1
|
Al Refaie A, Baldassini L, Mondillo C, De Vita M, Giglio E, Tarquini R, Gonnelli S, Caffarelli C. Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review. Nutrients 2024; 16:1144. [PMID: 38674837 PMCID: PMC11053479 DOI: 10.3390/nu16081144] [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: 02/24/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Nowadays, the interest in the extraskeletal effects of vitamin D is growing. In the literature, its several possible actions have been confirmed. Vitamin D seems to have a regulatory role in many different fields-inflammation, immunity, and the endocrine system-and many studies would demonstrate a possible correlation between vitamin D and cardiovascular disease. In this paper, we deepened the relationship between vitamin D and dyslipidemia by reviewing the available literature. The results are not entirely clear-cut: on the one hand, numerous observational studies suggest a link between higher serum vitamin D levels and a beneficial lipid profile, while on the other hand, interventional studies do not demonstrate a significant effect. Understanding the possible relationship between vitamin D and dyslipidemia may represent a turning point: another link between vitamin D and the cardiovascular system.
Collapse
Affiliation(s)
- Antonella Al Refaie
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Leonardo Baldassini
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Caterina Mondillo
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Michela De Vita
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Elisa Giglio
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Roberto Tarquini
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Stefano Gonnelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Carla Caffarelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| |
Collapse
|
2
|
Savino M, Guida CC, Nardella M, Murgo E, Augello B, Merla G, De Cosmo S, Savino AF, Tarquini R, Cei F, Aucella F, Mazzoccoli G. Circadian Genes Expression Patterns in Disorders Due to Enzyme Deficiencies in the Heme Biosynthetic Pathway. Biomedicines 2022; 10:biomedicines10123198. [PMID: 36551954 PMCID: PMC9775071 DOI: 10.3390/biomedicines10123198] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Heme is a member of the porphyrins family of cyclic tetrapyrroles and influences various cell processes and signalling pathways. Enzyme deficiencies in the heme biosynthetic pathway provoke rare human inherited metabolic diseases called porphyrias. Protein levels and activity of enzymes involved in the heme biosynthetic pathway and especially 5'-Aminolevulinate Synthase 1 are featured by 24-h rhythmic oscillations driven by the biological clock. Heme biosynthesis and circadian pathways intermingle with mutual modulatory roles. Notably, heme is a ligand of important cogs of the molecular clockwork, which upon heme binding recruit co-repressors and inhibit the transcription of numerous genes enriching metabolic pathways and encoding functional proteins bringing on crucial cell processes. Herein, we assessed mRNA levels of circadian genes in patients suffering from porphyrias and found several modifications of core clock genes and clock-controlled genes expression, associated with metabolic and electrolytic changes. Overall, our results show an altered expression of circadian genes accompanying heme biosynthesis disorders and confirm the need to deepen the knowledge of the mechanisms through which the alteration of the circadian clock circuitry could take part in determining signs and symptoms of porphyria patients and then again could represent a target for innovative therapeutic strategies.
Collapse
Affiliation(s)
- Maria Savino
- Interregional Reference Center for Porphyria, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
- Laboratory of Clinical Chemistry, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Claudio Carmine Guida
- Interregional Reference Center for Porphyria, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
- Department of Medical Sciences, Division of Nephrology, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Maria Nardella
- Interregional Reference Center for Porphyria, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
- Department of Medical Sciences, Division of Nephrology, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Emanuele Murgo
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Bartolomeo Augello
- Division of Medical Genetics, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Giuseppe Merla
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, 80121 Naples, Italy
- Laboratory of Regulatory and Functional Genomics, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Antonio Fernando Savino
- Laboratory of Clinical Chemistry, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Roberto Tarquini
- Division of Internal Medicine I, Regional Reference Center for Porphyria, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Francesco Cei
- Division of Internal Medicine I, Regional Reference Center for Porphyria, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Filippo Aucella
- Department of Medical Sciences, Division of Nephrology, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
| | - Gianluigi Mazzoccoli
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy
- Correspondence: ; Tel./Fax: +39-08-8241-0255
| |
Collapse
|
3
|
Colombini B, Dinu M, Murgo E, Lotti S, Tarquini R, Sofi F, Mazzoccoli G. Ageing and Low-Level Chronic Inflammation: The Role of the Biological Clock. Antioxidants (Basel) 2022; 11:2228. [PMID: 36421414 PMCID: PMC9686908 DOI: 10.3390/antiox11112228] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/16/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 09/01/2023] Open
Abstract
Ageing is a multifactorial physiological manifestation that occurs inexorably and gradually in all forms of life. This process is linked to the decay of homeostasis due to the progressive decrease in the reparative and regenerative capacity of tissues and organs, with reduced physiological reserve in response to stress. Ageing is closely related to oxidative damage and involves immunosenescence and tissue impairment or metabolic imbalances that trigger inflammation and inflammasome formation. One of the main ageing-related alterations is the dysregulation of the immune response, which results in chronic low-level, systemic inflammation, termed "inflammaging". Genetic and epigenetic changes, as well as environmental factors, promote and/or modulate the mechanisms of ageing at the molecular, cellular, organ, and system levels. Most of these mechanisms are characterized by time-dependent patterns of variation driven by the biological clock. In this review, we describe the involvement of ageing-related processes with inflammation in relation to the functioning of the biological clock and the mechanisms operating this intricate interaction.
Collapse
Affiliation(s)
- Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Emanuele Murgo
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS “Casa Sollievo della Sofferenza”, Opera di Padre Pio da Pietrelcina, 71013 San Giovanni Rotondo, Italy
| | - Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Roberto Tarquini
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Gianluigi Mazzoccoli
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS “Casa Sollievo della Sofferenza”, Opera di Padre Pio da Pietrelcina, 71013 San Giovanni Rotondo, Italy
| |
Collapse
|
4
|
Argirò A, Del Franco A, Mazzoni C, Allinovi M, Tomberli A, Tarquini R, Di Mario C, Perfetto F, Cappelli F, Zampieri M. Arrhythmic Burden in Cardiac Amyloidosis: What We Know and What We Do Not. Biomedicines 2022; 10:2888. [PMID: 36359408 PMCID: PMC9687719 DOI: 10.3390/biomedicines10112888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023] Open
Abstract
Cardiac amyloidosis (CA), caused by the deposition of insoluble amyloid fibrils, impairs different cardiac structures, altering not only left ventricle (LV) systo-diastolic function but also atrial function and the conduction system. The consequences of the involvement of the cardiac electrical system deserve more attention, as well as the study of the underlying molecular mechanisms. This is an issue of considerable interest, given the conflicting data on the effectiveness of conventional antiarrhythmic strategies. Therefore, this review aims at summarizing the arrhythmic burden related to CA and the available evidence on antiarrhythmic treatment in this population.
Collapse
Affiliation(s)
- Alessia Argirò
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Annamaria Del Franco
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Carlotta Mazzoni
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Marco Allinovi
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Alessia Tomberli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Roberto Tarquini
- Department of Internal Medicine I, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Carlo Di Mario
- Structural Interventional Cardiology Department, Careggi University Hospital, 50134 Florence, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| | - Mattia Zampieri
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, 50134 Florence, Italy
| |
Collapse
|
5
|
Masotti L, Cioni E, Grifoni E, Cei F, Tarquini R. Trends of thrombo-inflammation biomarkers after Tocilizumab predict treatment failure better than scores in patients with severe SARS-CoV2 related respiratory failure. Eur J Intern Med 2022; 103:111-112. [PMID: 35680497 PMCID: PMC9167827 DOI: 10.1016/j.ejim.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/27/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Affiliation(s)
- Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy.
| | - Elisa Cioni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | - Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | | |
Collapse
|
6
|
Salvetti S, Lavinia F, Rosi N, Vanni S, Masotti L, Tarquini R, Guarducci S, Rossolini GM, Montenora I. A rapid and cost-effective diagnostic algorithm for the detection of SARS-CoV-2 infection in the emergency area by combining highly sensitive antigenic test and RT-PCR. Diagn Microbiol Infect Dis 2022; 103:115727. [PMID: 35700658 PMCID: PMC9126613 DOI: 10.1016/j.diagmicrobio.2022.115727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/05/2022]
Abstract
A diagnostic algorithm for SARS-CoV-2 infection in patients admitted to the emergency area, based on a combination of rapid antigen and molecular testing, has been evaluated with 3070 nasopharyngeal swabs. Compared to molecular test alone, the proposed algorithm allowed to significantly reduce costs and average time to results.
Collapse
|
7
|
Masotti L, Landini G, Panigada G, Grifoni E, Tarquini R, Cei F, Cimolato BMA, Vannucchi V, Di Pietro M, Piani F, Fortini A, Faraone A, Nenci G, Cipollini F, Blanc P, Lotti P, Di Natale M, Risaliti F, Aquilini D, Seravalle C, Bribani A, Farsi A, Micheletti I, Cioni E, Pelagalli G, Mattaliano C, Pinto G, Madonia EM, Sivieri I, Mannini M, Valoriani A, Brancati S, Rosselli M, Pavone E, Burla MC, Sergi A. PREDICTORS OF POOR OUTCOME IN TOCILIZUMAB TREATED PATIENTS WITH SARS-CoV-2 RELATED SEVERE RESPIRATORY FAILURE: A MULTICENTRE REAL WORLD STUDY. Int Immunopharmacol 2022; 107:108709. [PMID: 35334359 PMCID: PMC8938681 DOI: 10.1016/j.intimp.2022.108709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy.
| | | | - Grazia Panigada
- Internal Medicine, SS Damiano and Cosma Hospital, Pescia, Italy
| | - Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | | | - Vieri Vannucchi
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | - Massimo Di Pietro
- Infectious Diseases, Santa Maria Annunziata Hospital, Florence, Italy
| | - Fiorella Piani
- Internal Medicine, Santa Maria Annunziata Hospital, Florence, Italy
| | - Alberto Fortini
- Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Antonio Faraone
- Internal Medicine, San Giovanni di Dio Hospital, Florence, Italy
| | - Gabriele Nenci
- Internal Medicine II, San Jacopo Hospital, Pistoia, Italy
| | | | | | - Pamela Lotti
- Internal Medicine, Santo Stefano Hospital, Prato, Italy
| | | | | | | | | | - Andrea Bribani
- Internal Medicine, Serristori Hospital, Figline Valdarno, Italy
| | - Alessandro Farsi
- Allergology and Clinical Immunology, Ex Misericordia and Dolce Hospital, Prato, Italy
| | | | - Elisa Cioni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | | | - Gabriele Pinto
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | - Irene Sivieri
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | | | | | | | - Eleonora Pavone
- SOC Governance Farmaceutica and Appropriatezza Prescrittiva, Azienda USL Toscana Centro, Italy
| | - Maria Chiara Burla
- SOC Governance Farmaceutica and Appropriatezza Prescrittiva, Azienda USL Toscana Centro, Italy
| | - Alessandro Sergi
- SOC Monitoraggio and Programmazione performance clinico-assistenziale, Azienda USL Toscana Centro, Italy
| |
Collapse
|
8
|
Masotti L, Grifoni E, Pelagalli G, Cioni E, Mattaliano C, Cioffi E, Maggi F, Pinto G, Madonia EM, Micheletti I, Gelli AMG, Ciambotti B, Mannucci A, Bello R, Cei F, Dolenti S, Tarquini R, Montenora I, Spina R, Vanni S. Prognostic role of Interleukin-6/lymphocytes ratio in SARS-CoV2 related pneumonia. Int Immunopharmacol 2022; 103:108435. [PMID: 34920336 PMCID: PMC8660176 DOI: 10.1016/j.intimp.2021.108435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 01/19/2023]
Abstract
Introduction and aim Materials and methods Results Conclusion
Collapse
|
9
|
De Vincentis A, Vespasiani-Gentilucci U, Costanzo L, Novella A, Cortesi L, Nobili A, Mannucci PM, Incalzi RA, Mannucci PM, Nobili A, Pietrangelo A, Perticone F, Licata G, Violi F, Corazza GR, Corrao S, Marengoni A, Salerno F, Cesari M, Tettamanti M, Pasina L, Franchi C, Franchi C, Cortesi L, Tettamanti M, Miglio G, Tettamanti M, Cortesi L, Ardoino I, Novella A, Prisco D, Silvestri E, Emmi G, Bettiol A, Mattioli I, Biolo G, Zanetti M, Bartelloni G, Vanoli M, Grignani G, Pulixi EA, Lupattelli G, Bianconi V, Alcidi R, Girelli D, Busti F, Marchi G, Barbagallo M, Dominguez L, Beneduce V, Cacioppo F, Corrao S, Natoli G, Mularo S, Raspanti M, Zoli M, Matacena ML, Orio G, Magnolfi E, Serafini G, Simili A, Palasciano G, Modeo ME, Gennaro CD, Cappellini MD, Fabio G, De Amicis MM, De Luca G, Scaramellini N, Cesari M, Rossi PD, Damanti S, Clerici M, Leoni S, Di Mauro AD, Di Sabatino A, Miceli E, Lenti MV, Pisati M, Dominioni CC, Pontremoli R, Beccati V, Nobili G, Leoncini G, Anastasio L, Carbone M, Cipollone F, Guagnano MT, Rossi I, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Delitala A, Muscaritoli M, Molfino A, Petrillo E, Giorgi A, Gracin C, Zuccalà G, D'Aurizio G, Romanelli G, Marengoni A, Volpini A, Lucente D, Picardi A, Gentilucci UV, Bellelli G, Corsi M, Antonucci C, Sidoli C, Principato G, Arturi F, Succurro E, Tassone B, Giofrè F, Serra MG, Bleve MA, Brucato A, De Falco T, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Prandini T, Manfredini R, Fabbian F, Boari B, De Giorgi A, Tiseo R, Paolisso G, Rizzo MR, Catalano C, Borghi C, Strocchi E, Ianniello E, Soldati M, Schiavone S, Bragagni A, Sabbà C, Vella FS, Suppressa P, De Vincenzo GM, Comitangelo A, Amoruso E, Custodero C, Fenoglio L, Falcetta A, Fracanzani AL, Tiraboschi S, Cespiati A, Oberti G, Sigon G, Peyvandi F, Rossio R, Colombo G, Agosti P, Monzani V, Savojardo V, Ceriani G, Salerno F, Pallini G, Montecucco F, Ottonello L, Caserza L, Vischi G, Liberato NL, Tognin T, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Pisciotta MS, Bellucci FB, Buffelli S, Montrucchio G, Peasso P, Favale E, Poletto C, Margaria C, Sanino M, Violi F, Perri L, Guasti L, Castiglioni L, Maresca A, Squizzato A, Campiotti L, Grossi A, Diprizio RD, Bertolotti M, Mussi C, Lancellotti G, Libbra MV, Galassi M, Grassi Y, Greco A, Sciacqua A, Perticone M, Battaglia R, Maio R, Stanghellini V, Ruggeri E, del Vecchio S, Salvi A, Leonardi R, Damiani G, Capeci W, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Cilli M, Labbadia G, Afeltra A, Pipita ME, Castellino P, Zanoli L, Gennaro A, Gaudio A, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Vigorito C, Cittadini A, Moreo G, Prolo S, Pina G, Ballestrero A, Ferrando F, Gonella R, Cerminara D, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Sechi L, Catena C, Colussi G, Cavarape A, Da Porto A, Passariello N, Rinaldi L, Berti F, Famularo G, Tarsitani P, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Grossi M, Del Giacco S, Firinu D, Costanzo G, Argiolas G, Montalto G, Licata A, Montalto FA, Corica F, Basile G, Catalano A, Bellone F, Principato C, Malatino L, Stancanelli B, Terranova V, Di Marca S, Di Quattro R, Malfa LL, Caruso R, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Ticinesi A, Nouvenne A, Minuz P, Fondrieschi L, Imperiale GN, Pirisi M, Fra GP, Sola D, Bellan M, Porta M, Riva P, Quadri R, Larovere E, Novelli M, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Napoli F, Aiello I, Landolfi R, Montalto M, Mirijello A, Purrello F, Di Pino A, del Primario NEC, Ghidoni S, Salvatore T, Monaco L, Ricozzi C, Pilotto A, Indiano I, Gandolfo F. The multifaceted spectrum of liver cirrhosis in older hospitalised patients: analysis of the REPOSI registry. Age Ageing 2021; 50:498-504. [PMID: 32926127 DOI: 10.1093/ageing/afaa150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. OBJECTIVES To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. METHODS A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. RESULTS LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT. CONCLUSIONS LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features.
Collapse
Affiliation(s)
| | | | - Luisa Costanzo
- Unit of Geriatrics, University Campus Bio-Medico, Rome, Italy
| | - Alessio Novella
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Laura Cortesi
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandro Nobili
- Laboratorio di Valutazione della Qualità delle Cure e dei Servizi per l'Anziano, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Grifoni E, Valoriani A, Cei F, Vannucchi V, Moroni F, Pelagatti L, Tarquini R, Landini G, Masotti L. The CALL Score for Predicting Outcomes in Patients With COVID-19. Clin Infect Dis 2021; 72:182-183. [PMID: 32474605 PMCID: PMC7314186 DOI: 10.1093/cid/ciaa686] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | | | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | - Vieri Vannucchi
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | - Federico Moroni
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | | | | | | | - Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| |
Collapse
|
11
|
Grifoni E, Vannucchi V, Valoriani A, Cei F, Lamanna R, Gelli AMG, Ciambotti B, Moroni F, Pelagatti L, Tarquini R, Landini G, Vanni S, Masotti L. Interleukin-6 added to CALL score better predicts the prognosis of COVID-19 patients. Intern Med J 2020; 51:146-147. [PMID: 33336833 DOI: 10.1111/imj.14974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| | - Vieri Vannucchi
- Internal Medicine, Santa, Maria Nuova Hospital, Florence, Italy
| | | | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | - Roberta Lamanna
- Clinical Pathology, Laboratory Department, San Giuseppe Hospital, Empoli, Italy
| | | | - Benedetta Ciambotti
- Clinical Pathology, Laboratory Department, San Giuseppe Hospital, Empoli, Italy
| | - Federico Moroni
- Internal Medicine, Santa, Maria Nuova Hospital, Florence, Italy
| | | | | | | | - Simone Vanni
- Emergency Department, San Giuseppe Hospital, Empoli, Italy
| | - Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Empoli, Italy
| |
Collapse
|
12
|
Carbone A, Linkova N, Polyakova V, Mironova E, Hashimova U, Gadzhiev A, Safikhanova K, Kvetnaia T, Krylova J, Tarquini R, Mazzoccoli G, Kvetnoy I. Melatonin and Sirtuins in Buccal Epithelium: Potential Biomarkers of Aging and Age-Related Pathologies. Int J Mol Sci 2020; 21:ijms21218134. [PMID: 33143333 PMCID: PMC7662974 DOI: 10.3390/ijms21218134] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/22/2022] Open
Abstract
Melatonin (MT) and sirtuins (SIRT) are geroprotective molecules that hold back the aging process and the development of age-related diseases, including cardiovascular pathologies. Buccal epithelium (BE) sampling is a non-invasive procedure, yielding highly informative material for evaluating the expression of genes and proteins as well as the synthesis of molecules. Among these, MT and SIRTs are valuable markers of the aging process and age-related pathologies. The purpose of this study was to examine age-related expression patterns of these signaling molecules, in particular MT, SIRT1, SIRT3, and SIRT6 in BE of subjects of different ages with and without arterial hypertension (AH). We used real-time polymerase chain reaction (RT-PCR) and immunofluorescence analysis by confocal microscopy. We found that MT immunofluorescence intensity in BE decreases with aging, more evidently in AH patients. SIRT3 and SIRT6 genes expression and immunofluorescence intensity in BE was decreased in aging controls. In AH patients, SIRT1, SIRT3, and SIRT6 gene expression and immunofluorescence intensity in BE was decreased in relation to age and in comparison with age-matched controls. In conclusion, the evaluation of MT and sirtuins in BE could provide a non-invasive method for appraising the aging process, also when accompanied by AH.
Collapse
Affiliation(s)
- Annalucia Carbone
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
- Correspondence: (A.C.); (G.M.)
| | - Natalia Linkova
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.M.); (T.K.)
- Department of Therapy, Geriatrics, and Anti-Aging Medicine, Academy of Postgraduate Education under FSBU FSCC of FMBA of Russia, 125310 Moscow, Russia
| | - Victoria Polyakova
- Laboratory of Cell Biology and Pathology, Saint Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia;
- Department of Physiology and Department of Pathology, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
| | - Ekaterina Mironova
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.M.); (T.K.)
| | - Ulduz Hashimova
- Garayev Institute of Physiology, Azerbaijan National Academy of Sciences, Baku AZ1100, Azerbaijan; (U.H.); (A.G.); (K.S.)
| | - Ahmed Gadzhiev
- Garayev Institute of Physiology, Azerbaijan National Academy of Sciences, Baku AZ1100, Azerbaijan; (U.H.); (A.G.); (K.S.)
| | - Khatira Safikhanova
- Garayev Institute of Physiology, Azerbaijan National Academy of Sciences, Baku AZ1100, Azerbaijan; (U.H.); (A.G.); (K.S.)
| | - Tatiana Kvetnaia
- Department of Biogerontology, Saint Petersburg Institute of Bioregulation and Gerontology, 197110 Saint Petersburg, Russia; (N.L.); (E.M.); (T.K.)
| | - Julia Krylova
- Department of Pathology, Pavlov First Saint-Petersburg State Medical University, 197022 Saint Petersburg, Russia;
| | - Roberto Tarquini
- Department of Clinical and Experimental Medicine, University of Florence, 50134 Florence, Italy;
- Inter-institutional Department for Continuity of Care of Empoli, University of Florence, 50134 Florence, Italy
| | - Gianluigi Mazzoccoli
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Laboratory, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
- Correspondence: (A.C.); (G.M.)
| | - Igor Kvetnoy
- Department of Physiology and Department of Pathology, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
- Center of Molecular Biomedicine, Saint-Petersburg Research Institute of Phthisiopulmonology, 191036 Saint Petersburg, Russia
| |
Collapse
|
13
|
Grifoni E, Valoriani A, Cei F, Lamanna R, Gelli AMG, Ciambotti B, Vannucchi V, Moroni F, Pelagatti L, Tarquini R, Landini G, Vanni S, Masotti L. Interleukin-6 as prognosticator in patients with COVID-19. J Infect 2020; 81:452-482. [PMID: 32526326 PMCID: PMC7278637 DOI: 10.1016/j.jinf.2020.06.008] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Elisa Grifoni
- Internal Medicine II, San Giuseppe Hospital, Viale Boccaccio 20, Empoli, 50053 Florence, Italy
| | | | - Francesco Cei
- Internal Medicine I, San Giuseppe Hospital, Empoli, Italy
| | - Roberta Lamanna
- Clinical Pathology, Laboratory Department, San Giuseppe Hospital, Empoli, Italy
| | | | - Benedetta Ciambotti
- Clinical Pathology, Laboratory Department, San Giuseppe Hospital, Empoli, Italy
| | - Vieri Vannucchi
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | - Federico Moroni
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | | | | | - Giancarlo Landini
- Clinical Pathology, Laboratory Department, San Giuseppe Hospital, Empoli, Italy
| | - Simone Vanni
- Emergency Department, San Giuseppe Hospital, Empoli, Italy
| | - Luca Masotti
- Internal Medicine II, San Giuseppe Hospital, Viale Boccaccio 20, Empoli, 50053 Florence, Italy.
| |
Collapse
|
14
|
Livi L, Barletta G, Martella F, Desideri I, Scotti V, Becherini C, Saieva C, Terziani F, Bacci C, Airoldi M, Allegrini G, Amoroso D, Venditti F, Tarquini R, Orzalesi L, Sanchez L, Bernini M, Nori J, Fioretto L, Meattini I. Pre-specified interim analysis of the SAFE trial (NCT2236806): A 4-arm randomized, double-blind, controlled study evaluating the efficacy and safety of cardiotoxicity prevention in non-metastatic breast cancer patients treated with anthracyclines with or without trastuzumab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
15
|
Carlotta F, Raffaella R, Ilaria A, Alessandro N, Mannuccio MP, Mannucci PM, Nobili A, Pietrangelo A, Perticone F, Licata G, Violi F, Corazza GR, Corrao S, Marengoni A, Salerno F, Cesari M, Tettamanti M, Pasina L, Franchi C, Franchi C, Cortesi L, Tettamanti M, Miglio G, Tettamanti M, Cortesi L, Ardoino I, Novella A, Prisco D, Silvestri E, Emmi G, Bettiol A, Caterina C, Biolo G, Zanetti M, Guadagni M, Zaccari M, Chiuch M, Zaccari M, Vanoli M, Grignani G, Pulixi EA, Bernardi M, Bassi SL, Santi L, Zaccherini G, Lupattelli G, Mannarino E, Bianconi V, Paciullo F, Alcidi R, Nuti R, Valenti R, Ruvio M, Cappelli S, Palazzuoli A, Girelli D, Busti F, Marchi G, Barbagallo M, Dominguez L, Cocita F, Beneduce V, Plances L, Corrao S, Natoli G, Mularo S, Raspanti M, Cavallaro F, Zoli M, Lazzari I, Brunori M, Fabbri E, Magalotti D, Arnò R, Pasini FL, Capecchi PL, Palasciano G, Modeo ME, Gennaro CD, Cappellini MD, Maira D, Di Stefano V, Fabio G, Seghezzi S, Mancarella M, De Amicis MM, De Luca G, Scaramellini N, Cesari M, Rossi PD, Damanti S, Clerici M, Conti F, Bonini G, Ottolini BB, Di Sabatino A, Miceli E, Lenti MV, Pisati M, Dominioni CC, Murialdo G, Marra A, Cattaneo F, Pontremoli R, Beccati V, Nobili G, Secchi MB, Ghelfi D, Anastasio L, Sofia L, Carbone M, Cipollone F, Guagnano MT, Valeriani E, Rossi I, Mancuso G, Calipari D, Bartone M, Delitala G, Berria M, Pes C, Delitala A, Muscaritoli M, Molfino A, Petrillo E, Zuccalà G, D’Aurizio G, Romanelli G, Marengoni A, Zucchelli A, Manzoni F, Volpini A, Picardi A, Gentilucci UV, Gallo P, Dell’Unto C, Annoni G, Corsi M, Bellelli G, Zazzetta S, Mazzola P, Szabo H, Bonfanti A, Arturi F, Succurro E, Rubino M, Tassone B, Sesti G, Interna M, Serra MG, Bleve MA, Gasbarrone L, Sajeva MR, Brucato A, Ghidoni S, Fabris F, Bertozzi I, Bogoni G, Rabuini MV, Cosi E, Scarinzi P, Amabile A, Omenetto E, Prandini T, Manfredini R, Fabbian F, Boari B, Giorgi AD, Tiseo R, De Giorgio R, Paolisso G, Rizzo MR, Borghi C, Strocchi E, Ianniello E, Soldati M, Sabbà C, Vella FS, Suppressa P, Schilardi A, Loparco F, De Vincenzo GM, Comitangelo A, Amoruso E, Fenoglio L, Falcetta A, Bracco C, Fracanzani AL, Fargion S, Tiraboschi S, Cespiati A, Oberti G, Sigon G, Peyvandi F, Rossio R, Ferrari B, Colombo G, Agosti P, Monzani V, Savojardo V, Folli C, Ceriani G, Salerno F, Pallini G, Dallegri F, Ottonello L, Liberale L, Caserza L, Salam K, Liberato NL, Tognin T, Bianchi GB, Giaquinto S, Purrello F, Di Pino A, Piro S, Rozzini R, Falanga L, Spazzini E, Ferrandina C, Montrucchio G, Petitti P, Peasso P, Favale E, Poletto C, Salmi R, Gaudenzi P, Violi F, Perri L, Landolfi R, Montalto M, Mirijello A, Guasti L, Castiglioni L, Maresca A, Squizzato A, Campiotti L, Grossi A, Bertolotti M, Mussi C, Lancellotti G, Libbra MV, Dondi G, Pellegrini E, Carulli L, Galassi M, Grassi Y, Perticone F, Perticone M, Battaglia R, FIlice M, Maio R, Stanghellini V, Ruggeri E, del Vecchio S, Salvi A, Leonardi R, Damiani G, Capeci W, Gabrielli A, Mattioli M, Martino GP, Biondi L, Pettinari P, Ghio R, Col AD, Minisola S, Colangelo L, Cilli M, Labbadia G, Afeltra A, Marigliano B, Pipita ME, Castellino P, Zanoli L, Pignataro S, Gennaro A, Blanco J, Saracco V, Fogliati M, Bussolino C, Mete F, Gino M, Cittadini A, Vigorito C, Arcopinto M, Salzano A, Bobbio E, Marra AM, Sirico D, Moreo G, Gasparini F, Prolo S, Pina G, Ballestrero A, Ferrando F, Berra S, Dassi S, Nava MC, Graziella B, Baldassarre S, Fragapani S, Gruden G, Galanti G, Mascherini G, Petri C, Stefani L, Girino M, Piccinelli V, Nasso F, Gioffrè V, Pasquale M, Scattolin G, Martinelli S, Turrin M, Sechi L, Catena C, Colussi G, Passariello N, Rinaldi L, Berti F, Famularo G, Tarsitani P, Castello R, Pasino M, Ceda GP, Maggio MG, Morganti S, Artoni A, Del Giacco S, Firinu D, Losa F, Paoletti G, Costanzo G, Montalto G, Licata A, Malerba V, Montalto FA, Lasco A, Basile G, Catalano A, Malatino L, Stancanelli B, Terranova V, Di Marca S, Di Quattro R, La Malfa L, Caruso R, Mecocci P, Ruggiero C, Boccardi V, Meschi T, Lauretani F, Ticinesi A, Nouvenne A, Minuz P, Fondrieschi L, Pirisi M, Fra GP, Sola D, Porta M, Riva P, Quadri R, Larovere E, Novelli M, Scanzi G, Mengoli C, Provini S, Ricevuti L, Simeone E, Scurti R, Tolloso F, Tarquini R, Valoriani A, Dolenti S, Vannini G, Tedeschi A, Trotta L, Volpi R, Bocchi P, Vignali A, Harari S, Lonati C, Cattaneo M, Napoli F. Prevalence of use and appropriateness of antidepressants prescription in acutely hospitalized elderly patients. Eur J Intern Med 2019; 68:e7-e11. [PMID: 31405773 DOI: 10.1016/j.ejim.2019.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022]
|
16
|
Tarquini R, Pala L, Brancati S, Vannini G, De Cosmo S, Mazzoccoli G, Rotella CM. Clinical Approach to Diabetic Cardiomyopathy: A Review of Human Studies. Curr Med Chem 2019; 25:1510-1524. [PMID: 28685679 DOI: 10.2174/0929867324666170705111356] [Citation(s) in RCA: 13] [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: 08/12/2016] [Revised: 03/15/2017] [Accepted: 03/21/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetic Cardiomyopathy (DC) has been defined as a distinct entity characterized by the presence of diastolic or systolic cardiac dysfunction in a diabetic patient in the absence of other causes for Cardiomyopathy, such as coronary artery disease (CAD), hypertension (HTN), or valvular heart disease. Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population. Diabetes-related heart disease occurs in the form of coronary artery disease (CAD), cardiac autonomic neuropathy or DC. The prevalence of cardiac failure is high in the diabetic population and DC is a common, but underestimated cause of heart failure in diabetes. The strong association between diabetes and heart failure has fueled intense human and animal research aimed at identifying the mechanisms underlying diabetic myocardial disease. Despite significant progress made, the precise pathogenesis of diabetic Cardiomyopathy is yet to be clearly defined. Hyperglycemia, dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn involved. METHODS We have reviewed the up-to-date scientific literature addressing these issues. RESULTS The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DC. In the early stages of the disease, diastolic dysfunction is the only abnormality, but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction. Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction, but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used for early detection of DC. Diabetic patients with microvascular complications show the strongest association between diabetes and Cardiomyopathy, an association that parallels the duration and severity of hyperglycemia. CONCLUSION The management of DC involves improvement in lifestyle, control of glucose and lipid abnormalities, together with treatment of hypertension and CAD, if present.
Collapse
Affiliation(s)
- Roberto Tarquini
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Laura Pala
- Department of Biomedical Experimental and Clinical Sciences, SOD Diabetology, University of Florence and Careggi University Hospital, Florence, Italy
| | - Simona Brancati
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Giulia Vannini
- Division of Intersystemic Internal Medicine, Department of Internal Medicine, USL Toscana Centro, S.Giuseppe Hospital, Empoli, Firenze, Italy
| | - Salvatore De Cosmo
- Division of Internal Medicine and Chronobiology Unit, Department of Medical Sciences, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | - Gianluigi Mazzoccoli
- Division of Internal Medicine and Chronobiology Unit, Department of Medical Sciences, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | - Carlo Maria Rotella
- Department of Biomedical Experimental and Clinical Sciences, SOD Diabetology, University of Florence and Careggi University Hospital, Florence, Italy
| |
Collapse
|
17
|
Tarquini R, Carbone A, Martinez M, Mazzoccoli G. Daylight saving time and circadian rhythms in the neuro-endocrine-immune system: impact on cardiovascular health. Intern Emerg Med 2019; 14:17-19. [PMID: 30488154 PMCID: PMC6668711 DOI: 10.1007/s11739-018-1984-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Roberto Tarquini
- Department of Clinical and Experimental Medicine, School of Medicine, University of Florence, Florence, Italy.
- Inter-institutional Department for Continuity of Care of Empoli, School of Medicine, University of Florence, Florence, Italy.
| | - Annalucia Carbone
- Division of Internal Medicine and Laboratory of Chronobiology, Department of Medical Sciences, Fondazione IRCCS "Casa Sollievo Della Sofferenza", Cappuccini Avenue, San Giovanni Rotondo, Foggia, 71013, Italy
| | - Micaela Martinez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Gianluigi Mazzoccoli
- Division of Internal Medicine and Laboratory of Chronobiology, Department of Medical Sciences, Fondazione IRCCS "Casa Sollievo Della Sofferenza", Cappuccini Avenue, San Giovanni Rotondo, Foggia, 71013, Italy.
| |
Collapse
|
18
|
Abstract
Aims and background Melatonin secretion is required to be a potential inhibitor of the development and growth of tumors, and cigarette smoking is a well established risk factor for cancer at various sites. Methods Circulating melatonin levels of 20 smokers and 20 non smokers (controls), sampled at the same hour from awaking in order to obtain a comparable circadian synchronization, were compared. Results Our data showed higher melatonin circulating levels in smokers (17.44 ±1.8 pg/ml) than in nonsmokers (9.77 ± 1.4 pg/ml). Conclusions The causes, mechanism and meaning of this phenomenon are still unknown. The most actractive hypothesis considers higher melatonin levels in smokers as an attempt to counterbalance cellular growth stimulus, a natural “brake” mechanism to restrain the proliferation of normally differentiated tissues: smoke is a prominent risk factor for several different tumors.
Collapse
Affiliation(s)
- B Tarquini
- Cattedra di Medicina Interna I, University of Florence, Italy
| | | | | | | |
Collapse
|
19
|
Gamberi S, Calamassi D, Coletta D, Dolenti S, Valoriani A, Tarquini R. The home management of Artificial Nutrition: a survey among doctors and nurses. Acta Biomed 2017; 88:161-166. [PMID: 28845830 PMCID: PMC6166141 DOI: 10.23750/abm.v88i2.5584] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 01/17/2017] [Indexed: 11/25/2022]
Abstract
Background and aim of the work: The management of Artificial Nutrition (NA), especially in the home environment (HAN) requires specific skills in order to ensure the correct therapeutic education, prevention of complications and the provision of appropriate treatment to the person. The aim of this survey was to identify the perceptions of nurses and doctors, as well as comparing to their perceived competence in NA and the gap between their perceived versus actual knowledge and management methods. Methods: This observational study was conducted in a Tuscan health region of Italy, involving 50 Home Care Services nurses and 50 general practitioners. Participants were asked to complete an online questionnaire that was constructed for purpose. Results: The results show that for the management of the person with NA, both for doctors and for nurses show great variability in responses. Less than half of those providing care make assessments of nutritional status and dysphagia as well as the possibility of re-feeding by natural means in NA patients. Care providers expressed uncertainty as to which professional should carry out such assessments. A mismatch was also evident between the skills possessed and the self-assessments performed regarding their knowledge base of NA. Almost all of doctors of nurses indicated a desire to participate in training events relating to NA. Conclusions: The results highlight the need for caregivers to have specific operating protocols. The results also highlight the need to aim to work as a team, emphasizing the importance of basic communication as well as the need for clarity as to the responsibilities and roles of the professionals involved. (www.actabiomedica.it)
Collapse
Affiliation(s)
- Sara Gamberi
- RN - Casa di Cura "Leonardo", Sovigliana, Ausl Centro Toscana, (Italy).
| | | | | | | | | | | |
Collapse
|
20
|
Abstract
The molecular clockwork drives rhythmic oscillations of signaling pathways managing intermediate metabolism; the circadian timing system synchronizes behavioral cycles and anabolic/catabolic processes with environmental cues, mainly represented by light/darkness alternation. Metabolic pathways, bile acid synthesis, and autophagic and immune/inflammatory processes are driven by the biological clock. Proper timing of hormone secretion, metabolism, bile acid turnover, autophagy, and inflammation with behavioral cycles is necessary to avoid dysmetabolism. Disruption of the biological clock and mistiming of body rhythmicity with respect to environmental cues provoke loss of internal synchronization and metabolic derangements, causing liver steatosis, obesity, metabolic syndrome, and diabetes mellitus.
Collapse
Affiliation(s)
- Roberto Tarquini
- Department of Clinical and Experimental Medicine, School of Medicine, University of Florence, Viale Gaetano Pieraccini, 6, 50139, Florence, Italy; Inter-institutional Department for Continuity of Care of Empoli, School of Medicine, University of Florence, Viale Gaetano Pieraccini, 6, 50139 Florence, Italy
| | - Gianluigi Mazzoccoli
- Chronobiology Unit, Division of Internal Medicine, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", Cappuccini Avenue, San Giovanni Rotondo, Foggia 71013, Italy.
| |
Collapse
|
21
|
Scholkmann F, Miscio G, Tarquini R, Bosi A, Rubino R, di Mauro L, Mazzoccoli G. The circadecadal rhythm of oscillation of umbilical cord blood parameters correlates with geomagnetic activity - An analysis of long-term measurements (1999-2011). Chronobiol Int 2016; 33:1136-1147. [PMID: 27409251 DOI: 10.1080/07420528.2016.1202264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recently, we have shown that the contents of total nucleated cells (TNCs) and CD34+ hematopoietic stem and progenitor cells (CD34+ HSPCs) as well as the cord blood volume (CBV) in umbilical cord blood (UCB) show a circadecadal (~10 years) rhythm of oscillation. This observation was based on an analysis of 17,936 cord blood donations collected during 1999-2011. The aim of the present study was to investigate whether this circadecadal rhythm of oscillation in TNCs, CD34+ HSPCs and CBV is related to geomagnetic activity. For the analysis, the yearly averages of TNCs, CD34+ HSPCs and CBV in UCB were correlated with geomagnetic activity (Dcx index). Our analysis revealed that (i) all three UCB parameters were statistically significantly correlated with the level of geomagnetic activity, (ii) CBV showed a linear correlation with the Dcx index (r = 0.5290), (iii) the number of TNCs and CD34+ HSPCs were quadratic inversely correlated with the Dcx index (r = -0.5343 and r = -0.7749, respectively). Furthermore, (iv) CBV and the number of TNCs were not statistically significantly correlated with the number of either modest or intense geomagnetic storms per year, but (v) the number of CD34+ HSPCs was statistically significantly correlated with the number of modest (r = 0.9253) as well as intense (r = 0.8683) geomagnetic storms per year. In conclusion, our study suggests that UCB parameters correlate with the state of the geomagnetic field (GMF) modulated by solar activity. Possible biophysical mechanisms underlying this observation, as well as the outcome of these findings, are discussed.
Collapse
Affiliation(s)
- Felix Scholkmann
- a Research Office for Complex Physical and Biological Systems (ROCoS) , Zurich , Switzerland
| | - Giuseppe Miscio
- b Apulia Cord Blood Bank , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Roberto Tarquini
- c Department of Clinical and Experimental Medicine, School of Medicine , University of Florence , Florence , Italy.,d Interinstitutional Department for Continuity of Care of Empoli, School of Medicine , University of Florence , Florence , Italy
| | - Alberto Bosi
- e Department of Clinical and Experimental Medicine, Unit of Haematology, School of Medicine , University of Florence , Florence , Italy
| | - Rosa Rubino
- f Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Lazzaro di Mauro
- b Apulia Cord Blood Bank , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| | - Gianluigi Mazzoccoli
- f Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit , IRCCS "Casa Sollievo della Sofferenza" , S. Giovanni Rotondo (FG) , Italy
| |
Collapse
|
22
|
Mazzoccoli G, Rubino R, Tiberio C, Giuliani F, Vinciguerra M, Oben J, De Cata A, Tarquini R, De Cosmo S, Liu S, Cai Y. Clock gene expression in human and mouse hepatic models shows similar periodicity but different dynamics of variation. Chronobiol Int 2016; 33:181-90. [DOI: 10.3109/07420528.2015.1132722] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
23
|
Celentano V, Esposito E, Perrotta S, Giglio M, Tarquini R, Luglio G, Bucci1 L. Madelung Disease: Report of a Case and Review of the Literature. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2014.11681055] [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: 10/28/2022]
Affiliation(s)
- V. Celentano
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - E. Esposito
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - S. Perrotta
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - M.C. Giglio
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - R. Tarquini
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - G. Luglio
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| | - L. Bucci1
- Department of General,Oncologic and Video-Assisted Surgery. University “Federico II” of Naples, Italy
| |
Collapse
|
24
|
Mazzoccoli G, Tarquini R, Valoriani A, Oben J, Vinciguerra M, Marra F. Management strategies for hepatocellular carcinoma: old certainties and new realities. Clin Exp Med 2015; 16:243-56. [PMID: 26077653 DOI: 10.1007/s10238-015-0368-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 02/27/2015] [Accepted: 06/04/2015] [Indexed: 12/18/2022]
Abstract
Hepatocellular carcinoma (HCC) is a highly prevalent disease ranking among the ten most common cancers worldwide with increasing trend of incidence in most developed countries. The great healthcare costs and economic burden of HCC dictate proper preventive interventions as well as surveillance and screening programs to decrease disease incidence and allow early diagnosis. HCC treatment outcomes are affected by several variables, including liver function, patient's performance status, and tumor stage. In line with the Barcelona Clinic Liver Cancer (BCLC) staging curative treatments, such as surgery or radio-frequency ablation, are indicated in early-stage HCC (BCLC-A), and the noncurative treatments are indicated in intermediate and advanced stages of HCC (BCLC-B, C). Transarterial chemoembolization (TACE) represents the treatment of choice for intermediate-stage HCC with Child-Pugh A cirrhosis, and the long-term survival after liver transplantation is inferior to that of early-stage HCCs. In advanced-stage HCC or when complete necrosis is not achieved or early recurrence after TACE develops, individualized treatments such as systemic treatment or combined radiation therapy are indicated. The increasing knowledge of the genomic landscape of HCC and the development of molecular-targeted therapies is heading toward expanding the armamentarium for HCC management.
Collapse
Affiliation(s)
- Gianluigi Mazzoccoli
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo, FG, Italy.
| | - Roberto Tarquini
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Inter-company Department for Continuity Assistance, School of Medicine, University of Florence, Florence, Italy.,San Giuseppe Hospital, Empoli, Italy
| | - Alice Valoriani
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Inter-company Department for Continuity Assistance, School of Medicine, University of Florence, Florence, Italy.,San Giuseppe Hospital, Empoli, Italy
| | - Jude Oben
- University College London (UCL) - Institute for Liver and Digestive Health, Division of Medicine, Royal Free Hospital, London, UK
| | - Manlio Vinciguerra
- University College London (UCL) - Institute for Liver and Digestive Health, Division of Medicine, Royal Free Hospital, London, UK.,Istituto EuroMEditerraneo di Scienza e Tecnologia (IEMEST), Palermo, Italy.,School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Fabio Marra
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| |
Collapse
|
25
|
Meattini I, Tarquini R, Saieva C, Valoriani A, Bonomo P, Desideri I, Loi M, Scotti V, De Luca Cardillo C, Magrini SM, Gensini G, Livi L. Cardiac toxicity prevention in non-metastatic breast cancer patients treated with anthracycline-based chemotherapy: A randomized, placebo controlled, phase III trial—SAFE trial. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.tps1100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Roberto Tarquini
- Dipartimento Interaziendale di Formazione per la Continuità dell'assistenza, AOU Careggi/ASL 11, Florence, Italy
| | | | - Alice Valoriani
- Dipartimento Interaziendale di Formazione per la Continuità dell'assistenza, AOU Careggi/ASL 11, Florence, Italy
| | | | | | - Mauro Loi
- Florence University, Florence, Italy
| | | | | | | | | | | |
Collapse
|
26
|
Celentano V, Esposito E, Perrotta S, Giglio MC, Tarquini R, Luglio G, Bucci L. Madelung disease : report of a case and review of the literature. Acta Chir Belg 2014; 114:417-420. [PMID: 26021689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Madelung disease is a rare disorder characterized by the presence of multiple, symmetric, nonencapsulated fatty accumulations diffusely involving the cheeks, the neck, the upper trunk, the shoulder girdle area, and the upper extremities. The cause of this syndrome is unknown, but it has been associated with alcoholism in 60% to 90% of -patients. The long-term lipomatous deposits are often large and cosmetically deforming, and the upper aerodigestive tract and great veins may be compressed. We report the case of a man with MD, involving the cervical and upper dorsal -regions, who underwent surgical treatment at our Department.
Collapse
Affiliation(s)
- V Celentano
- Department of General, Oncologic and Video-Assisted Surgery. University "Federico II" of Naples, Italy
| | | | | | | | | | | | | |
Collapse
|
27
|
Mazzoccoli G, Vinciguerra M, Oben J, Tarquini R, De Cosmo S. Non-alcoholic fatty liver disease: the role of nuclear receptors and circadian rhythmicity. Liver Int 2014; 34:1133-52. [PMID: 24649929 DOI: 10.1111/liv.12534] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/16/2014] [Indexed: 12/22/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the accumulation of triglycerides in the hepatocytes in the absence of excess alcohol intake, and is caused by an imbalance between hepatic synthesis and breakdown of fats, as well as fatty acid storage and disposal. Liver metabolic pathways are driven by circadian biological clocks, and hepatic health is maintained by proper timing of circadian patterns of metabolic gene expression with the alternation of anabolic processes corresponding to feeding/activity during wake times, and catabolic processes characterizing fasting/resting during sleep. A number of nuclear receptors in the liver are expressed rhythmically, bind hormones and metabolites, sense energy flux and expenditure, and connect the metabolic pathways to the molecular clockwork throughout the 24-h day. In this review, we describe the role played by the nuclear receptors in the genesis of NAFLD in relationship with the circadian clock circuitry.
Collapse
Affiliation(s)
- Gianluigi Mazzoccoli
- Division of Internal Medicine and Chronobiology Unit, Department of Medical Sciences, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | | | | | | | | |
Collapse
|
28
|
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease of unknown cause and a chronic and progressive inflammatory disorder ensuing in genetically predisposed subjects, characterized by synovitis causing joint destruction, as well as inflammation in body organ systems, leading to anatomical alteration and functional disability. Immune competent cells, deregulated synoviocytes and cytokines play a key role in the pathophysiological mechanisms. The immune system function shows time-related variations related to the influence of the neuroendocrine system and driven by the circadian clock circuitry. Immune processes and symptom intensity in RA are characterized by oscillations during the day following a pattern of circadian rhythmicity. A cross-talk between inflammatory and circadian pathways is involved in RA pathogenesis and underlies the mutual actions of disruption of the circadian clock circuitry on immune system function as well as of inflammation on the function of the biological clock. Modulation of molecular processes and humoral factors mediating in RA the interplay between the biological clock and the immune response and underlying the rhythmic fluctuations of pathogenic processes and symptomatology could represent a promising therapeutic strategy in the future.
Collapse
Affiliation(s)
- Angelo De Cata
- Department of Medical Sciences, Division of Internal Medicine and Chronobiology Unit, IRCCS Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy
| | | | | | | |
Collapse
|
29
|
Lunghi A, Petreni P, Romanelli RG, Vizzutti F, Marra F, Tarquini R, Laffi G. Aggressive gastric carcinoma producing alpha-fetoprotein: a case report and review of the literature. Case Rep Oncol 2014; 7:92-6. [PMID: 24575023 PMCID: PMC3934810 DOI: 10.1159/000358509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 65-year-old man presented to our hospital with abdominal pain, dyspepsia and anorexia. Laboratory tests showed an altered liver function and abdomen ultrasonography revealed multiple liver nodules, suspected to be metastatic lesions. Serous tumor markers were elevated and a very high level of alpha-fetoprotein was found. Computer tomography confirmed the hepatic lesions and disclosed a thickening of the lesser curvature of the gastric wall. A subsequent endoscopy showed an ulcer on the lesser curvature. Biopsies taken from the gastric ulcer and the liver nodule revealed an adenocarcinoma, both of gastric origin. Shortly after the diagnosis, the patient's condition worsened and he died only 15 days later. This case report illustrates how alpha-fetoprotein-producing gastric adenocarcinomas have a high incidence of venous and lymphatic invasion and a rapid hepatic spread with a very poor prognosis.
Collapse
Affiliation(s)
- A Lunghi
- Dipartimento di Oncologia, Oncologia Medica, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - P Petreni
- Dipartimento di Oncologia, Oncologia Medica, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - R G Romanelli
- Dipartimento di Medicina Interna, Medicina ed Epatologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - F Vizzutti
- Dipartimento di Medicina Interna, Medicina ed Epatologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - F Marra
- Dipartimento di Medicina Interna, Medicina ed Epatologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - R Tarquini
- Dipartimento di Medicina Interna, Medicina ed Epatologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - G Laffi
- Dipartimento di Medicina Interna, Medicina ed Epatologia, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| |
Collapse
|
30
|
Abstract
Recently, there is a growing interest in the concept of "continuity of care," since patients, being older and more complex, are increasingly seen by an array of providers in a wide variety of organizations and places. Different models of continuity of care have been proposed, yet no single model of care coordination has been proven to be universally applicable across patient (and disease) populations. In the present paper, we introduce a novel model of continuity of care, the Ospedale Santa Verdiana, in Castelfiorentino (Tuscany, Italy), and its first period (1 year) of implementation, since January 2010. There are two main cornerstones: (a) the clinical and urgent need to bridge the gap between primary care and hospital care; and (b) the development and implementation of a model of continuity and coordination of care, which target the so-called complex patient. It is not specific for a single disease but it works "across diseases." There are three driving forces: (a) "primary care" since one of the two Hospital Coordinators is a primary care physician; (b) "hospital care" since patients in the decompensated phase often require hospitalization; and (c) the "University of Florence", which is the "glue". The duties of the Hospital Coordinator, who is an assistant professor at University of Florence, are to guarantee an efficacious and dynamic communication between primary care physicians and hospitalists, and by creating a school for practitioners of the continuity and coordination of care, to make this model exportable.
Collapse
Affiliation(s)
- Roberto Tarquini
- Department of Continuity for Assistance, Castelfiorentino, University of Florence, Florence, Italy,
| | | | | | | |
Collapse
|
31
|
Boddi M, Tarquini R, Chiostri M, Marra F, Valente S, Giglioli C, Gensini GF, Abbate R. Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes. Eur J Clin Invest 2013; 43:429-38. [PMID: 23480577 DOI: 10.1111/eci.12065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Accepted: 02/10/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Growing evidence was collected that non-alcoholic liver fatty disease (NAFLD) is a risk factor for coronary atherosclerosis in terms of angiographic appearance, but its involvement in acute coronary syndromes is still debated. We investigated the prevalence and severity of NAFLD in non-diabetic patients admitted for ST-segment elevation myocardial infarction (STEMI) and its association with multi-vessel coronary artery disease (CAD). MATERIALS AND METHODS Ninety-five consecutive non-diabetic patients admitted to cardiac ICU for STEMI were studied by ultrasound within 72 h from admission. NAFLD was graded according to a semi-quantitative severity score as mild (score < 3) or moderate-severe (> 3 score). Prevalence of cardiovascular (CV) risk factors, atherosclerotic burden markers and metabolic syndrome (MS) was investigated. RESULTS The overall prevalence of NAFLD was 87%. Forty-eight patients showed moderate-severe NAFLD (SFLD). Thirty-five patients showed mild NAFLD (MLFD group) and 12 patients had no NAFLD. Patients with SFLD were younger and showed higher prevalence of multi-vessel CAD (i.e. > 2) than patients with mild MFLD (P < 0·01). Total cholesterol, triglycerides, body mass index and waist circumference were higher and HDL lower in SFLD than MFLD patients. About 50% of all NAFLD patients did not have MS. MS prevalence was higher in SFLD than MLFD patients (P < 0·05) and among MS components, waist circumference and triglyceride levels showed the strongest association with SFLD (P < 0·05). At logistic regression analysis, SFLD was independently associated with a three-fold risk of multi-vessel CAD. CONCLUSIONS In non-diabetic patients admitted for STEMI NAFLD prevalence was very high. Severe NAFLD independently increased the risk for multi-vessel CAD associated to CV events.
Collapse
Affiliation(s)
- Maria Boddi
- Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Vinciguerra M, Borghesan M, Pazienza V, Piepoli A, Palmieri O, Tarquini R, Tevy MF, De Cata A, Mazzoccoli G. The transcriptional regulators, the immune system and the the circadian clock. J BIOL REG HOMEOS AG 2013; 27:9-22. [PMID: 23489683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The immune system function oscillates with a 24-hour period driving circadian rhythmicity of immune responses. A circadian timing system comprising central and peripheral oscillators entrains body rhythmicity of physiology and behavior to environmental cues by means of humoral signals and autonomic neural outputs. In every single cell an oscillator goes ticking through a molecular clock operated by transcriptional/translational feedback loops driven by the rhythmic expression of circadian genes. This clock gene machinery steers daily oscillations in the regulation of immune cell activity, driving the periodicity in immune system function. The transcriptional networks that regulate temporal variation in gene expression in immunocompetent cells and tissues respond to diverse physiological clues, addressing well-timed adjustments of transcription and translation processes. Nuclear receptors comprise a unique class of transcriptional regulators that are capable of gauging hormones, metabolites, endobiotics and xenobiotics, linking ligand sensing to transcriptional responses in various cell types through switching between coactivator and corepressor recruitment. The expression of coregulators is highly responsive to physiological signals, and plays an important role in the control of rhythmic patterns of gene expression, optimizing the switch between nycthemeral patterns, and synchronizing circadian rhythmicity with changing physiological demands across the light-dark cycle. The nuclear receptors and transcription factors expressed in the immune components contribute to the cross-talk between the circadian timing system, the clock gene machinery and the immune system, influencing transcriptional activities and directing cell-type specific gene expression programs linked to innate and adaptive immune responses.
Collapse
|
33
|
Mazzoccoli G, Sothern RB, Francavilla M, Giuliani F, Carughi S, Muscarella LA, Fazio VM, Parrella P, Vinciguerra M, Tarquini R. Hormone and cytokine circadian alteration in non-small cell lung cancer patients. Int J Immunopathol Pharmacol 2012; 25:691-702. [PMID: 23058019 DOI: 10.1177/039463201202500315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Alterations in hormone secretion and cytokine levels have been evidenced in many neoplastic diseases. In this study we have evaluated the circadian profile of growth hormone (GH), insulin-like growth factor-1 (IGF-1), interleukin-2 (IL2), melatonin (MEL) and cortisol (COR) serum levels in non-small cell lung cancer patients. Blood was sampled every 4 h for 24 h in 11 healthy (H) men (ages 35-53 years) and 9 men with stage 2, 3 or 4 non-small cell lung cancer (C) (ages 43-63 years). Serum GH, total IGF1, IL2, MEL and COR were measured and examined for group differences, trends, and rhythm characteristics. 24-h means were significantly higher in C234 vs H for GH, GH/IGF1, IL2 and COR, and lower for IGF1, but IL2 and COR were not different for C23 vs H. A linear regression across 4 groups (H, C2, C3, C4) found a positive trend for COR, GH, GH/IGF1 and IL2, and a negative trend for IGF1. A linear regression run between the 24-h mean levels of GH, IGF1, COR, MEL and IL2 in healthy subjects evidenced a statistically significant positive trend between MEL and GH (R = 0.281, p = 0.022) and in cancer patients showed a statistically significant negative trend between GH and IGF1 (R = 0.332, p = 0.01), COR and IGF1 (R=0.430, p=0.001), and a statistically significant positive trend between the 24-h mean of COR and GH (R = 0.304, p = 0.02). Rhythms in MEL and COR (peaks near 01:00h and 08:00h, respectively) indicated identical synchronization to the light-dark cycle for both groups. A circadian rhythm was detected in GH and GH/IGF1 for C23 and H, with IGF1 and IL2 non-rhythmic in any group. In conclusion, an increasing trend and progressive loss of circadian rhythmicity in GH and GH/IGF1, an increasing trend in cortisol and IL2, and a decreasing trend in IGF1 in C, reflect a complex chain of events that could be involved in progression of neoplastic disease. A therapeutic strategy needs to take into account circadian patterns and complex interactions of the multiple functions that characterize the hormone and cytokine levels in the frame cancer progression.
Collapse
Affiliation(s)
- G Mazzoccoli
- Department of Medical Sciences,IRCCS Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Tarquini R, Mazzoccoli G, Fusi F, Laffi G, Gensini GF, Romano SM. Non invasive continuous hemodynamic evaluation of cirrhotic patients after postural challenge. World J Hepatol 2012; 4:149-53. [PMID: 22567187 PMCID: PMC3345539 DOI: 10.4254/wjh.v4.i4.149] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 11/08/2011] [Accepted: 04/24/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To assess whether Most Care is able to detect the cardiovascular alterations in response to physiological stress (posture). METHODS Non invasive hemodynamic was assessed in 26 cirrhotic patients compared to healthy subjects, both in the supine and standing positions. RESULTS In baseline conditions, when compared to healthy subjects, cirrhotic patients showed significantly lower values of dicrotic and diastolic pressures and systemic vascular resistance. While in the standing position, cirrhotic patients showed higher values of cardiac index, stroke volume index and cardiac cycle efficiency. When returning to the supine position, cirrhotic patients exhibited lower values of dicrotic and diastolic pressures and systemic vascular resistance in the presence of higher values of cardiac index, stroke volume index and cardiac cycle efficiency. CONCLUSION Most Care proved to be able to detect cardiovascular abnormalities bedside in the resting state and after postural challenge in cirrhotic patients.
Collapse
Affiliation(s)
- Roberto Tarquini
- Roberto Tarquini, Fulvio Fusi, Giacomo Laffi, Department of Internal Medicine, School of Medicine, 50134 Florence, Italy
| | | | | | | | | | | |
Collapse
|
35
|
Tarquini R, Masini E, La Villa G, Mazzoccoli G, Mastroianni R, Romanelli RG, Vizzutti F, Arena U, Santosuosso U, Laffi G. Hepato-systemic gradient of carbon monoxide in cirrhosis. Eur J Intern Med 2012; 23:e14-8. [PMID: 22153542 DOI: 10.1016/j.ejim.2011.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/25/2011] [Accepted: 10/10/2011] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Experimental data suggest that in liver cirrhosis splanchnic and systemic vasculature exhibit marked endothelial Carbon monoxide (CO) overproduction, while recent data demonstrated heme oxygenase (HO) hyperactivity in the liver of rats with cirrhosis. No data are so far available on CO levels in the hepatic veins of cirrhotic patients. We aimed at evaluating whether plasma CO levels differ between systemic (peripheral vein) and hepatic (hepatic vein) circulation in patients with viral cirrhosis with and without ascites. METHODS We enrolled 31 consecutive non-smoking in- or outpatients with liver cirrhosis. We measured wedge (occluded, WHVP) and free hepatic venous pressures (FHVP) and hepatic-vein pressure gradient (HVPG) was the calculated. Plasma level of NO and plasma CO concentration were determined both in peripheral vein and in the hepatic vein in cirrhotics. RESULTS In cirrhotic patients plasma CO levels were significantly higher in the hepatic vein (16.66±10.71 p.p.m.) than in the peripheral vein (11.71±7.00 p.p.m). Plasma NO levels were significantly higher in peripheral vein (97.02±21.11 μmol/ml) than in the hepatic vein (60.76±22.93 μmol/ml). CONCLUSIONS In patients with liver cirrhosis we documented a hepato-systemic CO gradient as inferred by the higher CO values in the hepatic vein than in the peripheral vein. In cirrhotic patients, CO and NO exhibit opposite behavior in the liver, while both molecules show increased values in the systemic circulation. It can be speculated that increased intra-hepatic CO levels might represent a counterbalancing response to reduced NO intra-hepatic levels in human liver cirrhosis.
Collapse
Affiliation(s)
- Roberto Tarquini
- Department of Internal Medicine, University of Florence, School of Medicine, 50134 Florence, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Mazzoccoli G, Sothern RB, Pazienza V, Piepoli A, Muscarella LA, Giuliani F, Tarquini R. Circadian Aspects of Growth Hormone–Insulin-Like Growth Factor Axis Function in Patients With Lung Cancer. Clin Lung Cancer 2012; 13:68-74. [DOI: 10.1016/j.cllc.2011.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 03/29/2011] [Indexed: 10/18/2022]
|
37
|
Araten DJ, Notaro R, Thaler HT, Kernan N, Boulad F, Castro-Malaspina H, Small T, Scaradavou A, Magnan H, Prockop S, Chaffee S, Gonsky J, Thertulien R, Tarquini R, Luzzatto L. Thrombolytic therapy is effective in paroxysmal nocturnal hemoglobinuria: a series of nine patients and a review of the literature. Haematologica 2011; 97:344-52. [PMID: 22133780 DOI: 10.3324/haematol.2011.049767] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Thrombosis is the major risk factor for death in patients with paroxysmal nocturnal hemoglobinuria. Previous case reports indicate that venous thrombosis in patients with paroxysmal nocturnal hemoglobinuria is amenable to thrombolysis. DESIGN AND METHODS We reviewed the outcome of thrombolytic therapy for patients with paroxysmal nocturnal hemoglobinuria who had thromboses refractory to anticoagulation at our institutions. RESULTS In this study of 41 patients who had at least one thrombotic event, we confirmed a very high incidence of recurrence despite anticoagulation. Nine patients with thrombosis were regarded as eligible for administration of intravenous tissue plasminogen activator, which was effective in reversing thrombi in all of 15 occasions in which it was given. Serious hemorrhagic complications developed in three cases. At last follow-up visit, of the nine patients treated, three had died, and six were in very good to excellent condition in terms of clinical outcome and radiological findings. The only patient in whom thrombolysis may have contributed to a fatal outcome also had complications of "heparin induced thrombocytopenia with thrombosis", which we diagnosed in three additional patients. In our review of the literature, nine out of 15 patients treated with thrombolysis have had a good outcome. CONCLUSIONS Although it is associated with a significant but manageable risk of bleeding, systemic thrombolysis is a highly effective treatment for reversing venous thromboses in patients with paroxysmal nocturnal hemoglobinuria.
Collapse
Affiliation(s)
- David J Araten
- Division of Hematology, NYU School of Medicine, NYU Langone Cancer Center, New York, NY 10016, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Giglio M, Tarquini R, Luglio G, Celentano V, Esposito E, Bucci L. Intersphinteric Resection for Low Rectal Cancer: Short Term Functional Results and Quality of Life. Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.09.028] [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: 10/15/2022] Open
|
39
|
Limite G, Esposito E, Sollazzo V, Ciancia G, Luglio G, Tarquini R, Celentano V, Forestieri P. Micrometastasis at Sentinel Node Biopsy in Early Breast Cancer: Can Axillary Node Dissection be Safely Omitted? Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.09.017] [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] Open
|
40
|
Luglio G, Celentano V, Tarquini R, Sollazzo V, Giglio M, Bucci L. Functional and Oncological Outcomes After Transanal Local Excision for Rectal Cancer. A Prospective Study. Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.09.016] [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: 11/26/2022] Open
|
41
|
Abstract
Diabetic cardiomyopathy has been defined as "a distinct entity characterized by the presence of abnormal myocardial performance or structure in the absence of epicardial coronary artery disease, hypertension, and significant valvular disease". The diagnosis stems from the detection of myocardial abnormalities and the exclusion of other contributory causes of cardiomyopathy. It rests on non-invasive imaging techniques which can demonstrate myocardial dysfunction across the spectra of clinical presentation. The presence of diabetes is associated with an increased risk of developing heart failure, and the 75% of patients with unexplained idiopathic dilated cardiomyopathy were found to be diabetic. Diabetic patients with microvascular complications show the strongest association between diabetes and cardiomyopathy, an association that parallels the duration and severity of hyperglycemia. Metabolic abnormalities (that is hyperglycemia, hyperinsulinemia, and hyperlipemia) can lead to the cellular alterations characterizing diabetic cardiomyopathy (that is myocardial fibrosis and/or myocardial hypertrophy) directly or indirectly (that is by means of renin-angiotensin system activation, cardiac autonomic neuropathy, alterations in calcium homeostasis). Moreover, metabolic abnormalities represent, on a clinical ground, the main therapeutic target in the patients with diabetes since the diagnosis of diabetes is made. Since diabetic cardiomyopathy is highly prevalent in the asymptomatic type 2 diabetic patients, screening for its presence at the earliest stage of development can lead to prevent the progression to chronic heart failure. The most sensitive test is standard echocardiogram, while a less expensive pre-screening method is the detection of microalbuminuria.
Collapse
Affiliation(s)
- Roberto Tarquini
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Italy.
| | | | | | | | | |
Collapse
|
42
|
Mazzoccoli G, Tarquini R, Durfort T, Francois JC. Chronodisruption in lung cancer and possible therapeutic approaches. Biomed Pharmacother 2011; 65:500-8. [PMID: 21993005 DOI: 10.1016/j.biopha.2011.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/05/2011] [Indexed: 01/05/2023] Open
Abstract
A customary temporal organization of physiological functions and biological processes is necessary to maintain body homeostasis and an altered body time structure may favour carcinogenesis. There is growing evidence that GH stimulates cancer growth, IGF1 may have a role in carcinogenesis and cancer promotion, GH-IGF1 axis, TRH, TSH, thyroxine, melatonin and cortisol modulate immune cell function and the immune system is often dysfunctional in patients with malignancies. The aim of our study was to evaluate GH-IGF1 axis, hypothalamus-pituitary-thyroid axis, melatonin, cortisol, lymphocyte subsets and IL2 in lung cancer patients. Peripheral blood samples were collected at 4-hour intervals in a 24-hour period from eleven healthy male subjects (age range 35-53 years) and nine male patients suffering from non-small cell lung cancer (age range 43-63 years). In each blood sample, lymphocyte subpopulations (CD3+, CD4+, CD8+, CD16+, CD20+, CD25+, HLA-DR+, γδTcR bearing cells) were analyzed and GH, IGF1, TRH, TSH, FT4, melatonin, cortisol and IL2 were measured. Circadian rhythmicity was evaluated and MESOR, amplitude and acrophase values were compared. In healthy subjects a significant circadian rhythm could be demonstrated with midday peaks for CD8+, CD16+, γδTCR expressing cells and cortisol, and peaks during the night for CD3+, CD4+, GH, TSH and melatonin. A borderline significant rhythm was also observed for CD20+, with a peak late in the evening. IGF1, TRH, FT4 and IL2 values did not show rhythmic variation. In cancer patients a significant circadian rhythm could be demonstrated with diurnal peak for CD16+ and peaks during the night for CD4+ and melatonin. GH, IGF1, TRH, TSH, FT4, cortisol and IL2 values did not show rhythmic variation. MESOR of CD8+ (P<0.0001), CD20+ (P=0.05), γδTCR expressing cells (P=0.01), IGF1 (P<0.001) and TSH (P=0.032) was higher in healthy subjects, whereas MESOR of CD16+ (P<0.0001), CD25+ (P=0.001), GH (P<0.001), TRH (P=0.002), FT4 (P=0.030), cortisol (P=0.01) and IL2 (P=0.02) was higher in cancer patients. Amplitude of circadian variation of γδTCR expressing cells (P=0.01), TSH (P<0.001) and cortisol (P=0.01) was higher in healthy subjects, whereas amplitude of circadian variation of CD4+ was higher in cancer patients (P=0.02). In conclusion, non-small cell lung cancer patients show severe alterations of periodic and quantitative characteristics of neuroendocrine and immune parameters with loss of circadian rhythmicity and internal desynchronization, leading to chronodisruption.
Collapse
Affiliation(s)
- Gianluigi Mazzoccoli
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital "Casa Sollievo della Sofferenza", S. Giovanni Rotondo-FG, Italy.
| | | | | | | |
Collapse
|
43
|
Mazzoccoli G, Carughi S, Greco A, De Cata A, Giuliani F, Perfetto F, Tarquini R. Neuroendocrine modulation of GH-IGF1 axis function. BIOL RHYTHM RES 2011. [DOI: 10.1080/09291016.2010.495841] [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: 10/19/2022]
|
44
|
Mazzoccoli G, Sothern RB, De Cata A, Giuliani F, Fontana A, Copetti M, Pellegrini F, Tarquini R. A timetable of 24-hour patterns for human lymphocyte subpopulations. J BIOL REG HOMEOS AG 2011; 25:387-395. [PMID: 22023763] [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: 05/31/2023]
Abstract
Specific lymphocyte cell surface molecules involved in antigen recognition and cell activation present different circadian patterns, with peaks and troughs reflecting a specific time-related compartment of immune cell function. In order to study the dynamics of variation in expression of cytotoxic lymphocyte cell surface molecules that trigger immune responses, several lymphocyte cell surface clusters of differentiation (CD) and antigen receptors, analyses were performed on blood samples collected every 4 h for 24 h from eleven clinically-healthy men. Assays for serum melatonin (peaking at night) and cortisol (peaking near awakening) confirmed 24-h synchronization of the subjects to the light-dark schedule. A significant (p≤0.05) circadian rhythm could be demonstrated for six of the 10 lymphocyte subpopulations, with midday peaks for CD8+dim (T cytotoxic cells, 11:15 h), gammadeltaTCR (gamma-delta T cell receptor-expressing cells, 11:33 h), CD8+ (T suppressor/cytotoxic cells, 12:08 h), and for CD16+ (natural killer cells, 12:59 h), and peaks during the night for CD4+ (T helper/inducer cells, 01:23 h) and CD3+ (total T cells, 02:58 h). A borderline significant rhythm (p = 0.056) was also observed for CD20+ (total B cells), with a peak late in the evening (23:06 h). Acrophases for 3 subsets, CD8+bright (T suppressor cells, 15:22 h), HLA-DR+ (B cells and activated T cells, 23:06 h) and CD25+ (activated T lymphocytes with expression of the alpha chain of IL2 receptor, 23:35 h), where a 24-h rhythm could not be definitively determined, nevertheless provide information on the location of their highest values and possible physiological significance. Thus, specific lymphocyte surface molecules present distinctly-timed profiles of nyctohemeral changes that indicate a temporal (i.e., circadian) organization of cellular immune function, which is most likely of physiological significance in triggering and regulating immune responses. Such a molecular cytotoxic timetable can potentially serve as a guide to sampling during experimental, diagnostic, therapeutic and/or other medical procedures.
Collapse
Affiliation(s)
- G Mazzoccoli
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Lazzeri C, Valente S, Tarquini R, Chiostri M, Picariello C, Gensini GF. The prognostic role of gamma-glutamyltransferase activity in non-diabetic ST-elevation myocardial infarction. Intern Emerg Med 2011; 6:213-9. [PMID: 20878500 DOI: 10.1007/s11739-010-0464-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 09/14/2010] [Indexed: 02/07/2023]
Abstract
In patients with acute coronary syndrome, gamma-glutamyltransferase activity (GGT) proved to be an independent predictor of the development of major adverse cardiac events at early and long terms. No data are available on GGT in ST-elevation myocardial infarction (STEMI). We assessed, in 337 consecutive STEMI patients without previously known diabetes submitted to mechanical revascularization, the prognostic role of GGT for in-Intensive Cardiac Care Unit mortality, together with the relation(s) between GGT and acute glucose dysmetabolism (admission glycemia, peak glycemia, insulin resistance as indicated by the Homeostatic Model Assessment HOMA index). At logistic regression analysis, GGT was an independent predictor for in-ICU mortality (OR 1.01 (95% CI 1.003-1.013) p = 0.002), when adjusted for BMI and for major bleedings [(OR 1.005 (95% CI 1.001-1.009) p = 0.029]. At linear regression analyses, GGT was significantly correlated with admission glycemia (r = 0.172; p = 0.002), uric acid (r = 0.146; p = 0.011), insulin (r = 0.171; p = 0.002) and age (r = -0.129; p = 0.020). We document that in STEMI patients without previously known diabetes submitted to mechanical revascularization, GGT values are an independent predictor of early mortality. The significant correlation between GGT and acute glucose dysmetabolism (as indicated by admission glycemia and insulin-resistance) can account, at least in part, for the prognostic role of GGT.
Collapse
Affiliation(s)
- Chiara Lazzeri
- Intensive Cardiac Coronary Unit, Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, University of Florence, VialeMorgagni 85, 50134, Florence, Italy.
| | | | | | | | | | | |
Collapse
|
46
|
Mazzoccoli G, Carughi S, Sperandeo M, Pazienza V, Giuliani F, Tarquini R. Neuro-endocrine correlations of hypothalamic-pituitary-thyroid axis in healthy humans. J BIOL REG HOMEOS AG 2011; 25:249-257. [PMID: 21880214] [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: 05/31/2023]
Abstract
Neuro-endocrine hormone secretion is characterized by circadian rhythmicity. Melatonin, GRH and GH are secreted during the night, CRH and ACTH secretion peak in the morning, determining the circadian rhythm of cortisol secretion, TRH and TSH show circadian variations with higher levels at night. Thyroxine levels do not change with clear circadian rhythmicity. In this paper we have considered a possible influence of cortisol and melatonin on hypothalamic-pituitary-thyroid axis function in humans. Melatonin, cortisol, TRH, TSH and FT4 serum levels were determined in blood samples obtained every four hours for 24 hours from ten healthy males, aged 36-51 years. We correlated hormone serum levels at each sampling time and evaluated the presence of circadian rhythmicity of hormone secretion. In the activity phase (06:00 h-10:00 h-14:00 h) cortisol correlated negatively with FT4, TSH correlated positively with TRH, TRH correlated positively with FT4 and melatonin correlated positively with TSH. In the resting phase (18:00 h-22:00 h-02:00 h) TRH correlated positively with FT4, melatonin correlated negatively with FT4, TSH correlated negatively with FT4, cortisol correlated positively with FT4 and TSH correlated positively with TRH. A clear circadian rhythm was validated for the time-qualified changes of melatonin and TSH secretion (with acrophase during the night), for cortisol serum levels (with acrophase in the morning), but not for TRH and FT4 serum level changes. In conclusion, the hypothalamic-pituitary-thyroid axis function may be modulated by cortisol and melatonin serum levels and by their circadian rhythmicity of variation.
Collapse
Affiliation(s)
- G Mazzoccoli
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital, Casa Sollievo della Sofferenza, S.Giovanni Rotondo (FG), Italy.
| | | | | | | | | | | |
Collapse
|
47
|
Lazzeri C, Valente S, Tarquini R, Gensini GF. Cardiorenal syndrome caused by heart failure with preserved ejection fraction. Int J Nephrol 2011; 2011:634903. [PMID: 21331316 PMCID: PMC3038429 DOI: 10.4061/2011/634903] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 01/03/2011] [Indexed: 01/08/2023] Open
Abstract
Since cardiorenal dysfunction is usually secondary to multiple factors acting in concert (and not only reduced cardiac output) in the present paper we are going to focus on the interrelationship between heart failure with normal ejection fraction and the development of cardiorenal syndrome. The coexistence of renal impairment in heart failure with preserved ejection fraction (CRS type 2 and 4) is common especially in older females with hypertension and/or diabetes. It can be hypothesized that the incidence of this disease association is growing, while clinical trials enrolling these patients are still lacking. The main mechanisms thought to be involved in the pathophysiology of this condition are represented by the increase of intra-abdominal and central venous pressure and the activation of the renin-angiotensin system. Differently from CRS in heart failure with reduced ejection fraction, the involvement of the kidney may be under-diagnosed in patients with heart failure and preserved ejection fraction and the optimal therapeutic strategy in this condition, though challenging, is far to be completely elucidated. Further studies are needed to assess the best therapeutic regimen in patients with renal dysfunction (and worsening) and heart failure and preserved ejection fraction.
Collapse
Affiliation(s)
- Chiara Lazzeri
- Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Serafina Valente
- Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Roberto Tarquini
- Department of Internal Medicine, University of Florence, 50134 Florence, Italy
| | - Gian Franco Gensini
- Heart and Vessel Department, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| |
Collapse
|
48
|
Abstract
A mature T-cell lineage with the capacity to proliferate in response to receptor-mediated signals and to display non-major histocompatibility complex (MHC)-restricted cytolysis expresses a CD3-associated heterodimer made up of the protein encoded by the T-cell receptor (TCR) gamma-gene. We investigated the possible differences in lymphocyte subpopulations between healthy young-middle-aged and elderly subjects, focusing attention on y8-TCR-expressing cells. The study was carried out on fifteen healthy young-middle-aged male subjects (age range 36–55 years) and fifteen healthy elderly male subjects (age range 67–79 years). Lymphocyte subpopulations were analyzed in blood samples collected every four hours for 24 hours. The presence of circadian rhythmicity on absolute counts was validated to evaluate the periodicity of variation, and the fractional variation between single time point values was calculated to evaluate the dynamics of variation. In the group of young and middle-aged subjects a clear circadian rhythm was validated for the time-qualified changes of all the lymphocyte subpopulations (CD3, CD4, CD4/CD8 ratio, CD20, CD25 and HLA-DR with acrophase at night, CD8, CD16 and TcRγδ with acrophase at noon). In the group of elderly subjects a clear circadian rhythm was validated for the nyctohemeral changes of CD3, CD8, CD4/CD8 ratio, CD 16, CD25. There was a statistically significant difference for the Midline Estimating Statistic of Rhythm (MESOR) of CD3 (p=0.001), CD25 (p=0.003) and γδ-TCR- expressing cells (p=0.004), higher in the elderly, and for the MESOR of HLA-DR (p=0.002) and CD20 (p=0.002) higher in the young and middle-aged subjects. There was a statistically significant difference between the groups in the fractional variation of TcRγδ-expressing cells between 18:00h and 22:00h values (higher in elderly subjects, p=0.007). In conclusion, specific lymphocyte subsets present different levels and different profiles of nyctohemeral changes in healthy young-middle aged in respect to elderly subjects, since B cells are decreased, whereas CD25 and γδ-TCR-bearing cells are higher in the elderly, but the rhythm and the dynamics of variation of this lymphocyte subset is severely altered and this phenomenon might contribute to the onset of age-related variations of the immune responses.
Collapse
Affiliation(s)
- G. Mazzoccoli
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S. Giovanni Rotondo, Foggia
| | - G. Vendemiale
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S. Giovanni Rotondo, Foggia
- Geriatrics Unit, Department of Medical Science, University of Foggia, Foggia
| | - A. De Cata
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital “Casa Sollievo della Sofferenza”, S. Giovanni Rotondo, Foggia
| | - R. Tarquini
- Department of Internal Medicine, University of Florence, Florence, Italy
| |
Collapse
|
49
|
Mazzoccoli G, Fontana A, Copetti M, Pellegrini F, Piepoli A, Muscarella LA, Pazienza V, Giuliani F, Tarquini R. Stage dependent destructuration of neuro-endocrine-immune system components in lung cancer patients. Biomed Pharmacother 2010; 65:69-76. [PMID: 21232906 DOI: 10.1016/j.biopha.2010.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 12/06/2010] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Close relationships among the nervous, endocrine and immune system components maintain body homeostasis. Alteration of time-related prophile of variation of system components and loss of integrated function may favour the developing of cancer and may be aggravated in the presence of neoplastic disease. The aim of our study was to evaluate the prophiles of time-related variation of neuro-endocrine-immune system components in lung cancer patients. METHODS Peripheral blood samples were collected at intervals of 4hours for 24hours from 11 healthy subjects (age range 35-53years, mean age±s.e. 43.6±1.7) and nine patients suffering from nonsmall cell lung cancer (age range 43-63years, mean age±s.e. 51.0±2.4). In each blood sample, lymphocyte subpopulations (CD3, CD4, CD8, HLA-DR, CD16, CD20, CD25, γδTcR) were analyzed and melatonin, cortisol, TRH, TSH, free thyroxine, GH, IGF1 and interleukin IL2 on serum were measured. RESULTS In our I-II stage lung cancer patients CD8+ lymphocytes (P=0.01), and in particular the T suppressor subset (P<0.0001), CD20+ cells (P=0.05), γδTCR expressing cells (P<0.01) and IGF1 (P=0.004) were diminished, whereas CD16+ cells (P<0.0001), CD25+ cells (P=0.03), free thyroxine (P=0.001) and GH (P<0.0001) were increased in respect of healthy subjects. In our III-IV stage lung cancer patients CD8+ lymphocytes (P=0.003) and in particular the T suppressor subset (P<0.0001), CD20+ cells (P=0.05), γδTCR expressing cells (P=0.01), melatonin (P=0.03), TSH (P=0.006) and IGF1 (P<0.0001) were diminished, whereas CD4+ cells (P=0.002), CD16+ cells (P<0.0001), CD25+ cells (P=0.002), cortisol (P=0.003), TRH (P=0.004), free thyroxine (P=0.001), GH (P<0.0001) and IL2 (P=0.0002) were increased in respect of healthy subjects. A statistically significant difference was evidenced between the two groups of cancer patients for the values of CD16+ cells (P<0.0001), free thyroxine (P=0.001) and IGF1 (P<0.0001) higher in I-II stage lung cancer patients and for the values of CD4+ cells (P<0.0001), γδTCR expressing cells (P=0.002), TRH (P=0.002) and IL2 (P=0.01) higher in III-IV stage lung cancer patients. Lung cancer patients showed alteration of the pattern of circadian variation of CD3+, CD8+, CD8+ dim, CD16+, CD20+ and γδTCR expressing cells and of cortisol, TSH and GH serum levels. Pair-wise comparisons showed severe and stage dependent alterations in lung cancer patients. CONCLUSIONS The prophiles of time-related variation of neuro-endocrine-immune system components are altered in a stage dependent manner in lung cancer patients and this alteration may impair the customary integrated system function.
Collapse
Affiliation(s)
- Gianluigi Mazzoccoli
- Department of Internal Medicine and Chronobiology Unit, Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza, S. Giovanni Rotondo (FG), Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Mazzoccoli G, Notarsanto I, de Pinto GD, Dagostino MP, De Cata A, D'Alessandro G, Tarquini R, Vendemiale G. Anti-tumor necrosis factor-α therapy and changes of flow-mediated vasodilatation in psoriatic and rheumatoid arthritis patients. Intern Emerg Med 2010; 5:495-500. [PMID: 20845087 DOI: 10.1007/s11739-010-0458-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Accepted: 08/31/2010] [Indexed: 01/18/2023]
Abstract
For a long time, the endothelial covering of the vessels has been considered an inert surface. On the contrary, the endothelial cells are active and dynamic elements in the interaction between blood and tissues. The control of the vessel basal tone is obtained by the complex balance between the relaxing and contracting endothelial factors. Previous clinical studies show that patients suffering from rheumatoid arthritis and other autoimmune rheumatologic pathologies are at high risk of death being prematurely affected by atherosclerosis and cardiovascular diseases. Blocking tumor necrosis factor (TNF)-α by biological drugs improves the endothelial function. The aim of our study was to evaluate the effects of two anti-TNF-α drugs (infliximab and etanercept) on the endothelial function by evaluating the flow-mediated dilatation (FMD), which was measured in the brachial artery before and after treatment and after 8-12 weeks. We enrolled 36 patients (average age 52 ± 9.8 years, 12 men and 24 women), 25 of them were affected by rheumatoid arthritis (RA) and 11 were affected by psoriatic arthritis (PsA) and they were divided into three groups: 10 patients were treated with etanercept, 13 patients were treated with infliximab, 13 patients were treated with DMARDs. We measured the common carotid intimal-medial thickness (ccIMT) and the endothelial function was evaluated by FMD measurement in the brachial artery, before treatment, 1 h after the beginning of treatment and after 8-12 weeks. No statistically significant difference between the three groups was found for the ultrasonographic evaluation of the carotid IMT. On the contrary, the differences between FMD values before and after the treatment in the patients treated with etanercept (13.1 ± 0.01 vs. 18.8 ± 0.01%, p < 0.01) and in the patients treated with infliximab (11.8 ± 0.09 vs. 16.7 ± 0.09%, p < 0.01) were statistically significant. Long-term evaluation for infliximab and etanercept was performed by comparing the FMD values, respectively, 8 and 12 weeks after the first treatment. After 8 weeks, FMD value was similar to the value recorded at enrollment in the infliximab group (11.9 ± 0.03 vs. 13.54 ± 0.04%, p = 0.236) and the FMD values in the etanercept group after 12 weeks showed a not statistically significant reduction of vasodilatating effect (13.01 ± 0.03 vs. 15.67 ± 0.02%, p = 0.197). In conclusion, the use of biological drugs in patients affected by autoimmune arthritis can modify the endothelial function, as indicated by the induced FMD changes, but the long-term effect tends to be considerably reduced.
Collapse
Affiliation(s)
- Gianluigi Mazzoccoli
- Department of Internal Medicine, Scientific Institute and Regional General Hospital Casa Sollievo della Sofferenza, Opera di Padre Pio da Pietrelcina, Cappuccini Avenue, 71013 S. Giovanni Rotondo (FG), Italy.
| | | | | | | | | | | | | | | |
Collapse
|