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Norelli F, Schiappoli M, Senna G, Pinter P, Olivieri B, Ottaviano G, De Corso E, Caminati M. Adherence to Intranasal Steroids in Chronic Rhinosinusitis with Nasal Polyposis Prior to and during Biologic Therapy: A Neglected Matter. J Clin Med 2024; 13:1066. [PMID: 38398379 PMCID: PMC10889709 DOI: 10.3390/jcm13041066] [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: 12/15/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Adherence to treatment is essential in chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal corticosteroids (INCS) are the first-line therapy, followed by systemic corticosteroids and surgery if needed. In cases of refractory disease, biologics are added to conventional treatment, making adherence to INCS crucial in assessing eligibility for these targeted therapies. The purpose of this review is to examine INCS adherence assessment and rate, before starting and during biologic therapy. We conducted a comprehensive literature review focusing on INCS adherence in CRSwNP treated with biologics, including randomized controlled trials and real-life studies. The search extended to studies on allergic and non-allergic rhinitis to provide broader insights into tools to assess the INCS adherence. The result was that adherence to INCS in CRSwNP is underexplored, with only a few studies addressing it directly. Various tools for adherence assessment have been identified, but none are universally accepted as standard. The review also highlights the complexity of factors influencing adherence rates. Effective CRSwNP management requires a paradigm shift to prioritize adherence in treatment guidelines and clinical practice. The review advocates for improved adherence assessment tools, a deeper understanding of influencing factors, and the integration of personalized medicine approaches, especially for biologic therapies.
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Affiliation(s)
- Francesca Norelli
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
| | - Michele Schiappoli
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Gianenrico Senna
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Patrick Pinter
- Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, Verona University Hospital, University of Verona, 37129 Verona, Italy;
| | - Bianca Olivieri
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
| | - Giancarlo Ottaviano
- Otolaryngology Section, Department of Neurosciences, University of Padova, 35122 Padova, Italy;
| | - Eugenio De Corso
- Otorhinolaryngology Unit, A. Gemelli University Hospital Foundation IRCCS, 00168 Rome, Italy;
| | - Marco Caminati
- Department of Medicine, University of Verona, 37129 Verona, Italy; (F.N.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 35134 Verona, Italy; (M.S.); (B.O.)
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Caminati M, Maule M, Benoni R, Bagnasco D, Beghè B, Braido F, Brussino L, Cameli P, Candeliere MG, Carpagnano GE, Costanzo G, Crimi C, D’Amato M, Del Giacco S, Guarnieri G, Yacoub MR, Micheletto C, Nicola S, Olivieri B, Pini L, Schiappoli M, Vaia R, Vianello A, Visca D, Spanevello A, Senna G. Dupilumab Efficacy on Asthma Functional, Inflammatory, and Patient-Reported Outcomes across Different Disease Phenotypes and Severity: A Real-Life Perspective. Biomedicines 2024; 12:390. [PMID: 38397992 PMCID: PMC10886692 DOI: 10.3390/biomedicines12020390] [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: 12/30/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Dupilumab is currently approved for the treatment of Type 2 severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Few studies have specifically reported on dupilumab efficacy on asthma outcomes as a primary objective in a real-life setting, in patients with and without CRSwNP. Our study aimed to explore the efficacy of dupilumab on functional, inflammatory, and patient-reported outcomes in asthma patients across different disease phenotypes and severity, including mild-to-moderate asthma coexisting with CRSwNP. Data from 3, 6, and 12 months follow-up were analyzed. Asthma (FEV1%, Tiffeneau%, ACT, FeNO, oral steroid use, exacerbation rate, and blood eosinophilia) and polyposis (SNOT22, VAS, NPS) outcomes showed a rapid (3 months) and sustained (6 and 12 months) significant change from baseline, despite most of the patients achieving oral steroid withdrawal. According to the sensitivity analysis, the improvement was not conditioned by either the presence of polyposis or severity of asthma at baseline. Of note, even in the case of milder asthma forms, a significant further improvement was recorded during dupilumab treatment course. Our report provides short-, medium-, and long-term follow-up data on asthma outcomes across different diseases phenotypes and severity, contributing to the real-world evidence related to dupilumab efficacy on upper and lower airways T2 inflammation.
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Affiliation(s)
- Marco Caminati
- Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy (R.V.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
| | - Matteo Maule
- Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy (R.V.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
| | - Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy;
| | - Diego Bagnasco
- Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (D.B.); (F.B.); (M.G.C.)
| | - Bianca Beghè
- AOU of Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Fulvio Braido
- Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (D.B.); (F.B.); (M.G.C.)
| | - Luisa Brussino
- SCDU Immunologia e Allergologia, AO Ordine Mauriziano di Torino, 10137 Torino, Italy; (L.B.); (S.N.)
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplantation Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy;
| | - Maria Giulia Candeliere
- Allergy and Respiratory Diseases Clinic, IRCCS Policlinico San Martino, University of Genoa, 16132 Genoa, Italy; (D.B.); (F.B.); (M.G.C.)
| | - Giovanna Elisiana Carpagnano
- Institute of Respiratory Disease, Department Translational Biomedicine and Neuroscience, University “Aldo Moro”, 70121 Bari, Italy;
| | - Giulia Costanzo
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (S.D.G.)
| | - Claudia Crimi
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy;
- Respiratory Medicine Unit, AOU Policlinico “G. Rodolico—San Marco”, 95123 Catania, Italy
| | - Mariella D’Amato
- Respiratory Department, Monaldi Hospital AO Dei Colli, Federico II University, 80131 Naples, Italy; (M.D.); (A.V.)
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (S.D.G.)
| | - Gabriella Guarnieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy;
| | - Mona-Rita Yacoub
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Claudio Micheletto
- Pulmonology Unit, Verona Integrated University Hospital, 37126 Verona, Italy;
| | - Stefania Nicola
- SCDU Immunologia e Allergologia, AO Ordine Mauriziano di Torino, 10137 Torino, Italy; (L.B.); (S.N.)
| | - Bianca Olivieri
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
| | - Laura Pini
- Respiratory Medicine Unit, ASST—“Spedali Civili” of Brescia, 25123 Brescia, Italy;
| | - Michele Schiappoli
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
| | - Rachele Vaia
- Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy (R.V.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
| | - Andrea Vianello
- Respiratory Department, Monaldi Hospital AO Dei Colli, Federico II University, 80131 Naples, Italy; (M.D.); (A.V.)
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, 21049 Tradate, Italy; (D.V.); (A.S.)
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, 21049 Tradate, Italy; (D.V.); (A.S.)
| | - Gianenrico Senna
- Department of Medicine, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy (R.V.); (G.S.)
- Allergy Unit and Asthma Center, Verona Integrated University Hospital, 37126 Verona, Italy; (B.O.); (M.S.)
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Argentino G, Olivieri B, Barbieri A, Beri R, Bason C, Friso S, Tinazzi E. Exploring the Utility of Circulating Endothelial Cell-Derived Extracellular Vesicles as Markers of Health and Damage of Vasal Endothelium in Systemic Sclerosis Patients Treated with Iloprost. Biomedicines 2024; 12:295. [PMID: 38397897 PMCID: PMC10886571 DOI: 10.3390/biomedicines12020295] [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: 01/05/2024] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
Endothelial cell-derived extracellular vesicles (eEVs) are released from endothelial cells, signifying endothelial integrity. Systemic Sclerosis (SSc) is a rare disease causing skin and organ fibrosis with early vascular damage. Iloprost, an SSc treatment, might affect eEV release, showing long-term benefits. We aimed to study eEVs in SSc, potentially serving as disease markers and linked to Iloprost's impact on organ involvement. We included 54 SSc patients and 15 healthy donors. Using flow cytometry on platelet-poor plasma (PPP) with specific antibodies (CD144, CD146, AnnexinV), we detected endothelial extracellular vesicles. Results showed fewer eEVs from apoptotic or normal cells in SSc patients than healthy controls. Specifically, patients with diffuse cutaneous SSc and lung issues had reduced eEVs from apoptotic endothelial cells (CD146+ AnnV+). No notable differences were seen in CD144 endothelial markers between patients and controls. After 1-day Iloprost infusion, there was an increase in eEVs, but not after 5 days. These findings suggest circulating eEVs reflect endothelial health/damage, crucial in early SSc stages. A 1-day Iloprost infusion seems effective in repairing endothelial damage, critical in scleroderma vasculopathy. Differences in marker outcomes may relate to CD146's surface expression and CD144's junctional location in endothelial cells.
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Affiliation(s)
- Giuseppe Argentino
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
| | - Bianca Olivieri
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
| | - Alessandro Barbieri
- Department of Laboratory Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Ruggero Beri
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
| | - Caterina Bason
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
| | - Simonetta Friso
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
| | - Elisa Tinazzi
- Department of Medicine, University of Verona, 37134 Verona, Italy; (B.O.); (R.B.); (C.B.); (S.F.); (E.T.)
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Caminati M, Micheletto C, Norelli F, Olivieri B, Ottaviano G, Padoan R, Piacentini G, Schiappoli M, Senna G, Menzella F. Safety of dupilumab in T2 airways conditions: focus on eosinophilia across trials and real-life evidence. Expert Opin Biol Ther 2024; 24:15-23. [PMID: 38197326 DOI: 10.1080/14712598.2024.2304556] [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: 11/28/2023] [Accepted: 01/09/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Dupilumab, a monoclonal antibody targeting the IL-4 receptor alpha subunit, effectively blocks both IL-4 and IL-13 mediated pathways. Its introduction has represented a significant advancement in the treatment of severe asthma and other Type 2 (T2) conditions, including nasal polyps, atopic dermatitis, and eosinophilic esophagitis. To date, Dupilumab has demonstrated optimal efficacy and safety profile. AREAS COVERED The safety profile of dupilumab has been extensively studied, especially for its effects on blood eosinophil count. Transient eosinophil increase during treatment is typically insignificant from a clinical point of view and related to its mechanism of action. Rare cases of hyper-eosinophilia associated with clinical conditions like eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES) have been reported. Those cases are often related to the drug's steroid-sparing effect or the natural trajectory of the underlying disease rather than a direct cause-effect relationship with dupilumab. EXPERT OPINION The management of hyper-eosinophilia during dupilumab treatment requires comprehensive diagnostic work-up and strict follow-up monitoring for early detection of systemic disease progression in order to avoid unnecessary discontinuation of an effective treatment. This approach highlights the importance of a personalized treatment.
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Affiliation(s)
- Marco Caminati
- Department of Medicine, University of Verona, Verona, Italy
- Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
| | | | | | - Bianca Olivieri
- Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
| | - Giancarlo Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Roberto Padoan
- Division of Rheumatology, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Giorgio Piacentini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Michele Schiappoli
- Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
| | - Gianenrico Senna
- Department of Medicine, University of Verona, Verona, Italy
- Allergy Unit and Asthma Center, Integrated University Hospital of Verona, Verona, Italy
| | - Francesco Menzella
- Pulmonology Unit, S. Valentino Hospital, AULSS 2 Marca Trevigiana, Treviso, Italy
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Olivieri B, Skypala IJ. New arrivals in anaphylaxis to foods. Curr Opin Allergy Clin Immunol 2023; 23:357-363. [PMID: 37490617 DOI: 10.1097/aci.0000000000000936] [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] [Indexed: 07/27/2023]
Abstract
PURPOSE OF REVIEW More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens. RECENT FINDINGS There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods. Insects can be a sustainable source of protein, but mealworm could provoke symptoms in individuals sensitized or allergic to shellfish or house dust mite. Novel plant food allergens such as gibberellin-regulated proteins and thaumatin-like proteins are increasingly being reported as significant causes of severe reactions to fruits. SUMMARY these findings make it even more imperative to take a full dietary history to ensure apparent idiopathic anaphylaxis is not in reality due to a novel food, especially in cases where other forms of the food are tolerated. Given the lack of diagnostic tests for these novel foods, a prick-to-prick skin prick test should be performed with the suspected food. There is currently more work needed to define and sequence many of the allergens involved.
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Affiliation(s)
- Bianca Olivieri
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - Isabel J Skypala
- Royal Brompton & Harefield Hospitals, part of Guys and St Thomas NHS Foundation Trust
- Department of Inflammation and repair, Imperial College, London, UK
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Senna G, Olivieri B, Castells M. Anaphylaxis: unraveling the mysteries and new perspectives. Curr Opin Allergy Clin Immunol 2023; 23:347-348. [PMID: 37641917 DOI: 10.1097/aci.0000000000000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- Gianenrico Senna
- Allergy and Asthma Center, University Hospital of Verona
- Department of Medicine, University of Verona, Verona, Italy
| | | | - Mariana Castells
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Guarnieri G, Olivieri B, Senna G, Vianello A. Relative Humidity and Its Impact on the Immune System and Infections. Int J Mol Sci 2023; 24:ijms24119456. [PMID: 37298409 DOI: 10.3390/ijms24119456] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Relative humidity (RH) represents an underestimated outdoor and indoor environmental parameter. Conditions below and above the optimal range could facilitate infectious transmission as well as the exacerbation of respiratory diseases. The aim of this review is to outline the consequences for health of suboptimal RH in the environment and how to limit this negative impact. RH primarily affects the rheological properties of the mucus, modifying its osmolarity and thus the mucociliary clearance. The integrity of the physical barrier, maintained by mucus and tight junctions, is critical for protection from pathogens or irritants. Moreover, the control of RH seems to be a strategy to prevent and control the spread of viruses and bacteria. However, the imbalance of RH in the outdoor and indoor environments is frequently associated with the presence of other irritants, allergens, and pathogens, and therefore the burden of a single risk factor is not clearly defined in different situations. Nonetheless, RHmay have a synergistic negative effect with these risk factors, and its normalization, if possible, may have a positive impact on a healthier environment.
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Affiliation(s)
- Gabriella Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Respiratory Pathophysiology Division, University of Padova, 35128 Padova, Italy
| | - Bianca Olivieri
- Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Gianenrico Senna
- Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Andrea Vianello
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Respiratory Pathophysiology Division, University of Padova, 35128 Padova, Italy
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Olivieri B, Stoenchev KV, Skypala IJ. Anaphylaxis across Europe: are pollen food syndrome and lipid transfer protein allergy so far apart? Curr Opin Allergy Clin Immunol 2022; 22:291-297. [PMID: 35942860 DOI: 10.1097/aci.0000000000000847] [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] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Traditionally pollen-food syndrome (PFS) is considered to be a mild cross-reacting food allergy affecting only Northern Europe, with lipid transfer protein (LTP) allergy being more severe and mainly occurring in Southern Europe. This review seeks to update the reader on both types of plant food allergy and to determine whether the stereotypical presentations of these plant food allergies remain the same, with a particular focus on reaction severity. RECENT FINDINGS Recent findings suggest that both these types of plant food allergy occur in children and adults. Although it is true that PFS allergy is more prevalent in Northern Europe and LTP allergy is more well known in Southern Europe, these conditions are not hidebound by geography, and the increasing spread and allergenicity of pollen due to global warming continues to change their presentation. Both conditions have a spectrum of symptom severity, with PFS sometimes presenting with more severe symptoms, including anaphylaxis and LTP allergy with milder reactions. SUMMARY It is important to consider that in many parts of Europe, reactions to plant foods, especially fruits or vegetables, could be mediated either by pollen cross-reactivity or primary sensitization to LTP allergens. All those presenting with symptoms to plant foods will benefit from a detailed clinical history and appropriate tests so that an accurate diagnosis can be made, and correct management implemented.
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Affiliation(s)
- Bianca Olivieri
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - Kostadin V Stoenchev
- Royal Brompton & Harefield Hospitals, Part of Guys and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Isabel J Skypala
- Royal Brompton & Harefield Hospitals, Part of Guys and St Thomas NHS Foundation Trust, London, United Kingdom
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Caminati M, Olivieri B, Dama A, Micheletto C, Paggiaro P, Pinter P, Senna G, Schiappoli M. Dupilumab-induced hypereosinophilia: review of the literature and algorithm proposal for clinical management. Expert Rev Respir Med 2022; 16:713-721. [PMID: 35703018 DOI: 10.1080/17476348.2022.2090342] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Dupilumab is a human monoclonal antibody that targets both IL-4 and IL-13 signaling. It is currently indicated for the treatment of asthma, moderate-to-severe atopic dermatitis, and chronic rhinosinusitis with nasal polyps (CRSwNP). Eosinophilia has been reported as a potential adverse event in treated patients. AREAS COVERED A selective search on PubMed and Medline up to January 2022 was performed, by focusing on dupilumab-induced hypereosinophilia described in clinical trials, real-life studies, and case reports. The possible mechanisms underlying dupilumab-induced hypereosinophilia and the eosinophil-related morbidity have also been explored. EXPERT OPINION Dealing with dupilumab-induced hypereosinophilia represents a clinical challenge for clinicians managing patients on dupilumab therapy. An algorithm for the practical management of dupilumab-induced hypereosinophilia has been proposed, in order to properly investigate potential eosinophil-related morbidity and avoid unnecessary drug discontinuation.
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Affiliation(s)
- Marco Caminati
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - Bianca Olivieri
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy
| | - Annarita Dama
- Allergy and Asthma Unit, Verona University Hospital, Verona, Italy
| | | | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
| | - Patrick Pinter
- Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, Verona University Hospital, Verona, Italy
| | - Gianenrico Senna
- Department of Medicine, Asthma, Allergy and Clinical Immunology Section, University of Verona, Verona, Italy.,Allergy and Asthma Unit, Verona University Hospital, Verona, Italy
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Bason C, Barbieri A, Martinelli N, Olivieri B, Argentino G, Bartoloni E, Beri R, Jadav G, Puccetti A, Tinazzi E, Lunardi C. Identification of a Novel Serological Marker in Seronegative Rheumatoid Arthritis Using the Peptide Library Approach. Front Immunol 2021; 12:753400. [PMID: 34675934 PMCID: PMC8525329 DOI: 10.3389/fimmu.2021.753400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation mainly affecting the joints leading to cartilage and bone destruction. The definition of seropositive or seronegative RA is based on the presence or absence of rheumatoid factor (RF) and anti-citrullinated peptide antibodies (ACPAs). Other autoantibodies have been identified in the last decade such as antibodies directed against carbamylated antigens, peptidyl-arginine deiminase type 4 and v-Raf murine sarcoma viral oncogene homologue B. In order to identify relevant autoantigens, we screened a random peptide library (RPL) with pooled IgGs obtained from 50 patients with seronegative RA. Patients’ sera were then used in an ELISA test to identify the most frequently recognized peptide among those obtained by screening the RPL. Sera from age- and sex-matched healthy subjects were used as controls. We identified a specific peptide (RA-peptide) recognized by RA patients’ sera, but not by healthy subjects or by patients with other immune-mediated diseases. The majority of sera from seronegative and seropositive RA patients (73.8% and 63.6% respectively) contained IgG antibodies directed against the RA-peptide. Interestingly, this peptide shares homology with some self-antigens, such as Protein-tyrosine kinase 2 beta, B cell scaffold protein, Liprin-alfa1 and Cytotoxic T lymphocyte protein 4. Affinity purified anti-RA-peptide antibodies were able to cross react with these autoantigens. In conclusion, we identified a peptide that is recognized by seropositive and, most importantly, by seronegative RA patients’ sera, but not by healthy subjects, conferring to this epitope a high degree of specificity. This peptide shares also homology with other autoantigens which can be recognized by autoantibodies present in seronegative RA sera. These newly identified autoantibodies, although present also in a percentage of seropositive RA patients, may be considered as novel serum biomarkers for seronegative RA, which lacks the presence of RF and/or ACPAs.
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Affiliation(s)
- Caterina Bason
- Department of Medicine, University of Verona, Verona, Italy
| | - Alessandro Barbieri
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | | | | | | | - Elena Bartoloni
- Division of Rheumatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Ruggero Beri
- Department of Medicine, University of Verona, Verona, Italy
| | | | - Antonio Puccetti
- Department of Experimental Medicine, Section of Histology, University of Genova, Genova, Italy
| | - Elisa Tinazzi
- Department of Medicine, University of Verona, Verona, Italy
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Olivieri B, Betterle C, Zanoni G. Vaccinations and Autoimmune Diseases. Vaccines (Basel) 2021; 9:vaccines9080815. [PMID: 34451940 PMCID: PMC8402446 DOI: 10.3390/vaccines9080815] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 12/12/2022] Open
Abstract
Vaccines represent one of the most effective measures of public health medicine, saving countless lives and preventing lifelong disabilities. Vaccines are extremely safe, however, no vaccine is completely free from risks and adverse events can occur following vaccination. An adverse event following immunization (AEFI) may be a true adverse reaction caused by the vaccine or an event that temporally occurred after immunization but is not caused by it. Among the adverse reactions to vaccines, one of the most feared is the triggering of autoimmune diseases, which are a heterogeneous group of disorders characterized by dysregulation of the immune system. Currently, no mechanisms have been demonstrated that could explain the correlation between vaccination and the development of autoimmune diseases. Furthermore, epidemiological studies do not support the hypothesis that vaccines cause systemic autoimmune diseases. The only confirmed associations, although very rare, are those between the flu vaccine and Guillain-Barré syndrome, especially with old vaccine preparations, and measles-mumps-rubella (MMR) vaccine and thrombocytopenia. Due to the SARS-CoV2 pandemic, new types of vaccines have been developed and are now available. Close vaccine safety-surveillance is currently underway for these new vaccines.
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Affiliation(s)
- Bianca Olivieri
- Department of Medicine, School of Specialization in Allergy and Clinical Immunology, University of Verona, 37134 Verona, Italy;
| | - Corrado Betterle
- Department of Medicine (DIMED), Clinical Immunology and Allergy, University of Padua, 35128 Padua, Italy;
| | - Giovanna Zanoni
- Immunology Unit, University Hospital, 37134 Verona, Italy
- Correspondence:
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12
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Adenikinju O, Vianna S, Rubin D, Ujueta F, Money B, Reynolds H, Patel M, Reyes D, Szomstein KB, Pirea A, Watchmaker J, Ayad M, Zybulewski A, Olivieri B, Beasly R. Abstract No. 12 Stay alive: drug-eluting versus bare-metal stent mortality rates in a high-volume vascular center. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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13
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Olivieri B, Rampakakis E, Gilbert G, Fezoua A, Wintermark P. Myelination may be impaired in neonates following birth asphyxia. Neuroimage Clin 2021; 31:102678. [PMID: 34082365 PMCID: PMC8182124 DOI: 10.1016/j.nicl.2021.102678] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 01/23/2023]
Abstract
Myelination is a developmental process that intensifies after birth during the first years of life. We used a T2* mapping sequence to assess myelination in healthy and critically ill neonates with neonatal encephalopathy. Birth asphyxia, in addition to causing the previously well-described direct injury to the brain, may impair myelination.
Background Myelination is a developmental process that begins during the end of gestation, intensifies after birth over the first years of life, and continues well into adolescence. Any event leading to brain injury around the time of birth and during the perinatal period, such as birth asphyxia, may impair this critical process. Currently, the impact of such brain injury related to birth asphyxia on the myelination process is unknown. Objective To assess the myelination pattern over the first month of life in neonates with neonatal encephalopathy (NE) developing brain injury, compared to neonates without injury (i.e., healthy neonates and neonates with NE who do not develop brain injury). Methods Brain magnetic resonance imaging (MRI) was performed around day of life 2, 10, and 30 in healthy neonates and near-term/term neonates with NE who were treated with hypothermia. We evaluated myelination in various regions of interest using a T2* mapping sequence. In each region of interest, we compared the T2* values of the neonates with NE with brain injury to the values of the neonates without injury, according to the MRI timing, by using a repeated measures generalized linear mixed model. Results We obtained 74 MRI scans over the first month of life for 6 healthy neonates, 17 neonates with NE who were treated with hypothermia and did not develop brain injury, and 16 neonates with NE who were treated with hypothermia and developed brain injury. The T2* values significantly increased in the neonates with NE who developed injury in the posterior limbs of the internal capsule (day 2: p < 0.001; day 10: p < 0.001; and day 30: p < 0.001), the thalami (day 2: p = 0.001; day 10: p = 0.006; and day 30: p = 0.016), the lentiform nuclei (day 2: p = 0.005), the anterior white matter (day 2: p = 0.002; day 10: p = 0.006; and day 30: p = 0.002), the posterior white matter (day 2: p = 0.001; day 10: p = 0.008; and day 30: p = 0.03), the genu of the corpus callosum (day 2: p = 0.01; and day 10: p = 0.006), and the optic radiations (day 30: p < 0.001). Conclusion In the neonates with NE who were treated with hypothermia and developed brain injury, birth asphyxia impaired myelination in the regions that are myelinated at birth or soon after birth (the posterior limbs of internal capsule, the thalami, and the lentiform nuclei), in the regions where the myelination process begins only after the perinatal period (optic radiations), and in the regions where this process does not occur until months after birth (anterior/posterior white matter), which suggests that birth asphyxia, in addition to causing the previously well-described direct injury to the brain, may impair myelination.
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Affiliation(s)
- Bianca Olivieri
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Emmanouil Rampakakis
- Medical Affairs, JSS Medical Research, Montreal, Québec, Canada; Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | | | - Aliona Fezoua
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Pia Wintermark
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada; Department of Pediatrics, Division of Newborn Medicine, Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
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14
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Caminati M, Cegolon L, Bacchini M, Segala N, Dama A, Bovo C, Olivieri B, Furci F, Senna G. The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study. BMC Public Health 2021; 21:19. [PMID: 33402150 PMCID: PMC7784353 DOI: 10.1186/s12889-020-10080-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.
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Affiliation(s)
- M Caminati
- Department of Medicine, University of Verona, Verona, Italy
| | - L Cegolon
- Local Health Unit N.2 "Marca Trevigiana", Public Health Department, Treviso, Italy.
| | - M Bacchini
- Pharmacists' Association of Verona, Verona, Italy
| | - N Segala
- Pharmacists' Association of Verona, Verona, Italy
| | - A Dama
- Asthma Centre & Allergy Unit, Verona University Hospital, Verona, Italy
| | - C Bovo
- Medical Directorate, Verona University Hospital, Verona, Italy
| | - B Olivieri
- Residency Programme in Allergy & Clinical Immunology, Verona University Hospital, Verona, Italy
| | - F Furci
- Department of Clinical & Experimental Medicine, University Hospital G. Martino, Messina, Italy
| | - G Senna
- Department of Medicine, University of Verona, Verona, Italy
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15
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Adenikinju O, Durscki Vianna S, Zybulewski A, Olivieri B, Beasley R. 3:45 PM Abstract No. 47 MicroStent: initial single-center experience at a vascular center of excellence. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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16
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Olivieri B, Marić M, Bridge C. Determining the effects of adulterants on drug detection via enzyme-linked immunosorbent assay and adulterant tests strips. Drug Test Anal 2018; 10:1383-1393. [DOI: 10.1002/dta.2404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Bianca Olivieri
- Department of Chemistry; University of Central Florida; Orlando Florida
| | - Mark Marić
- National Center for Forensic Science; University of Central Florida; Orlando Florida
| | - Candice Bridge
- Department of Chemistry; University of Central Florida; Orlando Florida
- National Center for Forensic Science; University of Central Florida; Orlando Florida
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17
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Mandel J, Olivieri B, Bergen M, Patel R, Kim E, Tabori N, Warner R, Lookstein R, Fischman A, Nowakowski F. Ki-67 index as a predictor of response to Y-90 radioembolization for neuroendocrine tumors metastatic to the liver. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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Kapadia F, Siconolfi DE, Barton S, Olivieri B, Lombardo L, Halkitis PN. Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men. AIDS Behav 2013; 17:1819-28. [PMID: 23553346 DOI: 10.1007/s10461-013-0468-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Associations between social support network characteristics and sexual risk among racially/ethnically diverse young men who have sex with men (YMSM) were examined using egocentric network data from a prospective cohort study of YMSM (n = 501) recruited in New York City. Bivariate and multivariable logistic regression analyses examined associations between social support network characteristics and sexual risk taking behaviors in Black, Hispanic/Latino, and White YMSM. Bivariate analyses indicated key differences in network size, composition, communication frequency and average relationship duration by race/ethnicity. In multivariable analyses, controlling for individual level sociodemographic, psychosocial and relationship factors, having a sexual partner in one's social support network was associated with unprotected sexual behavior for both Hispanic/Latino (AOR = 3.90) and White YMSM (AOR = 4.93). Further examination of key network characteristics across racial/ethnic groups are warranted in order to better understand the extant mechanisms for provision of HIV prevention programming to racially/ethnically diverse YMSM at risk for HIV.
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Affiliation(s)
- F Kapadia
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10016, USA.
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19
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De Padova P, Olivieri B, Mariot JM, Favre L, Berbezier I, Quaresima C, Paci B, Generosi A, Rossi Albertini V, Cricenti A, Ottaviani C, Luce M, Testa AM, Peddis D, Fiorani D, Scarselli M, De Crescenzi M, Heckmann O, Richter MC, Hricovini K, d'Acapito F. Ferromagnetic Mn-doped Si0.3Ge0.7 nanodots self-assembled on Si(100). J Phys Condens Matter 2012; 24:142203. [PMID: 22410688 DOI: 10.1088/0953-8984/24/14/142203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Densely packed epitaxial Mn-doped Si(0.3)Ge(0.7) nanodots self-assembled on Si(100) have been obtained. Their structural properties were studied using reflection high-energy electron diffraction, energy dispersive x-ray diffraction, atomic force microscopy, extended x-ray absorption fine structure measurements and high-resolution transmission electron microscopy. Mn(5)Ge(1)Si(2) crystallites embedded in Si(0.3)Ge(0.7) were found. They exhibit a ferromagnetic behaviour with a Curie temperature of about 225 K.
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Affiliation(s)
- P De Padova
- Consiglio Nazionale delle Ricerche-Istituto di Struttura della Materia, via Fosso del Cavaliere, 00133 Roma, Italy.
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20
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Romanha AJ, Castro SLD, Soeiro MDNC, Lannes-Vieira J, Ribeiro I, Talvani A, Bourdin B, Blum B, Olivieri B, Zani C, Spadafora C, Chiari E, Chatelain E, Chaves G, Calzada JE, Bustamante JM, Freitas-Junior LH, Romero LI, Bahia MT, Lotrowska M, Soares M, Andrade SG, Armstrong T, Degrave W, Andrade ZDA. In vitro and in vivo experimental models for drug screening and development for Chagas disease. Mem Inst Oswaldo Cruz 2010; 105:233-8. [PMID: 20428688 DOI: 10.1590/s0074-02762010000200022] [Citation(s) in RCA: 260] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 01/26/2010] [Indexed: 11/22/2022] Open
Abstract
Chagas disease, a neglected illness, affects nearly 12-14 million people in endemic areas of Latin America. Although the occurrence of acute cases sharply has declined due to Southern Cone Initiative efforts to control vector transmission, there still remain serious challenges, including the maintenance of sustainable public policies for Chagas disease control and the urgent need for better drugs to treat chagasic patients. Since the introduction of benznidazole and nifurtimox approximately 40 years ago, many natural and synthetic compounds have been assayed against Trypanosoma cruzi, yet only a few compounds have advanced to clinical trials. This reflects, at least in part, the lack of consensus regarding appropriate in vitro and in vivo screening protocols as well as the lack of biomarkers for treating parasitaemia. The development of more effective drugs requires (i) the identification and validation of parasite targets, (ii) compounds to be screened against the targets or the whole parasite and (iii) a panel of minimum standardised procedures to advance leading compounds to clinical trials. This third aim was the topic of the workshop entitled Experimental Models in Drug Screening and Development for Chagas Disease, held in Rio de Janeiro, Brazil, on the 25th and 26th of November 2008 by the Fiocruz Program for Research and Technological Development on Chagas Disease and Drugs for Neglected Diseases Initiative. During the meeting, the minimum steps, requirements and decision gates for the determination of the efficacy of novel drugs for T. cruzi control were evaluated by interdisciplinary experts and an in vitro and in vivo flowchart was designed to serve as a general and standardised protocol for screening potential drugs for the treatment of Chagas disease.
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Affiliation(s)
- Alvaro José Romanha
- Programa Integrado de Doença de Chagas, Fiocruz, Rio de Janeiro, RJ, Brasil.
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21
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Giménez LED, Hernández CCQ, Mattos EC, Brandão IT, Olivieri B, Campelo RP, Araújo-Jorge T, Silva CL, Campos de Carvalho AC, Kurtenbach E. DNA immunizations with M2 muscarinic and beta1 adrenergic receptor coding plasmids impair cardiac function in mice. J Mol Cell Cardiol 2005; 38:703-14. [PMID: 15850564 DOI: 10.1016/j.yjmcc.2004.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2004] [Revised: 11/09/2004] [Accepted: 12/14/2004] [Indexed: 02/08/2023]
Abstract
Autoimmune mediated myocardial damage is likely to be a pathogenic mechanism for acquired dilated cardiomyopathies. Evidence confirms that autoantibodies that bind to M(2) muscarinic (M(2)AChR) and beta(1) adrenergic receptors (beta(1)AR) are present in idiopathic dilated cardiomyopathy and Chagasic patients' sera. To elucidate the role of these antibodies in cardiac functional impairment, we used a murine model immunized with plasmids encoding the M(2)AChR or beta(1)AR via gene-gun bombardment. Anti-M(2)AChR and beta(1)AR antibodies were detected over the course of 37 weeks. These antibodies were directed to the second extracellular loop (el2) of both receptors and the third intracellular loop (il3) of the M(2)AChR. Peak antibody titers from weeks 2 to 5 against M(2)AChR-el2 and beta(1)AR-el2 as well as elevated titers against M(2)AChR-il3 were detected. Anti-M(2)AChR-il3 and anti-beta(1)AR-el2 antibodies were predominant in IgG1 subclass immunoglobulins, suggesting a T-helper-2 biased lymphocyte response. Heart morphology and function was assessed by echocardiography over the course of 42 weeks. Data showed progressive decrease in left ventricular (LV) wall thickness and LV mass that was mostly evident for beta(1)AR-immunized mice albeit a small change in LV dimensions. Fractional shortening was altered and values of 41%, 37% and 48% were observed at week 42 for the M(2)AChR, beta(1)AR and control groups respectively. In support of autonomic deregulation, a twofold increase in M(2)AChR and a similar decrease in beta(1)AR density were observed in radioligand saturation assays for both experimental groups. Histological analysis revealed myofibril disarray and fibrosis, pointing towards remodeling as a consequence of the long-term presence of anti-receptor antibodies.
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MESH Headings
- Amino Acid Sequence
- Animals
- Autoantibodies/biosynthesis
- Autoimmune Diseases/etiology
- Autoimmune Diseases/immunology
- Autoimmune Diseases/pathology
- Autoimmune Diseases/physiopathology
- Cardiomyopathy, Dilated/etiology
- Cardiomyopathy, Dilated/immunology
- Cardiomyopathy, Dilated/pathology
- Cardiomyopathy, Dilated/physiopathology
- Echocardiography
- Humans
- Male
- Mice
- Mice, Inbred BALB C
- Molecular Sequence Data
- Plasmids/genetics
- Receptor, Muscarinic M2/genetics
- Receptor, Muscarinic M2/immunology
- Receptors, Adrenergic, beta-1/genetics
- Receptors, Adrenergic, beta-1/immunology
- Vaccines, DNA/genetics
- Vaccines, DNA/pharmacology
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Affiliation(s)
- Luis E D Giménez
- Departamento de Bioquímica Médica, Instituto de Ciências Biomédicas, Universidade Federal de Rio de Janeiro, Centro de Ciências da Saúde, Cidade Universitária, 21941-590 Rio de Janeiro, RJ, Brazil
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22
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Boi P, Tonna G, Dalu G, Nakajima T, Olivieri B, Pompei A, Campanelli M, Rao R. Calibration and data elaboration procedure for sky irradiance measurements. Appl Opt 1999; 38:896-907. [PMID: 18305689 DOI: 10.1364/ao.38.000896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The problems encountered in the elaboration of measurements of direct and sky diffuse solar irradiance are the following: (1) to carry out the calibration for the direct irradiance, which consists in determining the direct irradiance at the upper limit of the atmosphere; (2) to carry out the calibration for the diffuse irradiance, which consists in determining the solid viewing angle of the sky radiometer; (3) to determine the input parameters, namely, ground albedo, real and imaginary parts of the aerosol refractive index, and aerosol radius range; and (4) to determine from the optical data the columnar aerosol optical depth and volume radius distribution. With experimental data and numerical simulations a procedure is shown that enables one to carry out the two calibrations needed for the sky radiometer, to determine a best estimate of the input parameters, and, finally, to obtain the average features of the atmospheric aerosols. An interesting finding is that inversion of only data of diffuse irradiance yields the same accuracy of result as data of both diffuse and direct irradiance; in this case, only calibration of the solid viewing angle of the sky radiometer is needed, thus shortening the elaboration procedure. Measurements were carried out in the Western Mediterranean Sea (Italy), in Tokyo (Japan), and in Ushuaia (Tierra del Fuego, Argentina); data were elaborated with a new software package, the Skyrad code, based on an efficient radiative transfer scheme.
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Affiliation(s)
- P Boi
- Department of Physics, University of Cagliari, via Ospedale 72, 09124 Cagliari, Italy
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D'Auria C, Olivieri B, Salvadore C. [Initial clinical experiences on the use of dixirazina (Esuco-UCB 3412) in anesthesia]. Rass Int Clin Ter 1970; 50:1302-5. [PMID: 4921992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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24
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D'Auria C, Olivieri B, Martinelli M, Polizio P. [Diazepam in endoscopic examinations in urology]. Rass Int Clin Ter 1969; 49:1046-1051. [PMID: 5802353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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25
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Olivieri B, Nastri D. [Problems in maritime resuscitation]. Rass Int Clin Ter 1969; 49:1052-9. [PMID: 5802354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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26
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Olivieri B, Nastri D, Grella A, Martinelli M. [Pathology caused by electricity and resuscitation. (Clinico-statistical study)]. Rass Int Clin Ter 1968; 48:877-84. [PMID: 5702869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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27
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Olivieri B, Tafuri A, Lauriello G. [On a case of cardiac arrest resolved by intracardiac injection of Alupent. (Case report)]. Minerva Cardioangiol 1966; 14:493-8. [PMID: 5990319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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28
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Concilio A, Olivieri B. [Clinico-statistical study on 181 cases of goiter]. Riforma Med 1965; 79:679-84. [PMID: 5827709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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