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Brancati GE, De Rosa U, Acierno D, Caruso V, De Dominicis F, Petrucci A, Moriconi M, Elefante C, Gemignani S, Medda P, Schiavi E, Perugi G. Development of a self-report screening instrument for emotional dysregulation: the Reactivity, Intensity, Polarity and Stability questionnaire, screening version (RIPoSt-SV). J Affect Disord 2024; 355:406-414. [PMID: 38570039 DOI: 10.1016/j.jad.2024.03.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Emotional dysregulation (ED) refers to the inability to manage emotional experiences or expressions hindering goal-oriented behavior. Moderate impairment on at least two domains among temper control, affective lability, and emotional over-reactivity has been proposed to identify ED in adults with attention-deficit/hyperactivity disorder (ADHD). No screening measure designed for use in diverse psychiatric samples exists. We aimed to develop a self-report screening tool for ED based on the 40-item version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-40). METHODS 150 adult outpatients with non-psychotic conditions were enrolled between February and July 2023 at the Second Psychiatry Unit of Pisa University Hospital. Clinically significant ED (CSED) was defined based on the previously suggested approach for ADHD. Differences between patients with and without CSED were tested. To develop our screening instrument, a decision tree algorithm was trained by hyperparameter tuning through 5-fold cross-validation in 120 subjects and tested on the remaining 30. RESULTS 75 subjects met criteria for CSED (50 %). CSED was associated with lower age and higher prevalence of psychiatric conditions, including minor mood disorders, ADHD, cannabis use disorders, and eating disorders. We identified a decision tree consisting of six items from RIPoSt-40 that effectively detected CSED, with accuracy, sensitivity, specificity, positive and negative predictive values of 80 % or higher in both the training and testing sets. LIMITATIONS Tertiary-level; no consensus on criteria; sample size. CONCLUSION The screening version of the Reactivity, Intensity, Polarity, and Stability questionnaire (RIPoSt-SV) demonstrates promise as a valuable tool for ED screening in clinical settings.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Ugo De Rosa
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Donatella Acierno
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Valerio Caruso
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Francesco De Dominicis
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy; Mental Health Centre, Local Health Unit 2, Spoleto, Italy
| | - Alessandra Petrucci
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy; Mental Health Centre, Local Health Unit 2, Terni, Italy
| | - Martina Moriconi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Camilla Elefante
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Samuele Gemignani
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Pierpaolo Medda
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Elisa Schiavi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, Psychiatry Unit 2, Pisa, Italy.
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Brancati GE, De Rosa U, De Dominicis F, Petrucci A, Nannini A, Medda P, Schiavi E, Perugi G. History of Childhood/Adolescence Referral to Speciality Care or Treatment in Adult Patients with Attention-Deficit/Hyperactivity Disorder: Mutual Relations with Clinical Presentation, Psychiatric Comorbidity and Emotional Dysregulation. Brain Sci 2023; 13:1251. [PMID: 37759852 PMCID: PMC10526193 DOI: 10.3390/brainsci13091251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that only rarely remits in adulthood. While several studies underlined differences between child and adult ADHD, the relationship between adult clinical presentation and early referral/treatment has been rarely investigated. In our study, 100 adults with ADHD were recruited and subdivided according to a history of referral to speciality care or treatment with methylphenidate (MPH) during childhood/adolescence. The early referral was associated with a history of disruptive behaviors during childhood/adolescence. Current ADHD symptoms were more pronounced in patients first referred during childhood/adolescence but never treated with MPH. Early MPH treatment was associated with lower rates of mood disorders and lower severity of emotional dysregulation at the time of assessment. Negative emotionality mediated the relationship between MPH treatment and mood disorders comorbidity. ADHD patients first referred during childhood/adolescence are characterized by more externalizing features than those first referred in adulthood. MPH treatment during the developmental age may have a role in preventing mood disorders in patients with ADHD, possibly by reducing emotional dysregulation.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Ugo De Rosa
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | | | - Alessandra Petrucci
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Alessandro Nannini
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Pierpaolo Medda
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Elisa Schiavi
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
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Brancati GE, De Dominicis F, Petrucci A, Pallucchini A, Carli M, Medda P, Schiavi E, De Rossi P, Vicari S, Perugi G. Long-term treatment of adult ADHD in a naturalistic setting: clinical predictors of attrition, medication choice, improvement, and response. World J Biol Psychiatry 2023:1-16. [PMID: 36637001 DOI: 10.1080/15622975.2023.2168750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objectives: The aim of this study was to identify clinical predictors of treatment attrition, medication choice, improvement and response to pharmacotherapy in adult attention-deficit/hyperactivity disorder (ADHD). Methods: 150 ADHD patients were enrolled and naturalistically followed-up for at least 4 months. Conners' Adult ADHD Rating Scales-Observer: Screening Version (CAARS-O:SV) were used to measure ADHD severity. Results: 58 subjects (38.7%) were lost at follow-up, while 75 (50%) completed follow-up assessment, on average after 26.05 ± 11.99 weeks; 35 were treated with atomoxetine (ATX) and 40 with methylphenidate (MPH). Treatments were moderately effective (d = 0.72) and 37 patients (49.3%) were responders (≥30% CAARS-O:SV decrease). Patients lost at follow-up had lower inattentive symptoms, less generalized anxiety and family history of bipolar disorder, more amphetamine use disorder than follow-up completers. Compared to ATX-treated subjects, MPH-treated patients had greater severity of hyperactivity/impulsivity and were more frequently diagnosed with alcohol use disorder. While MPH and ATX showed similar efficacy, more pronounced improvements were observed in patients with combined ADHD, anxiety and substance use disorders. ADHD severity and comorbid substance use positively predicted response. Conclusions: Consensus-based hierarchical treatment of ADHD comorbidity is not consistently supported. Comorbid anxiety, mood and substance use disorders should not discourage the treatment of adult ADHD.
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Affiliation(s)
- Giulio Emilio Brancati
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | | | - Alessandra Petrucci
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | | | - Marco Carli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pierpaolo Medda
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy
| | - Elisa Schiavi
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy
| | - Pietro De Rossi
- Department of Neuroscience, Child and Adolescence Neuropsychiatry Unit, I.R.C.C.S. Bambino Gesù Children's Hospital, Rome (Italy)
| | - Stefano Vicari
- Department of Neuroscience, Child and Adolescence Neuropsychiatry Unit, I.R.C.C.S. Bambino Gesù Children's Hospital, Rome (Italy)
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
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Barbuti M, Colombini P, Ricciardulli S, Amadori S, Gemmellaro T, De Dominicis F, Della Rocca F, Petrucci A, Schiavi E, Perugi G. Treatment adherence and tolerability of immediate- and prolonged-release lithium formulations in a sample of bipolar patients: a prospective naturalistic study. Int Clin Psychopharmacol 2021; 36:230-237. [PMID: 34310434 DOI: 10.1097/yic.0000000000000373] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/14/2022]
Abstract
The aim of this study was to compare treatment adherence and tolerability of different lithium formulations in 70 bipolar patients receiving lithium therapy for the first time. During the 1-year follow-up, information was collected regarding patient's clinical course, therapeutic adherence, side effects of the treatment and serum levels of lithium, creatinine and thyroid-stimulating hormone. At baseline, 30 patients (43%) were on prolonged-release lithium formulations and 40 (57%) on immediate-release formulations. At the final evaluation, 37 patients (53%) were considered lost to follow-up. Both prolonged- and immediate-release patients showed significant improvement in the Functioning Assessment Short Test and in the Clinical Global Impressions for Bipolar Disorder scores during the follow-up. At the first follow-up visit, the mean plasma lithium level of prolonged-release patients was higher than immediate-release patients (0.61 vs. 0.47, respectively; P = 0.063), as well as the therapeutic adherence (85 vs. 64%, respectively; P = 0.089). Fine tremor and gastrointestinal symptoms were more frequent in immediate-release patients than in prolonged-release patients at each follow-up visit, with the sole exception of gastrointestinal symptoms at the last evaluation. Prolonged-release lithium therapy could provide potential advantages over immediate-release formulations. Future naturalistic studies and clinical trials with a longer follow-up duration are needed.
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Affiliation(s)
- Margherita Barbuti
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Paola Colombini
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Sara Ricciardulli
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Salvatore Amadori
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Teresa Gemmellaro
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | | | - Filippo Della Rocca
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Alessandra Petrucci
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
| | - Elisa Schiavi
- Psychiatry 2 Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Giulio Perugi
- Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University of Pisa
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Groeger D, Schiavi E, Grant R, Kurnik-Łucka M, Michalovich D, Williamson R, Beinke S, Kiely B, Akdis CA, Hessel EM, Shanahan F, O' Mahony L. Intranasal Bifidobacterium longum protects against viral-induced lung inflammation and injury in a murine model of lethal influenza infection. EBioMedicine 2020; 60:102981. [PMID: 32927273 PMCID: PMC7495089 DOI: 10.1016/j.ebiom.2020.102981] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background Prophylactic strategies are urgently needed for prevention of severe inflammatory responses to respiratory viral infections. Bacterial-host interactions may modify the immune response to viral infections. Methods We examined the contribution of Intranasal administration of two different Bifidobacterium longum strains or its isolated cell wall in controlling viral induced inflammation using a murine model of influenza infection. We monitored mortality and morbidity over a 10-day period and viral load, differential broncho alveolar lavage (BAL) fluid inflammatory cell counts, Lung tissue histology, BAL and serum cytokines, markers of vascular damage and cell death were quantified. Findings Intranasal administration of Bifidobacterium longum35624® or its isolated cell wall prior to virus inoculation significantly reduced viral load within the lungs and significantly improved survival. Reduced viral load was associated with reduced lung injury as suggested by cell death and vascular leakage markers, a shift from neutrophil to macrophage recruitment, reduced inflammatory cytokine levels (including IL-6), reduced type 1 and 2 interferon levels, but increased levels of interferon-λ and surfactant protein D. These protective effects were maintained when the bifidobacterial cell wall preparation was administered 24 h after viral inoculation. The protective effects were also observed for the Bifidobacterium longumPB-VIR™ strain. Interpretation Exposure to these bifidobacterial strains protect against the inflammatory sequelae and damage associated with uncontrolled viral replication within the lung. Funding This work has been funded, in part, by a research grant from GlaxoSmithKline, PrecisionBiotics Group Ltd., Swiss National Science Foundation grants (project numbers CRSII3_154488, 310030_144219, 310030_127356 and 310030_144219) and Christine Kühne – Center for Allergy Research and Education (CK-CARE).
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Affiliation(s)
- David Groeger
- Alimentary Health Pharma Davos, Davos, Switzerland; PrecisionBiotics Group Ltd., Cork, Ireland; Lead contact.
| | - Elisa Schiavi
- Alimentary Health Pharma Davos, Davos, Switzerland; Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Ray Grant
- Alimentary Health Pharma Davos, Davos, Switzerland
| | | | | | | | | | | | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - Fergus Shanahan
- Department of Medicine and School of Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | - Liam O' Mahony
- Department of Medicine and School of Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
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Baldassarre ME, Di Mauro A, Labellarte G, Pignatelli M, Fanelli M, Schiavi E, Mastromarino P, Capozza M, Panza R, Laforgia N. Resveratrol plus carboxymethyl-β-glucan in infants with common cold: A randomized double-blind trial. Heliyon 2020; 6:e03814. [PMID: 32322697 PMCID: PMC7172624 DOI: 10.1016/j.heliyon.2020.e03814] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/02/2020] [Accepted: 04/16/2020] [Indexed: 12/30/2022] Open
Abstract
Objectives To evaluate effectiveness of a nasal resveratrol/carboxymethyl-β-glucan solution compared to nasal saline solution: a) on common cold symptoms by means of a validated measure scale (CARIFS score), b) on Rhinovirus infection and CCL2, CCL5, IL8, IL6, CXCL10 and TLR2 expression in nasal swabs, c) on frequency of relapses after 30 days of follow-up. Methods 89 infants with respiratory infection symptoms were randomly assigned to receive either a nasal resveratrol/carboxymethyl-β-glucan solution or nasal saline solution. All patients were evaluated with CARIFS score at enrollment, after 48 h, 7 and 30 days by physicians and parents. Nasal swabs were obtained at enrollment, after 48 h and after one week. Results CARIFS score improved in both groups. Episodes of sneezing and cough were fewer in study group after 7 days of follow-up (p < 0.05). No significant differences were found on nasopharyngeal swabs in Rhinovirus detection and cytokines expression after 48 h, nor in 30 days relapses. TLR2 expression was significantly higher in Rhinovirus infected children of the study group. No adverse effects occurred. Conclusions These data suggest that a solution containing resveratrol plus carboxymethyl-β-glucan might have a positive impact on both clinical and socio-economic burden due to infant common cold.
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Affiliation(s)
- Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Antonio Di Mauro
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Grazia Labellarte
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Mariacristina Pignatelli
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Margherita Fanelli
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, Rome 00100, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, Rome 00100, Italy
| | - Manuela Capozza
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Raffaella Panza
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, "Aldo Moro" University of Bari, Bari 70100, Italy
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Brancati GE, Barbuti M, Pallucchini A, Cotugno B, Schiavi E, Hantouche EG, Perugi G. Reactivity, Intensity, Polarity and Stability questionnaire (RIPoSt-40) assessing emotional dysregulation: Development, reliability and validity. J Affect Disord 2019; 257:187-194. [PMID: 31301622 DOI: 10.1016/j.jad.2019.07.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/06/2019] [Accepted: 07/04/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Emotional dysregulation (ED) is a heterogenous construct with great relevance in psychiatric research and clinical practice. In the present study, we validated a 40-items version of the Reactivity, Intensity, Polarity and Stability questionnaire (RIPoSt-40), a self-report measure of ED. METHODS A non-clinical sample (N = 396) and two clinical samples of patients with cyclothymia (N = 120) and ADHD (N = 54) were recruited. Items were selected and subscales were derived based on inter-item correlations and PCA with promax rotation in the non-clinical sample. Test-retest reliability was assessed in a subsample (N = 60). Internal consistency and concurrent validity with TEMPS-M factors were evaluated in each sample. The three groups results were compared to ascertain discriminant validity. RESULTS Four subscales were identified as measures of affective instability, emotional impulsivity, negative and positive emotionality. The first three subscales also sum up to a negative ED score comprising thirty items. Measures of reliability (test-retest r = 0.71-0.84) and internal consistency (Cronbach's α = 0.72-0.95) were generally high. Concurrent validity was supported by correlations with TEMPS-M factors. Discriminant validity was significant (p < 0.001) with cyclothymic and ADHD patients showing higher scores for each subscale, except for positive emotionality. LIMITATIONS The non-clinical sample was recruited through a web-survey and mainly included young and highly educated subjects. Mood and anxiety comorbidity of the clinical samples were not taken into consideration. CONCLUSION RIPoSt-40 questionnaire has proved to be a valid, reliable and useful tool to assess ED both in clinical and non-clinical contexts.
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Affiliation(s)
- Giulio E Brancati
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sant'Anna School of Advanced Studies, Pisa, Italy.
| | - Margherita Barbuti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Biagio Cotugno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Schiavi
- Azienda Ospedaliera Universitaria Pisana, Pisa Italy
| | - Elie G Hantouche
- Centre des Troubles Anxieux et de l'Humeur, Anxiety & Mood Center, 89 Boulevard de Courcelles 75008, Paris, France
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Astolfi ML, Protano C, Schiavi E, Marconi E, Capobianco D, Massimi L, Ristorini M, Baldassarre ME, Laforgia N, Vitali M, Canepari S, Mastromarino P. A prophylactic multi-strain probiotic treatment to reduce the absorption of toxic elements: In-vitro study and biomonitoring of breast milk and infant stools. Environ Int 2019; 130:104818. [PMID: 31279184 DOI: 10.1016/j.envint.2019.05.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 05/26/2023]
Abstract
Potential exposure to toxic elements initially occurs during gestation and after birth via breast milk, which is the principal source of nutrients for infants during the first months of life. In this study, we evaluated whether maternal oral supplementation with a multi-strain probiotic product can protect infants from exposure to arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) via breast milk. In-vitro studies of the bacterial strains present in this probiotic product showed a high bacterial tolerance for As, Cd, Hg, and Pb, and good binding capacity for Cd, Hg, and Pb (72%, 81%, and 64%, respectively) within 1 h of contact. We evaluated concentrations (5 mg L-1 for Cd and Pb, and 2 mg L-1 for Hg) that largely exceeded the provisional tolerable weekly intake of these toxic elements via food or water applicable for human consumption. Changes in the levels of these elements in breast milk and newborn stools were evaluated in the control (orally supplemented with placebo) and experimental (orally supplemented with probiotic) groups at birth (t0), 15 days (t15), and 30 days (t30) after delivery. Elemental analysis of breast milk did not show significant differences between the control and experimental groups at different stages of lactation; however, stool samples obtained from newborns of mothers supplemented with the probiotic product showed that Cd levels were significantly reduced (by 26%) at t15 compared with the levels of the controls. Our data did not show an association between concentration of toxic elements in breast milk and that in newborn stools. Indeed, the concentration of Cd, Hg, and Pb in breast milk decreased during the lactation period, whereas the levels of these elements in newborn stools were stable over time. Although our in-vitro data indicate that the consortium of these probiotic strains can absorb toxic compounds, this study was limited by its small sample size and potential uncontrolled confounding effects, such as maternal diet and lifestyle. Therefore, we could not confirm whether prophylactic use of this probiotic product can reduce the absorption of toxic elements. The risk assessment in the studied population evidenced a margin of exposure (MOE) of 1, or between 1 and 10 for Pb, and lower than 50 for As. This poses a potential risk for breastfed infants, indicating that interventions aimed to avoid breastfeeding-related health risks remain a major challenge in public health.
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Affiliation(s)
- Maria Luisa Astolfi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy.
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisabetta Marconi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Daniela Capobianco
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Lorenzo Massimi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Martina Ristorini
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care Unit, University "Aldo Moro" of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care Unit, University "Aldo Moro" of Bari, Piazza Giulio Cesare 11, I-70124 Bari, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Silvia Canepari
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
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Roduit C, Frei R, Ferstl R, Loeliger S, Westermann P, Rhyner C, Schiavi E, Barcik W, Rodriguez‐Perez N, Wawrzyniak M, Chassard C, Lacroix C, Schmausser‐Hechfellner E, Depner M, Mutius E, Braun‐Fahrländer C, Karvonen AM, Kirjavainen PV, Pekkanen J, Dalphin J, Riedler J, Akdis C, Lauener R, O'Mahony L, Hyvärinen A, Remes S, Roponen M, Chauveau A, Dalphin ML, Kaulek V, Ege M, Genuneit J, Illi S, Kabesch M, Schaub B, Pfefferle P, Doekes G. High levels of butyrate and propionate in early life are associated with protection against atopy. Allergy 2019; 74:799-809. [PMID: 30390309 DOI: 10.1111/all.13660] [Citation(s) in RCA: 272] [Impact Index Per Article: 54.4] [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: 06/19/2018] [Revised: 08/30/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dietary changes are suggested to play a role in the increasing prevalence of allergic diseases and asthma. Short-chain fatty acids (SCFAs) are metabolites present in certain foods and are produced by microbes in the gut following fermentation of fibers. SCFAs have been shown to have anti-inflammatory properties in animal models. Our objective was to investigate the potential role of SCFAs in the prevention of allergy and asthma. METHODS We analyzed SCFA levels by high-performance liquid chromatography (HPLC) in fecal samples from 301 one-year-old children from a birth cohort and examined their association with early life exposures, especially diet, and allergy and asthma later in life. Data on exposures and allergic diseases were collected by questionnaires. In addition, we treated mice with SCFAs to examine their effect on allergic airway inflammation. RESULTS Significant associations between the levels of SCFAs and the infant's diet were identified. Children with the highest levels of butyrate and propionate (≥95th percentile) in feces at the age of one year had significantly less atopic sensitization and were less likely to have asthma between 3 and 6 years. Children with the highest levels of butyrate were also less likely to have a reported diagnosis of food allergy or allergic rhinitis. Oral administration of SCFAs to mice significantly reduced the severity of allergic airway inflammation. CONCLUSION Our results suggest that strategies to increase SCFA levels could be a new dietary preventive option for allergic diseases in children.
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Affiliation(s)
- Caroline Roduit
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Ruth Ferstl
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Susanne Loeliger
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - Patrick Westermann
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Claudio Rhyner
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Elisa Schiavi
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Weronika Barcik
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Noelia Rodriguez‐Perez
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Marcin Wawrzyniak
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Christophe Lacroix
- Department of Health Sciences and Technology ETH‐Zurich Zurich Switzerland
| | - Elisabeth Schmausser‐Hechfellner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Martin Depner
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
| | - Erika Mutius
- Institute for Asthma and Allergy Prevention Helmholtz Zentrum Munich German Research Center for Environmental Health Munich Germany
- Dr von Hauner Children's Hospital of Ludwig Maximilian University of Munich Comprehensive Pneumology Center Munich (CPC‐M) Munich Germany
| | | | - Anne M. Karvonen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
| | - Pirkka V. Kirjavainen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Juha Pekkanen
- Department of Health Security National Institute for Health and Welfare Kuopio Finland
- Department of Public Health University of Helsinki Helsinki Finland
| | - Jean‐Charles Dalphin
- Department of Respiratory Disease University of Besançon UMR/CNRS 6249 Chrono‐environment University Hospital Besançon France
| | | | - Cezmi Akdis
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Roger Lauener
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Children's Hospital St Gallen St Gallen Switzerland
| | - Liam O'Mahony
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Departments of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
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Astolfi ML, Marconi E, Protano C, Vitali M, Schiavi E, Mastromarino P, Canepari S. Corrigendum to "Optimization and validation of a fast digestion method for the determination of major and trace elements in breast milk by ICP-MS" [ACA 1040 (2018) 49-62]. Anal Chim Acta 2018; 1044:200-202. [PMID: 30442404 DOI: 10.1016/j.aca.2018.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Luisa Astolfi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy.
| | - Elisabetta Marconi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Silvia Canepari
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
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11
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Astolfi ML, Marconi E, Protano C, Vitali M, Schiavi E, Mastromarino P, Canepari S. Optimization and validation of a fast digestion method for the determination of major and trace elements in breast milk by ICP-MS. Anal Chim Acta 2018; 1040:49-62. [PMID: 30327113 DOI: 10.1016/j.aca.2018.07.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 12/14/2022]
Abstract
Breast milk guarantees all the nutrients required by infants during their first few months of life and remains the most important food source for their health and growth. However, the mother may transfer potentially toxic chemicals to the suckling infant through breastfeeding. The aim of this study was to optimize and validate a fast method for the determination of a total content of 34 elements (Al, As, B, Ba, Be, Bi, Ca, Cd, Co, Cr, Cs, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Rb, Sb, Se, Si, Sn, Sr, Te, Ti, Tl, U, V, and Zn) in liquid and lyophilized breast milk. The samples were subjected to HNO3:H2O2 (2:1) digestion in an open vessel heated in a water bath (WBD; 80 °C) and subsequently analysed by quadrupole inductively coupled plasma mass spectrometry equipped with a collision-reaction interface. The performance of the proposed method was evaluated in terms of selectivity, detection and quantification limits, linearity, accuracy, and robustness by using standard reference materials and filed samples of breast milk. Compared to microwave-assisted acid digestion, the proposed open vessel digestion allows a significant reduction in treatment time and sample manipulation, while maintaining a similar analytical performance. Masses of 0.5 g of breast milk were efficiently digested with the WBD treatment allowing a residual carbon content lower than 60 mg L-1 and a residual acidity lower than 0.87 mol L-1 in final digested samples. Thus, it shows great potential for application to routine analysis. The method provides satisfactory detection limits and good performance (trueness and recovery percentages 80-111%; coefficient of variation <10%; and relative repeatability <15%) and allows a high sample throughput for multi-elemental determination in human biomonitoring studies.
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Affiliation(s)
- Maria Luisa Astolfi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy.
| | - Elisabetta Marconi
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
| | - Silvia Canepari
- Department of Chemistry, Sapienza University, Piazzale Aldo Moro 5, I-00185 Rome, Italy
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Schiavi E, Plattner S, Rodriguez-Perez N, Barcik W, Frei R, Ferstl R, Kurnik-Lucka M, Groeger D, Grant R, Roper J, Altmann F, van Sinderen D, Akdis CA, O'Mahony L. Exopolysaccharide from Bifidobacterium longum subsp. longum 35624™ modulates murine allergic airway responses. Benef Microbes 2018; 9:761-773. [PMID: 29726281 DOI: 10.3920/bm2017.0180] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Interactions between the host and the microbiota are thought to significantly influence immunological tolerance mechanisms at mucosal sites. We recently described that the loss of an exopolysaccharide (EPS) from Bifidobacterium longum 35624™ eliminated its protective effects in colitis and respiratory allergy murine models. Our goal was to investigate the immune response to purified EPS from B. longum 35624, determine if it has protective effects within the lung and identify the protective mechanisms. Isolated EPS from B. longum 35624 cultures was used for in vitro, ex vivo and in vivo studies. Human monocyte-derived dendritic cells (MDDCs) were used to investigate in vitro immunological responses to EPS. Cytokine secretion, expression of surface markers and signalling pathways were examined. The ovalbumin (OVA) respiratory allergy murine model was used to evaluate the in vivo immunomodulatory potential of EPS. In addition, interleukin (IL)-10 knockout (KO) mice and anti-Toll-like receptor (TLR)-2 blocking antibody were used to examine the underlying protective mechanisms of intranasal EPS administration. Stimulation of human MDDCs with EPS resulted in IL-10 secretion, but not proinflammatory cytokines. IL-10 secretion was TLR-2-dependent. Eosinophil recruitment to the lungs was significantly decreased by EPS intranasal exposure, which was associated with decreased expression of the Th2-associated markers C-C motif chemokine 11 (CCL11), C-C chemokine receptor type 3 (CCR3), IL-4 and IL-13. TLR-2-mediated IL-10 secretion was shown to be required for the reduction in eosinophils and Th2 cytokines. EPS-treatment reduced eosinophil recruitment within the lung in a respiratory inflammation mouse model, which is both TLR-2 and IL-10 mediated. EPS can be considered as a novel molecule potentially reducing the severity of chronic eosinophil-related airway disorders.
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Affiliation(s)
- E Schiavi
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,2 Alimentary Health Pharma Davos, Obere Strasse 22, 7270 Davos, Switzerland
| | - S Plattner
- 3 Alimentary Health, Building 4400, Cork Airport Business Park, Kinsale Road Cork, Ireland
| | - N Rodriguez-Perez
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland
| | - W Barcik
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland
| | - R Frei
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,4 Christine Kühne-Center for Allergy Research and Education (CK-CARE), Herman-Burchard-Strasse 1, 7265 Davos, Switzerland
| | - R Ferstl
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,4 Christine Kühne-Center for Allergy Research and Education (CK-CARE), Herman-Burchard-Strasse 1, 7265 Davos, Switzerland
| | - M Kurnik-Lucka
- 5 Department of Pathophysiology, Jagiellonian University Medical College, ul. św. Anny 12, 31-008 Kraków, Poland
| | - D Groeger
- 2 Alimentary Health Pharma Davos, Obere Strasse 22, 7270 Davos, Switzerland
| | - R Grant
- 2 Alimentary Health Pharma Davos, Obere Strasse 22, 7270 Davos, Switzerland
| | - J Roper
- 3 Alimentary Health, Building 4400, Cork Airport Business Park, Kinsale Road Cork, Ireland
| | - F Altmann
- 6 BOKU, Gregor-Mendel-Straße 33, 1180 Vienna, Austria
| | - D van Sinderen
- 7 APC Microbiome Institute and School of Microbiology, University College Cork, Western Road, 1234 AB Cork, Ireland
| | - C A Akdis
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,4 Christine Kühne-Center for Allergy Research and Education (CK-CARE), Herman-Burchard-Strasse 1, 7265 Davos, Switzerland
| | - L O'Mahony
- 1 Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland
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13
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Valenti P, Rosa L, Capobianco D, Lepanto MS, Schiavi E, Cutone A, Paesano R, Mastromarino P. Role of Lactobacilli and Lactoferrin in the Mucosal Cervicovaginal Defense. Front Immunol 2018; 9:376. [PMID: 29545798 PMCID: PMC5837981 DOI: 10.3389/fimmu.2018.00376] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [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: 12/07/2017] [Accepted: 02/09/2018] [Indexed: 01/26/2023] Open
Abstract
The innate defense system of the female mucosal genital tract involves a close and complex interaction among the healthy vaginal microbiota, different cells, and various proteins that protect the host from pathogens. Vaginal lactobacilli and lactoferrin represent two essential actors in the vaginal environment. Lactobacilli represent the dominant bacterial species able to prevent facultative and obligate anaerobes outnumber in vaginal microbiota maintaining healthy microbial homeostasis. Several mechanisms underlie the protection exerted by lactobacilli: competition for nutrients and tissue adherence, reduction of the vaginal pH, modulation of immunity, and production of bioactive compounds. Among bioactive factors of cervicovaginal mucosa, lactoferrin, an iron-binding cationic glycoprotein, is a multifunctional glycoprotein with antibacterial, antifungal, antiviral, and antiparasitic activities, recently emerging as an important modulator of inflammation. Lactobacilli and lactoferrin are largely under the influence of female hormones and of paracrine production of various cytokines. Lactoferrin is strongly increased in lower genital tract mucosal fluid of women affected by Neisseria gonorrheae, Chlamydia trachomatis, and Trichomonas vaginalis infections promoting both innate and adaptive immune responses. In vaginal dysbiosis characterized by low amounts of vaginal lactobacilli and increased levels of endogenous anaerobic bacteria, the increase in lactoferrin could act as an immune modulator assuming the role normally played by the healthy microbiota in vaginal mucosa. Then lactoferrin and lactobacilli may be considered as biomarkers of altered microbial homeostasis at vaginal level. Considering the shortage of effective treatments to counteract recurrent and/or antibiotic-resistant bacterial infections, the intravaginal administration of lactobacilli and lactoferrin could be a novel efficient therapeutic strategy and a valuable tool to restore mucosal immune homeostasis.
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Affiliation(s)
- Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Daniela Capobianco
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Maria Stefania Lepanto
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Elisa Schiavi
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Antimo Cutone
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Rosalba Paesano
- Department of Gynecological-Obstetric and Urological Sciences, University of Rome La Sapienza, Rome, Italy
| | - Paola Mastromarino
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
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Ferstl R, Frei R, Barcik W, Schiavi E, Wanke K, Ziegler M, Rodriguez-Perez N, Groeger D, Konieczna P, Zeiter S, Nehrbass D, Lauener R, Akdis C, O'Mahony L. Histamine receptor 2 modifies iNKT cell activity within the inflamed lung. Allergy 2017; 72:1925-1935. [PMID: 28618071 DOI: 10.1111/all.13227] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Histamine is a key immunoregulatory mediator and can dampen proinflammatory responses via activation of histamine receptor 2 (H2 R). The aim of this study was to determine the role of H2 R in modulating lung inflammatory responses. METHODS H2 R was blocked using famotidine or activated using dimaprit in both the ovalbumin (OVA) and house dust mite extract (HDM) murine models of respiratory inflammation. H2 R-deficient animals and CD1d/H2 R-deficient animals were utilized to examine the CD1d presentation of lipid antigens (αGalCer or OCH) to invariant natural killer T (iNKT) cells. RESULTS Famotidine treatment resulted in more severe airway disease in the OVA model, while dimaprit treatment significantly reduced disease severity. Both OVA and HDM-induced airway diseases were more severe in H2 R-deficient animals. Flow cytometric analysis of lung tissue from H2 R-deficient animals revealed increased numbers of CD1d+ dendritic cells and increased numbers of iNKT cells. In vitro, αGalCer-stimulated iNKT cells from H2 R-deficient mice secreted higher levels of IL-4, IL-5, and GM-CSF. In vivo, αGalCer or OCH administration to the lung resulted in enhanced mucus secretion, inflammatory cell recruitment, and cytokine production in H2 R-deficient or famotidine-treated animals, while dimaprit dampened the lung iNKT cell response to αGalCer. Removal of iNKT cells in H2 R-deficient (CD1d-/- H2 R-/- ) animals normalized the lung response to HDM. CONCLUSION The deliberate activation of H2 R, or its downstream signaling molecules, may represent a novel therapeutic target for chronic lung inflammatory diseases, especially when CD1d-mediated presentation of lipid antigens to iNKT cells is contributing to the pathology.
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Affiliation(s)
- R. Ferstl
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - R. Frei
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - W. Barcik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - E. Schiavi
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - K. Wanke
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - M. Ziegler
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - N. Rodriguez-Perez
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - D. Groeger
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Alimentary Health Pharma Davos; Davos Switzerland
| | - P. Konieczna
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - S. Zeiter
- AO Research Institute Davos (ARI); Davos Switzerland
| | - D. Nehrbass
- AO Research Institute Davos (ARI); Davos Switzerland
| | - R. Lauener
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
| | - C.A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - L. O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
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Rodriguez‐Perez N, Schiavi E, Frei R, Ferstl R, Wawrzyniak P, Smolinska S, Sokolowska M, Sievi N, Kohler M, Schmid‐Grendelmeier P, Michalovich D, Simpson K, Hessel E, Jutel M, Martin‐Fontecha M, Palomares O, Akdis C, O'Mahony L. Altered fatty acid metabolism and reduced stearoyl-coenzyme a desaturase activity in asthma. Allergy 2017; 72:1744-1752. [PMID: 28397284 DOI: 10.1111/all.13180] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Fatty acids and lipid mediator signaling play an important role in the pathogenesis of asthma, yet this area remains largely underexplored. The aims of this study were (i) to examine fatty acid levels and their metabolism in obese and nonobese asthma patients and (ii) to determine the functional effects of altered fatty acid metabolism in experimental models. METHODS Medium- and long-chain fatty acid levels were quantified in serum from 161 human volunteers by LC/MS. Changes in stearoyl-coenzyme A desaturase (SCD) expression and activity were evaluated in the ovalbumin (OVA) and house dust mite (HDM) murine models. Primary human bronchial epithelial cells from asthma patients and controls were evaluated for SCD expression and activity. RESULTS The serum desaturation index (an indirect measure of SCD) was significantly reduced in nonobese asthma patients and in the OVA murine model. SCD1 gene expression was significantly reduced within the lungs following OVA or HDM challenge. Inhibition of SCD in mice promoted airway hyper-responsiveness. SCD1 expression was suppressed in bronchial epithelial cells from asthma patients. IL-4 and IL-13 reduced epithelial cell SCD1 expression. Inhibition of SCD reduced surfactant protein C expression and suppressed rhinovirus-induced IP-10 secretion, which was associated with increased viral titers. CONCLUSIONS This is the first study to demonstrate decreased fatty acid desaturase activity in humans with asthma. Experimental models in mice and human epithelial cells suggest that inhibition of desaturase activity leads to airway hyper-responsiveness and reduced antiviral defense. SCD may represent a new target for therapeutic intervention in asthma patients.
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Affiliation(s)
- N. Rodriguez‐Perez
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - E. Schiavi
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - R. Frei
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - R. Ferstl
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - P. Wawrzyniak
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - S. Smolinska
- Department of Clinical ImmunologyWroclaw Medical University Wroclaw Poland
- ”ALL‐MED” Medical Research Institute Wroclaw Poland
| | - M. Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - N.A. Sievi
- Pulmonary Division University Hospital of Zürich Zürich Switzerland
| | - M. Kohler
- Pulmonary Division University Hospital of Zürich Zürich Switzerland
| | - P. Schmid‐Grendelmeier
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Allergy Unit Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - D. Michalovich
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - K.D. Simpson
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - E.M. Hessel
- Refractory Respiratory Inflammation Discovery Performance Unit GlaxoSmithKlineStevenage UK
| | - M. Jutel
- Department of Clinical ImmunologyWroclaw Medical University Wroclaw Poland
- ”ALL‐MED” Medical Research Institute Wroclaw Poland
| | - M. Martin‐Fontecha
- Departamento de Química Orgánica I Facultad de Ciencias Químicas Universidad Complutense de Madrid Madrid Spain
| | - O. Palomares
- Department of Biochemistry and Molecular Biology School of Chemistry Complutense University Madrid Spain
| | - C.A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - L. O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
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Del Grande C, Galli L, Schiavi E, Dell'Osso L, Bruschi F. Is Toxoplasma gondii a Trigger of Bipolar Disorder? Pathogens 2017; 6:pathogens6010003. [PMID: 28075410 PMCID: PMC5371891 DOI: 10.3390/pathogens6010003] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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: 10/03/2016] [Revised: 12/16/2016] [Accepted: 01/04/2017] [Indexed: 11/16/2022] Open
Abstract
Toxoplasma gondii, a ubiquitous intracellular parasite, has a strong tropism for the brain tissue, where it forms intracellular cysts within the neurons and glial cells, establishing a chronic infection. Although latent toxoplasmosis is generally assumed to be asymptomatic in immunocompetent individuals, it is now clear that it can induce behavioral manipulations in mice and infected humans. Moreover, a strong relation has emerged in recent years between toxoplasmosis and psychiatric disorders. The link between T. gondii and schizophrenia has been the most widely documented; however, a significant association with bipolar disorder (BD) and suicidal/aggressive behaviors has also been detected. T. gondii may play a role in the etiopathogenesis of psychiatric disorders affecting neurotransmitters, especially dopamine, that are implicated in the emergence of psychosis and behavioral Toxoplasma-induced abnormalities, and inducing brain inflammation by the direct stimulation of inflammatory cytokines in the central nervous system. Besides this, there is increasing evidence for a prominent role of immune dysregulation in psychosis and BD. The aim of this review is to describe recent evidence suggesting a link between Toxoplasma gondii and BD, focusing on the interaction between immune responses and this infectious agent in the etiopathogenesis of psychiatric symptoms.
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Affiliation(s)
- Claudia Del Grande
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy.
| | - Luca Galli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy.
| | - Elisa Schiavi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy.
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy.
| | - Fabrizio Bruschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy.
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Altmann F, Kosma P, O’Callaghan A, Leahy S, Bottacini F, Molloy E, Plattner S, Schiavi E, Gleinser M, Groeger D, Grant R, Rodriguez Perez N, Healy S, Svehla E, Windwarder M, Hofinger A, O’Connell Motherway M, Akdis CA, Xu J, Roper J, van Sinderen D, O’Mahony L. Genome Analysis and Characterisation of the Exopolysaccharide Produced by Bifidobacterium longum subsp. longum 35624™. PLoS One 2016; 11:e0162983. [PMID: 27656878 PMCID: PMC5033381 DOI: 10.1371/journal.pone.0162983] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 08/20/2016] [Indexed: 12/20/2022] Open
Abstract
The Bifibobacterium longum subsp. longum35624™ strain (formerly named Bifidobacterium longum subsp. infantis) is a well described probiotic with clinical efficacy in Irritable Bowel Syndrome clinical trials and induces immunoregulatory effects in mice and in humans. This paper presents (a) the genome sequence of the organism allowing the assignment to its correct subspeciation longum; (b) a comparative genome assessment with other B. longum strains and (c) the molecular structure of the 35624 exopolysaccharide (EPS624). Comparative genome analysis of the 35624 strain with other B. longum strains determined that the sub-speciation of the strain is longum and revealed the presence of a 35624-specific gene cluster, predicted to encode the biosynthetic machinery for EPS624. Following isolation and acid treatment of the EPS, its chemical structure was determined using gas and liquid chromatography for sugar constituent and linkage analysis, electrospray and matrix assisted laser desorption ionization mass spectrometry for sequencing and NMR. The EPS consists of a branched hexasaccharide repeating unit containing two galactose and two glucose moieties, galacturonic acid and the unusual sugar 6-deoxy-L-talose. These data demonstrate that the B. longum35624 strain has specific genetic features, one of which leads to the generation of a characteristic exopolysaccharide.
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Affiliation(s)
| | - Paul Kosma
- University of Natural Resources and Life Sciences, Vienna, Austria
| | - Amy O’Callaghan
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | - Sinead Leahy
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | - Francesca Bottacini
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | - Evelyn Molloy
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | | | - Elisa Schiavi
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Alimentary Health Pharma Davos, Davos, Switzerland
| | - Marita Gleinser
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | | | - Ray Grant
- Alimentary Health Pharma Davos, Davos, Switzerland
| | - Noelia Rodriguez Perez
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | | | - Elisabeth Svehla
- University of Natural Resources and Life Sciences, Vienna, Austria
| | | | - Andreas Hofinger
- University of Natural Resources and Life Sciences, Vienna, Austria
| | | | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Jun Xu
- Procter & Gamble, Cincinnati, United States of America
| | | | - Douwe van Sinderen
- APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
| | - Liam O’Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- * E-mail:
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18
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Konieczna P, Schiavi E, Ziegler M, Groeger D, Healy S, Grant R, O’Mahony L. Human dendritic cell DC-SIGN and TLR-2 mediate complementary immune regulatory activities in response to Lactobacillus rhamnosus JB-1. PLoS One 2015; 10:e0120261. [PMID: 25816321 PMCID: PMC4376398 DOI: 10.1371/journal.pone.0120261] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/21/2015] [Indexed: 02/07/2023] Open
Abstract
The microbiota is required for optimal host development and ongoing immune homeostasis. Lactobacilli are common inhabitants of the mammalian large intestine and immunoregulatory effects have been described for certain, but not all, strains. The mechanisms underpinning these protective effects are beginning to be elucidated. One such protective organism is Lactobacillus rhamnosus JB-1 (Lb. rhamnosus JB-1). Lb. murinus has no such anti-inflammatory protective effects and was used as a comparator organism. Human monocyte-derived dendritic cells (MDDCs) were co-incubated with bacteria and analysed over time for bacterial adhesion and intracellular processing, costimulatory molecule expression, cytokine secretion and induction of lymphocyte polarization. Neutralising antibodies were utilized to identify the responsible MDDC receptors. Lb. rhamnosus JB-1 adhered to MDDCs, but internalization and intracellular processing was significantly delayed, compared to Lb. murinus which was rapidly internalized and processed. Lb. murinus induced CD80 and CD86 expression, accompanied by high levels of cytokine secretion, while Lb. rhamnosus JB-1 was a poor inducer of costimulatory molecule expression and cytokine secretion. Lb. rhamnosus JB-1 primed MDDCs induced Foxp3 expression in autologous lymphocytes, while Lb. murinus primed MDDCs induced Foxp3, T-bet and Ror-γt expression. DC-SIGN was required for Lb. rhamnosus JB-1 adhesion and influenced IL-12 secretion, while TLR-2 influenced IL-10 and IL-12 secretion. Here we demonstrate that the delayed kinetics of bacterial processing by MDDCs correlates with MDDC activation and stimulation of lymphocytes. Thus, inhibition or delay of intracellular processing may be a novel strategy by which certain commensals may avoid the induction of proinflammatory responses.
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Affiliation(s)
- Patrycja Konieczna
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Elisa Schiavi
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - Mario Ziegler
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | | | | | - Ray Grant
- Alimentary Health Pharma Davos, Davos, Switzerland
| | - Liam O’Mahony
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
- * E-mail:
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Ferstl R, Frei R, Schiavi E, Konieczna P, Barcik W, Ziegler M, Lauener RP, Chassard C, Lacroix C, Akdis CA, O'Mahony L. Histamine receptor 2 is a key influence in immune responses to intestinal histamine-secreting microbes. J Allergy Clin Immunol 2014; 134:744-746.e3. [DOI: 10.1016/j.jaci.2014.04.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 04/02/2014] [Accepted: 04/07/2014] [Indexed: 02/01/2023]
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Barletta B, Rossi G, Schiavi E, Butteroni C, Corinti S, Boirivant M, Di Felice G. Probiotic VSL#3-induced TGF-β ameliorates food allergy inflammation in a mouse model of peanut sensitization through the induction of regulatory T cells in the gut mucosa. Mol Nutr Food Res 2013; 57:2233-44. [PMID: 23943347 DOI: 10.1002/mnfr.201300028] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/09/2013] [Accepted: 06/01/2013] [Indexed: 12/18/2022]
Abstract
SCOPE Among food allergies, peanut allergy is frequently associated with severe anaphylactic reactions. In the need for safe and effective therapeutic strategies, probiotics may be considered on the basis of their immunomodulatory properties. The aim of the present study was to investigate the immunological mediators involved in the effects of probiotic VSL#3 oral supplementation on Th2 inflammation and anaphylaxis in a mouse model of peanut allergy. METHODS AND RESULTS VSL#3 supplementation to peanut-sensitized mice was effective in ameliorating anaphylaxis and Th2-mediated inflammation, by promoting regulatory responses in the jejunum mucosa and in the mesenteric lymph node, as evaluated by ELISA, real-time PCR, histologic, and immunohistochemical analysis. Probiotic-induced TGF-β mediates its protective effects through the induction of regulatory T cells expressing FOXP3 and/or latency-associated peptide, as proven by in vivo blockade of TGF-β in VSL#3-treated mice with a neutralizing monoclonal antibody one day before challenge. CONCLUSION TGF-β, induced in the gut by VSL#3 supplementation, is capable of reducing the Th2 inflammation associated with food anaphylaxis in a mouse model of peanut sensitization. TGF-β acts through the induction/maintenance of regulatory T cells expressing FOXP3 and/or latency-associated peptide. Probiotics supplementation may represent an effective and safe strategy for treating food allergies in adult population.
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Affiliation(s)
- Bianca Barletta
- Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
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21
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Rovai L, Maremmani AGI, Pacini M, Pani PP, Rugani F, Lamanna F, Schiavi E, Mautone S, Dell'Osso L, Maremmani I. Negative dimension in psychiatry. Amotivational syndrome as a paradigm of negative symptoms in substance abuse. Riv Psichiatr 2013; 48:1-9. [PMID: 23438696 DOI: 10.1708/1228.13610] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Negative symptoms, conceptualized as clinical manifestations of schizophrenia, and subsequently described in other psychiatric disorders, include the loss of normal arousal, drive and affective reactivity. In the field of substance abuse, an interesting analogy can be detected between negative symptoms, in their classical meaning, and the amotivational syndrome (AS), which has been described as a form of chronic cannabis intoxication. AS also shows a close resemblance to the reward deficiency syndrome (RDS) of alcoholics and stimulant abusers, and to the post-withdrawal syndrome (PWS) of detoxified heroin addicts. A variety of substances share a common tropism for the dopaminergic system, leading to a state of hypophoria, which seems to represent a common pathway for chronic substance abusers. In the light of these convergences, a common treatment principle for addictive disorders can be enunciated. This consists in resorting to pro-dopaminergic drugs, that are supposed to replace damaged functions and control craving, and in avoiding anti-dopaminergic drugs, that are expected to exacerbate craving and impede the reversal of the reward deficiency.
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Affiliation(s)
- Luca Rovai
- Department of Psychiatry NFB, University of Pisa, Italy
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22
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Bonura A, Corinti S, Schiavi E, Giacomazza D, Gianguzza F, Di Felice G, Colombo P. The major allergen of the Parietaria pollen contains an LPS-binding region with immuno-modulatory activity. Allergy 2013; 68:297-303. [PMID: 23330732 DOI: 10.1111/all.12086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2012] [Indexed: 01/03/2023]
Abstract
BACKGROUND The major allergens in Parietaria pollen, Par j 1 and Par j 2, have been identified as lipid transfer proteins. The family of the Par j 1 allergens is composed of two isoforms, which differ by the presence of a 37 amino acid peptide (Par37) exclusive to the Par j 1.0101 isoform. The goal of this study was to elucidate the biological properties of the Par37 peptide. METHODS In silico analysis, spectrofluorimetric experiments and in vitro cell culture assays were used to identify the biological properties of Par37. In addition, a mouse model of sensitization was used to study the influence of Par37 in the murine immune response. RESULTS In silico analysis predicted that Par37 displays characteristics of a host defence peptide. Spectrofluorimetric analysis, real-time PCR and ELISA assays demonstrated that Par37 possesses an LPS-binding activity influencing cell signalling in vitro. In RAW264.7 cells, LPS-induced IL-6 and TNF-α transcription and translation were inhibited after preincubation with Par37. Consistent with these data, inhibition of IFN-γ secretion was observed in murine spleen cells and in human PBMC. Finally, mice immunized with the two Par j 1 isoforms differing in the presence or absence of the Par37 peptide showed different immunological behaviours in vivo. CONCLUSIONS This study demonstrates that the Par j 1.0101 allergen displays LPS-binding activity due to the presence of a 37 amino acid COOH-terminal region and that this region is capable of influencing cytokine and antibody responses in vitro and in vivo.
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Affiliation(s)
- A. Bonura
- Istituto di Biomedicina ed Immunologia Molecolare “Alberto Monroy” del Consiglio Nazionale delle Ricerche; Palermo; Italy
| | - S. Corinti
- Dipartimento di Malattie Infettive, Parassitarie e Immuno-mediate; Istituto Superiore di Sanità; Roma; Italy
| | - E. Schiavi
- Dipartimento di Malattie Infettive, Parassitarie e Immuno-mediate; Istituto Superiore di Sanità; Roma; Italy
| | - D. Giacomazza
- Istituto di Biofisica del Consiglio Nazionale delle Ricerche (UOS Palermo); Palermo; Italy
| | - F. Gianguzza
- Dipartimento di Scienze e Tecnologie Molecolari e Biomolecolari; Università degli Studi di Palermo; Palermo; Italy
| | - G. Di Felice
- Dipartimento di Malattie Infettive, Parassitarie e Immuno-mediate; Istituto Superiore di Sanità; Roma; Italy
| | - P. Colombo
- Istituto di Biomedicina ed Immunologia Molecolare “Alberto Monroy” del Consiglio Nazionale delle Ricerche; Palermo; Italy
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Marazziti D, Baroni S, Catena-Dell'Osso M, Schiavi E, Ceresoli D, Conversano C, Dell'Osso L, Picano E. Cognitive, psychological and psychiatric effects of ionizing radiation exposure. Curr Med Chem 2012; 19:1864-9. [PMID: 22376039 DOI: 10.2174/092986712800099776] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 02/02/2012] [Accepted: 02/03/2012] [Indexed: 11/22/2022]
Abstract
Radiation exposure leads to an increased risk for cancer and, possibly, additional ill-defined non-cancer risk, including atherosclerotic, cardiovascular, cerebro-vascular and neurodegenerative effects. Studies of brain irradiation in animals and humans provide evidence of apoptosis, neuro-inflammation, loss of oligo-dendrocytes precursors and myelin sheaths, and irreversible damage to the neural stem compartment with long-term impairment of adult neurogenesis. With the present paper we aim to present a comprehensive review on brain effects of radiation exposure, with a special focus on its impact on cognitive processes and psychological functions, as well as on their possible role in the pathophysiology of different psychiatric disorders.
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Affiliation(s)
- D Marazziti
- Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Via Roma, 67, I- 56100 Pisa, Italy.
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24
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Piccinni A, Marazziti D, Veltri A, Ceravolo R, Ramacciotti C, Carlini M, Del Debbio A, Schiavi E, Bonuccelli U, Dell'Osso L. Depressive symptoms in Parkinson's disease. Compr Psychiatry 2012; 53:727-31. [PMID: 22209634 DOI: 10.1016/j.comppsych.2011.11.002] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/02/2011] [Accepted: 11/08/2011] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE We aimed to investigate the relationship between the presence and severity of depression and the degree of motor and functional disability in Parkinson's disease (PD). METHODS One hundred twenty-two outpatients with PD were enrolled in a neurology department: 65 satisfied the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition criteria for major depression, and 57 did not (PD-C). Depressive symptoms were assessed by means of the Hamilton Rating Scale for Depression (HRSD), and the PD severity was assessed according to the Hoehn and Yahr System. Activities of daily living and motor symptoms were measured by the Unified PD Rating Scale (UPDRS), parts II and III. RESULTS Twenty-nine patients had a mild depression (HRSD total score ranging between 8 and 17), 30 had a moderate depression (HRSD total score ranging between 18 and 24), and 6 had a severe depression (HRSD total score, ≥25). By comparing the 3 groups of patients, it emerged that those with a severe depression showed significantly higher scores at the UPDRS II, UPDRS III, and HY scales than did PD-C or patients with a mild depression. Moreover, patients with a moderate depression scored significantly higher on the UPDRS II, UPDRS III, and HY scales than did PD-C or those with a mild depression. CONCLUSIONS Our findings suggest that depression and motor symptoms/well-being are highly intertwined in patients with PD.
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Affiliation(s)
- Armando Piccinni
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies, University of Pisa, Via Roma 67, 56126 Pisa, Italy.
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25
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Marazziti D, Baroni S, Giannaccini G, Piccinni A, Picchetti M, Massimetti G, Schiavi E, Palego L, Catena-Dell'Osso M. Plasma fluvoxamine levels and OCD symptoms/response in adult patients. Hum Psychopharmacol 2012; 27:397-402. [PMID: 22806821 DOI: 10.1002/hup.2240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In this study, we explored the possible relationships between plasma fluvoxamine levels and clinical features and/or response in adult obsessive-compulsive disorder (OCD) patients treated with this drug for 6 months. METHODS Twenty OCD outpatients of both sexes who were already taking fluvoxamine (mean dose ± SD: 216.7 ± 86.2) for at least 4 weeks were included in the study. The severity of OCD was assessed by means of the Yale-Brown obsessive-compulsive scale (Y-BOCS). The fluvoxamine plasma levels were measured by high-performance liquid chromatography analysis. All evaluations were performed after 4 weeks (t1) and 6 months (t2) of fluvoxamine intake. RESULTS The plasma levels of fluvoxamine remained stable at the two assessment times, with no sex-related differences. Sixteen (80%) patients responded to treatment as shown by the significant (>35%) decrease of the Y-BOCS total score. Men's compulsions improved more than those of women. Significant and positive correlations were detected between fluvoxamine plasma levels at t1 and t2 and the difference (delta) of the Y-BOCS total and compulsion subscale scores between t1 and t2. Another significant, albeit negative, correlation was measured between the difference of the compulsion subscale score and the difference of fluvoxamine levels at t1 and t2. CONCLUSIONS These findings underline the potential importance of evaluating fluvoxamine plasma levels in OCD and their relationships with the clinical response that may be gender-related on specific symptoms.
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Affiliation(s)
- Donatella Marazziti
- Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Pisa, Italy.
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26
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Schiavi E, Barletta B, Barone A, Butteroni C, Corinti S, Di Felice G. Probiotic treatment induces intestinal regulatory dendritic and T cells, and counter-regulates Th2 responses and anaphylaxis in a mouse model of food allergy. Clin Transl Allergy 2011. [PMCID: PMC3354088 DOI: 10.1186/2045-7022-1-s1-o30] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Maremmani AGI, Rovai L, Pani PP, Pacini M, Lamanna F, Rugani F, Schiavi E, Dell'Osso L, Maremmani I. Do methadone and buprenorphine have the same impact on psychopathological symptoms of heroin addicts? Ann Gen Psychiatry 2011; 10:17. [PMID: 21569624 PMCID: PMC3113325 DOI: 10.1186/1744-859x-10-17] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 05/15/2011] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The idea that the impact of opioid agonist treatment is influenced by the psychopathological profile of heroin addicts has not yet been investigated, and is based on the concept of a specific therapeutic action displayed by opioid agents on psychopathological symptoms. In the present report we compared the effects of buprenorphine and methadone on the psychopathological symptoms of 213 patients (106 on buprenorphine and 107 on methadone) in a follow-up study lasting 12 months. METHODS Drug addiction history was collected by means of the Drug Addiction History Rating Scale (DAH-RS) and psychopathological features were collected by means of the Symptom Checklist-90 (SCL-90), using a special five-factor solution. Toxicological urinalyses were carried out for each patient during the treatment period. RESULTS No statistically significant differences were detected in psychopathological symptoms, including 'worthlessness-being trapped', 'somatization', and 'panic-anxiety'. Methadone proved to be more effective on patients characterized by 'sensitivity-psychoticism', whereas buprenorphine was more effective on patients displaying a 'violence-suicide' symptomatology. CONCLUSIONS Heroin-dependent patients with psychiatric comorbidities may benefit from opioid agonist treatment not only because it targets their addictive problem, but also, precisely due to this, because it is effective against their mental disorder too.
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Affiliation(s)
- Angelo Giovanni Icro Maremmani
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
- AU-CNS, 'From Science to Public Policy' Association, Pietrasanta, Lucca, Italy
- 'G. De Lisio', Institute of Behavioral Sciences Pisa, Pisa, Italy
| | - Luca Rovai
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
| | - Pier Paolo Pani
- Sardinia Health and Social Administration, Sardinia Autonomous Region, Cagliari, Italy
| | - Matteo Pacini
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
- 'G. De Lisio', Institute of Behavioral Sciences Pisa, Pisa, Italy
| | | | - Fabio Rugani
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
| | - Elisa Schiavi
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
| | - Icro Maremmani
- 'Vincent P. Dole' Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, NPB, University of Pisa, Pisa, Italy
- AU-CNS, 'From Science to Public Policy' Association, Pietrasanta, Lucca, Italy
- 'G. De Lisio', Institute of Behavioral Sciences Pisa, Pisa, Italy
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Maremmani I, Dell'Osso L, Rovai L, Arduino G, Maremmani AGI, Schiavi E, Perugi G, Akiskal K, Akiskal HS. Temperamental traits of women applying for a type of job that has been characterized historically by male identity: the military career as case study. J Affect Disord 2011; 130:275-9. [PMID: 21056474 DOI: 10.1016/j.jad.2010.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 10/05/2010] [Accepted: 10/07/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Over the past fifty years in the Western world the professions and activities that were once practised only by males, are now available to females, too. Affective temperaments, in line with their adaptive function, influence career choices. In general, males and females have proved to have different temperamental profiles. In this study we inquire into the question whether gender differences in temperament have continued unchanged in a field, such as the military career, that has been historically characterized by a male identity. METHODS 1426 males and 122 females wishing to become a cadet in the Italian Air Force were tested using TEMPS-A[P] (the Temperament Evaluation of Memphis, Pisa, Paris and San Diego self-questionnaire, Pisan version). RESULTS Univariate and multivariate analyses failed to distinguish males from females. Both males and females tend to have a high score on the hyperthymic scale (generally, a typical male temperament) and a very low one on the cyclothymic scale (generally, a typical female temperament), with low scores on the depressive and the irritable scales. CONCLUSIONS This study supports the idea that different gender-related temperaments are functional to differences in the roles played by males and females during the biological and social evolutionary process.
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Affiliation(s)
- Icro Maremmani
- Santa Chiara University Hospital, Department of Psychiatry, University of Pisa, Italy.
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Schiavi E, Barletta B, Butteroni C, Corinti S, Boirivant M, Di Felice G. Oral therapeutic administration of a probiotic mixture suppresses established Th2 responses and systemic anaphylaxis in a murine model of food allergy. Allergy 2011; 66:499-508. [PMID: 21058959 DOI: 10.1111/j.1398-9995.2010.02501.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [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: 12/31/2022]
Abstract
BACKGROUND No effective treatment is available for food allergy and its primary management still consists of avoiding relevant allergens. Probiotics are claimed to beneficially affect the immune system. We sought to investigate the therapeutic potential of VSL#3 probiotic mixture on specific immune responses and anaphylactic reaction induced in mice by the major food allergen shrimp tropomyosin (ST). METHODS The cytokine production by spleen cell from ST-sensitized mice upon allergen re-stimulation in the presence of VSL#3 was analysed. Next, the effects of oral administration of VSL#3 on allergen-induced anaphylaxis and Th2 response in the murine model of food allergy to ST was investigated by evaluating symptom score and histamine content in the faeces after allergen challenge, antibody response in serum and faeces, and cytokine and transcription factor expression in the jejunum. RESULTS The in vitro studies on mouse spleen cells indicates that the VSL#3 preparation has the capacity to shift a polarized Th2 response to a Th1/T regulatory-type profile. Oral therapeutic administration of VSL#3 to ST-sensitized mice significantly reduces symptom score and histamine release in the faeces following allergen challenge, as well as specific IgE response. In the jejunum, IL-4, IL-5 and IL-13 tissue content was significantly reduced, whereas FOXP3 and IL-27 mRNA expression, IL-10, TGF-β and IFN-γ tissue content were up-regulated. CONCLUSIONS Oral therapeutic treatment with the probiotic mixture VSL#3 is effective in redirecting allergen-specific Th2-polarized immune responses towards Th1-T regulatory responses and in the protection against anaphylactic reactions induced by the allergen in a murine model of food allergy.
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Affiliation(s)
- E Schiavi
- Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
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Piccinni A, Marazziti D, Catena M, Domenici L, Del Debbio A, Bianchi C, Mannari C, Martini C, Da Pozzo E, Schiavi E, Mariotti A, Roncaglia I, Palla A, Consoli G, Giovannini L, Massimetti G, Dell'Osso L. Plasma and serum brain-derived neurotrophic factor (BDNF) in depressed patients during 1 year of antidepressant treatments. J Affect Disord 2008; 105:279-83. [PMID: 17553570 DOI: 10.1016/j.jad.2007.05.005] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.1] [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] [Received: 03/12/2007] [Revised: 05/07/2007] [Accepted: 05/07/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) has been hypothesized to be involved in the neurobiology of major depression. The aim of this study was to assess the possible relationships between depressive symptoms and serum and/or plasma BDNF levels during 1 year of antidepressant treatment. METHODS Plasma and serum BDNF levels were assayed in 15 drug-free depressed patients and in 15 healthy control subjects at baseline and the 1st, 3rd, 6th and 12th month of antidepressant treatment. RESULTS At baseline, patients' serum and plasma BDNF levels were significantly lower (p<.001 and p=.004, respectively) than those found in healthy control subjects. However, while from the 1st month of treatment patients' plasma BDNF levels did not differ significantly from those observed in healthy control subjects, serum BDNF levels in patients remained significantly lower at all times. LIMITATIONS The main limitations of the current study are represented by the small sample size and the high discontinuation rate. CONCLUSIONS Untreated depressed patients showed reduced baseline serum and plasma BDNF levels, as compared with control subjects. The clinical improvement paralleled the normalization of plasma BDNF after 1 month of treatment, while, at every assessment time, patients' serum BDNF levels were lower than those of control subjects. This would suggest that serum BDNF might represent a non-specific trait marker of depression.
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Affiliation(s)
- Armando Piccinni
- Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Pisa, Italy.
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Garamendi JF, Malpica N, Martel J, Schiavi E. Automatic Segmentation of the Liver in CT Using Level Sets Without Edges. Pattern Recognition and Image Analysis 2007. [DOI: 10.1007/978-3-540-72847-4_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Piccinni A, Catena M, Del Debbio A, Marazziti D, Monje C, Schiavi E, Mariotti A, Bianchi C, Palla A, Roncaglia I, Carlini M, Pini S, Dell'Osso L. Health-related quality of life and functioning in remitted bipolar I outpatients. Compr Psychiatry 2007; 48:323-8. [PMID: 17560952 DOI: 10.1016/j.comppsych.2006.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [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] [Received: 04/19/2006] [Revised: 08/28/2006] [Accepted: 12/26/2006] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to characterize the health-related quality of life (HR-QOL) and functioning in 90 bipolar I remitted outpatients. According to Diagnostic and Statistical Manual of Mental Disorders IV remission specifiers, patients were categorized into 4 groups: group 1, fully remitted; group 2, less than 2 months remitted; group 3, with persisting manic symptoms; group 4, with persisting depressive symptoms. The severity of psychopathology was evaluated by using the Bech-Rafaelsen Mania-Melancholia Scale. The HR-QOL, functioning, and insight were assessed via the medical outcomes study 36-item short form, the global assessment of functioning scale, and the scale to assess unawareness of mental disorder, respectively. Fully remitted patients reported the highest scores in almost all domains of medical outcomes study 36-item short form, and had significantly higher scores on physical functioning, general health, social functioning, and mental health compared to patients with persisting depressive symptoms. Furthermore, patients with persisting manic symptoms reported significantly higher scores on general health, vitality and mental health than the group with persisting depressive symptoms. In contrast, the global assessment of functioning scale score differed among the 4 groups, with fully remitted patients reporting higher, although not statistically significant, scores than the other groups. Our data suggest that the persistence of depressive or manic symptoms seem to affect self-report measures of HR-QOL. An affectively biased cognition may explain the gap between patient's perception of functioning and estimated functional adjustment, as assessed by clinicians.
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Affiliation(s)
- Armando Piccinni
- Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, 56127 Pisa, Italy.
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Catena M, Marazziti D, Piccinni A, Del Debbio A, Consoli G, Veltri A, Golia F, Schiavi E, Palla A, Picchetti M, Mariotti A, Bianchi C, Roncaglia I, Baroni S, Dell'Osso L. Follow-up of brain-derived neurotrophic factor (BDNF) during a one-year antidepressant treatment. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Luna CM, Efron ED, Schiavi E, Gené RJ, Famiglietti A, Jolly EC, Niederman MS. [Community-acquired pneumonia in adults. Clinical practice guideline for Argentina. Study Group on Community Acquired Pneumonia]. Medicina (B Aires) 1998; 57:343-55. [PMID: 9640771] [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: 02/07/2023] Open
Abstract
Community-acquired pneumonia (CAP) affects approximately 1% of the population annually. Initial antimicrobial therapy is most often empirical. Guidelines designed in other countries for the empirical management of CAP are not recommended for use in Argentina. Studies from other countries were considered together with unpublished local data to define the potential etiologic microorganisms and their antimicrobial susceptibility. Recommended diagnostic tests, groups of patients for different therapies and hospitalization criteria were defined. Severe CAP requiring intensive care was distinguished from the rest because of its distinct spectrum of etiologic agents and its high mortality, requiring a more focused therapy. Age, coexisting conditions and severity of illness were taken into account in the election of therapy.
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Affiliation(s)
- C M Luna
- Hospital de Clínicas José de San Martin, UBA
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Basano L, Ottonello P, Schiavi E. Multipurpose analyzers for photoelectron statistics: implementation and use. Appl Opt 1993; 32:4430-4436. [PMID: 20830102 DOI: 10.1364/ao.32.004430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The statistical properties of variously scattered laser light can be derived from photocount data through the estimate of different functions. Even if the second-order correlation usually plays the main role, other function (e.g., triggered and nontriggered distributions, moments of various order, and higher-order correlations) may give more appropriate results in many experimental conditions. We present a multifunction analyzer whose working principle is based on the acquisition of a long sequence of interpulse intervals (through a circuitally simple personal-computer front-end interface), which is followed by the off-line calculation of one or more of the functions for which an algorithm is available. Up to 5 × 10(5) photopulse intervals can be recorded at a maximum rate of approximately 2 × 10(5) data points/s. A short description of the algorithms used to calculate the different functions is given together with some useful hints and a table of typical processing times.
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Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin J, Dubin A, Schiavi E, Jorge M, Pusajo J. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992; 339:195-9. [PMID: 1346170 DOI: 10.1016/0140-6736(92)90002-k] [Citation(s) in RCA: 659] [Impact Index Per Article: 20.6] [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: 12/30/2022]
Abstract
Falls in gastric intramucosal pH (pHi) are associated with morbidity and mortality in patients admitted to intensive-care units (ICU). We tested the hypothesis that ICU outcome can be improved by therapy guided by changes in pHi and aimed at improving systemic oxygen availability. We studied 260 patients admitted to ICUs with APACHE II scores of 15-25. After insertion of a gastric tonometer, each patient was randomly assigned to a control or protocol group within the admission pHi category (normal = 7.35 or higher; low = below 7.35). The control groups were treated according to standard ICU practices. The protocol groups received, in addition, treatment to increase systemic oxygen transport or to reduce oxygen demand, whenever the pHi fell below 7.35 or by more than 0.10 units from the previous measurement. The protocol was used, because pHi fell, in 67 (85%) of the protocol group with normal pHi on admission. There were no significant differences between protocol and control groups in demographic characteristics, admission blood gases or haemoglobin concentration, number or type of organ system failures, or the intensity of ICU care. For patients admitted with low pHi, survival was similar in the protocol and control groups (37% vs 36%), whereas for those admitted with normal pHi, survival was significantly greater in the protocol than in the control group (58% vs 42%; p less than 0.01). Therapy guided by pHi measurements improved survival in patients whose pHi on admission to ICU was normal. pHi-guided resuscitation may help improve outcome in such patients by preventing splanchnic organ hypoxia and the development of a systemic oxygen deficit.
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Affiliation(s)
- G Gutierrez
- Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston 77030
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