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De Vitis C, Capalbo C, Torsello A, Napoli C, Salvati V, Loffredo C, Blandino G, Piaggio G, Auciello FR, Pelliccia F, Salerno G, Simmaco M, Di Magno L, Canettieri G, Coluzzi F, Mancini R, Rocco M, Sciacchitano S. Opposite Effect of Thyroid Hormones on Oxidative Stress and on Mitochondrial Respiration in COVID-19 Patients. Antioxidants (Basel) 2022; 11:antiox11101998. [PMID: 36290721 PMCID: PMC9598114 DOI: 10.3390/antiox11101998] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 01/08/2023] Open
Abstract
Background: Thyroid hormones (TH)s are master regulators of mitochondrial activity and biogenesis. Nonthyroidal illness syndrome (NTIS) is generally considered an adaptative response to reduced energy that is secondary to critical illness, including COVID-19. COVID-19 has been associated with profound changes in the cell energy metabolism, especially in the cells of the immune system, with a central role played by the mitochondria, considered the power units of every cell. Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects and alters mitochondrial functions, both to influence its intracellular survival and to evade host immunity. Aim of the study: This study was undertaken to analyze the oxidative balance and mitochondrial respiration in COVID-19 patients with and without NTIS to elucidate the role that thyroid hormones (TH)s play in this context. Methods: In our cohort of 54 COVID-19 patients, admitted to our University Hospital during the COVID-19 pandemic, we evaluated the generation of reactive oxygen species (ROS) by measuring the serum levels of derivatives of reactive oxygen metabolites (dROMs), and we analyzed the antioxidant capacity by measuring the serum biological antioxidant potential (BAP). We then analyzed the mitochondrial respiration in peripheral blood mononuclear cells (PBMC)s of 28 of our COVID-19 patients, using the seahorse instrument (Agilent). Results were correlated with the serum levels of THs and, in particular, of FT3. In addition, the role of T3 on bioelectrical impedance analysis (BIA) and mitochondrial respiration parameters was directly evaluated in two COVID-19 patients with NTIS, in which treatment with synthetic liothyronine (LT3) was given both in vivo and in vitro. Results: In our COVID-19 patients with NTIS, the dROMs values were significantly lower and the BAP values were significantly higher. Consequently, the oxidative stress index (OSi), measured as BAP/dROMs ratio was reduced compared to that observed in COVID-19 patients without NTIS, indicating a protective role exerted by NTIS on oxidative stress. In our COVID-19 patients, the mitochondrial respiration, measured in PBMCs, was reduced compared to healthy controls. Those with NTIS showed a reduced maximal respiratory capacity and a reduced proton leak, compared to those with normal FT3 serum values. Such lowered mitochondrial respiratory capacity makes the cells more vulnerable to bioenergetic exhaustion. In a pilot study involving two COVID-19 patients with NTIS, we could reinforce our previous observation regarding the role of T3 in the maintenance of adequate peripheral hydroelectrolytic balance. In addition, in these two patients, we demonstrated that by treating their PBMCs with LT3, both in vitro and in vivo, all mitochondrial respiration parameters significantly increased. Conclusions: Our results regarding the reduction in the serum levels of the reactive oxygen species (ROS) of COVID-19 patients with NTIS support the hypothesis that NTIS could represent an adaptative response to severe COVID-19. However, beside this beneficial effect, we demonstrate that, in the presence of an acute reduction of FT3 serum levels, the mitochondrial respiration is greatly impaired, with a consequent establishment of a hypoenergetic state of the immune cells that may hamper their capacity to react to massive viral infection.
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Affiliation(s)
- Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Carlo Capalbo
- Department of Medical Oncology, Sant’Andrea University Hospital, 00189 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Alessandra Torsello
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Christian Napoli
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, 00181 Rome, Italy
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Chiara Loffredo
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Giovanni Blandino
- Translational Oncology Research Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Giulia Piaggio
- UOSD SAFU, Department of Research, Diagnosis and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Roma, Italy
| | - Francesca Romana Auciello
- Translational Oncology Research Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Flaminia Pelliccia
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Gerardo Salerno
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Laura Di Magno
- Department of Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Gianluca Canettieri
- Department of Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
- Pasteur Institute, Cenci-Bolognetti Foundation, 00161 Rome, Italy
| | - Flaminia Coluzzi
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy
- Department Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Monica Rocco
- Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, 00181 Rome, Italy
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant’Andrea University Hospital, 00189 Rome, Italy
| | - Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
- Correspondence:
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Sciacchitano S, Capalbo C, Napoli C, Negro A, De Biase L, Marcolongo A, Anibaldi P, Salvati V, Petrella L, Merlo L, Alampi D, Alessandri E, Loffredo C, Ulivieri A, Lavra L, Magi F, Morgante A, Salehi LB, De Vitis C, Mancini R, Coluzzi F, Rocco M. Nonthyroidal illness syndrome (NTIS) in severe COVID-19 patients: role of T3 on the Na/K pump gene expression and on hydroelectrolytic equilibrium. J Transl Med 2021; 19:491. [PMID: 34861865 PMCID: PMC8640710 DOI: 10.1186/s12967-021-03163-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/23/2021] [Indexed: 12/27/2022] Open
Abstract
Background Nonthyroidal Illness Syndrome (NTIS) can be detected in many critical illnesses. Recently, we demonstrated that this condition is frequently observed in COVID-19 patients too and it is correlated with the severity the disease. However, the exact mechanism through which thyroid hormones influence the course of COVID-19, as well as that of many other critical illnesses, is not clear yet and treatment with T4, T3 or a combination of both is still controversial. Aim of this study was to analyze body composition in COVID-19 patients in search of possible correlation with the thyroid function. Methods and findings We report here our experience performed in 74 critically ill COVID-19 patients hospitalized in the intensive care unit (ICU) of our University Hospital in Rome. In these patients, we evaluated the thyroid hormone function and body composition by Bioelectrical Impedance Analysis (BIA) during the acute phase of the disease at admission in the ICU. To examine the effects of thyroid function on BIA parameters we analyzed also 96 outpatients, affected by thyroid diseases in different functional conditions. We demonstrated that COVID-19 patients with low FT3 serum values exhibited increased values of the Total Body Water/Free Fat Mass (TBW/FFM) ratio. Patients with the lowest FT3 serum values had also the highest level of TBW/FFM ratio. This ratio is an indicator of the fraction of FFM as water and represents one of the best-known body-composition constants in mammals. We found an inverse correlation between FT3 serum values and this constant. Reduced FT3 serum values in COVID-19 patients were correlated with the increase in the total body water (TBW), the extracellular water (ECW) and the sodium/potassium exchangeable ratio (Nae:Ke), and with the reduction of the intracellular water (ICW). No specific correlation was observed in thyroid patients at different functional conditions between any BIA parameters and FT3 serum values, except for the patient with myxedema, that showed a picture similar to that seen in COVID-19 patients with NTIS. Since the Na+/K+ pump is a well-known T3 target, we measured the mRNA expression levels of the two genes coding for the two major isoforms of this pump. We demonstrated that COVID-19 patients with NTIS had lower levels of mRNA of both genes in the peripheral blood mononuclear cells (PBMC)s obtained from our patients during the acute phase of the disease. In addition, we retrieved data from transcriptome analysis, performed on human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM)s treated with T3 and we demonstrated that in these cells T3 is able to stimulate the expression of these two genes in a dose-dependent manner. Conclusions In conclusion, we demonstrated that measurement of BIA parameters is a useful method to analyze water and salt retention in COVID-19 patients hospitalized in ICU and, in particular, in those that develop NTIS. Our results indicate that NTIS has peculiar similarities with myxedema seen in severe hypothyroid patients, albeit it occurs more rapidly. The Na+/K+ pump is a possible target of T3 action, involved in the pathogenesis of the anasarcatic condition observed in our COVID-19 patients with NTIS. Finally, measurement of BIA parameters may represent good endpoints to evaluate the benefit of future clinical interventional trials, based on the administration of T3 in patients with NTIS.
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Affiliation(s)
- Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy. .,Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy.
| | - Carlo Capalbo
- Department of Medical Oncology, Sant'Andrea University Hospital, 00189, Rome, Italy.,Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Christian Napoli
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy
| | - Andrea Negro
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Luciano De Biase
- Heart Failure Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Anibaldi
- Health Management Director, Sant'Andrea Hospital, Rome, Italy
| | - Valentina Salvati
- Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Lea Petrella
- Department of Methods and Models for Economics, Territory and Finance (MEMOTEF), Sapienza University of Rome, Rome, Italy
| | - Luca Merlo
- Department of Statistical Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniela Alampi
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy.,Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Elisa Alessandri
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Chiara Loffredo
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Alessandra Ulivieri
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Luca Lavra
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Fiorenza Magi
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Alessandra Morgante
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Leila B Salehi
- Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy.,U.O.C. of Medical Genetics, Policlinic of Tor Vergata, Rome, Italy
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena n. 324, 00161, Rome, Italy
| | - Flaminia Coluzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University, Rome, Italy.,Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, Rome, Italy
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Di Benedetto P, Pelli M, Loffredo C, La Regina R, Policastro F, Fiorelli S, De Blasi RA, Coluzzi F, Rocco M. Opioid-free anesthesia versus opioid-inclusive anesthesia for breast cancer surgery: a retrospective study. J Anesth Analg Crit Care 2021; 1:6. [PMCID: PMC10208445 DOI: 10.1186/s44158-021-00008-5] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/29/2023]
Abstract
Background Breast cancer surgery is usually managed using opioid-inclusive anesthesia (OIA), although opioids are associated with several adverse events, including nausea, vomiting, and constipation. Multimodal opioid-free anesthesia (OFA) has been introduced to reduce the incidence of these side effects. In this single-center retrospective study, we investigated whether ketamine, combined with magnesium and clonidine, could effectively control postoperative pain in patients undergoing quadrantectomy, while reducing postoperative nausea and vomiting (PONV). Results A total of 89 patients submitted to quadrantectomy were included and divided into an OFA group (38 patients) and an OIA group (51 patients) according to the received anesthetic technique. Analgesia in the OIA group was based on an intraoperative infusion of remifentanil, and analgesia in the OFA consisted of an intraoperative infusion of ketamine and magnesium sulfate. Postoperative pain in both groups was managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Postoperative pain, assessed with the numeric rating scale (NRS), requirements for additional analgesics, the incidence of PONV, and patient satisfaction evaluated using a QoR-40 questionnaire were compared between the two groups. Levels of pain at 30 min and 6, 12, and 24 h after surgery; number of paracetamol rescue doses; and the incidence of PONV were lower in the OFA group (p <0.05). Patient satisfaction was comparable in the two groups. Conclusions A combination of ketamine, magnesium, and clonidine could be more effective than opioid-based analgesia in reducing postoperative pain and lowering PONV occurrence after quadrantectomy for breast cancer.
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Affiliation(s)
- Pia Di Benedetto
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Massimiliano Pelli
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Chiara Loffredo
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Rosaria La Regina
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Federico Policastro
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Silvia Fiorelli
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Roberto Alberto De Blasi
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Flaminia Coluzzi
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino Latina, Italy
| | - Monica Rocco
- Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
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Pelli M, Loffredo C, Menna C, Fiorelli S, Massullo D. Anesthetic Management of an Adult Patient With Down Syndrome for Thoracic Surgery. Cureus 2021; 13:e17130. [PMID: 34548964 PMCID: PMC8437012 DOI: 10.7759/cureus.17130] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/20/2022] Open
Abstract
The anesthetic management of adult patient with Down syndrome (DS) can be challenging due to poor patient cooperation, age-related comorbidities, and a possible difficult airway. Thoracic anesthesia requires an advanced airway management; thus, treatment of DS patients can be particularly demanding. An accurate preoperative assessment is paramount in order to plan a well-designed perioperative strategy in advance. This report describes the anesthetic management of an adult patient affected by DS who underwent pleural decortication for pleural empyema.
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Affiliation(s)
- Massimiliano Pelli
- Division of Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, ITA
| | - Chiara Loffredo
- Division of Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, ITA
| | - Cecilia Menna
- Division of Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, ITA
| | - Silvia Fiorelli
- Division of Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, ITA
| | - Domenico Massullo
- Division of Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, ITA
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Rocco M, Maggi L, Loffredo C, Pelli M, Benedetto PD, Fiorelli S, Simmaco M, De Blasi RA. The impact of different gas mixtures on inflammatory responses in advanced recreational divers. Diving Hyperb Med 2021; 51:140-146. [PMID: 34157728 DOI: 10.28920/dhm51.2.140-146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/01/2020] [Accepted: 01/15/2021] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Decompression sickness (DCS) is considered a 'bubble disease'. Intravascular bubbles activate inflammatory responses associated with endothelial dysfunction. Breathing gas has been proposed as a potential risk factor but this is inadequately studied. Different gases are used in scuba diving. Helium-containing 'trimix' could theoretically mitigate inflammation and therefore reduce DCS risk. This study determined the effect of air and trimix on the inflammatory response following dives to 50 metres of sea water, and evaluated the differences between them in advanced recreational divers. METHODS Thirty-three divers were enrolled in this observational study and were divided in two groups: 17 subjects were included in the air group, and 16 different subjects were included in the trimix (21% oxygen, 35% helium, 44% nitrogen) group. Each subject conducted a single dive, and both groups used a similar diving profile of identical duration. A venous blood sample was taken 30 min before diving and 2 h after surfacing to evaluate changes in interleukins (IL) IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor α (TNFα), vascular endothelial growth factor (VEGF), Interferon γ (IFN-γ), monocyte chemoattractant protein 1 (MCP-1) and epithelial growth factor (EGF) after diving. RESULTS No differences were observed between groups in demographic data or diving experience. Following the dive, IL-6 values showed a slight increase, while IL-8 and EGF decreased in both groups, without significant variation between the groups. CONCLUSIONS In physically fit divers, trimix and air gas mixture during deep diving did not cause relevant changes in the inflammatory markers tested.
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Affiliation(s)
- Monica Rocco
- Department of Surgical and Medical Science and Translation Medicine, Sapienza University, Rome, Italy
| | - Luigi Maggi
- Department of Anesthesia, Sant'Andrea Hospital, Rome, Italy.,Corresponding author: Dr Luigi Maggi, Department of Anesthesia, Sant'Andrea Hospital, Rome, Italy,
| | - Chiara Loffredo
- Department of Surgical and Medical Science and Translation Medicine, Sapienza University, Rome, Italy
| | - Massimiliano Pelli
- Department of Surgical and Medical Science and Translation Medicine, Sapienza University, Rome, Italy
| | | | - Silvia Fiorelli
- Department of Surgical and Medical Science and Translation Medicine, Sapienza University, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University, Rome, Italy
| | - Roberto Alberto De Blasi
- Department of Surgical and Medical Science and Translation Medicine, Sapienza University, Rome, Italy
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Hercik C, Cosmas L, Mogeni O, Kohi W, Mfinanga S, Loffredo C, Montgomery J. Health Beliefs and Patient Perspectives of Febrile Illness in Kilombero, Tanzania. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.352] [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: 10/20/2022] Open
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Tokikawa R, Loffredo C, Uemi M, Machini MT, Bechara EJH. Radical acylation of L-lysine derivatives and L-lysine-containing peptides by peroxynitrite-treated diacetyl and methylglyoxal. Free Radic Res 2014; 48:357-70. [PMID: 24328571 DOI: 10.3109/10715762.2013.871386] [Citation(s) in RCA: 5] [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] [Indexed: 12/22/2022]
Abstract
Highly electrophilic α-dicarbonyls such as diacetyl, methylglyoxal, 3-deoxyglucosone, and4,5-dioxovaleric acid have been characterized as secondary catabolites that can aggregate proteins and form DNA nucleobase adducts in several human maladies, including Alzheimer's disease, rheumatoid arthritis, diabetes, sepsis, renal failure, and respiratory distress syndrome. In vitro, diacetyl and methylglyoxal have also been shown to rapidly add up the peroxynitrite anion (k2 ~ 10(4)-10(5) M(-1) s(-1)), a potent biological nucleophile, oxidant and nitrosating agent, followed by carbon chain cleavage to carboxylic acids via acetyl radical intermediate that can modify amino acids. In this study, we used the amino acid derivatives Ac-Lys-OMe and Z-Lys-OMe and synthesized the tetrapeptides H-KALA-OH, Ac-KALA-OH, and H-K(Boc)ALA-OH to reveal the preferential Lys amino group targeted by acyl radical generated by the α-dicarbonyl/peroxynitrite system. The pH profiles of the reactions are bell-shaped, peaking at approximately 7.5; hence, they are close to the pKa values of ONOOH and of the catalytic H2PO4(-) anion. RP-HPLC and ESI-MS analyses of reaction products confirmed (α)N- and (ϵ)N-acetylation of Lys by diacetyl as well as acetylation and formylation by methylglyoxal, with preference for the α-amino group. These data suggest the possibility of radical acylation of proteins in epigenetic processes, where enzymatic acetylation of these biomolecules is a well-documented event, recently reported to be as critical to the cell cycle as phosphorylation. Also noteworthy is the observed formylation of L-Lys containing peptides by methylglyoxal never reported to occur in amino acid residues of peptides and proteins.
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Affiliation(s)
- R Tokikawa
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo , SP , Brazil
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Ezzat S, Rashed W, Salem S, El-Daly M, Abdel-Hamid M, El-Haddad A, Sedhom I, Loffredo C, Amr S. 1144 Risk Factors for TEL-AML Fusion Gene and Childhood Acute Lymphoblastic Leukemia in Egypt. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71740-9] [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]
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Luta G, Dragomir A, Barbo A, Loffredo C. P1-35 On the use of empirical likelihood based methods to achieve balance on measured confounders. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976c.29] [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: 11/03/2022]
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Gebreselassie D, Lan R, Loffredo C, Goldman R, Abdel-Hamid M. Abstract B57: UBE3A (E6AP) auto antibodies in hepatocellular carcinoma. Cancer Prev Res (Phila) 2008. [DOI: 10.1158/1940-6207.prev-08-b57] [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: 11/16/2022]
Abstract
Abstract
B57
UBE3A (E6AP) auto antibodies in hepatocellular carcinoma
1Gebreselassie, D., 1Lan, R., 1Loffredo, C.A., 2Abdel-Hamid, M., 1Goldman, R.
1Lombardi Comprehensive Cancer Center Georgetown University Washington, D.C. & 2National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
Patients with cancer produce auto antibodies that could serve as biomarkers for detection and classification of the disease. To identify auto antibodies associated with hepatocellular carcinoma (HCC), we used a protein array of 5,000 human proteins (Invitrogen) to compare sera of ten cancer free controls and ten patients with HCC matched on age, gender, and viral infection. Thirty six proteins significantly associated with HCC (p<0.05) were spotted on a custom array. The array experiments confirmed increased auto antibodies in HCC for 20 of the 36 candidates. The frequency of increase was as high as 45% for some of the auto antibodies in a comparison of 20 HCC cases and 10 matched controls. To further validate the observed auto antibody response to Ubiquitin protein ligase E3A (UBE3A), we fused cDNA for the protein, with an N-terminal FLAG tag and an enzyme reporter gene, humanized Renilla luciferase (hRluc). The construct was expressed in the Cos-1 mammalian cell line and crude cell lysates were used for quantification of auto antibodies in serum of the same individuals used in the protein array experiment. The assay is based on immunoprecipitation (IP) of the antigenic protein-construct on protein G beads followed by the quantification of hRluc chemiluminescence. Antibodies to the FLAG tag and the antigen of interest were used to optimize the assay. We found that HCC patient sera contain significantly elevated auto antibodies to UBE3A (t-test P<0.01). The autoantibody response to UBE3A was observed in approximately 20% of the HCC patients and correlates with the results of the protein array experiment.
Citation Information: Cancer Prev Res 2008;1(7 Suppl):B57.
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Affiliation(s)
- Daniel Gebreselassie
- Lombardi Comprehensive Cancer Center, Washington, DC, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - R. Lan
- Lombardi Comprehensive Cancer Center, Washington, DC, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - C. Loffredo
- Lombardi Comprehensive Cancer Center, Washington, DC, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - R. Goldman
- Lombardi Comprehensive Cancer Center, Washington, DC, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - M. Abdel-Hamid
- Lombardi Comprehensive Cancer Center, Washington, DC, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
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Abstract
To assess the relationship between maternal intake of vitamin A and cardiac outflow tract defects, we examined data from a population-based case-control study among liveborn infants born from 1987 through 1989 to mothers residing in the Baltimore-Washington area. Case infants (126) had a nonsyndromic cardiac outflow tract defect. Control infants (679) did not have birth defects and were a stratified random sample of liveborn infants from the same area. The main exposure was average daily maternal intake of retinol and provitamin A carotenoids from foods and supplements during the year before conception. Compared with an average intake of less than 10,000 IU, retinol intake of 10,000 IU or more from supplements was associated with a ninefold increased risk for transposition of the great arteries (odds ratio = 9.2; 95% confidence interval = 4.0-21.2), but not for outflow tract defects with normally related arteries (odds ratio = 0.8; 95% confidence interval = 0.1-6.6). Similar intakes of carotenoids and dietary retinol were not associated with an increased risk for either type of outflow tract defect.
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Affiliation(s)
- L D Botto
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA
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Correa-Villaseñor A, Ferencz C, Loffredo C, Magee C. Paternal exposures and cardiovascular malformations. The Baltimore-Washington Infant Study Group. J Expo Anal Environ Epidemiol 1998; 3 Suppl 1:173-85. [PMID: 9857303] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Possible associations between paternal exposures and cardiovascular malformations were evaluated in the Baltimore-Washington Infant Study, a population based case-control investigation of congenital heart disease and environmental factors. Home interviews of case and control parents elicited information on parental home and occupational exposures. Analysis focused on twelve cardiac diagnostic groups and paternal exposures incurred during the six months preceding the pregnancy. Associations were identified between jewelry making and atrial septal defect (Odds ratio: 12.6; 95% confidence interval: 2.3-68.6) and membranous ventricular septal defect (8.1; 2.0-33.3), welding and endocardial cushion defect with Down syndrome (1.8; 1.1-3.0), lead soldering and pulmonary atresia (2.3; 1.1-4.9) and ionizing radiation and endocardial cushion defect without Down syndrome (4.7; 1.7-12.6). Ionizing radiation was found to be associated with endocardial cushion defect with Down syndrome only when father was present at interview (5.6; 1.7-17.9); a similar effect of father at interview was noted for paint stripping in relation to coarctation of the aorta (3.5; 1.5-8.0) and muscular ventricular septal defect (3.5; 1.5-8.5). Also, paint stripping was associated with hypoplastic left heart only in the presence of family history of cardiac defects (11.9; 2.4-60.0). This large study on cardiac diagnostic groups and specific preconceptional exposures provides new leads for further assessment of the role of paternal exposures on adverse pregnancy outcome.
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Affiliation(s)
- A Correa-Villaseñor
- Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA
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Abstract
We evaluated the effect of local specific immunotherapy in 40 patients suffering from seasonal allergic conjunctivitis. Twenty patients received saline solution in both eyes; and 20 others received local specific immunotherapy in both eyes. Sodium cromoglycate drops were instilled in both eyes in all patients. Subjective and objective symptoms, and cytological findings had significantly improved after 1 year in the group treated with local specific immunotherapy plus sodium cromoglycate compared to the group treated with sodium cromoglycate and saline solution.
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Affiliation(s)
- A Del Prete
- Istituto di Oftalmologia, Facoltà di Medicina, Università degli Studi di Napoli Federico II, Italy
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Del Prete A, Sepe G, Ferrante M, Loffredo C, Masciello M, Sebastiani A. Fungal keratitis due to Scopulariopsis brevicaulis in an eye previously suffering from herpetic keratitis. Ophthalmologica 1994; 208:333-5. [PMID: 7845651 DOI: 10.1159/000310533] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [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: 01/27/2023]
Abstract
In the case reported, herpes virus I after having caused relapsing keratitis in an eye promoted the formation of a severe corneal ulcer caused by Scopulariopsis brevicaulis, a saprophytic mycete found in soil, which only once has been described as the cause of keratitis in man. Scopulariopsis was identified microscopically after culturing the conjunctival secretion on Sabouraud dextrose agar medium, while DNA probe tests confirmed the absence of herpes virus I. Topical and oral administration of miconazole and scraping of the corneal infiltrate dispersed the infection. Subsequently local steroids were given to reduce the neovascularization, and a therapeutic contact lens was applied because of intercurrent corneal thinning. Three months after beginning antifungal therapy, the visual acuity had increased from 1/120 to 1/10. The case described confirms that S. brevicaulis can cause opportunist infections in a cornea previously damaged by a different agent.
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Affiliation(s)
- A Del Prete
- Department of Ophthalmology, University Federico II, Naples, Italy
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Abstract
We analyzed use of therapeutic drugs during pregnancy by 2752 mothers of infants without major congenital malformations. During pregnancy, 68% of the women used at least one prescription or non-prescription drug. Drug use in pregnancy was significantly more common for women who were white, older, married, better educated, of higher income and occupational status, receiving private prenatal care and not living in urban areas. Number of maternal illnesses, higher socioeconomic status, white race, multiparity and use of recreational drugs explained 26% of reported drug use. The mean number of drugs reported (1.2) underestimates total drug exposure due to exclusion of some drug categories including multivitamins and illicit drugs. Since the majority of women giving birth to normal infants report use of at least one pharmacologic agent during pregnancy, attribution of adverse outcome to drug use in an individual case is rarely justified.
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Affiliation(s)
- J D Rubin
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201
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Abstract
The combined medical and surgical mortality rate for 125 infants with tetralogy of Fallot registered in the Baltimore-Washington Infant Study from 1981 to 1985 was 28% (mean age at follow-up for living infants, 40 months). Despite early diagnosis and successful early repair in many infants, significant risk factors for death included pulmonary atresia, major additional cardiac anomalies, major noncardiac malformations, low birth weight, and prematurity. There is a wide spectrum of severity, ranging from infants with isolated tetralogy and no risk factors who have an excellent prognosis to infants with three or more risk factors and a high probability of neonatal death. Further treatment advances will improve outcome in some, but not all, infants. A regional all-inclusive study of a specific cardiac defect can define research and treatment challenges not obvious from selected clinical series.
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Affiliation(s)
- S S Karr
- Children's National Medical Center, Washington, DC
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Abstract
From 1968 to 1987, 123 consecutive patients with nonmetastatic choroidal melanoma were treated with cobalt-60 plaques. One hundred sixteen patients were followed up for a mean of 3.8 years. Twenty patients had local failure, and 14 patients had distant failure. Complications included 32 cataracts, and seven enucleations were required. Local recurrence did not correlate with tumor height, tumor volume, dose, or dose rate. Increased volume (P = .004) and height (P = .01) correlated with increased rates of distant metastases. Dose adjusted for volume did not correlate with the rate of metastases.
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Affiliation(s)
- J J Beitler
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
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