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Doneddu PE, Gentile L, Cocito D, Fazio R, Luigetti M, Briani C, Filosto M, Siciliano G, Benedetti L, Antonini G, Matà S, Marfia GA, Inghilleri M, Manganelli F, Cosentino G, Brighina F, Carpo M, Carta F, Mazzeo A, Peci E, Strano C, Romano A, Campagnolo M, Cotti-Piccinelli S, Viola DV, Germano F, Leonardi L, Sperti M, Mataluni G, Ceccanti M, Spina E, Vegezzi E, Di Stefano V, Nobile-Orazio E. Assessment of diagnostic criteria for multifocal motor neuropathy in patients included in the Italian database. Eur J Neurol 2024; 31:e16248. [PMID: 38376074 DOI: 10.1111/ene.16248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND AND PURPOSE This study aimed to assess the diagnostic criteria, ancillary investigations and treatment response using real-life data in multifocal motor neuropathy (MMN) patients. METHODS Clinical and laboratory data were collected from 110 patients enrolled in the Italian MMN database through a structured questionnaire. Twenty-six patients were excluded due to the unavailability of nerve conduction studies or the presence of clinical signs and symptoms and electrodiagnostic abnormalities inconsistent with the MMN diagnosis. Analyses were conducted on 73 patients with a confirmed MMN diagnosis and 11 patients who did not meet the diagnostic criteria. RESULTS The European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria were variably applied. AUTHOR When applying the American Association of Electrodiagnostic Medicine criteria, an additional 17% of patients fulfilled the criteria for probable/definite diagnosis whilst a further 9.5% missed the diagnosis. In 17% of the patients only compound muscle action potential amplitude, but not area, was measured and subsequently recorded in the database by the treating physician. Additional investigations, including anti-GM1 immunoglobulin M antibodies, cerebrospinal fluid analysis, nerve ultrasound and magnetic resonance imaging, supported the diagnosis in 46%-83% of the patients. Anti-GM1 immunoglobulin M antibodies and nerve ultrasound demonstrated the highest sensitivity. Additional tests were frequently performed outside the EFNS/PNS guideline recommendations. CONCLUSIONS This study provides insights into the real-world diagnostic and management strategies for MMN, highlighting the challenges in applying diagnostic criteria.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Dario Cocito
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore, Sede di Roma, Roma, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-Brescia Clinical center for Neuromuscular Diseases, Brescia, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giovanni Antonini
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza' University of Rome, Roma, Italy
| | - Sabrina Matà
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Maurizio Inghilleri
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, IRCCS Mondino Foundation, University of Pavia, Pavia, Italy
| | - Filippo Brighina
- Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | | | - Francesca Carta
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Erdita Peci
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Torino, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore, Sede di Roma, Roma, Italy
| | - Marta Campagnolo
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Cotti-Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-Brescia Clinical center for Neuromuscular Diseases, Brescia, Italy
| | - Divina Valeria Viola
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Luca Leonardi
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza' University of Rome, Roma, Italy
| | - Martina Sperti
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Marco Ceccanti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Elisa Vegezzi
- Department of Brain and Behavioral Sciences, IRCCS Mondino Foundation, University of Pavia, Pavia, Italy
| | - Vincenzo Di Stefano
- Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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2
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Gentile L, Mazzeo A, Briani C, Casagrande S, De Luca M, Fabrizi GM, Gagliardi C, Gemelli C, Forcina F, Grandis M, Guglielmino V, Iabichella G, Leonardi L, Lozza A, Manganelli F, Mussinelli R, My F, Occhipinti G, Fenu S, Russo M, Romano A, Salvalaggio A, Tagliapietra M, Tozza S, Palladini G, Obici L, Luigetti M. Long-term treatment of hereditary transthyretin amyloidosis with patisiran: multicentre, real-world experience in Italy. Neurol Sci 2024:10.1007/s10072-024-07494-9. [PMID: 38622453 DOI: 10.1007/s10072-024-07494-9] [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: 10/27/2023] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Hereditary transthyretin (ATTRv, v for variant) amyloidosis with polyneuropathy is a rare disease caused by mutations in the transthyretin gene. In ATTRv amyloidosis, multisystem extracellular deposits of amyloid cause tissue and organ dysfunction. Patisiran is a small interfering RNA molecule drug that reduces circulating levels of mutant and wild-type TTR proteins. Prior to its regulatory approval, patisiran was available in Italy through a compassionate use programme (CUP). The aim of this study was to analyse the long-term outcomes of patients who entered into the CUP. METHODS This was a multicentre, observational, retrospective study of patients with ATTRv amyloidosis treated with patisiran. The analysis included change from baseline to 12, 24, 36 and 48 months in familial amyloid polyneuropathy (FAP) stage, polyneuropathy disability (PND) class, neuropathy impairment score (NIS), modified body mass index (mBMI), Compound Autonomic Dysfunction Test (CADT), Karnofsky Performance Status (KPS) scale and Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) questionnaire. Safety data were also analysed. RESULTS Forty patients from 11 Italian centres were enrolled: 23 in FAP 1 (6 in PND 1 and 17 in PND 2) and 17 in FAP 2 (8 in PND 3a and 9 in PND 3b) stage. In this population, the mean NIS at baseline was 71.4 (± 27.8); mBMI, 917.1 (± 207) kg/m2; KPS, 67.1 (± 14.0); Norfolk QoL-DN, 62.2 (± 25.2); and CADT, 13.2 (± 3.3). Statistical analysis showed few significant differences from baseline denoting disease stability. No new safety signals emerged. CONCLUSIONS Patisiran largely stabilised disease in patients with ATTRv amyloidosis.
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Affiliation(s)
- Luca Gentile
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Anna Mazzeo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Chiara Briani
- Department of Neurosciences, Neurology Unit, University of Padova, Padua, Italy
| | - Silvia Casagrande
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Marcella De Luca
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gian Maria Fabrizi
- Department of Neurological Sciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Christian Gagliardi
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | | | - Francesca Forcina
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Marina Grandis
- IRCCS Policlinico San Martino Hospital, Genoa, Italy
- Dipartimento Di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università Di Genova, Genoa, Italy
| | - Valeria Guglielmino
- Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Iabichella
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Luca Leonardi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Alessandro Lozza
- Amyloidosis Research and Treatment Centre, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", Naples, Italy
| | - Roberta Mussinelli
- Amyloidosis Research and Treatment Centre, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Filomena My
- Department of Neurology, "Vito Fazzi" Hospital, Lecce, Italy
| | - Giuseppe Occhipinti
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Silvia Fenu
- S.C. Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Massimo Russo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Angela Romano
- Dipartimento Di Neuroscienze, Organi Di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Matteo Tagliapietra
- Department of Neurological Sciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", Naples, Italy
| | - Giovanni Palladini
- Amyloidosis Research and Treatment Centre, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Laura Obici
- Amyloidosis Research and Treatment Centre, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
| | - Marco Luigetti
- Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento Di Neuroscienze, Organi Di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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3
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Bertini A, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Tagliapietra M, Grandis M, Previtali SC, Falzone YM, Allegri I, Padua L, Pazzaglia C, Tramacere I, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Gentile L, Russo M, Mazzeo A, Vita G, Prada V, Zuccarino R, Ferraro F, Pisciotta C, Pareyson D. Use, tolerability, benefits and side effects of orthotic devices in Charcot-Marie-Tooth disease. J Neurol Neurosurg Psychiatry 2024; 95:434-441. [PMID: 37918904 DOI: 10.1136/jnnp-2023-332422] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Shoe inserts, orthopaedic shoes, ankle-foot orthoses (AFOs) are important devices in Charcot-Marie-Tooth disease (CMT) management, but data about use, benefits and tolerance are scanty. METHODS We administered to Italian CMT Registry patients an online ad hoc questionnaire investigating use, complications and perceived benefit/tolerability/emotional distress of shoe inserts, orthopaedic shoes, AFOs and other orthoses/aids. Patients were also asked to fill in the Quebec User Evaluation of Satisfaction with assistive Technology questionnaire, rating satisfaction with currently used AFO and related services. RESULTS We analysed answers from 266 CMT patients. Seventy per cent of subjects were prescribed lower limb orthoses, but 19% did not used them. Overall, 39% of subjects wore shoe inserts, 18% orthopaedic shoes and 23% AFOs. Frequency of abandonment was high: 24% for shoe inserts, 28% for orthopaedic shoes and 31% for AFOs. Complications were reported by 59% of patients and were more frequently related to AFOs (69%). AFO users experienced greater emotional distress and reduced tolerability as compared with shoe inserts (p<0.001) and orthopaedic shoes (p=0.003 and p=0.045, respectively). Disease severity, degree of foot weakness, customisation and timing for customisation were determinant factors in AFOs' tolerability. Quality of professional and follow-up services were perceived issues. CONCLUSIONS The majority of CMT patients is prescribed shoe inserts, orthopaedic shoes and/or AFOs. Although perceived benefits and tolerability are rather good, there is a high rate of complications, potentially inappropriate prescriptions and considerable emotional distress, which reduce the use of AFOs. A rational, patient-oriented and multidisciplinary approach to orthoses prescription must be encouraged.
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Affiliation(s)
- Alessandro Bertini
- Unità di Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Napoli, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Genova, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Napoli, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Matteo Tagliapietra
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Genova, Italy
| | | | - Yuri Matteo Falzone
- INSPE and Divisione di Neuroscienze, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Isabella Allegri
- Dipartimento di Neurologia, Azienda Ospedaliera di Parma, Parma, Italy
| | - Luca Padua
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Eleonora Cavalca
- Unità di Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Paola Saveri
- Unità di Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Andrea Quattrone
- Centro di Ricerche Neuroscienze, e Istituto di Neurologia, Università Magna Graecia, Catanzaro, Italy, Catanzaro, Italy
| | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Napoli, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Valeria Prada
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genova, Italy
- Fondazione Italiana Sclerosi Multipla, Genova, Italy
| | | | - Francesco Ferraro
- Struttura Complessa di Riabilitazione Neuromotoria ASST Mantova Presidio di Bozzolo, Mantova, Italy
| | - Chiara Pisciotta
- Unità di Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Davide Pareyson
- Unità di Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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4
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De Lorenzo A, Liberatore G, Doneddu PE, Manganelli F, Cocito D, Briani C, Fazio R, Mazzeo A, Schenone A, Di Stefano V, Cosentino G, Marfia GA, Benedetti L, Carpo M, Filosto M, Antonini G, Clerici AM, Luigetti M, Matà S, Rosso T, Lucchetta M, Siciliano G, Lauria Pinter G, Cavaletti G, Inghilleri M, Cantisani T, Notturno F, Ricciardi D, Habetswallner F, Spina E, Peci E, Salvalaggio A, Falzone Y, Strano C, Gentile L, Vegezzi E, Mataluni G, Cotti Piccinelli S, Leonardi L, Romano A, Nobile-Orazio E. Impact of 2021 European Academy of Neurology/Peripheral Nerve Society diagnostic criteria on diagnosis and therapy of chronic inflammatory demyelinating polyradiculoneuropathy variants. Eur J Neurol 2024; 31:e16190. [PMID: 38165011 DOI: 10.1111/ene.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND PURPOSE There are different criteria for the diagnosis of different variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). The 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) guidelines provide specific clinical criteria for each CIDP variant even if their therapeutical impact has not been investigated. METHODS We applied the clinical criteria for CIDP variants of the 2021 EAN/PNS guidelines to 369 patients included in the Italian CIDP database who fulfilled the 2021 EAN/PNS electrodiagnostic criteria for CIDP. RESULTS According to the 2021 EAN/PNS clinical criteria, 245 patients achieved a clinical diagnosis of typical CIDP or CIDP variant (66%). We identified 106 patients with typical CIDP (29%), 62 distal CIDP (17%), 28 multifocal or focal CIDP (7%), four sensory CIDP (1%), 27 sensory-predominant CIDP (7%), 10 motor CIDP (3%), and eight motor-predominant CIDP (2%). Patients with multifocal, distal, and sensory CIDP had milder impairment and symptoms. Patients with multifocal CIDP had less frequently reduced conduction velocity and prolonged F-wave latency and had lower levels of cerebrospinal fluid protein. Patients with distal CIDP more frequently had reduced distal compound muscle action potentials. Patients with motor CIDP did not improve after steroid therapy, whereas those with motor-predominant CIDP did. None of the patients with sensory CIDP responded to steroids, whereas most of those with sensory-predominant CIDP did. CONCLUSIONS The 2021 EAN/PNS criteria for CIDP allow a better characterization of CIDP variants, permitting their distinction from typical CIDP and more appropriate treatment for patients.
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Affiliation(s)
- Alberto De Lorenzo
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Dario Cocito
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Angelo Schenone
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Luana Benedetti
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino Genova, Genoa, Italy
| | - Marinella Carpo
- Department of Neurology, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST "Spedali Civili", University of Brescia, Brescia, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Angelo Maurizio Clerici
- Neurology Unit, Circolo and Macchi Foundation Hospital, University of Insubria, Varese, Italy
| | - Marco Luigetti
- Neurology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sabrina Matà
- Neurology Unit, Dipartimento Neuromuscoloscheletrico e Degli Organi di Senso, University Hospital Careggi, Florence, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassano, Vicenza, Italy
| | - Marta Lucchetta
- UOC Neurologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Lauria Pinter
- Unit of Neuroalgology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Maurizio Inghilleri
- Neurodegenerative Diseases Unit, Department of Human Neuroscience, Sapienza University, Policlinico Universitario Umberto I, Rome, Italy
| | - Teresa Cantisani
- Servizio di Neurofisiopatologia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | | | - Dario Ricciardi
- Division of Neurology and Neurophysiopathology, Department of Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy
| | | | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Erdita Peci
- Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Yuri Falzone
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | | | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST "Spedali Civili", University of Brescia, Brescia, Italy
| | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Angela Romano
- Neurology Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
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5
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Gentile L, Diemberger I, Plante-Bordeneuve V, Mazzeo A, Dori A, Luigetti M, Di Paolantonio A, Dispenzieri A, Grogan M, Waddington Cruz M, Adams D, Inamo J, Kristen AV, Lino Cirami C, Chapman D, Gupta P, Glass O, Amass L. Phenotypic characteristics of F64L, I68L, I107V, and S77Y ATTRv genotypes from the Transthyretin Amyloidosis Outcomes Survey (THAOS). PLoS One 2024; 19:e0292435. [PMID: 38241252 PMCID: PMC10798432 DOI: 10.1371/journal.pone.0292435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/20/2023] [Indexed: 01/21/2024] Open
Abstract
Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multi-systemic disease with wild-type (ATTRwt) and hereditary (ATTRv) forms. Over 130 variants associated with ATTRv amyloidosis have been identified, although little is known about the majority of these genotypes. This analysis examined phenotypic characteristics of symptomatic patients with ATTRv amyloidosis enrolled in the Transthyretin Amyloidosis Outcomes Survey (THAOS) with four less frequently reported pathogenic genotypes: F64L (c.250T>C, p.F84L), I68L (c.262A>T, p.I88L), I107V (c.379A>G; p.I127V), and S77Y (c.290C>A; p.S97Y). THAOS is the largest ongoing, global, longitudinal observational study of patients with ATTR amyloidosis, including both ATTRwt and ATTRv amyloidosis. This analysis describes the baseline demographic and clinical characteristics of untreated symptomatic patients with the F64L, I68L, I107V, or S77Y genotypes at enrollment in THAOS (data cutoff date: January 4, 2022). There were 141 symptomatic patients with F64L (n = 46), I68L (n = 45), I107V (n = 21), or S77Y (n = 29) variants at the data cutoff. Most patients were male and median age at enrollment was in the sixth decade for S77Y patients and the seventh decade for the others. A predominantly neurologic phenotype was associated with F64L, I107V, and S77Y genotypes, whereas patients with the I68L genotype presented with more pronounced cardiac involvement. However, a mixed phenotype was also reported in a considerable proportion of patients in each variant subgroup. This analysis from THAOS represents the largest study of ATTRv symptomatic patients with the F64L, I68L, I107V, and S77Y genotypes. These data add to the limited knowledge on the clinical profile of patients with specific ATTRv variants and emphasize the importance of comprehensive assessment of all patients. Trial registration ClinicalTrials.gov: NCT00628745.
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Affiliation(s)
- Luca Gentile
- Department of Clinical and Experimental Medicine, Università of Messina, Messina, Italy
| | - Igor Diemberger
- University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Violaine Plante-Bordeneuve
- Hopital Henri Mondor, Assistance Publique‐Hopitaux de Paris, East Paris‐Créteil University, Créteil, France
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Università of Messina, Messina, Italy
| | - Amir Dori
- Department of Neurology, Sheba Medical Center, Ramat Gan, and Tel-Aviv University, Tel-Aviv, Israel
| | - Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Di Paolantonio
- Universita Cattolica del Sacro Cuore, Rome, Italy
- U.O. Neurologia, Fondazione Poliambulanza, Brescia, Italy
| | - Angela Dispenzieri
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Martha Grogan
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Márcia Waddington Cruz
- National Amyloidosis Referral Center, CEPARM, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - David Adams
- Department of Neurology, CHU de Bicêtre, AP-HP, University Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Jocelyn Inamo
- CHU de Fort de France, Fort de France, Martinique, France
| | - Arnt V. Kristen
- Department of Cardiology, Angiology, and Respiratory Medicine, Medical University of Heidelberg, Heidelberg, Germany
| | - Calogero Lino Cirami
- Nephrology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Doug Chapman
- Pfizer Inc, New York, New York, United States of America
| | - Pritam Gupta
- Pfizer Inc, New York, New York, United States of America
| | - Oliver Glass
- Pfizer Inc, New York, New York, United States of America
| | - Leslie Amass
- Pfizer Inc, New York, New York, United States of America
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6
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Romano A, Primiano G, Antonini G, Ceccanti M, Fenu S, Forcina F, Gentile L, Inghilleri M, Leonardi L, Manganelli F, Obici L, Sabino A, Sciarrone MA, Tozza S, Vitali F, Luigetti M. Serum neurofilament light chain: a promising early diagnostic biomarker for hereditary transthyretin amyloidosis? Eur J Neurol 2024; 31:e16070. [PMID: 37724995 DOI: 10.1111/ene.16070] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/26/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND AND PURPOSE Hereditary transthyretin amyloidosis (ATTRv) is a life-threatening disease caused by mutations in the gene encoding transthyretin (TTR). The recent therapeutic advances have underlined the importance of easily accessible, objective biomarkers of both disease onset and progression. Preliminary evidence suggests a potential role in this respect for neurofilament light chain (NfL). In this study, the aim was to determine serum NfL (sNfL) levels in a late-onset ATTRv population and evaluate whether it might represent a reliable biomarker of disease onset (i.e., 'conversion' from the asymptomatic status to symptomatic disease in TTR mutation carriers). METHODS In all, 111 individuals harbouring a pathogenic TTR variant (61 symptomatic ATTRv patients and 50 presymptomatic carriers) were consecutively enrolled. Fifty healthy volunteers were included as the control group. Ella™ apparatus was used to assess sNfL levels. RESULTS Serum NfL levels were increased in ATTRv patients compared to both presymptomatic carriers and healthy controls, whilst not differing between carriers and healthy controls. An sNfL cut-off of 37.10 pg/mL could discriminate between asymptomatic and symptomatic individuals with high diagnostic accuracy (area under the curve 0.958; p < 0.001), sensitivity (81.4%) and specificity (100%). CONCLUSIONS Serum NfL seems to be a promising biomarker of peripheral nerve involvement in ATTRv amyloidosis and might become a reliable, objective measure to detect the transition from the presymptomatic stage to the onset of symptomatic disease. Further longitudinal studies are needed to confirm such a role and determine whether it could equally represent a biomarker of disease progression and response to therapy.
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Affiliation(s)
- Angela Romano
- Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Guido Primiano
- Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Antonini
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza Università di Roma, Rome, Italy
| | - Marco Ceccanti
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Silvia Fenu
- S.C. Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesca Forcina
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza Università di Roma, Rome, Italy
| | - Luca Gentile
- U.O.C. Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italy
| | - Maurizio Inghilleri
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy
| | - Luca Leonardi
- Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Sapienza Università di Roma, Rome, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples 'Federico II', Naples, Italy
| | - Laura Obici
- Centro per lo Studio e la Cura delle Amiloidosi Sistemiche, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Sabino
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Stefano Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples 'Federico II', Naples, Italy
| | - Francesca Vitali
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Luigetti
- Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
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7
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Gentile L, Coelho T, Dispenzieri A, Conceição I, Waddington-Cruz M, Kristen A, Wixner J, Diemberger I, Gonzalez-Moreno J, Cariou E, Maurer MS, Planté-Bordeneuve V, Garcia-Pavia P, Tournev I, Gonzalez-Costello J, Duarte AG, Grogan M, Mazzeo A, Chapman D, Gupta P, Glass O, Amass L. A 15-year consolidated overview of data in over 6000 patients from the Transthyretin Amyloidosis Outcomes Survey (THAOS). Orphanet J Rare Dis 2023; 18:350. [PMID: 37946256 PMCID: PMC10636983 DOI: 10.1186/s13023-023-02962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multisystemic, life-threatening disease resulting from the deposition of variant or wild-type (ATTRwt amyloidosis) transthyretin amyloid fibrils in various tissues and organs. METHODS Established in 2007, the Transthyretin Amyloidosis Outcomes Survey (THAOS) is the largest ongoing, global, longitudinal, observational study of patients with ATTR amyloidosis, including both hereditary and wild-type disease, and asymptomatic carriers of pathogenic TTR mutations. This analysis describes the baseline characteristics of symptomatic patients and asymptomatic gene carriers enrolled in THAOS since its inception in 2007 (data cutoff: August 1, 2022), providing a consolidated overview of 15-year data from the THAOS registry. RESULTS This analysis included 4428 symptomatic patients and 1707 asymptomatic gene carriers. The majority of symptomatic patients were male (70.8%) with a mean (standard deviation [SD]) age at symptom onset of 56.6 (17.9) years. Compared with the 14-year analysis, V30M remained the most prevalent genotype in Europe (62.2%), South America (78.6%), and Japan (74.2%) and ATTRwt remained most common in North America (56.2%). Relative to the 14-year analysis, there was an increase of mixed phenotype (from 16.6 to 24.5%) and a reduction of predominantly cardiac phenotype (from 40.7 to 31.9%). The proportion of patients with predominantly neurologic phenotype remained stable (from 40.1 to 38.7%). Asymptomatic gene carriers were 58.5% female with a mean age at enrollment of 41.9 years (SD 15.5). CONCLUSIONS This overview of > 6000 patients enrolled over 15 years in THAOS represents the largest registry analysis of ATTR amyloidosis to date and continues to emphasize the genotypic and phenotypic heterogeneity of the disease. Nearly a quarter of the symptomatic population within THAOS was mixed phenotype, underscoring the need for multidisciplinary management of ATTR amyloidosis. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00628745.
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Affiliation(s)
| | - Teresa Coelho
- Unidade Corino Andrade, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | | | - Isabel Conceição
- CHULN- Hospital de Santa Maria, FML, Universidade de Lisboa, Lisbon, Portugal
| | - Márcia Waddington-Cruz
- Federal University of Rio de Janeiro, National Amyloidosis Referral Center, CEPARM, Rio de Janeiro, Brazil
| | - Arnt Kristen
- Department of Cardiology, Angiology, Respiratory Medicine, Medical University of Heidelberg, Heidelberg, Germany
| | - Jonas Wixner
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Igor Diemberger
- Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy
- Cardiology Unit, IRCCS Policlinico di S. Orsola, Bologna, Italy
| | | | - Eve Cariou
- Department of Cardiology, University Hospital Rangueil, Toulouse, France
| | - Mathew S Maurer
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Violaine Planté-Bordeneuve
- Hopital Henri Mondor, East Paris-Créteil University, Assistance Publique-Hopitaux de Paris, Créteil, France
| | - Pablo Garcia-Pavia
- Hospital Universitario Puerta de Hierro Majadahonda, CIBERCV, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Ivailo Tournev
- Clinic of Nervous Diseases, Department of Neurology, UMBAL Aleksandrovska, Medical University-Sofia, Sofia, Bulgaria
- Department of Cognitive Science, New Bulgarian University, Sofia, Bulgaria
| | | | - Alejandra Gonzalez Duarte
- NYU Langone School of Medicine, New York, NY, USA
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Martha Grogan
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
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8
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Bellofatto M, Gentile L, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Scarlato M, Allegri I, Padua L, Pazzaglia C, Villani F, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Russo M, Mazzeo A, Vita G, Piacentini S, Didato G, Pisciotta C, Pareyson D. Daytime sleepiness and sleep quality in Charcot-Marie-Tooth disease. J Neurol 2023; 270:5561-5568. [PMID: 37540277 PMCID: PMC10576706 DOI: 10.1007/s00415-023-11911-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/05/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Sleep abnormalities have been reported in Charcot-Marie-Tooth disease (CMT), but data are scanty. We investigated their presence and correlation in a large CMT patients' series. METHODS Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were administered to CMT patients of the Italian registry and controls. ESS score > 10 indicated abnormal daytime somnolence, PSQI score > 5 bad sleep quality. We analyzed correlation with disease severity and characteristics, Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Body Mass Index, drug use. RESULTS ESS and PSQI questionnaires were filled by 257 and 253 CMT patients, respectively, and 58 controls. Median PSQI score was higher in CMT patients than controls (6 vs 4, p = 0.006), with no difference for ESS score. Abnormal somnolence and poor sleep quality occurred in 23% and 56% of patients; such patients had more frequently anxiety/depression, abnormal fatigue, and positive sensory symptoms than those with normal ESS/PSQI. Moreover, patients with PSQI score > 5 had more severe disease (median CMT Examination Score, CMTES, 8 vs 6, p = 0.006) and more frequent use of anxiolytic/antidepressant drugs (29% vs 7%, p < 0.001). CONCLUSIONS Bad sleep quality and daytime sleepiness are frequent in CMT and correlated with anxiety, depression and fatigue, confirming that different components affect sleep. Sleep disorders, such as sleep apnea and restless leg syndrome, not specifically investigated here, are other factors known to impact on sleep quality and somnolence. CMT patients' management must include sleep behavior assessment and evaluation of its correlated factors, including general distress and fatigue.
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Affiliation(s)
- Marta Bellofatto
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Alessandro Bertini
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Stefano C Previtali
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Marina Scarlato
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | | | - Luca Padua
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Costanza Pazzaglia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Flavio Villani
- Unità di U.O. Neurofisiopatologia, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Eleonora Cavalca
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Paola Saveri
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Aldo Quattrone
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Sylvie Piacentini
- Unità di Neuropsicologia, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta di Milano, 20133, Milan, Italy
| | - Giuseppe Didato
- Unità di Epilettologia Clinica e Sperimentale, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Chiara Pisciotta
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Davide Pareyson
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
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9
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Bellofatto M, Gentile L, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Scarlato M, Allegri I, Padua L, Pazzaglia C, Villani F, Cavalca E, Saveri P, Quattrone A, Valentino P, Tozza S, Russo M, Mazzeo A, Vita G, Piacentini S, Didato G, Pisciotta C, Pareyson D. Correction to: Daytime sleepiness and sleep quality in Charcot-Marie-Tooth disease. J Neurol 2023; 270:5569-5570. [PMID: 37733102 PMCID: PMC10576716 DOI: 10.1007/s00415-023-11989-4] [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: 09/22/2023]
Affiliation(s)
- Marta Bellofatto
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Alessandro Bertini
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, 37126, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Stefano C Previtali
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | - Marina Scarlato
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132, Milan, Italy
| | | | - Luca Padua
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Costanza Pazzaglia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Flavio Villani
- Unità di U.O. Neurofisiopatologia, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Eleonora Cavalca
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Paola Saveri
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Aldo Quattrone
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, 88100, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, 80131, Naples, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98124, Messina, Italy
| | - Sylvie Piacentini
- Unità di Neuropsicologia, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta di Milano, 20133, Milan, Italy
| | - Giuseppe Didato
- Unità di Epilettologia Clinica e Sperimentale, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133, Milan, Italy
| | - Chiara Pisciotta
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Davide Pareyson
- SC Malattie Neurologiche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
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10
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Fischer B, Gwinner F, Gepp MM, Schulz A, Danz K, Dehne A, Katsen-Globa A, Neubauer JC, Gentile L, Zimmermann H. A highly versatile biopolymer-based platform for the maturation of human pluripotent stem cell-derived cardiomyocytes enables functional analysis in vitro and 3D printing of heart patches. J Biomed Mater Res A 2023; 111:1600-1615. [PMID: 37317666 DOI: 10.1002/jbm.a.37558] [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: 11/16/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 06/16/2023]
Abstract
Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) represent a valuable tool for in vitro modeling of the cardiac niche and possess great potential in tissue engineering applications. However, conventional polystyrene-based cell culture substrates have adverse effects on cardiomyocytes in vitro due to the stress applied by a stiff substrate on contractile cells. Ultra-high viscosity alginates offer a unique versatility as tunable substrates for cardiac cell cultures due to their biocompatibility, flexible biofunctionalization, and stability. In this work, we analyzed the effect of alginate substrates on hPSC-CM maturity and functionality. Alginate substrates in high-throughput compatible culture formats fostered a more mature gene expression and enabled the simultaneous assessment of chronotropic and inotropic effects upon beta-adrenergic stimulation. Furthermore, we produced 3D-printed alginate scaffolds with differing mechanical properties and plated hPSC-CMs on the surface of these to create Heart Patches for tissue engineering applications. These exhibited synchronous macro-contractions in concert with more mature gene expression patterns and extensive intracellular alignment of sarcomeric structures. In conclusion, the combination of biofunctionalized alginates and human cardiomyocytes represents a valuable tool for both in vitro modeling and regenerative medicine, due to its beneficial effects on cardiomyocyte physiology, the possibility to analyze cardiac contractility, and its applicability as Heart Patches.
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Affiliation(s)
- B Fischer
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - F Gwinner
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - M M Gepp
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - A Schulz
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - K Danz
- Department of Bioprocessing and Bioanalytics, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - A Dehne
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - A Katsen-Globa
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - J C Neubauer
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - L Gentile
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - H Zimmermann
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
- Chair for Molecular and Cellular Biotechnology, Saarland University, Gebäude A, Saarbrücken, Germany
- Faculty of Marine Science, Universidad Católica del Norte, Coquimbo, Chile
- Department of Bioprocessing and Bioanalytics, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
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11
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Gentile A, Punziano C, Calvanese M, De Falco R, Gentile L, D’Alicandro G, Miele C, Capasso F, Pero R, Mazzaccara C, Lombardo B, Frisso G, Borrelli P, Mennitti C, Scudiero O, Faraonio R. Evaluation of Antioxidant Defence Systems and Inflammatory Status in Basketball Elite Athletes. Genes (Basel) 2023; 14:1891. [PMID: 37895240 PMCID: PMC10606456 DOI: 10.3390/genes14101891] [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: 08/14/2023] [Revised: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Intense physical activity can induce metabolic changes that modify specific biochemical biomarkers. In this scenario, the purpose of our study was to evaluate how intense physical activity can affect oxidative metabolism. Following this, fifteen professional basketball players and fifteen sedentary controls were recruited and subjected to two samplings of serum and urine in the pre-season (September) and two months after the start of the competitive season (November). Our results have shown an increase in athletes compared to controls in CK and LDH in September (respectively, p-value 0.003 and p-value < 0.001) and in November (both p-value < 0.001), whereas ALT is increased only in November (p-value 0.09). GGT serum levels were decreased in athletes compared to controls in both months (in September p-value 0.001 and in November p-value < 0.001). A gene expression analysis, carried out using RT-PCR, has revealed that IL-2, IL-6, IL-8, xCT and GCLM are increased in athletes in both months (p-value < 0.0001), while IL-10 and CHAC1 are increased only in September if compared to the controls (respectively, p-value 0.040 and p-value < 0.001). In conclusion, physical activity creates an adaptation of the systems involved in oxidative metabolism but without causing damage to the liver or kidney. This information could be of help to sports doctors for the prevention of injuries and illnesses in professional athletes for the construction of the athlete's passport.
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Affiliation(s)
- Alessandro Gentile
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
| | - Carolina Punziano
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
| | - Mariella Calvanese
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
| | - Renato De Falco
- Division of Laboratory Medicine, Istituto Nazionale Tumori—IRCCS Fondazione Pascale, 80129 Naples, Italy;
| | - Luca Gentile
- Integrated Department of Laboratory and Transfusion Medicine, University of Naples Federico II, 80131 Naples, Italy;
| | - Giovanni D’Alicandro
- Department of Neuroscience and Rehabilitation, Center of Sports Medicine and Disability, AORN, Santobono-Pausillipon, 80122 Naples, Italy;
| | - Ciro Miele
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- UOC Laboratory Medicine, Hematology and Laboratory Haemostasis and Special Investigations, AOU Federico II University of Naples, 80131 Naples, Italy;
- CEINGE, Biotecnologie Avanzate s.c.ar.l., 80131 Naples, Italy
| | - Filomena Capasso
- UOC Laboratory Medicine, Hematology and Laboratory Haemostasis and Special Investigations, AOU Federico II University of Naples, 80131 Naples, Italy;
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- CEINGE, Biotecnologie Avanzate s.c.ar.l., 80131 Naples, Italy
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- CEINGE, Biotecnologie Avanzate s.c.ar.l., 80131 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- CEINGE, Biotecnologie Avanzate s.c.ar.l., 80131 Naples, Italy
| | - Paola Borrelli
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
- CEINGE, Biotecnologie Avanzate s.c.ar.l., 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Raffaella Faraonio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy; (A.G.); (C.P.); (M.C.); (C.M.); (R.P.); (C.M.); (B.L.); (G.F.); (R.F.)
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12
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Planté-Bordeneuve V, Gorram F, Olsson M, Anan I, Mazzeo A, Gentile L, Cisneros-Barroso E, Gonzalez-Moreno J, Losada I, Waddington-Cruz M, Pinto LF, Parman Y, Fanen P, Alarcon F, Nuel G. A multicentric study of the disease risks and first manifestations in hereditary transthyretin amyloidosis (ATTRv): insights for an earlier diagnosis. Amyloid 2023; 30:313-320. [PMID: 36994840 DOI: 10.1080/13506129.2023.2178891] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/20/2023] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND In hereditary transthyretin amyloidosis (ATTRv), early manifestation and age at onset (AO) may vary strikingly. We assessed the disease'risk (penetrance), AO and initial features in ATTRv families to gain insights on the early disease presentation. METHODS Genealogical information, AO and first disease manifestations were collected in ATTRv families, from Sweden, Italy (Sicily), Spain (Mallorca), France, Turkey, Brazil. Penetrance was computed using a non-parametric survival method. RESULTS We analysed 258 TTRV30M kindreds and 84 carrying six other variants (TTRT49A, F64L, S77Y, S77F, E89Q, I107V). In ATTRV30M families, the earliest disease risk was found at age 20 years in the Portuguese and Mallorcan families and at age 30-35 years, in the French and Swedish groups. The risks were higher in men and in carriers of maternal descent. In families carrying TTR-nonV30M variants, the earliest disease risk ranged from 30 y-o in TTRT49A to 55 y-o in TTRI107V families. Peripheral neuropathy symptoms were the most frequent initial manifestations. Among patients carrying TTRnonV30M variants, about 25% had an initial cardiac phenotype, one third a mixed phenotype. CONCLUSION Our work provided solid data on the risks and early features of ATTRv in a spectrum of families to enhance an early diagnosis and treatment.
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Affiliation(s)
- Violaine Planté-Bordeneuve
- Department of Neurology, Henri Mondor University Hospital, APHP, Créteil, France
- Paris Est-Créteil University, Créteil, France
- Inserm U.955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Farida Gorram
- Department of Neurology, Henri Mondor University Hospital, APHP, Créteil, France
- Paris Est-Créteil University, Créteil, France
- Inserm U.955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Malin Olsson
- Department of Public Health and Clinical Medicine/Medicine, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Intissar Anan
- Department of Public Health and Clinical Medicine/Medicine, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Eugenia Cisneros-Barroso
- Research Health Institute of the Balearic Islands (IdISBa), Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Juan Gonzalez-Moreno
- Research Health Institute of the Balearic Islands (IdISBa), Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Ines Losada
- Research Health Institute of the Balearic Islands (IdISBa), Internal Medicine Department, Son Llàtzer University Hospital, Palma de Mallorca, Spain
| | - Marcia Waddington-Cruz
- CEPARM, Federal University of Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil
| | - Luiz Felipe Pinto
- CEPARM, Federal University of Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil
| | - Yeşim Parman
- Department of Neurology, Neuromuscular Unit Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pascale Fanen
- Paris Est-Créteil University, Créteil, France
- Inserm U.955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Department of Genetics, Henri Mondor University Hospital, APHP, Créteil, France
| | - Flora Alarcon
- Laboratory MAP5 UMR CNRS 8145 Paris University, Paris, France
| | - Gregory Nuel
- Stochastics and Biology Group, Department of Probability and Statistics (LPSM, UMR CNRS 8001), Sorbonne University, Paris, France
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13
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Marchi M, Salvi E, Andelic M, Mehmeti E, D'Amato I, Cazzato D, Chiappori F, Lombardi R, Cartelli D, Devigili G, Dalla Bella E, Gerrits M, Almomani R, Malik RA, Ślęczkowska M, Mazzeo A, Gentile L, Dib-Hajj S, Waxman SG, Faber CG, Vecchio E, de Tommaso M, Lauria G. TRPA1 rare variants in chronic neuropathic and nociplastic pain patients. Pain 2023; 164:2048-2059. [PMID: 37079850 PMCID: PMC10443199 DOI: 10.1097/j.pain.0000000000002905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/09/2022] [Revised: 12/15/2022] [Accepted: 12/28/2022] [Indexed: 04/22/2023]
Abstract
Supplemental Digital Content is Available in the Text. TRPA1 gene is significantly enriched of rare variants in neuropathic pain and fibromyalgia patients, with itch or cold-induced pain as the most common features, opening new treatment opportunities. Missing aspects of the heritability of chronic neuropathic pain, as a complex adult-onset trait, may be hidden within rare variants with low effect on disease risk, unlikely to be resolved by a single-variant approach. To identify new risk genes, we performed a next-generation sequencing of 107 pain genes and collapsed the rare variants through gene-wise aggregation analysis. The optimal unified sequence kernel association test was applied to 169 patients with painful neuropathy, 223 patients with nociplastic pain (82 diagnosed with chronic widespread pain and 141 with fibromyalgia), and 216 healthy controls. Frequency and features of variants in TRPA1 , which was the most significant gene, were further validated in 2 independent cohorts of 140 patients with chronic pain (90 with painful neuropathy and 50 with chronic widespread pain) and 34 with painless neuropathy. The effect of aminoacidic changes were modeled in silico according to physicochemical characteristics. TRPA1 was significantly enriched of rare variants which significantly discriminated chronic pain patients from healthy controls after Bonferroni correction (P = 6.7 × 10−4, ρ = 1), giving a risk of 4.8-fold higher based on the simple burden test (P = 0.0015, OR = 4.8). Among the 32 patients harboring TRPA1 variants, 24 (75%) were diagnosed with nociplastic pain, either fibromyalgia (12; 37.5%) or chronic widespread pain (12; 37.5%), whereas 8 (25%) with painful neuropathy. Irrespective of the clinical diagnosis, 12 patients (38%) complained of itch and 10 (31.3%) of cold-induced or cold-accentuated pain, mostly episodic. Our study widens the spectrum of channelopathy-related chronic pain disorders and contributes to bridging the gap between phenotype and targeted therapies based on patients' molecular profile. 1_tzjjvsic Kaltura
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Affiliation(s)
- Margherita Marchi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Erika Salvi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mirna Andelic
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Elkadia Mehmeti
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Ilaria D'Amato
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daniele Cazzato
- Clinical Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Federica Chiappori
- Consiglio Nazionale delle Ricerche, Istituto di Tecnologie Biomediche (CNR-ITB), Segrate (Milan), Italy
| | - Raffaella Lombardi
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daniele Cartelli
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Grazia Devigili
- Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Eleonora Dalla Bella
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Monique Gerrits
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rowida Almomani
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Rayaz A. Malik
- Institute of Cardiovascular Sciences, Cardiac Centre, Faculty of Medical and Human Sciences, The University of Manchester and NIHR/WellcomeTrust Clinical Research Facility, Manchester, United Kingdom
- Research Division, Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Milena Ślęczkowska
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Toxicogenomics, Maastricht University, Maastricht, the Netherlands
| | - Anna Mazzeo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Luca Gentile
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Sulayman Dib-Hajj
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen G. Waxman
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Catharina G. Faber
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Eleonora Vecchio
- Neurophysiopathology Unit, DiBrain Department, Aldo Moro University, Bari, Italy
| | - Marina de Tommaso
- Neurophysiopathology Unit, DiBrain Department, Aldo Moro University, Bari, Italy
| | - Giuseppe Lauria
- Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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14
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Doneddu PE, Akyil H, Manganelli F, Briani C, Cocito D, Benedetti L, Mazzeo A, Fazio R, Filosto M, Cosentino G, Di Stefano V, Antonini G, Marfia GA, Inghilleri M, Siciliano G, Clerici AM, Carpo M, Schenone A, Luigetti M, Lauria G, Matà S, Rosso T, Minicuci GM, Lucchetta M, Cavaletti G, Liberatore G, Spina E, Campagnolo M, Peci E, Germano F, Gentile L, Strano C, Cotti Piccinelli S, Vegezzi E, Leonardi L, Mataluni G, Ceccanti M, Schirinzi E, Romozzi M, Nobile-Orazio E. Unclassified clinical presentations of chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2023; 94:614-621. [PMID: 37015771 DOI: 10.1136/jnnp-2022-331011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/15/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND To assess the ability of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) clinical criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) to include within their classification the whole spectrum of clinical heterogeneity of the disease and to define the clinical characteristics of the unclassifiable clinical forms. METHODS The 2021 EAN/PNS clinical criteria for CIDP were applied to 329 patients fulfilling the electrodiagnostic (and in some cases also the supportive) criteria for the diagnosis of CIDP. Clinical characteristics were reviewed for each patient not strictly fulfilling the clinical criteria ('unclassifiable'). RESULTS At study inclusion, 124 (37.5%) patients had an unclassifiable clinical presentation, including 110 (89%) with a typical CIDP-like clinical phenotype in whom some segments of the four limbs were unaffected by weakness ('incomplete typical CIDP'), 10 (8%) with a mild distal, symmetric, sensory or sensorimotor polyneuropathy confined to the lower limbs with cranial nerve involvement ('cranial nerve predominant CIDP') and 4 (1%) with a symmetric sensorimotor polyneuropathy limited to the proximal and distal areas of the lower limbs ('paraparetic CIDP'). Eighty-one (65%) patients maintained an unclassifiable presentation during the entire disease follow-up while 13 patients progressed to typical CIDP. Patients with the unclassifiable clinical forms compared with patients with typical CIDP had a milder form of CIDP, while there was no difference in the distribution patterns of demyelination. CONCLUSIONS A proportion of patients with CIDP do not strictly fulfil the 2021 EAN/PNS clinical criteria for diagnosis. These unclassifiable clinical phenotypes may pose diagnostic challenges and thus deserve more attention in clinical practice and research.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Houseyin Akyil
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | - Chiara Briani
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Cocito
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | | | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience, and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Maurizio Inghilleri
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Angelo Schenone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Marco Luigetti
- UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Giuseppe Lauria
- Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milano, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
| | - Sabrina Matà
- Dipartimento Neuromuscoloscheletrico e degli organi di Senso, Neurology Unit, University Hospital Careggi, Firenze, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassiano, Vicenza, Italy
| | | | - Marta Lucchetta
- UOC Neurologia, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | - Guido Cavaletti
- School of Medicine and surgery and experimental Neurology Unit, University of Milan-Bicocca, Milano, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Emanuele Spina
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Napoli, Italy
| | | | - Erdita Peci
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | | | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | | | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Marco Ceccanti
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy
| | - Erika Schirinzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marina Romozzi
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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15
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La Civita E, Zannella C, Brusa S, Romano P, Schettino E, Salemi F, Carrano R, Gentile L, Punziano A, Lagnese G, Spadaro G, Franci G, Galdiero M, Terracciano D, Portella G, Loffredo S. BNT162b2 Elicited an Efficient Cell-Mediated Response against SARS-CoV-2 in Kidney Transplant Recipients and Common Variable Immunodeficiency Patients. Viruses 2023; 15:1659. [PMID: 37632002 PMCID: PMC10459971 DOI: 10.3390/v15081659] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
SARS-CoV-2 vaccination is the standard of care for the prevention of COVID-19 disease. Although vaccination triggers both humoral and cellular immune response, COVID-19 vaccination efficacy is currently evaluated by measuring antibodies only, whereas adaptative cellular immunity is unexplored. Our aim is to test humoral and cell-mediated response after three doses of BNT162b vaccine in two cohorts of fragile patients: Common Variable Immunodeficiency (CVID) patients and Kidney Transplant Recipients (KTR) patients compared to healthy donors. We enrolled 10 healthy controls (HCs), 19 CVID patients and 17 KTR patients. HC BNT162b third dose had successfully mounted humoral immune response. A positive correlation between Anti-Spike Trimeric IgG concentration and neutralizing antibody titer was also observed. CVID and KTR groups showed a lower humoral immune response compared to HCs. IFN-γ release induced by epitopes of the Spike protein in stimulated CD4+ and CD8+ T cells was similar among vaccinated HC, CVID and KTR. Patients vaccinated and infected showed a more efficient humoral and cell-mediated response compared to only vaccinated patients. In conclusion, CVID and KTR patients had an efficient cell-mediated but not humoral response to SARS-CoV-2 vaccine, suggesting that the evaluation of T cell responses could be a more sensitive marker of immunization in these subjects.
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Affiliation(s)
- Evelina La Civita
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Carla Zannella
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (M.G.)
- UOC of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Stefano Brusa
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Paolo Romano
- Department of Public Health, Section of Nephrology, University of Naples “Federico II”, 80131 Naples, Italy; (P.R.); (E.S.); (F.S.); (R.C.)
| | - Elisa Schettino
- Department of Public Health, Section of Nephrology, University of Naples “Federico II”, 80131 Naples, Italy; (P.R.); (E.S.); (F.S.); (R.C.)
| | - Fabrizio Salemi
- Department of Public Health, Section of Nephrology, University of Naples “Federico II”, 80131 Naples, Italy; (P.R.); (E.S.); (F.S.); (R.C.)
| | - Rosa Carrano
- Department of Public Health, Section of Nephrology, University of Naples “Federico II”, 80131 Naples, Italy; (P.R.); (E.S.); (F.S.); (R.C.)
| | - Luca Gentile
- Integrated Department of Laboratory and Trasfusion Medicine, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Alessandra Punziano
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Gianluca Lagnese
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples “Federico II”, 80131 Naples, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “ScholaMedicaSalernitana”, University of Salerno, 84081 Baronissi, Italy;
- Clinical Pathology and Microbiology Unit, San Giovanni di Dio e Ruggi D’Aragona University Hospital, 84125 Salerno, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.Z.); (M.G.)
- UOC of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Giuseppe Portella
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
| | - Stefania Loffredo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (E.L.C.); (S.B.); (A.P.); (G.L.); (G.S.); (D.T.); (S.L.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples “Federico II”, 80131 Naples, Italy
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, 80131 Naples, Italy
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Della-Morte D, Ambrosi C, Chiereghin F, Infante M, Pastore D, Pacifici F, Scaramella M, Gentile L, Mulas F, Quintavalle G. Methods for inactivation of seafood Anisakis larvae and prevention of human anisakiasis: a mini-review. Eur Rev Med Pharmacol Sci 2023; 27:5246-5256. [PMID: 37318499 DOI: 10.26355/eurrev_202306_32643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Anisakiasis is an arising zoonosis induced by parasitic nematodes belonging to the family Anisakidae. Anisakiasis is often caused by the ingestion of larval nematodes in uncooked or minimally processed seafood dishes, which are regularly consumed by humans. Significant potential sources of infection are raw fish (e.g., sushi and sashimi) that can be found in traditional Japanese cuisine and can be part of the culinary tradition of consumption of raw or marinated fish that is particularly diffused in European countries. During the last five decades, the global prevalence of human anisakiasis has been rising, becoming an emergent major public health problem. Thus, there is an unmet need for well-defined and cost-effective methods aimed at killing Anisakis larvae, thus reducing the incidence of anisakiasis. In this mini-review, we discuss the clinical features of anisakiasis as well as the effectiveness and mechanisms of action of the main methods employed for increasing seafood safety and killing Anisakis larvae, including freezing, heating, use of high hydrostatic pressure, salting process, pepsin digestion method and use of garlic oil.
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17
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Di Stefano V, Prinzi F, Luigetti M, Russo M, Tozza S, Alonge P, Romano A, Sciarrone MA, Vitali F, Mazzeo A, Gentile L, Palumbo G, Manganelli F, Vitabile S, Brighina F. Machine Learning for Early Diagnosis of ATTRv Amyloidosis in Non-Endemic Areas: A Multicenter Study from Italy. Brain Sci 2023; 13:brainsci13050805. [PMID: 37239276 DOI: 10.3390/brainsci13050805] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 04/06/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Hereditary transthyretin amyloidosis with polyneuropathy (ATTRv) is an adult-onset multisystemic disease, affecting the peripheral nerves, heart, gastrointestinal tract, eyes, and kidneys. Nowadays, several treatment options are available; thus, avoiding misdiagnosis is crucial to starting therapy in early disease stages. However, clinical diagnosis may be difficult, as the disease may present with unspecific symptoms and signs. We hypothesize that the diagnostic process may benefit from the use of machine learning (ML). METHODS 397 patients referring to neuromuscular clinics in 4 centers from the south of Italy with neuropathy and at least 1 more red flag, as well as undergoing genetic testing for ATTRv, were considered. Then, only probands were considered for analysis. Hence, a cohort of 184 patients, 93 with positive and 91 (age- and sex-matched) with negative genetics, was considered for the classification task. The XGBoost (XGB) algorithm was trained to classify positive and negative TTR mutation patients. The SHAP method was used as an explainable artificial intelligence algorithm to interpret the model findings. RESULTS diabetes, gender, unexplained weight loss, cardiomyopathy, bilateral carpal tunnel syndrome (CTS), ocular symptoms, autonomic symptoms, ataxia, renal dysfunction, lumbar canal stenosis, and history of autoimmunity were used for the model training. The XGB model showed an accuracy of 0.707 ± 0.101, a sensitivity of 0.712 ± 0.147, a specificity of 0.704 ± 0.150, and an AUC-ROC of 0.752 ± 0.107. Using the SHAP explanation, it was confirmed that unexplained weight loss, gastrointestinal symptoms, and cardiomyopathy showed a significant association with the genetic diagnosis of ATTRv, while bilateral CTS, diabetes, autoimmunity, and ocular and renal involvement were associated with a negative genetic test. CONCLUSIONS Our data show that ML might potentially be a useful instrument to identify patients with neuropathy that should undergo genetic testing for ATTRv. Unexplained weight loss and cardiomyopathy are relevant red flags in ATTRv in the south of Italy. Further studies are needed to confirm these findings.
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Affiliation(s)
- Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy
| | - Francesco Prinzi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario A, Gemelli-IRCCS, UOC Neurologia, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, 98182 Messina, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", 80131 Naples, Italy
| | - Paolo Alonge
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario A, Gemelli-IRCCS, UOC Neurologia, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Ausilia Sciarrone
- Fondazione Policlinico Universitario A, Gemelli-IRCCS, UOC Neurologia, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Vitali
- Fondazione Policlinico Universitario A, Gemelli-IRCCS, UOC Neurologia, 00168 Rome, Italy
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, 98182 Messina, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, 98182 Messina, Italy
| | - Giovanni Palumbo
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", 80131 Naples, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", 80131 Naples, Italy
| | - Salvatore Vitabile
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90127 Palermo, Italy
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18
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Pisciotta C, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Tozza S, Cavallaro T, Taioli F, Ferrarini M, Grandis M, Bellone E, Mandich P, Previtali SC, Falzone Y, Allegri I, Padua L, Pazzaglia C, Quattrone A, Valentino P, Gentile L, Russo M, Calabrese D, Moroni I, Pagliano E, Saveri P, Magri S, Baratta S, Taroni F, Mazzeo A, Santoro L, Vita G, Pareyson D. Clinical spectrum and frequency of Charcot-Marie-Tooth disease in Italy: data from the national CMT registry. Eur J Neurol 2023. [PMID: 37170966 DOI: 10.1111/ene.15860] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/31/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND We report data from the Italian CMT Registry. METHODS The Italian CMT Registry is a dual registry where the patient registers, chooses a reference centre, where the attending clinician collects a minimal dataset of information and administers the CMT Examination/Neuropathy Score. Entered data are encrypted. RESULTS Overall, 1012 patients had registered (535 females) and 711 had received a genetic diagnosis. Demyelinating CMT (65.3%) was more common than axonal CMT2 (24.6%) and intermediate CMT (9.0%). The PMP22 duplication was the most frequent mutation (45.2%), followed by variants in GJB1 and MPZ (both ~10%) and MFN2 (3.3%) genes. We observed a relatively high mutation rate in some "rare" genes (HSPB1 1.6%, NEFL 1.5%, SH3TC2 1.5%) and the presence of multiple mutation clusters across Italy. CMT4A was the most disabling type, followed by CMT4C and CMT1E. Disease progression rate differed, depending on the CMT subtype. Foot deformities and walking difficulties were the main features. Shoe inserts and orthotic aids were used by almost one half of all patients. Scoliosis was present in 20% of patients, especially in CMT4C. Recessive forms had more frequently walking delay, walking support need and wheelchair use. Hip dysplasia occurred in early-onset CMT. CONCLUSIONS The Italian CMT Registry has proven to be a powerful data source to collect information about epidemiology and genetic distribution, clinical features and disease progression of CMT in Italy and is a useful tool for recruiting patients in forthcoming clinical trials.
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Affiliation(s)
| | | | - Irene Tramacere
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | - Angelo Schenone
- Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | | | | | - Marina Grandis
- Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emilia Bellone
- Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paola Mandich
- Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | | | - Luca Padua
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | | | | | | | | | - Isabella Moroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Paola Saveri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Stefania Magri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Baratta
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Franco Taroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | | | - Davide Pareyson
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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19
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Doneddu PE, Briani C, Cocito D, Manganelli F, Fabrizi GM, Matà S, Mazzeo A, Fazio R, Benedetti L, Luigetti M, Inghilleri M, Ruiu E, Siciliano G, Cosentino G, Marfia GA, Carpo M, Filosto M, Antonini G, Notturno F, Sotgiu S, Cucurachi L, Dell'Aquila C, Bianchi E, Rosso T, Giordano A, Fernandes M, Campagnolo M, Peci E, Spina E, Tagliapietra M, Sperti M, Gentile L, Strano C, Germano F, Romozzi M, Moret F, Zarbo IR, Viola DV, Vegezzi E, Mataluni G, Piccinelli SC, Leonardi L, Carta A, Nobile-Orazio E. Risk of disease relapse, safety and tolerability of SARS-CoV-2 vaccination in patients with chronic inflammatory neuropathies. Eur J Neurol 2023. [PMID: 37000158 DOI: 10.1111/ene.15811] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND To evaluate the risk of relapse after SARS-CoV-2 vaccination, and its safety and tolerability, in patients with chronic inflammatory neuropathies. METHODS In this multicenter, cohort, and case-crossover study, the risk of relapse associated with SARS-CoV-2 vaccination was assessed by comparing frequency of relapse in CIDP and MMN patients who underwent or did not undergo vaccination. Frequency of relapse in the three months prior and after vaccination, and safety and tolerability of SARS-CoV-2 vaccination were also assessed. RESULTS 336 patients were included (278 CIDP; 58 MMN). 307 (91%) patients underwent SARS-CoV-2 vaccination. Twenty-nine patients (9%) did not undergo vaccination. Mild and transient relapses were observed in 16 (5%) patients (13 CIDP; 3 MMN) after SARS-CoV-2 vaccination and in none of the patients who did not undergo vaccination (RR= 3.21, 95% CI, 0.19-52.25). There was no increase in the specific risk of relapse associated with type of vaccine or diagnosis. Comparison with the 3-month control period preceding vaccination revealed an increased risk of relapse after vaccination (RR= 4.00; 95% CI, 1.35-11.82), which was restricted to CIDP patients (RR= 3.25, 95% CI, 1.07-9.84). The safety profile of SARS-CoV-2 vaccination was characterized by short-term, mild-to-moderate local and systemic adverse events. CONCLUSIONS SARS-CoV-2 vaccination in CIDP and MMN patients does not seem to be associated with an increased risk of relapse at primary endpoint, although a slightly increased risk in CIDP patients was found compared to the 3 months before vaccination.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele -, Milan, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Dario Cocito
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Gian Maria Fabrizi
- UOC Neurology B, Department of Neuroscience, University Hospital GB Rossi, AOUI and University of Verona, Verona, Italy
| | - Sabrina Matà
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | | | - Marco Luigetti
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS. UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | | | - Elisa Ruiu
- Neurology Unit, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | | | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-, Brescia, Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Giovanni Antonini
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Roma, Italy
| | | | - Stefano Sotgiu
- Child Neuropsychiatry Division, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | | | - Elisa Bianchi
- Laboratorio di Malattie Neurologiche, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Tiziana Rosso
- UOC di Neurologia, Ospedale San Bassiano, Bassano del Grappa, Vicenza, Italy
| | - Andrea Giordano
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
| | - Marco Fernandes
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
| | - Marta Campagnolo
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Erdita Peci
- SSD Patologie Neurologiche Specialistiche, AOU San Luigi, Torino, Italy
| | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Napoli, Italy
| | - Matteo Tagliapietra
- UOC Neurology B, Department of Neuroscience, University Hospital GB Rossi, AOUI and University of Verona, Verona, Italy
| | - Martina Sperti
- Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milano, Italy
| | | | - Marina Romozzi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS. UOC Neurologia, Roma, Italy
- Università Cattolica del Sacro Cuore. Sede di Roma, Roma, Italy
| | - Federica Moret
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Ignazio Roberto Zarbo
- Neurology Unit, Azienda Ospedaliera Universitaria di Sassari, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Divina Valeria Viola
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Roma, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia; NeMO-, Brescia, Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Luca Leonardi
- Unit of Neurophysiopathology, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Roma, Italy
| | - Alessandra Carta
- Child Neuropsychiatry Division, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano -, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milano, Italy
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20
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Medronho B, Pereira A, Duarte H, Gentile L, Rosa da Costa AM, Romano A, Olsson U. Probing cellulose-solvent interactions with self-diffusion NMR: Onium hydroxide concentration and co-solvent effects. Carbohydr Polym 2023; 303:120440. [PMID: 36657835 DOI: 10.1016/j.carbpol.2022.120440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/30/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
The molecular self-diffusion coefficients were accessed, for the first time, in solutions of microcrystalline cellulose, dissolved in 30 wt% and 55 wt% aqueous tetrabutylammonium hydroxide, TBAH (aq), and in mixtures of 40 wt% TBAH (aq) with an organic co-solvent, dimethylsulfoxide (DMSO), through pulsed field gradient stimulated echo NMR measurements. A two-state model was applied to estimate α (i.e., average number of ions that "bind" to each anhydroglucose unit) and Pb (i.e., fraction of "bound" molecules of DMSO, TBAH or H2O to cellulose) parameters. The α values suggest that TBA+ ions can bind to cellulose within 0.5 TBA+ to 2.3 TBA+/AGU. On the other hand, the Pb parameter increases when raising cellulose concentration for TBA+, DMSO and water in all solvent systems. Data suggests that TBAH interacts with the ionized OH groups from cellulose forming a sheath of bulky TBA+ counterions which consequently leads to steric hindrance between cellulose chains.
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Affiliation(s)
- B Medronho
- MED-Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Faculdade de Ciências e Tecnologia, Campus de Gambelas, Ed. 8, 8005-139 Faro, Portugal; FSCN Research Center, Surface and Colloid Engineering, Mid Sweden University, SE-851 70 Sundsvall, Sweden.
| | - A Pereira
- MED-Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Faculdade de Ciências e Tecnologia, Campus de Gambelas, Ed. 8, 8005-139 Faro, Portugal.
| | - H Duarte
- MED-Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Faculdade de Ciências e Tecnologia, Campus de Gambelas, Ed. 8, 8005-139 Faro, Portugal
| | - L Gentile
- Dipartimento di Chimica, Università di Bari "Aldo Moro" & CSGI (Consorzio per lo Sviluppo dei Sistemi a Grande Interfase), Via Orabona 4, Bari I-70126, Italy.
| | - A M Rosa da Costa
- Algarve Chemistry Research Centre (CIQA), Faculdade de Ciências e Tecnologia, Universidade do Algarve, 8005-139 Faro, Portugal.
| | - A Romano
- MED-Mediterranean Institute for Agriculture, Environment and Development, Universidade do Algarve, Faculdade de Ciências e Tecnologia, Campus de Gambelas, Ed. 8, 8005-139 Faro, Portugal.
| | - U Olsson
- Dipartimento di Chimica, Università di Bari "Aldo Moro" & CSGI (Consorzio per lo Sviluppo dei Sistemi a Grande Interfase), Via Orabona 4, Bari I-70126, Italy; Physical Chemistry, Chemistry Department and Biochemistry and Structural Biology, Chemistry Department, Lund University, P.O. Box 124, SE-22100 Lund, Sweden.
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21
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Bellofatto M, Bertini A, Tramacere I, Manganelli F, Fabrizi GM, Schenone A, Santoro L, Cavallaro T, Grandis M, Previtali SC, Falzone Y, Allegri I, Padua L, Pazzaglia C, Calabrese D, Saveri P, Quattrone A, Valentino P, Tozza S, Gentile L, Russo M, Mazzeo A, Vita G, Piacentini S, Pisciotta C, Pareyson D. Frequency, entity and determinants of fatigue in Charcot-Marie-Tooth disease. Eur J Neurol 2023; 30:710-718. [PMID: 36458502 PMCID: PMC10107642 DOI: 10.1111/ene.15643] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND PURPOSE Fatigue, a disabling symptom in many neuromuscular disorders, has been reported also in Charcot-Marie-Tooth disease (CMT). The presence of fatigue and its correlations in CMT was investigated. METHODS The Modified Fatigue Impact Scale (MFIS) was administered to CMT patients from the Italian Registry and a control group. An MFIS score >38 indicated abnormal fatigue. The correlation with disease severity and clinical characteristics, the Hospital Anxiety and Depression Scale and Epworth Sleepiness Scale scores, and drug use was analysed. RESULTS Data were collected from 251 CMT patients (136 women) and 57 controls. MFIS total (mean ± standard deviation 32 ± 18.3, median 33), physical (18.9 ± 9.7, 20) and psychosocial (2.9 ± 2.4, 3) scores in CMT patients were significantly higher than controls. Abnormal fatigue occurred in 36% of the patients who, compared to patients with normal scores, had more severe disease (median CMT Examination Score 9 vs. 7), more frequent use of foot orthotics (22% vs. 11%), need of support for walking (21% vs. 8%), hand disability (70% vs. 52%) and positive sensory symptoms (56% vs. 36%). Patients with abnormal fatigue had significantly increased frequency of anxiety/depression/general distress (Hospital Anxiety and Depression Scale), somnolence (Epworth Sleepiness Scale), obesity (body mass index ≥ 30) and use of anxiolytic/antidepressant or anti-inflammatory/analgesic drugs. CONCLUSIONS Fatigue is a relevant symptom in CMT as 36% of our series had scores indicating abnormal fatigue. It correlated with disease severity but also with anxiety, depression, sleepiness and obesity, indicating different components in the generation of fatigue. CMT patients' management must include treatment of fatigue and of its different generators, including general distress, sleepiness and obesity.
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Affiliation(s)
- Marta Bellofatto
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandro Bertini
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Irene Tramacere
- Dipartimento Gestionale di Ricerca e Sviluppo Clinico, Direzione Scientifica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Fiore Manganelli
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Gian Maria Fabrizi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Angelo Schenone
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Tiziana Cavallaro
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Marina Grandis
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze materno-infantili, Università di Genova, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Stefano C Previtali
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Yuri Falzone
- INSPE and Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Luca Padua
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Daniela Calabrese
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Paola Saveri
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Paola Valentino
- Dipartimento di Scienze Mediche, Università Magna Grecia, Catanzaro, Italy
| | - Stefano Tozza
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università Federico II di Napoli, Naples, Italy
| | - Luca Gentile
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Massimo Russo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Anna Mazzeo
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Giuseppe Vita
- Unità di Neurologia e Malattie Neuromuscolari, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy
| | - Sylvie Piacentini
- Unità di Neuropsicologia, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta di Milano, Milan, Italy
| | - Chiara Pisciotta
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Pareyson
- Unità di Malattie Neurodegenerative e Metaboliche Rare, Dipartimento di Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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22
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Tozza S, Luigetti M, Antonini G, Mazzeo A, Severi D, Di Paolantonio A, Leonardi L, Russo M, Romano A, Forcina F, Gentile L, Nolano M, Mattia C, Manganelli F. Neuropathic pain experience in symptomatic and presymptomatic subjects carrying a transthyretin gene mutation. Front Neurol 2023; 14:1109782. [PMID: 36846120 PMCID: PMC9944934 DOI: 10.3389/fneur.2023.1109782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Pain is a common symptom of hereditary transthyretin amyloidosis (ATTRv), however, its occurrence in late-onset ATTRv has not been investigated thoroughly. Our aim was to describe the pain experience and its impact on quality of life (QoL) in symptomatic patients and presymptomatic carriers harboring a transthyretin (TTR) gene mutation with a late-onset phenotype. Materials and methods Study participants (aged ≥18 years) were consecutively recruited from four Italian centers. Clinical disability was assessed using the Familial Amyloid Polyneuropathy (FAP) stage and Neuropathy Impairment Score (NIS). The Norfolk questionnaire evaluated QoL and the Compound Autonomic Dysfunction Test assessed autonomic involvement. Neuropathic pain was screened using the Douleur Neuropathique 4 (DN4) questionnaire, and pain intensity and its impact on daily activity were assessed using the Brief Pain Inventory severity and interference subscores. Data on the type of TTR mutation, presence of cardiomyopathy, treatment, and Body Mass Index (BMI) were collected. Results Overall, 102 subjects with TTR mutations (mean age ± SD 63.6 ± 13.5 years) were recruited, including 78 symptomatic patients (68.1 ± 10.9 years) and 24 presymptomatic carriers (49 ± 10.3 years). Pain was reported by 75.5% of all subjects, but was more frequent in symptomatic patients than in presymptomatic carriers (85.9 vs. 41.6%, respectively). Pain exhibited neuropathic features (DN4≥4) in 69.2% of symptomatic patients and in 8.3% of presymptomatic carriers. Subjects with neuropathic pain were older (p = 0.015) had worse FAP stage (p < 0.001), higher NIS scores (p < 0.001), greater autonomic involvement (p = 0.003), and a lower QoL (p < 0.001) than those without neuropathic pain. Neuropathic pain was associated with higher pain severity (p < 0.001) and had a significant negative impact on daily activities (p < 0.001) Neuropathic pain was not associated with gender, mutation type, TTR therapy, or BMI. Conclusion Approximately 70% of late-onset ATTRv patients complained of neuropathic pain (DN4≥4) that worsened as peripheral neuropathy progressed and increasingly interfered with daily activities and QoL. Notably, 8% of presymptomatic carriers complained of neuropathic pain. These results suggest that assessment of neuropathic pain may be useful to monitor disease progression and identify early manifestations of ATTRv.
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Affiliation(s)
- Stefano Tozza
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Rome, Italy,Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Antonini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
| | - Anna Mazzeo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Daniele Severi
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Andrea Di Paolantonio
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy,U.O. Neurologia, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Luca Leonardi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
| | - Massimo Russo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Rome, Italy,Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Forcina
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
| | - Luca Gentile
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Nolano
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy,Neurology Department, Skin Biopsy Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Italy
| | - Consalvo Mattia
- Department of Medical and Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, “Sapienza” University of Rome, Rome, Italy,Anesthesia, Intensive Care and Pain Unit, ICOT-Polo Pontino, Latina, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy,*Correspondence: Fiore Manganelli ✉
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23
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Ortmeier C, Gentile L. Papain-Based Dissociation of Schmidtea mediterranea Cells. Methods Mol Biol 2023; 2680:179-187. [PMID: 37428378 DOI: 10.1007/978-1-0716-3275-8_11] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The need of highly viable cells dissociated from Schmidtea mediterranea is constantly growing. In this chapter, we describe a cell dissociation method based on papain (papaya peptidase I). This enzyme, often used to dissociate cells with complex morphology, is a cysteine protease with a broad specificity and increases both the yield and the viability of the dissociated cell suspension. The papain dissociation is preceded by a pretreatment for mucus removal, as this was shown to greatly improve the yield of cell dissociation, regardless of the method used. Papain-dissociated cells are suitable for a variety of downstream applications, like live immunostaining, flow cytometry, cell sorting, transcriptomics, and cell transplantation, also at the single-cell level.
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Affiliation(s)
- Claudia Ortmeier
- Planarian Stem Cell Laboratory, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Luca Gentile
- Planarian Stem Cell Laboratory, Max Planck Institute for Molecular Biomedicine, Münster, Germany.
- Hasselt University, Campus Diepenbeek, Agoralaan, Diepenbeek, Belgium.
- Pluripotency and Regeneration Laboratory, Department Animal Physiology, University of Osnabrück, Osnabrück, Germany.
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24
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Ortmeier C, Gentile L. Live Immunostaining and Flow Cytometry of Schmidtea Mediterranea Cells. Methods Mol Biol 2023; 2680:189-207. [PMID: 37428379 DOI: 10.1007/978-1-0716-3275-8_12] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The use of flow cytometry and fluorescence-activated cell sorting to roughly separate subpopulations of cells in Schmidtea mediterranea is long established. In this chapter, we describe a method for the immunostaining-either single or double-of live planarian cells, using mouse monoclonal antibodies reactive against S. mediterranea plasma membrane antigens. This protocol allows to sort live cells according to their membrane signature, offering the possibility to further characterize the cell populations in S. mediterranea in a variety of downstream applications, like transcriptomics and cell transplantation, also at the single-cell level.
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Affiliation(s)
- Claudia Ortmeier
- Planarian Stem Cell Laboratory, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Luca Gentile
- Planarian Stem Cell Laboratory, Max Planck Institute for Molecular Biomedicine, Münster, Germany.
- Hasselt University, Campus Diepenbeek, Diepenbeek, Belgium.
- Pluripotency and Regeneration Laboratory, Dept. Animal Physiology, University of Osnabrück, Osnabrück, Germany.
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25
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Mennitti C, Ranieri A, Nigro E, Tripodi L, Brancaccio M, Ulisse J, Gentile L, Fimiani F, Cesaro A, D’Alicandro G, Limongelli G, Daniele A, Pero R, Frisso G, Calabrò P, Pastore L, Licenziati MR, Scudiero O, Lombardo B. The Impact of Physical Exercise on Obesity in a Cohort of Southern Italian Obese Children: Improvement in Cardiovascular Risk and Immune System Biomarkers. Int J Environ Res Public Health 2022; 20:602. [PMID: 36612926 PMCID: PMC9819595 DOI: 10.3390/ijerph20010602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Background: Childhood obesity (CO) is a serious medical condition affecting approximately 120 million children and adolescents worldwide. It is characterized by a persistent inflammatory state with inflammatory markers overexpressed, which in turn leads to a higher cardiovascular risk. It is well known that physical exercise reduces the inflammatory state in obese children. In the present study, we evaluated various biochemical parameters in obese children performing physical exercise compared to a group of obese sedentary children. Hence, the objective is to identify a panel of biomarkers to prevent numerous obesity-related complications. Methods: We examined two populations: 44 sedentary obese children (OSe), recruited on 5 November 2018 from Santobono−Pausilipon Children’s Hospital, Naples (Italy) of age = 11 ± 3.3 and 30 obese children who practice sport (OSp) of age = 10 ± 2.5. We observed a significant variation in some biochemical parameters such as white blood cells, C-reactive protein (CRP), glycemia and insulinemia. Moreover, we determined the levels of interleukins, chemokines and defensins by ELISA assay. Results: Our results showed a reduction in serum level of glycemia (p-value < 0.001), neutrophils (p-value < 0.05) and CRP (p-value < 0.05), whereas no relevant variations have been reported in insulin levels. Moreover, we found a decrease in serum levels of PDGF-β (p-value < 0.05), IL-9 (p-value < 0.01), IL-6 (p-value < 0.0001), IL-8 (p-value < 0.0001), IP-10 (p-value < 0.01), Eotaxin (p-value < 0.0001) and GM-CSF (p-value < 0.01) in OSp population in comparison to OSe. At the same time, we did not observe any significant variation in serum levels of IL-1ra and IL-17 between the two populations. On the other hand, we found an increase in HNP-1 (p-value < 0.0001) and HBD1 (p-value < 0.01) in OSp if compared to OSe. Conclusions: This study shed light on the role of physical exercise on CO, demonstrating in our population that an early evaluation of some biochemical parameters could be an assumption to prescribe physical exercise in order to monitor and prevent childhood obesity and related disorders.
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Affiliation(s)
- Cristina Mennitti
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | | | - Ersilia Nigro
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DISTABIF), University of Campania Luigi Vanvitelli, Via Vivaldi 43, 81100 Caserta, Italy
| | - Lorella Tripodi
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
| | - Mariarita Brancaccio
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Jacopo Ulisse
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Luca Gentile
- Integrated Department of Laboratory and Transfusion Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Fabio Fimiani
- Unit of Inherited and Rare Cardiovascular Diseases, A.O.R.N. Dei Colli “V. Monaldi”, Via Leonardo Bianchi, 80131 Naples, Italy
| | - Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Giovanni D’Alicandro
- Department of Neuroscience and Rehabilitation, Center of Sports Medicine and Disability, AORN, Santobono-Pausillipon, 80122 Naples, Italy
| | - Giuseppe Limongelli
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Aurora Daniele
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
| | - Raffaela Pero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Giulia Frisso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
- Division of Clinical Cardiology, A.O.R.N. “Sant’Anna e San Sebastiano”, 81100 Caserta, Italy
| | - Lucio Pastore
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
| | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Olga Scudiero
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80100 Naples, Italy
| | - Barbara Lombardo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
- Ceinge Biotecnologie Avanzate S. C. a R. L., 80131 Naples, Italy
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26
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Doneddu PE, De Lorenzo A, Manganelli F, Cocito D, Fazio R, Briani C, Mazzeo A, Filosto M, Cosentino G, Benedetti L, Schenone A, Marfia GA, Antonini G, Matà S, Luigetti M, Liberatore G, Spina E, Peci E, Strano C, Cacciavillani M, Gentile L, Cotti Piccinelli S, Cortese A, Bianchi E, Nobile-Orazio E. Comparison of the diagnostic accuracy of the 2021 EAN/PNS and 2010 EFNS/PNS diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry 2022; 93:1239-1246. [PMID: 36190959 DOI: 10.1136/jnnp-2022-329357] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/13/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the sensitivity and specificity of the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those of the 2010 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS). METHODS Sensitivity and specificity of the two sets of criteria were evaluated in 330 patients with CIDP and 166 axonal peripheral neuropathy controls. Comparison of the utility of nerve conduction studies with different number of nerves examined and of the sensitivity and specificity of the two criteria in typical CIDP and its variants were assessed. RESULTS EFNS/PNS criteria had a sensitivity of 92% for possible CIDP and 85% for probable/definite CIDP, while the EAN/PNS criteria had a sensitivity of 83% for possible CIDP and 74% for CIDP. Using supportive criteria, the sensitivity of the EAN/PNS criteria for possible CIDP increased to 85% and that of CIDP to 77%, remaining lower than that of the EFNS/PNS criteria. Specificity of the EFNS/PNS criteria was 68% for possible CIDP and 84% for probable/definite CIDP, while the EAN/PNS criteria had a specificity of 88% for possible CIDP and 98% for CIDP. More extended studies increased the sensitivity of both sets of criteria by 4%-7% but reduced their specificity by 2%-3%. The EFNS/PNS criteria were more sensitive for the diagnosis of typical CIDP while the EAN/PNS criteria were more specific for the diagnosis of distal and sensory CIDP. CONCLUSIONS In our population, the EAN/PNS criteria were more specific but less sensitive than the EFNS/PNS criteria. With the EAN/PNS criteria, more extended nerve conduction studies are recommended to obtain an acceptable sensitivity while maintaining a high specificity.
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Affiliation(s)
- Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center-IRCCS, Milano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto De Lorenzo
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center-IRCCS, Milano, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Campania, Italy
| | - Dario Cocito
- Divisione di Riabilitazione Neuromotoria, Istituti Clinici Scientifici Maugeri-Presidio Sanitario Major, Torino, Italy, Torino, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milano, Lombardia, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Sicilia, Italy
| | - Massimiliano Filosto
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Angelo Schenone
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Giovanni Antonini
- Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, University of Rome La Sapienza, Rome, Italy
| | - Sabrina Matà
- Dipartimento Neuromuscoloscheletrico e degli organi di Senso, Neurology Unit, Careggi University Hospital, Firenze, Italy
| | - Marco Luigetti
- UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center-IRCCS, Milano, Italy
| | - Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Campania, Italy
| | - Erdita Peci
- Department of Neuroscience, University of Turin, Torino, Italy
| | - Camilla Strano
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milano, Lombardia, Italy
| | | | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Sicilia, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, NeMO-Brescia Clinical Center for Neuromuscular Diseases, University of Brescia, Brescia, Italy
| | - Andrea Cortese
- IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elisa Bianchi
- Laboratorio di Malattie Neurologiche, Istituto di ricerche farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Unit, Humanitas Clinical and Research Center-IRCCS, Milano, Italy .,Department of Medical Biotechnology, Translational Medicine Milan University, Italy
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Porzio M, Rembado D, Gentile L. EXPOSURE INDEX MONITORING; A FIRST EXPERIENCE IN THE OPTIMIZATION PROCESS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)02465-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ancona A, Godoy M, Bertuccio P, Gentile L, Odone A, Signorelli C. Can YouTube be used as a credible source of information for COVID-19 vaccination in Italy? Eur J Public Health 2022. [PMCID: PMC9593524 DOI: 10.1093/eurpub/ckac131.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background The COVID-19 pandemic led to an ‘infodemic', as defined by the WHO, which made it difficult to be accurately informed on public health topics. For this purpose, many people use social media as a source of information, mainly YouTube. Given the great resonance of this platform, our study aims at assessing quality and reliability of its content regarding the COVID-19 vaccination. Methods During March 2022, six searches were performed on the Italian YouTube platform using the following terms: “Covid vaccination”, “Covid vaccine”, “Coronavirus vaccination”, “Coronavirus vaccine”, “Sars-Cov-2 vaccination” and “Sars-Cov-2 vaccine”. A total of 329 videos were analysed, after removing 271 duplicated videos, and classified in seven types of channel. The reliability of the content was evaluated through the HoNCode score, while quality was tested using the validated DISCERN tool. Results The most frequent category was ‘Internet Media’ (33%), while the less frequent one was ‘Educational Medical’ (7%). The content reliability (i.e. HoNCode score) resulted higher for videos produced by medical healthcare workers than non-medical ones. Concerning the quality, the DISCERN score resulted significantly higher for the Educational channels (median 46.0 for medical and 41.3 non-medical ones) as compared to Internet Media (26.5) and New Agencies (24.3). Conclusions Although YouTube has implemented a policy against misinformation related to the COVID-19 vaccination, the study highlights that there is extreme heterogeneity in reliability and quality of videos. Content produced by non-medical users, especially “Internet Media” and “News Agencies” categories should be evaluated with attention by users, as their quality is not appropriate to the importance of the topic. Key messages • Because of to the heterogeneity of its content, YouTube should be evaluated carefully when used as a source of information for Covid-19 vaccination. • Content produced by non-medical users, is generally of poor quality, not appropriate to the importance of the topic.
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Affiliation(s)
- A Ancona
- School of Public Health, University Vita-Salute San Raffaele , Milan, Italy
| | - M Godoy
- School of Public Health, University Vita-Salute San Raffaele , Milan, Italy
| | - P Bertuccio
- Department of Public Health, University of Pavia , Pavia, Italy
| | - L Gentile
- School of Public Health, University Vita-Salute San Raffaele , Milan, Italy
| | - A Odone
- Department of Public Health, University of Pavia , Pavia, Italy
| | - C Signorelli
- School of Public Health, University Vita-Salute San Raffaele , Milan, Italy
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Vecchio R, Meloni A, Gentile L, Gaeta M, Signorelli C, Odone A. Leo&Giulia: a cartoon series to promote health and prevention in primary school-aged children. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.589] [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: 11/13/2022] Open
Abstract
Abstract
Background
Coronavirus (COVID-19) pandemic control measures actively involved people who were called to adopt new and unusual lifestyles. In this context, children had to stay home from school for weeks, had to adapt to new teaching methods and give up socializing. In many countries, not much attention was paid to the educational sector, and, ultimately, to children's physical and psychological well-being.
Objectives
In this context, we developed an innovative health education audio-visual model to teach children about public health, empower them to adopt preventive behaviours and limit the risk of infection transmission in schools and in the community.
Results
We designed and produced the animated cartoon series “Leo&Giulia” to convey solid scientific content and key public health messages related to the ongoing COVID-19 pandemic to primary school-aged children. Contents and dialogues were validated by a scientific committee composed of experts in the fields of public health, paediatrics, infectious diseases, and neuroscience, as well as communication experts. The first episode of Leo&Giulia focused on COVID-19 and explained to children what SARS-CoV2 was, its transmission and why schools were closed. Endorsed by the European Commission, it was broadcasted by national public and private television channels and went viral on social media. The second episode of Leo&Giulia, funded by the Italian Ministry of Research, was launched in April 2022 and focused on vaccines and immunization explaining to children how vaccines work and why herd immunity is important for collective health.
Conclusions
Leo&Giulia is an innovative health education project to help children to better understand how to cope with COVID-19 as a public health challenge. More broadly, the series aims to increase youth engagement by promoting public health values and healthy behaviours.
Key messages
• Health promotion targeting children is important and contributes to societal health and wellbeing.
• Cartoon series are an innovative digital health education tool that effectively increase youth engagement on public health values.
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Affiliation(s)
- R Vecchio
- Department of Public Health, University of Pavia , Pavia, Italy
| | - A Meloni
- Department of Public Health, University of Pavia , Pavia, Italy
| | - L Gentile
- Department of Public Health, University of Pavia , Pavia, Italy
| | - M Gaeta
- Department of Public Health, University of Pavia , Pavia, Italy
| | - C Signorelli
- School of Medicine, Vita-Salute San Raffaele University , Milan, Italy
| | - A Odone
- Department of Public Health, University of Pavia , Pavia, Italy
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Cardiero G, Palma D, Vano M, Anastasio C, Pinchera B, Ferrandino M, Gianfico C, Gentile L, Savoia M, Gentile I, Di Taranto MD, Fortunato G. Calprotectin Levels and Neutrophil Count Are Prognostic Markers of Mortality in COVID-19 Patients. Diagnostics (Basel) 2022; 12:diagnostics12102554. [PMID: 36292243 PMCID: PMC9601504 DOI: 10.3390/diagnostics12102554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
Inflammation plays a crucial role in worsening coronavirus disease (COVID-19). Calprotectin is a pro-inflammatory molecule produced by monocytes and neutrophilic granulocytes. The aim of the study was to evaluate both the prognostic role of circulating calprotectin levels and neutrophil count toward fatal outcome in COVID-19 patients. We retrospectively collected and analyzed data on 195 COVID-19 adult patients, 156 hospitalized in the infectious disease unit and 39 in the intensive care unit (ICU). Calprotectin levels and neutrophil counts measured at the first hospitalization day were higher in the patients with a fatal outcome than in surviving ones. The association of high calprotectin levels and neutrophil count to patient death remain significant by logistic regression, independent of patient age. ROC curves analysis for calprotectin levels and neutrophil count revealed a good discriminatory power toward survival (area under the curve of 0.759 and 0.843, respectively) and identified the best cut-off (1.66 mg/L and 16.39 × 103/µL, respectively). Kaplan–Meier analysis confirmed the prognostic role of high calprotectin levels and neutrophil count in death prediction. In conclusion, this study highlights that calprotectin levels together with neutrophil count should be considered as biomarkers of mortality in COVID-19 patients.
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Affiliation(s)
- Giovanna Cardiero
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
| | - Daniela Palma
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
| | - Martina Vano
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Claudia Anastasio
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Biagio Pinchera
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie Infettive, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Martina Ferrandino
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Carlo Gianfico
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Luca Gentile
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Marcella Savoia
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Ivan Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Malattie Infettive, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
| | - Maria Donata Di Taranto
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
- Correspondence:
| | - Giuliana Fortunato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Franco Salvatore, 80145 Naples, Italy
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31
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Digiovanni A, Gentile L, Caulo M, Onofrj M, Sensi SL, De Angelis MV. Cerebral vasculitis due to nickel hypersensitivity: a case of intracranial “device syndrome”. Neurol Sci 2022; 43:6111-6115. [DOI: 10.1007/s10072-022-06149-x] [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] [Received: 03/21/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
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Di Bella G, Cappelli F, Licordari R, Piaggi P, Campisi M, Bellavia D, Minutoli F, Gentile L, Russo M, de Gregorio C, Perfetto F, Mazzeo A, Falletta C, Clemenza F, Vita G, Carerj S, Aquaro GD. Prevalence and diagnostic value of extra-left ventricle echocardiographic findings in transthyretin-related cardiac amyloidosis. Amyloid 2022; 29:197-204. [PMID: 35465808 DOI: 10.1080/13506129.2022.2064739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Cardiac amyloidosis (CA) is cardiomyopathy with a hypertrophic phenotype characterised by diffuse deposition of anomalous fibrillar proteins in the extracellular matrix. OBJECTIVES To evaluate the prevalence and diagnostic value of extra left ventricle echocardiographic findings in patients with left ventricular (LV) hypertrophic phenotype and amyloid deposition. METHODS A group of 146 patients with LV thickness ≥15 mm were enrolled: 70 patients who received a definite diagnosis of sarcomeric hypertrophic cardiomyopathy (HCM group) and 76 patients with transthyretin cardiac amyloidosis (CA group). Echocardiographic analysis of crista terminalis (CriT), atrio-ventricular plane (AVP), mitro-aortic lamina (MAL), anterior ascending aortic wall, interatrial septum (IAS), Eustachian valve (EusV) and coumadin ridge (CouR) was performed in all patients, and these structures were compared among the two groups. RESULTS CA group showed significantly higher dimensions of CriT, IAS, CouR, AVP, MAL and IAS compared to the HCM group. The logistic analysis showed that LV EF, LV septal thickness, CriT presence, CriT area, MAL and IAS were all predictors of CA in univariate analyses. The stepwise multivariate analysis showed independent predictors of CA: CriT area, MAL and LVEF. According to areas under the receiver operating characteristic curves the best cut-off values to determine CA were identified (IAS > 9 mm, MAL > 7 mm, CriT > 9 mm2). Among these 3 independent predictors, IAS > 9 mm had the best specificity (96%) and positive predictive value (93%) in identifying CA. CONCLUSIONS evidence of extra left ventricle sites of amyloid deposition is a frequent finding in CA. In the context of hypertrophic phenocopies, an increased thickness of IAS, and/or CT and/or MAL should suggest a diagnosis of transthyretin CA.
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Affiliation(s)
- Gianluca Di Bella
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloid Center, Careggi University Hospital, Firenze, Italy
| | - Roberto Licordari
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paolo Piaggi
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Pisa, Pisa, Italy
| | - Mariapaola Campisi
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Diego Bellavia
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Luca Gentile
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimo Russo
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Cesare de Gregorio
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloid Center, Careggi University Hospital, Firenze, Italy
| | - Anna Mazzeo
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Calogero Falletta
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Francesco Clemenza
- Division of Cardiovascular Diseases, Cardio-Thoracic Department, IRCCS-ISMETT, Palermo, Italy
| | - Giuseppe Vita
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Scipione Carerj
- Rare Cardiac Disease Centre, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Di Stefano V, Fava A, Gentile L, Guaraldi P, Leonardi L, Poli L, Tagliapietra M, Vastola M, Fanara S, Ferrero B, Giorgi M, Perfetto F, Russo M, Russo D. Italian Real-Life Experience of Patients with Hereditary Transthyretin Amyloidosis Treated with Patisiran. Pharmgenomics Pers Med 2022; 15:499-514. [PMID: 35592550 PMCID: PMC9113125 DOI: 10.2147/pgpm.s359851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Hereditary transthyretin amyloidosis (ATTRv) is a multisystemic, rare, inherited, progressive and adult-onset disease, affecting the sensorimotor nerves, heart, autonomic function and other organs. The actual scenario of pharmaceutical approaches for ATTRv amyloidosis includes five main groups: TTR stabilizers, TTR mRNA silencers, TTR fibril disruptors, inhibitor of TTR fibril seeding and gene therapy. Patisiran is a small, double-stranded interfering RNA encapsulated in a lipid nanoparticle, able to penetrate into hepatocytes, where it selectively targets TTR mRNA, reducing TTR production. We report and discuss 9 cases of different patients with ATTRv amyloidosis successfully managed with patisiran in the real clinical practice. Literature data, as well as the above presented case reports, show that this drug is effective and safe in improving both neurological and cardiovascular symptoms of ATTRv amyloidosis, and to maintain a good QoL, independently form the stage of the disease and the involved mutation. Recent studies correlated improved functional and biochemical outcomes with a regression of amyloid burden, especially at the cardiac level. Today, patisiran can be considered a valid therapeutic option for the management of patients with ATTRv amyloidosis and polyneuropathy and cardiovascular symptoms.
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Affiliation(s)
- Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
- Correspondence: Vincenzo Di Stefano, Department of Biomedicine, Neuroscience and advanced Diagnostic (BIND), University of Palermo Palermo, Italy, Via del Vespro 143, Palermo, 90127, Italy, Tel +39 3285781786, Fax +390916552974, Email
| | - Antonella Fava
- Division of Cardiology, Heart Vascular and Thoracic Department, Città della Salute e della Scienza (Molinette Hospital- University of Turin), Turin, Italy
| | - Luca Gentile
- Unit of Neurology and Neuromuscular Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Pietro Guaraldi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luca Leonardi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome Sant’Andrea Hospital, Rome, Italy
| | - Loris Poli
- Department of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Matteo Tagliapietra
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Vastola
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- Neurosciences Department, Florence University, Rome, Italy
| | - Salvatore Fanara
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, Palermo, Italy
| | - Bruno Ferrero
- SC Neurology 2U, Department of Neuroscience “Rita Levi Montalcini”, Città della Salute e della Scienza (Molinette Hospital -University of Turin), Turin, Italy
| | - Mauro Giorgi
- Division of Cardiology, Heart Vascular and Thoracic Department, Città della Salute e della Scienza (Molinette Hospital- University of Turin), Turin, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
| | - Massimo Russo
- Unit of Neurology and Neuromuscular Disease, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Domitilla Russo
- Division of Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
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Luigetti M, Antonini G, Di Paolantonio A, Gentile L, Grandis M, Leonardi L, Lozza A, Manganelli F, Mazzeo A, Mussinelli R, My F, Obici L, Pennisi EM, Romozzi M, Russo M, Sabatelli M, Salvalaggio A, Tagliapietra M, Tozza S. Real-life experience with inotersen in hereditary transthyretin amyloidosis with late-onset phenotype: data from an early-access program in Italy. Eur J Neurol 2022; 29:2148-2155. [PMID: 35289020 PMCID: PMC9314115 DOI: 10.1111/ene.15325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Abstract
Background and purpose Hereditary transthyretin (TTR) amyloidosis (ATTRv) is a dominantly inherited, adult‐onset, progressive, and fatal disease caused by mutations in the transthyretin gene. Therapeutic agents approved for this disease include the TTR stabilizer tafamidis and the gene‐silencing drugs patisiran and inotersen. Inotersen is an antisense oligonucleotide that suppresses the hepatic production of transthyretin. After European Medical Agency approval in 2018, an early‐access program was opened in Italy, and in this article, we present the long‐term outcome of a cohort of Italian ATTRv patients who received inotersen within this program. Methods This is a multicenter, observational, retrospective study of patients affected by ATTRv that started inotersen during the early‐access program. The primary end point was safety. Secondary end points included change from baseline in familial amyloid polyneuropathy (FAP) stage, Polyneuropathy Disability, Neuropathy Impairment Scale, Compound Autonomic Dysfunction Test, Norfolk Quality of Life–Diabetic Neuropathy, troponin, N‐terminal pro–brain natriuretic peptide, interventricular septum thickness, and body mass index. Results In total, 23 patients were enrolled. No patient permanently discontinued the treatment because of thrombocytopenia, and no cases of severe thrombocytopenia were observed. Five patients discontinued the treatment permanently because of voluntary withdrawal (two patients), renal failure after infective pyelonephritis, not related to inotersen, drug‐related hypotension, and amyloid‐negative crescentic glomerulonephritis. In seven patients, dosing frequency was reduced to every 2 weeks due to recurrent thrombocytopenia. Considering the FAP stage, only two patients worsened, whereas the other 21 patients remained stable until the last follow‐up available. Conclusions The long‐term safety profile of inotersen is favorable. Neurologic disease severity at baseline is the main factor associated with progression.
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Affiliation(s)
- Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS. UOC Neurologia, Rome, Italy.,Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Antonini
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Luca Gentile
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Marina Grandis
- University of Genova, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal Infantile Sciences, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Luca Leonardi
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandro Lozza
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", Naples, Italy
| | - Anna Mazzeo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Roberta Mussinelli
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Filomena My
- UOC Neurologia Ospedale Vito Fazzi Lecce, Italy
| | - Laura Obici
- Amyloidosis Research and Treatment Center, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Elena Maria Pennisi
- Neuromuscular and Rare Neurological Diseases - Neurology Unit, San Filippo Neri Hospital Rome, Italy
| | - Marina Romozzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS. UOC Neurologia, Rome, Italy.,Dipartimento Di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Russo
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Mario Sabatelli
- Centro Clinico NEMO - Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Matteo Tagliapietra
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefano Tozza
- Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples "Federico II", Naples, Italy
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Iglesias SL, Gentile L, López P, Pioli I, Mangupli M, Gómez J, Allende BL. [Lumbar plexus nerve block provides better analgesic management than periarticular infiltration in primary total hip arthroplasty. Comparative, prospective, and single-blind clinical trial]. Acta Ortop Mex 2022; 36:79-84. [PMID: 36481547] [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: 06/17/2023]
Abstract
INTRODUCTION joint replacement is a highly effective intervention that significantly improves the patient's quality of life, relieves symptoms, restores joint function, and improves mobility and independence. The optimal pain control after total hip replacement has become an important goal of postoperative management. The purpose of this paper is to compare periarticular infiltration (PAI) and lumbar plexus nerve block (LPNB) for the management of post-operative pain in primary total hip arthroplasty because we believe that LPNB provides better analgesic management and lower opioid consumption. We evaluated the opioid usage during hospitalization and the complications derived from either technique. MATERIAL AND METHODS we randomized 45 patients who underwent elective total hip arthroplasty between January 2019 and January 2020. Two groups were evaluated based on the association of PAI or LPNB. Both as part of a multimodal analgesic regimen. RESULTS a total of 45 patients were evaluated (22 PAI group, 23 LPNB group). Block group required less opioid administration (p = 0.069). Most of the patients in both groups reported mild/moderate pain. The LPNB group had lower pain scale with physiotherapy. We did not have complications derived from either technique. CONCLUSION lumbar plexus nerve block (LPNB) in patients undergoing total hip arthroplasty provides better pain management and reduced opioid consumption compared to PAI. The performance of this technique does not delay the beginning of physiotherapy and there were not any issues with the patient's recovery.
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Affiliation(s)
- S L Iglesias
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - L Gentile
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - P López
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - I Pioli
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - M Mangupli
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - J Gómez
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
| | - B L Allende
- Departamento de Reemplazo Articular y Trauma del Miembro Inferior, Instituto Allende de Cirugía Reconstructiva de los Miembros. Sanatorio Allende. Córdoba, Argentina
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Minutoli F, Russo M, Di Bella G, Laudicella R, Spataro A, Vento A, Comis A, Gentile L, Mazzeo A, Vita G, Baldari S. Correction to: Diagnosis of cardiac amyloid transthyretin (ATTR) amyloidosis by early (soft tissue) phase [99mTc]Tc-DPD whole body scan: comparison with late (bone) phase imaging. Eur Radiol 2022; 32:3610. [PMID: 35113214 DOI: 10.1007/s00330-022-08545-5] [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: 11/28/2022]
Affiliation(s)
- Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy. .,Nuclear Medicine Unit, University Hospital "Policlinico G.Martino", via Consolare Valeria n.1, 98125, Messina, Italy.
| | - Alessandro Spataro
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Antonio Vento
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Alessio Comis
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
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Minutoli F, Russo M, Di Bellaearly Phase Planar Imaging G, Laudicella R, Spataro A, Vento A, Comis A, Gentile L, Mazzeo A, Vita G, Baldari S. Diagnosis of cardiac amyloid transthyretin (ATTR) amyloidosis by early (soft tissue) phase [ 99mTc]Tc-DPD whole body scan: comparison with late (bone) phase imaging. Eur Radiol 2022; 32:3035-3044. [PMID: 35031838 DOI: 10.1007/s00330-021-08420-9] [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: 07/02/2021] [Revised: 09/29/2021] [Accepted: 10/17/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Although expert consensus recommendations suggest 2-3 h as the time interval between bone-seeking radiotracers injection and acquisition, it has been reported that images obtained early after [99mTc]Tc-HMDP administration are sufficient to diagnose cardiac amyloidosis. We evaluated the diagnostic performance of [99mTc]Tc-DPD early phase whole body scan with respect to late phase imaging. METHODS We qualitatively and semiquantitatively reviewed [99mTc]Tc-DPD imaging of 53 patients referred for suspect cardiac amyloidosis. Findings of early and late phase images were compared with SPECT results (considered the standard-of-reference) determining sensitivity and specificity for visual analysis of each phase imaging and for each semiquantitative index. RESULTS SPECT imaging was negative for cardiac accumulation in 25 patients and positive in 28. Visual analysis of early phase whole body scan had an extremely significant capability to predict SPECT results; nevertheless, complete agreement was not reached. Visual analysis of late phase imaging showed slightly better results. Semiquantitative analysis of early phase images, namely heart to mediastinum ratio, performed better than semiquantitative analysis of late phase images. CONCLUSION Visual analysis of [99mTc]Tc-DPD early phase whole body scan is promising in diagnosing cardiac amyloidosis; further studies are needed to confirm our results in different clinical scenarios. KEY POINTS • Visual analysis of early phase planar imaging using [99mTc]Tc-DPD is accurate to diagnose cardiac amyloidosis and may be satisfactory at least in frail patients with high cardiac burden of amyloid fibrils.
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Affiliation(s)
- Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy. .,Nuclear Medicine Unit, University Hospital "Policlinico G.Martino", via Consolare Valeria n.1, 98125, Messina, Italy.
| | - Alessandro Spataro
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Antonio Vento
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Alessio Comis
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
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Spina E, Doneddu PE, Liberatore G, Cocito D, Fazio R, Briani C, Filosto M, Benedetti L, Antonini G, Cosentino G, Jann S, Mazzeo A, Cortese A, Marfia GA, Clerici AM, Siciliano G, Carpo M, Luigetti M, Lauria G, Rosso T, Cavaletti G, Peci E, Tronci S, Ruiz M, Piccinelli SC, Schenone A, Leonardi L, Gentile L, Piccolo L, Mataluni G, Santoro L, Nobile-Orazio E, Manganelli F. The neurophysiological lesson from the Italian CIDP database. Neurol Sci 2022. [PMID: 34021439 DOI: 10.1007/s10072-020-04998-y.10.1007/s10072-020-04998-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Electrophysiological diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may be challenging. Thus, with the aim ofproviding some practical advice in electrophysiological approach to a patient with suspected CIDP, we analyzed electrophysiological data from 499 patients enrolled inthe Italian CIDP Database. METHODS We calculated the rate of each demyelinating feature, the rate of demyelinating features per nerve, the diagnostic rate for upper andlower limb nerves, and, using a ROC curve analysis, the diagnostic accuracy of each couple of nerves and each demyelinating feature, for every CIDP subtype.Moreover, we compared the electrophysiological data of definite and probable CIDP patients with those of possible and not-fulfilling CIDP patients, and by a logisticregression analysis, we estimated the odds ratio (OR) to make an electrophysiological diagnosis of definite or probable CIDP. RESULTS The ulnar nerve had the highestrate of demyelinating features and, when tested bilaterally, had the highest diagnostic accuracy except for DADS in which peroneal nerves were the most informative.In possible and not-fulfilling CIDP patients, a lower number of nerves and proximal temporal dispersion (TD) measurements had been performed compared to definiteand probable CIDP patients. Importantly, OR for each tested motor nerve and each TD measurement was 1.59 and 1.33, respectively. CONCLUSION Our findingsdemonstrated that the diagnosis of CIDP may be missed due to inadequate or incomplete electrophysiological examination or interpretation. At the same time, thesedata taken together could be useful to draw a thoughtful electrophysiological approach to patients suspected of CIDP.
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Affiliation(s)
- Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Dario Cocito
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
- IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
| | - Stefano Jann
- Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Andrea Cortese
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
- Molecular Neurosciences, University College London, London, UK
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Angelo Maurizio Clerici
- Neurology Unit, Circolo & Macchi Foundation Hospital, Insubria University, DBSV, Varese, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marinella Carpo
- Neurology Unit, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Lauria
- Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milan, Italy
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - Tiziana Rosso
- ULSS2 Marca Trevigiana, UOC Neurologia-Castelfranco Veneto, Treviso, Italy
| | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Erdita Peci
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Stefano Tronci
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Marta Ruiz
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
| | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Laura Piccolo
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.
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Allegra A, Rizzo V, Innao V, Alibrandi A, Mazzeo A, Leanza R, Terranova C, Gentile L, Girlanda P, Allegra AG, Alonci A, Musolino C. Diagnostic utility of Sudoscan for detecting bortezomib-induced painful neuropathy: a study on 18 patients with multiple myeloma. Arch Med Sci 2022; 18:696-703. [PMID: 35591819 PMCID: PMC9102521 DOI: 10.5114/aoms/114269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 11/16/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the past few years, treatment of multiple myeloma has undergone a deep change for the employment of novel treatment comprising proteasome inhibitors. Bortezomib is a first-line drug in therapy of multiple myeloma. The onset of peripheral neuropathy is a dose-limiting collateral effect of the drug. This neuropathy is a distal symmetric neuropathy that affects both large and small fibers. Nerve conduction study (NCS) can be used for the diagnosis of bortezomib neuropathy, but this technique demonstrates alterations of the large nerve fibers. Sudoscan is a novel technique utilized to offer an evaluation of sudomotor function. The main objective of this study was to compare the sensitivity and diagnostic specificity of Sudoscan with respect to the nerve conduction study after bortezomib treatment. MATERIAL AND METHODS A total of 18 multiple myeloma patients were studied, 10 (55.5%) men and 8 (44.5%) women. Patients were analyzed at baseline and after 6 months of treatment with bortezomib. Subjects were submitted to nerve conduction study and electrochemical skin conductance evaluation with the Sudoscan device. Patients were also submitted to a clinical measure of pain and neuropathy. RESULTS At baseline NCS showed that only the mean sural SAP amplitude was below the 2SD lower limit of normal in 3 (16.7%) patients, while at same time we found an alteration of Sudoscan profiles in 2 (11.1%) patients. After 6 months of treatment, the NCS profiles were altered in 13 (72.2%) patients, and the Sudoscan profiles were modified in 11 (61.1%) subjects. CONCLUSIONS Our results suggest that Sudoscan can be considered for the diagnosis of bortezomib-induced neuropathy. It is objective, reproducible, and surely easier than the traditional nerve conduction study. Sudoscan may be a useful help to manage the therapeutic interventions in multiple myeloma.
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Affiliation(s)
- Alessandro Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Vincenzo Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vanessa Innao
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Rossana Leanza
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Carmen Terranova
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paolo Girlanda
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Gaetano Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Andrea Alonci
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Caterina Musolino
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
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Gentile L, Russo M, Taioli F, Ferrarini M, Aguennouz M, Rodolico C, Toscano A, Fabrizi GM, Mazzeo A. Rare among Rare: Phenotypes of Uncommon CMT Genotypes. Brain Sci 2021; 11:brainsci11121616. [PMID: 34942918 PMCID: PMC8699517 DOI: 10.3390/brainsci11121616] [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: 11/16/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Charcot–Marie–Tooth disease (CMT) is the most frequent form of inherited chronic motor and sensory polyneuropathy. Over 100 CMT causative genes have been identified. Previous reports found PMP22, GJB1, MPZ, and MFN2 as the most frequently involved genes. Other genes, such as BSCL2, MORC2, HINT1, LITAF, GARS, and autosomal dominant GDAP1 are responsible for only a minority of CMT cases. (2) Methods: we present here our records of CMT patients harboring a mutation in one of these rare genes (BSCL2, MORC2, HINT1, LITAF, GARS, autosomal dominant GDAP1). We studied 17 patients from 8 unrelated families. All subjects underwent neurologic evaluation and genetic testing by next-generation sequencing on an Ion Torrent PGM (Thermo Fischer) with a 44-gene custom panel. (3) Results: the following variants were found: BSCL2 c.263A > G p.Asn88Ser (eight subjects), MORC2 c.1503A > T p.Gln501His (one subject), HINT1 c.110G > C p.Arg37Pro (one subject), LITAF c.404C > G p.Pro135Arg (two subjects), GARS c.1660G > A p.Asp554Asn (three subjects), GDAP1 c.374G > A p.Arg125Gln (two subjects). (4) Expanding the spectrum of CMT phenotypes is of high relevance, especially for less common variants that have a higher risk of remaining undiagnosed. The necessity of reaching a genetic definition for most patients is great, potentially making them eligible for future experimentations.
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Affiliation(s)
- Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
- Correspondence:
| | - Massimo Russo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
| | - Federica Taioli
- Department of Neurological Sciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (F.T.); (M.F.); (G.M.F.)
| | - Moreno Ferrarini
- Department of Neurological Sciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (F.T.); (M.F.); (G.M.F.)
| | - M’Hammed Aguennouz
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
| | - Carmelo Rodolico
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
| | - Gian Maria Fabrizi
- Department of Neurological Sciences, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (F.T.); (M.F.); (G.M.F.)
- Azienda Ospedaliera Universitaria Integrata Verona—Borgo Roma, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (M.R.); (M.A.); (C.R.); (A.T.); (A.M.)
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Porzio M, Rembado D, Gentile L. Photon counting as a valuable technology for breast screening: low glandular doses and good image quality. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00485-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Minutoli F, Di Bella G, Mazzeo A, Laudicella R, Gentile L, Russo M, Vita G, Baldari S. Serial scanning with 99mTc-3, 3-diphosphono-1, 2-propanodicarboxylic acid ( 99mTc-DPD) for early detection of cardiac amyloid deposition and prediction of clinical worsening in subjects carrying a transthyretin gene mutation. J Nucl Cardiol 2021; 28:1949-1957. [PMID: 31741327 DOI: 10.1007/s12350-019-01950-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/07/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND To determine the capability of 99mTc-DPD scintigraphy to detect early cardiac involvement and predict clinical worsening in transthyretin (TTR) gene mutation patients. METHODS Eleven mutated subjects with normal interventricular septum (IVS) thickness, NT-proBNP level and no cardiac symptoms underwent three seriate 99mTc-DPD scans (visually and semiquantitatively analyzed), and was followed-up for 5-8-years. RESULTS Six patients showed no myocardial accumulation in all scans. Increased IVS thickness occurring in one patient 4 years after the last scan was the only abnormal finding in these patients; no cardiac symptoms developed during the follow-up. In three patients, cardiac radiotracer uptake was found at enrollment; other laboratory/instrumental abnormal findings occurred later and cardiac symptoms developed during the follow-up period. Two patients had a negative 99mTc-DPD scan at enrollment and showed cardiac uptake in the following scans. Increased mean left-ventricular (LV) wall thickness was found 3 years after positive scintigraphy; NT-proBNP increased later in one patient. These patients developed cardiac symptoms during the follow-up period. CONCLUSIONS 99mTc-DPD scan detects cardiac involvement in subjects with TTR gene mutation earlier than ECG, echocardiography and biochemical markers, occurring some years before the fulfillment of current diagnostic criteria for cardiac amyloidosis. A positive 99mTc-DPD scan predicts cardiac symptoms onset.
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Affiliation(s)
- F Minutoli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - G Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - A Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - R Laudicella
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy.
| | - L Gentile
- Department of Clinical and Experimental Medicine, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - M Russo
- Nemo Sud Clinical Centre, University Hospital "G. Martino", Messina, Italy
| | - G Vita
- Department of Clinical and Experimental Medicine, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - S Baldari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, University Hospital "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
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Gentile L, Russo M, Luigetti M, Arimatea I, Sabatelli M, Toscano A, Vita G, Mazzeo A. Patisiran in hATTR amyloidosis: 6 months latency before efficacy. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118348] [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: 11/28/2022]
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Gentile L, Russo M, Rodolico C, Arimatea I, Vita G, Toscano A, Mazzeo A. Multifocal motor neuropathy: Long-term treatment with subcutaneous immunoglobulin. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.117814] [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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Provenzano S, Gentile L, Cuda A, Santangelo OE, Dallagiacoma G, Gianfredi V. Is there an association between self-reported vaccination knowledge and the immunization behaviour of Health Sciences students. Ann Ig 2021; 32:223-233. [PMID: 32266360 DOI: 10.7416/ai.2020.2345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The role of vaccinations is widely acknowledged. However, over the last decades, an alarming reduction in immunization coverage and a rising number of reported cases of vaccine-preventable diseases have been recorded. This multicentre cross-sectional study aimed at examining whether there is an association between self-reported vaccination knowledge and the immunization behaviour of Health Sciences students. METHODS A cross-sectional study was performed, using a validated questionnaire. A multivariate logistic regression with stepwise backward selection process with a univariate p-value <0.25 as the main criterion was used. The level of significance chosen for statistical analysis was 0.05. RESULTS The sample consisted of 3,131 students (68.1% females). 38.9% of them are medicine and surgery students and 33.1% are nursing students. The multivariate logistic regression analysis shows that, regarding the "suboptimal level of knowledge about vaccine-preventable diseases ", the main and statistically significant independent variables associated are: older age (OR 1.56), having developed a vaccine-preventable disease in the last 5 years (OR 1.38), having been vaccinated against seasonal influenza last year (OR 0.70), having recommended the vaccination to patients or family members during the last influenza season based on clinical evaluation (OR 0.53) and according to the ministerial indications (OR 0.48), planning of recommending the influenza vaccination during the next season based on clinical evaluation (OR 0.67) and according to the ministerial indications (OR 0.69). DISCUSSION The study highlighted the importance of academic education on vaccinations in order to build a future generation of health care workers that are aware not only of the usefulness of immunization, but particularly of the major role played by health professionals in promoting a vaccination culture among the general population.
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Affiliation(s)
- S Provenzano
- Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - L Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - A Cuda
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - O E Santangelo
- Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - G Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - V Gianfredi
- Post-Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Perugia, Italy
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Varricchi G, Modestino L, Poto R, Cristinziano L, Gentile L, Postiglione L, Spadaro G, Galdiero MR. Neutrophil extracellular traps and neutrophil-derived mediators as possible biomarkers in bronchial asthma. Clin Exp Med 2021; 22:285-300. [PMID: 34342773 PMCID: PMC9110438 DOI: 10.1007/s10238-021-00750-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/25/2021] [Indexed: 12/21/2022]
Abstract
Neutrophils (PMNs) contain and release a powerful arsenal of mediators, including several granular enzymes, reactive oxygen species (ROS) and neutrophil extracellular traps (NETs). Although airway neutrophilia is associated with severity, poor response to glucocorticoids and exacerbations, the pathophysiological role of neutrophils in asthma remains poorly understood. Twenty-four patients with asthma and 22 healthy controls (HCs) were prospectively recruited. Highly purified peripheral blood neutrophils (> 99%) were evaluated for ROS production and activation status upon stimulation with lipopolysaccharide (LPS), N-formylmethionyl-leucyl-phenylalanine (fMLP) and phorbol 12-myristate 13-acetate (PMA). Plasma levels of myeloperoxidase (MPO), CXCL8, matrix metalloproteinase-9 (MMP-9), granulocyte–monocyte colony-stimulating factor (GM-CSF) and vascular endothelial growth factor (VEGF-A) were measured by ELISA. Plasma concentrations of citrullinated histone H3 (CitH3) and circulating free DNA (dsDNA) were evaluated as NET biomarkers. Activated PMNs from asthmatics displayed reduced ROS production and activation status compared to HCs. Plasma levels of MPO, MMP-9 and CXCL8 were increased in asthmatics compared to HCs. CitH3 and dsDNA plasma levels were increased in asthmatics compared to controls and the CitH3 concentrations were inversely correlated to the % decrease in FEV1/FVC in asthmatics. These findings indicate that neutrophils and their mediators could have an active role in asthma pathophysiology.
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Affiliation(s)
- Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, 80131, Naples, Italy
| | - Luca Modestino
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
| | - Remo Poto
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
| | - Leonardo Cristinziano
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
| | - Luca Gentile
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131, Naples, Italy
| | - Loredana Postiglione
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences, University of Naples Federico II, 80131, Naples, Italy.
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131, Naples, Italy.
- World Allergy Organization (WAO) Center of Excellence, 80131, Naples, Italy.
- Institute of Experimental Endocrinology and Oncology (IEOS), National Research Council, 80131, Naples, Italy.
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Spina E, Doneddu PE, Liberatore G, Cocito D, Fazio R, Briani C, Filosto M, Benedetti L, Antonini G, Cosentino G, Jann S, Mazzeo A, Cortese A, Marfia GA, Clerici AM, Siciliano G, Carpo M, Luigetti M, Lauria G, Rosso T, Cavaletti G, Peci E, Tronci S, Ruiz M, Piccinelli SC, Schenone A, Leonardi L, Gentile L, Piccolo L, Mataluni G, Santoro L, Nobile-Orazio E, Manganelli F. Prolonged distal motor latency of median nerve does not improve diagnostic accuracy for CIDP. J Neurol 2021; 269:907-912. [PMID: 34173874 PMCID: PMC8782796 DOI: 10.1007/s00415-021-10672-w] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 12/22/2022]
Abstract
Compression of the median nerve at the carpal tunnel can give demyelinating features and result in distal motor latency (DML) prolongation fulfilling the EFNS/PNS demyelinating criteria for chronic inflammatory demyelinating polyneuropathy (CIDP). Accordingly, being carpal tunnel syndrome (CTS) common in the general population, the EFNS/PNS guidelines recommend excluding the DML of the median nerve when DML prolongation may be consistent with median neuropathy at the wrist from CTS. The main aims of this study were to verify whether the inclusion of DML of the median nerve (when consistent with CTS) could improve electrophysiological diagnostic accuracy for CIDP and if the median nerve at the carpal tunnel was more prone to demyelination. We analyzed electrophysiological data from 499 patients included consecutively into the Italian CIDP Database. According to the EFNS/PNS criteria, 352 patients had a definite, 10 a probable, and 57 a possible diagnosis of CIDP, while 80 were not fulfilling the diagnostic criteria. The inclusion of DML prolongation of median nerve did not improve significantly the diagnostic accuracy for CIDP; overall diagnostic class changed in 6 out of 499 patients (1.2%) and electrodiagnostic class of CIDP changed from not fulfilling to possible in only 2 patients (2.5% of not-fulfilling patients). In conclusion, we can infer that excluding DML prolongation of median nerve does not increase the risk of missing a diagnosis of CIDP thus corroborating the current EFNS/PNS criteria.
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Affiliation(s)
- Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Via Pansini, 5, 81025, Naples, Italy.
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Dario Cocito
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Briani
- Department of Neuroscience, Neurology Unit, University of Padova, Padova, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
- IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Jann
- Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Andrea Cortese
- IRCCS Mondino Foundation, Pavia, Italy
- Molecular Neurosciences, University College London, London, UK
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Angelo Maurizio Clerici
- Neurology Unit, Circolo and Macchi Foundation Hospital, Insubria University, DBSV, Varese, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marinella Carpo
- Neurology Unit, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy
| | - Marco Luigetti
- UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Lauria
- Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milan, Italy
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - Tiziana Rosso
- ULSS2 Marca Trevigiana, UOC Neurologia-Castelfranco Veneto, Treviso, Italy
| | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Erdita Peci
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Stefano Tronci
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Marta Ruiz
- Department of Neuroscience, Neurology Unit, University of Padova, Padova, Italy
| | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
| | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | | | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Via Pansini, 5, 81025, Naples, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Via Pansini, 5, 81025, Naples, Italy
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Gentile L, Tournev I, Amass L, Chapman D, Mazzeo A. Phenotypic Differences of Glu89Gln Genotype in ATTR Amyloidosis From Endemic Loci: Update From THAOS. Cardiol Ther 2021; 10:481-490. [PMID: 34148211 PMCID: PMC8555027 DOI: 10.1007/s40119-021-00226-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/16/2021] [Accepted: 06/05/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, clinically heterogeneous disease with spontaneous (wild-type) and hereditary (ATTRv) forms. The Glu89Gln variant is primarily associated with cardiomyopathy and prevalent in Italy and Bulgaria. The objective of this analysis was to better understand the profile of patients with ATTRv Glu89Gln amyloidosis in the Transthyretin Amyloidosis Outcomes Survey (THAOS). METHODS THAOS is an ongoing, global, longitudinal, observational survey of patients with ATTR amyloidosis, including both inherited and wild-type disease, and asymptomatic carriers with mutations in the transthyretin gene. Demographic and clinical characteristics of all symptomatic patients with the ATTRv Glu89Gln variant enrolled in THAOS are described (data cutoff, January 6, 2020). RESULTS There were 91 patients with ATTRv Glu89Gln amyloidosis with the majority from Bulgaria (n = 53) or Italy (n = 29). All patients were Caucasian and 50.5% were male. Patients from Bulgaria had a mean (standard deviation) age at enrollment of 57.1 (8.2) years, and duration of symptoms of 8.6 (9.6) years, compared with 54.8 (8.6) and 5.0 (4.1) years in Italy. In Bulgaria, 39.6% of patients were of a predominantly cardiac phenotype, 18.9% predominantly neurologic, and 41.5% mixed. In Italy, 3.4% of patients were predominantly cardiac, 62.1% predominantly neurologic, and 34.5% mixed. CONCLUSIONS The majority of patients with ATTRv Glu89Gln amyloidosis in THAOS are from Bulgaria or Italy. There were notable phenotypic differences, with the cardiac phenotype more common in Bulgaria and the neurologic phenotype more common in Italy. Over one-third of patients had a mixed phenotype, suggesting a potential role of multiple genetic and/or environmental factors and the need for comprehensive assessment of all patients. TRIAL REGISTRATION ClinicalTrials.gov: NCT00628745.
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Affiliation(s)
- Luca Gentile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Ivailo Tournev
- Department of Neurology, Alexandrovska University Hospital, Sofia Medical University, Sofia, Bulgaria.,Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | | | | | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Spina E, Doneddu PE, Liberatore G, Cocito D, Fazio R, Briani C, Filosto M, Benedetti L, Antonini G, Cosentino G, Jann S, Mazzeo A, Cortese A, Marfia GA, Clerici AM, Siciliano G, Carpo M, Luigetti M, Lauria G, Rosso T, Cavaletti G, Peci E, Tronci S, Ruiz M, Piccinelli SC, Schenone A, Leonardi L, Gentile L, Piccolo L, Mataluni G, Santoro L, Nobile-Orazio E, Manganelli F. The neurophysiological lesson from the Italian CIDP database. Neurol Sci 2021; 43:573-582. [PMID: 34021439 PMCID: PMC8724146 DOI: 10.1007/s10072-021-05321-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/14/2021] [Indexed: 12/22/2022]
Abstract
Introduction Electrophysiological diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may be challenging. Thus, with the aim ofproviding some practical advice in electrophysiological approach to a patient with suspected CIDP, we analyzed electrophysiological data from 499 patients enrolled inthe Italian CIDP Database. Methods We calculated the rate of each demyelinating feature, the rate of demyelinating features per nerve, the diagnostic rate for upper andlower limb nerves, and, using a ROC curve analysis, the diagnostic accuracy of each couple of nerves and each demyelinating feature, for every CIDP subtype.Moreover, we compared the electrophysiological data of definite and probable CIDP patients with those of possible and not-fulfilling CIDP patients, and by a logisticregression analysis, we estimated the odds ratio (OR) to make an electrophysiological diagnosis of definite or probable CIDP. Results The ulnar nerve had the highestrate of demyelinating features and, when tested bilaterally, had the highest diagnostic accuracy except for DADS in which peroneal nerves were the most informative.In possible and not-fulfilling CIDP patients, a lower number of nerves and proximal temporal dispersion (TD) measurements had been performed compared to definiteand probable CIDP patients. Importantly, OR for each tested motor nerve and each TD measurement was 1.59 and 1.33, respectively. Conclusion Our findingsdemonstrated that the diagnosis of CIDP may be missed due to inadequate or incomplete electrophysiological examination or interpretation. At the same time, thesedata taken together could be useful to draw a thoughtful electrophysiological approach to patients suspected of CIDP. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05321-z.
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Affiliation(s)
- Emanuele Spina
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Giuseppe Liberatore
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
| | - Dario Cocito
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Raffaella Fazio
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Briani
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Massimiliano Filosto
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Luana Benedetti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
- IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanni Antonini
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
| | - Stefano Jann
- Department of Neuroscience, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Anna Mazzeo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Andrea Cortese
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
- Molecular Neurosciences, University College London, London, UK
| | - Girolama Alessandra Marfia
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Angelo Maurizio Clerici
- Neurology Unit, Circolo & Macchi Foundation Hospital, Insubria University, DBSV, Varese, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marinella Carpo
- Neurology Unit, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy
| | - Marco Luigetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Lauria
- Unit of Neuroalgology, IRCCS Foundation 'Carlo Besta' Neurological Institute, Milan, Italy
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milan, Italy
| | - Tiziana Rosso
- ULSS2 Marca Trevigiana, UOC Neurologia-Castelfranco Veneto, Treviso, Italy
| | - Guido Cavaletti
- School of Medicine and Surgery and Experimental Neurology Unit, University of Milano-Bicocca, Monza, Italy
| | - Erdita Peci
- Presidio Sanitario Major, Istituti Clinici Scientifici Maugeri, Turin, Italy
| | - Stefano Tronci
- Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute, Milan, Italy
| | - Marta Ruiz
- Neurology Unit, Department of Neuroscience, University of Padova, Padova, Italy
| | - Stefano Cotti Piccinelli
- Center for Neuromuscular Diseases and Neuropathies, Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy
| | - Angelo Schenone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS San Martino, Genoa, Italy
| | - Luca Leonardi
- Unit of Neuromuscular Diseases, Department of Neurology Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, 'Sapienza' University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Luca Gentile
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy
| | - Laura Piccolo
- IRCCS Foundation C. Mondino National Neurological Institute, Pavia, Italy
| | - Giorgia Mataluni
- Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Lucio Santoro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy
| | - Eduardo Nobile-Orazio
- Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Fiore Manganelli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples 'Federico II', Via Pansini, 5, 81025, Naples, Italy.
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Chiappa F, Frascella B, Vigezzi GP, Moro M, Diamanti L, Gentile L, Lago P, Clementi N, Signorelli C, Mancini N, Odone A. The efficacy of ultraviolet light-emitting technology against coronaviruses: a systematic review. J Hosp Infect 2021; 114:63-78. [PMID: 34029626 PMCID: PMC8139389 DOI: 10.1016/j.jhin.2021.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
The ongoing pandemic of COVID-19 has underlined the importance of adopting effective infection prevention and control (IPC) measures in hospital and community settings. Ultraviolet (UV)-based technologies represent promising IPC tools: their effective application for sanitation has been extensively evaluated in the past but scant, heterogeneous and inconclusive evidence is available on their effect on SARS-CoV-2 transmission. With the aim of pooling the available evidence on the efficacy of UV technologies against coronaviruses, we conducted a systematic review following PRISMA guidelines, searching Medline, Embase and the Cochrane Library, and the main clinical trials' registries (WHO ICTRP, ClinicalTrials.gov, Cochrane and EU Clinical Trial Register). Quantitative data on studies' interventions were summarized in tables, pooled by different coronavirus species and strain, UV source, characteristics of UV light exposure and outcomes. Eighteen papers met our inclusion criteria, published between 1972 and 2020. Six focused on SARS-CoV-2, four on SARS-CoV-1, one on MERS-CoV, three on seasonal coronaviruses, and four on animal coronaviruses. All were experimental studies. Overall, despite wide heterogenicity within included studies, complete inactivation of coronaviruses on surfaces or aerosolized, including SARS-CoV-2, was reported to take a maximum exposure time of 15 min and to need a maximum distance from the UV emitter of up to 1 m. Advances in UV-based technologies in the field of sanitation and their proved high virucidal potential against SARS-CoV-2 support their use for IPC in hospital and community settings and their contribution towards ending the COVID-19 pandemic. National and international guidelines are to be updated and parameters and conditions of use need to be identified to ensure both efficacy and safety of UV technology application for effective infection prevention and control in both healthcare and non-healthcare settings.
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Affiliation(s)
- F Chiappa
- School of Public Health, University Vita-Salute San Raffaele, Milan, Italy
| | - B Frascella
- School of Public Health, University Vita-Salute San Raffaele, Milan, Italy
| | - G P Vigezzi
- School of Public Health, University Vita-Salute San Raffaele, Milan, Italy
| | - M Moro
- Infection Control Committee, IRCCS San Raffaele Hospital, Milan, Italy
| | - L Diamanti
- Clinical Engineering Unit, IRCCS San Raffaele Hospital, Milan, Italy; HTA Committee, IRCCS San Raffaele Hospital, Milan, Italy
| | - L Gentile
- Clinical Engineering Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Lago
- Clinical Engineering Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - N Clementi
- Laboratory of Microbiology and Virology, University Vita-Salute San Raffaele, Milan, Italy
| | - C Signorelli
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - N Mancini
- Laboratory of Microbiology and Virology, University Vita-Salute San Raffaele, Milan, Italy
| | - A Odone
- HTA Committee, IRCCS San Raffaele Hospital, Milan, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
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