1
|
Filosto M, Cotti Piccinelli S, Gazzina S, Foresti C, Frigeni B, Servalli MC, Sessa M, Cosentino G, Marchioni E, Ravaglia S, Briani C, Castellani F, Zara G, Bianchi F, Del Carro U, Fazio R, Filippi M, Magni E, Natalini G, Palmerini F, Perotti AM, Bellomo A, Osio M, Nascimbene C, Carpo M, Rasera A, Squintani G, Doneddu PE, Bertasi V, Cotelli MS, Bertolasi L, Fabrizi GM, Ferrari S, Ranieri F, Caprioli F, Grappa E, Manganotti P, Bellavita G, Furlanis G, De Maria G, Leggio U, Poli L, Rasulo F, Latronico N, Nobile-Orazio E, Beghi E, Padovani A, Uncini A. Guillain-Barré Syndrome and COVID-19: a one-year observational multicenter study. Eur J Neurol 2022; 29:3358-3367. [PMID: 35837806 PMCID: PMC9349567 DOI: 10.1111/ene.15497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/04/2022] [Accepted: 07/07/2022] [Indexed: 01/08/2023]
Abstract
Background and purpose Many single cases and small series of Guillain–Barré syndrome (GBS) associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection were reported during the coronavirus disease 19 (COVID‐19) outbreak worldwide. However, the debate regarding the possible role of infection in causing GBS is still ongoing. This multicenter study aimed to evaluate epidemiological and clinical findings of GBS diagnosed during the COVID‐19 pandemic in northeastern Italy in order to further investigate the possible association between GBS and COVID‐19. Methods Guillain–Barré syndrome cases diagnosed in 14 referral hospitals from northern Italy between March 2020 and March 2021 were collected and divided into COVID‐19‐positive and COVID‐19‐negative. As a control population, GBS patients diagnosed in the same hospitals from January 2019 to February 2020 were considered. Results The estimated incidence of GBS in 2020 was 1.41 cases per 100,000 persons/year (95% confidence interval 1.18–1.68) versus 0.89 cases per 100,000 persons/year (95% confidence interval 0.71–1.11) in 2019. The cumulative incidence of GBS increased by 59% in the period March 2020–March 2021 and, most importantly, COVID‐19‐positive GBS patients represented about 50% of the total GBS cases with most of them occurring during the two first pandemic waves in spring and autumn 2020. COVID‐19‐negative GBS cases from March 2020 to March 2021 declined by 22% compared to February 2019–February 2020. Conclusions Other than showing an increase of GBS in northern Italy in the “COVID‐19 era” compared to the previous year, this study emphasizes how GBS cases related to COVID‐19 represent a significant part of the total, thus suggesting a relation between COVID‐19 and GBS.
Collapse
Affiliation(s)
- Massimiliano Filosto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy
| | - Stefano Cotti Piccinelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Stefano Gazzina
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Camillo Foresti
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Barbara Frigeni
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | | | - Maria Sessa
- Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy
| | - Giuseppe Cosentino
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Enrico Marchioni
- IRCCS Mondino Foundation, Neurooncology and Neuroinflammation Unit, Pavia, Italy
| | - Sabrina Ravaglia
- IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Chiara Briani
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | | | - Gabriella Zara
- Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Francesca Bianchi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Ubaldo Del Carro
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Raffaella Fazio
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Massimo Filippi
- Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.,Vita Salute San Raffaele University, Milano, Italy
| | - Eugenio Magni
- Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy
| | - Giuseppe Natalini
- Unit of Intensive Care and Anesthesiology, Fondazione Poliambulanza, Brescia, Italy
| | | | | | - Andrea Bellomo
- "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milano, Italy
| | - Maurizio Osio
- Unit of Neurology, ASST Fatebenefratelli Sacco, Milano
| | | | | | | | | | - Pietro Emiliano Doneddu
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | | | | | - Laura Bertolasi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gian Maria Fabrizi
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Ranieri
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Elena Grappa
- Intensive Care Unit, ASST Cremona, Cremona, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Giulia Bellavita
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Trieste, Italy
| | | | - Ugo Leggio
- Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy
| | - Loris Poli
- Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Frank Rasulo
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili, Brescia; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Nicola Latronico
- Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili, Brescia; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Eduardo Nobile-Orazio
- Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine, Milan University, Milan, Italy
| | - Ettore Beghi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Neurology, ASST Spedali Civili, Brescia, Italy
| | - Antonino Uncini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy
| |
Collapse
|
2
|
Mattavelli D, Mele F, Bertora P, Rosa S, Bortolami C, Nascimbene C, Osio M, Pantoni L. Epileptiform Activity During Transient Focal Neurologic Episodes in Cerebral Amyloid Angiopathy. Neurol Clin Pract 2021; 11:e43-e45. [PMID: 33968493 DOI: 10.1212/cpj.0000000000000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/10/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Daniele Mattavelli
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Francesco Mele
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Pierluigi Bertora
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Silvia Rosa
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Cristina Bortolami
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Caterina Nascimbene
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Maurizio Osio
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Leonardo Pantoni
- "Luigi Sacco" Department of Biomedical and Clinical Sciences (DM, FM, PB, LP), University of Milan, Milan, Italy; and Neurology Unit (SR, CB, CN, MO), ASST Fatebenefratelli-Sacco, Milan, Italy
| |
Collapse
|
3
|
Zardoni M, Gianelli F, Bruno S, Raimondi E, Nascimbene C, Mariani C, Osio M. 51. Reference data for quantitative motor unit potential and interference pattern analysis in the genioglossus muscle. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.063] [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: 11/16/2022]
|
4
|
Raimondi E, Zardoni M, Bruno S, Nascimbene C, Pasanisi M, Morandi L, Gianelli F, Colombo M, Schindler A, Mariani C, Osio M. 37. Dysphagia in Myotonic Dystrophy type 1: Preliminary results of an integrated neurophysiological and swallowing protocol. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.045] [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]
|
5
|
Zardoni M, Bana C, Capiluppi E, Gambaro P, Giani L, Mariotti C, Osio M, Nascimbene C, Lovati C, Mariani C. 98. Early neurophysiological modifications in subacute polyneuropathy associated with meningeal carcinomatosis in linitis plastica. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.117] [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: 10/24/2022]
|
6
|
Bana C, Osio M, Spirito S, Caspani F, Gianelli F, Mangiatordi A, Colombo M, Taborelli C, Nascimbene C, Mariani C. 117. Lumbosacral dermatomal somatosensory evoked potential of pelvic floor: Stimulation and recording techniques and normative data. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Osio M, Bana C, Spirito S, Caspani F, Gianelli F, Mangiatordi A, Colombo M, Taborelli C, Nascimbene C, Gambaro P, Mariani C. 102. Middle Latency Somatosensory Evoked Potential (MLSEPs): Method development, normative data and application in Intensive Care Unit in post anoxic comatose patient as possible marker of good prognosis for awake. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.129] [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: 10/26/2022]
|
8
|
Osio M, Mailland E, Muscia F, Nascimbene C, Vanotti A, Bana C, Corsi F, Foschi D, Mariani C. Reply. Muscle Nerve 2011. [DOI: 10.1002/mus.21982] [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: 11/11/2022]
|
9
|
Osio M, Mailland E, Muscia F, Nascimbene C, Vanotti A, Bana C, Corsi F, Foschi D, Mariani C. Botulinum neurotoxin-A does not spread to distant muscles after intragastric injection: A double-blind single-fiber electromyography study. Muscle Nerve 2010; 42:165-9. [PMID: 20564593 DOI: 10.1002/mus.21662] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to perform a careful neurophysiological examination to identify subclinical signs of botulinum toxin spread distant to the injection site following intragastric injection for obesity treatment. Single-fiber electromyography of extensor digitorum communis and repetitive stimulation of abductor digiti minimi were performed before and 8 days after multiple intragastric injections of botulinum toxin A (Botox, 200 U per patient) or placebo. The study was performed in a randomized double-blind fashion. No patient in either group displayed results indicative of neuromuscular dysfunction either before or after the treatment. No significant change in muscle jitter was observed when comparing baseline with the after-treatment evaluation in either group, and no significant differences between groups were observed. After intragastric botulinum toxin injection no subclinical sign of distant spread was observed.
Collapse
Affiliation(s)
- Maurizio Osio
- Clinica Neurologica, Università degli Studi di Milano, Luigi Sacco Hospital, via G.B. Grassi, 74, (IT)-20157 Milan, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Comi C, Osio M, Ferretti M, Mesturini R, Cappellano G, Chiocchetti A, Carecchio M, Nascimbene C, Varrasi C, Cantello R, Mariani C, Monaco F, Dianzani U. Defective Fas-mediated T-cell apoptosis predicts acute onset CIDP. J Peripher Nerv Syst 2009; 14:101-6. [DOI: 10.1111/j.1529-8027.2009.00219.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
11
|
Vanotti A, Osio M, Mailland E, Nascimbene C, Capiluppi E, Mariani C. Overview on pathophysiology and newer approaches to treatment of peripheral neuropathies. CNS Drugs 2007; 21 Suppl 1:3-12; discussion 45-6. [PMID: 17696588 DOI: 10.2165/00023210-200721001-00002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Peripheral neuropathies are extremely heterogeneous nosological entities. One of the most common symptoms is pain, the underlying mechanisms of which are numerous and complex. Inflammation, reparative processes, and anatomical and gene expression alterations lead to chronic pain, the persistence of which is sustained by peripheral and central sensitisation mechanisms. Treatment of peripheral neuropathies is targeted to its symptomatic and aetiological features. For pain relief, several types of drugs may be used, notably antidepressants (e.g. tricyclic antidepressants, selective serotonin reuptake inhibitors, and both serotonin and noradrenaline [norepinephrine] reuptake inhibitors), antiepileptic drugs (e.g. carbamazepine, phenytoin, lamotrigine, valproic acid, gabapentin, topiramate and pregabalin), NSAIDs and opioid analgesics. Aetiological therapy is aimed at modifying the pathophysiological mechanisms underlying the neuropathy, some of which are common in different neuropathic conditions. Certain drugs are known to exert more than one action on different pathophysiological mechanisms. This is the case with acetyl-L-carnitine (ALC), which can be considered both a symptomatic therapy that can be used in any kind of painful neuropathy, and an aetiological therapy, at least in diabetic neuropathy and neuropathies induced by nucleoside reverse transcriptase inhibitors and cancer chemotherapeutic agents. ALC acts via several mechanisms, inducing regeneration of injured nerve fibres, reducing oxidative stress, supporting DNA synthesis in mitochondria, and enhancing nerve growth factor concentrations in neurons.
Collapse
|
12
|
Osio M, Muscia F, Zampini L, Nascimbene C, Mailland E, Cargnel A, Mariani C. Acetyl-l-carnitine in the treatment of painful antiretroviral toxic neuropathy in human immunodeficiency virus patients: an open label study. J Peripher Nerv Syst 2006; 11:72-6. [PMID: 16519785 DOI: 10.1111/j.1085-9489.2006.00066.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Antiretroviral toxic neuropathy causes morbidity in human immunodeficiency virus (HIV) patients under dideoxynucleoside therapy, benefits only partially from medical therapy, and often leads to drug discontinuation. Proposed pathogeneses include a disorder of mitochondrial oxidative metabolism, eventually related to a reduction of mitochondrial DNA content, and interference with nerve growth factor activity. Carnitine is a substrate of energy production reactions in mitochondria and is involved in many anabolic reactions. Acetyl carnitine treatment promotes peripheral nerve regeneration and has neuroprotective properties and a direct analgesic role related to glutamatergic and cholinergic modulation. The aim of this study was to evaluate acetyl-l-carnitine in the treatment of painful antiretroviral toxic neuropathy in HIV patients. Twenty subjects affected by painful antiretroviral toxic neuropathy were treated with oral acetyl-l-carnitine at a dose of 2,000 mg/day for a 4-week period. Efficacy was evaluated by means of the modified Short Form McGill Pain Questionnaire with each item rated on an 11-point intensity scale at weekly intervals and by electromyography at baseline and final visit. Mean pain intensity score was significantly reduced during the study, changing from 7.35 +/- 1.98 (mean +/- SD) at baseline to 5.80 +/- 2.63 at week 4 (p = 0.0001). Electrophysiological parameters did not significantly change between baseline and week 4. In this study, acetyl-l-carnitine was effective and well tolerated in symptomatic treatment of painful neuropathy associated with antiretroviral toxicity. On the contrary, no effect was noted on neurophysiological parameters.
Collapse
Affiliation(s)
- Maurizio Osio
- Clinica Neurologica, Università degli Studi di Milano, Milano, Italy.
| | | | | | | | | | | | | |
Collapse
|
13
|
Meloni F, Morosini M, Solari N, Passadore I, Nascimbene C, Novo M, Ferrari M, Cosentino M, Marino F, Pozzi E, Fietta AM. Foxp3 Expressing CD4+ CD25+ and CD8+CD28− T Regulatory Cells in the Peripheral Blood of Patients with Lung Cancer and Pleural Mesothelioma. Hum Immunol 2006; 67:1-12. [PMID: 16698419 DOI: 10.1016/j.humimm.2005.11.005] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Indexed: 01/24/2023]
Abstract
The role of T regulatory (Treg) cells in human cancer has not yet been clarified. We assessed the presence and function of CD4+ and CD8+ Treg cell subsets in the peripheral blood of patients with lung cancer (LC) and pleural mesothelioma (PM). We found a low but significant increase in the number of CD4+ T cells with phenotype and functional features of Treg cells in LC patients compared to normal healthy controls (NHC). Furthermore, total CD4+ T cells from LC patients proliferated less than cells from controls, suggesting that the increase in the CD4+ Treg cell pool has functional importance. LC patients also showed an expansion of the CD8+CD28- T cell subset and these cells expressed Foxp3 mRNA, as recently observed in alloantigen-specific CD8+CD28- T suppressor cells. No variation of peripheral Treg cell subsets was found in patients with PM, a disease with a predominantly localized nature. However, the lack of correlation between cancer stage and the number or the function of peripheral Treg cells in LC patients refuted the hypothesis that these cells are involved in tumor spreading. A possible involvement of the peripheral Treg cell pool in cancer development and/or in inducing systemic immunosuppression in LC patients can be hypothesized.
Collapse
Affiliation(s)
- Federica Meloni
- Department of Hematological, Pneumological, and Cardiovascular Sciences, Section of Pneumology, IRCCS Policlinico San Matteo-University of Pavia, Pavia, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Abstract
Autism is a neurodevelopmental disorder characterized by impaired communication and social interaction and may be accompanied by mental retardation and epilepsy. Its cause remains unknown, despite evidence that genetic, environmental, and immunological factors may play a role in its pathogenesis. To investigate whether immune-mediated mechanisms are involved in the pathogenesis of autism, we used immunocytochemistry, cytokine protein arrays, and enzyme-linked immunosorbent assays to study brain tissues and cerebrospinal fluid (CSF) from autistic patients and determined the magnitude of neuroglial and inflammatory reactions and their cytokine expression profiles. Brain tissues from cerebellum, midfrontal, and cingulate gyrus obtained at autopsy from 11 patients with autism were used for morphological studies. Fresh-frozen tissues available from seven patients and CSF from six living autistic patients were used for cytokine protein profiling. We demonstrate an active neuroinflammatory process in the cerebral cortex, white matter, and notably in cerebellum of autistic patients. Immunocytochemical studies showed marked activation of microglia and astroglia, and cytokine profiling indicated that macrophage chemoattractant protein (MCP)-1 and tumor growth factor-beta1, derived from neuroglia, were the most prevalent cytokines in brain tissues. CSF showed a unique proinflammatory profile of cytokines, including a marked increase in MCP-1. Our findings indicate that innate neuroimmune reactions play a pathogenic role in an undefined proportion of autistic patients, suggesting that future therapies might involve modifying neuroglial responses in the brain.
Collapse
Affiliation(s)
- Diana L Vargas
- Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | | | | | | | | |
Collapse
|
15
|
Osio M, Zampini L, Muscia F, Valsecchi L, Nascimbene C, Mariani C, Cargnel A. Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 78. J Peripher Nerv Syst 2003. [DOI: 10.1046/j.1529-8027.2003.00078.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
16
|
Zappasodi P, Vitulo P, Volpini E, Castagnola C, Nascimbene C, Corso A. Successful therapy with high-dose steroids and cyclosporine for the treatment of carmustine-mediated lung injury. Ann Hematol 2002; 81:347-9. [PMID: 12107568 DOI: 10.1007/s00277-002-0464-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2001] [Accepted: 04/12/2002] [Indexed: 10/27/2022]
Abstract
The treatment of the pulmonary toxicity induced by carmustine is nowadays based on the use of corticosteroids that generally lead to a rapid resolution of pneumonitis. On the contrary, no therapeutic alternatives are reported for those patients who do not respond to steroids. We describe a case of non-Hodgkin's lymphoma in a patient who developed a severe interstitial pneumonitis after an autologous transplantation including carmustine in the conditioning regimen. He was successfully treated with an association of steroids and cyclosporine A with a rapid improvement of symptoms and a complete resolution of pneumonitis. This is, to our knowledge, the first case of carmustine-induced pneumonitis, resistant to steroids alone, successfully treated with cyclosporine A. This suggests an immunoallergic mechanism in the pathogenesis of the damage, which can be reversed with prompt therapy.
Collapse
Affiliation(s)
- P Zappasodi
- Division of Hematology, IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
| | | | | | | | | | | |
Collapse
|
17
|
Alessandrino EP, Bernasconi P, Colombo A, Caldera D, Martinelli G, Vitulo P, Malcovati L, Nascimbene C, Varettoni M, Volpini E, Klersy C, Bernasconi C. Pulmonary toxicity following carmustine-based preparative regimens and autologous peripheral blood progenitor cell transplantation in hematological malignancies. Bone Marrow Transplant 2000; 25:309-13. [PMID: 10673703 DOI: 10.1038/sj.bmt.1702154] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sixty-five patients with hematological malignancies (25 multiple myeloma, 18 Hodgkin's disease, 22 non-Hodgkin's lymphomas) who received a carmustine-based regimen followed by autologous PBPC transplantation, were studied retrospectively to evaluate the incidence of post-transplant non-infective pulmonary complications (NIPCs), risk factors predictive of NIPCs, and response to steroids. Carmustine (BCNU) given i.v. at a dose of 600 mg/m2 was combined with etoposide and cyclophosphamide in 40 patients (BCV regimen) and with etoposide and melphalan in 25 patients (BEM regimen). Seventeen of 65 patients (26%) had one episode of NIPCs. The median time to NIPCs was 90 days (52-289). Factors that increased the risk of developing NIPCs on multivariate analysis were female sex (P < 0. 001) and BCV regimen (P < 0.05). All patients with NIPCs received prednisone at a dose of 1 mg/kg body weight for 10 days then tapered by 5 mg every two days; complete response to steroids was achieved in 15 of 17 patients; one unresponsive patient died of interstitial pneumonia. BCNU given at the dose of 600 mg/m2 is well tolerated when associated with melphalan and etoposide. In females and in patients receiving BCNU with cyclophosphamide, a BCNU dose reduction may be advisable. Bone Marrow Transplantation (2000) 25, 309-313.
Collapse
Affiliation(s)
- E P Alessandrino
- Centro Trapianti di Midollo Osseo, Istituto di Ematologia, Policlinico S Matteo, Pavia, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Nazari S, Mourad Z, Salvi S, Buniva P, Fraipont G, Nascimbene C, Cremaschi P. [Longitudinal bronchotomy on the pars membranacea for endoscopic foreign body extraction]. MINERVA CHIR 1999; 54:331-4. [PMID: 10443113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Purpose of this paper is to report a case of foreign body obstructing the middle lobe bronchial origin, surgically removed through a longitudinal bronchotomy on the pars membranacea, reached by passing posteriorly to the lung. Anatomical considerations suggest that longitudinal bronchotomy on the pars membranacea of the main bronchial axis (stem bronchi, intermedius br (right), and lower lobar bronchus) gives direct visualization from inside also of foreign bodies sited into the lobar bronchi (sup, middle and lingula), allowing an easy bronchotomy repair, without lumen distortion or stenosis. Since the pulmonary artery is not in contact with this pars membranacea, broncho-arterial fistula in case of suture line dehiscence is quite improbable.
Collapse
Affiliation(s)
- S Nazari
- Dipartimento di Chirurgia, Università degli Studi, Pavia.
| | | | | | | | | | | | | |
Collapse
|
19
|
Nano R, Capelli E, Civallero M, Terzuolo G, Volpini E, Nascimbene C, Cremaschi P. Effects of interleukin-2 for the treatment of malignant mesothelioma. Oncol Rep 1998; 5:489-92. [PMID: 9468586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The hematological profile, and clinical parameters in mesothelioma affected patients undergoing a clinical trial to evaluate the efficacy of IL-2 treatment were investigated. Six patients were monitored for 6 weeks following therapy. Blood cell count, morphological and immunophenotypical analysis were performed, as well as clinical evaluations of the patients before and after therapy. Activation of the immune system (increase in lymphocytes, monocytes, eosinophils and HMS lymphocytes) induced by IL-2 was observed. The treatment was well tolerated: our patients had only mild adverse reactions controlled by symptomatic therapy. Eosinophilia represented the most evident negative effect. A slight decrease in CD4-positive subset of lymphocytes was observed after rIL-2 treatment. The therapy did not induce significant changes in the progression of the disease. In one patient necrosis at the tumoral site was observed after loco-regional rIL-2 administration.
Collapse
Affiliation(s)
- R Nano
- Department of Animal Biology, University of Pavia and Center of Study for Histochemistry, CNR, Piazza Botta 9-10, Pavia, I-27100, Italy
| | | | | | | | | | | | | |
Collapse
|
20
|
Mastracci L, Bosi F, Oggionni T, Nascimbene C, Prati U, Maconi A, Gardino A, Baritusso A, Fiocca R. 688 Immunohistochemical characterization of lung adenocarcinoma with markers of bronchial and bronchiolar and alveolar differentiation. Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)80068-2] [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: 10/18/2022]
|
21
|
Nano R, Barni S, Capelli E, Cremaschi P, Catanese C, Tomaselli S, Nascimbene C, Prosperi E. Correlation between ultrastructural and histochemical parameters in lymphokine-activated killer (LAK) cells reacting with target cells in vitro. Acta Oncol 1994; 33:165-9. [PMID: 7515629 DOI: 10.3109/02841869409098399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Ultrastructural and fluorescence data allowed us to study the most important moments of the interaction between lymphokine-activated killer (LAK) cells against target cells (Chang) in vitro. The LAK cells, maintained at low doses of recombinant interleukin-2, were able to recognize, bind and destroy the tumoral cells. Before the attack, the LAK cells were characterized by a cytoplasm with a high ribosomes content; after the identification and the interaction cell-cell, a degeneration of the tumoral cell was observed. These observations allowed us to suppose that the interaction between the two types of cells may be mediated by a receptoral membrane system without the action of lytic enzymes.
Collapse
Affiliation(s)
- R Nano
- Department of Animal Biology, University of Pavia, Italy
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Cremaschi P, Nascimbene C, Vitulo P, Catanese C, Rota L, Barazzoni GC, Cornalba GP. Therapeutic embolization of bronchial artery: a successful treatment in 209 cases of relapse hemoptysis. Angiology 1993; 44:295-9. [PMID: 8457080 DOI: 10.1177/000331979304400405] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Still today bronchial artery embolization (BAE) is an important procedure in the management of hemoptysis, as an alternative to, or in association with, surgical or medical therapy. From 1974 to 1990, BAE was performed in 209 patients who suffered from hemoptysis with different etiopathogeneses and severity. Bronchiectasis were the most frequent indication (46%) followed by tuberculosis (31%), cystic fibrosis (16%), lung cancer (4%), and aspergillosis (3%). BAEs were performed by means of polyvinyl alcohol particles and absorbable gelatin sponge. In a few cases complete occlusion of the main truncus of particularly large bronchial arteries was obtained by use of Gianturco steel coin (5 mm o) technique. In the last seven years, together with the traditional angiographic techniques, selective digital angiography (SDA) was performed, above all in preliminary control phases, to evaluate occlusion during embolization. SDA reduced catheterization time and the mean quantity of contrast administered, decreasing side effects; 98% of hemoptysis was controlled in the first twenty-four hours, the other 2% in the following forty eight hours; 16% relapses occurred within the first year; 27 patients needed reembolization (15 patients twice, 11 patients three times, 1 patient five times). No complications were seen. If diagnosis, therapeutic indications, operative technique, and equipment selection are adequate, BAE has a high reliability in patients affected by relapsing hemoptysis, which is difficult to resolve.
Collapse
Affiliation(s)
- P Cremaschi
- Division of Pneumology, I.R.C.C.S. S. Matteo, Pavia, Italy
| | | | | | | | | | | | | |
Collapse
|
23
|
Dominioni L, Dionigi R, Cremaschi P, Nascimbene C, Cividini F, Mori A, Pecis C, Asti S, Moncalvo F, Campani M. [Immunological monitoring of patients operated on for epidermoid bronchogenic carcinoma]. Chir Ital 1981; 33:47-59. [PMID: 7261218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Sequential monitoring of non specific immunity has been carried out in 16 patients with squamous cell bronchogenic carcinoma undergoing radical surgery. At the time of diagnosis total lymphocyte counts, T-lymphocyte counts and the blastogenic response of lymphocytes to PHA were only slightly depressed; on the contrary C3c and C4 serum levels were significantly increased (P less than 0.01). Sequential determinations of the immunologic profile at monthly intervals up to the 12th postoperative month showed a transient increase of total lymphocyte and T-lymphocyte levels; the lymphocyte blastogenic response to PHA and also C3c and C4 serum levels progressively decreased. Delayed hypersensitivity response to cutaneous antigens, neutrophil chemotaxis, serum levels of IgG, IgA, IgM and B-lymphocyte counts were constantly found within normal range.
Collapse
|
24
|
Belli I, Crespi Porro R, Del Favero C, Nascimbene C, Tenti L. [Radiological study of prostate diseases (author's transl)]. Radiol Med 1978; 64:769-84. [PMID: 85316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
25
|
Belli I, Caresano A, Crespi Porro R, Del Favero C, Nascimbene C, Tenti L. [Radiological study of the neoplastic bladder]. Radiol Med 1976; 62:807-26. [PMID: 1078273] [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: 12/25/2022]
Abstract
Radiological methods useful in the examination of bladder tumours are reviewed, with particular reference to preoperative evaluation in accordance with the system. Examples are drawn from a personal series.
Collapse
Affiliation(s)
- I Belli
- Ospedale di Circolo Regionale, Varese
| | | | | | | | | | | |
Collapse
|
26
|
Tenti L, Nascimbene C, Del Favero C, Crespi-Porro R, Caresano A, Belli I. [Renal pseudotumors]. Radiol Med 1976; 62:713-30. [PMID: 1013399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|