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Pucci R, Cassoni A, Weyh A, Mangini N, Della Monaca M, Battisti A, Fernandes R, Valentini V. Transoral versus transfacial surgical approach to maxillary tumors: evaluation of outcomes and perspectives. Int J Oral Maxillofac Surg 2024; 53:101-108. [PMID: 37271627 DOI: 10.1016/j.ijom.2023.05.006] [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: 07/29/2022] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
Neoplasms of the maxilla have multiple different origins and histology, and often extend towards the infratemporal fossa, orbit, or skull base. Extensive resection may be required, often leading to poor esthetic and functional results. Usually, these lesions are removed via a transfacial approach. The aim of this study was to compare the outcomes of the transoral versus transfacial approach for maxillary tumors. A single-institution retrospective study was conducted on patients with maxillary-midface tumors, treated between January 2009 and December 2019. The patients were divided into two groups according to the surgical approach, transfacial or transoral, and the following outcomes were assessed: extent of the resection based on Brown's classification; postoperative pathology margin assessment; reconstruction technique; esthetic/functional results. A total of 178 patients were included. A satisfactory resection was obtained in both groups, with the transoral cohort achieving a higher rate of clear oncological margins (positive margins: transoral group 3.7% versus transfacial group 6.8%, P = 0.389) and a significantly higher University of Washington Quality of Life score (mean 72.2 versus 67.8, P < 0.001). Even large and invasive tumors can be treated successfully with the transoral approach, avoiding unesthetic facial scars while still providing complete resection of the tumor.
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Affiliation(s)
- R Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - A Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy.
| | - A Weyh
- Department of Oral and Maxillofacial Surgery, University of Florida Health, Jacksonville, FL, USA
| | - N Mangini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - M Della Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - A Battisti
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - R Fernandes
- Department of Oral and Maxillofacial Surgery, University of Florida Health, Jacksonville, FL, USA
| | - V Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Testoni B, Roca Suarez AA, Battisti A, Plissonnier ML, Heil M, Fontanges T, Villeret F, Chouik Y, Levrero M, Gill U, Kennedy P, Zoulim F. Evaluation of the HBV liver reservoir with fine needle aspirates. JHEP Rep 2023; 5:100841. [PMID: 37675272 PMCID: PMC10477677 DOI: 10.1016/j.jhepr.2023.100841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 09/08/2023] Open
Abstract
Background & Aims Finite duration of treatment associated with HBsAg loss is the current goal for improved therapeutic approaches against chronic HBV infection, as it indicates elimination or durable inactivation of intrahepatic covalently closed circular DNA (cccDNA). To assist drug development, the definition of early predictive markers of HBsAg loss by assessing their value in reflecting intrahepatic cccDNA levels and transcriptional activity is essential. Fine needle aspirates (FNAs) have recently emerged as a less invasive alternative to core liver biopsy (CLB) and showed to be useful for investigating intrahepatic immune responses. The aim of this study was to optimise and validate the use of FNA vs. CLB to evaluate the intrahepatic viral reservoir. Methods Paired FNA/CLB samples were obtained from patients with HBeAg+ chronic hepatitis (n = 4), HBeAg- chronic hepatitis (n = 4), and HBeAg- chronic infection (n = 1). One HBeAg+ patient was undergoing tenofovir treatment. HBV 3.5-kb RNA and cccDNA were quantified by droplet digital PCR. Results cccDNA was quantifiable in all but one FNA/CLB pair, showing the highest levels in untreated HBeAg+ patients, except for the tenofovir-treated patient. Similarly, 3.5-kb RNA was detectable in all but one FNA sample and showed higher levels in HBeAg+ patients. When comparing cccDNA and 3.5-kb RNA quantification in FNA vs. CLB samples, no statistically significant differences were identified. Conclusions These results demonstrate the possibility to quantify cccDNA and assess its transcriptional activity in patients with chronic hepatitis B by combining FNA and droplet digital PCR. This supports the use of FNA in clinical trials to evaluate the intrahepatic viral reservoir during the development of new antivirals and immunomodulatory agents. Impact and implications Chronic hepatitis B infection is characterised by a complex interplay between immune responses and viral replication in the liver, which determines the long-term outcome of the disease. In this study, we show that fine needle aspiration of the liver, a less-invasive alternative to core biopsies, allows the assessment of the hepatic viral reservoir.
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Affiliation(s)
- Barbara Testoni
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- University of Lyon, Université Claude-Bernard (UCBL), Lyon, France
- Hepatology Institute of Lyon, Lyon, France
| | - Armando Andres Roca Suarez
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- University of Lyon, Université Claude-Bernard (UCBL), Lyon, France
- Hepatology Institute of Lyon, Lyon, France
| | - Arianna Battisti
- Barts Liver Centre, Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marie-Laure Plissonnier
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- University of Lyon, Université Claude-Bernard (UCBL), Lyon, France
- Hepatology Institute of Lyon, Lyon, France
| | | | - Thierry Fontanges
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - François Villeret
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Yasmina Chouik
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Massimo Levrero
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- Hepatology Institute of Lyon, Lyon, France
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
- Department of Internal Medicine – DMISM and the IIT Center for Life Nanoscience (CLNS), Sapienza University, Rome, Italy
| | - Upkar Gill
- Barts Liver Centre, Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Patrick Kennedy
- Barts Liver Centre, Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Fabien Zoulim
- INSERM U1052, CNRS UMR-5286, Cancer Research Center of Lyon (CRCL), Lyon, France
- University of Lyon, Université Claude-Bernard (UCBL), Lyon, France
- Hepatology Institute of Lyon, Lyon, France
- Department of Hepatology, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
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Zannoli S, Brandolini M, Marino MM, Denicolò A, Mancini A, Taddei F, Arfilli V, Manera M, Gatti G, Battisti A, Grumiro L, Scalcione A, Dirani G, Sambri V. SARS-CoV-2 Co-Infection in Immunocompromised Host Leads to Generation of Recombinant Strain. Int J Infect Dis 2023; 131:65-70. [PMID: 36924839 PMCID: PMC10014127 DOI: 10.1016/j.ijid.2023.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 03/15/2023] Open
Abstract
Recombination related to co-infection is a huge driving force in determining the virus genetic variability, particularly in conditions of partial immune control leading to prolonged infection. Here we characterized a distinctive mutational pattern, highly suggestive of Delta-Omicron double infection, in a lymphoma patient. The specimen was characterized through a combined approach, analyzing the results of deep sequencing in primary sample, viral culture and plaque assay. Bioinformatic analysis on the sequences deriving from the primary sample supports the hypothesis of a double viral population within the host. Plaque assay on viral culture led to the isolation of a recombinant strain deriving from Delta and Omicron lineages, named XS, which virtually replaced its parent lineages within a single viral propagation. It is impossible to establish whether the recombination event happened within the host or in vitro, however it is important to monitor co-infections, especially in the exceptional intra-host environment of immunocompromised patients, as strong driving forces of viral evolution.
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Affiliation(s)
- Silvia Zannoli
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy.
| | - Martina Brandolini
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Maria Michela Marino
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Agnese Denicolò
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Andrea Mancini
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Francesca Taddei
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Valentina Arfilli
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Martina Manera
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Giulia Gatti
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Arianna Battisti
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Laura Grumiro
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Agata Scalcione
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Giorgio Dirani
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Pievesestina di Cesena (FC), Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Pievesestina di Cesena (FC), Italy
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Ruzzier E, Muzzi M, Kadej M, Battisti A, Di Giulio A. Trogoderma granarium Everts, 1898 (Coleoptera: dermestidae) – a model species to investigate hastisetae functional morphology. The European Zoological Journal 2022. [DOI: 10.1080/24750263.2022.2101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- E. Ruzzier
- Department of Agronomy, Food, Natural Resources, Animals and the Environment (DAFNAE), University of Padova, Padova, Italy
| | - M. Muzzi
- Department of Science, University of Roma Tre, Rome, Italy
- Laboratorio Interdipartimentale di Microscopia Elettronica (L.I.M.E.), University of Roma Tre, Rome, Italy
| | - M. Kadej
- Department of Invertebrate Biology, Evolution and Conservation, University of Wrocław, Wrocław, Poland
| | - A. Battisti
- Department of Agronomy, Food, Natural Resources, Animals and the Environment (DAFNAE), University of Padova, Padova, Italy
| | - A. Di Giulio
- Department of Science, University of Roma Tre, Rome, Italy
- Laboratorio Interdipartimentale di Microscopia Elettronica (L.I.M.E.), University of Roma Tre, Rome, Italy
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5
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Brandolini M, Dirani G, Taddei F, Zannoli S, Denicolò A, Arfilli V, Battisti A, Manera M, Mancini A, Grumiro L, Marino MM, Gatti G, Fantini M, Semprini S, Sambri V. Mutational induction in SARS-CoV-2 major lineages by experimental exposure to neutralising sera. Sci Rep 2022; 12:12479. [PMID: 35864211 PMCID: PMC9302871 DOI: 10.1038/s41598-022-16533-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
The ongoing evolution of SARS-CoV-2 and the emergence of new viral variants bearing specific escape mutations responsible for immune evasion from antibody neutralisation has required a more accurate characterisation of the immune response as one of the evolutive forces behind viral adaptation to a largely immunised human population. In this work, culturing in the presence of neutralising sera vigorously promoted mutagenesis leading to the acquisition of known escape mutations on the spike as well as new presumptive escape mutations on structural proteins whose role as target of the neutralizing antibody response might have been thus far widely neglected. From this perspective, this study, in addition to tracing the past evolution of the species back to interactions with neutralising antibody immune response, also offers a glimpse into future evolutive scenarios.
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Affiliation(s)
- Martina Brandolini
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Giorgio Dirani
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Francesca Taddei
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Silvia Zannoli
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Agnese Denicolò
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Valentina Arfilli
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Arianna Battisti
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Martina Manera
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Andrea Mancini
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Laura Grumiro
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Maria Michela Marino
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Giulia Gatti
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Michela Fantini
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Simona Semprini
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
| | - Vittorio Sambri
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES)-Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy.
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6
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Pancaldo D, Amoroso G, Armando E, Barbero U, Bassignana A, Battisti A, Bricco G, Cavallero E, Coppolino A, Correndo L, De Benedictis M, Dogliani S, Iacovino C, Moncalvo C, Pavani M, Valeri L. P304 CASE OF MYOCARDITIS AFTER COVID 19 VACCINATION. Eur Heart J Suppl 2022. [PMCID: PMC9384021 DOI: 10.1093/eurheartj/suac012.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
COVID 19 has so far found the only barrier in the use of mRNA and viral vector vaccines. Among the rare adverse effects related to mRNA vaccines is myocarditis (4.8 cases per million doses) a disease already found in COVID 19 infection but not in the safety studies of the vaccines. Males not older than 30 years (40% of the total), subjected to the second dose inoculation, are most affected. During our recent clinical practice there was a case of a patient with myocarditis, attributable to vaccination for COVID 19. It was a male, twenty–year–old, non–allergic smoker, subjected to second dose of Pfizer–BioNTech vaccine (BNT162b2). On the fifth day after the inoculation, the patient, already asthenic from the previous days, complained of an episode of oppressive chest pain, which lasted about 15 minutes, which returned, more intense the following night, associated with dyspnea, lasted for hours. When the patient went to the emergency room the pain was in regression and there was good hemodynamic compensation. EKG: sinus rhythm, slight diffuse ST segment elevation, more pronounced in the inferior–lateral leads, slight lowering of the P–R segment. Blood tests: troponin, CKMB and PCR increase, negativity of the molecular test for COVID 19. Echocardiography: normal left ventricle, non–dilated right sections, normokinetic right ventricle, normal valves, pericardial hyper–refraction without effusion, normal diastolic relaxation. In the suspicion of myocarditis, the patient was admitted to our intensive cardiological care. With the high–dose anti–inflammatory and beta–blocker therapy the pain gradually disappeared; never fever; EKG showed progressive ST segment improvement and T wave negativization. Never arrhythmic events. Negativity for all infections with common viral pathogens. MRI: hyperintensity (T2 STIR sequences and late enhancement) in the infero–lateral area. Patient discharged in therapy with lysine acetylsalicylate, to be reduced, associated with pantoprazole, and metoprolol and indicated for outpatient checks. In conclusion, the case presented reflects the scientific literature in the type of patient and in the favorable evolution of the disease.
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Affiliation(s)
- D Pancaldo
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - G Amoroso
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - E Armando
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - U Barbero
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - A Bassignana
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - A Battisti
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - G Bricco
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - E Cavallero
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - A Coppolino
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - L Correndo
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - M De Benedictis
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - S Dogliani
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - C Iacovino
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - C Moncalvo
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - M Pavani
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
| | - L Valeri
- S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. RADIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO; S.C. CARDIOLOGIA, OSPEDALE SS ANNUNZIATA, SAVIGLIANO
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7
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Bricco G, Coppolino A, Valeri L, Amoroso G, Cavallero E, Iacovino C, Barbero U, Battisti A, Scaglione M, Correndo L, Bessignana A, De Benedictis M. P172 AN ACCESSORY PATHWAY WITHOUT REENTRANT TACHYCARDIA. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A 65–year–old patient, hypertensive, dyslipidemic, strong smoker. He has heart disease with hypokinetic evolution EF 47%, mild MI. Negative Dipyridamole–stress echocardiography dated January 2008. Recently atrial fibrillation (AF) is found and anticoagulant therapy was started. Dyspnea and weight loss occurred in past two months. Detected keratinizing squamous pulmonary Ca with negative markers. This injury was judged to be inoperable, and the patient get indications for chemotherapy and radiotherapy. The patient also starts complaining of dyspnea and chest pain on exertion: Not serological modification, not ischemic ECG. Echocardiogram LVEF 47–50% highlights diffuse hypokinesia, regular valves. Ergometric test was not evaluable for ischemia. Coronary angiography shows stenosis of proximal and middle anterior interventricular coronary and non–critical lesions of circumflex and right coronary. Ecodobutamine test was positive for ischemia and arrhythmias (AF and wide QRS tachycardias in recovery phase), but negative for angor. The patient was treated with CT and IVA I – II. angioplasty Monitoring shows AF with high penetrance, wide QRS tachycardia runs and very short TVNS. ECG 1: During atrial tachycardia, show broad QRS conduction to BBSX alternating with narrow QRS with the same RR interval. ECG 2. show fusion between the wavefront conducted with narrow QRS and that with wide QRS. These are supraventricular arrhythmias that run along the atrioventricular nodal pathway (NAV) in the narrow QRS tracts and take an accessory pathway in the wide QRS run.
The Mahaim fibers have decremental conductivities like the AV node, therefore high ventricular frequencies does not occur AF appeared during ecodobutamine, but some beats were conducted by an anomalous path in a discontinuous way); they are generally directed from the atrium or the NAV, towards another part of the right ventricular conduction system, with atrium wave or NAV – RB, therefore the early activation of the RB generates a widened QRS, with a LBB morphology. ECG 3 Re–entry on Mahaim pathway, ventricular activation widened through Mahaim fiber, which generate LBB morphology with retrograde atrial depolarization. In this case there is no reentry, but we have an atrial tachycardia conducted alternately on an accessory pathway and across the NAV. Given the patient‘s clinical problems and the total absence of symptoms, the patient remains asymptomatic during therapy with amiodarone and beta–blocker.
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Affiliation(s)
- G Bricco
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - A Coppolino
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - L Valeri
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - G Amoroso
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - E Cavallero
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - C Iacovino
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - U Barbero
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - A Battisti
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - M Scaglione
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - L Correndo
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
| | - A Bessignana
- CARDIOLOGIA SAVIGLIANO ASLCN1, SAVIGLIANO; ASLAT, ASTI
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8
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Cerva C, Salpini R, Alkhatib M, Malagnino V, Piermatteo L, Battisti A, Bertoli A, Gersch J, Holzmayer V, Kuhns M, Cloherty G, Ferrari L, Laura C, Teti E, Cantonetti M, Arcese W, Ceccherini-Silberstein F, Perno CF, Andreoni M, Svicher V, Sarmati L. Highly Sensitive HBsAg, Anti-HBc and Anti HBsAg Titres in Early Diagnosis of HBV Reactivation in Anti-HBc-Positive Onco-Haematological Patients. Biomedicines 2022; 10:biomedicines10020443. [PMID: 35203653 PMCID: PMC8962433 DOI: 10.3390/biomedicines10020443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 12/21/2022] Open
Abstract
The role of novel HBV markers in predicting Hepatitis B virus reactivation (HBV-R) in HBsAg-negative/anti-HBc-positive oncohaematological patients was examined. One hundred and seven HBsAg-negative/anti-HBc-positive oncohaematological patients, receiving anti-HBV prophylaxis for >18 months, were included. At baseline, all patients had undetectable HBV DNA, and 67.3% were anti-HBs positive. HBV-R occurred in 17 (15.9%) patients: 6 during and 11 after the prophylaxis period. At HBV-R, the median (IQR) HBV-DNA was 44 (27–40509) IU/mL, and the alanine aminotransferase upper limit of normal (ULN) was 44% (median (IQR): 81 (49–541) U/L). An anti-HBc > 3 cut-off index (COI) plus anti-HBs persistently/declining to <50 mIU/mL was predictive for HBV-R (OR (95% CI): 9.1 (2.7–30.2); 63% of patients with vs. 15% without this combination experienced HBV-R (p < 0.001)). The detection of highly sensitive (HS) HBsAg and/or HBV-DNA confirmed at >2 time points, also predicts HBV-R (OR (95% CI): 13.8 (3.6–52.6); 50% of positive vs. 7% of negative patients to these markers experienced HBV-R (p = 0.001)). HS-HBs and anti-HBc titration proved to be useful early markers of HBV-R. The use of these markers demonstrated that HBV-R frequently occurs in oncohaematological patients with signs of resolved HBV infection, raising issues of proper HBV-R monitoring.
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Affiliation(s)
| | - Romina Salpini
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Mohammad Alkhatib
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Vincenzo Malagnino
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Arianna Battisti
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Ada Bertoli
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Jeff Gersch
- Infectious Disease Research, Abbott Diagnostics, Abbott Park, Green Oaks, IL 60064, USA; (J.G.); (V.H.); (M.K.); (G.C.)
| | - Vera Holzmayer
- Infectious Disease Research, Abbott Diagnostics, Abbott Park, Green Oaks, IL 60064, USA; (J.G.); (V.H.); (M.K.); (G.C.)
| | - Mary Kuhns
- Infectious Disease Research, Abbott Diagnostics, Abbott Park, Green Oaks, IL 60064, USA; (J.G.); (V.H.); (M.K.); (G.C.)
| | - Gavin Cloherty
- Infectious Disease Research, Abbott Diagnostics, Abbott Park, Green Oaks, IL 60064, USA; (J.G.); (V.H.); (M.K.); (G.C.)
| | - Ludovica Ferrari
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
| | - Campogiani Laura
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
| | - Elisabetta Teti
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
| | - Maria Cantonetti
- Stem Cell Transplant Unit, Department of Hematology, Tor Vergata University, 00133 Rome, Italy; (M.C.); (W.A.)
| | - William Arcese
- Stem Cell Transplant Unit, Department of Hematology, Tor Vergata University, 00133 Rome, Italy; (M.C.); (W.A.)
| | - Francesca Ceccherini-Silberstein
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | | | - Massimo Andreoni
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
| | - Valentina Svicher
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); mohammad-- (M.A.); (L.P.); (A.B.); (A.B.); (F.C.-S.); (V.S.)
| | - Loredana Sarmati
- Unit of Clinical Infectious Disease, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy; (V.M.); (L.F.); (C.L.); (E.T.); (M.A.)
- Correspondence:
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9
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Svicher V, Salpini R, Piermatteo L, Carioti L, Battisti A, Colagrossi L, Scutari R, Surdo M, Cacciafesta V, Nuccitelli A, Hansi N, Ceccherini Silberstein F, Perno CF, Gill US, Kennedy PTF. Whole exome HBV DNA integration is independent of the intrahepatic HBV reservoir in HBeAg-negative chronic hepatitis B. Gut 2021; 70:2337-2348. [PMID: 33402415 PMCID: PMC8588301 DOI: 10.1136/gutjnl-2020-323300] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/02/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The involvement of HBV DNA integration in promoting hepatocarcinogenesis and the extent to which the intrahepatic HBV reservoir modulates liver disease progression remains poorly understood. We examined the intrahepatic HBV reservoir, the occurrence of HBV DNA integration and its impact on the hepatocyte transcriptome in hepatitis B 'e' antigen (HBeAg)-negative chronic hepatitis B (CHB). DESIGN Liver tissue from 84 HBeAg-negative patients with CHB with low (n=12), moderate (n=25) and high (n=47) serum HBV DNA was analysed. Covalently closed circular DNA (cccDNA), pregenomic RNA (pgRNA) were evaluated by quantitative PCR, whole exome and transcriptome sequencing was performed by Illumina, and the burden of HBV DNA integrations was evaluated by digital droplet PCR. RESULTS Patients with low and moderate serum HBV DNA displayed comparable intrahepatic cccDNA and pgRNA, significantly lower than in patients with high HBV DNA, while hepatitis B core-related antigen correlated strongly with the intrahepatic HBV reservoir, reflecting cccDNA quantity. Whole exome integration was detected in a significant number of patients (55.6%, 14.3% and 25% in high, moderate and low viraemic patients, respectively), at a frequency ranging from 0.5 to 157 integrations/1000 hepatocytes. Hepatitis B surface antigen >5000 IU/mL predicted integration within the exome and these integrations localised in genes involved in hepatocarcinogenesis, regulation of lipid/drug metabolism and antiviral/inflammatory responses. Transcript levels of specific genes, including the proto-oncogene hRAS, were higher in patients with HBV DNA integration, supporting an underlying oncogenic risk in patients with low-level to moderate-level viraemia. CONCLUSIONS HBV DNA integration occurs across all HBeAg-negative patients with CHB, including those with a limited HBV reservoir; localising in genes involved in carcinogenesis and altering the hepatocyte transcriptome.
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Affiliation(s)
- Valentina Svicher
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Romina Salpini
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Arianna Battisti
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy,Barts Liver Cente, Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Luna Colagrossi
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy,Department of Microbiology and Virology, University of Milan, Milano, Lombardia, Italy
| | - Rossana Scutari
- Department of Experimental Medicine, University of Rome Tor Vergata, Roma, Lazio, Italy
| | - Matteo Surdo
- Molecular Genetics Laboratory, Eurofins GENOMA, Roma, Lazio, Italy
| | | | | | - Navjyot Hansi
- Barts Liver Cente, Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | | | - Carlo Federico Perno
- Department of Oncology and Haematooncology, University of Milan, Milano, Lombardia, Italy
| | - Upkar S Gill
- Barts Liver Cente, Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Patrick T F Kennedy
- Barts Liver Cente, Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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10
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Zannoli S, Dirani G, Taddei F, Gatti G, Poggianti I, Denicolò A, Arfilli V, Manera M, Mancini A, Battisti A, Sambri V. A deletion in the N gene may cause diagnostic escape in SARS-CoV-2 samples. Diagn Microbiol Infect Dis 2021; 102:115540. [PMID: 34649189 PMCID: PMC8447549 DOI: 10.1016/j.diagmicrobio.2021.115540] [Citation(s) in RCA: 6] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/07/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
Five SARS-CoV-2-positive samples showed N-gene drop-out with a RT-PCR multiplex test. WGS found all samples to harbor a deletion in the same region of the N gene, which is likely to impair the efficiency of amplification. This highlights the need for a continued surveillance of viral evolution and diagnostic test performance.
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Affiliation(s)
- Silvia Zannoli
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy.
| | - Giorgio Dirani
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Francesca Taddei
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Giulia Gatti
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Ilaria Poggianti
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Agnese Denicolò
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | | | - Martina Manera
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Andrea Mancini
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Arianna Battisti
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy
| | - Vittorio Sambri
- Unit of Microbiology, The Great Romagna Area Hub Laboratory, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna
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11
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Brancaccio G, Salpini R, Piermatteo L, Surdo M, Fini V, Colagrossi L, Cantone M, Battisti A, Oda Y, Di Carlo D, Ceccherini-Silberstein F, Perno CF, Gaeta GB, Svicher V. An Increase in the Levels of Middle Surface Antigen Characterizes Patients Developing HBV-Driven Liver Cancer Despite Prolonged Virological Suppression. Microorganisms 2021; 9:752. [PMID: 33918474 PMCID: PMC8065957 DOI: 10.3390/microorganisms9040752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 01/05/2023] Open
Abstract
Hepatitis B virus (HBV) contains three surface glycoproteins-Large-HBs (L-HBs), Middle-HBs (M-HBs), and Small-HBs (S-HBs), known to contribute to HBV-driven pro-oncogenic properties. Here, we examined the kinetics of HBs-isoforms in virologically-suppressed patients who developed or did not develop hepatocellular carcinoma (HCC). This study enrolled 30 chronically HBV-infected cirrhotic patients under fully-suppressive anti-HBV treatment. Among them, 13 patients developed HCC. Serum samples were collected at enrolment (T0) and at HCC diagnosis or at the last control for non-HCC patients (median (range) follow-up: 38 (12-48) months). Ad-hoc ELISAs were designed to quantify L-HBs, M-HBs and S-HBs (Beacle). At T0, median (IQR) levels of S-HBs, M-HBs and L-HBs were 3140 (457-6995), 220 (31-433) and 0.2 (0-1.7) ng/mL. No significant differences in the fraction of the three HBs-isoforms were noticed between patients who developed or did not develop HCC at T0. On treatment, S-HBs showed a >25% decline or remained stable in a similar proportion of HCC and non-HCC patients (58.3% of HCC- vs. 47.1% of non-HCC patients, p = 0.6; 25% of HCC vs. 29.4% of non-HCC, p = 0.8, respectively). Conversely, M-HBs showed a >25% increase in a higher proportion of HCC compared to non-HCC patients (50% vs. 11.8%, p = 0.02), in line with M-HBs pro-oncogenic role reported in in vitro studies. No difference in L-HBs kinetics was observed in HCC and non-HCC patients. In conclusion, an increase in M-HBs levels characterizes a significant fraction of HCC-patients while under prolonged HBV suppression and stable/reduced total-HBs. The role of M-HBs kinetics in identifying patients at higher HCC risk deserves further investigation.
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Affiliation(s)
| | - Romina Salpini
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (F.C.-S.)
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (F.C.-S.)
| | - Matteo Surdo
- Molecular Genetics Laboratory, Eurofins Genoma, 00138 Rome, Italy; (M.S.); (V.F.)
| | - Vanessa Fini
- Molecular Genetics Laboratory, Eurofins Genoma, 00138 Rome, Italy; (M.S.); (V.F.)
| | - Luna Colagrossi
- Department of Diagnostic Medicine and Laboratory, Bambin Gesù Children’s Hospital, 00165 Rome, Italy; (L.C.); (C.F.P.)
| | - Marco Cantone
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (M.C.); (G.B.G.)
| | - Arianna Battisti
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (F.C.-S.)
| | | | - Domenico Di Carlo
- Paediatric Clinical Research Center “Romeo and Enrica Invernizzi”, University of Milan, 26900 Milan, Italy;
| | | | - Carlo Federico Perno
- Department of Diagnostic Medicine and Laboratory, Bambin Gesù Children’s Hospital, 00165 Rome, Italy; (L.C.); (C.F.P.)
| | - Giovanni Battista Gaeta
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (M.C.); (G.B.G.)
| | - Valentina Svicher
- Department of Experimental Medicine, Tor Vergata University, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (F.C.-S.)
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12
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Pozza G, Pinto A, Crovato S, Mascarello G, Bano L, Dacasto M, Battisti A, Bartoli B, Ravarotto L, Marangon S. Antimicrobial use and antimicrobial resistance: standpoint and prescribing behaviour of Italian cattle and pig veterinarians. Italian Journal of Animal Science 2020. [DOI: 10.1080/1828051x.2020.1807419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- G. Pozza
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - A. Pinto
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - S. Crovato
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - G. Mascarello
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - L. Bano
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - M. Dacasto
- Dipartimento Biomedicina Comparata e Alimentazione, Università di Padova, Legnaro, Italy
| | - A. Battisti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Roma, Italy
| | | | - L. Ravarotto
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - S. Marangon
- Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
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13
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Salpini R, Battisti A, Piermatteo L, Carioti L, Anastasiou OE, Gill US, Di Carlo D, Colagrossi L, Duca L, Bertoli A, La Rosa KY, Fabeni L, Iuvara A, Malagnino V, Cerva C, Lichtner M, Mastroianni CM, De Sanctis GM, Paoloni M, Marignani M, Pasquazzi C, Iapadre N, Parruti G, Vecchiet J, Sarmati L, Andreoni M, Angelico M, Grelli S, T Kennedy P, Verheyen J, Aquaro S, Silberstein FC, Perno CF, Svicher V. Key mutations in the C-terminus of the HBV surface glycoprotein correlate with lower HBsAg levels in vivo, hinder HBsAg secretion in vitro and reduce HBsAg structural stability in the setting of HBeAg-negative chronic HBV genotype-D infection. Emerg Microbes Infect 2020; 9:928-939. [PMID: 32312174 PMCID: PMC7269061 DOI: 10.1080/22221751.2020.1757998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Increasing evidences suggest that HBsAg-production varies across HBV-genotypes. HBsAg C-terminus plays a crucial role for HBsAg-secretion. Here, we evaluate HBsAg-levels in different HBV-genotypes in HBeAg-negative chronic infection, the correlation of specific mutations in HBsAg C-terminus with HBsAg-levels in-vivo, their impact on HBsAg-secretion in-vitro and on structural stability in-silico. HBsAg-levels were investigated in 323 drug-naïve HBeAg-negative patients chronically infected with HBV genotype-D(N = 228), -A(N = 65) and -E(N = 30). Genotype-D was characterized by HBsAg-levels lower than genotype-A and -E (3.3[2.7–3.8]IU/ml; 3.8[3.5–4.2]IU/ml and 3.9[3.7–4.2]IU/ml, P < 0.001). Results confirmed by multivariable analysis correcting for patients’demographics, HBV-DNA, ALT and infection-status. In genotype-D, specific C-terminus mutations (V190A-S204N-Y206C-Y206F-S210N) significantly correlate with HBsAg<1000IU/ml(P-value from <0.001 to 0.04). These mutations lie in divergent pathways involving other HBsAg C-terminus mutations: V190A + F220L (Phi = 0.41, P = 0.003), S204N + L205P (Phi = 0.36, P = 0.005), Y206F + S210R (Phi = 0.47, P < 0.001) and S210N + F220L (Phi = 0.40, P = 0.006). Notably, patients with these mutational pairs present HBsAg-levels 1log lower than patients without them(P-value from 0.003 to 0.02). In-vitro, the above-mentioned mutational pairs determined a significant decrease in HBsAg secretion-efficiency compared to wt(P-value from <0.001 to 0.02). Structurally, these mutational pairs reduced HBsAg C-terminus stability and determined a rearrangement of this domain. In conclusion, HBsAg-levels in genotype-D are significantly lower than in genotype-A and -E in HBeAg-negative patients. In genotype-D, specific mutational clusters in HBsAg C-terminus correlate with lower HBsAg-levels in-vivo, hamper HBsAg-release in-vitro and affect its structural stability, supporting their detrimental role on HBsAg-secretion. In this light, genotypic-testing can be a valuable tool to optimize the clinical interpretation of HBsAg in genotype-D and to provide information on HBV-pathogenicity and disease-progression.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Arianna Battisti
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Olympia E Anastasiou
- Institute of Virology, University-Hospital, University Duisburg-Essen, Essen, Germany
| | - Upkar S Gill
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Domenico Di Carlo
- Paediatric Clinical Research Center "Romeo and Enrica Invernizzi", University of Milan, Milan, Italy
| | - Luna Colagrossi
- Microbiology and Virology Unit, University of Milan, Milan, Italy
| | - Leonardo Duca
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Katia Yu La Rosa
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lavinia Fabeni
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" -IRCCS, Rome, Italy
| | - Alessandra Iuvara
- Microbiology and Virology Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Carlotta Cerva
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Miriam Lichtner
- Public Health and Infectious Disease Department, "Sapienza" University, Rome, Italy
| | | | | | - Maurizio Paoloni
- Infectious Disease Unit, "S.S. Filippo e Nicola" Hospital, Avezzano, Italy
| | | | | | | | - Giustino Parruti
- Infectious Disease Unit, Pescara General Hospital, Pescara, Italy
| | - Jacopo Vecchiet
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Massimo Andreoni
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Mario Angelico
- Hepatology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Sandro Grelli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.,Microbiology and Virology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Patrick T Kennedy
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Jens Verheyen
- Institute of Virology, University-Hospital, University Duisburg-Essen, Essen, Germany
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | | | | | - Valentina Svicher
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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14
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Iorio S, Salvatori LM, Barnocchi A, Battisti A, Rinaldi A, Marceca M, Ricotta G, Brandimarte AM, Baglio G, Gazzaniga V, Paglione L. Social inequalities in the metropolitan area of Rome. A multidisciplinary analysis of the urban segregation of the "formerly-Bastogi" compound. Ann Ig 2020; 31:211-229. [PMID: 31069366 DOI: 10.7416/ai.2019.2284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study tries to evaluate, through a multidisciplinary approach, the relationship between urban structure, isolation and distribution of social determinants of health, in the so-called "formerly-Bastogi, a compound, with more than 1,500 inhabitants, located in north-western Rome, Italy. METHODS The architectural-urban analysis, conducted through site visits and evaluations of urban situation, showed how strongly the compound is isolated from the neighbourhoods, and structurally degraded. The socio-demographic analysis, based on the National Census data, showed significant differences in the distribution of the social determinants of health between "formerly-Bastogi" and the surrounding areas. RESULTS The area under study appears to be isolated from the surrounding urban space, both because of social and architectural factors. This situation could have some association with inhabitants' health. CONCLUSIONS If our preliminary investigation was useful for a diagnosis of the situation, a more complete - qualitative and quantitative - investigation of the context will be needed to plan appropriate multidisciplinary health-promoting interventions.
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Affiliation(s)
- S Iorio
- Department of Molecular Medicine, Unit of History of Medicine and Bioethics, Sapienza, University of Rome, Italy
| | - L M Salvatori
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - A Barnocchi
- Department of Planning, Design, and Technology of Architecture, Sapienza University of Rome, Italy
| | - A Battisti
- Department of Planning, Design, and Technology of Architecture, Sapienza University of Rome, Italy
| | - A Rinaldi
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - M Marceca
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
| | - G Ricotta
- Department of Social Sciences and Economics, Sapienza University of Rome, Italy
| | - A M Brandimarte
- Hygiene and Public Health Operational Service, Local Health Unit Roma1, Rome, Italy
| | - G Baglio
- National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy
| | - V Gazzaniga
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - L Paglione
- Department of Public Health and Infectious Diseases, Sapienza, University of Rome, Italy
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15
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Bigogno CM, Falahieh RR, Ho KMA, Jeffrey-Smith A, Jones M, Usai C, Battisti A, Gill U, Kennedy P. The genetic landscape of hepatitis delta virus infection. Clin Med (Lond) 2020; 20:s101. [DOI: 10.7861/clinmed.20-2-s101] [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: 11/27/2022]
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16
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Salpini R, Piermatteo L, Battisti A, Colagrossi L, Aragri M, Yu La Rosa K, Bertoli A, Saccomandi P, Lichtner M, Marignani M, Maylin S, Delaugerre C, Morisco F, Coppola N, Marrone A, Iapadre N, Cerva C, Aquaro S, Angelico M, Sarmati L, Andreoni M, Verheyen J, Ceccherini-Silberstein F, Levrero M, Perno CF, Belloni L, Svicher V. A Hyper-Glycosylation of HBV Surface Antigen Correlates with HBsAg-Negativity at Immunosuppression-Driven HBV Reactivation in Vivo and Hinders HBsAg Recognition in Vitro. Viruses 2020; 12:v12020251. [PMID: 32102257 PMCID: PMC7077195 DOI: 10.3390/v12020251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/17/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023] Open
Abstract
Immune-suppression driven Hepatitis B Virus (HBV)-reactivation poses serious concerns since it occurs in several clinical settings and can result in severe forms of hepatitis. Previous studies showed that HBV strains, circulating in patients with HBV-reactivation, are characterized by an enrichment of immune-escape mutations in HBV surface antigen (HBsAg). Here, we focused on specific immune-escape mutations associated with the acquisition of N-linked glycosylation sites in HBsAg (NLGSs). In particular, we investigated profiles of NLGSs in 47 patients with immunosuppression-driven HBV-reactivation and we evaluated their impact on HBsAg-antigenicity and HBV-replication in vitro. At HBV-reactivation, despite a median serum HBV-DNA of 6.7 [5.3–8.0] logIU/mL, 23.4% of patients remained HBsAg-negative. HBsAg-negativity at HBV-reactivation correlated with the presence of >1 additional NLGSs (p < 0.001). These NLGSs are located in the major hydrophilic region of HBsAg (known to be the target of antibodies) and resulted from the single mutation T115N, T117N, T123N, N114ins, and from the triple mutant S113N+T131N+M133T. In vitro, NLGSs strongly alter HBsAg antigenic properties and recognition by antibodies used in assays for HBsAg-quantification without affecting HBsAg-secretion and other parameters of HBV-replication. In conclusion, additional NLGSs correlate with HBsAg-negativity despite HBV-reactivation, and hamper HBsAg-antigenicity in vitro, supporting the role of NGSs in immune-escape and the importance of HBV-DNA for a proper diagnosis of HBV-reactivation.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Arianna Battisti
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Luna Colagrossi
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Marianna Aragri
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Katia Yu La Rosa
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Patrizia Saccomandi
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Miriam Lichtner
- Public Health and Infectious Disease Department, Sapienza University, 00185 Rome, Italy;
| | - Massimo Marignani
- Department of Gastroenterology, S.Andrea Hospital, 00189 Rome, Italy;
| | - Sarah Maylin
- Laboratoire de Virologie, AP-HP Hopital Saint-Louis, 75010 Paris, France; (S.M.); (C.D.)
| | - Constance Delaugerre
- Laboratoire de Virologie, AP-HP Hopital Saint-Louis, 75010 Paris, France; (S.M.); (C.D.)
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, 80138 Naples, Italy;
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80138 Naples, Italy;
| | - Aldo Marrone
- Internal Medicine and Hepatology Unit, Second University of Naples, 80138 Naples, Italy;
| | - Nerio Iapadre
- Infectious Diseases Unit, San Salvatore Hospital, 67100 L’Aquila, Italy;
| | - Carlotta Cerva
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (C.C.); (L.S.); (M.A.)
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy;
| | - Mario Angelico
- Hepatology Unit, Tor Vergata University Hospital, 00133 Rome, Italy;
| | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (C.C.); (L.S.); (M.A.)
| | - Massimo Andreoni
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (C.C.); (L.S.); (M.A.)
| | - Jens Verheyen
- Institute of Virology, University-Hospital, University Duisburg-Essen, 47057 Essen, Germany;
| | - Francesca Ceccherini-Silberstein
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
| | - Massimo Levrero
- Department of Internal Medicine-DMISM, Sapienza University, 00185 Rome, Italy; (M.L.); (L.B.)
- INSERM U1052-Cancer Research Center of Lyon (CRCL), University of Lyon, UMR_S1052, 69008 Lyon, France
| | - Carlo Federico Perno
- Department of Oncology and Haemato-oncology, University of Milan, 20122 Milan, Italy;
| | - Laura Belloni
- Department of Internal Medicine-DMISM, Sapienza University, 00185 Rome, Italy; (M.L.); (L.B.)
- Center for Life NanoSciences (CLNS), IIT-Sapienza, 00133 Rome, Italy
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (R.S.); (L.P.); (A.B.); (L.C.); (M.A.); (K.Y.L.R.); (A.B.); (P.S.); (F.C.-S.)
- Correspondence:
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17
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Abstract
Introduction: The availability of a preventative vaccine, interferon, and nucleos(t)ide analogs have provided progress in the control of chronic hepatitis B (CHB). Despite this, it remains a major contributor to global morbidity and mortality. Developments in our understanding of the pathogenesis of CHB and the emergence of new therapies are paving the way, as we move toward HBV cure.Areas covered: We performed bibliographical searches of online databases to review the literature regarding conventional disease phases of CHB. We provide the latest evidence challenging the perception of the natural history of CHB, noting that previously considered quiescent disease phases may not represent benign disease states devoid of progression. We explore the use of potential novel immunological and viral tools which should enhance disease stratification and management decisions in the coming years. Finally, we discuss the timing of treatment and how this could be initiated earlier to improve treatment outcomes, preventing sequelae of chronic infection.Expert opinion: The treatment paradigm in CHB is set to change with multiple novel agents in early phase clinical trials with the aim of a functional cure. An improved understanding of disease pathogenesis and the timing of treatment will be critical to the success of new therapies.
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Affiliation(s)
- Upkar S Gill
- Barts Liver Centre, Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Arianna Battisti
- Barts Liver Centre, Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Patrick T F Kennedy
- Barts Liver Centre, Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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18
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Salpini R, Battisti A, Colagrossi L, Di Carlo D, Fabeni L, Piermatteo L, Cerva C, Lichtner M, Mastroianni C, Marignani M, Maylin S, Delaugerre C, Morisco F, Coppola N, Marrone A, Angelico M, Sarmati L, Andreoni M, Perno CF, Ceccherini-Silberstein F, Svicher V. A snapshot of virological presentation and outcome of immunosuppression-driven HBV reactivation from real clinical practice: Evidence of a relevant risk of death and evolution from silent to chronic infection. J Viral Hepat 2019; 26:846-855. [PMID: 30974483 DOI: 10.1111/jvh.13101] [Citation(s) in RCA: 9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 12/12/2022]
Abstract
The study was undertaken in order to provide a snapshot from real clinical practice of virological presentation and outcome of patients developing immunosuppression-driven HBV reactivation. Seventy patients with HBV reactivation were included (66.2% treated with rituximab, 10% with corticosteroids and 23.8% with other immunosuppressive drugs). Following HBV reactivation, patients received anti-HBV treatment for a median (IQR) follow-up of 31(13-47) months. At baseline-screening, 72.9% of patients were HBsAg-negative and 27.1% HBsAg-positive. About 71.4% had a diagnosis of biochemical reactivation [median (IQR) HBV DNA and ALT: 6.9 (5.4-7.8) log IU/mL and 359 (102-775) U/L]. Moreover, 10% of patients died from hepatic failure. Antiviral prophylaxis was documented in 57.9% and 15.7% of HBsAg-positive and HBsAg-negative patients at baseline-screening (median [IQR] prophylaxis duration: 24[15-33] and 25[17-36] months, respectively). Notably, HBV reactivation occurred 2-24 months after completing the recommended course of anti-HBV prophylaxis in 35.3% of patients. By analysing treatment outcome, the cumulative probability of ALT normalization and of virological suppression was 97% and 69%, respectively. Nevertheless, in patients negative to HBsAg at baseline-screening, only 27% returned to HBsAg-negative status during prolonged follow-up, suggesting the establishment of chronic infection. In conclusion, most patients received a diagnosis of HBV reactivation accompanied by high ALT and 10% died for hepatic failure, supporting the importance of strict monitoring for an early HBV reactivation diagnosis. Furthermore, HBV reactivation correlates with high risk of HBV chronicity in patients negative for HBsAg at baseline-screening, converting a silent into a chronic infection, requiring long-term antiviral treatment. Finally, a relevant proportion of patients experienced HBV reactivation after completing the recommended course of anti-HBV prophylaxis, suggesting the need to reconsider proper duration of prophylaxis particularly in profound immunosuppression.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Arianna Battisti
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Luna Colagrossi
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy.,Department of Microbiology and Virology, University of Milan, Milan, Italy
| | - Domenico Di Carlo
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy.,Pediatric Clinical Research Center 'Romeo and Erica Invernizzi', University of Milan, Milan, Italy.,Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Lavinia Fabeni
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| | - Carlotta Cerva
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy
| | - Massimo Marignani
- Department of Digestive and Liver Disease, S.Andrea Hospital, Rome, Italy
| | - Sarah Maylin
- Laboratoire de Virologie, AP-HP Hopital Saint-Louis, Paris, France
| | | | - Filomena Morisco
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Nicola Coppola
- Section of Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Aldo Marrone
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Mario Angelico
- Hepatology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Massimo Andreoni
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Carlo-Federico Perno
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy.,Department of Oncology and Oncohematology, Università degli Studi di Milano, Milan, Italy
| | | | - Valentina Svicher
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
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19
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Bavaro DF, Di Carlo D, Zuccalà P, Bai F, Incardona F, Battisti A, Giachè S, Salomoni E, Gagliardini R, Di Giambenedetto S, Pecorari M, Zazzi M, De Luca A, Bezenchek A, Lo Caputo S. Letter to the editor: switching treatment to lamivudine plus boosted atazanavir or darunavir in virologically suppressed HIV-infected patients - evidence from a large observational cohort. Infect Dis (Lond) 2019; 51:234-239. [PMID: 30663927 DOI: 10.1080/23744235.2018.1544423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- D F Bavaro
- a University of Bari "Aldo Moro", Clinic of Infectious Diseases , Bari , Italy
| | - D Di Carlo
- b Pediatric Clinical Research Center "Romeo and Enrica Invernizzi" University of Milan , Milan , Italy.,c Department of Biology and Biotechnology , University of Pavia , Pavia , Italy
| | - P Zuccalà
- d Department of Public Health and Infectious Diseases , Italy "Sapienza" University of Rome , Rome , Italy
| | - F Bai
- e Department of Health Sciences , University of Milan, "San Paolo" Hospital, ASST "Santi Paolo e Carlo", Clinic of Infectious Diseases , Milan , Italy
| | - F Incardona
- f EuResist Network GEIE , Rome , Italy.,g InformaPRO S.r.l , Rome , Italy
| | - A Battisti
- h Experimental Medicine and Surgery, University of Rome "Tor Vergata" , Rome , Italy
| | - S Giachè
- i SOD Infectious and Tropical Diseases, AOU CAREGGI , Florence , Italy
| | - E Salomoni
- i SOD Infectious and Tropical Diseases, AOU CAREGGI , Florence , Italy
| | | | | | | | - M Zazzi
- m Department of Medical Biotechnologies , University of Siena , Siena , Italy
| | - A De Luca
- m Department of Medical Biotechnologies , University of Siena , Siena , Italy
| | | | - S Lo Caputo
- a University of Bari "Aldo Moro", Clinic of Infectious Diseases , Bari , Italy
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20
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Colagrossi L, Salpini R, Scutari R, Carioti L, Battisti A, Piermatteo L, Bertoli A, Fabeni L, Minichini C, Trimoulet P, Fleury H, Nebuloso E, De Cristofaro M, Cappiello G, Spanò A, Malagnino V, Mari T, Barlattani A, Iapadre N, Lichtner M, Mastroianni C, Lenci I, Pasquazzi C, De Sanctis GM, Galeota Lanza A, Stanzione M, Stornaiuolo G, Marignani M, Sarmati L, Andreoni M, Angelico M, Ceccherini-Silberstein F, Perno CF, Coppola N, Svicher V. HDV Can Constrain HBV Genetic Evolution in HBsAg: Implications for the Identification of Innovative Pharmacological Targets. Viruses 2018; 10:v10070363. [PMID: 29987240 PMCID: PMC6071122 DOI: 10.3390/v10070363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/06/2018] [Accepted: 07/07/2018] [Indexed: 02/07/2023] Open
Abstract
Chronic HBV + HDV infection is associated with greater risk of liver fibrosis, earlier hepatic decompensation, and liver cirrhosis hepatocellular carcinoma compared to HBV mono-infection. However, to-date no direct anti-HDV drugs are available in clinical practice. Here, we identified conserved and variable regions in HBsAg and HDAg domains in HBV + HDV infection, a critical finding for the design of innovative therapeutic agents. The extent of amino-acid variability was measured by Shannon-Entropy (Sn) in HBsAg genotype-d sequences from 31 HBV + HDV infected and 62 HBV mono-infected patients (comparable for demographics and virological-parameters), and in 47 HDAg genotype-1 sequences. Positions with Sn = 0 were defined as conserved. The percentage of conserved HBsAg-positions was significantly higher in HBV + HDV infection than HBV mono-infection (p = 0.001). Results were confirmed after stratification for HBeAg-status and patients’ age. A Sn = 0 at specific positions in the C-terminus HBsAg were correlated with higher HDV-RNA, suggesting that conservation of these positions can preserve HDV-fitness. Conversely, HDAg was characterized by a lower percentage of conserved-residues than HBsAg (p < 0.001), indicating higher functional plasticity. Furthermore, specific HDAg-mutations were significantly correlated with higher HDV-RNA, suggesting a role in conferring HDV replicative-advantage. Among HDAg-domains, only the virus-assembly signal exhibited a high genetic conservation (75% of conserved-residues). In conclusion, HDV can constrain HBsAg genetic evolution to preserve its fitness. The identification of conserved regions in HDAg poses the basis for designing innovative targets against HDV-infection.
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Affiliation(s)
- Luna Colagrossi
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Romina Salpini
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Rossana Scutari
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Luca Carioti
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Arianna Battisti
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Lorenzo Piermatteo
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Ada Bertoli
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Lavinia Fabeni
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania L. Vanvitelli, 81100 Naples, Italy.
| | - Pascale Trimoulet
- Laboratoire de Virologie, Hôpital Pellegrin tripode, 33076 Bordeaux, France.
| | - Hervé Fleury
- Laboratoire de Virologie, Hôpital Pellegrin tripode, 33076 Bordeaux, France.
| | - Elena Nebuloso
- Unit of Microbiology, Sandro Pertini Hospital, 00157 Rome, Italy.
| | | | | | - Alberto Spanò
- Unit of Microbiology, Sandro Pertini Hospital, 00157 Rome, Italy.
| | - Vincenzo Malagnino
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
| | - Terenzio Mari
- Hepatology Unit, Nuovo Regina Margherita Hospital, 00153 Rome, Italy.
| | - Angelo Barlattani
- Hepatology Unit, Nuovo Regina Margherita Hospital, 00153 Rome, Italy.
| | - Nerio Iapadre
- Infectious Diseases Unit, San Salvatore Hospital, 67100 L'Aquila, Italy.
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy.
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, 00185 Rome, Italy.
| | - Ilaria Lenci
- Hepatology Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
| | | | | | | | - Maria Stanzione
- Department of Internal Medicine, University of Campania L. Vanvitelli, Viral Unit, 81100 Naples, Italy.
| | - Gianfranca Stornaiuolo
- Department of Internal Medicine, University of Campania L. Vanvitelli, Viral Unit, 81100 Naples, Italy.
| | | | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
| | - Massimo Andreoni
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
| | - Mario Angelico
- Hepatology Unit, Tor Vergata University Hospital, 00133 Rome, Italy.
| | | | - Carlo-Federico Perno
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
- Haematology and Oncohematology, University of Milan, 20122 Milan, Italy.
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, University of Campania L. Vanvitelli, 81100 Naples, Italy.
| | - Valentina Svicher
- Department of Experimental Medicine and Surgery, Tor Vergata University, 00133 Rome, Italy.
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21
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Di Domenico M, Curini V, Di Lollo V, Massimini M, Di Gialleonardo L, Franco A, Caprioli A, Battisti A, Cammà C. Genetic diversity of Coxiella burnetii in domestic ruminants in central Italy. BMC Vet Res 2018; 14:171. [PMID: 29843709 PMCID: PMC5975477 DOI: 10.1186/s12917-018-1499-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/22/2018] [Indexed: 12/02/2022] Open
Abstract
Background As the epidemiology of human Q Fever generally reflects the spread of Coxiella burnetii in ruminant livestock, molecular characterization of strains is essential to prevent human outbreaks. In this study we report the genetic diversity of C. burnetii in central Italy accomplished by MST and MLVA-6 on biological samples from 20 goat, sheep and cow farms. Results Five MST and ten MLVA profiles emerged from the analysis establishing a part of C. burnetii strain world atlas. In particular, ST32 occurred on 12 farms (60%), prevalently in goat specimens, while ST12 (25%) was detected on 4 sheep and 1 goat samples. ST8 and a variant of this genotype were described on 2 different sheep farms, whereas ST55 was observed on a goat farm. Five complete MLVA profiles different from any other published genotypes were described in this study in addition to 15 MLVA incomplete panels. Despite this, polymorphic markers Ms23, Ms24 and Ms33 enabled the identification of samples sharing the same MST profile. Conclusions Integration of such data in international databases can be of further help in the attempt of building a global phylogeny and epidemiology of Q fever in animals, with a “One Health” perspective.
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Affiliation(s)
- M Di Domenico
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy.
| | - V Curini
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy
| | - V Di Lollo
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy
| | - M Massimini
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy
| | - L Di Gialleonardo
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy
| | - A Franco
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Roma, Italy
| | - A Caprioli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Roma, Italy
| | - A Battisti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Roma, Italy
| | - C Cammà
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale", Campo Boario, 64100, Teramo, Italy
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22
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Berardi L, Pivato M, Arrigoni G, Mitali E, Trentin AR, Olivieri M, Kerdelhué C, Dorkeld F, Nidelet S, Dubois E, Battisti A, Masi A. Proteome Analysis of Urticating Setae From Thaumetopoea pityocampa (Lepidoptera: Notodontidae). J Med Entomol 2017; 54:1560-1566. [PMID: 28981804 DOI: 10.1093/jme/tjx144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Indexed: 06/07/2023]
Abstract
Thaumetopoea pityocampa (Denis & Schiffermüller) (Lepidoptera: Notodontidae) is harmful to conifer trees because of defoliation and to public health because of the release of urticating setae from the caterpillars. Contact with setae by humans and domestic animals induces dermatitis, usually localized to the exposed areas. Recent studies demonstrated the presence of a complex urticating mechanism where proteins present in the setae may play a role as activators of immune responses. Yet, limited information is available at present about the proteins occurring in the setae of T. pityocampa. Using a refined method for protein extraction from the setae, and a combination of liquid chromatography tandem-mass spectrometry (LC-MS/MS), de novo assembly of transcriptomic data, and sequence similarity searches, an extensive data set of 353 proteins was obtained. These were further categorized by molecular function, biological process, and cellular location. All the 353 proteins identified were found to match through BLAST search with at least one Lepidoptera sequence available in databases. We found the previously known allergens Tha p 1 and Tha p 2 described from T. pityocampa, as well as enzymes involved in chitin biosynthesis, one of the principal components of the setae, and serine proteases that were responsible for inflammatory and allergic reactions in other urticating Lepidoptera. This new proteomic database may allow for a better understanding of the complexity of allergenic reactions due to T. pityocampa and to other Lepidoptera sharing similar defense systems.
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Affiliation(s)
- L Berardi
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
| | - M Pivato
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
| | - G Arrigoni
- Proteomics Center, University of Padova and Azienda Ospedaliera di Padova, via G. Orus 2/B, 35129 Padova, Padova, Italy
- Department of Biomedical Sciences, University of Padova, via U. Bassi 58/B, 35131 Padova, Padova, Italy
| | - E Mitali
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
| | - A R Trentin
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
| | - M Olivieri
- Occupational Medicine, University Hospital of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Verona, Italy
| | - C Kerdelhué
- INRA, UMR CBGP (INRA/CIRAD/IRD/Montpellier Supagro), 755 avenue du Campus Agropolis, CS30016, F-34988 Montferrier-sur-Lez Cedex, Montferrier-sur-Lez, France
| | - F Dorkeld
- INRA, UMR CBGP (INRA/CIRAD/IRD/Montpellier Supagro), 755 avenue du Campus Agropolis, CS30016, F-34988 Montferrier-sur-Lez Cedex, Montferrier-sur-Lez, France
| | - S Nidelet
- INRA, UMR CBGP (INRA/CIRAD/IRD/Montpellier Supagro), 755 avenue du Campus Agropolis, CS30016, F-34988 Montferrier-sur-Lez Cedex, Montferrier-sur-Lez, France
- MGX-Montpellier GenomiX, Institut de Génomique Fonctionnelle, 141 rue de la cardonille, 34094 Montpellier Cedex 05, Montpellier, France
| | - E Dubois
- MGX-Montpellier GenomiX, Institut de Génomique Fonctionnelle, 141 rue de la cardonille, 34094 Montpellier Cedex 05, Montpellier, France
| | - A Battisti
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
| | - A Masi
- Department of Agronomy Food Natural Resources Animals and Environment (DAFNAE), University of Padova, Viale dell'Universita 16, 35020 Legnaro, Padova, Italy
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Giacinti G, Carfora V, Caprioli A, Sagrafoli D, Marri N, Giangolini G, Amoruso R, Iurescia M, Stravino F, Dottarelli S, Feltrin F, Franco A, Amatiste S, Battisti A. Prevalence and characterization of methicillin-resistant Staphylococcus aureus carrying mecA or mecC and methicillin-susceptible Staphylococcus aureus in dairy sheep farms in central Italy. J Dairy Sci 2017; 100:7857-7863. [DOI: 10.3168/jds.2017-12940] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/17/2017] [Indexed: 11/19/2022]
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Cerva C, Maffongelli G, Svicher V, Salpini R, Colagrossi L, Battisti A, Mariotti B, Cerretti R, Cudillo L, Sarmati L. Hepatitis B reactivation characterized by HBsAg negativity and anti-HbsAg antibodies persistence in haematopoietic stem cell transplanted patient after lamivudine withdrawal. BMC Infect Dis 2017; 17:566. [PMID: 28806922 PMCID: PMC5557326 DOI: 10.1186/s12879-017-2672-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/07/2017] [Indexed: 12/11/2022] Open
Abstract
Background HBV reactivation is associated with high mortality rates in hematopoietic stem cell transplantation (HSCT) and prophylactic lamivudine (LMV) treatment is suggested to prevent this phenomenon. However, the duration of LMV treatment in HSCT patients is not fully defined and the time of immune recovery is considered the best parameter for a drug to be safely interrupted. In patients undergoing allogeneic HSCT, the time of immune recovery is not easy to define and may take years after transplantation and prolonged LMV treatments, which can lead to drug-resistant viral strains. Case presentation An anti-HBc-positive hematological patient who was undergoing prolonged immunosuppression and who experienced HBV reactivation 3 months after the suspension of a prolonged LMV prophylaxis is described. HBV-DNA matching an atypical serological profile characterized by HbsAg negativity and anti-HBs positivity was detected in the patient. The genotypic analysis of the HBV strain identified T127P, F170FL and S204R mutations of HbsAg, which can hinder HBsAg recognition in a diagnostic assay. Conclusions HBV reactivation in the HSCT host can be sustained by HBsAg viral variants with characteristics of altered immunogenicity that cannot be detected by usual laboratory tests. This clinical case description suggests the importance of screening for serum HBV-DNA levels in the diagnosis of HBV reactivation and monitoring HBV-DNA after prophylaxis suspension, particularly in HSCT subjects who have undergone prolonged periods of LMV treatment.
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Affiliation(s)
- C Cerva
- Clinical Infectious Disease, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - G Maffongelli
- Clinical Infectious Disease, Department of Systems Medicine, Tor Vergata University, Rome, Italy.
| | - V Svicher
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - R Salpini
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - L Colagrossi
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - A Battisti
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - B Mariotti
- Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - R Cerretti
- Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - L Cudillo
- Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy
| | - L Sarmati
- Clinical Infectious Disease, Department of Systems Medicine, Tor Vergata University, Rome, Italy
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Abstract
Bacteria able to accumulate porphyrins can be inactivated by visible light irradiation thanks to the photosensitizing properties of this class of aromatic pigments (photodynamic therapy, PDT). Since the bacterial resistance to antibiotic is growing, PDT is becoming a valid alternative. In this context, the pathogen Helicobacter pylori (Hp) is a suitable target for PDT since it spontaneously produces and accumulates porphyrins. It is then important to understand the spectroscopic behavior of these endogenous species to exploit them as photosensitizers, thus improving the results given by the application of PDT in the treatment of Hp infections. In this work we extracted porphyrins from both a laboratory-adapted and a virulent strain of Hp, and we performed spectroscopic and chromatographic experiments to collect information about the composition and the spectrophotometric features of the extracts. The main components of the porphyrin mixtures were identified and their relative contribution to the global red fluorescence was examined.
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Affiliation(s)
- A Battisti
- Istituto Nanoscienze, CNR and NEST Scuola Normale Superiore, p.zza San Silvestro 12, 56127 Pisa, Italy.
| | - P Morici
- Istituto Nanoscienze, CNR and NEST Scuola Normale Superiore, p.zza San Silvestro 12, 56127 Pisa, Italy
| | - G Signore
- NEST Scuola Normale Superiore and Center for Nanotechnology Innovation @NEST, Istituto Italiano di Tecnologia, p.zza San Silvestro 12, 56127 Pisa, Italy
| | - F Ghetti
- Istituto Nanoscienze, CNR and NEST Scuola Normale Superiore, p.zza San Silvestro 12, 56127 Pisa, Italy
| | - A Sgarbossa
- Istituto Nanoscienze, CNR and NEST Scuola Normale Superiore, p.zza San Silvestro 12, 56127 Pisa, Italy
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26
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Battisti A, Minei P, Pucci A, Bizzarri R. Hue-based quantification of mechanochromism towards a cost-effective detection of mechanical strain in polymer systems. Chem Commun (Camb) 2017; 53:248-251. [PMID: 27928558 DOI: 10.1039/c6cc08360a] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
HSV is a digital colour space easily accessible by the transformation of RGB images. In this work, the hue parameter H was used to assess mechanically induced colour changes of the aggregation-sensitive fluorescent dye 4,4'-bis-(2-benzoxazolyl)stilbene (BBS), thus implementing a cheap and reliable method for the detection of mechanical deformation in a polymer matrix.
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Affiliation(s)
- A Battisti
- NEST - Scuola Normale Superiore, Istituto Nanoscienze - CNR (CNR-NANO), p.zza San Silvestro 12, 56127 Pisa, Italy. and M3-Village, Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali - INSTM, p.zza San Silvestro 12, 56127 Pisa, Italy
| | - P Minei
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, via Moruzzi 13, 56124 Pisa, Italy.
| | - A Pucci
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, via Moruzzi 13, 56124 Pisa, Italy.
| | - R Bizzarri
- NEST - Scuola Normale Superiore, Istituto Nanoscienze - CNR (CNR-NANO), p.zza San Silvestro 12, 56127 Pisa, Italy. and M3-Village, Consorzio Interuniversitario Nazionale per la Scienza e Tecnologia dei Materiali - INSTM, p.zza San Silvestro 12, 56127 Pisa, Italy
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27
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Salpini R, Piermatteo L, Gill U, Battisti A, Stazi F, Guenci T, Giannella S, Serafini V, Kennedy PTF, Perno CF, Svicher V, Ciotti M. Quantification of intrahepatic total HBV DNA in liver biopsies of HBV-infected patients by a modified version of COBAS ® Ampliprep/COBAS ®TaqMan HBV test v2.0. Med Microbiol Immunol 2017; 206:295-299. [PMID: 28401351 DOI: 10.1007/s00430-017-0504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
Intrahepatic total HBV DNA (it-HBV DNA) level might reflect the size of virus reservoir and correlate with the histological status of the liver. To quantitate it-HBV DNA in a series of 70 liver biopsies obtained from hepatitis B chronic patients, a modified version of the COBAS®Ampliprep/COBAS®TaqMan HBV test v2.0 was used for this purpose. The linearity and reproducibility of the modified protocol was tested by quantifying serial dilutions of a full-length HBV containing plasmid and it-HBV DNA from a reference patient. A good linear trend between the expected values and those generated by the assay was observed at different concentrations of both plasmid and reference patient (R 2 = 0.994 and 0.962, respectively). Differences between the values obtained in two independent runs were ≤0.3 log IU for the plasmid and ≤0.6 log IU/mg for the reference patient, showing a high inter-run reproducibility. In the 70 liver biopsies, it-HBV DNA level ranged from 1.4 to 5.4 log IU/mg, with a good linearity and reproducibility between the values obtained in two runs [R 2 = 0.981; median (IQR) difference of it-HBV DNA 0.05 (0.02-0.09) IU/mg]. The modified COBAS®Ampliprep/COBAS®TaqMan HBV test v2.0 allows an accurate quantitation of it-HBV DNA. Its determination may have prognostic value and may be a useful tool for the new therapeutic strategies aimed at eradicating the HBV infection.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Piermatteo
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Upkar Gill
- Hepatology, Centre for Immunobiology, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Arianna Battisti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Francesca Stazi
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Tania Guenci
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Sara Giannella
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Serafini
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Patrick T F Kennedy
- Hepatology, Centre for Immunobiology, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Carlo Federico Perno
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Svicher
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Marco Ciotti
- Laboratory of Molecular Virology, Polyclinic Tor Vergata Foundation, Viale Oxford 81, 00133, Rome, Italy.
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Affiliation(s)
- F. Colombari
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE); University of Padova; Agripolis 35020, Legnaro (Italy)
| | - A. Battisti
- Department of Agronomy, Food, Natural Resources, Animals and Environment (DAFNAE); University of Padova; Agripolis 35020, Legnaro (Italy)
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29
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Carfora V, Giacinti G, Sagrafoli D, Marri N, Giangolini G, Alba P, Feltrin F, Sorbara L, Amoruso R, Caprioli A, Amatiste S, Battisti A. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus in dairy sheep and in-contact humans: An intra-farm study. J Dairy Sci 2016; 99:4251-4258. [PMID: 27060817 DOI: 10.3168/jds.2016-10912] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 01/19/2016] [Accepted: 02/14/2016] [Indexed: 11/19/2022]
Abstract
Staphylococcus aureus is involved in a wide variety of diseases in humans and animals, and it is considered one of the most significant etiological agents of intramammary infection in dairy ruminants, causing both clinical and subclinical infections. In this study, the intra-farm prevalence and circulation of methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) were investigated on an Italian dairy sheep farm previously identified as MRSA-positive by testing bulk tank milk (first isolation in 2012). Human samples (nasal swabs, hand skin samples, and oropharyngeal swabs) from 3 persons working in close contact with the animals were also collected, and the genetic characteristics and relatedness of the MRSA isolates from human and animal sources within the farm were investigated. After 2yr from the first isolation, we confirmed the presence of the same multidrug-resistant strain of MRSA sequence type (ST)1, clonal complex (CC)1, spa type t127, staphylococcal cassette chromosome mec (SCCmec) type IVa, showing identical pulsed field gel electrophoresis (PFGE) and resistance profiles at the farm level in bulk tank milk. Methicillin-resistant S. aureus isolates were detected in 2 out of 556 (0.34%) individual milk samples, whereas MSSA isolates were detected in 10 samples (1.8%). The MRSA were further isolated from udder skin samples from the 2 animals that were MRSA-positive in milk and in 2 of the 3 examined farm personnel. All MRSA isolates from both ovine and human samples belonged to ST(CC)1, spa type t127, SCCmec type IVa, with some isolates from animals harboring genes considered markers of human adaptation. In contrast, all MSSA isolates belonged to ruminant-associated CC130, ST700, spa type t528. Analysis by PFGE performed on selected MRSA isolates of human and animal origin identified 2 closely related (96.3% similarity) pulsotypes, displaying only minimal differences in gene profiles (e.g., presence of the immune evasion cluster genes). Although we observed low MRSA intra-farm prevalence, our findings highlight the importance of considering the possible zoonotic potential of CC1 livestock-associated MRSA, in view of the ability to persist over years at the farm level. Biosecurity measures and good hygiene practices could be useful to prevent MRSA spread at the farm level and to minimize exposure in the community and in categories related to farm animal industry (e.g., veterinarians, farmers, and farm workers).
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Affiliation(s)
- V Carfora
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - G Giacinti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," Centro di Referenza Nazionale per la Qualità del Latte e dei Prodotti Derivati degli Ovini e dei Caprini, Via Appia Nuova 1411, 00178 Rome, Italy
| | - D Sagrafoli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," Centro di Referenza Nazionale per la Qualità del Latte e dei Prodotti Derivati degli Ovini e dei Caprini, Via Appia Nuova 1411, 00178 Rome, Italy
| | - N Marri
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," Centro di Referenza Nazionale per la Qualità del Latte e dei Prodotti Derivati degli Ovini e dei Caprini, Via Appia Nuova 1411, 00178 Rome, Italy
| | - G Giangolini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," Centro di Referenza Nazionale per la Qualità del Latte e dei Prodotti Derivati degli Ovini e dei Caprini, Via Appia Nuova 1411, 00178 Rome, Italy
| | - P Alba
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - F Feltrin
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - L Sorbara
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - R Amoruso
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - A Caprioli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy
| | - S Amatiste
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," Centro di Referenza Nazionale per la Qualità del Latte e dei Prodotti Derivati degli Ovini e dei Caprini, Via Appia Nuova 1411, 00178 Rome, Italy
| | - A Battisti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri," General Diagnostic Department, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova 1411, 00178 Rome, Italy.
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Valeri L, Coppolino A, Rossetti G, Vado A, Amoroso G, Bricco G, Battisti A, Correndo L, Dogliani S, Magliarditi A, Pancaldo D, Benedictis MD, Bassignana A, Doronzo B. Persistent Atrial Fibrillation And Atrial Flutter Complicated By Tachycardiomyopathy Because Of Intermittent Conduction Through Accessory Pathway. J Atr Fibrillation 2016; 8:1379. [PMID: 27909497 PMCID: PMC5089472 DOI: 10.4022/jafib.1379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/04/2016] [Accepted: 04/24/2016] [Indexed: 06/06/2023]
Abstract
The term tachycardiomyopathy refers to a specific form of tachycardia-related cardiomyopathy caused by supraventricular or ventricular tachyarrhytmias that are both associated with ventricular rates higher than 120 bpm. The arrhythmias which are most frequently associated with these forms of heart disease are atrial fibrillation and atrial flutter, particularly found in the elderly population. The most frequent clinical manifestation is heart failure. In this case we are reporting a clinical case of a patient that came to our attention because of an episode of heart failure associated with atrial fibrillation and atrial flutter. The patient had also prolonged and repetitive strips of rapid conduction with wide QRS morphology. We don't know if the cause is pre excitation or ectopia. We showed that those strips of tachycardia with wide QRS, particularly when they were associated with atrial flutter, were so fast and consistent to determine the left ventricular contractile dysfunction; we showed also that those strips of wide complex tachycardia were caused by pre-excitation through an accessory right posteroseptal pathway and supported by the reentry circuit of common atrial flutter. The block of conduction through the accessory pathway and the elimination of atrial arrhythmia allowed the regression of left ventricular contractile dysfunction. We believe that this case is interesting because it shows that there is a strict continuity between sophisticated electrophysiological mechanisms and clinical manifestation.
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Affiliation(s)
- L Valeri
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - A Coppolino
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - G Rossetti
- Department of Cardiology Electrophysiology Lab, ASO S. Croce e Carle Hospital, Cuneo, Italy
| | - A Vado
- Department of Cardiology Electrophysiology Lab, ASO S. Croce e Carle Hospital, Cuneo, Italy
| | - G Amoroso
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - G Bricco
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - A Battisti
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - L Correndo
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - S Dogliani
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - A Magliarditi
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - D Pancaldo
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - M De Benedictis
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - A Bassignana
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
| | - B Doronzo
- Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy
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Aragri M, Alteri C, Battisti A, Di Carlo D, Minichini C, Sagnelli C, Bellocchi MC, Pisaturo MA, Starace M, Armenia D, Carioti L, Pollicita M, Salpini R, Sagnelli E, Perno CF, Coppola N, Svicher V. Multiple Hepatitis B Virus (HBV) Quasispecies and Immune-Escape Mutations Are Present in HBV Surface Antigen and Reverse Transcriptase of Patients With Acute Hepatitis B. J Infect Dis 2016; 213:1897-905. [PMID: 26908731 DOI: 10.1093/infdis/jiw049] [Citation(s) in RCA: 34] [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: 11/04/2015] [Accepted: 01/28/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study characterizes and defines the clinical value of hepatitis B virus (HBV) quasispecies with reverse transcriptase and HBV surface antigen (HBsAg) heterogeneity in patients with acute HBV infection. METHODS Sixty-two patients with acute HBV infection (44 with genotype D infection and 18 with genotype A infection) were enrolled from 2000 to 2010. Plasma samples obtained at the time of the first examination were analyzed by ultradeep pyrosequencing. The extent of HBsAg amino acid variability was measured by Shannon entropy. RESULTS Median alanine aminotransferase and serum HBV DNA levels were 2544 U/L (interquartile range, 1938-3078 U/L) and 5.88 log10 IU/mL (interquartile range, 4.47-7.37 log10 IU/mL), respectively. Although most patients serologically resolved acute HBV infection, only 54.1% developed antibody to HBsAg (anti-HBs). A viral population with ≥1 immune-escape mutation was found in 53.2% of patients (intrapatient prevalence range, 0.16%-100%). Notably, by Shannon entropy, higher genetic variability at HBsAg amino acid positions 130, 133, and 157 significantly correlated with no production of anti-HBs in individuals infected with genotype D (P < .05). Stop codons were detected in 19.3% of patients (intrapatient prevalence range, 1.6%-47.5%) and occurred at 11 HBsAg amino acid positions, including 172 and 182, which are known to increase the oncogenic potential of HBV.Finally, ≥1 drug resistance mutation was detected in 8.1% of patients (intrapatient prevalence range, 0.11%-47.5% for primary mutations and 10.5%-99.9% for compensatory mutations). CONCLUSIONS Acute HBV infection is characterized by complex array of viral quasispecies with reduced antigenicity/immunogenicity and enhanced oncogenic potential. These viral variants may induce difficult-to-treat HBV forms; favor HBV reactivation upon iatrogenic immunosuppression, even years after infection; and potentially affect the efficacy of the current HBV vaccination strategy.
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Affiliation(s)
- Marianna Aragri
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Claudia Alteri
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Arianna Battisti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Domenico Di Carlo
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Carmine Minichini
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Caserta
| | - Caterina Sagnelli
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Italy
| | | | - Maria Antonietta Pisaturo
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Caserta
| | - Mario Starace
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Caserta
| | - Daniele Armenia
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Luca Carioti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Michela Pollicita
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Romina Salpini
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Caserta
| | - Carlo Federico Perno
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Caserta
| | - Valentina Svicher
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome
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Berardi L, Branco M, Paiva M, Santos H, Battisti A. Development time plasticity of the pine processionary moth (Thaumetopoea pityocampa) populations under laboratory conditions. ACTA ACUST UNITED AC 2015. [DOI: 10.4081/entomologia.2015.273] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The pine processionary moth Thaumetopoea pityocampa (Lepidoptera, Notodontidae) is a univoltine defoliator that is active over a wide range of latitudes and elevations, being largely influenced by temperature variations, especially during larval development across the winter. This work compares field development time with that observed in the laboratory rearing under controlled conditions, in four Th. pityocampa populations characterized by different life history phenology: two populations from the Italian Alps characterized by early and late adult emergence, and two populations from Portugal, the first characterized by winter feeding and late adult emergence, the second by a switch of the larval feeding from winter to summer. The rearing started from the egg stage and was maintained in the laboratory at 20-25°C under natural light in transparent boxes. In spite of the different geographic origins and asynchrony of the period of larval development, all populations maintained an annual life cycle under laboratory conditions, as well as a phenology similar to that of the field populations. Such an outcome was possible due to a trade-off in the duration of the larval and pupal stages, the latter being identified as the phase of development when an efficient regulatory mechanism is acting to maintain the univoltine life cycle.
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Pollicita M, Alteri C, Bellocchi M, Armenia D, Carioti L, Salpini R, Colagrossi L, Battisti A, Aragri M, Fabeni L, Mariani R, Dalessandro M, Ranelli A, Paoloni M, Parruti G, Perno C, Svicher V. A recent epidemiological cluster of acute hepatitis B genotype F1b infection in a restricted geographical area of Italy. Clin Microbiol Infect 2015; 21:1124.e1-4. [DOI: 10.1016/j.cmi.2015.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 06/19/2015] [Accepted: 07/24/2015] [Indexed: 12/28/2022]
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Panocchia N, Marino M, Sabetta T, Cappelletti M, Finazzi Agrò A, Solipaca A, Battisti A, Ricciardi W. Hospital accessibility and clinical pathways for people with disabilities: an Italian survey. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv172.048] [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: 11/12/2022] Open
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35
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Cortimiglia C, Bianchini V, Franco A, Caprioli A, Battisti A, Colombo L, Stradiotto K, Vezzoli F, Luini M. Short communication: Prevalence of Staphylococcus aureus and methicillin-resistant S. aureus in bulk tank milk from dairy goat farms in Northern Italy. J Dairy Sci 2015; 98:2307-11. [PMID: 25648812 DOI: 10.3168/jds.2014-8923] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/17/2014] [Indexed: 12/12/2022]
Abstract
Staphylococcus aureus is regarded as a leading cause of mastitis in goats. However, few data are available on the presence of methicillin-resistant S. aureus (MRSA) in this species. The aim of this study was to assess the prevalence of S. aureus and MRSA in bulk tank milk samples from dairy goat farms in Northern Italy. Eighty-five out of 197 samples (43.1%) tested positive for S. aureus with counts ranging from 10 to more than 1.5 × 10(4) cfu/mL. The MRSA was screened by both direct plating followed by a disk diffusion test to evaluate methicillin resistance and a selective enrichment method. Methicillin-resistance was confirmed by mecA-specific PCR. Methicillin-resistant S. aureus was identified in 4 samples (2.0%) and multilocus sequence typing (MLST) showed the presence of livestock-associated MRSA belonging to lineages ST398 (n = 3) and ST1 (n = 1). In one case we demonstrated that the same MRSA strain was able to persist over time on the farm, being isolated from both bulk tank milk and the udder of 3 goats 1 yr after the first isolation. The high prevalence of S. aureus-positive herds detected in this study and the presence of MRSA strains belonging to livestock-associated genotypes is of concern, and represents a novel finding in the Italian dairy goat production system. The application of stringent measures for the control of S. aureus mastitis at the farm level seems appropriate to reduce the economic losses, and to minimize the risk of foodborne illness and the transmission of MRSA to humans by occupational exposure.
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Affiliation(s)
- C Cortimiglia
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi 26900, Italy
| | - V Bianchini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi 26900, Italy
| | - A Franco
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome 00178, Italy
| | - A Caprioli
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome 00178, Italy
| | - A Battisti
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome 00178, Italy
| | - L Colombo
- Associazione Regionale Allevatori, Crema 26013 (CR), Italy
| | - K Stradiotto
- Associazione Regionale Allevatori, Crema 26013 (CR), Italy
| | - F Vezzoli
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi 26900, Italy
| | - M Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi 26900, Italy.
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36
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Manno N, Sherratt S, Boaretto F, Coico FM, Camus CE, Campos CJ, Musumeci S, Battisti A, Quinnell RJ, León JM, Vazza G, Mostacciuolo ML, Paoletti MG, Falcone FH. High prevalence of chitotriosidase deficiency in Peruvian Amerindians exposed to chitin-bearing food and enteroparasites. Carbohydr Polym 2014; 113:607-14. [PMID: 25256524 PMCID: PMC4194353 DOI: 10.1016/j.carbpol.2014.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 06/19/2014] [Revised: 07/04/2014] [Accepted: 07/09/2014] [Indexed: 11/27/2022]
Abstract
Catalytic deficiency of chitotriosidase has a very high frequency in Amerindians highly exposed to chitin from enteroparasites and diet. Mutation frequencies are similar to those found in East Asian populations, and is probably conserved for a founder effect. Such condition precludes the use of CHIT1 as a disease biomarker in South American populations with strong ethnic ancestry.
The human genome encodes a gene for an enzymatically active chitinase (CHIT1) located in a single copy on Chromosome 1, which is highly expressed by activated macrophages and in other cells of the innate immune response. Several dysfunctional mutations are known in CHIT1, including a 24-bp duplication in Exon 10 causing catalytic deficiency. This duplication is a common variant conserved in many human populations, except in West and South Africans. Thus it has been proposed that human migration out of Africa and the consequent reduction of exposure to chitin from environmental factors may have enabled the conservation of dysfunctional mutations in human chitinases. Our data obtained from 85 indigenous Amerindians from Peru, representative of populations characterized by high prevalence of chitin-bearing enteroparasites and intense entomophagy, reveal a very high frequency of the 24-bp duplication (47.06%), and of other single nucleotide polymorphisms which are known to partially affect enzymatic activity (G102S: 42.7% and A442G/V: 25.5%). Our finding is in line with a founder effect, but appears to confute our previous hypothesis of a protective role against parasite infection and sustains the discussion on the redundancy of chitinolytic function.
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Affiliation(s)
- N Manno
- Department of Biology, Università degli Studi di Padova, Padova, Italy; Facultad de Ciencias Biologicas, Universidad Nacional de Trujillo, Trujillo, Peru
| | - S Sherratt
- Division of Molecular and Cellular Science, School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
| | - F Boaretto
- Department of Biology, Università degli Studi di Padova, Padova, Italy
| | - F Mejìa Coico
- Facultad de Ciencias Biologicas, Universidad Nacional de Trujillo, Trujillo, Peru
| | - C Espinoza Camus
- Facultad de Ciencias Sociales, Universidad Nacional de Trujillo, Trujillo, Peru
| | - C Jara Campos
- Facultad de Ciencias Biologicas, Universidad Nacional de Trujillo, Trujillo, Peru
| | - S Musumeci
- Dpt. of Chemical Sciences, Università di Catania and Institute of Biomolecular Chemistry, CNR, Catania, Italy
| | - A Battisti
- Department DAFNAE, Università degli Studi di Padova, Legnaro, Padova, Italy
| | - R J Quinnell
- School of Biology, University of Leeds, Leeds, United Kingdom
| | - J Mostacero León
- Facultad de Ciencias Biologicas, Universidad Nacional de Trujillo, Trujillo, Peru
| | - G Vazza
- Department of Biology, Università degli Studi di Padova, Padova, Italy
| | - M L Mostacciuolo
- Department of Biology, Università degli Studi di Padova, Padova, Italy
| | - M G Paoletti
- Department of Biology, Università degli Studi di Padova, Padova, Italy.
| | - F H Falcone
- Division of Molecular and Cellular Science, School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
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Guardabassi L, Larsen J, Weese JS, Butaye P, Battisti A, Kluytmans J, Lloyd DH, Skov RL. Public health impact and antimicrobial selection of meticillin-resistant staphylococci in animals. J Glob Antimicrob Resist 2013; 1:55-62. [PMID: 27873579 DOI: 10.1016/j.jgar.2013.03.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/25/2013] [Accepted: 03/26/2013] [Indexed: 12/17/2022] Open
Abstract
Whilst meticillin-resistant Staphylococcus aureus (MRSA) infections reported sporadically in companion animals and cattle in the 1970s were probably of human origin, the recently emerged livestock-associated MRSA (LA-MRSA) and meticillin-resistant Staphylococcus pseudintermedius (MRSP) strains clearly have animal origins and their isolation from humans is usually associated with exposure to livestock and companion animals, respectively. LA-MRSA is primarily an occupational health risk to farm workers and veterinarians. The risk that this zoonotic agent may spread in the community is particularly acute in countries with high livestock production and low MRSA prevalence in the human population. MRSP is primarily a threat to animal health, and cases of human infection are rare but may be overlooked in diagnostic laboratories. There is no conclusive evidence of antimicrobial selection associated with the sudden emergence of LA-MRSA and MRSP. However, the rapid global spread of these bacteria has presumably been favoured by antimicrobial selective pressure. Tetracyclines, zinc and extended-spectrum cephalosporins (including extra-label use) are the most likely selective drivers implicated in the spread of LA-MRSA, whilst increased use of broad-spectrum β-lactams and fluoroquinolones, partly enhanced by extra-label use and the introduction of cheap generics, may have played an important role in the rapid dissemination of MRSP. Control of LA-MRSA and MRSP requires a dual approach aimed at reducing antimicrobial consumption and preventing transmission between animals and from animals to humans or vice versa. Restricted use of fluoroquinolones and cephalosporins in livestock, and national practice guidelines for rational antimicrobial use both in food and companion animals are warranted.
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Affiliation(s)
- L Guardabassi
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - J Larsen
- Statens Serum Institut, Copenhagen, Denmark
| | - J S Weese
- Department of Pathobiology and Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - P Butaye
- CODA-CERVA, Brussels, Belgium; Department of Pathology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - A Battisti
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome, Italy
| | - J Kluytmans
- Amphia Hospital, Breda/Oosterhout, The Netherlands; VU University Medical Center, Amsterdam, The Netherlands
| | - D H Lloyd
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, UK
| | - R L Skov
- Statens Serum Institut, Copenhagen, Denmark
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38
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Merialdi G, Galletti E, Guazzetti S, Rosignoli C, Alborali G, Battisti A, Franco A, Bonilauri P, Rugna G, Martelli P. Environmental methicillin-resistant Staphylococcus aureus contamination in pig herds in relation to the productive phase and application of cleaning and disinfection. Res Vet Sci 2012; 94:425-7. [PMID: 23168262 DOI: 10.1016/j.rvsc.2012.10.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 10/04/2012] [Accepted: 10/21/2012] [Indexed: 11/19/2022]
Abstract
The aim of the study is to better understand MRSA environmental contamination in pig holdings in relation to the productive phase and the application of environmental cleaning and disinfection practices (C&D). This study was carried out on six herds. Dust samples from farrowing crates, weaning boxes, growing and finishing pens were collected from each herd environment prior to and after C&D and cultured for MRSA. Ten samples were collected at the end of each productive phase with the animals present and 10 additional samples were collected after C&D, prior to introduction of a new stock. The proportion of positive samples prior to C&D was lower in fattening than in other phases. The proportion of positive samples prior to and after C&D was 121/240 (50%) and 46/240 (19%) respectively. In the mixed effects logistic regression analysis it was shown not only that both productive phase and C&D were associated with the probability of having a positive sample but also that the C&D effect was different in the different productive phases. In particular the effect of C&D was stronger in farrowing crates than in the other productive phases. The results of this study show that, although current practices of cleaning and disinfection reduce MRSA environmental contamination, they are likely to be inadequate to the elimination of the microorganism. However, a strict application of hygienic protocols can lead to a marked reduction of MRSA environmental contamination.
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Affiliation(s)
- G Merialdi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Italy.
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Damiani G, Colosimo SC, Sicuro L, Baldassarre G, Solipaca A, Battisti A, Burgio A, Crialesi R, Ricciardi W. [The supply of long-term care services for the elderly in Italian regions]. Ann Ig 2010; 22:485-489. [PMID: 21384692] [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: 05/30/2023]
Abstract
In Italy, as in other European Countries, ageing population drives policymakers to redesign the Long Term Care (LTC) system for the elderly. This study analyses the LTC supply for elderly considering the distribution of different components: formal care (institutional and alternative), and informal one in Italian regions. An observational, cross-sectional, ecological study was carried out using statistical data drawn from the Italian National Institute of Statistics and Ministry of Health referred to 2004. Factorial analysis selected the most important components of LTC phenomenon. These components were used for the application of cluster analysis. Cluster Analysis was performed on main components of Factorial Analysis. Then, the ratio of mean value in each cluster on national mean value was calculated for each indicator. Factorial analysis showed three factors characterized by autovalue > 1 that accounted for 61% of the total variance. Cluster analysis highlighted four groups of regions with different way of supply. High level of home care (141,9) and social network (121,3) emerged in group 1. High level of family who received help and family paying a caregiver (108,3 e 121,1) resulted in group 2. High level of no profit LTC (168) supply was reported in group 3. High level of public residential care (451,4) was found in group 4. These remarkable differences in the way of service supply, highlight the need of improvement of the information system on LTC. Thus LTC policy and practice might be better supported both in planning and organizational targets.
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Affiliation(s)
- G Damiani
- Istituto di Igiene, Universitì Cattolica del Sacro Cuore, Roma.
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Ankola DD, Battisti A, Solaro R, Kumar MNVR. Nanoparticles made of multi-block copolymer of lactic acid and ethylene glycol containing periodic side-chain carboxyl groups for oral delivery of cyclosporine A. J R Soc Interface 2010; 7 Suppl 4:S475-81. [PMID: 20504806 DOI: 10.1098/rsif.2010.0046.focus] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose of this study was to evaluate the potential of new carboxylated multi-block copolymer of lactic acid and ethylene glycol (EL14) for nanoparticle (NP) formation and their ability to deliver high molecular weight hydrophobic drug--cyclosporine A (CsA). CsA-loaded EL14 NPs were compared with traditional poly(lactide-co-glycolide) (PLGA) NPs, both prepared by emulsion-diffusion-evaporation process. On the one hand, the increase in drug payload from 10 to 30 per cent for EL14 NPs showed no difference in particle size, however the entrapment efficiency tends to decrease from 50 to 43 per cent; on the other hand, the more hydrophobic PLGA showed an increasing trend in entrapment efficiency from 20 to 62 per cent with increasing particle size. Over 90 per cent of CsA was released in vitro from both the nanoparticulates; however, the release was much slower in the case of more hydrophobic PLGA. On in vivo evaluation in rats, the NPs made of EL14 showed a higher C(max), a faster T(max) and enhanced tissue levels to that of PLGA that are crucial for CsA's activity and toxicity; however, the overall bioavailability of the nanoparticulates was similar and higher than Neoral. Together these data demonstrate the feasibility of NPs made of low molecular weight, hydrophilic polymer EL14 for efficient delivery of CsA.
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Affiliation(s)
- D D Ankola
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 27 Taylor Street, Glasgow G4 0NR, UK
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Perreten V, Kadlec K, Schwarz S, Gronlund Andersson U, Finn M, Greko C, Moodley A, Kania SA, Frank LA, Bemis DA, Franco A, Iurescia M, Battisti A, Duim B, Wagenaar JA, van Duijkeren E, Weese JS, Fitzgerald JR, Rossano A, Guardabassi L. Clonal spread of methicillin-resistant Staphylococcus pseudintermedius in Europe and North America: an international multicentre study. J Antimicrob Chemother 2010; 65:1145-54. [DOI: 10.1093/jac/dkq078] [Citation(s) in RCA: 347] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Traversa A, Bianchi D, Parlato C, Fossati L, Cavallerio P, Domenis L, Spedicato R, Battisti A, Decastelli L. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS STRAINS IN FOOD AND ANIMAL. Ital J Food Saf 2010. [DOI: 10.4081/ijfs.2010.7.65] [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: 11/23/2022] Open
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Battisti A, Fisher J, Duffin J. Measuring the Hypoxic Ventilatory Response. Advances in Experimental Medicine and Biology 2010; 669:221-4. [DOI: 10.1007/978-1-4419-5692-7_44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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44
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Franco A, Donati V, Lorenzetti R, Zini M, Autorino GL, Battisti A, Troiano P, Petrella A, Maggi A. Detection of Taylorella asinigenitalis
in donkey jacks in Italy. Vet Rec 2009; 165:540-1. [DOI: 10.1136/vr.165.18.540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | | | | | - A. Battisti
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana; Via Appia Nuova 1411 00178 Rome Italy
| | | | - A. Petrella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata; via Manfredonia 20 71100 Foggia Italy
| | - A. Maggi
- Istituto Regionale per l'Incremento Ippico; via R. Caggese 1 71100 Foggia Italy
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Battisti A, Franco A, Merialdi G, Hasman H, Iurescia M, Lorenzetti R, Feltrin F, Zini M, Aarestrup FM. Heterogeneity among methicillin-resistant Staphylococcus aureus from Italian pig finishing holdings. Vet Microbiol 2009; 142:361-6. [PMID: 19914010 DOI: 10.1016/j.vetmic.2009.10.008] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 10/09/2009] [Accepted: 10/13/2009] [Indexed: 10/20/2022]
Abstract
A survey for methicillin-resistant Staphylococcus aureus (MRSA) in finishing pig holdings was carried out in Italy in 2008. MRSA isolates were characterised by spa-, MLST-, SCCmec- and antimicrobial susceptibility typing. A prevalence of 38% (45/118, 95% CI 29.4-46.9%) positive holdings was observed. Eleven different spa-types were found among 102 MRSA isolates, clustering in lineages associated with farm animals (ST398, ST9, ST(CC)97 in 36 holdings) and humans (ST1, 7 holdings). Nine (7.6%) holdings were positive for two, three or four different and unrelated spa-types in various combinations. ST398 was the most prevalent lineage (33 positive holdings). The most prevalent spa-type was t899 (ST398), detected in 22 positive holdings. Three novel spa-types (t4794 of ST9; t4795 of ST97; t4838 of ST398) were detected. Ten holdings were positive for spa-type t1730, that proved to be a new single-locus variant of ST97, within the CC97 (ST1476). The most prevalent SCCmec was Type V (79 isolates), while Type IVb was found in 10 isolates. None of the isolates was positive for Panton-Valentine Leukocidin, while most of the t127 and t1730 isolates, one t4794, one t4795, and one t2922 were positive for LukE-LukD genes. All 64 antimicrobial susceptibility tested isolates were resistant to tetracyclines, with high resistance rates to trimethoprim (68.8%), erythromycin (60.9%), and ciprofloxacin (35.4%). All t127, ST1 isolates were resistant to tetracycline-ciprofloxacin-erythromycin. This survey provides the first report of MRSA ST1 and ST(CC)97 among pigs and the first report of MRSA ST9 from pigs in Europe. The presence of human-associated CA-MRSA (t127, ST1, SCCmec type V) in 6% holdings surveyed can represent an additional MRSA reservoir for infections in humans.
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Affiliation(s)
- A Battisti
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome, Italy.
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Franco A, Lovari S, Cordaro G, Di Matteo P, Sorbara L, Iurescia M, Donati V, Buccella C, Battisti A. Prevalence and concentration of Verotoxigenic Escherichia coli O157:H7 in adult sheep at slaughter from Italy. Zoonoses Public Health 2009; 56:215-20. [PMID: 18990195 DOI: 10.1111/j.1863-2378.2008.01188.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 1-year study on the animal-level prevalence and concentration of Escherichia coli O157 in adult sheep at slaughter was performed, to collect qualitative and quantitative information on the diffusion of the pathogen in adult sheep from Italy. A total 533 samples were collected, with a similar distribution in the four seasons. For prevalence estimates, a simple random sampling technique was used. An immuno-magnetic separation technique was used for sample screening, with enumeration of the pathogen in positive samples, along with molecular and serological identification of isolates. An overall prevalence of 7.1% (38/ 533, 95% CI 4.9-9.3%) was observed for fully virulent E. coli O157. A wide interval of VTEC O157 per gram was observed (< 100 to 6 x 10(5) CFU g(-1)), with 28.9% (11/38) of positive samples > or = 1 x 10(3) CFU g(-1), set as the threshold for those animals defined 'active shedders' for the purpose of the study. Eight per cent (3/38) of animals shed > 1 x 10(4) g(-1) VTEC O157, which represents > 96% of the total VTEC O157 bacteria cultured from all animals tested. The prevalence estimate of active shedders was therefore 2.1% (95% CI 0.9-3.3%). Most (34/38, 89.5%) of the positive animals were found in summer (July-September). Prevalence and concentrations of virulent VTEC O157 obtained in this study contribute to the demonstration that adult sheep represent a relevant source of environmental contamination from virulent VTEC O157, as well as a source of VTEC O157 contamination for food of ovine origin (meat and dairy products), especially during warm months.
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Affiliation(s)
- A Franco
- Istituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana, Rome, Italy
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Duranti A, Cacciò SM, Pozio E, Di Egidio A, De Curtis M, Battisti A, Scaramozzino P. Risk Factors Associated withCryptosporidium parvumInfection in Cattle. Zoonoses Public Health 2009; 56:176-82. [DOI: 10.1111/j.1863-2378.2008.01173.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Baker RHA, Battisti A, Bremmer J, Kenis M, Mumford J, Petter F, Schrader G, Bacher S, De Barro P, Hulme PE, Karadjova O, Lansink AO, Pruvost O, Pyšek P, Roques A, Baranchikov Y, Sun JH. PRATIQUE: a research project to enhance pest risk analysis techniques in the European Union. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.1365-2338.2009.02246.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Valentini V, Cassoni A, Battisti A, Marianetti T, Anelli A, Iannetti G. O.607 Microvascular reconstruction of anterior & middle skull base. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cassoni A, Aboh I, Terenzi V, Bartoli D, Battisti A, Valentini V. P.136 Vascular microsurgical techniques. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71924-3] [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: 10/21/2022] Open
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