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Loi B, Sartorius V, Vivalda L, Fardi A, Regiroli G, Dellacà R, Ahsani-Nasab S, Vedovelli L, De Luca D. Global and regional heterogeneity of lung aeration in neonates with different respiratory disorders: a physiological, observational study. Anesthesiology 2024:140091. [PMID: 38657112 DOI: 10.1097/aln.0000000000005026] [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: 04/26/2024]
Abstract
BACKGROUND. Aeration heterogeneity affects lung stress and influences outcomes in adults with acute respiratory distress syndrome (ARDS). We hypothesize that aeration heterogeneity may differ between neonatal respiratory disorders and is associated with oxygenation, so its evaluation may be relevant in managing respiratory support. METHODS. Observational, prospective study. Neonates with respiratory distress syndrome (RDS), transient tachypnea (TTN), evolving bronchopulmonary dysplasia (BPD) and neonatal ARDS (NARDS) were enrolled. Quantitative lung ultrasound and transcutaneous blood gas measurements were simultaneously performed. Global aeration heterogeneity (with its intra- and inter-patient components) and regional aeration heterogeneity were primary outcomes; oxygenation metrics were the secondary outcomes. RESULTS. 230 (50 RDS, TTN or evolving BPD and 80 NARDS) patients were studied. Intra-patient aeration heterogeneity was higher in TTN (mean: 61% [standard deviation: 33%]) and evolving BPD (mean: 57% [standard deviation: 20%], p<0.001), with distinctive aeration distributions. Inter-patient aeration heterogeneity was high for all disorders (Gini-Simpson index: between 0.6 and 0.72) except RDS (Gini-Simpson index: 0.5) whose heterogeneity was significantly lower than all others (p<0.001). NARDS and evolving BPD had the most diffuse injury and worst gas exchange metrics. Regional aeration heterogeneity was mostly localized in upper anterior and posterior zones. Aeration heterogeneity and total lung aeration had an exponential relationship (p<0.001; adj-R 2=0.62). Aeration heterogeneity is associated with greater total lung aeration (i.e., higher heterogeneity means a relatively higher proportion of normally aerated lung zones, thus greater aeration; p<0.001; adj-R 2=0.83) and better oxygenation metrics upon multivariable analyses. CONCLUSIONS. Global aeration heterogeneity and regional aeration heterogeneity differ amongst neonatal respiratory disorders. TTN and evolving BPD have the highest intra-patient aeration heterogeneity. TTN, evolving BPD and NARDS have the highest inter-patient aeration heterogeneity, but the latter two have the most diffuse injury and worst gas exchange. Higher aeration heterogeneity is associated with better total lung aeration and oxygenation.
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Affiliation(s)
- Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
- Physiopathology and Therapeutic Innovation Unit, Paris Saclay University - Paris, France
| | - Victor Sartorius
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
| | - Laura Vivalda
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
| | - Avand Fardi
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
| | - Giulia Regiroli
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
- Physiopathology and Therapeutic Innovation Unit, Paris Saclay University - Paris, France
| | - Raffaele Dellacà
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano University - Milan, Italy
| | | | | | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris Saclay University Hospital, APHP - Paris, France
- Physiopathology and Therapeutic Innovation Unit, Paris Saclay University - Paris, France
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Loi B, Barra PF, Vivalda L, Raimondi F, De Luca D. Inspiratory-expiratory variation of pleural line thickness in neonates with and without acute respiratory failure. Respir Res 2024; 25:12. [PMID: 38178128 PMCID: PMC10765855 DOI: 10.1186/s12931-023-02651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND There are relatively few data about the ultrasound evaluation of pleural line in patients with respiratory failure. We measured the pleural line thickness during different phases of the respiratory cycle in neonates with and without acute respiratory failure as we hypothesized that this can significantly change. METHODS Prospective, observational, cohort study performed in an academic tertiary neonatal intensive care unit recruiting neonates with transient tachypnoea of the neonate (TTN), respiratory distress syndrome (RDS) or neonatal acute respiratory distress syndrome (NARDS). Neonates with no lung disease (NLD) were also recruited as controls. Pleural line thickness was measured with high-frequency ultrasound at end-inspiration and end-expiration by two different raters. RESULTS Pleural line thickness was slightly but significantly higher at end-expiration (0.53 [0.43-0.63] mm) than at end-inspiration (0.5 [0.4-0.6] mm; p = 0.001) for the whole population. End-inspiratory (NLD: 0.45 [0.38-0.53], TTN: 0.49 [0.43-0.59], RDS: 0.53 [0.41-0.62], NARDS: 0.6 [0.5-0.7] mm) and -expiratory (NLD: 0.47 [0.42-0.56], TTN: 0.48 [0.43-0.61], RDS: 0.53 [0.46-0.65], NARDS: 0.61 [0.54-0.72] mm) thickness were significantly different (overall p = 0.021 for both), between the groups although the absolute differences were small. The inter-rater agreement was optimal (ICC: 0.95 (0.94-0.96)). Coefficient of variation was 2.8% and 2.5% for end-inspiratory and end-expiratory measurements, respectively. These findings provide normative data of pleural line thickness for the most common forms of neonatal acute respiratory failure and are useful to design future studies to investigate possible clinical applications.
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Affiliation(s)
- Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Center, Paris- Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
| | - Pasquale Fabio Barra
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Center, Paris- Saclay University Hospitals, APHP, Paris, France
- Division of Neonatology, Department of Translational Medical Sciences, Università "Federico II" di Napoli, Naples, Italy
| | - Laura Vivalda
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Center, Paris- Saclay University Hospitals, APHP, Paris, France
| | - Francesco Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, Università "Federico II" di Napoli, Naples, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Center, Paris- Saclay University Hospitals, APHP, Paris, France.
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France.
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De Luca D, Loi B, Tingay D, Fiori H, Kingma P, Dellacà R, Autilio C. Surfactant status assessment and personalized therapy for surfactant deficiency or dysfunction. Semin Fetal Neonatal Med 2023; 28:101494. [PMID: 38016825 DOI: 10.1016/j.siny.2023.101494] [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] [Indexed: 11/30/2023]
Abstract
Surfactant is a pivotal neonatal drug used both for respiratory distress syndrome due to surfactant deficiency and for more complex surfactant dysfunctions (such as in case of neonatal acute respiratory distress syndrome). Despite its importance, indications for surfactant therapy are often based on oversimplified criteria. Lung biology and modern monitoring provide several diagnostic tools to assess the patient surfactant status and they can be used for a personalized surfactant therapy. This is desirable to improve the efficacy of surfactant treatment and reduce associated costs and side effects. In this review we will discuss these diagnostic tools from a pathophysiological and multi-disciplinary perspective, focusing on the quantitative or qualitative surfactant assays, lung mechanics or aeration measurements, and gas exchange metrics. Their biological and technical characteristics are described with practical information for clinicians. Finally, available evidence-based data are reviewed, and the diagnostic accuracy of the different tools is compared. Lung ultrasound seems the most suitable tool for assessing the surfactant status, while some other promising tests require further research and/or development.
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Affiliation(s)
- Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit, INSERM U999, Paris Saclay University, Paris, France; Department of Pediatrics, Division of Neonatology, Stanford University, School of Medicine - Lucile Packard Children's Hospital, Palo Alto, CA, USA.
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit, INSERM U999, Paris Saclay University, Paris, France
| | - David Tingay
- Neonatal Research Unit, Murdoch Children's Research Institute, Parkville, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Humberto Fiori
- Division of Neonatology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Paul Kingma
- Perinatal Institute, Cincinnati Children's University Hospital Medical Center, Cincinnati, OH, USA
| | - Raffaele Dellacà
- Department of Electronics, Information and Bio-engineering, Polytechnical University of Milan, Milan, Italy
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology and Research Institute Hospital October 12 (imas12), Faculty of Biology, Complutense University, Madrid, Spain; Clinical Pathology and Microbiology Unit, San Carlo Hospital, Potenza, Italy
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Ruberti N, Brundu G, Ceccherelli G, Grech D, Guala I, Loi B, Farina S. Intensive sea urchin harvest rescales Paracentrotus lividus population structure and threatens self-sustenance. PeerJ 2023; 11:e16220. [PMID: 38025682 PMCID: PMC10666612 DOI: 10.7717/peerj.16220] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/11/2023] [Indexed: 12/01/2023] Open
Abstract
The harvest of the edible sea urchin Paracentrotus lividus is intensively practiced in some regions of the Western Mediterranean Sea. The removal of the largest individuals can determine an overall reduction in population size and a size class truncation that can lead to a drastic drop the self-sustenance. The aim of this study is to evaluate the variability of the population reproductive potential across 5 years in one of the main harvest hotspots of Sardinia (Western Mediterranean Sea). The breeding stock consists of commercial and under-commercial size individuals which were sampled on a monthly basis to estimate their GonadoSomatic Index (GSI) and the Individual Gamete Output (IGO). In addition, the reproductive potential of the population-Total Gamete Output (TGO)-was calculated across the 5-year period in relation with the variation of the density of the breeding stock. During the last year, the reproductive potential was also estimated in a well-conserved population of a nearby Marine Protected Area. No significant variability in GSI and IGO was found over the 5 years nor when compared with the ones of protected population in the last year. However, the intensive harvest drastically rescaled the population body-size: although density of the commercial size class remained low, density of the under-commercial size-class halved from the beginning to the end of the study. Accordingly, the proportional decrease of their gamete output contribution led to a 40% loss of the reproductive potential of the whole population in the 5-year period. Interestingly, despite the loss of reproductive potential due to the decrease of the breeding stock density, the average values of IGO slightly increased across the years leading to the highest Annual Gamete Output (AGO) during the fourth year of sampling. This positive pattern could suggest a mechanism of reproductive investments of the survivors in terms of gonad production rate or increase in spawning intensity. This work provides evidence of the direct effect of size-selective harvesting on the rapid loss of population self-sustenance. Furthermore, it lays new prospective for future research of the indirect effects of the rescaling population body-size in functional traits of the sea urchin P. lividus and that could become important for both, sustainable exploitation and ecosystem conservation management.
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Affiliation(s)
- Nicole Ruberti
- Department of Architecture, Design and Planning, University of Sassari, Sassari, Italy
| | - Gianni Brundu
- IMC-International Marine Centre, Torre Grande (OR), Italy
| | - Giulia Ceccherelli
- Department of Chemical Physical Mathematical and Natural Science, University of Sassari, Sassari, Italy
- NBFC, National Biodiversity Future Center, Palermo, Italy
| | - Daniele Grech
- IMC-International Marine Centre, Torre Grande (OR), Italy
| | - Ivan Guala
- IMC-International Marine Centre, Torre Grande (OR), Italy
| | - Barbara Loi
- IMC-International Marine Centre, Torre Grande (OR), Italy
| | - Simone Farina
- Department of Integrative Marine Ecology (EMI), Stazione Zoologica Anton Dohrn–National Institute of Marine Biology, Ecology and Biotechnology, Genoa Marine Centre, Genoa, Italy
- National Research Council, Institute for the study of Anthropic Impacts and Sustainability in the Marine Environment (CNR-IAS), Torre Grande, Italy
- NBFC, National Biodiversity Future Center, Palermo, Italy
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Sartorius V, Loi B, Vivalda L, Regiroli G, de la Rubia Ortega S, Centorrino R, De Luca D. Ultra-high frequency lung ultrasound in preterm neonates: a test validation study on interpretation agreement and reliability. Arch Dis Child Fetal Neonatal Ed 2023; 108:607-611. [PMID: 37080733 DOI: 10.1136/archdischild-2023-325300] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To verify if increasing frequency, through the use of ultra-high frequency transducers, has an impact on lung ultrasound pattern recognition. DESIGN Test validation study. SETTING Tertiary academic referral neonatal intensive care unit. PATIENTS Neonates admitted with respiratory distress signs. INTERVENTIONS Lung ultrasound performed with four micro-linear probes (10, 15, 20 and 22 MHz), in random order. Anonymised images (600 dpi) were randomly included in a pictorial database: physicians with different lung ultrasound experience (beginners (n=7), competents (n=6), experts (n=5)) blindly assessed it. Conformity and reliability of interpretation were analysed using intraclass correlation coefficient (ICC), area under the curve (AUC) of the multi-class ROC analysis, correlation and multivariate linear regressions (adjusting for frequency, expertise and their interaction). OUTCOME MEASURES A (0-3) score based on classical lung ultrasound semiology was given to each image as done in the clinical routine. RESULTS ICC (0.902 (95% CI: 0.862 to 0.936), p<0.001) and AUC (0.948, p<0.001) on the whole pictorial database (48 images acquired on 12 neonates), and irrespective of the frequency and physicians' expertise, were excellent. Physicians detected more B-lines with increasing frequency: there was a positive correlation between score and frequency (ρ=0.117, p=0.001); multivariate analysis confirmed the score to be higher using 22 MHz-probes (β=0.36 (0.02-0.7), p=0.041). CONCLUSION Overall conformity and reliability of interpretations of lung ultrasound patterns were excellent. There were differences in the identification of the B-patterns and severe B-patterns as increasing probe frequency is associated with higher score given to these patterns.
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Affiliation(s)
- Victor Sartorius
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
| | - Barbara Loi
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
| | - Laura Vivalda
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
| | - Giulia Regiroli
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
| | | | - Roberta Centorrino
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
| | - Daniele De Luca
- Division of Paediatric and Neonatal Critical Care, Hôpital Antoine-Béclère, Clamart, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
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Vivalda L, Loi B, Bisceglie V, Ben-Ammar R, De Luca D. Effect of preterm chorioamnionitis on lung ultrasound score used to guide surfactant replacement. Pediatr Pulmonol 2023; 58:2761-2768. [PMID: 37378462 DOI: 10.1002/ppul.26576] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/27/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE Lung ultrasound score (LUS) accurately guides surfactant replacement in preterm neonates with respiratory distress syndrome due to surfactant deficiency. However, surfactant deficiency is not the unique pathobiological feature, as there may be relevant lung inflammation, such as in certain cases of clinical chorioamnionitis (CC). We aim to investigate if CC influences LUS and ultrasound-guided surfactant treatment. DESIGN Retrospective (2017-2022), large, cohort study targeted to recruit a homogeneous population treated with unchanged respiratory care policy and lung ultrasound protocol. Patients with (CC+: 207) and without (CC-: 205) chorioamnionitis were analyzed with propensity score matching and subsequent additional multivariate adjustments. RESULTS LUS was identical at unmatched and matched comparisons. Consistently, at least one surfactant dose was given in 98 (47.3%) and 83 (40.5%) neonates in the CC+ and CC- matched cohorts, respectively (p = .210). Multiple doses were needed in 28 (13.5%) and 21 (10.2%) neonates in the CC+ and CC- cohorts, respectively (p = .373). Postnatal age at surfactant dosing was also similar. LUS was higher in patients who were diagnosed with neonatal acute respiratory distress syndrome (NARDS) (CC+ cohort: 10.3 (2.9), CC- cohort: 11.4 (2.6)), than in those without NARDS (CC+ cohort: 6.1 (3.7), CC- cohort: 6.2 (3.9); p < .001, for both). Surfactant use was more frequent in neonates with, than in those without NARDS (p < .001). Multivariate adjustments confirmed NARDS as the variable with greater effect size on LUS. CONCLUSIONS CC does not influence LUS in preterm neonates, unless inflammation is enough severe to trigger NARDS. The occurrence of NARDS is key factor influencing the LUS.
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Affiliation(s)
- Laura Vivalda
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
| | - Valeria Bisceglie
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Rafik Ben-Ammar
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris-Saclay University, Paris, France
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Regiroli G, La Malfa G, Loi B, Vivanti A, Centorrino R, De Luca D. Ultrasound-assessed lung aeration, oxygenation and respiratory care in neonatal bile acid pneumonia: A nested case-control study. Acta Paediatr 2023; 112:1898-1904. [PMID: 37265415 DOI: 10.1111/apa.16865] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/03/2023]
Abstract
AIM Neonatal bile acid pneumonia (NBAP) occurs in neonates following obstetric cholestasis. We aimed to study the lung aeration and respiratory support of NBAP. METHODS Nested, case/control study enrolling age-matched neonates with NBAP, respiratory distress syndrome (RDS) or transient tachypnoea (TTN). Lung aeration and oxygenation were assessed with lung ultrasound score, oxygenation index and SpO2 /FiO2 . RESULTS Nineteen, 22 and 25 neonates with NBAP, RDS and TTN, respectively were studied (mean gestational age = 33 (2.2) weeks, 30 (45.5%) males). Upon admission, RDS patients had the worst lung ultrasound score (p = 0.022) and oxygenation index (p = 0.001), while NBAP and TTN neonates had similar values. At the worst time-point, NBAP and RDS patients showed similar oxygenation index (NBAP: 4.6 [2], RDS: 5.7 [3]) and SpO2 /FiO2 (NBAP: 3.1 [1.1], RDS: 2.7 [1]) which were worse than those of TTN patients (oxygenation index: p = 0.015, SpO2 /FiO2 : p = 0.001). RDS neonates needed the longest continuous positive airway pressure and highest mean airway pressure, but NBAP neonates needed invasive ventilation (26.3%, p = 0.01) and surfactant (31.6%, p = 0.003) more often than TTN patients who never needed these. CONCLUSION NBAP was a mild disorder in the first hours of life but subsequently worsened and became similar to RDS.
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Affiliation(s)
- Giulia Regiroli
- Division of Paediatrics and Neonatal Critical Care, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Giulia La Malfa
- Division of Paediatrics and Neonatal Critical Care, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Barbara Loi
- Division of Paediatrics and Neonatal Critical Care, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Alexandre Vivanti
- Division of Obstetrics and Gynaecology, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Roberta Centorrino
- Division of Paediatrics and Neonatal Critical Care, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Daniele De Luca
- Division of Paediatrics and Neonatal Critical Care, "A.Beclere" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
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Quirós-Pozo R, Concu D, Robaina L, Vallainc D, Loi B, Roo J. Effects of Different Co-Feeding Protocols on the Early Weaning of Flathead Grey Mullet ( Mugil cephalus) Larvae. Animals (Basel) 2023; 13:ani13101685. [PMID: 37238115 DOI: 10.3390/ani13101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The sustainable expansion of aquaculture relies on a sufficient supply of eggs and larvae, which are the first step of life cycle management. However, marine fish larval rearing generally depends on live feed production, which needs additional facilities and labor. The flathead grey mullet (Mugil cephalus), a promising species for aquaculture diversification, has a precocious digestive system development, supporting the feasibility of early weaning strategies. For these reasons, this study evaluated survival, growth, proximate and fatty acid composition, and gene expression of Mugil cephalus larvae reared under three different weaning protocols. Three co-feeding treatments, two with different Artemia sp. concentrations (A100 and A50, 2 and 1 Artemia sp. mL-1 day-1, respectively) and one with only rotifers administered as live feed along the feeding trial (A0), were assessed from 22 to 36 days post-hatching (dph). The A0 treatment performed better in survival (64.79 ± 7.40%) than the A100 protocol (32.46 ± 12.82%). In contrast, the larvae of the A100 treatment presented significantly higher final length (15.51 ± 0.86 mm) than those of the A0 treatment (12.19 ± 1.45 mm) and higher final weight (41.28 ± 1.48 mg) than those of the A50 and A0 treatments (31.23 ± 3.65 mg and 24.03 ± 7.99 mg, respectively). On the other hand, the expression of digestive enzyme- and somatotropic factor-related genes did not show differences between treatments. The present results support the convenience of treatment A0 in maximizing survival, as rotifers should be maintained until 30-32 dph (until a total larval length of at least 10 mm). However, to improve growth and minimize size dispersion, Artemia sp. addition is recommended from day 26 to day 29 post-hatching (total larval length of 8 to 9 mm).
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Affiliation(s)
- Raquel Quirós-Pozo
- Grupo de Investigación en Acuicultura, IU-ECOAQUA, Universidad de Las Palmas de Gran Canaria, 35214 Telde, Spain
| | - Danilo Concu
- International Marine Centre-IMC Foundation, Loc. Sa Mardini, Torregrande, 09170 Oristano, Italy
- Department of Veterinary Medical Sciences, University of Bologna, 40064 Bologna, Italy
| | - Lidia Robaina
- Grupo de Investigación en Acuicultura, IU-ECOAQUA, Universidad de Las Palmas de Gran Canaria, 35214 Telde, Spain
| | - Dario Vallainc
- International Marine Centre-IMC Foundation, Loc. Sa Mardini, Torregrande, 09170 Oristano, Italy
| | - Barbara Loi
- International Marine Centre-IMC Foundation, Loc. Sa Mardini, Torregrande, 09170 Oristano, Italy
| | - Javier Roo
- Grupo de Investigación en Acuicultura, IU-ECOAQUA, Universidad de Las Palmas de Gran Canaria, 35214 Telde, Spain
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Regiroli G, Loi B, Pezza L, Sartorius V, Foti A, Barra PF, Centorrino R, Di Nardo M, De Luca D. Continuous Venovenous Hemofiltration Performed by Neonatologists With Cardio-Renal Pediatric Dialysis Emergency Machine to Treat Fluid Overload During Multiple Organ Dysfunction Syndrome: A Case Series. Pediatr Crit Care Med 2023; 24:e196-e201. [PMID: 36728157 DOI: 10.1097/pcc.0000000000003177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES A new device is available for neonates needing extracorporeal renal replacement therapy. We reviewed the use of this device (in continuous venovenous hemofiltration [CVVH] mode) in term or preterm neonates affected by multiple organ dysfunction syndrome (MODS) with fluid overload. DESIGN Case series. SETTING Academic specialized referral neonatal ICU (NICU) with expertise on advanced life support and monitoring. PATIENTS Neonates with MODS and fluid overload despite conventional treatments and receiving at least one CVVH session. INTERVENTION CVVH with the Cardio-Renal Pediatric Dialysis Emergency Machine. MEASUREMENTS AND MAIN RESULTS Ten (three preterm) neonates were treated using 18 consecutive CVVH sessions. All patients were in life-threatening conditions and successfully completed the CVVH treatments, which almost always lasted 24 hr/session, without major side effects. Three neonates survived and were successfully discharged from hospital with normal follow-up. CVVH reduced fluid overload (before versus after represented as a weight percentage: 23.5% [12-34%] vs 14.6% [8.2-24.1%]; p = 0.006) and lactate (before versus after: 4.6 [2.9-12.1] vs 2.9 mmol/L [2.3-5.5 mmol/L]; p = 0.001). CVVH also improved the Pa o2 to Fio2 (before vs after: 188 mm Hg [118-253 mm Hg] vs 240 mm Hg [161-309 mm Hg]; p = 0.003) and oxygenation index (before vs after: 5.9 [3.8-14.6] vs 4 [2.9-11]; p = 0.002). The average cost of CVVH in these patients was minor (≈3%) in comparison with the median total cost of NICU care per patient. CONCLUSIONS We have provided CVVH to critically ill term and preterm neonates with MODS. CVVH improved fluid overload and oxygenation. The cost of CVVH was minimal compared with the overall cost of neonatal intensive care.
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Affiliation(s)
- Giulia Regiroli
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Lucilla Pezza
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Victor Sartorius
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Anna Foti
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Pasquale Fabio Barra
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Roberta Centorrino
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Bambino Gesù Children Hospital-IRCCS, Rome, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
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Loi B, Regiroli G, Foligno S, Centorrino R, Yousef N, Vedovelli L, De Luca D. Respiratory and haemodynamic effects of 6h-pronation in neonates recovering from respiratory distress syndrome, or affected by acute respiratory distress syndrome or evolving bronchopulmonary dysplasia: a prospective, physiological, crossover, controlled cohort study. EClinicalMedicine 2023; 55:101791. [PMID: 36712892 PMCID: PMC9874350 DOI: 10.1016/j.eclinm.2022.101791] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 08/29/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Pronation ameliorates oxygenation in adults with acute respiratory distress syndrome (ARDS); the effect in neonates with ARDS or other types of respiratory failure is unknown. We aimed to verify if pronation has similar respiratory and haemodynamic effects in three common types of neonatal respiratory failure. METHODS Prospective, physiologic, crossover, quasi-randomised, controlled cohort study performed in a tertiary academic neonatal intensive care unit. We enrolled neonates with: 1) recovering respiratory distress syndrome (RDS, mild restrictive pattern); 2) neonatal ARDS (NARDS, severe restrictive pattern); or 3) evolving bronchopulmonary dysplasia (BPD), that is chronic pulmonary insufficiency of prematurity (mixed restrictive/obstructive pattern). Neonates with other lung disorders, malformations or haemodynamic impairment were excluded. Patients were started prone or supine and then shifted to the alternate position for 6h; measurements were performed after 30' of "wash out" from the positioning and at the end of 6h period. Primary outcomes were respiratory (PtcCO2, modified ventilatory index, PtcO2/FiO2, SpO2/FiO2, oxygenation index, ultrasound-assessed lung aeration) and haemodynamic (perfusion index, heart rate, arterial pressure, cardiac output) parameters. FINDINGS Between May 1st, 2019, and May 31st, 2021, 161 participants were enrolled in this study, and included in the final analysis. Pronation improved gas exchange and lung aeration (p always <0.01) and these effects were overturned in the alternate position, except for lung aeration in NARDS where the improvement persisted. The effects were greater in patients recovering from RDS than in those with evolving BPD than in those with NARDS, in this order (p always <0.01). Pronation produced a net recruitment as lung ultrasound score decreased in patients shifted from supine (16.9 (standard deviation: 5.8)) to prone (14.1 (standard deviation: 3.3), p < 0.01) and this reduction correlated with oxygenation improvement. Haemodynamic parameters remained within normal ranges. INTERPRETATION 6h-pronation can be used to improve gas exchange and lung aeration in neonates with recovering RDS, evolving BPD or NARDS without relevant haemodynamic effects. FUNDING None.
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Affiliation(s)
- Barbara Loi
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Giulia Regiroli
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Silvia Foligno
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Roberta Centorrino
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Nadya Yousef
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Daniele De Luca
- Division of Paediatrics and Neonatal Critical Care, “A.Béclère” Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
- Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
- Corresponding author. Service de Pédiatrie et Réanimation Néonatale, Hôpital “A. Béclère”- APHP Université Paris Saclay, 157 rue de la Porte de Trivaux, 92140 Clamart (Paris-IDF), France.
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11
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Pezza L, Sartorius V, Loi B, Regiroli G, Centorrino R, Lanciotti L, Carnielli VP, De Luca D. Evolution of Ultrasound-Assessed Lung Aeration and Gas Exchange in Respiratory Distress Syndrome and Transient Tachypnea of the Neonate. J Pediatr 2022; 256:44-52.e2. [PMID: 36493883 DOI: 10.1016/j.jpeds.2022.11.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To use clinical, lung ultrasound, and gas exchange data to clarify the evolution of lung aeration and function in neonates with respiratory distress syndrome (RDS) and transient tachypnea of the neonate (TTN), the most common types of neonatal respiratory failure. STUDY DESIGN In this prospective observational cohort study, lung aeration and function were measured with a semiquantitative lung ultrasound score (LUS) and transcutaneous blood gas measurement performed at 1 hour (time point 0), 6 hours (time point 1), 12 hours (time point 2), 24 hours (time point 3) and 72 hours (time point 4) of life. Endogenous surfactant was estimated using lamellar body count (LBC). LUS, oxygenation index (OI), oxygen saturation index (OSI), and transcutaneous pressure of carbon dioxide (PtcCO2) were the primary outcomes. All results were adjusted for gestational age. RESULTS Sixty-nine neonates were enrolled in the RDS cohort, and 58 neonates were enrolled in the TTN cohort. LUS improved over time (within-subjects, P < .001) but was worse for the RDS cohort than for the TTN cohort at all time points (between-subjects, P < .001). Oxygenation improved over time (within-subjects, P = .011 for OI, P < .001 for OSI) but was worse for the RDS cohort than for the TTN cohort at all time points (between-subjects, P < .001 for OI and OSI). PtcCO2 improved over time (within-subjects, P < .001) and was similar in the RDS and TTN cohorts at all time points. Results were unchanged after adjustment for gestational age. LBC was associated with RDS (β = -0.2 [95% CI, -0.004 to -0.0001]; P = .037) and LUS (β = -3 [95% CI, -5.5 to -0.5]; P = .019). CONCLUSIONS For the first 72 hours of life, the RDS cohort had worse lung aeration and oxygenation compared with the TTN cohort at all time points. CO2 clearance did not differ between the cohorts, whereas both lung aeration and function improved in the first 72 hours of life.
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Affiliation(s)
- Lucilla Pezza
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Victor Sartorius
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Giulia Regiroli
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Roberta Centorrino
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France
| | - Lucia Lanciotti
- Division of Neonatology, "G. Salesi" Women and Children's Hospital, Polytechnical University of Marche, Ancona, Italy
| | - Virgilio P Carnielli
- Division of Neonatology, "G. Salesi" Women and Children's Hospital, Polytechnical University of Marche, Ancona, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A. Béclère" Medical Center, Paris-Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit, INSERM U999, Paris-Saclay University, Paris, France
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12
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Pighi M, Tomai F, Fezzi S, Pesarini G, Petrolini A, Spedicato L, Tarantini G, Ferlini M, Calabro P, Loi B, Tovar Forero N, Daemen J, Ribichini FT. Everolimus-eluting bioresorabable scaffold system in the treatment of cardiac allograft vasculopathy: the cardiac allograft reparative therapy (CART) prospective multicentre pilot study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2648] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is still the main drawback of heart transplantation (HTx) and percutaneous coronary intervention (PCI) is a palliative measure because of the high incidence of PCI failure. The bioresorbable scaffolds (BRS) could represent a potential novel therapeutic tool for the treatment of coronary obstructions in CAV.
Purpose
To investigates the effects of BRS implantation in CAV patients in a Nationwide prospective study.
Methods
Multicentre, single-arm, prospective, open-label study that included patients affected by advanced CAV treated with PCI and second-generation ABSORB BRS. The primary endpoint was the incidence of 12-month angiographic in-segment scaffold restenosis (ISSR). Secondary endpoints were the composite of cardiac death, myocardial infarction, and target lesion revascularisation at 12-and 36-month follow-up and the incidence of ISSR at 36 months. A paired analysis of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) at baseline and follow-up was also performed.
Results
Between 2015–2017 35 HTx patients were enrolled and treated on 44 coronary lesions with 51 BRS. The primary endpoint occurred in 13.5% of the lesions (5/37), with a cumulative ISSR rate up to 3 years of 16.2% (6/37).Angiographic lumen loss was 0.40±0.62mm at 12 months and 0.53±0.57mm at 36 months. Overall survival was 91.4% and 74.3%, and MACEs 14.2% and 31.4% at 12 and 36 months, respectively. At the paired intracoronary imaging analysis a significant increase of the vessel external elastic membrane area in the treated segment of the BRS was described at the OCT, while some progression of CAV was detected proximally at the IVUS assessment.
Conclusions
BRS in CAV was feasible and safe, with an ISSR incidence similar to drug-eluting stents. For the first time, a positive remodeling was observed in HTx patients after PCI. Vessel enlargement and the lack of metallic stents may allow repeated PCI avoiding the vessel shrinkage caused by the addition of multiple metal layers, being CAV a complex clinical scenario with a high incidence of MACEs, mainly driven by PCI failure.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Partial funding by Abbott Vascular Italy
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Affiliation(s)
- M Pighi
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | - F Tomai
- European Hospital , Rome , Italy
| | - S Fezzi
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | - G Pesarini
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | | | - L Spedicato
- Citta di Udine C.D.C Health Centre , Udine , Italy
| | | | - M Ferlini
- I.R.C.C.S. San Matteo Polyclinic , Pavia , Italy
| | - P Calabro
- Luigi Vanvitelli University Hospital , Naples , Italy
| | - B Loi
- AO Brotzu Hospital , Cagliari , Italy
| | - N Tovar Forero
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - J Daemen
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - F T Ribichini
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
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13
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Vallainc D, Concu D, Loi B, Pitzalis A, Frongia C, Chindris A, Carboni S. Spawning induction and larval rearing in the thinlip grey mullet (Chelon ramada). The use of the slow release gonadotropin releasing hormone analog (GnRHa) preparation, leuprorelin acetate. Anim Reprod Sci 2022; 247:107145. [DOI: 10.1016/j.anireprosci.2022.107145] [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] [Received: 05/25/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 11/01/2022]
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14
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Manca F, Cocco D, Siotto P, Melis M, Fele G, Corda M, Loi B. C33 PERCUTANEOUS CLOSURE OF MITRAL PARAVALVULAR LEAK (PVL): WHEN REVERSAL MAKES ALL THE DIFFERENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.032] [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: 11/14/2022]
Abstract
Abstract
PVL is a complication associated with the implantation of a prosthetic valve. Since surgical re–intervention has a high operative risk, percutaneous closure (PC) has emerged due to its reduced invasiveness and the development of dedicated materials. We describe the case of a 66–year–old man with a mechanical oscillating disc mitral prosthesis who was admitted for acute heart failure. An echo showed a left ventricle with normal motion and a postero–medial mitral PVL with significant regurgitation. A transoesophageal echo confirmed the PVL in the 5 o’clock viewing portal with severe regurgitation. After optimising the medical therapy and with no change in echo findings, a cardiac catheterisation showed persistent post–capillary pulmonary hypertension, and therefore PC of the PVL was scheduled. Given the postero–medial location of the PVL, a transseptal puncture was performed using a 8.5 Fr Agilis introducer (Terumo) with telescoping system of a 6 r. JR4 catheter. The PVL was passed through with a Terumo 0.035 J–shaped guide, but without managing to advance the catheter beyond the leak. The guide was therefore advanced into the abdominal aorta and an arteriovenous circuit was created, which allowed the catheter to be advanced beyond the PVL and a closure device (AVPIII 14/5,Abbott St.Jude) was positioned with anterograde placement, with a distal disc on the ventricular side. Obliteration of the PVL, interference with the prosthetic disc and high transprosthetic gradients were observed despite several attempts to relocate the AVP, which was therefore removed. A second procedure was performed at a distance, creating a similar arteriovenous circuit by using a long introducer (110cm–Cook) which was advanced from the femoral artery beyond the leak in the opposite direction. An AVPIII (12/5) with a distal disc on the atrial side was positioned, this time with retrograde placement, with effective closure of the PVL and minimal residual regurgitation, without interference with the prosthesis. The course was free of complications; after one month the echo confirmed the result. Transcatheter closure of the PVL is a complex procedure, but relatively safe in experienced hands. This case is of particular interest due to the difficulty presented by the location of the PVL, which required measures of high technical complexity and because it describes a possible complication of the procedure, which was resolved by the simple reversal of the placement of the device.
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Affiliation(s)
- F Manca
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - D Cocco
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - P Siotto
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - M Melis
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - G Fele
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - M Corda
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - B Loi
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
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15
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Manca F, Cocco D, Pistis L, Serra E, Loi B, Corda M, Pilleri A. P313 TAKOTSUBO SYNDROME – FOCAL VARIANT. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.300] [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
Takotsubo syndrome (TTS) is a cardiomyopathy induced by physical and/or emotional stress, characterised by transient changes of the regional motion generally extending beyond the territory distribution of one single coronary vessel. The classic form of TTS presents, in 43.7% of cases, with ST segment elevation and in about 80% with cardiac apical ballooning. In 1.5% of TTS cases, however, regional changes in motion are observed which may mimic an acute coronary syndrome. We describe the case of a 77–year–old woman with hypertension and hypercholesterolemia. The patient came to the ER due to polytrauma secondary to an accidental fall. During hospitalisation, the patient complained of a sudden onset of a retrosternal aching chest pain radiating to the back and right shoulder, associated with neurovegetative symptoms. An electrocardiogram showed a normofrequent sinus rhythm and T–negative waves in the infero–lateral region. Upon cardiology consultation, a transthoracic echocardiogram was performed showing a left ventricle with akinesia of the middle and apical segments of the inferolateral wall with compensatory hyperkinesis of the other segments. When an acute coronary syndrome was suspected, urgent coronary imaging was performed, showing coronary arteries without significant stenosis, while ventriculography confirmed the alterations in ventricular motion. Blood chemistry tests showed a phasic increase in myocardial necrosis enzymes and, in particular, in HS troponin values (max value 2714 ng/L). Therapy with an ace–inhibitor and a beta blocker was introduced; seriate echocardiographic controls showed a progressive normalisation of the alterations in motion. A TTS diagnosis was therefore made, according to InterTAK 2018 diagnostic criteria. This case is of particular interest as it is a prime example of a rare variant of TTS: the clinical presentation, the ECG alterations and the regional akinesia may lead to a clinical suspicion of ACS. A good knowledge of the TTS, including the focal variant, enables the cardiologist to make a correct diagnosis and to initiate suitable therapy.
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Affiliation(s)
- F Manca
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - D Cocco
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - L Pistis
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - E Serra
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - B Loi
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - M Corda
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
| | - A Pilleri
- POLICLINICO UNIVERSITARIO DI MONSERRATO, CAGLIARI; ARNAS G.BROTZU, CAGLIARI
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Del Prete G, Lixi G, Spina A, Loi B, Cirio E. P49 SURGICAL OPEN AORTA TRANSCATHETER VALVE IN VALVE IMPLANT FOR A MALFUNCTIONING AORTIC BIOPROSTHESIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.047] [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
Background
Most cases of aortic valve bioprosthesis degenerative disease are currently best managed by transcatheter aortic valve replacement (TAVR). Compared to redo surgery, advantages of TAVR include reduced invasiveness and a minimized prosthesis gradient; however, this approach is occasionally unfeasible due to the risk for coronary flow impairment or prosthesis stent dimensions unfit to accommodate an appropriately sized device. We present a case of an open TAVR after surgical leaflets excision of a failing aortic valve bioprosthesis.
Case Summary
A 76 years old female with type 2 diabetes, hypertension and dyslipidemia was referred to our institution for a malfunctioning 21 Carpentier Edwards pericardial aortic valve bioprosthesis implanted 9 years earlier. Patient was initially considered for a valve in valve TAVR. However, because of very low–lying coronary arteries origin at preoperative CT scan we estimated substantial chances for ostia impingement when prosthesis leaflets would have been stretched out by the deploying transcatheter device (Figure 1); although feasible, conventional redo surgery with bioprosthesis excision and re–suture was not preferred because of patients age and comorbidities; risk of damaging the aortic ring and wall including coronaries emergence when dissecting out the stent of the biopsosthesis and reimplanting a new one was also evaluated. We therefore opted for an hybrid procedure. After redo median sternotomy, careful dissection of adhesions, central Cardio–Pulmonary Bypass (CPB), aortic cross clamp and antegrade cardioplegia, a transverse aortotomy was done. The prosthesis was inspected and found grossly deteriorated: leaflets only were excised leaving the stent intact (Figure 2) and a 23 Sapien3 Ultra valve was carefully deployed under direct vision. Coronary ostia were checked and found patent. Myocardial ischemia and CPB times were 61 and 85 minutes respectively. Intensive care unit stay was 2 days. After a reassuring postoperative CT scan (Figure 3), patient was discharged home 11 days after surgery.
Conclusions
We found this approach a good compromise when dealing with challenging aortic valve reoperations, as it is associated to reduced surgical complexity and potential for less morbidity and mortality compared to conventional surgery when low coronary ostia make valve in valve TAVR unachievable.
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Affiliation(s)
- G Del Prete
- AZIENDA OSPEDALIERA BROTZU, SC CARDIOCHIRURGIA, CAGLIARI; AZIENDA OSPEDALIERA BROTZU, SC CARDIOLOGIA INTERVENTISTICA, CAGLIARI
| | - G Lixi
- AZIENDA OSPEDALIERA BROTZU, SC CARDIOCHIRURGIA, CAGLIARI; AZIENDA OSPEDALIERA BROTZU, SC CARDIOLOGIA INTERVENTISTICA, CAGLIARI
| | - A Spina
- AZIENDA OSPEDALIERA BROTZU, SC CARDIOCHIRURGIA, CAGLIARI; AZIENDA OSPEDALIERA BROTZU, SC CARDIOLOGIA INTERVENTISTICA, CAGLIARI
| | - B Loi
- AZIENDA OSPEDALIERA BROTZU, SC CARDIOCHIRURGIA, CAGLIARI; AZIENDA OSPEDALIERA BROTZU, SC CARDIOLOGIA INTERVENTISTICA, CAGLIARI
| | - E Cirio
- AZIENDA OSPEDALIERA BROTZU, SC CARDIOCHIRURGIA, CAGLIARI; AZIENDA OSPEDALIERA BROTZU, SC CARDIOLOGIA INTERVENTISTICA, CAGLIARI
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17
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Biasucci DG, Loi B, Centorrino R, Raschetti R, Piastra M, Pisapia L, Consalvo LM, Caricato A, Grieco DL, Conti G, Antonelli M, De Luca D. Ultrasound-assessed lung aeration correlates with respiratory system compliance in adults and neonates with acute hypoxemic restrictive respiratory failure: an observational prospective study. Respir Res 2022; 23:360. [PMID: 36529748 PMCID: PMC9759805 DOI: 10.1186/s12931-022-02294-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Lung ultrasound allows lung aeration to be assessed through dedicated lung ultrasound scores (LUS). Despite LUS have been validated using several techniques, scanty data exist about the relationships between LUS and compliance of the respiratory system (Crs) in restrictive respiratory failure. Aim of this study was to investigate the relationship between LUS and Crs in neonates and adults affected by acute hypoxemic restrictive respiratory failure, as well as the effect of patients' age on this relationship. METHODS Observational, cross-sectional, international, patho-physiology, bi-center study recruiting invasively ventilated, adults and neonates with acute respiratory distress syndrome (ARDS), neonatal ARDS (NARDS) or respiratory distress syndrome (RDS) due to primary surfactant deficiency. Subjects without lung disease (NLD) and ventilated for extra-pulmonary conditions were recruited as controls. LUS, Crs and resistances (Rrs) of the respiratory system were measured within 1 h from each other. RESULTS Forty adults and fifty-six neonates were recruited. LUS was higher in ARDS, NARDS and RDS and lower in control subjects (overall p < 0.001), while Crs was lower in ARDS, NARDS and RDS and higher in control subjects (overall p < 0.001), without differences between adults and neonates. LUS and Crs were correlated in adults [r = - 0.86 (95% CI - 0.93; - 0.76), p < 0.001] and neonates [r = - 0.76 (95% CI - 0.85; - 0.62), p < 0.001]. Correlations remained significant among subgroups with different causes of respiratory failure; LUS and Rrs were not correlated. Multivariate analyses confirmed the association between LUS and Crs both in adults [B = - 2.8 (95% CI - 4.9; - 0.6), p = 0.012] and neonates [B = - 0.045 (95% CI - 0.07; - 0.02), p = 0.001]. CONCLUSIONS Lung aeration and compliance of the respiratory system are significantly and inversely correlated irrespective of patients' age. A restrictive respiratory failure has the same ultrasound appearance and mechanical characteristics in adults and neonates.
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Affiliation(s)
- Daniele Guerino Biasucci
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Barbara Loi
- grid.460789.40000 0004 4910 6535Division of Pediatrics and Neonatal Critical Care, A. Béclère Medical Center, Paris-Saclay University Hospitals, Public Assistance – Paris Hospitals, Paris, France
| | - Roberta Centorrino
- grid.460789.40000 0004 4910 6535Division of Pediatrics and Neonatal Critical Care, A. Béclère Medical Center, Paris-Saclay University Hospitals, Public Assistance – Paris Hospitals, Paris, France
| | - Roberto Raschetti
- grid.460789.40000 0004 4910 6535Division of Pediatrics and Neonatal Critical Care, A. Béclère Medical Center, Paris-Saclay University Hospitals, Public Assistance – Paris Hospitals, Paris, France
| | - Marco Piastra
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Luca Pisapia
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Ludovica Maria Consalvo
- grid.414818.00000 0004 1757 8749Anesthesiology and Intensive Care, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anselmo Caricato
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192Catholic University of the Sacred Heart in Rome, Milan, Italy
| | - Domenico Luca Grieco
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Giorgio Conti
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192Catholic University of the Sacred Heart in Rome, Milan, Italy
| | - Massimo Antonelli
- grid.414603.4Department of Emergency, Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy ,grid.8142.f0000 0001 0941 3192Catholic University of the Sacred Heart in Rome, Milan, Italy
| | - Daniele De Luca
- grid.460789.40000 0004 4910 6535Division of Pediatrics and Neonatal Critical Care, A. Béclère Medical Center, Paris-Saclay University Hospitals, Public Assistance – Paris Hospitals, Paris, France ,grid.460789.40000 0004 4910 6535Physiopathology and Therapeutic Innovation Unit, Paris-Saclay University, Paris, France
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Centorrino R, Loi B, De Luca D. Extremely preterm infants experienced good comfort with various nasal respiratory support techniques delivered with masks. Acta Paediatr 2021; 110:2753-2755. [PMID: 33964040 DOI: 10.1111/apa.15907] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Roberta Centorrino
- Division of Paediatrics and Neonatal Critical Care A.Béclère Medical Centre Paris Saclay University Hospitals Paris France
| | - Barbara Loi
- Division of Paediatrics and Neonatal Critical Care A.Béclère Medical Centre Paris Saclay University Hospitals Paris France
| | - Daniele De Luca
- Division of Paediatrics and Neonatal Critical Care A.Béclère Medical Centre Paris Saclay University Hospitals Paris France
- Physiopathology and Therapeutic Innovation Unit Paris Saclay University Paris France
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19
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Loi B, Vigo G, Baraldi E, Raimondi F, Carnielli VP, Mosca F, De Luca D. Lung Ultrasound to Monitor Extremely Preterm Infants and Predict Bronchopulmonary Dysplasia. A Multicenter Longitudinal Cohort Study. Am J Respir Crit Care Med 2021; 203:1398-1409. [PMID: 33352083 DOI: 10.1164/rccm.202008-3131oc] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rationale: Lung ultrasound is useful in critically ill patients with acute respiratory failure. Given its characteristics, it could also be useful in extremely preterm infants with evolving chronic respiratory failure, as we lack accurate imaging tools to monitor them. Objectives: To verify if lung ultrasound can monitor lung aeration and function and has good reliability to predict bronchopulmonary dysplasia in extremely preterm neonates. Methods: A multicenter, international, prospective, longitudinal, cohort, diagnostic accuracy study consecutively enrolling inborn neonates with gestational age 30+6 weeks or younger. Lung ultrasound was performed on the 1, 7, 14, and 28 days of life, and lung ultrasound scores were calculated and correlated with simultaneous blood gases and work of breathing score. Gestational age-adjusted lung ultrasound scores were created, verified in multivariate models, and subjected to receiver operator characteristics (ROC) analyses to predict bronchopulmonary dysplasia at 36 weeks postmenstrual age. Measurements and Main Results: Mean lung ultrasound scores are different between infants developing (n = 72) or not developing (n = 75) bronchopulmonary dysplasia (P < 0.001 at any time point). Lung ultrasound scores significantly correlate with oxygenation metrics and work of breathing at any time point (P always < 0.0001). Gestational age-adjusted lung ultrasound scores significantly predict bronchopulmonary dysplasia at 7 (area under ROC curve, 0.826-0.833; P < 0.0001) and 14 (area under ROC curve, 0.834-0.858; P < 0.0001) days of life. Bronchopulmonary dysplasia severity and gestational age-adjusted lung ultrasound scores are significantly correlated at 7 and 14 days (P always < 0.0001). Conclusions: Lung ultrasound scores allow monitoring of lung aeration and function in extremely preterm infants. Gestational age-adjusted scores significantly predict the occurrence of bronchopulmonary dysplasia, starting from the seventh day of life.
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Affiliation(s)
- Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, A.Béclère Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Giulia Vigo
- Division of Pediatrics and Neonatal Critical Care, A.Béclère Medical Center, Paris Saclay University Hospitals, APHP, Paris, France
| | - Eugenio Baraldi
- Department of Women's and Children's Health, Neonatal ICU, Padova University Hospital, Padova, Italy
| | - Francesco Raimondi
- Department of Translational Medical Science, Neonatal ICU, Federico II University, Naples, Italy
| | - Virgilio P Carnielli
- Division of Neonatology, G. Salesi Women and Children Hospital, Polytechnical University of Marche, Ancona, Italy
| | - Fabio Mosca
- Neonatal ICU, "Ca' Granda Ospedale Maggiore Policlinico," IRCCS Foundation, University of Milan, Milan, Italy; and
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, A.Béclère Medical Center, Paris Saclay University Hospitals, APHP, Paris, France.,Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
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20
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Loi B, Casiraghi C, Catozzi C, Storti M, Lucattelli M, Bartalesi B, Yousef N, Salomone F, De Luca D. Lung ultrasound features and relationships with respiratory mechanics of evolving BPD in preterm rabbits and human neonates. J Appl Physiol (1985) 2021; 131:895-904. [PMID: 34292788 DOI: 10.1152/japplphysiol.00300.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Evolving broncho-pulmonary dysplasia (BPD) is a regionally heterogeneous disorder characterized by impaired alveolarization leading to lung aeration inhomogeneities. Hyperoxia-exposed preterm rabbits have been proposed to mimic evolving BPD and we aim to verify if this model has the same lung ultrasound and mechanical features of evolving BPD in human neonates. Twenty-five preterm rabbits and twenty-five neonates with evolving BPD were enrolled and subjected to semi-quantitative lung ultrasound and lung mechanics measurement. A modified rabbit lung ultrasound score (rLUS), the previously validated neonatal lung ultrasound score (LUS) and classical mechanics measurements were obtained. Lung ultrasound images were also recorded and evaluated by two independent observers with different expertise blinded to each other's evaluation. Lung ultrasound findings were equally heterogeneous both in rabbits as in human neonates: images were very similar and encompassed all the classical lung ultrasound semiology. The inter-rater absolute agreement for the evaluation of lung ultrasound images in rabbits was very high (ICC: 0.989 (95%CI: 0.975-0.995); p<0.0001) and there was no difference between the two observers. Lung mechanics parameters were similarly altered both in rabbits and human neonates. There were significant correlations between airway resistances and lung ultrasound scores both in rabbits (r=0.519; p=0.008) and in neonates (r=0.409; p=0.042). No significant correlation between rLUS, LUS and any other mechanics parameter. Lung ultrasound was easy to be performed and accurate even in these small animals and with a short training. In conclusion, the preterm rabbit model fairly reproduces the lung ultrasound and mechanical characteristics of preterm neonates with evolving BPD.
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Affiliation(s)
- Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Costanza Casiraghi
- Neonatology and Pulmonary Rare Disease Unit. Pharmacology and Toxicology Dept. Corporate Preclinical R&D, Chiesi, Parma, Italy
| | - Chiara Catozzi
- Neonatology and Pulmonary Rare Disease Unit. Pharmacology and Toxicology Dept. Corporate Preclinical R&D, Chiesi, Parma, Italy
| | - Matteo Storti
- Department of Chemical and Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Monica Lucattelli
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - Barbara Bartalesi
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - Nadya Yousef
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Fabrizio Salomone
- Neonatology and Pulmonary Rare Disease Unit. Pharmacology and Toxicology Dept. Corporate Preclinical R&D, Chiesi, Parma, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France.,Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
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Anedda R, Siliani S, Melis R, Loi B, Baroli M. Lipid metabolism of sea urchin Paracentrotus lividus in two contrasting natural habitats. Sci Rep 2021; 11:14174. [PMID: 34239001 PMCID: PMC8266866 DOI: 10.1038/s41598-021-93669-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Sea urchins Paracentrotus lividus were harvested monthly from April 2015 to March 2016 from two sites in Sardinia (Italy). The two sites, a Posidonia oceanica meadow and a rocky bottom habitat, were naturally characterized by different food sources and availability, being mainly populated by the sea grass Posidonia oceanica and the brown algae Halopteris scoparia, respectively. Total lipids showed a minimum during winter in mature gonads, and a maximum in the summer (recovery stage). Fatty acid (FA) profiles of gut contents and gonads differed from those of the most available food sources. Levels of C18:3 (n-3) (ALA) discriminated samples from the two sites. Despite the very low amounts of C20:5 (n-3) (EPA) and C20:4 (n-6) (ARA) in P. oceanica, the main FA in gonads and gut contents were EPA and ARA in both sites. Increase in green algae intake prior to gametogenesis, especially C. cylindracea, likely affected EPA and ARA levels in gonads. The results show that P. lividus is able to concentrate lipids in gut contents and also to selectively store EPA, ARA and their precursors ALA and 18:2 (n-6) (LA). Moreover, bioconversion of ALA to EPA and of LA to ARA in P. lividus is suggested.
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Affiliation(s)
- Roberto Anedda
- Porto Conte Ricerche S.r.l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Silvia Siliani
- Porto Conte Ricerche S.r.l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy
| | - Riccardo Melis
- Porto Conte Ricerche S.r.l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy
| | - Barbara Loi
- IMC-International Marine Centre, Loc. Sa Mardini, 09170, Torregrande, OR, Italy
| | - Maura Baroli
- IMC-International Marine Centre, Loc. Sa Mardini, 09170, Torregrande, OR, Italy
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22
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Regiroli G, Loi B, Fortas F, Centorrino R, Mosca F, De Luca D. Effect of inspired gas temperature on lung mechanics and gas exchange in neonates in normothermia or therapeutic hypothermia. Resuscitation 2021; 163:116-123. [PMID: 33895234 DOI: 10.1016/j.resuscitation.2021.04.015] [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: 02/06/2021] [Revised: 03/27/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Respiratory critical care guidelines suggest heating the air/oxygen mixture but do not recommend a specific temperature target. We aimed to clarify if the inspired gas temperature influences lung mechanics and gas exchange in intubated patients treated with whole body hypothermia (WBH) or normothermia (NT). METHODS Prospective cohort study enrolling neonates ventilated for perinatal asphyxia resuscitation (no lung disease) or acute hypoxemic respiratory failure. Patients were divided between those ventilated in NT or WBH. Compliance (Cdyn), airway resistances (Raw), oxygenation index (OI), PaO2/FiO2, A-a gradient, a/A ratio, estimated alveolar dead space (VDalv), ventilatory index (VI) and CO2 production (VCO2) were registered at the study beginning (inspired gas at 37°C). Then, gas temperature was decreased (32 °C) and variables were recorded again after 1 and 3 h. Data were analysed with univariate and multivariate repeated measures-ANOVA. RESULTS Cdyn, Raw, OI, PaO2/FiO2, A-a gradient, a/A ratio, VDalv, VI and VCO2 are similar between WBH and NT at any timepoint (between-subjects effect); these results do not change adjusting for the presence of respiratory failure. When this is considered in multivariate ANOVA (within-subjects effect), Cdyn (p = 0.016), Raw (p = 0.034) and VDalv (p < 0.001) were worse in patients with respiratory failure than in those without lung disease. CONCLUSIONS Decreasing the gas temperature from 37 °C to 32 °C for 3 h does not change lung mechanics and gas exchange, neither in neonates with, nor in those without respiratory failure and in those treated in NT or WBH. These findings fill a knowledge gap regarding the effect of inspired gas temperature during WBH: they may inform future respiratory critical care guidelines.
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Affiliation(s)
- Giulia Regiroli
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France; Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France
| | - Feriel Fortas
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Roberta Centorrino
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France.
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Sahai MA, Loi B, De Luca MA, Shiref H, Opacka-Juffry J. Using Computational and Neurobiological Methods to Characterise the Stimulant Properties of Novel Psychoactive Substances (NPS) at the Dopamine Transporter. Biophys J 2021. [DOI: 10.1016/j.bpj.2020.11.957] [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: 10/22/2022] Open
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24
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Asnaghi V, Chindris A, Leggieri F, Scolamacchia M, Brundu G, Guala I, Loi B, Chiantore M, Farina S. Decreased pH impairs sea urchin resistance to predatory fish: A combined laboratory-field study to understand the fate of top-down processes in future oceans. Mar Environ Res 2020; 162:105194. [PMID: 33126114 DOI: 10.1016/j.marenvres.2020.105194] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 06/11/2023]
Abstract
Changing oceans represent a serious threat for a wide range of marine organisms, with severe cascading effects on ecosystems and their services. Sea urchins are particularly sensitive to decreased pH expected for the end of the century and their key ecological role in regulating community structure and functioning could be seriously compromised. An integrated approach of laboratory and field experiments has been implemented to investigate the effects of decreased pH on predator-prey interaction involving sea urchins and their predators. Our results suggest that under future Ocean Acidification scenarios adult sea urchins defence strategies, such as spine length, test robustness and oral plate thickness, could be compromised together with their survival chance to natural predators. Sea urchins represent the critical linkage between top-down and bottom-up processes along Mediterranean rocky reefs, and the cumulative impacts of global and local stressors could lead to a decline producing cascading effects on benthic ecosystems.
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Affiliation(s)
- V Asnaghi
- DISTAV, University of Genoa, C.so Europa 26, 16132, Genoa, Italy.
| | - A Chindris
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - F Leggieri
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy; CNR - National Research Council, IAS - Institute of Anthropic Impacts and Sustainability in Marine Environment, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - M Scolamacchia
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy; CNR - National Research Council, IAS - Institute of Anthropic Impacts and Sustainability in Marine Environment, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - G Brundu
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - I Guala
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - B Loi
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
| | - M Chiantore
- DISTAV, University of Genoa, C.so Europa 26, 16132, Genoa, Italy
| | - S Farina
- IMC - International Marine Centre, Loc. Sa Mardini, Torre Grande, 09170, Oristano, Italy
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Raschetti R, Vivanti AJ, Vauloup-Fellous C, Loi B, Benachi A, De Luca D. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nat Commun 2020; 11:5164. [PMID: 33060565 PMCID: PMC7566441 DOI: 10.1038/s41467-020-18982-9] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [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: 07/23/2020] [Accepted: 09/23/2020] [Indexed: 12/15/2022] Open
Abstract
A number of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections have been reported in neonates. Here, we aim to clarify the transmission route, clinical features and outcomes of these infections. We present a meta-analysis of 176 published cases of neonatal SARS-CoV-2 infections that were defined by at least one positive nasopharyngeal swab and/or the presence of specific IgM. We report that 70% and 30% of infections are due to environmental and vertical transmission, respectively. Our analysis shows that 55% of infected neonates developed COVID-19; the most common symptoms were fever (44%), gastrointestinal (36%), respiratory (52%) and neurological manifestations (18%), and lung imaging was abnormal in 64% of cases. A lack of mother-neonate separation from birth is associated with late SARS-CoV-2 infection (OR 4.94 (95% CI: 1.98-13.08), p = 0.0002; adjusted OR 6.6 (95% CI: 2.6-16), p < 0.0001), while breastfeeding is not (OR 0.35 (95% CI: 0.09-1.18), p = 0.10; adjusted OR 2.2 (95% CI: 0.7-6.5), p = 0.148). Our findings add to the literature on neonatal SARS-CoV-2 infections.
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Affiliation(s)
- Roberto Raschetti
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Alexandre J Vivanti
- Division of Obstetrics and Gynecology, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Christelle Vauloup-Fellous
- Division of Virology, "Paul Brousse" Hospital, Paris Saclay University Hospitals, APHP, Villejuif, France
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Alexandra Benachi
- Division of Obstetrics and Gynecology, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, Paris Saclay University Hospitals, APHP, Clamart, France.
- Physiopathology and Therapeutic Innovation Unit-INSERM, Paris Saclay University, U999, Le Plessis Robinson, France.
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Foligno S, Loi B, Pezza L, Piastra M, Autilio C, De Luca D. Extrapulmonary Surfactant Therapy: Review of Available Data and Research/Development Issues. J Clin Pharmacol 2020; 60:1561-1572. [PMID: 32578234 DOI: 10.1002/jcph.1675] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/21/2020] [Indexed: 11/07/2022]
Abstract
Since the discovery of surfactant, a large amount of knowledge has been accumulated about its biology and pharmacology. Surfactant is the cornerstone of neonatal respiratory critical care, but its proteins and phospholipids are produced in various tissues and organs, with possible roles only partially similar to that played in the alveoli. As surfactant research is focused mainly on its respiratory applications, knowledge about the possible role of surfactant in extrapulmonary disorders has never been summarized. Here we aim to comprehensively review the data about surfactant biology and pharmacology in organs other than the lung, especially focusing in the more promising surfactant extrapulmonary roles. We also review any preclinical or clinical data available about the therapeutic use of surfactant in these contexts. We offer a summary of knowledge and research/development milestones, as possible useful guidance for researchers of multidisciplinary background.
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Affiliation(s)
- Silvia Foligno
- Division of Pediatrics and Neonatal Critical Care, Medical Center, "A. Béclère," South Paris University Hospitals, Assistance Publique-Hopitaux de Paris (APHP), Paris, France
| | - Barbara Loi
- Division of Pediatrics and Neonatal Critical Care, Medical Center, "A. Béclère," South Paris University Hospitals, Assistance Publique-Hopitaux de Paris (APHP), Paris, France
| | - Lucilla Pezza
- Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital "A.Gemelli"-IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Marco Piastra
- Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care, University Hospital "A.Gemelli"-IRCCS, Catholic University of the Sacred Heart, Rome, Italy
| | - Chiara Autilio
- Department of Biochemistry and Molecular Biology, Faculty of Biology, and Research Institut-Hospital "12 de Octubre,", Complutense University, Madrid, Spain
| | - Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, Medical Center, "A. Béclère," South Paris University Hospitals, Assistance Publique-Hopitaux de Paris (APHP), Paris, France.,Physiopathology and Therapeutic Innovation Unit-INSERM U999, South Paris/Saclay University, Paris, France
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Loi B, Sahai MA, De Luca MA, Shiref H, Opacka-Juffry J. The Role of Dopamine in the Stimulant Characteristics of Novel Psychoactive Substances (NPS)-Neurobiological and Computational Assessment Using the Case of Desoxypipradrol (2-DPMP). Front Pharmacol 2020; 11:806. [PMID: 32670057 PMCID: PMC7289955 DOI: 10.3389/fphar.2020.00806] [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] [Received: 02/10/2020] [Accepted: 05/18/2020] [Indexed: 11/13/2022] Open
Abstract
Stimulant drugs, including novel psychoactive substances (NPS, formerly “legal highs”) have addictive potential which their users may not realize. Stimulants increase extracellular dopamine levels in the brain, including the reward and addiction pathways, through interacting with dopamine transporter (DAT). This work aimed to assess the molecular and atomistic mechanisms of stimulant NPS actions at DAT, which translate into biological outcomes such as dopamine release in the brain’s reward pathway. We applied combined in vitro, in vivo, and in silico methods and selected 2-diphenylmethylpiperidine (2-DPMP) as an example of stimulant NPS for this study. We measured in vitro binding of 2-DPMP to rat striatum and accumbens DAT by means of quantitative autoradiography with a selective DAT-radioligand [125I]RTI-121. We evaluated the effects of intravenously administered 2-DPMP on extracellular dopamine in the accumbens-shell and striatum using in vivo microdialysis in freely moving rats. We used dynamic modeling to investigate the interactions of 2-DPMP within DAT, in comparison with cocaine and amphetamine. 2-DPMP potently displaced the radioligand in the accumbens and striatum showing dose-dependence from 0.3 to 30 μM. IC50 values were: 5.65 × 10-7M for accumbens shell and 6.21 × 10-7M for dorsal striatum. Dose-dependent responses were also observed in accumbens-shell and striatum in vivo, with significant increases in extracellular dopamine levels. Molecular dynamics simulations identified contrasting conformational changes of DAT for inhibitors (cocaine) and releasers (amphetamine). 2-DPMP led to molecular rearrangements toward an outward-facing DAT conformation that suggested a cocaine-type effect. The present combination of molecular modeling with experimental neurobiological procedures allows for extensive characterization of the mechanisms of drug actions at DAT as the main molecular target of stimulants, and provides an insight into the role of dopamine in the molecular and neurobiological mechanisms of brain responses to stimulant NPS that have addictive potential. Such knowledge reveals the risk of addiction related to NPS use. The research presented here can be adapted for other psychostimulants that act at their membrane protein targets.
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Affiliation(s)
- Barbara Loi
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Postgraduate Medicine and Pharmacology, University of Hertfordshire, Hatfield, United Kingdom.,Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Michelle A Sahai
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | | | - Hana Shiref
- Department of Life Sciences, University of Roehampton, London, United Kingdom
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Ramachandran M, Loi B, Mat Ariff N, Ng OC, Zahari Sham SY, Thambiah SC, Samsudin IN. Appropriateness of metformin prescription for type 2 diabetes mellitus patients with chronic kidney disease (Stages 3-5). Malays J Pathol 2020; 42:71-76. [PMID: 32342933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Metformin is the first-line pharmacological therapy for type 2 diabetes mellitus (T2DM). Guidelines recommend metformin to be given at reduced dosages for those with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and omitted in those with eGFR<30 mL/min/1.73m2. Lactic acidosis is a known complication of those on metformin. This study aimed to determine the appropriateness of metformin prescription in T2DM patients with chronic kidney disease (CKD) stages 3-5 in a tertiary centre in Malaysia. MATERIALS AND METHODS A cross-sectional design using retrospective secondary data of T2DM patients on metformin attending nephrology and diabetic clinics in the year 2017. eGFR calculated using the CKD-EPI formula identified those in CKD stage 3-5 defined using the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative criteria. Metformin prescription was considered appropriate when the metformin maximum daily dosage does not exceed 1500 mg in CKD stage 3a and 1000 mg in CKD stage 3b and metformin stopped in CKD stages 4 and 5. RESULTS A total of 143 patients were included. Majority were in the elderly age group (62.9%), male (60.8%) and had concurrent hypertension (85.3%). Median HbA1c was 8.3% (67 mmol/mol) with most patients (88.8%) having HbA1c above 6.5% (48 mmol/ mol). Majority (92.3%) were categorised as stage 3 CKD. Eleven (7.7%) subjects had inappropriate metformin prescription. Seven of nine (78%) subjects in CKD stage 4 were on metformin with a maximum daily dose of 500 mg to1000 mg. Three patients had serum lactate measured. CONCLUSION The majority of CKD patients had appropriate metformin prescription. However, a considerable number of CKD stage 4 patients continued to be on metformin. The many benefits of metformin may be a reason why it is still continued against recommendations. Only three patients had lactate measured which, although may suggest that lactic acidosis is not a common occurrence, the potential for metformin-associated lactic acidosis especially in those at risk should be considered.
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Affiliation(s)
- M Ramachandran
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Malaysia.
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Corkery JM, Loi B, Claridge H, Goodair C, Schifano F. Deaths in the Lesbian, Gay, Bisexual and Transgender United Kingdom Communities Associated with GHB and Precursors. Curr Drug Metab 2018; 19:1086-1099. [DOI: 10.2174/1389200218666171108163817] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 05/05/2017] [Accepted: 10/08/2017] [Indexed: 11/22/2022]
Affiliation(s)
- John M. Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Barbara Loi
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hertfordshire, United Kingdom
| | - Hugh Claridge
- National Programme on Substance Abuse Deaths, Population Health Research Institute, St George's University of London, Tooting, United Kingdom
| | - Christine Goodair
- National Programme on Substance Abuse Deaths, Population Health Research Institute, St George's University of London, Tooting, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, Hertfordshire, United Kingdom
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Sanna R, Siliani S, Melis R, Loi B, Baroli M, Roggio T, Uzzau S, Anedda R. The role of fatty acids and triglycerides in the gonads of Paracentrotus lividus from Sardinia: Growth, reproduction and cold acclimatization. Mar Environ Res 2017; 130:113-121. [PMID: 28754521 DOI: 10.1016/j.marenvres.2017.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 06/07/2023]
Abstract
A detailed characterization of lipid extracts from gonads of P. lividus over a year has been performed combining GC and NMR measurements. For this purpose, sea urchins from two different Sardinian coastal areas were collected monthly. The results underlined a correlation between gonad fatty acids profiles and both water temperature and reproduction process. In particular, EPA and ARA appear to be the most altered fatty acids following seasonal changes. It is suggested that EPA could represent a biomarker of reproduction, reaching a content around 14% during gametogenesis, mainly due to an increase of the sn-1,3 position in TAGs. On the contrary, ARA seems to play a more important role in response to cold acclimatization, which is reflected in a modulation of ARA content in the sn-1,3 position in TAGs.
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Affiliation(s)
- Roberta Sanna
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
| | - Silvia Siliani
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
| | - Riccardo Melis
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
| | - Barbara Loi
- IMC - International Marine Centre, Loc. Sa Mardini, 09170, Torregrande, OR, Italy; University of Tuscia, Department of Ecological and Biological Sciences, Via S. Camillo de Lellis, 01100, Viterbo, VT, Italy.
| | - Maura Baroli
- IMC - International Marine Centre, Loc. Sa Mardini, 09170, Torregrande, OR, Italy.
| | - Tonina Roggio
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
| | - Sergio Uzzau
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
| | - Roberto Anedda
- Porto Conte Ricerche S. r. l. - S.P. 55 Porto Conte - Capo Caccia, Km 8.400, Loc. Tramariglio, 07041, Alghero, SS, Italy.
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Deidda M, Cadeddu Dessalvi C, Binaghi G, Congia D, Boi A, Loi B, Sanna F, Pani A, Piras C, Atzori L, Mercuro G, Porcu M. P5575STEMI metabolic fingerprint depends on ischemic time and inflammation status. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5575] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moscarella E, Ielasi A, Varricchio A, Cortese B, Loi B, Steffenino G. 1966One-year clinical outcomes following bioresorbable vascular scaffold implantation in patients presenting with acute coronary syndromes versus stable coronary artery disease: results from RAI registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1966] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Loi B, Zloh M, De Luca MA, Pintori N, Corkery J, Schifano F. 4,4'-Dimethylaminorex ("4,4'-DMAR"; "Serotoni") misuse: A Web-based study. Hum Psychopharmacol 2017; 32. [PMID: 28657180 DOI: 10.1002/hup.2575] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/21/2017] [Accepted: 01/27/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND 4,4'-DMAR (4,4'-dimethylaminorex; "Serotoni") is a potent stimulant drug that has recently been associated with a number of fatalities in Europe. Over the last few years, online communities have emerged as important resources for disseminating levels of technical knowledge on novel psychoactive substances. OBJECTIVE Analysing the information provided by the fora communities on 4,4'-DMAR use, additionally critical reviewing the available evidence-based literature on this topic. METHODS Different website drug fora were identified. A critical review of the existing evidence-based literature was undertaken. Individuation and analysis of qualitative data from the identified website fora were performed. RESULTS The combined search results identified six website fora from which a range of qualitative data on recurring themes was collected. These themes included routes of administration and doses; desired effects; adverse effects; comparison with other drugs; association with other drugs; medications self-administered to reverse 4,4'-DMAR action; overall impression; and provision of harm-reduction advice. CONCLUSIONS Although being characterized by a number of methodological limitations, the social networks' Web monitoring approach (netnography) may be helpful to better understand some of the clinical and psychopharmacological issues pertaining to a range of novel psychoactive substances, including 4,4'-DMAR, for which only extremely little, if any, scientific knowledge is available.
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Affiliation(s)
- Barbara Loi
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Mire Zloh
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Maria Antonietta De Luca
- Department of Biomedical Sciences, Division of Neuropsychopharmacology, University of Cagliari, Cagliari, Italy
| | - Nicholas Pintori
- Department of Biomedical Sciences, Division of Neuropsychopharmacology, University of Cagliari, Cagliari, Italy
| | - John Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
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Loi B, Guala I, Pires da Silva R, Brundu G, Baroli M, Farina S. Hard time to be parents? Sea urchin fishery shifts potential reproductive contribution of population onto the shoulders of the young adults. PeerJ 2017; 5:e3067. [PMID: 28289567 PMCID: PMC5345490 DOI: 10.7717/peerj.3067] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 11/04/2016] [Accepted: 02/05/2017] [Indexed: 11/20/2022] Open
Abstract
Background In Sardinia, as in other regions of the Mediterranean Sea, sustainable fisheries of the sea urchin Paracentrotus lividus have become a necessity. At harvesting sites, the systematic removal of large individuals (diameter ≥ 50 mm) seriously compromises the biological and ecological functions of sea urchin populations. Specifically, in this study, we compared the reproductive potential of the populations from Mediterranean coastal areas which have different levels of sea urchin fishing pressure. The areas were located at Su Pallosu Bay, where pressure is high and Tavolara-Punta Coda Cavallo, a marine protected area where sea urchin harvesting is low. Methods Reproductive potential was estimated by calculating the gonadosomatic index (GSI) from June 2013 to May 2014 both for individuals of commercial size (diameter without spines, TD ≥ 50 mm) and the undersized ones with gonads (30 ≤ TD < 40 mm and 40 ≤ TD < 50 mm). Gamete output was calculated for the commercial-size class and the undersized individuals with fertile gonads (40 ≤ TD < 50 mm) in relation to their natural density (gamete output per m2). Results The reproductive potential of populations was slightly different at the beginning of the sampling period but it progressed at different rates with an early spring spawning event in the high-pressure zone and two gamete depositions in early and late spring in the low-pressure zone. For each fertile size class, GSI values changed significantly during the year of our study and between the two zones. Although the multiple spawning events determined a two-fold higher total gamete output of population (popTGO) in the low-pressure zone, the population mean gamete output (popMGO) was similar in the two zones. In the high-pressure zone, the commercial-sized individuals represented approximatively 5% of the population, with almost all the individuals smaller than 60 mm producing an amount of gametes nearly three times lower than the undersized ones. Conversely, the high density of the undersized individuals released a similar amount of gametes to the commercial-size class in the low-pressure zone. Discussion Overall, the lack of the commercial-size class in the high-pressure zone does not seem to be very alarming for the self-supporting capacity of the population, and the reproductive potential contribution seems to depend more on the total density of fertile sea urchins than on their size. However, since population survival in the high-pressure zone is supported by the high density of undersized sea urchins between 30 and 50 mm, management measures should be addressed to maintain these sizes and to shed light on the source of the larval supply.
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Affiliation(s)
- Barbara Loi
- IMC-International Marine Centre, Torregrande, Oristano, Italy; Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Ivan Guala
- IMC-International Marine Centre , Torregrande, Oristano , Italy
| | | | - Gianni Brundu
- IMC-International Marine Centre, Torregrande, Oristano, Italy; Department of Ecological and Biological Sciences, University of Tuscia, Viterbo, Italy
| | - Maura Baroli
- IMC-International Marine Centre , Torregrande, Oristano , Italy
| | - Simone Farina
- IMC-International Marine Centre , Torregrande, Oristano , Italy
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Carai MAM, Colombo G, Loi B, Zaru A, Riva A, Cabri W, Morazzoni P. Hypoglycemic Effects of a Standardized Extract of Salvia miltiorrhiza Roots in Rats. Pharmacogn Mag 2016; 11:S545-9. [PMID: 27013792 PMCID: PMC4787086 DOI: 10.4103/0973-1296.172959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/01/2023] Open
Abstract
Background and Aims: Salvia miltiorrhiza Bunge (Labiatae) is a Chinese medicinal plant, the dried roots of which (known as Dan-Shen) have been used for hundreds of years in the treatment of a series of ailments, including hyperglycemia. This study was designed to evaluate the hypoglycemic effect of a new, standardized extract of S. miltiorrhiza. Materials and Methods: S. miltiorrhiza extract (containing 21% total tanshinones and 3.7% tanshinone IIA) was administered acutely and intragastrically at the doses of 0, 50, 100, and 200 mg/kg to male, healthy, fasted Wistar rats 60 min before the intragastric infusion of a bolus of starch (3 g/kg; a semi-naturalistic experimental condition) (Experiment 1) or glucose (2 g/kg) (Experiment 2). Results: In both experiments, treatment with S. miltiorrhiza extract produced a dose-related decrease in glycemia, evidenced in terms of reduction of peak value and/or area under the curve of the time-course of glycemia. The effect of S. miltiorrhiza extract occurred at doses devoid of any behavioral toxicity in rats. Conclusion: The results of this study suggest that the hypoglycemic effect of S. miltiorrhiza extract was likely secondary to an action on carbohydrate metabolism. These results are consistent with several preclinical and clinical data and add further support to the hypothesis that S. miltiorrhiza extracts may act as effective anti-hyperglycemic remedies. SUMMARY Acute treatment with Salvia miltiorrhiza extract reduced the glycemia rise induced by a bolus of starch in rats Acute treatment with Salvia miltiorrhiza extract reduced the glycemia rise induced by a bolus of glucose in rats This effect relates to both glycemia peak value and area under the curve of the time-course of glycemia.
Abbreviations used: Intragastric: i.g., Least significant difference: LSD test.
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Affiliation(s)
- Mauro A M Carai
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, Monserrato (CA), Italy; Cagliari Pharmacological Research S.R.L., Cagliari (CA), Italy
| | - Giancarlo Colombo
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, Monserrato (CA), Italy
| | - Barbara Loi
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, Monserrato (CA), Italy
| | - Alessandro Zaru
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, Monserrato (CA), Italy
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Siliani S, Melis R, Loi B, Guala I, Baroli M, Sanna R, Uzzau S, Roggio T, Addis MF, Anedda R. Influence of seasonal and environmental patterns on the lipid content and fatty acid profiles in gonads of the edible sea urchin Paracentrotus lividus from Sardinia. Mar Environ Res 2016; 113:124-133. [PMID: 26713559 DOI: 10.1016/j.marenvres.2015.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 10/02/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
The influence of seasonal and environmental patterns on the lipid fraction of Paracentrotus lividus gonads was investigated. For this purpose, sea urchins were collected monthly over a year from two Sardinian coastal areas. Total lipids in gonads follow an annual cyclical trend, described by a sine wave curve, that it is more influenced by season than by growing area. The lowest lipid content in gonads corresponds to a high percentage of mature reproductive stages (i.e. winter season), independently of sampling area. A variation in total lipid content follows a change in photoperiod, while it is related to sea surface temperature. Multivariate analysis on fatty acid profiles of gonads, detected by gas chromatography, clusters the collected specimens mainly according to the sampling area, secondly according to the sites within the same sampling area and finally according to season.
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Affiliation(s)
- Silvia Siliani
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Riccardo Melis
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Barbara Loi
- IMC - International Marine Centre, Loc. Sa Mardini, 09170 Torregrande, OR, Italy.
| | - Ivan Guala
- IMC - International Marine Centre, Loc. Sa Mardini, 09170 Torregrande, OR, Italy.
| | - Maura Baroli
- IMC - International Marine Centre, Loc. Sa Mardini, 09170 Torregrande, OR, Italy.
| | - Roberta Sanna
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Sergio Uzzau
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Tonina Roggio
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Maria Filippa Addis
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
| | - Roberto Anedda
- Porto Conte Ricerche S. r. l., S.P. 55 Porto Conte, Capo Caccia, Km 8.400, Loc. Tramariglio, Alghero, SS, Italy.
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De Luca MA, Castelli MP, Loi B, Porcu A, Martorelli M, Miliano C, Kellett K, Davidson C, Stair JL, Schifano F, Di Chiara G. Native CB1 receptor affinity, intrinsic activity and accumbens shell dopamine stimulant properties of third generation SPICE/K2 cannabinoids: BB-22, 5F-PB-22, 5F-AKB-48 and STS-135. Neuropharmacology 2015; 105:630-638. [PMID: 26686391 DOI: 10.1016/j.neuropharm.2015.11.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 08/07/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 01/07/2023]
Abstract
In order to investigate the in vivo dopamine (DA) stimulant properties of selected 3rd generation Spice/K2 cannabinoids, BB-22, 5F-PB-22, 5F-AKB-48 and STS-135, their in vitro affinity and agonist potency at native rat and mice CB1 receptors was studied. The compounds bind with high affinity to CB1 receptors in rat cerebral cortex homogenates and stimulate CB1-induced [(35)S]GTPγS binding with high potency and efficacy. BB-22 and 5F-PB-22 showed the lowest Ki of binding to CB1 receptors (0.11 and 0.13 nM), i.e., 30 and 26 times lower respectively than that of JWH-018 (3.38 nM), and a potency (EC50, 2.9 and 3.7 nM, respectively) and efficacy (Emax, 217% and 203%, respectively) as CB1 agonists higher than JWH-018 (EC50, 20.2 nM; Emax, 163%). 5F-AKB-48 and STS-135 had higher Ki for CB1 binding, higher EC50 and lower Emax as CB1 agonists than BB-22 and 5F-PB-22 but still comparatively more favourable than JWH-018. The agonist properties of all the compounds were abolished or drastically reduced by the CB1 antagonist/inverse agonist AM251 (0.1 μM). No activation of G-protein was observed in CB1-KO mice. BB-22 (0.003-0.01 mg/kg i.v.) increased dialysate DA in the accumbens shell but not in the core or in the medial prefrontal cortex, with a bell shaped dose-response curve and an effect at 0.01 mg/kg and a biphasic time-course. Systemic AM251 (1.0 mg/kg i.p.) completely prevented the stimulant effect of BB-22 on dialysate DA in the NAc shell. All the other compounds increased dialysate DA in the NAc shell at doses consistent with their in vitro affinity for CB1 receptors (5F-PB-22, 0.01 mg/kg; 5F-AKB-48, 0.1 mg/kg; STS-135, 0.15 mg/kg i.v.). 3rd generation cannabinoids can be even more potent and super-high CB1 receptor agonists compared to JWH-018. Future research will try to establish if these properties can explain the high toxicity and lethality associated with these compounds.
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Affiliation(s)
| | - M Paola Castelli
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - Barbara Loi
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Alessandra Porcu
- Department of Biomedical Sciences, University of Cagliari, Italy
| | | | - Cristina Miliano
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - Kathryn Kellett
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Colin Davidson
- Pharmacology and Cell Physiology, Division of Biomedical Science, St George's University of London, London, UK
| | | | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Gaetano Di Chiara
- Department of Biomedical Sciences, University of Cagliari, Italy; CNR Institute of Neuroscience, Cagliari Section, University of Cagliari, Italy.
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Colombo G, Maccioni P, Lobina C, Lorrai I, Acciaro C, Loi B, Zaru A, Contini A, Carai MAM, Gessa GL. SY17AN INTERNATIONAL AND INTERDISCIPLINARY APPROACH TO CHARACTERIZE NEW MODELS OF ALCOHOL ADDICTION IN RODENTS AND NOVEL THERAPIES FOR AUDSY17-1BINGE-LIKE DRINKING IN SARDINIAN ALCOHOL-PREFERRING RATS. Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv076.70] [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: 11/14/2022] Open
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Abstract
OBJECTIVE Mephedrone is a stimulant drug chemically related to amphetamine, with effects similar to those of amphetamine and cocaine. This study aims to analyse fatalities following ingestion of mephedrone in the UK amongst 16- to 24-year-olds in 2009-2013, providing an update on data presented at the 2nd International Conference on Novel Psychoactive Substances. METHODS A literature search was undertaken to identify published information on pharmacology, toxicity and fatalities associated with mephedrone. Fatalities involving mephedrone were extracted from the National Programme on Substance Abuse Deaths database, which receives information on drug-related deaths from coroners in the UK and Islands and other data suppliers. Selection criteria are as follows: deceased aged 16-24 years at time of death and mephedrone directly implicated in the cause of death and/or mentioned in the coroner's verdict. RESULTS Thirty cases met the study criteria, and when known, all were of White ethnicity, most (85%) had a history of drug use and 73% were male. Two-thirds (63%) were accidental poisonings. Mephedrone was used with other substances in most cases (87%); other substances were implicated in 60% of deaths. CONCLUSIONS Mephedrone use can have potentially fatal consequences, especially in combination with other substances. Deaths from its use in the 16-24 years' age group continue to occur in the UK, despite it being a controlled drug. Health professionals and potential consumers should be alert to this risk.
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Affiliation(s)
- Barbara Loi
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
| | - John Martin Corkery
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
| | - Hugh Claridge
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
| | - Christine Goodair
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
| | - Stefania Chiappini
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
| | - Carla Gimeno Clemente
- National Programme on Substance Abuse Deaths (NPSAD), St George's, University of London, London, UK
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Abstract
OBJECTIVE The goal of this study is to provide an update on the data given on methoxetamine (MXE)-related fatalities that occurred in 2011-2013, presented at the Second International Conference on Novel Psychoactive Substances. METHODS Fatalities involving MXE were extracted from the database of the National Programme on Substance Abuse Deaths, which receives information on drug-related deaths from Coroners in the UK and Islands (Isle of Man, Jersey, Guernsey) and other data suppliers. RESULTS Eight cases, received by 3 September 2013, in which MXE was found at post-mortem and/or directly implicated in the death and/or mentioned in the Coroner's verdict are described. The median age at death was 27 years, with the majority of White ethnicity (6/8) and male (7/8). MXE was used together with other substances in 7/8 cases. MXE was found at post-mortem in all cases, directly implicated in the deaths of four and likely to have had an influence in two. CONCLUSIONS More research needs to be conducted into its health effects and toxicity potential. Health care professionals should be made aware of the potential health harms of MXE, in order to develop early intervention measures and minimise the number of MXE-related poisonings and fatalities.
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Affiliation(s)
- Stefania Chiappini
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
| | - Hugh Claridge
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
| | - John M Corkery
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
| | - Christine Goodair
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
| | - Barbara Loi
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
| | - Fabrizio Schifano
- National Programme on Substance Abuse Deaths (NPSAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London, UK
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Colombo G, Maccioni P, Vargiolu D, Loi B, Lobina C, Zaru A, Carai MAM, Gessa GL. The dopamine β-hydroxylase inhibitor, nepicastat, reduces different alcohol-related behaviors in rats. Alcohol Clin Exp Res 2015; 38:2345-53. [PMID: 25257286 DOI: 10.1111/acer.12520] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/24/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent experimental data indicate that treatment with the selective dopamine β-hydroxylase inhibitor, nepicastat, suppressed different reward-related behaviors, including self-administration of chocolate and reinstatement of cocaine and chocolate seeking, in rats. This study was designed to extend to different alcohol-related behaviors the investigation on the "anti-addictive" properties of nepicastat. METHODS Sardinian alcohol-preferring (sP) rats, selectively bred for excessive alcohol consumption, were exposed to different procedures of alcohol drinking and self-administration. RESULTS Repeated treatment with nepicastat (0, 25, 50, and 100 mg/kg, intraperitoneally [i.p.], once daily for 10 consecutive days) produced a stable and dose-related reduction in daily alcohol intake in sP rats exposed to the homecage 2-bottle "alcohol (10% v/v) versus water" choice regimen with unlimited access. Acute treatment with nepicastat (0, 25, 50, and 100 mg/kg, i.p.) completely suppressed the "alcohol deprivation effect" (i.e., the temporary increase in alcohol intake occurring after a period of abstinence; model of alcohol relapse episodes) in sP rats exposed to the 2-bottle choice regimen. Acute treatment with nepicastat (0, 25, 50, and 100 mg/kg, i.p.) dose dependently and selectively reduced oral alcohol self-administration in sP rats trained to lever respond for alcohol (15% v/v) on a fixed ratio 4 schedule of reinforcement. Finally, combination of nepicastat (0, 50, and 100 mg/kg, i.p.) and alcohol (2 g/kg, intragastrically) did not alter spontaneous locomotor activity in sP rats. CONCLUSIONS Together, these data extend to alcohol the capacity of nepicastat to suppress different behaviors motivated by natural stimuli and drugs of abuse.
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Affiliation(s)
- Giancarlo Colombo
- Section of Cagliari, Neuroscience Institute, National Research Council of Italy, Monserrato (CA), Italy
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Lobina C, Carai MAM, Loi B, Gessa GL, Riva A, Cabri W, Petrangolini G, Morazzoni P, Colombo G. Protective effect of Panax ginseng in cisplatin-induced cachexia in rats. Future Oncol 2015; 10:1203-14. [PMID: 24947261 DOI: 10.2217/fon.13.276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM This study investigated the protective effect of a standardized extract of Panax ginseng on multiple cisplatin-induced 'sickness behaviors' (model of cancer-induced cachexia) in rats. MATERIALS & METHODS Cisplatin was administered twice weekly (1-2 mg/kg, intraperitoneal) for 5 consecutive weeks. Panax ginseng extract (0, 25 and 50 mg/kg, intragastric) was administered daily over the 5-week period of cisplatin exposure. Malaise, bodyweight and temperature, pain sensitivity, and endurance running were recorded at baseline and at 5 weekly intervals. RESULTS Treatment with cisplatin produced severe signs of malaise, marked loss of bodyweight, hypothermia, hyperalgesia and reduction in running time. Treatment with Panax ginseng extract completely prevented all cisplatin-induced alterations. CONCLUSION These data indicate that treatment with Panax ginseng extract exerted a protective effect in a rat model of cachexia and suggest that Panax ginseng extract may be a therapeutic promising tool for supportive care in oncology.
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Affiliation(s)
- Carla Lobina
- Giancarlo Colombo Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500 I-09042 Monserrato (CA), Italy
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Loi B, Colombo G, Maccioni P, Carai MAM, Franconi F, Gessa GL. High alcohol intake in female Sardinian alcohol-preferring rats. Alcohol 2014; 48:345-51. [PMID: 24555906 DOI: 10.1016/j.alcohol.2014.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 06/07/2013] [Revised: 12/16/2013] [Accepted: 01/07/2014] [Indexed: 12/30/2022]
Abstract
Sardinian alcohol-preferring (sP) rats have been selectively bred for high alcohol preference and consumption. When exposed to the standard, home cage 2-bottle "alcohol (10%, v/v) vs. water" choice regimen with continuous access, male sP rats consume daily approximately 6 g/kg alcohol. Conversely, when exposed to the intermittent (once every other day) access to 2 bottles containing alcohol (20%, v/v) and water, respectively, male sP rats display marked increases in daily alcohol intake and signs of alcohol intoxication and "behavioral" dependence. The present study was designed to assess alcohol intake in female sP rats exposed, under the 2-bottle choice regimen, to (a) 10% (v/v) alcohol with continuous access (CA10%), (b) 10% (v/v) alcohol with intermittent access (IA10%), (c) 20% (v/v) alcohol with continuous access (CA20%), and (d) 20% (v/v) alcohol with intermittent access (IA20%). Male sP rats (exposed to CA10% and IA20% conditions) were included for comparison. Over 20 daily drinking sessions, daily alcohol intake in female CA10% and IA20% rats averaged 7.0 and 9.6 g/kg, respectively. The rank of alcohol intake was IA20% > IA10% = CA20% > CA10%. Conversely, daily alcohol intake in male CA10% and IA20% rats averaged 6.0 and 8.2 g/kg, respectively. Comparison of female and male rats yielded the following rank of alcohol intake: female IA20% > male IA20% > female CA10% ≥ male CA10%. An additional experiment found that alcohol drinking during the first hour of the drinking session produced mean blood alcohol levels of 35-40 mg% and 85-100 mg% in the CA10% and IA20% rats, respectively. These results (a) extend to female sP rats previous data demonstrating the capacity of the IA20% condition to markedly escalate alcohol drinking, and (b) demonstrate that female sP rats consume more alcohol than male sP rats. This sex difference is more evident under the IA20% condition, suggesting that female sP rats are highly sensitive to the promoting effect of the IA20% condition on alcohol drinking. These data contribute to the characterization of sP rats as a model of excessive alcohol consumption.
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Affiliation(s)
- Barbara Loi
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Giancarlo Colombo
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy.
| | - Paola Maccioni
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Mauro A M Carai
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Flavia Franconi
- Department of Biomedical Sciences, University of Sassari, I-07100, Sassari (SS), Italy
| | - Gian Luigi Gessa
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
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Colombo G, Maccioni P, Acciaro C, Lobina C, Loi B, Zaru A, Carai MAM, Gessa GL. Binge drinking in alcohol-preferring sP rats at the end of the nocturnal period. Alcohol 2014; 48:301-11. [PMID: 24680256 DOI: 10.1016/j.alcohol.2014.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 12/27/2013] [Accepted: 02/18/2014] [Indexed: 01/08/2023]
Abstract
Sardinian alcohol-preferring (sP) rats have been selectively bred for high alcohol preference and consumption using the standard 2-bottle "alcohol (10%, v/v) vs. water" choice regimen with unlimited access; under this regimen, sP rats daily consume 6-7 g/kg alcohol. The present study assessed a new paradigm of alcohol intake in which sP rats were exposed to the 4-bottle "alcohol (10%, 20%, and 30%, v/v) vs. water" choice regimen during one of the 12 h of the dark phase of the daily light/dark cycle; the time of alcohol exposure was changed daily in a semi-random order and was unpredictable to rats. Alcohol intake was highly positively correlated with the time of the drinking session and averaged approximately 2 g/kg when the drinking session occurred during the 12th hour of the dark phase. Alcohol drinking during the 12th hour of the dark phase resulted in (a) blood alcohol levels averaging approximately 100 mg% and (b) severe signs of alcohol intoxication (e.g., impaired performance at a Rota-Rod task). The results of a series of additional experiments indicate that (a) both singular aspects of this paradigm (i.e., unpredictability of alcohol exposure and concurrent availability of multiple alcohol concentrations) contributed to this high alcohol intake, (b) alcohol intake followed a circadian rhythm, as it decreased progressively over the first 3 h of the light phase and then maintained constant levels until the beginning of the dark phase, and (c) sensitivity to time schedule was specific to alcohol, as it did not generalize to a highly palatable chocolate-flavored beverage. These results demonstrate that unpredictable, limited access to multiple alcohol concentrations may result in exceptionally high intakes of alcohol in sP rats, modeling - to some extent - human binge drinking. A progressively increasing emotional "distress" associated to rats' expectation of alcohol might be the neurobehavioral basis of this drinking behavior.
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Affiliation(s)
- Giancarlo Colombo
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy.
| | - Paola Maccioni
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Carla Acciaro
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Carla Lobina
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Barbara Loi
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Alessandro Zaru
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Mauro A M Carai
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
| | - Gian Luigi Gessa
- Neuroscience Institute, National Research Council of Italy, Section of Cagliari, S.S. 554, km. 4,500, I-09042 Monserrato (CA), Italy
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Pietrzykowski A, Mead E, Wang Y, Thekkumthala A, Hot A, Tejeda L, Collins M, Tajuddin N, Moon KH, Neafsey E, Nixon K, Colombo G, Maccioni P, Lobina C, Loi B, Acciaro C, Zaru A, Carai M, Gessa GL, Klintsova A. O1 * FREE ORAL COMMUNICATIONS 1: BASIC NEUROBIOLOGICAL MECHANISMS OF ALCOHOL ADDICTION. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Razvodovsky Y, Borodinsky A, Pascual-Mora M, Pla A, Renau-Piqueras J, Guerri C, Haass-Koffler C, Kenna G, Henry A, Bartlett S, Dudek M, Abo-Ramadan U, Hyytia P, Maccioni P, Gessa GL, Thomas A, Malherbe P, Mugnaini C, Corelli F, Colombo G, Maccioni P, Vargiolu D, Loi B, Lobina C, Zaru A, Carai M, Gessa GL, Colombo G, Maccioni P, Vargiolu D, Carai M, Gessa GL, Riva A, Bombardelli E, Morazzoni P, Colombo G, Osna N, Kharbanda K, McVicker B, Casey C, Mercer D, Naassila M, Legastelois R, Alaux-Cantin S, Houchi H, Botia B, Pronko PS, Khomich TI, Satanovskaya VI, Karaedova LM, Borodinsky AN, Lis RE, Feltmann K, Steensland P, Ledesma JC, Bali P, Bali P, Ledesma JC, Gonzalez C, Bali P, Ledesma JC, Aragon C, Etelalahti T, Eriksson P, Todkar A, Granholm L, Comasco E, Oreland L, Hodgins S, Nilsson K, Nylander I, Phedina K, Zimatkin S, Smutek M, Parkitna JR, Przewlocki R, Janeczek P, Van Steenwyk G, Lewohl J, Napper R, Hopping M, Stragier E, Massart R, Hamon M, Lanfumey L. BASIC RESEARCH. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Sala M, Braida D, Pucci L, Manfredi I, Marks MJ, Wageman CR, Grady SR, Loi B, Fucile S, Fasoli F, Zoli M, Tasso B, Sparatore F, Clementi F, Gotti C. CC4, a dimer of cytisine, is a selective partial agonist at α4β2/α6β2 nAChR with improved selectivity for tobacco smoking cessation. Br J Pharmacol 2013; 168:835-49. [PMID: 22957729 PMCID: PMC3631374 DOI: 10.1111/j.1476-5381.2012.02204.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 08/27/2012] [Accepted: 08/29/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Many of the addictive and rewarding effects of nicotine are due to its actions on the neuronal nicotinic ACh receptor (nAChR) subtypes expressed in dopaminergic mesocorticolimbic cells. The partial agonists, cytisine and varenicline, are helpful smoking cessation aids. These drugs have a number of side effects that limit their usefulness. The aim of this study was to investigate the preclinical pharmacology of the cytisine dimer1,2-bisN-cytisinylethane (CC4). EXPERIMENTAL APPROACH The effects of CC4 on nAChRs were investigated using in vitro assays and animal behaviours. KEY RESULTS When electrophysiologically tested using heterologously expressed human subtypes, CC4 was less efficacious than cytisine on neuronal α4β2, α3β4, α7 and muscle-type receptors, and had no effect on 5-hydroxytryptamine3 receptors. Acting through α4β2 and α6β2 nAChRs, CC4 is a partial agonist of nAChR-mediated striatal dopamine release and, when co-incubated with nicotine, prevented nicotine's maximal effect on this response. In addition, it had low affinity for, and was less efficacious than nicotine and cytisine on the α3β4 and α7-nAChR subtypes. Like cytisine and nicotine, CC4-induced conditioned place preference (CPP), and its self-administration shows an inverted-U dose-response curve. Pretreatment with non-reinforcing doses of CC4 significantly reduced nicotine-induced self-administration and CPP without affecting motor functions. CONCLUSION AND IMPLICATIONS Our in vitro and in vivo findings reveal that CC4 selectively reduces behaviours associated with nicotine addiction consistent with the partial agonist selectivity of CC4 for β2-nAChRs. The results support the possible development of CC4 or its derivatives as a promising drug for tobacco smoking cessation.
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Affiliation(s)
- Mariaelvina Sala
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeMilan, Italy
- Dipartimento di Farmacologia, Chemioterapia e Tossicologia Medica, Università degli Studi di MilanoMilano, Italy
| | - Daniela Braida
- Dipartimento di Farmacologia, Chemioterapia e Tossicologia Medica, Università degli Studi di MilanoMilano, Italy
| | - Luca Pucci
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeMilan, Italy
- Dipartimento di Farmacologia, Chemioterapia e Tossicologia Medica, Università degli Studi di MilanoMilano, Italy
| | | | - Michael J Marks
- Institute for Behavioral Genetics, University of ColoradoBoulder, CO, USA
| | - Charles R Wageman
- Institute for Behavioral Genetics, University of ColoradoBoulder, CO, USA
| | - Sharon R Grady
- Institute for Behavioral Genetics, University of ColoradoBoulder, CO, USA
| | - Barbara Loi
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeCagliari, Italy
| | - Sergio Fucile
- IRCCS NEUROMEDPozzilli, Italy
- Dipartimento di Fisiologia e Farmacologia, Università di Roma La SapienzaRome, Italy
| | - Francesca Fasoli
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeMilan, Italy
| | - Michele Zoli
- Dipartimento di Scienze Biomediche, Sezione di Fisiologia, Università di Modena e Reggio EmiliaModena, Italy
| | - Bruno Tasso
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di GenovaGenoa, Italy
| | - Fabio Sparatore
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di GenovaGenoa, Italy
| | - Francesco Clementi
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeMilan, Italy
- Dipartimento di Farmacologia, Chemioterapia e Tossicologia Medica, Università degli Studi di MilanoMilano, Italy
| | - Cecilia Gotti
- Consiglio Nazionale delle Ricerche (CNR), Istituto di NeuroscienzeMilan, Italy
- Dipartimento di Farmacologia, Chemioterapia e Tossicologia Medica, Università degli Studi di MilanoMilano, Italy
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Loi B, Maccioni P, Lobina C, Carai MA, Gessa GL, Thomas AW, Malherbe P, Colombo G. Reduction of alcohol intake by the positive allosteric modulator of the GABA(B) receptor, rac-BHFF, in alcohol-preferring rats. Alcohol 2013; 47:69-73. [PMID: 23218664 DOI: 10.1016/j.alcohol.2012.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 11/20/2012] [Accepted: 11/23/2012] [Indexed: 01/05/2023]
Abstract
Previous research has demonstrated that treatment with the positive allosteric modulator (PAM) of the GABA(B) receptor (GABA(B) PAM), rac-BHFF, suppressed lever-responding for alcohol and amount of self-administered alcohol in Sardinian alcohol-preferring (sP) rats. The present study was designed to extend the investigation on the anti-alcohol effects of rac-BHFF to alcohol drinking behavior. To this end, sP rats were exposed to the homecage, 2-bottle "alcohol (10%, v/v) vs water" choice regimen, with unlimited access for 24 h/day. rac-BHFF was administered once daily and for 7 consecutive days at the doses of 0, 50, 100, and 200 mg/kg (i.g.). Treatment with rac-BHFF resulted in an immediate, stable, and dose-related reduction in daily alcohol intake; the overall magnitude of reduction in alcohol intake averaged approximately 25%, 40%, and 65% in 50, 100, and 200 mg/kg rac-BHFF-treated rat groups, respectively. An increase in daily water intake fully compensated the reduction in alcohol intake, so that daily total fluid intake was unaffected by treatment with rac-BHFF. Daily food intake tended to be reduced only by the highest dose of rac-BHFF. These results complement closely with previous data indicating that (a) rac-BHFF suppressed operant, oral alcohol self-administration in sP rats and (b) the prototypic GABA(B) PAMs, CGP7930 and GS39783, reduced alcohol drinking in sP rats. However, while the reducing effect of CGP7930 and GS39783 on the daily alcohol intake tended to vanish after the first 2-3 days of treatment, the reducing effect of rac-BHFF on daily alcohol intake remained unchanged over the entire 7-day treatment period. These data strengthen the hypothesis that GABA(B) PAMs may represent a step forward in the search for GABA(B) receptor ligands with therapeutic potential for alcoholism.
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Loi B, Fantini N, Colombo G, Gessa GL, Riva A, Bombardelli E, Morazzoni P, Carai MAM. Reducing effect of a combination of Phaseolus vulgaris and Cynara scolymus extracts on food intake and glycemia in rats. Phytother Res 2012; 27:258-63. [PMID: 22565861 DOI: 10.1002/ptr.4704] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/01/2012] [Accepted: 03/26/2011] [Indexed: 11/06/2022]
Abstract
Extracts from Phaseolus vulgaris and Cynara scolymus may reduce food intake and/or postprandial glycemia. This study investigated the effect of standardized extracts of P. vulgaris and C. scolymus and their combination on food intake and glycemia in rats. P. vulgaris and C. scolymus extracts, and their 1:2 combination, were administered acutely to rats (a) given access to regular food and water, (b) given access to regular food, water, and a chocolate-flavored beverage, or (c) infused with a starch bolus. P. vulgaris extract and the combination produced comparable reductions in intake of regular food and chocolate-flavored beverage; conversely, C. scolymus extract was ineffective on both parameters. P. vulgaris and C. scolymus extracts additively contributed to the reducing effect of the combination on glycemic rise. These results suggest that a mixture of P. vulgaris and C. scolymus extracts is preferable over each single extract, as it combines the anorectic effect of the P. vulgaris extract with the hypoglycemic effect of both extracts. These data support the recent clinical use of the combination of P. vulgaris and C. scolymus extracts in the control of appetite, food intake, and postprandial glycemia and represent a successful example of translational research in the nutraceutical field.
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Affiliation(s)
- Barbara Loi
- Neuroscience Institute, Section of Cagliari, National Research Council of Italy, S.S. 554 km. 4, 500, I-09042, Monserrato, Cagliari, Italy
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Maccioni P, Zaru A, Loi B, Lobina C, Carai MAM, Gessa GL, Capra A, Mugnaini C, Pasquini S, Corelli F, Hyytiä P, Lumeng L, Colombo G. Comparison of the effect of the GABAΒ receptor agonist, baclofen, and the positive allosteric modulator of the GABAB receptor, GS39783, on alcohol self-administration in 3 different lines of alcohol-preferring rats. Alcohol Clin Exp Res 2012; 36:1748-66. [PMID: 22486245 DOI: 10.1111/j.1530-0277.2012.01782.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 02/02/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Administration of the GABA(B) receptor agonist, baclofen, and positive allosteric modulator, GS39783, has been repeatedly reported to suppress multiple alcohol-related behaviors, including operant oral alcohol self-administration, in rats. This study was designed to compare the effect of baclofen and GS39783 on alcohol self-administration in 3 lines of selectively bred, alcohol-preferring rats: Indiana alcohol-preferring (P), Sardinian alcohol-preferring (sP), and Alko Alcohol (AA). METHODS Rats of each line were initially trained to respond on a lever, on a fixed ratio (FR) 4 (FR4) schedule of reinforcement, to orally self-administer alcohol (15%, v/v) in daily 30-minute sessions. Once responding reached stable levels, rats were exposed to a sequence of experiments testing baclofen (0, 1, 1.7, and 3 mg/kg; i.p.) and GS39783 (0, 25, 50, and 100 mg/kg; i.g.) on FR4 and progressive ratio (PR) schedules of reinforcement. Finally, to assess the specificity of baclofen and GS39783 action, rats were slightly food-deprived and trained to lever-respond for food pellets. RESULTS The rank of order of the reinforcing and motivational properties of alcohol was P>sP>AA rats. Under both FR and PR schedules of reinforcement, the rank of order of potency and efficacy of baclofen and GS39783 in suppressing alcohol self-administration was P>sP>AA rats. Only the highest dose of baclofen reduced lever-responding for food pellets; this effect was common to all 3 rat lines. Conversely, no dose of GS39783 altered lever-responding for food in any rat line. CONCLUSIONS These results suggest that: (i) the strength of the reinforcing and motivational properties of alcohol differ among P, sP, and AA rats; (ii) the reinforcing and motivational properties of alcohol in P, sP, and AA rats are differentially sensitive to treatment with baclofen and GS39783; (iii) the heterogeneity in sensitivity to baclofen and GS39783 of alcohol self-administration in P, sP, and AA rats may resemble the differential effectiveness of pharmacotherapies among the different typologies of human alcoholics; and (iv) the GABA(B) receptor is part of the neural substrate mediating the reinforcing and motivational properties of alcohol.
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Affiliation(s)
- Paola Maccioni
- Section of Cagliari, Neuroscience Institute, National Research Council of Italy, Monserrato, Italy
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