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Li Y, Lauriola M, Kim D, Francesconi M, D'Uva G, Shibata D, Malafa MP, Yeatman TJ, Coppola D, Solmi R, Cheng JQ. Editorial Expression of Concern: Adenomatous polyposis coli (APC) regulates miR17-92 cluster through β-catenin pathway in colorectal cancer. Oncogene 2024; 43:837. [PMID: 38378921 DOI: 10.1038/s41388-024-02979-5] [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: 02/22/2024]
Affiliation(s)
- Y Li
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - M Lauriola
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - D Kim
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - M Francesconi
- EMBL-CRG Systems Biology Unit, Centre for Genomic Regulation (CRG), Dr. Aiguader, Barcelona, Spain
| | - G D'Uva
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - D Shibata
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - M P Malafa
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - T J Yeatman
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Gibbs Cancer Center and Research Institute, Spartanburg, SC, USA
| | - D Coppola
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
| | - R Solmi
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy.
| | - J Q Cheng
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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Roberts E, Francesconi M, Flouri E. The role of inflammation in the effects of peer victimisation and stressful life events on mental health in childhood. Brain Behav Immun Health 2023; 34:100695. [PMID: 37964767 PMCID: PMC10641088 DOI: 10.1016/j.bbih.2023.100695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 11/16/2023] Open
Abstract
Background Peer victimisation represents a salient stressor during childhood. However, studies investigating the mechanism of its impact on children's mental health typically examine socio-cognitive factors as mediators. The current study sought to provide novel insight through testing a potential biological mechanism, inflammation. It also tested for pathway-specific effects by comparing how inflammation may mediate the effect of peer victimisation and that of another important stressor in childhood: adverse life events. Method Data from 4,583 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. Path analysis was carried out to investigate whether inflammation (IL-6 and CRP) at age 9 years mediates the effect of peer victimisation and stressful life events at age 8 years on internalising (peer and emotional) or externalising (hyperactivity and conduct) problems (measured at age 11 years), both before and after adjustment for potential confounders. Results IL-6 partially mediated the effect of peer victimisation on peer problems, even after adjustment for potential confounders. Inflammation did not mediate the effect of stressful life events on either type of internalising problems. Neither stressor predicted externalising problems via inflammation. Conclusion We did not find evidence that inflammation mediates the effect of stressful life events on mental health in childhood when they are considered alongside experiences of peer victimisation. Inflammation may already represent a form of biological embedding of peer victimisation in the early years.
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Affiliation(s)
- Ellie Roberts
- Department of Arts and Sciences, University College London, Malet Place, London, NW1 6AP, UK
| | - Marta Francesconi
- Department of Psychology and Human Development, University College London, 25 Woburn Square, London, WC1H 0AA, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, University College London, 25 Woburn Square, London, WC1H 0AA, UK
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Francesconi M, Minichino A, Flouri E. The role of mild stressors in children's cognition and inflammation: positive and negative impacts depend on timing of exposure. Eur Psychiatry 2023; 66:e95. [PMID: 37881843 PMCID: PMC10755563 DOI: 10.1192/j.eurpsy.2023.2468] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023] Open
Abstract
Although the impact of stressful life events (SLEs) on mental health is well-established, the research on the impact of such stressors on cognitive outcomes has produced mixed results. Arguably, the timing and severity of exposure may play a key role. In this study, we shed light on the relationship between timing of exposure to relatively minor SLEs and cognitive ability in children, while taking into account the role of a plausible biological mediator: inflammation. Using data from the Avon Longitudinal Study of Parents and Children, a general population birth cohort, we explored the role of relatively minor SLEs, experienced during two crucial developmental stages: up to transition to school (1-4.5 years) and up to transition to puberty (5.5-8.5 years). We then tested if they may impact differently on inflammatory markers (serum C-reactive protein [CRP] and interleukin 6 [IL-6]) at age 9 and general intelligence, measured with the Wechsler Abbreviated Scale of Intelligence at age 15. Data (n = 4,525) were analyzed using path analysis while controlling for covariates. We found that when relatively minor stressful events were experienced up to transition to school they were significantly associated with higher IQ at age 15, whereas when experienced up to transition to puberty they were significantly associated with higher levels of IL-6 at age 9. Results were robust to adjustment for relevant covariates, including IQ at age 8. Mild stressors in childhood may result in positive (i.e., improved cognition) or negative (i.e., inflammation) outcomes depending on the timing of exposure.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, Institute of Education, University College London, London, UK
| | | | - Eirini Flouri
- Department of Psychology and Human Development, Institute of Education, University College London, London, UK
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Francesconi M, Flouri E, Harrison A. Decision-making difficulties mediate the association between poor emotion regulation and eating disorder symptoms in adolescence. Psychol Med 2023; 53:3701-3710. [PMID: 35227340 PMCID: PMC10277753 DOI: 10.1017/s003329172200037x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/14/2021] [Accepted: 01/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The emergence of eating problems during childhood increases the risk for eating disorders (EDs) during young adulthood. Previous studies highlight a relationship between poor self-regulation and onset of eating pathology. In this study, we investigated whether this association is mediated by decision-making difficulties. METHODS To test this hypothesis, we used data from the Millennium Cohort Study. Decision-making performance was assessed with the Cambridge Gambling Task at age 11. Principal components analysis was used to derive an index of ED symptoms at age 14. The trajectories of scores of two subscales of the Child Social Behaviour Questionnaire, Independence and Self-Regulation (ISR) and Emotional Dysregulation (EmotDy), were modelled from ages 3 to 7 years in a latent growth curve analysis. The individual predicted values of the intercept (set at baseline, 3 years) and the slope (rate of annual change) were then used in the mediation analysis. RESULTS In our sample of 11 303 individuals, there was evidence for mediation by three measures of decision-making at age 11 (poor quality of decision-making, delay aversion and low risk-adjustment) in the association between EmotDy across ages 3-7 and ED symptoms at age 14 even after the adjustment for relevant covariates. We found no evidence of association between ISR and ED symptoms. CONCLUSION Our findings suggest that emotion regulation processes during childhood may be relevant for the future onset of ED symptoms via their association with decision-making skills. These findings, obtained from a large, representative, sample, shed light on the relationship between self-regulation, decision-making and symptoms of EDs.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, Institute of Education, University College London, 25 Woburn Square, London WC1H 0AA, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, Institute of Education, University College London, 25 Woburn Square, London WC1H 0AA, UK
| | - Amy Harrison
- Department of Psychology and Human Development, Institute of Education, University College London, 25 Woburn Square, London WC1H 0AA, UK
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Ji D, Francesconi M, Flouri E, Papachristou E. The role of inflammatory markers and cortisol in the association between early social cognition abilities and later internalising or externalising problems: Evidence from a UK birth cohort. Brain Behav Immun 2022; 105:225-236. [PMID: 35835432 DOI: 10.1016/j.bbi.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/29/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Deficits in social cognition are associated with internalising (emotional and peer problems) and externalising (conduct problems and hyperactivity/inattention) symptoms in youth. It has been suggested that stress may be one of the mechanisms underlying these associations. However, no empirical studies have investigated if physiological stress can explain the prospective associations between social cognition deficits and internalising and externalising symptoms in the general youth population. This study addressed this question and focused on two indicators of physiological stress, dysregulated diurnal cortisol patterns and systemic inflammation. METHOD Participants were 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort. Bayesian structural equation modelling was used to investigate a) the associations of social cognition abilities at ages 8, 11, and 14 years with internalising and externalising problems at age 17 years and b) the potential mediating effects of cortisol parameters at age 15 years and inflammatory markers [interleukin 6 (IL-6) and C-reactive protein (CRP)] at ages 9 and 16 years. RESULTS We found that social cognition difficulties were associated with later internalising and externalising problems. Flattened diurnal cortisol slope was associated with hyperactivity/inattention problems two years later. Lower morning cortisol partially mediated the direct association between social communication deficits at 8 years and hyperactivity/inattention and conduct problems at 17 years, even after adjustments for inflammation and confounders (for hyperactivity/inattention: indirect effect = 0.07, 95% CI [0.00, 0.18], p = .042; for conduct problems: indirect effect = 0.04, 95% CI [0.00, 0.11], p = .040). We did not find a significant association between systemic inflammation and social cognition difficulties, internalising problems, or externalising problems. CONCLUSION Our findings suggest that part of the effect of social communication difficulties in childhood on externalising problems in adolescence was mediated by lower morning cortisol. Hence, our study indicates that the hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis may be one of the physiological mechanisms linking some social cognition deficits to externalising problems.
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Affiliation(s)
- Dongying Ji
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
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Harrison A, Francesconi M, Flouri E. Does decision-making at age 11 predict prodromal eating pathology at ages 14 and 17? A prospective, observational, UK population-based cohort study. BMJ Open 2022; 12:e051351. [PMID: 36104121 PMCID: PMC9476154 DOI: 10.1136/bmjopen-2021-051351] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We examined whether decision-making at age 11 and 14 is associated with prodromal eating pathology at age 14 and whether it would persist across adolescence and also be present at age 17. DESIGN This prospective, observational, population-based cohort study used a longitudinal design. SETTING Data from the Millennium Cohort Study (MCS), a UK longitudinal cohort study involving 19 244 families from England, Scotland, Wales and Northern Ireland, were analysed. PARTICIPANTS We modelled data from 8922 boys and girls aged 11, 14 and 17 (MCS sweeps 5, 6 and 7). PRIMARY AND SECONDARY OUTCOMES We investigated decision-making using the risk-taking, quality of decision-making, deliberation time, delay aversion and risk adjustment subscales of the Cambridge Gambling Task and prodromal eating pathology through binary response items measuring: body dissatisfaction (whether the participant perceived their body as being too overweight); intention to lose weight (whether participants reported a strong desire to lose weight); dietary restriction (whether participants reported actively eating less to influence their shape/weight) and excessive exercise (whether participants reported exercising in a driven way in order to influence weight/shape). Data were analysed using latent class analysis and logistic regression. RESULTS Lower scores on quality of decision-making (OR=0.46) and deliberation time (OR=0.99) at age 14 were associated with prodromal eating pathology at both ages 14 and 17 (all p<0.05), indicating an association between less frequently opting to bet on the most likely outcome and taking less time to decide on which bet to choose and the persistence of prodromal eating pathology over adolescence. Lower deliberation time (OR=0.99) and delay aversion (OR=0.62) at 11 and lower risk-taking scores at 14 (OR=0.43) were associated with the absence of prodromal eating pathology at 14 and 17 (all p<0.05), indicating that a moderate approach under conditions of risk in childhood and mid-adolescence is associated with reduced eating pathology across adolescence. CONCLUSIONS Training advantageous decision-making might protect from later prodromal eating pathology.
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Affiliation(s)
- Amy Harrison
- Department of Psychology and Human Development, UCL, London, UK
| | | | - Eirini Flouri
- Department of Psychology and Human Development, UCL, London, UK
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Ji D, Papachristou S, Francesconi M. The role of inflammation and cortisol in the relationship between social cognition abilities and later emotional or behavioural problems: evidence from a UK birth cohort. Eur Psychiatry 2022. [PMCID: PMC9562928 DOI: 10.1192/j.eurpsy.2022.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Deficits in social cognition have been associated with the onset of emotional and behavioural problems, but the biological mechanisms underlying this relationship remain unclear. Objectives This study examined whether diurnal cortisol patterns, systemic inflammation, or both, explained the association between social cognition difficulties and subsequent emotional and behavioural symptoms. Methods The sample consisted of 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC) with valid data on cortisol measures (age 15 years) and emotional or behavioural problems (age 17 years). Social cognition abilities were measured at 8, 11, and 14 years old. Inflammation was measured using serum levels of interleukin 6 (IL-6, age 9 years) and C-reactive protein (CRP, age 9 and 16 years). Bayesian structural equation modelling was used to investigate the mediating effect of cortisol or inflammation on the association between social cognitive difficulties and emotional or behavioural problems. Results Children with social cognition difficulties were associated with later emotional and behavioural problems. Flattened diurnal cortisol slope was associated with the hyperactivity/inattention problem two years later. Mediation analyses revealed that lower morning cortisol significantly mediated the associations between social communication difficulties at 8 years with hyperactivity/inattention and conduct problems in adolescence, with the adjustment of inflammation and all covariates. Systemic inflammation was not related to social cognitive difficulties or future emotional and behavioural problems. Conclusions The finding suggests that social cognition is related to cortisol activities longitudinally. It also expands the evidence that adolescents with behavioural problems are characterised by hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Disclosure No significant relationships.
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Harrison A, Francesconi M, Flouri E. Types of Eating Disorder Prodrome in Adolescence: The Role of Decision Making in Childhood. Front Psychol 2022; 13:743947. [PMID: 35369201 PMCID: PMC8966721 DOI: 10.3389/fpsyg.2022.743947] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Psychiatric disorders like eating disorders (EDs) might be underpinned by differences in decision making. However, little previous research has investigated this potential relationship using longitudinal data. This study aimed to understand how components of decision making (delay aversion, risk adjustment, risk taking, quality of decision making and deliberation time) measured by the Cambridge Gambling Task in the United Kingdom’s Millennium Cohort Study (MCS; n = 11,303; female = 50.17%) at age 11 might explain clusters/types of ED prodrome involving body dissatisfaction, intention to lose weight, dietary restraint, excessive exercise and significant under/overweight measured in the MCS at age 14. Latent class analysis revealed two groups within the cohort: a non-prodromal eating pathology group, who were more likely to be of “average” weight, according to the UK90, with minimal disordered attitudes and behaviors in relation to eating and weight; and a second group with prodromal eating pathology, who had more body dissatisfaction, a desire to lose weight, were using dietary restriction and exercise to influence weight and were more likely to be “overweight” according to the UK90. Logistic regression showed that, after adjustment for confounding, higher risk-taking scores were associated with a 60% greater probability of being in the prodromal eating pathology group (b = 0.47, OR = 1.60, p < 0.01), and higher scores on quality of decision making were associated with a 30% lower probability of being in the prodromal eating pathology group (b = −0.34, OR = 0.70, p < 0.05). Helping young people to engage in moderate risk taking and improving decision making might reduce the later presence of ED prodromes.
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Affiliation(s)
- Amy Harrison
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - Marta Francesconi
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - Eirini Flouri
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
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Ji D, Flouri E, Papachristou E, Francesconi M. Childhood Trajectories of Hyperactivity/Inattention Symptoms and Diurnal Cortisol in Middle Adolescence: Results from a UK Birth Cohort. J Atten Disord 2022; 26:809-821. [PMID: 34378439 PMCID: PMC8859655 DOI: 10.1177/10870547211036755] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Children with attention-deficit/hyperactivity disorder (ADHD) show hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis. Whether the association between hyperactivity/inattention symptoms with HPA axis dysfunction holds in the general child population too is not clear. METHOD We assessed associations between longitudinal trajectories of hyperactivity/inattention symptoms during ages 4 to 13 years and basal cortisol profiles at age 15 in a British general population cohort. RESULTS Adolescents with persistently high levels of hyperactivity/inattention symptoms since childhood showed lower total morning cortisol and a smaller diurnal decline, even after adjusting for confounders. No associations were found between any of the symptom trajectories and cortisol awakening response, diurnal slope or daily output of cortisol. CONCLUSION This study provides evidence for hypocortisolism among adolescents with chronic hyperactivity/inattention symptoms in the general population.
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Affiliation(s)
- Dongying Ji
- UCL Institute of Education, London, UK,Dongying Ji, Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
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Minichino A, Jackson MA, Francesconi M, Steves CJ, Menni C, Burnet PWJ, Lennox BR. Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort. Mol Psychiatry 2021; 26:6269-6276. [PMID: 34002020 PMCID: PMC8760063 DOI: 10.1038/s41380-021-01147-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 02/02/2023]
Abstract
Anhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2 ± 7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (β = -0.37; 95%CI: -0.71 to -0.03; P = 0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (β = -0.13; 95%CI: -0.24 to -0.01; P = 0.03), as was the total effect (β = -0.38; 95%CI: -0.72 to -0.04; P = 0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (β = -0.25; 95%CI: -0.60 to 0.09; P = 0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.
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Affiliation(s)
| | | | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital, London, UK
| | | | - Belinda R Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Francesconi M, Minichino A, Khandaker GM, Midouhas E, Lewis G, Flouri E. Reprint of: Internalising symptoms mediate the longitudinal association between childhood inflammation and psychotic-like experiences in adulthood. Schizophr Res 2020; 226:24-29. [PMID: 33341190 DOI: 10.1016/j.schres.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 10/22/2022]
Abstract
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adolescence. To test this hypothesis, we used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated a subsample of 4525 individuals from this cohort with data on interleukin 6 (IL-6) and C-reactive protein (CRP) in childhood (age 9 years). We measured PLEs at age 18 years, and we used latent growth curve modelling to estimate longitudinal trajectories of internalising and externalising symptoms from ages 9 to 16 years. The individual predicted values of the intercept (set at baseline, 9 years) and the slope (rate of annual change) were then used in the mediation analysis. There was evidence for full mediation by the intercept of internalising symptoms. Our findings suggest that inflammation during childhood may be relevant for the future onset of PLEs via its association with a high level of internalising symptoms. These findings, although obtained from a non-clinical population, provide an additional step in advancing knowledge on the relationship between inflammation and symptoms of the psychosis continuum.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | | | | | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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Abstract
BACKGROUND Despite the growing interest in the involvement of decision-making under conditions of risk in the onset of eating disorders in adolescence, no studies have investigated how the development of decision-making across that period may influence such a risk. Using data from the Millennium Cohort Study this study explored whether changes in performance on the Cambridge Gambling Task (CGT) between age 11 and age 14 were associated with presence of eating disorder (ED) symptoms at age 14. METHODS Latent class analysis was used to identify groups with distinct profiles based on their responses to questions investigating eating and dieting at age 14. CGT change scores were used as predictors of latent class membership in a logistic regression while accounting for confounders. RESULTS In our sample of 11,303 participants, the best class solution was a two-class one reflecting high and low risk for ED symptoms. Higher risk-taking scores and lower quality of decision-making scores at age 11 were associated with increased odds of belonging to the high-risk group at age 14. Risk-taking was reduced from age 11 to age 14, but a smaller reduction was associated with a higher probability of being in the higher risk group at age 14. The change over time in the other CGT measures was not associated with risk for ED symptoms. CONCLUSIONS Atypical change in risk-taking from early to middle adolescence may be implicated in the risk of ED symptoms in middle adolescence. These results should be replicated in clinical samples.
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Affiliation(s)
- M Francesconi
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - E Flouri
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
| | - A Harrison
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom
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Flouri E, Lewis G, Francesconi M. Trajectories of internalising and externalising symptoms and inflammation in the general child population. Psychoneuroendocrinology 2020; 118:104723. [PMID: 32479966 DOI: 10.1016/j.psyneuen.2020.104723] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 04/17/2020] [Accepted: 05/18/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Elevations in inflammatory marker levels have been shown to precede internalising and externalising problems in the general child population. One study has found the reverse, that elevations in inflammatory marker levels in childhood follow internalising and externalising problems. However, the authors did not explore the role of the course of these problems in childhood or adjust for a number of potential confounders including psychosocial stressors and prenatal and perinatal exposures. AIMS To investigate the association in childhood between the growth of internalising and externalising symptoms and levels of inflammatory markers, while accounting for potential confounders. METHODS Using data from the Avon Longitudinal Study of Parents and Children, we tested the association between the trajectories of internalising (emotional and social) and externalising (hyperactivity and conduct) problems, at ages 4, 6, 8 and 9 years, and levels of C-reactive protein (CRP) and interleukin 6 (IL-6) at age 9 years. We analysed data (n = 4525) using latent growth curve modelling and linear regression. RESULTS Children who had increasing levels of internalising symptoms over childhood were more likely to have higher levels of CRP and IL-6 at 9 years of age, even after adjustment for confounders. A one-unit increase in the rate of annual change of internalising symptoms was related to an increase of 12% and 8% in the level of CRP and IL-6, respectively. However, there was no evidence for an association between externalising symptoms and either inflammatory marker. CONCLUSIONS This study is the first step towards identifying a robust pathway, via increases in emotional and social difficulties, to elevated inflammation in healthy children. This association, if causal, suggests that effective interventions for children experiencing chronic emotional and social difficulties could also have physical health benefits.
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Affiliation(s)
- Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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Mattei I, Alexandrov A, Alunni Solestizi L, Ambrosi G, Argiro S, Bartosik N, Battistoni G, Belcari N, Biondi S, Bisogni MG, Bruni G, Camarlinghi N, Carra P, Catanzani E, Ciarrocchi E, Cerello P, Clozza A, Colombi S, De Lellis G, Del Guerra A, De Simoni M, Di Crescenzo A, Donetti M, Dong Y, Durante M, Embriaco A, Emde M, Faccini R, Ferrero V, Ferroni F, Fiandrini E, Finck C, Fiorina E, Fischetti M, Francesconi M, Franchini M, Galli L, Gentile V, Hetzel R, Hild S, Iarocci E, Ionica M, Kanxheri K, Kraan AC, Lante V, Lauria A, La Tessa C, Lopez Torres E, Massimi C, Marafini M, Mengarelli A, Mirabelli R, Montesi MC, Morone MC, Morrocchi M, Muraro S, Narici L, Pastore A, Pastrone N, Patera V, Pennazio F, Placidi P, Pullia M, Ramello L, Ridolfi R, Rosso V, Rovituso M, Sanelli C, Sartorelli G, Sato O, Savazzi S, Scavarda L, Schiavi A, Schuy C, Scifoni E, Sciubba A, Secher A, Selvi M, Servoli L, Silvestre G, Sitta M, Spighi R, Spiriti E, Sportelli G, Stahl A, Tomassini S, Tommasino F, Traini G, Toppi M, Valeri T, Valle SM, Vanstalle M, Villa M, Weber U, Zoccoli A, Sarti A. Measurement of 12C Fragmentation Cross Sections on C, O, and H in the Energy Range of Interest for Particle Therapy Applications. IEEE Trans Radiat Plasma Med Sci 2020. [DOI: 10.1109/trpms.2020.2972197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Francesconi M, Minichino A, Khandaker GM, Midouhas E, Lewis G, Flouri E. Internalising symptoms mediate the longitudinal association between childhood inflammation and psychotic-like experiences in adulthood. Schizophr Res 2020; 215:424-429. [PMID: 31387824 DOI: 10.1016/j.schres.2019.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/01/2018] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 01/18/2023]
Abstract
Psychotic-like experiences (PLEs) are part of a continuum of psychosis. Previous longitudinal studies highlighted a relationship between peripheral inflammation during childhood and onset of PLEs in adulthood. In this study, we tested if this association is mediated by internalising and externalising symptoms experienced during childhood and adolescence. To test this hypothesis, we used data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated a subsample of 4525 individuals from this cohort with data on interleukin 6 (IL-6) and C-reactive protein (CRP) in childhood (age 9 years). We measured PLEs at age 18 years, and we used latent growth curve modelling to estimate longitudinal trajectories of internalising and externalising symptoms from ages 9 to 16 years. The individual predicted values of the intercept (set at baseline, 9 years) and the slope (rate of annual change) were then used in the mediation analysis. There was evidence for full mediation by the intercept of internalising symptoms. Our findings suggest that inflammation during childhood may be relevant for the future onset of PLEs via its association with a high level of internalising symptoms. These findings, although obtained from a non-clinical population, provide an additional step in advancing knowledge on the relationship between inflammation and symptoms of the psychosis continuum.
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Affiliation(s)
- Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | | | | | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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Papachristou E, Flouri E, Kokosi T, Francesconi M. Correction to: Main and interactive effects of inflammation and perceived neighbourhood cohesion on psychological distress: results from a population-based study in the UK. Qual Life Res 2019; 28:2159. [PMID: 30993604 PMCID: PMC6620368 DOI: 10.1007/s11136-019-02178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, London, WC1H 0AA, UK.
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, London, WC1H 0AA, UK
| | - Theodora Kokosi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, London, WC1H 0AA, UK
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, London, WC1H 0AA, UK
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Flouri E, Francesconi M, Papachristou E, Midouhas E, Lewis G. Stressful life events, inflammation and emotional and behavioural problems in children: A population-based study. Brain Behav Immun 2019; 80:66-72. [PMID: 30807839 DOI: 10.1016/j.bbi.2019.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/15/2019] [Accepted: 02/22/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To test the hypothesis that higher plasma levels of inflammatory markers due to exposure to adverse life events may lead to internalising and externalising symptoms in children. METHOD Using data from the Avon Longitudinal Study of Parents and Children, a general population birth cohort, we explored if inflammatory markers [serum C-reactive protein (CRP) and interleukin-6 (IL-6)] at age 9 years explain the longitudinal association between adverse life events (at ages 1-9 and 9-11 years) and internalising and externalising symptoms (at ages 9 and 11 years). Data (n = 4583) were analysed using cross-lagged panel modelling to take into account reciprocal associations and reverse causality, and path analyses to test for mediation. Gender, ethnicity, body mass index, maternal education, paternal social class and maternal depression were used as potential confounders. RESULTS CRP was not associated with adverse life events. There was evidence for partial mediation by IL-6 such that exposure to adverse life events was associated with increased levels of IL-6 later, in turn associated with later internalising symptoms. These associations were robust to adjustment for confounders. IL-6 did not explain part of the opposite association, that of earlier internalising symptoms and later life events, nor did it explain either direction of the association between life events and externalising symptoms. CONCLUSION Our findings suggest a pathway that may connect early psychosocial adversity and childhood internalising symptoms via higher plasma levels of inflammatory markers, such as IL-6.
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Affiliation(s)
- Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
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Flouri E, Sarmadi Z, Francesconi M. Paternal Psychological Distress and Child Problem Behavior From Early Childhood to Middle Adolescence. J Am Acad Child Adolesc Psychiatry 2019; 58:453-458. [PMID: 30768392 DOI: 10.1016/j.jaac.2018.06.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/21/2018] [Accepted: 08/15/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To explore whether paternal psychological distress is related to the longitudinal course of child problem behavior after accounting for maternal psychological distress. METHOD We used data from the Millennium Cohort Study (MCS), a large general-population birth cohort in the United Kingdom. Maternal and paternal psychological distress was measured with the Kessler 6-item Psychological Distress Scale (K-6) at child ages 3, 5, 7, 11, and 14 years. Problem behavior was measured with the Strengths and Difficulties Questionnaire at these ages. Data were analyzed using growth curve modeling, before and after adjustment for confounders (N = 13,442). RESULTS The effect of paternal psychological distress was weaker than that of maternal psychological distress. However, even after adjustment for maternal psychological distress and confounding, paternal psychological distress predicted all four domains of child problem behavior that we examined (hyperactivity, conduct, emotional, and peer problems). Child problem scores were generally lower in biological father families, but the effect of paternal psychological distress was the same for children in biological and nonbiological father families and did not depend on the level of maternal psychological distress. High levels of paternal psychological distress predicted some problems (emotional symptoms and hyperactivity) more strongly in boys than in girls. CONCLUSION There was evidence for a robust association between psychological distress in fathers and problem behavior in their offspring. Our findings suggest that the mental health of both fathers and mothers is important for the behavior of their children.
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Affiliation(s)
- Eirini Flouri
- UCL Institute of Education, University College London, UK.
| | - Zahra Sarmadi
- UCL Institute of Education, University College London, UK
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Minichino A, Ando' A, Francesconi M, Salatino A, Delle Chiaie R, Cadenhead K. Investigating the link between drug-naive first episode psychoses (FEPs), weight gain abnormalities and brain structural damages: Relevance and implications for therapy. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:9-22. [PMID: 28363765 DOI: 10.1016/j.pnpbp.2017.03.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/08/2017] [Accepted: 03/20/2017] [Indexed: 02/08/2023]
Abstract
Evidence suggests that obesity and overweight may be associated with severe brain structural abnormalities and poor cognitive and functional outcomes in the general population. Despite these observations and the high prevalence of weight gain abnormalities in patients with psychosis spectrum disorders (PSDs), no studies have investigated the impact that these metabolic disturbances may have on brain structures and development in the earliest stages of PSDs. In the present review we shed light on the association between weight gain and brain structural abnormalities that may affect the course of illness in drug-naïve FEPs. Given the lack of studies directly investigating this issue, we firstly identified and critically evaluated the literature assessing weight gain abnormalities and gray or white matter (GM, WM) volumes (either globally or in specific regions of interest) in otherwise healthy obese/overweight adolescents and young adults. We then compared the results of this systematic review with those of two recent meta-analysis investigating GM and WM abnormalities in drug-naïve FEPs. Weight gain in otherwise healthy subjects was consistently associated with frontal and temporal GM atrophy and with reduced integrity of WM in the corpus callosum. Of relevance, all these brain regions are affected in drug-naïve FEPs, and their integrity is associated with clinical, cognitive and functional outcomes. The underlying mechanisms that may explain the association between weight gain, adiposity, and brain damage in both healthy subjects and drug-naïve FEPs are widely discussed. On the basis of this knowledge, we tried: a) to deduce an integrative model for the development of obesity in psychosis spectrum disorders; b) to identify the key vulnerability factors underlying the association between weight gain and psychosis; c) to provide information on new potential targets of intervention.
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Affiliation(s)
- Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States.
| | - Agata Ando'
- Department of Psychology, University of Turin, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States
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Minichino A, Francesconi M, Carrión RE, Bevilacqua A, Parisi M, Rullo S, Ando' A, Biondi M, Delle Chiaie R, Cadenhead K. Prediction of functional outcome in young patients with a recent-onset psychiatric disorder: Beyond the traditional diagnostic classification system. Schizophr Res 2017; 185:114-121. [PMID: 28041918 DOI: 10.1016/j.schres.2016.12.019] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 12/13/2016] [Accepted: 12/17/2016] [Indexed: 01/04/2023]
Abstract
A critical research goal is to identify modifiable risk factors leading to functional disabilities in young psychiatric patients. The authors developed a multidimensional trans-diagnostic predictive model of functional outcome in patients with the recent-onset of a psychiatric illness. Baseline clinical, psychosis-risk status, cognitive, neurological-soft-signs measures, and dopamine-related-gene polymorphisms (DRD1-rs4532, COMT-rs165599, and DRD4-rs1800955) were collected in 138 young non-psychotic outpatients. 116 individuals underwent follow-up (mean=2.2years, SD=0.9) examination. A binary logistic model was used to predict low-functioning status at follow-up as defined by a score lower than 65 in the social occupational functioning assessment scale. A total of 54% of patients experiences low functioning at follow-up. Attention, Avolition, and Motor-Coordination subscale were significant predictors of low-functioning with an accuracy of 79.7%. A non-significant trend was found for a dopamine-related-gene polymorphism (DRD1-rs4532). The model was independent of psychotic-risk status, DSM-diagnosis, and psychotic conversion. A trans-diagnostic approach taking into account specific neurocognitive, clinical, and neurological information has the potential to identify those individuals with low-functioning independent of DSM diagnosis or the level of psychosis-risk. Specific early interventions targeting modifiable risk factors and emphasize functional recovery in young psychiatric samples, independent of DSM-diagnosis and psychosis-risk, are essential.
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Affiliation(s)
- Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States.
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States
| | - Ricardo E Carrión
- Division of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - Arturo Bevilacqua
- Research Center in Neurobiology, Daniel Bovet (CRiN), Rome, Italy; Department of Psychology, Section of Neuroscience, Sapienza University of Rome, Italy
| | | | | | - Agata Ando'
- Department of Psychology, University of Turin
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
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Minichino A, Francesconi M, Carrión RE, Delle Chiaie R, Bevilacqua A, Parisi M, Rullo S, Bersani FS, Biondi M, Cadenhead K. From neurological soft signs to functional outcome in young individuals in treatment with secondary services for non-psychotic disorders: a path analysis. Psychol Med 2017; 47:1192-1203. [PMID: 28052777 DOI: 10.1017/s0033291716003056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Functional decline among patients with mental illness is not unique to individuals with psychotic disorders. Despite this, research on early predictors of functional outcome mainly focused on individuals thought to have an 'at risk mental state' (ARMS) for psychosis. There is evidence suggesting that certain early vulnerability markers, such as neurological soft signs (NSS), may explain variability in functional outcomes independent of the level of psychosis risk and the traditional diagnostic classification. METHOD Structural equation modeling was applied to baseline data from a prospective longitudinal study of 138 young individuals in treatment with secondary services for non-psychotic disorders. We evaluated theoretically based models of pathways to functional outcome starting from NSS. The intervening variables were established according to previous evidence and drawn from two general categories: cognition (neuro- and social-) and negative symptoms (expressive and experiential). RESULTS A final trimmed model was a single path running from NSS to neurocognition to experiential negative symptoms to outcome. It could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from NSS to outcome was significant. The validity of the model was independent of the ARMS status and the psychiatric diagnosis. CONCLUSIONS Our results provide evidence for a single pathway model in which the starting and intervening variables represent modifiable trans-diagnostic therapeutic targets to improve functional trajectories in young individuals with a recent-onset psychiatric diagnosis and different levels of psychosis risk.
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Affiliation(s)
- A Minichino
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M Francesconi
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - R E Carrión
- Division of Psychiatry,Zucker Hillside Hospital,Long Island,NY,USA
| | - R Delle Chiaie
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - A Bevilacqua
- Research Center in Neurobiology,Daniel Bovet (CRiN),Rome,Italy
| | | | - S Rullo
- Casa di Cura Villa Letizia,Rome,Italy
| | - F S Bersani
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M Biondi
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - K Cadenhead
- Department of Psychiatry,UCSD,La Jolla,CA,USA
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Francesconi M, Minichino A, Carrión RE, Delle Chiaie R, Bevilacqua A, Parisi M, Rullo S, Bersani FS, Biondi M, Cadenhead K. Psychosis prediction in secondary mental health services. A broad, comprehensive approach to the "at risk mental state" syndrome. Eur Psychiatry 2016; 40:96-104. [PMID: 27992839 DOI: 10.1016/j.eurpsy.2016.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Accuracy of risk algorithms for psychosis prediction in "at risk mental state" (ARMS) samples may differ according to the recruitment setting. Standardized criteria used to detect ARMS individuals may lack specificity if the recruitment setting is a secondary mental health service. The authors tested a modified strategy to predict psychosis conversion in this setting by using a systematic selection of trait-markers of the psychosis prodrome in a sample with a heterogeneous ARMS status. METHODS 138 non-psychotic outpatients (aged 17-31) were consecutively recruited in secondary mental health services and followed-up for up to 3 years (mean follow-up time, 2.2 years; SD=0.9). Baseline ARMS status, clinical, demographic, cognitive, and neurological soft signs measures were collected. Cox regression was used to derive a risk index. RESULTS 48% individuals met ARMS criteria (ARMS-Positive, ARMS+). Conversion rate to psychosis was 21% for the overall sample, 34% for ARMS+, and 9% for ARMS-Negative (ARMS-). The final predictor model with a positive predictive validity of 80% consisted of four variables: Disorder of Thought Content, visuospatial/constructional deficits, sensory-integration, and theory-of-mind abnormalities. Removing Disorder of Thought Content from the model only slightly modified the predictive accuracy (-6.2%), but increased the sensitivity (+9.5%). CONCLUSIONS These results suggest that in a secondary mental health setting the use of trait-markers of the psychosis prodrome may predict psychosis conversion with great accuracy despite the heterogeneity of the ARMS status. The use of the proposed predictive algorithm may enable a selective recruitment, potentially reducing duration of untreated psychosis and improving prognostic outcomes.
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Affiliation(s)
- M Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States
| | - A Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy; Department of Psychiatry, UCSD, La Jolla, CA, United States.
| | - R E Carrión
- Division of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - R Delle Chiaie
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - A Bevilacqua
- Research Center in Neurobiology, Daniel Bovet (CRiN), Rome, Italy; Department of Psychology, Section of Neuroscience, Sapienza University of Rome, Italy
| | - M Parisi
- Villa Armonia Nuova, Rome, Italy
| | - S Rullo
- Casa di Cura Villa Letizia, Rome, Italy
| | - F Saverio Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - M Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - K Cadenhead
- Department of Psychiatry, UCSD, La Jolla, CA, United States
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Minichino A, Delle Chiaie R, Cruccu G, Piroso S, Di Stefano G, Francesconi M, Bersani FS, Biondi M, Truini A. Pain-processing abnormalities in bipolar I disorder, bipolar II disorder, and schizophrenia: A novel trait marker for psychosis proneness and functional outcome? Bipolar Disord 2016; 18:591-601. [PMID: 27782355 DOI: 10.1111/bdi.12439] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/02/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Overlapping neural system dysfunctions, mainly involving the secondary somatosensory cortex (S2), the anterior cingulate cortex (ACC) and the anterior insular cortex (AIC), seem to be related to both pain-perception abnormalities and psychotic symptoms in schizophrenia (SCZ) and bipolar disorder (BD). Laser-evoked potentials (LEPs) were used to investigate pain-perception and central pain-processing abnormalities in SCZ, bipolar I disorder (BD-I), and bipolar II disorder (BD-II), and to evaluate their relationship with history of psychosis, and social-cognitive and functional impairments. METHODS Twenty patients with SCZ, 17 patients with BD-I, and 21 patients with BD-II who were all under similar pharmacological treatment underwent clinical, functional, and neuro-psychological assessment. LEPs were analyzed in patients and 19 healthy subjects (HS). LEPs elicit responses reflecting the activity of the S2 (N1 wave) and the ACC/AIC cortices (N2/P2 complex). A four-group ANOVA was conducted between patients and HS to compare pain-perceptive thresholds (PThs), N1, and N2/P2-LEP components. RESULTS Compared to HS: (i) patients with SCZ showed pain-processing and pain-perception abnormalities, as revealed by significantly higher PTh (P<.01), and lower N1 (P<.01) and N2/P2 (P<.01) amplitudes, (ii) patients with BD-I showed only pain-processing abnormalities, as revealed by significantly lower N1 (P<.05) and N2 (P<.01) amplitudes; and patients with BD-II did not differ for any of the LEP variables investigated. N1 and N2 amplitudes negatively correlated to history of psychosis (P<.01), social-cognition (P<.05), and real-world functioning (P<.01) measures in the whole group of patients. CONCLUSIONS To the best of our knowledge, this is the first study comparing central pain processing in patients with SCZ, BD-I, and BD-II. Our results suggest that pain-processing abnormalities may represent a novel locus of interest for research investigating trait markers of the psychosis spectrum.
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Affiliation(s)
- Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Roberto Delle Chiaie
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Giorgio Cruccu
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Serena Piroso
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Giulia Di Stefano
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Andrea Truini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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Francesconi M, Freschi C, Sinceri S, Carbone M, Cappelli C, Morelli L, Ferrari V, Ferrari M. New training methods based on mixed reality for interventional ultrasound: Design and validation. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:5098-101. [PMID: 26737438 DOI: 10.1109/embc.2015.7319538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Currently the learning model for ultrasound imaging diagnosis and intervention follows a traditional approach based on learning by doing but this model exposes the patient to the whole learning curve of the novice. In order to enable training in a safe environment without compromising patient's health we have developed and demonstrated face, content and construct validity of a hybrid simulator for ultrasound-guided biopsy. This hybrid simulator is able to provide a support to acquire skills in term of 3D perception and hand-eye coordination thanks to a mixed reality visualization that allows accurate and easy planning of probe position/orientation and needle trajectory to reach the target.
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Bersani FS, Santacroce R, Coviello M, Imperatori C, Francesconi M, Vicinanza R, Minichino A, Corazza O. Cannabis: a self-medication drug for weight management? The never ending story. Drug Test Anal 2015; 8:177-9. [DOI: 10.1002/dta.1891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/21/2015] [Accepted: 09/01/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Francesco Saverio Bersani
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
| | - Rita Santacroce
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
- Department of Neuroscience and Imaging; Gabriele D'Annunzio University; Chieti Italy
| | - Marialuce Coviello
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | | | - Marta Francesconi
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Roberto Vicinanza
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences; Sapienza University of Rome; Rome Italy
| | - Amedeo Minichino
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Ornella Corazza
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
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Bersani FS, Coviello M, Imperatori C, Francesconi M, Hough CM, Valeriani G, De Stefano G, Bolzan Mariotti Posocco F, Santacroce R, Minichino A, Corazza O. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products. Biomed Res Int 2015; 2015:120679. [PMID: 26457296 PMCID: PMC4589574 DOI: 10.1155/2015/120679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/02/2015] [Indexed: 12/24/2022]
Abstract
Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs) as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs) often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications.
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Affiliation(s)
- F. Saverio Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Marialuce Coviello
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Imperatori
- Department of Human Sciences, European University of Rome, 00163 Rome, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Christina M. Hough
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143, USA
| | - Giuseppe Valeriani
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Psychiatry, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Gianfranco De Stefano
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Rita Santacroce
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Neuroscience and Imaging, Gabriele D'Annunzio University, 66100 Chieti, Italy
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
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Bersani FS, Minichino A, Fattapposta F, Bernabei L, Spagnoli F, Mannarelli D, Francesconi M, Pauletti C, Corrado A, Vergnani L, Taddei I, Biondi M, Delle Chiaie R. Prefrontocerebellar transcranial direct current stimulation increases amplitude and decreases latency of P3b component in patients with euthymic bipolar disorder. Neuropsychiatr Dis Treat 2015; 11:2913-7. [PMID: 26640377 PMCID: PMC4657792 DOI: 10.2147/ndt.s91625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Neurocognitive impairments have been observed in patients with bipolar disorder (BD) even during the euthymic phase of the disease, potentially representing trait-associated rather than state-associated characteristics of the disorder. In the present study, we used transcranial direct current stimulation (tDCS) applied to cerebellar and prefrontal cortices to improve the neurophysiological performances of patients with euthymic BD. METHODS Twenty-five outpatients with BD underwent open-label prefrontocerebellar tDCS for 3 consecutive weeks. Neurophysiological performances were assessed through the examination of the P3b and P3a subcomponents of P300 event-related potential at baseline and after stimulation. RESULTS Compared to baseline, P3b component after tDCS showed significantly higher amplitude and shorter latency (latency: Fz P=0.02, Cz P=0.03, and Pz P=0.04; amplitude: Fz P=0.24, Cz P=0.02, and Pz P=0.35). CONCLUSION In our sample of patients with euthymic BD, concomitant prefrontoexcitatory and cerebellar-inhibitory modulations led to improved brain information processing stream. This improvement may at least partially result from neuroplastic modulation of prefrontocerebellar circuitry activity.
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Affiliation(s)
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Laura Bernabei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Francesco Spagnoli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Alessandra Corrado
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Lucilla Vergnani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Ines Taddei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Roberto Delle Chiaie
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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Antonelli M, Baccioli A, Francesconi M, Lensi R, Martorano L. Analysis of a Low Concentration Solar Plant with Compound Parabolic Collectors and a Rotary Expander for Electricity Generation. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.egypro.2014.01.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Antonelli M, Baccioli A, Francesconi M, Martorano L. Experimental and Numerical Analysis of the Valve Timing Effects on the Performances of a Small Volumetric Rotary Expansion Device. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.egypro.2014.01.113] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Carini F, Giamberini C, Cappelletti D, Francesconi M, Porcaro G. Prevalenza e gestione chirurgica degli elementi sovrannumerari. Uno studio retrospettivo. Dental Cadmos 2013. [DOI: 10.1016/s0011-8524(13)70109-0] [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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Minichino A, Bersani FS, Calò WK, Spagnoli F, Francesconi M, Vicinanza R, Delle Chiaie R, Biondi M. Smoking behaviour and mental health disorders--mutual influences and implications for therapy. Int J Environ Res Public Health 2013; 10:4790-811. [PMID: 24157506 PMCID: PMC3823321 DOI: 10.3390/ijerph10104790] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 12/27/2022]
Abstract
Tobacco use is strongly associated with a variety of psychiatric disorders. Smokers are more likely than non-smokers to meet current criteria for mental health conditions, such as mood disorders, anxiety disorders and psychosis. Evidence also suggest that smokers with psychiatric disorders may have more difficulty quitting, offering at least a partial explanation for why smoking rates are higher in this population. The mechanisms linking mental health conditions and cigarette smoking are complex and likely differ across each of the various disorders. The most commonly held view is that patients with mental health conditions smoke in an effort to regulate the symptoms associated with their disorder. However some recent evidence suggests that quitting smoking may actually improve mental health symptoms. This is particularly true if the tobacco cessation intervention is integrated into the context of ongoing mental health treatment. In this paper we reviewed and summarized the most relevant knowledge about the relationship between tobacco use and dependence and psychiatric disorders. We also reviewed the most effective smoking cessation strategies available for patients with psychiatric comorbidity and the impact of smoking behavior on psychiatric medication.
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Affiliation(s)
- Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Francesco Saverio Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Wanda Katharina Calò
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Francesco Spagnoli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Roberto Vicinanza
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University, Rome 00185, Italy; E-Mail:
| | - Roberto Delle Chiaie
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome 00185, Italy; E-Mails: (F.S.B.); (W.K.C.); (F.S.); (M.F.); (R.D.C.); (M.B.)
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Kelly Y, Sacker A, Del Bono E, Francesconi M, Marmot M. What role for the home learning environment and parenting in reducing the socioeconomic gradient in child development? Findings from the Millennium Cohort Study. Arch Dis Child 2011; 96:832-7. [PMID: 21666278 DOI: 10.1136/adc.2010.195917] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Early child health and development (ECD) is important for health in later life. Objectives were to (1) examine the extent of socioeconomic inequality in markers of ECD at ages 3 and 5 years; (2) examine whether the ECD-income gap widens between these ages; (3) assess the contribution of the home learning environment, family routines and psychosocial environment to observed inequalities in ECD. METHODS Data on socioemotional difficulties, and tests of cognitive ability in 3-year-old (n=15 382) and 5-year-old (n=15 042) children from the UK Millennium Cohort Study were used. RESULTS Children in the highest income group were less likely to have socioemotional difficulties compared with those in the lowest income group at 3 and 5 years (2.4% vs 16.4% and 2.0% vs 15.9%, respectively) and had higher mean scores: age 3 'school readiness' 114 versus 99; verbal ability 54 versus 48, and age 5: verbal ability 60 versus 51, non-verbal ability 58 versus 54 and spatial ability 54 versus 48 (all p<0.001). The income gap in verbal ability scores widened between ages 3 and 5 (Wald test, p=0.04). Statistical adjustment for markers of home learning, family routines and psychosocial environments did more to explain the income gap in socioemotional difficulties than in cognitive test scores. CONCLUSION Our results suggest that relationships between family income and markers of ECD are amenable to change. The role of home learning, family routines and psychosocial environmental factors are potentially important in closing income gaps in ECD.
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Affiliation(s)
- Y Kelly
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, UK.
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Cevenini E, Bellavista E, Tieri P, Castellani G, Lescai F, Francesconi M, Mishto M, Santoro A, Valensin S, Salvioli S, Capri M, Zaikin A, Monti D, de Magalhães JP, Franceschi C. Systems biology and longevity: an emerging approach to identify innovative anti-aging targets and strategies. Curr Pharm Des 2010; 16:802-13. [PMID: 20388091 DOI: 10.2174/138161210790883660] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Accepted: 10/16/2009] [Indexed: 11/22/2022]
Abstract
Human aging and longevity are complex and multi-factorial traits that result from a combination of environmental, genetic, epigenetic and stochastic factors, each contributing to the overall phenotype. The multi-factorial process of aging acts at different levels of complexity, from molecule to cell, from organ to organ systems and finally to organism, giving rise to the dynamic "aging mosaic". At present, an increasing amount of experimental data on genetics, genomics, proteomics and other -omics are available thanks to new high-throughput technologies but a comprehensive model for the study of human aging and longevity is still lacking. Systems biology represents a strategy to integrate and quantify the existing knowledge from different sources into predictive models, to be later tested and then implemented with new experimental data for validation and refinement in a recursive process. The ultimate goal is to compact the new acquired knowledge into a single picture, ideally able to characterize the phenotype at systemic/organism level. In this review we will briefly discuss the aging phenotype in a systems biology perspective, showing four specific examples at different levels of complexity, from a systemic process (inflammation) to a cascade-process pathways (coagulation) and from cellular organelle (proteasome) to single gene-network (PON-1), which could also represent targets for anti-aging strategies.
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Affiliation(s)
- E Cevenini
- CIG - Interdepartmental Centre L Galvani, University of Bologna, Bologna, Italy
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Heinisch BB, Francesconi M, Mittermayer F, Schaller G, Gouya G, Wolzt M, Pleiner J. Alpha-lipoic acid improves vascular endothelial function in patients with type 2 diabetes: a placebo-controlled randomized trial. Eur J Clin Invest 2010; 40:148-54. [PMID: 20050880 DOI: 10.1111/j.1365-2362.2009.02236.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of alpha-lipoic acid (ALA) treatment on endothelium-dependent and -independent vasodilatation, assessed by forearm blood flow (FBF), in patients with type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS A total of 30 subjects with type 2 diabetes were included in this randomized, controlled, double-blinded, parallel group study. FBF responses to intra-arterial acetylcholine (ACh) and glycerol trinitrate (GTN) were measured before and after 21 days of intravenous treatment with 600 mg alpha-lipoic acid or placebo. RESULTS FBF responses were comparable at baseline. After treatment, FBF reactivity to ACh and GTN was unchanged in subjects receiving placebo. By contrast, ALA treatment increased endothelium-dependent vasodilatation to ACh (P < 0.05) but not to GTN compared with baseline. CONCLUSIONS Intravenous ALA treatment improves endothelium-dependent vasodilatation in patients with type 2 diabetes, in the absence of effects on forearm vasomotor function. If this salutary action translates into vascular risk reduction remains to be established.
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Bertolini A, Carelli G, Francesconi F, Francesconi M, Marchesini L, Marsili P, Sorrentino F, Cristoforetti G, Legnaioli S, Palleschi V, Pardini L, Salvetti A. Modì: a new mobile instrument for in situ double-pulse LIBS analysis. Anal Bioanal Chem 2006; 385:240-7. [PMID: 16614821 DOI: 10.1007/s00216-006-0413-6] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Revised: 03/03/2006] [Accepted: 03/06/2006] [Indexed: 11/25/2022]
Abstract
Laser-induced breakdown spectroscopy (LIBS) is a promising technique for in situ elemental analysis. A new mobile instrument for LIBS analysis, developed in a collaboration between Marwan Technology s.r.l. and the Applied Laser Spectroscopy Laboratory in Pisa, is presented, and some applications of it and results from it are outlined. The innovative experimental set-up, based on the use of two suitably retarded laser pulses and a standardless analysis procedure, which overcomes problems related to matrix effects, greatly improves the potential of this technique for accurate quantitative analysis.
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Affiliation(s)
- A Bertolini
- Marwan Technology s.r.l., Spin off INFM-CNR and Università di Pisa, c/o Dipartimento di Fisica E. Fermi Largo Pontecorvo 3, 56127, Pisa, Italy
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Spiriti MAA, Latagliata R, Niscola P, Cortelezzi A, Francesconi M, Ferrari D, Volpe E, Clavio M, Grossi A, Reyes MT, Musto P, Mitra ME, Azzarà A, Pagnini D, D'Arena G, Spadano A, Balleari E, Pecorari P, Capochiani E, De Biasi E, Perego D, Monarca B, Pisani F, Scaramella G, Petti MC. Impact of a new dosing regimen of epoetin alfa on quality of life and anemia in patients with low-risk myelodysplastic syndrome. Ann Hematol 2004; 84:167-76. [PMID: 15592833 DOI: 10.1007/s00277-004-0961-9] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2004] [Accepted: 09/26/2004] [Indexed: 11/27/2022]
Abstract
This study evaluated the impact of a new epoetin alfa dosing regimen on quality of life (QOL), transfusion requirements, and hemoglobin (Hb) levels in 133 patients with low-risk myelodysplastic syndrome (MDS) and Hb < or =10 g/dl. Epoetin alfa 40,000 IU was given subcutaneously twice weekly; after 4 weeks, the dose could be reduced to 40,000 IU weekly in patients achieving erythroid response. QOL was assessed using the functional assessment of cancer therapy-anemia (FACT-An) questionnaire. FACT-An scores increased on average by 7.5 after 4 weeks and by 8.8 after 8 weeks compared with baseline. FACT-An scores were positively associated with Hb values (r=0.53, P<0.01). The mean FACT-An score increase at week 8 was 10.2 in responders and 5.6 in nonresponders. The overall erythroid response rate at week 8 was 68%: 74% in transfusion-independent patients and 59% in transfusion-dependent patients. Of all responders at week 8, response was maintained in 86% at week 12, 71% at week 16, 65% at week 20, and 54% at week 24. Treatment was generally well tolerated. Our data provide new and encouraging results regarding the benefits of 40,000 IU biweekly induction doses followed by 40,000 IU weekly in improving QOL, correcting anemia, and reducing transfusion requirements in low-risk MDS patients.
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Affiliation(s)
- M A Aloe Spiriti
- II Facoltà di Medicina e Chirurgia, Università di Roma La Sapienza-Azienda Ospedaliera Sant'Andrea, Rome, Italy
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Perno CF, Balestra E, Francesconi M, Abdelahad D, Caliò R, Balzarini J, Aquaro S. Antiviral profile of HIV inhibitors in macrophages: implications for therapy. Curr Top Med Chem 2004; 4:1009-15. [PMID: 15134554 DOI: 10.2174/1568026043388565] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Macrophages (M/M) are identified as the second cellular target of HIV and a crucial virus reservoir. M/M are persistently infected cells and not susceptible to the HIV cytophatic effects typical of infected CD4+ T-lymphocytes. HIV replication in M/M is a crucial pathogenetic event during the whole course of the disease. Moreover, the dynamics of HIV-1 replication and cumulative virus production is quite different in M/M and CD4+ T-lymphocytes in the presence or in the absence of antiviral drugs. Thus, for their unique cellular characteristics, the activity of anti-HIV compounds could be different in M/M than in CD4+ T-lymphocytes. Indeed, nucleoside analogues inhibitors of HIV-reverse transcriptase (NRTIs) show potent antiviral activity in macrophages, although the limited penetration of these compounds in sequestered body compartments and the scarce phosphorylation ability of macrophages, suggest that a phosphate group linked to NRTIs may confer a greater anti-HIV activity in such cells. The antiviral activity of non-nucleoside reverse transcriptase inhibitors (NNRTIs) in macrophages is similar to that found in CD4-lymphocytes. Interestingly, protease inhibitors (PIs), acting at post-integrational stages of virus replication, are the only drugs able to interfere with virus production and release from macrophages with established and persistent HIV infection. For these reasons, a careful analysis of the distribution of antiviral drugs, and the assessment of their activity in cells of macrophage lineage, represent key factors in the development of therapeutic strategies aimed to the treatment of the HIV-infected patients.
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Affiliation(s)
- C-F Perno
- Department of Experimental Medicine and Biochemical Sciences, University of Rome Tor Vergata, via Montpellier, 1 00133 Roma, Italy.
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Amighi J, Sabeti S, Schlager O, Francesconi M, Ahmadi R, Minar E, Schillinger M. Outcome of Conservative Therapy of Patients with Severe Intermittent Claudication. Eur J Vasc Endovasc Surg 2004; 27:254-8. [PMID: 14760593 DOI: 10.1016/j.ejvs.2003.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intermittent claudication due to peripheral artery disease (PAD) can be treated conservatively, or by revascularization. OBJECTIVES To assess the short-term outcome of conservatively-treated claudicants, and determine predictors for clinical improvement. Design. A retrospective cohort study. METHODS We evaluated Fontaine stage, walking distance and ankle brachial index (ABI) at baseline and after median 9 months (interquartile range (IQR) 6-24) in 181 patients with severe claudication. RESULTS We found clinical improvement by at least one Fontaine stage in 38 patients (21%) with an increased walking distance from baseline median 100 m (IQR 50-150) to follow-up median 650 m (IQR 300 to unlimited; p<0.001), but without changes in ABI (median 0.57, IQR 0.48-0.73 vs. median 0.54, IQR 0.45-0.81; p=0.10). One hundred and thirty-eight patients (76%) remained clinically and hemodynamically stable. A worsening of the clinical stage but without amputation was recorded in five patients (3%). Female gender (hazard ratio (HR) 0.51, p=0.052), diabetes (HR 0.35, p=0.020), and baseline ABI below 0.44 (HR 0.31, p=0.019) were associated with a reduced probability of clinical improvement. CONCLUSION Certain patients with intermittent claudication show substantial clinical improvement with conservative medical therapy, despite any lack of hemodynamic improvement. Given the low number of patients with clinical deterioration in the short term, primarily conservative therapy should be the preferred initial option for most claudicants.
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Affiliation(s)
- J Amighi
- Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria
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Francesconi M. [Demographic and metabolic data of persons with different risk for diabetes mellitus based on "random" blood glucose values]. Acta Med Austriaca Suppl 2003; 56:9-11. [PMID: 12436705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Four risk-categories for diabetes probability where defined by measured random-blood glucose values: minimum risk (random blood glucose < or = 95 mg/dl), low (96-139 mg/dl), moderate (140-199 mg/dl), and high (> or = 200 mg/dl). Using these risk categories and other risk factors as age, sex, BMI, and cholesterol, further data analysis were made. Among high-risk patients, male sex was represented two fold compared to female sex. In +65 year old subjects the diabetes risk increased from 8.2% for the whole study cohort up to 12.1%. An increase of body weight was paralleled by an increased risk for diabetes, whereas in the highest diabetes risk-group, obese subjects (BMI subgroup 4) were twice as frequent as in the next lower risk category. Additionally, 62% of subjects with a high diabetes risk had elevated cholesterol levels.
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Affiliation(s)
- M Francesconi
- Rehabilitationszentrum Alland, Pensionsversicherungsanstalt der Arbeiter, A-2534 Alland.
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40
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Tosti ME, Solinas S, Prati D, Salvaneschi L, Manca M, Francesconi M, Ciuffreda M, Girelli G, Mele A. An estimate of the current risk of transmitting blood-borne infections through blood transfusion in Italy. Br J Haematol 2002; 117:215-9. [PMID: 11918558 DOI: 10.1046/j.1365-2141.2002.03334.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We conducted a retrospective cohort study to estimate the incidence of major blood-borne agents among Italian blood donors and calculated the risk of infection among blood recipients using the 'incidence/window period model'. The study was conducted among 46 180 blood donors enrolled in six blood centres between 1994 and 1999. During follow-up, seven new infections were confirmed: three donors seroconverted for anti-human immunodeficiency virus (HIV); two for anti-hepatitis C virus (HCV); and two showed hepatitis B surface antigen (HBsAg) reactivity; no cases of syphilis were observed. The incidence rates per 100 000 person/years were: 4.06 (95% CI: 0.82-11.85) for HIV; 2.41 (95% CI: 0.29-8.70) for HCV; and 2.70 (95% CI: 0.32-9.77) for HBsAg; the incidence for total hepatitis B virus (HBV) infection was 9.77 per 100 000 person/years (95% CI: 1.16-35.36). The estimated risk of an infectious blood unit not being detected was: 2.45 (95% CI: 0.13-12.33) per 1 million units for HIV; 4.35 (95% CI: 0.30-22.39) for HCV; and 15.78 (95% CI: 1.16-84.23) for HBV. Overall, an estimated 22.58 per 1 million units are infected. In Italy, the risk of transfusion-transmitted infections is low and is similar to that in other western countries. The introduction of new more sensitive screening tests could reduce the residual risk of transfusion-transmitted infection by 40-80%.
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Affiliation(s)
- M E Tosti
- Reparto di Epidemiologia Clinica, Istituto Superiore di Sanità, Servizio Trasfusionale e Immunoematologia, Università La Sapienza, Rome, Italy.
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41
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Wiesinger GF, Pleiner J, Quittan M, Fuchsjäger-Mayrl G, Crevenna R, Nuhr MJ, Francesconi C, Seit HP, Francesconi M, Fialka-Moser V, Wolzt M. Health related quality of life in patients with long-standing insulin dependent (type 1) diabetes mellitus: benefits of regular physical training. Wien Klin Wochenschr 2001; 113:670-5. [PMID: 11603101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND AND AIMS Regular exercise is recommended to diabetic patients in addition to dietary restrictions and drug therapy. We have studied whether health related quality of life (HRQOL) can be improved by a regular physical training program. METHODS 23 otherwise healthy patients with history of type 1 diabetes for 20 +/- 10 years were included. 15 patients (age: 41 +/- 2 years) participated in an aerobic physical training program over 4 months and 8 patients (33 +/- 11 years) served as a control group. HRQOL was assessed by a validated questionnaire (MOS SF-36). Tests were carried out at baseline and after 4 months. RESULTS Physical training increased peak oxygen uptake (VO2max) by 27 +/- 13% after 4 months (p = 0.04) in the training group. There was no significant change in hand or leg isometric muscle strength. All HRQOL scales improved in the training group with significantly higher (p < 0.04) Social Functioning and Vitality scores, respectively. Moreover, insulin requirements decreased during physical training program (p < 0.05). CONCLUSIONS Our data indicate that physical exercise training in patients with type I diabetes mellitus improves metabolic control and various aspects of HRQOL. Besides enhanced cardiorespiratory capacity, this is an important subjective benefit in patients with longstanding insulin dependent (type 1) diabetes mellitus.
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Affiliation(s)
- G F Wiesinger
- Department of Physical Medicine and Rehabilitation, University of Vienna, Austria
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42
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Francesconi M, Koizar C, Wascher TC. Postprandial impairment of resistance vessel function in insulin treated patients with diabetes mellitus type-2. Clin Physiol 2001; 21:300-7. [PMID: 11380529 DOI: 10.1046/j.1365-2281.2001.00333.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Reduced postischaemic reactive hyperaemia, is considered a marker of impaired resistance vessel function. Acute postprandial hyperlipidaemia has been shown to induce vascular dysfunction. In the present study, the impact of postprandial hyperglycaemia on resistance vessel reactivity was investigated in insulin treated type-2 diabetic patients. The study was performed in 16 insulin treated type-2 diabetics (eight male/eight female, age 47 +/- 3 years, HbA1c 7.2 +/- 0.2) and 16 controls. Reactive hyperaemia was measured in the forearm by venous occlusion plethysmography after 5 min of ischaemia in the fasting state and 90 min after a test meal. In diabetics, blood glucose increased from 8.7 +/- 1.1 to 15.3 +/- 1.0 mmol l-1 (P<0.001) postprandially. This resulted in (i) a significant increase of resting blood flow (3.4 +/- 0.3 to 4.8 +/- 0.4 ml min-1 100 ml-1, P<0.01) and (ii) in a reduced peak reactive hyperaemia (52.3 +/- 7.4 to 36.8 +/- 4.3 ml min-1 100 ml-1, P<0.005). In controls, a similar effect of the meal on resting flow was observed but reactive hyperaemia was unaltered. In the absence of a test meal, basal flow as well as peak reactive hyperaemia remained unchanged in diabetic as well as in non-diabetic subjects. Our data provide evidence that in the postprandial state resistance vessel reactivity becomes reduced in insulin treated type-2 diabetic patients.
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Affiliation(s)
- M Francesconi
- Rehabilitation Center for Diabetes and Metabolic Diseases, Alland, Austria
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Francesconi M, Scapin M, Casonato A, Girolami A, Deana R. Adrenaline potentiates type 2B von Willebrand factor-induced activation of human platelets by enhancing both the formation and action of thromboxanes. Thromb Res 2000; 100:293-303. [PMID: 11113273 DOI: 10.1016/s0049-3848(00)00318-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Von Willebrand factor (vWF) is a large plasma glycoprotein that mediates platelet adhesion at sites of vascular injury. We have previously reported that the pathological type 2B (formerly named type IIB) variant of vWF promotes platelet activation through phospholipase A(2)-mediated release of arachidonic acid. The present report shows that adrenaline (1 microM) potentiates type 2B vWF-induced platelet aggregation, serotonin secretion, rise in cytosolic Ca(2+) concentration, and pleckstrin phosphorylation, as well as thromboxane B(2) production. The hormone also increases the partially inhibited release of serotonin observed in platelets pretreated with the anti-GPIIb-IIIa antibody LJCP8 but does remove the total inhibition on the secretion caused by the anti-GPIb antibody LJIB1. Adrenaline also increases type 2B vWF-elicited tyrosine phosphorylation of proteins with apparent molecular masses of 60 and 80 kDa. Furthermore, adrenaline potentiates the rise in cytosolic Ca(2+) and the release of thromboxane B(2) in platelets stimulated with arachidonic acid (2 microM) as well as the increase in Ca(2+) induced by the thromboxane mimetic U46619 (0.3 microM). Platelet pretreatment with yohimbine or 13-azaprostanoic acid, which are antagonists of the alpha(2)-adrenergic and thromboxane receptors, respectively, or with acetylsalicylate and indomethacin, both of which act as inhibitors of thromboxane formation, abolishes the potentiating effect of adrenaline. These observations lead to the conclusion that the potentiating action of adrenaline on type 2B vWF-promoted platelet responses is due to an increase in both the formation and activating action of thromboxanes.
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Affiliation(s)
- M Francesconi
- Department of Biological Chemistry, C.N.R. Unit for the Study of Biomembranes, University of Padova, Italy
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Via LD, Francesconi M, Mazzucato M, Pradella P, De Marco L, Vecchia FD, Rascio N, Deana R. On the mechanism of the spermine-exerted inhibition on alpha-thrombin-induced platelet activation. Thromb Res 2000; 98:59-71. [PMID: 10706934 DOI: 10.1016/s0049-3848(99)00212-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previous reports have shown that various amines inhibited platelet activation, but no definitive conclusions on their action mechanism were drawn. We have further investigated the action of spermine on platelet responses evoked by alpha-thrombin and other agonists. Spermine inhibited in a concentration-dependent manner (1-10 mM), and more efficiently than spermidine and putrescine, the alpha-thrombin-induced (1.5 nM) platelet activation. Spermine added at a concentration that inhibited completely aggregation only partially affected the thrombin-induced increase in cytosolic Ca(2+) concentration, protein phosphorylation, and ATP secretion. The polyamine had little effect on the morphology of resting platelets, as measured by electron microscopy, thrombin hydrolytic activity, and fibrinogen clotting capacity but decreased the thrombin binding to platelets and isolated glycocalicin. Spermine partially inhibited the aggregation elicited by ADP, vasopressin, platelet-activating factor, thrombin receptor-activating peptide, fluoroaluminate, ionomycin, and dioctanoylglycerol but did not affect the cytosolic Ca(2+) increase induced by these agonists. The polyamine bound to both glycocalicin and platelets, and it inhibited the fibrinogen binding to stimulated platelets. The amount of 14C-spermine bound to resting cells decreased in the presence of the glycoprotein GPIb-antibody LJIB1, whereas the polyamine bound to activated platelets, which was higher than that tied to resting cells, was markedly reduced by LJCP8 or decorsin, a GPIIb/IIIa antibody and antagonist-peptide, respectively. These results indicate that spermine specifically inhibits the thrombin binding to GPIb of resting platelets and the fibrinogen binding to GPIIb/IIIa (integrin alpha(IIb)beta(3)) of activated platelets.
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Affiliation(s)
- L D Via
- Department of Biological Chemistry and Unit for the Study of Biomembranes of C.N.R., University of Padova, 35121, Padova, Italy
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Abstract
Dysfunction of resistance arteries is thought to be an early reversible stage in the development of atherosclerosis. Dynamics of post-ischaemic reactive hyperaemia are believed to constitute a useful tool for monitoring resistance vessel function. Patient characteristics influencing reactive hyperaemia, however, need to be defined more precisely. Since reactive hyperaemia is a dynamic process, yielding submaximal peak values after 5 min of ischaemia, this period was chosen to investigate the determinants of reactive hyperaemia in 100 type II diabetic patients as well as in 61 control subjects. Reactive hyperaemia was measured by venous-occlusion plethysmography; clinical and laboratory data were acquired by routine methods. Statistical comparison was performed with SYSTAT 5.0 for Apple Macintosh. Overall, no significant differences between diabetic patients and controls were observed by group comparison. In control subjects, only gender showed an influence on peak reactive hyperaemia (females 40.5 +/- 15.3; males 51.8 +/- 17.7 ml min-1 100 ml-1, P < 0.01). In diabetic patients, in addition to gender, actual blood glucose (r = 0.377, P < 0.05) and meal intake (non-fasting 42.8 +/- 19.2; fasting 51.2 +/- 19.5 ml min-1 100 ml-1, P < 0.05) were found to influence reactive hyperaemia. Further investigation revealed a loss of the correlation between peak reactive hyperaemia and actual blood glucose observed in the fasting state (P < 0.001) in non-fasting diabetic patients, indicating an influence of meal intake on resistance vessel reactivity. Our results suggest that, in diabetic subjects, in addition to gender actual blood glucose and the postprandial situation impacts on peak reactive hyperaemia.
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Affiliation(s)
- M Francesconi
- Rehabilitation Centre for Diabetes and Metabolic Diseases, Alland, Austria
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Stacher G, Schernthaner G, Francesconi M, Kopp HP, Bergmann H, Stacher-Janotta G, Weber U. Cisapride versus placebo for 8 weeks on glycemic control and gastric emptying in insulin-dependent diabetes: a double blind cross-over trial. J Clin Endocrinol Metab 1999; 84:2357-62. [PMID: 10404803 DOI: 10.1210/jcem.84.7.5859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In insulin-dependent diabetes mellitus, slow gastric emptying may make absorption unpredictable and foster glycemic instability. Cisapride accelerates emptying, but controlled long term studies are scarce, and effects on glycemic control unknown. We investigated, in patients with insulin-dependent diabetes mellitus and unstable glycemia, the effects of 10 mg cisapride 4 times daily for 8 weeks vs. placebo on glycemic control and gastric emptying under random, cross-over, double blind conditions. In 14 patients with delayed and 9 with nondelayed emptying, blood glucose variability over 28-week treatment periods separated by a 4-week wash-out and gastric emptying of a semisolid 1168-kJ meal immediately after the treatment periods were assessed. Cisapride did not affect glycemic control [SD of within-patient mean blood glucose, 4.2 mmol/L +/-0.1 (+/- SEM) vs. 4.0+/-0.1 mmol/L after placebo; hemoglobin A1c, 8.3+/-0.2% vs. 8.5+/-0.2%]. Emptying was faster after cisapride than after placebo in 8 of 14 patients with delayed vs. 7 of 9 with nondelayed emptying (P = NS) and in 11 of 15 without vs. 4 of 8 with cardiovascular autonomic neuropathy (P = NS). Autonomic neuropathy prevailed in 7 of 14 patients with delayed and 1 of 9 with nondelayed emptying. Blood glucose immediately before and during assessment of emptying was unrelated to the emptying rate, whereas blood glucose increases over fasting levels were greater with faster emptying (P<0.002). In conclusion, cisapride's effects were not different from those of placebo on glycemic control and gastric emptying, it did not differently affect patients with delayed vs. nondelayed emptying, and it slightly accelerated emptying (P = NS) in patients without, but not in those with, cardiovascular autonomic neuropathy. Blood glucose levels before and during assessment of emptying did not affect emptying, but the glucose rise over fasting levels was greater with faster emptying.
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Affiliation(s)
- G Stacher
- Department of Surgery, University of Vienna, Austria.
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Aquaro S, Caliò R, Balestra E, Bagnarelli P, Cenci A, Bertoli A, Tavazzi B, Di Pierro D, Francesconi M, Abdelahad D, Perno CF. Clinical implications of HIV dynamics and drug resistance in macrophages. J BIOL REG HOMEOS AG 1998; 12:23-7. [PMID: 9689575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Macrophages are widely recognized as the second major target of HIV in the body. The cellular characteristics of such resting cells markedly affect the dynamics of virus lifecycle, that is slower but far more prolonged that in lymphocytes. In addition, the limited concentrations of endogenous nucleotide pools in macrophages downregulate the enzymatic activity of reverse transcriptase. As a consequence, both the anti-HIV activity and the development of resistance to antiviral drugs in macrophages are substantially different than those found in activated lymphocytes. These peculiar characteristics of virus replication and efficacy of antiviral drugs in macrophages have a natural in vivo counterpart in extralymphoid tissues, where macrophages account for the majority of cells infected by HIV. Furthermore, the replication of HIV in macrophages of testis and central nervous system is far less affected by antiviral drugs than in lymph nodes, because of the presence of natural barriers that markedly diminish the concentration of such drugs. For all these reasons, HIV infection of macrophages should be taken into account in therapeutic strategies aimed to achieve an optimal therapeutic effect in all tissue compartments where the virus hides and replicates.
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Affiliation(s)
- S Aquaro
- Department of Experimental Medicine and Biochemical Sciences, University of Roma Tor Vergata, Italy
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Ambrosch F, Francesconi M, Graf H, Huber W, Kollaritsch H, Kunze M, Maurer G, Popp W, Prior C, Sertl K, Slany J, Wiedermann G. [Pneumococcal preventive vaccination. Consensus report, 3]. Wien Med Wochenschr 1998; 148:203. [PMID: 9677677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Aquaro S, Balestra E, Panti S, Cenci A, Serra F, Francesconi M, Abdelahad D, Caliò R, Perno CF. [Correlation between HIV-inhibiting drug activity in human macrophages and clinical outcome]. Clin Ter 1998; 149:37-41. [PMID: 9621487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the comparative efficacy of drugs inhibitors of human immunodeficiency virus (HIV) in human macrophages and lymphocytes, and to correlate the results with the clinical outcome. MATERIALS AND METHODS Human primary macrophages and lymphocytes were infected with HIV in the presence of the following HIV inhibitors, all currently in clinical use: zidovudine, stavudine, zalcitabine, didanosine, lamivudine, PMEA, PMPA (all inhibitors of HIV reverse transcriptase), saquinavir and U-75875 (inhibitors of HIV protease). RESULTS All reverse transcriptase inhibitors tested showed a markedly higher antiviral activity in macrophages than in lymphocytes. Also protease inhibitors have a substantial anti-HIV activity in macrophages, yet their efficacy is markedly diminished if the drugs are added to macrophage culture after HIV, that is when the virus has established a chronical infection. Under these experimental conditions, however, only protease inhibitors among all HIV-inhibitors in clinical use are able to decrease virus replication in chronically-infected macrophages. CONCLUSIONS The results have strong clinical implications, due to the important role of macrophages in the pathogenesis of HIV infection. Macrophages are the major source of HIV at extralymphoid tissue levels, particularly in the central nervous system, where the blood-brain barrier strongly limits the penetration of antiviral drugs. For these reasons, only drugs, like stavudine and zidovudine, provided with good anti-HIV activity in macrophages, and reasonable barrier penetration have substantial chances to be effective in the central nervous system, and thus affect virus replication in a sanctuary where HIV hides and replicates out of the control of the immune system.
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Affiliation(s)
- S Aquaro
- Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Università Tor Vergata, Roma, Italia
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Aquaro S, Perno CF, Balestra E, Balzarini J, Cenci A, Francesconi M, Panti S, Serra F, Villani N, Caliò R. Inhibition of replication of HIV in primary monocyte/macrophages by different antiviral drugs and comparative efficacy in lymphocytes. J Leukoc Biol 1997; 62:138-43. [PMID: 9226005 DOI: 10.1002/jlb.62.1.138] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Several anti-HIV drugs acting on different steps of virus replication were tested in our experimental model of primary monocyte/macrophages; the results were compared with the activity found in lymphocytes. Nucleoside analogues (AZT, ddI, ddC, d4T, PMEA, 3TC etc.) show greater activity in macrophages (M/M) than in lymphocytes. In particular, the EC50 of AZT, ddC, and ddI in M/M is 2- to 100-fold lower than that found in lymphocytes. This greater efficacy of nucleoside analogues in M/M depends on the enhancement of their chain-terminating activity by the low levels of endogenous deoxynucleoside-triphosphates (dNTP) usually found in resting cells such as M/M. Non-nucleoside reverse transcriptase inhibitors (NNRTI) do not act as chain terminators (thus their antiviral effect is not related to the intracellular concentrations of dNTP); as a consequence the activity of TSAO, HEPT, TIBO, and other NNRTI tested in M/M is similar to that found in lymphocytes. Regarding inhibitors of binding and fusion of HIV, we found that their anti-HIV activity is markedly decreased (or even nullified) when M/M are treated with cytokine activators of M/M function and enhancers of HIV replication. More relevant from a clinical standpoint, protease inhibitors are able to inhibit HIV replication in chronically infected macrophages (i.e., cells carrying the proviral genome already integrated in the host genome). All other inhibitors of late stage of virus life cycle tested (antisense-rev, anti-tat, interferon-alpha and -gamma, phosphorothioate analogues, GLQ-223, etc.) were totally inactive in chronically infected macrophages. The different effects of various classes of HIV inhibitors in lymphocytes and macrophages suggests that AIDS therapy should consider all aspects of the pathogenesis of HIV infection and must be restricted to drugs, or combinations of drugs, active against both lymphocytes and M/M in all body compartments where the virus hides and replicates.
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Affiliation(s)
- S Aquaro
- Department of Experimental Medicine and Biochemical Sciences, University of Rome Tor Vergata, Italy
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