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Grosu C, Hatoum W, Piras M, Laaboub N, Ranjbar S, Gamma F, Plessen KJ, von Gunten A, Preisig M, Conus P, Eap CB. Associations of Valproate Doses With Weight Gain in Adult Psychiatric Patients: A 1-Year Prospective Cohort Study. J Clin Psychiatry 2024; 85:23m15008. [PMID: 38535509 DOI: 10.4088/jcp.23m15008] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: The aim of this study was to evaluate valproate dose association with weight change, blood glucose, lipid levels, and blood pressure in a psychiatric population. Methods: Data from 215 patients taking valproate for up to 1 year were collected from 2 longitudinal studies that monitored metabolic variables between 2007 and 2022. Linear mixed-effect models and logistic regressions were used to analyze the associations between valproate doses and metabolic outcomes. Results: An increase in valproate dose of 500 mg was associated with a weight change of +0.52% per month over a year (P < .001). The association between valproate dose and weight change was evident both before and after 3 months of treatment. Weight increase was greater for treatment durations of < 3 months compared to ≥ 3 months (+0.56%, P < .001 and +0.12%, P = .02 per month, respectively). Using piecewise regression, a significant association between dose and weight gain was observed in patients receiving doses equal to or above the median dose (1,300 mg/d), with a +0.50% increase in weight for each dose increment of 500 mg (P = .004). Among men, each 500 mg dose increment was associated with weight increases of +0.59% per month (P = .004), whereas a trend was observed for women (+0.40%, P = .09). No associations were found between valproate doses and blood glucose, lipid levels, or blood pressure over a 6-month treatment period. Conclusions: This study provides evidence that valproate dose, mainly for doses at or above 1,300 mg/d, is associated with weight gain in psychiatric patients, suggesting that the lowest effective doses should be prescribed to minimize weight gain.
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Affiliation(s)
- Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - William Hatoum
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Setareh Ranjbar
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin J Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Prilly
- Corresponding Author: Chin B. Eap, PhD, Hôpital de Cery, 1008 Prilly-Lausanne, Switzerland
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Grosu C, Klauser P, Dwir D, Khadimallah I, Alemán-Gómez Y, Laaboub N, Piras M, Fournier M, Preisig M, Conus P, Draganski B, Eap CB. Associations between antipsychotics-induced weight gain and brain networks of impulsivity. Transl Psychiatry 2024; 14:162. [PMID: 38531873 DOI: 10.1038/s41398-024-02881-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
Given the unpredictable rapid onset and ubiquitous consequences of weight gain induced by antipsychotics, there is a pressing need to get insights into the underlying processes at the brain system level that will allow stratification of "at risk" patients. The pathophysiological hypothesis at hand is focused on brain networks governing impulsivity that are modulated by neuro-inflammatory processes. To this aim, we investigated brain anatomy and functional connectivity in patients with early psychosis (median age: 23 years, IQR = 21-27) using anthropometric data and magnetic resonance imaging acquired one month to one year after initiation of AP medication. Our analyses included 19 patients with high and rapid weight gain (i.e., ≥5% from baseline weight after one month) and 23 patients with low weight gain (i.e., <5% from baseline weight after one month). We replicated our analyses in young (26 years, IQR = 22-33, N = 102) and middle-aged (56 years, IQR = 51-62, N = 875) healthy individuals from the general population. In early psychosis patients, higher weight gain was associated with poor impulse control score (β = 1.35; P = 0.03). Here, the observed brain differences comprised nodes of impulsivity networks - reduced frontal lobe grey matter volume (Pcorrected = 0.007) and higher striatal volume (Pcorrected = 0.048) paralleled by disruption of fronto-striatal functional connectivity (R = -0.32; P = 0.04). Weight gain was associated with the inflammatory biomarker plasminogen activator inhibitor-1 (β = 4.9, P = 0.002). There was no significant association between increased BMI or weight gain and brain anatomy characteristics in both cohorts of young and middle-aged healthy individuals. Our findings support the notion of weight gain in treated psychotic patients associated with poor impulse control, impulsivity-related brain networks and chronic inflammation.
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Affiliation(s)
- Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
| | - Paul Klauser
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Daniella Dwir
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Ines Khadimallah
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Yasser Alemán-Gómez
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
- Connectomics Lab, Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Margot Fournier
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging LREN, Centre for Research in Neuroscience - Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Neurology Department, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland.
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva and University of Lausanne, Lausanne, Switzerland.
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Dubath C, Porcu E, Delacrétaz A, Grosu C, Laaboub N, Piras M, von Gunten A, Conus P, Plessen KJ, Kutalik Z, Eap CB. DNA methylation may partly explain psychotropic drug-induced metabolic side effects: results from a prospective 1-month observational study. Clin Epigenetics 2024; 16:36. [PMID: 38419113 PMCID: PMC10903022 DOI: 10.1186/s13148-024-01648-4] [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: 09/12/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Metabolic side effects of psychotropic medications are a major drawback to patients' successful treatment. Using an epigenome-wide approach, we aimed to investigate DNA methylation changes occurring secondary to psychotropic treatment and evaluate associations between 1-month metabolic changes and both baseline and 1-month changes in DNA methylation levels. Seventy-nine patients starting a weight gain inducing psychotropic treatment were selected from the PsyMetab study cohort. Epigenome-wide DNA methylation was measured at baseline and after 1 month of treatment, using the Illumina Methylation EPIC BeadChip. RESULTS A global methylation increase was noted after the first month of treatment, which was more pronounced (p < 2.2 × 10-16) in patients whose weight remained stable (< 2.5% weight increase). Epigenome-wide significant methylation changes (p < 9 × 10-8) were observed at 52 loci in the whole cohort. When restricting the analysis to patients who underwent important early weight gain (≥ 5% weight increase), one locus (cg12209987) showed a significant increase in methylation levels (p = 3.8 × 10-8), which was also associated with increased weight gain in the whole cohort (p = 0.004). Epigenome-wide association analyses failed to identify a significant link between metabolic changes and methylation data. Nevertheless, among the strongest associations, a potential causal effect of the baseline methylation level of cg11622362 on glycemia was revealed by a two-sample Mendelian randomization analysis (n = 3841 for instrument-exposure association; n = 314,916 for instrument-outcome association). CONCLUSION These findings provide new insights into the mechanisms of psychotropic drug-induced weight gain, revealing important epigenetic alterations upon treatment, some of which may play a mediatory role.
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Affiliation(s)
- Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland.
| | - Eleonora Porcu
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Zoltán Kutalik
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
- University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Chin Bin Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Hôpital de Cery, 1008, Prilly, Lausanne, Switzerland.
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.
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Laaboub N, Locatelli I, Grosu C, Piras M, Ngoc TH, Ranjbar S, Preisig M, Elowe J, von Gunten A, Conus P, Eap CB. Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients. Front Psychiatry 2024; 15:1256416. [PMID: 38414502 PMCID: PMC10896922 DOI: 10.3389/fpsyt.2024.1256416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/22/2024] [Indexed: 02/29/2024] Open
Abstract
Background Psychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hospitals and 2) to identify other clinical and sociodemographic predictors of readmission. Methods Between 2007 and 2019, data on 16727 admissions of 7786 adult and elderly patients admitted to the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to the International Diabetes Federation definition. Cox frailty models were used to investigate the associations between readmission and metabolic disturbances. Results A total of 2697 (35%) patients were readmitted to our psychiatric hospital. Novel risk factors for readmission in non-smokers were identified, including being overweight (HR=1.26; 95%CI=[1.05; 1.51]) or obese (HR=1.33; 95%CI=[1.08; 1.62]), displaying hypertriglyceridemia (HR=1.21; 95%CI=[1.04; 1.40]) and metabolic syndrome (HR=1.26; 95%CI=[1.02; 1.55]). Central obesity and hyperglycemia increased the risk of readmission when considering the Health of the Nation Outcome Scales variable. In first-episode psychosis patients, obesity (HR=2.23; 95%CI=[1.14; 4.30]) and high-density lipoprotein hypocholesterolemia (HR=1.90; 95%CI=[1.14; 3.20]) doubled the risk of readmission. Conclusion The observed interaction between smoking and metabolic variables are compatible with a ceiling effect; metabolic variables increase the risk of readmission in non-smokers but not in smokers who are already at higher risk. Future studies should determine whether better metabolic monitoring and treatment can reduce readmission risk.
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Affiliation(s)
- Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Isabella Locatelli
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Tram Ho Ngoc
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Setareh Ranjbar
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Julien Elowe
- Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B. Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
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Kuzo N, Haen E, Ho DM, Takeuchi H, Piras M, Eap CB, de Filippis R, Homan P, Kane JM, Roy MA, Paulzen M, Schoretsanitis G. Clozapine once- versus multiple-daily dosing: a two-center cross-sectional study, systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2023; 273:1567-1578. [PMID: 36580106 PMCID: PMC10465369 DOI: 10.1007/s00406-022-01542-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022]
Abstract
Evidence regarding effectiveness and safety of clozapine once- vs. multiple-daily dosing is limited. We compared demographic and clinical parameters between patients with once- vs. multiple-daily dosing in the Department of Psychiatry and Psychotherapy, University of Regensburg, Germany (AGATE dataset), and the Department of Psychiatry, Lausanne University Hospital, Switzerland, using non-parametric tests. Effectiveness and safety outcomes were available in the AGATE dataset. We performed a systematic review in PubMed/Embase until February 2022, meta-analyzing studies comparing clozapine once- vs. multiple-daily-dosing. We estimated a pooled odds ratio for adverse drug-induced reactions (ADRs) and meta-analyzed differences regarding clinical symptom severity, age, percentage males, smokers, clozapine dose, and co-medications between patients receiving once- vs. multiple-daily dosing. Study quality was assessed using the Newcastle-Ottawa-Scale. Of 1494 and 174 patients included in AGATE and Lausanne datasets, clozapine was prescribed multiple-daily in 74.8% and 67.8%, respectively. In the AGATE cohort, no differences were reported for the clinical symptoms severity or ADR rate (p > 0.05). Meta-analyzing eight cohorts with a total of 2810 clozapine-treated individuals, we found more severe clinical symptoms (p = 0.036), increased ADR risk (p = 0.01), higher clozapine doses (p < 0.001), more frequent co-medication with other antipsychotics (p < 0.001), benzodiazepines (p < 0.001), anticholinergics (p = 0.039), and laxatives (p < 0.001) in patients on multiple- vs. once-daily dosing. Of six studies, five were rated as good, and one as poor quality. Patients responding less well to clozapine may be prescribed higher doses multiple-daily, also treated with polypharmacy, potentially underlying worse safety outcomes. Patient preferences and adherence should be considered during regimen selection.
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Affiliation(s)
- Nazar Kuzo
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Ekkehard Haen
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - Dominic M Ho
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hiroyoshi Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Chin-Bin Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Philipp Homan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Marc-André Roy
- Département de Psychiatrie et Neurosciences, Université Laval, Québec City, QC, Canada
- Centre de Recherche CERVO, Quebec City, QC, Canada
| | - Michael Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, JARA Translational Brain Medicine, RWTH Aachen University, Aachen, Germany
- Alexianer Hospital Aachen, Aachen, Germany
| | - Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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Piras M, Coni P, Piludu M, Coni S, Lachowicz JI, Jaremko M, Faa G, Cau F, Scano A, Orrù G, Murru R, Pichiri G. Human breast milk cells are positive for the pioneer transcription factor ISL1. Eur Rev Med Pharmacol Sci 2023; 27:8842-8849. [PMID: 37782193 DOI: 10.26355/eurrev_202309_33804] [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] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE ISL1 is a pioneer transcription factor that plays important roles in cell lineage specification and differentiation, by programming the epigenome and recruiting additional regulatory factors. The aim of this study is to determine whether the human breastmilk contains ISL1-positive stem cells, and, if so, to describe the subcellular localization of ISL1. MATERIALS AND METHODS Breast milk was obtained from fourteen healthy females during the first 2-6 months of lactation. Cell morphology was examined in the breast milk with the automatic ThinPrep® processor (Hologic® Inc.) in commercial Cytological ThinPrep® solution (Hologic® Inc.), followed by standard immunohistochemical staining of ISL1. RESULTS ISL1 had a granular diffuse cytoplasmic localization, with varying intensity of staining in both single and grouped cells. Nuclear staining was also present, as was staining of intracellular and extracellular vesicles with ISL1 antibody. CONCLUSIONS These preliminary results suggest that ISL1 could distinguish a readily available source of putative stem cells in human breast milk. These stem cells may complete the network created between the mother and the newborn during gestation, thereby improving the efficiency of programming and reprogramming postnatal events.
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Affiliation(s)
- M Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Electron Microscopy Laboratory, Division Pathological Anatomy, Cagliari, Italy.
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Sjaarda J, Delacrétaz A, Dubath C, Laaboub N, Piras M, Grosu C, Vandenberghe F, Crettol S, Ansermot N, Gamma F, Plessen KJ, von Gunten A, Conus P, Kutalik Z, Eap CB. Identification of four novel loci associated with psychotropic drug-induced weight gain in a Swiss psychiatric longitudinal study: A GWAS analysis. Mol Psychiatry 2023; 28:2320-2327. [PMID: 37173452 PMCID: PMC10611564 DOI: 10.1038/s41380-023-02082-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
Patients suffering from mental disorders are at high risk of developing cardiovascular diseases, leading to a reduction in life expectancy. Genetic variants can display greater influence on cardiometabolic features in psychiatric cohorts compared to the general population. The difference is possibly due to an intricate interaction between the mental disorder or the medications used to treat it and metabolic regulations. Previous genome wide association studies (GWAS) on antipsychotic-induced weight gain included a low number of participants and/or were restricted to patients taking one specific antipsychotic. We conducted a GWAS of the evolution of body mass index (BMI) during early (i.e., ≤ 6) months of treatment with psychotropic medications inducing metabolic disturbances (i.e., antipsychotics, mood stabilizers and some antidepressants) in 1135 patients from the PsyMetab cohort. Six highly correlated BMI phenotypes (i.e., BMI change and BMI slope after distinct durations of psychotropic treatment) were considered in the analyses. Our results showed that four novel loci were associated with altered BMI upon treatment at genome-wide significance (p < 5 × 10-8): rs7736552 (near MAN2A1), rs11074029 (in SLCO3A1), rs117496040 (near DEFB1) and rs7647863 (in IQSEC1). Associations between the four loci and alternative BMI-change phenotypes showed consistent effects. Replication analyses in 1622 UK Biobank participants under psychotropic treatment showed a consistent association between rs7736552 and BMI slope (p = 0.017). These findings provide new insights into metabolic side effects induced by psychotropic drugs and underline the need for future studies to replicate these associations in larger cohorts.
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Affiliation(s)
- Jennifer Sjaarda
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- Swiss Institute of Bioinformatics, Lausanne, Switzerland.
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Séverine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Zoltan Kutalik
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
- University Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland.
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.
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Gerosa C, Cerrone G, Suri JS, Aimola V, Cau F, Coni P, Piras M, Cau R, Balestrieri A, Scano A, Orrù G, Van Eyken P, La Nasa G, Coghe F, Castagnola M, Gibo Y, Fanni D, Saba L. The human carotid atherosclerotic plaque: an observational review of histological scoring systems. Eur Rev Med Pharmacol Sci 2023; 27:3784-3792. [PMID: 37140327 DOI: 10.26355/eurrev_202304_32179] [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] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The atherosclerotic plaque is a complex dynamic pathological lesion of the arterial wall, characterized by multiple elementary lesions of different diagnostic and prognostic significance. Fibrous cap thickness, lipid necrotic core dimension, inflammation, intra-plaque hemorrhage (IPH), plaque neovascularization and endothelial dysfunction (erosions) are generally considered the most relevant morphological details of plaque morphology. In this review, the most relevant features able to discriminate between stable and vulnerable plaques at histological level are discussed. SUBJECTS AND METHODS Retrospectively, we have evaluated the laboratory results from one hundred old histological samples from patients treated with carotid endarterectomy. These results were analyzed to assess elementary lesions that characterize stable and unstable plaques. RESULTS A thin fibrous cap (<65 micron), loss of smooth muscle cells, collagen depletion, a large lipid-rich necrotic core, infiltrating macrophages, IPH and intra-plaque vascularization are identified as the most important risk factors associated with plaque rupture. CONCLUSIONS Immunohistochemistry for smooth muscle actin (smooth muscle cell marker) and for CD68 (marker of monocytes/macrophages) and glycophorin (marker of red blood cells) are suggested as useful tools for an in deep characterization of any carotid plaque and for distinguishing plaque phenotypes at histology. Since patients with a carotid vulnerable plaque are at higher risk of developing vulnerable plaques in other arteries as well, the definition of the vulnerability index is underlined, in order to stratify patients at higher risk for undergoing cardiovascular events.
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Affiliation(s)
- C Gerosa
- Division of Pathology, Department of Medical Sciences and Public Health, University of Cagliari, AOU of Cagliari, Cagliari, Italy.
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9
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Piras M, Chahma J, Ranjbar S, Laaboub N, Grosu C, Plessen KJ, von Gunten A, Conus P, Eap CB. Is Clozapine-induced Weight Gain Dose-dependent? Results From a Prospective Cohort Study. Schizophr Bull 2023:7058425. [PMID: 36841954 DOI: 10.1093/schbul/sbad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND Antipsychotic-induced metabolic adverse effects are risk factors for cardiometabolic comorbidities. Whether dose lowering could mitigate such effects remains unclear. The present study aims to investigate the associations between clozapine doses and modifications of weight, blood pressure, blood glucose, and lipid levels. STUDY DESIGN Linear mixed-effects models of weight changes over 1 year and of variations of other metabolic parameters over 4 months were applied to a prospective cohort of 115 patients. Age- and sex-stratified analyses of weight changes were also performed. STUDY RESULTS Each 100 mg dose increment of clozapine was associated on average with a +0.48% weight increase (P = .004) over 1 year of treatment. Weight increase was greater for treatment duration ≤3 vs >3 months (+0.84% and +0.47% per month, respectively, P < .001), with a significant association with the dose for durations >3 months (+0.54%, P = .004) and a trend for durations ≤3 months (+0.33%, P = .075). Dose increments of 100 mg were also associated with weight increases of +0.71% among adults (P = .001), +1.91% among the elderly (P < .001) and +1.32% among men (P < .001) with no associations among women (P = .62). Among young adults, weight change was positively associated with doses ≤300 mg/day (+2.19% per 100 mg, P = .001), whereas no association was found with doses >300 mg/day (P = .60). No significant effect of clozapine dose on other metabolic parameters was found. CONCLUSIONS This study reports a modest effect of clozapine dose increases on weight gain over 1 year with differences among age categories and sexes and no dose effect on other metabolic parameters over 4 months.
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Affiliation(s)
- Marianna Piras
- Department of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Jihane Chahma
- Department of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Setareh Ranjbar
- Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Department of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Department of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Department of Psychiatry, Service of Child and Adolescent Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Department of Psychiatry, Service of Old Age Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin Bin Eap
- Department of Psychiatry, Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva and Lausanne, Switzerland
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10
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Piras M, Ranjbar S, Laaboub N, Grosu C, Gamma F, Plessen KJ, von Gunten A, Conus P, Eap CB. Evolutions of Metabolic Parameters Following Switches of Psychotropic Drugs: A Longitudinal Cohort Study. Schizophr Bull 2023; 49:24-33. [PMID: 36156101 PMCID: PMC9810014 DOI: 10.1093/schbul/sbac133] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several psychotropic drugs can induce weight gain and metabolic alterations. The authors compared metabolic evolutions of patients switching versus continuing psychotropic treatments with different risk profiles. METHODS Patients either switched from a high- to a medium- (N = 36) or low-risk drug (N = 27), from a medium- to a low-risk drug (N = 71), or to a same-risk drug (N = 61). Controls were kept using either a high- (N = 35), medium- (N = 155), or low-risk drug (N = 47). The evolution over 2 years of weight and metabolic parameters was analyzed using linear mixed-effect models, also examining the influence of polygenic risk scores for body mass index (BMI) or BMI and psychiatric disorders. STUDY RESULTS High-, medium-, or low-risk controls gained on average 1.32%, 0.42%, and 0.36% more weight per month than patients switching from or within these risk categories (P < .001, P < .001, and P = .003, respectively). High-to-high or high-to-medium switches resulted in a greater weight increase than switching to lower-risk categories (+0.77% and + 0.39% respectively, P < .001). No difference was found between switching medium-to-medium and medium-to-low (P ≈ 1). Switching high-to-low resulted in 10% weight loss after 2 years, with the greatest loss occurring the first 6 months after the switch. Compared with high-risk controls, lower total cholesterol (-0.27 mmol/l, P = .043) in the high-to-low group, and lower glucose (-0.44 mmol/l, P = .032) and systolic blood pressure (-5.50 mmHg, P = .034) in the low-to-low group were found. Polygenic scores were not associated with weight changes in controls or after switching. CONCLUSION Psychotropic switches to a lower- or same-risk drug can attenuate weight gain, with only switching high to low resulting in weight loss.
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Affiliation(s)
- Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Setareh Ranjbar
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin Bin Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
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11
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Piras M, Fanni D, Congiu T, Cau F, Piludu M, Coni S, Coni P, Pichiri G, Orgerie J, Scano A, Orrù G, Gerosa C, Faa G. CD44 is highly expressed in stem/progenitor cells originating the intervertebral discs in the human notochord. Eur Rev Med Pharmacol Sci 2022; 26:8502-8507. [PMID: 36459031 DOI: 10.26355/eurrev_202211_30385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The notochord acts as a patterning structure, playing a key role in the formation of the vertebral column, both indirectly by inducing sclerotome cell differentiation and directly by forming the nucleus pulposus of intervertebral discs. The abnormal development of the notochord results in an easy equation with a variety of birth defects. Therefore, we focused our attention on the analysis of the early stages of human notochord development by highlighting the role of progenitor stem cells involved in the origin of intervertebral discs (IVDs). MATERIALS AND METHODS Eight human fetuses, ranging from 8 up to 21 weeks of gestational age, were obtained from spontaneous abortion or voluntary interruption of gestation. Samples were 10% formalin-fixed, routinely processed, and paraffin-embedded. Five micron-tick paraffin sections were obtained from each sample. Sections were stained with hematoxylin-eosin and PAS stain for a morphological examination. Tissue samples were immunostained with a commercial anti-human CD44 rabbit monoclonal antibody at 1:100 dilution. RESULTS Immunoreactivity for CD44 was detected in six out of eight notochords examined in this study. Reactivity for CD44 was restricted to progenitor cells giving rise to the nucleus pulposus (NP) of the developing IVDs. Positive cells showed a membranous and/or cytoplasmic immunostaining, no reactivity was observed in the nuclear compartment. CD44 expression was always restricted to IVD precursor cells, whereas cartilage precursors were devoid of labelling. CONCLUSIONS Our study shows, for the first time, that the stem cell marker CD44 selectively marks intervertebral disc progenitor cells, paralleling their differentiation toward a discogenic phenotype. Therefore, our results suggest that CD44 plays a key role in IVD development, allowing its differentiation from surrounding undifferentiated notochordal cells toward a IVD phenotype. Given the role of CD44 in IVD development, we may hypothesize that low CD44 levels might be associated with changes in IVD development and with susceptibility to develop back pain later in life.
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Affiliation(s)
- M Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Electron Microscopy Laboratory, Division Pathological Anatomy, Cagliari, Italy.
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12
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Perry BI, Vandenberghe F, Garrido-Torres N, Osimo EF, Piras M, Vazquez-Bourgon J, Upthegrove R, Grosu C, De La Foz VOG, Jones PB, Laaboub N, Ruiz-Veguilla M, Stochl J, Dubath C, Canal-Rivero M, Mallikarjun P, Delacrétaz A, Ansermot N, Fernandez-Egea E, Crettol S, Gamma F, Plessen KJ, Conus P, Khandaker GM, Murray GK, Eap CB, Crespo-Facorro B. The psychosis metabolic risk calculator (PsyMetRiC) for young people with psychosis: International external validation and site-specific recalibration in two independent European samples. Lancet Reg Health Eur 2022; 22:100493. [PMID: 36039146 PMCID: PMC9418905 DOI: 10.1016/j.lanepe.2022.100493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Cardiometabolic dysfunction is common in young people with psychosis. Recently, the Psychosis Metabolic Risk Calculator (PsyMetRiC) was developed and externally validated in the UK, predicting up-to six-year risk of metabolic syndrome (MetS) from routinely collected data. The full-model includes age, sex, ethnicity, body-mass index, smoking status, prescription of metabolically-active antipsychotic medication, high-density lipoprotein, and triglyceride concentrations; the partial-model excludes biochemical predictors. Methods To move toward a future internationally-useful tool, we externally validated PsyMetRiC in two independent European samples. We used data from the PsyMetab (Lausanne, Switzerland) and PAFIP (Cantabria, Spain) cohorts, including participants aged 16-35y without MetS at baseline who had 1-6y follow-up. Predictive performance was assessed primarily via discrimination (C-statistic), calibration (calibration plots), and decision curve analysis. Site-specific recalibration was considered. Findings We included 1024 participants (PsyMetab n=558, male=62%, outcome prevalence=19%, mean follow-up=2.48y; PAFIP n=466, male=65%, outcome prevalence=14%, mean follow-up=2.59y). Discrimination was better in the full- compared with partial-model (PsyMetab=full-model C=0.73, 95% C.I., 0.68-0.79, partial-model C=0.68, 95% C.I., 0.62-0.74; PAFIP=full-model C=0.72, 95% C.I., 0.66-0.78; partial-model C=0.66, 95% C.I., 0.60-0.71). As expected, calibration plots revealed varying degrees of miscalibration, which recovered following site-specific recalibration. PsyMetRiC showed net benefit in both new cohorts, more so after recalibration. Interpretation The study provides evidence of PsyMetRiC's generalizability in Western Europe, although further local and international validation studies are required. In future, PsyMetRiC could help clinicians internationally to identify young people with psychosis who are at higher cardiometabolic risk, so interventions can be directed effectively to reduce long-term morbidity and mortality. Funding NIHR Cambridge Biomedical Research Centre (BRC-1215-20014); The Wellcome Trust (201486/Z/16/Z); Swiss National Research Foundation (320030-120686, 324730- 144064, and 320030-173211); The Carlos III Health Institute (CM20/00015, FIS00/3095, PI020499, PI050427, and PI060507); IDIVAL (INT/A21/10 and INT/A20/04); The Andalusian Regional Government (A1-0055-2020 and A1-0005-2021); SENY Fundacion Research (2005-0308007); Fundacion Marques de Valdecilla (A/02/07, API07/011); Ministry of Economy and Competitiveness and the European Fund for Regional Development (SAF2016-76046-R and SAF2013-46292-R).For the Spanish and French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Benjamin I. Perry
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nathalia Garrido-Torres
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), University of Seville, First-episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Emanuele F. Osimo
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, United Kingdom
- MRC London Institute of Medical Sciences, Institute of Clinical Sciences, Imperial College, Hammersmith Campus, London, England, United Kingdom
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Javier Vazquez-Bourgon
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), University of Seville, First-episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
- Department of Psychiatry, Marques de Valdecilla University Hospital, Institute of Biomedicine Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, England, United Kingdom
- Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Victor Ortiz-Garcia De La Foz
- Department of Psychiatry, Marques de Valdecilla University Hospital, Institute of Biomedicine Marqués de Valdecilla (IDIVAL), Universidad de Cantabria, Santander, Spain
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Miguel Ruiz-Veguilla
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), University of Seville, First-episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Department of Kinanthropology, Charles University, Prague, Czech Republic
| | - Celine Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Manuel Canal-Rivero
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), University of Seville, First-episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
| | - Pavan Mallikarjun
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, England, United Kingdom
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Severine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Centre, Lausanne, Switzerland
| | - Kerstin J. Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Golam M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, United Kingdom
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, United Kingdom
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, England, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Chin B. Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Benedicto Crespo-Facorro
- Virgen del Rocío University Hospital, Network Centre for Biomedical Research in Mental Health (CIBERSAM), Institute of Biomedicine of Seville (IBiS), University of Seville, First-episode Psychosis Research Network of Andalusia (Red PEPSur), Spain
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Cau F, Fanni D, Manchia M, Gerosa C, Piras M, Murru R, Paribello P, Congiu T, Coni P, Pichiri G, Piludu M, Van Eyken P, Gibo Y, La Nasa G, Orrù G, Scano A, Coghe F, Saba L, Castagnola M, Faa G. Expression of L1 Cell Adhesion Molecule (L1CAM) in extracellular vesicles in the human spinal cord during development. Eur Rev Med Pharmacol Sci 2022; 26:6273-6282. [PMID: 36111928 DOI: 10.26355/eurrev_202209_29651] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE L1 cell adhesion molecule (L1CAM) is a glycoprotein characterized by three components: an extracellular region, a transmembrane segment, and a cytoplasmic tail. L1CAM is expressed in multiple human cells, including neurons. The neural cell adhesion molecule L1 has been implicated in a variety of neurologic processes, including neuritogenesis and cerebellar cell migration. The presence of L1CAM on the surface of nerve cells allows the adhesion of neurons among them. Furthermore, when it is bound to itself or to other proteins, L1-CAM induces signals inside the cell. The aim of this work was to study L1CAM expression in the human spinal cord during development, at different gestational ages, through immunohistochemistry. MATERIALS AND METHODS Immunohistochemical analysis for L1CAM was performed in five human spinal cord samples, including three embryos and two fetuses of different gestational ages, ranging from 8 to 12 weeks. RESULTS L1CAM expression was detected in all 5 spinal cords examined in this study. The adhesion molecule was found in the vast majority of cells. The highest levels of immunoreactivity for L1CAM were detected at the periphery of the developing organs, in the spinal cord zones occupied by sensory and motor fibers. In the alar and basal columns, immunoreactivity for L1CAM was characterized by a reticular pattern, being mainly expressed in axons. Strong reactivity of L1CAM was also found in extracellular vesicles. This extracellular localization might indicate the ability of L1CAM to mediate the transduction of extracellular signals that support axon outgrowth. CONCLUSIONS The high reactivity of L1cam in the axons of developing neurons in the fetal spinal cord confirms previous studies on the ability of L1CAM to promote axon sprouting and branching in the developing nervous system. In this work, a new actor is reported to have a role in the complex field of human spinal cord development: L1CAM, whose expression is highly found in the developing neuronal and glial precursors.
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Affiliation(s)
- F Cau
- Department of Medical Sciences and Public Health, Division of Pathology, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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14
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Laaboub N, Dubath C, Ranjbar S, Sibailly G, Grosu C, Piras M, Délessert D, Richard-Lepouriel H, Ansermot N, Crettol S, Vandenberghe F, Grandjean C, Delacrétaz A, Gamma F, Plessen KJ, von Gunten A, Conus P, Eap CB. Publisher Correction: Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort. BMC Psychiatry 2022; 22:457. [PMID: 35804331 PMCID: PMC9264573 DOI: 10.1186/s12888-022-04040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Nermine Laaboub
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Céline Dubath
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Setareh Ranjbar
- grid.8515.90000 0001 0423 4662Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Guibet Sibailly
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Claire Grosu
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Marianna Piras
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Didier Délessert
- grid.8515.90000 0001 0423 4662Prison Medicine and Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Hélène Richard-Lepouriel
- grid.150338.c0000 0001 0721 9812Unit of Mood Disorders, Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Ansermot
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Severine Crettol
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Frederik Vandenberghe
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Carole Grandjean
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Aurélie Delacrétaz
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland ,Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- grid.8515.90000 0001 0423 4662Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- grid.8515.90000 0001 0423 4662Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- grid.8515.90000 0001 0423 4662Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B. Eap
- grid.8515.90000 0001 0423 4662Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland ,grid.8591.50000 0001 2322 4988School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland ,grid.9851.50000 0001 2165 4204Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland ,grid.9851.50000 0001 2165 4204Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne, Switzerland
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15
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Perry B, Vandenberghe F, Osimo E, Grosu C, Piras M, Jones P, Mallikarjun P, Stochl J, Upthegrove R, Khandaker G, Eap C. An International External Validation and Revision of the PsyMetRiC Cardiometabolic Risk Prediction Algorithm for Young People with Psychosis. Eur Psychiatry 2022. [PMCID: PMC9567930 DOI: 10.1192/j.eurpsy.2022.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The comorbidity between cardiometabolic and psychotic disorders develops early. This is a crucial window of opportunity to reduce excess morbidity and mortality. Recently, a cardiometabolic risk prediction algorithm for young people with psychosis, the psychosis metabolic risk calculator (PsyMetRiC) was developed and externally validated in the UK. However, its international transportability is unknown.
Objectives
We performed the first international validation study of PsyMetRiC in Lausanne, Switzerland, and examined whether additional variables (clinical and/or genetic) may improve the predictive performance of the algorithm
Methods
We included people aged 16-35y with psychosis from the PsyMetab cohort, who did not have MetS at baseline, and who had 1-6y follow-up data. The PsyMetRiC partial (age, sex, ethnicity, body mass index, smoking status, and prescription of a metabolically-active antipsychotic) and full (also including high-density lipoprotein and triglycerides) algorithms were applied. Predictive performance was assessed using measures of discrimination (C-statistic) and calibration (calibration plots). Recalibration steps included refitting the intercept and/or slope if necessary. Additional variables (e.g. speed of weight gain, polygenic risk scores) were added to the model and predictive performance was reassessed.
Results
We included 545 participants. The discrimination performance of both PsyMetRiC algorithms was good (C>0.75), and calibration plots showed good agreement between observed and predicted risk. Additional analyses to be conducted.
Conclusions
PsyMetRiC is likely to be generalizable for use in Switzerland, suggesting that PsyMetRiC may also be suitable for use in other European populations. While additional international validations are required, these findings are an encouraging step toward an international cardiometabolic risk prediction algorithm for young people with psychosis.
Disclosure
No significant relationships.
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16
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Laaboub N, Gholam M, Dubath C, Grosu C, Piras M, Von Plessen K, Von Gunten A, Conus P, Preisig M, Eap C. Metabolic disturbances are associated with psychiatric readmission: results from a Swiss psychiatric cohort. Eur Psychiatry 2022. [PMCID: PMC9567304 DOI: 10.1192/j.eurpsy.2022.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
High BMI has been associated with psychiatric rehospitalisation.
Objectives
We aimed to replicate this finding in a large Swiss psychiatric cohort and to examine whether other metabolic disturbances are independently associated with psychiatric readmission.
Methods
Data on 16’727 hospitalizations of 7’786 patients admitted between January 1st, 2007 and December 31st, 2019 at the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to International Diabetes Federation definition. Generalized Linear Mixed Models were used to investigate the associations between psychiatric readmission and metabolic syndrome and/or its five components.
Results
The readmitted population (N=2’935; 37.7% patients) had higher BMI, and were more likely to have central obesity, hypertriglyceridemia, and hypertension. Multivariate analyses confirmed that having a BMI ≥ 25 kg.m-2 was associated with psychiatric readmission (25 kg.m-2≤ BMI< 30 kg.m-2: OR = 1.88; 95%CI [1.55-2.29]; BMI≥30 kg.m-2: OR = 3.5; 95%CI [2.85-4.30]) when compared to patients with 18.5≤BMI<25 kg.m-2. Interestingly, novel factors associated with readmission were identified including metabolic syndrome (OR = 1.57, 95%CI [1.05-2.33]), central obesity (OR = 1.81, 95%CI [1.33-2.46]), hypertriglyceridemia (OR = 1.59; 95%CI [1.38-1.83]), HDL hypocholesterolemia (OR = 1.22; 95%CI [1.06-1.40]) and hyperglycemia (OR = 1.58; 95%CI [1.35-1.85]).
Conclusions
Metabolic syndrome, central obesity, hypertriglyceridemia, HDL hypocholesterolemia, hyperglycemia and obesity were associated with psychiatric readmission. Possible causes will be presented and discussed (e.g. reduced adherence to treatment in patients with metabolic disorders, multiple psychotropic treatments in non-responders increasing the risk of metabolic worsening).
Disclosure
No significant relationships.
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17
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Cau F, Gerosa C, Murru R, Pichiri G, Coni P, Piras M, Scano A, Orrù G, La Nasa G, Coghe F, Castagnola M, Van Eyken P, Saba L, Fanni D, Faa G. Interindividual variability in L1CAM expression in the human kidney during development: are there implications for fetal programming of kidney diseases presenting in adulthood? Eur Rev Med Pharmacol Sci 2022; 26:4346-4353. [PMID: 35776035 DOI: 10.26355/eurrev_202206_29073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE L1 cell adhesion molecule (L1CAM) is a member of the immunoglobulin superfamily of cell adhesion molecules. The present study investigated the expression of L1CAM during the development in the fetal human kidney at different gestational ages, to reach a better knowledge on the role of L1CAM in renal morphogenesis. MATERIALS AND METHODS The immunohistochemical analysis for L1CAM was performed in 24 fetal kidneys of different gestational ages, ranging from 10 to 38 weeks. L1CAM expression was observed in all 24 kidneys examined. RESULTS Immunoreactivity for L1CAM was restricted to the collecting tubules, of the developing fetal kidneys. Moreover, L1CAM was detected in the ureteric bud tips, near the subcapsular metanephric mesenchymal stem/progenitor cells. L1CAM was also expressed in the collecting tubules undergoing fusion with the distal tubules of the developing nephrons. L1CAM was mainly expressed along the cell membrane. In fetal kidneys in which the renal pelvis was observed, epithelial cells of the renal pelvis showed strong membranous reactivity for L1CAM. CONCLUSIONS Our study shows that L1CAM is expressed in all stages of human kidney nephrogenesis, being restricted to the renal structures derived from the ureteric bud. The expression of L1CAM in the cells of the ureteric bud tips suggests a major role for this adhesion molecule in the induction of metanephric mesenchymal cells to undergo mesenchymal-to-epithelial transition and differentiation into new nephrons. The interindividual variability in L1CAM expression observed in this study might be related to different levels of nephrogenesis, suggesting L1CAM involvement in the fetal programming of adult kidney diseases.
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Affiliation(s)
- F Cau
- Department of Medical Sciences and Public Health, Division of Pathology, AOU of Cagliari, Cagliari, Italy.
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18
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Dubath C, Porcu E, Delacrétaz A, Grosu C, Laaboub N, Piras M, Von Gunten A, Conus P, Von Plessen K, Kutalik Z, Eap C. DNA methylation may mediate psychotropic drug-induced metabolic side effects: results from a 1-month observational study. Eur Psychiatry 2022. [PMCID: PMC9567522 DOI: 10.1192/j.eurpsy.2022.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Metabolic side effects of psychotropic medications are a major drawback to patients’ effective treatment. Among the mechanisms underlying their development, DNA methylation may be involved. Objectives The aim of this study was to estimate DNA methylation changes occurring secondary to psychotropic treatment and evaluate associations between 1-month metabolic changes and baseline DNA methylation or 1-month DNA methylation changes, using an epigenome-wide approach. Methods Seventy-nine psychiatric patients recruited as part of PsyMetab study, who started a treatment with either an antipsychotic, a mood stabilizer or mirtazapine were selected. Epigenome-wide DNA methylation was measured using the Illumina Methylation EPIC BeadChip at baseline and after one month of treatment. Results A global methylation increase was observed after 1 month of treatment, which was more pronounced in patients whose weight remained stable (i.e., <2.5% weight increase). Epigenome-wide significant methylation changes were observed at 52 loci in the whole cohort and at one site, namely cg12209987, located in an intergenic region within an enhancer, specifically in patients who underwent important early weight gain (i.e., ≥5% weight increase) during the same period of treatment (p<5*10-8). Multivariable analysis confirmed an association between an increase in methylation at this locus and weight gain in the whole cohort (p=0.004). Epigenome-wide association analyses failed to identify any significant link between other metabolic changes (e.g. glucose or lipid levels) and methylation data. Conclusions These findings give new insight into the mechanisms of psychotropic drug-induced weight gain. With improved understanding of the metabolic side effects, the use of precision medicine with epigenetics may become possible Disclosure No significant relationships.
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19
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Piras M, Ranjbar S, Dubath C, Laaboub N, Grosu C, Gamma F, Von Plessen K, Von Gunten A, Conus P, Eap C. Effects of psychotropic switches on weight change: a prospective cohort study. Eur Psychiatry 2022. [PMCID: PMC9567840 DOI: 10.1192/j.eurpsy.2022.1887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Many psychotropic drugs can induce weight gain with differences in their metabolic risk profiles (i.e. high, medium or low-risk).
Objectives
To compare the weight evolution of patients switching versus patients keeping their psychotropic drugs with different risk-profiles.
Methods
Data for patients switching or keeping the same drug were obtained from the Psyclin (from 2007 to 2015) and Psymetab (2007- 2019) cohort studies, conducted at the Lausanne University Hospital, Switzerland. Patients either switched from a high to a low-risk, a high to a medium-risk, a medium to a low-risk drug, or for a drug with the same risk category. Patients not switching either kept a high, medium or low-risk drug. The evolution of weight is currently being analyzed using a linear mixed-effect model.
Results
Preliminary results showed that switching from a high to low-risk molecule had the strongest impact on weight changes. The analysis being ongoing, the quantitative results will be presented at the congress.
Conclusions
Switching from a high-risk to a low-risk molecule is likely to have the strongest impact on weight changes.
Disclosure
No significant relationships.
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20
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Laaboub N, Dubath C, Ranjbar S, Sibailly G, Grosu C, Piras M, Délessert D, Richard-Lepouriel H, Ansermot N, Crettol S, Vandenberghe F, Grandjean C, Delacrétaz A, Gamma F, Plessen KJ, von Gunten A, Conus P, Eap CB. Insomnia disorders are associated with increased cardiometabolic disturbances and death risks from cardiovascular diseases in psychiatric patients treated with weight-gain-inducing psychotropic drugs: results from a Swiss cohort. BMC Psychiatry 2022; 22:342. [PMID: 35581641 PMCID: PMC9116036 DOI: 10.1186/s12888-022-03983-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
STUDY OBJECTIVES Insomnia disorders as well as cardiometabolic disorders are highly prevalent in the psychiatric population compared to the general population. We aimed to investigate their association and evolution over time in a Swiss psychiatric cohort. METHODS Data for 2861 patients (8954 observations) were obtained from two prospective cohorts (PsyMetab and PsyClin) with metabolic parameters monitored routinely during psychotropic treatment. Insomnia disorders were based on the presence of ICD-10 "F51.0" diagnosis (non-organic insomnia), the prescription of sedatives before bedtime or the discharge letter. Metabolic syndrome was defined using the International Diabetes Federation definition, while the 10-year risk of cardiovascular event or death was assessed using the Framingham Risk Score and the Systematic Coronary Risk Estimation, respectively. RESULTS Insomnia disorders were observed in 30% of the cohort, who were older, predominantly female, used more psychotropic drugs carrying risk of high weight gain (olanzapine, clozapine, valproate) and were more prone to suffer from schizoaffective or bipolar disorders. Multivariate analyses showed that patients with high body mass index (OR = 2.02, 95%CI [1.51-2.72] for each ten-kg/m2 increase), central obesity (OR = 2.20, [1.63-2.96]), hypertension (OR = 1.86, [1.23-2.81]), hyperglycemia (OR = 3.70, [2.16-6.33]), high density lipoprotein hypocholesterolemia in women (OR = 1.51, [1.17-1.95]), metabolic syndrome (OR = 1.84, [1.16-2.92]) and higher 10-year risk of death from cardiovascular diseases (OR = 1.34, [1.17-1.53]) were more likely to have insomnia disorders. Time and insomnia disorders were associated with a deterioration of cardiometabolic parameters. CONCLUSIONS Insomnia disorders are significantly associated with metabolic worsening and risk of death from cardiovascular diseases in psychiatric patients.
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Affiliation(s)
- Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Setareh Ranjbar
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Guibet Sibailly
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Didier Délessert
- Prison Medicine and Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Hélène Richard-Lepouriel
- Unit of Mood Disorders, Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Severine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Carole Grandjean
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland.,Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, 1008 Prilly, Prilly, Switzerland. .,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland. .,Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland. .,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne, Switzerland.
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21
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Piras M, Dubath C, Gholam M, Laaboub N, Grosu C, Gamma F, Solida A, Plessen KJ, von Gunten A, Conus P, Eap CB. Daily Dose Effects of Risperidone on Weight and Other Metabolic Parameters: A Prospective Cohort Study. J Clin Psychiatry 2022; 83. [PMID: 35551499 DOI: 10.4088/jcp.21m14110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Atypical antipsychotics can induce metabolic side effects, but whether they are dose-dependent remains unclear. Objective: To assess the effect of risperidone and/or paliperidone dosing on weight gain and blood lipids, glucose, and blood pressure alterations. Methods: Data for 438 patients taking risperidone and/or its metabolite (paliperidone) for up to 1 year were obtained between 2007 and 2018 from a longitudinal study monitoring metabolic parameters. Results: For each milligram increase in dose, we observed a weight increase of 0.16% at 1 month of treatment (P = .002) and increases of 0.29%, 0.21%, and 0.25% at 3, 6, and 12 months of treatment, respectively (P < .001 for each). Moreover, dose increases of 1 mg raised the risk of a ≥ 5% weight gain after 1 month (OR = 1.18; P = .012), a strong predictor of important weight gain in the long term. When we split the cohort into age categories, the dose had an effect on weight change after 3 months of treatment (up to 1.63%, P = .008) among adolescents (age ≤ 17 years), at 3 (0.13%, P = .013) and 12 (0.13%, P = .036) months among adults (age > 17 and < 65 years), and at each timepoint (up to 1.58%, P < .001) among older patients (age ≥ 65 years). In the whole cohort, for each additional milligram we observed a 0.05 mmol/L increase in total cholesterol (P = .018) and a 0.04 mmol/L increase in LDL cholesterol (P = .011) after 1 year. Conclusions: Although of small amplitude, these results show an effect of daily risperidone dose on weight gain and blood cholesterol levels. Particular attention should be given to the decision of increasing the drug dose, and minimum effective dosages should be preferred.
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Affiliation(s)
- Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Mehdi Gholam
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Alessandra Solida
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland.,Corresponding author: Chin B. Eap, PhD, Hôpital de Cery, 1008 Prilly-Lausanne, Switzerland
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22
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Coghe F, Fanni D, Gerosa C, Ravarino A, Mureddu M, Cerrone G, Coni P, Pichiri G, Congiu T, Piras M, Cau F, Aimola V, Balestrieri A, Lai E, Manchia M, Scano A, Orrù G, La Nasa G, Van Eyken P, Saba L, Scartozzi M, Castagnola M, Faa G. The role of fetal programming in human carcinogenesis - May the Barker hypothesis explain interindividual variability in susceptibility to cancer insurgence and progression? Eur Rev Med Pharmacol Sci 2022; 26:3585-3592. [PMID: 35647840 DOI: 10.26355/eurrev_202205_28854] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The growing incidence of cancers is pushing oncologists to find out new explanations other than the somatic mutation theory, based on the accumulation of DNA mutations. In particular, the embryo-fetal exposure to an increasing number of environmental factors during gestation might represent a trigger able to influence the susceptibility of the newborn to develop cancer later in life. This idea agrees with the fetal programming theory, also known as the Barker hypothesis. Here the role of insulin-like growth factors, thymosin beta-4, and epigenome are discussed as mediators of cancer in prenatal human development. The role of epigenetic factors that during gestation increase the predisposition to develop cancer and the similarities in the gene expression (like MMP9, OPN, TP53 and CDKN2A) between embryonic development and cancer are key factors. Likewise, maternal obesity might be able to re-program embryo-fetal development with long-term changes, including an increased risk to develop neuroblastoma and acute leukemia. Birth weight alone and birth weight corrected for gestational age are proposed as important variables capable of predicting the vulnerability to develop cancers. According to the findings here reported, we hypothesize that cancer prevention should start during gestation by improving the quality of maternal diet. In conclusion, the Barker hypothesis should be applied to cancer as well. Therefore, the identification of the epigenetic factors of cancer appears mandatory, so that the cancer prevention might start in the womb before birth.
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Affiliation(s)
- F Coghe
- Department of Clinical Laboratory, Azienda Ospedaliero Universitaria (AOU) di Cagliari - Polo di Monserrato, Cagliari, Italy.
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23
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Piras M, Gerosa C, Fanni D, Cau F, Coni P, Murru R, Denotti G, Orrù G, Scano A, Ledda F, Van Eyken P, Coghe F, Faa G, Castagnola M. Acyl-CoA binding protein (ACBP) is highly expressed in the developing human kidney. Eur Rev Med Pharmacol Sci 2022; 26:3301-3309. [PMID: 35587082 DOI: 10.26355/eurrev_202205_28749] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Acyl-CoA-binding protein (ACBP), also known as diazepam binding inhibitor (DBI), is a small phylogenetically conserved protein. This ancestral peptide is multifunctional, performing intracellular activities as ACBP protein or extracellular roles as DBI. Several studies showed its endless facets, including a relevant activity as appetite stimulator and as anabolic factor. High levels of ACBP have been described in erythrocytes, liver, kidney, and gut cells. The aim of this study was to analyze, at immunohistochemical level, the expression of ACBP in fetal human tissues during development, focusing on the developing kidney. MATERIALS AND METHODS Immunohistochemistry for ACBP was performed on 30 human fetal kidneys, from 15 fetuses of gestational age ranging from 13 to 19 weeks. At autopsy, all kidney samples were 10% formalin-fixed, routinely processed and paraffin-embedded. Five micron-thick paraffin sections were stained with Hematoxylin and Eosin and PAS stain for a morphological examination. RESULTS ACBP was detected in all 30 kidneys analyzed in this study. No significant changes in ACBP expression were observed at different gestational ages. Immunostaining for ACBP was restricted to the epithelium covering the renal pelvis, the papillae, the collecting tubules, and the proximal and distal tubules. On the other hand, medullary regions and in the metanephric mesenchymal stem/progenitor cells did not show any reactivity for ACBP. CONCLUSIONS According to our findings, ACBP should be considered as a new player in the complex field of human nephrogenesis, given that it was detected in all fetal kidneys immunostained. Its preferential localization in the renal structures derived from the Wolf duct, such as pelvis epithelium and collecting ducts, suggests a major role for ACBP in the induction of the metanephric mesenchymal cells toward the differentiation into glomerular structures. ACBP expression in proximal and distal tubules, two structures originating from the metanephric mesenchyme, indicates a further role of this protein in nephron development. In conclusion, ACBP should be added to the multiple molecules involved in human nephrogenesis.
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Affiliation(s)
- M Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Electron Microscopy Laboratory, Division Pathological Anatomy, Cagliari, Italy.
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Cantini L, Mentrasti G, Lo Russo G, Signorelli D, Pasello G, Rijavec E, Russano M, Antonuzzo L, Rocco D, Giusti R, Adamo V, Genova C, Tuzi A, Morabito A, Gori S, La Verde N, Chiari R, Cortellini A, Cognigni V, Pecci F, Indini A, De Toma A, Zattarin E, Oresti S, Pizzutilo E, Frega S, Erbetta E, Galletti A, Citarella F, Fancelli S, Caliman E, Della Gravara L, Malapelle U, Filetti M, Piras M, Toscano G, Zullo L, De Tursi M, Di Marino P, D’Emilio V, Cona M, Guida A, Caglio A, Salerno F, Spinelli G, Bennati C, Morgillo F, Russo A, Dellepiane C, Vallini I, Sforza V, Inno A, Rastelli F, Tassi V, Nicolardi L, Pensieri M, Emili R, Roca E, Migliore A, Galassi T, Rocchi M, Berardi R. Erratum to ‘Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario’. ESMO Open 2022; 7:100471. [PMID: 35378403 PMCID: PMC8973259 DOI: 10.1016/j.esmoop.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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25
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Piras M, Cau F, Manchia M, Paribello P, Saba L, Suri JS, Faa G, Pichiri G, Cerrone G, Scano A, Orrù G, La Nasa G, Coghe F, Castagnola M, Fanni D, Gerosa C. Strong ACE-2 expression in the choroidal vessels: do high choroid plexuses serve as a gateway for SARS-CoV-2 infection on the human brain? Eur Rev Med Pharmacol Sci 2022; 26:3025-3029. [PMID: 35503602 DOI: 10.26355/eurrev_202204_28633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous studies have confirmed the key mechanism by which SARS-CoV-2 enters human cells. It is well established that ACE2 is the receptor that can mark the beginning of the infection. In light of this, the organs that express higher levels of ACE2 are generally considered at higher risk, while those with lower levels should be somehow more protected. This - if related to the scarcity of ace2-expressing cells in the brain - seems to contrast with the presence of a variety of neurological symptoms that follow infection with ace2. The aim of this work was to analyze ACE2 expression in the human brain, focusing on the choroid plexuses. PATIENTS AND METHODS Twenty brain samples were obtained at autopsy from ten human fetuses and from ten adult subjects. All samples were selected to contain the choroid plexus. Specimens were fixed in 10% formalin, routinely processed and paraffin embedded. 5-micron sections were stained with Hematoxylin and Eosin (H&E) and immunostained with a commercial anti-human ACE2 rabbit monoclonal antibody at 1:100 dilution. RESULTS We analyzed 20 samples by immunohistochemistry, and we noted that, as far as fetal samples are concerned, a strong reactivity for ACE2 was detected in the myxoid stroma of the choroid plexuses and in the endothelial cells in fetuses. The complete absence of the ACE2 marker was detected in epithelial cells, neurons and glial cells of the cerebral cortex, both in fetuses and in adults. Whereas a strong but selective reactivity for ACE2 was also detected in adult choroid plexuses, mainly localized in the endothelial cells of the choroid capillaries. CONCLUSIONS Our study shows a strong expression of ACE in the fetal and adult brain choroid plexuses. This new histopathological finding may clarify the susceptibility of the human brain to SARS-COV-2 infection. Our data indicate the choroid plexus as the entry gate of virus for in the human brain; therefore, the entrance of SARS-CoV-2 into the cerebrospinal fluid through the choroid plexuses might represent the mechanism utilized by this coronavirus to cause direct injury to brain cells.
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Affiliation(s)
- M Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Electron Microscopy Laboratory, Division Pathological Anatomy, Cagliari, Italy.
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26
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Schoretsanitis G, Dubath C, Grosu C, Piras M, Laaboub N, Ranjbar S, Ansermot N, Crettol S, Vandenberghe F, Gamma F, von Gunten A, Plessen KJ, Seifritz E, Conus P, Eap CB. Olanzapine-associated dose-dependent alterations for weight and metabolic parameters in a prospective cohort. Basic Clin Pharmacol Toxicol 2022; 130:531-541. [PMID: 35150056 PMCID: PMC9305461 DOI: 10.1111/bcpt.13715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
Metabolic abnormalities have been associated with olanzapine treatment. We assessed if olanzapine has dose‐dependent effects on metabolic parameters with changes for weight, blood pressure, lipid and glucose profiles being modelled using linear mixed‐effects models. The risk of metabolic abnormalities including early weight gain (EWG) (≥5% during first month) was assessed using mixed‐effects logistic regression models. In 392 olanzapine‐treated patients (median age 38.0 years, interquartile range [IQR] = 26.0–53.3, median dose 10.0 mg/day, IQR = 5.0–10.0 for a median follow‐up duration of 40.0 days, IQR = 20.7–112.2), weight gain was not associated with olanzapine dose (p = 0.61) although it was larger for doses versus ≤10 mg/day (2.54 ± 5.55 vs. 1.61 ± 4.51% respectively, p = 0.01). Treatment duration and co‐prescription of >2 antipsychotics, antidepressants, benzodiazepines and/or antihypertensive agents were associated with larger weight gain (p < 0.05). Lower doses were associated with increase in total and HDL cholesterol and systolic and diastolic blood pressure (p < 0.05), whereas higher doses were associated with glucose increases (p = 0.01). Patients receiving >10 mg/day were at higher EWG risk (odds risk: 2.15, 1.57–2.97). EWG might be prominent in high‐dose olanzapine‐treated patients with treatment duration and co‐prescription of other medications being weight gain moderators. The lack of major dose‐dependent patterns for weight gain emphasizes that olanzapine‐treated patients are at weight gain risk regardless of the dose.
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Affiliation(s)
- Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York, USA.,Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Setareh Ranjbar
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Séverine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital and University of Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
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27
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Cantini L, Mentrasti G, Russo GL, Signorelli D, Pasello G, Rijavec E, Russano M, Antonuzzo L, Rocco D, Giusti R, Adamo V, Genova C, Tuzi A, Morabito A, Gori S, Verde NL, Chiari R, Cortellini A, Cognigni V, Pecci F, Indini A, De Toma A, Zattarin E, Oresti S, Pizzutilo EG, Frega S, Erbetta E, Galletti A, Citarella F, Fancelli S, Caliman E, Della Gravara L, Malapelle U, Filetti M, Piras M, Toscano G, Zullo L, De Tursi M, Di Marino P, D'Emilio V, Cona MS, Guida A, Caglio A, Salerno F, Spinelli G, Bennati C, Morgillo F, Russo A, Dellepiane C, Vallini I, Sforza V, Inno A, Rastelli F, Tassi V, Nicolardi L, Pensieri V, Emili R, Roca E, Migliore A, Galassi T, Rocchi MLB, Berardi R. Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario. ESMO Open 2022; 7:100406. [PMID: 35219245 PMCID: PMC8810307 DOI: 10.1016/j.esmoop.2022.100406] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. Methods Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables. Results A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36). Conclusions Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. The COVID-19 outbreak had an impact on access to lung cancer (LC) diagnosis and treatment. A slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019. Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease. The Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts. A reverse migration from high-volume to low-volume cancer centers was noted during the pandemic.
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Affiliation(s)
- L Cantini
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy. https://twitter.com/LucaCantiniMD
| | - G Mentrasti
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - G L Russo
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - D Signorelli
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - G Pasello
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Rijavec
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Russano
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - L Antonuzzo
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - D Rocco
- Department of Pulmonology and Oncology, AORN dei Colli Monaldi, Naples, Italy
| | - R Giusti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - V Adamo
- Oncologia Medica, A.O.Papardo & Università di Messina, Messina, Italy
| | - C Genova
- UOC Clinica di Oncologia Medica, IRCCS Ospedale San Martino, Department of Internal Medicine and Medical Specialties (DIMI), Università degli Studi di Genova, Genoa, Italy
| | - A Tuzi
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - A Morabito
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - S Gori
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - N La Verde
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - R Chiari
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - A Cortellini
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - V Cognigni
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - F Pecci
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - A Indini
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A De Toma
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - E Zattarin
- Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - S Oresti
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - E G Pizzutilo
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - S Frega
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - E Erbetta
- Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padua, Italy
| | - A Galletti
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - F Citarella
- Department of Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - S Fancelli
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - E Caliman
- Medical Oncology Unit, Careggi University Hospital, Florence, Italy
| | - L Della Gravara
- Dipartment of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - U Malapelle
- Department of Public Health, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - M Filetti
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - M Piras
- UOC Oncologia Medica, Azienda Ospedaliero Universitaria Sant'Andrea, Università La Sapienza, Rome, Italy
| | - G Toscano
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - L Zullo
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - M De Tursi
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - P Di Marino
- Department of Innovative Technologies in Medicine & Dentistry, Università G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - V D'Emilio
- UOC Pneumologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - M S Cona
- Department of Oncology, Ospedale Luigi Sacco, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Guida
- Oncologia Medica e Traslazionale, AO Santa Maria, Terni, Italy
| | - A Caglio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - F Salerno
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
| | - G Spinelli
- UOC Territorial Oncology, University "Sapienza", AUSL Latina, Cds Aprilia, Aprilia, Italy
| | - C Bennati
- Department of Onco-Hematology, AUSL della Romagna, Ravenna, Italy
| | - F Morgillo
- UOC Oncologia ed Ematologia, Department of Precision Medicine, Università degli studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - A Russo
- Oncologia Medica, A.O.Papardo, Messina, Italy
| | - C Dellepiane
- UOC Oncologia Medica 2, IRCCS Ospedale San Martino, Genoa, Italy
| | - I Vallini
- Oncologia Medica, ASST Sette Laghi, Varese, Italy
| | - V Sforza
- Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale", IRCCS, Naples, Italy
| | - A Inno
- UOC Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - F Rastelli
- UOC Oncologia, Ospedale Mazzoni, Ascoli Piceno, Italy
| | - V Tassi
- Chirurgia Toracica, AO Santa Maria, Terni, Italy
| | - L Nicolardi
- Medical Oncology, Ospedali Riuniti Padova Sud, Monselice, Italy
| | - V Pensieri
- Medical Oncology, St Salvatore Hospital, L'Aquila, Italy
| | - R Emili
- Operative Oncology Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - E Roca
- Thoracic Oncology - Lung Unit, Pederzoli Hospital, Peschiera Del Garda, Italy
| | - A Migliore
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - T Galassi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - M L Bruno Rocchi
- Biomolecular Sciences Department, University of Urbino, Urbino, Italy
| | - R Berardi
- Department of Medical Oncology, Università Politecnica delle Marche, AOU Ospedali Riuniti di Ancona, Ancona, Italy.
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Congiu T, Demontis R, Cau F, Piras M, Fanni D, Gerosa C, Botta C, Scano A, Chighine A, Faedda E, Cau R, Van Eyken P, Marongiu F, Barcellona D, Saba L, Orrù G, Coghe F, Suri JS, Faa G, d'Aloja E. Scanning electron microscopy of lung disease due to COVID-19 - a case report and a review of the literature. Eur Rev Med Pharmacol Sci 2022; 25:7997-8003. [PMID: 34982463 DOI: 10.26355/eurrev_202112_27650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The ongoing Coronavirus pandemic (COVID-19) showed similar characteristics with the severe acute respiratory syndrome (SARS). In the most compromised cases, COVID-19 infection leads to death due to severe respiratory complications. COVID-19-related acute respiratory distress syndrome (ARDS) is the primary cause of death in these patients. In the present study, we show an ultrastructural analysis on the lungs of a patient affected by COVID-19. PATIENTS AND METHODS Lung specimens obtained at autopsy from a 63-years old patient affected by COVID-19 were fixed in 1% paraformaldehyde. Slices of 300 µm thickness were dehydrated and dried by Critical Point Drying in CO2. Slices were covered with a conductive gold film approximately 30 nm thick and observed at a Zeiss Sigma 300 SEM FEG in the secondary electron (SE) and backscattered electron (BSE) modes. As case control a lung biopsy from a 60-year-old man was considered. RESULTS At low power in all COVID-19 lung specimens severe changes in the pulmonary architecture were found, due to the collapse of air spaces. Moreover, alveolar cavities were covered by large membranes. At high power, alveolar membranes showed a fibrillar structure, suggestive of a loose network of fibrin. It has been also found that intra-alveolar red blood cells were frequently present in the alveolar spaces, surrounded by a reticular fibrin network, suggestive for fibrin-hemorrhagic alveolitis. Alveolar changes were constantly associated with pathological features related to the pulmonary vessels. Vascular changes were prominent, including endothelial damage and thrombosis of large pulmonary vessels. Fibrinous microthrombi were frequently detected in the inter-alveolar septal capillaries. In addition, it has been frequently detected capillary proliferation in the alveolar septa with finding suggestive for intussusceptive neo-angiogenesis. CONCLUSIONS In conclusion, our electron microscopy analysis showed that COVID-19-related lung disease is characterized by a substantial architectural distortion, with the interactions between alveolar and vascular changes. Intra-alveolar hyaline membranes are associated with macro- and micro-thrombotic angiopathy, ending with capillary proliferation. The new blood vessel formation originates from the septa and extends into the surrounding parenchyma. Our findings confirm previous reports on the specificity of the multiple and complex morphological pattern typical, and apparently specific, of COVID-19-related lung disease.
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Affiliation(s)
- T Congiu
- Department of Medical Sciences and Public Health, Electron Microscopy Laboratory, Division Pathological Anatomy, University of Cagliari, Cagliari, Italy.
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29
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Congiu T, Fanni D, Piras M, Gerosa C, Cau F, Barcellona D, D'Aloja E, Demontis R, Chighine A, Nioi M, Coni P, Ravarino A, Cerrone G, Aimola V, Botta C, Scano A, Orrù G, Coghe F, Van Eyken P, La Nasa G, Saba L, Suri JS, Faa G, Marongiu F. Ultrastructural findings of lung injury due to Vaccine-induced Immune Thrombotic Thrombo- cytopenia (VITT) following COVID-19 vaccination: a scanning electron microscopic study. Eur Rev Med Pharmacol Sci 2022; 26:270-277. [PMID: 35049004 DOI: 10.26355/eurrev_202201_27777] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare new syndrome occurring after the ChAdOx1 nCoV-19 vaccine immunization. Patients with VITT are characterized by a variable clinical presentation, likewise also the outcome of these patients is very variable. Here we report the lung ultrastructural findings in the course of VITT of a 58-year-old male patient. Alveoli were mainly dilated, irregular in shape, and occupied by a reticular network of fibrin, while interalveolar septa appeared thickened. The proliferation of small capillaries gave rise to plexiform structures and pulmonary capillary hemangiomatosis-like features. Near the alveoli occupied by a dense fibrin network, the medium-sized arteries showed a modified wall and an intraluminal thrombus. This scenario looks quite similar to that found during COVID-19, where the lungs suffer from the attack of the antigen-antibodies complexes and the virus respectively. In both diseases, the final outcome is a severe inflammation, activation of the haemostatic system and fibrinolysis.
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Affiliation(s)
- T Congiu
- Division of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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Gerosa C, Faa G, Fanni D, Cerrone G, Suri JS, Barcellona D, Coni P, Congiu T, Lai ML, Piras M, Cau F, Coghe F, Balestrieri A, Cau R, Orru' G, Scano A, Van Eyken P, La Nasa G, Campagna M, Castagnola M, Gibo Y, Marongiu F, Saba L. Fetal programming of atherosclerosis: may the barker hypothesis explain the susceptibility of a subset of patients to develop stroke or cardiac infarct? Eur Rev Med Pharmacol Sci 2021; 25:6633-6641. [PMID: 34787867 DOI: 10.26355/eurrev_202111_27107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The risk stratification of young adults between subjects who will develop a mild form of atherosclerosis and subjects who will undergo a severe disease remains inaccurate. In the eighties of the previous century, David JP Barker has demonstrated the relationship between fetal conditions and occurrence of pathologies in adulthood. In this paper, the multiple evidence that might explain the increased susceptibility to severe forms of atherosclerosis, including stroke and cardiac infarct, in subjects who underwent intrauterine growth restriction (IUGR) will be analyzed. Specifically, we will review those inter-connected data indicating an association between a low weight at birth and an adult phenotype which might favor a severe outcome of atherosclerosis. Young and adult subjects born too small (IUGR) or too early (pre-terms) might represent a subgroup of "at risk subjects", more susceptible toward severe forms of atherosclerosis. Given that low birth weight (LBW) may be considered a surrogate of IUGR, this phenotypic feature could be considered among those indispensable clinical data collected in every patient presenting with atherosclerosis, irrespectively of age. According to the hypothesis that structural arterial changes might represent the link between LBW and susceptibility to atherosclerosis later in life, we suggest that the prevention of atherosclerosis should begin at birth. Regenerative and physiological substances such as thymosin Beta-4 could be challenged for a new "arterial regenerative medicine" in the perinatal period. The goal of this new approach should be the reinforcement of the structure of the arterial wall, allowing LBW newborns to avoid the most severe complications of atherosclerosis later in life: a dream that our research could contribute to bringing to life.
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Affiliation(s)
- C Gerosa
- Division of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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Fanni D, Cerrone G, Saba L, Demontis R, Congiu T, Piras M, Gerosa C, Suri J, Coni P, Caddori A, Piga M, Mancosu G, Barcellona D, Ravarino A, Chighine A, Cau F, Scano A, Balestrieri A, Coghe F, Orrù G, Van Eyken P, La Nasa G, D'Aloia E, Marongiu F, Faa G. Thrombotic sinusoiditis and local diffuse intrasinusoidal coagulation in the liver of subjects affected by COVID-19: the evidence from histology and scanning electron microscopy. Eur Rev Med Pharmacol Sci 2021; 25:5904-5912. [PMID: 34661248 DOI: 10.26355/eurrev_202110_26866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Liver injury has been reported in patients with COVID-19. This condition is characterized by severe outcome and could be related with the ability of SARS-CoV-2 to activate cytotoxic T cells. The purpose of this study is to show the histological and scanning electron microscopy features of liver involvement in COVID-19 to characterize the liver changes caused by the activation of multiple molecular pathways following this infection. PATIENTS AND METHODS Liver biopsies from 4 patients (3 post-mortems and 1 in vivo) with COVID-19 were analyzed with histology and by scanning electron microscopy. RESULTS The liver changes showed significant heterogeneity. The first case showed ground glass hepatocytes and scattered fibrin aggregates in the sinusoidal lumen. The second evidenced intra-sinusoidal thrombi. The third was characterized by sinusoidal dilatation, atrophy of hepatocytes, Disse's spaces dilatation and intra-sinusoidal aggregates of fibrin and red blood cells. The fourth case exhibited diffuse fibrin aggregates in the dilated Disse spaces and microthrombi in the sinusoidal lumen. CONCLUSIONS In COVID-19-related liver injury, a large spectrum of pathological changes was observed. The most peculiar features were very mild inflammation, intra-sinusoidal changes, including sinusoidal dilatation, thrombotic sinusoiditis and diffuse intra-sinusoidal fibrin deposition. These findings suggested that a thrombotic sinusoiditis followed by a local diffuse intra-vascular (intra-sinusoidal) coagulation could be the typical features of the SARS-CoV-2-related liver injury.
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Affiliation(s)
- D Fanni
- Division of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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Gerosa C, Faa G, Fanni D, Manchia M, Suri JS, Ravarino A, Barcellona D, Pichiri G, Coni P, Congiu T, Piras M, Cerrone G, Cau F, Ledda F, Aimola V, Coghe F, Porcu M, Cau R, Orru' G, Van Eyken P, La Nasa G, Castagnola M, Marongiu F, Saba L. Fetal programming of COVID-19: may the barker hypothesis explain the susceptibility of a subset of young adults to develop severe disease? Eur Rev Med Pharmacol Sci 2021; 25:5876-5884. [PMID: 34604981 DOI: 10.26355/eurrev_202109_26810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The risk stratification of young adults between subjects who will develop a mild form COVID-19 and subjects who will undergo a severe disease remains inaccurate. In this review, we propose that the Barker hypothesis might explain the increased susceptibility to severe forms of COVID-19 in subjects who underwent intrauterine growth restriction (IUGR). In this paper evidence indicating an association between a low birth weight and an adult phenotype which might favor a severe outcome of SARS-CoV-2 infection are presented: lower lung functional capacity; increased respiratory morbidity; changes in fibrinogen and Factor VII serum levels and dysregulation of the hemostasis and thrombosis system; acquisition of a pro-thrombotic phenotype; low nephron number, with decreased ability to sustain renal function and increased renal morbidity; heart remodeling, with a less efficient cardiac function; endothelial dysfunction, a risk factor for the insurgence of the multiple organ failure; remodeling of arteries, with changes in the elastic properties of the arterial wall, predisposing to the insurgence and progression of atherosclerosis; dysfunction of the innate immune system, a risk factor for immune diseases in adulthood. These data suggest that young and adult subjects born too small (IUGR) or too early (pre-terms) might represent a subgroup of "at risk subjects", more susceptible toward severe forms of COVID-19. Given that LBW may be considered a surrogate of IUGR, this phenotypic marker should be included among the indispensable clinical data collected in every patient presenting with SARS-COV-2 infection, irrespectively of his/her age.
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Affiliation(s)
- C Gerosa
- Division of Pathology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
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Dubath C, Piras M, Gholam M, Laaboub N, Grosu C, Sentissi O, Gamma F, Solida A, von Gunten A, Conus P, Eap CB. Effect of Quetiapine, from Low to High Dose, on Weight and Metabolic Traits: Results from a Prospective Cohort Study. Pharmacopsychiatry 2021; 54:279-286. [PMID: 34388836 DOI: 10.1055/a-1525-2820] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The atypical antipsychotic quetiapine is known to induce weight gain and other metabolic complications. The underlying mechanisms are multifactorial and poorly understood with almost no information on the effect of dosage. Concerns were thus raised with the rise in low-dose quetiapine off-label prescription (i. e.,<150 mg/day). METHODS In this study, we evaluated the influence of quetiapine dose for 474 patients included in PsyMetab and PsyClin studies on weight and metabolic parameter evolution. Weight, blood pressure, lipid, and glucose profiles were evaluated during a follow-up period of 3 months after treatment initiation. RESULTS Significant dose-dependent metabolic alterations were observed. The daily dose was found to influence weight gain and increase the risk of undergoing clinically relevant weight gain (≥7% from baseline). It was also associated with a change in plasma levels of cholesterol (total cholesterol, LDL cholesterol, and HDL cholesterol) as well as with increased odds of developing hypertriglyceridemia, as well as total and LDL hypercholesterolemia. No impact of a dose increase on blood pressure and plasma glucose level was observed. DISCUSSION The dose-dependent effect highlighted for weight gain and lipid alterations emphasizes the importance of prescribing the minimal effective dose. However, as the effect size of a dose increase on metabolic worsening is low, the potential harm of low-dose quetiapine should not be dismissed. Prescriptions must be carefully evaluated and regularly questioned in light of side effect onset.
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Affiliation(s)
- Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Mehdi Gholam
- Center for Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Othman Sentissi
- Adult Psychiatry Division, Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Alessandra Solida
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
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Gerosa C, Fanni D, Cau F, Ravarino A, Senes G, Demontis R, Coni P, Piras M, Orrù G, Coghe F, Congiu T, La Nasa G, D'Aloja E, Saba L, Faa G. Immunohistochemical findings in the lungs of COVID-19 subjects: evidence of surfactant dysregulation. Eur Rev Med Pharmacol Sci 2021; 25:4639-4643. [PMID: 34286505 DOI: 10.26355/eurrev_202107_26257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Acute respiratory distress syndrome (ARDS) is characterized by quantitative and qualitative changes in surfactant composition, leading to surfactant dysregulation with alveolar collapse and acute respiratory hypoxic failure. Recently, surfactant has been hypothesized to play a relevant role in COVID-19, representing a strong defender against SARS-CoV-2 infection. The aim of our work was the study of immunohistochemical surfactant expression in the lungs of patients died following SARS-CoV-2 ARDS, in order to shed light on a possible therapeutic surfactant administration. PATIENTS AND METHODS We investigated four patients who died due to ARDS following SARS-COV-2 infection and four patients submitted to lung biopsy, in the absence of SARS-CoV-2 infection. In all 8 cases, lung specimens were immunostained with anti-surfactant protein A (SP-A) and B (SP-B). RESULTS In control subjects, reactivity for SP-B was restricted to type II alveolar cells. Immunostaining for SP-A was observed on the surface of alveolar spaces. In the COVID-19 positive lungs, immunoreactivity for SP-B was similar to that observed in control lungs; SP-A was strongly expressed along the alveolar wall. Moreover, dense aggregates of SP-A positive material were observed in the alveolar spaces. CONCLUSIONS Our immunohistochemical data show the dysregulation of surfactant production in COVID-19 patients, particularly regarding SP-A expression. The increased presence of SP-A in condensed masses inside alveolar spaces could invalidate the therapeutic efficacy of the treatment with exogenous surfactant.
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Affiliation(s)
- C Gerosa
- Division of Pathology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
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Faa G, Piras M, Mancuso L, Coni P, Pichiri G, Orrù G, Fanni D, Gerosa C, Cao G, Taibi R, Pavone P, Castagnola M. Thymosin beta-4 prenatal administration improves fetal development and halts side effects due to preterm delivery. Eur Rev Med Pharmacol Sci 2021; 25:431-437. [PMID: 33506933 DOI: 10.26355/eurrev_202101_24411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Thymosin beta 4 (TB4) is the most abundant member of the beta-thymosin family in humans. The main physiological role of TB4 is the regulation of actin polymerization. TB4 is also involved in angiogenesis, cell survival, cell migration and fetal development. The aim of this study was to evaluate the activity of TB4 as a fetal growth promoter when administered during pregnancy. MATERIALS AND METHODS Our protocols have been carried out in full conformity with the rules and guidelines expected for this kind of trial. 10 pregnant mice received the same injection regimen. Only 6 of these 10 are part of this experiment because they were pregnant. At 10:00 a.m. on day E14 and E17 of gestation mice were weighed and treated with an intraperitoneal injection of TB4 (Regene RX, Rockville, MD, USA; 6 mg/kg in PBS). RESULTS The mothers treated with TB4 for two days precisely E14 and E17, showed a higher cranio-caudal length when compared to control newborns. At histology, maternal TB4 treatment was associated with more advanced development of lungs, heart, kidney, cerebral cortex and notochord. CONCLUSIONS Our study shows that TB4 administration during gestation may act as a powerful fetal growth promoter, by accelerating the development of newborn organs and tissues.
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Affiliation(s)
- G Faa
- Department of Medical Sciences and Public Health, Division Pathological Anatomy, Cagliari, Italy.
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Fanni D, Gerosa C, Nurchi VM, Suri JS, Nardi V, Congiu T, Coni P, Ravarino A, Cerrone G, Piras M, Cau F, Kounis NG, Balestrieri A, Gibo Y, Van Eyken P, Coghe F, Venanzi Rullo E, Taibi R, Orrù G, Faa G, Saba L. Trace elements and the carotid plaque: the GOOD (Mg, Zn, Se), the UGLY (Fe, Cu), and the BAD (P, Ca)? Eur Rev Med Pharmacol Sci 2021; 25:3772-3790. [PMID: 34109586 DOI: 10.26355/eurrev_202105_25945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Multiple epidemiological studies have suggested that industrialization and progressive urbanization should be considered one of the main factors responsible for the rising of atherosclerosis in the developing world. In this scenario, the role of trace metals in the insurgence and progression of atherosclerosis has not been clarified yet. In this paper, the specific role of selected trace elements (magnesium, zinc, selenium, iron, copper, phosphorus, and calcium) is described by focusing on the atherosclerotic prevention and pathogenesis plaque. For each element, the following data are reported: daily intake, serum levels, intra/extracellular distribution, major roles in physiology, main effects of high and low levels, specific roles in atherosclerosis, possible interactions with other trace elements, and possible influences on plaque development. For each trace element, the correlations between its levels and clinical severity and outcome of COVID-19 are discussed. Moreover, the role of matrix metalloproteinases, a family of zinc-dependent endopeptidases, as a new medical therapeutical approach to atherosclerosis is discussed. Data suggest that trace element status may influence both atherosclerosis insurgence and plaque evolution toward a stable or an unstable status. However, significant variability in the action of these traces is evident: some - including magnesium, zinc, and selenium - may have a protective role, whereas others, including iron and copper, probably have a multi-faceted and more complex role in the pathogenesis of the atherosclerotic plaque. Finally, calcium and phosphorus are implicated in the calcification of atherosclerotic plaques and in the progression of the plaque toward rupture and severe clinical complications. In particular, the role of calcium is debated. Focusing on the COVID-19 pandemia, optimized magnesium and zinc levels are indicated as important protective tools against a severe clinical course of the disease, often related to the ability of SARS-CoV-2 to cause a systemic inflammatory response, able to transform a stable plaque into an unstable one, with severe clinical complications.
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Affiliation(s)
- D Fanni
- Department of Medical Sciences and Public Health, Division of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - University Hospital San Giovanni di Dio, University of Cagliari, Cagliari, Italy.
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Laaboub N, Gholam M, Sibailly G, Sjaarda J, Delacrétaz A, Dubath C, Grosu C, Piras M, Ansermot N, Crettol S, Vandenberghe F, Grandjean C, Gamma F, Bochud M, von Gunten A, Plessen KJ, Conus P, Eap CB. Associations Between High Plasma Methylxanthine Levels, Sleep Disorders and Polygenic Risk Scores of Caffeine Consumption or Sleep Duration in a Swiss Psychiatric Cohort. Front Psychiatry 2021; 12:756403. [PMID: 34987426 PMCID: PMC8721597 DOI: 10.3389/fpsyt.2021.756403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: We first sought to examine the relationship between plasma levels of methylxanthines (caffeine and its metabolites) and sleep disorders, and secondarily between polygenic risk scores (PRS) of caffeine consumption or sleep duration with methylxanthine plasma levels and/or sleep disorders in a psychiatric cohort. Methods: Plasma levels of methylxanthines were quantified by ultra-high performance liquid chromatography/tandem mass spectrometry. In inpatients, sleep disorder diagnosis was defined using ICD-10 "F51.0," sedative drug intake before bedtime, or hospital discharge letters, while a subgroup of sedative drugs was used for outpatients. The PRS of coffee consumption and sleep duration were constructed using publicly available GWAS results from the UKBiobank. Results: 1,747 observations (1,060 patients) were included (50.3% of observations with sleep disorders). Multivariate analyses adjusted for age, sex, body mass index, setting of care and psychiatric diagnoses showed that patients in the highest decile of plasma levels of methylxanthines had more than double the risk for sleep disorders compared to the lowest decile (OR = 2.13, p = 0.004). PRS of caffeine consumption was associated with plasma levels of caffeine, paraxanthine, theophylline and with their sum (β = 0.1; 0.11; 0.09; and 0.1, pcorrected = 0.01; 0.02; 0.02; and 0.01, respectively) but not with sleep disorders. A trend was found between the PRS of sleep duration and paraxanthine levels (β = 0.13, pcorrected = 0.09). Discussion: Very high caffeine consumption is associated with sleep disorders in psychiatric in- and outpatients. Future prospective studies should aim to determine the benefit of reducing caffeine consumption in high caffeine-consuming patients suffering from sleep disorders.
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Affiliation(s)
- Nermine Laaboub
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Mehdi Gholam
- Center of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Guibet Sibailly
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Jennifer Sjaarda
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Aurélie Delacrétaz
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Céline Dubath
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Claire Grosu
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Marianna Piras
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Nicolas Ansermot
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Severine Crettol
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Carole Grandjean
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Franziska Gamma
- Les Toises Psychiatry and Psychotherapy Center, Lausanne, Switzerland
| | - Murielle Bochud
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Kerstin Jessica Plessen
- Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Centre for Psychiatric Neuroscience, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.,Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
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Saba L, Gerosa C, Fanni D, Marongiu F, La Nasa G, Caocci G, Barcellona D, Balestrieri A, Coghe F, Orru G, Coni P, Piras M, Ledda F, Suri JS, Ronchi A, D'Andrea F, Cau R, Castagnola M, Faa G. Molecular pathways triggered by COVID-19 in different organs: ACE2 receptor-expressing cells under attack? A review. Eur Rev Med Pharmacol Sci 2021; 24:12609-12622. [PMID: 33336781 DOI: 10.26355/eurrev_202012_24058] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE In human pathology, SARS-CoV-2 utilizes multiple molecular pathways to determine structural and biochemical changes within the different organs and cell types. The clinical picture of patients with COVID-19 is characterized by a very large spectrum. The reason for this variability has not been clarified yet, causing the inability to make a prognosis on the evolution of the disease. MATERIALS AND METHODS PubMed search was performed focusing on the role of ACE 2 receptors in allowing the viral entry into cells, the role of ACE 2 downregulation in triggering the tissue pathology or in accelerating previous disease states, the role of increased levels of Angiotensin II in determining endothelial dysfunction and the enhanced vascular permeability, the role of the dysregulation of the renin angiotensin system in COVID-19 and the role of cytokine storm. RESULTS The pathological changes induced by SARS-CoV-2 infection in the different organs, the correlations between the single cell types targeted by the virus in the different human organs and the clinical consequences, COVID-19 chronic pathologies in liver fibrosis, cardiac fibrosis and atrial arrhythmias, glomerulosclerosis and pulmonary fibrosis, due to the systemic fibroblast activation induced by angiotensin II are discussed. CONCLUSIONS The main pathways involved showed different pathological changes in multiple tissues and the different clinical presentations. Even if ACE2 is the main receptor of SARS-CoV-2 and the main entry point into cells for the virus, ACE2 expression does not always explain the observed marked inter-individual variability in clinical presentation and outcome, evidencing the complexity of this disorder. The proper interpretation of the growing data available might allow to better classifying COVID-19 in human pathology.
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Affiliation(s)
- L Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (AOU), di Cagliari - Polo di Monserrato, Cagliari, Italy.
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Filetti M, Rossi A, Piras M, Salimbeni BT, Rizzo F, Giusti R. 79P Statins and immunotherapy: Togetherness makes strength - the potential effect of statins on immunotherapy for NSCLC. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Carta MG, Said M, Piras M, Moro MF. [An evolutionist approach of mood disorders from a transcultural perspective]. Encephale 2019; 45:530-532. [PMID: 30879780 DOI: 10.1016/j.encep.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The objective of this paper is to verify if traits and symptoms defined as pathological and maladjusted in certain contexts may produce adaptive effects in other contexts, especially if they occur in sub-threshold forms. METHODS A historical examination of how the symptoms of depression have changed in front of great social changes and an analysis of Sardinian migrants' thymic profiles toward several metropolises. RESULTS AND CONCLUSIONS Mood disorders have been increasing since the "English malady" in the 17th century, and we suppose that some forms of mood disorders might have an adaptive advantage. Otherwise, the increase of such an epidemic would have been self-limited. From a sociobiological point of view, it is highly probable that the environment of a rapidly evolving society can select people who are explorers and able to support accelerated biorhythms and that the condition of social change stimulates psychological and psychopathologic changes. It is also possible that hyperthymic persons modulate and create the new environment. If this model can explain the epidemic of mood disorders, its verification should guide future research.
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Affiliation(s)
- M G Carta
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italie
| | - M Said
- Razi Hospital, Faculty of medicine of Tunis, Tunis, Tunisia.
| | - M Piras
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italie
| | - M F Moro
- Mailman School of Public Health Columbia University, New York, United States
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Gerosa C, Fanni D, Congiu T, Piras M, Cau F, Moi M, Faa G. Liver pathology in Wilson's disease: From copper overload to cirrhosis. J Inorg Biochem 2019; 193:106-111. [PMID: 30703747 DOI: 10.1016/j.jinorgbio.2019.01.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/11/2019] [Accepted: 01/12/2019] [Indexed: 02/07/2023]
Abstract
Wilson's disease (WD) is a genetic metabolic disease strictly associated with liver cirrhosis. In this review, the genetic bases of the disease are discussed, with emphasis on the role of ATP7B (the Wilson disease protein) dysfunction as a determinant factor of systemic copper overload. Regarding the different multiple mutations described in WD patients, the peculiarity of Sardinian population is highlighted, Sardinians carrying a rare deletion in the promoter (5' UTR) of the WD gene. The role of epigenetic changes in the clinical presentation and evolution of liver disease in WD patients is also discussed, nutrition probably representing a relevantly risk factor in WD patients. The role of transmission electron microscopy in the diagnosis of WD-related liver disease is underlined. Mitochondrial changes, increased peroxisomes fat droplets, lipolysosomes and intranuclear glycogen inclusions are reported as the most frequent ultrastructural changes in the liver of WD carriers. The role of histochemical stains for copper is analyzed, and the Timm's method is suggested as the most sensitive one for revealing hepatic copper overload in all stage of WD. The marked variability of the histological liver changes occurring in WD is underlined simple steatosis may represent the only pathological changes, frequently associated with glycogenated nuclei. Mallory-Denk bodies lipogranulomas alcoholic and non-alcoholic fatty liver disease ending with bridging fibrosis and cirrhosis. Finally, the reversal of fibrosis as a possible therapeutic objective in WD is discussed.
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Affiliation(s)
- C Gerosa
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy
| | - D Fanni
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy
| | - T Congiu
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy
| | - M Piras
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy.
| | - F Cau
- Division of Pathological, San Gavino Hospital, ATS, San Gavino, Italy
| | - M Moi
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy
| | - G Faa
- Division of Pathological, University of Cagliari AOU Cagliari, Cagliari, Italy
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Piras M, Russo MC, De Ferrari F, Verzeletti A. Cyclists fatalities: Forensic remarks regarding 335 cases. J Forensic Leg Med 2016; 44:169-173. [PMID: 27810588 DOI: 10.1016/j.jflm.2016.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Received: 07/25/2016] [Revised: 10/09/2016] [Accepted: 10/22/2016] [Indexed: 11/18/2022]
Abstract
A retrospective study was carried out on post-mortem examination data regarding 335 cyclists involved in fatal accidents along the period 1983-2012. The following variables were considered: temporal data (year, month, day of the week and hour of the day), circumstances of the accident, vehicles involved, victims' features (sex, age), pathological and toxicological findings, cause of death. Most victims were male (77.62%), with a mean age of 58 years. In most cases vehicles other than only bicycles were involved, more frequently cars, followed by heavy motor vehicles. Head was the most frequently body region involved in lethal injuries (65.37%); low extremities were the body district most frequently involved in non-lethal injuries (63.9%). This study confirmed the importance of using helmet; head protection should be a priority for bikers.
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Affiliation(s)
- M Piras
- Forensic Medicine Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Italy
| | - M C Russo
- Forensic Medicine Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Italy
| | - F De Ferrari
- Forensic Medicine Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Italy
| | - A Verzeletti
- Forensic Medicine Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Italy.
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Affiliation(s)
- M. Piras
- Istituto Zootecnico e Caseario per la Sardegna. Olmedo, Italy
| | - S. Ligios
- Istituto Zootecnico e Caseario per la Sardegna. Olmedo, Italy
| | - M. Sitzia
- Istituto Zootecnico e Caseario per la Sardegna. Olmedo, Italy
| | - N. Fois
- Istituto Zootecnico e Caseario per la Sardegna. Olmedo, Italy
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Faa G, Marcialis MA, Ravarino A, Piras M, Pintus MC, Fanos V. Fetal programming of the human brain: is there a link with insurgence of neurodegenerative disorders in adulthood? Curr Med Chem 2015; 21:3854-76. [PMID: 24934353 DOI: 10.2174/0929867321666140601163658] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 11/22/2022]
Abstract
In recent years, evidence is growing on the role played by gestational factors in shaping brain development and on the influence of intrauterine experiences on later development of neurodegenerative diseases including Parkinson's (PD) and Alzheimer's disease (AD). The nine months of intrauterine development and the first three years of postnatal life are appearing to be extremely critical for making connections among neurons and among neuronal and glial cells that will shape a lifetime of experience. Here, the multiple epigenetic factors acting during gestation - including maternal diet, malnutrition, stress, hypertension, maternal diabetes, fetal hypoxia, prematurity, low birth weight, prenatal infection, intrauterine growth restriction, drugs administered to the mother or to the baby - are reported, and their ability to modulate brain development, resulting in interindividual variability in the total neuronal and glial burden at birth is discussed. Data from recent literature suggest that prevention of neurodegeneration should be identified as the one method to halt the diffusion of neurodegenerative diseases. The "two hits" hypothesis, first introduced for PD and successfully applied to AD and other neurodegenerative human pathologies, should focus our attention on a peculiar period of our life: the intrauterine and perinatal periods. The first hit to our nervous system occurs early in life, determining a PD or AD imprinting to our brain that will condition our resistance or, alternatively, our susceptibility to develop a neurodegenerative disease later in life. In conclusion, how early life events contribute to late-life development of adult neurodegenerative diseases, including PD and AD, is emerging as a new fascinating research focus. This assumption implies that research on prevention of neurodegenerative diseases should center on events taking place early in life, during gestation and in the perinatal periods, thus presenting a new challenge to perinatologists: the prevention of neurodegenerative human diseases.
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Affiliation(s)
| | | | | | | | | | - V Fanos
- Istituto di Anatomia Patologica, Ospedale San Giovanni di Dio, Via Ospedale n. 56, 09100 CAGLIARI, Italy.
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Fanni D, Fanos V, Gerosa C, Piras M, Dessi A, Atzei A, Van EP, Gibo Y, Faa G. Effects of iron and copper overload on the human liver: an ultrastructural study. Curr Med Chem 2015; 21:3768-74. [PMID: 24934354 DOI: 10.2174/0929867321666140601163244] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 03/12/2014] [Accepted: 04/16/2014] [Indexed: 11/22/2022]
Abstract
Iron and copper ions play important roles in many physiological functions of our body, even though the exact mechanisms regulating their absorption, distribution and excretion are not fully understood. Metal-related human pathology may be observed in two different clinical settings: deficiency or overload. The overload in liver cells of both trace elements leads to multiple cellular lesions. Here we report the main pathological changes observed at transmission electron microscopy in the liver of subjects affected by Beta-thalassemia and by Wilson's disease. The hepatic iron overload in beta-thalassemia patients is associated with haemosiderin storage both in Kupffer cells and in the cytoplasm of hepatocytes. Haemosiderin granules are grouped inside voluminous lysosomes, also called siderosomes. Other ultrastructural changes are fat droplets, proliferation of the smooth endoplasmic reticulum and fibrosis. Apoptosis of hepatocytes and infiltration of sinusoids by polymorphonucleates is also detected in beta-thalassemia. Ultrastructural changes in liver biopsies from Wilson's disease patients are characterized by severe mitochondrial changes, associated with an increased number of perossisomes, cytoplasmic lipid droplets and the presence of lipolysosomes, characteristic cytoplasmic bodies formed by lipid vacuoles surrounded by electron-dense lysosomes. In patients affected by Wilson's disease, nuclei are frequently involved, with disorganization of the nucleoplasm and with glycogen inclusions. On the contrary, no significant changes are detected in Kupffer cells. Our data show that iron and copper, even though are both transition metals, are responsible of different pathological changes at ultrastructural level. In particular, copper overload is associated with mitochondrial damage, whereas iron overload only rarely may cause severe mitochondrial changes. These differences underlay the need for further studies in which biochemical analyses should be associated with ultrastructural data, in order to better understand the molecular ways associated with iron- and copper-related pathology at subcellular level.
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Affiliation(s)
| | | | | | | | | | | | | | | | - G Faa
- Pathologist, Department of surgical sciences, University of Cagliari, Cagliari, Italy and University Hospital "San Giovanni di Dio", AOU Cagliari, Via Ospedale, 54, 09124 Cagliari.
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Kotoni D, Piras M, Cabri W, Giorgi F, Mazzanti A, Pierini M, Quaglia M, Villani C, Gasparrini F. Thermodynamic and kinetic investigation of monoketo-aldehyde-peroxyhemiacetal (MKA), a stereolabile degradation product of dihydroartemisinin. RSC Adv 2014. [DOI: 10.1039/c4ra00879k] [Citation(s) in RCA: 7] [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: 01/24/2023] Open
Abstract
Theβ⇆αepimerization process ofMKAhas been studied under a thermodynamic and kinetic point of view in several solvents. LSER analyses and molecular modeling calculations allowed an effective rationalization of the findings.
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Affiliation(s)
- D. Kotoni
- Dipartimento di Chimica e Tecnologie del Farmaco
- Sapienza Università di Roma
- 00185 Roma, Italy
| | - M. Piras
- Dipartimento di Chimica e Tecnologie del Farmaco
- Sapienza Università di Roma
- 00185 Roma, Italy
- Kosterlitz Centre for Therapeutics
- Institute of Medical Sciences
| | - W. Cabri
- Analytical Development
- R&D Department
- Sigma-Tau S.p.A
- 00040 Pomezia, Italy
| | - F. Giorgi
- Analytical Development
- R&D Department
- Sigma-Tau S.p.A
- 00040 Pomezia, Italy
| | - A. Mazzanti
- Dipartimento di Chimica Industriale “T. Montanari”
- Università di Bologna
- 40136 Bologna, Italy
| | - M. Pierini
- Dipartimento di Chimica e Tecnologie del Farmaco
- Sapienza Università di Roma
- 00185 Roma, Italy
| | - M. Quaglia
- Analytical Development
- R&D Department
- Sigma-Tau S.p.A
- 00040 Pomezia, Italy
| | - C. Villani
- Dipartimento di Chimica e Tecnologie del Farmaco
- Sapienza Università di Roma
- 00185 Roma, Italy
| | - F. Gasparrini
- Dipartimento di Chimica e Tecnologie del Farmaco
- Sapienza Università di Roma
- 00185 Roma, Italy
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Kanta Goswami S, Banerjee S, Saha P, Chakraborty P, Kabir SN, Karimzadeh MA, Mohammadian F, Mashayekhy M, Saldeen P, Kallen K, Karlstrom PO, Rodrigues-Wallberg KA, Salerno A, Nazzaro A, Di Iorio L, Marino S, Granato C, Landino G, Pastore E, Ghoshdastidar B, Chakraborty C, Ghoshdastidar BN, Ghoshdastidar S, Partsinevelos GA, Papamentzelopoulou M, Mavrogianni D, Marinopoulos S, Dinopoulou V, Theofanakis C, Anagnostou E, Loutradis D, Franz C, Nieuwland R, Montag M, Boing A, Rosner S, Germeyer A, Strowitzki T, Toth B, Mohamed M, Vlismas A, Sabatini L, Caragia A, Collins B, Leach A, Zosmer A, Al-Shawaf T, Beyhan Z, Fisch JD, Danner C, Keskintepe L, Aydin Y, Ayca P, Oge T, Hassa H, Papanikolaou E, Pados G, Grimbizis G, Bili H, Karastefanou K, Fatemi H, Kyrou D, Humaidan P, Tarlatzis B, Gungor F, Karamustafaoglu B, Iyibozkurt AC, Ozsurmeli M, Bastu E, Buyru F, Di Emidio G, Vitti M, Mancini A, Baldassarra T, D'Alessandro AM, Polsinelli F, Tatone C, Leperlier F, Lammers J, Dessolle L, Lattes S, Barriere P, Freour T, Elodie P, Assou S, Van den Abbeel E, Arce JC, Hamamah S, Assou S, Dechaud H, Haouzi D, Van den Abbeel E, Arce JC, Hamamah S, Tiplady S, Johnson S, Jones G, Ledger W, Eizadyar N, Ahmad Nia S, Seyed Mirzaie M, Azin SA, Yazdani Safa M, Onaran Y, Iltemir Duvan C, Keskin E, Ayrim A, Kafali H, Kadioglu N, Guler B, Var T, Cicek MN, Batioglu AS, Lichtblau I, Olivennes F, de Mouzon J, Dumont M, Junca AM, Cohen-Bacrie M, Hazout A, Belloc S, Cohen-Bacrie P, Allegra A, Marino A, Sammartano F, Coffaro F, Scaglione P, Gullo S, Volpes A, Cohen-Bacrie P, Cohen-Bacrie M, Hazout A, Lichtblau I, Dumont M, Junca AM, Belloc S, Prisant N, de Mouzon J, Saare M, Vaidla K, Salumets A, Peters M, Jindal UN, Thakur M, Shvell V, Diamond MP, Awonuga AO, Veljkovic M, Macanovic B, Milacic I, Borogovac D, Arsic B, Pavlovic D, Lekic D, Bojovic Jovic D, Garalejic E, Jayaprakasan K, Eljabu H, Hopkisson J, Campbell B, Raine-Fenning N, Kop P, van Wely M, Mol BW, Melker AA, Janssens PMW, Nap A, Arends B, Roovers JPWR, Ruis H, Repping S, van der Veen F, Mochtar MH, Sargin A, Yilmaz N, Gulerman C, Guven A, Polat B, Ozel M, Bardakci Y, Vidal C, Giles J, Remohi J, Pellicer A, Garrido N, Javdani M, Fallahzadeh H, Davar R, Sheibani H, Leary C, Killick S, Sturmey RG, Kim SG, Lee KH, Park IH, Sun HG, Lee JH, Kim YY, Choi EM, Van Loendersloot LL, Van Wely M, Repping S, Bossuyt PMM, Van Der Veen F, Roychoudhury Sarkar M, Roy D, Sahu R, Bhattacharya J, Eguiluz Gutierrez- Barquin I, Sanchez Sanchez V, Torres Afonso A, Alvarez Sanchez M, De Leon Socorro S, Molina Cabrillana J, Seara Fernandez S, Garcia Hernandez JA, Ozkan ZS, Simsek M, Kumbak B, Atilgan R, Sapmaz E, Agirregoikoa JA, DePablo JL, Abanto E, Gonzalez M, Anarte C, Barrenetxea G, Aleyasin A, Mahdavi A, Agha Hosseini M, Safdarian L, Fallahi P, Bahmaee F, Guler B, Kadioglu N, Sarikaya E, Cicek MN, Batioglu AS, Segawa T, Teramoto S, Tsuchiyama S, Miyauchi O, Watanabe Y, Ohkubo T, Shozu M, Ishikawa H, Yelian F, Papaioannou S, Knowles T, Aslam M, Milnes R, Takashima A, Takeshita N, Kinoshita T, Chapman MG, Kilani S, Ledger W, Dadras N, Parsanezhad ME, Zolghadri J, Younesi M, Floehr J, Dietzel E, Wessling J, Neulen J, Rosing B, Tan S, Jahnen-Dechent W, Lee KS, Joo JK, Son JB, Joo BS, Risquez F, Confino E, Llavaneras F, Marval I, D'Ommar G, Gil M, Risquez M, Lozano L, Paublini A, Piras M, Risquez A, Prochazka R, Blaha M, Nemcova L, Weghofer A, Kim A, Barad DH, Gleicher N, Kilic Y, Bastu E, Ergun B, Howard B, Weiss H, Doody K, Dietzel E, Wessling J, Floehr J, Schafer C, Ensslen S, Denecke B, Neulen J, Veitinger T, Spehr M, Tropartz T, Tolba R, Egert A, Schorle H, Jahnen-Dechent W, Bastu E, Alanya S, Yumru H, Ergun B. FEMALE (IN)FERTILITY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Virgilio S, Lorenzoni G, Marongiu E, Tedde T, Terrosu G, Campus G, Rosa M, Mura A, Delogu P, Piras M. PRESENCE OF P.S.P. TOXINS (PARALYTIC SHELLFISH POISON) IN MUSSELS OF SARDINIA AND NON-CONFORMITY MANAGEMENT. Ital J Food Saf 2010. [DOI: 10.4081/ijfs.2010.8.71] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Salivary mucins MG1 and MG2 have been found in the oral cavity where they perform several functions such as the formation of the mucous layer covering the oral mucosa and teeth. Recent studies have demonstrated their presence in other organs and tissues. The aim of this study was to determine their expression in human bulbourethral (Cowper's) glands. Normal bulbourethral glands were obtained at surgery and fixed in a mixture of 1% paraformaldehyde-1.25% glutaraldehyde in 0.1 M cacodylate buffer and embedded in Epon resin. Thin sections were labeled with rabbit antibodies to MG1 or to an N-terminal synthetic peptide of MG2, followed by gold-labeled goat anti-rabbit IgG. The granules of all mucous cells were intensely reactive with anti-MG1, whereas no labeling was detected for MG2. These results indicate that MG1 is not exclusively a salivary component and furthermore show that bulbourethral glands represent a significant source of the MG1 detected in human seminal plasma.
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Affiliation(s)
- M Piludu
- Department of Cytomorphology, University of Cagliari, Italy.
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Piludu M, Cossu M, De Lisa A, Piras M, Lantini MS. Ultrastructural localization of glycodelin oligosaccharides Le-x and Le-y in human seminal vesicles by immunogold staining. J Anat 2007; 210:352-6. [PMID: 17331183 PMCID: PMC2100286 DOI: 10.1111/j.1469-7580.2007.00690.x] [Citation(s) in RCA: 6] [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: 01/23/2023] Open
Abstract
Histo-blood group antigens Le-x and Le-y are oligosaccharidic terminals that characterize many glycoproteins in the human tissues. In seminal plasma, they are expressed as part of the so-called glycodelin S, which is suggested to regulate sperm capacitation/decapacitation. It has recently been demonstrated that the core protein of glycodelin S is secreted by seminal vesicles. Here we show that epithelial cells of human seminal vesicles also release the Le-x and Le-y antigens. The presence of these substances in secretory material was revealed by means of an immunogold staining method in normal surgical samples. The results suggest that glycodelin S is secreted by seminal vesicles in its finished glycosylated form. Moreover, antigen reactivity was also revealed associated with plasma membranes.
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Affiliation(s)
- M Piludu
- Dipartimento di Citomorfologia, Università di Cagliari, Italy.
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