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Bottari G, Caruso M, Paionni E, De Luca M, Romani L, Pisani M, Grandin A, Gargiullo L, Zampini G, Gagliardi C, Fegatelli DA, Vestri A, Lancella L, Porzio O, Muda AO, Villani A, Atti MCD, Raponi M, Cecchetti C. Accuracy of Pancreatic Stone Protein for diagnosis of sepsis in children admitted to pediatric intensive care or high-dependency care: a pilot study. Ital J Pediatr 2023; 49:134. [PMID: 37805604 PMCID: PMC10559422 DOI: 10.1186/s13052-023-01540-6] [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: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Pancreatic Stone Protein (PSP) is one of the most promising diagnostic and prognostic markers. The aim of the study was to assess the accuracy of PSP, compared to C-Reactive Protein (CRP), and Procalcitonin (PCT) for sepsis diagnosis in pediatric patients. Furthermore, we explored the correlation of PSP levels with sepsis severity and organ failure measured with PELOD-2 score. METHODS Forty pediatric patients were enrolled following admission to pediatric intensive care, high dependency care or pediatric ward. PSP blood levels were measured in Emergency Department (nanofluidic point-of-care immunoassay; abioSCOPE, Abionic SA, Switzerland) on day 1, 2, 3, 5 and 7 from the onset of the clinical signs and symptoms of sepsis or SIRS. Inclusion criteria were: 1) patient age (1 month to 18 years old), 2) signs and symptoms of SIRS, irrespective of association with organ dysfunction. Exclusion criteria were: 1) hemato-oncological diseases and/or immunodeficiencies, 2) pancreatic diseases. RESULTS Septic patients showed higher PSP levels than those with non-infectious systemic inflammation. The optimal cut-off in diagnosis of sepsis for PSP at day 1 was 167 ng/ml resulted in a sensitivity of 59% (95% IC 36%-79%) and a specificity of 83% (95% IC 58%-96%) with an AUC of 0.636 for PSP in comparison to AUC of 0.722 for PCT and 0.503 for C-RP. ROC analysis for outcome (survival versus no survival) has showed AUC 0.814 for PSP; AUC 0.814 for PCT; AUC of 0.657 for C-RP. CONCLUSIONS PSP could distinguish sepsis from non-infectious systemic inflammation; however, our results need to be confirmed in larger pediatric population.
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Affiliation(s)
- Gabriella Bottari
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCSS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Mariangela Caruso
- Department of Anesthesia and Intensive Care, Catholic University of Rome, Residency School of Anesthesia and Intensive Care, Catholic University, Rome, Italy
| | - Emanuel Paionni
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maia De Luca
- Infectious Disease Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Lorenza Romani
- Infectious Disease Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Mara Pisani
- Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Annalisa Grandin
- General Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Livia Gargiullo
- General Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Giorgio Zampini
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCSS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Chiara Gagliardi
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCSS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | - Laura Lancella
- Infectious Disease Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ottavia Porzio
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Onetti Muda
- Clinical Laboratory Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Scientific Direction, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alberto Villani
- General Pediatric and Infectious Disease Unit, Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marta Ciofi Degli Atti
- Clinical Pathways and Epidemiology Unit-Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Corrado Cecchetti
- Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCSS, Piazza Sant'Onofrio 4, 00165, Rome, Italy
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Guerra L, Dellambra E, Panacchia L, Paionni E. Tissue Engineering for Damaged Surface and Lining Epithelia: Stem Cells, Current Clinical Applications, and Available Engineered Tissues. Tissue Engineering Part B: Reviews 2009; 15:91-112. [DOI: 10.1089/ten.teb.2008.0418] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Liliana Guerra
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Elena Dellambra
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Laura Panacchia
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Emanuel Paionni
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
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Bondanza S, Maurelli R, Paterna P, Migliore E, Giacomo FD, Primavera G, Paionni E, Dellambra E, Guerra L. Keratinocyte cultures from involved skin in vitiligo patients show an impaired in vitro behaviour. ACTA ACUST UNITED AC 2007; 20:288-300. [PMID: 17630962 DOI: 10.1111/j.1600-0749.2007.00385.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vitiligo depigmentation is considered a consequence of either melanocyte disappearance or loss of functioning melanocytes in the involved areas. However, it has been reported that keratinocytes in involved vitiligo skin are damaged too. Based on this evidence, we evaluated the in vitro behaviour, in life span cultures, of involved and uninvolved vitiligo keratinocytes and their expression of proliferation, differentiation and senescence markers. An additional purpose was to investigate whether vitiligo keratinocytes from depigmented skin are able to sustain survival and growth of normal melanocytes (when added in co-culture experiments), as normal human keratinocytes manage to do. Our results demonstrate that almost all involved vitiligo keratinocytes have a shorter life span in vitro than the uninvolved cells and all of them do not maintain melanocytes in culture in a physiological ratio. Modification of proliferation and senescence marker expression also occurs. Indeed, we detected low initial expression levels of the senescence marker p16 in involved vitiligo keratinocytes, despite their shorter in vitro life span, and increased expression of proliferating cell nuclear antigen and p53. This preliminary analysis of a small number of in vitro cultured vitiligo keratinocytes suggests an impaired senescence process in lesional vitiligo keratinocytes and attempts to regulate it.
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Affiliation(s)
- Sergio Bondanza
- Tissue Engineering and Cutaneous Physiopathology Laboratory, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
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Bondanza S, Bellini M, Roversi G, Raskovic D, Maurelli R, Paionni E, Paterna P, Dellambra E, Larizza L, Guerra L. Piebald Trait: Implication of kit Mutation on In Vitro Melanocyte Survival and on the Clinical Application of Cultured Epidermal Autografts. J Invest Dermatol 2007; 127:676-86. [PMID: 17124503 DOI: 10.1038/sj.jid.5700639] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Piebald trait leukoderma results from "loss-of-function" mutations in the kit gene. Correlations between mutation type and clinical phenotype have been reported. However, mutation classification has been mainly based on the clinical features of patients. The aim of this study was to get a better understanding of the pathogenesis of human piebaldism by establishing whether the kit mutation type may affect the in vitro survival/proliferation of patient melanocytes. Overall, the research was finalized to implement the clinical application of the autologous cultured epidermis in the treatment of piebald patients. Seven patients, who were transplanted with autologous in vitro reconstituted epidermis, showed an average percentage of repigmentation of 90.7. Six novel and one previously reported mutations were found and their postulated effects discussed in relation to the clinical phenotype and in vitro behavior of epidermal cells. Although mutation type did not impair repigmentation given by autotransplantation, it was shown to influence the survival/proliferation of co-cultured melanocytes and keratinocytes. In particular, tyrosine kinase domain mutations were found with melanocyte loss and keratinocyte senescence during expansion of epidermal cultures. Results indicate that the clinical application of cultured epidermis in piebald patients may be optimized by investigating mutation functional effects before planning surgical operations.
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Affiliation(s)
- Sergio Bondanza
- Laboratory of Tissue Engineering and Cutaneous Physiopathology, Istituto Dermopatico dell'Immacolata, IRCCS, Via dei Monti di Creta 104, Rome, Italy
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