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Coppola L, Smaldone G, Grimaldi AM, Estraneo A, Magliacano A, Soddu A, Ciccarelli G, Salvatore M, Cavaliere C. Peripheral blood BDNF and soluble CAM proteins as possible markers of prolonged disorders of consciousness: a pilot study. Sci Rep 2024; 14:341. [PMID: 38172270 PMCID: PMC10764320 DOI: 10.1038/s41598-023-50581-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Although clinical examination still represents the gold standard for the differential diagnosis of prolonged disorders of consciousness (pDoC), the introduction of innovative markers is essential for diagnosis and prognosis, due to the problem of covert cognition. We evaluated the brain-derived neurotrophic factor protein (BDNF) and the soluble cell adhesion molecules proteins (CAMs) in a cohort of prolonged disorders of consciousness patients to identify a possible application in the clinical context. Furthermore, peripheral blood determinations were correlated with imaging parameters such as white matter hyperintensities (WMH), cranial standardized uptake value (cSUV), electroencephalography (EEG) data and clinical setting. Our results, although preliminary, identify BDNF as a possible blood marker for the diagnosis of pDoC (p value 0.001), the soluble CAMs proteins CD44, Vcam-1, E-selectin (p value < 0.01) and Icam-3 (p value < 0.05) showed a higher peripheral blood value in pDoC compared with control. Finally, soluble Ncam protein could find useful applications in the clinical evolution of the pDoC, showing high levels in the MCS and EMCS subgroups (p value < 0. 001) compared to VS/UWS.
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Affiliation(s)
| | | | | | - A Estraneo
- Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi, Florence, Italy
| | - A Magliacano
- Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi, Florence, Italy
| | - A Soddu
- Department of Physics and Astronomy, Western Institute of Neuroscience, University of Western Ontario, London, ON, Canada
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Coppola L, Mirabelli P, Baldi D, Smaldone G, Estraneo A, Soddu A, Grimaldi AM, Mele G, Salvatore M, Cavaliere C. An innovative approach for the evaluation of prolonged disorders of consciousness using NF-L and GFAP biomarkers: a pivotal study. Sci Rep 2022; 12:18446. [PMID: 36323711 PMCID: PMC9630372 DOI: 10.1038/s41598-022-21930-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022] Open
Abstract
Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them with imaging parameters to investigate the prolonged disorders of consciousness (pDoC).We assessed the serum concentration of neurofilament light chain(NF-L) and glial fibrillary acidic protein (GFAP) in pDoC (n = 16), and healthy controls (HC, n = 6) as well as several clinical imaging parameters such as Fractional Anisotropy (FA), Whole Brain SUV, and White Matter Hyperintensities volumes (WMH) using PET-MRI acquisition. As for differential diagnosis task, only the imaging WMH volume was able to discriminate between vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS) patients (p-value < 0.01), while all selected markers (both imaging and in vitro) were able to differentiate between pDoC patients and HC. At subject level, serum NF-L concentrations significantly differ according to clinical progression and consciousness recovery (p-value < 0.01), highlighting a potential play for the longitudinal management of these patients.
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Affiliation(s)
| | | | | | | | - A. Estraneo
- grid.418563.d0000 0001 1090 9021Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS) Fondazione Don Carlo Gnocchi, Florence, Italy
| | - A. Soddu
- grid.39381.300000 0004 1936 8884Department of Physics and Astronomy, Western Institute of Neuroscience, University of Western Ontario, London, ON Canada
| | | | - G. Mele
- IRCCS Synlab SDN, Napoli, Italy
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Vecchione D, Grimaldi AM, Forte E, Bevilacqua P, Netti PA, Torino E. Hybrid Core-Shell (HyCoS) Nanoparticles produced by Complex Coacervation for Multimodal Applications. Sci Rep 2017; 7:45121. [PMID: 28327584 PMCID: PMC5361191 DOI: 10.1038/srep45121] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/16/2017] [Indexed: 12/20/2022] Open
Abstract
Multimodal imaging probes can provide diagnostic information combining different imaging modalities. Nanoparticles (NPs) can contain two or more imaging tracers that allow several diagnostic techniques to be used simultaneously. In this work, a complex coacervation process to produce core-shell completely biocompatible polymeric nanoparticles (HyCoS) for multimodal imaging applications is described. Innovations on the traditional coacervation process are found in the control of the reaction temperature, allowing a speeding up of the reaction itself, and the production of a double-crosslinked system to improve the stability of the nanostructures in the presence of a clinically relevant contrast agent for MRI (Gd-DTPA). Through the control of the crosslinking behavior, an increase up to 6 times of the relaxometric properties of the Gd-DTPA is achieved. Furthermore, HyCoS can be loaded with a high amount of dye such as ATTO 633 or conjugated with a model dye such as FITC for in vivo optical imaging. The results show stable core-shell polymeric nanoparticles that can be used both for MRI and for optical applications allowing detection free from harmful radiation. Additionally, preliminary results about the possibility to trigger the release of a drug through a pH effect are reported.
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Affiliation(s)
- D. Vecchione
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for Health Care IIT@CRIB, Largo Barsanti e Matteucci 53, 80125, Naples, Italy
- University of Naples Federico II, Department of Chemical, Materials and Industrial Production Engineering, P.le Tecchio 80, 80125, Naples, Italy
| | | | - E. Forte
- IRCSS SDN, Via E. Gianturco 113, 80143, Naples, Italy
| | | | - P. A. Netti
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for Health Care IIT@CRIB, Largo Barsanti e Matteucci 53, 80125, Naples, Italy
- University of Naples Federico II, Department of Chemical, Materials and Industrial Production Engineering, P.le Tecchio 80, 80125, Naples, Italy
- University of Naples Federico II, Interdisciplinary Research Center of Biomaterials, CRIB P.le Tecchio 80, 80125, Naples, Italy
| | - E. Torino
- Istituto Italiano di Tecnologia, Center for Advanced Biomaterials for Health Care IIT@CRIB, Largo Barsanti e Matteucci 53, 80125, Naples, Italy
- University of Naples Federico II, Interdisciplinary Research Center of Biomaterials, CRIB P.le Tecchio 80, 80125, Naples, Italy
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De Divitiis C, von Arx C, Grimaldi AM, Cicala D, Tatangelo F, Arcella A, Romano GM, Simeone E, Iaffaioli RV, Ascierto PA, Tafuto S. Metronomic temozolomide as second line treatment for metastatic poorly differentiated pancreatic neuroendocrine carcinoma. J Transl Med 2016; 14:113. [PMID: 27142424 PMCID: PMC4855772 DOI: 10.1186/s12967-016-0857-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 04/10/2016] [Indexed: 12/22/2022] Open
Abstract
Neuroendocrine Neoplasms (NEN) are a group of heterogeneous malignancies derived from neuroendocrine cell compartment, with different roles in both endocrine and nervous system. Most NETs have gastroentero-pancreatic (GEP) origin, arising in the foregut, midgut, or hindgut. The 2010 WHO classification divides GEP-NETs into two main subgroups, neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC), according with Ki-67 levels. NET are tumors with low (<20 %) Ki-67 value, and NECs, including small cell lung carcinomas and Merkel Cell carcinomas, are all NETs with high Ki-67 levels (>20 %–G3). Poorly differentiated neuroendocrine carcinomas (NEC) are usually treated with cisplatin-based chemotherapy regimens. Here we present a case of a patient with pancreatic NEC progressing after cisplatin and etoposide, treated with temozolomide as palliative, second line treatment. According with the poor Performance Status (PS = 2) and to reduce the toxicity of the treatment was chosen an intermittent dosing regimen of metronomic temozolomide (75 mg/m2/day—one-week-on/on-week-off). MGMT resulted methylated. On July 2014 the patient started the treatment. On August 2014 the patient obtained a significant clinical benefit (PS = 0) and the total body CT scan performed on October 2014 showed a RECIST partial response on all the sites of disease. No drug-related side effects were reported by the patient. After 18 months of therapy the treatment continues without significant toxicity, and with further remission of the metastases. Treatment with metronomic “one-week-on/on-week-off” Temozolomide can be considered a good treatment option in patients with poor performance status, affected by pNEC with MGMT methylation.
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Affiliation(s)
- C De Divitiis
- Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - C von Arx
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - A M Grimaldi
- Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - D Cicala
- Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | - F Tatangelo
- Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - A Arcella
- IRCCS Neuromed, Località Camerelle, Pozzilli-Isernia, Italy
| | - G M Romano
- Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - E Simeone
- Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - R V Iaffaioli
- Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - P A Ascierto
- Melanoma, Cancer Immunotherapy, and Innovative Therapy Unit, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy
| | - S Tafuto
- Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS-Fondazione "G. Pascale", Naples, Italy.
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De Portu S, Mantovani LG, Ravaioli A, Tamburini E, Bollina R, Cozzi C, Grimaldi AM, Testa TE, Bianchessi C, Carteni G. Cost analysis of capecitabine vs 5-fluorouracil-based treatment for metastatic colorectal cancer patients. J Chemother 2010; 22:125-8. [PMID: 20435573 DOI: 10.1179/joc.2010.22.2.125] [Citation(s) in RCA: 12] [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] [Indexed: 10/31/2022]
Abstract
The aim was to evaluate the cost of capecitabine vs conventional combination chemotherapics such as 5-fluorouracil (5-FU) for the treatment of metastatic colorectal cancer (mCRC) in Italy. The study was a multicenter, retrospective longitudinal treatment-cost analysis. Patients older than 18 years, diagnosis of mCRC and at least 3 completed cycles of chemotherapy with oral capecitabine or 5-FU also in association with other chemotherapic agents were enrolled. Direct healthcare resources attributable to mCRC treatment were quantified using 2007 prices and tariffs. The analysis was conducted from the National Health Service perspective with a 6-month time horizon. A total of 231 patients affected by mCRC (55% males; mean age 63.7+/-10.31 yrs) were studied. Total direct costs per patient per month in capecitabine and 5-FU groups were euro1,001.66 +/- euro434.93 and euro3,172.81 +/- euro1,232.37 respectively (p<0.0001). Oral capecitabine therapy cost the health service less than intravenous therapies.
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Affiliation(s)
- S De Portu
- CIRFF, Federico II University of Naples, Italy.
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Abstract
Tyrosine kinase receptors (RTKs) are a heterogeneous group of transmembrane proteins involved in signal transduction. These receptors are expressed in many different cells and regulate cellular growth, differentiation and angiogenesis. Overexpression and/or the structural alteration of different RTKs classes are generally associated to cancer and, when RTKs-mediated signal transduction pathways are abnormally activated, generate cancer growth, angiogenesis and metastatization. Therapeutic intervention targeting RTKs concerns antagonist drugs as little molecules or monoclonal antibodies. Sunitinib malate is a little molecule able to block intracellular tyrosine kinase domain of RTKs, which has both direct anticancer and antiangiogenetic activity. Sunitinib targets selectively vascular endothelial growth factor, KIT, Flt3 and platelet-derived growth factor receptors and the receptor encoded by the ret proto-oncogene. This drug is used in the treatment of gastrointestinal stromal cancer (GIST) resistant to imatinib and metastatic renal cell carcinoma (RCC). In this review, we report preclinical data of sunitinib, even about synergism with chemotherapy and radiotherapy, data relative to phase III trials of sunitinib in the treatment of GIST and RCC, and we try to plan what will be future applications of sunitinib in different types of cancer, even in association to chemotherapy, radiotherapy and monoclonal antibodies.
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Affiliation(s)
- A M Grimaldi
- Division of Oncology, Azienda Ospedaliera di Rilievo Nazionale A, Naples, Italy
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Del Principe D, Menichelli A, Di Giulio S, Giordani M, De Matteis W, Grimaldi AM, Finazzi-Agrò A. Metabolic and functional properties of cholesterol-poor platelets. Ann N Y Acad Sci 1991; 623:437-40. [PMID: 2042861 DOI: 10.1111/j.1749-6632.1991.tb43762.x] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- D Del Principe
- Department of Public Health and Cellular Biology, University Tor Vergata, Rome, Italy
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Athens AT, Grimaldi AM. Responses of metastatic prostatic carcinoma to endocrine therapy: report of a case. J Am Osteopath Assoc 1983; 83:307-11. [PMID: 6668239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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