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Guerrini R, Conti V. Epileptic encephalopathies and progressive neurodegeneration. Rev Neurol (Paris) 2024:S0035-3787(24)00481-8. [PMID: 38582661 DOI: 10.1016/j.neurol.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
Developmental encephalopathies (DE), epileptic encephalopathies (EE) and developmental and epileptic encephalopathies (DEE) are overlapping neurodevelopmental disorders characterized by early-onset, often severe epileptic seizures, developmental delay, or regression and have multiple etiologies. Classical nosology in child neurology distinguished progressive and nonprogressive conditions. A progressive course with global cognitive worsening in DEE is usually attributed to severe seizures and electroencephalographic abnormalities whose deleterious effects interfere with developmental processes both in an apparently healthy brain and in an anatomically compromised one. Next generation sequencing and functional studies have helped identifying and characterizing clinical conditions, each with a broad spectrum of clinical and anatomic severity corresponding to a variable level of neurodegeneration, such that both a rapidly progressive course and considerably milder phenotypes with no obvious deterioration can be configured with mutations in the same gene. In this mini review, we present examples of genetic DEE that draw connections between neurodevelopmental and neurodegenerative disorders.
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Affiliation(s)
- R Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy; Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
| | - V Conti
- Neuroscience Department, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, 50139 Florence, Italy
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Beretta M, Paglia M, Di Lorenzo E, Conti V, Marzo G, Gatto R, Mattei A, Colombo S. ZeroExpander® effectiveness assessment in PEEK or PA12 in a group of paediatric patients with transverse maxillary deficiency. Eur J Paediatr Dent 2024:1. [PMID: 38623062 DOI: 10.23804/ejpd.2024.2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
AIM The aim of this article is to compare the performance of ZeroExpander® realised using PEEK or PA12 for the expansion of the maxilla in paediatric patients, exploring a new concept for approaching maxillary expansion with a metal-free fixed automatic appliance, based on pre-programmed set-up and anchored on deciduous teeth. MATERIALS It is a retrospective comparative study with a sample of 40 children in early or mixed deciduous dentition and transversal maxillary deficit, 20 treated with ZeroExpander® in PEEK and 20 treated with ZeroExpander® in PA12 with a mean age of 7.3 years old. The intraoral scans at T0 and at the end of the expansion were all performed by the same operator to obtain digital models on which were performed measurements by two other different operators. A descriptive analysis was conducted using frequencies and percentages for nominal variables and means and standard deviations for continuous variables. CONCLUSION In cases of allergy or hypersensitivity to metals or to specific chronic or acute pathological conditions, which may require periodic magnetic resonance imaging (MRI), it may not be possible to use traditional and metal fixed expansion devices. Moreover the concept of autonomous driving in paediatric orthodontics is not only possible, but it is and will be more real and very useful in the future. The "ortho-paediatric dentistry concept" will increase the range of benefits for children and their families which, in addition to care and thanks to technology, demand well-being, safety, comfort and quality of life beyond clinics.
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Affiliation(s)
- M Beretta
- DDS, MS Ortho, MS Digital Dentistry, Adjunct Professor Postgraduate School of Orthodontics, University of Brescia, and for the Master of Digital Paediatric Dentistry, University of L'Aquila, Private Practice in Varese, Italy
| | - M Paglia
- DDS,MS Ortho, MS Paediatric dentistry, Department of Maternal and Paediatric dentistry Italian Stomatological Institute Milan Italy and private practice in Milan , Italy
| | - E Di Lorenzo
- DDS, MS Ortho, Private Practice in Varese, Italy
| | - V Conti
- DDS, MS Ortho, Private Practice in Varese, Italy
| | - G Marzo
- Ordinary professor in Orthodontics, Department of Life, Health and Environmental Sciences, University of L'Aquila -Dean of Postagraduate School of Orthodontics, L'Aquila, Italy
| | - R Gatto
- Ordinary Professor in Paediatric Dentistry, Department of Life , Health and Environmental Science, Dean of Postagraduate School of Paediatric Dentistry , University of L' Aquila, L'Aquila, Italy
| | - A Mattei
- Associate Professor of Medical Statistics, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - S Colombo
- DDS, MS Ortho, Private Practice in Milan, Italy
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Conti V, Bertini N, Ricciardi R, Stefanelli B, De Bellis E, Sellitto C, Cascella M, Sabbatino F, Corbi G, Pagliano P, Filippelli A. Adverse events related to drug-drug interactions in COVID-19 patients. A persistent concern in the post-pandemic era: a systematic review. Expert Opin Drug Metab Toxicol 2024; 20:275-292. [PMID: 38568077 DOI: 10.1080/17425255.2024.2339397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Since COVID-19 patients are often polytreated, monitoring drug-drug interaction (DDIs) is necessary. We evaluated whether drugs used after the second COVID-19 pandemic wave were associated with DDI-related adverse events and the role of drug interaction checkers in identifying them. METHODS The study (PROSPERO-ID: CRD42024507634) included: 1) consulting the drug interaction checkers Drugs.com, Liverpool COVID-19 Interactions, LexiComp, Medscape, and Micromedex; 2) systematic review; 3) reviewed studies analysis; 4) evaluating drug interaction checkers potential to anticipate DDI-related adverse events.The systematic review was performed searching PubMed, Scopus, ScienceDirect, and Cochrane databases from 1 March 2022 to 11 November 2023. Observational studies, and clinical trials were included. Article without reporting direct association between DDIs and adverse events were excluded. The risk of bias was assessed by Newcastle-Ottawa scale. RESULTS The most frequent DDIs involved nirmatrelvir/ritonavir (N/R) and fluvoxamine. Fifteen studies, including 150 patients and 35 DDI-related outcomes, were analyzed. The most frequent DDIs involved tacrolimus with N/R, resulting in creatinine increase.Eighty percent of reported DDI-related adverse events would have been identified by all drug-interaction checkers, while the remaining 20% by at least 2 of them. CONCLUSIONS Drug interaction checkers are useful but show inconsistencies. Multiple sources are needed to tailor treatment in the context of COVID-19.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Nicola Bertini
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
| | - Rosaria Ricciardi
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Emanuela De Bellis
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Marco Cascella
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Infectious Disease Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
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Polcaro G, Liguori L, Manzo V, Chianese A, Donadio G, Caputo A, Scognamiglio G, Dell'Annunziata F, Langella M, Corbi G, Ottaiano A, Cascella M, Perri F, De Marco M, Col JD, Nassa G, Giurato G, Zeppa P, Filippelli A, Franci G, Piaz FD, Conti V, Pepe S, Sabbatino F. rs822336 binding to C/EBPβ and NFIC modulates induction of PD-L1 expression and predicts anti-PD-1/PD-L1 therapy in advanced NSCLC. Mol Cancer 2024; 23:63. [PMID: 38528526 PMCID: PMC10962156 DOI: 10.1186/s12943-024-01976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
Efficient predictive biomarkers are needed for immune checkpoint inhibitor (ICI)-based immunotherapy in non-small cell lung cancer (NSCLC). Testing the predictive value of single nucleotide polymorphisms (SNPs) in programmed cell death 1 (PD-1) or its ligand 1 (PD-L1) has shown contrasting results. Here, we aim to validate the predictive value of PD-L1 SNPs in advanced NSCLC patients treated with ICIs as well as to define the molecular mechanisms underlying the role of the identified SNP candidate. rs822336 efficiently predicted response to anti-PD-1/PD-L1 immunotherapy in advanced non-oncogene addicted NSCLC patients as compared to rs2282055 and rs4143815. rs822336 mapped to the promoter/enhancer region of PD-L1, differentially affecting the induction of PD-L1 expression in human NSCLC cell lines as well as their susceptibility to HLA class I antigen matched PBMCs incubated with anti-PD-1 monoclonal antibody nivolumab. The induction of PD-L1 expression by rs822336 was mediated by a competitive allele-specificity binding of two identified transcription factors: C/EBPβ and NFIC. As a result, silencing of C/EBPβ and NFIC differentially regulated the induction of PD-L1 expression in human NSCLC cell lines carrying different rs822336 genotypes. Analysis by binding microarray further validated the competitive allele-specificity binding of C/EBPβ and NFIC to PD-L1 promoter/enhancer region based on rs822336 genotype in human NSCLC cell lines. These findings have high clinical relevance since identify rs822336 and induction of PD-L1 expression as novel biomarkers for predicting anti-PD-1/PD-L1-based immunotherapy in advanced NSCLC patients.
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Affiliation(s)
- Giovanna Polcaro
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Luigi Liguori
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Naples "Federico II", Naples, 80131, Italy
| | - Valentina Manzo
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
| | - Annalisa Chianese
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Giuliana Donadio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Alessandro Caputo
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
- Pathology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Giosuè Scognamiglio
- Pathology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Federica Dell'Annunziata
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Maddalena Langella
- Hematology and Transplant Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, 80131, Italy
| | - Alessandro Ottaiano
- Division of Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Marco Cascella
- Unit of Anesthesiology, Intensive Care Medicine, and Pain Medicine, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Francesco Perri
- Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Margot De Marco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Jessica Dal Col
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Giovanni Nassa
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Giorgio Giurato
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Pio Zeppa
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
- Pathology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Amelia Filippelli
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
| | - Gianluigi Franci
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
- Clinical Microbiology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Fabrizio Dal Piaz
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy
| | - Valeria Conti
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy.
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy.
| | - Stefano Pepe
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy.
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy.
| | - Francesco Sabbatino
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy.
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, 84131, Italy.
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Carollo M, Boccardi V, Crisafulli S, Conti V, Gnerre P, Miozzo S, Omodeo Salè E, Pieraccini F, Zamboni M, Marengoni A, Onder G, Trifirò G. Medication review and deprescribing in different healthcare settings: a position statement from an Italian scientific consortium. Aging Clin Exp Res 2024; 36:63. [PMID: 38459218 PMCID: PMC10923734 DOI: 10.1007/s40520-023-02679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/17/2023] [Indexed: 03/10/2024]
Abstract
Recent medical advancements have increased life expectancy, leading to a surge in patients affected by multiple chronic diseases and consequent polypharmacy, especially among older adults. This scenario increases the risk of drug interactions and adverse drug reactions, highlighting the need for medication review and deprescribing to reduce inappropriate medications and optimize therapeutic regimens, with the ultimate goal to improving patients' health and quality of life. This position statement from the Italian Scientific Consortium on medication review and deprescribing aims to describe key elements, strategies, tools, timing, and healthcare professionals to be involved, for the implementation of medication review and deprescribing in different healthcare settings (i.e., primary care, hospital, long-term care facilities, and palliative care). Challenges and potential solutions for the implementation of medication review and deprescribing are also discussed.
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Affiliation(s)
- Massimo Carollo
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy
| | - Virginia Boccardi
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Salvatore Crisafulli
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy
| | - Valeria Conti
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Simonetta Miozzo
- Italian Society of General Medicine and Primary Care, Florence, Italy
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO European Institute of Oncology IRCCS, Milan, Italy
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | | | - Mauro Zamboni
- Department of Medicine-Geriatric Division, University of Verona, Verona, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Graziano Onder
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy.
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Cascella M, Capuozzo M, Ferrara F, Ottaiano A, Perri F, Sabbatino F, Conti V, Santoriello V, Ponsiglione AM, Romano M, Amato F, Piazza O. Two-year Opioid Prescription Trends in Local Sanitary Agency Naples 3 South, Campania Region, Italy. Descriptive Analyses and AI-based Translational Perspectives. Transl Med UniSa 2024; 26:1-14. [PMID: 38560616 PMCID: PMC10980290 DOI: 10.37825/2239-9747.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 04/04/2024] Open
Abstract
Aims This study delves into the two-year opioid prescription trends in the Local Sanitary Agency Naples 3 South, Campania Region, Italy. The research aims to elucidate prescribing patterns, demographics, and dosage categories within a population representing 1.7% of the national total. Perspectives on artificial intelligence research are discussed. Methods From the original dataset, spanning from January 2022 to October 2023, we processed multiple variables including demographic data, medications, dosages, drug consumption, and administration routes. The dispensing quantity was calculated as defined daily doses (DDD). Results The analysis reveals a conservative approach to opioid therapy. In subjects under the age of 20, prescriptions accounted for 2.1% in 2022 and declined to 1.4% in 2023. The drug combination paracetamol/codeine was the most frequently prescribed, followed by tapentadol. Approximately two-thirds of the consumption pertains to oral formulations. Transdermal formulations were 15% (fentanyl 9.8%, buprenorphine 5.1%) in 2022; and 16.6% (fentanyl 10%, buprenorphine 6.6%) in 2023. These data were confirmed by the DDD analysis. The trend analysis demonstrated a significant reduction ( p < 0.001) in the number of prescribed opioids from 2022 to 2023 in adults (40-69 years). The study of rapid-onset opioids (ROOs), drugs specifically used for breakthrough cancer pain, showed higher dosage (>267 mcg) consumption among women, whereas a lower dosage (<133 mcg) was calculated for men. Fentanyl pectin nasal spray accounted for approximately one-fifth of all ROOs. Conclusion Despite limitations, the study provides valuable insights into prescribing practices involving an important study population. The findings underscore the need for tailored approaches to prescribing practices, recognizing the complexities of pain management in different contexts. This research can contribute to the ongoing discourse on opioid use, advocating for innovative strategies that optimize therapeutic outcomes while mitigating potential risks.
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Affiliation(s)
- Marco Cascella
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Salerno,
Italy
| | - Maurizio Capuozzo
- Pharmaceutical Department, ASL Napoli 3 Sud, Ercolano, 80056, Naples,
Italy
| | - Francesco Ferrara
- Pharmaceutical Department, ASL Napoli 3 Sud, Ercolano, 80056, Naples,
Italy
| | - Alessandro Ottaiano
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, via M. Semmola, 80131, Naples,
Italy
| | - Francesco Perri
- Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, via M. Semmola, 80131, Naples,
Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Salerno,
Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Salerno,
Italy
| | - Vittorio Santoriello
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, 80125, Naples,
Italy
| | - Alfonso Maria Ponsiglione
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, 80125, Naples,
Italy
| | - Maria Romano
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, 80125, Naples,
Italy
| | - Francesco Amato
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, 80125, Naples,
Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Salerno,
Italy
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Parri S, Campani T, Conti V, Cai G, Romi M, Casini S, Zari R, Caldini F, Marsili L. New olive-pomace fertilizer tested with a 2-tiers approach: Biomarkers on Eisenia fetida, physiochemical effects on Solanum lycopersicum and Olea europaea. J Environ Manage 2024; 351:119915. [PMID: 38169256 DOI: 10.1016/j.jenvman.2023.119915] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Every year, the olive oil industry generates a substantial amount of pomace, a semi-solid residue made up of skin, pulp, pit, and kernel fragments. Rather than being disposed of, the pomace can be dried and transported to an extraction facility where pomace oil can be extracted. Utilizing its high thermal capacity, the extracted pomace can be used as a supplementary fuel in the drying process, resulting in the production of ashes. In this study, the effect of pomace waste applied to the soil was investigated by testing two mixtures with different proportions of de-oiled pomace flour and kernel ash (50:50 and 70:30, respectively) in powder and pellet form. We used a dual approach, evaluating the effects of the mixtures on both soil communities and plant physiology and productivity, to assess the actual usability of the fertilizer in agriculture. The biomarker approach was valuable in assessing the sublethal effects of the two mixtures in powder form in soil. After 30 days of exposure, the bioindicator organism Eisena fetida showed lipid peroxidation, glutathione S-transferase and lactate dehydrogenase levels similar to the control, while lysozyme activity was reduced in all treatments. The powder mixture was lethal to the tomato plants, while there was no evidence of any damage to the olive trees. During 60 days of monitoring, both mixtures in pellet form showed a slight increase in physiological parameters, suggesting a benefit to the photosynthetic system. The improved carbon assimilation in tomato plants treated with the mixtures results in increased plant productivity, both in terms of number and weight of fruits, while maintaining the antioxidant content. This study paves the way for the use of the pomace mixture as a soil improver, thus increasing the value of this waste product.
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Affiliation(s)
- S Parri
- Department of Life Science, University of Siena, 53100, Siena, Italy
| | - T Campani
- Department of Physical, Sciences, Earth and Environment, University of Siena, 53100, Siena, Italy.
| | - V Conti
- Department of Biological, Geological and Environmental Sciences, University of Bologna, 40126, Bologna, Italy
| | - G Cai
- Department of Life Science, University of Siena, 53100, Siena, Italy
| | - M Romi
- Department of Life Science, University of Siena, 53100, Siena, Italy
| | - S Casini
- Department of Physical, Sciences, Earth and Environment, University of Siena, 53100, Siena, Italy
| | - R Zari
- Studio ZARI Agronomi & Forestali, 53014, Monteroni d'Arbia, Siena, Italy
| | - F Caldini
- Caldini Guido s.r.l., 53030, Radicondoli, Siena, Italy
| | - L Marsili
- Department of Physical, Sciences, Earth and Environment, University of Siena, 53100, Siena, Italy
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Iacotucci P, Carnovale V, Ferrillo L, Somma J, Bocchino M, D’Ippolito M, Sanduzzi Zamparelli A, Rengo G, Ferrara N, Conti V, Corbi G. Cystic Fibrosis in Adults: A Paradigm of Frailty Syndrome? An Observational Study. J Clin Med 2024; 13:585. [PMID: 38276090 PMCID: PMC10816671 DOI: 10.3390/jcm13020585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
This study aimed to assess the main clinical and anamnestic characteristics of adult Cystic Fibrosis (CF) patients and to evaluate the association of frailty with the CF genotyping classification. In an observational cross-sectional study, all ambulatory CF patients over 18 years old who received a diagnosis at the Regional Cystic Fibrosis Center for adults were enrolled and assessed by spirometry for respiratory function, by ADL and IADL for functional status, and by the Study of Osteoporotic Fractures (SOF) Index for frailty. The study population consisted of 139 CF patients (mean age 32.89 ± 10.94 years old, 46% women). Most of the subjects were robust (60.4%). The pre-frail/frail group was more frequently females (p = 0.020), had a lower BMI (p = 0.001), worse respiratory function, a higher number of pulmonary exacerbations/years, cycles of antibiotic therapy, and hospitalization (all p < 0.001) with respect to robust patients. The pre-frail/frail subjects used more drugs and were affected by more CF-related diseases (all p < 0.001). In relation to logistic regression, the best predictor of the pre-frail/frail status was a low FEV1 level. The CF patients show similarities to older pre-frail/frail subjects, suggesting that CF might be considered an early expression of this geriatric syndrome. This finding could help to better define the possible progression of CF, but overall, it could also suggest the usefulness employing of some tools used in the management and therapy of frailty subjects to identify the more severe CF subjects.
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Affiliation(s)
- Paola Iacotucci
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Vincenzo Carnovale
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Lorenza Ferrillo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Jolanda Somma
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Marialuisa Bocchino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Marcella D’Ippolito
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Valeria Conti
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, 84084 Salerno, Italy;
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
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9
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De Simone M, Conti V, Palermo G, De Maria L, Iaconetta G. Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques. Biomedicines 2023; 12:8. [PMID: 38275370 PMCID: PMC10813759 DOI: 10.3390/biomedicines12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Despite significant advances in understanding the molecular pathways of glioma, translating this knowledge into effective long-term solutions remains a challenge. Indeed, gliomas pose a significant challenge to neurosurgical oncology because of their diverse histopathological features, genetic heterogeneity, and clinical manifestations. Relevant sections: This study focuses on glioma complexity by reviewing recent advances in their management, also considering new classification systems and emerging neurosurgical techniques. To bridge the gap between new neurosurgical approaches and standards of care, the importance of molecular diagnosis and the use of techniques such as laser interstitial thermal therapy (LITT) and focused ultrasound (FUS) are emphasized, exploring how the integration of molecular knowledge with emerging neurosurgical approaches can personalize and improve the treatment of gliomas. CONCLUSIONS The choice between LITT and FUS should be tailored to each case, considering factors such as tumor characteristics and patient health. LITT is favored for larger, complex tumors, while FUS is standard for smaller, deep-seated ones. Both techniques are equally effective for small and superficial tumors. Our study provides clear guidance for treating pediatric low-grade gliomas and highlights the crucial roles of LITT and FUS in managing high-grade gliomas in adults. This research sets the stage for improved patient care and future developments in the field of neurosurgery.
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Affiliation(s)
- Matteo De Simone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
| | - Giuseppina Palermo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
| | - Lucio De Maria
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25123 Brescia, Italy;
- Unit of Neurosurgery, Department of Clinical Neuroscience, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
| | - Giorgio Iaconetta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (G.P.); (G.I.)
- Neurosurgery Unit, University Hospital “San Giovanni di Dio e Ruggi, D’Aragona”, 84131 Salerno, Italy
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10
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Appanna R, Gargano D, Caputo A, De Bartolomeis F, Ricciardi L, Santonicola A, Stefanelli B, Caiazza L, Guarciariello M, D'Antonio A, D'Auria R, Conti V, Casolaro V, Iovino P. Changes in mucosal IgG4 +- and IL-10 +-cell frequencies in adults with eosinophilic esophagitis on a two-food elimination diet. Clin Immunol 2023; 257:109853. [PMID: 38013163 DOI: 10.1016/j.clim.2023.109853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
Eosinophilic esophagitis (EoE) is increasingly diagnosed in patients with dysphagia. Type-2 immunity can induce EoE histopathology via non-IgE-dependent mechanisms, possibly involving IgG4 and IL-10. To elucidate the contribution of this response to EoE pathogenesis, we examined its association with clinical and histologic endpoints in adult EoE patients given a two-food elimination diet. IgG4- and IL-10-expressing cells were counted in esophageal biopsies and serum food-specific IgG4 measured at baseline and follow-up. Variables were correlated with histologic measures of disease activity. Patients exhibited significant reduction in esophageal eosinophilia and overall histology. A significant decrease in IL-10+-cell frequencies correlated with histologic changes. In contrast, a decline in serum and esophageal IgG4, while substantial, did not correlate with IL-10+-cell frequencies or histologic parameters. These results suggest a critical role of IL-10 in EoE pathogenesis. Conversely, IgG4 expression, while reflecting exposure to food antigens, is not obviously related to EoE histopathology or IL-10 expression.
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Affiliation(s)
- Ramapraba Appanna
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | | | - Alessandro Caputo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | | | - Luca Ricciardi
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Antonella Santonicola
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Laura Caiazza
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | | | - Antonio D'Antonio
- San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Raffaella D'Auria
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.
| | - Paola Iovino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.
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11
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Sabbatino F, Pagliano P, Sellitto C, Stefanelli B, Corbi G, Manzo V, De Bellis E, Liguori L, Salzano FA, Pepe S, Filippelli A, Conti V. Different Prognostic Role of Soluble PD-L1 in the Course of Severe and Non-Severe COVID-19. J Clin Med 2023; 12:6812. [PMID: 37959277 PMCID: PMC10649852 DOI: 10.3390/jcm12216812] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Understanding the link between COVID-19 and patient immune characteristics is crucial. We previously demonstrated that high levels of the soluble Programmed Death-Ligand1 (sPD-L1) at the beginning of the infection correlated with low lymphocyte number and high C-reactive protein (CRP), longer length of stay (LOS), and death. This study investigated whether sPD-L1 can be a prognosis biomarker during COVID-19. Severe and non-severe COVID-19 patients were enrolled at the University Hospital of Salerno. During hospitalization, at admission, and after 12-14 days, patients' data were collected, and sPD-L1 levels were measured by enzyme-linked immunosorbent assay. The peripheral lymphocyte number negatively correlated with the time of negativization (p = 0.006), length of stay (LOS) (p = 0.032), and CRP (p = 0.004), while sPD-L1 positively correlated with LOS (p = 0.015). Patients with increased sPD-L1 and lymphocyte number showed a shorter LOS than those with decreased sPD-L1 and lymphocyte number (p = 0.038) and those with increased sPD-L1 and decreased lymphocyte number (p = 0.025). Moreover, patients with increased sPD-L1 and decreased CRP had a shorter LOS than those with increased sPD-L1 and CRP (p = 0.034) and those with decreased sPD-L1 and CRP (p = 0.048). In conclusion, while at an early phase of COVID-19, sPD-L1 promotes an immune escape, later, it might act to dampen an excessive immune response, proving its role in COVID-19 prognosis.
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Affiliation(s)
- Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Oncology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84131 Salerno, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Infectious Disease Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84131 Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
| | - Luigi Liguori
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Otolaryngology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84131 Salerno, Italy
| | - Stefano Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Oncology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84131 Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (F.S.); (P.P.); (C.S.); (B.S.); (V.M.); (E.D.B.); (F.A.S.); (S.P.); (A.F.); (V.C.)
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy
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12
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Piccolo R, Avvedimento M, Canonico ME, Gargiulo P, Paolillo R, Conti V, Dal Piaz F, Filippelli A, Morisco C, Simonetti F, Leone A, Marenna A, Bruzzese D, Gargiulo G, Stabile E, Di Serafino L, Franzone A, Cirillo P, Esposito G. Platelet Inhibition with Ticagrelor 60 mg Versus 90 mg Twice Daily in Elderly Patients with Acute Coronary Syndrome: Rationale and Design of the PLINY THE ELDER Trial. Cardiovasc Drugs Ther 2023; 37:1031-1038. [PMID: 35048203 DOI: 10.1007/s10557-021-07302-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Accepted: 12/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Elderly status is steadily increasing among patients with acute coronary syndrome (ACS). Dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 receptor inhibitor is the cornerstone of treatment to prevent recurrent thrombotic complications in patients with ACS. However, DAPT in older patients is challenged by a concurrent heightened risk of ischemia and bleeding. The aim of this study is to evaluate the pharmacodynamic and pharmacokinetic profile of a lower dose of ticagrelor (60 mg twice daily) among elderly patients during the early phase of ACS. STUDY DESIGN PLINY THE ELDER (PLatelet INhibition with two different doses of potent P2y12 inhibitors in THE ELDERly population) (NCT04739384) is a prospective, randomized, open-label, crossover trial to evaluate the non-inferiority of a lower dose of ticagrelor (60 mg twice daily) compared with a standard dose (90 mg twice daily) among elderly patients with ACS undergoing percutaneous coronary intervention (PCI). A total of 50 patients, aged 75 years or more, with indication to potent P2Y12 receptor inhibitors will be randomized within 3 days from PCI for the index ACS. Patients with indication to oral anticoagulant therapy, treatment with glycoprotein IIb/IIIa inhibitors, or active bleeding will be excluded. The primary endpoint is platelet reactivity determined by P2Y12 reaction units (PRU) (VerifyNow, Accumetrics, San Diego, CA, USA) after treatment with ticagrelor 60 or 90 mg twice daily for 14 days. Secondary endpoints will include other pharmacodynamic tests of ADP-induced aggregation (light transmittance aggregometry and multiple electrode aggregometry) and determination of pharmacokinetic profile (plasma levels of ticagrelor and its metabolite AR-C124910XX) by high performance liquid chromatography-tandem mass spectrometry. CONCLUSIONS The PLINY THE ELDER trial will determine whether a lower dose of ticagrelor confers non-inferior platelet inhibition compared with the standard dose in the early phase of ACS among elderly patients undergoing PCI, informing future clinical investigation.
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Affiliation(s)
- Raffaele Piccolo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy.
| | - Marisa Avvedimento
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Mario Enrico Canonico
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Paola Gargiulo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Roberta Paolillo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
- Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona", Salerno, Italy
| | - Fabrizio Dal Piaz
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
- Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona", Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, SA, Italy
- Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona", Salerno, Italy
| | - Carmine Morisco
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Fiorenzo Simonetti
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Attilio Leone
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Alessandra Marenna
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giuseppe Gargiulo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Eugenio Stabile
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Luigi Di Serafino
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Anna Franzone
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Plinio Cirillo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy
- UNESCO Chair On Health Education and Sustainable Development, University of Naples Federico II, Naples, Italy
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13
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Costantino M, Conti V, Corbi G, Giudice V, Caro FD, Filippelli A. Marked Reduction of Oxidant Species after Sulfureous Crenotherapy in Females with Joint Diseases and Psoriasis: A Retrospective Real-Life Study. J Clin Med 2023; 12:5731. [PMID: 37685798 PMCID: PMC10488333 DOI: 10.3390/jcm12175731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/26/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Oxidative stress, a condition induced by an excessive amount of free radicals, such as reactive oxygen species (ROS), shows several gender-related differences in basal cellular redox state and antioxidant responses. Crenotherapy with sulfureous mineral water can improve the cellular redox state. In this retrospective observational study, gender-related differences in the efficacy of sulfureous crenotherapy in decreasing oxidant species were investigated. Seventy-eight patients, stratified by sex, with osteoarthritis or degenerative joint disease and Vulgar psoriasis who have received a cycle of sulfureous mud-bath therapy + sulfureous hydropinotherapy were enrolled. Plasma concentration of oxidant species and clinical outcomes were measured at baseline and at the end of treatment. After 2 weeks of sulfureous crenotherapy, a significant amelioration of clinical outcomes and a significant reduction of oxidant species were observed in both sexes, more marked in females than in males (p = 0.0001 and p = 0.04, respectively). For patients with high oxidant species at baseline, females showed a greater reduction in itching compared to males (-95% vs. -50%), while men had a higher amelioration in pain and morning stiffness (-45% vs. -32%, and -50% vs. -37%, respectively). In conclusion, sulfureous crenotherapy can be a valuable strategy to improve cellular redox state in both sexes.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (V.G.); (F.D.C.); (A.F.)
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80070 Bacoli, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (V.G.); (F.D.C.); (A.F.)
- Clinical Pharmacology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy;
- Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy
| | - Valentina Giudice
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (V.G.); (F.D.C.); (A.F.)
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (V.G.); (F.D.C.); (A.F.)
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (V.G.); (F.D.C.); (A.F.)
- Clinical Pharmacology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
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14
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Corbi G, Nobile V, Conti V, Cannavo A, Sorrenti V, Medoro A, Scapagnini G, Davinelli S. Equol and Resveratrol Improve Bone Turnover Biomarkers in Postmenopausal Women: A Clinical Trial. Int J Mol Sci 2023; 24:12063. [PMID: 37569440 PMCID: PMC10419295 DOI: 10.3390/ijms241512063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Estrogen deficiency is a major cause of loss of postmenopausal bone mineral density (BMD). This study aimed to evaluate the effects of equol and resveratrol on bone turnover biomarkers in postmenopausal women. Sixty healthy postmenopausal women were randomly assigned to receive 200 mg fermented soy containing 10 mg equol and 25 mg resveratrol or a placebo for 12 months. Whole-body BMD and bone turnover biomarkers, such as deoxypyridinoline (DPD), tartrate-resistant acid phosphatase 5b (TRACP-5b), osteocalcin, and bone-specific alkaline phosphatase (BAP), were measured at baseline and after 12 months of treatment. At the end of treatment, DPD, osteocalcin, and BAP significantly improved in the active group (p < 0.0001 for all) compared to the placebo group. Conversely, TRACP-5b levels were unaffected by supplementation (p = 0.051). Statistically significant changes in the concentrations of DPD (p < 0.0001), osteocalcin (p = 0.0001), and BAP (p < 0.0001) compared to baseline were also identified. Overall, the intervention significantly increased BMD measured in the whole body (p = 0.0220) compared with the placebo. These data indicate that the combination of equol and resveratrol may positively modulate bone turnover biomarkers and BMD, representing a potential approach to prevent age-related bone loss in postmenopausal women.
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Affiliation(s)
- Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (G.C.); (A.C.)
| | | | - Valeria Conti
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy;
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (G.C.); (A.C.)
| | - Vincenzo Sorrenti
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy;
| | - Alessandro Medoro
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (S.D.)
| | - Giovanni Scapagnini
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (S.D.)
| | - Sergio Davinelli
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.M.); (S.D.)
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Pagliano P, Spera A, Sellitto C, Scarpati G, Folliero V, Piazza O, Franci G, Conti V, Ascione T. Preclinical discovery and development of nirmatrelvir/ritonavir combinational therapy for the treatment of COVID-19 and the lessons learned from SARS-COV-2 variants. Expert Opin Drug Discov 2023; 18:1301-1311. [PMID: 37614103 DOI: 10.1080/17460441.2023.2248879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Nirmatrelvir/ritonavir (Paxlovid®) represent an oral antiviral therapy approved for the treatment of COVID-19. Extensive in vitro and in vivo studies have reported the promising activity of nirmatrelvir/ritonavir against numerous emerging viruses. This combination consists of nirmatrelvir, a protease reversible inhibitor of coronavirus 3CLpro mainly metabolized by cytochrome P450 (CYP)3A4, and ritonavir, an inhibitor of the CYP3A isoforms that enhances the efficacy of nirmatrelvir by fixing its suboptimal pharmacokinetic properties. AREAS COVERED This review comprehensively examines the efficacy of nirmatrelvir/ritonavir through rigorous analysis of in vitro and in vivo studies. Moreover, it thoroughly assesses its safety, tolerability, pharmacokinetics, and antiviral efficacy against SARS-COV-2 infection, based on the main pre-authorization randomized controlled trials. EXPERT OPINION Nirmatrelvir/ritonavir has a good tolerability profile. Its administration during the early stages of mild-to-moderate COVID-19 holds potential benefits, as it can help prevent the onset of an aberrant immune response that could lead to pulmonary and extra-pulmonary complications. However, its drug - drug interactions can be a factor limiting its use, at least in populations on some chronic therapies, along with the risk of infection relapse after treatment.
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Affiliation(s)
- Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Annamaria Spera
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Giuliana Scarpati
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Veronica Folliero
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Unit of Microbiology, University of Salerno, Baronissi, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Unit of Microbiology, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
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Molteni L, Charlier B, Izzo V, Coglianese A, Conti V, Eleopra R, Cilia R, Capelli C, D'Urso A, de Grazia U. Development and Validation of a New LC-MS/MS Bioanalytical Method for the Simultaneous Determination of Levodopa, Levodopa Methyl Ester, and Carbidopa in Human Plasma Samples. Molecules 2023; 28:molecules28114264. [PMID: 37298741 DOI: 10.3390/molecules28114264] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Levodopa (L-DOPA) treatment, combined with the administration of dopa-decarboxylase inhibitors (DDCIs), is still the most effective symptomatic treatment of Parkinson's disease (PD). Although its efficacy in the early stage of the disease has been confirmed, its complex pharmacokinetics (PK) increases the variability of the intra-individual motor response, thus amplifying the risk of motor/non-motor fluctuations and dyskinesia. Moreover, it has been demonstrated that L-DOPA PK is strongly influenced by several clinical, therapeutic, and lifestyle variables (e.g., dietary proteins). L-DOPA therapeutic monitoring is therefore crucial to provide personalized therapy, hence improving drug efficacy and safety. To this aim, we have developed and validated an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method to quantify L-DOPA, levodopa methyl ester (LDME), and the DDCI carbidopa in human plasma. The compounds were extracted by protein precipitation and samples were analyzed with a triple quadrupole mass spectrometer. The method showed good selectivity and specificity for all compounds. No carryover was observed, and dilution integrity was demonstrated. No matrix effect could be retrieved; intra-day and inter-day precision and accuracy values met the acceptance criteria. Reinjection reproducibility was assessed. The described method was successfully applied to a 45-year-old male patient to compare the pharmacokinetic behavior of an L-DOPA-based medical treatment involving commercially available Mucuna pruriens extracts and an LDME/carbidopa (100/25 mg) formulation.
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Affiliation(s)
- Linda Molteni
- Laboratory of Neurological Biochemistry and Neuropharmacology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Bruno Charlier
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84131 Salerno, Italy
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84131 Salerno, Italy
| | - Albino Coglianese
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy
- Graduate School in Clinical Pathology and Clinical Biochemistry, University of Salerno, Baronissi, 84081 Salerno, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84131 Salerno, Italy
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Roberto Cilia
- Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Chiara Capelli
- Laboratory of Neurological Biochemistry and Neuropharmacology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Annachiara D'Urso
- Laboratory of Neurological Biochemistry and Neuropharmacology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Ugo de Grazia
- Laboratory of Neurological Biochemistry and Neuropharmacology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
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Conti V, Randriamboavonjy JI, Rafatro H, Manzo V, Dal Col J, Filippelli A, Corbi G, Tesse A. SIRT1 Signaling Is Involved in the Vascular Improvement Induced by Moringa Oleifera Seeds during Aging. Pharmaceuticals (Basel) 2023; 16:ph16050761. [PMID: 37242544 DOI: 10.3390/ph16050761] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Vascular aging is linked to reduce NO bioavailability, endothelial dysfunction, oxidative stress, and inflammation. We previously showed that a 4-week treatment of middle-aged Wistar rats (MAWRs, 46 weeks old) with Moringa oleifera seed powder (MOI, 750 mg/kg/day) improved vascular function. Here, we investigated the involvement of SIRT1 in MOI-induced vascular improvement. MAWRs were treated with a standard or MOI-containing diet. Young rats (YWR, 16 weeks old) were the controls and received a standard diet. The hearts and aortas were harvested to evaluate SIRT1 and FOXO1 expression via Western blot and/or immunostaining, SIRT1 activity via a fluorometric assay, and oxidative stress using the DHE fluorescent probe. In the hearts and aortas, SIRT1 expression, reduced in MAWRs compared to YWRs, was enhanced in MOI MAWRs. In the hearts, SIRT1 activity did not differ between YWRs and MAWRs, whereas it was increased in MOI MAWRs compared with them. In the aortas, SIRT1 activity decreased in MAWRs, and it was similar in the MOI MAWRs and YWRs. FOXO1 expression increased in the nuclei of MAWR aortas compared to YWR and was reversed in MOI MAWRs. Interestingly, MOI treatment normalized oxidative stress enhanced in MAWRs, in both the heart and aorta. These results demonstrate the protective role of MOI against cardiovascular dysfunction due to aging via enhanced SIRT1 function and subsequently reduced oxidative stress.
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Affiliation(s)
- Valeria Conti
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, S. Allende, 84081 Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, San Leonardo 1, 84131 Salerno, SA, Italy
| | - Joseph Iharinjaka Randriamboavonjy
- INSERM, Université de Nantes, CHU Nantes, CNRS, L'Institut du Thorax, CEDEX 01, F-44000 Nantes, France
- Laboratoire d'Évaluation Pharmaco Clinique (LEPC), Institut Malgache de Recherches Appliquées (IMRA) Fondation Albert et Suzanne Rakoto-Ratsimamanga (FASRR), Avarabohitra Itaosy, Antananarivo 102, Madagascar
| | - Herintsoa Rafatro
- Laboratoire d'Évaluation Pharmaco Clinique (LEPC), Institut Malgache de Recherches Appliquées (IMRA) Fondation Albert et Suzanne Rakoto-Ratsimamanga (FASRR), Avarabohitra Itaosy, Antananarivo 102, Madagascar
| | - Valentina Manzo
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, San Leonardo 1, 84131 Salerno, SA, Italy
| | - Jessica Dal Col
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, S. Allende, 84081 Baronissi, SA, Italy
| | - Amelia Filippelli
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, S. Allende, 84081 Baronissi, SA, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, San Leonardo 1, 84131 Salerno, SA, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, NA, Italy
| | - Angela Tesse
- INSERM, Université de Nantes, CHU Nantes, CNRS, L'Institut du Thorax, CEDEX 01, F-44000 Nantes, France
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Cabeza-Segura M, Garcia-Micò B, La Noce M, Nicoletti GF, Conti V, Filippelli A, Fleitas T, Cervantes A, Castillo J, Papaccio F. How organoids can improve personalized treatment in patients with gastro-esophageal tumors. Curr Opin Pharmacol 2023; 69:102348. [PMID: 36842387 DOI: 10.1016/j.coph.2023.102348] [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] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/21/2022] [Indexed: 02/26/2023]
Abstract
Gastro-esophageal tumors constitute a big health problem. Treatment options still mainly rely on chemotherapy, and apart from human epidermal growth factor receptor 2 positive and microsatellite instable/Epstein-Barr Virus disease, there are no molecularly guided options. Therefore, despite the large number of identified molecular alterations, precision medicine is still far from the clinic. In this context, the recently developed technology of patient-derived organoids (PDOs) could offer the chance to accelerate drug development and biomarker discovery. Indeed, PDOs are 3D primary cultures that were shown to reproduce patient's tumor characteristics. Moreover, several reports indicated that PDOs can replicate patient's response to a given drug; therefore, they are one of the most promising tools for functional precision medicine.
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Affiliation(s)
- Manuel Cabeza-Segura
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain
| | - Blanca Garcia-Micò
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain
| | - Marcella La Noce
- Department of Experimental Medicine, Section of Biotechnology, Molecular Medicine and Medical Histology, University of Campania "L. Vanvitelli", Via L. de Crecchio 7, 80138, Naples, Italy
| | - Giovanni Francesco Nicoletti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "L. Vanvitelli", Via L. de Crecchio 6, 80138, Naples, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy; Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy; Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Tania Fleitas
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain; Centro de Investigacion Biomedica en Red (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Andrés Cervantes
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain; Centro de Investigacion Biomedica en Red (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Josefa Castillo
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain; Centro de Investigacion Biomedica en Red (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain; Department of Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain
| | - Federica Papaccio
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario, Department Medical Oncology, University of Valencia, Valencia, Spain; Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.
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19
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Conti V, Corbi G, Sabbatino F, De Pascale D, Sellitto C, Stefanelli B, Bertini N, De Simone M, Liguori L, Di Paola I, De Bernardo M, Tesse A, Rosa N, Pagliano P, Filippelli A. Long COVID: Clinical Framing, Biomarkers, and Therapeutic Approaches. J Pers Med 2023; 13:334. [PMID: 36836568 PMCID: PMC9959656 DOI: 10.3390/jpm13020334] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
More than two years after the onset of the COVID-19 pandemic, healthcare providers are facing an emergency within an emergency, the so-called long COVID or post-COVID-19 syndrome (PCS). Patients diagnosed with PCS develop an extended range of persistent symptoms and/or complications from COVID-19. The risk factors and clinical manifestations are many and various. Advanced age, sex/gender, and pre-existing conditions certainly influence the pathogenesis and course of this syndrome. However, the absence of precise diagnostic and prognostic biomarkers may further complicate the clinical management of patients. This review aimed to summarize recent evidence on the factors influencing PCS, possible biomarkers, and therapeutic approaches. Older patients recovered approximately one month earlier than younger patients, with higher rates of symptoms. Fatigue during the acute phase of COVID-19 appears to be an important risk factor for symptom persistence. Female sex, older age, and active smoking are associated with a higher risk of developing PCS. The incidence of cognitive decline and the risk of death are higher in PCS patients than in controls. Complementary and alternative medicine appears to be associated with improvement in symptoms, particularly fatigue. The heterogeneous nature of post-COVID symptoms and the complexity of patients with PCS, who are often polytreated due to concomitant clinical conditions, suggest a holistic and integrated approach to provide useful guidance for the treatment and overall management of long COVID.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Domenico De Pascale
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Nicola Bertini
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Matteo De Simone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Luigi Liguori
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Ilenia Di Paola
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Angela Tesse
- CNRS, INSERM, L'institut du Thorax, Université de Nantes, F-44000 Nantes, France
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
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Caporalini C, Scagnet M, Giunti L, Cetica V, Mei D, Conti V, Moscardi S, Macconi L, Giordano F, D'Incerti L, Genitori L, Guerrini R, Buccoliero A. Myxoid glioneuronal tumor: Histopathologic, neuroradiologic, and molecular features in a single center series. Neoplasia 2023; 37:100885. [PMID: 36764090 PMCID: PMC9929589 DOI: 10.1016/j.neo.2023.100885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Myxoid glioneuronal tumor (MGT) is a benign glioneuronal neoplasm recently introduced in the World Health Organization (WHO) classification of the central nervous system (CNS) tumors. MGTs are typically located in the septum pellucidum, foramen of Monro or periventricular white matter of the lateral ventricle. They were previously diagnosed as dysembryoplastic neuroepithelial tumors (DNT), showing histological features almost indistinguishable from classical cortical DNT. Despite that, MGTs have been associated with a specific dinucleotide substitution at codon 385 in the platelet-derived growth factor receptor alpha (PDGFRA) gene, replacing a lysine residue with either leucine or isoleucine (p. LysK385Leu/Iso). This genetic variation has never been described in any other CNS tumor. MATERIALS AND METHODS Thirty-one consecutive tumors, previously diagnosed as DNTs at the Meyer Children's Hospital IRCCS between January 2010 and June 2021 were collected for a comprehensive study of their clinical, imaging, pathological features, and molecular profile. RESULTS In six out of the thirty-one tumors we had previously diagnosed as DNTs, we identified the recurrent dinucleotide mutation in the PDGFRA. All six tumors were typically located within the periventricular white matter of the lateral ventricle and in the septum pellucidum. We then renamed these lesions as MGT, according to the latest WHO CNS classification. In all patients we observed an indolent clinical course, without recurrence. CONCLUSION MGT represent a rare but distinct group of neoplasm with a typical molecular profiling, a characteristic localization, and a relative indolent clinical course.
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Affiliation(s)
- C. Caporalini
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy,Corresponding author.
| | - M. Scagnet
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Cetica
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - D. Mei
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Conti
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - S. Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
| | - L. Macconi
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - F. Giordano
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. D'Incerti
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Genitori
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - R. Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - A.M. Buccoliero
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
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Pagliano P, Sellitto C, Ascione T, Scarpati G, Folliero V, Piazza O, Franci G, Filippelli A, Conti V. The preclinical discovery and development of molnupiravir for the treatment of SARS-CoV-2 (COVID-19). Expert Opin Drug Discov 2022; 17:1299-1311. [PMID: 36508255 DOI: 10.1080/17460441.2022.2153828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Molnupiravir (MOV) is a broad-spectrum oral antiviral agent approved for the treatment of COVID-19. The results from in vitro and in vivo studies suggested MOV activity against many RNA viruses such as influenza virus and some alphaviruses agents of epidemic encephalitis. MOV is a prodrug metabolized into the ribonucleoside analog β-D-N4-hydroxycytidine. It is incorporated into the viral RNA chain causing mutations impairing coding activity of the virus, thereby inhibiting viral replication. AREAS COVERED This review analyzes the in vitro and in vivo studies that have highlighted the efficacy of MOV and the main pre-authorization randomized controlled trials evaluating its safety, tolerability, and pharmacokinetics, as well as its antiviral efficacy against SARS-COV-2 infection. EXPERT OPINION MOV is an antiviral agent with an excellent tolerability profile with few drug-drug interactions. Treatment of mild-to-moderate COVID-19 can benefit from MOV administration in the precocious phases of the disease, prior to the trigger of an aberrant immune response responsible for the parenchymal damage to pulmonary and extrapulmonary tissues. However, its suspected mutagenic effect can be a factor limiting its use at least in selected populations and studies on its teratogen effects should be planned before it is authorized for use in the pediatric population or in pregnant women.
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Affiliation(s)
- Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Giuliana Scarpati
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Veronica Folliero
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Unit of Microbiology, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
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22
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Conti V, Manzo V, De Bellis E, Stefanelli B, Sellitto C, Bertini N, Corbi G, Ferrara N, Filippelli A. Opposite Response to Vitamin K Antagonists: A Report of Two Cases and Systematic Review of Literature. J Pers Med 2022; 12:jpm12101578. [PMID: 36294717 PMCID: PMC9605490 DOI: 10.3390/jpm12101578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Vitamin K antagonists (VKAs) are used in the prophylaxis and treatment of thromboembolic disorders. Despite a high efficacy, their narrow therapeutic window and high response variability hamper their management. Several patients experience fluctuations in dose−response and are at increased risk of over- or under-anticoagulation. Therefore, it is essential to monitor the prothrombin time/international normalized ratio to determine the so-called stable dose and to adjust the dosage accordingly. Three polymorphisms, CYP2C9∗2, CYP2C9∗3 and VKORC1-1639G>A, are associated with increased sensitivity to VKAs. Other polymorphisms are associated with a request for a higher dose and VKA resistance. We described the clinical cases of two patients who were referred to the Clinical Pharmacology and Pharmacogenetics Unit of the University Hospital of Salerno for pharmacological counseling. One of them showed hypersensitivity and the other one was resistant to VKAs. A systematic review was performed to identify randomized clinical trials investigating the impact of pharmacogenetic testing on increased sensitivity and resistance to VKAs. Although international guidelines are available and information on the genotype-guided dosing approach has been included in VKA drug labels, VKA pharmacogenetic testing is not commonly required. The clinical cases and the results of the systematically reviewed RCTs demonstrate that the pharmacogenetic-based VKA dosing model represents a valuable resource for reducing VKA-associated adverse events.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, Italy
| | - Valentina Manzo
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, Italy
| | - Emanuela De Bellis
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, Italy
- Correspondence: (E.D.B.); (B.S.); Tel.: +39-089-672-424 (E.D.B.)
| | - Berenice Stefanelli
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
- Correspondence: (E.D.B.); (B.S.); Tel.: +39-089-672-424 (E.D.B.)
| | - Carmine Sellitto
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Nicola Bertini
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
- Istituti Clinici Scientifici Maugeri SpA Società Benefit, 82037 Telese, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, 84131 Salerno, Italy
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23
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Sellitto C, Corbi G, Bertini N, Ascione T, Costantino M, Scarpati G, Piazza O, Filippelli A, Conti V, Pagliano P. Effect of remdesivir on mortality rate and clinical status of COVID-19 patients: a systematic review with meta-analysis. J Chemother 2022:1-14. [PMID: 36102273 DOI: 10.1080/1120009x.2022.2121091] [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: 12/15/2022]
Abstract
Remdesivir (RDV) is a broad-spectrum antiviral drug, now approved by Regulatory Agencies for COVID-19 treatment. RDV is associated with improvements in clinical outcomes, but no conclusive studies have shown an effect in reducing mortality. This study aimed to carry out a systematic review with meta-analysis to investigate whether RDV can significantly modify the outcome of COVID-19 patients evaluating its effects on mortality, length of stay, time to clinical improvement and need for oxygen supplementation. No significant improvement in terms of survival in patients treated with standard therapy (ST)+RDV as compared to ST alone (P = 0.24) was found. The duration of oxygen support was significantly lower in patients treated with ST + RDV compared with ST alone (P = 0.03). Further investigations should be planned to assess the real impact of RDV in the management of COVID-19 patients.
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Affiliation(s)
- Carmine Sellitto
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Nicola Bertini
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Maria Costantino
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), Naples, Italy
| | - Giuliana Scarpati
- Unit of Anesthesiology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Ornella Piazza
- Unit of Anesthesiology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Pasquale Pagliano
- Unit of Infectious Diseases, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
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24
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Gaeta F, Conti V, Pepe A, Vajro P, Filippelli A, Mandato C. Drug dosing in children with obesity: a narrative updated review. Ital J Pediatr 2022; 48:168. [PMID: 36076248 PMCID: PMC9454408 DOI: 10.1186/s13052-022-01361-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to any other possible health problem commonly affecting the pediatric age. Uncertainties may arise concerning drug dosing when children with obesity need pharmacologic therapies. In general, in pediatric practice, there is a tendency to adapt drug doses to a child’s total body weight. However, this method does not consider the pharmacological impact that a specific drug can have under a two-fold point of view, that is, across various age and size groups as well. Moreover, there is a need for a therapeutic approach, as much as possible tailored considering relevant interacting aspects, such as modification in metabolomic profile, drug pharmacokinetics and pharmacodynamics. Taking into account the peculiar differences between children with overweight/obesity and those who are normal weight, the drug dosage in the case of obesity, cannot be empirically determined solely by the per kg criterion. In this narrative review, we examine the pros and cons of several drug dosing methods used when dealing with children who are affected also by obesity, focusing on specific aspects of some of the drugs most frequently prescribed in real-world practice by general pediatricians and pediatric subspecialists.
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Affiliation(s)
- Francesca Gaeta
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Valeria Conti
- Pharmacology Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Angela Pepe
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Pietro Vajro
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Amelia Filippelli
- Pharmacology Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Claudia Mandato
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy.
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25
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Corbi G, Conti V, Filippelli A. Editorial: Women in science - geriatric medicine 2021. Front Med (Lausanne) 2022; 9:1008061. [PMID: 36059839 PMCID: PMC9428687 DOI: 10.3389/fmed.2022.1008061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
- *Correspondence: Graziamaria Corbi
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
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26
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Ciccarelli M, Merciai F, Carrizzo A, Sommella E, Di Pietro P, Caponigro V, Salviati E, Musella S, Sarno VD, Rusciano M, Toni AL, Iesu P, Izzo C, Schettino G, Conti V, Venturini E, Vitale C, Scarpati G, Bonadies D, Rispoli A, Polverino B, Poto S, Pagliano P, Piazza O, Licastro D, Vecchione C, Campiglia P. Untargeted lipidomics reveals specific lipid profiles in COVID-19 patients with different severity from Campania region (Italy). J Pharm Biomed Anal 2022; 217:114827. [PMID: 35569273 PMCID: PMC9085356 DOI: 10.1016/j.jpba.2022.114827] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 02/08/2023]
Abstract
COVID-19 infection evokes various systemic alterations that push patients not only towards severe acute respiratory syndrome but causes an important metabolic dysregulation with following multi-organ alteration and potentially poor outcome. To discover novel potential biomarkers able to predict disease's severity and patient's outcome, in this study we applied untargeted lipidomics, by a reversed phase ultra-high performance liquid chromatography-trapped ion mobility mass spectrometry platform (RP-UHPLC-TIMS-MS), on blood samples collected at hospital admission in an Italian cohort of COVID-19 patients (45 mild, 54 severe, 21 controls). In a subset of patients, we also collected a second blood sample in correspondence of clinical phenotype modification (longitudinal population). Plasma lipid profiles revealed several lipids significantly modified in COVID-19 patients with respect to controls and able to discern between mild and severe clinical phenotype. Severe patients were characterized by a progressive decrease in the levels of LPCs, LPC-Os, PC-Os, and, on the contrary, an increase in overall TGs, PEs, and Ceramides. A machine learning model was built by using both the entire dataset and with a restricted lipid panel dataset, delivering comparable results in predicting severity (AUC= 0.777, CI: 0.639-0.904) and outcome (AUC= 0.789, CI: 0.658-0.910). Finally, re-building the model with 25 longitudinal (t1) samples, this resulted in 21 patients correctly classified. In conclusion, this study highlights specific lipid profiles that could be used monitor the possible trajectory of COVID-19 patients at hospital admission, which could be used in targeted approaches.
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Affiliation(s)
- Michele Ciccarelli
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Fabrizio Merciai
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy,PhD Program in Drug Discovery and Development, University of Salerno, Fisciano, SA, Italy
| | - Albino Carrizzo
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy,IRCCS Neuromed, Loc. Camerelle, Pozzilli, IS, Italy
| | - Eduardo Sommella
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy
| | - Paola Di Pietro
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Vicky Caponigro
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy
| | | | - Simona Musella
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy
| | | | | | - Anna Laura Toni
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Paola Iesu
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Carmine Izzo
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | | | - Valeria Conti
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | | | - Carolina Vitale
- San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Giuliana Scarpati
- San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Domenico Bonadies
- San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Antonella Rispoli
- San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | | | - Sergio Poto
- San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Pasquale Pagliano
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Ornella Piazza
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | | | - Carmine Vecchione
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy,IRCCS Neuromed, Loc. Camerelle, Pozzilli, IS, Italy,Corresponding author at: Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy,Corresponding author
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27
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Costantino M, Conti V, Corbi G, Iannelli AA, Marongiu F, Torsiello M, Della Vecchia A, Sellitto C, Genovese A, Moccia G, Filippelli A, De Caro F. Impact and Value of Hospital Antibiotic Stewardship: Retrospective Pre-COVID-19-Pandemic Analysis. J Clin Med 2022; 11:jcm11154412. [PMID: 35956030 PMCID: PMC9369048 DOI: 10.3390/jcm11154412] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
Aim: “Antimicrobial stewardship” (AMS) is defined as a healthcare-system-wide approach to promoting and monitoring the judicious use of antimicrobials to preserve their future effectiveness. Therefore, we structured an observational study to monitor the hospital trend of antibiotic consumption and related expenditure before the COVID-19 pandemic and to evaluate how much AMS could affect this trend. Methods: The research covered the antibiotic prescriptions at the University Hospital (U.H.) “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy, comparing data on the therapies prescribed from 1 January to 31 December 2017 (27,384 patients) with those collected during the same period in 2019 (27,047 patients). Results: Unlike national data, our results highlighted a decreasing trend in the consumption of antibiotics that did not concern only carbapenems and fluoroquinolones, but also the third-generation cephalosporins. Noteworthily, there was also a reduction in 2019 compared with 2017 in the consumption of colistin, an antibiotic towards which an increase in bacterial resistance in animals has been found nationally. In agreement with the national data, our research confirms a trend of an increase (+3.7%) in the total antibiotic consumption corresponding to more than 26% and 29% reductions in the total and therapy per-day costs, respectively. Conclusions: The results show a positive impact of the AMS at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona”.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Naples, Italy;
- Correspondence: or ; Tel.: +39-08965041; Fax: +39-1786070323
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy;
- Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy
| | - Alessandra Anna Iannelli
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Francesco Marongiu
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Naples, Italy;
- Department of Industrial Engineering, University of Salerno, 84084 Fisciano, Italy
| | - Martina Torsiello
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
| | - Antonio Della Vecchia
- General Directorate of Health Planning, Office 3—Italian Ministry of Health, 00144 Roma, Italy;
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Armando Genovese
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Giuseppina Moccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
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Conti V, Izzo V, Russillo MC, Picillo M, Amboni M, Scaglione CLM, Nicoletti A, Cani I, Cicero CE, De Bellis E, Charlier B, Giudice V, Somma G, Corbi G, Barone P, Filippelli A, Pellecchia MT. Gender Differences in Levodopa Pharmacokinetics in Levodopa-Naïve Patients With Parkinson's Disease. Front Med (Lausanne) 2022; 9:909936. [PMID: 35712091 PMCID: PMC9193593 DOI: 10.3389/fmed.2022.909936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/02/2022] [Indexed: 01/02/2023] Open
Abstract
Background Levodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). Unfortunately, prolonged use of LD leads to complications, mainly motor/non-motor fluctuations (MNMF) and dyskinesias (DYS). Women seem more prone to develop such LD-related complications. Nonetheless, there is a paucity of prospective studies examining gender-related predictors of MNMF and DYS. Among several factors, which concur with a very complex scenario, changes in LD pharmacokinetics influence the drug’s effectiveness. The present study aimed to assess gender-related differences in LD pharmacokinetics in patients with PD at their first-ever intake of LD. Materials and Methods This is a multicentric study enrolling patients with PD, who were LD-naïve and received a single dose of LD/benserazide (100/25 mg) formulation. All participants gave their written informed consent, and the study was approved by the local Ethics Committees. To measure plasma LD concentrations and pharmacokinetic parameters (AUC, Cmax, Tmax, t1/2), fasting blood samples were collected before drug intake and then at 8-time points until 260 min. LD concentrations were measured by ultra-high-performance liquid chromatography coupled with mass spectrometry (UHPLC-MS). Multiple linear regression analyses were performed to identify the predictors of the parameters. Results Thirty-five patients (16 women and 19 men) were consecutively enrolled. Area under curve (AUC) and maximum plasma concentration (Cmax) were significantly higher in women than men (p = 0.0006 and p = 0.0014, respectively). No statistically significant difference was found regarding Tmax and t1/2. Multiple linear regression analyses revealed that female sex (β = 1.559116, 95% CI 0.8314479 2.286785; p < 0.0001) and body mass index (BMI) (β = −0.0970631, 95% CI −0.1733004 −0.0208258; p = 0.014) significantly predicted AUC. Only female sex significantly predicted Cmax (β = 1,582.499, 95% CI 731.581 2,433.417; p = 0.001). Moreover, only BMI significantly predicted t1/2 (β = 0.0756267, 95% CI 0.0143407 0.1369126; p = 0.017). Stratifying by gender, BMI was confirmed to significantly predict t1/2 in women (β = 0.1300486, 95% CI 0.0172322 0.242865; p = 0.027), but not in men. Conclusion This study provides novel insights on gender differences in LD pharmacokinetics, possibly contributing to the later development of motor complications and dyskinesia in PD.
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Affiliation(s)
- Valeria Conti
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Viviana Izzo
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Maria Claudia Russillo
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Marina Picillo
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Marianna Amboni
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Cesa L M Scaglione
- IRCCS "Istituto delle Scienze Neurologiche di Bologna", UOC Neurological Clinic, Bellaria Hospital, Bologna, Italy
| | - Alessandra Nicoletti
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Ilaria Cani
- IRCCS "Istituto delle Scienze Neurologiche di Bologna", UOC Neurological Clinic, Bellaria Hospital, Bologna, Italy
| | - Calogero E Cicero
- Neurologic Unit, AOU "Policlinico-San Marco", Department of Medical, Surgical Sciences and Advanced Technologies, GF Ingrassia, University of Catania, Catania, Italy
| | - Emanuela De Bellis
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Bruno Charlier
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Valentina Giudice
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Gerardina Somma
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Paolo Barone
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Maria Teresa Pellecchia
- Neuroscience Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
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Sellitto C, Corbi G, Stefanelli B, Manzo V, Trucillo M, Charlier B, Mensitieri F, Izzo V, Lucariello A, Perna A, Guerra G, De Luca A, Filippelli A, Conti V. Antioxidant Supplementation Hinders the Role of Exercise Training as a Natural Activator of SIRT1. Nutrients 2022; 14:nu14102092. [PMID: 35631233 PMCID: PMC9146003 DOI: 10.3390/nu14102092] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 12/14/2022] Open
Abstract
Exercise training (ET) is a natural activator of silent mating type information regulation 2 homolog 1 (SIRT1), a stress-sensor able to increase the endogenous antioxidant system. SIRT1 activators include polyphenols and vitamins, the antioxidant properties of which are well-known. Antioxidant supplements are used to improve athletic performance. However, they might blunt ET-related benefits. Middle-distance runners (MDR) taking (MDR-S) or not taking antioxidant supplements (MDR-NoS) were compared with each other and with sedentary subjects (CTR) to evaluate the ET effects on SIRT1 levels and oxidative stress, and to investigate whether an exogenous source of antioxidants could interfere with such effects. Thirty-two MDR and 14 CTR were enrolled. MDR-S took 240 mg vitamin C and 15 mg vitamin E together with mineral salts. SIRT1 mRNA and activity were measured in PBMCs. Total oxidative status (TOS) and total antioxidant capacity (TEAC) were determined in plasma. MDR showed higher levels of SIRT1 mRNA (p = 0.0387) and activity (p = 0.0055) than did CTR. MDR-NoS also showed higher levels than did MDR-S without reaching statistical significance. SIRT1 activity was higher (p = 0.0012) in MDR-NoS (1909 ± 626) than in MDR-S (1276 ± 474). TOS did not differ among the groups, while MDR showed higher TEAC levels than did CTR (2866 ± 581 vs. 2082 ± 560, p = 0.0001) as did MDR-S (2784 ± 643) and MDR-NoS (2919 ± 551) (MDR-S vs. CTR, p = 0.0007 and MDR-NoS vs. CTR, p = 0.003). TEAC (β = 0.4488356, 95% CI 0.2074645 0.6902067; p < 0.0001) and the MDR-NoS group (β = 744.6433, 95% CI 169.9954 1319.291; p= 0.012) predicted SIRT1 activity levels. Antioxidant supplementation seems to hinder the role of ET as a natural activator of SIRT1.
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Affiliation(s)
- Carmine Sellitto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Medicina Traslazionale dello Sviluppo e dell’Invecchiamento Attivo, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (C.S.); (B.C.)
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy; (V.M.); (A.F.); (V.C.)
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.P.); (G.G.)
- Correspondence: ; Tel.: +39-(0)8-7440-4771
| | - Berenice Stefanelli
- Postgraduate School of Clinical Pharmacology and Toxicology, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
| | - Valentina Manzo
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy; (V.M.); (A.F.); (V.C.)
| | - Marta Trucillo
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (A.D.L.)
| | - Bruno Charlier
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Medicina Traslazionale dello Sviluppo e dell’Invecchiamento Attivo, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (C.S.); (B.C.)
| | - Francesca Mensitieri
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.M.); (V.I.)
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.M.); (V.I.)
| | - Angela Lucariello
- Department of Sport Sciences and Wellness, Section of Human Anatomy, University of Naples “Parthenope”, 80100 Naples, Italy;
| | - Angelica Perna
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.P.); (G.G.)
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (A.P.); (G.G.)
| | - Antonio De Luca
- Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (A.D.L.)
| | - Amelia Filippelli
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy; (V.M.); (A.F.); (V.C.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.M.); (V.I.)
| | - Valeria Conti
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Via San Leonardo 1, 84131 Salerno, Italy; (V.M.); (A.F.); (V.C.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.M.); (V.I.)
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Giudice V, Iannaccone T, Faiella F, Ferrara F, Aversano G, Coppola S, De Chiara E, Romano MG, Conti V, Filippelli A. Gender Differences in the Impact of COVID-19 Pandemic on Mental Health of Italian Academic Workers. J Pers Med 2022; 12:jpm12040613. [PMID: 35455729 PMCID: PMC9030948 DOI: 10.3390/jpm12040613] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 01/09/2023] Open
Abstract
The 2020 pandemic for coronavirus SARS-CoV-2 infection has required strict measures for virus spreading reduction, including stay-at-home orders. To explore gender differences in mental health status after the first wave of the pandemic and in teleworking, we analyzed the frequency and distribution of emotions and coping strategies for facing the pandemic stratified by gender using data from an online survey conducted at the University of Salerno, Italy, between 11 May and 10 June 2020. The online questionnaire included 31 items on demographics, teleworking, COVID-19 emergency, and gender-based violence, with multiple-choice answers for some questions. Females felt significantly sadder (p = 0.0019), lonelier (p = 0.0058), more fearful (p = 0.0003), and more insecure (p = 0.0129) than males, experienced more sleep disorders (p = 0.0030), and were more likely to sanitize surfaces compared to males (p < 0.0001). Our results show gender differences in awareness and concerns about the COVID-19 pandemic that differently influenced mood, as females were more frightened and worried than males.
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Affiliation(s)
- Valentina Giudice
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (T.I.); (V.C.); (A.F.)
- Clinical Pharmacology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
- Correspondence: ; Tel.: +39-089-672493
| | - Teresa Iannaccone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (T.I.); (V.C.); (A.F.)
- Clinical Pharmacology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Filomena Faiella
- Department of Humanistic Studies, University of Salerno, 84084 Fisciano, Italy;
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
| | - Filomena Ferrara
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
| | - Giusi Aversano
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
| | - Silvia Coppola
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
| | - Elisa De Chiara
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
| | - Maria Grazia Romano
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
- Department of Economy and Statistics, University of Salerno, 84084 Fisciano, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (T.I.); (V.C.); (A.F.)
- Clinical Pharmacology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (T.I.); (V.C.); (A.F.)
- Clinical Pharmacology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
- Single Guarantee Committee, University of Salerno, 84084 Fisciano, Italy; (F.F.); (G.A.); (S.C.); (E.D.C.); (M.G.R.)
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Conti V, Sellitto C, Torsiello M, Manzo V, De Bellis E, Stefanelli B, Bertini N, Costantino M, Maci C, Raschi E, Sabbatino F, Corbi G, Pagliano P, Filippelli A. Identification of Drug Interaction Adverse Events in Patients With COVID-19: A Systematic Review. JAMA Netw Open 2022; 5:e227970. [PMID: 35438752 PMCID: PMC9020212 DOI: 10.1001/jamanetworkopen.2022.7970] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE During the COVID-19 pandemic, urgent clinical management of patients has mainly included drugs currently administered for other diseases, referred to as repositioned drugs. As a result, some of these drugs have proved to be not only ineffective but also harmful because of adverse events associated with drug-drug interactions (DDIs). OBJECTIVE To identify DDIs that led to adverse clinical outcomes and/or adverse drug reactions in patients with COVID-19 by systematically reviewing the literature and assessing the value of drug interaction checkers in identifying such events. EVIDENCE REVIEW After identification of the drugs used during the COVID-19 pandemic, the drug interaction checkers Drugs.com, COVID-19 Drug Interactions, LexiComp, Medscape, and WebMD were consulted to analyze theoretical DDI-associated adverse events in patients with COVID-19 from March 1, 2020, through February 28, 2022. A systematic literature review was performed by searching the databases PubMed, Scopus, and Cochrane for articles published from March 1, 2020, through February 28, 2022, to retrieve articles describing actual adverse events associated with DDIs. The drug interaction checkers were consulted again to evaluate their potential to assess such events. FINDINGS The DDIs identified in the reviewed articles involved 46 different drugs. In total, 575 DDIs for 58 drug pairs (305 associated with at least 1 adverse drug reaction) were reported. The drugs most involved in DDIs were lopinavir and ritonavir. Of the 6917 identified studies, 20 met the inclusion criteria. These studies, which enrolled 1297 patients overall, reported 115 DDI-related adverse events: 15 (26%) were identifiable by all tools analyzed, 29 (50%) were identifiable by at least 1 of them, and 14 (24%) remained nonidentifiable. CONCLUSIONS AND RELEVANCE The main finding of this systematic review is that the use of drug interaction checkers could have identified several DDI-associated adverse drug reactions, including severe and life-threatening events. Both the interactions between the drugs used to treat COVID-19 and between the COVID-19 drugs and those already used by the patients should be evaluated.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Doctoral School, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Italy
| | - Martina Torsiello
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
| | - Emanuela De Bellis
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
- Postgraduate Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Italy
| | - Berenice Stefanelli
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
- Postgraduate Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Italy
| | - Nicola Bertini
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
- Postgraduate Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana,” University of Salerno, Baronissi, Italy
| | - Maria Costantino
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Chiara Maci
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
| | - Emanuel Raschi
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Oncology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Infectious Diseases Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy
- Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, Italy
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Sellitto C, Scarpati G, Ascione T, Franci G, Piazza O, Filippelli A, Conti V, Pagliano P. Pharmacological Approaches to Visceral Leishmaniasis in Immunocompromised Patients. mjima 2022. [DOI: 10.4274/mjima.galenos.2022.2021.21] [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: 12/01/2022]
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D'Amore C, Grimaldi P, Ascione T, Conti V, Sellitto C, Franci G, Kafil SH, Pagliano P. West Nile Virus diffusion in temperate regions and climate change. A systematic review. Infez Med 2022; 31:20-30. [PMID: 36908379 PMCID: PMC9994819 DOI: 10.53854/liim-3101-4] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/02/2023] [Indexed: 03/07/2023]
Abstract
West Nile virus (WNV) is a member of the Japanese encephalitis serocomplex, which was first described in 1937 as neurotropic virus in Uganda in 1937. Subsequently, WNV was identified in the rest of the old-world and from 1999 in North America. Birds are the primary hosts, and WNV is maintained in a bird-mosquito-bird cycle, with pigs as amplifying hosts and humans and horses as incidental hosts. WNV transmission is warranted by mosquitoes, usually of the Culex spp., with a tendency to spill over when mosquitoes' populations build up. Other types of transmissions have been described in endemic areas, as trough transplanted organs and transfused blood, placenta, maternal milk, and in some occupational settings. WNV infections in North America and Europe are generally reported during the summer and autumn. Extreme climate phenomena and soil degradation are important events which contribute to expansion of mosquito population and consequently to the increasing number of infections. Draught plays a pivotal role as it makes foul water standing in city drains and catch basins richer of organic material. The relationship between global warming and WNV in climate areas is depicted by investigations on 16,298 WNV cases observed in the United States during the period 2001-2005 that showed that a 5°C increase in mean maximum weekly temperature was associated with a 32-50% higher incidence of WNV infection. In Europe, during the 2022 season, an increase of WNV cases was observed in Mediterranean countries where 1,041 cases were reported based on ECDC data. This outbreak can be associated to the climate characteristics reported during this period and to the introduction of a new WNV-1 lineage. In conclusion, current climate change is causing an increase of mosquito circulation that supports the widest spread of some vector-borne virus including WNV diffusion in previously non-permissible areas. This warrant public health measures to control vectors circulation to reduce WNV and to screen blood and organ donations.
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Affiliation(s)
- Chiara D'Amore
- Department of Infectious Diseases, AOU "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Pierantonio Grimaldi
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Tiziana Ascione
- Service of Infectious Diseases, AORN "A. Cardarelli", Naples, Italy
| | - Valeria Conti
- Clinical Pharmacology Unit. Department of Medicine, Surgery, and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Clinical Pharmacology Unit. Department of Medicine, Surgery, and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Clinical Microbiology Unit. Department of Medicine, Surgery, and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Samadi Hossein Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Pasquale Pagliano
- Unit of Infectious Diseases, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
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Conti V, Migliorini F, Pilone M, Barriopedro MI, Ramos-Álvarez JJ, Montero FJC, Maffulli N. Right heart exercise-training-adaptation and remodelling in endurance athletes. Sci Rep 2021; 11:22532. [PMID: 34795399 PMCID: PMC8602371 DOI: 10.1038/s41598-021-02028-1] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/01/2021] [Indexed: 01/11/2023] Open
Abstract
Long-term sports training leads to myocardial adaptations, with remodelling of the heart chambers. However, while myocardial adaptations of the left heart are well described, remodelling of the right heart and its impact on the development of arrhythmias is still debated. To conduct a systematic review on right ventricle (RV) and right atrium (RA) structural and functional changes in athletes who participate in long-term endurance training. Systematic review. A systematic literature search was conducted. All the articles reporting right heart echocardiographic (ECHO) and cardiac magnetic resonance (CMR) parameters evaluated in endurance athletes and sedentary subjects were considered eligible. A multivariate analysis was conducted to investigate whether age, sex, body surface area (BSA), intensity of training are associated with RV ECHO, CMR parameters and RA ECHO parameters. A positive association between age and right atrium area (RAA) (P = 0.01) was found. This is a negative association to RV E/A (P = 0.004), and RV end diastolic diameter (RVED) longitudinal (P = 0.01). A positive association between BSA and RVED middle (P = 0.001), as well between BSA and RAA (P = 0.05) was found, along with a negative association with RV E/A (P = 0.002). A positive association between intensity of training and RV end systolic area (RVESA) (P = 0.03), RV end diastolic volume indexed (RVEDVI) (P = 0.01), RV end systolic volume indexed (RVESVI) (P = 0.01) was found, along with a negative association with ejection fraction (EF %) (P = 0.01). Endurance athletes demonstrated an association between RV remodelling and age, BSA and intensity of training.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Recontructive Surgery, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Marco Pilone
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - María I Barriopedro
- Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Juan José Ramos-Álvarez
- Escuela de Medicina Deportiva. Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Javer Calderon Montero
- Escuela de Medicina Deportiva. Departamento de Radiología, Rehabilitación y Fisioterapia, Universidad Complutense de Madrid, Madrid, Spain
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London, E1 4DG, England, UK
- Department of Musculoskeletal Disorders, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Costantino M, Conti V, Corbi G, Filippelli A. Hydropinotherapy with Sulphurous Mineral Water as Complementary Treatment to Improve Glucose Metabolism, Oxidative Status, and Quality of Life. Antioxidants (Basel) 2021; 10:antiox10111773. [PMID: 34829645 PMCID: PMC8614851 DOI: 10.3390/antiox10111773] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/10/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Hydropinotherapy is a salus per aquam (Spa) treatment suitable as a complementary approach to treat several diseases, which strongly affect the quality of life (QoL). Hydropinotherapy with sulphurous mineral water exerts benefits thanks to components, such as hydrogen sulphide, which is considered mainly responsible for antioxidant and hypoglycaemic effects. Such properties, linked from each other, could favour an improvement in patients’ QoL. However, data on humans are scarce. This study aimed to investigate whether a cycle of sulphurous hydropinotherapy was able to modify plasma levels of glucose and reactive oxygen metabolites (ROMs) and improve QoL in patients suffering from several chronic disorders. A prospective, observational study involved patients with gastrointestinal diseases who received a prescription of a cycle of sulphurous hydropinotherapy (S-HT). Age- and sex-matched control group was enrolled (No S-HT). Glycaemia and plasma concentration of ROMs were measured in all subjects. The impact of spa treatment on the QoL was assessed using the Short Form 36 Health Status Survey questionnaire (SF-36). All parameters were measured at baseline and at the end of a 2-week treatment. Between the groups, no differences were found in glycaemia and ROMs at baseline. In the S-HT group, a reduction in glycaemia and ROMs, both in respect to baseline (p = 0.005 and p = 0.031, respectively) and to control group, as shown by the delta value calculated, as the difference between the values at 2 weeks and baseline (p = 0.0009 and p = 0.0001, respectively). In the S-HT, delta ROMs was the best predictor of delta glycaemia with a direct linear correlation (beta = 0.559, 95% CI 0.471 to 0.647, p < 0.0001). In the S-HT, the SF-36 total score was improved both when compared with baseline (p = 0.002) and with No S-HT (p = 0.001). Sulphurous hydropinotherapy induces a decrease in glycaemia and ROM levels, also ameliorating the patients’ QoL. Therefore, it could be considered a useful complementary therapeutic approach.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (A.F.)
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences) in Italian National Register of Research of MIUR, 80078 Pozzuoli, Italy
- Correspondence: ; Tel.: +39-08965041; Fax: +39-1786070323
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (A.F.)
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (V.C.); (A.F.)
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences) in Italian National Register of Research of MIUR, 80078 Pozzuoli, Italy
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Pagliano P, Sellitto C, Scarpati G, Ascione T, Conti V, Franci G, Piazza O, Filippelli A. An overview of the preclinical discovery and development of remdesivir for the treatment of coronavirus disease 2019 (COVID-19). Expert Opin Drug Discov 2021; 17:9-18. [PMID: 34412564 PMCID: PMC8425432 DOI: 10.1080/17460441.2021.1970743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction Remdesivir (RDV) is an inhibitor of the viral RNA-dependent RNA polymerases that are active in some RNA viruses, including the Ebola virus and zoonotic coronaviruses. When severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent of the coronavirus disease 2019 (COVID-19), several investigations have assessed the potential activity of RDV in inhibiting viral replication, giving rise to hope for an effective treatment. Areas covered In this review, the authors describe the main investigations leading to the discovery of RDV and its subsequent development as an antiviral agent, focusing on the main clinical trials investigating its efficacy in terms of symptom resolution and mortality reduction. Expert opinion RDV is the most widely investigated antiviral drug for the treatment of COVID-19. This attention on RDV activity against SARS-CoV-2 is justified by promising in vitro studies, which demonstrated that RDV was able to suppress viral replication without significant toxicity. Such activity was confirmed by an investigation in an animal model and by the results of preliminary clinical investigations. Nevertheless, the efficacy of RDV in reducing mortality has not been clearly demonstrated.
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Affiliation(s)
- Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Giuliana Scarpati
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Unit of Microbiology, University of Salerno, Baronissi, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", Unit of Pharmacology, University of Salerno, Baronissi, Italy
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Cammarota S, Conti V, Corbi G, Di Gregorio L, Dolce P, Fogliasecca M, Iannaccone T, Manzo V, Passaro V, Toraldo B, Valente A, Citarella A. Predictors of Opioid Prescribing for Non-Malignant Low Back Pain in an Italian Primary Care Setting. J Clin Med 2021; 10:jcm10163699. [PMID: 34441993 PMCID: PMC8397205 DOI: 10.3390/jcm10163699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
This study explores which patient characteristics could affect the likelihood of starting low back pain (LBP) treatment with opioid analgesics vs. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in an Italian primary care setting. Through the computerized medical records of 65 General Practitioners, non-malignant LBP subjects who received the first pain intensity measurement and an NSAID or opioid prescription, during 2015–2016, were identified. Patients with an opioid prescription 1-year before the first pain intensity measurement were excluded. A multivariable logistic regression model was used to determine predictive factors of opioid prescribing. Results were reported as Odds Ratios (ORs) with a 95% confidence interval (CI), with p < 0.05 indicating statistical significance. A total of 505 individuals with LBP were included: of those, 72.7% received an NSAID prescription and 27.3% an opioid one (64% of subjects started with strong opioid). Compared to patients receiving an NSAID, those with opioid prescriptions were younger, reported the highest pain intensity (moderate pain OR = 2.42; 95% CI 1.48–3.96 and severe pain OR = 2.01; 95% CI 1.04–3.88) and were more likely to have asthma (OR 3.95; 95% CI 1.99–7.84). Despite clinical guidelines, a large proportion of LBP patients started with strong opioid therapy. Asthma, younger age and pain intensity were predictors of opioid prescribing when compared to NSAIDs for LBP treatment.
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Affiliation(s)
- Simona Cammarota
- LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., 80143 Naples, Italy; (M.F.); (A.C.)
- Correspondence: ; Tel.: +39-333-532-0054
| | - Valeria Conti
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84084 Salerno, Italy; (V.C.); (T.I.); (V.M.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy;
- Italian Society of Gerontology and Geriatrics (SIGG), 50122 Florence, Italy
| | - Luigi Di Gregorio
- Parmenide Medical Cooperative, 84084 Salerno, Italy; (L.D.G.); (V.P.)
| | - Pasquale Dolce
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy;
| | - Marianna Fogliasecca
- LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., 80143 Naples, Italy; (M.F.); (A.C.)
| | - Teresa Iannaccone
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84084 Salerno, Italy; (V.C.); (T.I.); (V.M.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Valentina Manzo
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84084 Salerno, Italy; (V.C.); (T.I.); (V.M.)
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Vincenzo Passaro
- Parmenide Medical Cooperative, 84084 Salerno, Italy; (L.D.G.); (V.P.)
| | | | - Alfredo Valente
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Anna Citarella
- LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., 80143 Naples, Italy; (M.F.); (A.C.)
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Ciaglia E, Lopardo V, Montella F, Sellitto C, Manzo V, De Bellis E, Iannaccone T, Franci G, Zannella C, Pagliano P, Di Pietro P, Carrizzo A, Vecchione C, Conti V, Filippelli A, Puca AA. BPIFB4 Circulating Levels and Its Prognostic Relevance in COVID-19. J Gerontol A Biol Sci Med Sci 2021; 76:1775-1783. [PMID: 34396395 PMCID: PMC8436991 DOI: 10.1093/gerona/glab208] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Indexed: 02/06/2023] Open
Abstract
Aging and comorbidities make individuals at greatest risk of COVID-19 serious illness and mortality due to senescence-related events and deleterious inflammation. Long-living individuals (LLIs) are less susceptible to inflammation and develop more resiliency to COVID-19. As demonstrated, LLIs are characterized by high circulating levels of BPIFB4, a protein involved in homeostatic response to inflammatory stimuli. Also, LLIs show enrichment of homozygous genotype for the minor alleles of a 4 missense single-nucleotide polymorphism haplotype (longevity-associated variant [LAV]) in BPIFB4, able to counteract progression of diseases in animal models. Thus, the present study was designed to assess the presence and significance of BPIFB4 level in COVID-19 patients and the potential therapeutic use of LAV-BPIFB4 in fighting COVID-19. BPIFB4 plasma concentration was found significantly higher in LLIs compared to old healthy controls while it significantly decreased in 64 COVID-19 patients. Further, the drop in BPIFB4 values correlated with disease severity. Accordingly to the LAV-BPIFB4 immunomodulatory role, while lysates of SARS-CoV-2-infected cells induced an inflammatory response in healthy peripheral blood mononuclear cells in vitro, the co-treatment with recombinant protein (rh) LAV-BPIFB4 resulted in a protective and self-limiting reaction, culminating in the downregulation of CD69 activating-marker for T cells (both TCD4+ and TCD8+) and in MCP-1 reduction. On the contrary, rhLAV-BPIFB4 induced a rapid increase in IL-18 and IL-1b levels, shown largely protective during the early stages of the virus infection. This evidence, along with the ability of rhLAV-BPIFB4 to counteract the cytotoxicity induced by SARS-CoV-2 lysate in selected target cell lines, corroborates BPIFB4 prognostic value and open new therapeutic possibilities in more vulnerable people.
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Affiliation(s)
- Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Valentina Lopardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Teresa Iannaccone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Infectious Diseases Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Department of Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy
| | - Annibale Alessandro Puca
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Baronissi, Italy.,Cardiovascular Research Unit, IRCCS MultiMedica, Milan, Italy
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Conti V, Corbi G, Sellitto C, Sabbatino F, Maci C, Bertini N, De Bellis E, Iuliano A, Davinelli S, Pagliano P, Filippelli A. Effect of Tocilizumab in Reducing the Mortality Rate in COVID-19 Patients: A Systematic Review with Meta-Analysis. J Pers Med 2021; 11:jpm11070628. [PMID: 34357095 PMCID: PMC8307114 DOI: 10.3390/jpm11070628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/03/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
Data supporting the use of Tocilizumab (TCZ) in COVID-19 are contrasting and inconclusive. This meta-analysis aimed to assess TCZ effectiveness in reducing the mortality rate in COVID-19 patients. PubMed, Scopus, Embase, Cochrane, WILEY, and ClinicalTrials.gov were searched to evaluate observational studies and RCTs. The outcome was the mortality rate. Forty observational studies and seven RCTs, involving 9640 and 5556 subjects treated with Standard Therapy (ST) + TCZ or ST alone, respectively, were included. In patients treated with ST+TCZ, a higher survival (Log odds ratio = −0.41; 95% CI: −0.68 −0.14; p < 0.001) was found. Subgroups analyses were performed to better identify the possible interference of some parameters in modifying the efficacy of TCZ therapy on COVID-19 mortality. Separating observational from RCTs, no statistically significant (p = 0.70) TCZ-related reduction of mortality regarding RCTs was found, while a significant reduction (Log odds ratio = −0.52; 95% CI: −0.82 −0.22, p < 0.001) was achieved regarding the observational studies. Stratifying for the use of Invasive Mechanic Ventilation (IMV), a higher survival was found in patients treated with TCZ in the No-IMV and IMV groups (both p < 0.001), but not in the No-IMV/IMV group. Meta-regression analyses were also performed. The meta-analysis of observational studies reveals that TCZ is associated with reducing the mortality rate in both severe and critically ill patients. Although the largest RCT, RECOVERY, is in line with this result, the meta-analysis of RCTs failed to found any difference between ST + TCZ and ST. It is crucial to personalize the therapy considering the patients’ characteristics.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, 84125 Salerno, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
- Italian Society of Gerontology and Geriatrics (SIGG), Via G.C. Vanini, 5, 50129 Firenze, Italy
- Correspondence: ; Tel.: +39-0874404771
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
- Oncology Unit, University Hospital San Giovanni di Dio e Ruggi D’Aragona, 84125 Salerno, Italy
| | - Chiara Maci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
| | - Nicola Bertini
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
| | - Antonio Iuliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
| | - Sergio Davinelli
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
- Infectious Diseases Unit, Hospital San Giovanni di Dio e Ruggi D’Aragona, 84125 Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (V.C.); (C.S.); (F.S.); (C.M.); (N.B.); (E.D.B.); (A.I.); (P.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, 84125 Salerno, Italy
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Sabbatino F, Conti V, Franci G, Sellitto C, Manzo V, Pagliano P, De Bellis E, Masullo A, Salzano FA, Caputo A, Peluso I, Zeppa P, Scognamiglio G, Greco G, Zannella C, Ciccarelli M, Cicala C, Vecchione C, Filippelli A, Pepe S. PD-L1 Dysregulation in COVID-19 Patients. Front Immunol 2021; 12:695242. [PMID: 34163490 PMCID: PMC8215357 DOI: 10.3389/fimmu.2021.695242] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [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: 04/14/2021] [Accepted: 05/24/2021] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic has reached direct and indirect medical and social consequences with a subset of patients who rapidly worsen and die from severe-critical manifestations. As a result, there is still an urgent need to identify prognostic biomarkers and effective therapeutic approaches. Severe-critical manifestations of COVID-19 are caused by a dysregulated immune response. Immune checkpoint molecules such as Programmed death-1 (PD-1) and its ligand programmed death-ligand 1 (PD-L1) play an important role in regulating the host immune response and several lines of evidence underly the role of PD-1 modulation in COVID-19. Here, by analyzing blood sample collection from both hospitalized COVID-19 patients and healthy donors, as well as levels of PD-L1 RNA expression in a variety of model systems of SARS-CoV-2, including in vitro tissue cultures, ex-vivo infections of primary epithelial cells and biological samples obtained from tissue biopsies and blood sample collection of COVID-19 and healthy individuals, we demonstrate that serum levels of PD-L1 have a prognostic role in COVID-19 patients and that PD-L1 dysregulation is associated to COVID-19 pathogenesis. Specifically, PD-L1 upregulation is induced by SARS-CoV-2 in infected epithelial cells and is dysregulated in several types of immune cells of COVID-19 patients including monocytes, neutrophils, gamma delta T cells and CD4+ T cells. These results have clinical significance since highlighted the potential role of PD-1/PD-L1 axis in COVID-19, suggest a prognostic role of PD-L1 and provide a further rationale to implement novel clinical studies in COVID-19 patients with PD-1/PD-L1 inhibitors.
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Affiliation(s)
- Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Oncology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Clinical Pathology and Microbiology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Infectious Disease Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Alfonso Masullo
- Infectious Disease Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Otolaryngology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Alessandro Caputo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pathology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Ilaria Peluso
- Hematology Unit, AORN Cardarelli Hospital, Naples, Italy
| | - Pio Zeppa
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pathology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Giosuè Scognamiglio
- Pathology Unit, Istituto Nazionale Tumori, IRCSS, "Fondazione G Pascale", Naples, Italy
| | - Giuseppe Greco
- Section of Microbiology and Virology, University Hospital "Luigi Vanvitelli", Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Cardiology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Claudia Cicala
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Vascular Pathophysiology Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Pharmacology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
| | - Stefano Pepe
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi (SA), Italy.,Oncology Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Salerno, Italy
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Rea F, Biffi A, Ronco R, Franchi M, Cammarota S, Citarella A, Conti V, Filippelli A, Sellitto C, Corrao G. Cardiovascular Outcomes and Mortality Associated With Discontinuing Statins in Older Patients Receiving Polypharmacy. JAMA Netw Open 2021; 4:e2113186. [PMID: 34125221 PMCID: PMC8204202 DOI: 10.1001/jamanetworkopen.2021.13186] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Polypharmacy is a major health concern among older adults. While deprescribing may reduce inappropriate medicine use, its effect on clinical end points remains uncertain. OBJECTIVE To assess the clinical implications of discontinuing the use of statins while maintaining other drugs in a cohort of older patients receiving polypharmacy. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-based cohort study included the 29 047 residents in the Italian Lombardy region aged 65 years or older who were receiving uninterrupted treatment with statins, blood pressure-lowering, antidiabetic, and antiplatelet agents from October 1, 2013, until January 31, 2015, with follow-up through June 30, 2018. Data were collected using the health care utilization database of Lombardy region in Italy. Data analysis was conducted from March to November 2020. EXPOSURES Cohort members were followed up to identify those who discontinued statins. Among this group, those who maintained other therapies during the first 6 months after statin discontinuation were 1:1 propensity score matched with patients who discontinued neither statins nor other drugs. MAIN OUTCOME AND MEASURES The pairs of patients discontinuing and maintaining statins were followed up from the initial discontinuation until June 30, 2018, to estimate the hazard ratios (HRs) and 95% CIs for fatal and nonfatal outcomes associated with statin discontinuation. RESULTS The full cohort inclued 29 047 patients exposed to polypharmacy (mean [SD] age, 76.5 [6.5] years; 18 257 [62.9%] men). Of them, 5819 (20.0%) discontinued statins while maintaining other medications, and 4010 (68.9%) of them were matched with a comparator. In the discontinuing group, the mean (SD) age was 76.5 (6.4) years, 2405 (60.0%) were men, and 506 (12.6%) had Multisource Comorbidity Scores of 4 or 5. In the maintaining group, the mean (SD) age was 76.1 (6.3) years, 2474 (61.7%) were men, and 482 (12.0%) had multisource comorbidity scores of 4 or 5. Compared with the maintaining group, patients in the discontinuing group had increased risk of hospital admissions for heart failure (HR, 1.24; 95% CI, 1.07-1.43) and any cardiovascular outcome (HR, 1.14; 95% CI, 1.03-1.26), deaths from any cause (HR, 1.15; 95% CI, 1.02-1.30), and emergency admissions for any cause (HR, 1.12; 95% CI, 1.05-1.19). CONCLUSIONS AND RELEVANCE In this study of patients receiving polypharmacy, discontinuing statins while maintaining other drug therapies was associated with an increase in the long-term risk of fatal and nonfatal cardiovascular outcomes.
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Affiliation(s)
- Federico Rea
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Annalisa Biffi
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Raffaella Ronco
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Simona Cammarota
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
- LinkHealth, Health Economics, Outcomes and Epidemiology, Naples, Italy
| | - Anna Citarella
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
- LinkHealth, Health Economics, Outcomes and Epidemiology, Naples, Italy
| | - Valeria Conti
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy
| | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Laboratory of Healthcare Research and Pharmacoepidemiology, Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
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Pagliano P, Scarpati G, Sellitto C, Conti V, Spera AM, Ascione T, Piazza O, Filippelli A. Experimental Pharmacotherapy for COVID-19: The Latest Advances. J Exp Pharmacol 2021; 13:1-13. [PMID: 33442304 PMCID: PMC7800714 DOI: 10.2147/jep.s255209] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/12/2020] [Indexed: 12/17/2022] Open
Abstract
The coronavirus infectious disease-2019 (COVID-19) has overwhelmed like a shock wave in a completely unprepared world. Despite coronavirus infections were involved in previous epidemic outbreaks, no antiviral agent was developed for specific treatment. As a consequence, since the beginning of this pandemic, both repositioned and experimental drugs were used to treat the infected patients without evidence of clinical efficacy. Just based on experience coming from the use of antiviral agents to treat other viruses (eg, lopinavir/ritonavir, remdesivir) and supposed antiviral or immunomodulatory activities of drugs with no approved antiviral indications (eg hydroxychloroquine, tocilizumab), clinicians have faced the ongoing pandemic. Currently, after about 9 months from the COVID-19 spread, there is still no antiviral agent capable of ensuring the cure of this syndrome. Clinical trials are beginning to confirm the benefits of some drugs, while for other compounds, efficacy and safety have not yet been confirmed. Randomized clinical trials (RCT) have denied or downsized the beneficial effects attributed to certain molecules, such as aminoquinolines, largely used in clinical practice at the beginning of COVID-19 spread. Conversely, at the same time, they have provided evidence for unexpected effectiveness of other agents that have been underutilized, such as steroids, which were not used in SARS treatment because of the threatened effect on viral replication. Evidence deriving from pathologic studies have demonstrated that the prothrombotic effects of SARS-CoV-2 can be prevented by heparin prophylaxis, underlining the need for personalized treatment for patients with severe disease. The main aim of this review is to synthesize the available information and evidence on both repositioned and experimental drugs for the treatment of COVID-19, focusing on the need to exercise caution on the use of unproven medical therapies.
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Affiliation(s)
- Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Giuliana Scarpati
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Anna Maria Spera
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Pharmacology, University of Salerno, Baronissi, Italy
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Conti V, Corbi G, Manzo V, Sellitto C, Iannello F, Esposito S, De Bellis E, Iannaccone T, Filippelli A. The role of pharmacogenetics for antithrombotic therapy management: new achievements and barriers yet to overcome. Curr Med Chem 2020; 28:6675-6703. [PMID: 33390104 DOI: 10.2174/0929867328666201231124715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/30/2020] [Accepted: 11/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Pharmacogenetics investigates the response to pharmacological treatments based on individual genetic background. Actually, numerous pharmacogenetic tests help to predict the response to drugs used in different medical areas, contributing to the so-called personalized medicine. OBJECTIVE This review aims to update the available data on the genotype-guided treatment with both the anticoagulant and antiplatelet agents. Moreover, it shed light on the pitfalls still contrasting the implementation of cardiovascular pharmacogenetics. METHODS A review of the literature on the studies investigating the effects of the genotype-guided anticoagulant and antiplatelet treatment was performed. RESULTS Considering the large use of antithrombotic drugs, pharmacogenetics has particular importance in this field. Several polymorphisms influence the response to both anticoagulant and antiplatelet agents, and tests, based on their identification, are now available. CONCLUSIONS Recent randomized clinical trials demonstrated that pharmacogenetics might successfully contribute to optimizing the antiplatelet therapy also in patients particularly complicated to treat. However, despite accumulating evidence on the utility and feasibility of some pharmacogenetics tests, several barriers still contrast their implementation into clinical practice.
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Affiliation(s)
- V Conti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - G Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso. Italy
| | - V Manzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - C Sellitto
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - F Iannello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - S Esposito
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - E De Bellis
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - T Iannaccone
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
| | - A Filippelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi. Italy
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Sabbatino F, Liguori L, Malapelle U, Schiavi F, Tortora V, Conti V, Filippelli A, Tortora G, Ferrone CR, Pepe S. Case Report: BAP1 Mutation and RAD21 Amplification as Predictive Biomarkers to PARP Inhibitor in Metastatic Intrahepatic Cholangiocarcinoma. Front Oncol 2020; 10:567289. [PMID: 33330039 PMCID: PMC7728995 DOI: 10.3389/fonc.2020.567289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/30/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction Intrahepatic cholangiocarcinoma (ICC) is a rare hepatobiliary cancer characterized by a poor prognosis and a limited response to conventional therapies. Currently chemotherapy is the only therapeutic option for patients with Stage IV ICC. Due to the poor response rate, there is an urgent need to identify novel molecular targets to develop novel effective therapies. Precision oncology tests utilizing targeted next-generation sequencing (NGS) platforms have rapidly entered into clinical practice. Profiling the genome and transcriptome of cancer to identify potentially targetable oncogenic pathways may guide the clinical care of the patient. Case presentation We present a 56-year-old male patient affected with metastatic ICC, whose cancer underwent several precision oncology tests by different NGS platforms. A novel BAP1 mutation (splice site c.581-17_585del22) and a RAD21 amplification were identified by a commercial available platform on a metastatic lesion. No germline BAP1 mutations were identified. Several lines of evidences indicate that PARP inhibitor administration might be an effective treatment in presence of BAP1 and/or RAD21 alterations since both BAP1 and RAD21 are involved in the DNA repair pathway, BAP1 interacts with BRCA1 and BRCA1-mediated DNA repair pathway alterations enhance the sensitivity to PARP inhibitor administration. In this case, after failing conventional therapies, patient was treated with PARP inhibitor olaparib. The patient had a partial response according to RECIST criteria with an overall survival of 37.2 months from the time of diagnosis of his ICC. Following 11.0 months on olaparib treatment, sustained stable disease control is ongoing. The patient is still being treated with olaparib and no significant toxicity has been reported. Conclusion These findings have clinical relevance since we have shown PARP inhibitor as a potential treatment for ICC patients harboring BAP1 deletion and RAD21 amplification. We have also highlighted the utility of NGS platforms to identify targetable mutations within a cancer.
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Affiliation(s)
- Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Oncology Unit, University Hospital San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Luigi Liguori
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Francesca Schiavi
- Familial Cancer Clinic and Oncoendocrinology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Vincenzo Tortora
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Giampaolo Tortora
- Oncologia Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Roma, Italy
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Stefano Pepe
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.,Oncology Unit, University Hospital San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
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Ribero S, Conti V, Gambardella A, DE Rosa AB, Dapavo P, Argenziano G. Brodalumab treatment in psoriasis patients with severe renal failure. Ital J Dermatol Venerol 2020. [PMID: 33228335 DOI: 10.23736/s0392-0488.20.06719-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Simone Ribero
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy -
| | - Valeria Conti
- Unit of Clinical Pharmacology, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | | | - Alina B DE Rosa
- Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Paolo Dapavo
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
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Ribero S, Conti V, Gambardella A, DE Rosa AB, Dapavo P, Argenziano G. Brodalumab treatment in psoriasis patients with severe renal failure. Ital J Dermatol Venerol 2020; 156:406-408. [PMID: 33228335 DOI: 10.23736/s2784-8671.20.06719-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Simone Ribero
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy -
| | - Valeria Conti
- Unit of Clinical Pharmacology, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | | | - Alina B DE Rosa
- Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Paolo Dapavo
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
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Conti V, Corbi G, Polito MV, Ciccarelli M, Manzo V, Torsiello M, De Bellis E, D’Auria F, Vitulano G, Piscione F, Carrizzo A, Di Pietro P, Vecchione C, Ferrara N, Filippelli A. Sirt1 Activity in PBMCs as a Biomarker of Different Heart Failure Phenotypes. Biomolecules 2020; 10:biom10111590. [PMID: 33238655 PMCID: PMC7700185 DOI: 10.3390/biom10111590] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 02/06/2023] Open
Abstract
Heart Failure (HF) is a syndrome, which implies the existence of different phenotypes. The new categorization includes patients with preserved ejection fraction (HFpEF), mid-range EF (HFmrEF), and reduced EF (HFrEF) but the molecular mechanisms involved in these HF phenotypes have not yet been exhaustively investigated. Sirt1 plays a crucial role in biological processes strongly related to HF. This study aimed to evaluate whether Sirt1 activity was correlated with EF and other parameters in HFpEF, HFmrEF, and HFrEF. Seventy patients, HFpEF (n = 23), HFmrEF (n = 23) and HFrEF (n = 24), were enrolled at the Cardiology Unit of the University Hospital of Salerno. Sirt1 activity was measured in peripheral blood mononuclear cells (PBMCs). Angiotensin-Converting Enzyme 2 (ACE2) activity, Tumor Necrosis Factor-alpha (TNF-α) and Brain Natriuretic Peptide (BNP) levels were quantified in plasma. HFpEF showed lower Sirt1 and ACE2 activities than both HFmrEF and HFrEF (p < 0.0001), without difference compared to No HF controls. In HFmrEF and HFrEF a very strong correlation was found between Sirt1 activity and EF (r2 = 0.899 and r2 = 0.909, respectively), and between ACE2 activity and Sirt1 (r2 = 0.801 and r2 = 0.802, respectively). HFrEF showed the highest TNF-α levels without reaching statistical significance. Significant differences in BNP were found among the groups, with the highest levels in the HFrEF. Determining Sirt1 activity in PBMCs is useful to distinguish the HF patients’ phenotypes from each other, especially HFmrEF/HFrEF from HFpEF.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy;
| | - Maria Vincenza Polito
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
- Correspondence: ; Tel.: +39-089-672-424
| | - Martina Torsiello
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Emanuela De Bellis
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Federica D’Auria
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Gennaro Vitulano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Federico Piscione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
- Department of Vascular Physiopathology, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
- Department of Vascular Physiopathology, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy;
- Istituti Clinici Scientifici Maugeri SPA-Società Benefit, IRCCS, 82037 Telese Terme (BN), Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (M.V.P.); (M.C.); (M.T.); (E.D.B.); (F.D.); (G.V.); (F.P.); (A.C.); (P.D.P.); (C.V.); (A.F.)
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Conti V, Corbi G, Iannaccone T, Corrado B, Giugliano L, Lembo S, Filippelli A, Guida M. Effectiveness and Tolerability of a Patch Containing Onion Extract and Allantoin for Cesarean Section Scars. Front Pharmacol 2020; 11:569514. [PMID: 33101027 PMCID: PMC7546780 DOI: 10.3389/fphar.2020.569514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background The prevention or early treatment of pathological scars is the most appropriate therapeutic approach. Gels and patches containing onion extract and allantoin are safe and effective in patients with scars of various origins and severity. However, no controlled studies have evaluated the effects of the patch formulation in women after Cesarean delivery. This study aimed to investigate the effects of a patch containing Allium cepa and allantoin on Cesarean section (C-section) scars. Methods This is an observational study. Women were consecutively recruited at the University Hospital of Salerno and subdivided into two groups considering the number of C-section. Group A included subjects without and group B with a history of C-section. Scars assessment was made using digital photographs and the Patient and Observer Scar Assessment Scale (POSAS). After 4 weeks, the C-section of the women who had applied a patch containing Allium cepa and allantoin and those of women who had not used any products (controls) were re-evaluated as at baseline. The Observers independently performed the scars assessment at baseline and after 4 weeks. Data are expressed as the difference of the POSAS scores after 4 weeks minus the POSAS scores at baseline. The statistical significance was established at a p value <0.05. Results Ninety-three subjects completed the study (47 in group A and 46 in group B). Women who had used a patch showed an improvement in total score by observer scale when compared with controls (p = 0.013). By the patient scale, no significant changes from baseline were found in group A and group B. Group B with patch showed changes in scars’ pigmentation (p = 0.015), relief (p = 0.039), and pliability (p = 0.046) in comparison of controls. Digital photographs confirmed such improvements in women who had already undergone previous C-section, while no significant changes from baseline were found in women without a history of C-section. Conclusions Intense treatment of just 4 weeks with a patch containing Alium Cepa extract and allantoin was able to improve pigmentation, relief, and pliability of C-section scars in women with a history of C-section. Clinical trial registration ClinicalTrials.gov, identifier NCT04046783.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - Teresa Iannaccone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Bianca Corrado
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Luigi Giugliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Serena Lembo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Maurizio Guida
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
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Conti V, De Bellis E, Manzo V, Sabbatino F, Iannello F, Dal Piaz F, Izzo V, Charlier B, Stefanelli B, Torsiello M, Iannaccone T, Coglianese A, Colucci F, Pepe S, Filippelli A. A Genotyping/Phenotyping Approach with Careful Clinical Monitoring to Manage the Fluoropyrimidines-Based Therapy: Clinical Cases and Systematic Review of the Literature. J Pers Med 2020; 10:jpm10030113. [PMID: 32899374 PMCID: PMC7564232 DOI: 10.3390/jpm10030113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 12/27/2022] Open
Abstract
Fluoropyrimidines (FP) are mainly metabolised by dihydropyrimidine dehydrogenase (DPD), encoded by the DPYD gene. FP pharmacogenetics, including four DPYD polymorphisms (DPYD-PGx), is recommended to tailor the FP-based chemotherapy. These polymorphisms increase the risk of severe toxicity; thus, the DPYD-PGx should be performed prior to starting FP. Other factors influence FP safety, therefore phenotyping methods, such as the measurement of 5-fluorouracil (5-FU) clearance and DPD activity, could complement the DPYD-PGx. We describe a case series of patients in whom we performed DPYD-PGx (by real-time PCR), 5-FU clearance and a dihydrouracil/uracil ratio (as the phenotyping analysis) and a continuous clinical monitoring. Patients who had already experienced severe toxicity were then identified as carriers of DPYD variants. The plasmatic dihydrouracil/uracil ratio (by high-performance liquid chromatography (HPLC)) ranged between 1.77 and 7.38. 5-FU clearance (by ultra-HPLC with tandem mass spectrometry) was measured in 3/11 patients. In one of them, it reduced after the 5-FU dosage was halved; in the other case, it remained high despite a drastic dosage reduction. Moreover, we performed a systematic review on genotyping/phenotyping combinations used as predictive factors of FP safety. Measuring the plasmatic 5-FU clearance and/or dihydrouracil/uracil (UH2/U) ratio could improve the predictive potential of DPYD-PGx. The upfront DPYD-PGx combined with clinical monitoring and feasible phenotyping method is essential to optimising FP-based chemotherapy.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Emanuela De Bellis
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy; (E.D.B.); (B.S.); (M.T.); (F.C.)
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy; (E.D.B.); (B.S.); (M.T.); (F.C.)
- Correspondence: ; Tel.: +39-089-672-424
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Oncology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Francesco Iannello
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy;
| | - Fabrizio Dal Piaz
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Bruno Charlier
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Berenice Stefanelli
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy; (E.D.B.); (B.S.); (M.T.); (F.C.)
| | - Martina Torsiello
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy; (E.D.B.); (B.S.); (M.T.); (F.C.)
| | - Teresa Iannaccone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
| | - Albino Coglianese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
| | - Francesca Colucci
- Postgraduate School in Clinical Pharmacology and Toxicology, University of Salerno, 84081 Baronissi, Italy; (E.D.B.); (B.S.); (M.T.); (F.C.)
| | - Stefano Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Oncology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (V.C.); (F.S.); (F.D.P.); (V.I.); (B.C.); (T.I.); (A.C.); (S.P.); (A.F.)
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy
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Sabbatino F, Polcaro G, Liguori L, Manzo V, Conti V, Col JD, Vergatti A, Stellato C, Casolaro V, Filippelli A, Ferrone S, Pepe S. Abstract 3132: Single nucleotide polymorphisms (SNPs) in PD-L1 as predictive biomarkers for checkpoint inhibitor based-immunotherapy in caucasian patients with advanced NSCLC. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-3132] [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
Effective predictive biomarkers are needed for checkpoint inhibitors (ICI) based-immunotherapy in non-small-cell lung cancer (NSCLC). This study aims to evaluate whether single nucleotide polymorphisms (SNPs) in programmed cell death-ligand 1 (PD-L1) might effectively predict tumor response to ICI in Caucasian patients with advanced NSCLC. Peripheral blood samples and clinico-pathological data were prospectively collected from advanced NSCLC patients treated with anti-Programmed cell death protein 1 (PD-1) inhibitor nivolumab. rs822336, rs2282055 and rs4143815 PD-L1 SNPs were analysed based on previous reports available in the literature. PD-L1 SNPs were analysed following DNA extraction from stored peripheral blood lymphocytes by Taqman Real-Time PCR assay. Presence of PD-L1 SNPs were correlated with clinico-pathological data. Mechanisms underlying the effect of PD-L1 SNPs on PD-L1 expression were analysed in vitro utilizing five NSCLC cell lines, RNA expression and flow cytometry analysis as well as PROMO bioinformatic tool. PD-L1 SNPs localization were analysed utilizing Ensembl genome browser. Differences were considered statistically significant with p value< 0.05. Twenty-eight patients were included in the study. rs2282055 was present as wild type (wt) TT (rs2282055>T), GT and GG genotype in 56.25%, 34.38% and 9.38%, respectively, of patients. On the other hand, rs822336 was present as wt GG (rs822336>G), GC and CC genotype in 28.13%, 37.50% and 34.38%, respectively, of patients. Progression free survival (PFS) was significantly correlated with presence of both PD-L1 SNPs rs2282055 and rs822336 but not with rs4143815. Patients carrying GG either for rs2282055 or rs822336 had a significantly (p=0.0434 and p=0.0131, respectively) shorter PFS as compared to those carrying other PD-L1 SNP genotypes. NSCLC cell lines carrying either GG for rs2282055 or rs822336 significantly (p<0.05) expressed a higher level of PD-L1 expression as compared to cells with other PD-L1 SNP genotypes. Interferon gamma treatment induced PD-L1 expression regardless of PD-L1 SNPs. rs822336 and rs2282055 mapped in enhancer-promoter and intronic regions of PD-L1 gene, respectively. rs822336 was further investigated because of its highest clinical significance and gene localization. Twelve transcription factors were identified to potentially bind rs822336. Two of them discriminated between alternative alleles at the SNP locus and are further under investigation. Previous studies have shown the role of SNPs in cancer patient outcome as well as in mRNA and protein expression changing. In the present study we demonstrated that some of PD-L1 SNPs can affect the basal expression of PD-L1. These results have clinical significance since PD-L1 SNPs predict tumor response to nivolumab-based immunotherapy in Caucasian patients with advanced NSCLC.
Citation Format: Francesco Sabbatino, Giovanna Polcaro, Luigi Liguori, Valentina Manzo, Valeria Conti, Jessica Dal Col, Anita Vergatti, Cristiana Stellato, Vincenzo Casolaro, Amelia Filippelli, Soldano Ferrone, Stefano Pepe. Single nucleotide polymorphisms (SNPs) in PD-L1 as predictive biomarkers for checkpoint inhibitor based-immunotherapy in caucasian patients with advanced NSCLC [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3132.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Soldano Ferrone
- 3Massachussetts General Hospital, Harvard Medical School, Boston, MA
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