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de Franchis R, Bozza L, Canale P, Chiacchio M, Cortese P, D’Avino A, De Giovanni M, Iacovo MD, D’Onofrio A, Federico A, Gasparini N, Iaccarino F, Romano G, Spadaro R, Tedesco M, Vitiello G, Antignani A, Auricchio S, Valentino V, De Filippis F, Ercolini D, Bruzzese D. The Effect of Weaning with Adult Food Typical of the Mediterranean Diet on Taste Development and Eating Habits of Children: A Randomized Trial. Nutrients 2022; 14:nu14122486. [PMID: 35745216 PMCID: PMC9227033 DOI: 10.3390/nu14122486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Mediterranean Diet (Med Diet) is one of the healthiest dietary patterns. We aimed to verify the effects of weaning (i.e., the introduction of solid foods in infants previously fed only with milk) using adult foods typical of Med Diet on children eating habits, and on the microbiota composition. A randomized controlled clinical trial on 394 healthy infants randomized in a 1:1 ratio in a Med Diet group weaned with fresh; seasonal and tasty foods of Med Diet and control group predominantly weaned with industrial baby foods. The primary end point was the percentage of children showing a good adherence to Med Diet at 36 months. Secondary end points were mother’s changes in adherence to Med Diet and differences in children gut microbiota. At 36 months, children showing a good adherence to Med Diet were 59.3% in the Med Diet group and 34.3% in the control group (p < 0.001). An increase in adherence to the Med Diet was observed in the mothers of the Med Diet group children (p < 0.001). At 4 years of age children in the Med Diet group had a higher gut microbial diversity and a higher abundance of beneficial taxa. A Mediterranean weaning with adult food may become a strategy for early nutritional education, to develop a healthy microbiota, to prevent inflammatory chronic diseases and to ameliorate eating habits in children and their families.
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Affiliation(s)
- Raffaella de Franchis
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
- Correspondence:
| | - Luigi Bozza
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Pasquale Canale
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Maria Chiacchio
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Paolo Cortese
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Antonio D’Avino
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Maria De Giovanni
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Mirella Dello Iacovo
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Antonietta D’Onofrio
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Aniello Federico
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Nicoletta Gasparini
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Felicia Iaccarino
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Giuseppe Romano
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Raffaella Spadaro
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Mariangela Tedesco
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Giuseppe Vitiello
- Italian Federation of Maedical Paediatrics (FIMP), 80142 Naples, Italy; (L.B.); (P.C.); (M.C.); (P.C.); (A.D.); (M.D.G.); (M.D.I.); (A.D.); (A.F.); (N.G.); (F.I.); (G.R.); (R.S.); (M.T.); (G.V.)
| | - Angelo Antignani
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Salvatore Auricchio
- European Laboratory for the Investigation of Food-Induced Diseases, Department of Medical Translational Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Vincenzo Valentino
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy; (V.V.); (F.D.F.); (D.E.)
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy; (V.V.); (F.D.F.); (D.E.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy; (V.V.); (F.D.F.); (D.E.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
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Nocerino R, Paparo L, Terrin G, Pezzella V, Amoroso A, Cosenza L, Cecere G, De Marco G, Micillo M, Albano F, Nugnes R, Ferri P, Ciccarelli G, Giaccio G, Spadaro R, Maddalena Y, Berni Canani F, Berni Canani R. Cow's milk and rice fermented with Lactobacillus paracasei CBA L74 prevent infectious diseases in children: A randomized controlled trial. Clin Nutr 2015; 36:118-125. [PMID: 26732025 DOI: 10.1016/j.clnu.2015.12.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/24/2015] [Accepted: 12/10/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIM Fermented foods have been proposed for the prevention of infectious diseases. We evaluated the efficacy of fermented foods in reducing common infectious diseases (CIDs) in children attending daycare. METHODS Prospective randomized, double-blind, placebo-controlled trial (registered under Clinical Trials.gov identifier NCT01909128) on healthy children (aged 12-48 months) consuming daily cow's milk (group A) or rice (group B) fermented with Lactobacillus paracasei CBA L74, or placebo (group C) for three months during the winter season. The main study outcome was the proportion of children who experienced at least one CID. All CIDs were diagnosed by family pediatricians. Fecal concentrations of innate (α- and β-defensins and cathelicidin LL-37) and acquired immunity biomarkers (secretory IgA) were also evaluated. RESULTS 377 children (193 males, 51%) with a mean (SD) age of 32 (10) months completed the study: 137 in group A, 118 in group B and 122 in group C. Intention-to-treat analysis showed that the proportion of children who experienced at least one CID was lower in group A (51.8%) and B (65.9%) compared to group C (80.3%). Per-protocol analysis showed that the proportion of children presenting upper respiratory tract infections was lower in group A (48.2%) and group B (58.5%) compared with group C (70.5%). The proportion of children presenting acute gastroenteritis was also lower in group A (13.1%) and group B (19.5%) compared with group C (31.1%). A net increase of all fecal biomarkers of innate and acquired immunity was observed for groups A and B compared to group C. Moreover, there was a negative association between fecal biomarkers and the occurrence of CID. CONCLUSION Dietary supplementation with cow's milk or rice fermented with L. paracasei CBA L74 prevents CIDs in children attending daycare possibly by means of a stimulation of innate and acquired immunity.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Gianluca Terrin
- Department of Gynecology-Obstetrics and Perinatal Medicine, University of Rome "La Sapienza", Rome, Italy
| | - Vincenza Pezzella
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Antonio Amoroso
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Gaetano Cecere
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Giulio De Marco
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Maria Micillo
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Fabio Albano
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Rosa Nugnes
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Pasqualina Ferri
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Ciccarelli
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Giuliana Giaccio
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Raffaella Spadaro
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Ylenia Maddalena
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | | | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy; European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples "Federico II", Naples, Italy; CEINGE - Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy.
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Franzese A, Iafusco D, Spadaro R, Cavaliere O, Prisco F, Auricchio R, Troncone R, Valerio G. Potential celiac disease in type 1 diabetes: a multicenter study. Diabetes Res Clin Pract 2011; 92:53-6. [PMID: 21239079 DOI: 10.1016/j.diabres.2010.12.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 12/08/2010] [Accepted: 12/21/2010] [Indexed: 12/17/2022]
Abstract
AIMS To describe the prevalence of potential celiac disease (pot-CD) in young patients with type 1 diabetes mellitus (T1DM) and characterize their clinical features. METHODS This cross-sectional multicenter study involved 8717 T1DM patients from 31 Italian centers. Information was collected on the total number of T1DM patients, CD patients and pot-CD patients. The following data were collected on pot-CD patients: gender, age at T1DM diagnosis, age at the first CD serological positivity, presence of CD-related symptoms, presence of other autoimmune disorders and treatment with gluten free diet (GFD). One thousand-three-hundred-sixty-one patients who were positive for CD serology were the control group. RESULTS CD serological positivity was found in 7.2% T1DM patients. Prevalence of pot-CD was 12.2% (n=77) among CD positive patients: symptoms were present in 12/77; a third autoimmune disorder was found in 15 patients. Prevalence of pot-CD in the control population was 8.4% (n=114; p=0.005). No difference was found with regard to clinical features. Only few symptomatic patients were on GFD both in T1DM and control patients. CONCLUSIONS A higher prevalence of pot-CD was found in T1DM patients, that may be ascribed to the routine screening, although the influence of genetic factors cannot be excluded.
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Affiliation(s)
- Adriana Franzese
- Department of Pediatrics, Federico II University, Via S. Pansini 5, 80131 Naples, Italy.
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Maglio M, Florian F, Vecchiet M, Auricchio R, Paparo F, Spadaro R, Zanzi D, Rapacciuolo L, Franzese A, Sblattero D, Marzari R, Troncone R. Majority of children with type 1 diabetes produce and deposit anti-tissue transglutaminase antibodies in the small intestine. Diabetes 2009; 58:1578-84. [PMID: 19401430 PMCID: PMC2699874 DOI: 10.2337/db08-0962] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Anti-tissue transglutaminase (TG2) antibodies are the serological marker of celiac disease. Given the close association between celiac disease and type 1 diabetes, we investigated the production and deposition of anti-TG2 antibodies in the jejunal mucosa of type 1 diabetic children. RESEARCH DESIGN AND METHODS Intestinal biopsies were performed in 33 type 1 diabetic patients with a normal mucosal architecture: 14 had high levels (potential celiac disease patients) and 19 had normal levels of serum anti-TG2 antibodies. All biopsy specimens were investigated for intestinal deposits of IgA anti-TG2 antibodies by double immunofluorescence. In addition, an antibody analysis using the phage display technique was performed on the intestinal biopsy specimens from seven type 1 diabetic patients, of whom four had elevated and three had normal levels of serum anti-TG2 antibodies. RESULTS Immunofluorescence studies showed that 11 of 14 type 1 diabetic children with elevated levels and 11 of 19 with normal serum levels of anti-TG2 antibodies presented with mucosal deposits of such autoantibodies. The phage display analysis technique confirmed the intestinal production of the anti-TG2 antibodies; however, whereas the serum-positive type 1 diabetic patients showed a preferential use of the VH5 antibody gene family, in the serum-negative patients the anti-TG2 antibodies belonged to the VH1 and VH3 families, with a preferential use of the latter. CONCLUSIONS Our findings demonstrate that there is intestinal production and deposition of anti-TG2 antibodies in the jejunal mucosa of the majority of type 1 diabetic patients. However, only those with elevated serum levels of anti-TG2 antibodies showed the VH usage that is typical of the anti-TG2 antibodies that are produced in patients with celiac disease.
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Affiliation(s)
- Mariantonia Maglio
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Fiorella Florian
- Department of Health Sciences, University of Trieste, Trieste, Italy
| | - Monica Vecchiet
- Department of Health Sciences, University of Trieste, Trieste, Italy
| | - Renata Auricchio
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Francesco Paparo
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Raffaella Spadaro
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Delia Zanzi
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Luciano Rapacciuolo
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Adriana Franzese
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
| | - Daniele Sblattero
- Department of Medical Sciences and Research Centre on Autoimmune Diseases, University of Eastern Piedmont, Novara, Italy
| | - Roberto Marzari
- Department of Health Sciences, University of Trieste, Trieste, Italy
| | - Riccardo Troncone
- Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II,” Naples, Italy
- Corresponding author: Riccardo Troncone,
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Valerio G, Spadaro R, Iafusco D, Lombardi F, Del Puente A, Esposito A, De Terlizzi F, Prisco F, Troncone R, Franzese A. The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease. Bone 2008; 43:322-326. [PMID: 18499552 DOI: 10.1016/j.bone.2008.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Revised: 04/02/2008] [Accepted: 04/05/2008] [Indexed: 10/22/2022]
Abstract
A reduced bone mineral density has been reported in patients with untreated celiac disease (CD) as well as in patients with poorly controlled type 1 diabetes mellitus (T1DM). The aim of this study was to evaluate the bone mineral status by phalangeal quantitative ultrasound in 52 children and adolescents with both diseases (mean age 13.3+/-4.9 years). As a control group 50 patients with T1DM and no CD (age 12.2+/-4.0 years) were studied. The following bone parameters, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were considered and expressed as z score. Compliance to gluten free diet and long term glycemic control (mean of four determinations of HbA1c in the last year) were also assessed. The lowest mean AD-SoS z score values were found in patients with T1DM and CD, who reported transgressions to gluten free diet and exhibited positivity for serum anti-tissue transglutaminase antibodies (tTG) and/or endomysial antibodies (EmA), compared with patients with occasional transgressions but negative for anti-tTG and/or -EmA, patients strictly adherent to the diet, and patients who suffered only from diabetes (ANOVA p=0.021). No difference was found between patients with diabetes alone and patients with both diseases strictly adherent to gluten free diet. Prevalence of osteopenia (z AD-SoS values <-2 SD) was higher in patients with T1DM and CD and poor compliance to the diet (45.5%) compared with patients with T1DM (8%) or patients with both diseases strictly compliant to diet (12.9%) (p=0.015). A negative correlation between Ad-SoS z score and HbA1c (r -0.236, p=0.036) was found when patients with T1DM and patients with T1DM and CD, who strictly adhere to the diet, were pooled. In conclusion the quality of bone as assessed by phalangeal ultrasound in patients with T1DM and CD, who strictly adhere to gluten free diet, is similar to that found in T1DM patients. A higher prevalence of osteopenia is present in patients with both diseases who reported habitual transgressions to gluten free diet. The gluten free diet, as well as the optimization of glycemic control, plays an important role in preventing the osteopenic status caused by the clustering of these two chronic diseases.
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Affiliation(s)
- Giuliana Valerio
- School of Movement Sciences (DiSiST), Parthenope University, Naples, Italy.
| | | | - Dario Iafusco
- Department of Pediatrics, Seconda Università, Naples, Italy
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Tinto N, Zagari A, Capuano M, De Simone A, Capobianco V, Daniele G, Giugliano M, Spadaro R, Franzese A, Sacchetti L. Glucokinase gene mutations: structural and genotype-phenotype analyses in MODY children from South Italy. PLoS One 2008; 3:e1870. [PMID: 18382660 PMCID: PMC2270336 DOI: 10.1371/journal.pone.0001870] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 02/19/2008] [Indexed: 01/29/2023] Open
Abstract
Background Maturity onset diabetes of the young type 2 (or GCK MODY) is a genetic form of diabetes mellitus provoked by mutations in the glucokinase gene (GCK). Methodology/Principal Findings We screened the GCK gene by direct sequencing in 30 patients from South Italy with suspected MODY. The mutation-induced structural alterations in the protein were analyzed by molecular modeling. The patients' biochemical, clinical and anamnestic data were obtained. Mutations were detected in 16/30 patients (53%); 9 of the 12 mutations identified were novel (p.Glu70Asp, p.Phe123Leu, p.Asp132Asn, p.His137Asp, p.Gly162Asp, p.Thr168Ala, p.Arg392Ser, p.Glu290X, p.Gln106_Met107delinsLeu) and are in regions involved in structural rearrangements required for catalysis. The prevalence of mutation sites was higher in the small domain (7/12: ∼59%) than in the large (4/12: 33%) domain or in the connection (1/12: 8%) region of the protein. Mild diabetic phenotypes were detected in almost all patients [mean (SD) OGTT = 7.8 mMol/L (1.8)] and mean triglyceride levels were lower in mutated than in unmutated GCK patients (p = 0.04). Conclusions The prevalence of GCK MODY is high in southern Italy, and the GCK small domain is a hot spot for MODY mutations. Both the severity of the GCK mutation and the genetic background seem to play a relevant role in the GCK MODY phenotype. Indeed, a partial genotype-phenotype correlation was identified in related patients (3 pairs of siblings) but not in two unrelated children bearing the same mutation. Thus, the molecular approach allows the physician to confirm the diagnosis and to predict severity of the mutation.
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Affiliation(s)
- Nadia Tinto
- Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Adriana Zagari
- Dipartimento delle Scienze Biologiche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Marina Capuano
- Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Alfonso De Simone
- Dipartimento delle Scienze Biologiche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Valentina Capobianco
- Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Gerardo Daniele
- Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
| | - Michela Giugliano
- Dipartimento di Pediatria, Università di Napoli “Federico II”, Napoli, Italia
| | - Raffaella Spadaro
- Dipartimento di Pediatria, Università di Napoli “Federico II”, Napoli, Italia
| | - Adriana Franzese
- Dipartimento di Pediatria, Università di Napoli “Federico II”, Napoli, Italia
| | - Lucia Sacchetti
- Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli “Federico II” and CEINGE Biotecnologie Avanzate, Napoli, Italia
- * E-mail:
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Santamaria F, Montella S, De Stefano S, Sperlì F, Barbarano F, Spadaro R, Franzese A. Asthma, atopy, and airway inflammation in obese children. J Allergy Clin Immunol 2007; 120:965-7. [PMID: 17637474 DOI: 10.1016/j.jaci.2007.06.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 06/01/2007] [Accepted: 06/04/2007] [Indexed: 11/17/2022]
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Franzese A, Brunetti-Pierri N, Spadaro R, Mukai T, Valerio G. Inappropriate tall stature and renal ectopy in a male patient with X-linked congenital adrenal hypoplasia due to a novel missense mutation in theDAX-1 gene. Am J Med Genet A 2005. [DOI: 10.1002/ajmg.a.30782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Franzese A, Brunetti-Pierri N, Spagnuolo MI, Spadaro R, Giugliano M, Mukai T, Valerio G. Inappropriate tall stature and renal ectopy in a male patient with X-linked congenital adrenal hypoplasia due to a novel missense mutation in theDAX-1 gene. Am J Med Genet A 2005; 135:72-4. [PMID: 15800903 DOI: 10.1002/ajmg.a.30670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Mutations in DAX-1 gene cause congenital adrenal hypoplasia (AHC). We present a male patient affected by X-linked adrenal hypoplasia congenita due to a novel DAX-1 missense mutation. The mutation V287G affects the C-terminal end of the DAX-1 protein which plays an important role in functioning of the receptor. In addition, our patient presented an inappropriate tall stature and renal ectopy, which have not been described in AHC so far.
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Affiliation(s)
- Adriana Franzese
- Department of Pediatrics, Federico II University, Via S. Pansini 5, I-80131 Naples, Italy.
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Salvia G, De Vizia B, Manguso F, Iula VD, Terrin G, Spadaro R, Russo G, Cucchiara S. Effect of intragastric volume and osmolality on mechanisms of gastroesophageal reflux in children with gastroesophageal reflux disease. Am J Gastroenterol 2001; 96:1725-32. [PMID: 11419821 DOI: 10.1111/j.1572-0241.2001.03865.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Both transient lower esophageal sphincter (LES) relaxations (TLESRs) and periods of low/absent LES pressure (LESP) are the main mechanisms of gastroesophageal reflux. These events are believed to be triggered by stimuli from different areas of the upper GI tract. We aimed at investigating the relationship between LESP profile and gastric emptying and distension after meals of different composition in 30 children with gastroesophageal reflux disease (median age 7.0 yr, range 12 months-12 yr). METHODS Recordings of LESP and intraesophageal pH for 1 h fasting and for 2 postprandial h were performed with a perfused sleeve catheter and flexible electrode, respectively; gastric emptying and distension of antral area were simultaneously recorded with real-time ultrasonography. Ten patients had a standard meal (group A), 10 had a high-volume meal (group B), and 10 had a high-volume and osmolality meal (group C). RESULTS Postprandial esophageal acid exposure was significantly higher in patients of groups B and C than in patients of group A (p < 0.01); it was also more prolonged in patients of group C than in subjects of group B (p < 0.05). A higher postfeeding rate of reflux episodes caused by TLESRs was detected in patients of groups B and C as compared with patients of group A (p < 0.01). This increase did not statistically differ in patients of groups B and C. Patients of group C exhibited a higher postprandial rate of reflux episodes associated with low/absent tone of the LES as well as a more prolonged gastric emptying time and a higher postfeeding gastric distension as compared with patients of groups A and B (p < 0.01). Finally, a significant correlation was only found between the postprandial rate of reflux events resulting from low/absent LESP and the degree of antral distension in patients of group C (p < 0.01). CONCLUSION Gastroesophageal reflux is worsened by increasing the volume and osmolality of meals through significant changes of LESP. Meals of high volume and meals with high volume and osmolality cause a comparable increase of reflux episodes as a result of TLESRs. However, meals with high volume and osmolality cause the higher degrees of esophageal acid exposure than meals with high volume resulting from a higher rate of reflux episodes associated with low/absent LESP. This finding correlates with a high postfeeding antral distension.
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Affiliation(s)
- G Salvia
- Department of Pediatrics, University of Naples, Federico II, Italy
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Abstract
BACKGROUND Acid suppressive therapy is the mainstay of pharmacologic treatment of gastro-oesophageal reflux disease. Use of proton pump inhibitors in children is still limited and has only included omeprazole in a few controlled studies. AIM To determine efficacy of lansoprazole, a relatively new proton pump inhibitor, on symptoms and oesophagitis in a group of children with gastro-oesophageal reflux disease refractory to H2 receptor antagonists. The required dose of the drug for inhibiting gastric acidity was also determined. PATIENTS AND METHODS A series of 35 children (median age: 7.6 years, range: 3-15) with oesophagitis refractory to H2 receptor antagonists received a 12-week therapeutic course with lansoprazole. Prior to the study children underwent symptomatic and endoscopic assessment, oesophageal manometry and 24-hour intragastric and intra-oesophageal pH test. The latter was repeated after one week of therapy while patients were on treatment in order to monitor the degree of acid suppression and adjust the dose of the drug. Symptomatic assessment and endoscopy were repeated at the end of the trial RESULTS AND CONCLUSIONS In 12 patients (group A), the initial dose of the drug was efficacious (1.3 to 1.5 mg/kg/day), whereas in 23 [group B) the initial dose (0.8 to 1.0 mg/kg/day) was increased by half because of insufficient inhibition of intragastric acidity (i.e., when the intra-gastric pH remained below 4.0 for more than 50% of the recording time). Nine patients in group A (75%) and 8 in group B (53.5%) healed (chi2: 3.6, p<0.05); 1 patient in group A [8.3%) and 7 in group B (30.5%) remained unchanged (chi2: 6.9, p<0.01); 2 patients in group A and 8 in group B improved and underwent a further month of therapy. The two groups did not differ as far as concerns baseline pH, endoscopic and clinical variables. In both groups, those patients failing to respond at the end of the trial showed a more impaired oesophageal motility than improved or healed patients. The drug was well tolerated and no significant laboratory abnormalities occurred. In children with gastro-oesophageal reflux disease refractory to H2 receptor antagonists, a 12-week course of lansoprazole is effective both in healing oesophagitis and improving symptoms. An initial dose of 1.5 mg/kg/day of the drug is suggested. However, if during treatment, patients remain symptomatic the dose should be increased and a prolonged intra-gastric and intra-oesophageal pH test performed to evaluate the acid suppression efficacy of the adjusted dose. A short course of lansoprazole appears to be safe and well tolerated in paediatric age.
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Affiliation(s)
- M T Franco
- Gastrointestinal Motility and Endoscopy, Clinical Department of Pediatrics, University of Naples Federico II, Italy
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12
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Abstract
Gastro-oesophageal reflux (GOR) is the effortless passage of gastric contents into the distal oesophagus. It can be classified as functional (or symptomatic), in which the infant remains free from disease, or a pathological (GOR disease, GORD), in which gastrointestinal, respiratory or neurobehavioural signs occur with intraoesophageal acidification and the development of oesophagitis. Functional or symptomatic GOR is successfully treated by conservative measures and does not require investigative diagnostic tools; however, both drug administration and an investigative approach are mandatory in patients with GORD. There is currently a great range of proven therapeutic options for GORD that are directed at counteracting the pathogenetic components of the disorder. In this report we discuss the role of different drug classes for treating GORD in children. The choice of therapy for GORD depends upon the severity of signs and the degree of oesophagitis. The presence of oesophagitis, as documented by endoscopy, suggests the use of antisecretory drugs; H2 receptor antagonists are the first-line agents. Nevertheless, individuals with refractory disease or those patients requiring potent inhibition of acid secretion (for example, GORD with respiratory involvement) can be given proton pump inhibitors. Other groups of patients who need potent inhibition of acid secretion are children with neurological dysfunction and those with Barrett's oesophagus. It is still unclear whether patients with frequent relapses are candidates for long term administration of antisecretory drugs or for surgical fundoplication.
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Affiliation(s)
- S Cucchiara
- Department of Paediatrics, University of Naples Federico II, Italy.
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Marmo E, Lampa E, Chieppa S, Bile G, Romano AR, Vacca C, Spadaro R. Antagonistic effects of guanabenz, carteolol, and muzolimine on hypertensive responses in the anesthetized dog. Res Commun Chem Pathol Pharmacol 1984; 46:25-33. [PMID: 6505388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In dogs, treatment with guanabenz, carteolol, and muzolimine for 7 days, reduced the blood pressure responses to bilateral occlusion of the carotid arteries, electric stimulation of central vagus nerve, acetylcholine after atropinization, nicotine, l-noradrenaline, angiotensin II, l-adrenaline, KC1 and asphyxia.
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Mariani E, Bondavalli F, Schenone P, Ranise A, Vacca C, Chieppa S, Spadaro R, Marmo E. Derivatives of 1,3,3-trimethyl-6-azabicyclo[3.2.1]octane with hypotensive activity. I. Farmaco Sci 1983; 38:653-63. [PMID: 6641931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The synthesis of three series of glycinamides (IV), amides (V) and diamines (VI) starting from 1,3,3-trimethyl-6-azabicyclo[3.2.1]octane is described. Some of compounds (IV), (V) and (VI) showed a moderate hypotensive activity in rats. Effects on heart rate in rats, infiltration anesthesia and antiarrhythmic activity in mice, as well as antiacetylcholine activity in vitro, are also reported.
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Mariani E, Bondavalli F, Schenone P, Ciarallo G, Spadaro R, De Marco G, D'Angelo G, Marmo E. Derivatives of 5,7,7-trimethyl-6-oxa-3-azatricyclo[3.2.2.0(2.4)]nonane with antiarrhythmic, local anesthetic and hypotensive activities. Farmaco Sci 1982; 37:438-49. [PMID: 7128802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The synthesis of ureas (IV) and amides (V) derived from the tricyclic terpenoid amine 5,7,7-trimethyl-6-oxa-3-azatricyclo[3.2.2.0(2.4)]nonane (III) is described. A number of these compounds showed hypotensive and bradycardic activity in rats, as well as infiltration anesthesia and antiarrhythmic activity in mice. In particular, the n-butylurea (IV b) was superior to lidocaine concerning the anesthetic effect, and the benzamide (V f) showed the same degree of local anesthetic and antiarrhythmic activity as lidocaine. Antiacetylcholine activity in vitro and antitumor activity against P388 lymphocytic leukemia in mice are also reported.
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Montinaro C, De Gennaro G, Scafuro MA, Spaziante G, Ruta A, Ruggiero E, D'Angelo G, Spadaro R, De Marco G. [Experimental research on a new respiratory analeptic: almitrine]. Minerva Anestesiol 1982; 48:373-82. [PMID: 6127655] [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: 01/18/2023]
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Ottavo R, Marfella A, Ruta A, Pentimalli D, De Marco G, D'Angelo G, Scognamiglio M, Spadaro R, De Gennaro G. [Carotid sinus baroreceptor reactivity and chemoreceptor reactivity of the carotid body in anesthetized dogs treated with endocarotid administration of beta-adrenolytics]. Minerva Anestesiol 1982; 48:203-8. [PMID: 6127654] [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: 01/18/2023]
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18
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Mazzeo V, Scognamiglio M, Pentimalli D, De Gennaro G, Ruta A, Spadaro R, D'Angelo G, De Marco G. [Phosphocreatine and skeletal musculature: in vivo research]. Minerva Anestesiol 1982; 48:13-6. [PMID: 7078747] [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: 01/23/2023]
Abstract
Phosphocreatine has been shown having significant effects on striated skeletal musculature. In fact, it was shown, by experimental researches, that phosphocreatine interfered with the state of fatigue induced in the Mus musculus and in rats, by the swimming test.
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Marmo E, Spadaro R, Vacca C, De Rosa G. [Analysis of the hypolipemic, hypocholesteremic and platelet anti-aggregating effects of tibric acid]. Farmaco Sci 1975; 30:666-75. [PMID: 1149877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Tibric acid shows interesting hypocholesteremic and hypolipemic activity greater than that of clofibrate. In addition high concentrations of tibric acid affect platelet aggregation. Tibric acid does not show choleretic activity and does not affect liver function.
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Marmo E, Lampa E, Vacca C, Rossi F, Spadaro R, Sannino A. [Experimental analysis of the interactions between heparin and a duodenal heparinoid]. Arch Sci Med (Torino) 1975; 132:83-115. [PMID: 56927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
It is shown that positive synergism exists between the clarifying, hypocholesterolaemising, hypolipidaemising and fibrinolytic effects of heparin sodium and a duodenal heparinoid. The results of pharmacokinetic and chemicophysical investigations are also presented.
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Marmo E, Imperatore A, Chieppa S, Brita G, Spadaro R, Cecchetti M. [Experimental studies of tranexamic acid (AMCHA)]. Arch Sci Med (Torino) 1975; 132:9-23. [PMID: 1171672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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