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Wang HJ, Kusumo RW, Kiss A, Tennen G, Marotta G, Viaje S, Lanctôt KL. Characterizing PRN Use of Psychotropic Medications for Acute Agitation in Canadian Long-Term Care Residents with Dementia Before and During COVID-19. J Alzheimers Dis Rep 2023; 7:575-587. [PMID: 37313488 PMCID: PMC10259051 DOI: 10.3233/adr-230009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/15/2023] [Indexed: 06/15/2023] Open
Abstract
Background Agitation is a disabling neuropsychiatric symptom of dementia. Pro re nata (PRN) injections of psychotropics can be administered for severe acute agitation, but little is known about the frequency of their actual use. Objective Characterize actual use of injectable PRN psychotropics for severe acute agitation in Canadian long-term care (LTC) residents with dementia and compare use before and during the COVID-19 pandemic. Methods Residents from two Canadian LTC facilities with orders for PRN haloperidol, olanzapine, or lorazepam between January 1, 2018- May 1, 2019 (i.e., pre-COVID-19) and January 1, 2020- May 1, 2021 (i.e., COVID-19) were identified. Electronic medical records were reviewed to document PRN injections of psychotropic medications and collect data on reason and demographic characteristics. Descriptive statistics were used to characterize frequency, dose, and indications of use, and multivariate regression models were used to compare use between time periods. Results Of the 250 residents, 45 of 103 (44%) people in the pre-COVID-19 period and 85 of 147 (58%) people in the COVID-19 period with standing orders for PRN psychotropics received ≥1 injections. Haloperidol was the most frequently used agent in both time periods (74% (155/209 injections) pre-COVID-19; 81% (323/398 injections) during COVID-19). Residents in the COVID-19 period were almost two times more likely to receive injections compared with those in the pre-COVID-19 period (odds ratio = 1.96; 95% CI = 1.15-3.34; p = 0.01). Conclusion Our results suggest that use of PRN injections increased in LTC during the pandemic and contribute to the mounting evidence that agitation worsened during that time.
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Affiliation(s)
- Hui Jue Wang
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Raphael W. Kusumo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gayla Tennen
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Giovanni Marotta
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Geriatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Villa Colombo Homes for the Aged Inc, North York, ON, Canada
| | - Shirley Viaje
- Villa Colombo Homes for the Aged Inc, North York, ON, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
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Battiato S, Caponnetto P, Leotta R, Marotta G, Midolo A, Ortis A, Polosa R. Development and User Evaluation of a Food-recognition app (FoodRec): Experimental Data and Qualitative Analysis. Health Psychol Res 2023; 11:70401. [PMID: 36844645 PMCID: PMC9946798 DOI: 10.52965/001c.70401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Background different studies revealed strong correlation between smoking cessation and a worsening of the diet, whose consequence include loss of appetite, weight loss, etc. Objective the objective of FoodRec project is to exploit technology to monitor the dietary habits of people during their smoke quitting process, catching relevant changes which can affect the patient health and the success of the process. This work was an uncontrolled pre-test post-test open pilot study in which an interdisciplinary group created an app for food recognition (FoodRec) to monitor their mood status and dietary habits during the test period. Methods participants used the FoodRec App for two consecutive weeks for usability and suitability assessment. Tests included 149 smokers involved in a smoke quitting process, aged between 19 and 80. For the quantitative test, data were analyzed regarding users features, meals uploads, mood states and drink intakes. For the qualitative test, a user evaluation test of the app has been performed with four assignments being carried out on a group of 50 participants. Results the App was perceived as extremely user-friendly and lightweight. It also turned out to be useful in the perception of users' dietary habits and helpful in relieving the stress of a food intake reduction process. Conclusion this work investigated the role and impact of the FoodRec App in a large international and multicultural context. The experience gained in the current study will be used to modify and refine the large international RCT protocol version of the app.
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Bawa KK, Ba J, Kiss A, Wang R, Feng V, Swardfager W, Andreazza AC, Gallagher D, Marotta G, Herrmann N, Lanctôt KL. Lipid oxidation as a marker of apathy and executive dysfunction in patients at risk of vascular cognitive impairment. Alzheimers Dement 2022. [DOI: 10.1002/alz.063958] [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: 12/24/2022]
Affiliation(s)
- Kritleen Kaur Bawa
- Sunnybrook Research Institute Toronto ON Canada
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group Toronto ON Canada
| | - Alex Kiss
- Sunnybrook Research Institute Toronto ON Canada
- ICES Toronto ON Canada
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto Toronto ON Canada
| | | | - Vivian Feng
- Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
| | - Walter Swardfager
- University of Toronto Toronto ON Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute Toronto ON Canada
- Department of Pharmacology & Toxicology University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Damien Gallagher
- Neuropsychopharmacology Research Group Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute Toronto ON Canada
- University of Toronto Toronto ON Canada
- Sunnybrook Health Sciences Centre Toronto ON Canada
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Bawa KK, Ba J, Kiss A, Wang R, Feng V, Swardfager W, Andreazza A, Gallagher D, Marotta G, Herrmann N, Lanctôt KL. Lipid Peroxidation as a Marker of Apathy and Executive Dysfunction in Patients at Risk for Vascular Cognitive Impairment. J Alzheimers Dis 2022; 89:733-743. [DOI: 10.3233/jad-220274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The co-occurrence of apathy and executive dysfunction, a correlate of vascular cognitive impairment (VCI), is highly prevalent, yet facilitating factors are largely unknown. Objective: This study investigates the relationship between lipid peroxidation, apathy, and executive dysfunction in patients at risk for VCI. Methods: In participants with coronary artery disease, who are at a high risk of VCI, apathy (Apathy Evaluation Scale), and executive function (composite z-score based on age and education population norms from trails making test B, animal naming, and phonemic fluency tests) were assessed. Serum concentrations of an early (lipid hydroperoxide (LPH)) and late (8-isoprostane (8-ISO)) lipid peroxidation marker, were measured and the 8-ISO/LPH ratio was calculated. Results: Participants (n = 206, age±SD = 63.0±7.5, 80% men, total years of education = 15.9±3.4, AES score = 28.3±8.8, executive function = 0±1) demonstrated significantly different 8-ISO/LPH ratios between groups (F(3, 202) = 10.915, p < 0.001) with increasing levels in the following order: no apathy or executive dysfunction, only executive dysfunction (executive function composite score≤–1), only apathy (AES≥28), and both apathy and executive dysfunction. A model adjusting for demographics showed that lipid peroxidation was associated with both apathy (B(SE) = 4.63 (0.954), t = 4.852, p < 0.001) and executive function (B(SE) = –0.19 (0.079), t = –2.377, p = 0.018). However, when controlling for both demographics and vascular risk factors, lipid peroxidation was associated with only apathy (B(SE) = 3.11 (0.987), t = 3.149, p = 0.002). Conclusion: The results highlight a potentially important involvement of lipid peroxidation in the co-occurrence of apathy and executive dysfunction in those at risk for VCI.
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Affiliation(s)
- Kritleen K. Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Joycelyn Ba
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Alex Kiss
- ICES, Sunnybrook Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - RuoDing Wang
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Vivian Feng
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Walter Swardfager
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Ana Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Damien Gallagher
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Giovanni Marotta
- Division of Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Cancilla N, Gurreri L, Marotta G, Ciofalo M, Cipollina A, Tamburini A, Micale G. A porous media CFD model for the simulation of hemodialysis in hollow fiber membrane modules. J Memb Sci 2022. [DOI: 10.1016/j.memsci.2021.120219] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Apathy is a highly prevalent symptom of dementia. Despite its association with faster cognitive and functional decline, decreased quality of life and increased mortality, no therapies are currently approved to treat apathy. The objective of this review was to summarize the drugs that have been studied for apathy treatment in patients with dementia (specifically Alzheimer's disease [AD], Huntington's disease [HD] and Parkinson's disease [PD] dementia; dementia with Lewy bodies [DLB]; vascular dementia [VaD]; and frontotemporal dementia [FTD]) based on their putative mechanisms of action. A search for relevant studies was performed using ClinicalTrials.gov and PubMed. Eligible studies were randomized controlled trials that were available in English and included at least one drug intervention and an apathy measure scale. A total of 52 studies that included patients with AD (n = 33 studies), PD (n = 5), HD (n = 1), DLB (n = 1), FTD (n = 3), VaD (n = 1), VaD and AD (n = 4), VaD and mixed dementia (n = 1), and AD, VaD and mixed dementia (n = 3) were eligible for inclusion. These studies showed that methylphenidate, olanzapine, cholinesterase inhibitors, choline alphoscerate, citalopram, memantine, and mibampator are the only beneficial drugs in AD-related apathy. For PD-related apathy, only methylphenidate, rotigotine and rivastigmine showed benefits. Regarding FTD- and DLB-related apathy, initial studies with agomelatine and rivastigmine showed benefits, respectively. As for HD- and only-VaD-related apathy, no drugs demonstrated benefits. With regards to mixed populations, memantine, galantamine and gingko biloba showed effects on apathy in the AD plus VaD populations and nimodipine in the VaD plus mixed dementia populations. Of the drugs with positive results, some are already prescribed to patients with dementia to target other symptoms, some have characteristics-such as medical contraindications (e.g., cardiovascular) and adverse effects (e.g., gastrointestinal disturbances)-that limit their clinical use and some require further study. Future studies should investigate apathy as a primary outcome, making use of appropriate sample sizes and study durations to ensure durability of results. There should also be a consensus on using scales with high test/retest and interrater reliabilities to limit the inconsistencies between clinical trials. In conclusion, there are currently no US FDA-approved drugs that target apathy in dementia, so there is an ongoing need for the development of such drugs.
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Affiliation(s)
- Laiba Azhar
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Raphael W Kusumo
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Giovanni Marotta
- Geriatric Medicine Division, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Krista L Lanctôt
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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7
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Tumati S, Herrmann N, Marotta G, Li A, Lanctôt KL. Blood-based biomarkers of agitation in Alzheimer's disease: Advances and future prospects. Neurochem Int 2021; 152:105250. [PMID: 34864088 DOI: 10.1016/j.neuint.2021.105250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/19/2021] [Accepted: 11/27/2021] [Indexed: 12/19/2022]
Abstract
Agitation is a common neuropsychiatric symptom that becomes more prevalent as Alzheimer's disease (AD) increases in severity. The treatment of agitation is an urgent and unmet need due to the poor outcomes associated with it, its disruptive impact on patients and caregivers, and the lack of efficacious and safe treatments. Recent research on agitation in AD with blood-based biomarkers has advanced the search for its biomarkers beyond the brain and provides new insights to understand its mechanisms and improve treatments. Here, we reviewed studies of blood-based biomarkers of agitation in AD, which show that inflammatory biomarkers are increased in patients with agitation, may predict the development of agitation, and are associated with symptom severity. In addition, they may also track symptom severity and response to treatment. Other biomarkers associated with agitation include markers of oxidative stress, brain cholesterol metabolism, motor activity, and clusterin, a chaperone protein. These results are promising and need to be replicated. Preliminary evidence suggests a role for these biomarkers in interventional studies for agitation to predict and monitor treatment response, which may eventually help enrich study samples and deliver therapy likely to benefit individual patients. Advances in blood-based biomarkers of AD including those identified in "-omic" studies and high sensitivity assays provide opportunities to identify new biomarkers of agitation. Future studies of agitation and its treatment should investigate blood-based biomarkers to yield novel insights into the neurobiological mechanisms of agitation, monitoring symptoms and response to treatment, and to identify patients likely to respond to treatments.
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Affiliation(s)
- Shankar Tumati
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Giovanni Marotta
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Division of Geriatric Medicine, University of Toronto, Toronto, Canada
| | - Abby Li
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
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8
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Faletti S, Osti D, Ceccacci E, Richichi C, Costanza B, Marotta G, Corà D, Pelicci G. OS06.3A LSD1-directed therapy curtails glioblastoma tumorigenicity by limiting the adaptation of tumor initiating cells to stressful environments. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) is a fatal tumor whose aggressiveness, heterogeneity, therapy resistance and poor blood-brain-barrier penetration hinder the amelioration of the standard-of-care. Included in the GBM mass are the tumor initiating cells (TICs), representing the driver of GBM growth and relapse in virtue of their stem-like traits and therapy-resistance. Being constantly exposed to environmental stress, including nutrients deficiency, hypoxia and therapeutic insults, all GBM cells -and TICs in particular- have to be highly adaptive in order to survive. Thus, their ability to cope with stress could be targeted to curtail TICs maintenance and the whole GBM aggressiveness. The key of TICs adaptation relies, among the others, on their epigenetic plasticity, hence encouraging epigenetic drugs testing.
MATERIAL AND METHODS
By exploiting patient-derived GBM TICs and orthotopic xenograft models, we tested the antitumorigenic features of a novel, selective, orally bioavailable and brain-penetrant Lysine-specific histone demethylase 1 inhibitor (LSD1i). We confirmed the specificity of its effects by LSD1 genetic targeting. A combination of RNA-seq, Chromatin Immunoprecipitation(ChIP)-seq, Mass Spectrometry and reverse genetic experiments unraveled LSD1 molecular players in GBM TICs.
RESULTS
We identified LSD1 as a druggable target in human GBM: LSD1i treatment, mirrored by LSD1 genetic targeting, impairs growth, viability, stem-like traits and in vivo tumorigenicity of GBM TICs. Mechanistically, LSD1 is crucial for the expression of the activating transcription factor 4 (ATF4), which coordinates the integrated stress response (ISR) to manage stressful stimuli as nutrient deprivation and endoplasmic reticulum stress. By mimicking these stress cues in vitro, we found that LSD1i triggers a delayed but unabated ATF4 translation which provokes an over-lasting ISR, eventually culminating in GBM TICs apoptosis. Lastly, LSD1 demethylase activity is dispensable for ATF4 induction. Rather, LSD1i exerts its anti-tumorigenic potential by interfering with LSD1 scaffolding function in GBM TICs.
CONCLUSION
LSD1-directed therapy is likely a promising strategy to hinder GBM. By sensitizing GBM TICs to stress, LSD1i endangers the GBM TICs pool. The effectiveness of LSD1i administration in different patient-derived GBM TICs and xenografts, regardless of their molecular profile, places a strong rationale toward the clinical translation of this approach for GBM management.
FUNDING
Italian association for Cancer Research (AIRC) and Italian Ministry of Health
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Affiliation(s)
- S Faletti
- European Institute of Oncology, Milan, Italy
| | - D Osti
- European Institute of Oncology, Milan, Italy
| | - E Ceccacci
- European Institute of Oncology, Milan, Italy
| | - C Richichi
- European Institute of Oncology, Milan, Italy
| | - B Costanza
- European Institute of Oncology, Milan, Italy
| | - G Marotta
- European Institute of Oncology, Milan, Italy
| | - D Corà
- Center for Translational Research on Autoimmune and Allergic Disease (CAAD), University of Piemonte Orientale, Novara, Italy
| | - G Pelicci
- European Institute of Oncology, Milan, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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Kanike N, Hospattankar KG, Marotta G, Kumar D. Management of severe right lung cystic pulmonary interstitial emphysema in an infant at 24 weeks gestation with bedside selective left main stem bronchial intubation: Case report and review of the literature. J Neonatal Perinatal Med 2021; 14:299-305. [PMID: 32986686 DOI: 10.3233/npm-180178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pulmonary interstitial emphysema (PIE) is a severe complication of mechanical ventilation in preterm infants. Selective bronchial intubation is a rarely used treatment strategy, as it is challenging, especially left main stem bronchial intubation. We report our experience in an infant at 24 weeks gestation with bedside left main stem bronchial intubation using flexible fiberoptic bronchoscopy. We also describe in detail the procedural details involved in the selective left main stem bronchial intubation including the helpful technique of gently bending the tip of the endotracheal tube to create "memory" to better direct the tube into the left main-stem bronchus while using the flexible fiberoptic bronchoscope. A review of the literature regarding selective bronchial intubation in newborn infants is presented. This case report and literature review suggest that bedside left main stem bronchial intubation using a flexible fiberoptic bronchoscope is a viable option to successfully manage even the most unstable extreme premature infant with unilateral right lung cystic PIE. This may potentially prevent a rare but necessary invasive surgical procedure like lobectomy or even death.
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Affiliation(s)
- N Kanike
- Pediatrics (Neonatology), Case Western Reserve University (CWRU), Metro Health Medical Center, Cleveland, OH, USA
| | - K G Hospattankar
- Pediatrics (Neonatology), Case Western Reserve University (CWRU), Metro Health Medical Center, Cleveland, OH, USA
| | - G Marotta
- Otolaryngology Department, Case Western Reserve University (CWRU), Metro Health Medical Center, Cleveland, OH, USA
| | - D Kumar
- Pediatrics (Neonatology), Case Western Reserve University (CWRU), Metro Health Medical Center, Cleveland, OH, USA
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10
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Scarioni M, Arighi A, Fenoglio C, Sorrentino F, Serpente M, Rotondo E, Mercurio M, Marotta G, Dijkstra AA, Pijnenburg YAL, Scarpini E, Galimberti D. Late-onset presentation and phenotypic heterogeneity of the rare R377W PSEN1 mutation. Eur J Neurol 2020; 27:2630-2634. [PMID: 32894632 DOI: 10.1111/ene.14506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/31/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Mutations in the PSEN1 gene are the most common cause of autosomal-dominant Alzheimer's disease and have been associated with the earliest disease onset. We describe an unusual presentation of the rare R377W PSEN1 mutation with a late age of onset, and we provide for the first time in vivo pathological evidence for this mutation. METHODS A 71-year-old female patient with progressive cognitive decline in the past 3 years and positive family history for dementia underwent neurological evaluation, neuropsychological testing, lumbar puncture, conventional brain imaging, amyloid-positron emission tomography (PET) and extensive genetic screening with a next-generation sequencing technique. RESULTS The diagnostic workup revealed mixed behavioural and amnestic disease features on neuropsychological tests, magnetic resonance imaging, and 18-fluorodeoxyglucose (FDG)-PET. Amyloid-PET detected amyloid deposition in the frontal areas, in the parietal lobes and the precunei. The genetic screening revealed the presence of the rare R377W mutation in the PSEN1 gene. CONCLUSIONS Extensive genetic screening is also advisable for late-onset presentations of Alzheimer's disease, especially in the presence of a positive family history or atypical clinical features.
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Affiliation(s)
- M Scarioni
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy.,Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - A Arighi
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - C Fenoglio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - F Sorrentino
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - M Serpente
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - E Rotondo
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - M Mercurio
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - G Marotta
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy
| | - A A Dijkstra
- Department of Pathology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Y A L Pijnenburg
- Department of Neurology, Alzheimer Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - E Scarpini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
| | - D Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurodegenerative Diseases Unit, Milan, Italy.,Dino Ferrari Center, University of Milan, Milan, Italy
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11
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Licito A, Marotta G, Battaglia M, Benincasa G, Mentone L, Grillo MR, De Lucia V, Leonardi G, Bignucolo A, Comello F, Di Francia R, De Lucia D. Assessment of pharmacogenomic SLCO1B1 assay for prediction of neuromuscular pain in type 2 diabetes mellitus and cardiovascular patients: preliminary results. Eur Rev Med Pharmacol Sci 2020; 24:469-477. [PMID: 31957862 DOI: 10.26355/eurrev_202001_19948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE At present, several strategies for preventing neuromuscular pain in Type 2 Diabetes Mellitus (T2DM) have been investigated. Recently, findings on genetic variants associated with adverse events to statin-based therapy have been reported. The study aimed at measuring whether Pharmacogenomics (PGx) profile can affect neuromuscular pain in patients carrying T2DM and cardiovascular diseases. An extensive panel of 5 polymorphisms on 4 candidate genes, previously validated as significant markers related to Sulphonylureas and Glitinides (SU-G) plus Simvastatin neuromuscular toxicity, is herein analyzed and discussed. PATIENTS AND METHODS We genotyped 76 T2DM patients carrying cardiovascular dyscrasia undergone anti-diabetic and anti-cholesterolemic polypharmacy. 35 subjects out of the total received concurrent SU-G and Statin-based therapy. Candidate variants consisted of drug transporters, such as Solute Carrier Organic 1B1 (SLCO1B1) Val174Ala ATP-binding cassette subfamily B member (ABCB1), subfamily C member 8 (ABCC8), and drug biotransformers of Cytochrome P450 Family (CYP) including CYP2C9*2 CYP2C9*3 CYP2C8*3, and CYP3A4*22. Moreover, we also focused on an early outline evaluation of the genotyping costs and benefits. RESULTS 6 out of 35 patients treated with SU-G plus statins (17.1% experienced adverse neuropathy events). Pharmacogenomics analysis showed a lack of any correlation between candidate gene polymorphisms and toxicity, except for the SLCO1B1 T521C allele; 14.3% of patients had a high risk for grade >2 neuromuscular pain (Odds Ratio [OR] 2.61.95% CI 0.90-7.61, p=0.03). CONCLUSIONS The clinical polymorphism effectiveness outlined therein will be assured by diagnostic improvements suitable for driving treatment decisions. In light of our experimental results and literature data, the analysis of the SLCO1B1 T521C variant will allow clinicians to take advantage from a better treatment planned for their patients in order to minimize neuromuscular pain and maximize benefits.
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Affiliation(s)
- A Licito
- Institute for Study and the Cure of Diabetes (ISCD), "Abetaia", Casagiove (CE), Italy.
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12
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Di Martino S, Di Iorio C, Marotta G. MiR-340-5p is a potential prognostic indicator of colorectal cancer and modulates ANXA3. It is a cost-effective genetic test. Eur Rev Med Pharmacol Sci 2018; 22:5769-5770. [PMID: 30280753 DOI: 10.26355/eurrev_201809_15900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S Di Martino
- Pathology Unit, Cav. Apicella Hospital, Pollena Trocchia (ASL NA 3 SUD), Naples, Italy.
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13
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Benti R, Bruno A, Glacomelli M, Gasparini M, Marotta G, Castellani M, Longari V, Sdraiati C, Di Maio D, Bissl A, Gerundini P. Internal Mammary Chain Lymphoscintigraphy (Iml) and Iml-Guided Internal Mammary Chain Biopsy (Gimb) in Breast Cancer. Tumori 2018; 83:533-6. [PMID: 9226012 DOI: 10.1177/030089169708300208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- R Benti
- IRCCS Ospedale Maggiore, Policlinico, Milan, Italy
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14
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Motolese E, Rubegni P, Poggiali S, Motolese P, Marotta G, Russo L, D'ascenzo G, Carcagnì M, Fruschelli M, Motolese I, Fimiani M. Ocular Manifestations of Chronic Graft-Versus-Host Disease in Patients Treated with Extracorporeal Photochemotherapy. Eur J Ophthalmol 2018; 17:961-9. [DOI: 10.1177/112067210701700615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose Eye involvement has long been appreciated in patients with chronic graft versus host disease (cGVHD). In particular, ocular complications are frequent and can be potentially severe in patients with steroid-refractory cGVHD, and therefore necessitate close monitoring. This prospective study was designed to describe eye manifestations of cGVHD in a large series of patients monitoring them before and after 1 year of extracorporeal photochemotherapy (ECP). ECP is a relatively new therapeutic approach based on the biological effects of psoralen 8-methoxypsoralen (8-MOP) and ultraviolet A light (UVA) on mononuclear cells collected by apheresis, and reinfused into the patient. Methods Only patients with steroid-refractory cGVHD under treatment with ECP, who developed cGVHD-related eye symptoms, were selected for the study. Ophthalmologic examination was repeated every 3 months. Only patients with complete recovery of the ocular manifestations and symptoms were considered responsive. Results In our study we observed eye alterations in 24 out of 140 patients (17%) with cGVHD. After 12 months of ECP, 10 out of 21 patients (48%) completely responded to the therapy. In all these cases the contribution of ECP was also essential in all the other organs subject to cGVHD. Conclusions Further studies are necessary to clarify the role of ECP in patients with cGVHD, especially in associated eye manifestations. Although our experience is limited, it suggests that ECP could be a safe and effective therapy for steroid-refractory eye manifestations of cGVHD.
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Affiliation(s)
- E. Motolese
- Department of Ophthalmology and Neurosurgery
| | - P. Rubegni
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | - S. Poggiali
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | | | - G. Marotta
- Department of Clinical Medicine and Immunological Sciences, Section of Hematology, University of Siena - Italy
| | - L. Russo
- Department of Ophthalmology and Neurosurgery
| | - G. D'ascenzo
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | - M.R. Carcagnì
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | | | - I. Motolese
- Department of Ophthalmology and Neurosurgery
| | - M. Fimiani
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
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15
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Palmisano C, Brandt G, Pozzi N, Brumberg J, Leporini A, Marotta G, Cavallari P, Frigo C, Pezzoli G, Isaias I. A selective role of striatal dopamine in the timing of anticipatory postural adjustments at gait initiation in patients with Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.264] [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: 11/30/2022]
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Altamura AC, Delvecchio G, Marotta G, Oldani L, Pigoni A, Ciappolino V, Caletti E, Rovera C, Dobrea C, Arici C, Benatti B, Camuri G, Prunas C, Paoli RA, Dell'osso B, Cinnante C, Triulzi FM, Brambilla P. Structural and metabolic differentiation between bipolar disorder with psychosis and substance-induced psychosis: An integrated MRI/PET study. Eur Psychiatry 2016; 41:85-94. [PMID: 28049086 DOI: 10.1016/j.eurpsy.2016.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Received: 05/23/2016] [Revised: 09/20/2016] [Accepted: 09/24/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET). METHODS Twenty-seven BD type I psychotic patients with (n=10) or without (n=17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired. RESULTS Gray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients. CONCLUSIONS These findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis.
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Affiliation(s)
- A C Altamura
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Delvecchio
- Scientific Institute IRCCS "E. Medea", San Vito al Tagliamento (PN), Italy
| | - G Marotta
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Oldani
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Pigoni
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - V Ciappolino
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - E Caletti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Rovera
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Dobrea
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Arici
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Benatti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Camuri
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Prunas
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - R A Paoli
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Dell'osso
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry, Bipolar Disorders Clinic, Stanford University, CA, USA
| | - C Cinnante
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F M Triulzi
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
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Vandenberghe R, Riviere ME, Caputo A, Sovago J, Maguire RP, Farlow M, Marotta G, Sanchez-Valle R, Scheltens P, Ryan JM, Graf A. Active Aβ immunotherapy CAD106 in Alzheimer's disease: A phase 2b study. Alzheimers Dement (N Y) 2016; 3:10-22. [PMID: 29067316 PMCID: PMC5651373 DOI: 10.1016/j.trci.2016.12.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction This randomized, double-blind, placebo-controlled, 90-week study assessed safety, tolerability, and immunogenicity of CAD106 with/without adjuvant in patients with mild Alzheimer's disease. Methods One hundred twenty-one patients received up to seven intramuscular injections of CAD106 (150 μg or 450 μg) or placebo ± adjuvant over 60 weeks. An amyloid positron emission tomography (PET) substudy was also conducted. Results CAD106 induced strong serological responses (amyloid-beta [Aβ]–Immunoglobuline G[IgG]) in 55.1% (150 μg) and 81.1% (450 μg) of patients (strong serological responders [SSRs]). Serious adverse events (SAEs) were reported in 24.5% (95% confidence interval [CI] 16.7–33.8) of the patients in the active treatment group and in 6.7% (95% CI 0.2–31.9) in the placebo group. Three of the SAEs were classified as possibly related to study drug by the investigators. No evidence of central nervous system inflammation was found. Amyloid-related imaging abnormalities (ARIAs) occurred in six cases, all of them were strong serological responders. None of the ARIAs were symptomatic. Serum Aβ-IgG titer area under the curves correlated negatively with amyloid PET standardized uptake value ratio percentage change from baseline to week 78 within the CAD106-treated patients (r = −0.84, P = .0004). Decrease in cortical gray-matter volume from baseline to week 78 was larger in SSRs than in controls (P = .0077). Discussion Repeated CAD106 administration was generally well tolerated. CAD106 450 μg with alum adjuvant demonstrated the best balance between antibody response and tolerability.
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Affiliation(s)
- Rik Vandenberghe
- Department of Neurosciences, KU Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Belgium
| | | | | | - Judit Sovago
- Neuroscience Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - R Paul Maguire
- Biomarker Development, Clinical Imaging, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, IN, USA
| | - Giovanni Marotta
- Division of Geriatric Medicine, University of Toronto, Toronto, Canada
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clinic, Barcelona, Spain
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - J Michael Ryan
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Ana Graf
- Neuroscience, Novartis Pharma AG, Basel, Switzerland
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Di Francia R, Rinaldi L, Cillo M, Varriale E, Facchini G, D'Aniello C, Marotta G, Berretta M. Antioxidant diet and genotyping as tools for the prevention of liver disease. Eur Rev Med Pharmacol Sci 2016; 20:5155-5163. [PMID: 28051253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
It is well-known that 75% of risk factors of chronic liver disease (CLD) are related to nutrition. These circumstances potentially progress towards liver steatosis, fibrosis and hepatocellular carcinoma (HCC). It still represents an enormous problem for the economy of public health worldwide. Furthermore, validated prevention programs could be the solution. Recent knowledge in understanding molecular determinants of energy liver metabolism and new genetic markers offers new insights into the pathogenesis of CLD and HCC. The main rationale of the present issue is to provide a summary of recent insights into the inherited variants regulating lipid metabolism (steatohepatitis) and acquired mutation for early diagnosis of HCC, specifically focusing on the significance of antioxidant agents and genotyping tests as a cost-effectiveness tool for the prevention of liver disease. Several national healthy programs worldwide promote the daily use of antioxidant nutrients either for the prevention and/or as complementary and alternative medicines (CAM). This review could be advising for the planning of a large-scale clinical trial including a combination strategy of antioxidant agents and genotyping tests in patients with high risk of CLD.
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Affiliation(s)
- R Di Francia
- Department of Hematology, National Cancer Institute, Fondazione "G. Pascale" IRCCS, Naples, Italy.
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Rubegni P, Sbano P, Cevenini G, Perari M, Marotta G, Risulo M, Carcagnì M, D'Ascenzo G, De Aloe G, Fimiani M. CD4+CD25+ Lymphocyte Subsets in Chronic Graft versus Host Disease Patients Undergoing Extracorporeal Photochemotherapy. Int J Immunopathol Pharmacol 2016; 20:801-7. [DOI: 10.1177/039463200702000416] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Extracorporeal photochemotherapy (ECP) has been used successfully for the treatment of chronic Graft versus Host Disease (cGvHD). However, the mechanism by which ECP exerts its protective effects remains elusive. Some recent observations have suggested a possible role of certain subsets of T lymphocytes with immunosuppressive properties (T-regulatory cells) that coexpress CD4 and high levels of the interleukin-2 receptor chain: CD4+CD25+ T lymphocytes. We studied whether ECP affects the percentage of these cells in the peripheral blood of patients with cGvHD. The study population consisted of 14 patients with cGvHD refractory to systemic steroids. On enrolment in each cycle of ECP, patients underwent clinical examination, blood chemistry analysis and other instrumental procedures to document and assess involvement of the various organs and systems. For cytofluorimetric identification and phenotyping of CD4+CD25+ T lymphocytes, peripheral blood samples were collected in EDTA anticoagulant before ECP, after 48 hours, and after 6 and 12 months from the start of treatment. The 14 patients in this study received a total of more than 300 cycles of ECP, with only minor side effects. The clinical outcome was negative in 2 patients and positive in 12 patients. Within-subject analysis indicated that the percentage of CD4+CD25+ T lymphocytes before ECP and after 12 months of treatment was significantly increased. Our study confirms that changes in the percentage of CD4+CD25+ T cells induced by ECP could be a central aspect in the cascade of immune events leading to the immunological and clinical effects of this treatment in patients with cGvHD.
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Affiliation(s)
| | | | - G. Cevenini
- Department of Surgery and Bioengineering, University of Siena, Italy
| | - M.G. Perari
- Section of Respiratory Diseases, University of Siena, Italy
| | - G. Marotta
- Division of Hematology and Hematopoietic Stem Cell Transplantation, University of Siena, Italy
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Cameli M, Righini FM, Sparla S, Tacchini D, Dokollari A, Sassi CG, Di Tommaso C, Curci V, Censini S, Incampo E, Cassano F, Droandi G, Bernazzali S, Focardi M, Ietta F, Sartiani L, Romagnoli R, Marotta G, Mugelli A, Paulesu L, Sani G, Tanganelli P, Maccherini M, Mondillo S. First Evidence of Cardiac Stem Cells From the Left Ventricular Apical Tip in Patients With Left Ventricular Assist Device Implantation. Transplant Proc 2016; 48:395-8. [PMID: 27109964 DOI: 10.1016/j.transproceed.2015.12.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/30/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent studies have challenged the dogma that the adult heart is a postmitotic organ and raise the possibility of the existence of resident cardiac stem cells (CSCs). Our study aimed to explore if these CSCs are present in the "ventricular tip" obtained during left ventricular assist device (LVAD) implantation from patients with end-stage heart failure (HF) and the relationship with LV dysfunctional area extent. METHODS Four consecutive patients with ischemic cardiomyopathy and end-stage HF submitted to LVAD implantation were studied. The explanted "ventricular tip" was used as a sample of apical myocardial tissue for the pathological examination. Patients underwent clinical and echocardiographic examination, both standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE), before LVAD implantation. RESULTS All patients presented severe apical dysfunction, with apical akinesis/diskinesis and very low levels of apical longitudinal strain (-3.5 ± 2.9%). Despite this, the presence of CSCs was demonstrated in pathological myocardial samples of "ventricular tip" in all 4 of the patients. It was found to be a mean of 6 c-kit cells in 10 fields magnification 40×. CONCLUSIONS Cardiac stem cells can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis.
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Affiliation(s)
- M Cameli
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
| | - F M Righini
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - S Sparla
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - D Tacchini
- Department of Pathological Anatomy, University of Siena, Siena, Italy
| | - A Dokollari
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - C G Sassi
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - C Di Tommaso
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - V Curci
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - S Censini
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - E Incampo
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - F Cassano
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - G Droandi
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - S Bernazzali
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - M Focardi
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - F Ietta
- Department of Life Sciences, University of Siena, Siena, Italy
| | - L Sartiani
- Department of NeuroFarBa, Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Florence, Florence, Italy
| | - R Romagnoli
- Department of Life Sciences, University of Siena, Siena, Italy
| | - G Marotta
- Department of Hematology, University of Siena, Siena, Italy
| | - A Mugelli
- Department of NeuroFarBa, Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Florence, Florence, Italy
| | - L Paulesu
- Department of Life Sciences, University of Siena, Siena, Italy
| | - G Sani
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - P Tanganelli
- Department of Pathological Anatomy, University of Siena, Siena, Italy
| | - M Maccherini
- Department of Cardiac Surgery, University of Siena, Siena, Italy
| | - S Mondillo
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
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Graf A, Riviere M, Caputo A, Farlow MR, Marotta G, Sanchez‐Valle R, Scheltens P, Ryan JM, Vandenberghe RR. O4‐11‐04: ACTIVE Aβ IMMUNOTHERAPY CAD106 PHASE II DOSE‐ADJUVANT FINDING STUDY: SAFETY AND CNS BIOMARKERS. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.04.448] [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: 10/24/2022]
Affiliation(s)
- Ana Graf
- Novartis Pharma AGBaselSwitzerland
| | | | | | | | | | | | | | - J. Michael Ryan
- Novartis Pharmaceuticals CorporationEast HanoverNew JerseyUnited States
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Black SE, Lanctôt KL, Zotovic L, Oh P, Masellis M, Greenberg BD, Borrie M, Cohen S, Fischer C, Garcia A, Goldlist B, Ingram KJ, Kumar S, Marotta G, Patterson C, Pollock B, Thorpe KE, Verhoeff P. P4‐180: DESIGN OF THE SARTAN‐AD TRIAL. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.1697] [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: 11/25/2022]
Affiliation(s)
- Sandra E. Black
- L.C. Campbell Cognitive Neurology Research UnitSunnybrook Research Institute, Sunnybrook Health Sciences Center, University of TorontoTorontoOntarioCanada
| | - Krista L. Lanctôt
- L.C. Campbell Cognitive Neurology Research UnitSunnybrook Research Institute, Sunnybrook Health Sciences Center, University of TorontoTorontoOntarioCanada
| | - Ljubica Zotovic
- L.C. Campbell Cognitive Neurology Research UnitSunnybrook Research Institute, Sunnybrook Health Sciences Center, University of TorontoTorontoOntarioCanada
| | - Paul Oh
- Toronto Rehabilitation Institute, University Health Network, University of TorontoTorontoOntarioCanada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Research UnitSunnybrook Research Institute, Sunnybrook Health Sciences Center, University of TorontoTorontoOntarioCanada
| | - Barry D. Greenberg
- Toronto Western Research Institute, University Health Network, University of TorontoTorontoOntarioCanada
| | - Michael Borrie
- Lawson Health Research Institute, Western UniversityLondonOntarioCanada
| | | | - Corinne Fischer
- St. Michael's Hospital, University of TorontoTorontoOntarioCanada
| | - Angeles Garcia
- Providence Care ‐ St. Mary's of the Lake Hospital, Queen's UniversityKingstonOntarioCanada
| | - Barry Goldlist
- Mt. Sinai Hospital, University of TorontoTorontoOntarioCanada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental HealthUniversity of TorontoTorontoOntarioCanada
| | | | | | - Bruce Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of TorontoTorontoOntarioCanada
| | - Kevin E. Thorpe
- Dalla Lana School of Public Health, University of TorontoTorontoOntarioCanada
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Gentile M, Panico S, Mattiello A, de Michele M, Iannuzzi A, Jossa F, Marotta G, Rubba P. Plasma creatinine levels, estimated glomerular filtration rate and carotid intima media thickness in middle-aged women: a population based cohort study. Nutr Metab Cardiovasc Dis 2014; 24:677-680. [PMID: 24472637 DOI: 10.1016/j.numecd.2013.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 10/21/2013] [Revised: 11/22/2013] [Accepted: 11/30/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIM The relationships between high Creatinine (Cr) levels or low estimated Glomerular Filtration Rate (eGFR) and common carotid Intima Media thickness (IMT) have been evaluated in a population-based cohort study in women, aged 30-69 (Progetto ATENA). METHODS AND RESULTS Serum Cr and eGFR were measured in 310 women, as a part of 5.062. In this group carotid ultrasound examination (B-Mode imaging) was performed and mean max IMT was calculated. Women were classified by Cr levels >1 mg/dL or eGFR < 56 ml/min. Women with Cr > 1 mg/dL (90th percentile of creatinine distribution) or eGFR less than 56 ml/min (5th percentile of eGFR distribution) had relatively more carotid plaques as compared to the rest of the cohort. Multivariate logistic analysis, after adjustment for age, demonstrated a significant association between Cr (>1 mg/dL) and IMT (≥1.2 mm): OR 4.12 (C.I 1.22-13.86), p = 0.022; or eGFR (<56 ml/min) and IMT (≥1.2 mm): OR 4.31 (C.I 1.27-14.66), p = 0.019. CONCLUSIONS These findings on an independent relationship between Cr and common carotid plaques in this population of middle aged women, independently of age, suggest the value of screening for early carotid disease in asymptomatic middle aged-women with mild renal insufficiency, in order to predict those at relatively higher risk for future cardiovascular events.
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Affiliation(s)
- M Gentile
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy.
| | - S Panico
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy
| | - A Mattiello
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy
| | - M de Michele
- Division of Cardiology, Moscati Hospital, Aversa, Italy
| | | | - F Jossa
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy
| | - G Marotta
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy
| | - P Rubba
- Department of Clinical Medicine and Surgery, University "Federico II" Medical School - Naples, Via Pansini 5, 80131 Naples, Italy
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Rubegni P, Feci L, Poggiali S, Marotta G, D'Ascenzo G, Murdaca F, Fimiani M. Extracorporeal photopheresis: a useful therapy for patients with steroid-refractory acute graft-versus-host disease but not for the prevention of the chronic form. Br J Dermatol 2014; 169:450-7. [PMID: 23534380 DOI: 10.1111/bjd.12332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Extracorporeal photopheresis (ECP) has been used successfully to treat severe steroid-refractory acute and chronic graft-versus-host disease (aGVHD, cGVHD) since the late 1990s. OBJECTIVES To evaluate retrospectively the efficacy and safety of ECP in patients with aGVHD. We also assessed whether ECP may play a role in the prevention of cGVHD. PATIENTS AND METHODS Nine consecutive patients with allografts with aGVHD grade II-III, as defined by consensus criteria, and refractory to steroids, were treated with ECP. ECP was started at a median interval of 46·3 days (range 10-70) from aGVHD onset. Patients were treated initially on two consecutive days (one cycle) at 1-week intervals until improvement and then every 2 weeks. Treatment was then tapered off individually. To evaluate statistical relationships with outcome after 30, 60 and 90 days of ECP, all clinical and historical variables of the patients before treatment were analysed. RESULTS All patients survived and responded within 90 days. The average aGVHD score was 1·72 at aGVHD onset, 2·44 when ECP was started and then gradually declined to 0·44 on day 90. At the same time, the average dose of methylprednisolone declined from 2·22 mg kg(-1) to 0·27 mg kg(-1) (day 90), while the average dose of ciclosporin declined from 2·46 mg kg(-1) to 0·77 mg kg(-1) (day 90). Six of nine patients showed a complete skin response after 90 days of treatment. All patients with liver and gastrointestinal tract involvement had complete responses after 90 days, apart from one patient. All our patients developed cGVHD, seven of nine while still on maintenance regimen (6-13 months after haematopoietic stem cell transplantation, HSCT) and the other two patients after suspension of ECP (6 and 9 months after HSCT). CONCLUSIONS ECP is effective in patients with mild to moderate steroid-refractory aGVHD (grade II-III). On the other hand, ECP did not prevent the development of cGVHD in our patients.
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Affiliation(s)
- P Rubegni
- Section of Dermatology, University of Siena, Siena, Italy
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Marotta G. A new project for studying the language of the blind: Linguistic and neurocognitive evidence. Int J Psychophysiol 2012. [DOI: 10.1016/j.ijpsycho.2012.06.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Sicurelli F, Carluccio MA, Toraldo F, Tozzi M, Bucalossi A, Lenoci M, Jacomelli G, Micheli V, Cardaioli E, Mondelli M, Federico A, Marotta G, Dotti MT. Clinical and biochemical improvement following HSCT in a patient with MNGIE: 1-year follow-up. J Neurol 2012; 259:1985-7. [PMID: 22532170 DOI: 10.1007/s00415-012-6500-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 03/27/2012] [Indexed: 11/30/2022]
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Longari V, Calabrese L, Zito F, Lambertini R, Leo R, Rognoni M, Marotta G, Gerundini P. 59 poster: Effect of Respiration Motion on SUV Assessement. Radiother Oncol 2010. [DOI: 10.1016/s0167-8140(15)34478-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lemoli RM, D'Addio A, Marotta G, Pezzullo L, Zuffa E, Montanari M, De Vivo A, Bonini A, Galieni P, Carella AM, Guidi S, Michieli M, Olivieri A, Bosi A. BU/melphalan and auto-SCT in AML patients in first CR: a ‘Gruppo Italiano Trapianto di Midollo Osseo (GITMO)’ retrospective study. Bone Marrow Transplant 2009; 45:640-6. [DOI: 10.1038/bmt.2009.235] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wilkinson D, Cohen S, Inglis F, Marotta G, Davis C, Kooy J, Nasreddine Z, Lam S, Decosterd G, Grosgurin P, Porchet H, Tamches E. O1‐04‐05: Results of a double‐blind phase 2b study of monthly mimopezil implants compared to oral donepezil in patients with moderate Alzheimer's disease (BRAINZ study). Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.05.218] [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: 10/20/2022]
Affiliation(s)
- David Wilkinson
- Memory Assessment & Research Centre Southampton UniversitySouthamptonUnited Kingdom
| | | | | | | | - Chris Davis
- The Prince Charles HospitalBrisbaneAustralia
| | - Jack Kooy
- The Medical Arts Health Research GroupPentictonBCCanada
| | | | - Sy Lam
- Calgary West Medical CenterCalgaryABCanada
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Gentile M, Rubba P, Pauciullo P, Iannuzzo G, Ubaldi S, Marotta G, Jossa F, Mattiello A, Panico S. Abstract: P1253 APO B, SMALL-DENSE LDL AND CAROTID ATHEROSCLEROSIS IN MENOPAUSAL WOMEN. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Gentile M, Mattiello A, Pauciullo P, Jossa F, Marotta G, Santucci de Magistris M, Del Pezzo M, Iannuzzo G, Rubba F, Rubba P, Panico S. EFFECTS OF WEIGHT MODIFICATION ON HS-CRP IN A COHORT OF MEDITERRANEAN WOMEN: FINDINGS FROM PROGETTO ATENA. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Rivellese A, DeNatale C, Minerva V, Patti L, Mazzarella R, Ciano O, Maione S, Marotta G, Turco S, Ciati R, Melegari C, Riccardi G. BAKED PRODUCTS ENRICHED WITH N-3 FATTY ACIDS, FOLATES, BETA-GLUCANS AND TOCOFEROLS: METABOLIC EFFECTS IN PATIENTS WITH MILD MIXED HYPERLIPIDEMIA. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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33
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Cilia R, Marotta G, Landi A, Isaias IU, Vergani F, Benti R, Sganzerla E, Gerundini P, Pezzoli G, Antonini A. Cerebral activity modulation by extradural motor cortex stimulation in Parkinson's disease: a perfusion SPECT study. Eur J Neurol 2007; 15:22-8. [PMID: 18042244 DOI: 10.1111/j.1468-1331.2007.01993.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Extradural motor cortex stimulation (EMCS) has been proposed as alternative to deep brain stimulation (DBS) in the treatment of Parkinson's disease (PD). Its mechanisms of action are still unclear. Neuroimaging evidenced motor cortical dysfunction in PD that can be reversed by therapy. We performed left hemisphere EMCS surgery in six advanced PD patients fulfilling CAPSIT criteria for DBS with the exception of age >70 years. After 6 months, we measured regional cerebral blood flow (rCBF) at rest with SPECT and Tc-99m cysteinate dimer bicisate off-medication with stimulator off and on. Clinical assessment included Unified Parkinson's Disease Rating Scale part II and III, Abnormal Involuntary Movement Scale and mean dopaminergic medication dosage. We used statistical parametric mapping for imaging data analysis. Clinically we observed no mean changes in motor scales, although blinded evaluation revealed some benefit in individual patients. We found significant rCBF decrements in the pre-central gyrus, pre-motor cortex and caudate nucleus bilaterally, left prefrontal areas and right thalamus. Perfusion increments were found in cerebellum bilaterally. EMCS determined significant modulation of neuronal activity within the cortico-basal ganglia-thalamo-cortical motor loop in our cohort of advanced PD patients. However, these effects were paralleled by mild and variable clinical efficacy.
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Affiliation(s)
- R Cilia
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy, and Department of Neurology, University of Milan-Biocca, San Gerardo Hospital, Monza, Italy.
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34
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Cilia R, Righini A, Marotta G, Benti R, Marconi R, Isaias IU, Pezzoli G, Antonini A. Clinical and imaging characterization of a patient with idiopathic progressive ataxia and palatal tremor. Eur J Neurol 2007; 14:944-6. [PMID: 17662021 DOI: 10.1111/j.1468-1331.2007.01796.x] [Citation(s) in RCA: 11] [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: 11/28/2022]
Abstract
We describe clinical and imaging features of a patient with sporadic progressive ataxia and palatal tremor (PAPT) of unknown etiology. There was hypertrophy of bilateral inferior olivary nuclei with hyperintense T2-weighted signal and mild cerebellar atrophy at brain magnetic resonance imaging. 18F-fluoro-2-desoxy-d-glucose positron emission tomography scanning (FDG-PET) showed hypometabolism in the red nucleus, external globus pallidus and precuneus while FP-CIT-SPECT imaging revealed mild and progressive loss of striatal dopaminergic terminals. Our findings suggest that in idiopathic PAPT involvement of the dentato-rubro-olivary pathway occurs along with some dopaminergic dysfunction.
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Affiliation(s)
- R Cilia
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
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35
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Gentile M, Panico S, Jossa F, Mattiello A, Marotta G, Pauciullo P, Rubba P. YI-795 SMALL DENSE LDL PARTICLES AND METABOLIC SYNDROME IN A SAMPLE OF MIDDLE-AGED WOMEN FROM SOUTHERN ITALY. FINDINGS FROM PROGETTO ATENA. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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36
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Pauciullo P, Gentile M, Marotta G, Jossa F, Ubaldi S, Baiano A, Rubba P. PO3-74 LDL SCORE IS A MARKER OF FAMILIAL COMBINED HYPERLIPIDEMIA, INDEPENDENTLY OF PLASMA TRIGLYCERIDE. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71084-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Canesi M, Benti R, Marotta G, Cilia R, Isaias IU, Gerundini P, Pezzoli G, Antonini A. Striatal dopamine transporter binding in patients with Parkinson's disease and severe occupational hydrocarbon exposure. Eur J Neurol 2007; 14:297-9. [PMID: 17355550 DOI: 10.1111/j.1468-1331.2006.01642.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We used 123I-Ioflupane SPECT to study striatal dopamine transporter (DAT) binding in 36 Parkinson's disease (PD) patients with history of severe occupational exposure to hydrocarbons. Data were compared with 38 PD patients without exposure history as well as healthy controls. Both PD cohorts showed significant striatal uptake decrements compared with controls. We found significantly lower values in the whole striatum of exposed compared with non-exposed patients (0.83 +/- 0.25 vs. 1.05 +/- 0.39; P = 0.004), more pronounced in the putamen (0.61 +/- 0.24 vs. 0.85 +/- 0.42; P = 0.004). We conclude that severe occupational exposure to hydrocarbons may modify disease course and ultimately accelerate nigro-striatal denervation.
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Affiliation(s)
- M Canesi
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.
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38
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Cilia R, Marotta G, Benti R, Pezzoli G, Antonini A. Brain SPECT imaging in multiple system atrophy. J Neural Transm (Vienna) 2006; 112:1635-45. [PMID: 16284908 DOI: 10.1007/s00702-005-0382-5] [Citation(s) in RCA: 41] [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] [Subscribe] [Scholar Register] [Received: 03/02/2005] [Accepted: 09/13/2005] [Indexed: 12/30/2022]
Abstract
Clinical diagnosis of multiple system atrophy (MSA) relays on signs and symptoms that are often difficult to identify particularly at early stage. Indeed neuropathological studies have demonstrated that MSA is the first cause of misdiagnosis in a cohort of patients presenting with parkinsonian features. Dopamine transporter imaging (DAT) shows striatal decrements in both MSA and Parkinson's disease (PD) making it not sensitive for differential diagnosis. Studies of dopamine D2 receptors with IBZM may help revealing striatal degeneration but a large overlap exist particularly if PD patients with advanced disease are included. We have measured brain flow with technetium-99m ethyl cysteinate dimer (ECD-SPECT) in 36 MSA patients and compared it with 43 PD and 39 age-matched controls. Using Statistical Parametric Mapping (SPM99) we found areas of significant reduced perfusion in the striatum, brain stem and cerebellum in MSA compared to the other groups. We believe that ECD-SPECT imaging may offer significant advantages compared to other imaging techniques in the assessment of neuronal degeneration in MSA and may help the clinician in the diagnostic characterization of patients presenting with atypical parkinsonism.
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Affiliation(s)
- R Cilia
- Parkinson Institute, Instituti Clinici di Perfezionamento, Milan, Italy
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39
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Pauciullo P, Gentile M, Marotta G, Ubaldi S, Jossa F, Iannuzzo G, Faccenda F, Baiano A, Mormile C, Rubba P. Tu-P7:211 More inflammation in familial hypercholesterolemia than in familial combined hyperlipidemia. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80915-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Gentile M, Pauciullo P, Ubaldi S, Marotta G, Jossa F, Iannuzzo G, Faccenda F, Rubba P. Tu-P10:445 Inflammatory markers in familial combined hyperlipidemia. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Minciullo PL, Saija A, Patafi M, Marotta G, Ferlazzo B, Gangemi S. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine 2006; 13:115-8. [PMID: 16360941 DOI: 10.1016/j.phymed.2004.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Accepted: 09/14/2004] [Indexed: 05/05/2023]
Abstract
Extracts of black cohosh (Cimicifuga racemosa) are commonly used for the treatment of symptoms associated with menopause. Adverse events with black cohosh are rare, mild and reversible. A few number of serious adverse events, including hepatic and circulatory conditions, have been also reported, but without a clear causality relationship. We report the case of a woman with severe asthenia and very high blood levels of creatine phosphokinase and lactate dehydrogenase. The patient referred to take a dietary supplement derived from black cohosh for ameliorating menopause vasomotor symptoms. To exclude a possible involvement of this product, the patient was suggested to discontinue this therapy. After suspicion the patient showed a progressive normalization of biochemical parameters and improvement of clinical symptoms. We can hypothesise a causative role for black cohosh in the muscle damage observed in this patient. Factors suggesting an association between black cohosh and the observed myopathy included the temporal relationship between use of herbal product and asthenia and the absence of other identified causative factors. Rechallenge with the suspected agent was inadvisable for ethic reasons because of the risk of a serious relapse. This is the first time that asthenia associated with high muscle enzymes serum levels by black cohosh has been reported. In our opinion, this report is of interest because of the widespread diffusion of use of black cohosh as an alternative medicine for relief from menopausal symptoms.
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Affiliation(s)
- P L Minciullo
- Department of Human Pathology, Division and School of Allergy and Clinical Immunology, University of Messina, Italy.
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42
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Rubegni P, Cuccia A, Sbano P, Cevenini G, Carcagnì MR, D'Ascenzo G, De Aloe G, Guidi S, Guglielmelli P, Guglielmetti P, Marotta G, Lauria F, Bosi A, Fimiani M. Role of extracorporeal photochemotherapy in patients with refractory chronic graft-versus-host disease. Br J Haematol 2005; 130:271-5. [PMID: 16029456 DOI: 10.1111/j.1365-2141.2005.05586.x] [Citation(s) in RCA: 50] [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: 12/01/2022]
Abstract
Recent studies suggest that extracorporeal photochemotherapy (ECP) may be beneficial in patients with steroid-refractory chronic graft-versus-host disease (cGvHD). However, it is not yet clear whether certain conditions, such as age, mode of onset of cGvHD etc., influence clinical response and whether certain affected organs are more sensitive to ECP than others. We analysed the main clinical and laboratory parameters related to evolution of the disease in 32 steroid-refractory cGvHD patients, to identify any useful response predictors to ECP. ECP affected the course of the disease positively in 78% (25/32) of our cases.
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Affiliation(s)
- P Rubegni
- Department of Clinical Medicine and Immunological Science, Sections of Dermatology, University of Siena, Siena, Italy.
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Gentile M, Rubba F, Mattiello A, Jossa F, Marotta G, Santucci de Magistris M, Del Pezzo M, Celentano E, Galasso R, Rubba P, Panico S. W08-P-007 Central adiposity and HS-CRP in acohort of mediterranean women: Findings from progetto atena. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ferlazzo B, Ferlazzo E, Isola S, Marotta G, Saitta S, Ricciardi L. Fibrotic involution of sural muscles secondary to lupus panniculitis. Clin Exp Rheumatol 2005; 23:276. [PMID: 15895908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Abstract
Vardenafil is a potent selective and reversible inhibitor of the cGMP phosphodiesterase type 5 that has been shown to improve erectile function in men. Vardenafil is usually well tolerated; the most common adverse events are headache, flushing, rhinitis, sinusitis and dyspepsia. We report a case of a 48-year-old man with an acute episode of widespread urticaria following vardenafil consumption and in absence of other identifiable causative factors. The patient had no previous episodes of urticaria. This appears to be the first report of urticaria associated with vardenafil.
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Affiliation(s)
- P L Minciullo
- Department of Human Pathology, Division and School of Allergy and Clinical Immunology, University of Messina, Italy
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46
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Affiliation(s)
- A Fabbri
- Division of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
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47
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De Cicco C, Trifirò G, Intra M, Marotta G, Ciprian A, Frasson A, Prisco G, Luini A, Viale G, Paganelli G. Optimised nuclear medicine method for tumour marking and sentinel node detection in occult primary breast lesions. Eur J Nucl Med Mol Imaging 2003; 31:349-54. [PMID: 14647985 DOI: 10.1007/s00259-003-1390-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2003] [Accepted: 10/10/2003] [Indexed: 10/26/2022]
Abstract
The aim of this study was to evaluate the feasibility of sentinel node (SN) biopsy in occult breast lesions with different radiopharmaceuticals and to establish the optimal lymphoscintigraphic method to detect both occult lesions and SNs (SNOLL: sentinel node and occult lesion localisation). Two hundred and twenty-seven consecutive patients suspected to have clinically occult breast carcinoma were enrolled in the study. In addition to the radioguided occult lesion localisation (ROLL) procedure, using macroaggregates of technetium-99m labelled human serum albumin (MAA) injected directly into the lesion, lymphoscintigraphy was performed with nanocolloids (NC) injected in a peritumoral (group I) or a subdermal site (group II). In group III, a sole injection of NC was done into the lesion in order to perform both ROLL and SNOLL. Overall, axillary SNs were identified in 205 of the 227 patients (90.3%). In 12/62 (19.4%) patients of group I and 9/79 (11.4%) patients of group III, radioactive nodes were not visualised, whereas SNs were successfully localised in 85 of 86 patients of group II ( P<0.001). Pathological findings revealed breast carcinoma in 148/227 patients (65.2%) and benign lesions in 79 (34.8%). A total of 131 axillary SNs were removed in 118 patients with breast carcinoma; intraoperative examination of the SNs revealed metastatic involvement in 16 out of 96 cases of invasive carcinoma (16.7%). It is concluded that the combination of the ROLL procedure with direct injection of MAA into the lesion and lymphoscintigraphy performed with subdermal injection of radiocolloids represents the method of choice for accurate localisation of both non-palpable lesions and SNs.
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Affiliation(s)
- C De Cicco
- Division of Nuclear Medicine, European Institute of Oncology and University of Milan, Milan, Italy.
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Antonini A, Marotta G, Benti R, Landi A, De Notaris R, Mariani C, Gerundini P, Pezzoli G, Gaini SM. Brain flow changes before and after deep brain stimulation of the subthalamic nucleus in Parkinson’s disease. Neurol Sci 2003; 24:151-2. [PMID: 14598061 DOI: 10.1007/s10072-003-0104-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) markedly improves motor symptoms and reduces medication needs in Parkinson's disease (PD) patients. However, its effect on brain function has remained unclear. We used SPECT and the tracer ECD to measure regional cerebral blood flow before and 6 months after DBS of the STN in 22 PD patients and 13 healthy controls. PD patients were divided into good and poor responders to DBS, if changes in "off" UPDRS motor scores after surgery were >60% or <40%, respectively. Statistical analysis was performed using the SPM99 software. At baseline, all PD patients showed significant perfusion reductions in cortical areas (premotor frontal, parietal, and occipital). After DBS, changes were normalized only in the good responders, while cortical defects in the poor responders were unchanged. No flow decrements were detected in basal ganglia and thalamus in both groups, suggesting that DBS does not have a "lesion-like" effect. We conclude that good surgery outcome is associated with normalization of cortical flow abnormalities in PD.
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Affiliation(s)
- A Antonini
- Centro per la malattia di Parkinson, Dipartimento di Neuroscienze, Istituti Clinici di Perfezionamento, Via Bignami 1, Milan, Italy
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Antonini A, Landi A, Benti R, Mariani C, De Notaris R, Marotta G, Pezzoli G, Gaini SM, Gerundini P. Functional neuroimaging (PET and SPECT) in the selection and assessment of patients with Parkinson's disease undergoing deep brain stimulation. J Neurosurg Sci 2003; 47:40-6. [PMID: 12900731] [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: 03/04/2023]
Abstract
Deep brain Stimulation (DBS) is an effective treatment for patients with advanced Parkinson's disease (PD) and motor complications who can no longer be improved by adjustment of medical therapy. Selection of surgery candidates and follow-up after surgery are critical for good outcome. Functional neuroimaging can help in the clinical assessment of these patients. We have used single photon emission computed tomography (SPECT) and the tracer ECD to measure regional cerebral blood flow before and 6 months after DBS of the subthalamic nucleus (STN) in 20 patients with advanced PD. We found a significant increase in the anterior cingulate/supplementary motor cortex in the 12 good responders (change in off unified UPDRS >50%). Conversely, patients with poor response (n=8; change in off UPDRS-III <50% following DBS) revealed a significant worsening of cortical hypoperfusion particularly in the prefrontal areas. No flow decrements were detected in the basal ganglia and in the thalamus in both groups during DBS stimulation suggesting that DBS does not have a "lesion like" effect. If DBS stimulates and does not inactivate STN projection neurons, flow reduction in the poor responders may be secondary to increased inhibitory basal ganglia output.
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Affiliation(s)
- A Antonini
- Department of Neurosciences, Parkinson's Disease, Centre Istituti Clinici di Perfezionamento, Milan, Italy
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