151
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Guarnieri B, Musicco M, Caffarra P, Adorni F, Appollonio I, Arnaldi D, Bartoli A, Bonanni E, Bonuccelli U, Caltagirone C, Cerroni G, Concari L, Cosentino FII, Fermi S, Ferri R, Gelosa G, Lombardi G, Mearelli S, Nobili F, Passero S, Perri R, Rocchi R, Sucapane P, Tognoni G, Zabberoni S, Sorbi S. Recommendations of the Sleep Study Group of the Italian Dementia Research Association (SINDem) on clinical assessment and management of sleep disorders in individuals with mild cognitive impairment and dementia: a clinical review. Neurol Sci 2014; 35:1329-48. [PMID: 25037740 DOI: 10.1007/s10072-014-1873-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/26/2014] [Indexed: 02/02/2023]
Abstract
Clinical assessment and management of sleep disturbances in patients with mild cognitive impairment and dementia has important clinical and social implications. Poor sleep results in an increased risk of morbidities and mortality in demented patients and is a source of stress for caregivers. Sleep disturbances show high prevalence in mild cognitive impairment and dementia patients and they are often associated one to another in the same patient. A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of individuals with cognitive decline. The Sleep Study Group of the Italian Dementia Research Association (SINDem) reviewed evidence from original research articles, meta-analyses and systematic reviews published up to December 2013. The evidence was classified in quality levels (I, II, III) and strength of recommendations (A, B, C, D, E). Where there was a lack of evidence, but clear consensus, good practice points were provided. These recommendations may not be appropriate for all circumstances and should therefore be adopted only after a patient's individual characteristics have been carefully evaluated.
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Affiliation(s)
- B Guarnieri
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy,
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152
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McGregor R, Li G, Penny H, Lombardi G, Afzali B, Goldsmith DJ. Vitamin D in renal transplantation - from biological mechanisms to clinical benefits. Am J Transplant 2014; 14:1259-70. [PMID: 24840071 PMCID: PMC4441280 DOI: 10.1111/ajt.12738] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 01/25/2023]
Abstract
Recent developments in our understanding of vitamin D show that it plays a significant role in immunological health, uniquely occupying both an anti-microbial and immunoregulatory niche. Vitamin D deficiency is widespread amongst renal transplant recipients (RTRs), thus providing one patho-mechanism that may influence the achievement of a successful degree of immunosuppression. It may also influence the development of the infectious, cardiovascular and neoplastic complications seen in RTRs. This review examines the biological roles of vitamin D in the immune system of relevance to renal transplantation (RTx) and evaluates whether vitamin D repletion may be relevant in determining immunologically-related clinical outcomes in RTRs, (including graft survival, cardiovascular disease and cancer). While there are plausible biological and epidemiological reasons to undertake vitamin D repletion in RTRs, there are few randomized-controlled trials in this area. Based on the available literature, we cannot at present categorically make the case for routine measurement and repletion of vitamin D in clinical practice but we do suggest that this is an area in urgent need of further randomized controlled level evidence.
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Affiliation(s)
- R McGregor
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
- National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College LondonLondon, UK
| | - G Li
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
| | - H Penny
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
| | - G Lombardi
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
- National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College LondonLondon, UK
| | - B Afzali
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
- National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College LondonLondon, UK
- Guy's and St Thomas' NHS Foundation TrustLondon, UK
| | - DJ Goldsmith
- Medical Research Council Centre for Transplantation, King's College LondonLondon, UK
- National Institute for Health Research Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College LondonLondon, UK
- Guy's and St Thomas' NHS Foundation TrustLondon, UK
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153
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Fusaro M, Giannini S, Miozzo D, Noale M, Tripepi G, Plebani M, Zaninotto M, Piccoli A, Vilei MT, Cristofaro R, Gallieni M, Hamamoto K, Inaba M, Okuno S, Imanishi Y, Ishimura E, Yamakawa T, Shoji S, Rothe HM, Eller P, Mayer G, Ketteler M, Kramar R, Shaheen F, Al Rukhaimi M, Alsahow A, Al-Ali F, Al Salmi I, Al Ghareeb S, Wang M, Bieber B, Robinson BM, Pisoni RL, Waniewski J, Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W, De Broe ME, Wilson RJ, Copley JB, Hiramtasu R, Ubara Y, Hoshino J, Takaichi K, Ghalli FG, Ghalli FG, Ibakkanavar R, Chess J, Roberts G, Riley S, Oliveira ASA, Carvalho CJB, Oliveira CBL, Pessoa CTBC, Leao RAS, Gueiros JEB, Gueiros APS, Okano K, Tsuruta Y, Hibi A, Tsukada M, Miwa N, Kimata N, Tsuchiya K, Akiba T, Nitta K, Mizobuchi M, Ogata H, Hosaka N, Sanada D, Arai N, Koiwa F, Kinugasa E, Shibata T, Akizawa T, Delanaye P, Krzesinski JM, Warling X, Moonen M, Smelten N, Medart L, Pottel H, Cavalier E, Delanaye P, Souberbielle JC, Gadisseur R, Dubois BE, Krzesinski JM, Cavalier E, Matias P, Jorge C, Mendes M, Azevedo A, Navarro D, Ferreira C, Amaral T, Aires I, Gil C, Ferreira A, Kikuchi H, Shimada H, Karasawa R, Suzuki M, An WS, Lee SM, Oh YJ, Son YK, De Paola L, Lombardi G, Panzino MT, Lombardi L, Reichel H, Hahn KM, Kohnle M, Guggenberger C, Delanna F, Sasaki N, Tsunoda M, Ikee R, Hashimoto N, Sola L, Leyun MN, Diaz JC, Sehabiague C, Gonzalez S, Alallon W, Bourbeau K, Lajoie C, Macway F, Fujii T, Suzuki S, Shinozaki M, Tanaka H, Klingele M, Seiler S, Poppleton A, Lepper P, Fliser D, Seidel R, Lun L, Liu D, Li X, Wei X, Miao J, Gao Z, Hu R, De Paola L, Lombardi G, Panzino MT, Lombardi L, Gros B, Galan A, Gonzalez-Parra E, Herrero JA, Echave M, Vegter S, Tolley K, Oyaguez I, Gutzwiller FS, Braunhofer PG, Szucs TD, Schwenkglenks M, Yilmaz VT, Ozdem S, Donmez L, Kocak H, Dinckan A, Cetinkaya R, Suleymanlar G, Ersoy FF. DIALYSIS BONE DISEASE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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154
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Lombardi G, Grasso D, Berjano P, Banfi G, Lamartina C. Is Minimally Invasive Spine Surgery Also Minimally Pro-Inflammatory? Muscular Markers, Inflammatory Parameters and Cytokines to Quantify the Operative Invasiveness Assessment in Spine Fusion. EUR J INFLAMM 2014. [DOI: 10.1177/1721727x1401200203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Over the last decades, minimally invasive surgery (MIS) techniques entered in the surgical routine due to their major advantage in reducing the unnecessary exposure of tissue and, thus, the trauma. Even in the context of orthopedics and spine surgery these practices have been widely developed and applied. Besides the clinical outcome of the patients, few studies have quantitatively assessed the traumatic and inflammatory effects of a specific surgical technique. Indeed, currently, a universally accepted biological outcome measure, such as a panel of biochemical markers, to define the success of MIS approach is still lacking. We reviewed the literature to collect the published data regarding the quantitative analysis of trauma induced by either conventional or minimally invasive surgery with the aim of highlighting evidence useful to guide future studies. Previous publications show some evidence in support of the hypothesis that MIS approaches are less traumatic, and possibly less pro-inflammatory, than conventional ones. Creatin kinase (as a marker of muscular damage) and C-reactive protein (as a marker of systemic inflammation) seem to reproducibly follow different trends in minimally invasive surgery compared to conventional procedures. Moreover, cytokines, such as interleukin (IL)-6 and IL-10 are also promising markers in this context.
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Affiliation(s)
- G. Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - D. Grasso
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - P. Berjano
- O.U. Orthopaedics and Traumatology, Spine Surgery IV, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - G. Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - C. Lamartina
- O.U. Orthopaedics and Traumatology, Spine Surgery II, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
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155
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Palatucci V, Lombardi G, Lombardi L, Giglio F, Giordano F, Lombardi D. Spontaneous muscle haematomas: management of 10 cases. Transl Med UniSa 2014; 10:13-7. [PMID: 25147761 PMCID: PMC4140424] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This is a retrospective study about the treatment of spontaneous muscle haematomas (SMH) that are an uncommon disease that occurs especially in elderly patients with acquired coagulopathy. We report the management of 10 cases admitted to our Emergency Surgical Unit (ESU) between March 2011 and October 2012. For this analysis we have considered some parameters such as age, drug history, current symptoms, location of the haematoma, cause, and imaging examination. Our attention focused on: clinical presentation, differential diagnosis, diagnostic imaging techniques and treatments.
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Affiliation(s)
- V Palatucci
- Department of General and Emergency Surgery, University of Salerno, Italy,Corresponding Author: Valeria Palatucci ()
| | - G Lombardi
- Operating Unit of Emergency Surgery, “S. Maria della Pietà” Hospital of Nola, Napoli, Italy
| | - L Lombardi
- Division of Anesthesiology and Intensive Care Unit, “S. Maria delle Grazie” Hospital of Pozzuoli, Napoli, Italy
| | - F Giglio
- Department of General and Emergency Surgery, University of Salerno, Italy
| | - F Giordano
- Department of Radiology, Federico II University of Naples, Italy
| | - D Lombardi
- Department of General and Emergency Surgery, University of Salerno, Italy
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156
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Grasso D, Lanteri P, Di Bernardo C, Mauri C, Porcelli S, Colombini A, Zani V, Bonomi FG, Melegati G, Banfi G, Lombardi G. Salivary steroid hormone response to whole-body cryotherapy in elite rugby players. J BIOL REG HOMEOS AG 2014; 28:291-300. [PMID: 25001661] [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: 06/03/2023]
Abstract
Saliva represents a low stress, not-invasively collected matrix that allows steroid hormone monitoring in athletes by reflecting type, intensity and duration of exercise. Whole body cryotherapy (WBC) consists of short whole-body exposures to extremely cold air (-110° to -140°C) which, despite being initially used to treat inflammatory diseases, is currently acquiring increasing popularity in sports medicine. Cryostimulation practice is now widely accepted as an effective treatment to accelerate muscle recovery in rugby players. The aim of this work was to study the changes of steroid hormones in saliva of rugby players after both 2 and 14 consecutive WBC sessions, in order to investigate the effects of the treatment on their salivary steroid hormonal profile. Twenty-five professional rugby players, belonging to the Italian National Team, underwent a 7-day cryotherapy protocol consisting of 2 daily sessions. Saliva samples were taken in the morning prior to the start of the WBC, in the evening after the end of the second WBC, and in the morning of the day after the last WBC session. The samples were analyzed for cortisol, DHEA, testosterone and estradiol using competitive enzyme-linked immunosorbent assays. Cortisol and DHEA showed a reduction already after the 2 WBC sessions of the first day; after 14 consecutive WBC sessions cortisol, DHEA, and estradiol levels decreased, while testosterone increased as did the testosterone to cortisol ratio. These results were confirmed by the fact that the majority of subjects showed variations exceeding the critical difference (CD). In conclusion, we found that WBC acutely affects the salivary steroid hormone profile, and the results are evident already after only one twice-daily session. Most significantly, after one-week of consecutive twice-daily WBC sessions, all the hormones were modified. This is the first experimental report that links changes in the hormonal asset to WBC.
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Affiliation(s)
- D Grasso
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - P Lanteri
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - C Di Bernardo
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - C Mauri
- Department of Multifunctional Rehabilitation, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - S Porcelli
- Institute of Bioimaging and Molecular Physiology, National Research Council, Segrate, Italy
| | - A Colombini
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - V Zani
- Centre of Systemic Cryotherapy, Poliambulatorio Bongi, Orzinuovi, Italy
| | - F G Bonomi
- Centre of Systemic Cryotherapy, Poliambulatorio Bongi, Orzinuovi, Italy
| | - G Melegati
- Department of Multifunctional Rehabilitation, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - G Banfi
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - G Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
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157
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Cecchin D, Schiorlin I, Della Puppa A, Lombardi G, Zucchetta P, Bodanza V, Gardiman MP, Rolma G, Frigo AC, Bui F. Assessing response using 99mTc-MIBI early after interstitial chemotherapy with carmustine-loaded polymers in glioblastoma multiforme: preliminary results. Biomed Res Int 2014; 2014:684383. [PMID: 24800247 PMCID: PMC3985177 DOI: 10.1155/2014/684383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 03/04/2014] [Indexed: 11/17/2022]
Abstract
Introduction. Early signs of response after applying wafers of carmustine-loaded polymers (gliadel) are difficult to assess with imaging because of time-related imaging changes. (99m)Tc-sestamibi (MIBI) brain single-photon emission tomography (SPET) has reportedly been used to reveal areas of cellularity distinguishing recurrent neoplasm from radionecrosis. Our aim was to explore the role of MIBI SPET in assessing response soon after gliadel application in glioblastoma multiforme (GBM). Methods. We retrospectively reviewed the charts on 28 consecutive patients with a radiological diagnosis of GBM who underwent MIBI SPET/CT before surgery (with intracavitary gliadel placement in 17 patients), soon after surgery, and at 4 months. The area of uptake was selected using a volume of interest that was then mirrored contralaterally to obtain a semiquantitative ratio. Results. After adjusting for ratio at the baseline, the effect of treatment (gliadel versus non-gliadel) was not statistically significant. Soon after surgery, however, 100% of patients treated with gliadel had a decreased ratio, as opposed to 62.5% of patients in the non-gliadel group (P = 0.0316). The difference between ratios of patients with radical versus partial resection reached statistical significance by a small margin (P = 0.0528). Conclusions. These data seem to suggest that the MIBI ratio could be a valuable tool for monitoring the effect of gliadel early after surgery.
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Affiliation(s)
- D. Cecchin
- Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
| | - I. Schiorlin
- Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
| | - A. Della Puppa
- Department of Neurosurgery, University Hospital, 35128 Padova, Italy
| | - G. Lombardi
- Department of Medical Oncology 1, IOV, IRCCS, Venetian Oncology Institute, 35128 Padova, Italy
| | - P. Zucchetta
- Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
| | - V. Bodanza
- Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
| | - M. P. Gardiman
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
| | - G. Rolma
- Neuroradiology Unit, University Hospital, 35128 Padova, Italy
| | - A. C. Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital, 35128 Padova, Italy
| | - F. Bui
- Nuclear Medicine Service, Department of Medicine (DIMED), University Hospital, 35128 Padova, Italy
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158
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Montagna MT, Lovero G, Borghi E, Amato G, Andreoni S, Campion L, Lo Cascio G, Lombardi G, Luzzaro F, Manso E, Mussap M, Pecile P, Perin S, Tangorra E, Tronci M, Iatta R, Morace G. Candidemia in intensive care unit: a nationwide prospective observational survey (GISIA-3 study) and review of the European literature from 2000 through 2013. Eur Rev Med Pharmacol Sci 2014; 18:661-674. [PMID: 24668706] [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: 06/03/2023]
Abstract
BACKGROUND Candida bloodstream infections (BSI) represent an important problem in Intensive Care Units (ICUs). The epidemiology of candidemia is changing with an increase in the proportion of Candida (C.) non-albicans. OBJECTIVES An Italian 2-year observational survey on ICU was conducted to evaluate the species distribution and possible differences between BSI caused by C. albicans and C. non-albicans. For comparative purposes, we performed a European literature-based review to evaluate distribution and frequency of Candida spp. causing ICU candidemia, during the period 2000-2013. MATERIALS AND METHODS This laboratory-based survey involved 15 microbiology centers (GISIA-3 study). All candidemia episodes in adult patients were considered. Data were prospectively collected from 2007 to 2008. PubMed was searched for peer-reviewed articles. RESULTS In total, 462 candidemia episodes were collected. C. albicans accounted for 49.4% of the isolates, followed by C. parapsilosis (26.2%) and C. glabrata (10.4%). Mortality was higher in patients with C. non-albicans than C. albicans (47.3% vs. 32.4 %, p > 0.05). Among risk factors, parenteral nutrition was more common (p = 0.02) in non-albicans candidemia, while surgery was more frequent (p = 0.02) in C. albicans candidemia. Twenty-four relevant articles were identified. C. albicans was the predominant species in almost all studies (range 37.9% -76.3%). C. glabrata was commonly isolated in the German-speaking countries, France, UK and North Europe; C. parapsilosis in Turkey, Greece and Spain. CONCLUSIONS Although C. non-albicans BSI is increasing, our study shows that C. albicans is still the predominant species in ICU candidemia. There are differences in the epidemiology of Candida BSI among European countries, with a prevalence of C. glabrata and C. parapsilosis in Northern and Southern countries, respectively.
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Affiliation(s)
- M T Montagna
- Department of Biomedical Science and Human Oncology, Hygiene Section, University of Bari Aldo Moro, Bari, Italy.
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159
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Putnam AL, Safinia N, Medvec A, Laszkowska M, Wray M, Mintz MA, Trotta E, Szot GL, Liu W, Lares A, Lee K, Laing A, Lechler RI, Riley JL, Bluestone JA, Lombardi G, Tang Q. Clinical grade manufacturing of human alloantigen-reactive regulatory T cells for use in transplantation. Am J Transplant 2013; 13:3010-20. [PMID: 24102808 PMCID: PMC4161737 DOI: 10.1111/ajt.12433] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/15/2013] [Accepted: 07/15/2013] [Indexed: 01/25/2023]
Abstract
Regulatory T cell (Treg) therapy has the potential to induce transplantation tolerance so that immunosuppression and associated morbidity can be minimized. Alloantigen-reactive Tregs (arTregs) are more effective at preventing graft rejection than polyclonally expanded Tregs (PolyTregs) in murine models. We have developed a manufacturing process to expand human arTregs in short-term cultures using good manufacturing practice-compliant reagents. This process uses CD40L-activated allogeneic B cells to selectively expand arTregs followed by polyclonal restimulation to increase yield. Tregs expanded 100- to 1600-fold were highly alloantigen reactive and expressed the phenotype of stable Tregs. The alloantigen-expanded Tregs had a diverse TCR repertoire. They were more potent than PolyTregs in vitro and more effective at controlling allograft injuries in vivo in a humanized mouse model.
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Affiliation(s)
- A. L. Putnam
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA
| | - N. Safinia
- MRC Centre for Transplantation, King’s College London, London, UK
| | - A. Medvec
- Department of Microbiology, University of Pennsylvania, Philadelphia, PA
| | - M. Laszkowska
- Department of Surgery, University of California, San Francisco, San Francisco CA
| | - M. Wray
- Department of Surgery, University of California, San Francisco, San Francisco CA
| | - M. A. Mintz
- Department of Surgery, University of California, San Francisco, San Francisco CA
| | - E. Trotta
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA,Department of Surgery, University of California, San Francisco, San Francisco CA
| | - G. L. Szot
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA,Department of Surgery, University of California, San Francisco, San Francisco CA
| | - W. Liu
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA
| | - A. Lares
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA
| | - K. Lee
- Department of Surgery, University of California, San Francisco, San Francisco CA
| | - A. Laing
- MRC Centre for Transplantation, King’s College London, London, UK
| | - R. I. Lechler
- MRC Centre for Transplantation, King’s College London, London, UK
| | - J. L. Riley
- Department of Microbiology, University of Pennsylvania, Philadelphia, PA
| | - J. A. Bluestone
- UCSF Diabetes Center, University of California, San Francisco, San Francisco CA
| | - G. Lombardi
- MRC Centre for Transplantation, King’s College London, London, UK
| | - Q. Tang
- Department of Surgery, University of California, San Francisco, San Francisco CA,Corresponding author: Qizhi Tang,
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160
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Grasso D, Corsetti R, Lanteri P, Di Bernardo C, Colombini A, Graziani R, Banfi G, Lombardi G. Bone-muscle unit activity, salivary steroid hormones profile, and physical effort over a 3-week stage race. Scand J Med Sci Sports 2013; 25:70-80. [DOI: 10.1111/sms.12147] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2013] [Indexed: 11/26/2022]
Affiliation(s)
- D. Grasso
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
| | - R. Corsetti
- Medical Board Liquigas-Cannondale Pro-tour Cycling Team; Sesto al Reghena Italy
| | - P. Lanteri
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
| | - C. Di Bernardo
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
| | - A. Colombini
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
| | - R. Graziani
- Centro Diagnostico Alto-Lombardo - CEDAL; Gallarate Italy
| | - G. Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - G. Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology; I.R.C.C.S. Istituto Ortopedico Galeazzi; Milano Italy
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161
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Lombardi G, Morello G. CAUSES RARES D'ELARGISSEMENT DU CANAL RACHIDIEN. Acta Radiol 2013. [DOI: 10.1177/028418515805000130] [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: 11/15/2022]
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162
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Montagna MT, Lovero G, Coretti C, Martinelli D, Delia M, De Giglio O, Caira M, Puntillo F, D'Antonio D, Venditti M, Sambri V, Di Bernardo F, Barbui A, Lo Cascio G, Concia E, Mikulska M, Viscoli C, Maximova N, Candoni A, Oliveri S, Lombardi G, Pitzurra L, Sanguinetti M, Masciari R, Santantonio T, Andreoni S, Barchiesi F, Pecile P, Farina C, Viale P, Specchia G, Caggiano G, Pagano L. SIMIFF study: Italian fungal registry of mold infections in hematological and non-hematological patients. Infection 2013; 42:141-51. [PMID: 24150958 PMCID: PMC3906525 DOI: 10.1007/s15010-013-0539-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/24/2013] [Indexed: 11/29/2022]
Abstract
Purpose We compared the risk factors, the diagnostic tools and the outcome of filamentous fungal infections (FFIs) in hematological patients (HAEs) and non-hematological patients (non-HAEs). Methods Prospective surveillance (2009–2011) of proven and probable FFIs was implemented in 23 Italian hospitals. Results Out of 232 FFIs, 113 occurred in HAEs and 119 in non-HAEs. The most frequent infection was invasive aspergillosis (76.1 % for HAEs, 56.3 % for non-HAEs), and the localization was principally pulmonary (83.2 % for HAEs, 74.8 % for non-HAEs). Neutropenia was a risk factor for 89.4 % HAEs; the main underlying condition was corticosteroid treatment (52.9 %) for non-HAEs. The distribution of proven and probable FFIs was different in the two groups: proven FFIs occurred more frequently in non-HAEs, whereas probable FFIs were correlated with the HAEs. The sensitivity of the galactomannan assay was higher for HAEs than for non-HAEs (95.3 vs. 48.1 %). The overall mortality rate was 44.2 % among the HAEs and 35.3 % among the non-HAEs. The etiology influenced the patient outcomes: mucormycosis was associated with a high mortality rate (57.1 % for HAEs, 77.8 % for non-HAEs). Conclusions The epidemiological and clinical data for FFIs were not identical in the HAEs and non-HAEs. The differences should be considered to improve the management of FFIs according to the patients’ setting.
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Affiliation(s)
- M T Montagna
- Hygiene Section, Department of Biomedical Science and Human Oncology, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy,
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Lombardi G. Orbitography with Water-Soluble Contrast Media. Acta Radiol 2013. [DOI: 10.1177/028418515704700601] [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: 11/17/2022]
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164
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Ferrari C, Nacmias B, Bagnoli S, Piaceri I, Lombardi G, Pradella S, Tedde A, Sorbi S. Imaging and Cognitive Reserve Studies Predict Dementia in Presymptomatic Alzheimer's Disease Subjects. NEURODEGENER DIS 2013; 13:157-9. [DOI: 10.1159/000353690] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 05/29/2013] [Indexed: 11/19/2022] Open
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165
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Martinelli N, Pavoni E, Filogari D, Ferrari N, Chiari M, Canelli E, Lombardi G. Hepatitis E virus in wild boar in the central northern part of Italy. Transbound Emerg Dis 2013; 62:217-22. [PMID: 23865469 DOI: 10.1111/tbed.12118] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Indexed: 12/31/2022]
Abstract
Hepatitis E virus (HEV) is responsible for sporadic acute hepatitis in developed countries, where the infection is acquired probably through ingestion of contaminated food, in addition to travel-related cases. In this study, the circulation of HEV in wild boar from nine Italian provinces was evaluated. An overall seroprevalence of 10.2% was found, although there were differences among the provinces, while no samples were positive for HEV RNA detection. This study indicates an active circulation of HEV in the Italian wild boar populations and suggests to consider the zoonotic risk in handling and eating meat from this animal.
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Affiliation(s)
- N Martinelli
- IZSLER - Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "B. Ubertini", Brescia, Italy
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166
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Safinia N, Leech J, Hernandez-Fuentes M, Lechler R, Lombardi G. Promoting transplantation tolerance; adoptive regulatory T cell therapy. Clin Exp Immunol 2013; 172:158-68. [PMID: 23574313 DOI: 10.1111/cei.12052] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 01/09/2023] Open
Abstract
Transplantation is a successful treatment for end-stage organ failure. Despite improvements in short-term outcome, long-term survival remains suboptimal because of the morbidity and mortality associated with long-term use of immunosuppression. There is, therefore, a pressing need to devise protocols that induce tolerance in order to minimize or completely withdraw immunosuppression in transplant recipients. In this review we will discuss how regulatory T cells (T(regs)) came to be recognized as an attractive way to promote transplantation tolerance. We will summarize the preclinical data, supporting the importance of these cells in the induction and maintenance of immune tolerance and that provide the rationale for the isolation and expansion of these cells for cellular therapy. We will also describe the data from the first clinical trials, using T(regs) to inhibit graft-versus-host disease (GVHD) after haematopoietic stem cell transplantation and will address both the challenges and opportunities in human T(reg) cell therapy.
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Affiliation(s)
- N Safinia
- MRC Centre for Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK
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167
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Leech JM, Sharif-Paghaleh E, Maher J, Livieratos L, Lechler RI, Mullen GE, Lombardi G, Smyth LA. Whole-body imaging of adoptively transferred T cells using magnetic resonance imaging, single photon emission computed tomography and positron emission tomography techniques, with a focus on regulatory T cells. Clin Exp Immunol 2013; 172:169-77. [PMID: 23574314 DOI: 10.1111/cei.12087] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2013] [Indexed: 01/03/2023] Open
Abstract
Cell-based therapies using natural or genetically modified regulatory T cells (T(regs)) have shown significant promise as immune-based therapies. One of the main difficulties facing the further advancement of these therapies is that the fate and localization of adoptively transferred T(regs) is largely unknown. The ability to dissect the migratory pathway of these cells in a non-invasive manner is of vital importance for the further development of in-vivo cell-based immunotherapies, as this technology allows the fate of the therapeutically administered cell to be imaged in real time. In this review we will provide an overview of the current clinical imaging techniques used to track T cells and T(regs) in vivo, including magnetic resonance imaging (MRI) and positron emission tomography (PET)/single photon emission computed tomography (SPECT). In addition, we will discuss how the finding of these studies can be used, in the context of transplantation, to define the most appropriate T(reg) subset required for cellular therapy.
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Affiliation(s)
- J M Leech
- Medical Research Council, Centre for Transplantation, King's College London, King's Health Partners, London, UK
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168
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Finazzi-Agrò E, Topazio L, Perugia C, Lombardi G, Finita Celso M, De Nunzio C, Del Popolo G. The use of oxybutynin in patients treated by means of botulinum neurotoxin A for neurogenic detrusor overactivity: an observational study. Spinal Cord 2013; 51:637-41. [PMID: 23689390 DOI: 10.1038/sc.2013.42] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 03/13/2013] [Accepted: 03/31/2013] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is an observational prospective noncontrolled study. We enrolled 105 patients affected by neurogenic detrusor overactivity (NDO) who underwent botulinum neurotoxin A (BONT-A) intradetrusor injection and were followed-up for 270 days. OBJECTIVES To investigate the use of oxybutynin after BONT-A administration in NDO patients. SETTING Careggi University Hospital in Florence and Tor Vergata University Hospital in Rome. METHODS Prospective data from two Italian centers were collected in 1 year. Patients showing limited efficacy but good tolerability and adherence to oxybutynin 5 mg three times a day (t.i.d.). were enrolled in the study. Patients received BONT-A intradetrusor injection (onabotulinumtoxinA, 300 U) with a trigone-sparing technique, and the use of oxybutynin was registered at every visit. RESULTS 105 patients were included. At visit 1, only 30 patients (28.6%) used oxybutynin t.i.d., whereas 47 (45,2%) used a lower dosage and 28 (26.7%) stopped the therapy. At visit 2, 77.3% of patients who had reduced oxybutynin intake, maintained the dosage decided at visit 1. At visit 3, 51.9% returned to oxybutynin t.i.d.; 44.8% were on a reduced dosage and only 3 (2.9%) were not taking the drug. At visit 4, only 37.5% of patients were taking less than oxybutynin t.i.d. CONCLUSION This study provides some important insights on the use of oral antimuscarinics in patients treated by means of BONT-A intradetrusor administration for NDO; in particular, it suggests that, after an initial reduction in the use of oxybutynin, patients tend to increase the dosage of this drug during the follow-up after the BONT-A treatment.
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Affiliation(s)
- E Finazzi-Agrò
- Unit of Functional Urology, Policlinico Tor Vergata, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
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Lombardi G, Corsetti R, Lanteri P, Grasso D, Vianello E, Marazzi MG, Graziani R, Colombini A, Galliera E, Corsi Romanelli MM, Banfi G. Reciprocal regulation of calcium-/phosphate-regulating hormones in cyclists during the Giro d'Italia 3-week stage race. Scand J Med Sci Sports 2013; 24:779-87. [PMID: 23647316 DOI: 10.1111/sms.12080] [Citation(s) in RCA: 22] [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] [Subscribe] [Scholar Register] [Accepted: 10/20/2012] [Indexed: 12/25/2022]
Abstract
Calcium and phosphate are essential for cell functions, and their serum concentrations result from the balance between intestinal absorption, bony storage, and urinary excretion. Fibroblast growth factor 23 (FGF23), expressed by osteocytes and osteoblasts, acts in the kidney, leading to hypophosphatemia and low 1,25-dihydroxycholecalciferol synthesis, but suppresses parathyroid function. The aim of this study was to explore the effects of a high-energy demanding cycling race on this bone-kidney-parathyroid axis. We studied nine cyclists during the 2011 Giro d'Italia stage race. Pre-analytical and analytical phases followed academic and anti-doping recommendations. Serum parathyroid hormone (PTH), 25(OH)D, total calcium, inorganic phosphorus, and plasma FGF23 were measured on days -1, 12, and 22 and corrected for changes in plasma volume. Dietary calcium and phosphorus, anthropometric parameters (height, weight, and body mass index) and indexes of metabolic effort (net energy expenditure, power output) were recorded. Dietary calcium and phosphorus intakes were kept at the same levels throughout the race. Twenty-five (OH)D, PTH, and calcium concentrations remained stable. FGF23 increased 50% with a positive correlation with the indexes of metabolic effort and, consequently, phosphorous decreased, although only in the first half. The strong metabolic effort acts on the bone-kidney-parathyroid system, and the rise in FGF23 plasma concentration might be aimed at maintaining calcium and phosphorus homeostasis.
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Affiliation(s)
- G Lombardi
- Experimental Biochemistry and Molecular Biology Laboratory, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy
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Abstract
BACKGROUND AND PURPOSE In osteosarcoma (OS) patients, only a limited number of drugs are active and the regimens currently in use include a combination of at least two of these drugs: doxorubicin, cisplatin, methotrexate and ifosfamide. Today, 30-40% of patients still die of OS highlighting the urgent need for new treatments. Invariant NKT (iNKT) cells are a lymphocyte lineage with features of both T and NK cells, playing important roles in tumour suppression. Our aim was to test whether the cytoxicity induced by cisplatin, doxorubicin and methotrexate against OS cells can be enhanced by iNKT cell treatment. EXPERIMENTAL APPROACH iNKT cells were purified from human peripheral blood mononuclear cells by cell sorting (Vα24Vβ11(+) cells) and used as effector cells against OS cells (U2-OS, HOS, MG-63). Cell death (calcein-AM method), perforin/granzyme B and Fas/FasL expressions were determined by flow cytometry. CD1d expression was analysed at both the gene and protein level. KEY RESULTS iNKT cells were cytotoxic against OS cells through a CD1d-dependent mechanism. This activity was specific for tumour cells, because human CD1d(+) mesenchymal stem cells and CD1d(-) osteoblasts were not affected. iNKT cell treatment enhanced drug-induced OS cell death in a concentration-dependent manner and this effect was reduced in CD1d-silenced OS cells. CONCLUSION AND IMPLICATIONS iNKT cells kill malignant, but not non-malignant, cells. iNKT cell treatment enhances the cytotoxicity of anti-neoplastic drugs against OS cells in a CD1d-dependent manner. The present data encourage further studies on the use of iNKT cells in OS therapy.
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Affiliation(s)
- S Fallarini
- Department of Pharmaceutical Sciences, University of 'Piemonte Orientale Amedeo Avogadro', Novara, Italy
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171
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Abstract
Enniatins (ENs) are fungal secondary metabolites produced by genus Fusarium. The ENs exert antimicrobial and insecticidal effect, and has also been demonstrated cytotoxic effects on several mammalian cell lines. On the other hands, it has been proved that natural polyphenols have antioxidant effect. In this study, cell effects at low levels of exposure of four ENs (A, A(1), B and B(1)) and five polyphenols (quercetin, quercetin-3-β-D-glucoside, rutin, myricetin and t-pterostilbene) present in wine; and the cytoprotective effect of these polyphenols exposed simultaneously with ENs in Chinese Hamster Ovary (CHO-K1) cells, were studied. Cell effects were determined by the MTT test after 24 h of exposure. All ENs showed cytotoxic effect. The IC(50) obtained ranged from 4.5 ± 1.2 to 11.0 ± 2.7 µM. The concentration of polyphenols tested ranged from 5 to 50 µM. Polyphenols did not show cytotoxicity and the cytoprotective effect of polyphenols varies depending on the EN tested. The cytoprotective effect of polyphenols in CHO-K1 cells exposed to ENs was as follow: quercetin, from 24 to 84%; quercetin-3-β-D-glucoside, from 12 to 76%; rutin, from 17 to 83%; myricetin, from 16 to 92% and pterostilbene from 25 to 100%. All polyphenols protected CHO-K1 cells against EN A(1) exposure.
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Affiliation(s)
- G Lombardi
- Dipartmento di Scienze Economico-Estimative e degli Alimenti, Sezione di Chimica Bromatologica, Biochimica, Fisiologia e Nutrizione, Facoltà di Farmacia, Università degli Studi di Perugia, Perugia, Italy
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172
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Ciociano N, Romano F, Lombardi G, Alfieri M, Elberti M, Grisi L. OHP-010 Analysis of Therapeutic Plans For Patients with Multiple Sclerosis at Salerno University Hospital: First Results. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.384] [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: 11/03/2022] Open
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173
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Mitchell PJ, Afzali B, Fazekasova H, Chen D, Ali N, Powell N, Lord GM, Lechler RI, Lombardi G. Helicobacter pylori induces in-vivo expansion of human regulatory T cells through stimulating interleukin-1β production by dendritic cells. Clin Exp Immunol 2013; 170:300-9. [PMID: 23121671 DOI: 10.1111/j.1365-2249.2012.04659.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Helicobacter pylori is one of the most common infections in the world. Despite inciting inflammation, immunological clearance of the pathogen is often incomplete. CD4(+) CD25(hi) forkhead box protein 3 (FoxP3(+)) regulatory T cells (T(regs)) are potent suppressors of different types of immune responses and have been implicated in limiting inflammatory responses to H. pylori. Investigating the influence of H. pylori on T(reg) function and proliferation, we found that H. pylori-stimulated dendritic cells (DCs) induced proliferation in T(regs) and impaired their suppressive capability. This effect was mediated by interleukin (IL)-1β produced by H. pylori-stimulated DCs. These data correlated with in-vivo observations in which H. pylori(+) gastric mucosa contained more T(regs) in active cell division than uninfected stomachs. Inciting local proliferation of T(regs) and inhibiting their suppressive function may represent a mechanism for the chronic gastritis and carcinogenesis attributable to H. pylori.
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Affiliation(s)
- P J Mitchell
- MRC Centre for Transplantation, National Institute for Health Research (NIHR), Comprehensive Biomedical Research Centre at Guy's and St Thomas', NHS Foundation Trust, King's College London, London, UK
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174
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Lombardi G, Di Somma C, Grasso LFS, Savanelli MC, Colao A, Pivonello R. The cardiovascular system in growth hormone excess and growth hormone deficiency. J Endocrinol Invest 2012; 35:1021-9. [PMID: 23143695 DOI: 10.3275/8717] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [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: 11/17/2022]
Abstract
The clinical conditions associated with GH excess and GH deficiency (GHD) are known to be associated with an increased risk for the cardiovascular morbidity and mortality, suggesting that either an excess or a deficiency in GH and/or IGF-I is deleterious for cardiovascular system. In patients with acromegaly, chronic GH and IGF-I excess commonly causes a specific cardiomyopathy characterized by a concentric cardiac hypertrophy associated with diastolic dysfunction and, in later stages, with systolic dysfunction ending in heart failure if GH/IGF-I excess is not controlled. Abnormalities of cardiac rhythm and anomalies of cardiac valves can also occur. Moreover, the increased prevalence of cardiovascular risk factors, such as hypertension, diabetes mellitus, and insulin resistance, as well as dyslipidemia, confer an increased risk for vascular atherosclerosis. Successful control of the disease is accompanied by a decrease of the cardiac mass and improvement of cardiac function and an improvement in cardiovascular risk factors. In patients with hypopituitarism, GHD has been considered the under- lying factor of the increased mortality when appropriate standard replacement of the pituitary hormones deficiencies is given. Either childhood-onset or adulthood-onset GHD are characterized by a cluster of abnormalities associated with an increased cardiovascular risk, including altered body composition, unfavorable lipid profile, insulin resistance, endothelial dysfunction and vascular atherosclerosis, a decrease in cardiac mass together with an impairment of systolic function mainly after exercise. Treatment with recombinant GH in patients with GHD is followed by an improvement of the cardiovascular risk factors and an increase in cardiac mass together with an improvement in cardiac performance. In conclusion, acromegaly and GHD are associated with an increased risk for cardiovascular morbidity and mortality, but the control of GH/IGF-I secretion reverses cardiovascular abnormalities and restores the normal life expectancy.
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Affiliation(s)
- G Lombardi
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
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175
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Faggiano A, Ramundo V, Assanti AP, Fonderico F, Macchia PE, Misso C, Marciello F, Marotta V, Del Prete M, Papini E, Lombardi G, Colao A, Spiezia S. Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study. J Clin Endocrinol Metab 2012; 97:4439-45. [PMID: 23019349 DOI: 10.1210/jc.2012-2251] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Percutaneous radiofrequency thermal ablation (RTA) was reported as an effective tool for the management of thyroid nodules (TNs). The aim of this study was to investigate the effects of RTA and to establish whether they were treatment-related by comparison with a matched, untreated control group. PATIENTS AND METHODS The study population included 40 patients with compressive TNs: 22 had nontoxic TNs, and 18 had toxic TNs and were treated with methimazole. In all patients, a fine-needle aspiration cytology was performed to exclude a thyroid malignancy. STUDY DESIGN Twenty patients were treated with RTA (group A), and 20 others did not receive any treatment (group B). At baseline, age, gender, and TN features did not differ significantly between groups. All patients were clinically, biochemically, and morphologically evaluated at baseline and after 1, 3, 6, and 12 months. RESULTS TN volume significantly decreased in group A (1.8 ± 0.3 ml at 12 months vs. 13.3 ± 1.8 ml at baseline; P < 0.0001) and remained stable in group B [11.7 ± 1.5 ml at 12 months vs. 11.2 ± 1.5 ml at baseline; P = not significant (NS)]. At 3-, 6-, and 12-month evaluations, TN volume was significantly lower in group A than in group B (P < 0.005). At the end of the follow-up, pressure symptoms were improved in all patients in group A but persisted unchanged in group B. In group A, hyperthyroidism completely recovered in 40% and improved in 40% of patients with toxic TNs, whereas it persisted in all patients with toxic TNs in group B. RTA was safe and well tolerated in all patients. CONCLUSIONS RTA induced a marked TN volume shrinkage resulting in parallel improvement of pressure symptoms. In most patients with toxic TNs, hyperthyroidism significantly improved as well. RTA may represent a valid therapeutic approach in patients with TNs not receiving conventional treatments.
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Affiliation(s)
- A Faggiano
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Sharif-Paghaleh E, Leech J, Lechler R, Smyth L, Mullen G, Lombardi G. Use of SPECT Reporter Gene for Tracking of Regulatory T Cells in Adoptive Transfer Therapy for Skin Transplantation: a Pre-Clinical Model. Transplantation 2012. [DOI: 10.1097/00007890-201211271-00701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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177
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Bonaccini Calia D, Guidolin I, Friedenauer A, Hager M, Karpov V, Pfrommer T, Holzlöhner R, Lewis S, Hackenberg W, Lombardi G, Centrone M, Pedichini F. The ESO transportable LGS Unit for measurements of the LGS photon return and other experiments. ACTA ACUST UNITED AC 2012. [DOI: 10.1117/12.926898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Arosio M, Reimondo G, Malchiodi E, Berchialla P, Borraccino A, De Marinis L, Pivonello R, Grottoli S, Losa M, Cannavò S, Minuto F, Montini M, Bondanelli M, De Menis E, Martini C, Angeletti G, Velardo A, Peri A, Faustini-Fustini M, Tita P, Pigliaru F, Borretta G, Scaroni C, Bazzoni N, Bianchi A, Appetecchia M, Cavagnini F, Lombardi G, Ghigo E, Beck-Peccoz P, Colao A, Terzolo M. Predictors of morbidity and mortality in acromegaly: an Italian survey. Eur J Endocrinol 2012; 167:189-98. [PMID: 22596288 DOI: 10.1530/eje-12-0084] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To describe demographic and hormonal characteristics, comorbidities (diabetes mellitus and hypertension), therapeutic procedures and their effectiveness, as well as predictors of morbidity and mortality in a nationwide survey of Italian acromegalic patients. DESIGN Retrospective multicenter epidemiological study endorsed by the Italian Society of Endocrinology and performed in 24 tertiary referral Italian centers. The mean follow-up time was 120 months. RESULTS A total of 1512 patients, 41% male, mean age: 45±13 years, mean GH: 31±37 μg/l, IGF1: 744±318 ng/ml, were included. Diabetes mellitus was reported in 16% of cases and hypertension in 33%. Older age and higher IGF1 levels at diagnosis were significant predictors of diabetes and hypertension. At the last follow-up, 65% of patients had a controlled disease, of whom 55% were off medical therapy. Observed deaths were 61, with a standardized mortality ratio of 1.13 95% (confidence interval (CI): 0.87-1.46). Mortality was significantly higher in the patients with persistently active disease (1.93; 95% CI: 1.34-2.70). Main causes of death were vascular diseases and malignancies with similar prevalence. A multivariate analysis showed that older age, higher GH at the last follow-up, higher IGF1 levels at diagnosis, malignancy, and radiotherapy were independent predictors of mortality. CONCLUSIONS Pretreatment IGF1 levels are important predictors of morbidity and mortality in acromegaly. The full hormonal control of the disease, nowadays reached in the majority of patients with modern management, reduces greatly the disease-related mortality.
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Affiliation(s)
- M Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Unit of Endocrine Diseases and Diabetology, S. Giuseppe Hospital Multimedica, Via S Vittore, 12, 20123 Milan, Italy.
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Martino E, Lombardi G. Endocrinology and art. Judith and Holofernes--Anonymous (XVII century). J Endocrinol Invest 2012; 35:619. [PMID: 22776975 DOI: 10.1007/bf03345799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E Martino
- Department of Endocrinology, University of Pisa, Pisa, Italy
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Takasawa K, Takaeda C, Higuchi M, Maeda T, Tomosugi N, Ueda N, Sasaki Y, Ikezoe M, Hagiwara M, Furuhata S, Murakami M, Shimonaka Y, Yamazaki S, Hamahata S, Hamahata S, Oue M, Kuragano T, Furuta M, Yahiro M, Kida A, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Sarafidis P, Rumjon A, Ackland D, Maclaughlin H, Bansal SS, Macdougall IC, Panichi V, Rosati A, Malagnino E, Giusti R, Casani A, Betti G, Conti P, Bernabini G, Bernabini G, Gabrielli C, Caiani D, Scatena A, Migliori M, Pizzarelli F, Mitsopoulos E, Tsiatsiou M, Minasidis I, Kousoula V, Intzevidou E, Passadakis P, Vargemezis V, Tsakiris D, Yahiro M, Kida A, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Kuragano T, Lines SW, Carter AM, Dunn EJ, Wright MJ, Aoyagi R, Miura T, De Paola L, Lombardi G, Coppolino G, Lombardi L, Hasuike Y, Fukumoto H, Kaibe S, Tokuyama M, Kida A, Otaki Y, Kuragano T, Nonoguchi H, Hiwasa M, Miyamoto T, Ohue H, Matsumoto A, Toyoda K, Nakanishi T, Rottembourg J, Emery C, Lafuma A, Wernli J, Zakin L, Mahi L, Borzych-Duzalka D, Bilginer Y, Pape L, Ha IS, Bak M, Chua A, Rees L, Pesle S, Cano F, Urzykowska A, Emre S, Russcasso J, Ramela V, Printza N, White C, Kuzmanovska D, Andrea V, Muller-Wiefel D, Warady B, Schaefer F, Chung JH, Park MK, Kim HL, Shin BC, Fujikawa T, Kuji T, Kakimoto M, Shibata K, Satta H, Nishihara M, Kawata S, Koguchi N, Toya Y, Umemura S, David V, Michel G, Maxime H, Paul L, Sebastien K, Francois V, Kuntsevich V, Dou Y, Thijssen S, Levin NW, Kotanko P, Kim BS, Kim BS, Park WD, Song HC, Kim HG, Kim YO, Woodburn K, Fong KL, Moriya Y, Tagawa Y, Maeda T, Kanda F, Morita N, Tomosugi N, London G, London G, Zaoui P, Covic A, Dellanna F, Goldsmith D, Gesualdo L, Mann J, Combe C, Turner M, Meunzberg M, Macdonald K, Abraham I, Gesualdo L, Combe C, Covic A, Dellanna F, Goldsmith D, London G, Mann J, Zaoui P, Turner M, Meunzberg M, Macdonald K, Abraham I, Rottembourg J, Guerin A, Diaconita M, Apruzzese R, Dou Y, Thijssen S, Kruse A, Ouellet G, Levin NW, Kotanko P, Bond C, Jensen D, Wang S, Pham E, Rubin J, Sika M, Niecestro R, Woodburn K, Fong KL, Sloneker S, Strzemienski P, Solon E, Moriya Y, Tagawa Y, Stamopoulos D, Mpakirtzi N, Grapsa E, Gogola B, Manios E, Afentakis N, Ewer J, Macdougall IC. Renal anaemia - CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs244] [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: 11/13/2022] Open
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182
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Rendina D, De Filippo G, Mossetti G, Zampa G, Muscariello R, Benvenuto G, Vivona CL, Ippolito S, Galante F, Lombardi G, Biondi B, Strazzullo P. Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. J Endocrinol Invest 2012; 35:407-12. [PMID: 21737999 DOI: 10.3275/7842] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 12/20/2022]
Abstract
BACKGROUND Obesity and insulin resistance predispose individuals to the development of both metabolic syndrome and non-toxic nodular thyroid diseases. AIM The aim of this observational, cross-sectional study is to evaluate the relationship between metabolic syndrome and multinodular nontoxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. SUBJECTS AND METHODS We examined 1422 Caucasian euthyroid inpatients. Thyroid volume was determined by ultrasound of the neck. A fine-needle aspiration biopsy was performed to evaluate single thyroid nodules and dominant nodules ≥15 mm in euthyroid multinodular goiter. The diagnosis of metabolic syndrome was made according to the criteria of the American Heart Association/ National Heart, Lung, and Blood Institute. RESULTS Of the sample, 277 patients had clinical evidence of multinodular nontoxic goiter, 461 met the criteria for the diagnosis of metabolic syndrome, and 132 were found to have both conditions. After adjusting for age, gender, body mass index, nicotinism, parity, alcohol intake, thyroid function, and metabolic syndrome- related pharmacological treatment, metabolic syndrome was found to be an independent risk factor for the occurrence of multinodular non-toxic goiter. The relationship between metabolic syndrome and multi nodular non-toxic goiter was apparent in both men and women. CONCLUSIONS In this study of euthyroid inpatients, we demonstrate that metabolic syndrome is an independent risk factor for the occurrence of multinodular non-toxic goiter in a geographic area with moderate iodine deficiency. We propose that patients meeting the criteria for metabolic syndrome should be screened for the presence of multinodular non-toxic goiter.
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Affiliation(s)
- D Rendina
- Department of Clinical and Experimental Medicine, Federico II University, Via S. Pansini 5, Naples, Italy
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183
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Guarnieri B, Adorni F, Musicco M, Appollonio I, Bonanni E, Caffarra P, Caltagirone C, Cerroni G, Concari L, Cosentino F, Ferrara S, Fermi S, Ferri R, Gelosa G, Lombardi G, Mazzei D, Mearelli S, Morrone E, Murri L, Nobili F, Passero S, Perri R, Rocchi R, Sucapane P, Tognoni G, Zabberoni S, Sorbi S. Prevalence of sleep disturbances in mild cognitive impairment and dementing disorders: a multicenter Italian clinical cross-sectional study on 431 patients. Dement Geriatr Cogn Disord 2012; 33:50-8. [PMID: 22415141 PMCID: PMC3696366 DOI: 10.1159/000335363] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [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] [Accepted: 11/23/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Sleep disturbances are common in the elderly and in persons with cognitive decline. The aim of this study was to describe frequency and characteristics of insomnia, excessive daytime sleepiness, sleep-disordered breathing, REM behavior disorder and restless legs syndrome in a large cohort of persons with mild cognitive impairment or dementia. METHODS 431 consecutive patients were enrolled in 10 Italian neurological centers: 204 had Alzheimer's disease, 138 mild cognitive impairment, 43 vascular dementia, 25 frontotemporal dementia and 21 Lewy body dementia or Parkinson's disease dementia. Sleep disorders were investigated with a battery of standardized questions and questionnaires. RESULTS Over 60% of persons had one or more sleep disturbances almost invariably associated one to another without any evident and specific pattern of co-occurrence. Persons with Alzheimer's disease and those with mild cognitive impairment had the same frequency of any sleep disorder. Sleep-disordered breathing was more frequent in vascular dementia. REM behavior disorder was more represented in Lewy body or Parkinson's disease dementia. CONCLUSION A careful clinical evaluation of sleep disorders should be performed routinely in the clinical setting of persons with cognitive decline. Instrumental supports should be used only in selected patients.
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Affiliation(s)
- B. Guarnieri
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Bicocca University, Milan,*Dr. Biancamaria Guarnieri, Center of Sleep Medicine, Villa Serena Hospital, Viale L. Petruzzi 42, IT–65013 Città S. Angelo (Italy), Tel. +39 08 5959 0237, E-Mail
| | - F. Adorni
- Italian National Research Center (ITB-CNR), Bicocca University, Milan
| | - M. Musicco
- Italian National Research Center (ITB-CNR), Bicocca University, Milan
| | - I. Appollonio
- Neuroscience Department, S. Gerardo Hospital Monza, Bicocca University, Milan
| | - E. Bonanni
- Neuroscience Department, University of Pisa, Pisa
| | - P. Caffarra
- Neuroscience Department, University of Parma, Parma
| | - C. Caltagirone
- Tor Vergata University, S. Lucia Foundation, IRCCS, Rome
| | - G. Cerroni
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Bicocca University, Milan
| | - L. Concari
- Neuroscience Department, University of Parma, Parma
| | | | - S. Ferrara
- Department of Neurology, Villa Serena Hospital, Città S. Angelo, Italy
| | - S. Fermi
- Neuroscience Department, S. Gerardo Hospital Monza, Bicocca University, Milan
| | - R. Ferri
- Department of Neurology, Oasi Institute IRCCS, Troina
| | - G. Gelosa
- Neuroscience Department, S. Gerardo Hospital Monza, Bicocca University, Milan
| | - G. Lombardi
- Department of Neurological and Psychiatric Sciences, University of Florence, Florence
| | - D. Mazzei
- Clinical Neurophysiology, Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Genoa
| | - S. Mearelli
- Department of Neurology, University of L’Aquila, L’Aquila
| | - E. Morrone
- Sleep Physiopathology, S. Martino Hospital, Genoa
| | - L. Murri
- Neuroscience Department, University of Pisa, Pisa
| | - F.M. Nobili
- Clinical Neurophysiology, Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Genoa
| | - S. Passero
- Neuroscience Department, University of Siena, Siena
| | - R. Perri
- S. Lucia Foundation, IRCCS, Rome
| | - R. Rocchi
- Neuroscience Department, University of Siena, Siena
| | - P. Sucapane
- Department of Neurology, University of L’Aquila, L’Aquila
| | - G. Tognoni
- Neuroscience Department, University of Pisa, Pisa
| | | | - S. Sorbi
- Department of Neurological and Psychiatric Sciences, University of Florence, Florence
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184
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Ferolla P, Faggiano A, Grimaldi F, Ferone D, Scarpelli G, Ramundo V, Severino R, Bellucci MC, Camera LM, Lombardi G, Angeletti G, Colao A. Shortened interval of long-acting octreotide administration is effective in patients with well-differentiated neuroendocrine carcinomas in progression on standard doses. J Endocrinol Invest 2012; 35:326-31. [PMID: 21757992 DOI: 10.3275/7869] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [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: 12/13/2022]
Abstract
BACKGROUND In patients with well-differentiated (WD) neuroendocrine tumors (NET), long-acting octreotide (LAR), conventionally administered at a dose of 30 mg every 28 days, has well-documented anti-secretive but limited antiproliferative effects. AIM The objective of this study was to evaluate a different schedule of LAR treatment consistent with a shorter interval between administrations (21 days) in WDNET patients with progressive disease at standard-dose interval. SUBJECTS AND METHODS Twenty-eight patients followed for diagnosis and therapy of WDNET who had tumor progression during therapy with LAR 30 mg every 28 days were enrolled. Clinical, biological, and objective tumor response was evaluated after LAR 30 mg every 21 days. Time to progression was also evaluated after LAR 30 mg every 21 days and compared to LAR 30 mg every 28 days. RESULTS The treatment with LAR 30 mg every 21 days resulted in complete and partial control of clinical symptoms in 40% and 60% of cases, respectively. Circulating neuroendocrine markers were significantly decreased in 30% of cases. A stabilization of disease was obtained in 93% and objective response in 7%. The median time to progression was significantly longer by using the shortened interval of LAR administration as compared to the standard one (30 vs 9 months, p<0.0001). The treatment was safe and well tolerated. CONCLUSIONS The shortened schedule of LAR administration was able to re-institute control of clinical symptoms, to decrease level of circulating neuroendocrine markers and to increase time to progression in patients previously escaping from a standard schedule treatment.
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Affiliation(s)
- P Ferolla
- Multidisciplinary Group for Diagnosis and Treatment of Neuroendocrine Tumors, Umbria Regional Cancer Network, Perugia, Italy
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185
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Lombardi G, Lanteri P, Colombini A, Mariotti M, Banfi G. Sclerostin concentrations in athletes: role of load and gender. J BIOL REG HOMEOS AG 2012; 26:157-163. [PMID: 22475109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bone mass is the net product of formation and resorption, which are closely regulated by the equilibrium between endogenous/exogenous factors. Sclerostin inhibits the Wnt canonical signaling and is considered an anti-anabolic factor. We compared sclerostin serum concentrations between genders in athletes belonging to different sport disciplines, characterized by a different weight-bearing, and in their sedentary counterparts in order to study the possible link between bone metabolism in athletes and its peripheral concentration. We also compared sclerostin levels with bone alkaline phosphatase activity, a marker of bone formation. Sixty-one elite athletes, belonging to weight-bearing (15 male rugby players, 11 male enduro racers, 8 female basketball players), high-impact (6 male tennis players, 8 female ice skaters), non weight-bearing sports (13 male cyclists) and 16 sedentary controls were enrolled. Higher levels of sclerostin were found in females. Sclerostin was higher in weight-bearing than in non-weight-bearing disciplines in males. Significant inverse age-related correlation was found. Higher bone alkaline phosphatase activity was observed in females. The young adult elite athlete represents a peculiar physiologic model for studying sclerostin behavior: the applied load increased the marker concentrations, testifying a high bone turnover rate; however, a gender effect is evident.
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186
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Ramundo V, Milone F, Severino R, Savastano S, Di Somma C, Vuolo L, De Luca L, Lombardi G, Colao A, Faggiano A. Clinical and prognostic implications of the genetic diagnosis of hereditary NET syndromes in asymptomatic patients. Horm Metab Res 2011; 43:794-800. [PMID: 22009375 DOI: 10.1055/s-0031-1286324] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Neuroendocrine tumors (NETs) can be sporadic or they can arise in complex hereditary syndromes. Patients with hereditary NETs can be identified before the development of tumors by performing genetic screenings. The aim of the study was to evaluate the clinical and prognostic impact of a preclinical genetic screening in subjects with hereditary NET syndromes. 46 subjects referred for hereditary NET syndrome [22 MEN1, 12 MEN2, 12 Familial Paragangliomatosis (FPGL)] were enrolled and divided in 2 groups (group A, 20 subjects with clinical appearance of NET before the genetic diagnosis; group B, 26 subjects with genetic diagnosis of hereditary NET syndromes before the clinical appearance of NETs). The main outcome measures were severity of disease, prognosis, and survival. The rate of surgery for MEN1-, MEN2-, FPGL4-related tumors was 90% in group A and 35% in group B (p<0.01). Both symptoms related to tumors and symptoms related to therapies were significantly less frequent in group B than in group A (p<0.05). Tumor stage was locally advanced or metastatic in 50% of group A and in no one of group B (p<0.01). The mortality rate was 25% in group A and 0% in group B (p<0.05). An early genetic screening for hereditary NET syndromes results in an improvement in clinical presentation and morbidity. A potential impact of the genetic screening on the mortality rate of these subjects is suggested and needs to be investigated in further and more appropriate studies.
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Affiliation(s)
- V Ramundo
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy
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187
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Di Somma C, Brunelli V, Savanelli MC, Scarano E, Savastano S, Lombardi G, Colao A. Somatopause: state of the art. MINERVA ENDOCRINOL 2011; 36:243-255. [PMID: 22019753] [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: 05/31/2023]
Abstract
Aging is associated with decay in the somatotroph axis, that has been considered to cause many of the catabolic sequelae of normal aging. The physiological changes that the human body undergoes during aging are similar to those observed in GH deficiency (GHD). Changes of aging are represented by increased fat mass, increased cardiovascular risk, reduced muscle mass, reduced exercise tolerance, decreased strength and impaired quality of life. Some authors conjecture that the elderly could be GH deficient and would benefit from GH treatment. However, the endocrine pattern of aging is distinct from the decrease of GH/IGF-I levels associated with hypopituitarism, although there is not sufficient evidence for a clear therapeutic role of GH treatment during somatopause. So, further studies are needed to evaluate the real benefit of somatotropic treatment in aging. This review is focused on the effects of the somatopause and summarize the potentials for a therapeutic role of the recombinant human GH (rhGH) or of GH secretagogues in aging.
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Affiliation(s)
- C Di Somma
- IRCCS SDN Fondazione Napoli, Naples, Italy.
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188
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Affiliation(s)
- E Martino
- Department of Endocrinology, University of Pisa, Pisa, Italy
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189
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Afzali B, Mitchell P, Scottà C, Canavan J, Edozie FC, Fazekasova H, Lord GM, John S, Barber LD, Hernandez-Fuentes MP, Lechler RI, Lombardi G. Relative resistance of human CD4(+) memory T cells to suppression by CD4(+) CD25(+) regulatory T cells. Am J Transplant 2011; 11:1734-42. [PMID: 21749646 PMCID: PMC3815568 DOI: 10.1111/j.1600-6143.2011.03635.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Successful expansion of functional CD4(+) CD25(+) regulatory T cells (T(reg)) ex vivo under good manufacturing practice conditions has made T(reg) -cell therapy in clinical transplant tolerance induction a feasible possibility. In animals, T(reg) cells home to both transplanted tissues and local lymph nodes and are optimally suppressive if active at both sites. Therefore, they have the opportunity to suppress both naïve and memory CD4(+) CD25(-) T cells (Tresp). Clinical transplantation commonly involves depleting therapy at induction (e.g. anti-CD25), which favors homeostatic expansion of memory T cells. Animal models suggest that T(reg) cells are less suppressive on memory, compared with naïve Tresp that mediate allograft rejection. As a result, in the context of human T(reg) -cell therapy, it is important to define the effectiveness of T(reg) cells in regulating naïve and memory Tresp. Therefore, we compared suppression of peripheral blood naïve and memory Tresp by fresh and ex vivo expanded T(reg) cells using proliferation, cytokine production and activation marker expression (CD154) as readouts. With all readouts, naïve human Tresp were more suppressible by approximately 30% than their memory counterparts. This suggests that T(reg) cells may be more efficacious if administered before or at the time of transplantation and that depleting therapy should be avoided in clinical trials of T(reg) cells.
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Affiliation(s)
- B. Afzali
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
,Corresponding author: Behdad Afzali,
| | - P.J. Mitchell
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - C. Scottà
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - J. Canavan
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - F. C. Edozie
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - H. Fazekasova
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - G. M. Lord
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - S. John
- Department of Immunobiology, King’s College London, London, UK
| | - L. D. Barber
- Department of Hematology, King’s College London, London, UK
| | - M. P. Hernandez-Fuentes
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - R. I. Lechler
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - G. Lombardi
- MRC Centre for Transplantation and National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Tsang JYS, Ratnasothy K, Li D, Chen Y, Bucy RP, Lau KF, Smyth L, Lombardi G, Lechler R, Tam PKH. The potency of allospecific Tregs cells appears to correlate with T cell receptor functional avidity. Am J Transplant 2011; 11:1610-20. [PMID: 21797973 DOI: 10.1111/j.1600-6143.2011.03650.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
CD4(+) CD25(+) regulatory T cells (T(reg) cells) are an attractive adoptive cell therapy in mediating transplantation tolerance. T-cell receptor (TcR) activation is critical for T(reg) function, suggesting that the TcR avidity of T(reg) cells used in therapy may affect the therapeutic outcome. To address this, we compared the regulatory capacity of T(reg) lines expressing TcRs derived from two TcR transgenic mice shown to have the same specificity but different functional avidities. T(reg) lines generated from CD4(+)CD25(+) T cells from C57BL/6 mice were transduced with one of either of these TcRs. The antigen specificity of the transduced T(reg) lines was confirmed in vitro. T(reg) lines expressing the TcR with higher functional avidity showed stronger suppressive capacity in a linked suppression model in vitro. Furthermore, the same T(reg) lines demonstrated a stronger proliferation in vivo following antigen exposure. Pretreatment of recipient BL/6 mice with these T(reg) cells, together with anti-CD8 antibody and Rapamycin therapies, prolonged survival of BALB/c skins, as compared with mice that received T(reg) lines with lower TcR avidity. Taken together, these data suggest that the TcR functional avidity may be important for T(reg) function. It highlights the fact that strategies to select T(reg) with higher functional avidity might be beneficial for immunotherapy in transplantation.
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Affiliation(s)
- J Y S Tsang
- Department of Surgery, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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191
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Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E. Endoscopic endonasal transsphenoidal approach: an additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 2011; 9:109-17. [PMID: 17171126 PMCID: PMC1656809 DOI: 10.1055/s-2008-1058157] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The outcome of endoscopic endonasal transsphenoidal surgery in 10 patients with pituitary adenomas was compared with that of traditional transnasal transsphenoidal approach (TTA) in 20 subjects. Among the 10 individuals subjected to "pure endoscopy," 2 had a microadenoma, 1 an intrasellar macroadenoma, 4 had a macroadenoma with suprasellar expansion, 2 had a macroadenoma with supra-parasellar expansion, and 1 a residual tumor; 5 had acromegaly and 5 had a nonfunctioning adenoma (NFA). Among the patients subjected to TTA, 4 had a microadenoma, 2 had an intrasellar macroadenoma, 6 had a macroadenoma with suprasellar expansion, 4 had a macroadenoma with supra-parasellar expansion, and 4 had a residual tumor; 9 patients had acromegaly, 1 hyperprolactinemia, 1 Cushing's disease, and 9 a NFA. At the macroscopic evaluation, tumor removal was total (100%) after endoscopy in 9 patients and after TTA in 14 patients. Six months after surgery, magnetic resonance imaging (MRI) confirmed the total tumor removal in 21 of 23 patients (91.3%). Circulating growth hormone (GH) and insulin-like growth factor-I (IGF-I) significantly decreased 6 months after surgery in all 14 acromegalic patients: normalization of plasma IGF-I levels was obtained in 4 of 5 patients after the endoscopic procedure and in 4 of 9 patients after TTA. Before surgery, pituitary hormone deficiency was present in 14 out of 30 patients: pituitary function improved in 4 patients, remaining unchanged in the other 10 patients. Visual field defects were present before surgery in 4 patients, and improved in all. Early surgical results in the group of 10 patients who underwent endoscopic pituitary tumor removal were at least equivalent to those of standard TTA, with excellent postoperative course. Postsurgical hospital stay was significantly shorter (3.1 +/- 0.4 vs. 6.2 +/- 0.3 days, p < 0.001) after endoscopy as compared to TTA.
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192
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Lombardi G, Di Somma C, Rubino M, Faggiano A, Vuolo L, Guerra E, Contaldi P, Savastano S, Colao A. The roles of parathyroid hormone in bone remodeling: prospects for novel therapeutics. J Endocrinol Invest 2011; 34:18-22. [PMID: 21985975] [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: 04/19/2023]
Abstract
The aim of this review is to focus on the roles of PTH in bone remodeling. PTH plays a central role in regulating calcium-phosphate metabolism and its production increases in response to low serum calcium levels. A continue hypersecretion of PTH, as occurs in primary hyperparathyroidism, leads to bone resorption. On the other hand, there is clear evidence of the anabolic properties of PTH.When administered at a low dose and intermittently, this hormone seems to be able to exert positive effects on bone volume and microarchitecture. The effects of PTH are mediated by PTH/PTH-related protein receptor, a G protein that can activate the cAMP-dependent protein kinase (PK)A and calcium-dependent PKC; the activation of PKA account for most of the PTH anabolic action. The anabolic actions of PTH involve direct effects on osteoblasts and indirect effects mediated by activation of skeletal growth factors (IGF-I) and inhibition of growth factor antagonists, such as sclerostin. PTH enhances the number and the activation of osteoblast through 4 pathways: increasing osteoblast proliferation and differentiation, decreasing osteoblast apoptosis and reducing the negative effects of peroxisome proliferator activator (PPAR)γ receptor on osteoblast differentiation. Moreover PTH enhances the Wnt-β catenin pathway, that is central to osteogenesis and bone formation, inhibiting sclerostin. Finally, PTH induces the synthesis of IGF-I and, due to its prodifferentiating and pro-survival effects on osteoblasts, this could be a key mediator of PTH effect on osteoblasts. In conclusion, the intermittent administration of PTH has a pleiotropic anabolic effect on bone; further studies about mechanisms of action of PTH could be a starting point to new osteoporosis treatments.
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Affiliation(s)
- G Lombardi
- Department of Molecular and Clinical Endocrinology and Oncology University Federico II, Naples, Italy.
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Calogero AE, La Vignera S, Condorelli RA, Perdichizzi A, Valenti D, Asero P, Carbone U, Boggia B, De Rosa N, Lombardi G, D'Agata R, Vicari LO, Vicari E, De Rosa M. Environmental car exhaust pollution damages human sperm chromatin and DNA. J Endocrinol Invest 2011; 34:e139-43. [PMID: 20959722 DOI: 10.1007/bf03346722] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [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: 12/01/2022]
Abstract
OBJECTIVE The adverse role of traffic pollutants on male fertility is well known. Aim of this study was to evaluate their effects on sperm chromatin/DNA integrity. METHODS To accomplish this, 36 men working at motorway tollgates and 32 unexposed healthy men (controls) were enrolled. All of them were interviewed about their lifestyle. Hormone, semen samples, and environmental and biological markers of pollution were evaluated. Sperm chromatin and DNA integrity were evaluated by flow cytometry following propidium iodide staining and TUNEL assay, respectively. RESULTS LH, FSH, and testosterone serum levels were within the normal range in tollgate workers. Sperm concentration, total sperm count, total and progressive motility, and normal forms were significantly lower in these men compared with controls. Motorway tollgate workers had a significantly higher percentage of spermatozoa with damaged chromatin and DNA fragmentation, a late sign of apoptosis, compared with controls. A significant direct correlation was found between spermatozoa with damaged chromatin or fragmented DNA and the length of occupational exposure, suggesting a time-dependent relationship. CONCLUSION This study showed that car exhaust exposure has a genotoxic effect on human spermatozoa. This may be of relevant importance not only for the reproductive performance of the men exposed, but also for the offspring health.
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Affiliation(s)
- A E Calogero
- Section of Endocrinology, Andrology and Internal Medicine and Master in Andrological, Human Reproduction and Biotechnology Sciences, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.
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194
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Faggiano A, Di Somma C, Ramundo V, Severino R, Vuolo L, Coppola A, Panico F, Savastano S, Lombardi G, Colao A, Gasperi M. Cinacalcet hydrochloride in combination with alendronate normalizes hypercalcemia and improves bone mineral density in patients with primary hyperparathyroidism. Endocrine 2011; 39:283-7. [PMID: 21445714 DOI: 10.1007/s12020-011-9459-0] [Citation(s) in RCA: 53] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 03/15/2011] [Indexed: 11/30/2022]
Abstract
Cinacalcet is effective in controlling the biochemical abnormalities in patients with primary hyperparathyroidism (PHPT) but it seems to be less effective on bone mineral density (BMD). In the same patients, bisphosphonates are reported to be effective on bone resorption but less effective on calcium and PTH excess. In this study, the efficacy of cinacalcet in combination with alendronate has been retrospectively evaluated in patients with PHPT. Twenty-three patients with PHPT who had not been operated were retrospectively investigated. Cinacalcet was evaluated in combination with alendronate in 10 of the 23 patients, and in monotherapy in 13 other patients. Serum calcium, phosphorus and PTH, 24 h urine calcium and phosphorus as well as BMD, evaluated by DXA and expressed as T-score, were measured before and after treatment. In all patients serum calcium and phosphorus and urinary calcium excretion were effectively and stably controlled and PTH was significantly decreased after treatment. There was no difference in the rate of serum calcium and PTH decrease between subjects treated with cinacalcet plus alendronate and those treated with cinacalcet alone. T-score increased by 9.6% at lumbar spine and 3.9% at femur level in the cinacalcet plus alendronate subgroup and was unchanged in the cinacalcet subgroup (P < 0.01). In patients with PHPT, the biochemical abnormalities are rapidly improved by cinacalcet regardless from the administration in monotherapy or in combination with alendronate. BMD is significantly improved in patients receiving cinacalcet plus alendronate and stable in those receiving cinacalcet in monotherapy.
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Affiliation(s)
- A Faggiano
- IRCCS Fondazione SDN, Via E. Gianturco 113, 80143, Naples, Italy.
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195
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Lombardi G, Zustovich F, Della Puppa A, Gardiman MP, Farina P, Carollo C, Landi L, Cecchin D, Bertorelle R, Berti F, Fiduccia P, D'Avella D, Zagonel V. A retrospective study analyzing the association between tumor response (TR) according to Mcdonald criteria (MC) on MRI and survival (OS) in patients (PTS) with glioblastoma (GBM) treated with antiangiogenic drugs (AD). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e12514] [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: 11/20/2022] Open
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196
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Zustovich F, Landi L, Lombardi G, Galli L, Porta C, Amoroso D, Fontana A, Andreuccetti M, Galli C, Falcone A, Zagonel V. Sorafenib plus daily low dose temozolomide for relapsed glioblastoma: A phase II study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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197
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Blasi F, Giua L, Lombardi G, Codini M, Simonetti MS, Damiani P, Cossignani L. Improved HRGC separation of cis, trans CLA isomers as Diels-Alder adducts of alkyl esters. J Chromatogr Sci 2011; 49:379-83. [PMID: 21549030 DOI: 10.1093/chromsci/49.5.379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper reports the separation of four isomers of conjugated linoleic acid (CLA), c,t/t,c-8,10; c,t/t,c-9,11; c,t/t,c-10,12; c,t/t,c-11,13, after reaction of esterification with aliphatic alcohols of different chain length and adduct formation with 4-methyl-1,2,4-triazoline-3,5-dione (MTAD). The high resolution gas chromatographic analyses were carried out using a simple 50-m cyanopropyl polysiloxane capillary column both with a flame ionization detector and a mass spectrometer. The resolution between the two pair of isomers: c,t/t,c-9,11 and c,t/t,c-10,12 and between c,t/t,c-10,12 and c,t/t,c-11,13 isomers were good for all the investigated alkyl esters and increased with the chain length of alcohol esterified to carboxylic moiety of CLA isomers. The most interesting result was relative to the c,t/t,c-8,10 and c,t/t,c-9,11 isomers, critical pair of isomers also when analyzed with a 120-m cyanopropyl polysiloxane capillary column; their resolution also increased from methyl to hexyl esters of CLA isomers and reached an acceptable value (0.8) in the case of hexyl esters. The best resolutions of the four considered CLA isomers were obtained with the hexyl esters of MTAD adducts of the isomers, without excessive analysis time. This method was useful and simple to evaluate the profile of the four main c,t isomers in commercial CLA samples.
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Affiliation(s)
- F Blasi
- Università degli Studi di Perugia, Dipartimento di Scienze Economico-Estimative e degli Alimenti, Sezione di Chimica Bromatologica, Biochimica, Fisiologia e Nutrizione
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198
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Brizio A, Nosari A, Lombardi G, Riva M, Cantoni S, Morra E. Oral voriconazole for neutropenia: a leukemia patient with probable pulmonary aspergillosis and scedosporidiosis. J Chemother 2011; 23:53-4. [PMID: 21482497 DOI: 10.1179/joc.2011.23.1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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199
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Faggiano A, Severino R, Ramundo V, Russo R, Vuolo L, Del Prete M, Marciello F, Lombardi G, Cianciaruso B, Colao A, Pisani A. Thyroid function in Fabry disease before and after enzyme replacement therapy. MINERVA ENDOCRINOL 2011; 36:1-5. [PMID: 21460782] [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: 05/30/2023]
Abstract
UNLABELLED AM: Patients with Fabry disease (FD), a genetic disorder caused by lysosomal a-galactosidase-A enzyme deficiency and characterized by a systemic accumulation of globotriaosylceramides, present high prevalence of subclinical hypothyroidism. The pathogenic mechanism is thought not to be related to anti-thyroid autoimmunity and may be dependent by intra-thyroid lipid accumulation. In this study, it was investigated whether thyroid function recovers in FD after long-term enzyme replacement therapy (ERT). METHODS Study population included 14 FD patients (7 females, 7 males, aged 21-62 years) and 14 sex- and age-matched normal subjects. Thyroid function was evaluated in each patient at baseline and after the beginning of ERT with rh-a-galactosidase-A (1 mg/kg/BW every 2 weeks) for three years. RESULTS TSH levels were higher in FD patients than in controls (P<0.05). In FD patients, TSH levels were higher before than after ERT (1.9±0.2 vs 1.2±0.2 mU/L, P<0.01) while fT3 and fT4 levels were normal at baseline and unchanged after ERT. At baseline, TSH levels were >3 mU/L in three patients and normalize after ERT. Anti-Tg and/or anti-TPO titres were positive in 14% of patients and 21% of controls. After ERT, the rate of autoimmunity was unchanged. At the thyroid ultrasonography, a slight hypoechoic pattern was found in 71% of patients at baseline and decreased to 43% after ERT. CONCLUSION Primary hypothyroidism in FD patients is reverted after long-term ERT. A screening of thyroid function and periodical re-evaluation during ERT is mandatory in all FD patients.
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Affiliation(s)
- A Faggiano
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
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200
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Di Somma C, Rivellese A, Pizza G, Patti L, De Rosa A, Cipriano P, Nedi V, Rossi A, Lombardi G, Colao A, Savastano S. Effects of short-term treatment with orlistat on growth hormone/insulin-like growth factor-I axis in obese post-menopausal women. J Endocrinol Invest 2011; 34:90-6. [PMID: 21502796 DOI: 10.1007/bf03347036] [Citation(s) in RCA: 3] [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: 10/25/2022]
Abstract
AIM Obesity is associated with an altered GH/IGF-I axis status, accounting for the increased cardiovascular risk in obese subjects with GH deficiency. Aim of this randomized, simple-blind, cross-over study was to verify the effectiveness of a short-term treatment with orlistat in reducing non-esterified fatty acid (NEFA) and influencing the endogenous activity of GH/IGF-I axis in obese subjects. OUTCOME MEASURES The primary outcome measures were post-prandial lipemia; GH peak after GHRH+arginine; IGF-I; IGF-binding protein (BP)-3, IGF-I/IGFBP-3 ratio. Secondary outcome measures were insulin resistance (IR) indexes (homeostasis model assessment of insulin resistance and Insulin Sensitivity Index). STUDY DESIGN Twenty obese post-menopausal women (age: 53.6 ± 6.2; body mass index: 34.1 ± 4.0) were randomized to receive normo-caloric diet plus + orlistat (Roche, UK; 120 mg tid) or normo-caloric diet without the additional treatment. The duration of follow-up was 10 days for each treatment period. RESULTS Orlistat induced a weight-independent reduction in post-prandial NEFA levels compared with diet alone, with higher GH peak, IGF-I, and IGF-I/IGFBP3 ratio. GH peak was correlated negatively with postprandial NEFA and positively with IGF-I and IGF-I/IGFBP-3 ratio. CONCLUSIONS Orlistat is effective in inducing a weight-independent higher reduction in post-prandial NEFA levels than dietary treatment alone along with increase in GH peak, IGF-I levels, and IGFI/ IGFBP-3 ratio. These results might add a new potential benefit of orlistat in the management of obese subjects.
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Affiliation(s)
- C Di Somma
- IRCCS SDN Foundation Naples, Naples, Italy
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