affiliation(s)
- G Radetti
- Department of Paediatrics, Regional Hospital of Bolzano, Italy
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40
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Gasparoni A, Ciardelli L, Avanzini MA, Bonfichi M, di Mario M, Piazzi G, Martinotti L, Vanelli L, Rondini G, Chirico G. Immunophenotypic changes of fetal cord blood hematopoietic progenitor cells during gestation. Pediatr Res 2000; 47:825-9. [PMID: 10832745 DOI: 10.1203/00006450-200006000-00024] [Citation(s) in RCA: 20] [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: 11/06/2022]
Abstract
We measured cell surface expression of CD34, HLA-DR, CD38, CD19, CD33, CD71, and CD45 antigens in the hematopoietic progenitor cells of fetal cord blood to investigate immunophenotypic changes at different gestational ages. These antigens were identified by flow cytometry in 11 fetuses (gestational age 19-24 wk, in 12 preterm (25-28 wk) and in ten newborn infants born at term. The frequency and number of CD34+ cells were higher in the blood of the 11 fetuses; in addition, a statistically significant inverse correlation between number of CD34+ cells and advancing gestational age was noted. The numbers of CD34+ CD19+, CD34+ CD33+, and CD34+ CD45+ coexpressing cells were significantly higher in the fetuses, whereas CD34+ CD38+ cells were more represented in the neonates at term. Gestational age was inversely correlated with the number of CD34+ CD19+ and CD34+ CD33+ coexpressing cells. A positive correlation between gestational age and CD34+ CD38+ cells was noted. The number of CD34- CD19+, CD34- CD38+, and CD34- CD45+ cells was higher in term infants; furthermore, a significant correlation between advancing gestational age and CD34- CD38+ or CD34- CD45+ cells was demonstrated. The proliferative capacity was also higher at lower gestational ages. These data suggest that the development and lineage commitment of fetal cord blood hematopoietic progenitor cells are very active during the last two trimesters of pregnancy. The most significant changes of hematopoietic cells maturation seem to occur within 25 wk of gestation.
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Affiliation(s)
- A Gasparoni
- Research Laboratories (Pediatric Oncohematology and Neonatal Immunology) Policlinico San Matteo-IRCCS, University of Pavia, Italy
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41
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Lorini R, Avanzini MA, Lenta E, Cotellessa M, De Giacomo C, d'Annunzio G. Antibodies to tissue transglutaminase C in newly diagnosed and long-standing type I diabetes mellitus. Diabetologia 2000; 43:815-6. [PMID: 10907129 DOI: 10.1007/s001250051381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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42
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Iacona I, Lazzarino M, Avanzini MA, Rupolo M, Arcaini L, Astori C, Lunghi F, Orlandi E, Morra E, Zagonel V, Regazzi MB. Rituximab (IDEC-C2B8): validation of a sensitive enzyme-linked immunoassay applied to a clinical pharmacokinetic study. Ther Drug Monit 2000; 22:295-301. [PMID: 10850396 DOI: 10.1097/00007691-200006000-00010] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Rituximab is a chimeric monoclonal antibody (MAb) directed against the B-cell CD20 antigen that has been approved for therapy of relapsed and resistant follicular non-Hodgkin's lymphoma (NHL). This study describes the development and validation of a highly sensitive, rapid, accurate, precise enzyme-linked immunosorbent assay (ELISA) to measure Rituximab serum concentrations. This study also describes the application of the ELISA method to a pharmacokinetic study in a homogeneous group of patients with follicular lymphoma who received 4 weekly doses of MAb at the standard dose of 375 mg/m2 as consolidation of chemotherapy. In the patients in this study, the median Rituximab serum concentrations increased during therapy, and showed a slow decline during the posttreatment period. The Rituximab elimination half-life of approximately 20 days accounts for the demonstrated accumulation of MAb in serum samples. Because previous pharmacokinetic studies showed a correlation between Rituximab serum levels and tumor response, the ELISA method used in this study, which allows a precise control of serum concentrations, could be useful for predicting the final response to the MAb and for selecting patients able to benefit from higher dosage or repeated drug administration.
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Affiliation(s)
- I Iacona
- Department of Pharmacology, University of Pavia, IRCCS Policlinico San Matteo, Italy
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43
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Marconi M, Plebani A, Avanzini MA, Maccario R, Pistorio A, Duse M, Stringa M, Monafo V. IL-10 and IL-4 co-operate to normalize in vitro IgA production in IgA-deficient (IgAD) patients. Clin Exp Immunol 1998; 112:528-32. [PMID: 9649225 PMCID: PMC1905004 DOI: 10.1046/j.1365-2249.1998.00589.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the present study we evaluated in vitro immunoglobulin production from IgAD individuals and healthy controls. Peripheral blood mononuclear cells (PBMC) from IgAD and controls were cultured with anti-CD40 MoAb presented on a CDw32-transfected fibroblast cell line (CD40 system) in the presence of IL-10, IL-2, IL-4, transforming growth factor-beta (TGF-beta) alone as well as of IL-10 in combination with each of the other three cytokines. Only IL-10 added alone induced significant changes in baseline immunoglobulin production; marked increases in median supernatant levels of all three isotypes were observed in both groups. The most striking finding of this study was the synergizing effect of IL-4 on IgA production in the IgAD group when added with IL-10; median IgA supernatant level increased to a value superimposable on that found in the normal controls which remained about the same as when stimulated with IL-10 alone. The synergic effect of IL-4 and IL-10 was specific to the IgA isotype.
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Affiliation(s)
- M Marconi
- Department of Paediatrics, University of Pavia, Italy
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44
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Avanzini MA, Carrà AM, Maccario R, Zecca M, Zecca G, Pession A, Comoli P, Bozzola M, Prete A, Esposito R, Bonetti F, Locatelli F. Immunization with Haemophilus influenzae type b conjugate vaccine in children given bone marrow transplantation: comparison with healthy age-matched controls. J Clin Immunol 1998; 18:193-201. [PMID: 9624578 DOI: 10.1023/a:1020578921706] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Forty-seven patients (age range, 7 months-18 years) with malignant (38 cases) and nonmalignant (9 cases) disorders given an allogeneic or an autologous bone marrow transplantation (BMT) were immunized with Haemophilus influenzae type b (Hib) polysaccharide-diphtheria toxoid conjugate vaccine administered in a single dose at different time points after transplantation. Results were compared with those of 13 healthy children matched for age and sex who received the same immunization schedule. Serum and saliva samples for measurement of total IgG subclass and specific antibody levels were obtained from patients and healthy controls before and 3 weeks after vaccination. Twenty-five of the 47 patients (53%) had a specific anti-Hib IgG response, while an effective IgA and IgM response was mounted by 23 (49%) and 11 (23%) children, respectively. In the control group, 13 of 13 subjects mounted a specific IgG antibody production (P < 0.005 in comparison to the patients' response rate), while an IgA and IgM response was demonstrated in 12 (92%; P < 0.01 compared to transplanted patients) and 7 (54%; P < 0.05 in comparison to BMT recipients) children, respectively. Lapse of time from BMT to immunization was the most important factor predicting antibody response, as proved by an effective increase in prevaccination specific IgG levels in the majority of patients vaccinated after 2 years from transplant. Our data demonstrate that BMT recipients have a reduced capacity to mount an antibody response to polysaccharide antigens compared to normal controls, even when a protein-conjugated vaccine is employed. Since time after transplant is the major factor influencing the recovery of immune reactivity to polysaccharide antigens, the ontogeny of the B cell repertoire seems to follow a predetermined sequential program of development.
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Affiliation(s)
- M A Avanzini
- Laboratori Sperimentali, IRCCS Policlinico San Matteo, Pavia, Italy
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45
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Avanzini MA, Vitali L, d'Annunzio G, De Amici M, Strigazzi C, Alibrandi A, Lorini R. Enhancement of soluble CD23 serum levels and cell-surface CD23-expression in subjects at increased risk of type 1 diabetes mellitus and in diabetic patients. Diabet Med 1998; 15:320-6. [PMID: 9585398 DOI: 10.1002/(sici)1096-9136(199804)15:4<320::aid-dia563>3.0.co;2-i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/05/2022]
Abstract
The low affinity receptor for IgE, CD23, is expressed on lymphocytes among other cell types. The purpose of the present study was to assess serum sCD23 levels and CD23 expression on peripheral blood mononuclear cells (PBMC) in people at increased risk of developing Type 1 diabetes mellitus and in diabetic patients. Serum sCD23 levels were significantly higher in first-degree relatives of Type 1 patients (median: 3.2 U ml(-1)) (p < 0.001) and in newly diagnosed (median: 3.3 U ml(-1)) (p < 0.001) and long-standing (median: 2.5 U ml(-1)) (p = 0.01) Type 1 diabetic patients than in controls (median: 1.2 U ml(-1)). Newly diagnosed patients showed higher levels than those with long-standing disease (p = 0.026). Moreover the percentage of B cells expressing CD23 were significantly higher in first-degree relatives (median: 48.6%) (p < 0.001) and in newly diagnosed (median: 58%) (p < 0.001) and long-standing (median: 44.8%) (p = 0.03) Type 1 diabetic patients than in controls (median: 28.5%). The increased sCD23 levels and the increased number of cells expressing CD23 observed in subjects at increased risk of Type 1 diabetes and diabetic patients may be indicators of Th2 activity in Type 1 diabetes.
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Affiliation(s)
- M A Avanzini
- Laboratori Sperimentali di Ricerca, IRCCS, Policlinico S. Matteo, Pavia, Italy
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46
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Abstract
The aim of the present study was to evaluate if maternal-foetal antibody placental transfer may be affected by antibody avidity. We compared the avidity index (AI) of IgG antibodies to tetanus toxoid (TT) and to type 3 pneumococcal antigen (Pn) in cord blood of 10 healthy term and 8 preterm infants and in their mothers' sera at delivery. In order to evaluate whether a heavier antigenic exposure may influence the placental transfer, we also studied 15 Pakistani maternal sera and cord blood pairs. TT- and Pn-specific antibody AI was significantly higher in Italian and Pakistani term infants than in their mothers, while a significant difference in specific TT antibody AI, but not in specific Pn antibody AI was observed between preterm infants and their mothers. Italian and Pakistani cord blood/maternal serum pairs showed comparable values of AI. Our data suggest that high avidity antibodies preferentially cross the placenta; this seems to start early during gestation and appears to be related to the nature of the antigen to which the antibodies are directed, but not to the degree of antigenic exposure.
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Affiliation(s)
- M A Avanzini
- Research Laboratories (Paediatric Oncohaematology and Neonatal Immunology), Policlinico San Matteo IRCCS, Pavia, Italy
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47
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Vitali L, De Giacomo C, Avanzini MA, Lorini R. Celiac disease. J Pediatr Gastroenterol Nutr 1997; 25:367-8. [PMID: 9285396 DOI: 10.1097/00005176-199709000-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Lorini R, Scotta MS, Cortona L, Avanzini MA, Vitali L, De Giacomo C, Scaramuzza A, Severi F. Celiac disease and type I (insulin-dependent) diabetes mellitus in childhood: follow-up study. J Diabetes Complications 1996; 10:154-9. [PMID: 8807465 DOI: 10.1016/1056-8727(96)00056-6] [Citation(s) in RCA: 25] [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: 02/02/2023]
Abstract
To ascertain the specificity of IgA and IgG antigliadin (IgA-AGA, IgG-AGA), IgA-antireticulin (R1-ARA), and antiendomysial (AEA) antibodies for the diagnosis of celiac disease, we evaluated 133 type I diabetic children aged 1.4-28.4 years (mean 14.1 +/- 6.6), with diabetes from onset to 20.5 years. Fifty-three patients were considered at onset and 49 of these also during follow-up. IgA-AGA and IgG-AGA were determined by enzyme-linked immunosorbent assay (ELISA), R1-ARA and AEA by indirect immunofluorescence. IgA-AGA were positive in 20 of 133 (15%), IgG-AGA were positive in seven of 133 (5.26%), while R1-ARA and AEA were positive in three patients. At the onset of disease we found elevated IgA-AGA in 17 of 53 (32%) patients, IgG-AGA in four (7.55%) patients, three of them with IgA-AGA as well; R1-ARA and AEA were present in three (5.66%) patients, all with high IgA-AGA levels. During 1-10 year follow-up IgA-AGA decreased to within the normal range in 13 patients, with elevated IgA-AGA at onset but without R1-ARA and AEA; in four patients with high IgA-AGA at onset, IgA-AGA remained constantly elevated as did R1-ARA and AEA in three of them; and two patients, without IgA-AGA, R1-ARA, and AEA at onset, became positive for all three antibodies. Intestinal biopsy confirmed a diagnosis of celiac disease in five of these with IgA-AGA, R1-ARA, and AEA, but not in one patient with persistent IgA-AGA but no AEA and R1-ARA, suggesting that R1-ARA and AEA are more reliable markers for the screening of celiac disease in type I diabetic patients.
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Affiliation(s)
- R Lorini
- Department of Paediatrics, University of Pavia, Policlinico San Matteo I.R.C.C.S., Italy
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Lorini R, Scaramuzza A, Vitali L, d'Annunzio G, Avanzini MA, De Giacomo C, Severi F. Clinical aspects of coeliac disease in children with insulin-dependent diabetes mellitus. J Pediatr Endocrinol Metab 1996; 9 Suppl 1:101-11. [PMID: 8887160 DOI: 10.1515/jpem.1996.9.s1.101] [Citation(s) in RCA: 26] [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: 02/02/2023]
Abstract
Coeliac disease (CD) is heterogeneous in its clinical presentation and pathological expression. Silent, latent and potential forms represent the submerged part of the so-called "coeliac iceberg". The association of insulin-dependent diabetes mellitus (IDDM) and CD has been widely reported. For the screening of CD in diabetic patients, anti-reticulin R1 (ARA-R1) and anti-endomysium (AEA) antibodies are more reliable markers than anti-gliadin (AGA) antibodies. Recent studies have reported an increased prevalence of CD in children with IDDM. In our experience intestinal biopsy confirmed a diagnosis of CD in 6 out of 172 diabetic patients, with a prevalence of 3.5%. Only occasionally does CD precede the onset of IDDM; more often CD is diagnosed shortly or sometimes years after the onset of diabetes. Typical gastrointestinal complaints of CD (such as diarrhoea, abdominal distension) are rare in IDDM patients, while atypical isolated signs or symptoms of CD are more common, in particular sideropenic anemia, short stature, delayed puberty, epilepsy, hypertransaminasemia, dyspeptic symptoms, herpetiform dermatitis, and recurrent aphthous stomatitis. It is recommended that all diabetic children, even those asymptomatic, should be screened yearly for CD, using a combination of AGA plus ARA-R1 and AEA.
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Affiliation(s)
- R Lorini
- Department of Pediatrics, University of Pavia, Italy
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Avanzini MA, Carra AM, Maccario R, Zecca M, Pignatti P, Marconi M, Comoli P, Bonetti F, De Stefano P, Locatelli F. Antibody response to pneumococcal vaccine in children receiving bone marrow transplantation. J Clin Immunol 1995; 15:137-44. [PMID: 7559916 DOI: 10.1007/bf01543105] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Fifty-three pediatric patients given an allogeneic or an autologous bone marrow transplantation (BMT) were immunized with a polyvalent pneumococcal capsular polysaccharide vaccine (Pneumovax II). Vaccine was administered six months or more after BMT and the pneumococcal IgM, total IgG, and IgG subclasses levels were evaluated before and three weeks after immunization. Immunization promoted a significant rise in antibody serum levels (P < 0.000001), and all children vaccinated more than two years after transplantation responded to pneumococcal polysaccharides, whereas only 20-30% and 50% of patients given BMT between six months and one year and one and two years, respectively, mounted an effective antibody production (P < 0.0001). In univariate analysis, lapse of time from BMT to vaccination, chronic graft-versus-host disease occurrence, and female sex influenced the response rate. However, in multivariate analysis, only time between marrow transplant and immunization was a powerful predictor of response. Interestingly, four of 11 patients with IgG2 deficiency before immunization normalized serum levels of this IgG subclass after the pneumococcal antigenic challenge. Our study suggests that time after transplant is the major factor influencing the recovery of immune reactivity to polysaccharide antigens. This seems to confirm the hypothesis that ontogeny of the B-cell repertoire follows a predetermined sequential program in which polysaccharide antigens are some of the last to evoke an antibody response.
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Affiliation(s)
- M A Avanzini
- Department of Pediatrics University of Pavia, I.R.C.C.S. Policlinico San Matteo, Italy
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