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Canonica GW, Blasi F, Carpagnano GE, Guida G, Heffler E, Paggiaro P, Allegrini C, Antonelli A, Aruanno A, Bacci E, Bagnasco D, Beghè B, Bonavia M, Bonini M, Brussino L, Caiaffa MF, Calabrese C, Camiciottoli G, Caminati M, Caruso C, Cavallini M, Chieco Bianchi F, Conte ME, Corsico AG, Cosmi L, Costantino M, Costanzo G, Crivellaro M, D'Alò S, D'Amato M, Detoraki A, Di Proietto MC, Facciolongo NC, Ferri S, Fierro V, Foschino MP, Latorre M, Lombardi C, Macchia L, Milanese M, Montagni M, Parazzini EM, Parente R, Passalacqua G, Patella V, Pelaia G, Pini L, Puggioni F, Ricciardi L, Ridolo E, Rolo J, Scichilone N, Scioscia G, Senna G, Solidoro P, Varricchi G, Vianello A, Yacoub MR, Yang B. Severe Asthma Network Italy Definition of Clinical Remission in Severe Asthma: A Delphi Consensus. J Allergy Clin Immunol Pract 2023; 11:3629-3637. [PMID: 37558162 DOI: 10.1016/j.jaip.2023.07.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
Severe asthma affects about 10% of the population with asthma and is characterized by low lung function and a high count of blood leukocytes, mainly eosinophils. Various definitions are used in clinical practice and in the literature to identify asthma remission: clinical remission, inflammatory remission, and complete remission. This work highlights a consensus for asthma remission using a Delphi method. In the context of the Severe Asthma Network Italy, which accounts for 57 severe asthma centers and more than 2,200 patients, a board of six experts drafted a list of candidate statements in a questionnaire, which has been revised to minimize redundancies and ensure clear and consistent wording for the first round (R1) of the analysis. Thirty-two statements were included in the R1 questionnaire and then submitted to a panel of 80 experts, which used a 5-point Likert scale to measure agreement regarding each statement. Then, an interim analysis of R1 data was performed, and items were discussed and considered to produce a consistent questionnaire for round 2 (R2) of the analysis. Then, the board set the R2 questionnaire, which included only important topics. Panelists were asked to vote on the statements in the R2 questionnaire afterward. During R2, the criteria of complete clinical remission (the absence of the need for oral corticosteroids, symptoms, exacerbations or attacks, and pulmonary function stability) and those of partial clinical remission (the absence of the need for oral corticosteroids, and two of three criteria: the absence of symptoms, exacerbations or attacks, and pulmonary stability) were confirmed. This Severe Asthma Network Italy Delphi analysis defined a valuable and independent tool that is easy to use, to test the efficacy of different treatments in patients with severe asthma enrolled into the SANI registry.
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Affiliation(s)
- Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - Francesco Blasi
- Respiratory Unit and Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giovanna Elisiana Carpagnano
- Department of Translational Biomedicine and Neuroscience DiBraiN, University of Bari Aldo Moro, Bari, Italy; Section of Respiratory Diseases, Policlinico Hospital of Bari, Bari, Italy
| | - Giuseppe Guida
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy; Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology, and Critical Care, University of Pisa, Pisa, Italy
| | - Chiara Allegrini
- Unit Asma Grave, Ambulatorio Asma Grave Pneumologia e Fisiopatologia ToracoPolmonare, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Andrea Antonelli
- Responsabile SS Allergologia e Fisiopatologia Respiratoria, Ospedale S Croce e Carle, Cuneo, Italy
| | - Arianna Aruanno
- Allergologia dell'Istituto di Clinica Medica del Policlinico Gemelli, Università Cattolica di Roma, Rome, Italy
| | - Elena Bacci
- Fisiopatologia Respiratoria e Riabilitazione, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Diego Bagnasco
- UO Clinica Malattie Respiratorie e Allergologia, IRCCS-AOU San Martino, San Martino, Italy
| | - Bianca Beghè
- Section of Respiratory Diseases, Department of Medical and Surgical Sciences, Maternal, Infant and Adult, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
| | - Marco Bonavia
- SS Pneumologia Riabilitativa, SC Pneumologia, Dipartimento Specialità Mediche, Ospedale la Colletta, Arenzano, Genoa, Italy
| | - Matteo Bonini
- UOC Pneumologia, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy
| | - Luisa Brussino
- SSDDU Immunologia Clinica ed Allergologia, AO Mauriziano, Turin, Italy
| | - Maria Filomena Caiaffa
- Malattie Apparato Respiratorio, Dipartimenti delle funzioni Mediche e Sanitarie, Azienda Ospedaliero Universitaria, Ospedali Riuniti, Foggia, Italy
| | - Cecilia Calabrese
- UO Clinica Pneumologica SUN, Dipartimento Pneumologia ed Oncologia, Azienda Ospedaliera Specialistica dei Colli, Naples, Italy
| | - Gianna Camiciottoli
- Unit Asma Grave, Ambulatorio Asma Grave Pneumologia e Fisiopatologia ToracoPolmonare, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Marco Caminati
- USD Allergologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Cristiano Caruso
- Allergologia dell'Istituto di Clinica Medica del Policlinico Gemelli, Università Cattolica di Roma, Rome, Italy; UOSD DH Internal Medicine and Digestive Disease, Fondazione Policlinico A Gemelli IRCCS, Rome, Italy
| | - Mirta Cavallini
- Broncopneumologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Maria Elisabetta Conte
- Struttura Complessa di Pneumologia, Azienda per l'Assistenza Sanitaria n. 5 Friuli Occidentale, Pordenone, Italy
| | | | - Lorenzo Cosmi
- SOD Immunologia e Terapie Cellulari, AOUC Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Mariateresa Costantino
- Centro Day Hospital, Allergologia e Immunologia Clinica, Dipartimento Medico, Ospedale Carlo Poma, ASST-Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
| | - Giulia Costanzo
- Allergologia e Immunologia Clinica, Policlinico Universitario di Cagliari, Cagliari, Italy
| | | | - Simona D'Alò
- UO Allergologia, Azienda Sanitaria Unica Regionale Marche, Civitanova Marche, Marche, Italy
| | - Mariella D'Amato
- UOC Pneumofisiologia Università Federico II, Azienda Ospedaliera Dei Colli, Naples, Italy
| | - Aikaterini Detoraki
- UODS Allergologia ed Immunodeficienze, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | | | | | - Sebastian Ferri
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Vincenzo Fierro
- UOC Allergologia, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Maria Pia Foschino
- Malattie Apparato Respiratorio, Azienda Ospedaliera Universitaria, Foggia, Italy
| | - Manuela Latorre
- UO Pneumologia, Ospedale Nuovo Apuano di Massa, Massa, Italy
| | - Carlo Lombardi
- Unità di Allergologia, Immunologia e Malattie Respiratorie, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Luigi Macchia
- Unità Dipartimentale di Allergologia ed Immunologia Clinica, AO Universitaria Policlinico di Bari, Bari, Italy
| | - Manlio Milanese
- SC Pneumologia - Dipartimento Specialità Mediche, Ospedale S Corona, Pietra Ligure, Pietra Ligure, Savona, Italy
| | - Marcello Montagni
- Unità Dipartimentale di Allergologia, Ospedale Guglielmo da Saliceto AUSL Piacenza, Piacenza, Italy
| | | | - Roberta Parente
- UO di Diagnosi e Terapia delle Malattie Allergiche e del Sistema Immunitario, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Giovanni Passalacqua
- Clinica di Malattie Respiratorie e Allergologia, Dip. Medicina Interna, Univ degli Studi di Genova, IRCCS-AOU San Martino, San Martino, Italy
| | | | - Girolamo Pelaia
- UO Malattie dell'Apparato Respiratorio, AOU Mater Domini, Catanzaro, Italy
| | - Laura Pini
- Ambulatorio Asma Grave, UOC Medicina Generale 2, Spedali Civili di Brescia, Brescia, Italy
| | - Francesca Puggioni
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Luisa Ricciardi
- Allergologia e Immunologia Clinica, AOU Policlinico G Martino, Università di Messina, Messina, Italy
| | - Erminia Ridolo
- Ambulatorio di Allergologia ed Immunologia Clinica, UO Lungodegenza, Azienda Ospedaliero, Universitaria di Parma, Parma, Italy
| | - Joyce Rolo
- SC Pneumologia, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nicola Scichilone
- UOC Pneumologia, Azienda Ospedaliera Universitaria Policlinico P Giaccone di Palermo, Palermo, Italy
| | - Giulia Scioscia
- Malattie Apparato Respiratorio, Dipartimenti delle funzioni Mediche e Sanitarie, Azienda Ospedaliero Universitaria, Ospedali Riuniti, Foggia, Italy
| | - Gianenrico Senna
- USD Allergologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Paolo Solidoro
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gilda Varricchi
- Dipartimento di Scienze Mediche Translazionali, Centro per la Ricerca di Base ed Immunologia Clinica, Università Federico II, Naples, Italy
| | - Andrea Vianello
- UOC Fisiopaologia Respiratoria, Azienda Ospedaliera di Padova, Padua, Italy
| | - Mona Rita Yacoub
- Unità di Immunologia, Reumatologia, Allergologia e Malattie Rare, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Baoran Yang
- Centro Day Hospital, Allergologia e Immunologia Clinica, Dipartimento Medico, Ospedale Carlo Poma, ASST-Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
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2
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Islas F, Bottino R, Jimenez P, Nombela L, Marcos Alberca P, D'Amato M, Lepori A, Olmos C, Perez De Isla L, De Agustin A. Ventricular-arterial coupling in hypertensive patients after TAVR. It is not all about the valve. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In severe aortic stenosis, the left ventricle faces the challenge of the valvular load and the arterial load caused by abnormalities in systemic arterial compliance and systemic vascular resistance. The aim of this study is to assess the effect of hypertension control on left ventricular performance in patients that underwent TAVR.
Methods
68 consecutive patients who underwent TAVR were analyzed; all patients were evaluated to confirm severe aortic stenosis with transthoracic echo (TTE). Conventional echo parameters were assessed as well as left ventricular mechanics parameters and vascular parameters such as arterial elastance (Ea), ventricular elastance (Ees) and V/Ac; besides all patients underwent TTE prior to TAVR, at discharge and 90 days follow-up visit.
Results
Mean age was 82±5; mean aortic valve area was 0.69±0.19, mean left ventricular ejection fraction was 58.3±12.1 and mean ventricular-arterial coupling was 1.6±0.9. At 90 days follow up we observed a significant worsening in V/Ac in those patients with poor control of blood pressure (>140/90mmHg), (1.8±0.5 vs 2.1±0.3, p=0.03). Aortic impedance was significantly higher (4.4±1.4 vs 3.5±1.2, p=0.05); Ea and Ees were also significantly higher in hypertensive patients (2.3±0.8 vs 1.7±0.6, p=0.05) and (1.4±0.7 vs 0.9±0.6, p=0.01) respectively. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) showed a slightly reduction in hypertensive patients, although not statistically significant.
Conclusions
Control of blood pressure seems to be an important factor that contributes to a better or rather worse LV performance and could have a potential role in systolic function and clinical outcome of patients after TAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Islas
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - R Bottino
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - P Jimenez
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - L Nombela
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - P Marcos Alberca
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - M D'Amato
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - A Lepori
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - C Olmos
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - L Perez De Isla
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
| | - A De Agustin
- Hospital Clinic San Carlos, Cardiovascular Institute, Madrid, Spain
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3
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Bozzini S, Pandolfi L, Vertui V, Frangipane V, Violatto M, De Luigi A, D'Amato M, Morosini M, Bigini P, Salmona M, Meloni F. Induction of Epithelial-Mesenchymal Transition (EMT) by Neutrophil Extracellular Traps (NETs) as Possible Molecular Mechanism in CLAD. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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4
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Pandolfi L, Frangipane V, D'Amato M, Bozzini S, Viglio S, Iadarola P, De Amici M, Lettieri S, Morosini M, Meloni F. NETosis in Broncho-Alveolar Lavage-Fluid (BAL-f) from Bronchiolitis Obliterans Syndrome (BOS) Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.859] [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: 10/21/2022] Open
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5
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Liccardi G, Calzetta L, Berra A, Caiazzo R, Califano F, Ciccarelli A, Cutajar M, D'Amato M, De Bartolomeis F, Dello Iacono I, Gargano D, Lo Schiavo M, Madonna F, Maniscalco M, Milanese M, Montera C, Narducci R, Papa G, Pedicini A, Sabatino G, Sacerdoti C, Savoia A, Stanziola A, Bilò MB, Rogliani P. Unmet needs and relationship between general practitioners (GPs) and allergists living in Campania region (southern Italy). Eur Ann Allergy Clin Immunol 2020; 52:230-234. [PMID: 32374559 DOI: 10.23822/eurannaci.1764-1489.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology. Division of Pulmonology. Unit of Allergology, High Speciality A.Cardarelli Hospital, Naples, Italy.,Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine University of Rome, Tor Vergata, Rome, Italy
| | - A Berra
- Respiratory Allergy Unit. G. Da Procida Hospital, Salerno, Italy
| | - R Caiazzo
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - F Califano
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico Loreto Crispi Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine. Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Disease, Federico II University AO Dei Colli, Naples, Italy
| | - F De Bartolomeis
- Allergy Unit. High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - I Dello Iacono
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - D Gargano
- Allergy Unit. High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit. ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit ICS Maugeri Telese Terme, Benevento, Italy
| | - M Milanese
- Division of Pulmonology, S.Corona Hospital, Pietra Ligure, Savona, Italy
| | - C Montera
- Allergy and Clinical Immunology, G. Fucito, Hospital and University Hospital, Salerno, Italy
| | - R Narducci
- Unit of Allergology, San Michele Clinic, Maddaloni, Caserta, Italy
| | - G Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | | | | | - A Savoia
- Unit of Allergology. Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - A Stanziola
- Department of Respiratory Disease, Federico II University AO Dei Colli, Naples, Italy
| | - M B Bilò
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine University of Rome, Tor Vergata, Rome, Italy
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6
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Carone M, Pennisi A, D'Amato M, Donati AF, Ricci A, Scognamillo C, Chun L, Aliani M, Ronsivalle V, Pelaia G. Physical Functioning in Patients with Chronic Obstructive Pulmonary Disease Treated with Tiotropium/Olodaterol Respimat in Routine Clinical Practice in Italy. Pulm Ther 2020; 6:261-274. [PMID: 32557394 PMCID: PMC7672142 DOI: 10.1007/s41030-020-00122-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction Clinical studies have shown significant improvements in exercise capacity in patients with chronic obstructive pulmonary disease (COPD) who are treated with a tiotropium/olodaterol fixed-dose combination (FDC). However, the effects of this treatment, which is administered in a single device, on physical functioning in a real-life setting of patients with COPD had not been fully determined. Methods An open-label, observational study was conducted in 309 patients with COPD from 29 sites across Italy who received tiotropium/olodaterol FDC for 6 weeks. Physical functioning was evaluated using the Physical Functioning Questionnaire (PF-10). The primary endpoint was the proportion of patients with therapeutic success, defined as a ten-point increase in the PF-10 score from the baseline visit. Secondary endpoints were absolute changes in PF-10 score from baseline visit, the patient’s general condition assessed by the Physician’s Global Evaluation (PGE) score, and patient satisfaction with treatment, inhaling and handling of the device. Results According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) multimodality assessment, most patients were allocated to groups B (44.4%) and D (24.5%). Comorbidities were present in 73.9% of the patients. The primary endpoint was reached in more than half of the patients (52.5%), especially in groups B and D of GOLD. Patients’ satisfaction with treatment, inhaling and handling of device was high, with a range of more than 86% to more than 89%, and very high in both groups B and D. The rates of drug-related adverse events were very low. Conclusions This real-life study showed that the tiotropium/olodaterol FDC treatment delivered via the Respimat device improves physical functioning and general patients’ condition and is associated with a high degree of satisfaction and very low rates of drug-related adverse events, regardless of the group they belong to and their comorbidities. Clinical Trial ID NCT03003494. Electronic supplementary material The online version of this article (10.1007/s41030-020-00122-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mauro Carone
- Division of Pneumology, Istituti Clinici Scientifici Maugeri IRCCS, Via Salvatore Maugeri, 4, 27100, Pavia, Italy.
| | - Alfio Pennisi
- Department of Pneumology, Casa Di Cura Mons. Calaciuria, Catania, Italy
| | | | | | - Alberto Ricci
- Department of Pneumology, Azienda Ospedaliera Sant'Andrea, Roma, Italy
| | | | - Li Chun
- Boehringer-Ingelheim, Ridgefield, CT, USA
| | - Maria Aliani
- Division of Pneumology, Istituti Clinici Scientifici Maugeri IRCCS, Via Salvatore Maugeri, 4, 27100, Pavia, Italy
| | | | - Girolamo Pelaia
- Department of Scienze Mediche E Chirurgiche, Università "Magna Grecia", Catanzaro, Italy
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7
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Braido F, Baiardini I, Ferrando M, Scichilone N, Santus P, Petrone A, Di Marco F, Corsico AG, Zanforlin A, Milanese M, Steinhilber G, Bonavia M, Pirina P, Micheletto C, D'Amato M, Lacedonia D, Benassi F, Propati A, Ruggeri P, Tursi F, Bocchino ML, Patella V, Canonica GW, Blasi F. The prevalence of sleep impairments and predictors of sleep quality among patients with asthma. J Asthma 2020; 58:481-487. [PMID: 31903810 DOI: 10.1080/02770903.2019.1711391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sleep is a significant dimension of daily life. However, only a few studies have examined the sleep quality of asthmatics in a real-world clinical settings. OBJECTIVE This study is aimed to estimate the prevalence of sleep impairments among asthmatic patients and examine the relationship between sleep quality, asthma control, rhinitis symptoms, and sociodemographic characteristics. METHODS The present study adopted the observational cross-sectional research design that has been designed by the Italian Respiratory Society and used valid assessments to measure the study variables. RESULTS Data from 1150 asthmatic patients (mean age 51.01 years ± 16.03) were subjected to analysis. 58.3% of the patients had impaired sleep quality (Pittsburgh Sleep Quality Index [PSQI] total scores > 5), and their mean PSQI score was 5.68 (SD = 3.4). A significant correlation emerged between sleep quality and asthma control (p = 0.0001) and a significant albeit weak correlation emerged between PSQI total scores and Total 5 Symptoms Score (r = 0.24, p = 0.0001). Sleep quality was significantly associated health-related quality of life [HRQoL]. (r = 0.50, p < 0.001). After exclusion of patients at risk for Obstructive Sleep Apnea Syndrome (OSAS) and Gastro Esophageal Reflux Disease (GERD), the most important determinants of PSQI score were HRQoL, In the entire sample asthma control is the strongest predictor of both sleep quality and HRQoL. CONCLUSIONS The results of this real-world study highlight the prevalence, impact and predictors of sleep disturbances in asthmatic patients and suggest the need for physicians to detect poor sleep quality.
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Affiliation(s)
- F Braido
- Dipartimento di Medicina Interna (DiMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - I Baiardini
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - M Ferrando
- Dipartimento di Medicina Interna (DiMI), University of Genoa, Genoa, Italy
| | - N Scichilone
- Scichilone N. PROMISE Department, AOUP University Hospital, University of Palermo, Palermo, Italy
| | - P Santus
- Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Division of Respiratory Diseases, L. Sacco University Hospital, Milano, Italy
| | - A Petrone
- UOC Pneumologia, Presidio Ospedaliero, Santa Barbaral, Rogliano, Italy
| | - F Di Marco
- Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - A G Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - A Zanforlin
- Medicina Interna, Ospedale di Bolzano, Bolzano, Italy
| | - M Milanese
- SSD Pneumologia ASL2 Savonese, Ospedale S. Corona, Pietra Ligure, Italy
| | - G Steinhilber
- Pneumology Unit, Spedali Civili di Brescia, Brescia, Italy
| | - M Bonavia
- Pneumologia, Ospedale La Colletta, Arenzano, Italy
| | - P Pirina
- Respiratory Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - C Micheletto
- UOC di Pneumologia Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - M D'Amato
- Malattie Respiratorie "Federico II"- AO "Dei Colli", Napoli, Italy
| | - D Lacedonia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - F Benassi
- Dipartimento di Malattie Polmonari UOSD Insufficienza respiratoria e riabilitazione, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | - A Propati
- Unità Operativa Pneumologia, Ospedale C, Forlanini, Roma, Italy
| | - P Ruggeri
- Unità Operativa Complessa di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy
| | - F Tursi
- USS Servizio di pneumologia di Codogno, ASST di Lodi, Lodi, Italy
| | - M L Bocchino
- UOC Pneumotisioligia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - V Patella
- Division of Respiratory Allergy, Santa Maria della Speranza Hospital, Salerno, Italy.,Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - G W Canonica
- Personalized Medicine, Asthma and Allergy - Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy
| | - F Blasi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
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8
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Rovati LC, Brambilla N, Blicharski T, Connell J, Vitalini C, Bonazzi A, Giacovelli G, Girolami F, D'Amato M. Efficacy and safety of the first-in-class imidazoline-2 receptor ligand CR4056 in pain from knee osteoarthritis and disease phenotypes: a randomized, double-blind, placebo-controlled phase 2 trial. Osteoarthritis Cartilage 2020; 28:22-30. [PMID: 31526875 DOI: 10.1016/j.joca.2019.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 08/09/2019] [Accepted: 09/01/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE CR4056 is a selective imidazoline-2 (I2) receptor ligand with potent analgesic activity in animal pain models. This proof-of-concept study tested CR4056 efficacy and safety in patients with knee osteoarthritis (OA) and different phenotypes. DESIGN This is a multicenter, randomized, double-blind, placebo-controlled trial. Knee OA patients with moderate to severe pain received CR4056 (women 100 mg bid; men 200 mg bid) or placebo (both genders) for 14 days. The primary outcome was the change in WOMAC pain score (0-100 scale) compared to placebo, analyzed in the intention-to-treat population and pre-defined OA phenotypes. RESULTS 213 patients were treated with CR4056 (92 women; 52 men) or placebo (69 overall). After 14 days, median WOMAC pain improvements were 10 points on placebo and 14, 20 and 16 in women, men, and pooled CR4056 groups (P = 0.184, 0.030 and 0.070 vs placebo, respectively). Pre-specified subgroup analysis in the metabolic OA phenotype (BMI ≥ 27.5 kg/m2, N = 156) showed statistically significant differences in all CR4056-treated groups vs placebo of 12-18 points. Conversely, there were too few patients with a neuropathic or inflammatory phenotype for a meaningful analysis. CR4056 was well tolerated; the most common adverse event was mild headache. CONCLUSIONS Although the primary endpoint was met in males only, this exploratory phase 2 trial shows that CR4056 might be an effective analgesic against knee OA pain, especially in overweight patients representing the metabolic OA phenotype. These findings, along with the broad-spectrum analgesic activity of CR4056 in animal models, warrant further clinical investigation in OA and other pain conditions. CLINICAL TRIAL REGISTRATION NUMBER EudraCT 2015-001136-37.
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Affiliation(s)
- L C Rovati
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | - N Brambilla
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | | | - J Connell
- MAC Clinical Research, Manchester, UK.
| | - C Vitalini
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | - A Bonazzi
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | - G Giacovelli
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | - F Girolami
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
| | - M D'Amato
- Rottapharm Biotech, Via Valosa di Sopra 9, I-20900, Monza, MB, Italy.
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9
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Lombardi C, Bagnasco D, Caruso C, D'Amato M, Menzella F, Milanese M, Senna G, Canonica GW, Passalacqua G. Analysis of the drop-out rate in patients receiving mepolizumab for severe asthma in real life. Pulm Pharmacol Ther 2018; 54:87-89. [PMID: 30597278 DOI: 10.1016/j.pupt.2018.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 11/24/2022]
Abstract
Mepolizumab (anti IL-5, monoclonal antibody) is commercially available in Italy since more than one year for the treatment of severe hypereosinophilic asthma. Its efficacy and safety were evaluated in several regulatory trials. The characteristics of this drug in real life began to be assessed only recently. We describe herein the drop-out rate observed with mepolizumab in real life, because this datum can indirectly reflect the safety and tolerability aspects. The demographic and clinical data of patients receiving mepolizumab for severe asthma were collected, and the number and reasons for discontinuation of the treatment were analyzed. The database involves 143 patients (67 male, age range 19-80 year) who received at least one dose of mepolizumab. The observed discontinuation rate was 6/143 (4.2%). Five out of 6 discontinuations were due to lack of response, and one was an adverse event (urticaria) probably related to the treatment. There was no clinical difference between the drop-out group and the patients still ongoing. As compared to the clinical trials published the discontinuation rate was lower in our population, especially for adverse events (7% vs 23.7%). Thus, the tolerability of mepolizumab, as derived from discontinuations, seems to be better in real-life than in clinical trials.
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Affiliation(s)
- Carlo Lombardi
- Departmental Unit of Allergology & Pneumology, Fondazione Poliambulanza Hospital, Brescia, Italy
| | - Diego Bagnasco
- Allergy & Respiratory Diseases, University of Genoa, Genoa, Italy.
| | - Cristiano Caruso
- Allergy Unit, Fondazione Policlinico A. Gemelli, IRCSS, Rome Ital
| | - Mariella D'Amato
- Department of Pneumology, "Federico II University", AO "Dei Colli" Monaldi Hospital, Naples, Italy
| | - Francesco Menzella
- Unità Operativa di Pneumologia, Arcispedale Santa Maria Nuova, Azienda Ospedaliera di Reggio Emilia, Italy
| | | | - Gianenrico Senna
- Servizio di Allergologia, Ente Ospedaliero-Universitario di Verona, Italy
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10
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Bonfiglio F, Henström M, Nag A, Hadizadeh F, Zheng T, Cenit MC, Tigchelaar E, Williams F, Reznichenko A, Ek WE, Rivera NV, Homuth G, Aghdassi AA, Kacprowski T, Männikkö M, Karhunen V, Bujanda L, Rafter J, Wijmenga C, Ronkainen J, Hysi P, Zhernakova A, D'Amato M. A GWAS meta-analysis from 5 population-based cohorts implicates ion channel genes in the pathogenesis of irritable bowel syndrome. Neurogastroenterol Motil 2018; 30:e13358. [PMID: 29673008 DOI: 10.1111/nmo.13358] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/23/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) shows genetic predisposition, however, large-scale, powered gene mapping studies are lacking. We sought to exploit existing genetic (genotype) and epidemiological (questionnaire) data from a series of population-based cohorts for IBS genome-wide association studies (GWAS) and their meta-analysis. METHODS Based on questionnaire data compatible with Rome III Criteria, we identified a total of 1335 IBS cases and 9768 asymptomatic individuals from 5 independent European genotyped cohorts. Individual GWAS were carried out with sex-adjusted logistic regression under an additive model, followed by meta-analysis using the inverse variance method. Functional annotation of significant results was obtained via a computational pipeline exploiting ontology and interaction networks, and tissue-specific and gene set enrichment analyses. KEY RESULTS Suggestive GWAS signals (P ≤ 5.0 × 10-6 ) were detected for 7 genomic regions, harboring 64 gene candidates to affect IBS risk via functional or expression changes. Functional annotation of this gene set convincingly (best FDR-corrected P = 3.1 × 10-10 ) highlighted regulation of ion channel activity as the most plausible pathway affecting IBS risk. CONCLUSION & INFERENCES Our results confirm the feasibility of population-based studies for gene-discovery efforts in IBS, identify risk genes and loci to be prioritized in independent follow-ups, and pinpoint ion channels as important players and potential therapeutic targets warranting further investigation.
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Affiliation(s)
- F Bonfiglio
- Department of Gastrointestinal and Liver Diseases, Biodonostia Health Research Institute, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - M Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - A Nag
- Department of Twin Research & Genetic Epidemiology, King's College London, London, England
| | - F Hadizadeh
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - T Zheng
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - M C Cenit
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - E Tigchelaar
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - F Williams
- Department of Twin Research & Genetic Epidemiology, King's College London, London, England
| | - A Reznichenko
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - W E Ek
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - N V Rivera
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - G Homuth
- Department of Functional Genomics, Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - A A Aghdassi
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - T Kacprowski
- Department of Functional Genomics, Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - M Männikkö
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - V Karhunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland.,Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - L Bujanda
- Department of Gastrointestinal and Liver Diseases, Biodonostia Health Research Institute, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco (UPV/EHU), San Sebastián, Spain
| | - J Rafter
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - C Wijmenga
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - J Ronkainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Primary Health Care Center, Tornio, Finland
| | - P Hysi
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, London, UK
| | - A Zhernakova
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - M D'Amato
- Department of Gastrointestinal and Liver Diseases, Biodonostia Health Research Institute, Spain.,Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,BioCruces Health Research Institute, Bilbao, Spain.,IKERBASQUE, Basque Science Foundation, Bilbao, Spain
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11
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Liccardi G, Calzetta L, Apicella G, Baldi G, Berra A, Califano F, Ciccarelli A, Cutajar M, D'Amato M, De Crescenzo G, Di Maro E, Gargano D, Giannattasio D, Inciso G, Lo Schiavo M, Madonna F, Maniscalco M, Montera C, Papa G, Pedicini A, Pio R, Salzillo A, Stanziola A, Rogliani P, Musarra A. Allergy in adolescent population (14-18 years) living in Campania region (Southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2018; 51. [PMID: 30066997 DOI: 10.23822/eurannaci.1764-1489.65] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Adolescents (Ad) constitute a difficult to manage population among individuals suffering from asthma. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic Ad living in the Campania region (Southern Italy). Sixteen Allergy units or Centers belonging to the Italian Association of Hospital and Territorial Allergologists (AAIITO, Campania region) participated in this cross-sectional study. A case report form (CRF) was specifically designed for this study and commercial allergen extracts used for screening SPTs were provided by ALK-Abelló Group (Milan, Italy). A total of 443 patients were examined (females, f 220, 49.6 %; males, m 223, 50.3%). Dust mites represent the most common sensitizing agents in allergic Ad living in Campania region (Dermatoph. pteronyssinus 67.4% and Dermatoph. farinae 66.5%), followed by Parietaria (58.9%), grasses (45.8%), Artemisia vulgaris (16.7%), Olea Europaea (32.2%), dog dander (17.1%), cat dander (20.0%), Alternaria alternata (8.1%), Cupressus sempervirens (4.9%), Betula pendula (4.7%), other allergens (19.4%). An interesting comparison has been made between clinical data of our Ad with data of elderly patients (E). The role of allergic sensitization is significantly higher in Ad compared to E. Dermatophagoides pteronyssinus is the first sensitizing allergen in Ad and the last in E. Parietaria constitutes the first sensitizing pollen both in Ad and E, the percentage of sensitization is higher in Ad. Another important difference is the higher prevalence of As, as only symptom, in E compared to Ad (19.7% versus 7.6%). In conclusion, our findings confirm the high prevalence and clinical significance of airway allergic sensitization in the adolescents living in Campania region.
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Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy.,Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Apicella
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit. G. Da Procida Hospital, Salerno, Italy
| | - F Califano
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico Loreto Crispi Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento (NA), Italy
| | - M D'Amato
- Department of Respiratory Disease, Federico II University, AO Dei Colli, Naples, Italy
| | - G De Crescenzo
- Allergy and Clinical Immunology Unit, High Speciality Sant'Anna and San Sebastiano Hospital, Caserta, Italy
| | - E Di Maro
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center Mauro Scarlato Hospital, Scafati (SA), Italy
| | - G Inciso
- Allergy Unit, ASL Na 3 (Sanitary District 59), Meta di Sorrento (NA), Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District 12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit ICS Maugeri, Telese Terme, Benevento, Italy
| | - C Montera
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - G Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Allergology Unit, Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Salzillo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Disease, Federico II University, AO Dei Colli, Naples, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine. Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - A Musarra
- Allergy Unit, National Healthcare System, Reggio Calabria, Italy
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12
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Liccardi G, Calzetta L, Baldi G, Berra A, Billeri L, Caminati M, Capano P, Carpentieri E, Ciccarelli A, Crivellaro MA, Cutajar M, D'Amato M, Folletti I, Gani F, Gargano D, Giannattasio D, Giovannini M, Lombardi C, Schiavo ML, Madonna F, Maniscalco M, Meriggi A, Micucci C, Milanese M, Montera C, Paolocci G, Parente R, Pedicini A, Pio R, Puggioni F, Russo M, Salzillo A, Scavalli P, Scichilone N, Sposato B, Stanziola A, Steinhilber G, Vatrella A, Rogliani P, Passalacqua G. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study. Clin Mol Allergy 2018. [PMID: 29434523 DOI: 10.1186/s12948-018-0081-z.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The query "are there animals at home?" is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150-20.75%) or indirect contact (103-14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions Only 213 patients (29.46%) would be classified as "exposed to animals" and 510 (70.54%) as "not exposed" according to usual query. Our classification has shown that many "not-exposed" subjects (399-55.19%) were "really exposed". The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.
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Affiliation(s)
- G Liccardi
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.,2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - L Calzetta
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - L Billeri
- 6Department of Laboratory Medicine, University Hospital Padova, Padua, Italy
| | - M Caminati
- 7Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - P Capano
- Unit of Pulmonary Immunology and Respiratory Diseases Ospedale "Santa Maria Della Speranza", Battipaglia, Salerno Italy
| | - E Carpentieri
- Division of Pneumology, "Santa Maria Novella" Hospital, Galatina, Lecce Italy
| | - A Ciccarelli
- Allergy Unit, Loreto Crispi Hospital, Naples, Italy
| | - M A Crivellaro
- 11Unit of Allergy and Occupational Medicine, University Hospital Padova, Padua, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - I Folletti
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - F Gani
- Allergy Unit, S. Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - D Gargano
- 16Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - M Giovannini
- Pulmonary Diseases Department, Mirandola Hospital, Modena, Italy
| | - C Lombardi
- 19Departmental Unit of Allergy, Clinical Immunology and Respiratory Diseases, Fondazione Poliambulanza, Brescia, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri, Telese Terme, Benevento Italy
| | - A Meriggi
- 23Allergy and Immunology Unit, Fondazione "Salvatore Maugeri", Institut of Research and Care, Scientific Institute of Pavia, Pavia, Italy
| | - C Micucci
- Division of Pneumology and Allergology Hospital "Carlo Urbani", Jesi, Ancona Italy
| | - M Milanese
- 25Division of Pneumology, S. Corona Hospital, Pietra Ligure, Savona Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - G Paolocci
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - R Parente
- 26Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Pedicini
- 27Division of Internal Medicine and Allergy, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Puggioni
- Respiratory Diseases Department-IRCCS Humanitas Research and Clinical Center, Rozzano, Milan, Italy
| | - M Russo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - P Scavalli
- Unit of Respiratory Physiopathology, Allergy and Occupational Medicine, ASL Viterbo, Viterbo, Italy
| | - N Scichilone
- 30Biomedical Department of Specialistic and Internal Medicine, University of Palermo, Palermo, Italy
| | - B Sposato
- Pneumology Unit, Azienda Ospedaliera "Misericordia", Grosseto, Italy
| | - A Stanziola
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G Steinhilber
- 32Division of Pneumology, Spedali Civili Brescia, Brescia, Italy
| | - A Vatrella
- 33Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - P Rogliani
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Passalacqua
- 34Allergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Genoa, Italy
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13
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Liccardi G, Calzetta L, Baldi G, Berra A, Billeri L, Caminati M, Capano P, Carpentieri E, Ciccarelli A, Crivellaro MA, Cutajar M, D'Amato M, Folletti I, Gani F, Gargano D, Giannattasio D, Giovannini M, Lombardi C, Schiavo ML, Madonna F, Maniscalco M, Meriggi A, Micucci C, Milanese M, Montera C, Paolocci G, Parente R, Pedicini A, Pio R, Puggioni F, Russo M, Salzillo A, Scavalli P, Scichilone N, Sposato B, Stanziola A, Steinhilber G, Vatrella A, Rogliani P, Passalacqua G. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study. Clin Mol Allergy 2018; 16:3. [PMID: 29434523 PMCID: PMC5796344 DOI: 10.1186/s12948-018-0081-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/22/2018] [Indexed: 12/28/2022] Open
Abstract
Background The query “are there animals at home?” is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150–20.75%) or indirect contact (103–14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions Only 213 patients (29.46%) would be classified as “exposed to animals” and 510 (70.54%) as “not exposed” according to usual query. Our classification has shown that many “not-exposed” subjects (399–55.19%) were “really exposed”. The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.
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Affiliation(s)
- G Liccardi
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.,2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - L Calzetta
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - L Billeri
- 6Department of Laboratory Medicine, University Hospital Padova, Padua, Italy
| | - M Caminati
- 7Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy
| | - P Capano
- Unit of Pulmonary Immunology and Respiratory Diseases Ospedale "Santa Maria Della Speranza", Battipaglia, Salerno Italy
| | - E Carpentieri
- Division of Pneumology, "Santa Maria Novella" Hospital, Galatina, Lecce Italy
| | - A Ciccarelli
- Allergy Unit, Loreto Crispi Hospital, Naples, Italy
| | - M A Crivellaro
- 11Unit of Allergy and Occupational Medicine, University Hospital Padova, Padua, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - I Folletti
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - F Gani
- Allergy Unit, S. Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - D Gargano
- 16Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory Physiopathology and Allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - M Giovannini
- Pulmonary Diseases Department, Mirandola Hospital, Modena, Italy
| | - C Lombardi
- 19Departmental Unit of Allergy, Clinical Immunology and Respiratory Diseases, Fondazione Poliambulanza, Brescia, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M Maniscalco
- Pulmonary Rehabilitation Unit, ICS Maugeri, Telese Terme, Benevento Italy
| | - A Meriggi
- 23Allergy and Immunology Unit, Fondazione "Salvatore Maugeri", Institut of Research and Care, Scientific Institute of Pavia, Pavia, Italy
| | - C Micucci
- Division of Pneumology and Allergology Hospital "Carlo Urbani", Jesi, Ancona Italy
| | - M Milanese
- 25Division of Pneumology, S. Corona Hospital, Pietra Ligure, Savona Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - G Paolocci
- 14Department of Medicine, Section of Occupational Medicine, Respiratory Diseases and Toxicology, Terni Hospital, University of Perugia, Perugia, Italy
| | - R Parente
- 26Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Pedicini
- 27Division of Internal Medicine and Allergy, Fatebenefratelli Hospital, Benevento, Italy
| | - R Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital, S. Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - F Puggioni
- Respiratory Diseases Department-IRCCS Humanitas Research and Clinical Center, Rozzano, Milan, Italy
| | - M Russo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- 1Department of Pulmonology, Haematology and Oncology. Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - P Scavalli
- Unit of Respiratory Physiopathology, Allergy and Occupational Medicine, ASL Viterbo, Viterbo, Italy
| | - N Scichilone
- 30Biomedical Department of Specialistic and Internal Medicine, University of Palermo, Palermo, Italy
| | - B Sposato
- Pneumology Unit, Azienda Ospedaliera "Misericordia", Grosseto, Italy
| | - A Stanziola
- 13Department of Respiratory Disease, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G Steinhilber
- 32Division of Pneumology, Spedali Civili Brescia, Brescia, Italy
| | - A Vatrella
- 33Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - P Rogliani
- 2Postgraduate School of Respiratory Medicine. Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.,3Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - G Passalacqua
- 34Allergy and Respiratory Diseases, Policlinico San Martino, University of Genoa, Genoa, Italy
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14
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Merino-Azpitarte M, Lozano E, Perugorria MJ, Esparza-Baquer A, Erice O, Santos-Laso A, O'Rourke CJ, Andersen JB, Jiménez-Agüero R, Lacasta A, D'Amato M, Briz O, Jalan-Sakrikar N, Huebert RC, Thelen KM, Gradilone SA, Aransay AM, Lavín JL, Fernández-Barrena MG, Matheu A, Marzioni M, Gores GJ, Bujanda L, Marin JJG, Banales JM. SOX17 regulates cholangiocyte differentiation and acts as a tumor suppressor in cholangiocarcinoma. J Hepatol 2017; 67:72-83. [PMID: 28237397 PMCID: PMC5502751 DOI: 10.1016/j.jhep.2017.02.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [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: 08/28/2016] [Revised: 01/25/2017] [Accepted: 02/14/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Cholangiocarcinoma (CCA) is a biliary malignancy linked to genetic and epigenetic abnormalities, such as hypermethylation of SOX17 promoter. Here, the role of SOX17 in cholangiocyte differentiation and cholangiocarcinogenesis was studied. METHODS SOX17 expression/function was evaluated along the differentiation of human induced pluripotent stem cells (iPSC) into cholangiocytes, in the dedifferentiation process of normal human cholangiocytes (NHC) in culture and in cholangiocarcinogenesis. Lentiviruses for SOX17 overexpression or knockdown were used. Gene expression and DNA methylation profiling were performed. RESULTS SOX17 expression is induced in the last stage of cholangiocyte differentiation from iPSC and regulates the acquisition of biliary markers. SOX17 becomes downregulated in NHC undergoing dedifferentiation; experimental SOX17 knockdown in differentiated NHC downregulated biliary markers and promoted baseline and Wnt-dependent proliferation. SOX17 expression is lower in human CCA than in healthy tissue, which correlates with worse survival after tumor resection. In CCA cells, SOX17 overexpression decreased their tumorigenic capacity in murine xenograft models, which was related to increased oxidative stress and apoptosis. In contrast, SOX17 overexpression in NHC did not affect their survival but inhibited their baseline proliferation. In CCA cells, SOX17 inhibited migration, anchorage-independent growth and Wnt/β-catenin-dependent proliferation, and restored the expression of biliary markers and primary cilium length. In human CCA, SOX17 promoter was found hypermethylated and its expression inversely correlates with the methylation grade. In NHC, Wnt3a decreased SOX17 expression in a DNMT-dependent manner, whereas in CCA, DNMT1 inhibition or silencing upregulated SOX17. CONCLUSIONS SOX17 regulates the differentiation and maintenance of the biliary phenotype and functions as a tumor suppressor for CCA, being a potential prognostic marker and a promising therapeutic target. LAY SUMMARY Understanding the molecular mechanisms involved in the pathogenesis of CCA is key in finding new valuable diagnostic and prognostic biomarkers, as well as therapeutic targets. This study provides evidence that SOX17 regulates the differentiation and maintenance of the biliary phenotype, and its downregulation promotes their tumorigenic transformation. SOX17 acts as a tumor suppressor in CCA and its genetic, molecular and/or pharmacological restoration may represent a new promising therapeutic strategy. Moreover, SOX17 expression correlates with the outcome of patients after tumor resection, being a potential prognostic biomarker.
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Affiliation(s)
- M Merino-Azpitarte
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - E Lozano
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain,Experimental Hepatology and Drug Targeting (HEVEFARM), Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain
| | - MJ Perugorria
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain,IKERBASQUE, Basque Foundation for Science, University of Copenhagen, Copenhagen, Denmark
| | - A Esparza-Baquer
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - O Erice
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - A Santos-Laso
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - CJ O'Rourke
- Biotech Research and Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - JB Andersen
- Biotech Research and Innovation Centre, Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R Jiménez-Agüero
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - A Lacasta
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - M D'Amato
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain,IKERBASQUE, Basque Foundation for Science, University of Copenhagen, Copenhagen, Denmark
| | - O Briz
- Experimental Hepatology and Drug Targeting (HEVEFARM), Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain
| | - N Jalan-Sakrikar
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - RC Huebert
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - KM Thelen
- The Hormel Institute, University of Minnesota, Austin, MN, USA
| | - SA Gradilone
- The Hormel Institute, University of Minnesota, Austin, MN, USA
| | - AM Aransay
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain,Genome Analysis Platform, CIC bioGUNE, Bizkaia Technology Park, Derio, Spain
| | - JL Lavín
- Genome Analysis Platform, CIC bioGUNE, Bizkaia Technology Park, Derio, Spain
| | | | - A Matheu
- IKERBASQUE, Basque Foundation for Science, University of Copenhagen, Copenhagen, Denmark,Neuro-Oncology Group, Biodonostia Research Institute – Donostia University Hospital –, San Sebastian, Spain
| | - M Marzioni
- Department of Gastroenterology, “Università Politecnica delle Marche”, Ancona, Italy
| | - GJ Gores
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - L Bujanda
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain
| | - JJG Marin
- Experimental Hepatology and Drug Targeting (HEVEFARM), Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain
| | - JM Banales
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute – Donostia University Hospital –, University of the Basque Country (UPV/EHU), San Sebastian, Spain,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Spain,IKERBASQUE, Basque Foundation for Science, University of Copenhagen, Copenhagen, Denmark
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15
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Bonfiglio F, Hysi PG, Ek W, Karhunen V, Rivera NV, Männikkö M, Nordenstedt H, Zucchelli M, Bresso F, Williams F, Tornblom H, Magnusson PK, Pedersen NL, Ronkainen J, Schmidt PT, D'Amato M. A meta-analysis of reflux genome-wide association studies in 6750 Northern Europeans from the general population. Neurogastroenterol Motil 2017; 29. [PMID: 27485664 DOI: 10.1111/nmo.12923] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 04/25/2016] [Accepted: 07/18/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD), the regurgitation of gastric acids often accompanied by heartburn, affects up to 20% of the general population. Genetic predisposition is suspected from twin and family studies but gene-hunting efforts have so far been scarce and no conclusive genome-wide study has been reported. We exploited data available from general population samples, and studied self-reported reflux symptoms in relation to genome-wide single nucleotide polymorphism (SNP) genotypes. METHODS We performed a GWAS meta-analysis of three independent population-based cohorts from Sweden, Finland, and UK. GERD cases (n=2247) and asymptomatic controls (n=4503) were identified using questionnaire-derived symptom data. Upon stringent quality controls, genotype data for more than 2.5M markers were used for association testing. Bioinformatic characterization of genomic regions associated with GERD included gene-set enrichment analysis (GSEA), in silico prediction of genetic risk effects on gene expression, and computational analysis of drug-induced gene expression signatures using Connectivity Map (cMap). KEY RESULTS We identified 30 GERD suggestive risk loci (P≤5×10-5 ), with concordant risk effects in all cohorts, and predicted functional effects on gene expression in relevant tissues. GSEA revealed involvement of GERD risk genes in biological processes associated with the regulation of ion channel and cell adhesion. From cMap analysis, omeprazole had significant effects on GERD risk gene expression, while antituberculosis and anti-inflammatory drugs scored highest among the repurposed compounds. CONCLUSIONS We report a large-scale genetic study of GERD, and highlight genes and pathways that contribute to further our understanding of its pathogenesis and therapeutic opportunities.
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Affiliation(s)
- F Bonfiglio
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - P G Hysi
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, London, UK
| | - W Ek
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - V Karhunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Oulu University Hospital, Oulu, Finland
| | - N V Rivera
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - M Männikkö
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - H Nordenstedt
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - M Zucchelli
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - F Bresso
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - F Williams
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | - H Tornblom
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - J Ronkainen
- Primary Health Care Centre, Tornio, Finland.,Center for Family Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P T Schmidt
- Department of Medicine Solna, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - M D'Amato
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,BioCruces Health Research Institute and Ikerbasque, Basque Foundation for Science, Bilbao, Spain
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16
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D'Amato G, Vitale C, D'Amato M, Cecchi L, Liccardi G, Molino A, Vatrella A, Sanduzzi A, Maesano C, Annesi-Maesano I. Thunderstorm-related asthma: what happens and why. Clin Exp Allergy 2016; 46:390-6. [PMID: 26765082 DOI: 10.1111/cea.12709] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 12/21/2015] [Accepted: 01/05/2016] [Indexed: 01/07/2023]
Abstract
The fifth report issued by the Intergovernmental Panel on Climate Change forecasts that greenhouse gases will increase the global temperature as well as the frequency of extreme weather phenomena. An increasing body of evidence shows the occurrence of severe asthma epidemics during thunderstorms in the pollen season, in various geographical zones. The main hypotheses explaining association between thunderstorms and asthma claim that thunderstorms can concentrate pollen grains at ground level which may then release allergenic particles of respirable size in the atmosphere after their rupture by osmotic shock. During the first 20-30 min of a thunderstorm, patients suffering from pollen allergies may inhale a high concentration of the allergenic material that is dispersed into the atmosphere, which in turn can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack. All subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe exacerbations. In light of these observations, it is useful to predict thunderstorms and thus minimize thunderstorm-related events.
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Affiliation(s)
- G D'Amato
- Division of Respiratory and Allergic Diseases, Department of Chest Diseases, High Speciality A. Cardarelli Hospital, Napoli, Italy
| | - C Vitale
- First Division of Pneumology, High Speciality Hospital 'V. Monaldi' and University 'Federico II' Medical School Naples, Napoli, Italy
| | - M D'Amato
- First Division of Pneumology, High Speciality Hospital 'V. Monaldi' and University 'Federico II' Medical School Naples, Napoli, Italy
| | - L Cecchi
- University of Florence, Florence, Italy.,Allergy and Clinical Immunology Section, Azienda Sanitaria di Prato, Prato, Italy
| | - G Liccardi
- Division of Respiratory and Allergic Diseases, Department of Chest Diseases, High Speciality A. Cardarelli Hospital, Napoli, Italy
| | - A Molino
- First Division of Pneumology, High Speciality Hospital 'V. Monaldi' and University 'Federico II' Medical School Naples, Napoli, Italy
| | - A Vatrella
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Sanduzzi
- First Division of Pneumology, High Speciality Hospital 'V. Monaldi' and University 'Federico II' Medical School Naples, Napoli, Italy
| | - C Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), UPMC Univ Paris 06, INSERM, Saint-Antoine Medical School, Sorbonne Universités, Paris, France
| | - I Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), UPMC Univ Paris 06, INSERM, Saint-Antoine Medical School, Sorbonne Universités, Paris, France
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17
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Liccardi G, Baldi G, Berra A, Ciccarelli A, Cutajar M, D'Amato M, D'Angelo R, Gargano D, Giannattasio D, Leone G, Lo Schiavo M, Madonna F, Montera C, Monti R, Parente R, Pedicini A, Pio A, Russo M, Salzillo A, Stanziola A, Vatrella A, Manzi F, Bilò MB. Allergy in urban elderly population living in Campania region (Southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2016; 48:156-160. [PMID: 27425174] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Given the increasing life expectancy observed in Western countries, there is a marked interest to know more about how aging could influence respiratory health. The aim of our study was to assess the prevalence, clinical characteristics and age of onset of allergic sensitization and clinical symptoms in a sample of atopic elders living in Campania region area (Southern Italy). Fourteen Allergy units or Centres examined a total of 462 patients. In this context 215 (46.53%) had positive skin prick tests (SPTs) to at least one allergen and were diagnosed with respiratory allergy. Parietaria represents the most common sensitizing agent in elders living in Campania region, followed by dust mites, grass pollen and Olea europaea. A relatively high percentage of atopic subjects suffered from respiratory symptoms at a fairly advanced age, namely 8.3% at 60-64 years, 10.2% at 65-70 and 5.7% at > 70 years. In conclusion, the prevalence and clinical significance of airway allergic sensitization in the elderly living in Campania region is more significant than expected in latter stages of life. Physicians should not neglect the role of atopy as a risk factor for the onset of allergic respiratory symptoms even in elderly patients.
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Affiliation(s)
- G Liccardi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy. Phone: +39 081 747 3335-4-3 Fax: + 39 081 747 3331 E-mail:
| | - G Baldi
- Respiratory Medicine Unit. ASL (district 66), Salerno, Italy
| | - A Berra
- Respiratory Allergy Unit, G. Da Procida Hospital, Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico "Loreto Crispi", Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Disease, "Federico II" University, AO "Dei Colli", Naples, Italy
| | - R D'Angelo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory physiopathology and allergy, High Speciality Center, "Mauro Scarlato" Hospital, Scafati, Salerno, Italy
| | - G Leone
- Allergy and Clinical Immunology Unit, High Speciality "Sant'Anna and San Sebastiano" Hospital, Caserta, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - R Monti
- Private Center for Allergy Diagnosis, Ischia, Naples, Italy
| | - R Parente
- Department of Medicine and Surgery, University of Salerno, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, "Fatebenefratelli" Hospital, Benevento, Italy
| | - A Pio
- Allergy and Clinical Immunology. "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - M Russo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Salzillo
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Disease, "Federico II" University, AO "Dei Colli", Naples, Italy
| | - A Vatrella
- Department of Medicine and Surgery, University of Salerno, Italy
| | - F Manzi
- Department of Pulmonology, Haematology and Oncology, Division of Pulmonology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - M B Bilò
- Allergy Unit, Department of Immunology, Allergy and Respiratory Diseases. University Hospital Ancona, Italy
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18
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D'Amato G, Vitale C, Lanza M, Sanduzzi A, Molino A, Mormile M, Vatrella A, Bilò MB, Antonicelli L, Bresciani M, Micheletto C, Vaghi A, D'Amato M. Near fatal asthma: treatment and prevention. Eur Ann Allergy Clin Immunol 2016; 48:116-122. [PMID: 27425166] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Near-fatal asthma (NFA) is described as acute asthma associated with a respiratory arrest or arterial carbon dioxide tension greater than 50 mmHg, with or without altered consciousness, requiring mechanical ventilation. Risk factors for near fatal asthma have not been fully elucidated. In 80-85% of all fatal events, a phenotype, characterized by eosinophilic inflammation associated with gradual deterioration occurring in patients with severe and poorly controlled asthma, has been identified. Regarding to the management, acute severe asthma remains a significant clinical problem, which needs to be identified to facilitate early and appropriate therapeutic interventions. The assessment relies on clinical signs, but additional information might be obtained from chest radiography or blood gas analysis. No investigation should delay the initiation of appropriate therapy. The goals of therapy are the maintenance of oxygenation, relief of airflow obstruction, reduction of airways edema and mucus plugging (with Increased use of medications such as beta-agonists via metered dose inhalers and nebulizers, oral and/or intravenous (other than by inhalation) corticosteroids and oral or intravenous theophylline) whereas supporting ventilation as clinically indicated. Of course, the emergency physician needs to consider the wide range of potential complications, as attention to these problems when managing severe acute asthma might significantly improve outcome. An understanding of the available agents and potential pitfalls in the management of NFA is mandatory for the emergency physician.
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Affiliation(s)
- G D'Amato
- Division of Respiratory and Allergic Diseases, Department of Chest Diseases High Speciality, A. Cardarelli Hospital, Napoli, Italy. University "Federico II", Medical School of Respiratory Diseases, Naples, Italy. E-mail:
| | - C Vitale
- Department of medicine and surgery, University of Salerno, Italy
| | - M Lanza
- First Division of Pneumology, High Speciality Hospital "V. Monaldi" and University "Federico II" Medical School, Naples, Italy
| | - A Sanduzzi
- Second Division of Pneumology, High Speciality Hospital "V. Monaldi" and University "Federico II" Medical School, Naples, Italy
| | - A Molino
- First Division of Pneumology, High Speciality Hospital "V. Monaldi" and University "Federico II" Medical School, Naples, Italy
| | - M Mormile
- Autonomic Service of Pneumology, Policlinical University Federico II, Naples, Italy
| | - A Vatrella
- Department of medicine and surgery, University of Salerno, Italy
| | - M B Bilò
- Service of Immunoallergology, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - L Antonicelli
- Service of Immunoallergology, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - M Bresciani
- Service of Allergology, Hospital san Paolo, Civitavecchia, Italy
| | - C Micheletto
- Division of Pneumology, Hospital Mater Salutis, Legnago,Verona, Italy
| | - A Vaghi
- Division of Pneumology, Hospital Salvini, Garbagnate, Milan, Italy
| | - M D'Amato
- First Division of Pneumology, High Speciality Hospital "V. Monaldi" and University "Federico II" Medical School, Naples, Italy
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Fiamegkos I, Cordeiro F, Robouch P, Vélez D, Devesa V, Raber G, Sloth JJ, Rasmussen RR, Llorente-Mirandes T, Lopez-Sanchez JF, Rubio R, Cubadda F, D'Amato M, Feldmann J, Raab A, Emteborg H, de la Calle MB. Accuracy of a method based on atomic absorption spectrometry to determine inorganic arsenic in food: Outcome of the collaborative trial IMEP-41. Food Chem 2016; 213:169-179. [PMID: 27451169 DOI: 10.1016/j.foodchem.2016.06.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/22/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
A collaborative trial was conducted to determine the performance characteristics of an analytical method for the quantification of inorganic arsenic (iAs) in food. The method is based on (i) solubilisation of the protein matrix with concentrated hydrochloric acid to denature proteins and allow the release of all arsenic species into solution, and (ii) subsequent extraction of the inorganic arsenic present in the acid medium using chloroform followed by back-extraction to acidic medium. The final detection and quantification is done by flow injection hydride generation atomic absorption spectrometry (FI-HG-AAS). The seven test items used in this exercise were reference materials covering a broad range of matrices: mussels, cabbage, seaweed (hijiki), fish protein, rice, wheat, mushrooms, with concentrations ranging from 0.074 to 7.55mgkg(-1). The relative standard deviation for repeatability (RSDr) ranged from 4.1 to 10.3%, while the relative standard deviation for reproducibility (RSDR) ranged from 6.1 to 22.8%.
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Affiliation(s)
- I Fiamegkos
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, 111 Retieseweg, 2440 Geel, Belgium
| | - F Cordeiro
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, 111 Retieseweg, 2440 Geel, Belgium
| | - P Robouch
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, 111 Retieseweg, 2440 Geel, Belgium
| | - D Vélez
- Metal Contamination Laboratory (IATA-CSIC), Avd. Agustín Escardino 7, 46980 Paterna, Valencia, Spain
| | - V Devesa
- Metal Contamination Laboratory (IATA-CSIC), Avd. Agustín Escardino 7, 46980 Paterna, Valencia, Spain
| | - G Raber
- Institute of Chemistry, University of Graz, Universitätsplatz 1, 8010 Graz, Austria
| | - J J Sloth
- Technical University of Denmark, National Food Institute, Division of Food Chemistry, Mørkhøj Bygade 19, 2860 Søborg, Denmark
| | - R R Rasmussen
- Technical University of Denmark, National Food Institute, Division of Food Chemistry, Mørkhøj Bygade 19, 2860 Søborg, Denmark
| | - T Llorente-Mirandes
- Department of Analytical Chemistry, University of Barcelona, Martí I Franque's 1-11, 08028 Barcelona, Spain
| | - J F Lopez-Sanchez
- Department of Analytical Chemistry, University of Barcelona, Martí I Franque's 1-11, 08028 Barcelona, Spain
| | - R Rubio
- Department of Analytical Chemistry, University of Barcelona, Martí I Franque's 1-11, 08028 Barcelona, Spain
| | - F Cubadda
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - M D'Amato
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - J Feldmann
- Trace Element Speciation Laboratory (TESLA), University of Aberdeen, College of Physical Science, Chemistry, Meston Walk, Aberdeen AB24 3UE, Scotland, United Kingdom
| | - A Raab
- Trace Element Speciation Laboratory (TESLA), University of Aberdeen, College of Physical Science, Chemistry, Meston Walk, Aberdeen AB24 3UE, Scotland, United Kingdom
| | - H Emteborg
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, 111 Retieseweg, 2440 Geel, Belgium
| | - M B de la Calle
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, 111 Retieseweg, 2440 Geel, Belgium.
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20
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Assadi G, Saleh R, Hadizadeh F, Vesterlund L, Bonfiglio F, Halfvarson J, Törkvist L, Eriksson AS, Harris HE, Sundberg E, D'Amato M. LACC1 polymorphisms in inflammatory bowel disease and juvenile idiopathic arthritis. Genes Immun 2016; 17:261-4. [PMID: 27098602 DOI: 10.1038/gene.2016.17] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 02/06/2023]
Abstract
The function of the Laccase domain-containing 1 (LACC1) gene is unknown, but genetic variation at this locus has been reported to consistently affect the risk of Crohn's disease (CD) and leprosy. Recently, a LACC1 missense mutation was found in patients suffering from monogenic forms of CD, but also systemic juvenile idiopathic arthritis. We tested the hypothesis that LACC1 single nucleotide polymorphisms (SNPs), in addition to CD, are associated with juvenile idiopathic arthritis (JIA, non-systemic), and another major form of inflammatory bowel disease, ulcerative colitis (UC). We selected 11 LACC1 tagging SNPs, and tested their effect on disease risk in 3855 Swedish individuals from three case-control cohorts of CD, UC and JIA. We detected false discovery rate corrected significant associations with individual markers in all three cohorts, thereby expanding previous results for CD also to UC and JIA. LACC1's link to several inflammatory diseases suggests a key role in the human immune system and justifies further characterization of its function(s).
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Affiliation(s)
- G Assadi
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - R Saleh
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - F Hadizadeh
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - L Vesterlund
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - F Bonfiglio
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - J Halfvarson
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - L Törkvist
- Gastrocentrum, Karolinska University Hospital, StockhoCrohn'slm, Sweden
| | - A S Eriksson
- Gatroenterology Unit, Department of Internal Medicine, Sahlgren's University Hospital/Östra, Göteborg, Sweden
| | - H E Harris
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - E Sundberg
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - M D'Amato
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,BioCruces Health Research Institute and IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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21
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Dlugosz A, Nowak P, D'Amato M, Mohammadian Kermani G, Nyström J, Abdurahman S, Lindberg G. Increased serum levels of lipopolysaccharide and antiflagellin antibodies in patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterol Motil 2015; 27:1747-54. [PMID: 26387872 DOI: 10.1111/nmo.12670] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/11/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Innate immune responses to conserved microbial products such as lipopolysaccharide (LPS) and flagellin are likely important in microbial-host interactions and intestinal homeostasis. We hypothesized that bacterial translocation and activation of mucosal immunity against common microbial antigens might be involved in the development of irritable bowel syndrome (IBS). We therefore compared serum levels of LPS, soluble CD14 (sCD14), and flagellin antibodies between patients with different subtypes of IBS and healthy controls. METHODS We analyzed serum obtained from 88 patients (74 females) aged 19(43)-73 years and 106 healthy volunteers (77 females) aged 19(38)-62 years. Diarrhea-predominant IBS (D-IBS) was present in 32 patients (36%), 23 patients (26%) had constipation-predominant IBS (C-IBS), and 33 patients (38%) had A-IBS. We used ELISA for sCD14 and antiflagellin immunoglobulin G and limulus amebocyte assay for LPS. Abdominal symptoms and psychiatric comorbidities were assessed using validated questionnaires. KEY RESULTS We found a significantly higher serum level of LPS in patients with D-IBS compared to controls (p = 0.0155). The level of antibodies to flagellin was higher in patients with IBS than in controls (mainly driven by higher levels in D-IBS, p = 0.0018). The levels of sCD14 were lower in D-IBS patients compared to controls (p = 0.0498). We found a weak, but significant correlation between the levels of antiflagellin antibodies and anxiety among IBS patients (ρ = 0.38; p = 0.0045). CONCLUSIONS & INFERENCES Our results support the concept that immune reactivity to luminal antigens may have a role in the development of D-IBS. The serum level of antiflagellin antibodies was found to correlate with patients' self-reported anxiety score.
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Affiliation(s)
- A Dlugosz
- Karolinska Institutet, Department of Medicine and Center for Digestive Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - P Nowak
- Karolinska Institutet, Department of Medicine, Unit of Infectious Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - M D'Amato
- Karolinska Institutet, Department of Biosciences and Nutrition, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - G Mohammadian Kermani
- Karolinska Institutet, Department of Medicine and Center for Digestive Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - J Nyström
- Karolinska Institutet, Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - S Abdurahman
- Department of Science and Technology, Örebro Life Science Center, Örebro University, Örebro, Sweden
| | - G Lindberg
- Karolinska Institutet, Department of Medicine and Center for Digestive Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
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Cubadda F, D'Amato M, Mancini FR, Aureli F, Raggi A, Busani L, Mantovani A. Assessing human exposure to inorganic arsenic in high-arsenic areas of Latium: a biomonitoring study integrated with indicators of dietary intake. Ann Ig 2015; 27:39-51. [PMID: 25748504 DOI: 10.7416/ai.2015.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In Latium (central Italy), arsenic concentrations exceeding the regulatory limit of 10 μg/L for drinking water are present in groundwater from a large area of volcanic origin. At least in part of the area, high arsenic concentrations have been detected also in soil and phytoavailable geogenic arsenic enters the food chain. As a result, local population may be exposed to inorganic arsenic via water and also through consumption of food with higher than background arsenic concentrations. METHODS A cross sectional study was conducted to assess inorganic arsenic exposure and metabolism in 269 residents of 27 municipalities in the provinces of Viterbo, Rome and Latina. Total arsenic in toenails and the sum of inorganic arsenic and methylated metabolites in urine, the latter determined by HPLC-ICP-MS, were used as biomarkers of inorganic arsenic exposure. All the subjects involved in the study provided samples of the water(s) used for drinking and cooking as well as detailed information on water use. To get an insight into dietary intake from locally-processed food, inorganic arsenic in bread samples collected in affected municipalities of the three provinces was determined and compared to background levels of samples from reference areas. RESULTS 30% of the sample used bottled water or resorted to water treatment in order to lower the arsenic content <10 μg/L (Group 1), 51% of the sample drank bottled water and used tap water with an arsenic content exceeding 10 μg/L for cooking only (Group 2), 19% of the sample used tap water with an arsenic content exceeding 10 μg/L for both drinking and cooking (Group 3). Nail arsenic was higher for Group 2 and 3 compared to Group 1, whereas all groups had higher nail arsenic than the reference group. The sum of inorganic arsenic and related metabolites in urine was higher in Group 3 than in the other two groups, and higher in Group 2 compared to Group 1. White bread from the study area showed significantly higher inorganic arsenic levels compared to samples from reference areas. CONCLUSIONS Use of toenail arsenic as biomarker of long-term exposure allowed to retrospectively reconstruct exposure irrespective of recent modifications due to changes in water use. In Group 3, urinary concentration of inorganic arsenic and metabolites exceeded the upper limit of the reference concentration range for the Italian population. Inter-individual variability of the efficiency of arsenic metabolism in the study population was substantial indicating that a subgroup of the population is more susceptible to the toxic effects of inorganic arsenic owing to a lower methylation capability.
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Affiliation(s)
- F Cubadda
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
| | - M D'Amato
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
| | - F R Mancini
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy - Department of Veterinary Medicine, University of Bologna, Italy
| | - F Aureli
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
| | - A Raggi
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
| | - L Busani
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
| | - A Mantovani
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità-Italian National Health Institute, Rome, Italy
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23
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D'Amato M, Vitale C, Sanduzzi A, Stanziola A, Lanza M, Vatrella A, Molino A, Annesi-Maesano I, D'Amato G. Social Networks, Asthma and Much More... J Investig Allergol Clin Immunol 2015; 25:445-447. [PMID: 26817145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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24
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Sorino C, D'Amato M, Steinhilber G, Patella V, Corsico AG. Spirometric criteria to diagnose airway obstruction in the elderly: fixed ratio vs lower limit of normal. Minerva Med 2014; 105:15-21. [PMID: 25586765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
COPD is the most common chronic lung disease. It becomes more prevalent with increasing age but remains under-diagnosed in the elderly. A heated debate concerns the most suitable way to diagnose airway obstruction in this age group. Most COPD guidelines recommend to use a FEV1/FVC of 0.70 as threshold to define an obstructive ventilatory defect. While the use of a 0.70 ratio may be simple, it may result in under-diagnosis of airflow obstruction in young people and over-diagnosis in the elderly due to an age-related decline in pulmonary volumes, especially in FEV1. This might lead to unnecessary use of medications and increased risk of adverse effects. A proposed strategy for reducing the misclassification of airway obstruction include the use of the statistically derived lower limit of normal (LLN) for FEV1/FVC, calculated as the fifth percentile of the normal distribution in a healthy population. Some authors addressed the possibility to evaluate lung function through high-resolution CT. In contrast to spirometry, CT imaging may allow for regional assessment of the compartments involved (airways, parenchyma, vasculature), and may enable a phenotype-driven characterization of COPD. Bhatt et al. recently observed that a small proportion (7%) of subjects with CT-defined emphysema were identified by the 0.70 threshold for FEV1/FVC but not by the LLN. However, there is no evidence that CT-emphysema corresponds to a clinical entity that can benefit by inhaled therapy. Further studies are needed to assess the classificatory and prognostic value of the different proposed criteria to diagnose airway obstruction in the elderly.
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Affiliation(s)
- C Sorino
- Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, "Villa Sofia-Cervello"Hospital, Palermo, Italy -
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Jakobsson T, Vedin LL, Hassan T, Venteclef N, Greco D, D'Amato M, Treuter E, Gustafsson JÅ, Steffensen KR. The oxysterol receptor LXRβ protects against DSS- and TNBS-induced colitis in mice. Mucosal Immunol 2014; 7:1416-28. [PMID: 24803164 DOI: 10.1038/mi.2014.31] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 04/01/2014] [Indexed: 02/04/2023]
Abstract
We examined the function of the oxysterol receptors (LXRs) in inflammatory bowel disease (IBD) through studying dextran sodium sulfate (DSS)- and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice and by elucidating molecular mechanisms underlying their anti-inflammatory action. We observed that Lxr-deficient mice are more susceptible to colitis. Clinical indicators of colitis including weight loss, diarrhea and blood in feces appeared earlier and were more severe in Lxr-deficient mice and particularly LXRβ protected against symptoms of colitis. Addition of an LXR agonist led to faster recovery and increased survival. In contrast, Lxr-deficient mice showed slower recovery and decreased survival. In Lxr-deficient mice, inflammatory cytokines and chemokines were increased together with increased infiltration of immune cells in the colon epithelium. Activation of LXRs strongly suppressed expression of inflammatory mediators including TNFα. While LXRα had anti-inflammatory effects in CD11b(+) immune cell populations, LXRβ in addition had anti-inflammatory effects in colon epithelial cells. Lack of LXRβ also induced CD4(+)/CD3(+) immune cell recruitment to the inflamed colon. Expression of both LXRA and LXRB was significantly suppressed in inflamed colon from subjects with IBD compared with non-inflamed colon. Taken together, our observations suggest that the LXRs could provide interesting targets to reduce the inflammatory responses in IBD.
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Affiliation(s)
- T Jakobsson
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - L-L Vedin
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - T Hassan
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - N Venteclef
- Institute of Cardiometabolism and Nutrition, INSERM, Université Pierre et Marie Curie-Paris 6, Cordeliers Research Center, Paris, France
| | - D Greco
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - M D'Amato
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - E Treuter
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - J-Å Gustafsson
- 1] Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden [2] Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, Texas, USA
| | - K R Steffensen
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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26
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Henström M, Zucchelli M, Söderhäll C, Bergström A, Kere J, Melén E, Olén O, D'Amato M. NPSR1 polymorphisms influence recurrent abdominal pain in children: a population-based study. Neurogastroenterol Motil 2014; 26:1417-25. [PMID: 25091462 DOI: 10.1111/nmo.12401] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/23/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recurrent abdominal pain (RAP) occurs frequently among children and is one of the cardinal symptoms of functional gastrointestinal disorders (FGID). The mechanisms of visceral pain and RAP are not fully understood. A heritable component has been demonstrated and a few candidate genes proposed. NPSR1 encodes the receptor for neuropeptide S (NPS) and NPS-NPSR1 signaling is involved in anxiety, inflammation, and nociception. NPSR1 polymorphisms are associated with asthma and chronic inflammatory diseases, but also with IBS-related intermediate phenotypes such as colonic transit time and rectal sensory ratings. Here, we sought to determine whether genetic variability in the NPSR1 gene influences the presence of RAP in children. METHODS Twenty-eight single-nucleotide polymorphisms (SNPs) in the NPSR1 gene region were successfully genotyped in 1744 children from the Swedish birth cohort BAMSE. Questionnaire information was used to define RAP as episodes of abdominal pain occurring at least once a month in 12-year-olds. KEY RESULTS The prevalence of RAP was 9% in BAMSE. Association with RAP was observed for seven NPSR1 SNPs, five of which withstood false discovery rate (FDR) correction for multiple testing (best p = 0.00054, OR: 1.55 for SNP rs2530566). The associated SNPs all map in a putative regulatory region upstream NPSR1, where they may exert their genetic effects through the modulation of gene expression. CONCLUSIONS & INFERENCES Genetic variation at the NPSR1 locus impacts children's predisposition to RAP episodes in a Swedish population.
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Affiliation(s)
- M Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
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Stickel F, Buch S, Zoller H, Hultcrantz R, Gallati S, Osterreicher C, Finkenstedt A, Stadlmayr A, Aigner E, Sahinbegovic E, Sarrazin C, Schafmayer C, Braun F, Erhart W, Nothnagel M, Lerch MM, Mayerle J, Volzke H, Schaller A, Kratzer W, Boehm BO, Sipos B, D'Amato M, Torkvist L, Stal P, Arlt A, Franke A, Becker T, Krawczak M, Zwerina J, Berg T, Hinrichsen H, Krones E, Dejaco C, Strasser M, Datz C, Hampe J. Evaluation of genome-wide loci of iron metabolism in hereditary hemochromatosis identifies PCSK7 as a host risk factor of liver cirrhosis. Hum Mol Genet 2014; 23:3883-90. [DOI: 10.1093/hmg/ddu076] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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29
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Liccardi G, Baldi G, Ciccarelli A, Cutajar M, D'Amato M, Gargano D, Giannattasio D, Leone G, Lo Schiavo M, Madonna F, Montera C, Piccolo A, Pio A, Russo M, Stanziola A, D'Amato G. Sensitization to cockroach allergens in the urban atopic populations living in Campania district (southern Italy). A multicenter study. Eur Ann Allergy Clin Immunol 2014; 46:12-16. [PMID: 24702867] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Although cockroach (CR) is an important cause of allergic sensitization worldwide, only a few data are available in Italy and in a previous study we have observed, in Naples area, a low prevalence of CR sensitization. OBJECTIVES We sought to perform a prospective study for assessing the prevalence of allergic sensitization to CR in a sample of atopic population living in Campania district area (Southern Italy). METHODS Ten Allergy Units or Centres of Campania district participated in this cross-sectional study. Each centre was required to collect the results of at least 100 allergy consultations in consecutive outpatients referred for actual or suspected respiratory allergy. We registered demographic data, type and duration of respiratory symptoms, pets ownership, possible exposure to CR allergens, results of the skin prick tests (SPTs). RESULTS A total of 1477 patients were examined, 985 (66.68%) had a SPTs positivity to at least one allergen. In this context, ninety were sensitized to CR, thus the overall sensitization prevalence in subjects with respiratory allergy was 6.09% ranging between 0-11% and only five patients were mono-sensitized. Thirteen patients reported rhinitis (R) + bronchial asthma (A), twenty-one R + A + conjunctivitis (C), thirty-seven R + C, five only A and eleven individuals only R. Sixty-seven patients exhibited persistent and twenty-three intermittent symptoms. Dust mite constituted the first cause of associated sensitization to CR. CONCLUSIONS The prevalence of allergic sensitization to CR is not negligible in population living in Campania district and shows a higher trend in comparison to that found recently and some years ago in Naples area. Finally, we suggest atopic individuals and especially those highly sensitized to mite allergens or those living in low-income areas to be tested by SPTs / evaluation of serum specific IgE to CR allergens to exclude the occurrence of CR allergic sensitization.
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Affiliation(s)
- G Liccardi
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy.
| | - G Baldi
- Respiratory Medicine Unit, ASL (District 66), Salerno, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico "Loreto Crispi", Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine, Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - M D'Amato
- Department of Respiratory Diseases, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality "San Giuseppe Moscati" Hospital, Avellino, Italy
| | - D Giannattasio
- Respiratory physiopathology and allergy, High Speciality Center "S. Maria Incoronata dell'Olmo" Hospital, Cava dei Tirreni, Salerno, Italy
| | - G Leone
- Allergy and Clinical Immunology Unit, High Speciality "Sant'Anna e San Sebastiano" Hospital, Caserta, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n° 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - A Piccolo
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Pio
- Allergy and Clinical Immunology, "G. Fucito" Hospital and University Hospital, Salerno, Italy
| | - M Russo
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
| | - A Stanziola
- Department of Respiratory Diseases, "Federico II" University - AO "Dei Colli", Naples, Italy
| | - G D'Amato
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality "A. Cardarelli" Hospital, Naples, Italy
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D'Amato G, D'Amato M, Rumi G, Cantera E, Cortes M, Dattilo R. Improvement of quality of life in allergic rhinoconjunctivitis patients using nasal filters, a preliminary study. Eur Ann Allergy Clin Immunol 2013; 45:167-175. [PMID: 24129044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Allergic rhinoconjunctivitis is a clinical condition that impairs quality of life. The use of traditional drugs in many cases is not enough to improve quality of life in these patients. METHODS In this pilot study we used the Sanispira Nasal filters in 15 patients (mean age 34,7 years) affected by allergic rhinoconjunctivitis for 18 days. At each follow-up visit, patients were assessed with a specific quality of life questionnaire, a symptoms form and a drugs form that evaluates the use of antiallergic drugs in the last week. Patients sensitive to environmental allergens wore Sanispira nasal filters during the day, while patients sensitive to domestic allergens wore the device during the night. RESULTS Thirteen patients completed the study. We found an improvement significative (p=0,0241) of the total score of RQLQ of 23,10 points between baseline and 18 days ( total score at baseline prior to nasal filter insertion= 60,60, at 1 week = 42, 28, at 18 days= 34, 10). A significative improvement in the nasal symptoms domain between baseline and 18 days (in particular stuffy nose p=0,047; runny nose p=0,012; sneezing p=0,0021; ) and one item of practical problems domain, the need to repeatedly blow the nose(p=0,082). The total score of symptoms evaluated with the symptoms form improved significantly from baseline to 18 days. Total symptoms score at baseline was 9,7; at 1 week it was 8,1 and at 18 days it was 4,7. The improvement was statistically significant (p=0,0092). Three of the thirteen patients that completed the study eliminated completely the use of drugs during of the study. CONCLUSIONS The use of SANISPIRA ®, has shown encouraging results, with an improvement in the quality of life in Rhinoconjunctivitis patients specially an improvement in nasal and ocular symptoms.
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Zuliani G, Bonetti F, Magon S, Prandini S, Sioulis F, D'Amato M, Zampi E, Gasperini B, Cherubini A. Subsyndromal Delirium and Its Determinants in Elderly Patients Hospitalized for Acute Medical Illness. J Gerontol A Biol Sci Med Sci 2013; 68:1296-302. [DOI: 10.1093/gerona/glt021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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D'Amato G, Corrado A, Cecchi L, Liccardi G, Stanziola A, Annesi-Maesano I, D'Amato M. A relapse of near-fatal thunderstorm-asthma in pregnancy. Eur Ann Allergy Clin Immunol 2013; 45:116-117. [PMID: 23862404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Thunderstorm-related asthma is a dramatic example of the allergenic potential of pollen antigens. Pollen allergic patients who encounter the allergenic cloud of pollen during a thunderstorm are at higher risk of having an asthma attack. Relapse is also possible and we describe here the first case of relapse of near fatal thunderstorm-asthma occurred in a 36 years old, 20 weeks pregnant woman affected by seasonal asthma and sensitized to allergens released by Parietariapollen. Patients suffering from pollen allergy should be alerted of the danger of being outdoors during a thunderstorm in the pollen season and if they experienced an episode of severe thunderstorm-related asthma could be at risk of a relapse during a heavy precipitation event.
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Affiliation(s)
- G D'Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Speciality Hospital A. Cardarelli, Napoli, Italy.
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Liccardi G, Salzillo A, Piccolo A, Russo M, D'Amato M, Stanziola A, Bovenzi D, D'Amato G. Has sensitization to cockroach allergens changed during the last 17 years in the urban atopic population living in Naples (Southern Italy)? J Investig Allergol Clin Immunol 2013; 23:57-59. [PMID: 23653978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- G Liccardi
- Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality Hospital "A. Cardarelli", Naples, Italy
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Liccardi G, Salzillo A, Sofia M, Piccolo A, Dente B, Russo M, D'Amato M, Stanziola A, D'Amato G. Sensitization to rodents (mouse/rat) in an urban atopic population without occupational exposure living in Naples, Italy. Eur Ann Allergy Clin Immunol 2012; 44:200-204. [PMID: 23156068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Until now no data on allergic sensitization to rodents allergens in Western Europe and Italy are available. The aim of this report was to investigate clinical significance and characteristics of IgE-mediated sensitization to mouse/rat (M/Rt) allergens in atopic subjects not occupationally exposed to these animals and living in urban area of Naples. METHODS In 1765 consecutive outpatients, we selected all subjects with an immediate skin reaction to M/WRt dander clinical history including a carefijul evaluation ofthe modality of exposure, the results of skin-prick tests (SPTs) and specific IgE antibodies were recorded. RESULTS Among 1185 SPT-positive patients, 22 were sensitized to M/Rt dander (respectively 1.60% and 0.59%). No patient was mono-sensitized Only three of 22 patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low degree of SPT positivity and low levels of circulating IgE antibodies to M/WRt. Highfrequency of concomitant allergic sensitization to pet (and other animal) dander has been found. CONCLUSIONS Our results suggest that role of allergic sensitization to rodents is negligible in atopic subjects without occupational exposure living in urban area of Naples. However, highly atopic individuals especially those already sensitized to common pet dander should be tested by SPTs/evaluation of serum specific IgE to rodents in the case they could begin an occupational exposure to M/Rt or keeping these animals as pets.
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Affiliation(s)
- G Liccardi
- Department of Chest Diseases, Division of Pneumology and Allergology. High Speciality A. Cardarelli Hospital, Naples, Italy.
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de la Calle MB, Baer I, Robouch P, Cordeiro F, Emteborg H, Baxter MJ, Brereton N, Raber G, Velez D, Devesa V, Rubio R, Llorente-Mirandes T, Raab A, Feldmann J, Sloth JJ, Rasmussen RR, D'Amato M, Cubadda F. Is it possible to agree on a value for inorganic arsenic in food? The outcome of IMEP-112. Anal Bioanal Chem 2012; 404:2475-88. [PMID: 22986988 DOI: 10.1007/s00216-012-6398-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 08/24/2012] [Accepted: 08/29/2012] [Indexed: 11/24/2022]
Abstract
Two of the core tasks of the European Union Reference Laboratory for Heavy Metals in Feed and Food (EU-RL-HM) are to provide advice to the Directorate General for Health and Consumers (DG SANCO) on scientific matters and to organise proficiency tests among appointed National Reference Laboratories. This article presents the results of the 12th proficiency test organised by the EU-RL-HM (IMEP-112) that focused on the determination of total and inorganic arsenic in wheat, vegetable food and algae. The test items used in this exercise were: wheat sampled in a field with a high concentration of arsenic in the soil, spinach (SRM 1570a from NIST) and an algae candidate reference material. Participation in this exercise was open to laboratories from all around the world to be able to judge the state of the art of the determination of total and, more in particular, inorganic arsenic in several food commodities. Seventy-four laboratories from 31 countries registered to the exercise; 30 of them were European National Reference Laboratories. The assigned values for IMEP-112 were provided by a group of seven laboratories expert in the field of arsenic speciation analysis in food. Laboratory results were rated with z and ζ scores (zeta scores) in accordance with ISO 13528. Around 85 % of the participants performed satisfactorily for inorganic arsenic in vegetable food and 60 % did for inorganic arsenic in wheat, but only 20 % of the laboratories taking part in the exercise were able to report satisfactory results in the algae test material.
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Affiliation(s)
- M B de la Calle
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg, Geel, Belgium.
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Liccardi G, Salzillo A, Piccolo A, Foglia M, Russo M, D'Amato M, Stanziola A, Bovenzi D, Sapio C, Pio R, D'Amato G. Is there any relationship between allergic sensitization to milk and animal allergens in atopic adults? Eur Ann Allergy Clin Immunol 2012; 44:141-143. [PMID: 22905597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
No data on the relationship between allergic sensitization to animal dander and milk allergens are available in literature in adults. Considering the high rate of allergic sensitization to mammals in atopic adults living in Naples area, we aimed to evaluate if sensitization to milk allergens could be a risk factor for these subjects. From 755 consecutive outpatients examined between May 1 2009 and December 31 2010, we selected those with an immediate skin reaction to animal dander and milk. A clinical history including evaluation of pet exposure, the results of skin-prick tests (SPTs) and specific IgE antibodies for milk allergens were recorded. Among three hundred sixty SPT-positive patients, 140 were sensitized to animal dander (38.9%) and 9 to milk allergens (6.4%). Among one hundred forty patients sensitized to animals only one was sensitized also to milk allergens; among 9 milk-sensitized individuals 5 were allergic also to animal allergens (only one to cow dander) while 4 were not sensitized to mammals. Our results suggest that relationship between allergic sensitization to milk and animal allergens is negligible in adult atopic individuals living in urban area of Naples and that high rate of sensitization to animals is likely to be due to other mechanisms such as direct/indirect exposure, and allergen cross-reactions.
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Parmar AS, Lappalainen M, Paavola-Sakki P, Halme L, Färkkilä M, Turunen U, Kontula K, Aromaa A, Salomaa V, Peltonen L, Halfvarson J, Törkvist L, D'Amato M, Saavalainen P, Einarsdottir E. Association of celiac disease genes with inflammatory bowel disease in Finnish and Swedish patients. Genes Immun 2012; 13:474-80. [DOI: 10.1038/gene.2012.21] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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D'Amato G, Cecchi L, Liccardi G, Pellegrino F, D'Amato M, Sofia M. Social networks: a new source of psychological stress or a way to enhance self-esteem? Negative and positive implications in bronchial asthma. J Investig Allergol Clin Immunol 2012; 22:402-405. [PMID: 23101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
The Internet and, in particular, social networks are an increasingly important part of daily life for both adolescents and adults who maintain a virtual relationship with others sharing interests and goals. Very often, they disclose more about themselves online than they do in person. However, cyberbullying and cyberostracism can be problematic for adolescents and sensitive individuals, who might be negatively affected by social networks. Some studies have shown an increased risk of depression, whereas others suggest beneficial effects through enhanced communication, social connection, and self-esteem. Bronchial asthma is an increasingly frequent disease in the industrialized world, and psychological implications play a role in increasing or in reducing its severity. One year after the case report of an asthma exacerbation that may have been triggered by Facebook, it seems reasonable to analyze the effects of social networks on bronchial asthma.
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Affiliation(s)
- G D'Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Speciality Hospital A. Cardarelli, Napoli, Italy.
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Jarvinen TM, Hellquist A, Zucchelli M, Koskenmies S, Panelius J, Hasan T, Julkunen H, D'Amato M, Kere J. Replication of GWAS-identified systemic lupus erythematosus susceptibility genes affirms B-cell receptor pathway signalling and strengthens the role of IRF5 in disease susceptibility in a Northern European population. Rheumatology (Oxford) 2011; 51:87-92. [DOI: 10.1093/rheumatology/ker263] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Little TJ, Gopinath A, Patel E, McGlone A, Lassman DJ, D'Amato M, McLaughlin JT, Thompson DG. Gastric emptying of hexose sugars: role of osmolality, molecular structure and the CCK₁ receptor. Neurogastroenterol Motil 2010; 22:1183-90, e314. [PMID: 20584263 DOI: 10.1111/j.1365-2982.2010.01552.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND It is widely reported that hexose sugars slow gastric emptying (GE) via osmoreceptor stimulation but this remains uncertain. We evaluated the effects of a panel of hexoses of differing molecular structure, assessing the effects of osmolality, intra-individual reproducibility and the role of the CCK(1) receptor, in the regulation of GE by hexoses. METHODS Thirty one healthy non-obese male and female subjects were studied in a series of protocols, using a (13) C-acetate breath test to evaluate GE of varying concentrations of glucose, galactose, fructose and tagatose, with water, NaCl and lactulose as controls. GE was further evaluated following the administration of a CCK(1) receptor antagonist. Three subjects underwent repeated studies to evaluate intra-individual reproducibility. KEY RESULTS At 250 mOsmol, a hexose-specific effect was apparent: tagatose slowed GE more potently than water, glucose and fructose (P < 0.05). Fructose (P < 0.05) also slowed GE, but with substantial inter-, but not intra-, individual differences. As osmolality increased further the hexose-specific differences were lost. At 500 mOsmol, all hexoses slowed GE compared with water (P < 0.05), whereas lactulose and saline did not. The slowing of GE by hexose sugars appeared to be CCK(1) receptor-dependent. CONCLUSIONS & INFERENCES The effects of hexose sugars on GE appear related to their molecular structure rather than osmolality per se, and are, at least in part, CCK(1) receptor-dependent.
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Affiliation(s)
- T J Little
- Section of Gastrointestinal Sciences, Manchester Academic Health Sciences Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Salford, UK.
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D'Amato G, Perticone M, Bucchioni E, Salzillo A, D'Amato M, Liccardi G. Treating moderate-to-severe allergic asthma with anti-IgE monoclonal antibody (omalizumab). An update. Eur Ann Allergy Clin Immunol 2010; 42:135-140. [PMID: 21114196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Increased asthma severity is not only associated with enhanced recurrent hospitalisation and mortality but also with higher social costs. Most cases of asthma are atopic in nature, with the trigger for acute asthma attacks and chronic worsening of inflammation being allergens inducing an immune response through immunoglobulins of IgE class. Currently antiinflammatory treatments are effective for most of asthma patients, but there are subjects whose disease is incompletely controlled by inhaled or systemic corticosteroids and these patients account for about 50% of the healthcare costs of asthma. Omalizumab is a humanized recombinant monoclonal anti-IgE antibody developed for the treatment of allergic diseases and with clear efficacy in adolescent and adult patients with moderate-to-severe allergic asthma.. The anti-IgE antibody inhibits IgE functions blocking free serum IgE and inhibiting their binding to cellular receptors. By reducing serum IgE levels and IgE receptor expression on inflammatory cells in the context of allergic cascade, omalizumab represents a really new approach to the treatment of atopic asthma. Omalizumab improves quality of life of patients with severe persistent allergic asthma that is inadequately controlled by currently available asthma medications. This therapy is well tolerated and significantly improves symptoms, disease control, reducing asthma exacerbations and the need to use high dosage of inhaled corticosteroids. In other words, omalizumab may fulfil an important need in patients with moderate-to-severe asthma.
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Affiliation(s)
- G D'Amato
- Division of Respiratory and Allergic Diseases, Department of Respiratory Diseases, High Speciality Hospital A. Cardarelli, Naples, Italy
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D'Amato G, Cecchi L, D'Amato M, Liccardi G. Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol 2010; 20:95-102. [PMID: 20461963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
The incidence of allergic respiratory diseases and bronchial asthma appears to be increasing worldwide, and people living in urban areas more frequently experience these conditions than those living in rural areas. One of the several causes of the rise in morbidity associated with allergic respiratory diseases is the increased presence of outdoor air pollutants resulting from more intense energy consumption and exhaust emissions from cars and other vehicles. Urban air pollution is now a serious public health hazard. Laboratory studies confirm epidemiologic evidence that air pollution adversely affects lung function in asthmatics. Damage to airway mucous membranes and impaired mucociliary clearance caused by air pollution may facilitate access of inhaled allergens to the cells of the immune system, thus promoting sensitization of the airway. Consequently, a more severe immunoglobulin (Ig) E-mediated response to aeroallergens and airway inflammation could account for increasing prevalence of allergic respiratory diseases in polluted urban areas. The most abundant components of urban air pollution in urban areas with high levels of vehicle traffic are airborne particulate matter, nitrogen dioxide, and ozone. In addition, the earth's temperature is increasing, mainly as a result of anthropogenic factors (e.g., fossil fuel combustion and greenhouse gas emissions from energy supply, transport, industry, and agriculture), and climate change alters the concentration and distribution of air pollutants and interferes with the seasonal presence of allergenic pollens in the atmosphere by prolonging these periods.
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Affiliation(s)
- G D'Amato
- Division of Pneumology and Allergology, Department of Respiratory Diseases, High Specialty Hospital A. Cardarelli, Naples, Italy.
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Sundman L, Saarialho-Kere U, Vendelin J, Lindfors K, Assadi G, Kaukinen K, Westerholm-Ormio M, Savilahti E, Mäki M, Alenius H, D'Amato M, Pulkkinen V, Kere J, Saavalainen P. Neuropeptide S receptor 1 expression in the intestine and skin--putative role in peptide hormone secretion. Neurogastroenterol Motil 2010; 22:79-87, e30. [PMID: 19614867 DOI: 10.1111/j.1365-2982.2009.01366.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Neuropeptide S receptor 1 (NPSR1) was recently found to be genetically associated with inflammatory bowel disease in addition to asthma and related traits. Epithelia of several organs express NPSR1 isoforms A and B, including the intestine and the skin, and NPSR1 appears to be upregulated in inflammation. In this study, we used cell lines and tissue samples to characterize the expression of NPSR1 and its ligand neuropeptide S (NPS) in inflammation. We used polyclonal and monoclonal antibodies to investigate the expression of NPS and NPSR1 in intestinal diseases, such as celiac disease and food allergy, and in cutaneous inflammatory disorders. We found that NPSR1-A was expressed by the enteroendocrine cells of the gut. Overall, the expression pattern of NPS was similar to its receptor suggesting an autocrine mechanism. In an NPSR1-A overexpressing cell model, stimulation with NPS resulted in a dose-dependent upregulation of glycoprotein hormone, alpha polypeptide (CGA), tachykinin 1 (TAC1), neurotensin (NTS) and galanin (GAL) encoding peptide hormones secreted by enteroendocrine cells. Because NPSR1 was also expressed in macrophages, neutrophils, and intraepithelial lymphocytes, we demonstrated that stimulation with the pro-inflammatory cytokines tumour necrosis factor alpha and interferon gamma increased NPSR1 expression in the THP-1 monocytic cells. In conclusion, similar to other neuropeptides and their receptors, NPSR1 signalling might play a dual role along the gut-brain axis. The NPS/NPSR1 pathway may participate in the regulation of the peptide hormone production in enteroendocrine cells of the small intestine.
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Affiliation(s)
- L Sundman
- Department of Medical Genetics and Research Program for Molecular Medicine, University of Helsinki, Helsinki, Finland.
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Hellquist A, Sandling JK, Zucchelli M, Koskenmies S, Julkunen H, D'Amato M, Garnier S, Syvanen AC, Kere J. Variation in STAT4 is associated with systemic lupus erythematosus in a Finnish family cohort. Ann Rheum Dis 2009; 69:883-6. [DOI: 10.1136/ard.2009.112284] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Herpes simplex virus (HSV) type 1 infection may cause orofacial infections in humans. The virus resides in a latent form in neural ganglia and occasionally reactivates and infects epithelial cells. Natural killer (NK) cells have been implicated in immune control of herpes virus infections, possibly by downmodulating major histocompatibility complex (MHC) class I and by other, as yet unidentified, mechanisms. Upon HSV-1 infection of cell lines, surface levels of NKG2D ligands MHC class I related proteins (MIC) A and UL16 binding protein 2 were downmodulated due to late viral gene product(s). As also MHC class I levels were reduced by HSV-1, NK cell recognition of HeLa cells was not affected by infection. Total cellular MICA contents remained unchanged, suggesting masking, internalization or intracellular retention of MICA as possible mechanisms of viral downregualtion of MICA surface levels. Furthermore, NK cells from patients with active HSV-1 infection had a tendency towards increased expression level of the activating receptor NKG2D. These data support a role for NKG2D-MICA interactions in immune responses to HSV-1 reactivation.
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Affiliation(s)
- D Schepis
- Department of Microbiology, Tumor and Cell Biology and Strategic Research Center IRIS, Karolinska Institutet, Stockholm, Sweden.
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Liedén A, Ekelund E, Kuo IC, Kockum I, Huang CH, Mallbris L, Lee SP, Seng LK, Chin GY, Wahlgren CF, Palmer CNA, Björkstén B, Ståhle M, Nordenskjöld M, Bradley M, Chua KY, D'Amato M. Cornulin, a marker of late epidermal differentiation, is down-regulated in eczema. Allergy 2009; 64:304-11. [PMID: 19133922 DOI: 10.1111/j.1398-9995.2008.01856.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Eczema is a common chronic inflammatory skin disorder which shows strong genetic predisposition. To identify new potential molecular determinants of the disease pathogenesis, we performed a gene expression study in an eczema mouse model. This analysis identified a marked down regulation of the cornulin gene (CRNN), a member of the epidermal differentiation complex, in the eczema-like skin. We then investigated CRNN as an eczema candidate gene and studied its polymorphism and the expression in the skin of eczema patients. METHODS An eczema-like phenotype was induced in mice by allergen (Der p2) patching. Gene expression analysis was performed with the subtractive suppression hybridization method and validated by real time PCR and the transmission disequilibrium test was used to test for genetic associations in 406 multiplex eczema families. RESULTS Der p 2 patched mice developed a localized eczema and a Th 2 skewed systemic response. Real time PCR analysis confirmed a down regulation of CRNN mRNA in eczema-like skin in the mouse model and in human eczema. The CRNN polymorphism rs941934 was significantly associated with atopic eczema in the genetic analysis (P = 0.006), though only as part of an extended haplotype including a known associated variant (2282del4) in the filaggrin gene. CONCLUSIONS CRNN mRNA expression is decreased in eczematous skin. Further studies are needed to verify whether the associated cornulin polymorphism contribute to the genetic susceptibility in eczema.
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Affiliation(s)
- A Liedén
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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D'Ilio S, Petrucci F, D'Amato M, Di Gregorio M, Senofonte O, Violante N. Method validation for determination of arsenic, cadmium, chromium and lead in milk by means of dynamic reaction cell inductively coupled plasma mass spectrometry. Anal Chim Acta 2008; 624:59-67. [PMID: 18706310 DOI: 10.1016/j.aca.2008.06.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 06/11/2008] [Accepted: 06/12/2008] [Indexed: 11/27/2022]
Abstract
With Regulation No. 1881/2006 the European Union fixed a maximum level for lead in milk. Consequently, there is the need to determine very low concentration of elements that may be present in milk in trace and ultratrace levels. Quadrupole inductively coupled plasma mass spectrometry (Q-ICP-MS) combined with dynamic reaction cell (DRC) has been widely employed in order to reach very low concentration, requested for this product. Furthermore, the DRC technology can help in removing polyatomic and argon-based interferences. In the present study, a method for the determination of arsenic, cadmium, chromium and lead in bovine milk was validated according to the EU common standards by means of DRC-ICP-MS. The main parameters evaluated in the validation were: recovery, repeatability and within-laboratory reproducibility, detection and quantification limits, linearity range and measurement uncertainty. Additionally, stability studies of the analyte in solution and ruggedness studies were carried out. The results obtained for limit of detection (LoD) and limit of quantification (LoQ) in microg kg(-1) were respectively: As, 3.1 and 9.5; Cd, 0.08 and 0.24; Cr, 0.229 and 0.693; Pb, 0.5 and 1.5. While for the recovery: As, 91%; Cd 96%; Cr 99%; Pb, 95%. As for the repeatability: As, 7%; Cd, 3%; Cr, 6%; Pb, 4%.
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Affiliation(s)
- S D'Ilio
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy.
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Orzella L, Perria C, Jefferson T, Pasquarella A, D'Amato M, Faraone M, Volpe E, Guasticchi G. Influenza like Illness (ILI): prescribing behaviour of 83 sentry doctors in Lazio region in the period 2001-2002. Is it adherent to Italian ILI guidelines? Ann Ig 2007; 19:19-26. [PMID: 17405509] [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: 05/14/2023]
Abstract
To describe different doctors' attitudes in drug prescribing in case of influenza-Like-Illness during 2001-2002 influenza season in Lazio region, with regard to consumption and expenditure and its adherence to Italian Guidelines on ILI Management. Prospective study aimed to assess doctors' behaviour in prescribing in respect with the following events: (a) ILI and subsequent controls after diagnosis, (b) complications, (c) adverse events to influenza vaccine. 7,629 subjects, have been identified and only 17% presents one or more comorbidities. There are totally 7,766 cases of ILI: 23% are complicated and out of the remaining 77%, only 14% presents comorbidities. Almost all elderly people have been vaccinated. Antibiotics were prescribed to complicated cases (82%) with comorbidities (55%); 1,075 patients (12%) had second or third contact with doctors in a period longer than 7 days and about 65% of them received antibiotics in case of acute bronchitis; children received mainly ibuprofen and paracetamol for fever control; acetylsalicylic acid in children group has been delivered only in 1% of cases. Overall, doctors' attitude in prescribing is generally coherent with Italian Guidelines on ILI even though a high variability still persists.
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Affiliation(s)
- L Orzella
- Agency of Public Health (ASP) Lazio Region, Rome, Italy.
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McDermott JR, Leslie FC, D'Amato M, Thompson DG, Grencis RK, McLaughlin JT. Immune control of food intake: enteroendocrine cells are regulated by CD4+ T lymphocytes during small intestinal inflammation. Gut 2006; 55:492-7. [PMID: 16299028 PMCID: PMC1856184 DOI: 10.1136/gut.2005.081752] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [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: 01/11/2023]
Abstract
BACKGROUND AND AIMS Gastrointestinal inflammation reduces food intake but the biological mechanisms explaining suppressed feeding during inflammation are unknown. We have used a model of upper gut infection (Trichinella spiralis in the mouse) to study the effect of inflammation on food intake, and explored the role of a key enteroendocrine cell (EEC) in the regulation of feeding by the immune response. METHODS Food intake of NIH mice infected with the intestinal nematode Trichinella spiralis was measured. Duodenal cholecystokinin (CCK) cells were counted. Plasma CCK was measured. Infected mice were treated with a specific CCK1 receptor antagonist, and food intake reassessed. The influence of the immune response on food intake and CCK was mechanistically examined by treating mice with CD4 or mast cell neutralising antibodies. The role of the T helper 2 response was further explored in mice genetically deficient for interleukin (IL)-4, IL-13, or IL-4Ralpha (receptor alpha subunit). RESULTS Food intake of infected mice was significantly reduced at the temporal peak of intestinal inflammation. CCK expressing EEC were upregulated in infected mice, and plasma CCK levels were increased. A CCK1 receptor antagonist restored the food intake of infected mice to a significant degree. Furthermore, suppression of food intake was completely abolished in the absence of CD4+ T lymphocytes or IL-4Ralpha. CONCLUSIONS The data show for the first time that intestinal inflammation results in reduced food intake due to upregulation of CCK. Moreover, following infection, food intake and CCK expressing cells are under the specific control of CD4+ T-cells, via release of IL-4 and IL-13.
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Affiliation(s)
- J R McDermott
- Faculty of Life Sciences, University of Manchester, Manchester, UK
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