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Sirico A, Simonelli S, Pignatiello S, Fulgione C, Sarno L, Chiuso F, Maruotti GM, Sansone M, Guida M, Insabato L. BDNF and NGF Expression in Preneoplastic Cervical Disease According to HIV Status. Int J Mol Sci 2023; 24:10729. [PMID: 37445902 DOI: 10.3390/ijms241310729] [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: 05/02/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Neurotrophins, such as BDNF and NGF, are overexpressed in tumor cells in cervical cancer, and HIV infection is associated with the upregulation of neurotrophin expression. Therefore, we aimed to investigate whether BDNF and NGF are overexpressed in preneoplastic cervical disease from HIV-infected women. METHODS Women with preneoplastic cervical lesions (cervical intraepithelial neoplasia grade 2 or 3) were prospectively enrolled and grouped according to their HIV status. Samples from Loop Electrosurgical Excision Procedure (LEEP) for suspected cervical cancer were obtained, and immunohistochemistry was performed to evaluate BDNF and NGF expression. RESULTS We included in our analysis 12 HIV-infected patients who were matched with 23 HIV-negative patients as a control group. Immunohistochemistry analysis showed that BDNF expression was significantly higher in cervical preneoplastic lesions from HIV-positive women than in the lesions from the control group. In particular, BDNF was expressed in 8/12 HIV-positive patients and 7/23 HIV-negative patients (66.7% vs. 30.4%, χ2 = 4.227; p = 0.040). NGF expression was not significantly higher in cervical preneoplastic lesions from HIV-positive women compared with that in the lesions from the control group. In particular, NGF was expressed in 8/12 HIV-positive patients and in 12/23 HIV-negative patients (66.7% vs. 52.2% χ2 = 0.676; p = 0.411). Logistic regression analysis showed that the HIV status is an independent predictor of BDNF expression in pre-invasive preneoplastic cervical disease when considered alone (crude OR 4.6, 95% CI 0.027-20.347; p = 0.046) and when analyzed with other co-factors (adjusted OR 6.786, 95% CI 1.084-42.476; p = 0.041). CONCLUSIONS In preneoplastic cervical disease, BDNF expression is higher in HIV-infected women than in non-infected controls, and this is independent of the clinical features of the patients and from the presence of the HPV-HR genotype. BDNF can play a key role as a link between the pathways by which HIV and HPV interact to accelerate cervical cancer progression and invasion. These data can be useful to better understand the role of neurotrophins in the cancerogenesis of cervical cancer and the possible therapeutic strategies to improve disease outcomes.
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Affiliation(s)
- Angelo Sirico
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Saverio Simonelli
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | | | - Caterina Fulgione
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Laura Sarno
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco Chiuso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Matilde Sansone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Luigi Insabato
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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Mesolella M, Allosso S, Varricchio S, Russo D, Pignatiello S, Buono S, Motta G. Small-Cell Carcinoma of Nasopharynx: A Case Report of Unusual Localization. Ear Nose Throat J 2023; 102:NP13-NP18. [PMID: 33371727 DOI: 10.1177/0145561320973780] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Neuroendocrine tumors are a spectrum of rare and highly heterogeneous neoplasms with distinct functional and biological behavior in relation to location, tumor size, and histological differentiation. Neuroendocrine tumors arise from the neuroendocrine cells of the diffuse neuroendocrine system located in almost every organ. Neuroendocrine tumors in the head and neck district are usually reported in sinonasal cavities and larynx. We present the case of a nasopharyngeal small-cell neuroendocrine carcinoma, which, as far as we know, is the 16th case reported in literature.
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Affiliation(s)
- Massimo Mesolella
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Salvatore Allosso
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - Sarah Buono
- Department of Neuroscience, Unit of Otorhinolaryngology, Reproductive Sciences and Dentistry, Federico II University of Naples, Italy
| | - Gaetano Motta
- Unit of Otorhinolaryngology, University Luigi Vanvitelli, Napoli, Italy
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Palinski W, Monti M, Camerlingo R, Iacobucci I, Bocella S, Pinto F, Iannuzzi C, Mansueto G, Pignatiello S, Fazioli F, Gallo M, Marra L, Cozzolino F, De Chiara A, Pucci P, Bilancio A, de Nigris F. Lysosome purinergic receptor P2X4 regulates neoangiogenesis induced by microvesicles from sarcoma patients. Cell Death Dis 2021; 12:797. [PMID: 34404763 PMCID: PMC8371002 DOI: 10.1038/s41419-021-04069-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 04/02/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 12/20/2022]
Abstract
The tumor microenvironment modulates cancer growth. Extracellular vesicles (EVs) have been identified as key mediators of intercellular communication, but their role in tumor growth is largely unexplored. Here, we demonstrate that EVs from sarcoma patients promote neoangiogenesis via a purinergic X receptor 4 (P2XR4) -dependent mechanism in vitro and in vivo. Using a proteomic approach, we analyzed the protein content of plasma EVs and identified critical activated pathways in human umbilical vein endothelial cells (HUVECs) and human progenitor hematopoietic cells (CD34+). We then showed that vessel formation was due to rapid mitochondrial activation, intracellular Ca2+ mobilization, increased extracellular ATP, and trafficking of the lysosomal P2XR4 to the cell membrane, which is required for cell motility and formation of stable branching vascular networks. Cell membrane translocation of P2XR4 was induced by proteins and chemokines contained in EVs (e.g. Del-1 and SDF-1). Del-1 was found expressed in many EVs from sarcoma tumors and several tumor types. P2XR4 blockade reduced EVs-induced vessels in angioreactors, as well as intratumor vascularization in mouse xenografts. Together, these findings identify P2XR4 as a key mediator of EVs-induced tumor angiogenesis via a signaling mediated by mitochondria-lysosome-sensing response in endothelial cells, and indicate a novel target for therapeutic interventions.
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Affiliation(s)
- Wulf Palinski
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Maria Monti
- Department of Chemical Sciences, University of Napoli Federico II and CEINGE Advanced Biotechnologies, Naples, Italy
| | - Rosa Camerlingo
- Department of Cell Biology and Biotherapy Research, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ilaria Iacobucci
- Department of Chemical Sciences, University of Napoli Federico II and CEINGE Advanced Biotechnologies, Naples, Italy
| | - Serena Bocella
- Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Federica Pinto
- Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Clara Iannuzzi
- Department of Precision Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Gelsomina Mansueto
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Flavio Fazioli
- Division of Skeletal Muscle Oncology Surgery, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Michele Gallo
- Division of Skeletal Muscle Oncology Surgery, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Laura Marra
- Department of Cell Biology and Biotherapy Research, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Flora Cozzolino
- Department of Chemical Sciences, University of Napoli Federico II and CEINGE Advanced Biotechnologies, Naples, Italy
| | - Annarosaria De Chiara
- Division of Anatomy, Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Piero Pucci
- Department of Chemical Sciences, University of Napoli Federico II and CEINGE Advanced Biotechnologies, Naples, Italy
| | - Antonio Bilancio
- Department of Precision Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Filomena de Nigris
- Department of Precision Medicine, University of Campania "LuigiVanvitelli", Naples, Italy.
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Travaglino A, Russo D, Varricchio S, Pignatiello S, Baldo A, Picardi M, Pane F, Mascolo M. Prognostic Significance of CD30 in Transformed Mycosis Fungoides. Am J Clin Pathol 2021; 156:350-355. [PMID: 33769436 DOI: 10.1093/ajcp/aqaa261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/06/2023] Open
Abstract
OBJECTIVES Several studies suggested that CD30 expression is a favorable prognostic marker in transformed mycosis fungoides (tMF). However, evidence in this field is still unclear. This systematic review and meta-analysis aimed to evaluate the prognostic significance of CD30 in tMF. METHODS Electronic databases were searched from their inception to June 2020 for all studies assessing the prognostic value of CD30 in tMF. Pooled hazard ratio (HR) for death was calculated; a P value less than .05 was considered significant. Inconsistency index (I2) was used to assess statistical heterogeneity among studies. RESULTS Seven studies with 323 patients were included. CD30 expression in tMF was significantly associated with a decreased hazard of death both on univariate (HR, 0.459; 95% confidence interval [CI], 0.319-0.660; P < .001) and multivariate analysis (HR, 0.503; 95% CI, 0.345-0.734; P < .001), and the statistical heterogeneity among studies was null in all analyses (I2 = 0%). CONCLUSIONS tMF cases with CD30 expression in large cells have a hazard of death two times lower than CD30-negative cases.
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Affiliation(s)
- Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Antonello Baldo
- Department of Clinical Medicine and Surgery, Dermatology Section Naples, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II,” Naples, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II,” Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
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Russo D, Varricchio S, Ilardi G, Martino F, Di Crescenzo RM, Pignatiello S, Scalvenzi M, Costa C, Mascolo M, Merolla F, Staibano S. Tissue Expression of Carbonic Anhydrase IX Correlates to More Aggressive Phenotype of Basal Cell Carcinoma. Front Oncol 2021; 11:659332. [PMID: 33842375 PMCID: PMC8027352 DOI: 10.3389/fonc.2021.659332] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/05/2021] [Indexed: 11/13/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the white-skinned population accounting for about 15% of all neoplasms. Its incidence is increasing worldwide, at a rate of about 10% per year. BCC, although infrequently metastasizing, very often causes extensive tissue losses, due to the high propensity toward stromal infiltration, particularly in its dedifferentiated forms, with disfiguring and debilitating results. To date, there still is limited availability of therapeutic treatments alternative to surgery. We evaluated the immunohistochemical expression of the carbonic anhydrase IX (CAIX), one of the main markers of tissue hypoxia, in a set of 85 archived FFPE BCC tissues, including the main subtypes, with different clinical outcomes, to demonstrate a possible relationship between hypoxic phenotype and biological aggressiveness of these neoplasms. Our results showed that the expression level of the CAIX protein contributes to the stratification of BCC in the different risk classes for recurrence. We hypothesize for CAIX a potential therapeutic role as a target therapy in the treatment of more aggressive BCCs, thus providing an alternative to surgical and pharmacological therapy with Hedgehog inhibitors, a promising example of target therapy in BCCs.
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Affiliation(s)
- Daniela Russo
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Silvia Varricchio
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gennaro Ilardi
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Francesco Martino
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Rosa Maria Di Crescenzo
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Sara Pignatiello
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Massimiliano Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Claudia Costa
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Massimo Mascolo
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Francesco Merolla
- Department of Medicine and Health Sciences "V.Tiberio", University of Molise, Campobasso, Italy
| | - Stefania Staibano
- Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Guadagno E, Solari D, Pignatiello S, Somma T, Sgariglia R, Ilardi G, Cappabianca P, De Caro MDB. A 45-Year Old Man With An Intraventricular Mass. Brain Pathol 2021; 30:405-406. [PMID: 32100434 DOI: 10.1111/bpa.12814] [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] [Indexed: 11/27/2022] Open
Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Domenico Solari
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Teresa Somma
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy
| | - Roberta Sgariglia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Gennaro Ilardi
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Paolo Cappabianca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, University of Naples Federico II, Naples, Italy
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Russo D, Di Crescenzo RM, Broggi G, Merolla F, Martino F, Varricchio S, Ilardi G, Borzillo A, Carandente R, Pignatiello S, Mascolo M, Caltabiano R, Staibano S. Expression of P16INK4a in Uveal Melanoma: New Perspectives. Front Oncol 2020; 10:562074. [PMID: 33154942 PMCID: PMC7590828 DOI: 10.3389/fonc.2020.562074] [Citation(s) in RCA: 21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022] Open
Abstract
Uveal melanoma (UM) is the most common intraocular tumor in adults. Despite sharing the name and similar morphological features with cutaneous melanoma (CM), it is an entirely different neoplasia with a particular genetic background and clinical behavior. CDKN2A is a gene located at chromosome 9p21, encoding for P16INK4a and P14(ARF) proteins, whose role as a tumor suppressor has been clearly defined in many malignant tumors. CDKN2A frequently presents germline mutations in familial CM and epigenetic downregulation in a considerable percentage of sporadic CM. It has been hypothesized that CDKN2A alterations are early events in CM development, playing a central role in the malignant transformation of melanocytes. Alterations of the CDKN2A gene reduce the expression of P16INK4a in most CM subtypes. Immunohistochemical evaluation of P16INK4a is currently used, in association with Ki67 and HMB45, in pathology practice to discriminate between dysplastic nevi and melanoma. On the other hand, CKDN2A is rarely mutated in UM, and the immunohistochemical expression of P16INK4a has only been reported in small case series. We tested P16INK4a expression on paraffin-embedded tissue sections from 9 tissue microarrays (TMAs), built with 2 mm cores derived from 133 uveal melanoma FFPE blocks, collected from 1990 to 2018, and from selected paraffin-blocks of 3 UM liver metastases. The immunohistochemical expression of P16INK4a was assessed with a visual evaluation by light microscopy and then with a digital approach. Both approaches, with an acceptable concordance rate, revealed P16INK4a expression in a large proportion of UM cases and all liver metastases, opening new possibilities of using it in the differential diagnosis between cutaneous and uveal melanoma metastases in cases of unknown primary tumor or patients with two different primary melanomas.
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Affiliation(s)
- Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Rosa Maria Di Crescenzo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Giuseppe Broggi
- Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy
| | - Francesco Merolla
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy
| | - Francesco Martino
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Gennaro Ilardi
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Alessandra Borzillo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Raffaella Carandente
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
| | - Rosario Caltabiano
- Department G.F. Ingrassia, Section of Anatomic Pathology, University of Catania, Catania, Italy
| | - Stefania Staibano
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples Federico II, Naples, Italy
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Guadagno E, Russo D, Pignatiello S, Del Basso De Caro M. Inflammation in the neoplasms of the adrenal gland: Is there a prognostic role? An immunohistochemical study. Pathol Res Pract 2020; 216:153070. [PMID: 32825943 DOI: 10.1016/j.prp.2020.153070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Adrenal gland neoplasms are mostly benign. The differential diagnosis between adrenocortical adenoma and carcinoma relies on nine morphologic parameters (Weiss criteria) that are mostly subjective. Although rare, carcinomas represent an aggressive disease that require short time follow-up. For this reason, the diagnosis should be accurate. Neoplasms of the medulla are mostly represented by phaeochromocytomas, all potentially metastatic. Prognostic score systems (GAPP and PASS) have been implemented but not enough objective and useful in borderline cases. More objective parameters should be introduced. Little is known in literature on the inflammatory response in these tumors. Aim of our study was the definition (type, density and distribution) of inflammation in the adrenal neoplasms. MATERIAL AND METHODS Immunohistochemistry for CD45 (inflammatory cells), CD20 (B cells) and CD3 (T cells) antibodies was performed in 15 adrenocortical neoplasms and 17 phaeochromocytomas. A manual count of the signal was set for each marker, to establish the cellular type, their density (cells/mm2) and location within the tumor. Fisher's exact test was applied to assess the correlation between the immunoscore and clinico-pathologic parameters. RESULTS The difference of cellular density between the three markers was statistically significant (p value = 0.0028), with highest values for CD45 and CD3. No differences were detected between the periphery and the center of the lesions. The most relevant finding was the detection of a higher immunoscore in adrenocortical adenomas, compared to carcinomas. Moreover, most of phaeochromocytomas showed high expression of inflammation, except the only metastatic case. CONCLUSIONS The present study showed that inflammation could represent a valuable diagnostic and potential prognostic parameter, useful for the correct management of these lesions.
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Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Via Pansini, 5- 80131, Naples, Italy.
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Via Pansini, 5- 80131, Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Via Pansini, 5- 80131, Naples, Italy
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, Via Pansini, 5- 80131, Naples, Italy
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Pagano E, Romano B, Iannotti F, Parisi O, D’Armiento M, Pignatiello S, Coretti L, Lucafò M, Venneri T, Stocco G, Lembo F, Orlando P, Capasso R, Di Marzo V, Izzo A, Borrelli F. The non-euphoric phytocannabinoid cannabidivarin counteracts intestinal inflammation in mice and cytokine expression in biopsies from UC pediatric patients. Pharmacol Res 2019; 149:104464. [DOI: 10.1016/j.phrs.2019.104464] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 01/27/2023]
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Guadagno E, Pignatiello S, Borrelli G, Cervasio M, Della Corte L, Bifulco G, Insabato L. Ovarian borderline tumors, a subtype of neoplasm with controversial behavior. Role of Ki67 as a prognostic factor. Pathol Res Pract 2019; 215:152633. [PMID: 31542184 DOI: 10.1016/j.prp.2019.152633] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/22/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Ovarian borderline tumors (OBT) are tumors with an intermediate grade of malignancy whose diagnosis is purely based on morphological criteria. They usually occur in young women (under 40 years) and are characterized by a cellular proliferation with slight nuclear atypia and lacking stromal invasion with a destructive pattern. Aim of this study was to explore the immunohistochemical expression of Ki67 proliferative index in OBT and to correlate it with known clinicopathologic prognostic factors in patients older than 40 years. MATERIAL AND METHODS Twenty cases of OBTdiagnosed in the period ranging from 2016 to 2018 were retrieved. Each specimen was taken from hysterectomy or adnexectomy surgery. Immunohistochemical studies were performed on the most representative sample of the tumor. Positive signal was nuclear and it was evaluated by three independent pathologists. RESULTS Ki67 Labelling Index (L.I.) value ranged from 2% to 40%, with an average value of 14% and a median of 10%. Higher Ki67 L.I. was observed in patients older than 40 years (pvalue = 0.0194) and in those with tumors with a maximum diameter ≥ 10 cm (pvalue = 0.0547). Furthermore, a direct correlation was evident between tumor size value and Ki67 L.I. (p value<0.0001, r = 0.7745). Hitherto no known prognostic factor correlated with high Ki67 L.I. CONCLUSIONS Overall, OBT are tumors with greater risk of evolution at a more advanced age and when they are greater in size. The assessment of Ki67 could be a valid support in the diagnosis of a more aggressive tumor. Further studies are needed to assess possible correlation with data concerning recurrences rate, that in our cases were not available.
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Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences- Pathology Section, "Federico II" University of Naples, Italy.
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences- Pathology Section, "Federico II" University of Naples, Italy
| | - Giorgio Borrelli
- Department of Advanced Biomedical Sciences- Pathology Section, "Federico II" University of Naples, Italy
| | - Mariarosaria Cervasio
- Department of Advanced Biomedical Sciences- Pathology Section, "Federico II" University of Naples, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Bifulco
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences- Pathology Section, "Federico II" University of Naples, Italy
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Guadagno E, Borrelli G, Pignatiello S, Donato A, Presta I, Arcidiacono B, Malara N, Solari D, Somma T, Cappabianca P, Donato G, Del Basso De Caro M. Anti-Apoptotic and Anti-Oxidant Proteins in Glioblastomas: Immunohistochemical Expression of Beclin and DJ-1 and Its Correlation with Prognosis. Int J Mol Sci 2019; 20:ijms20164066. [PMID: 31434323 PMCID: PMC6720904 DOI: 10.3390/ijms20164066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/13/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
DJ-1 deglycase is a protein with anti-oxidative and anti-apoptotic properties and its role in oncogenesis is controversial. Indeed in primary breast cancer and non-small-cell lung carcinoma, its higher expression was shown in more aggressive tumors while in other neoplasms (e.g., pancreatic adenocarcinoma), higher expression was related to better prognosis. Beclin has a relevant role in autophagy and cellular death regulation, processes that are well known to be impaired in neoplastic cells. DJ-1 shows the ability to modulate signal transduction. It can modulate autophagy through many signaling pathways, a process that can mediate either cell survival or cell death depending on the circumstances. Previously, it has been suggested that the involvement of DJ-1 in autophagy regulation may play a role in tumorigenesis. The aim of our study was to investigate the link between DJ-1 and Beclin-1 in glioblastoma through the immunohistochemical expression of such proteins and to correlate the data obtained with prognosis. Protein expression was assessed by immunohistochemistry and the immunoscores were correlated with clinicopathologic parameters. Kaplan–Meier survival curves were generated. A statistically significant association between DJ-1 score and recurrence (p = 0.0189) and between the former and Isocitrate Dehydrogenase 1 (IDH1) mutation (p = 0.0072) was observed. Kaplan–Meier survival curve analysis revealed that a higher DJ-1 score was associated with longer overall survival (p = 0.0253, ĸ2 = 5.005). Furthermore, an unexpected direct correlation (p = 0.0424, r = 0.4009) between DJ-1 and Beclin score was evident. The most significant result of the present study was the evidence of high DJ-1 expression in IDH-mutant tumors and in cases with longer overall survival. This finding could aid, together with IDH1, in the identification of glioblastomas with better prognosis.
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Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, 80131 Napoli, Italy.
| | - Giorgio Borrelli
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, 80131 Napoli, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, 80131 Napoli, Italy
| | - Annalidia Donato
- Department of Medical and Surgical Sciences-University of Catanzaro "Magna Graecia"-viale Europa, 88100 Catanzaro, Italy
| | - Ivan Presta
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy
| | - Biagio Arcidiacono
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy
| | - Natalia Malara
- Department of Clinical and Experimental Medicine-University of Catanzaro "Magna Graecia"-viale Europa, 88100 Catanzaro, Italy
| | - Domenico Solari
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Federico II University of Naples, 80131 Napoli, Italy
| | - Teresa Somma
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Federico II University of Naples, 80131 Napoli, Italy
| | - Paolo Cappabianca
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Federico II University of Naples, 80131 Napoli, Italy
| | - Giuseppe Donato
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, Pathology Section, Federico II University of Naples, 80131 Napoli, Italy
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Travaglino A, D'Armiento FP, Cassese G, Campanino MR, Borrelli G, Pignatiello S, Luglio G, Maione F, De Palma GD, D'Armiento M. Clinicopathological factors associated with BRAF-V600E mutation in colorectal serrated adenomas. Histopathology 2019; 75:160-173. [PMID: 30815911 DOI: 10.1111/his.13846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/18/2022]
Abstract
Serrated adenomas are genetically heterogeneous, and the histological classification into sessile serrated (SSA) adenoma and traditional serrated adenoma (TSA) does not reflect the molecular landscape. The objective of this study was to assess clinical or pathological factors associated with BRAF-V600E mutation in serrated adenomas. Systematic review and meta-analysis was performed by searching electronic databases from January 2011 to January 2019 for studies assessing the association of BRAF-V600E mutation with clinical or pathological features of serrated adenomas. Odds ratio (OR) was calculated for each factor; a P-value <0.05 was considered significant. Forty studies assessing 3511 serrated adenomas (2375 SSAs and 1136 TSAs) were included. BRAF-V600E mutation was significantly associated with proximal localisation (OR = 2.71; P < 0.00001) and CIMP-H status (OR = 4.81; P < 0.0001) in both SSA and TSA, with polyp size <10 mm (OR = 0.41; P = 0.02) in TSA, and with endoscopic pit pattern II-O (OR = 13.11; P < 0.00001) and expression of MUC5A5 (OR = 4.43; P = 0.003) and MUC6 (OR = 2.28; P < 0.05) in SSA. Conversely, BRAF mutation was not associated with age <70 years (OR = 1.63; P = 0.34), age <60 years (OR = 0.86; P = 0.79), female sex (OR = 0.77; P = 0.12), flat morphology (OR = 1.52; P = 0.16), presence of any dysplasia (OR = 1.01; P = 0.59), serrated dysplasia (OR = 1.23; P = 0.72) and invasive cancer (OR = 0.67; P = 0.32), nuclear β-catenin expression (OR = 0.73; P = 0.21) and p53 overexpression (OR = 1.24; P = 0.82). In conclusion, BRAF-V600E mutation is associated with proximal localisation and CIMP-H status in both SSA and TSA, with size <10 mm only in TSA, and with expression of MUC5A5 and MUC6 and endoscopic pit pattern II-O at least in SSA. In serrated adenomas, BRAF-V600E mutation does not seem to be associated with age and sex, with the prevalence of dysplasia and cancer and with the morphology of the dysplastic component.
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Affiliation(s)
- Antonio Travaglino
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco P D'Armiento
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gianluca Cassese
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria R Campanino
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giorgio Borrelli
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gaetano Luglio
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Maione
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giovanni D De Palma
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria D'Armiento
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
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Travaglino A, Raffone A, Saccone G, Mascolo M, Pignatiello S, Mollo A, De Placido G, Insabato L, Zullo F. PTEN immunohistochemistry in endometrial hyperplasia: which are the optimal criteria for the diagnosis of precancer? APMIS 2019; 127:161-169. [DOI: 10.1111/apm.12938] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 02/11/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Antonio Travaglino
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II NaplesItaly
| | - Antonio Raffone
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Massimo Mascolo
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II NaplesItaly
| | - Sara Pignatiello
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II NaplesItaly
| | - Antonio Mollo
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Giuseppe De Placido
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
| | - Luigi Insabato
- Anatomic Pathology Unit Department of Advanced Biomedical Sciences School of Medicine University of Naples Federico II NaplesItaly
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit Department of Neuroscience, Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples Italy
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Romano FJ, Guadagno E, Solari D, Borrelli G, Pignatiello S, Cappabianca P, Del Basso De Caro M. ATM and p53 combined analysis predicts survival in glioblastoma multiforme patients: A clinicopathologic study. J Cell Biochem 2018; 119:4867-4877. [PMID: 29369420 DOI: 10.1002/jcb.26699] [Citation(s) in RCA: 9] [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: 11/16/2017] [Accepted: 01/23/2018] [Indexed: 12/19/2022]
Abstract
Glioblastoma is one of the most malignant cancers, with a distinguishing dismal prognosis: surgery followed by chemo- and radiotherapy represents the current standard of care, and chemo- and radioresistance underlie disease recurrence and short overall survival of patients suffering from this malignancy. ATM is a kinase activated by autophosphorylation upon DNA doublestrand breaks arising from errors during replication, byproducts of metabolism, chemotherapy or ionizing radiations; TP53 is one of the most popular tumor suppressor, with a preeminent role in DNA damage response and repair. To study the effects of the immunohistochemical expression of p-ATM and p53 in glioblastoma patients, 21 cases were retrospectively examined. In normal brain tissue, p-ATM was expressed only in neurons; conversely, in tumors cells, the protein showed a variable cytoplasmic expression (score: +,++,+++), with being completely undetectable in three cases. Statistical analysis revealed that high p-ATM score (++/+++) strongly correlated to shorter survival (P = 0.022). No difference in overall survival was registered between p53 normally expressed (NE) and overexpressed (OE) glioblastoma patients (P = 0.669). Survival analysis performed on the results from combined assessment of the two proteins showed that patients with NE p53 /low pATM score had longer overall survival than the NE p53/ high pATM score counterpart. Cox-regression analysis confirmed this finding (HR = 0.025; CI 95% = 0.002-0.284; P = 0.003). Our study outlined the immunohistochemical expression of p-ATM/p53 in glioblastomas and provided data on their possible prognostic/predictive of response role. A "non-oncogene addiction" to ATM for NEp53 glioblastoma could be postulated, strengthening the rationale for development of ATM inhibiting drugs.
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Affiliation(s)
| | - Elia Guadagno
- Department of Advanced Biomedical Sciences, Pathology Section, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
| | - Domenico Solari
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
| | - Giorgio Borrelli
- Department of Advanced Biomedical Sciences, Pathology Section, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
| | - Paolo Cappabianca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences, Pathology Section, Division of Neurosurgery - University of Naples Federico II, Naples, Italy
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Guadagno E, Del Basso De Caro M, Pignatiello S, Sciammarella C, Solari D, Cappabianca P, Maiuri F, Dones F. Expression of p40 (∆Np63) protein in meningiomas, an unexpected finding: immunohistochemical study and evaluation of its possible prognostic role. J Neurooncol 2016; 129:405-413. [PMID: 27394131 DOI: 10.1007/s11060-016-2205-y] [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] [Received: 02/05/2016] [Accepted: 07/03/2016] [Indexed: 10/21/2022]
Abstract
According to the 2007 WHO (World Health Organization) Classification, meningiomas are divided into three grades of malignancy, with different recurrence rate, based exclusively on histopathological parameters. Loss/reduction of PgR (Progesterone Receptor) expression and increased Ki67 L.I. (Labeling Index) have been proven as possible prognostic factors able to predict the relapse of the disease. However, they sometimes result unreliable, especially when discordant. p40 is the short form of the p53 homologue gene p63, also named ∆Np63, and its antibody has recently been introduced as a highly specific diagnostic marker of the squamous cell carcinoma of the lung. Nevertheless its expression has been found in many other unconventional sites (e.g. placenta, urotheluim, etc). Herein we assessed the immuno-expression of p40 protein in a series of 72 meningiomas (35 grade I and 37 grade II) and analyzed its correlation with clinicopathological parameters, overall survival and recurrence free interval. We found that a high p40 score correlated with high histological grade, presence of recurrence, increased Ki67 L.I. and loss/reduction of PgR signal. Moreover, a higher expression of p40 was shown to be a significant prognostic factor for the development of recurrences and resulted a prognostic independent variable in multivariate analysis. Overall, for the first time, we investigated the expression of p40 protein in meningiomas and explored its usefulness as prognostic marker in addition to PgR and Ki67 L.I.
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Affiliation(s)
- Elia Guadagno
- Pathology Section, Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Marialaura Del Basso De Caro
- Pathology Section, Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Sara Pignatiello
- Pathology Section, Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Concetta Sciammarella
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Domenico Solari
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Paolo Cappabianca
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Francesco Maiuri
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Flavia Dones
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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Barone M, Della Valle N, Rosania R, Facciorusso A, Trotta A, Cantatore FP, Falco S, Pignatiello S, Viggiani MT, Amoruso A, De Filippis R, Di Leo A, Francavilla R. A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects. Eur J Clin Nutr 2016; 70:23-7. [PMID: 26173865 DOI: 10.1038/ejcn.2015.114] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/20/2015] [Accepted: 05/06/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES There are conflicting data on the effect of a gluten-free diet (GFD) on the nutritional status of celiac patients. In the present study, we evaluated, in adult celiac patients, the influence of a long-term, strictly GFD on their nutritional status and compared it with matched healthy volunteers. SUBJECTS/METHODS Our study included 39 celiac patients and 39 healthy volunteers. The body mass index (BMI) of patients and controls was evaluated at enrollment, while the patients' BMI before the GFD was retrieved from clinical records. In addition, at enrollment, in both groups, we compared BMI, fat mass (FM), bone mineral density (BMD), as well as their dietary intake, recorded on a 7-day diary. RESULTS At the time of diagnosis, the majority of celiac patients (82.0%) had a normal BMI or were overweight, while 10.3% were malnourished. After the GFD, patients with a normal BMI showed a significant weight increase (P=0.002), but none of them switched in the overweight or obese category. Two (50%) of the four malnourished patients achieved a normal BMI. Controls and patients on a GFD had a similar BMI, FM, BMD and total calorie intake, but the amount of lipids and fiber intake was significantly different in the two groups (P=0.003 and P<0.0001, respectively). CONCLUSIONS Our study demonstrates that a GFD is able to improve the nutritional status of celiac patients without inducing overweight or obesity. Our findings are related to a celiac population adopting a GFD based on a Mediterranean-type diet.
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Affiliation(s)
- M Barone
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Bari, Italy
| | - N Della Valle
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - R Rosania
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - A Facciorusso
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - A Trotta
- Rheumatology Units, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - F P Cantatore
- Rheumatology Units, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - S Falco
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - S Pignatiello
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - M T Viggiani
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Bari, Italy
| | - A Amoruso
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - R De Filippis
- Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - A Di Leo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation (D.E.T.O.), University of Bari, Bari, Italy
| | - R Francavilla
- Department of Biomedicina dell'Età Evolutiva, University of Bari, Bari, Italy
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