[Chronic Inflammatory Polyradiculopathy Post-Covid-19 and the Role of Therapeutic Apheresis: A Clinical Case]

There is a strong correlation between SARS-CoV-2 and the onset of autoimmune neurological disease with atypical clinical presentation, characterized by limited response to medical therapy, likely caused by the underlying mechanism of the virus itself. In situations like these, after the failure of pharmacological therapy, therapeutic apheresis, including immunoadsorption, can be pursued. Treatments with IMMUSORBA TR-350 columns have proven to be particularly effective in managing refractory forms of post-Covid-19 nephropathies, leading to complete recovery of disability and elimination of neurological signs and symptoms. We discuss the case of a patient with chronic inflammatory polyradiculopathy post-Covid-19, resistant to medical therapy, effectively treated with immunoadsorption.

Dupilumab ocular side effects in patients with atopic dermatitis: a systematic review

Atopic dermatitis (AD) is a chronic, inflammatory skin disorder that most frequently occurs in children, but it can also affect adults. Even though most AD cases can be managed with topical treatments, moderate-to-severe forms require systemic therapies. Dupilumab is the first human monoclonal antibody approved for the treatment of AD. Its action is through IL-4 receptor alpha subunit inhibition, thus blocking IL-4 and IL-13 signaling pathways. It has been shown to be an effective, well tolerated therapy for AD, as well as for asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP) and eosinophilic esophagitis (EoE). However, an increasing incidence of Dupilumab-induced ocular surface disease (DIOSD) has been reported in patients treated with Dupilumab, as compared to placebo. The aim of this study was to summarize scientific data regarding DIOSD in AD patients treated with Dupilumab. A search of PubMed and clinicaltrials.gov databases was performed. There was no limit to study design. All AD cases were moderate-to-severe. DIOSD was either dermatologist-, allergist-, or ophtalmologist-assessed. Evidence shows that DIOSD occurs most frequently in patients with atopic dermatitis and not in other skin conditions, neither in patients with asthma, CRSwNP, nor EoE who are on Dupilumab treatment. Further studies are warranted in order to establish a causal relationship between Dupilumab and ocular surface disease. Nevertheless, ophtalmological evaluations prior to Dupilumab initiation can benefit AD patients with previous ocular pathology or current ocular symptomatology. Also, patch testing for ocular allergic contact dermatitis might be advantageous in patients with a history of allergic conjunctivitis. Furthermore, TARC, IgE and circulating eosinophils levels might be important biomarkers for a baseline assessment of future candidates to Dupilumab treatment. However, TARC measurements should be resumed for research purposes only.

Development of a method for the detection of zinc in Brassica oleracea using solid phase extraction and size-exclusion chromatography inductively coupled plasma mass spectrometry (SEC-ICP-MS)

The aim of this work is the development of a suitable method to extract and detect zinc-bound compounds from cabbage, broccoli and kale (family Brassicaceae, species oleracea) using solid phase extraction (SPE) and size-exclusion chromatography inductively coupled plasma mass spectrometry (SEC-ICP-MS). Tris [2-Amino-2-(hydroxymethyl)-1,3-propanediol]/hydrochloric acid (Tris/HCl) or ammonium nitrate were used as extractants added to the freeze-dried samples, which were then sonicated and centrifuged. An enzymatic mixture was added to the extracts and then incubated for 5- and 18 h prior to analysis by SEC-ICP-MS. Results showed a good coefficient of variation (CV) of the elution time (0.06-0.9%), concentration (4.7-16.9%) and molecular size (0.4-5.4%). The limit of detection (LOD) and the limit of quantitation (LOQ) were 0.9 μg L-1 and 2.8 μg L-1, respectively. The proposed method is reliable and robust and can be applied to samples with difficult matrices like vegetables and soil.•Good precision, stability and reproducibility.•Easy to execute and suitable for analysis of vegetables and other samples with complex matrices, eg. soil.•This method contributed to good maintenance of the instrument and to minimal cleaning time.

Qualitative in vitro study on the degradation of mineral complexes in vegetables

Mechanisms of degradation and absorption of mineral complexes by the human digestive system are complex and still under investigation. The elaborate matrix of vegetables, and the presence of phytates and other inhibitors make study of these mechanisms difficult. In this qualitative study, extracts from freeze-dried savoy cabbage, broccoli, kale and spinach were subjected to digestion in vitro at pH 2.0 and pH 7.5 and analysed using SEC-ICP-MS. The results suggest that low molecular weight species (peak 6), related to the iron and zinc fractions, which appeared after acidic digestion in all vegetables, except in kale, were considerably reduced after digestion at pH 7.5. Low molecular weight species (peak 9), related to the phosphorus fraction, were present in all vegetables, except in kale, after alkaline digestion. While cabbage, broccoli and spinach showed similar degradation patterns, kale showed a different degradation behaviour.

Development of a reproducible method of analysis of iron, zinc and phosphorus in vegetables digests by SEC-ICP-MS

Vegetables contain iron, zinc and phosphorus as complexes with phytates limiting their availability from a vegetarian diet, meaning non-haem iron deficiency anaemia and zinc deficiency immune malfunction are a risk. Although these elements have been analysed previously in biological fluids and cereal using LC-ICP-MS, there is no method suitable for analysing iron, zinc and phosphorus simultaneously in vegetables because of their complex matrix. In this study, we analysed iron, zinc and phosphorus in cabbage, broccoli, pepper, spinach, kale and rocket after a simulated gastrointestinal digestion using a newly optimised SEC-ICP-MS method. Ammonium nitrate, as the mobile phase, and a suitable rinsing regime, allowed good reproducibility and maintenance of the equipment. The method showed good reproducibility and can be easily adapted to other vegetables, as required.

Quality of life and hormones after sex reassignment surgery

BACKGROUND

Transpeople often look for sex reassignment surgery (SRS) to improve their quality of life (QoL). The hormonal therapy has many positive effects before and after SRS. There are no studies about correlation between hormonal status and QoL after SRS.

AIM

To gather information on QoL, quality of sexual life and body image in transpeople at least 2 years after SRS,to compare these results with a control group and to evaluate the relations between the chosen items and hormonal status.

SUBJECTS AND METHODS

Data from 60 transsexuals and from 60 healthy matched controls were collected. Testosterone,estradiol, LH and World Health Organization Quality of Life (WHOQOL-100) self-reported questionnaire were evaluated. Student’s t test was applied to compare transsexuals and controls. Multiple regression model was applied to evaluate WHOQOL’s chosen items and LH.

RESULTS

The QoL and the quality of body image scores intranspeople were not statistically different from the matched control groups’ ones. In the sexual life subscale,transwomen’s scores were similar to biological women’s ones, whereas transmen’s scores were statistically lower than biological men’s ones (P = 0.003). The quality of sexual life scored statistically lower in transmen than intranswomen (P = 0.048). A significant inverse relationship between LH and body image and between LH and quality of sexual life was found.

CONCLUSIONS

This study highlights general satisfaction after SRS. In particular, transpeople’s QoL turns out to be similar to Italian matched controls. LH resulted inversely correlated to body image and sexual life scores.

Phytoestrogen content of foods of animal origin: dairy products, eggs, meat, fish, and seafood

Dietary phytoestrogens may be involved in the occurrence of chronic diseases. Reliable information on the phytoestrogen content in foods is required to assess dietary exposure and disease risk in epidemiological studies. However, existing analyses have focused on only one class of these compounds in plant-based foods, and there is only little information on foods of animal origin, leading to an underestimation of intake. This is the first comprehensive study of phytoestrogen content in animal food. We have determined the phytoestrogen content (isoflavones: biochanin A, daidzein, formononetin, genistein, and glycitein; lignans: secoisolariciresinol and matairesinol; coumestrol; equol; enterolactone; and enterodiol) in 115 foods of animal origin (including milk and milk-products, eggs, meat, fish, and seafood) and vegetarian substitutes using liquid chromatography-mass spectrometry (LC-MS) with (13)C-labeled internal standards. Phytoestrogens were detected in all foods analyzed; the average content was 20 microg/100 g of wet weight (isoflavones, 6 microg/100 g; lignans, 6 microg/100 g; equol, 3 microg/100 g; and enterolignans, 6 microg/100 g). In infant soy formula, 19 221 microg/100 g phytoestrogens were detected (compared to 59 microg/100 g in non-soy formula). Our study shows that all foods analyzed contained phytoestrogens and most foods (except for fish, seafood, and butter) contained mammalian phytoestrogens (enterolignans and equol). This is the first comprehensive study of phytoestrogen content of foods of animal origin and will allow for a more accurate estimation of exposure to dietary phytoestrogens.

Phytoestrogen content of beverages, nuts, seeds, and oils

Phytoestrogens are secondary plant metabolites that have received increasing attention for their bioactivity, in particular due to their structural and functional similarity to 17beta-estradiol. Although urinary and plasma phytoestrogens can be used as biomarkers for dietary intake, this is often not possible in large epidemiological studies or in the assessment of general exposure in free-living individuals. Accurate information about dietary phytoestrogens is therefore important, but there are very limited data concerning food contents. In this study was analyzed a comprehensive selection of tea, coffee, alcoholic beverages, nuts, seeds, and oils for their phytoestrogen content using a newly developed sensitive method based on LC-MS incorporating (13)C 3-labeled standards. Phytoestrogens were detected in all foods analyzed, although the contents in gin and bitter (beer) were below the limit of quantification (1.5 microg/100 g). Lignans were the main type of phytoestrogens detected. Tea and coffee contained up to 20 microg/100 g phytoestrogens and beer (except bitter) contained up to 71 microg/100 g, mainly lignans. As these beverages are commonly consumed, they are a main source of dietary lignans. The results published here will contribute to databases of dietary phytoestrogen content and allow a more accurate determination of phytoestrogen exposure in free-living individuals.

Natural history and clinical features of progressive supranuclear palsy: a clinical study

Progressive supranuclear palsy (PSP or Steele-Richardson-Olszewski syndrome) is one of the most-common types of atypical parkinsonism. To characterize the natural history and the clinical features of PSP, we reviewed the records of 25 patients followed in our clinic since 1991, with a clinical diagnosis of PSP according to NINDS and Golbe criteria. Progressive onset of early bilateral bradykinesia and postural instability with falls during the 5th decade strongly support the diagnosis of PSP in our patients. Pseudobulbar symptoms are very common at onset and during the course of the illness.

Separation of tricyclic antidepressants by capillary zone electrophoresis with N,N,N',N'-tetramethyl-1,3-butanediamine (TMBD) as an effective electrolyte additive

Five tricyclic antidepressants (TADs), desipramyne, nortriptyline, imipramine, doxepin and amitriptyline, were separated by using the N,N,N',N'-tetramethyl-1,3-butanediamine (TMBD) as additive in the background electrolyte solution. Because the tricyclic antidepressants are similar in structure, mass and pka values, their separation, by capillary zone electrophoresis, requires the careful manipulation of parameters, such as the pH and the composition of the electrolyte solution. As basic drugs, the TADs interact with the silanol groups on the capillary wall giving rise to peak broadening and asymmetry, non reproducible migration times and failing in selectivity. Different concentrations of TMBD (40, 60, 100 and 150 mM) were used at pH 9.5, but only a 100 mM TMBD allowed a good separation and a high efficiency for all the TADs. At this pH the separation was not possible without additive. This result is due to the reduced electroosmotic flow whose mobility is at a value of 10(-9) m(2) V(-1) s(-1).

Direct MALDI-TOF MS analysis of oligonucleotides on solid support through a photolabile linker

MALDI-TOF mass spectrometry was used to analyze oligonucleotides still anchored to long-chain alkylamine controlled-pore glass (LCAA-CPG) through a photolabile linker. This technique is useful to follow supported chemical reactions in real time and monitor by-products formation.

Lipophilic pro-oligonucleotides are rapidly and efficiently internalized in HeLa cells

Model t-Bu-SATE pro-dodecathymidines labeled with fluorescein and exhibiting various lipophilicities were evaluated for their uptake by cells in culture. Pro-oligonucleotides with appropriate lipophilicity were found to permeate across the HeLa cell membrane much more extensively than the control phosphorothioate oligo or than the hydrophilic pro-oligos. Fluorescence patterns of internalization were consistent with a diffusion mechanism resulting in the appearance of a uniform cytoplasmic distribution and nuclear accumulation, as confirmed by confocal microscopy.

The pro-oligonucleotide approach: solid phase synthesis and preliminary evaluation of model pro-dodecathymidylates

A modified phosphoramidite method has been designed for the solid-phase synthesis of two dodecathymidine phosphotriesters and two dodecathymidine thionophosphotriesters. In these analogs, each internucleoside link bears an S -acyl-2-thioethyl (Me-SATE or tBu-SATE) group removable upon esterase activation. Efficient synthesis of these lipophilic analogs was achieved thanks to the use of a photolabile linker anchored to the solid support in combination with thymidine-3'- O -phosphoramidites having a SATE group in place of the regular 2-cyanoethyl one. Both dodecathymidine phosphotriester and thionophosphotriester having S -acetyl-2-thioethyl groups were found to be stable in the presence of snake venom and calf spleen phosphodiesterases whereas, upon incubation in CEM cell extracts, they were selectively hydrolyzed to the anionic parent dodecathymidylate and dodecathymidine phosphorothioate, respectively. In addition, Me-SATE-protected dodecathymidine thionophosphotriester was stable in mouse and human sera as well as in human gastric juice. These results depict the potential of SATE-protected oligonucleotides as prodrugs of antisense oligonucleotides.

The indirect UV detection in the analysis of ursodeoxycholic acid and related compounds by HPCE

A high-performance capillary zone electrophoretic (HPCE) assay has been developed for the determination of ursodeoxycholic acid (UDCA) and its usual impurities. Considering the low molecular absorptivity of UDCA and its related compounds indirect UV detection was used. The electrophoretic capillary was filled with a background electrolyte (BGE) containing an UV absorbing ion: benzoic acid (BA) or 5,5-diethylbarbituric acid (DBA). To enhance the selectivity of the assay diimethyl-beta-cyclodextrines (D-beta-CDs) or trimethyl-beta-cyclodextrines (T-beta-CDs) have been added to the running buffer together with methylcellulose or urea. All considered impurities were well resolved with two buffers studied, with the exception of methylursodehoxycholate, a neutral compound.

Determination of the binding of a beta 2-blocker drug, frusemide and ceftriaxone to serum proteins by capillary zone electrophoresis

A modified Hummel-Dreyer method was used to study the binding of drugs with serum proteins by high performance capillary electrophoresis. The study was carried out to check the possible interaction between serum proteins and a highly selective beta 2-blocker, ICI 118551 (ICI). To prove the suitability of the method the protein binding of frusemide and ceftriaxone, drugs previously investigated, was also studied. The analyses were carried out by injecting a solution of s alpha(1)-acidic glycoprotein (alpha(1)-AGP) or human serum albumin in 70 mM NaH2PO4/Na2HPO4(pH 7.4) buffer into an uncoated fused silica capillary filled with the same buffer. In the capillary, maintained at a working temperature of 35 degrees C, a known amount of the ICI, frusemide or ceftriaxone was added. The method allows the bound drug to be determined directly.

Analysis of non-benzodiazepinic anxiolytic agents by capillary zone electrophoresis

A simple capillary electrophoretic method was developed for the analysis of a new generation of serotonergic anxiolytics and their related substances: zalospirone, gepirone, ipsapirone and buspirone. All compounds run in a Tris/phosphate buffer at pH 3 as cations and the experimental conditions allowed good resolution of four drugs and their principal impurities. The analyses were made using two different kinds of capillary. The suitability of CZE and HPLC methods for the analysis of these non-benzodiazepinic anxiolytic agents and their impurities was compared.