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Quercioli C, Bosco R, Bova G, Mandò M, De Marco MF, Dei S, Gusinu R, Messina G. Evaluating the effect of COVID-19 incidence on Emergency Departments admissions. Results from a retrospective study in Central Italy during the first year of pandemic. Ann Ig 2023; 35:572-585. [PMID: 37082931 DOI: 10.7416/ai.2023.2570] [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] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Introduction The COVID-19 pandemic has had a major impact on the Healthcare System, changing the patterns of Emergency Department access. In fact, accesses for trauma and less severe cases decreased significantly. This decline has generally been attributed to both the effects of the lockdown, imposed by the government, and the fear of being infected by SARS-CoV-2 in the hospital. However, the correlation between these elements is not yet clear, since the accesses to the Emergency Department did not increase either at the end of the lockdown or in the summer when the epidemiological situation was more favorable. Aim: To evaluate the association between trends of Emergency Department accesses and COVID-19 incidence in 2020. Methods Data on Emergency Department accesses, by month and severity triage code, from 14 hospitals in southeastern Tuscany (Italy) were obtained from hospitals' data warehouse. Official data on new cases of COVID-19 infection were used to calculate incidence. Hospitals were classified into 4 categories. Differences in Emergency Department access by month, triage code, and hospital type were investigated using Kruskal-Wallis analysis. Association between Emergency Department accesses and COVID-19 incidence was evaluated using a random-effect panel data analysis, adjusting for hospital type and triage code. Results The trend of 268,072 Emergency Department accesses decreases substantially at the first pandemic peak; thereafter, it increased and decreased again until the minimum peak in November 2020. COVID-19 incidence appeared to be overlapping with an inverse direction. Monthly differences were significant (p<0.01) except for most severe codes. There was a significant inverse association between Emergency Department accesses and COVID-19 incidence (Coef. =-0.074, p<0.001) except for most severe cases (triage code 1: Coef. =-0.028, p=0.154). Conclusion Emergency Department admissions trend followed the COVID-19 incidence, except for the most severe cases. Fear of infection seems to discourage patients from accessing Emergency Department for illnesses perceived as not serious.
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Affiliation(s)
- C Quercioli
- Post Graduate School of Public Health, University of Siena, Italy
- Healthcare Management, Local Health Authority Southern-East Tuscany, Italy
| | - R Bosco
- Post Graduate School of Public Health, University of Siena, Italy
| | - G Bova
- Emergency Director, University Hospital "Santa Maria alle Scotte", Siena, Italy
| | - M Mandò
- Emergency Department Director, Local Health Authority Southern-East Tuscany, Italy
| | - M F De Marco
- Medical Management, University Hospital "Santa Maria alle Scotte", Siena, Italy
| | - S Dei
- Healthcare Director, Local Health Authority Southern-East Tuscany, Italy
| | - R Gusinu
- Healthcare Director, University Hospital "Santa Maria alle Scotte", Siena, Italy
| | - G Messina
- Post Graduate School of Public Health, University of Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Italy
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Quercioli C, Bosco R, Bova G, Mandò M, Dei S, Gusinu R, Messina G. COVID-19 incidence on Emergency Departments accesses. Health need and fear of infection, what wins? Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.541] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
The COVID-19 pandemic has changed the patterns of access to the Emergency Department (ED), but it is unclear whether this change was due to COVID-19 incidence or the lockdown imposed by law.
Aim
To evaluate the association between trends of ED accesses and COVID-19 incidence in the period 1 January - 31 December 2020.
Material and methods
The data of accesses to the ED per month and severity triage code of 14 hospitals in the Southeast Tuscany (Italy, Provinces of Siena, Arezzo, Grosseto) were obtained from hospitals data warehouses. Data on new cases of COVID-19 infection (obtained by the Ministry of Health) for the 3 provinces were used to calculate the incidence of infection. Hospitals were classified in 4 categories based on beds number, medical specialties offered, services provided. Differences in ED accesses by month, triage code and hospital type were investigated by a Kruskal-Wallis analysis of variance. Association between ED accesses and COVID-19 incidence was evaluated using a random effect panel data analysis adjusting for hospital type and triage code.
Results
A total of 268,072 ED accesses have been studied. Their trends saw a strong decrease in correspondence of the first pandemic peak, subsequently they are increased and then decreased again until the minimum peak in November 2020. COVID-19 incidence appeared to overlap, but in the reverse direction, with ED admissions trends. Monthly differences of the ED accesses were significant (p < 0.01) except for most severity code. There is a statistically significant inverse association between ED accesses and COVID-19 incidence (Coef. = -0.074, p < 0.001) except for most severe cases (triage code 1: Coef. = -0.028, p = 0.154).
Conclusions
ED admissions trends followed the COVID-19 incidence independently from the period of lockdown except for the most severe cases. The fear to contract the infection seemed to discourage patients to access ED for diseases that were perceived as not serious.
Key messages
• The pandemic has changed the lifestyle of people worldwide, modifying even the perception that the patient has of own state of health and their access to Emergency Department.
• The decrease in accesses involved less severe cases. Reflect on both the adequacy of accesses in the pre-pandemic period and on what is the best setting to manage these cases in the pandemic period.
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Affiliation(s)
- C Quercioli
- Post Graduate School of Public Health, University of Siena , Siena, Italy
- Hospital Healthcare Management, Poggibonsi Hospital, Local Health Unit Toscana Sud-Est , Poggibonsi, Italy
| | - R Bosco
- Post Graduate School of Public Health, University of Siena , Siena, Italy
| | - G Bova
- University Hospital “Santa Maria alle Scotte” , Siena, Italy
| | - M Mandò
- Emergency Department Director, Local Health Unit Toscana Sud-Est , Arezzo, Italy
| | - S Dei
- Local Health Unit Toscana Sud-Est , Arezzo, Italy
| | - R Gusinu
- University Hospital “Santa Maria alle Scotte” , Siena, Italy
| | - G Messina
- Post Graduate School of Public Health, University of Siena , Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena , Siena, Italy
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Di Viccaro D, Perugia G, Cerulli C, Olivieri V, Bova G, Balla J, Zanza C, Teodonio S, Liberti M. The Accuracy of Tissue Resonance Interaction Method Probe (Trimprob Tm) in Non-Invasive Diagnosis of Prostatic Cancer. Analysis of the Results of 782 Patients. Urologia 2018. [DOI: 10.1177/039156030907604s01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of our study was to evaluate the real utility of the TRIMprob test before TRUS-guided biopsy approach, putting in relation the number of positive tests of the TRIMprob with the number of positive prostate biopsies that were performed successfully. Sensitivity, Specificity, PPV (Positive predicted value), NPV (Negative predicted value) of the TRIMprob test were analyzed with statistical software package for Social Sciences (SPSS Inc, Chicago, Illinois USA).
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Affiliation(s)
- D. Di Viccaro
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - G. Perugia
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - C. Cerulli
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - V. Olivieri
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - G. Bova
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - J. Balla
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - C. Zanza
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - S. Teodonio
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
| | - M. Liberti
- Department of Urology, Policlinico Umberto I, “Sapienza” University of Rome, Rome
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Wedge D, Gundem G, Van Loo P, Brewer D, Leinonen K, Eeles R, Cooper C, Visakorpi T, McDermott U, Bova G. 12: Proffered Paper: The life history of lethal metastatic prostate cancer (The UK prostate cancer working group of the International Cancer Genome Consortium). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50012-3] [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]
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Pasqui AL, Di Renzo M, Bova G, Maffei S, Pompella G, Auteri A, Puccetti L. Pro-inflammatory/anti-inflammatory cytokine imbalance in acute coronary syndromes. Clin Exp Med 2008; 6:38-44. [PMID: 16550343 DOI: 10.1007/s10238-006-0092-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [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: 09/14/2005] [Accepted: 12/23/2005] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the presence of an imbalance between proinflammatory and anti-inflammatory mediators in patients affected by acute coronary syndromes (ACS). We considered two groups of 26 and 28 patients with acute myocardial infarction (AMI) and unstable angina (UA) respectively, compared with a group of 30 patients with stable angina and 30 healthy volunteers. We evaluated the production in cultured and stimulated lymphomonocytes of interferon (IFN)gamma and tumour necrosis factor (TNF)alpha, which are well known to possess proinflammatory effects, and of interleukin (IL)10, which has been shown to have a protective anti-inflammatory activity. We also assessed the clinical characteristics of groups and, particularly, we evaluated the circulating levels of C-reactive protein (hs-CRP). We found a significant increase of IFNgamma and TNFalpha production (P<0.01) and a significant decrease of IL10 production (P<0.05) in cultures of lymphomonocytes taken from patients with AMI and UA compared with SA patients and controls. No significant changes where found between AMI and UA patients and SA patients and controls. Circulating levels of hs-CRP were significantly increased (P<0.01) in patients with ACS compared with the other control groups. Our data showed an increased production of proinflammatory mediators in ACS that may be detectable both in circulating blood and in cell cultures where it is possible to evaluate in a better way the functional state of cells; this finding was associated with a reduced production of the antiinflammatory cytokine IL10. In conclusion, a relevant imbalance is present in ACS and this fact could contribute to plaque instability and clinical manifestations.
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Affiliation(s)
- A L Pasqui
- Dip Medicina Clinica e Scienze Immunologiche, Sezione di Medicina Interna, Policlinico Le Scotte, I-53100, Siena, Italy.
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Pasqui A, Maffei S, Capati E, Bova G, DiRenzo M, Puccetti L, Auteri A. PO9-232 THE ROLE OF CYTOKINES IN LEFT VENTRICULAR REMODELING AFTER MYOCARDIAL INFARCTION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71242-4] [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: 10/23/2022]
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Maffei S, Di Renzo M, Puccetti L, Bova G, Pastorelli M, Pasqui A, Auteri A. Mo-P2:180 Cytokines imbalance in acute coronary syndromes. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bruni F, Pasqui AL, Pastorelli M, Bova G, Di Renzo M, Cercigani M, Leo A, Auteri A, Puccetti L. Effect of atorvastatin on different fibrinolyis mechanisms in hypercholesterolemic subjects. Int J Cardiol 2004; 95:269-74. [PMID: 15193831 DOI: 10.1016/j.ijcard.2003.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [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: 04/22/2003] [Accepted: 08/11/2003] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hydroxymethyl-glutaryl-CoA-reductase inhibitors (statins) reduce cardiovascular events by cholesterol lowering as well as non-lipid related actions. Among them, the modulation of fibrinolysis could play a relevant role in vascular protection. Atorvastatin is able of reducing platelet activity and thrombin generation before low-density lipoprotein cholesterol (LDL-C) decrease in hypercholesterolemic subjects in which coagulation and fibrinolysis are linked by the activation of thrombin activable fibrinolysis inhibitor (TAFI). The aim of our study was to evaluate whether atorvastatin could modulate fibrinolysis by interactions with endothelial mechanisms and thrombin generation. METHODS Forty-four pure hypercholesterolemic subjects (26 M, 18 F, mean age 52.7+/-13.7, LDL-C 194.8+/-9.3t mg/dl) were evaluated for plasmin-antiplasmin complexes (PAP), tissue-plasminogen acivator (t-PA) and its inhibitor (PAI-1) (ELISA), TAFI activity (HPLC), platelet P-selectin (P-sel) (cytofluorymetric detection), platelet-dependent thrombin generation (PDTG, coagulative-chromogenic method) and lipid profile at baseline and after 7, 14, 28 and 90 days of atorvastatin (10 mg/die) treatment. RESULTS PAP were significantly reduced at baseline in hypercholesterolemic versus control subjects (P<0.05) and were related to P-sel (P<0.01), PDTG (P<0.01) and its inhibitor (PAI-1) after venous occlusion (VO) (P<0.05). Atorvastatin induced a significant increase of PAP at T(2) related to modifications of P-sel (P<0.01) and PDTG (P<0.01) before significant LDL-C reduction (P=0.132). PAI-1 was significantly changed at T(3) with relation to LDL-C (P<0.01), Von Willebrand factor (VWF) (P<0.01) and sE-sel (P<0.05). CONCLUSIONS The profibrinolytic activity of atorvastatin in hypercholesterolemic subjects is related, initially, to the positive effects exerted on platelet function and thrombin generation which can modulate fibrinolysis by TAFI activity.
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Affiliation(s)
- F Bruni
- Department of Clinical Medicine and Immunological Sciences, Internal Medicine Division, Center for Metabolic Diseases and Atherosclerosis, University of Siena, Policlinico Le Scotte, V.le Bracci, 53100 Siena, Italy
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9
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Pasqui AL, Di Renzo M, Bova G, Bruni F, Puccetti L, Pompella G, Auteri A. T cell activation and enhanced apoptosis in non-ST elevation myocardial infarction. Clin Exp Med 2003; 3:37-44. [PMID: 12748878 DOI: 10.1007/s102380300014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Recent studies have shown that inflammation plays a major role in coronary plaque destabilization and in the induction of thrombosis in acute coronary syndromes. The aim of this study was to evaluate circulating lymphocyte activation and apoptosis in patients with non-ST elevation myocardial infarction (NSTEMI) in comparison with subjects with stable angina and with age-matched healthy controls. We considered T cell subpopulations, T cell surface HLA-DR and CD69 expression (evaluated by flow cytometry), lymphomonocyte spontaneous apoptosis (evaluated by ELISA), and IL2 production (evaluated by ELISA) in peripheral blood within 6 hours of onset of NSTEMI. We also investigated Fas expression on T cells (evaluated by flow cytometry) and FasL mRNA (evaluated by RT-PCR), as well as Fas functionality. In NSTEMI patients we found a significant increase of HLADR+ CD3+ and CD69+CD4+ cells. Spontaneous apoptosis was significantly increased in NSTEMI patients in comparison with the two control groups and was associated with an increased expression of Fas, an increased susceptibility to Fas agonist (CH11), and a normal production of IL2 in cell cultures. These data suggest that the enhanced apoptosis is due to a mechanism of "active" antigen-driven death, induced by the expression of death cytokines and not by the failure of cell growth factors. We conclude that peripheral lymphocytes are activated in NSTEMI and undergo an enhanced programmed cell death due to activation mechanisms. It is likely that lymphocyte activation occurs before the onset of acute ischemia and contributes to the plaque rupture and to the myocardial ischemic insult.
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Affiliation(s)
- A L Pasqui
- Istituto di Semeiotica Medica, Policlinico Le Scotte, I-53100 Siena, Italy.
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Bruni F, Puccetti L, Pasqui AL, Pastorelli M, Bova G, Cercignani M, Palazzuoli A, Leo A, Auteri A. Different effect induced by treatment with several statins on monocyte tissue factor expression in hypercholesterolemic subjects. Clin Exp Med 2003; 3:45-53. [PMID: 12748879 DOI: 10.1007/s102380300015] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Platelets and monocytes are involved in atherothrombosis via tissue factor expression. Moreover, they are activated in hypercholesterolemia, a classic risk factor for atherothrombosis. Cholesterol-lowering drugs (statins) reduce cardiovascular risk either by decreasing cholesterol or non-lipidic actions, such as platelet and monocyte activity. The aim of our study was to evaluate the effect of several statins on platelet and monocyte activity in hypercholesterolemic subjects. Platelet activity (P-selectin, cytofluorimetric detection), tissue factor levels (ELISA) and activity (detected in whole blood and cellular preparations by a specific clotting assay) were measured in hypercholesterolemic subjects (41 males, 23 females, aged 34-65 years, total cholesterol 6.86+/-0.60 mmol/l) treated with atorvastatin 10 mg, simvastatin 20 mg, fluvastatin 40 mg, or pravastatin 40 mg for 6 weeks. P-selectin and tissue factor expression in whole blood and isolated cells were increased in hypercholesterolemic subjects with respect to controls (all P<0.001). Simvastatin, atorvastatin, and fluvastatin reduced monocyte procoagulant activity in whole blood and P-selectin (P<0.01). Tissue factor antigen and activity in isolated cells were further reduced (all P<0.05) independently of cholesterol lowering. Pravastatin decreased tissue factor expression in whole blood in direct relationship to reduction of P-sel and cholesterol (P<0.05). Our data show a different impact of several statins on monocyte tissue factor expression in whole blood, suggesting a possible role of decreased platelet activity and a direct action on monocytes. In contrast, pravastatin decreased monocyte procoagulant activity with relation to cholesteroldependent modifications of platelet function.
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Affiliation(s)
- F Bruni
- Department of Clinical Medicine and Immunological Sciences, Medical Semeiotics Section, Policlinico Le Scotte, University of Siena, V.le Bracci, I-53100, Siena, Italy.
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Puccetti L, Pasqui AL, Pastorelli M, Bova G, Cercignani M, Palazzuoli A, Angori P, Auteri A, Bruni F. Time-dependent effect of statins on platelet function in hypercholesterolaemia. Eur J Clin Invest 2002; 32:901-8. [PMID: 12534449 DOI: 10.1046/j.1365-2362.2002.01086.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Reduction of platelet activity induced by statins has been described as a positive effect exerted by such molecules on vascular thrombotic events. However, the relations among cholesterol (LDL-C) reduction, the timing of the antiplatelet effect, the involved mechanisms and the doses of each statin able to reduce platelet function are not actually well known. The aim of our study was to evaluate the impact of simvastatin (20 mg day-1), atorvastatin (10 mg day-1), fluvastatin (40 mg day-1) and pravastatin (40 mg day-1) on platelet function in hypercholesterolaemic subjects with relation to (LDL-C), oxidized-LDL (ox-LDL) and antiport mechanism modifications. MATERIALS AND METHODS Sixteen subjects were assigned to each treatment (40 males, 24 females, mean age 48.7 +/- 13.4, LDL-C 5.13 +/- 0,23 mmol L-1) and evaluated for platelet surface P-selectin (P-sel), lipid profile, ox-LDL, platelet-associated ox-LDL (Pox-LDL), platelet cholesterol content, antiport mechanisms, and intracellular and systemic NO synthase every 7 days for one month. RESULTS Our data show a strong relation between enhanced P-sel and Pox-LDL (r = 0.68, P < 0.01). Simvastatin, atorvastatin, fluvastatin and pravastatin reduce platelet activity after 1, 2, 3 and 4 weeks of treatment, respectively (P < 0.001, P < 0.001, P < 0.01, P < 0.05). Pox-LDL are modulated early by simvastatin, atorvastatin and fluvastatin Pox-LDL (r = 0.66, 0.65 and 0.52; P < 0.001, 0.001 and 0.01, respectively) whereas LDL-C and ox-LDL reductions associated to modifications of antiport activity act later. Moreover, they are the most relevant finding in pravastatin-related subjects. CONCLUSIONS Our data suggest a different impact of several statins on platelet function, which is initially related to interference with Pox-LDL rather than LDL-C reduction.
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Affiliation(s)
- L Puccetti
- Department of Clinical Medicine and Immunological Sciences, Center for Metabolic Diseases and Atherosclerosis, University of Siena, Siena, Italy.
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Puccetti L, Pasqui AL, Pastorelli M, Bova G, Cercignani M, Palazzuoli A, Auteri A, Bruni F. Different mechanisms of fibrinolysis impairment among dyslipidemic subjects. Int J Clin Pharmacol Res 2002; 21:147-55. [PMID: 12067144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
To determine whether there is a correlation between fibrinolytic activity and dyslipidemia, we performed a study of 72 subjects (20 patients with hypercholesterolemia, 20 with hypertriglyceridemia, 12 with isolated low high-density lipoprotein (HDL)-cholesterol (mean age 47.7 +/- 6.3, body mass index 24.7 +/- 0.4) and 20 healthy controls. Plasminogen activator inhibitor-1 (PAI-1), tissue-plasminogen activator activity and plasmin-antiplasmin complexes (PAP) were detected at baseline and after venous occlusion test. We also measured at baseline lipidic pattern, soluble E and P selectins (sE-sel, sP-sel), prothrombin factor 1+2 (F1+2), lipoprotein(a), factor VII, plasma insulin, fibrinogen, homocysteine, and thrombin activable fibrinolysis inhibitor (TAFI) activity. Fibrinolysis was significantly reduced in hypertriglyceridemic patients compared with hypercholesterolemic patients and control subjects (PAP, p < 0.01 and p < 0.001) and was associated with increased PAI-1 (at baseline and after venous occlusion test, p < 0.001). sP-sel, F1 +2 and TAFI were not significantly different compared with controls, while hypercholesterolemic subjects showed a significant increase in these parameters (p < 0.001), which were related to decreased PAP only at the upper low-density lipoprotein (LDL)-cholesterol levels (>160 mg/dl) (p < 0.001, r = -0.76). Moreover, there was no significant difference in PAI-1 activity (at baseline and after venous occlusion test) compared with controls. In conclusion, endothelial dysfunction was the main mechanism of decreased fibrinolysis in subjects with hypertriglyceridemia and low HDL-cholesterol, while enhanced thrombin generation and TAFI activity were the main determinants in hypercholesterolemia.
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Affiliation(s)
- L Puccetti
- Institute of Medical Semeiotics, Center for Metabolic Diseases and Atherosclerosis, University of Siena, Italy.
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Pasqui AL, Puccetti L, Bova G, Di Renzo M, Bruni F, Pastorelli M, Palazzuoli A, Auteri A. Relationship between serum complement and different lipid disorders. Clin Exp Med 2002; 2:33-8. [PMID: 12049187 DOI: 10.1007/s102380200004] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [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: 11/25/2022]
Abstract
Inflammatory and lipid factors share an important role in atherosclerosis. Recent studies showed the concomitant presence and increase of complement components and lipids both in the atherosclerotic plaque and the circulating blood. The aim of this study was to examine the relationship between the complement system and lipid disorders. We evaluated the circulating complement terminal complex C5b-9, a clear sign of complement activation, in three groups of 30 patients the first with hypercholesterolemia, the second with hypertriglyceridemia (associated with low values of HDL-cholesterol), the third with low levels of HDL-cholesterol compared with an equivalent group of matched normolipemic subjects. We found a significant increase of sC5b-9 in each group of patients compared with controls. The mean sC5b-9 level in the hypercholesterolemic population was 366.2 +/- 141.2 ng/ml (P<0.01), 395.4 +/- 118.2 ng/ml in the hypertrygliceridemic group (P<0.01), 414.8 +/- 126.4 ng/ml in the low HDL-chol subjects (P<0.01), and 182.0 +/- 40.8. ng/ml in the control group. Regression analysis showed a significant direct correlation between sC5b-9 and triglycerides (r=0.64), and a significant inverse correlation between sC5b-9, HDL-chol (r=-0.74), and apo-A1 (r=-0.68); no significant relationship was found between sC5b-9 and cholesterol. We suggest that complement activation is associated with the various lipid disorders and is more important in those dyslipidemic conditions in which other factors may be involved. In particular, hypertriglyceridemia may be associated with endothelial and fibrinolytic disturbances, and the decrease of HDL may induce the failure of the regulatory proteins transported by the same HDL.
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Affiliation(s)
- A L Pasqui
- Istituto di Semeiotica Medica, Università degli Studi di Siena, Policlinico Le Scotte, Italy.
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Puccetti L, Bruni F, Bova G, Cercignani M, Palazzuoli A, Console E, Auteri A, Pasqui AL. Effect of diet and treatment with statins on platelet-dependent thrombin generation in hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis 2001; 11:378-387. [PMID: 12055702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND AND AIM Platelets are strictly involved in arterial thrombosis and their hyperactivity has been shown in hypercholesterolemia. It has been reported that drugs affecting cholesterol metabolism (statins) decrease cardiovascular events by lowering lipid levels or by means of non-lipidic actions such as the direct inhibition of platelet function. The aim of this study was to detect the effect on platelet-dependent thrombin generation (PDTG) of a reduction in cholesterol obtained by means of a lipid-lowering diet or treatment with statins. METHODS AND RESULTS We compared PDTG (T0) in 144 hypercholesterolemic subjects (94 males and 50 females of child-bearing age, mean age 48.2 +/- 13.8, plasma total cholesterol 6.93 +/- 0.64, high density lipoprotein cholesterol 1.25 +/- 0.14, triglycerides 1.15 +/- 0.19 mmol/L) and 70 normolipidemic controls (37 males and 33 females, mean age 43.1 +/- 12.6. After six weeks on an appropriate diet, the patients were randomised to receive different statin therapies if there was no reduction in their lipid profile and/or PDTG (T1). They were re-evaluated six weeks later, and the drug doses were maintained or increased on the basis of the variables (T2). A final evaluation was made after a further six weeks (T3). All of the data were evaluated using ANOVA and Spearman's correlation coefficent. The results showed increased PDTG in hypercholesterolemic subjects (418.2 +/- 29.2 mIU/mL, p < 0.001 vs controls). Diet alone did not reduce PDTG (380.2 +/- 28.5 mIU/mL, p = 0.226 vs controls). At T2, simvastatin and atorvastatin significantly decreased PDTG (P < 0.001 vs T0-1) and low-density lipoprotein cholesterol (LDL-C). No correlation was found between the two variables in the simvastatin group (r = 0.16). Cerivastatin reduced PDTG without significantly decreasing LDL-C (p < 0.001 and p = 0.476, r = 0.14). Pravastatin and fluvastatin significantly reduced thrombin generation only at T3 (40 mg/day); pravastatin was also associated with a decrease in LDL-C (p < 0.01, r = 0.66). CONCLUSIONS Our results confirm an increased PDTG in patients with type IIa hyperlipoproteinemia, which is not reduced by diet. Statins at different doses significantly decrease PDTG but do not correlate with a reduction in LDL-C.
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Affiliation(s)
- L Puccetti
- Institute of Medical Semeiotics, Centro per lo Studio delle Malattie Dismetaboliche e della Aterosclerosi, University of Siena, Siena, Italy.
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Puccetti L, Bruni F, Bova G, Cercignani M, Pompella G, Auteri A, Pasqui AL. Role of platelets in tissue factor expression by monocytes in normal and hypercholesterolemic subjects. In vitro effect of cerivastatin. Int J Clin Lab Res 2001; 30:147-56. [PMID: 11196073 DOI: 10.1007/s005990070014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Thrombosis is a complication of atherosclerosis and monocytes play a determinant role either in the progression of atherosclerotic plaque or in blood coagulation by way of tissue factor expression. Platelets play a direct role in thrombosis and a hyperfunctional state has been described in hypercholesterolemic subjects. Moreover, platelets seem to be able to enhance monocyte activity. Cholesterol-lowering molecules (statins) are reported to reduce cardiovascular risk, either by decreasing the circulating level of cholesterol or by non-lipidic actions such as the reduction of monocyte and platelet activity. The aim of our study was to investigate the influence of platelets on the expression of tissue factor by monocytes and the effect induced by cerivastatin. We measured tissue factor levels by ELISA and the procoagulant activity of stimulated monocytes by a clotting assay on cellular preparations and whole blood in 40 hypercholesterolemic subjects (22 male, 18 female, mean age 52.7 +/- 12 years, total cholesterol 251.6 +/- 19.9 mg/dl) before and after cerivastatin addition. Tissue factor expression was enhanced in hypercholesterolemic subjects compared with normal subjects (31.6 +/- 7.6 vs. 23 +/- 5.8 pg/cells, P < 0.01). The presence of platelets increased the amount of tissue factor (55.3 +/- 7.3 pg/cells, P < 0.001) and cerivastatin reduced the expression of tissue factor in isolated monocytes, in the mixed cellular system, and in whole blood (19.6 +/- 4.1 pg/cells, P < 0.001). In conclusion, tissue factor expression by monocytes is enhanced in hypercholesterolemic subjects compared with normal controls. Platelets enhance monocyte production of tissue factor, and cerivastatin is able to counteract this prothrombotic mechanism.
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Affiliation(s)
- L Puccetti
- Institute of Medical Semeiotics, Centro per lo Studio delle Malattie Dismetaboliche e della Aterosclerosi, University of Siena, Italy
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Pasqui AL, Bova G, Puccetti L, Bruni F, Pompella G, Auteri A. Complement activation in hypercholesterolemia. Nutr Metab Cardiovasc Dis 2000; 10:137-142. [PMID: 11006922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIM Inflammatory and lipid factors share an important role in atherosclerosis. This study evaluates their relations in dyslipidemic subjects. METHODS AND RESULTS We compared the complement system (serum hemolytic activity CH50, C3 and C4 fractions and terminal complex sC5b-9) in 30 hypercholesterolemic patients with elevated cholesterol and decreased HDL-cholesterol levels, 30 normolipemic patients with clinical atherosclerosis and 30 matched normal subjects. In addition we evaluated the circulating immune complexes containing cholesterol (chol-CIC) on the assumption that they might be important in complement activation, and the circulating levels of the adhesion molecule ICAM-1 (sICAM-1) as a sign of endhotelial dysfunction. We found a significant increase of sC5b-9 (but not of CH50 and C3, C4) in the hypercholesterolemics compared with the other groups. The plasma sC5b-9 level was inversely and significantly related to HDL-chol (regression analysis), whereas no direct significant relation was found between sC5b-9 and cholesterol. Chol-CIC were also significantly increased in this group. The atherosclerosis patients also presented a significant increase of sC5b-9. Lastly, both patient groups displayed a significant increase of sICAM-1. CONCLUSIONS We suggest that complement activation in dyslipidemics may be induced by their increased immune complexes. However, the decrease of complement regulatory proteins carried by HDL is another important factor, while complement changes may be related to variations of other humoral and cell systems (endothelium, coagulative/fibrinolytic system), whose involvement is suggested in our study by the changes of sICAM-1.
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Affiliation(s)
- A L Pasqui
- Department of Internal Medicine and Immunology, University of Siena, Italy
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Thio CL, Smith D, Merz WG, Streifel AJ, Bova G, Gay L, Miller CB, Perl TM. Refinements of environmental assessment during an outbreak investigation of invasive aspergillosis in a leukemia and bone marrow transplant unit. Infect Control Hosp Epidemiol 2000; 21:18-23. [PMID: 10656349 DOI: 10.1086/501691] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [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: 11/03/2022]
Abstract
OBJECTIVES To investigate an outbreak of aspergillosis in a leukemia and bone marrow transplant (BMT) unit and to improve environmental assessment strategies to detect Aspergillus. DESIGN Epidemiological investigation and detailed environmental assessment. SETTING A tertiary-care university hospital with a 37-bed leukemia and BMT unit PARTICIPANTS Leukemic or BMT patients with invasive aspergillosis identified through prospective surveillance and confirmed by chart review. INTERVENTIONS We verified the diagnosis of invasive fungal infection by reviewing medical charts of at-risk patients, performing a case-control study to determine risk factors for infection, instituting wet mopping to clean all floors, providing N95 masks to protect patients outside high-efficiency particulate air (HEPA)-filtered areas, altering traffic patterns into the unit, and performing molecular typing of selected Aspergillus flavus isolates. To assess the environment, we verified pressure relationships between the rooms and hallway and between buildings, and we compared the ability of large-volume (1,200 L) and small-volume (160 L) air samplers to detect Aspergillus spores. RESULTS Of 29 potential invasive aspergillosis cases, 21 were confirmed by medical chart review. Risk factors for developing invasive aspergillosis included the length of time since malignancy was diagnosed (odds ratio [OR], 1.0; P=.05) and hospitalization in a patient room located near a stairwell door (OR, 3.7; P=.05). Two of five A. flavus patient isolates were identical to one of the environmental isolates. The pressure in most of the rooms was higher than in the corridors, but the pressure in the oncology unit was negative with respect to the physically adjacent hospital; consequently, the unit acted essentially as a vacuum that siphoned non-HEPA-filtered air from the main hospital. Of the 78 samples obtained with a small-volume air sampler, none grew an Aspergillus species, whereas 10 of 40 cultures obtained with a large-volume air sampler did. CONCLUSIONS During active construction, Aspergillus spores may have entered the oncology unit from the physically adjacent hospital because the air pressure differed. Guidelines that establish the minimum acceptable pressures and specify which pressure relationships to test in healthcare settings are needed. Our data show that large-volume air samples are superior to small-volume samples to assess for Aspergillus in the healthcare environment.
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Affiliation(s)
- C L Thio
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Puccetti L, Bruni F, Di Renzo M, Bova G, Cercignani M, Iadanza A, Auteri A, Pasqui AL. Hypercoagulable state in hypercholesterolemic subjects assessed by platelet-dependent thrombin generation: in vitro effect of cerivastatin. Eur Rev Med Pharmacol Sci 1999; 3:197-204. [PMID: 11075617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Hypercholesterolemia is an important risk factor to develop acute thrombotic complications of atherosclerosis like to myocardial infarction and ischemic stroke. Platelets and coagulation factors are strictly involved in the genesis of such thrombotic events and their hyperactivity in hypercholesterolemic patients has been previously reported. Moreover some cholesterol-lowering molecules (statins) seem to be able of reducing platelet activity. METHODS We performed platelet-dependent thrombin generation (colorimetric method) to assess the coagulative potential of 40 caucasian hypercholesterolemic subjects with respect to normal controls and to the grade of hypercholesterolemia. Moreover we observed the effect of platelets from hypercholesterolemics on thrombin generation in plasma from normal subjects. The effect of Cerivastatin on thrombin generation was evaluated too. RESULTS Our data show an increased thrombin generation both in mild and high hypercholesterolemic subjects with respect to controls (424.6+/-30.5 vs. 197.1+/-27.4 mIU/ml). No significant difference in the amount of thrombin generation was found between mild and high hypercholesterolemics (399.6+/-20.7 vs. 440.2+/-21.4 mIU/ml). Platelets directly influence thrombin generation and they present an intrinsic hyperactivity that can be modulated by Cerivastatin (223.6+/-24.8 vs. 424.6+/-30.5 mIU/ml). CONCLUSIONS Mild hypercholesterolemia is associated with an increased thrombinic potential that may be considered an added risk factor to develop thrombotic events. Platelets directly influences this hypercoagulative state and Cerivastatin is able to reduce thrombin generation by way of a direct interaction with platelets.
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Affiliation(s)
- L Puccetti
- Institute of Medical Semeiotics, Centro per lo Studio delle Malattie Dismetaboliche e della Aterosclerosi, University of Siena, Italy
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Bova G, Pasqui A, Saletti M, Auteri A. P41 Complement system in myocardial infarction. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)90185-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bova G, Partin A, Isaacs S, Carter B, Beaty T, Isaacs W, Walsh P. RE: BIOLOGICAL AGGRESSIVENESS OF HEREDITARY PROSTATE CANCER. J Urol 1999. [DOI: 10.1016/s0022-5347(05)68985-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Xu J, Meyers D, Freije D, Isaacs S, Wiley K, Nusskern D, Ewing C, Wilkens E, Bujnovszky P, Bova G, Walsh P, Isaacs W, Schleutker J, Matikainen M, Tammela T, Visakorpi T, Kallioniemi OP, Berry R, Schaid D, French A, McDonnell S, Schroeder J, Blute M, Thibodeau S, Gronberg H, Emanuelsson M, Damber JE, Bergh A, Jonsson BA, Smith J, Bailey-Wilson J, Carpten J, Stephan D, Gillanders E, Amundson I, Kainu T, Freas-Lutz D, Baffoe-Bonnie A, Van Aucken A, Sood R, Collins F, Brownstein M, Trent J. Evidence for a Prostate Cancer Susceptibility Locus on the X Chromosome. J Urol 1999. [DOI: 10.1016/s0022-5347(01)61689-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J. Xu
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Meyers
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Freije
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - S. Isaacs
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - K. Wiley
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Nusskern
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - C. Ewing
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - E. Wilkens
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - P. Bujnovszky
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - G.S. Bova
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - P. Walsh
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - W. Isaacs
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Schleutker
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - M. Matikainen
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - T. Tammela
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - T. Visakorpi
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - O.-P. Kallioniemi
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - R. Berry
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Schaid
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - A. French
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - S. McDonnell
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Schroeder
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - M. Blute
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - S. Thibodeau
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - H. Gronberg
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - M. Emanuelsson
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J.-E. Damber
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - A. Bergh
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - B.-A. Jonsson
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Smith
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Bailey-Wilson
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Carpten
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Stephan
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - E. Gillanders
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - I. Amundson
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - T. Kainu
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - D. Freas-Lutz
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - A. Baffoe-Bonnie
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - A. Van Aucken
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - R. Sood
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - F. Collins
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - M. Brownstein
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
| | - J. Trent
- Center for Genetics of Asthma and Complex Diseases, University of Maryland and Departments of Urology, Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore and Prostate Cancer Investigation Group, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland, Departments of Laboratory Medicine and Pathology, Health
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22
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Bova G, Pasqui AL, Saletti M, Bruni F, Auteri A. POEMS syndrome with vascular lesions: a role for interleukin-1beta and interleukin-6 increase--a case report. Angiology 1998; 49:937-40. [PMID: 9822051 DOI: 10.1177/000331979804901110] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [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: 11/15/2022]
Abstract
The authors describe the case of a 60-year-old man with POEMS syndrome associated with vascular lesions. The patient had osteosclerotic myeloma IgA (lambda), polyneuropathy, endocrinopathy, and skin changes. Subsequently, he developed gangrene of the lower limbs with no response to heparin therapy. The humoral study showed thrombocythemia, high levels of interleukin-1beta (IL-1beta) and IL-6 and of some coagulative/fibrinolytic and endothelial factors (von Willebrand factor, plasmin-antiplasmin complexes, plasminogen activator, and endothelial adhesion molecule ICAM-1). The authors suggest that these factors, induced by the increased levels of cytokines, could be responsible for microvascular damage, gangrene, and heparin resistance.
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Affiliation(s)
- G Bova
- Department of Clinical Immunology, Atherosclerosis Research Center, University of Siena, Italy
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23
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Gronberg H, Xu J, Smith J, Carpten J, Isaacs S, Freije D, Bova G, Walsh P, Collins F, Trent J, Meyers D, Isaacs W. Early Age at Diagnosis in Families Providing Evidence of Linkage to the Hereditary Prostate Cancer Locus (HPC1) on Chromosome 1. J Urol 1998. [DOI: 10.1016/s0022-5347(01)63105-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- H. Gronberg
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J. Xu
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.R. Smith
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.D. Carpten
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - S.D. Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - D. Freije
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - G.S. Bova
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - P.C. Walsh
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - F.S. Collins
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.M. Trent
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - D.A. Meyers
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - W.B. Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins University, School of Medicine, Center for Genetics of Asthma and Complex Diseases, University of Maryland, School of Medicine, Baltimore and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
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24
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Pasqui AL, Bova G, Saletti M, Bruni F, Di Renzo M, Auteri A. POEMS syndrome with vascular lesions and renal carcinoma - possible role of cytokines. Eur J Med Res 1998; 3:304-6. [PMID: 9620893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We describe here the case of a 60 years man with POEMS syndrome associated with renal tumor and vascular lesions. The patient had osteosclerotic myeloma IgA-lambda, polyneuropathy, endocrinopathy and skin changes. In addition, he developed renal clear cell carcinoma and gangrena of lower limbs. The humoral study showed thrombocytosis, high levels of IL-1beta and IL-6 and of some coagulative/fibrinolytic and endothelial factors (von Willebrand factor, plasmin-antiplasmine complexes, plasminogen activator). We suggest the hypothesis that these factors are capable of determining some manifestations of POEMS syndrome.
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Affiliation(s)
- A L Pasqui
- U.O. Immunologia Clinica, Policlinico Le Scotte , I-53100 Siena, Italy.
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25
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Gronberg H, Isaacs S, Smith J, Carpten J, Bova G, Freije D, Xu J, Meyers D, Collins F, Trent J, Walsh P, Isaacs W. Characteristics of Prostate Cancer in Families Potentially Linked to the Hereditary Prostate Cancer 1 (HPC1) Locus. J Urol 1998. [DOI: 10.1016/s0022-5347(01)63631-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- H. Gronberg
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - S.D. Isaacs
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.R. Smith
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.D. Carpten
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - G.S. Bova
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - D. Freije
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J. Xu
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - D.A. Meyers
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - F.S. Collins
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - J.M. Trent
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - P.C. Walsh
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
| | - W.B. Isaacs
- James Buchanan Brady Urological Institute, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, and National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, and Department of Oncology, Umea University, Umea, Sweden
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26
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Di Renzo M, Pasqui AL, Bruni F, Saletti M, Bova G, Chiarion C, Carducci A, Auteri A. Evaluation of some immune functions in a patient affected by common variable immunodeficiency using luminescent techniques. J Biolumin Chemilumin 1997; 12:193-7. [PMID: 9481606 DOI: 10.1002/(sici)1099-1271(199707/08)12:4<193::aid-bio441>3.0.co;2-n] [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] [Indexed: 02/06/2023]
Abstract
Common variable immunodeficiency is a primary immunodeficiency characterized by a failure of antibody synthesis, whose fundamental immunologic abnormality is still unknown. In our study, we evaluated some immune functions using chemiluminescence in a 32-year-old woman affected by common variable immunodeficiency. In particular, we showed an impairment of her lymphomonocyte proliferative response which was evaluated using a method based on the bioluminescent measurement of ATP. Besides, we found a reduction of her lymphomonocyte IL2 and IL4 production: the IL4 production was evaluated through an ELISA method, whereas the IL2 activity was determined by its ability to support the IL2-dependent murine T-cell line (CTLL) proliferation which was established through a method based on the bioluminescent measurement of ATP. Finally, we evaluated both yeast-induced and fMLP-induced polymorphonuclear and monocyte oxidative metabolism through a luminol-amplified chemiluminescence; these functions were within normal values. Therefore, in our patient affected by common variable immunodeficiency, we demonstrated an impairment of cellular immunity, which might contribute to the pathogenesis of the disease.
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Affiliation(s)
- M Di Renzo
- Department of Clinical Immunology, University of Siena, Italy
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27
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Di Renzo M, Pasqui AL, Bruni F, Saletti M, Bova G, Chiarion C, Girardello R, Ferrì P, Auteri A. The in vitro effect of Pidotimod on some immune functions in cancer patients. Immunopharmacol Immunotoxicol 1997; 19:37-51. [PMID: 9049658 DOI: 10.3109/08923979709038532] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There are several reports concerning an impairment of cellular immune response in patients affected by malignant disease. The aim of this study was to evaluate the in vitro effect of Pidotimod, a synthetic biological response modifier, on some immune functions in 14 cancer patients. In particular, we showed that these subjects had a significantly reduced peripheral blood mononuclear cell (PBMC) proliferation both in response to PHA and to Con A in comparison with a group of healthy subjects. Besides, they showed a significantly reduced PBMC IL2 production, which was evaluated both through an ELISA method and a biological assay. The in vitro addition of increasing concentrations of Pidotimod (10, 25 and 50 ug/ml) was able to enhance PBMC proliferation and IL2 production significantly. However, in spite of the addition of Pidotimod, both immune functions in our neoplastic patients did not reach normal values.
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Affiliation(s)
- M Di Renzo
- Department of Clinical Immunology, University of Siena, Italy
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28
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Pasqui AL, Di Renzo M, Bova G, Bruni F, Saletti M, Chiarion C, Auteri A. Changes of some immune functions after percutaneous transluminal coronary angioplasty (PTCA). Int J Clin Pharmacol Res 1995; 15:139-144. [PMID: 8871263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study aimed to evaluate some aspects of the immune response in 10 cardiopathic patients during the execution of percutaneous transluminal coronary angioplasty (PTCA) by obtaining blood samples from coronary sinus. In particular we considered some PMN functions as well as lysosomal release and oxidative metabolism evaluated as chemiluminescence and superoxide anion (O2) production. We also studied serum levels of complement C3 and C4, lymphocyte populations (CD3, CD4, CD8, CD19, CD16) and plasmatic determinations of interleukin 2 (IL2). After PTCA, we found a decrease of total count of blood lymphocytes, whereas the number of neutrophils remained unchanged. The decrease involved to a similar extent the lymphocyte subsets CD3, CD4 and CD8, whereas CD19 and CD16 were unchanged. The plasmatic levels of IL2 did not show any significant modification. Concerning PMN, their chemiluminescence was significantly increased after PTCA as compared to basal values: this response was promptly detectable in isolated PMN, both without and with stimulation with fMLP. Similarly superoxide anion production, both spontaneous and stimulated, was increased in PMN suspensions after PTCA, even if this increase did not reach statistical significance. As regards circulating levels of lysosomal enzymes, we found a significant increase of plasmatic levels of elastase, whereas the serum determinations of lysozyme and betaglucuronidase did not change. Concerning the complement system, we found a significant decrease of complement fractions C3 and C4. In conclusion, our results showed certain changes in some humoral and cellular systems; in particular the neutrophil activation through the release of proteolytic enzymes and the generation of oxygen radicals could increase the damage to vessel walls and activate other systems having a negative effect in the ischaemia-associated consequences.
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Affiliation(s)
- A L Pasqui
- Department of Clinical Immunology and Allergology, University of Siena, Italy
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29
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Auteri A, Pasqui AL, Bruni F, Saletti M, Di Renzo M, Bova G. Effect of Pidotimod, a new immunostimulating agent, on some aspects of immune response. In vitro study. Pharmacol Res 1992; 26 Suppl 2:196-7. [PMID: 1409308 DOI: 10.1016/1043-6618(92)90662-u] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A Auteri
- Istituto di Clinica Medica Generale e Terapia Medica, Università di Siena, Italia
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30
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Marsico SA, Grembiale RD, Pelaia G, Bova G. [Effect of procaterol in dosed aerosol and the procaterol-theophylline combination]. Arch Monaldi Mal Torace 1989; 44:825. [PMID: 2577802] [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: 01/01/2023]
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31
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Perticone F, Monda V, Tropea R, Pintaudi C, Columbro C, Bova G, Spadea F. [Importance of retrograde occult conduction on the modulation of the ventricular response in the cardiac pre-excitation syndrome]. Cardiologia 1987; 32:671-5. [PMID: 3690592] [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: 01/07/2023]
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32
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De Francesca F, Grembiale RD, Bova G, Pelaia G, Tranfa CM, Marsico SA. [Comparative evaluation of the protective effect of broxaterol and salbutamol in bronchial spasm induced with an ultrasonic aerosol of distilled water]. Arch Monaldi 1985; 40:111-22. [PMID: 3842058] [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: 01/07/2023]
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