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Hutanu A, Signori C, Moritz B, Gregoritza M, Rohde A, Schwarz MA. Using Peptide Nucleic Acid Hybridization Probes for Qualitative and Quantitative Analysis of Nucleic Acid Therapeutics by Capillary Electrophoresis. Anal Chem 2023; 95:4914-4922. [PMID: 36888566 PMCID: PMC10034743 DOI: 10.1021/acs.analchem.2c04813] [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: 03/09/2023]
Abstract
The space of advanced therapeutic modalities is currently evolving in rapid pace necessitating continuous improvement of analytical quality control methods. In order to evaluate the identity of nucleic acid species in gene therapy products, we propose a capillary electrophoresis-based gel free hybridization assay in which fluorescently labeled peptide nucleic acids (PNAs) are applied as affinity probes. PNAs are engineered organic polymers that share the base pairing properties with DNA and RNA but have an uncharged peptide backbone. In the present study, we conduct various proof-of-concept studies to identify the potential of PNA probes for advanced analytical characterization of novel therapeutic modalities like oligonucleotides, plasmids, mRNA, and DNA released by recombinant adeno-associated virus. For single-stranded nucleic acids up to 1000 nucleotides, the method is an excellent choice that proved to be highly specific by detecting DNA traces in complex samples, while having a limit of quantification in the picomolar range when multiple probes are used. For double-stranded samples, only fragments that are similar in size to the probe could be quantified. This limitation can be circumvented when target DNA is digested and multiple probes are used opening an alternative to quantitative PCR.
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Affiliation(s)
- Andrei Hutanu
- Analytical Development and Quality Control, Pharma Technical Development Europe, F. Hoffmann-La Roche AG, Basel 4070, Switzerland
- University of Basel, Basel 4056, Switzerland
| | - Chiara Signori
- Analytical Development and Quality Control, Pharma Technical Development Europe, F. Hoffmann-La Roche AG, Basel 4070, Switzerland
| | - Bernd Moritz
- Analytical Development and Quality Control, Pharma Technical Development Europe, F. Hoffmann-La Roche AG, Basel 4070, Switzerland
| | - Manuel Gregoritza
- Analytical Development and Quality Control, Pharma Technical Development Europe, F. Hoffmann-La Roche AG, Basel 4070, Switzerland
| | - Adelheid Rohde
- Analytical Development and Quality Control, Pharma Technical Development Europe, F. Hoffmann-La Roche AG, Basel 4070, Switzerland
| | - Maria A Schwarz
- University of Basel, Basel 4056, Switzerland
- Solvias AG, Kaiseraugst 4303, Switzerland
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Signori C, Meessen JMTA, Laaksonen R, Maggioni AP, Novelli D, Blanda A, Jylhä A, Nicolis E, Targher G, Tavazzi L, Tognoni G, Hilvo M, Latini R. Coffee, Atrial Fibrillation, and Circulating Ceramides in Patients with Chronic Heart Failure. J Agric Food Chem 2021; 69:11236-11245. [PMID: 34533314 DOI: 10.1021/acs.jafc.1c03741] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ceramides are sphingolipids that play roles as structural lipids and as second messengers in biological processes. Circulating ceramides are influenced by diet/food and predict major cardiovascular (CV) events, such as atrial fibrillation (AF). In 1227 patients with symptomatic chronic heart failure (HF), an association between diet and ceramides was found for coffee consumption of ≥3 cups and Cer(d18:1/24:0). Increased Cer(d18:1/24:0) was associated with lower incident AF (24.3% vs 15.4% tertile 1 vs 3, P = 0.016) and lower CV mortality (28.4% vs 12.0% tertile 1 vs 3, P < 0.0001). For coffee consumption, only an association with incident AF was found (24.5% never, 5.2% ≥3 cups). These inverse associations with AF were confirmed in survival analyses corrected for biomarkers (Cer(d18:1/24:0) HR: 0.79, P = 0.018; coffee consumption HR: 0.22, P = 0.001). In conclusion, higher coffee intake was associated with a lower risk of incident AF and with higher concentrations of Cer(d18:1/24:0). Cer(d18:1/24:0) was inversely associated to risk of AF.
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Affiliation(s)
- Chiara Signori
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
| | - Jennifer M T A Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
| | | | | | - Deborah Novelli
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
| | - Adriana Blanda
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
| | | | - Enrico Nicolis
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
| | - Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona 37126, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research, Cotignola 48033, Italy
| | - Gianni Tognoni
- Department of Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - Mika Hilvo
- Zora Biosciences Oy, Espoo 02150, Finland
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20157, Italy
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Bonifazi M, Meessen J, Pérez A, Vasques F, Busana M, Vassalli F, Novelli D, Bernasconi R, Signori C, Masson S, Romitti F, Giosa L, Macrì M, Pasticci I, Palumbo MM, Mota F, Costa M, Caironi P, Latini R, Quintel M, Gattinoni L. Albumin Oxidation Status in Sepsis Patients Treated With Albumin or Crystalloids. Front Physiol 2021; 12:682877. [PMID: 34447316 PMCID: PMC8383812 DOI: 10.3389/fphys.2021.682877] [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: 03/22/2021] [Accepted: 07/07/2021] [Indexed: 11/24/2022] Open
Abstract
Inflammation and oxidative stress characterize sepsis and determine its severity. In this study, we investigated the relationship between albumin oxidation and sepsis severity in a selected cohort of patients from the Albumin Italian Outcome Study (ALBIOS). A retrospective analysis was conducted on the oxidation forms of human albumin [human mercapto-albumin (HMA), human non-mercapto-albumin form 1 (HNA1) and human non-mercapto-albumin form 2 (HNA2)] in 60 patients with severe sepsis or septic shock and 21 healthy controls. The sepsis patients were randomized (1:1) to treatment with 20% albumin and crystalloid solution or crystalloid solution alone. The albumin oxidation forms were measured at day 1 and day 7. To assess the albumin oxidation forms as a function of oxidative stress, the 60 sepsis patients, regardless of the treatment, were grouped based on baseline sequential organ failure assessment (SOFA) score as surrogate marker of oxidative stress. At day 1, septic patients had significantly lower levels of HMA and higher levels of HNA1 and HNA2 than healthy controls. HMA and HNA1 concentrations were similar in patients treated with albumin or crystalloids at day 1, while HNA2 concentration was significantly greater in albumin-treated patients (p < 0.001). On day 7, HMA was significantly higher in albumin-treated patients, while HNA2 significantly increased only in the crystalloids-treated group, reaching values comparable with the albumin group. When pooling the septic patients regardless of treatment, albumin oxidation was similar across all SOFA groups at day 1, but at day 7 HMA was lower at higher SOFA scores. Mortality rate was independently associated with albumin oxidation levels measured at day 7 (HMA log-rank = 0.027 and HNA2 log-rank = 0.002), irrespective of treatment group. In adjusted regression analyses for 90-day mortality, this effect remained significant for HMA and HNA2. Our data suggest that the oxidation status of albumin is modified according to the time of exposure to oxidative stress (differences between day 1 and day 7). After 7 days of treatment, lower SOFA scores correlate with higher albumin antioxidant capacity. The trend toward a positive effect of albumin treatment, while not statistically significant, warrants further investigation.
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Affiliation(s)
- Matteo Bonifazi
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Jennifer Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alba Pérez
- Bioscience Research Group, Grifols, Barcelona, Spain
| | - Francesco Vasques
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Mattia Busana
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Francesco Vassalli
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Deborah Novelli
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Roberto Bernasconi
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Signori
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Serge Masson
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Federica Romitti
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Lorenzo Giosa
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Matteo Macrì
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Iacopo Pasticci
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Maria Michela Palumbo
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | | | | | - Pietro Caironi
- Department of Anaesthesia and Critical Care, AOU "S. Luigi Gonzaga, Turin, Italy.,Department of Oncology, University of Turin, Turin, Italy
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michael Quintel
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
| | - Luciano Gattinoni
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Göttingen, Germany
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Mancosu P, Signori C, Clerici E, Comito T, D'Agostino GR, Franceschini D, Franzese C, Lobefalo F, Navarria P, Paganini L, Reggiori G, Tomatis S, Scorsetti M. Critical Re-Evaluation of a Failure Mode Effect Analysis in a Radiation Therapy Department After 10 Years. Pract Radiat Oncol 2020; 11:e329-e338. [PMID: 33197646 DOI: 10.1016/j.prro.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Failure mode effect analysis (FMEA) is a proactive methodology that allows one to analyze a process, regardless of whether an adverse event occurs. In our radiation therapy (RT) department, a first FMEA was performed in 2009. In this paper we critically re-evaluate the RT process after 10 years and present it in terms of a lesson learned. METHODS AND MATERIALS A working group (WG), led by a qualified clinical risk engineer, which included radiation oncologists, physicists, a radiation therapist, and a nurse, evaluated the possible failure modes (FMs) of the RT process. For each FM, the estimated frequency of occurrence (O, range 1-4), the expected severity of the damage (S, range 1-5), and the detectability lack (D, range 1-4) were scored. A risk priority number (RPN) was obtained as RPN = OxSxD. The data were compared with the 2009 edition. RESULTS In the 2020 analysis, 67 FMs were identified (27 in the 2009 series). The absolute risk values of the previous 3 highest FMs were generally reduced. The patient identification risk (highest value in the 2009 analysis) was reduced from 48.0 to 6.9, becoming the 51st RPN score, thanks to a patient barcode recognition within the bunker. The 2020 highest risk values regarded: (i-2020) the patient's inadequate recollection and reporting of his/her medical history (ie, anamnesis) during the first medical examination and (ii-2020) the incorrect interpretation of tumor and normal tissue in computed tomography images. The WG proposed corrective actions. CONCLUSIONS In this single institution experience, the 10-year FMEA analysis showed a reduction in the previous higher RPN values thanks to the corrective actions taken. The new FMs and subsequent RPNs reveal the need for a continuous iterative improvement process.
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Affiliation(s)
- Pietro Mancosu
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy.
| | - Chiara Signori
- Risk Management Unit, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Elena Clerici
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Tiziana Comito
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | | | - Davide Franceschini
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Ciro Franzese
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Francesca Lobefalo
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Piera Navarria
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Lucia Paganini
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Giacomo Reggiori
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Stefano Tomatis
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Mancosu P, Signori C, Clerici E, Comito T, De Rose F, Ferrante S, Ferrara M, Galdieri C, Iftode C, Navarria P, Stravato A, Scorsetti M. PD-0546: Ten years critical re-evaluation of a Failure mode effect analysis in a radiotherapy department. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00568-5] [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: 11/25/2022]
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Stepniewska AK, Verrazzo P, Savelli L, Trivella G, Signori C, Clarizia R, Guerriero M, Mollo A, De Placido G, Ceccaroni M. Comparison of Virtual Ultrasonographic Hysteroscopy with Conventional Hysteroscopy in the Workup of Patients Who Are Infertile. J Minim Invasive Gynecol 2020; 28:63-74. [PMID: 32197993 DOI: 10.1016/j.jmig.2020.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/08/2020] [Accepted: 03/11/2020] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE To compare the tolerability and diagnostic accuracy of virtual ultrasonographic hysteroscopy (VUH) with that of conventional diagnostic outpatient hysteroscopy in the workup of patients who are infertile. DESIGN A single-center, retrospective cohort study. SETTING Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery Unit of Sacred Heart Hospital Don Calabria in Negrar, Italy. PATIENTS A total of 120 consecutive women who underwent hysterosalpingosonography and subsequent VUH and conventional hysteroscopy for infertility evaluation were included. The inclusion criterion was infertility for at least 1 year, with evaluation in the early or intermediate follicular phase of the menstrual cycle. INTERVENTIONS After the placement of an intracervical catheter, a Ringer Lactate solution was injected into the uterine cavity and fallopian tubes, and a 3D volume was obtained. The ultrasound volume acquired was successively elaborated offline, and a VUH was performed. Subsequently, a variable amount of air was introduced into the uterine cavity, and the patency of the salpinges was evaluated. MEASUREMENTS AND MAIN RESULTS The VUH findings were compared with those of conventional hysteroscopy performed in the subsequent month. For the detection of endometrial pathology in the overall pool, the sensitivity and specificity of VUH in comparison with conventional hysteroscopy were 100% (95% confidence interval [CI], 84.6%-100%) and 100% (95% CI, 96.3%-100%), respectively. For the detection of uterine cavity pathology and uterine malformations in the overall pool, the sensitivities of VUH were 80% (95% CI, 28.4%-99.5%) and 100% (95% CI, 75.3%-100%), respectively, with specificities of 100% (95% CI, 96.8%-100%) and 100% (95% CI, 96.6%-100%), respectively, when compared with conventional hysteroscopy. The positive predictive values for endometrial pathology, uterine cavity alterations, and uterine malformations were 100% (95% CI, 84.6%-100%), 100% (95% CI, 39.8%-100%), and 100% (95% CI, 75.3%-100%), respectively, with a receiver operating characteristic area of 100%, 90% (95% CI, 70%-100%), and 100%, respectively. There were no cases of severe vasovagal reactions or other complications. Most patients (67%, 81 of 120 women) described the examination as "less painful than expected," 25% (30 of 120 women) "just as expected," and only 7% (9 of 120 women) as "more painful than expected." CONCLUSION VUH was well tolerated and showed a high accuracy (100%) in the study of the uterine cavity when compared with conventional hysteroscopy.
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Affiliation(s)
- Anna Katarzyna Stepniewska
- Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona (Drs. Stepniewska, Trivella, Signori, Clarizia, and Ceccaroni).
| | - Paolo Verrazzo
- University Department of Neuroscience, Reproductive Medicine, and Odontostomatology, University of Naples Federico II, Naples (Drs. Verrazzo, Mollo, and De Placido)
| | - Luca Savelli
- Department of Obstetrics and Gynecology (Dr. Savelli) University of Bologna, Bologna
| | - Giamberto Trivella
- Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona (Drs. Stepniewska, Trivella, Signori, Clarizia, and Ceccaroni)
| | - Chiara Signori
- Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona (Drs. Stepniewska, Trivella, Signori, Clarizia, and Ceccaroni)
| | - Roberto Clarizia
- Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona (Drs. Stepniewska, Trivella, Signori, Clarizia, and Ceccaroni)
| | - Massimo Guerriero
- Department of Computer Science (Dr. Guerriero), University of Verona, Verona, Italy; Clinical Research Unit (Dr. Guerriero), IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona
| | - Antonio Mollo
- University Department of Neuroscience, Reproductive Medicine, and Odontostomatology, University of Naples Federico II, Naples (Drs. Verrazzo, Mollo, and De Placido)
| | - Giuseppe De Placido
- University Department of Neuroscience, Reproductive Medicine, and Odontostomatology, University of Naples Federico II, Naples (Drs. Verrazzo, Mollo, and De Placido)
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology, and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacred Heart Hospital Don Calabria, Negrar, Verona (Drs. Stepniewska, Trivella, Signori, Clarizia, and Ceccaroni)
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Azevedo MS, van de Sande FH, Maske TT, Signori C, Romano AR, Cenci MS. Correlation between the cariogenic response in biofilms generated from saliva of mother/child pairs. Biofouling 2014; 30:903-909. [PMID: 25184431 DOI: 10.1080/08927014.2014.948868] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study aimed to correlate the cariogenic responsiveness of biofilms generated from the saliva of mothers and children. The mother-child pairs were classified according to the children's caries levels: caries-free, early childhood caries (ECC) or severe ECC. Microcosm biofilms were grown on enamel discs for 10 days. Factors under evaluation were caries experience levels, inoculum source (mothers and children) and growth conditions including cariogenic challenge (growth medium provided with and without sucrose) and no cariogenic challenge (growth medium sucrose-free). Statistical analysis was performed with ANOVA and Tukey's test, and the Spearman correlation test. Regular sucrose exposure resulted in a higher surface hardness change (%SHC). The correlation between biofilms formed from saliva of mother-child pairs was significant regarding pH, total aciduric microorganisms and lactobacilli counts under cariogenic challenge. Biofilm growth originating from mother-child pairs under regular sucrose exposure promoted the same cariogenic response independently of caries experience and the microbiological profile of the donors.
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Affiliation(s)
- M S Azevedo
- a Graduate Program in Dentistry , Federal University of Pelotas , Pelotas , Brazil
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Di Sarra D, Tosi F, Bonin C, Fiers T, Kaufman JM, Signori C, Zambotti F, Dall'Alda M, Caruso B, Zanolin ME, Bonora E, Moghetti P. Metabolic inflexibility is a feature of women with polycystic ovary syndrome and is associated with both insulin resistance and hyperandrogenism. J Clin Endocrinol Metab 2013; 98:2581-8. [PMID: 23596136 DOI: 10.1210/jc.2013-1161] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 12/23/2022]
Abstract
CONTEXT Metabolic inflexibility, ie, the impaired ability of the body to switch from fat to carbohydrate oxidation under insulin-stimulated conditions, is associated with insulin resistance. This alteration in metabolic plasticity can lead to organ dysfunction and is considered a key issue among the abnormalities of the metabolic syndrome. It is still unknown whether this phenomenon occurs in women with polycystic ovary syndrome (PCOS). OBJECTIVE Our objective was to examine whether metabolic inflexibility is a feature of PCOS women and whether hyperandrogenism may contribute to this phenomenon. DESIGN AND PATIENTS Eighty-nine Caucasian women with PCOS were submitted to hyperinsulinemic-euglycemic clamp. Respiratory exchange ratios were evaluated at baseline and during hyperinsulinemia by indirect calorimetry to quantify substrate oxidative metabolism. Total testosterone was measured by liquid chromatography mass spectrometry and free testosterone by equilibrium dialysis. SETTING Outpatients were seen in a tertiary care academic center. MAIN OUTCOME MEASURE Metabolic flexibility was assessed by the change in respiratory quotient upon insulin stimulation. RESULTS Sixty-five of the 89 PCOS women (73%) had increased serum free testosterone, 68 (76%) were insulin resistant, and 62 (70%) had an impaired metabolic flexibility. Comparison of hyperandrogenemic and normoandrogenemic women showed that the 2 subgroups were of similar age but differed in terms of several anthropometric and metabolic features. In particular, hyperandrogenemic women had greater body mass index (32.9 ± 1.0 vs 24.7 ± 0.9 kg/m(2), P < .001) and lower glucose utilization during the clamp (9.2 ± 0.4 vs 10.9 ± 0.7 mg/kg fat-free mass · min, P = .023) and metabolic flexibility (0.09 ± 0.06 vs 0.12 ± 0.01, P = .014). In univariate analysis, metabolic flexibility was associated with several anthropometric, endocrine, and metabolic features. In multivariate analysis, this feature was directly associated with baseline respiratory quotient and insulin sensitivity and inversely with free testosterone and free fatty acids concentrations under insulin suppression (R(2) = 0.634, P < .001). CONCLUSIONS Metabolic inflexibility is a feature of PCOS women. Both insulin resistance and androgen excess might contribute to this abnormality.
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Affiliation(s)
- Daniela Di Sarra
- Department of Endocrinology, Diabetes and Metabolism, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, I-37126 Verona, Italy
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Moghetti P, Tosi F, Bonin C, Di Sarra D, Fiers T, Kaufman JM, Giagulli VA, Signori C, Zambotti F, Dall'Alda M, Spiazzi G, Zanolin ME, Bonora E. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab 2013; 98:E628-37. [PMID: 23476073 DOI: 10.1210/jc.2012-3908] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONTEXT/OBJECTIVE Current diagnostic criteria for polycystic ovary syndrome (PCOS) have generated distinct PCOS phenotypes, based on the different combinations of diagnostic features found in each patient. Our aim was to assess whether either each single diagnostic feature or their combinations into the PCOS phenotypes may predict insulin resistance in these women. PATIENTS/DESIGN A total of 137 consecutive Caucasian women with PCOS, diagnosed by the Rotterdam criteria, underwent accurate assessment of diagnostic and metabolic features. Insulin sensitivity was measured by the glucose clamp technique. RESULTS Among women with PCOS, 84.7% had hyperandrogenism, 84.7% had chronic oligoanovulation, and 89% had polycystic ovaries. According to the individual combinations of these features, 69.4% of women had the classic phenotype, 15.3% had the ovulatory phenotype, and 15.3% had the normoandrogenic phenotype. Most subjects (71.4%) were insulin resistant. However, insulin resistance frequency differed among phenotypes, being 80.4%, 65.0%, and 38.1%, respectively, in the 3 subgroups (P < .001). Although none of the PCOS diagnostic features per se was associated with the impairment in insulin action, after adjustment for covariates, the classic phenotype and, to a lesser extent, the ovulatory phenotype were independently associated with insulin resistance, whereas the normoandrogenic phenotype was not. Metabolic syndrome frequency was also different among phenotypes (P = .030). CONCLUSIONS There is a scale of metabolic risk among women with PCOS. Although no single diagnostic features of PCOS are independently associated with insulin resistance, their combinations, which define PCOS phenotypes, may allow physicians to establish which women should undergo metabolic screening. In metabolic terms, women belonging to the normoandrogenic phenotype behave as a separate group.
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Affiliation(s)
- Paolo Moghetti
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Piazzale Stefani, Verona, Italy.
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Signori C, Richie JP, Prokopczyk B, Calcagnotto A, Hamilton C, Trushin N, Dubrock C, Demers LM, Liao J, El-Bayoumy K, Manni A. Effect of omega-3 fatty acids alone and in combination with raloxifene on biomarkers of breast cancer risk in postmenopausal healthy women at high risk. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Scorsetti M, Signori C, Lattuada P, Urso G, Bignardi M, Navarria P, Castiglioni S, Mancosu P, Trucco P. Applying failure mode effects and criticality analysis in radiotherapy: Lessons learned and perspectives of enhancement. Radiother Oncol 2010; 94:367-74. [DOI: 10.1016/j.radonc.2009.12.040] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/11/2009] [Accepted: 12/29/2009] [Indexed: 10/19/2022]
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Signori C, Ceriotti F, Sanna A, Plebani M, Messeri G, Ottomano C, Di Serio F, Bonini P. Process and risk analysis to reduce errors in clinical laboratories. ACTA ACUST UNITED AC 2007; 45:742-8. [PMID: 17579526 DOI: 10.1515/cclm.2007.172] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 11/15/2022]
Abstract
AbstractClin Chem Lab Med 2007;45:742–8.
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Hadjistilianou T, de Francesco S, Signori C, Menicacci F, Galluzzi P, Toti P. Pleomorphic adenoma of the lacrimal gland in an 18-year-old girl irradiated for bilateral retinoblastoma. Orbit 2006; 25:51-3. [PMID: 16527777 DOI: 10.1080/01676830500506135] [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] [Indexed: 05/07/2023]
Abstract
PURPOSE To report a case of pleomorphic adenoma of the lacrimal gland following irradiation for bilateral retinoblastoma. MATERIALS AND METHODS Case report. A 4-month-old girl, with bilateral retinoblastoma, underwent enucleation of the right eye, systemic chemotherapy and bilateral external beam irradiation with a lateral field. The right anophthalmic socket (because of infiltration of the optic nerve) and the left eye (for relapse) were irradiated;. 17 years later, she developed a mass in the superotemporal quadrant of the left orbit. The mass was completely excised. RESULTS Pleomorphic adenoma is rare in children and teenagers; it usually presents as a painless, slow growing mass in healthy adults. In this case, it developed as a second primary tumor after irradiation for retinoblastoma.
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Chou IC, Trakht T, Signori C, Smith J, Felt BT, Vazquez DM, Barks JD. Behavioral/environmental intervention improves learning after cerebral hypoxia-ischemia in rats. Stroke 2001; 32:2192-7. [PMID: 11546916 DOI: 10.1161/hs0901.095656] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE In premature infants, many of whom experience ischemic brain insults, the environment of rearing influences cognitive outcome. We developed a model to evaluate the effect of rearing conditions on learning after unilateral cerebral hypoxia-ischemia (HI) in 7-day-old (P7) rats. We hypothesized that neonatal handling would benefit rats recovering from an episode of HI. METHODS Seventeen litters of P7 Long-Evans rats underwent either HI (right carotid ligation followed by 1.5 hours in 8% O(2)) or control procedures. From P8 to P14, randomized litters were either handled (15 minutes of separation from dam per day) or nonhandled. After P55, learning was tested in the Morris water maze. To evaluate injury severity, hippocampal, cortical, and striatal volumes were measured. RESULTS In water-maze performance, ANCOVA revealed an interaction between handling and severity of hippocampal damage. Among HI rats, handled rats learned faster when hippocampal damage was moderate (P<0.01, repeated-measures ANOVA), with no benefit when damage was mild or severe. CONCLUSIONS These observations suggest the beneficial cognitive effect of neonatal handling was limited to animals with moderate damage. Neonatal handling in post-HI rats may be a useful model in which to study mechanisms underlying the benefits of post-HI developmental intervention.
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Affiliation(s)
- I C Chou
- Department of Pediatrics, Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
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Signori C, Iorio F, Di Sandro F, Scopinaro F, Colella C. [Cerebral uptake of Tc-99m-hexamethyl-propylene amino oxime in the diagnosis of cerebrovascular diseases]. Minerva Med 1988; 79:715-7. [PMID: 3261405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- C Signori
- Istituto di Ricovero e Cura a Carattere Scientifico Sanatrix, Venafro, Isernia
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Iorio F, Buonaiuto L, Signori C, Cantarano G, Di Benedetto C. [99m-Tc-HM-PAO in the study of cerebral ischemia. Comparison with Doppler echography, digital angiography and computerized axial tomography]. Minerva Med 1988; 79:719-21. [PMID: 3043270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- F Iorio
- Istituto di Ricovero e Cura a Carattere Scientifico Sanatrix, Venafro, Isernia
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