1
|
Ricci S, Guarnieri V, Capitanini F, Pelosi C, Astorino V, Boscia S, Calistri E, Canessa C, Cortimiglia M, Lippi F, Lodi L, Malvagia S, Moriondo M, La Marca G, Azzari C. EXPANDED NEWBORN SCREENING FOR INBORN ERRORS OF IMMUNITY: THE EXPERIENCE OF TUSCANY. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00395-7. [PMID: 38636590 DOI: 10.1016/j.jaip.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Inborn errors of immunity (IEIs) include 485 inherited disorders characterized by an increased susceptibility to life threatening infectious diseases, autoimmunity and malignant diseases with a high mortality rate in the first years of life. Severe Combined Immunodeficiency is the most severe of the IEIs and its detection should be a primary goal in a newborn screening (NBS) program. The term "actionable" has recently been used for all IEIs with outcomes that can be demonstrably improved through early specialized intervention. OBJECTIVE to evaluate the results of the expanded NBS strategy for IEIs in Tuscany Region (Italy), based on TREC (T-cell Receptor Excision Circles), KREC (Kappa Recombining Excision Circles) and Tandem Mass-based assays. METHODS This is a retrospective study collecting data from all infants born in Tuscany from October 10, 2018, to October 10, 2022. Tandem mass assay to identify Adenosine deaminase (ADA) and purine nucleoside phosphorylase (PNP) deficiency, together with TREC and KREC molecular analysis were conducted on dried blood spot (DBS) from the newborns' Guthrie Cards. A new DBS and evaluation by an immunologist were carried out when the results of the first test were outside the diagnostic cut-offs. RESULTS 94,319 newborns were evaluated. Referral rates for TREC (0.031%) and KREC (0.074%) in this study are in line with the data available in literature. The results from the expanded NBS strategy revealed an incidence rate of 1/9,431 affected newborns. CONCLUSION This work represents the first description of a sustainable and real-life based expanded NBS program for IEIs with a high diagnostic incidence facilitating prompt management of identified patients.
Collapse
Affiliation(s)
- Silvia Ricci
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
| | - Valentina Guarnieri
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
| | | | - Caterina Pelosi
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - Valeria Astorino
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Silvia Boscia
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - Elisa Calistri
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - Clementina Canessa
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Martina Cortimiglia
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Francesca Lippi
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Lorenzo Lodi
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
| | - Sabrina Malvagia
- Newborn Screening, Clinical Chemistry and Pharmacology Laboratory, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
| | - Maria Moriondo
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy.
| | - Giancarlo La Marca
- Newborn Screening, Clinical Chemistry and Pharmacology Laboratory, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
| | - Chiara Azzari
- Immunology Division, Section of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy.
| |
Collapse
|
2
|
Baroncelli GI, Carlucci G, Freri E, Giuca MR, Guarnieri V, Navarra G, Toschi B, Mora S. The diagnosis of hypophosphatasia in children as a multidisciplinary effort: an expert opinion. J Endocrinol Invest 2024; 47:739-747. [PMID: 37752373 PMCID: PMC10904512 DOI: 10.1007/s40618-023-02199-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Hypophosphatasia (HPP) is a rare genetic disorder in which pathogenic variants of the ALPL gene lead to a marked decrease of tissue non-specific alkaline phosphatase (TNSALP) activity. Although HPP is a systemic disorder, its clinical manifestations are more evident on bones, teeth, muscle and central nervous system. The clinical spectrum ranges from severe forms with extreme skeletal deformities, respiratory impairment, seizures, to very mild forms with onset in late adulthood and few clinical signs. The diagnosis can be suspected by measurement of TNSALP activity, but the insufficient awareness among health professionals and the lack of official guidelines are responsible for delayed diagnosis in children with HPP. The purpose of the current document is to provide an expert opinion directed at optimizing the diagnostic pathway of pediatric HPP. From April to December 2022, a multidisciplinary working group of 6 experts including two pediatric endocrinologists, a pediatric neurologist, a pediatric odontologist, a clinical geneticist, and a molecular biologist gathered in a series of periodic meetings to discuss the main issues related to the diagnosis of HPP in children and formalize an Expert Opinion statement. The experts agreed on a diagnostic trail that begins with the recognition of specific clinical signs, leading to biochemical analyses of TNSALP activity and vitamin B6 serum concentration. Very important are the neurological and dental manifestation of the disease that should be thoroughly investigated. The evaluation of TNSALP activity must consider sex and age variability and low activity must be persistent. Repeated blood measurements are thus necessary. The molecular analysis is then mandatory to confirm the diagnosis and for genetic counseling.
Collapse
Affiliation(s)
- G I Baroncelli
- Pediatric and Adolescent Endocrinology, Division of Pediatrics, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, Pisa, Italy
| | - G Carlucci
- OPT S.P.A., Soluzioni Per Il Mondo Healthcare, Milan, Italy
| | - E Freri
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M R Giuca
- Unit of Pediatric Dentistry, Department of Surgical Medical Molecular Pathology and Critical Area, Dental and Oral Surgery Clinic, University of Pisa, Pisa, Italy
| | - V Guarnieri
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, Foggia, Italy
| | - G Navarra
- OPT S.P.A., Soluzioni Per Il Mondo Healthcare, Milan, Italy
| | - B Toschi
- Section of Medical Genetics, Department of Medical and Oncological Area, University Hospital, Pisa, Italy
| | - S Mora
- Laboratory of Pediatric Endocrinology, Department of Pediatrics, IRCCS San Raffaele Hospital, Milan, Italy.
| |
Collapse
|
3
|
Tregnago D, Avancini A, Belluomini L, Trestini I, Sposito M, Insolda J, Bianchi F, Sava T, Gaiani C, Del Piccolo L, Guarnieri V, Verlato G, Tfaily A, Vesentini R, Zuliani S, Pilotto S, Milella M. Cross-sectional survey evaluating the psychological impact of the COVID-19 vaccination campaign in patients with cancer: The VACCINATE study. PLoS One 2024; 19:e0290792. [PMID: 38271378 PMCID: PMC10810487 DOI: 10.1371/journal.pone.0290792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/15/2023] [Indexed: 01/27/2024] Open
Abstract
The COVID-19 pandemic has profoundly impacted on cancer patients' psychological well-being and clinical status. We assessed the levels of anxiety, depression, and distress and the attitude towards COVID-19 vaccination in cancer patients, accepting vaccination at the Verona University Hospital and Camposampiero Hospital in the Veneto region. Self-reported questionnaires were administered to patients undergoing COVID-19 vaccination between March and May 2021 (first and second dose). Twenty-seven items were investigated: i) demographics/clinical characteristics; ii) anxiety, depression, and distress (Hospital Anxiety and Depression Scale-HADS-and Distress Thermometer-DT); iii) four specific items regarding awareness about infection risks, interference with anticancer treatments, and vaccine side effects. Sixty-two and 57% of the patients who accepted to be vaccinated responded to the survey in the two participating Hospitals, respectively. Mean age was 63 years (SD: 12 years; range 19-94 years), women were slightly more prevalent (57.6%), most participants were married (70%), and either worker or retired (60%). Borderline and clinical levels of anxiety were recorded in 14% and 10% of respondents; borderline and clinical levels of depression in 14% and 8%; and moderate and severe distress levels in 33% and 9%. Overall, there was high confidence that vaccination would reduce the risk of contracting COVID-19 (70%), which would make patients feel less worried about contracting the infection (60%). Fear that vaccine-related side effects would interfere with anticancer treatment and/or global health status was low (10% and 9% for items 3 and 4, respectively) and significantly associated with baseline levels of anxiety, depression, and distress at multivariate analysis. Results did not differ between the Verona and Camposampiero cohorts. During the COVID-19 vaccination campaign, adult cancer patients demonstrated high levels of confidence towards vaccination; baseline levels of anxiety, depression, and distress were the only significant predictors of reduced confidence.
Collapse
Affiliation(s)
- Daniela Tregnago
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Alice Avancini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Ilaria Trestini
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Marco Sposito
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Jessica Insolda
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Federica Bianchi
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Teodoro Sava
- Medical Oncology, Camposampiero Hospital, Padova, Italy
| | - Chiara Gaiani
- Medical Oncology, Camposampiero Hospital, Padova, Italy
| | - Lidia Del Piccolo
- Department of Neuroscience, Psychological and Psychiatric Sciences and Movement Sciences, University of Verona and Verona University Hospital Trust, Verona, Italy
| | | | - Giuseppe Verlato
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, Istituti Biologici II – University of Verona, Verona, VR, Italy
| | - Ahmad Tfaily
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, Istituti Biologici II – University of Verona, Verona, VR, Italy
| | - Roberta Vesentini
- Department of Public Health and Community Medicine, Unit of Epidemiology and Medical Statistics, Istituti Biologici II – University of Verona, Verona, VR, Italy
| | - Serena Zuliani
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, Verona, VR, Italy
| |
Collapse
|
4
|
Lodi L, Barbati F, Amicizia D, Baldo V, Barbui AM, Bondi A, Costantino C, Da Dalt L, Ferrara L, Fortunato F, Guarnieri V, Icardi G, Indolfi G, Martinelli D, Martini M, Moriondo M, Nieddu F, Peroni DG, Prato R, Ricci S, Russo F, Tirelli F, Vitale F, Ladhani SN, Azzari C. Four-Component Recombinant Protein-Based Vaccine Effectiveness Against Serogroup B Meningococcal Disease in Italy. JAMA Netw Open 2023; 6:e2329678. [PMID: 37594762 PMCID: PMC10439479 DOI: 10.1001/jamanetworkopen.2023.29678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/21/2023] [Indexed: 08/19/2023] Open
Abstract
Importance Population-based data on the 4-component recombinant protein-based (4CMenB) vaccine effectiveness and reduction in incidence rate ratios (IRRs) are continuously needed to assess vaccine performance in the prevention of serogroup B invasive meningococcal disease (IMD). Objective To assess the effectiveness and reduction in IRRs associated with the 4CMenB vaccine in the pediatric population in 6 regions in Italy. Design, Setting, and Participants This retrospective cohort screening study and case-control study included data from children aged younger than 6 years in 6 highly populated Italian regions from January 1, 2006, to January 1, 2020. Participants included children younger than 6 years diagnosed with serogroup B IMD without predisposing factors. Data were collected from regional surveillance and vaccination registries and were analyzed from September 2021 to January 2022. Exposures Routine 4CMenB vaccination, per regional vaccination programs. Main Outcomes and Measures The main outcome was the effectiveness of the 4CMenB vaccine in the prevention of serogroup B IMD in the population of children aged younger than 6 years in 6 Italian regions. The percentages of vaccine effectiveness (VE) were obtained through the concomitant use of a screening method and a case-control study. Secondary outcomes were the comparison of effectiveness results obtained using the 2 different computational methods, the description of serogroup B IMD incidence rates, and reduction in IRRs before and after 4CMenB introduction, as a proxy for vaccine impact. Results The cohort screening study included a resident population of 587 561 children younger than 6 years in 3 regions with similar surveillance protocols, and the matched-case controls study assessed a resident population of 1 080 620 children younger than 6 years in 6 regions. Analyses found that 4CMenB VE in fully immunized children was 94.9% (95% CI, 83.1%-98.4%) using the screening method and 91.7% (95% CI, 24.4%-98.6%) using the case-control method. Overall reduction in IRR was 50%, reaching 70% in regions with early-start vaccination schedules. The case-control method involving 6 highly-populated Italian regions included 26 cases and 52 controls and found an estimated VE of 92.4% (95% CI, 67.6%-97.9%) in children old enough for the first vaccine dose and 95.6% (95% CI, 71.7%-99.1%) in fully immunized children. VE was more than 90% for partially immunized children. Even in regions where the first dose was administered at age 2 months, almost 20% of unvaccinated cases were among infants too young to receive the first 4CMenB dose. Conclusions and Relevance This screening cohort study and matched case-controls study found high effectiveness of 4CMenB vaccination and greater reduction in IRR for early-start vaccination schedules in preventing invasive serogroup B meningococcal disease. The high proportion of children too young to be vaccinated among unvaccinated cases suggests that starting the vaccination even earlier may prevent more cases. Screening and case-control methods provided similar estimates of VE: either method may be used in different study settings, but concomitant use can provide more robust estimates.
Collapse
Affiliation(s)
- Lorenzo Lodi
- Immunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Federica Barbati
- Immunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua, Padua, Italy
| | - Anna Maria Barbui
- S.C. Microbiology and Virology Laboratory, City of Health and Science, Turin, Italy
| | - Alessandro Bondi
- S.C. Microbiology and Virology Laboratory, City of Health and Science, Turin, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro,” University of Palermo, Palermo, Italy
| | - Liviana Da Dalt
- Department of Woman’s and Child’s Health, Padua University Hospital, Padua, Italy
| | - Lorenza Ferrara
- Regional Epidemiology Reference Service for the Surveillance, Prevention and Control of Infectious Diseases, Local Health Unit of Alessandria, Alessandria, Italy
| | - Francesca Fortunato
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
| | - Valentina Guarnieri
- Immunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Neurofarba, University of Florence, Florence, Italy
| | - Domenico Martinelli
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
| | | | - Maria Moriondo
- Laboratory of Immunology and Molecular Microbiology, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Francesco Nieddu
- Laboratory of Immunology and Molecular Microbiology, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Diego G. Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rosa Prato
- Hygiene Unit, Department of Medical and Surgical Sciences, Policlinico Foggia Hospital, University of Foggia, Foggia, Italy
| | - Silvia Ricci
- Immunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Francesca Russo
- Veneto Regional Directorate of Prevention, Food Safety, Veterinary, Public Health, Venice, Italy
| | - Francesca Tirelli
- Department of Woman’s and Child’s Health, Padua University Hospital, Padua, Italy
| | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro,” University of Palermo, Palermo, Italy
| | - Shamez N. Ladhani
- National Infection Service, Public Health England, London, United Kingdom
- Paediatric Infectious Diseases Research Group, St George’s University of London, London, United Kingdom
| | - Chiara Azzari
- Immunology Unit, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| |
Collapse
|
5
|
Pessina B, Guarnieri V, Scarallo L. Entering the era of phage therapy: A 'happy hour' for inflammatory bowel diseases. Allergy 2023; 78:889-891. [PMID: 36600597 DOI: 10.1111/all.15636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Benedetta Pessina
- Department of Health Sciences, Anna Meyer Children's University Hospital, Florence, Italy
| | - Valentina Guarnieri
- Department of Health Sciences, Anna Meyer Children's University Hospital, Florence, Italy
| | - Luca Scarallo
- Gastroenterology and Nutrition Unit, Anna Meyer Children's University Hospital, Florence, Italy
| |
Collapse
|
6
|
Lascialfari G, Sarti L, Barni S, Liccioli G, Paladini E, Guarnieri V, Ricci S, Giovannini M, Mori F. Relapse or worsening of chronic spontaneous urticaria during SARS-CoV-2 infection and vaccination in children: A telemedicine follow-up. Allergol Immunopathol (Madr) 2022; 50:1-7. [PMID: 36156167 DOI: 10.15586/aei.v50isp2.722] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/21/2022] [Indexed: 09/08/2023]
Abstract
BACKGROUND Chronic urticaria (CU), characterized by daily wheals and/or angioedema lasting more than 6 weeks, is a common skin disease. CU is classified as spontaneous or inducible. Because of Coronavirus Disease-19 (COVID-19) pandemic, face-to-face visits were reduced, and many centers started remote consultations to minimize hospital admissions and risk for viral diffusion. Telemedicine became a valuable tool for evaluating and monitoring patients with chronic diseases, such as CU. This study aims to evaluate the effectiveness of telemedicine as a means for the follow-up of patients with chronic spontaneous urticaria (CSU) during the COVID-19 pandemic. In particular, we collected data related to CSU evolution and treatment by remote consultation. Moreover, we specifically investigated the impact of SARS-CoV-2 infection or vaccination on CSU in relapsing or worsening of such a disease. METHODS The electronic charts were reviewed for patients diagnosed with CSU, who were referred to the allergy unit of Meyer Children's Hospital, Florence. For each patient, a review of demographic characteristics, diagnostic workup, efficacy, and tolerability of the treatment was performed. Patients with a physical agent triggering CU were excluded from the study. Disease activity was monitored using the Urticaria Activity Score (UAS7). In addition, when the COVID-19 pandemic started, follow-up continued through telemedicine after an initial face-to-face visit when possible. Approximately 1 year after the diagnosis of CSU, patients were recontacted to investigate whether they had experienced a relapse or worsening of urticaria during a possible COVID-19 or immediately after receiving a COVID-19 vaccine. RESULTS From January 2020 to March 2021, 84 cases of CSU were identified, with 71 (84.5%) of these being evaluated via televisit (remote consultation). During the remote follow-up period, 38/71 (53.5%) patients who were evaluated via televisit recovered completely from CSU, while 24 (33.8%) made therapy adjustments, and 9 (12.7%) had to discontinue follow-up through remote visits and return to face-to-face visits. In February 2022, we recontacted the 71 patients with CSU, and 50 (70.4%) of them answered by phone call interview. Four (19.2%) of the 26 patients who had COVID-19 showed CSU relapse, while 1 (3.8%) had a CSU worsening. Instead, 1 (3.8%) patient of the 26 who were vaccinated had a relapse of CSU, and 1 (3.8%) had a worsening of CSU, both after the first dose. CONCLUSION Our data showed that telemedicine can be an effective tool for the follow-up of patients with CSU. Moreover, COVID-19, as well as COVID-19 vaccination, may trigger CSU relapse or worsening, but both are unspecific triggers, and urticaria shows a very short duration in most cases.
Collapse
Affiliation(s)
- Giulia Lascialfari
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Lucrezia Sarti
- Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's Hospital, Florence, Italy
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Erika Paladini
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Valentina Guarnieri
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| | - Silvia Ricci
- Division of Immunology, Section of Pediatrics, Department of Health Sciences, University of Florence and Meyer Children's Hospital, Florence, Italy
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy;
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy
| |
Collapse
|
7
|
Guarnieri V, Giovannini M, Lodi L, Astorino V, Pisano L, Di Cicco E, Canessa C, Citera F, Peroni D, Azzari C, Ricci S. Severe pertussis disease in a paediatric population: The role of age, vaccination status and prematurity. Acta Paediatr 2022; 111:1781-1787. [PMID: 35638439 DOI: 10.1111/apa.16436] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 03/10/2022] [Accepted: 05/24/2022] [Indexed: 11/27/2022]
Abstract
AIM To estimate hospitalisation rate and investigate the role of age, prematurity and vaccination status in severe pertussis cases. METHODS We retrospectively evaluated 200 children aged 0-14 years, admitted to the emergency rooms of Meyer Hospital of Florence and Pisa Hospital with a diagnosis of pertussis from 1 October 2010 to 31 January 2020. RESULTS Children younger than 12 months were 63.0%. Preterm infants were 6.5%. The rate of hospitalisation was 49.0%. Among hospitalised cases, 80.6% were younger than 5 months. Overall, 62.0% were unvaccinated; this percentage increased among hospitalised (73.5%) and preterm subsamples (76.9%). Delays in pertussis vaccination were found in 57.7% of term infants and in 80.0% of preterms. Multivariable analysis confirmed the age under 2 months as the variable at higher risk for hospitalisation (OR 4.49, 95% CI 1.85-10.96, p < 0.001). Being fully vaccinated represented a significant protective factor (OR 0.12, 95% CI 0.04-0.35, p < 0.001). CONCLUSION Older classes of age and a complete vaccination, in time with the recommended schedule, are both protective factors for hospitalisation in severe pertussis disease. The widespread vaccination delay frequently observed in preterm children may be the cause for their higher rate of hospitalisation.
Collapse
Affiliation(s)
- Valentina Guarnieri
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
| | - Mattia Giovannini
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Allergy Unit, Department of Pediatrics Meyer Children's University Hospital Florence Italy
| | - Lorenzo Lodi
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
| | - Valeria Astorino
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Laura Pisano
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Elisa Di Cicco
- Pediatric Clinic, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Clementina Canessa
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Francesco Citera
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Diego Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Chiara Azzari
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| | - Silvia Ricci
- Department of Pediatrics, Department of Health Sciences University of Florence Florence Italy
- Immunology and Molecular Microbiology Unit Meyer Children's Hospital Florence Italy
| |
Collapse
|
8
|
Guarnieri V, Barni S, Giovannini M, Liccioli G, Sarti L, Ricci S, Lodi L, Canessa C, Lippi F, Moriondo M, Pisano L, Citera F, Azzari C, Mori F. Adverse reactions to BNT162B2 vaccine in health care workers from an Italian Tertiary Care Hospital. Clin Exp Allergy 2022; 52:911-915. [PMID: 35491497 PMCID: PMC9347586 DOI: 10.1111/cea.14155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Valentina Guarnieri
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Mattia Giovannini
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Ricci
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Lorenzo Lodi
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Clementina Canessa
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Francesca Lippi
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Maria Moriondo
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Laura Pisano
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Francesco Citera
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Chiara Azzari
- Section of Pediatrics, Department of Health Sciences, University of Florence, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| |
Collapse
|
9
|
Guarnieri V, Sileri F, Indirli R, Guabello G, Longhi M, Dito G, Verdelli C, Corbetta S. Clinical, biochemical and genetic findings in adult patients with chronic hypophosphatasemia. J Endocrinol Invest 2022; 45:125-137. [PMID: 34213743 PMCID: PMC8741696 DOI: 10.1007/s40618-021-01625-1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/24/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE The study aimed to define the clinical, biochemical and genetic features of adult patients with osteopenia/osteoporosis and/or bone fragility and low serum alkaline phosphatase (sALP). METHODS Twenty-two patients with at least two sALP values below the reference range were retrospectively enrolled after exclusion of secondary causes. Data about clinical features, mineral and bone markers, serum pyridoxal-5'-phosphate (PLP), urine phosphoethanolamine (PEA), lumbar and femur bone densitometry, and column X-ray were collected. Peripheral blood DNA of each participant was analyzed to detect ALPL gene anomalies. RESULTS Pathogenic ALPL variants (pALPL) occurred in 23% and benign variants in 36% of patients (bALPL), while nine patients harbored wild-type alleles (wtALPL). Fragility fractures and dental anomalies were more frequent in patients harboring pALPL and bALPL than in wtALPL patients. Of note, wtALPL patients comprised women treated with tamoxifen for hormone-sensitive breast cancer. Mineral and bone markers were similar in the three groups. Mean urine PEA levels were significantly higher in patients harboring pALPL than those detected in patients harboring bALPL and wtALPL; by contrast, serum PLP levels were similar in the three groups. A 6-points score, considering clinical and biochemical features, was predictive of pALPL detection [P = 0.060, OR 1.92 (95% CI 0.972, 3.794)], and more significantly of pALPL or bALPL [P = 0.025, OR 14.33 (95% CI 1.401, 14.605)]. CONCLUSION In osteopenic/osteoporotic patients, single clinical or biochemical factors did not distinguish hypophosphatasemic patients harboring pALPL or bALPL from those harboring wtALPL. Occurrence of multiple clinical and biochemical features is predictive of ALPL anomalies, and, therefore, they should be carefully identified. Tamoxifen emerged as a hypophosphatasemic drug.
Collapse
Affiliation(s)
- V Guarnieri
- Division of Medical Genetics, Fondazione IRCCS Ospedale Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - F Sileri
- Lab of Endocrine and Metabolic Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - R Indirli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Endocrinology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Guabello
- Reumatology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - M Longhi
- Reumatology Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - G Dito
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - C Verdelli
- Laboratory of Experimental Endocrinology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - S Corbetta
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
- Department of Biochemical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
| |
Collapse
|
10
|
Anastasilakis AD, Makras P, Doulgeraki A, Polyzos SA, Guarnieri V, Papapoulos SE. Denosumab for the treatment of primary pediatric osteoporosis. Osteoporos Int 2021; 32:2377-2381. [PMID: 33987688 DOI: 10.1007/s00198-021-06002-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022]
Abstract
Primary osteoporosis is rare in children and adolescents and its optimal pharmacological management is uncertain. Bisphosphonates are commonly used while denosumab has only been administered to a few children with osteogenesis imperfecta. We studied a treatment-naïve 13.5-year-old boy with severe osteoporosis and multiple vertebral deformities who presented with back pain and difficulty in walking. Causes of secondary osteoporosis were excluded and there were no abnormalities in genes known to cause bone fragility. He was treated with denosumab 60 mg subcutaneously every 3 months for 30 months, and he was pain-free within 6 weeks after the first injection. Lumbar spine BMD and femoral neck BMD increased with treatment by 65.6% and 25.3%, respectively, and deformed vertebrae regained their normal shape; linear growth was not impaired. During the second year of treatment, transient hypercalcemia (maximum 3.09 mmol/l) before the denosumab injection was observed. In conclusion, denosumab was highly effective in this case of primary pediatric osteoporosis, with remarkable clinical and radiological response. Transient hypercalcemia was probably due to amplification of the effect of growth spurt and puberty on bone remodeling by the transient, short-term discontinuation of the drug. Furthermore, our data suggest that mobilization of calcium from treatment-induced sclerotic transverse lines in bone metaphyses may contribute to the development of hypercalcemia.
Collapse
Affiliation(s)
- A D Anastasilakis
- Department of Endocrinology, 424 General Military Hospital, Ring Road, 564 29 N.Efkarpia, Thessaloniki, Greece.
| | - P Makras
- Department of Endocrinology and Diabetes and Department of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece
| | - A Doulgeraki
- Department of Bone and Mineral Metabolism, Institute of Child Health, Athens, Greece
| | - S A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Guarnieri
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - S E Papapoulos
- Center for Bone Quality, Department of Internal Medicine, Section Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
11
|
Guarnieri V, Moriondo M, Giovannini M, Lodi L, Ricci S, Pisano L, Barbacci P, Bini C, Indolfi G, Zanobini A, Azzari C. Surveillance on Healthcare Workers During the First Wave of SARS-CoV-2 Pandemic in Italy: The Experience of a Tertiary Care Pediatric Hospital. Front Public Health 2021; 9:644702. [PMID: 34381749 PMCID: PMC8350057 DOI: 10.3389/fpubh.2021.644702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/22/2021] [Indexed: 11/23/2022] Open
Abstract
Healthcare workers (HCWs) play a central role in handling the ongoing coronavirus disease 2019 (COVID-19) pandemic. Monitoring HCWs, both symptomatic and asymptomatic, through screening programs, are critical to avoid the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the hospital environment to rapidly identify and isolate infected individuals and to allow their prompt return to work as soon as necessary. We aim to describe our healthcare surveillance experience (April 2–May 6, 2020) based on a combined screening consisting of real-time PCR (RT-PCR) on nasopharyngeal (NP) swabs and rapid serologic tests (RST) for SARS-CoV-2 in all HCWs of Meyer Children's University Hospital in Florence. Among the analyzed workers, 13/1690 (0.8%), all of them without clinical manifestations, was found positive for SARS-CoV-2 by using RT-PCR on NP swab: 8/1472 (0.5%) were found positive during the screening, 1/188 (0.5%) during contact with a positive individual (p > 0.05 vs. screening group), while 4/30 (13.3%) were found positive on the day of re-admission at work after an influenza-like-illness (p < 0.05). Concerning working areas, the majority of RT-PCR positivity (12/13) and serologic positivity (34/42) was found in non-COVID-19 dedicated areas (p > 0.05 vs. COVID-19 dedicated areas). No cases were registered among non-patients-facing workers (p = 0.04 vs. patient-facing group). Nurses and residents represented, respectively, the working role with the highest and lowest percentage of RT-PCR positivity. In conclusion, accurate surveillance is essential to reduce virus spread among HCWs, patients, and the community and to limit the shortage of skilled professionals. The implementation of the surveillance system through an efficient screening program was offered to all professionals, regardless of the presence of clinical manifestations and the level of working exposure risk, maybe wise and relevant.
Collapse
Affiliation(s)
- Valentina Guarnieri
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria Moriondo
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Mattia Giovannini
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Lorenzo Lodi
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Silvia Ricci
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Laura Pisano
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Costanza Bini
- Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Meyer Children's University Hospital, Florence, Italy.,Department of Neurofarba, University of Florence, Florence, Italy
| | | | - Chiara Azzari
- Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| |
Collapse
|
12
|
Ricci S, Lodi L, Citera F, Nieddu F, Moriondo M, Guarnieri V, Giovannini M, Indolfi G, Resti M, Zanobini A, Azzari C. How home anterior self-collected nasal swab simplifies SARS-CoV-2 testing: new surveillance horizons in public health and beyond. Virol J 2021; 18:59. [PMID: 33743711 PMCID: PMC7980800 DOI: 10.1186/s12985-021-01533-z] [Citation(s) in RCA: 9] [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: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 11/26/2022] Open
Abstract
The sample collection procedure for SARS-CoV-2 has a strong impact on diagnostic capability, contact tracing approach, ultimately affecting the infection containment performance. This study demonstrates that self-collected nasal-swab has shown to be a valid and well tolerated procedure to SARS-CoV-2 surveillance in a healthcare system. More significantly, no performance adequacy difference was detected in self-administered swabs between healthcare worker (HCW) and non-HCW which allows to speculate that this procedure could be successfully extended to the entire population for mass screening.
Collapse
Affiliation(s)
- Silvia Ricci
- Section of Pediatrics, Department of Health Sciences, University of Florence, Viale Gaetano Pieraccini 24, 50139, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Lorenzo Lodi
- Section of Pediatrics, Department of Health Sciences, University of Florence, Viale Gaetano Pieraccini 24, 50139, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Francesco Citera
- Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy.
| | - Francesco Nieddu
- Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Maria Moriondo
- Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Valentina Guarnieri
- Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Mattia Giovannini
- Section of Pediatrics, Department of Health Sciences, University of Florence, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Giuseppe Indolfi
- Section of Pediatrics, Department of Neurofarba, University of Florence, viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Massimo Resti
- Pediatric Department, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Alberto Zanobini
- Meyer Children's Hospital, viale Gaetano Pieraccini 24, 50139, Florence, Italy
| | - Chiara Azzari
- Section of Pediatrics, Department of Health Sciences, University of Florence, Viale Gaetano Pieraccini 24, 50139, Florence, Italy.,Immunology and Molecular Microbiology Unit, Meyer Children's Hospital, Viale Gaetano Pieraccini 24, 50139, Florence, Italy
| |
Collapse
|
13
|
Giovannini M, Lodi L, Sarti L, Guarnieri V, Barni S, Canessa C, Liccioli G, Mangone G, Azzari C, Mori F, Ricci S. Pediatric Allergy and Immunology Practice During the COVID-19 Pandemic in Italy: Perspectives, Challenges, and Opportunities. Front Pediatr 2020; 8:565039. [PMID: 33330268 PMCID: PMC7719701 DOI: 10.3389/fped.2020.565039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Lorenzo Lodi
- Department of Health Sciences, University of Florence, Florence, Italy.,Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | - Valentina Guarnieri
- Department of Health Sciences, University of Florence, Florence, Italy.,Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Clementina Canessa
- Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giusi Mangone
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Chiara Azzari
- Department of Health Sciences, University of Florence, Florence, Italy.,Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Silvia Ricci
- Department of Health Sciences, University of Florence, Florence, Italy.,Immunology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| |
Collapse
|
14
|
Morotti A, Forno I, Verdelli C, Guarnieri V, Terrasi A, Silipigni R, Guerneri S, Cetani F, Corbetta S, Vaira V. PO-450 Interplay between coding and non-coding genome in human parathyroid tumours. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
15
|
Pascual T, Tanioka M, Dieci MV, Pernas S, Gavila J, Guarnieri V, Cortes J, Llombart A, Conte P, Oliveira M, Paré L, Galván P, Perou CM, Prat A, Carey L. Abstract P2-09-05: Independent validation of the PAM50-based chemo-endocrine score (CES) in hormonal receptor positive (HR+)/HER2+ breast cancer (BC) treated with neoadjuvant (NA) anti-HER2-based therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. HER2+/HR+ BC is heterogeneous and subgroups with different treatment sensitivities need to be identified. We previously reported a PAM50-based CES in HR+/HER2-negative BC (Prat et al. CCR 2016). Here, we evaluated the association of CES with pathologic complete response (pCR) following anti-HER2-based therapy in HR+/HER2+ BC across 6 NA studies.
Methods. Intrinsic subtype and clinico-pathological data were obtained from 6 NA clinical studies (CHERLOB, OptiHERHEART[OHH], PAMELA, LPT109096, ICO and CALGB 40601 [CALGB is part of the Alliance for Clinical Trials in Oncology]). All patients (pts) received chemotherapy (CT) and trastuzumab, except for pts in the PAMELA study who did not receive CT. A second anti-HER2 agent (lapatinib or pertuzumab) was included in the NA of all pts in OHH and PAMELA and in one of the treatment arms in CHERLOB, LPT and C40601. CES was evaluated as a continuous variable, and categorically (CES-E[endocrine-sensitive], CES-U[uncertain] and CES-C[chemo-sensitive]) using the previously reported cut-offs. In all studies, except CHERLOB and C40601, ERBB2 mRNA levels were measured using the nCounter platform. pCR in the breast was the endpoint. We first performed statistical analyses in each dataset individually, and then in a dataset with combined patient-level data. Univariate and multivariable logistic regressions analyses were used.
Results. A total of 345 pts were included in the analysis. In the combined cohort, CES-E, CES-U and CES-C were identified in 27.5%, 23.7% and 48.6% of the pts, respectively. Table 1 summarizes the distribution and pCR rates by CES groups. In the combined cohort, CES-C was associated with higher pCR rates compared to CES-U and CES-E independent of tumor size, nodal status, anti-HER2 treatment (single vs. dual HER2 blockade), intrinsic subtype (HER2-enriched [HER2E] versus not) and study (Table 2). In the PAMELA trial (no CT), CES-C was also found associated with higher pCR rates compared to CES-E (31.6% vs. 0%). Concordant with this finding, CES-C tumors showed higher ERBB2 mRNA levels than non-CES-C (P<0.01).
Conclusion. CES shows clinical validity for predicting CT/HER2-targeting sensitivity in HER2+/HR+ BC beyond intrinsic subtype and clinicopathologic characteristics. HER2+/HR+/CES-E tumors, which represent ˜20% of all HER2+ tumors, show low sensitivity to anti-HER2 regimens (with and without CT); other treatment strategies might be needed for this group.
Support: U10CA180882;U10CA180821;U24CA196171;P50-CA58823;BCRF;Komen.
Table 1. Distribution and pCR rates of CES-E, CES-U and CES-C groups across studies.n(%pCR)LPTCHERLOBOHHICOPAMELAC40601TOTALCES-E00/9(0)1/5(20)0/7(0)0/14(0)16/60(27)17/95 (18)CES-U0/1(0)4/15(27)5/7(71)4/13(30)2/25(8)10/21(47)25/82 (30)CES-C20/29(69)12/32(37)22/28(78)15/29(52)12/38(32)3/6(50)84/162(52)P0.330.080.040.03<0.01<0.01<0.01
Table 2. Association of CES, intrinsic subtype, clinicopathologic variables and study with pCR in a multivariable model (including type of study). OR95% CIPCES CES-E1 CES-U2.91.2-7.0<0.01CES-C6.22.3-16.4<0.01T3-4 vs T1-20.40.2-0.90.02N+ vs N00.90.4-1.70.68HER2E vs not2.21.1-4.30.02AntiHER2: 2vs12.90.7-3.20.20
Citation Format: Pascual T, Tanioka M, Dieci MV, Pernas S, Gavila J, Guarnieri V, Cortes J, Llombart A, Conte P, Oliveira M, Paré L, Galván P, Perou CM, Prat A, Carey L. Independent validation of the PAM50-based chemo-endocrine score (CES) in hormonal receptor positive (HR+)/HER2+ breast cancer (BC) treated with neoadjuvant (NA) anti-HER2-based therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-05.
Collapse
Affiliation(s)
- T Pascual
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - M Tanioka
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - MV Dieci
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - S Pernas
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - J Gavila
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - V Guarnieri
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - J Cortes
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - A Llombart
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - P Conte
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - M Oliveira
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - L Paré
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - P Galván
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - CM Perou
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - A Prat
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| | - L Carey
- IDIBAPs, Hospital Clínic, Barcelona, Spain; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Padua and Veneto Institute of Oncology IOV-IRCCS, Padua, Spain; Instituto Catalán de Oncología (ICO)-Hospitalet, Barcelona, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain; Hospital Arnau de Vilanova, Valencia, Spain; Hospital Universitari Vall d' Hebro, Barcelona, Spain
| |
Collapse
|
16
|
Castellano E, Pellegrino M, Attanasio R, Guarnieri V, Maffè A, Borretta G. Primary hyperparathyroidism and Klinefelter's syndrome in a young man. Endocrinol Diabetes Metab Case Rep 2015; 2015:150019. [PMID: 25859391 PMCID: PMC4390990 DOI: 10.1530/edm-15-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 03/24/2015] [Indexed: 11/26/2022] Open
Abstract
We report the association of primary hyperparathyroidism (PHPT) and Klinefelter's syndrome (KS) in a 22-year-old male complaining of worsening fatigue. PHPT was asymptomatic at the diagnosis, but the patient had worsening hypercalcemia and osteoporosis, and developed acute renal colic. He then underwent parathyroidectomy with resection of a single adenoma and normalization of calcium and parathyroid hormone levels. Clinical and therapeutic implications of this rare association are discussed.
Collapse
Affiliation(s)
| | | | - R Attanasio
- 1 Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy
| | - V Guarnieri
- 2 Genetics Unit, Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy
| | - A Maffè
- 3 Genetics and Molecular Biology, Santa Croce and Carle, Cuneo, Italy
| | | |
Collapse
|
17
|
Verdelli C, Avagliano L, Creo P, Guarnieri V, Scillitani A, Vicentini L, Steffano GB, Beretta E, Soldati L, Costa E, Spada A, Bulfamante GP, Corbetta S. Tumour-associated fibroblasts contribute to neoangiogenesis in human parathyroid neoplasia. Endocr Relat Cancer 2015; 22:87-98. [PMID: 25515730 DOI: 10.1530/erc-14-0161] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Components of the tumour microenvironment initiate and promote cancer development. In this study, we investigated the stromal component of parathyroid neoplasia. Immunohistochemistry for alpha-smooth muscle actin (α-SMA) showed an abundant periacinar distribution of α-SMA(+) cells in normal parathyroid glands (n=3). This pattern was progressively lost in parathyroid adenomas (PAds; n=6) where α-SMA(+)cells were found to surround new microvessels, as observed in foetal parathyroid glands (n=2). Moreover, in atypical adenomas (n=5) and carcinomas (n=4), α-SMA(+) cells disappeared from the parenchyma and accumulated in the capsula and fibrous bands. At variance with normal glands, parathyroid tumours (n=37) expressed high levels of fibroblast-activation protein (FAP) transcripts, a marker of tumour-associated fibroblasts. We analysed the ability of PAd-derived cells to activate fibroblasts using human bone-marrow mesenchymal stem cells (hBM-MSCs). PAd-derived cells induced a significant increase in FAP and vascular endothelial growth factor A (VEGFA) mRNA levels in co-cultured hBM-MSCs. Furthermore, the role of the calcium-sensing receptor (CASR) and of the CXCL12/CXCR4 pathway in the PAd-induced activation of hBM-MSCs was investigated. Treatment of co-cultures of hBM-MSCs and PAd-derived cells with the CXCR4 inhibitor AMD3100 reduced the stimulated VEGFA levels, while CASR activation by the R568 agonist was ineffective. PAd-derived cells co-expressing parathyroid hormone (PTH)/CXCR4 and PTH/CXCL12 were identified by FACS, suggesting a paracrine/autocrine signalling. Finally, CXCR4 blockade by AMD3100 reduced PTH gene expression levels in PAd-derived cells. In conclusion, i) PAd-derived cells activated cells of mesenchymal origin; ii) PAd-associated fibroblasts were involved in tumuor neoangiogenesis and iii) CXCL12/CXCR4 pathway was expressed and active in PAd cells, likely contributing to parathyroid tumour neoangiogenesis and PTH synthesis modulation.
Collapse
Affiliation(s)
- C Verdelli
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - L Avagliano
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - P Creo
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - V Guarnieri
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - A Scillitani
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - L Vicentini
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - G B Steffano
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - E Beretta
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - L Soldati
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - E Costa
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - A Spada
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - G P Bulfamante
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - S Corbetta
- Laboratory of Molecular BiologyIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Human PathologySan Paolo Hospital, University of Milan, Milan, ItalyLaboratory of Stem Cells for Tissue EngineeringIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyMedical GeneticsEndocrinology UnitIRCCS Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Foggia, ItalyEndocrine SurgeryIRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, ItalySurgery UnitIRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalySurgery UnitIRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Health SciencesEndocrinology and Diabetology UnitDepartment of Clinical and Community Sciences, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, ItalyEndocrinology and Diabetology UnitDepartment of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| |
Collapse
|
18
|
Stratta P, Merlotti G, Musetti C, Quaglia M, Pagani A, Izzo C, Radin E, Airoldi A, Baorda F, Palladino T, Leone MP, Guarnieri V. Calcium-sensing-related gene mutations in hypercalcaemic hypocalciuric patients as differential diagnosis from primary hyperparathyroidism: detection of two novel inactivating mutations in an Italian population. Nephrol Dial Transplant 2014; 29:1902-1909. [DOI: 10.1093/ndt/gfu065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
19
|
Letavernier E, Letavernier E, Rodenas A, Guerrot D, Haymann JP, Quaglia M, Quaglia M, Merlotti G, Fenoglio R, Menegotto A, Izzo C, Airoldi A, Guarnieri V, Stratta P, Edvardsson V, Haroarson S, Palsson R, Thorens B, Muriel A, Olivier B, Froeder L, Calabria Baxmann A, Pfeferman Heilberg I. Mineral homeostasis and nephrolithiasis. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
20
|
Scillitani A, Guarnieri V, Battista C, Chiodini I, Salcuni AS, Minisola S, Francucci CM, Carnevale V. Carboxyl-terminal parathyroid hormone fragments: biologic effects. J Endocrinol Invest 2011; 34:23-6. [PMID: 21985976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Carboxyl-terminal PTH fragments (C-PTH), are generated by both direct secretion from parathyroids in relation to serum calcium levels and catabolism of PTH operated by the Kupffer cells in the liver. These molecular fragments have been till recently regarded as inert byproducts of PTH metabolism, since they do not interact with the PTH/PTH-related peptide (rP) receptor, which mediates the classical hormone actions. Current findings instead indicate that C-PTH would interact with a putative C-PTH receptor. This way, C-PTH seem to exert specific effects on calcium homeostasis and bone metabolism, opposite to those of the synthetic agonist of PTH/PTHrP receptor (i.e. PTH 1-34). In vitro and in vivo data actually indicate that C-PTH, by interacting with specific receptors, could have an anti-calcemic action, as well as a pro-apoptotic effect on both osteocytes and osteoclasts. This in turn could result in a reduced activity of the latter cells, with a consequent inhibition of bone resorption.
Collapse
Affiliation(s)
- A Scillitani
- Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Foggia, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Pepe J, Cipriani C, Pilotto R, De Lucia F, Castro C, Lenge L, Russo S, Guarnieri V, Scillitani A, Carnevale V, D'Erasmo E, Romagnoli E, Minisola S. Sporadic and hereditary primary hyperparathyroidism. J Endocrinol Invest 2011; 34:40-4. [PMID: 21985979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Primary hyperparathyroidism (PHPT) is a common endocrine disorder, particularly frequent in post-menopausal women. It is characterized by hypercalcemia with inappropriately high spontaneous plasma PTH. Singlegland adenoma is the most common cause (75- 85%). PHPT is usually a sporadic disease but in approximately <5% of cases, a familial hyperparathyroid syndrome is diagnosed. Familial hyperparathyroidism is a clinically and genetically heterogeneous group of disorders including: multiple endocrine neoplasia (MEN) type 1, MEN type 2A, MEN4, benign familial hypocalciuric hypercalcemia, neonatal severe hyperparathyroidism, hyperparathyroidism-jaw tumor syndrome, and familial isolated hyperparathyroidism. These syndromes show mendelian inheritance patterns and the main genes for most of them have been defined. The classic form of PHPT, which presents with hypercalcemia, kidney stones, and bone disease, is no longer common. Currently, there is an increasing interest in the subtle manifestations of PHPT, particularly the cardiovascular and neuropsychiatric manifestations. Parathyroidectomy is the definitive cure for PHPT even though patients with the asymptomatic form of the disease can be followed conservatively.
Collapse
Affiliation(s)
- J Pepe
- Department of Internal Medicine and Medical Disciplines, University of Rome Sapienza, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Corbetta S, Vaira V, Guarnieri V, Scillitani A, Eller-Vainicher C, Ferrero S, Vicentini L, Chiodini I, Bisceglia M, Beck-Peccoz P, Bosari S, Spada A. Differential expression of microRNAs in human parathyroid carcinomas compared with normal parathyroid tissue. Endocr Relat Cancer 2010; 17:135-46. [PMID: 19926710 DOI: 10.1677/erc-09-0134] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Parathyroid carcinoma (PaC) is a rare cause of primary hyperparathyroidism. Though the loss of the oncosuppressor CDC73/HRPT2 gene product, parafibromin, has been involved in the hyperparathyroidism-jaw tumor syndrome and in a consistent set of sporadic PaCs, parathyroid carcinogenesis remains obscure. MicroRNAs are a new class of small, non-coding RNAs implicated in development of cancer, since their deregulation can induce aberrant expression of several target genes. The aim of the present study was to identify differentially expressed microRNAs in parathyroid cancers compared with normal tissues. We performed a TaqMan low-density array profiling of four parathyroid cancers harboring CDC73 inactivating mutations and negative for parafibromin immunostaining. Their microRNA profiling was compared with that of two normal parathyroid biopsies. Out of 362 human microRNAs assayed, 279 (77%) were successfully amplified. Fourteen and three microRNAs were significantly down- and over-expressed in parathyroid cancers respectively. Of these, miR-296 and miR-139 were down-regulated, and miR-503 and miR-222 were over-expressed with a null false discovery rate. Carcinomas could be discriminated from parathyroid adenomas by a computed score based on the expression levels of miR-296, miR-222, and miR-503 as miR-139 was similarly down-regulated in both cancers and adenomas. Finally, miR-296 and miR-222 levels negatively correlated with mRNA levels of the hepatocyte growth factor receptor-regulated tyrosine kinase substrate and p27/kip1 levels respectively. These results suggest the existence of an altered microRNA expression pattern in PaCs together with a potential role of miR-296 as novel oncosuppressor gene in these neoplasia.
Collapse
Affiliation(s)
- S Corbetta
- Endocrinology and Diabetology Unit, Department of Medical-Surgical Sciences, Università di Milano, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Lobascio C, Briccarello M, Destefanis R, Faraud M, Gialanella G, Grossi G, Guarnieri V, Manti L, Pugliese M, Rusek A, Scampoli P, Durante M. Accelerator-based tests of radiation shielding properties of materials used in human space infrastructures. Health Phys 2008; 94:242-247. [PMID: 18301097 DOI: 10.1097/01.hp.0000288560.21906.4e] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Shielding is the only practical countermeasure for the exposure to cosmic radiation during space travel. It is well known that light, hydrogenated materials, such as water and polyethylene, provide the best shielding against space radiation. Kevlar and Nextel are two materials of great interest for spacecraft shielding because of their known ability to protect human space infrastructures from meteoroids and debris. We measured the response to simulated heavy-ion cosmic radiation of these shielding materials and compared it to polyethylene, Lucite (PMMA), and aluminum. As proxy to galactic nuclei we used 1 GeV n iron or titanium ions. Both physics and biology tests were performed. The results show that Kevlar, which is rich in carbon atoms (about 50% in number), is an excellent space radiation shielding material. Physics tests show that its effectiveness is close (80-90%) to that of polyethylene, and biology data suggest that it can reduce the chromosomal damage more efficiently than PMMA. Nextel is less efficient as a radiation shield, and the expected reduction on dose is roughly half that provided by the same mass of polyethylene. Both Kevlar and Nextel are more effective than aluminum in the attenuation of heavy-ion dose.
Collapse
Affiliation(s)
- C Lobascio
- Thales Alenia Space Italia SpA, Turin, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
D'Amelio M, Ricci I, Sacco R, Liu X, D'Agruma L, Muscarella LA, Guarnieri V, Militerni R, Bravaccio C, Elia M, Schneider C, Melmed R, Trillo S, Pascucci T, Puglisi-Allegra S, Reichelt KL, Macciardi F, Holden JJA, Persico AM. Paraoxonase gene variants are associated with autism in North America, but not in Italy: possible regional specificity in gene-environment interactions. Mol Psychiatry 2005; 10:1006-16. [PMID: 16027737 DOI: 10.1038/sj.mp.4001714] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Organophosphates (OPs) are routinely used as pesticides in agriculture and as insecticides within the household. Our prior work on Reelin and APOE delineated a gene-environment interactive model of autism pathogenesis, whereby genetically vulnerable individuals prenatally exposed to OPs during critical periods in neurodevelopment could undergo altered neuronal migration, resulting in an autistic syndrome. Since household use of OPs is far greater in the USA than in Italy, this model was predicted to hold validity in North America, but not in Europe. Here, we indirectly test this hypothesis by assessing linkage/association between autism and variants of the paraoxonase gene (PON1) encoding paraoxonase, the enzyme responsible for OP detoxification. Three functional single nucleotide polymorphisms, PON1 C-108T, L55M, and Q192R, were assessed in 177 Italian and 107 Caucasian-American complete trios with primary autistic probands. As predicted, Caucasian-American and not Italian families display a significant association between autism and PON1 variants less active in vitro on the OP diazinon (R192), according to case-control contrasts (Q192R: chi2=6.33, 1 df, P<0.025), transmission/disequilibrium tests (Q192R: TDT chi2=5.26, 1 df, P<0.025), family-based association tests (Q192R and L55M: FBAT Z=2.291 and 2.435 respectively, P<0.025), and haplotype-based association tests (L55/R192: HBAT Z=2.430, P<0.025). These results are consistent with our model and provide further support for the hypothesis that concurrent genetic vulnerability and environmental OP exposure may possibly contribute to autism pathogenesis in a sizable subgroup of North American individuals.
Collapse
Affiliation(s)
- M D'Amelio
- Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Persico AM, D'Agruma L, Zelante L, Militerni R, Bravaccio C, Schneider C, Melmed R, Trillo S, Montecchi F, Elia M, Palermo M, Rabinowitz D, Pascucci T, Puglisi-Allegra S, Reichelt KL, Muscarella L, Guarnieri V, Melgari JM, Conciatori M, Keller F. Enhanced APOE2 transmission rates in families with autistic probands. Psychiatr Genet 2005; 14:73-82. [PMID: 15167692 DOI: 10.1097/01.ypg.0000128768.37838.17] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We have previously described linkage/association between reelin gene polymorphisms and autistic disorder. APOE also participates in the Reelin signaling pathway, by competitively antagonizing Reelin binding to APOE receptor 2 and to very-low-density lipoprotein receptors. The APOE2 protein variant displays the lowest receptor binding affinity compared with APOE3 and APOE4. In this study, we assess linkage/association between primary autism and APOE alleles in 223 complete trios, from 119 simplex Italian families and 44 simplex and 29 multiplex Caucasian-American families. Statistically significant disequilibrium favors the transmission of epsilon2 alleles to autistic offspring, over epsilon3 and epsilon4 (allele-wise transmission/disequilibrium test [TDT], chi2 = 6.16, 2 degrees of freedom [d.f.], P<0.05; genotype-wise TDT, chi2 = 10.68, 3 d.f., P<0.05). A novel epsilon3r allele was also discovered in an autistic child and his mother. Autistic patients do not differ significantly from unaffected siblings (allele-wise TDT comparing autistic patients versus unaffected sibs, chi2 = 1.83, 2 d.f., P<0.40, not significant). The major limitation of this study consists of our small sample size of trios including one unaffected sibling, currently not possessing the statistical power necessary to conclusively discriminate a specific association of epsilon2 with autism, from a distorted segregation pattern characterized by enhanced epsilon2 transmission rates both to affected and unaffected offspring. Our findings are thus compatible with either (a) pathogenetic contributions by epsilon2 alleles to autism spectrum vulnerability, requiring additional environmental and/or genetic factors to yield an autistic syndrome, and/or (b) a protective effect of epsilon2 alleles against the enhanced risk of miscarriage and infertility previously described among parents of autistic children.
Collapse
Affiliation(s)
- A M Persico
- Laboratory of Molecular Psychiatry and Neurogenetics, University 'Campus Bio-Medico', Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Costantino P, Norelli F, Giannozzi A, D'Ascenzi S, Bartoloni A, Kaur S, Tang D, Seid R, Viti S, Paffetti R, Bigio M, Pennatini C, Averani G, Guarnieri V, Gallo E, Ravenscroft N, Lazzeroni C, Rappuoli R, Ceccarini C. Size fractionation of bacterial capsular polysaccharides for their use in conjugate vaccines. Vaccine 1999; 17:1251-63. [PMID: 10195638 DOI: 10.1016/s0264-410x(98)00348-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We have developed a chromatographic method suitable for the fractionation of polysaccharides having a negatively charged group. The method permits the removal of all those polysaccharide fragments having a short sequence and which are likely unsuitable for conjugate vaccine construction. The selected polysaccharide fragments can be used to produce glycoconjugate vaccines containing a restricted saccharide polydispersion. We have applied this chromatographic method to three different antigens, Haemophilus influenzae type b and Neisseria meningitidis group A and group C polysaccharides. The method is easily adapted for manufacturing purposes.
Collapse
|
27
|
Granoff DM, Bartoloni A, Ricci S, Gallo E, Rosa D, Ravenscroft N, Guarnieri V, Seid RC, Shan A, Usinger WR, Tan S, McHugh YE, Moe GR. Bactericidal Monoclonal Antibodies That Define Unique Meningococcal B Polysaccharide Epitopes That Do Not Cross-React with Human Polysialic Acid. The Journal of Immunology 1998. [DOI: 10.4049/jimmunol.160.10.5028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
The poor immunogenicity of the Neisseria meningitidis group B polysaccharide capsule, a homopolymer of α(2→8) sialic acid, has been attributed to immunologic tolerance induced by prenatal exposure to host polysialyated glycoproteins. Substitution of N-propionyl (N-Pr) for N-acetyl groups on the meningococcal B polysaccharide, and conjugation of the resulting polysaccharide to a protein carrier, have been reported to yield a conjugate vaccine that elicits protective Abs with minimal autoantibody activity. To characterize the protective epitopes on the derivatized polysaccharide, we isolated 30 anti-N-Pr meningococcal B polysaccharide mAbs. These Abs were heterogeneous with respect to complement-mediated bactericidal activity, fine antigenic specificity, and autoantibody activity as defined by binding to the neuroblastoma cell line, CHP-134, which expresses long-chain α(2→8)-linked polysialic acid. Eighteen of the Abs could activate complement-mediated bacteriolysis. Seven of these 18 Abs cross-reacted with N-acetyl meningococcal B polysaccharide by ELISA and had strong autoantibody activity. Thus, N-Pr meningococcal B polysaccharide conjugate vaccine has the potential to elicit autoantibodies. However, 7 of the 18 bactericidal mAbs had no detectable autoantibody activity. These Abs may be useful for the identification of molecular mimetics capable of eliciting protective Abs specific to the bacteria, without the risk of evoking autoimmune disease.
Collapse
Affiliation(s)
- Dan M. Granoff
- *Chiron Vaccines, Emeryville, CA 94608
- ‡Children’s Hospital Oakland Research Institute, Oakland, CA 94609
| | | | | | | | | | | | | | | | - Asra Shan
- ‡Children’s Hospital Oakland Research Institute, Oakland, CA 94609
| | | | - Siqi Tan
- ‡Children’s Hospital Oakland Research Institute, Oakland, CA 94609
| | | | - Gregory R. Moe
- ‡Children’s Hospital Oakland Research Institute, Oakland, CA 94609
| |
Collapse
|
28
|
Granoff DM, Bartoloni A, Ricci S, Gallo E, Rosa D, Ravenscroft N, Guarnieri V, Seid RC, Shan A, Usinger WR, Tan S, McHugh YE, Moe GR. Bactericidal monoclonal antibodies that define unique meningococcal B polysaccharide epitopes that do not cross-react with human polysialic acid. J Immunol 1998; 160:5028-36. [PMID: 9590252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The poor immunogenicity of the Neisseria meningitidis group B polysaccharide capsule, a homopolymer of alpha(2-->8) sialic acid, has been attributed to immunologic tolerance induced by prenatal exposure to host polysialyated glycoproteins. Substitution of N-propionyl (N-Pr) for N-acetyl groups on the meningococcal B polysaccharide, and conjugation of the resulting polysaccharide to a protein carrier, have been reported to yield a conjugate vaccine that elicits protective Abs with minimal autoantibody activity. To characterize the protective epitopes on the derivatized polysaccharide, we isolated 30 anti-N-Pr meningococcal B polysaccharide mAbs. These Abs were heterogeneous with respect to complement-mediated bactericidal activity, fine antigenic specificity, and autoantibody activity as defined by binding to the neuroblastoma cell line, CHP-134, which expresses long-chain a(2-->8)-linked polysialic acid. Eighteen of the Abs could activate complement-mediated bacteriolysis. Seven of these 18 Abs cross-reacted with N-acetyl meningococcal B polysaccharide by ELISA and had strong autoantibody activity. Thus, N-Pr meningococcal B polysaccharide conjugate vaccine has the potential to elicit autoantibodies. However, 7 of the 18 bactericidal mAbs had no detectable autoantibody activity. These Abs may be useful for the identification of molecular mimetics capable of eliciting protective Abs specific to the bacteria, without the risk of evoking autoimmune disease.
Collapse
|
29
|
Ciamberlini C, Guarnieri V, Longobardi G, Poggi P, Donati MC, Panzardi G. Indocyanine green videoangiography using cooled charge-coupled devices in central serous choroidopathy. J Biomed Opt 1997; 2:218-225. [PMID: 23014876 DOI: 10.1117/12.268939] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
30
|
Guarnieri V, Gaia E, Battocchio L, Pitzurra M, Savino A, Pasquarella C, Vago T, Cotronei V. New methods for microbial contamination monitoring: an experiment on board the MIR orbital station. Acta Astronaut 1997; 40:195-201. [PMID: 11540769 DOI: 10.1016/s0094-5765(97)00102-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Experiment T2, carried out during the Euromir'95 mission, was an important step toward innovative methods for spacecraft microbial contamination monitoring. A new standard sampling technique permitted samples to be analysed by different means. On board, two analysis methods were tested in parallel: Bioluminescence and Miniculture. In turn, downloaded samples are being analysed by polymerase chain reaction (PCR), a powerful and promising method for the rapid detection, identification and quantification of pathogens and biofouling agents in closed manned habitats.
Collapse
|
31
|
Cescutti P, Bigio M, Guarnieri V. Determination of the size and degree of acetyl substitution of oligosaccharides from Neisseria meningitidis group A by ionspray mass spectrometry. Biochem Biophys Res Commun 1996; 224:444-50. [PMID: 8702408 DOI: 10.1006/bbrc.1996.1046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The capsular polysaccharide produced by Neisseria meningitidis group A has the following structure: [formula: see text] [formula: see text] This polysaccharide was partially hydrolysed with acetic acid, and the oligomers obtained were separated by fast performance liquid chromatography. Six fractions were collected and characterised by ionspray mass spectrometry in the positive ion mode. This soft ionisation technique established the size of the obtained oligosaccharides and the degree of O-acetyl substitution for each fraction.
Collapse
Affiliation(s)
- P Cescutti
- Dipartimento di Biochimica, Biofisica e Chimica delle Macromolecole, Trieste, Italy.
| | | | | |
Collapse
|