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Migliorisi G, Collura M, Ficili F, Pensabene T, Bongiorno D, Collura A, Di Bernardo F, Stefani S. Elexacaftor-Tezacaftor-Ivacaftor as a Final Frontier in the Treatment of Cystic Fibrosis: Definition of the Clinical and Microbiological Implications in a Case-Control Study. Pharmaceuticals (Basel) 2022; 15:ph15050606. [PMID: 35631432 PMCID: PMC9145356 DOI: 10.3390/ph15050606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
The use of modulator drugs that target the Cystic Fibrosis transmembrane conductance regulator (CFTR) is the final frontier in the treatment of Cystic Fibrosis (CF), a genetic multiorgan disease. F508del is the most common mutation causing defective formation and function of CFTR. Elexacaftor-tezacaftor-ivacaftor is the first triple combination of CFTR modulators. Herein, we report on a one-year case-control study that involved 26 patients with at least one F508del mutation. Patients were assigned to two similar groups, and patients with the worse clinical condition received treatment with the triple combination therapy. The study aimed to define the clinical and especially microbiological implications of treatment administration. The treatment provided significant clinical benefits in terms of respiratory, pancreatic, and sweat function. After one year of therapy, airway infection rates decreased and pulmonary exacerbations were dramatically reduced. Finally, treated patients reported a surprising improvement in their quality of life. The use of triple combination therapy has become essential in most CF people carrying the F508del mutation. Although the clinical and instrumental benefits of treatment are thoroughly known, further investigations are needed to properly define its microbiological respiratory implications and establish the real advantage of life-long treatment with elexacaftor-tezacaftor-ivacaftor.
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Affiliation(s)
- Giuseppe Migliorisi
- Unit of Clinical Microbiology, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (G.M.); (T.P.); (A.C.); (F.D.B.)
| | - Mirella Collura
- Cystic Fibrosis and Respiratory Pediatric Center, Children’s Hospital G. Di Cristina, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (M.C.); (F.F.)
| | - Francesca Ficili
- Cystic Fibrosis and Respiratory Pediatric Center, Children’s Hospital G. Di Cristina, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (M.C.); (F.F.)
| | - Tiziana Pensabene
- Unit of Clinical Microbiology, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (G.M.); (T.P.); (A.C.); (F.D.B.)
| | - Dafne Bongiorno
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy;
| | - Antonina Collura
- Unit of Clinical Microbiology, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (G.M.); (T.P.); (A.C.); (F.D.B.)
| | - Francesca Di Bernardo
- Unit of Clinical Microbiology, ARNAS Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy; (G.M.); (T.P.); (A.C.); (F.D.B.)
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy;
- Correspondence: ; Tel.: +39-0954781232
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Campana S, Ravenni N, Cariani L, Colombo C, Fiscarelli E, Lucidi V, Raia V, Iula D, Pensabene T, Collura M, Braggion C, Taccetti G. 73 Impact of community-acquired MRSA and hospital-acquired MRSA on pulmonary function of CF patients. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dolce D, Cariani L, Campana S, Ravenni N, Mergni G, Biffi A, Colombo C, Gagliardini R, Cirilli N, Manso E, Padoan R, Soncini E, Forte FR, D'Aprile A, Ratclif L, Amboni M, Casciaro R, Minicucci L, Borio T, Cosimi A, Vieni G, Zinnarello C, Fiscarelli E, Collura M, Pensabene T, Braggion C, Döring G, Taccetti G. Evaluation of specific immune response in early P. aeruginosa infection in cystic fibrosis patients. J Cyst Fibros 2013; 13:116-7. [PMID: 24022018 DOI: 10.1016/j.jcf.2013.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
Affiliation(s)
| | - Lisa Cariani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, CF Center, Milan, Italy
| | | | | | | | - Arianna Biffi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, CF Center, Milan, Italy
| | - Carla Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, CF Center, Milan, Italy
| | - Rolando Gagliardini
- CF Center, U.O. Pediatric Medicin, AOU Ospedali Riuniti "G. Salesi", Ancona, Italy
| | - Natalia Cirilli
- CF Center, U.O. Pediatric Medicin, AOU Ospedali Riuniti "G. Salesi", Ancona, Italy
| | - Ester Manso
- CF Center, U.O. Pediatric Medicin, AOU Ospedali Riuniti "G. Salesi", Ancona, Italy
| | - Rita Padoan
- Pediatric Department, AO Spedali Civili Brescia, Brescia, Italy
| | - Elena Soncini
- Pediatric Department, AO Spedali Civili Brescia, Brescia, Italy
| | - Fabio Rocco Forte
- Pediatric and Neonatology Division, Ospedale di Matera, Matera, Italy
| | | | - Luigi Ratclif
- CF Center, Ospedale "G. Tatarella", Cerignola, Italy
| | - Maura Amboni
- Pediatric and Neonatology Pathology, Ospedale "M. Bufalini", Cesena, Italy
| | - Rosaria Casciaro
- CF Center, Pediatric Department, Ospedale "G. Gaslini", Genova, Italy
| | - Laura Minicucci
- CF Center, Pediatric Department, Ospedale "G. Gaslini", Genova, Italy
| | - Tatiana Borio
- CF Center, Ospedale di Gubbio-Gualdo Tadino, Gubbio, Italy
| | - Angelo Cosimi
- CF Center, Ospedale di Gubbio-Gualdo Tadino, Gubbio, Italy
| | - Giuseppe Vieni
- CF Center, CF and Pediatric Gastroenterology Unit, Policlinico Universitario, Messina, Italy
| | - Clara Zinnarello
- CF Center, CF and Pediatric Gastroenterology Unit, Policlinico Universitario, Messina, Italy
| | | | - Mirella Collura
- CF Center, Ospedale dei Bambini "G. Di Cristina", Palermo, Italy
| | | | | | - Gerd Döring
- Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany
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Mattoscio D, Evangelista V, De Cristofaro R, Recchiuti A, Pandolfi A, Di Silvestre S, Manarini S, Martelli N, Rocca B, Petrucci G, Angelini DF, Battistini L, Robuffo I, Pensabene T, Pieroni L, Furnari ML, Pardo F, Quattrucci S, Lancellotti S, Davì G, Romano M. Cystic fibrosis transmembrane conductance regulator (CFTR) expression in human platelets: impact on mediators and mechanisms of the inflammatory response. FASEB J 2010; 24:3970-80. [PMID: 20530751 DOI: 10.1096/fj.10-159921] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Inflammatory lung disease is a primary cause of morbidity and mortality in cystic fibrosis (CF). Mechanisms of unresolved acute inflammation in CF are not completely known, although the involvement of cystic fibrosis transmembrane conductance regulator (CFTR) in nonrespiratory cells is emerging. Here we examined CFTR expression and function in human platelets (PLTs) and found that they express a biologically active CFTR. CFTR blockade gave an ∼50% reduction in lipoxin A(4) (LXA(4)) formation during PLT/polymorphonuclear leukocytes (PMN) coincubations by inhibiting the lipoxin synthase activity of PLT 12-lipoxygenase. PLTs from CF patients generated ∼40% less LXA(4) compared to healthy subject PLTs. CFTR inhibition increased PLT-dependent PMN viability (33.0±5.7 vs. 61.2±8.2%; P=0.033), suppressed nitric oxide generation (0.23±0.04 vs. 0.11±0.002 pmol/10(8) PLTs; P=0.004), while reducing AKT (1.02±0.12 vs. 0.71±0.007 U; P=0.04), and increasing p38 MAPK phosphorylation (0.650±0.09 vs. 1.04±0.24 U; P=0.03). Taken together, these findings indicate that PLTs from CF patients are affected by the molecular defect of CFTR. Moreover, this CF PLT abnormality may explain the failure of resolution in CF.
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Affiliation(s)
- Domenico Mattoscio
- Department of Biomedical Sciences, Aging Research Center, CeSI, Gabriele D'Annunzio University Foundation, Via Colle dell'Ara, 66013 Chieti, Italy
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Agodi A, Barchitta M, Gianninò V, Collura A, Pensabene T, Garlaschi ML, Pasquarella C, Luzzaro F, Sinatra F, Mahenthiralingam E, Stefani S. Burkholderia cepacia complex in cystic fibrosis and non-cystic fibrosis patients: identification of a cluster of epidemic lineages. J Hosp Infect 2002; 50:188-95. [PMID: 11886194 DOI: 10.1053/jhin.2001.1160] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study was performed in order to compare Burkholderia cepacia complex strains from cystic fibrosis (CF) and non-CF patients at the genomovar, genetic and epidemiological levels. A total of 92 B. cepacia respiratory tract isolates were obtained from patients attending the following CF centres: Catania and Palermo, Sicily; Gualdo Tadino, Central Italy, and Milan, Northern Italy. A total of 23 B. cepacia isolates were obtained from blood, surgical wound, and intravenous catheter sources of patients without CF, hospitalized in Catania and Varese, Northern Italy. Genomovar status identification, clonality and genetic relatedness determination, antibiotic susceptibility pattern determination and electron microscopy were performed. Transmission of infection was shown in both CF and non-CF patients by identifying clonality of responsible strains. In total 13 clones were involved in cross-transmission episodes. No outbreak was described involving both CF and non-CF patients. The present study indicates the existence of a distinct cluster of strains responsible for epidemics in CF and non-CF patients, based on their genetic relatedness, distinct from strains associated with no or negligible transmissibility. This result suggests that transmissibility is not only associated with a specific genomovar in CF patients, but also with a group of genetically related lineages in CF and non-CF patients. A key role is shown for both segregation measures and careful surveillance of infection, based on selective culture, molecular identification and epidemiological characterization of individual isolates.
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Affiliation(s)
- A Agodi
- Department of Biomedical Sciences, University of Catania, Italy
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