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Rotundo S, Tassone MT, Marascio N, Morrone HL, Gigliotti S, Quirino A, Russo A, Matera G, Trecarichi EM, Torti C. A systematic review on antibiotic therapy of cutaneous bacillary angiomatosis not related to major immunocompromising conditions: from pathogenesis to treatment. BMC Infect Dis 2024; 24:380. [PMID: 38589795 PMCID: PMC11000314 DOI: 10.1186/s12879-024-09253-9] [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: 11/19/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella spp. that mostly affects people living with HIV (PLWH), transplanted patients and those taking immunosuppressive drugs. Since cBA is mostly related to these major immunocompromising conditions (i.e., T-cell count impairment), it is considered rare in relatively immunocompetent patients and could be underdiagnosed in them. Moreover, antimicrobial treatment in this population has not been previously investigated. METHODS We searched the databases PubMed, Google Scholar, Scopus, OpenAIRE and ScienceDirect by screening articles whose title included the keywords "bacillary" AND "angiomatosis" and included case reports about patients not suffering from major immunocompromising conditions to provide insights about antibiotic treatments and their duration. RESULTS Twenty-two cases of cBA not related to major immunocompromising conditions were retrieved. Antibiotic treatment duration was shorter in patients with single cBA lesion than in patients with multiple lesions, including in most cases macrolides and tetracyclines. CONCLUSIONS cBA is an emerging manifestation of Bartonella spp. infection in people not suffering from major immunocompromising conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
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Affiliation(s)
- Salvatore Rotundo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Maria Teresa Tassone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Nadia Marascio
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
| | - Simona Gigliotti
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Alessandro Russo
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Giovanni Matera
- Dipartimento di Scienze della Vita, Unità Operativa Complessa di Microbiologica Clinica, Università "Magna Graecia", Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Dipartimento di Scienze Mediche e Chirurgiche, Università "Magna Graecia", Catanzaro, Italy
- Unità Operativa Complessa di Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria "R. Dulbecco", Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy.
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Rotundo S, Tassone MT, Serapide F, Russo A, Trecarichi EM. Incipient tuberculosis: a comprehensive overview. Infection 2024:10.1007/s15010-024-02239-4. [PMID: 38589748 DOI: 10.1007/s15010-024-02239-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024]
Abstract
In the context of the evolving global health landscape shaped by the COVID-19 pandemic, tuberculosis (TB) is gaining renewed attention as a reemerging threat even in low-endemic countries. Immunological tests such as the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) are pivotal in identifying tuberculosis infection (TBI). However, their inability to distinguish between past and ongoing infection poses a diagnostic challenge, possibly leading to the unnecessary treatment of a significant portion of the population with potential side effects. This review delves into the concept of incipient tuberculosis (ITB), a dynamic, presymptomatic stage characterized by heightened Mycobacterium tuberculosis complex (MTC) metabolic activity and replication that result in minimal radiological changes, signifying a transitional state between TBI and TB. Key focus areas include epidemiological factors, underlying pathogenesis, imaging findings, and the ongoing challenges in the identification of individuals with ITB through the development of new biomarkers and the use of whole-genome sequencing-based analyses to implement early treatment strategies.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
| | - Maria Teresa Tassone
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, "Renato Dulbecco" Teaching Hospital, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, "Renato Dulbecco" Teaching Hospital, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, "Renato Dulbecco" Teaching Hospital, Catanzaro, Italy
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Cozzi-Lepri A, Borghi V, Rotundo S, Mariani B, Ferrari A, Del Borgo C, Bai F, Colletti P, Miraglia P, Torti C, Cattelan AM, Cenderello G, Berruti M, Tascini C, Parruti G, Coladonato S, Gori A, Marchetti G, Lichtner M, Coppola L, Sorace C, D'Abramo A, Mazzotta V, Guaraldi G, Franceschini E, Meschiari M, Sarmati L, Antinori A, Nicastri E, Mussini C. Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia. Front Med (Lausanne) 2024; 11:1293431. [PMID: 38529120 PMCID: PMC10961453 DOI: 10.3389/fmed.2024.1293431] [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: 09/19/2023] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm. Methods This is a retrospective, observational cohort study conducted in 12 hospitals in Italy. Adult patients who were consecutively hospitalized from November 2021 to February 2022 receiving CAS/IMV were included. A multivariable logistic regression model was used to identify predictors of MV or death by day 28 from treatment initiation, and β-coefficients from the model were used to develop a risk score that was derived by means of leave-one-out internal cross-validation (CV), external CV, and calibration. Secondary outcome was mortality. Results A total of 480 hospitalized patients in the training set and 157 patients in the test set were included. By day 28, 36 participants (8%) underwent MV and 28 died (6%) for a total of 58 participants (12%) experiencing the composite primary endpoint. In multivariable analysis, four factors [age, PaO2/FiO2 ratio, lactate dehydrogenase (LDH), and platelets] were independently associated with the risk of MV/death and were used to generate the proposed risk score. The accuracy of the score in the area under the curve (AUC) was 0.80 and 0.77 in internal validation and test for the composite endpoint and 0.87 and 0.86 for death, respectively. The model also appeared to be well calibrated with the raw data. Conclusion The mortality risk reported in our study was lower than that previously reported. Although CAS/IMV is no longer used, our score might help in identifying which patients are not likely to benefit from monoclonal antibodies and may require alternative interventions.
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Affiliation(s)
- Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, United Kingdom
| | - Vanni Borghi
- Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy
| | - Salvatore Rotundo
- Unit of Infectious and Tropical Diseases, University Magna Græcia, Catanzaro, Italy
| | - Bianca Mariani
- Unità Organizzativa Complessa Malattie Infettive, Fondazione Istituto di Ricovero e Cura a Caratetre Scientifico, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Ferrari
- Unità Organizzativa Complessa Malattie Infettive, Azienda Ospedale Università, Padova, Italy
| | - Cosmo Del Borgo
- Unità Organizzativa Complessa Malattie Infettive, Ospedale SM Goretti, Latina, Italy
| | - Francesca Bai
- Clinica delle Malattie Infettive, Dipartimento di Scienze della Salute, ASST Santi Paolo e Carlo, University of Milano, Milan, Italy
| | - Pietro Colletti
- Unit of Infectious Diseases, Paolo Borsellino Hospital, ASP Trapani, Trapani, Italy
| | - Piermauro Miraglia
- Unit of Infectious Diseases, Paolo Borsellino Hospital, ASP Trapani, Trapani, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, University Magna Græcia, Catanzaro, Italy
| | - Anna Maria Cattelan
- Unità Organizzativa Complessa Malattie Infettive, Azienda Ospedale Università, Padova, Italy
| | | | - Marco Berruti
- SC Malattie Infettive Asl1 Imperiese, Imperia, Italy
| | - Carlo Tascini
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
| | - Giustino Parruti
- Unit of Infectious Diseases, Hospital of Pescara, Pescara, Italy
| | | | - Andrea Gori
- Infectious Disease Unit, Ospedale L. Sacco, University of Milano, Milan, Italy
| | - Giulia Marchetti
- Clinica delle Malattie Infettive, Dipartimento di Scienze della Salute, ASST Santi Paolo e Carlo, University of Milano, Milan, Italy
| | - Miriam Lichtner
- Unità Organizzativa Complessa Malattie Infettive, Ospedale SM Goretti, Latina, Italy
| | - Luigi Coppola
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Sorace
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | | | | | - Giovanni Guaraldi
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Erica Franceschini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Marianna Meschiari
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Andrea Antinori
- Istituto Nazionale Malattie Infettive L. Spallanzani, Rome, Italy
| | | | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy
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Rotundo S, Morrone HL, Gallo L, Dodaro S, D'Aleo F, Minchella P, Matera G, Greco F, Principe L, Trecarichi EM, Nisticò S, Torti C. Are we doing enough for controlling tuberculosis and multi-drug resistance in an epicenter of the current migration emergency (Calabria Region, Southern Italy)? Infection 2024; 52:277-279. [PMID: 37838640 DOI: 10.1007/s15010-023-02106-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/16/2023]
Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Luigia Gallo
- Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Saveria Dodaro
- Microbiology and Virology Unit, "Annunziata" Hospital, Cosenza, Italy
| | - Francesco D'Aleo
- Clinical Pathology and Microbiology Unit, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Pasquale Minchella
- Unit of Microbiology and Virology, Renato Dulbecco" University Hospital, Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Francesca Greco
- Microbiology and Virology Unit, "Annunziata" Hospital, Cosenza, Italy
| | - Luigi Principe
- Clinical Pathology and Microbiology Unit, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Salvatore Nisticò
- Unit of Microbiology and Virology, Renato Dulbecco" University Hospital, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy.
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Trecarichi EM, Olivadese V, Davoli C, Rotundo S, Serapide F, Lionello R, Tassone B, La Gamba V, Fusco P, Russo A, Borelli M, Torti C. Evolution of in-hospital patient characteristics and predictors of death in the COVID-19 pandemic across four waves: are they moving targets with implications for patient care? Front Public Health 2024; 11:1280835. [PMID: 38249374 PMCID: PMC10800172 DOI: 10.3389/fpubh.2023.1280835] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives The aim of this work was to study characteristics, outcomes and predictors of all-cause death in inpatients with SARS-CoV-2 infection across the pandemic waves in one large teaching hospital in Italy to optimize disease management. Methods All patients with SARS-CoV-2 infection admitted to our center from March 2020 to June 2022 were included in this retrospective observational cohort study. Both descriptive and regression tree analyses were applied to identify factors influencing all-cause mortality. Results 527 patients were included in the study (65.3% with moderate and 34.7% with severe COVID-19). Significant evolutions of patient characteristics were found, and mortality increased in the last wave with respect to the third wave notwithstanding vaccination. Regression tree analysis showed that in-patients with severe COVID-19 had the greatest mortality across all waves, especially the older adults, while prognosis depended on the pandemic waves in patients with moderate COVID-19: during the first wave, dyspnea was the main predictor, while chronic kidney disease emerged as determinant factor afterwards. Conclusion Patients with severe COVID-19, especially the older adults during all waves, as well as those with moderate COVID-19 and concomitant chronic kidney disease during the most recent waves require more attention for monitoring and care. Therefore, our study drives attention towards the importance of co-morbidities and their clinical impact in patients with COVID-19 admitted to hospital, indicating that the healthcare system should adapt to the evolving features of the epidemic.
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Affiliation(s)
- Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Chiara Davoli
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
| | - Francesca Serapide
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Rosaria Lionello
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Bruno Tassone
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Valentina La Gamba
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Catanzaro, Italy
- Infectious and Tropical Disease Unit, “Renato Dulbecco” Teaching Hospital, Catanzaro, Italy
| | - Massimo Borelli
- UMG School of PhD Programmes "Life Sciences and Technologies", “Magna Graecia” University, Catanzaro, Italy
| | - Carlo Torti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
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Vecchio E, Rotundo S, Veneziano C, Abatino A, Aversa I, Gallo R, Giordano C, Serapide F, Fusco P, Viglietto G, Cuda G, Costanzo F, Russo A, Trecarichi EM, Torti C, Palmieri C. The spike-specific TCRβ repertoire shows distinct features in unvaccinated or vaccinated patients with SARS-CoV-2 infection. J Transl Med 2024; 22:33. [PMID: 38185632 PMCID: PMC10771664 DOI: 10.1186/s12967-024-04852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The evolving variants of SARS-CoV-2 may escape immunity from prior infections or vaccinations. It's vital to understand how immunity adapts to these changes. Both infection and mRNA vaccination induce T cells that target the Spike protein. These T cells can recognize multiple variants, such as Delta and Omicron, even if neutralizing antibodies are weakened. However, the degree of recognition can vary among people, affecting vaccine efficacy. Previous studies demonstrated the capability of T-cell receptor (TCR) repertoire analysis to identify conserved and immunodominant peptides with cross-reactive potential among variant of concerns. However, there is a need to extend the analysis of the TCR repertoire to different clinical scenarios. The aim of this study was to examine the Spike-specific TCR repertoire profiles in natural infections and those with combined natural and vaccine immunity. METHODS A T-cell enrichment approach and bioinformatic tools were used to investigate the Spike-specific TCRβ repertoire in peripheral blood mononuclear cells of previously vaccinated (n = 8) or unvaccinated (n = 6) COVID-19 patients. RESULTS Diversity and clonality of the TCRβ repertoire showed no significant differences between vaccinated and unvaccinated groups. When comparing the TCRβ data to public databases, 692 unique TCRβ sequences linked to S epitopes were found in the vaccinated group and 670 in the unvaccinated group. TCRβ clonotypes related to spike regions S135-177, S264-276, S319-350, and S448-472 appear notably more prevalent in the vaccinated group. In contrast, the S673-699 epitope, believed to have super antigenic properties, is observed more frequently in the unvaccinated group. In-silico analyses suggest that mutations in epitopes, relative to the main SARS-CoV-2 variants of concern, don't hinder their cross-reactive recognition by associated TCRβ clonotypes. CONCLUSIONS Our findings reveal distinct TCRβ signatures in vaccinated and unvaccinated individuals with COVID-19. These differences might be associated with disease severity and could influence clinical outcomes. TRIAL REGISTRATION FESR/FSE 2014-2020 DDRC n. 585, Action 10.5.12, noCOVID19@UMG.
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Affiliation(s)
- Eleonora Vecchio
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
- Interdepartmental Centre of Services, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Claudia Veneziano
- Interdepartmental Centre of Services, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Antonio Abatino
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Ilenia Aversa
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Raffaella Gallo
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Caterina Giordano
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Francesca Serapide
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Francesco Costanzo
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
- Interdepartmental Centre of Services, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100, Catanzaro, Italy
| | - Camillo Palmieri
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy.
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Rotundo S, Bono F, Mazzitelli M, Scaglione V, Lamberti AG, Giancotti A, Tucci L, Costa C, Tassone MT, Morrone HL, Trecarichi EM, Torti C. An autochthonous case of cutaneous bacillary angiomatosis not related to major immunosuppression: An emerging or overlooked disease? Int J Infect Dis 2024; 138:21-24. [PMID: 37967716 DOI: 10.1016/j.ijid.2023.11.016] [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: 07/04/2023] [Revised: 10/19/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023] Open
Abstract
Cutaneous bacillary angiomatosis (cBA) is a vascular proliferative disorder due to Bartonella henselae or Bartonella quintana that has been mostly described in people living with HIV. Since cBA is considered to be rare in hosts not affected by major immunosuppression, it could be underdiagnosed in this population. Moreover, antimicrobial treatment of cBA has been poorly validated, thus reporting experiences on this clinical entity is important. We reported a challenging and well-characterized case of an Italian 67-year-old gentleman without a history of major immunocompromizing conditions, although he was affected by conditions that can be associated with impaired immune function. The patient reported herein was diagnosed after a long time since the initiation of symptoms and was successfully treated with combined antibiotic therapy including macrolides and quinolones under the guidance of molecular test results. Physicians should consider cBA as a possible manifestation of Bartonella spp. Infection in patients not suffering from major immunocompromizing conditions. Until evidence-based guidelines are available, molecular tests together with severity and extension of the disease can be useful to personalize the type of treatment and its duration.
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Affiliation(s)
- Salvatore Rotundo
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Francesco Bono
- Neurological Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy.
| | - Vincenzo Scaglione
- Infectious and Tropical Diseases Unit, Padua University Hospital, Padua, Italy.
| | | | - Aida Giancotti
- Microbiology Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Luigi Tucci
- Pathology Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Chiara Costa
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Maria Teresa Tassone
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Helen Linda Morrone
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Enrico Maria Trecarichi
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
| | - Carlo Torti
- Infectious and Tropical Diseases Unit, "Renato Dulbecco" University Hospital, Catanzaro, Italy.
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Rotundo S, Borelli M, Scaglione V, Lionello R, Biamonte F, Olivadese V, Quirino A, Morrone HL, Matera G, Costanzo FS, Russo A, Trecarichi EM, Torti C. Interleukin-6 2/lymphocyte as a proposed predictive index for COVID-19 patients treated with monoclonal antibodies. Clin Exp Med 2023; 23:3681-3687. [PMID: 37097384 PMCID: PMC10127195 DOI: 10.1007/s10238-023-01081-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023]
Abstract
In a convenience sample of 93 patients treated with monoclonal antibodies (moAbs) against SARS-CoV-2, the interleukin-62/lymphocyte count ratio (IL-62/LC) was able to predict clinical worsening both in early stages of COVID-19 and in oxygen-requiring patients. Moreover, we analysed 18 most at-risk patients with asymptomatic or mild disease treated with both moAbs and antiviral treatment and found that only 2 had clinical progression, while patients with a similar risk were reported to have an unfavourable outcome in most cases from recent data. In only one of our 18 patients, clinical progression was attributable to COVID-19, and in the other cases, clinical progression was observed despite IL-62/LC being above the risk cut-off. In conclusion, IL-62/LC may be a valuable method to identify patients requiring more aggressive treatments both in earlier and later stages of the disease; however, most at-risk patients can be protected from clinical worsening by combining moAbs and antivirals, even if levels of the IL-62/LC biomarker are lower than the risk cut-off.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy.
| | - Massimo Borelli
- UMG School of PhD Programmes, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Scaglione
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Flavia Biamonte
- Department of Clinical and Experimental Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Vincenzo Olivadese
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Angela Quirino
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Giovanni Matera
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Alessandro Russo
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
| | | | - Carlo Torti
- Department of Medical and Surgical Sciences, University "Magna Graecia", Catanzaro, Italy
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9
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Lionello FCP, Rotundo S, Bruno G, Marino G, Morrone HL, Fusco P, Costa C, Russo A, Trecarichi EM, Beltrame A, Torti C. Touching Base with Some Mediterranean Diseases of Interest from Paradigmatic Cases at the "Magna Graecia" University Unit of Infectious Diseases: A Didascalic Review. Diagnostics (Basel) 2023; 13:2832. [PMID: 37685370 PMCID: PMC10486464 DOI: 10.3390/diagnostics13172832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Among infectious diseases, zoonoses are increasing in importance worldwide, especially in the Mediterranean region. We report herein some clinical cases from a third-level hospital in Calabria region (Southern Italy) and provide a narrative review of the most relevant features of these diseases from epidemiological and clinical perspectives. Further, the pathogenic mechanisms involved in zoonotic diseases are reviewed, focusing on the mechanisms used by pathogens to elude the immune system of the host. These topics are of particular concern for individuals with primary or acquired immunodeficiency (e.g., people living with HIV, transplant recipients, patients taking immunosuppressive drugs). From the present review, it appears that diagnostic innovations and the availability of more accurate methods, together with better monitoring of the incidence and prevalence of these infections, are urgently needed to improve interventions for better preparedness and response.
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Affiliation(s)
- Ferdinando Carmelo Pio Lionello
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriele Bruno
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriella Marino
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Chiara Costa
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Anna Beltrame
- College of Public Health, University of South Florida, Gainesville, FL 33620, USA;
| | - Carlo Torti
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
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10
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Mimmi S, Zimbo AM, Rotundo S, Cione E, Nisticò N, Aloisio A, Maisano D, Tolomeo AM, Dattilo V, Lionello R, Fioravanti A, Di Loria A, Quirino A, Marascio N, Russo A, Trecarichi EM, Matera G, Quinto I, Torti C, Iaccino E. SARS CoV-2 spike protein-guided exosome isolation facilitates detection of potential miRNA biomarkers in COVID-19 infections. Clin Chem Lab Med 2023; 61:1518-1524. [PMID: 36972680 DOI: 10.1515/cclm-2022-1286] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 10/26/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES Nearly three years into the pandemic, SARS-CoV-2 infections are occurring in vaccinated and naturally infected populations. While humoral and cellular responses in COVID-19 are being characterized, novel immune biomarkers also being identified. Recently, an increase in angiotensin-converting enzyme 2 expressing (aka, ACE2 positive) circulating exosomes (ExoACE2) were identified in the plasma of COVID-19 patients (El-Shennawy et al.). In this pilot study, we describe a method to characterize the exosome-associated microRNA (exo-miRNA) signature in ACE2-positive and ACE2-negative exosomal populations (non-ExoACE2). METHODS We performed a sorting protocol using the recombinant biotin-conjugated SARS CoV-2 spike protein containing the receptor binding domain (RBD) on plasma samples from six patients. Following purification, exo-miRNA were characterized for ACE2-positive and ACE2-negative exosome subpopulations by RT-PCR. RESULTS We identified differential expression of several miRNA. Specifically let-7g-5p and hsa-miR-4454+miR-7975 were upregulated, while hsa-miR-208a-3p and has-miR-323-3p were downregulated in ExoACE2 vs. non-ExoACE2. CONCLUSIONS The SARS CoV-2 spike-protein guided exosome isolation permits isolation of ExoACE2 exosomes. Such purification facilitates detailed characterization of potential biomarkers (e.g. exo-miRNA) for COVID-19 patients. This method could be used for future studies to further the understanding mechanisms of host response against SARS CoV-2.
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Affiliation(s)
- Selena Mimmi
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Anna Maria Zimbo
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, CS, Italy
| | - Nancy Nisticò
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Annamaria Aloisio
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Anna Maria Tolomeo
- Department of Cardiac, Thoracic and Vascular Science and Public Health, University of Padova, Padua, Italy
| | - Vincenzo Dattilo
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rosaria Lionello
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonella Fioravanti
- Structural and Molecular Microbiology, Structural Biology Research Center, Brussels, Belgium
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Productions, University Federico II of Napoli, Napoli, Italy
| | - Angela Quirino
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Nadia Marascio
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovanni Matera
- Clinical Microbiology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ileana Quinto
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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11
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Quirino A, Marascio N, Scarlata GGM, Cicino C, Pavia G, Pantanella M, Carlisi G, Mercurio M, Familiari F, Rotundo S, Olivadese V, La Gamba V, Serapide F, Gasparini G, Matera G. Orthopedic Device-Related Infections Due to Emerging Pathogens Diagnosed by a Combination of Microbiological Approaches: Case Series and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12123224. [PMID: 36553231 PMCID: PMC9778170 DOI: 10.3390/diagnostics12123224] [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: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Orthopedic and trauma device-related infections (ODRI) due to high virulence microorganisms are a devastating complication after orthopedic surgery. Coagulase-negative Staphylococci (CoNS) are mainly involved but commensal bacteria, located in human mucous membranes, are emerging pathogens in ODRI. Currently, bacterial culture is the gold standard for ODRI but the diagnostic process remains time consuming and laborious. We evaluated a combination of microbiological approaches in the diagnosis of emerging pathogens involved in ODRI. We analyzed two synovial fluids, five tissue samples and five surgical wound swabs from two different patients with ODRI, attending the Department of Orthopedic and Trauma Surgery of Mater Domini Teaching Hospital, Catanzaro, Italy. Identification was carried out with a combination of microbiological approaches (culture, mass spectrometry and 16s rRNA gene sequencing). We demonstrated the importance of a combination of microbiological approaches for the diagnosis of emerging pathogens in ODRI, because the low number of cases in the literature makes it very difficult to formulate guidelines for the management of patients.
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Affiliation(s)
- Angela Quirino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Nadia Marascio
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
- Correspondence:
| | | | - Claudia Cicino
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Grazia Pavia
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Marta Pantanella
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giovanni Carlisi
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Michele Mercurio
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Filippo Familiari
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Vincenzo Olivadese
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Francesca Serapide
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Giorgio Gasparini
- Unit of Orthopedic and Trauma Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University, 88100 Catanzaro, Italy
| | - Giovanni Matera
- Unit of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, 88100 Catanzaro, Italy
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12
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C, Russo A, Serapide F, Tassone B, Fusco P, Scaglione V, Davoli C, Lionello R, Gamba VL, Rotundo S, Morrone H, Berardelli L, Tassone MT, Olivadese V, Serraino R, Costa C, Alcaro S, Filippo CD, Sarro GD, Pujia A, Quattrone A, Costanzo FS, Cuda G, Foti DP, Viglietto G, Matera G, Longhini F, Bruni A, Garofalo E, Biamonte E, Brescia V, Laganà D, Petullà M, Bertucci B, Quirino A, Barreca GS, Giancotti A, Gallo L, Lamberti A, Marascio N, Francesco AED, Mirarchi S, Torti C. Publisher Correction: Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:883. [PMID: 36434528 PMCID: PMC9700875 DOI: 10.1186/s12879-022-07871-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Vincenzo Scaglione
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Salvatore Rotundo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Nadia Marascio
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Carmela De Marco
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Rosaria Lionello
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Claudia Veneziano
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Lavinia Berardelli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Angela Quirino
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Vincenzo Olivadese
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesca Serapide
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Bruno Tassone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Helen Linda Morrone
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Chiara Davoli
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Valentina La Gamba
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Andrea Bruni
- grid.411489.10000 0001 2168 2547Chair of Intensive Care, Department of Medical and Surgical Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Bruno Mario Cesana
- grid.4708.b0000 0004 1757 2822Unit of Medical Statistics, Biometrics and Bioinformatics “Giulio A. Maccacaro”, Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- grid.411489.10000 0001 2168 2547Chair of Clinical Microbiology, Department of Health Sciences, “Magna Græcia” University, Catanzaro, Italy
| | - Alessandro Russo
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Francesco Saverio Costanzo
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, “Magna Græcia” University, Catanzaro, Italy
| | - Giuseppe Viglietto
- grid.411489.10000 0001 2168 2547Department of Experimental and Clinical Medicine, “Magna Græcia” University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
| | - Carlo Torti
- grid.411489.10000 0001 2168 2547Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, “Magna Græcia” University, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy
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13
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Scaglione V, Rotundo S, Marascio N, De Marco C, Lionello R, Veneziano C, Berardelli L, Quirino A, Olivadese V, Serapide F, Tassone B, Morrone HL, Davoli C, La Gamba V, Bruni A, Cesana BM, Matera G, Russo A, Costanzo FS, Viglietto G, Trecarichi EM, Torti C. Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study. BMC Infect Dis 2022; 22:793. [PMID: 36266619 PMCID: PMC9583059 DOI: 10.1186/s12879-022-07774-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Monoclonal antibodies (mAbs) and antivirals have been approved for early therapy of coronavirus disease (COVID-19), however, in the real-life setting, there are difficulties to prescribe these therapies within few days from symptom onset as recommended, and effectiveness of combined use of these drugs have been hypothesised in most-at-risk patients (such as those immunocompromised) but data supporting this strategy are limited. Methods We describe the real-life experience of SARS-CoV-2 antivirals and/or monoclonal antibodies (mAbs) and focus on the hospitalisation rate due to the progression of COVID-19. Clinical results obtained through our risk-stratification algorithm and benefits achieved through a strategic proximity territorial centre are provided. We also report a case series with an in-depth evaluation of SARS-CoV-2 genome in relationship with treatment strategy and clinical evolution of patients. Results Two hundred eighty-eight patients were analysed; 94/288 (32.6%) patients were treated with mAb monotherapy, 171/288 (59.4%) patients were treated with antivirals, and 23/288 (8%) patients received both mAbs and one antiviral drug. Haematological malignancies were more frequent in patients treated with combination therapy than in the other groups (p = 0.0003). There was a substantial increase in the number of treated patients since the opening of the centre dedicated to early therapies for COVID-19. The provided disease-management and treatment appeared to be effective since 98.6% patients recovered without hospital admission. Moreover, combination therapy with mAbs and antivirals seemed successful because all patients admitted to the hospital for COVID-19 did not receive such therapies, while none of the most-at-risk patients treated with combination therapy were hospitalized or reported adverse events. Conclusions A low rate of COVID-19 progression requiring hospital admission was observed in patients included in this study. The dedicated COVID-19 proximity territorial service appeared to strengthen the regional sanitary system, avoiding the overwhelming of other services. Importantly, our results also support early combination therapy: it is possible that this strategy reduces the emergence of escape mutants of SARS-CoV-2, thereby increasing efficacy of early treatment, especially in immunocompromised individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07774-9.
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Affiliation(s)
- Vincenzo Scaglione
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Salvatore Rotundo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Nadia Marascio
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Carmela De Marco
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Rosaria Lionello
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Claudia Veneziano
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Lavinia Berardelli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Angela Quirino
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Vincenzo Olivadese
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesca Serapide
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Bruno Tassone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Helen Linda Morrone
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Chiara Davoli
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Valentina La Gamba
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Andrea Bruni
- Chair of Intensive Care, Department of Medical and Surgical Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Bruno Mario Cesana
- Unit of Medical Statistics, Biometrics and Bioinformatics "Giulio A. Maccacaro", Department of Clinical Sciences and Community Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Matera
- Chair of Clinical Microbiology, Department of Health Sciences, "Magna Græcia" University, Catanzaro, Italy
| | - Alessandro Russo
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, Interdepartmental Center of Services (CIS), Molecular Genomics and Pathology, "Magna Græcia" University, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, "Magna Græcia" University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy
| | - Carlo Torti
- Chair of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Græcia" University, Viale Europa, Loc. Germaneto, 88100, Catanzaro, Italy.
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14
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Rotundo S, Vecchio E, Abatino A, Giordano C, Mancuso S, Tassone MT, Costa C, Russo A, Trecarichi EM, Cuda G, Costanzo FS, Palmieri C, Torti C. Spike-specific T-cell responses in COVID-19 patients successfully treated with neutralizing monoclonal antibodies against SARS-CoV-2. Int J Infect Dis 2022; 124:55-64. [PMID: 36116671 PMCID: PMC9477616 DOI: 10.1016/j.ijid.2022.09.016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Neutralizing monoclonal antibodies (moAbs) improves clinical outcomes in patients with COVID-19 when administered during the initial days of infection. The action of moAbs may impair the generation or maintenance of effective immune memory, similar to that demonstrated in other viral diseases. We aimed to evaluate short-term memory T-cell responses in patients effectively treated with bamlanivimab/etesevimab, casirivimab/imdevimab, or sotrovimab (SOT). Methods Spike (S)-specific T-cell responses were analyzed in 23 patients with COVID-19 (vaccinated or unvaccinated) before and after a median of 50 (range: 28-93) days from moAb treatment, compared with 11 vaccinated healthy controls. T-cell responses were measured by interferon-γ-enzyme-linked immunospot and flow cytometric activation-induced marker assay. Results No statistically significant difference in S-specific T-cell responses was observed between patients treated with moAb and vaccinated healthy controls. Bamlanivimab/etesevimab and casirivimab/imdevimab groups showed significant increases in cellular responses in paired baseline/postrecovery series, as well as vaccinated patients receiving SOT. In contrast, unvaccinated patients prescribed SOT presented no statistically significant increases in T-cell-responses, suggesting diverse impacts of different moAbs on the evolution of S-specific T-cell responses in vaccinated and unvaccinated patients. Conclusion The moAbs did not hinder short-term memory S-specific T-cell responses in the overall group of patients; however, differences among moAbs must be further investigated both in vaccinated and unvaccinated individuals.
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Affiliation(s)
- Salvatore Rotundo
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
| | - Eleonora Vecchio
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy; Interdepartmental Centre of Services, "Magna Graecia" University of Catanzaro, Italy
| | - Antonio Abatino
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy
| | - Caterina Giordano
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy
| | - Serafina Mancuso
- Unit of Clinical Biochemistry, University Hospital "Mater Domini", Catanzaro, Italy
| | - Maria Teresa Tassone
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy; Unit of Clinical Biochemistry, University Hospital "Mater Domini", Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy; Interdepartmental Centre of Services, "Magna Graecia" University of Catanzaro, Italy; Unit of Clinical Biochemistry, University Hospital "Mater Domini", Catanzaro, Italy
| | - Camillo Palmieri
- Department of Experimental and Clinical Medicine, Chair of Clinical Biochemistry University "Magna Graecia", 88100 Catanzaro, Italy; Unit of Clinical Biochemistry, University Hospital "Mater Domini", Catanzaro, Italy.
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Chair of Infectious and Tropical Diseases, University "Magna Graecia", 88100 Catanzaro, Italy
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15
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Russo A, Morrone HL, Rotundo S, Trecarichi EM, Torti C. Cytokine Profile of Invasive Pulmonary Aspergillosis in Severe COVID-19 and Possible Therapeutic Targets. Diagnostics (Basel) 2022; 12:diagnostics12061364. [PMID: 35741174 PMCID: PMC9221957 DOI: 10.3390/diagnostics12061364] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/27/2022] Open
Abstract
During the SARS-CoV-2 pandemic, a higher incidence of invasive pulmonary aspergillosis was observed in patients affected by Coronavirus disease 2019 (COVID-19), leading to the delineation of a new entity named COVID-19 associated pulmonary aspergillosis (CAPA). A predisposition to invasive infection caused by Aspergillus spp. in SARS-CoV-2 infected patients can be ascribed either to the direct viral-mediated damage of the respiratory epithelium, as already observed in influenza H1N1 virus infections, or to the dysregulated immunity associated with COVID-19. This narrative review focuses on the impact of immune impairment, particularly due to cytokine dysregulation caused by Aspergillus spp. superinfection in COVID-19 for a more in-depth understanding of the molecular pathways implicated in CAPA. As immune competence has proven to be essential in protecting against CAPA onset, a role already threatened by SARS-CoV-2 infection itself, preventive strategies should focus on reducing factors that could further target the host immune system. We also aimed to focus on well-known and less-known risk factors for IPA in COVID-19 patients, related to the main causes of immune suppression, both virus-mediated and iatrogenic, including treatments currently indicated for COVID-19. Lastly, possible preventive strategies aimed at reducing morbidity and mortality due to CAPA could be implemented.
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16
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Marascio N, Rotundo S, Quirino A, Matera G, Liberto MC, Costa C, Russo A, Trecarichi EM, Torti C. Similarities, differences, and possible interactions between hepatitis E and hepatitis C viruses: Relevance for research and clinical practice. World J Gastroenterol 2022; 28:1226-1238. [PMID: 35431515 PMCID: PMC8968488 DOI: 10.3748/wjg.v28.i12.1226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/06/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus (HEV) and hepatitis C virus (HCV) are both RNA viruses with a tropism for liver parenchyma but are also capable of extrahepatic manifestations. Hepatitis E is usually a viral acute fecal-oral transmitted and self-limiting disease presenting with malaise, jaundice, nausea and vomiting. Rarely, HEV causes a chronic infection in immunocompromised persons and severe fulminant hepatitis in pregnant women. Parenteral HCV infection is typically asymptomatic for decades until chronic complications, such as cirrhosis and cancer, occur. Despite being two very different viruses in terms of phylogenetic and clinical presentations, HEV and HCV show many similarities regarding possible transmission through organ transplantation and blood transfusion, pathogenesis (production of antinuclear antibodies and cryoglobulins) and response to treatment with some direct-acting antiviral drugs. Although both HEV and HCV are well studied individually, there is a lack of knowledge about coinfection and its consequences. The aim of this review is to analyze current literature by evaluating original articles and case reports and to hypothesize some interactions that can be useful for research and clinical practice.
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Affiliation(s)
- Nadia Marascio
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Angela Quirino
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Maria Carla Liberto
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro 88100, Italy
| | - Chiara Costa
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Unit of Infectious and Tropical Diseases, "Magna Graecia" University of Catanzaro, Catanzaro 88100, Italy
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17
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Trimboli F, Rotundo S, Armili S, Mimmi S, Lucia F, Montenegro N, Antico GC, Cerra A, Gaetano M, Galato F, Giaquinto Carinci L, Iania D, Mancuso S, Martucci M, Teti C, Greco M, Cuda G, Angotti E. Serum 25-hydroxyvitamin D measurement: Comparative evaluation of three automated immunoassays. Pract Lab Med 2021; 26:e00251. [PMID: 34386568 PMCID: PMC8342948 DOI: 10.1016/j.plabm.2021.e00251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: the different analytical methods for measurement of serum 25-hydroxyvitamin D (25(OH)D) are not yet fully harmonized and no consensus exists on a threshold of 25(OH)D defining a deficiency status. In this study, we compared the results from the assays of serum 25(OH)D performed with three different methods to evaluate the presence of potential biases and how much these biases can influence the assignment of patients to specific 25(OH)D deficiency/sufficiency categories. Design and Methods: Liaison 25(OH) Vitamin D Total (DiaSorin Liaison XL), Elecsys Vitamin D Total II (Roche Elecsys) and Lumipulse G25(OH) Vitamin D (Fujirebio Lumipulse G1200) were used. Methods comparability was established performing Passing-Bablok regression and Bland-Altman analysis to prove whether the differences found were lower than the preliminarily pre-established maximum acceptable bias. Results: all Passing-Bablok regressions exhibited the presence of a proportional and constant systematic error. Bland-Altman analysis revealed biases well above the maximum acceptable bias, so the 25(OH)D concentrations measured were not comparable. To evaluate whether the three methods had the same ability to classify patients into different categories of vitamin D levels, we categorized results obtained by each method in reference classes. Lumipulse categorized most patients into the class with the lowest 25(OH)D concentrations (<20 ng/mL) whereas Elecsys ranked the lowest number. Conclusions: Liaison XL and Elecsys have shown good accuracy compared to Lumipulse in measuring 25(OH)D levels. Nevertheless, the assays were not interchangeable due to the lack of comparability of results as well as to the disagreement in classification of hormone deficiency or sufficiency. Three immunometric assays for the measuring of serum 25(OH)Vitamin D were compared. Two of three assay show good accuracy whereas the third only fair. Due to the lack of comparability of the results, the assays were not exchangeable. Assays are at odds in the classification of hormone deficiency or sufficiency. Efforts will be required in the future to improve the immunoassays harmonization.
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Affiliation(s)
- Francesca Trimboli
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
- Corresponding author.
| | - Salvatore Rotundo
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
| | - Simone Armili
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
| | - Selena Mimmi
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Fortunata Lucia
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Nicola Montenegro
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Giulio Cesare Antico
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Alessandro Cerra
- Clinical Pathology Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Maria Gaetano
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Francesco Galato
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Lorenza Giaquinto Carinci
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Danilo Iania
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Serafina Mancuso
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Maria Martucci
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Consuelo Teti
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Marta Greco
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
- Clinical Pathology Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
- Corresponding author.
| | - Elvira Angotti
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
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18
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Biamonte F, Botta C, Mazzitelli M, Rotundo S, Trecarichi EM, Foti D, Torti C, Viglietto G, Torella D, Costanzo F. Combined lymphocyte/monocyte count, D-dimer and iron status predict COVID-19 course and outcome in a long-term care facility. J Transl Med 2021; 19:79. [PMID: 33596963 PMCID: PMC7887565 DOI: 10.1186/s12967-021-02744-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Sars-CoV-2 can cause severe pneumonia with multiorgan disease; thus, the identification of clinical and laboratory predictors of the progression towards severe and fatal forms of this illness is needed. Here, we retrospectively evaluated and integrated laboratory parameters of 45 elderly subjects from a long-term care facility with Sars-CoV-2 outbreak and spread, to identify potential common patterns of systemic response able to better stratify patients' clinical course and outcome. METHODS Baseline white blood cells, granulocytes', lymphocytes', and platelets' counts, hemoglobin, total iron, ferritin, D-dimer, and interleukin-6 concentration were used to generate a principal component analysis. Statistical analysis was performed by using R statistical package version 4.0. RESULTS We identified 3 laboratory patterns of response, renamed as low-risk, intermediate-risk, and high-risk, strongly associated with patients' survival (p < 0.01). D-dimer, iron status, lymphocyte/monocyte count represented the main markers discriminating high- and low-risk groups. Patients belonging to the high-risk group presented a significantly longer time to ferritin decrease (p: 0.047). Iron-to-ferritin-ratio (IFR) significantly segregated recovered and dead patients in the intermediate-risk group (p: 0.012). CONCLUSIONS Our data suggest that a combination of few laboratory parameters, i.e. iron status, D-dimer and lymphocyte/monocyte count at admission and during the hospital stay, can predict clinical progression in COVID-19.
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Affiliation(s)
- Flavia Biamonte
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | | | - Maria Mazzitelli
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Salvatore Rotundo
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - Enrico Maria Trecarichi
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Daniela Foti
- Department of Health Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Carlo Torti
- Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy.
| | - Francesco Costanzo
- Center of Interdepartmental Services (CIS), "Magna Graecia" University of Catanzaro, Catanzaro, Italy
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19
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Nisticò N, Maisano D, Iaccino E, Vecchio E, Fiume G, Rotundo S, Quinto I, Mimmi S. Role of Chronic Lymphocytic Leukemia (CLL)-Derived Exosomes in Tumor Progression and Survival. Pharmaceuticals (Basel) 2020; 13:ph13090244. [PMID: 32937811 PMCID: PMC7557731 DOI: 10.3390/ph13090244] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a B-lymphoproliferative disease, which consists of the abnormal proliferation of CD19/CD5/CD20/CD23 positive lymphocytes in blood and lymphoid organs, such as bone marrow, lymph nodes and spleen. The neoplastic transformation and expansion of tumor B cells are commonly recognized as antigen-driven processes, mediated by the interaction of antigens with the B cell receptor (BCR) expressed on the surface of B-lymphocytes. The survival and progression of CLL cells largely depend on the direct interaction of CLL cells with receptors of accessory cells of tumor microenvironment. Recently, much interest has been focused on the role of tumor release of small extracellular vesicles (EVs), named exosomes, which incorporate a wide range of biologically active molecules, particularly microRNAs and proteins, which sustain the tumor growth. Here, we will review the role of CLL-derived exosomes as diagnostic and prognostic biomarkers of the disease.
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Affiliation(s)
- Nancy Nisticò
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
| | - Domenico Maisano
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
- Correspondence: (E.I.); (S.M.)
| | - Eleonora Vecchio
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
| | - Giuseppe Fiume
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
| | - Salvatore Rotundo
- Department of Health Sciences–University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Ileana Quinto
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
| | - Selena Mimmi
- Department of Experimental and Clinical Medicine – University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (N.N.); (D.M.); (E.V.); (G.F.); (I.Q.)
- Correspondence: (E.I.); (S.M.)
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20
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Provenzano M, Rotundo S, Chiodini P, Gagliardi I, Michael A, Angotti E, Borrelli S, Serra R, Foti D, De Sarro G, Andreucci M. Contribution of Predictive and Prognostic Biomarkers to Clinical Research on Chronic Kidney Disease. Int J Mol Sci 2020; 21:ijms21165846. [PMID: 32823966 PMCID: PMC7461617 DOI: 10.3390/ijms21165846] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 06/29/2020] [Revised: 08/09/2020] [Accepted: 08/12/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD), defined as the presence of albuminuria and/or reduction in estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, is considered a growing public health problem, with its prevalence and incidence having almost doubled in the past three decades. The implementation of novel biomarkers in clinical practice is crucial, since it could allow earlier diagnosis and lead to an improvement in CKD outcomes. Nevertheless, a clear guidance on how to develop biomarkers in the setting of CKD is not yet available. The aim of this review is to report the framework for implementing biomarkers in observational and intervention studies. Biomarkers are classified as either prognostic or predictive; the first type is used to identify the likelihood of a patient to develop an endpoint regardless of treatment, whereas the second type is used to determine whether the patient is likely to benefit from a specific treatment. Many single assays and complex biomarkers were shown to improve the prediction of cardiovascular and kidney outcomes in CKD patients on top of the traditional risk factors. Biomarkers were also shown to improve clinical trial designs. Understanding the correct ways to validate and implement novel biomarkers in CKD will help to mitigate the global burden of CKD and to improve the individual prognosis of these high-risk patients.
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Affiliation(s)
- Michele Provenzano
- Renal Unit, Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (I.G.); (A.M.)
- Correspondence: (M.P.); (M.A.); Tel.: +39-3407544146 (M.P.); +39-3396814750 (M.A.)
| | - Salvatore Rotundo
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (S.R.); (D.F.)
| | - Paolo Chiodini
- Medical Statistics Unit, University of Campania Luigi Vanvitelli, I-80138 Naples, Italy;
| | - Ida Gagliardi
- Renal Unit, Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (I.G.); (A.M.)
| | - Ashour Michael
- Renal Unit, Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (I.G.); (A.M.)
| | - Elvira Angotti
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, I-88100 Catanzaro, Italy;
| | - Silvio Borrelli
- Renal Unit, University of Campania “Luigi Vanvitelli”, I-80138 Naples, Italy;
| | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy;
| | - Daniela Foti
- Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (S.R.); (D.F.)
| | - Giovambattista De Sarro
- Pharmacology Unit, Department of Health Sciences, School of Medicine, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy;
| | - Michele Andreucci
- Renal Unit, Department of Health Sciences, “Magna Graecia” University of Catanzaro, I-88100 Catanzaro, Italy; (I.G.); (A.M.)
- Correspondence: (M.P.); (M.A.); Tel.: +39-3407544146 (M.P.); +39-3396814750 (M.A.)
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