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Miller A, Cutroneo G, Lombardo GP, D'Angelo R, Pallio S, Migliorato A, Fumia A, Favaloro A, Lauriano ER, Pergolizzi S. Association between neuropeptides and mucins in Crohn's disease mucous cells. Acta Histochem 2023; 125:152115. [PMID: 37979446 DOI: 10.1016/j.acthis.2023.152115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023]
Abstract
Crohn's disease (CD) and ulcerative colitis (UC) are both inflammatory bowel diseases (IBD). Unlike UC, which is limited to the mucosa of the colon, CD inflammation is characterized by chronic mucosal ulcerations affecting the entire gastrointestinal tract. Goblet cells (GCs) can be found in some lining epithelia, particularly in the respiratory and digestive tracts. GCs represent the main source of mucin that are the significant components of the mucus layer; hypertrophy of GCs and an increase in mucin production are observed in many enteric infections. The cytoplasm of goblet cells may also contain neuropeptides, such as serotonin, that can be altered in inflammatory bowel disease (IBD). The defense system of the gut is represented by the intestinal mucosal barrier, its protective function is strictly connected to the regulation of the mucus layer and the coordination of the neuro-immune response. Paraformaldehyde-fixed intestinal tissues, obtained from fifteen patients with Crohn's disease, were analyzed by immunostaining for MUC2, MUC4, 5-HT, and VAChT. This study aims to define the link between neuropeptides and mucins in mucous cells and their involvement in the inflammation process. Our results showed in mucous cells of Crohn's disease (CD) patients a high expression of MUC4 and a decrease in the expression of vesicular acetylcholine transporter (VAChT) demonstrating the presence of an inflammatory state.
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Affiliation(s)
- Anthea Miller
- Department of Veterinary Sciences, University of Messina, Polo Universitario dell'Annunziata, 98168 Messina, Italy
| | - Giuseppina Cutroneo
- Department of Biomedical and Dental Sciences and Morphofunctional Images, University of Messina, 98125 Messina, Italy
| | - Giorgia Pia Lombardo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Roberta D'Angelo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Socrate Pallio
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy
| | - Alba Migliorato
- Department of Biomedical and Dental Sciences and Morphofunctional Images, University of Messina, 98125 Messina, Italy
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy.
| | - Angelo Favaloro
- Department of Biomedical and Dental Sciences and Morphofunctional Images, University of Messina, 98125 Messina, Italy
| | - Eugenia Rita Lauriano
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy
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Alesci A, Fumia A, Albano M, Messina E, D'Angelo R, Mangano A, Miller A, Spanò N, Savoca S, Capillo G. Investigating the internal system of defense of Gastropoda Aplysia depilans (Gmelin, 1791): Focus on hemocytes. Fish Shellfish Immunol 2023; 137:108791. [PMID: 37146849 DOI: 10.1016/j.fsi.2023.108791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/01/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
The internal defense system of mollusks represents an efficient protection against pathogens and parasites, involving several biological immune processes, such as phagocytosis, encapsulation, cytotoxicity, and antigenic recognition of self/non-self. Mollusks possess professional, migratory, and circulating cells that play a key role in the defense of the organism, the hemocytes. Several studies have been performed on hemocytes from different mollusks, but, to date, these cells are still scarcely explored. Different hemocyte populations have been found, according to the presence or absence of granules, size, and the species of mollusks studied. Our study aims to deepen the knowledge of the hemocytes of the gastropod Aplysia depilans using morphological techniques and light and confocal microscopy, testing Toll-like receptor 2, inducible nitric oxide synthetase, and nicotinic acetylcholine receptor alpha 7 subunit. Our results show two hemocyte populations distinguishable by size, and presence/absence of granules in the cytoplasm, strongly positive for the antibodies tested, suggesting for the first time the presence of these receptors on the surface of sea hare hemocytes by immunohistochemistry. These data help in the understanding of the immune system of this gastropod, providing additional data for comprehending the evolution of the defense response in metazoan phylogenesis.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, Padiglione C, A. O. U. Policlinico "G. Martino", 98124, Messina, Italy.
| | - Marco Albano
- Department of Veterinary Sciences, University of Messina, 98168, Messina, Italy.
| | - Emmanuele Messina
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Roberta D'Angelo
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Angelica Mangano
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, 98168, Messina, Italy.
| | - Nunziacarla Spanò
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98125, Messina, Italy; Institute for Marine Biological Resources and Biotechnology (IRBIM), National Research Council (CNR), Section of Messina, 98100, Messina, Italy.
| | - Serena Savoca
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98125, Messina, Italy; Institute for Marine Biological Resources and Biotechnology (IRBIM), National Research Council (CNR), Section of Messina, 98100, Messina, Italy.
| | - Gioele Capillo
- Department of Veterinary Sciences, University of Messina, 98168, Messina, Italy; Institute for Marine Biological Resources and Biotechnology (IRBIM), National Research Council (CNR), Section of Messina, 98100, Messina, Italy.
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Alesci A, Pergolizzi S, Mokhtar DM, Fumia A, Aragona M, Lombardo GP, Messina E, D'Angelo R, Lo Cascio P, Sayed RKA, Albano M, Capillo G, Lauriano ER. Morpho-structural adaptations of the integument in different aquatic organisms. Acta Histochem 2023; 125:152031. [PMID: 37075648 DOI: 10.1016/j.acthis.2023.152031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
The integument acts as a barrier to protect the body from harmful pathogenic infectious agents, parasites, UV rays, trauma, and germs. The integument of invertebrates and vertebrates are structurally different: while invertebrates usually have a simple monolayer epidermis frequently covered by mucus, cuticles, or mineralized structures, vertebrates possess a multilayered epidermis with several specialized cells. This study aims to describe by morphological, histological, and immunohistochemical analyses, the morpho-structural adaptations throughout evolution of the integument of gastropod Aplysia depilans (Gmelin, 1791), ascidian Styela plicata (Lesuer, 1823), myxine hagfish Eptatretus cirrhatus (Forster, 1801) and teleost Heteropneustes fossilis (Bloch, 1794) for the first time, with special reference to sensory epidermal cells. Different types of cells could be identified that varied according to the species; including mucous cells, serous glandular cells, clavate cells, club cells, thread cells, and support cells. In all integuments of the specimens analyzed, sensory solitary cells were identified in the epidermis, immunoreactive to serotonin and calbindin. Our study provided an essential comparison of integuments, adding new information about sensory epidermal cells phylogenetic conservation and on the structural changes that invertebrates and vertebrates have undergone during evolution.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy.
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Doaa M Mokhtar
- Department of Anatomy and Histology, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, Padiglione C, A. O. U. Policlinico "G. Martino", 98124 Messina, Italy.
| | - Marialuisa Aragona
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy
| | - Giorgia Pia Lombardo
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Emmanuele Messina
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Roberta D'Angelo
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Patrizia Lo Cascio
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Ramy K A Sayed
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
| | - Marco Albano
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy
| | - Gioele Capillo
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; Institute for Marine Biological Resources and Biotechnology (IRBIM), National Research Council (CNR), Section of Messina, 98100 Messina, Italy
| | - Eugenia Rita Lauriano
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
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Pergolizzi S, Fumia A, D'Angelo R, Mangano A, Lombardo GP, Giliberti A, Messina E, Alesci A, Lauriano ER. Expression and function of toll-like receptor 2 in vertebrate. Acta Histochem 2023; 125:152028. [PMID: 37075649 DOI: 10.1016/j.acthis.2023.152028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
Toll-like receptors (TLRs) are essential for identifying and detecting pathogen-associated molecular patterns (PAMPs) produced by a variety of pathogens, including viruses and bacteria. Since TLR2 is the only TLR capable of creating functional heterodimers with more than two other TLR types, it is very important for vertebrate immunity. TLR2 not only broadens the variety of PAMPs that it can recognize but has also the potential to diversify the subsequent signaling cascades. TLR2 is ubiquitous, which is consistent with the wide variety of tasks and functions it serves. Immune cells, endothelial cells, and epithelial cells have all been found to express TLR2. This review aims to gather currently available information about the preservation of this intriguing immunological molecule in the phylum of vertebrates.
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Affiliation(s)
- Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, Padiglione C, A. O. U. Policlinico "G. Martino", 98124 Messina, Italy
| | - Roberta D'Angelo
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Angelica Mangano
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Giorgia Pia Lombardo
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Angelo Giliberti
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Emmanuele Messina
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
| | - Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy.
| | - Eugenia Rita Lauriano
- Department of Chemical, Biological, Pharmaceutical, and Environmental Sciences, University of Messina, 98166 Messina, Italy
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Guaraldi P, Rocchi C, Cani I, Gagliardi C, Longhi S, Baschieri F, Rinaldi R, Frezza E, D'Angelo R, Barletta G, Calandra-Buonaura G, Galiè N, Massa R, Cortelli P. Cardiovascular reflex tests detect autonomic dysfunction in symptomatic and pre-symptomatic subjects with hereditary transthyretin amyloidosis. Clin Auton Res 2023; 33:15-22. [PMID: 36625973 DOI: 10.1007/s10286-022-00921-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Autonomic dysfunction is a distinctive but undervalued feature of hereditary transthyretin amyloidosis (ATTRv). It may predate the onset of polyneuropathy and cardiomyopathy, thereby providing crucial prognostic and therapeutic information. The objective of this study was to assess autonomic function by means of the standardized cardiovascular autonomic reflex tests (CRTs) in a cohort of subjects with genetically proven ATTRv from non-endemic areas who were in the symptomatic and pre-symptomatic stages. METHODS All subjects enrolled in this cross-sectional study had genetically proven ATTRv. They underwent the head-up tilt test, Valsalva manoeuvre, deep breathing test, cold face test and handgrip test while under continuous blood pressure and heart rate monitoring. Based on the results of the nerve conduction study, the subjects were divided into two groups: those with polyneuropathy (ATTRv-wPN) and those without polyneuropathy (ATTRv-woPN). Age- and sex-matched healthy controls (HC) were used for comparison. RESULTS Thirty-seven ATTRv subjects (19 with ATTRv-wPN, 18 with ATTRv-woPN) and 41 HC performed the CRTs. Of these 37 subjects with ATTRv, four (11%) presented neurogenic orthostatic hypotension the during head-up tilt test. Based on the results of the CRTs, autonomic dysfunction characterized by either sympathetic or parasympathetic impairment was detected in 37% and 63% of ATTRv-wPN subjects, respectively. Subjects with ATTRv-woPN presented a significant impairment of autonomic responses to the Valsalva manoeuvre compared to the HC (overshoot p = 0.004; Valsalva ratio p = 0.001). CONCLUSION Autonomic dysfunctions are frequent in subjects with ATTRv when investigated by means of standardized CRTs, and are also relevant in the pre-symptomatic stage. Cardiovagal functions are the primary functions affected, among others. This may be crucial in defining the proper diagnostic workout for early diagnosis and improving the likelihood of providing the patient with prompt administration of disease-modifying treatments.
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Affiliation(s)
- P Guaraldi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - C Rocchi
- Neurology Unit, Department of Systems Medicine, Policlinico Tor Vergata, Rome, Italy
| | - I Cani
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - C Gagliardi
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - S Longhi
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - F Baschieri
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R Rinaldi
- UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - E Frezza
- Neuromuscular Diseases Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - R D'Angelo
- UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - G Barletta
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Calandra-Buonaura
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - N Galiè
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
- UO Cardiologia, IRCCS Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - R Massa
- Neuromuscular Diseases Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - P Cortelli
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Wildemann R, Karalis D, Mirachi N, Thoma B, D'Angelo R. Change in Diuretic Dose After Initiation of a SGLT2 Inhibitor in Patients with Heart Failure with Reduced Ejection Fraction. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1405] [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: 11/30/2022] Open
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Fileccia E, Rinaldi R, Minicuci G, D'Angelo R, Bartolomei L, Liguori R, Donadio V. Subcutaneous immunoglobulin for maintenance therapy in stiff-person syndrome: One-year follow-up in two patients. Neuromuscul Disord 2020; 30:921-924. [DOI: 10.1016/j.nmd.2020.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
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Gramegna LL, Pisano A, Testa C, Manners DN, D'Angelo R, Boschetti E, Giancola F, Pironi L, Caporali L, Capristo M, Valentino ML, Plazzi G, Casali C, Dotti MT, Cenacchi G, Hirano M, Giordano C, Parchi P, Rinaldi R, De Giorgio R, Lodi R, Carelli V, Tonon C. Cerebral Mitochondrial Microangiopathy Leads to Leukoencephalopathy in Mitochondrial Neurogastrointestinal Encephalopathy. AJNR Am J Neuroradiol 2018; 39:427-434. [PMID: 29348134 DOI: 10.3174/ajnr.a5507] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 10/30/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Mitochondrial neurogastrointestinal encephalopathy is a rare disorder due to recessive mutations in the thymidine phosphorylase gene, encoding thymidine phosphorylase protein required for mitochondrial DNA replication. Clinical manifestations include gastrointestinal dysmotility and diffuse asymptomatic leukoencephalopathy. This study aimed to elucidate the mechanisms underlying brain leukoencephalopathy in patients with mitochondrial neurogastrointestinal encephalopathy by correlating multimodal neuroradiologic features to postmortem pathology. MATERIALS AND METHODS Seven patients underwent brain MR imaging, including single-voxel proton MR spectroscopy and diffusion imaging. Absolute concentrations of metabolites calculated by acquiring unsuppressed water spectra at multiple TEs, along with diffusion metrics based on the tensor model, were compared with those of healthy controls using unpaired t tests in multiple white matters regions. Brain postmortem histologic, immunohistochemical, and molecular analyses were performed in 1 patient. RESULTS All patients showed bilateral and nearly symmetric cerebral white matter hyperintensities on T2-weighted images, extending to the cerebellar white matter and brain stem in 4. White matter, N-acetylaspartate, creatine, and choline concentrations were significantly reduced compared with those in controls, with a prominent increase in the radial water diffusivity component. At postmortem examination, severe fibrosis of brain vessel smooth muscle was evident, along with mitochondrial DNA replication depletion in brain and vascular smooth-muscle and endothelial cells, without neuronal loss, myelin damage, or gliosis. Prominent periependymal cytochrome C oxidase deficiency was also observed. CONCLUSIONS Vascular functional and histologic alterations account for leukoencephalopathy in mitochondrial neurogastrointestinal encephalopathy. Thymidine toxicity and mitochondrial DNA replication depletion may induce microangiopathy and blood-brain-barrier dysfunction, leading to increased water content in the white matter. Periependymal cytochrome C oxidase deficiency could explain prominent periventricular impairment.
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Affiliation(s)
- L L Gramegna
- From the Functional MR Unit (L.L.G., C.T., D.N.M., R.L., C.T.).,Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.)
| | - A Pisano
- Departments of Radiology, Oncology, and Pathology (A.P., C.G.)
| | - C Testa
- From the Functional MR Unit (L.L.G., C.T., D.N.M., R.L., C.T.).,Neurology Unit (R.D., R.R.), S.Orsola-Malpighi Hospital, Bologna, Italy.,Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.)
| | - D N Manners
- From the Functional MR Unit (L.L.G., C.T., D.N.M., R.L., C.T.).,Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.)
| | - R D'Angelo
- Neurology Unit (R.D., R.R.), S.Orsola-Malpighi Hospital, Bologna, Italy
| | - E Boschetti
- Surgical and Medical Sciences (E.B., F.G., L.P., R.D.G.), University of Bologna, Bologna, Italy
| | - F Giancola
- Surgical and Medical Sciences (E.B., F.G., L.P., R.D.G.), University of Bologna, Bologna, Italy
| | - L Pironi
- Surgical and Medical Sciences (E.B., F.G., L.P., R.D.G.), University of Bologna, Bologna, Italy
| | - L Caporali
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - M Capristo
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - M L Valentino
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - G Plazzi
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - C Casali
- Medico-Surgical Sciences and Biotechnologies (C.C.), Sapienza, University of Rome, Rome, Italy
| | - M T Dotti
- Department of Medicine, Surgery, and Neuroscience (M.T.D.), University of Siena, Siena, Italy
| | - G Cenacchi
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.)
| | - M Hirano
- Department of Neurology (M.H.), Columbia University Medical Centre, New York, New York
| | - C Giordano
- Departments of Radiology, Oncology, and Pathology (A.P., C.G.)
| | - P Parchi
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - R Rinaldi
- Neurology Unit (R.D., R.R.), S.Orsola-Malpighi Hospital, Bologna, Italy
| | - R De Giorgio
- Surgical and Medical Sciences (E.B., F.G., L.P., R.D.G.), University of Bologna, Bologna, Italy
| | - R Lodi
- From the Functional MR Unit (L.L.G., C.T., D.N.M., R.L., C.T.) .,Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.)
| | - V Carelli
- Departments of Biomedical and Neuromotor Sciences (L.L.G., C.T., D.N.M., L.C., M.C., M.L.V., G.P., G.C., P.P., R.L., V.C., C.T.).,Istituto di Ricovero e Cura a Carattere Scientifico Institute of Neurological Sciences (L.C., M.C., M.L.V., G.P., P.P., V.C.), Bologna, Italy
| | - C Tonon
- From the Functional MR Unit (L.L.G., C.T., D.N.M., R.L., C.T.)
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Falcone M, Russo A, Gentiloni Silverj F, Marzorati D, Bagarolo R, Monti M, Velleca R, D'Angelo R, Frustaglia A, Zuccarelli GC, Prina R, Vignati M, Marnati MG, Venditti M, Tinelli M. Predictors of mortality in nursing-home residents with pneumonia: a multicentre study. Clin Microbiol Infect 2017; 24:72-77. [PMID: 28583738 DOI: 10.1016/j.cmi.2017.05.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 02/17/2017] [Revised: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate predictors of mortality in patients residing in nursing-homes (NHs) or long-term care facilities (LTCFs) with diagnosis of NH-acquired pneumonia (NHAP). METHODS We conducted an observational, prospective study (December 2013-December 2015) of patients residing in nine NHs/LTCFs of Central and Northern Italy with diagnosis of NHAP. Data on demographics, comorbidities, microbiology, and therapies were entered into an electronic database. To identify risk factors associated with 30-day mortality, we performed univariable and multivariable analyses, and predictors were internally validated using a bootstrap resampling procedure. We derived a prediction rule using the coefficients obtained from the multivariable logistic regression. The model obtained was assessed using the area under the receiver operating characteristic curve (AUROC). RESULTS Overall, 446 patients with NHAP were included in the final cohort. The median age was 80 (IQR 75-87) years. A definite aetiology was obtained in 120 (26.9%) patients; of these, 66 (55%) had a culture positive for a multidrug-resistant pathogen. The 30-day mortality was 28.7%. On multivariate analysis, malnutrition (OR 7.8; 95% CI 3-20.2, 2 points), bilateral pneumonia (OR 3.7; 95% CI 1.4-9.8, 1 point), acute mental status deterioration (OR 6.2; 95% CI 2.2-17.6, 2 points), hypotension (OR 7.7; 95% CI 2.3-24.9, 2 points), and PaO2/FiO2 ratio ≤250 (OR 7.4; 95% CI 2.2-24.2, 2 points) were independently associated with 30-day mortality. The derived prediction rule showed an AUROC of 0.83 (95% CI 0.78-0.87, p <0.001). CONCLUSIONS NH residents with pneumonia have specific risk factors associated with 30-day mortality. Malnutrition and acute mental change appear as major determinants of death in this population.
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Affiliation(s)
- M Falcone
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Italy.
| | - A Russo
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Italy
| | | | - D Marzorati
- Italian Auxological Institute, "San Luca" Hospital, Milan, Italy
| | - R Bagarolo
- "Don Gnocchi Foundation", Palazzolo Long Term Care Facility, Milan, Italy
| | - M Monti
- "Pio Albergo Trivulzio" Long Term Care Facility, Milan, Italy
| | - R Velleca
- "Pio Albergo Trivulzio" Long Term Care Facility, Milan, Italy
| | - R D'Angelo
- "Golgi-Redaelli" Long Term Care Facility, Milan, Italy
| | - A Frustaglia
- "Golgi-Redaelli" Long Term Care Facility, Vimodrone, Italy
| | - G C Zuccarelli
- "Golgi-Redaelli" Long Term Care Facility, Vimodrone, Italy
| | - R Prina
- "Golgi-Redaelli" Long Term Care Facility, Vimodrone, Italy
| | - M Vignati
- "Sandro Pertini" Long Term Care Facility, Garbagnate, Italy
| | | | - M Venditti
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Italy
| | - M Tinelli
- Division of Infectious and Tropical Diseases, Hospital of Lodi, Lodi, Italy
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10
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Fileccia E, Rinaldi R, Liguori R, Incensi A, D'Angelo R, Giannoccaro MP, Donadio V. Post-ganglionic autonomic neuropathy associated with anti-glutamic acid decarboxylase antibodies. Clin Auton Res 2016; 27:51-55. [PMID: 27913968 DOI: 10.1007/s10286-016-0390-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/18/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE Antibodies to glutamic acid decarboxylase (GAD-Abs) have been associated with several conditions, rarely involving the autonomic nervous system. Here, we describe two patients complaining of autonomic symptoms in whom a post-ganglionic autonomic neuropathy has been demonstrated in association with significantly elevated serum and CSF GAD-Abs levels. METHODS Patients underwent nerve conduction studies, sympathetic skin response testing, evaluation of autonomic control of the cardiovascular system and skin biopsy. Also, serum screening to exclude predisposing causes of peripheral neuropathy was performed. Anti-GAD65 antibodies were evaluated in serum and CSF. RESULTS GAD-Abs titer was increased in both serum and CSF in both patients. Sympathetic skin response was absent and skin biopsy revealed a non-length-dependent small-fiber neuropathy with sympathetic cholinergic and adrenergic post-ganglionic damage in both patients. Nerve conduction studies and evaluation of autonomic control of the cardiovascular system were normal in both patients. Both patients were treated with steroids with good, but partial, (patient 2) recovery of the autonomic dysfunctions. CONCLUSIONS Although the pathophysiological mechanisms involved are not fully defined, GAD-abs positivity in serum and CSF should be searched in patients with autonomic neuropathy when no other acquired causes are evident. This positivity may help to clarify autoimmune etiology and, subsequently, to consider immunomodulatory treatment.
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Affiliation(s)
- E Fileccia
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - R Rinaldi
- Neurology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - R Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - A Incensi
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - R D'Angelo
- Neurology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - M P Giannoccaro
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - V Donadio
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
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Nahapetyan H, Swiader A, Faccini J, D'Angelo R, Mucher E, Elbaz M, Boya P, Vindis C. Mitophagy acts as a safeguard mechanism against human vascular smooth muscle cell apoptosis induced by atherogenic lipids. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.115] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Ameri SK, Singh PK, D'Angelo R, Stoppel W, Black L, Sonkusale SR. Three dimensional graphene scaffold for cardiac tissue engineering and in-situ electrical recording. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016:4201-4203. [PMID: 28269209 DOI: 10.1109/embc.2016.7591653] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this paper, we present a three-dimensional graphene foam made of few layers of CVD grown graphene as a scaffold for growing cardiac cells and recording their electrical activity. Our results show that graphene foam not only provides an excellent extra-cellular matrix (ECM) for the culture of such electrogenic cells but also enables recording of its extracellular electrical activity in-situ. Recording is possible due to graphene's excellent conductivity. In this paper, we present our results on the fabrication of the graphene scaffold and initial studies on the culture of cardiac cell lines such as HL-1 and recording of their real-time electrical activity.
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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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Booth JL, Pan PH, Thomas JA, Harris LC, D'Angelo R. A retrospective review of an epidural blood patch database: the incidence of epidural blood patch associated with obstetric neuraxial anesthetic techniques and the effect of blood volume on efficacy. Int J Obstet Anesth 2016; 29:10-17. [PMID: 27378709 DOI: 10.1016/j.ijoa.2016.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 05/21/2015] [Revised: 04/27/2016] [Accepted: 05/30/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The optimal volume of blood required to treat post-dural puncture headache remains in question. In our institution a target volume of 30mL is used for an epidural blood patch unless the patient experiences pain during injection. METHODS The institutional database was retrospectively reviewed for epidural blood patch and delivery statistics over a 15-year period to determine if the volume of blood administered during the procedure directly correlated with the number of epidural blood patches administered. The primary endpoint was defined as the need for a repeat epidural blood patch. RESULTS There were 466 epidural blood patches performed on 394 patients, associated with 84 804 obstetric neuraxial procedures. Thirty-two percent (95% CI 28.3 to 34.9%) of patients who had an inadvertent dural puncture with an epidural needle received an epidural blood patch versus 0.19% (0.16% to 0.22%) of patients who received neuraxial anesthesia with no documented dural puncture with an epidural needle. All patients experienced relief of post-dural puncture headache, although 17% required two and 1.5% required three epidural blood patches. The mean±SD volume of blood administered was 20.5±5.4mL and only 35 patients (8.9%) received 30mL. CONCLUSION Increasing blood volumes up to 30mL did not reduce the need for repeat epidural blood patch. Although the optimal volume of blood to administer during epidural blood patch placement remains unknown, our institution will continue to administer up to 30mL or until the patient experiences pain during epidural injection.
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Affiliation(s)
- J L Booth
- Department of Anesthesiology, Wake Forest University Medical School, Winston-Salem, NC, USA
| | - P H Pan
- Department of Anesthesiology, Wake Forest University Medical School, Winston-Salem, NC, USA
| | - J A Thomas
- Department of Anesthesiology, Wake Forest University Medical School, Winston-Salem, NC, USA
| | - L C Harris
- Department of Anesthesiology, Wake Forest University Medical School, Winston-Salem, NC, USA
| | - R D'Angelo
- Department of Anesthesiology, Wake Forest University Medical School, Winston-Salem, NC, USA.
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Affiliation(s)
- R Vetrugno
- Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, I-40123, Bologna, Italy,
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16
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Rinaldi C, Bramanti P, Famà A, Scimone C, Donato L, Antognelli C, Alafaci C, Tomasello F, D'Angelo R, Sidoti A. GLYOXALASE I A111E, PARAOXONASE 1 Q192R AND L55M POLYMORPHISMS IN ITALIAN PATIENTS WITH SPORADIC CEREBRAL CAVERNOUS MALFORMATIONS: A PILOT STUDY. J BIOL REG HOMEOS AG 2015; 29:493-500. [PMID: 26122242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
It is already known that the conditions of increased oxidative stress are associated to a greater susceptibility to vascular malformations including cerebral cavernous malformations (CCMs). These are vascular lesions of the CNS characterized by abnormally enlarged capillary cavities that can occur sporadically or as a familial autosomal dominant condition with incomplete penetrance and variable clinical expression attributable to mutations in three different genes: CCM1(Krit1), CCM2 (MGC4607) and CCM3 (PDCD10). Polymorphisms in the genes encoding for enzymes involved in the antioxidant systems such as glyoxalase I (GLO I) and paraoxonase I (PON I) could influence individual susceptibility to the vascular malformations. A single nucleotide polymorphism was identified in the exon 4 of GLO 1 gene that causes an amino acid substitution of Ala for Glu (Ala111Glu). Two common polymorphisms have been described in the coding region of PON1, which lead to glutamine → arginine substitution at 192 (Q192R) and a leucine → methionine substitution at 55 (L55M). The polymorphisms were characterized in 59 patients without mutations in the CCM genes versus 213 healthy controls by PCR/RFLP methods using DNA from lymphocytes. We found that the frequency of patients carrying the GLO1 A/E genotype among the case group (56%) was four-fold higher than among the controls (14.1%). In the cohort of CCM patients, an increase in the frequency of PON192 Q/R genotype was observed (39% in the CCM group versus 3.7% in the healthy controls). Similarly, an increase was observed in the proportion of individuals with the genotype R/R in the disease group (5%) in respect to the normal healthy cohort (0.5%). Finally, the frequency of the PON55 heterozygotes L/M genotype was 29% in patients with CCMs and 4% in the healthy controls. The same trend was observed in PON55 homozygous M/M genotype frequency (CCMs 20% vs controls 10%). The present study aimed to investigate the possible association of GLO1 A111E, PON1 Q192R and L55M polymorphisms with the risk of CCMs. We found that individuals with the GLO1 A /E genotype, PON192/QR-RR genotypes and PON55/LM-MM genotypes had a significantly higher risk of CCMs compared with the other genotypes. However, because CCM is a heterogeneous disease, other additional factors might be involved in the initiation and progression of CCM disease.
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Affiliation(s)
- C Rinaldi
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
| | - P Bramanti
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | - A Famà
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
| | - C Scimone
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
| | - L Donato
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
| | - C Antognelli
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - C Alafaci
- Department of Neurosciences, University of Messina, Messina, Italy
| | - F Tomasello
- Department of Neurosciences, University of Messina, Messina, Italy
| | - R D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
| | - A Sidoti
- Department of Biomedical Sciences and Morphological and Functional Images, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Messina, Italy
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Guerriero G, Gallo A, Roselli CE, D'Angelo R, Ciarcia G. Reproductive health assessment and quantitative real-time PCR analysis of estrogen receptor mRNA expression in Mytilus galloprovincialis gametes. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547781] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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D'Angelo R, Rinaldi R, Parchi P, Cirignotta F. Wait and see: a 5 year history of 'recurrent dementia'. Case Reports 2014; 2014:bcr-2014-205991. [DOI: 10.1136/bcr-2014-205991] [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: 11/03/2022] Open
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D'Angelo R, Morreale A, Donadio V, Boriani S, Maraldi N, Plazzi G, Liguori R. Neuropathic pain following spinal cord injury: what we know about mechanisms, assessment and management. Eur Rev Med Pharmacol Sci 2013; 17:3257-3261. [PMID: 24338470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In biology, it is easy to understand how a damaged functional system may generate wrong signals, but why this should happen when the system is disconnected is less clear. For this reason, among other pain syndromes, neuropathic pain (NP) following spinal cord injury (SCI) leaves most questions unanswered. AIMS AND METHODS Our purpose is to review current knowledge on NP after SCI, focusing on the mechanisms, assessment and management of the syndrome. RESULTS The mechanisms responsible for NP following SCI are poorly understood: NP is classically considered a "central pain syndrome" but recent evidence from experimental models reveals a possible "peripheral sensitization". Assessment of NP following SCI is well-established: in addition to clinical evaluation and self-reported scales, many neurophysiological, radiological and microscopic investigations may be performed. The management of NP following SCI is very difficult: evidence of effective drugs is lacking and alternative new treatment approaches yield different outcomes. CONCLUSIONS Recently clinical and instrumental tools have increased our knowledge on NP, suggesting that the discovery of new treatment agents will depend on an explanation of what changes after SCI: future research must point in this direction.
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Affiliation(s)
- R D'Angelo
- IRCCS Istituto delle Scienze Neurologiche, Dipartimento di Scienze Biomediche e NeuroMotorie, Alma Mater Studiorun, University of Bologna, Bologna, Italy.
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Fabbri M, Vetrugno R, Antelmi E, D'Angelo R, Rinaldi R. Orthostatic tremor heralding the onset of stiff-person syndrome. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.443] [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: 10/26/2022]
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Balletta A, Bonifaci G, Citro A, Continisio R, Di Palma P, D'Angelo R, Iacoviello P. [Asbestos: fifty years of work exposure in Campania and other Italian regions through INAIL experience]. G Ital Med Lav Ergon 2012; 34:545-551. [PMID: 23405712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of the work is to proceed to the recognition of asbestos phenomenon in Campania and in the other regions with emphasis on the incidence and development of several related diseases. Using data from first INAIL Annual Report on the progress of occupational diseases until 1999, and the data provided by the INAIL CSA regarding the last 12 years (2000 to 2011), the incidence is illustrated for two-year periods, from 2000 to 2011, for the total of diseases and separately for: asbestosis, mesotheliomas, lung cancer and non-cancerous pleural lesions. The total of diseases by region for the period 2000-2011 has been reported. The survey results show a gradual increase in the total asbestos related diseases (15,998) due to the mesotheliomas portion (5739) while the trend of lung cancer is stationary (2,287). Pleural plaques have a variable growth in the various regions during recent years. Some significant case studies from Campania are reported.
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Affiliation(s)
- A Balletta
- Specialista e libero docente in medicina del lavoro, già dirigente medico INAIL, Italy.
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Maumus M, Peyrafitte JA, D'Angelo R, Fournier-Wirth C, Bouloumié A, Casteilla L, Sengenès C, Bourin P. Native human adipose stromal cells: localization, morphology and phenotype. Int J Obes (Lond) 2011; 35:1141-53. [PMID: 21266947 PMCID: PMC3172585 DOI: 10.1038/ijo.2010.269] [Citation(s) in RCA: 403] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives: Beside having roles in energy homeostasis and endocrine modulation, adipose tissue (AT) is now considered a promising source of mesenchymal stromal cells (adipose-derived stromal cells or ASCs) for regenerative medicine. Despite numerous studies on cultured ASCs, native human ASCs are rarely investigated. Indeed, the phenotype of ASCs in their native state, their localization within AT and comparison with bone marrow-derived mesenchymal stromal cells (BM-MSCs) has been poorly investigated. Design: To address these issues, the stroma vascular fraction (SVF) of human AT was extracted and native cell subtypes were isolated by immunoselection to study their clonogenic potential in culture. Immunohistology on samples of human AT in combination with reconstruction of confocal sections were performed in order to localize ASCs. Results: Compared with BM-MNCs, all native ASCs were found in the CD34+ cell fraction of the AT-SVF. Native ASCs expressed classical mesenchymal markers described for BM-MSCs. Interestingly, CD34 expression decreased during ASC cell culture and was negatively correlated with cell proliferation rate. Immunohistological analysis revealed that native ASCs exhibited specific morphological features with protrusions. They were found scattered in AT stroma and did not express in vivo pericytic markers such as NG2, CD140b or alpha-smooth muscle actin, which appeared during the culture process. Finally, ASCs spontaneous commitment to adipocytic lineage was enhanced in AT from obese humans. Conclusions: The use of complementary methodological approaches to study native human ASCs revealed their immunophenotype, their specific morphology, their location within AT and their stemness. Furthermore, our data strongly suggest that human ASCs participate in adipogenesis during AT development.
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Affiliation(s)
- M Maumus
- Institut National de Santé et de Recherche Médicale (INSERM), U858, Université Toulouse III Paul Sabatier, Institut de Médecine Moléculaire de Rangueil (I2MR), Equipe n°1 AVENIR, Toulouse, France
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D'Angelo R. All parturients receiving neuraxial morphine should be monitored with continuous pulse oximetry. Int J Obstet Anesth 2010; 19:202-4. [PMID: 20202817 DOI: 10.1016/j.ijoa.2009.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 08/02/2009] [Indexed: 11/19/2022]
Affiliation(s)
- R D'Angelo
- Department of Obstetric Anesthesia, Wake Forest University, Winston-Salem, NC 27103, USA.
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D'Angelo R, Barzaghi C, Giovanetti A, Albanese A, Goldwurm S, Garavaglia B. P3.030 GBA mutations and Parkinson disease in Italian population. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70594-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Catathrenia (nocturnal groaning) is a rare condition characterized by monotonous irregular groans occurring during sleep. Ten patients (five women; mean age: 27 +/- 7.4 years, range: 15-41) with sleep-related groaning persisting for years or decades and normal daytime fibreoptic laryngoscopy and respiratory function tests underwent videopolysomnographic recording (VPSG) analysing their respiratory patterns during sleep. After the VPSG, all patients were clinically followed up for a mean period of 4.9 +/- 3.5 years. On VPSG, all patients showed nocturnal groaning during NREM sleep and particularly during REM sleep stages. Groaning was associated with disproportionate prolonged expiration causing reduced breathing rate without oxygen desaturation. The breathing pattern with prolonged expiration and sound production alternated with a normal respiratory pattern without groaning. Endoesophageal pressure during groaning showed mildly positive swings at the initial phase of expiration suggesting a partial mild expiratory upper airway obstruction. At the end of the follow-up period, all patients reported persistent nocturnal groaning but no other clinical manifestations. Groaning confined to sleep alternating with normal breathing and the absence of long-term clinical consequences suggest that catathrenia is because of an abnormality of the internal respiratory drive system, possibly related to persistence of a neonatal (vestigial) type of breathing pattern.
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Affiliation(s)
- R Vetrugno
- Department of Neurological Sciences, University of Bologna, Bologna, Italy.
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Sidoti A, Antognelli C, Rinaldi C, D'Angelo R, Dattola V, Girlanda P, Talesa V, Amato A. Glyoxalase I A111E, paraoxonase 1 Q192R and L55M polymorphisms: susceptibility factors of multiple sclerosis? Mult Scler 2007; 13:446-53. [PMID: 17463067 DOI: 10.1177/13524585070130040201] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis (MS) is characterized by chronic inflammation and demyelination of the central nervous system (CNS). Accumulating data indicate that oxidative stress, leading to reactive oxygen species (ROS) production and lipid peroxidation, as well as elevated levels of advanced glycation end products (AGE) in CNS neurons, might play a pivotal role in the pathogenesis of a number of diseases with a neurodegenerative aspect, such as MS. Therefore, polymorphisms of genes encoding endogenous free-radical scavenging systems, such as paraoxonase 1 (PON1), and anti-glycation defences, such as glyoxalase I (GI), could influence susceptibility to MS. In the present study, we have undertaken a case-control study to investigate the possible association of GI A111E, PON1 Q192R and L55M polymorphisms with the risk of MS. The three polymorphisms were characterized in 209 patients with relapsing-remitting MS (RRMS) and in 213 healthy controls by PCR/RFLP methods using DNA from lymphocytes. We found that individuals with the GI/AE-EE genotypes and PON55/LM-MM genotypes had a significantly higher risk of MS compared with the other genotypes. The two polymorphisms appear to be common genetic traits that are associated with an increased risk for MS--the analysis of both, in each single case, may be a revealing predictable factor for MS risk.
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Affiliation(s)
- A Sidoti
- Department of Biomorphology and Biotechnologies, University of Messina, 98100, Italy
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Sidoti A, Antognelli C, Rinaldi C, D'Angelo R, Dattola V, Girlanda P, Talesa V, Amato A. Glyoxalase I A111E, paraoxonase 1 Q192R and L55M polymorphisms: susceptibility factors of multiple sclerosis? Mult Scler 2007. [DOI: 10.1177/1352458506069539] [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: 11/15/2022]
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Vetrugno R, Stecchi S, Scandellari C, Pierangeli G, Sabattini L, D'Angelo R, Provini F, Plazzi G, Cortelli P, Montagna P. Sleep--wake and body core temperature rhythms in multiple sclerosis with fatigue. Clin Neurophysiol 2006; 118:228-34. [PMID: 17095290 DOI: 10.1016/j.clinph.2006.09.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 09/13/2006] [Accepted: 09/27/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study sleep-wake and body core temperature (BCT) circadian rhythms in patients with multiple sclerosis (MS)-associated with chronic fatigue. METHODS Six relapsing-remitting MS patients with chronic fatigue underwent 48 consecutive hours polysomnography (PSG) with BCT measurement, followed by a Multiple Sleep Latency Test (MSLT). All patients were relapse- and drug-free. Mood depression, brain and cervical cord enhanced MRI, dynamic spirometry and Fatigue Severity Scale (FSS) were assessed just before PSG. RESULTS In all patients mood depression was absent and dynamic spirometry normal, but FSS confirmed fatigue. MRI showed non-enhancing lesions. Nocturnal sleep was characterized by normal architecture and mean sleep efficiency was only slightly reduced. Arousal index was normal and periodic limb movements during sleep (PLMS) were present in four patients, with an increased index (PLMS-I) in only two of them. Upon MSLT, mean sleep latency was normal in all patients with one sleep onset REM period in one patient. All patients displayed a normal BCT 24-h rhythm. Mesor, amplitude and acrophase of BCT rhythm did not show significant differences between MS and controls. CONCLUSIONS We found substantially normal sleep-wake and BCT rhythmicity in six patients with MS and fatigue. Non-restorative sleep and abnormal BCT regulation were unlikely mechanisms of chronic fatigue in our MS patients. SIGNIFICANCE Subjective fatigue and abnormal sleep and BCT can be independent manifestation in MS patients. The findings support the notion that objective measures of fatigue comparable to the MSLT for sleepiness do not exist.
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Affiliation(s)
- R Vetrugno
- Department of Neurological Sciences, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy.
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Sidoti A, D'Angelo R, Rinaldi C, De Luca G, Pino F, Salpietro C, Giunta DE, Saltalamacchia F, Amato A. Distribution of the mutated delta 32 allele of the CCR5 gene in a Sicilian population. Int J Immunogenet 2006; 32:193-8. [PMID: 15932625 DOI: 10.1111/j.1744-313x.2005.00507.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/28/2022]
Abstract
The CCR5 gene encodes a cell-surface chemokine receptor molecule that serves as a co-receptor for macrophage-tropic strains of human immunodeficiency virus type 1 (HIV-1). A mutation in this gene may alter the expression or the function of the protein product, thereby altering chemokine binding and/or signalling or HIV-1 infection of cells that normally express CCR5 protein. Individuals homozygous for a 32-bp deletion allele of CCR5 (CCR5 delta32), heritable as a Mendelian trait, are relatively resistant to HIV-1 infection. The CCR5 delta32 mutation is present in the Caucasian population at different frequencies. The aim of this study was to investigate the frequency of truncated alleles of the CCR5 delta32 gene in a Sicilian population, as the interpopulation variation in CCR5 delta32 frequency may be a significant factor in the prediction of AIDS endemicity in future studies. We examined 901 healthy individuals from several Sicilian provinces. We found a mean (+/- standard deviation) delta32 allele frequency (fr) of 0.04 +/- 0.012. The highest value was observed in the province of Messina, with a mean delta32 allele frequency of 0.06 +/- 0.024, where we collected samples from a cohort of 114 HIV-1-infected individuals. The observed frequency amongst these patients was quite low (fr = 0.03 +/- 0.031) compared to the healthy population, although the difference was not statistically significant.
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Affiliation(s)
- A Sidoti
- Department of Biomorphology and Biotechnologies, Division of Biology and Genetics, Faculty of Medicine and Surgery, University of Messina, Italy.
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Affiliation(s)
- M O Columb
- South Manchester University Hospital, Wythenshawe, UK.
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D'Angelo R, Philip B, Gan TJ, Kovac A, Hantler C, Doblar D, Melson T, Minkowitz H, Dalby P, Coop A. A randomized, double-blind, dose-ranging, pilot study of intravenous granisetron in the prevention of postoperative nausea and vomiting in patients undergoing abdominal hysterectomy 1. Eur J Anaesthesiol 2005; 22:774-9. [PMID: 16211739 DOI: 10.1017/s0265021505001286] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Postoperative nausea and vomiting (PONV) is a frequent and unpleasant experience that may increase postoperative complications and costs. For surgical procedures with a high risk of PONV, prevention is preferable to treatment. In this study, the authors explore the dose-response relationship between granisetron administered just prior to the end of surgery and post-operative nausea and vomiting in patients undergoing abdominal hysterectomy. METHODS This was a randomized, double-blind, placebo-controlled, pilot study of post-operative nausea and vomiting prevention. Patients undergoing elective open abdominal hysterectomy requiring general anaesthesia received a single dose of granisetron 0.1, 0.2 or 0.3 mg or placebo administered approximately 15 min prior to the end of surgery. The primary efficacy end-point was the proportion of patients with no vomiting in the 0--6 h interval following medication administration. No inferential statistics were planned. RESULTS The proportion of patients with no vomiting episode in the 0--6 h interval after administration of study medication was higher in each granisetron treatment group (>90%) than in the placebo group (77%). Proportions of patients with no vomiting episodes in the 0--24 h interval were similar across treatment groups. Results of analyses of proportions of patients with no moderate or severe nausea episodes, proportions of those requiring rescue medication and times to first use of rescue medication suggested a treatment effect of granisetron relative to placebo in both the 0--6 and 0--24 h intervals. Similar proportions of patients in each treatment group reported at least one adverse event. CONCLUSIONS Granisetron at doses of 0.1, 0.2 and 0.3 mg administered just prior to the end of surgery suggested a trend of improved efficacy compared to placebo in preventing postoperative nausea and vomiting in the first 6 h after abdominal hysterectomy. This pilot study did not identify a dose-response relationship.
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Facchini G, Fiore F, Caraglia M, D'Angelo R, Nasti G, Caponigro F, Formato R, Budillon A, Iaffaioli RV. A liver angioma colonized by colon cancer cells in a patient with two primitive localizations by colon adenocarcinoma: biologic, diagnostic and therapeutic implications. Ann Oncol 2005; 16:1980-1. [PMID: 16033872 DOI: 10.1093/annonc/mdi389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Malara NM, Leotta A, Sidoti A, Lio S, D'Angelo R, Caparello B, Munao F, Pino F, Amato A. Ageing, hormonal behaviour and cyclin D1 in ductal breast carcinomas. Breast 2005; 15:81-9. [PMID: 16473739 DOI: 10.1016/j.breast.2004.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2004] [Accepted: 12/08/2004] [Indexed: 02/06/2023] Open
Abstract
Owing to the gradual modification of breast tissue in postmenopausal women, there can be differential effects on local oestrogen receptor (ER) expression, with potential impingement on the biological behaviour of cancer cells in the ageing. A series of 45 ductal carcinoma (DC) cases were selected in postmenopausal women who were not being treated with HRT. Immunohistochemical analyses were performed for hormone receptors and Ki67 expression. Fluorescence in situ hybridisation (FISH) analysis was carried out to study CCND1 amplification. The selected population was subdivided into three groups by age and was subjected to statistical studies: linear model analysis, estimation of relative incidence (RI), multivariate analysis, and nonparametric tests were performed to investigate whether there were any links between age and molecular variables in DCs. The results show a low rate of proliferation and high ER expression in the oldest age group. In the same group a close correlation was found between high ER expression and CCN in the older age group D1 amplification (P=0.000), as was a more advanced phenotype in terms of tumour size and presence of positive lymph nodes than in the other age groups considered. The results suggest that ductal breast cancer has a favourable molecular prognosis, especially in extreme old age. In particular, there is an inverse correlation between ageing and proliferation rate despite the presence of an accentuated proliferation stimulus (high ER with CCD1 amplifications) in the oldest group relative to the other groups considered.
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Affiliation(s)
- N M Malara
- Department of Biomorphology and Biotechnologies, Division of Biology and Genetics, Faculty of Medicine, University of Messina, Consolare Valeria Street 1, 98125 Messina, Italy.
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Mazzotta G, Floridi F, Mattioni A, D'Angelo R, Gallai B. The role of neuroimaging in the diagnosis of headache in childhood and adolescence: a multicentre study. Neurol Sci 2004; 25 Suppl 3:S265-6. [PMID: 15549554 DOI: 10.1007/s10072-004-0303-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Following the diagnostic indications of the Guidelines for the diagnosis and therapy of juvenile headache, we present the results of a prospective, multicentre study of headache patients aimed at evaluating the utility of neuroradiologic testing in the diagnosis of headache. A total of 6535 subjects up to age 18 were studied, and 1485 underwent neuroimaging testing based on the indications of the diagnostic Flow-Chart. Abnormal results were observed in 273 (18.5%) subjects. Incidental findings were observed in 138 (9.3%) subjects, not correlated with the headache pathology, whereas alterations that led to the diagnosis of secondary headache were observed in 135 (9.1%) subjects. In conclusion, our data support a greater incidence of positive neuroimaging examinations among patients who underwent testing based on suspicion of a secondary headache pathology when compared with the low percentages observed in study populations.
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Affiliation(s)
- G Mazzotta
- Neurosciences Department, University of Perugia, Via Enrico Dal Pozzo, I-06126 Perugia, Italy.
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Strocchi E, Iaffaioli RV, Facchini G, Mantovani G, Ricci S, Cavallo G, Tortoriello A, D'Angelo R, Formato R, Rosato G, Fiore F, Iaccarino V, Petrella G, Memoli B, Santangelo M, Camaggi CM. Stop-flow technique for loco-regional delivery of high dose chemotherapy in the treatment of advanced pelvic cancers. Eur J Surg Oncol 2004; 30:663-70. [PMID: 15256242 DOI: 10.1016/j.ejso.2004.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2004] [Indexed: 11/30/2022] Open
Abstract
AIM To verify the rationale of a pelvic stop-flow technique for the perfusion of high-doses of mitomycin C and anthacyclines in patients with inoperable, recurrent pelvic cancer. METHODS The stop-flow technique was realized by using percutaneous double-balloon arterial-venous catheters that selectively isolate the pelvic vascular section and a perfusion provided by an extracorporeal pump for 20 min. Ten patients (pts) with unresectable pelvic recurrence from colon-rectal cancer were treated with a combination of Mitomycin C (MMC, 20 mg/sqm) plus doxorubicin (DOXO, 75 mg/sqm; 8pts) or epirubicin (EPI, 75 mg/sqm; 2pts) infused into the isolated pelvic compartment. Blood samples were collected from the extracorporeal vascular flow and from peripheral plasma, and analysed for drug quantitation. RESULTS During the procedure, there were no technical or hemodynamic complications, and no deaths occurred during surgery or in the postoperative period. MMC and DOXO peak levels measured in the extracorporeal system which irrotates the tumor area, were on average 21.6 (range: 4.3-44.3, MMC) and 17.2 (range: 1.8-48.4, DOXO) times higher than those observed in the peripheral blood. Similarly; the area under concentration (AUC) versus time curves measured in the pelvic compartment during stop-flow perfusion were 19.9 (range: 3.8-45.0, MMC) and 13.4 (range: 1.2-26.6, DOXO) times higher than the corresponding value in peripheral circulation. The drug percentage eliminated in the ultra filtrate was only 7.7% (MMC) and 0.9% (DOXO), and the plasmatic AUC(0-24) were similar to those observed with iv bolus of equivalent drug doses. Minimal systemic and local toxicities were observed. One complete pathological and 2 partial responses were observed; pain remission in 8/10 patients. median survival was 12 months (8-31). CONCLUSION The endo-arterial administration into the local vasculature produces high pelvic-systemic concentration gradients during the stop-flow perfusion with limited local and systemic toxicity. The encouraging clinical results suggest further evaluation.
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Affiliation(s)
- E Strocchi
- Laboratorio di Farmacocinetica e Metabolismo ANT, Dipartimento di Chimica Organica, Università di Bologna, Viale Risorgimento, 4-40136 Bologna, Italy.
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Cremona F, Pignata A, Izzo F, Ruffolo F, Delrio P, Fiore F, D'Angelo R, Palaia R, Daniele B, Graziano F, Puppio B, Guidetti GM, Parisi V. [Tolerability of external electro-hyperthermia in the treatment of solid tumors]. Tumori 2003; 89:239-40. [PMID: 12903605] [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: 03/04/2023]
Affiliation(s)
- F Cremona
- Unità Operativa Complessa di Chirurgia Oncologica C, INT Fondazione G Pascale, Napoli
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D'Angelo R, Russo E, Lama G. [Assessment of chemical risk according to the D.L. vo 25/2002 in the goldsmith craft industry]. G Ital Med Lav Ergon 2003; 25 Suppl:54-6. [PMID: 14979081] [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: 04/29/2023]
Abstract
In the last year, various companies of the goldsmith handicraft field have been inquired. These factories are in an area of the Caserta territory. Scope of that job was to apply the method for the chemical risk assessment previewed by D.L.vo 25/2002, using the scheme proposed by Work Minister--General Directorate-Work condition protection. In particular, it has been estimated biological and environmental expositions concerned several chemical metallic agents: Au, Ag, Cu, Zn, Cd, In, Co and Pd. Moreover, it has been focused the attention on the biological and environmental monitoring of Ag, because there are a good correlation between environmental and urinary doses. The analyses have been carried out using atomic absorption techniques. It turns out to you evidence that environmental and biological silver values are often under the detection limit of the method. Therefore, concerning the chemical risk assessment of the investigated factories, it is possible to conclude that: "the potential chemical risk has to be considered moderate".
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Fiore F, D'Angelo R, Barletta E, Daniele B, Pignata S, laffaioli RV. II Line Trans-catheter Arterial Treatment with 5-fluorouracil, Leucovorin, Epidoxorubicine and Carboplatin (Flec) in Locally Advanced Pancreatic Adenocarcinoma Our Experience. Tumori 2002. [DOI: 10.1177/030089160208800445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- F Fiore
- Dipartimento di Diagnostica Radiologica, Naples, Italy
| | - R D'Angelo
- Dipartimento di Diagnostica Radiologica, Naples, Italy
| | - E Barletta
- UO Oncologia Medico B Istituto Nazionale Tumori, Naples, Italy
| | - B Daniele
- UO Oncologia Medico B Istituto Nazionale Tumori, Naples, Italy
| | - S Pignata
- UO Oncologia Medico B Istituto Nazionale Tumori, Naples, Italy
| | - RV laffaioli
- UO Oncologia Medico B Istituto Nazionale Tumori, Naples, Italy
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Iaffaioli RV, Facchini G, Tortoriello A, Crovella F, Romano G, De Maio E, Formato R, Fiore F, D'Angelo R, Deraco M, Pilati PL, Pignata S, Daniele B, Laccarino V, Memoli B, Massidda B, Mantovani G. Stop Flow in Abdominal and Pelvic Relapses. Phase I Study and Phase Ii Preliminary. Sitilo National Project Data. Tumori 2002. [DOI: 10.1177/030089160208800454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Barletta E, Fiore F, Daniele B, Pisano C, D'Angelo R, Ottaiano A, Tambaro RVR, Iaffaioli RV. Intra-arterial Second Line Chemotherapy with 5-fluorouracil, Leucovorin, Epidoxorubicin and Carboplatin (Flec) for Advanced Adenocarcinoma of the Pancreas. Tumori 2002. [DOI: 10.1177/030089160208800428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- E Barletta
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - F Fiore
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - B Daniele
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - C Pisano
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - R D'Angelo
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - A Ottaiano
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - RVR Tambaro
- Medical Oncology B, National Cancer Institute Naples, Italy
| | - RV Iaffaioli
- Medical Oncology B, National Cancer Institute Naples, Italy
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Abstract
UNLABELLED We previously found that spinal clonidine prolongs labor analgesia when combined with spinal bupivacaine and sufentanil. We sought to determine whether the addition of spinal neostigmine to these drugs would further enhance labor analgesia. By use of a combined spinal/epidural technique, 36 patients were randomized to receive a hyperbaric spinal injection of bupivacaine 2.5 mg plus clonidine 50 microg and sufentanil 10 microg with or without neostigmine 10 microg. Pain, maternal hemodynamics, fetal heart rate, nausea, pruritus, sedation, motor block, sensory levels to pinprick, and maternal oxygen saturation were assessed at regularly specified intervals after spinal injection until additional analgesia was requested. The duration of spinal analgesia was similar between groups (215 +/- 60 min in the Control group versus 205 +/- 62 min in the Neostigmine group). Likewise, pain scores, the duration of labor, Apgar scores, and side effects were similar between groups except that patients administered neostigmine experienced significantly more nausea and vomiting (53% vs 7%, P = 0.01). We conclude that spinal neostigmine 10 microg produces severe nausea and does not potentiate the duration of spinal analgesia in laboring women from spinal bupivacaine, clonidine, and sufentanil. IMPLICATIONS Spinal neostigmine 10 microg as an adjunct to spinal bupivacaine, clonidine, and sufentanil produces severe nausea and fails to potentiate analgesia in laboring women.
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Affiliation(s)
- R D'Angelo
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27103, USA.
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Gesztesi Z, Scuderi PE, White PF, Wright W, Wender RH, D'Angelo R, Black LS, Dalby PL, MacLean D. Substance P (Neurokinin-1) antagonist prevents postoperative vomiting after abdominal hysterectomy procedures. Anesthesiology 2000; 93:931-7. [PMID: 11020741 DOI: 10.1097/00000542-200010000-00009] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The safety and antiemetic efficacy of CP-122,721, a novel neurokinin-1 antagonist, was evaluated when administered alone or in combination with ondansetron. METHODS Using a randomized, double-blind, placebo-controlled study design, CP-122,721 was initially compared with placebo and subsequently to ondansetron alone and in combination for prophylaxis against postoperative nausea and vomiting in 243 women undergoing abdominal hysterectomy. In the dose-ranging studies (n = 86), patients received either CP-122,721 100 mg (vs. placebo) or 200 mg (vs. placebo) orally 60-90 min before induction of anesthesia. In the interaction study (n = 157), patients received CP-122,721 200 mg or placebo 60-90 min before induction of anesthesia, and ondansetron 4 mg or saline 2 ml intravenously 15-30 min before the end of surgery. Patients assessed their level of nausea and pain on arrival in the postanesthesia care unit and at 0.5-, 1-, 1.5-, 2-, 4-, 8-, 12-, and 24-h intervals postoperatively. Emetic episodes, need for rescue antiemetic-antinausea medication, postoperative complications, and patient satisfaction were recorded. RESULTS In the initial dose-ranging study, only 10% of the patients experienced emesis within the first 8 h after surgery with CP-122,721 200 mg compared with 50% in the placebo group. CP-122,721 200 mg also decreased the need for rescue medication (25% vs. 48%). CP-122,721 100 mg was less effective than 200 mg in decreasing the incidence of repeated episodes of emesis. In the interaction study, 6% of the patients receiving CP-122,721 200 mg orally experienced emesis less than 2 h after surgery compared with 17% with ondansetron alone. With combined therapy, only 2% experienced emesis. In addition, the median times for 75% of patients to remain free from postoperative nausea and vomiting were 82, 75, and 362 min in the ondansetron, CP-122,721, and combination groups, respectively. CONCLUSIONS Oral CP-122,721 200 mg decreased emetic episodes compared with ondansetron (4 mg intravenously) during the first 24 h after gynecologic surgery; however, there was no difference in patient satisfaction.
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Affiliation(s)
- Z Gesztesi
- Departments of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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Meister GC, D'Angelo R, Owen M, Nelson KE, Gaver R. A comparison of epidural analgesia with 0.125% ropivacaine with fentanyl versus 0.125% bupivacaine with fentanyl during labor. Anesth Analg 2000; 90:632-7. [PMID: 10702449 DOI: 10.1097/00000539-200003000-00024] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We previously found that the extent of an epidural motor block produced by 0.125% ropivacaine was clinically indistinguishable from 0.125% bupivacaine in laboring patients. By adding fentanyl to the 0. 125% ropivacaine and bupivacaine solutions in an attempt to reduce hourly local anesthetic requirements, we hypothesized that differences in motor block produced by the two drugs may become apparent. Fifty laboring women were randomized to receive either 0. 125% ropivacaine with fentanyl 2 microg/mL or an equivalent concentration of bupivacaine/fentanyl using patient-controlled epidural analgesia (PCEA) with settings of: 6-mL/hr basal rate, 5-mL bolus, 10-min lockout, 30-mL/h dose limit. Analgesia, local anesthetic use, motor block, patient satisfaction, and side effects were assessed until the time of delivery. No differences in verbal pain scores, local anesthetic use, patient satisfaction, or side effects between groups were observed; however, patients administered ropivacaine/fentanyl developed significantly less motor block than patients administered bupivacaine/fentanyl. Ropivacaine 0.125% with fentanyl 2 microg/mL produces similar labor analgesia with significantly less motor block than an equivalent concentration of bupivacaine/fentanyl. Whether this statistical reduction in motor block improves clinical outcome or is applicable to anesthesia practices which do not use the PCEA technique remains to be determined. IMPLICATIONS By using a patient-controlled epidural analgesia technique, ropivacaine 0.125% with fentanyl 2 microg/mL produces similar analgesia with significantly less motor block than a similar concentration of bupivacaine with fentanyl during labor. Whether this statistical reduction in motor block improves clinical outcome or is applicable to anesthesia practices which do not use the patient-controlled epidural analgesia technique remains to be determined.
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Affiliation(s)
- G C Meister
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Abstract
BACKGROUND Recent efforts to improve the combined spinal epidural (CSE) technique have focused on adding opioids to other classes of analgesics. In this study, the authors used intrathecal neostigmine in combination with intrathecal sufentanil to investigate the usefulness of neostigmine for reducing side effects and prolonging the duration of sufentanil. METHODS One hundred six healthy pregnant women in labor were enrolled in this study, which was divided into four phases. In all phases, patients received a CSE anesthetic while in the lateral position. In phase I, three groups of six women each received intrathecal neostigmine, 5, 10, or 20 microg, in an open-label, dose-escalating safety assessment. In phase II, 24 women received intrathecal sufentanil alone to establish an ED50 (dose that produces > 60 min of labor analgesia in 50% of patients). In phase III, an ED50 was established for sufentanil combined with a fixed dose of neostigmine (10 microg). In phase IV, 40 women received either twice the ED50 of sufentanil alone or twice the ED50 of sufentanil plus neostigmine, 10 microg. RESULTS Neostigmine alone had no adverse effects on maternal vital signs, fetal heart rate, or Apgar scores. Neostigmine, 20 microg, produced analgesia in one patient and severe nausea and vomiting in another. The ED50 for intrathecal sufentanil alone was 4.1 +/- 0.31 microg, and the ED50 for intrathecal sufentanil combined with neostigmine, 10 microg, was 3.0 +/- 0.28 microg. The duration of analgesia and side effects from double these ED50s (sufentanil, 9 microg, or sufentanil, 6 microg, plus neostigmine, 10 microg) were similar between groups. CONCLUSIONS The 10-microg intrathecal neostigmine dose alone produced no analgesia or side effects, but reduced the ED50 of intrathecal sufentanil by approximately 25%. Additionally, doses approximately double these ED50s each produced a similar duration of analgesia and side effects, indicating intrathecal neostigmine shifts the dose-response curve for intrathecal sufentanil to the left.
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Affiliation(s)
- K E Nelson
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27103, USA.
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Abstract
UNLABELLED We sought to determine whether spinal clonidine 50 microg prolongs the analgesia from the spinal administration of sufentanil 7.5 microg and bupivacaine 2.5 mg early in the first stage of labor. Thirty patients were randomized to receive a 2-mL spinal injection of sufentanil 7.5 microg + bupivacaine 2.5 mg with or without clonidine 50 microg using a combined spinal-epidural (CSE) technique. Pain, nausea, pruritus, sedation, motor block, blood pressure, and heart rate were assessed until the patient requested additional analgesia. Analgesia was significantly prolonged in patients who received spinal sufentanil + bupivacaine + clonidine (197 +/- 70 vs 132 +/- 39 min; P = 0.004). Pain scores and side effects, including motor block, sedation, and hypotension, were similar between groups. Spinal clonidine significantly prolongs labor analgesia from spinal sufentanil and bupivacaine without producing serious adverse side effects. IMPLICATIONS We studied the effects of spinal clonidine administered with spinal sufentanil and bupivacaine on labor analgesia using a combined spinal-epidural technique and conclude that spinal clonidine significantly prolongs labor analgesia from spinal sufentanil and bupivacaine without producing serious adverse effects.
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Affiliation(s)
- R D'Angelo
- Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Blasi F, Riccio M, Brogi A, Strazza M, Taddei ML, Romagnoli S, Luddi A, D'Angelo R, Santi S, Costantino-Ceccarini E, Melli M. Constitutive expression of interleukin-1beta (IL-1beta) in rat oligodendrocytes. Biol Chem 1999; 380:259-64. [PMID: 10195433 DOI: 10.1515/bc.1999.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The RT-PCR analysis of RNA from progenitor and differentiated primary rat oligodendrocytes, and from the oligodendrocyte CG-4 cell line, shows the presence of the IL-1beta mRNA, the type I IL-1beta receptor and the IL-1 receptor accessory protein in these cells. In situ hybridization of a rat IL-1beta probe to primary progenitor and differentiated rat oligodendrocytes results in a positive signal. The double hybridization of the IL-1beta probe, together with an oligodendrocyte-specific differentiation marker, to sections of postnatal rat brain at different stages of differentiation is also positive. The double immuno-labelling technique utilized indicates coincidence of the signals on the brain slices. The results show that IL-1beta mRNA is constitutively expressed in rat brain oligodendrocytes from 1 day after birth onward. In agreement with this observation, CG-4 cells, primary progenitor and differentiated rat oligodendrocytes are positively stained by antibodies against IL-1beta. Postnatal brain slices from 1 and 4 day old and adult rats, labelled with a double immunofluorescence technique, are also stained by antibodies against IL-1beta. This signal coincides with that of antibodies against oligodendrocyte-specific surface markers. We conclude that IL-1beta is constitutively expressed in rat brain progenitor and differentiated oligodendrocytes.
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Affiliation(s)
- F Blasi
- Dipartimento Biologia Evoluzionistica Sperimentale, Università di Bologna, Italy
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