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Palomba G, Basile R, Capuano M, Pesce M, Rurgo S, Sarnelli G, De Palma GD, Aprea G. Nasogastric tube after laparoscopic Heller-Dor surgery: Do you really need it? Curr Probl Surg 2024; 61:101457. [PMID: 38548426 DOI: 10.1016/j.cpsurg.2024.101457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/04/2024] [Accepted: 02/07/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Giuseppe Palomba
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Raffaele Basile
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marianna Capuano
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Domenico De Palma
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Aprea
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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de Bortoli N, Visaggi P, Penagini R, Annibale B, Baiano Svizzero F, Barbara G, Bartolo O, Battaglia E, Di Sabatino A, De Angelis P, Docimo L, Frazzoni M, Furnari M, Iori A, Iovino P, Lenti MV, Marabotto E, Marasco G, Mauro A, Oliva S, Pellegatta G, Pesce M, Privitera AC, Puxeddu I, Racca F, Ribolsi M, Ridolo E, Russo S, Sarnelli G, Tolone S, Zentilin P, Zingone F, Barberio B, Ghisa M, Savarino EV. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis-Current Treatment and Monitoring. Dig Liver Dis 2024:S1590-8658(24)00301-3. [PMID: 38521670 DOI: 10.1016/j.dld.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/11/2024] [Accepted: 02/28/2024] [Indexed: 03/25/2024]
Abstract
The present document constitutes Part 2 of the EoETALY Consensus Statements guideline on the diagnosis and management of eosinophilic esophagitis (EoE) developed by experts in the field of EoE across Italy (i.e., EoETALY Consensus Group). Part 1 was published as a different document, and included three chapters discussing 1) definition, epidemiology, and pathogenesis; 2) clinical presentation and natural history and 3) diagnosis of EoE. The present work provides guidelines on the management of EoE in two final chapters: 4) treatment and 5) monitoring and follow-up, and also includes considerations on knowledge gaps and a proposed research agenda for the coming years. The guideline was developed through a Delphi process, with grading of the strength and quality of the evidence of the recommendations performed according to accepted GRADE criteria.This document has received the endorsement of three Italian national societies including the Italian Society of Gastroenterology (SIGE), the Italian Society of Neurogastroenterology and Motility (SINGEM), and the Italian Society of Allergology, Asthma, and Clinical Immunology (SIAAIC). The guidelines also involved the contribution of members of ESEO Italia, the Italian Association of Families Against EoE.
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Affiliation(s)
- Nicola de Bortoli
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pierfrancesco Visaggi
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Roberto Penagini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bruno Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, 00189, Rome, Italy
| | - Federica Baiano Svizzero
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Barbara
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | | | - Edda Battaglia
- Gastroenterology Unit ASLTO4, Chivasso - Ciriè - Ivrea, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, 27100, Pavia, Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, 27100, Pavia, Italy
| | - Paola De Angelis
- Digestive Endoscopy Unit - Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marzio Frazzoni
- Digestive Pathophysiology Unit and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Ospedale Civile di Baggiovara, Modena, Italy
| | - Manuele Furnari
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa,Genoa,Italy, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit, 'Santa Chiara' Hospital, Trento, Italy
| | - Paola Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84084, Baronissi, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, 27100, Pavia, Italy
| | - Elisa Marabotto
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa,Genoa,Italy, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Marasco
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Aurelio Mauro
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Salvatore Oliva
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy
| | - Gaia Pellegatta
- Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Marcella Pesce
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | | | - Ilaria Puxeddu
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Mentore Ribolsi
- Unit of Gastroenterology and Digestive Endoscopy, Campus Bio Medico University, Rome, Italy
| | - Erminia Ridolo
- Allergy Unit, Department of Internal Medicine, University Hospital of Parma, Parma, Italy
| | - Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliera Universitaria of Modena, Modena, Italy
| | - Giovanni Sarnelli
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | - Salvatore Tolone
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Campania "Luigi Vanvitelli", 80131, Naples, Italy
| | - Patrizia Zentilin
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Fabiana Zingone
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Brigida Barberio
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Matteo Ghisa
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Edoardo Vincenzo Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
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Sarnelli G, Del Re A, Palenca I, Franzin SB, Lu J, Seguella L, Zilli A, Pesce M, Rurgo S, Esposito G, Sanseverino W, Esposito G. Intranasal administration of Escherichia coli Nissle expressing the spike protein of SARS-CoV-2 induces long-term immunization and prevents spike protein-mediated lung injury in mice. Biomed Pharmacother 2024; 174:116441. [PMID: 38518597 DOI: 10.1016/j.biopha.2024.116441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024] Open
Abstract
While current anti-Spike protein (SP) vaccines have been pivotal in managing the pandemic, their limitations in delivery, storage, and the inability to provide mucosal immunization (preventing infections) highlight the ongoing necessity for research and innovation. To tackle these constraints, our research group developed a bacterial-based vaccine using a non-pathogenic E. coli Nissle 1917 (EcN) strain genetically modified to express the SARS-CoV-2 spike protein on its surface (EcN-pAIDA1-SP). We intranasally delivered the EcN-pAIDA1-SP in two doses and checked specific IgG/IgA production as well as the key immune mediators involved in the process. Moreover, following the initial and booster vaccine doses, we exposed both immunized and non-immunized mice to intranasal delivery of SARS-CoV-2 SP to assess the effectiveness of EcN-pAIDA1-SP in protecting lung tissue from the inflammation damage. We observed detectable levels of anti-SARS-CoV-2 spike IgG in serum samples and IgA in bronchoalveolar lavage fluid two weeks after the initial treatment, with peak concentrations in the respective samples on the 35th day. Moreover, immunoglobulins displayed a progressively enhanced avidity index, suggesting a selective binding to the spike protein. Finally, the pre-immunized group displayed a decrease in proinflammatory markers (TLR4, NLRP3, ILs) following SP challenge, compared to the non-immunized groups, along with better preservation of tissue morphology. Our probiotic-based technology provides an effective immunobiotic tool to protect individuals against disease and control infection spread.
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Affiliation(s)
- Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples 80138, Italy; Nextbiomics S.R.L. (Società a Responsabilità Limitata), Naples 80100, Italy.
| | - Alessandro Del Re
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
| | - Irene Palenca
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
| | - Silvia Basili Franzin
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
| | - Jie Lu
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), Naples 80100, Italy; Department of Anatomy and Cell Biology, China Medical University, Shenyang 110122, China.
| | - Luisa Seguella
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
| | - Aurora Zilli
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples 80138, Italy
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples 80138, Italy.
| | - Giovanni Esposito
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), Naples 80100, Italy; Department of Molecular Medicine and Medical Biotechnologies, Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, Naples 80131, Italy.
| | - Walter Sanseverino
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), Naples 80100, Italy.
| | - Giuseppe Esposito
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), Naples 80100, Italy; Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome 00185, Italy.
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de Bortoli N, Visaggi P, Penagini R, Annibale B, Baiano Svizzero F, Barbara G, Bartolo O, Battaglia E, Di Sabatino A, De Angelis P, Docimo L, Frazzoni M, Furnari M, Iori A, Iovino P, Lenti MV, Marabotto E, Marasco G, Mauro A, Oliva S, Pellegatta G, Pesce M, Privitera AC, Puxeddu I, Racca F, Ribolsi M, Ridolo E, Russo S, Sarnelli G, Tolone S, Zentilin P, Zingone F, Barberio B, Ghisa M, Savarino EV. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis - Definition, Clinical Presentation and Diagnosis. Dig Liver Dis 2024:S1590-8658(24)00265-2. [PMID: 38423918 DOI: 10.1016/j.dld.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/26/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Eosinophilic esophagitis (EoE) is a chronic type 2-mediated inflammatory disease of the esophagus that represents the most common eosinophilic gastrointestinal disease. Experts in the field of EoE across Italy (i.e., EoETALY Consensus Group) including gastroenterologists, endoscopists, allergologists/immunologists, and paediatricians conducted a Delphi process to develop updated consensus statements for the management of patients with EoE and update the previous position paper of the Italian Society of Gastroenterology (SIGE) in light of recent evidence. Grading of the strength and quality of the evidence of the recommendations was performed using accepted GRADE criteria. The guideline is divided in two documents: Part 1 includes three chapters, namely 1) definition, epidemiology, and pathogenesis; 2) clinical presentation and natural history, and 3) diagnosis, while Part 2 includes two chapters: 4) treatment and 5) monitoring and follow-up. This document has received the endorsement of three Italian national societies including the SIGE, the Italian Society of Neurogastroenterology and Motility (SINGEM), and the Italian Society of Allergology, Asthma, and Clinical Immunology (SIAAIC). With regards to patients' involvement, these guidelines involved the contribution of members of ESEO Italia, the Italian Association of Families Against EoE.
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Affiliation(s)
- Nicola de Bortoli
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pierfrancesco Visaggi
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Roberto Penagini
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bruno Annibale
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy
| | - Federica Baiano Svizzero
- Gastroenterology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Barbara
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Edda Battaglia
- Gastroenterology Unit ASLTO4, Chivasso - Ciriè - Ivrea, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia 27100, Italy; First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy
| | - Paola De Angelis
- Digestive Endoscopy Unit - Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Marzio Frazzoni
- Digestive Pathophysiology Unit and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Ospedale Civile di Baggiovara, Modena, Italy
| | - Manuele Furnari
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit,' Santa Chiara' Hospital, Trento, Italy
| | - Paola Iovino
- Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84084, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia 27100, Italy
| | - Elisa Marabotto
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni Marasco
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Aurelio Mauro
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | - Salvatore Oliva
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Italy
| | - Gaia Pellegatta
- Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
| | - Marcella Pesce
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | | | - Ilaria Puxeddu
- Immunoallergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Mentore Ribolsi
- Unit of Gastroenterology and Digestive Endoscopy, Campus Bio Medico University, Rome, Italy
| | - Erminia Ridolo
- Allergy Unit, Department of Internal Medicine, University Hospital of Parma, Parma, Italy
| | - Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliera Universitaria of Modena, Modena, Italy
| | - Giovanni Sarnelli
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | - Salvatore Tolone
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Campania "Luigi Vanvitelli", Naples 80131, Italy
| | - Patrizia Zentilin
- Division of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Fabiana Zingone
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua 35128, Italy
| | - Brigida Barberio
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua 35128, Italy
| | - Matteo Ghisa
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua 35128, Italy
| | - Edoardo Vincenzo Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, Padua 35128, Italy.
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Palomba G, Capuano M, Pegoraro F, Basile R, Pesce M, Rurgo S, Effice E, Sarnelli G, De Palma GD, Aprea G. Laparoscopic Heller-Dor myotomy in elderly achalasia patients: a single center experience with PSM analysis. MINIM INVASIV THER 2024; 33:13-20. [PMID: 37747454 DOI: 10.1080/13645706.2023.2261032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Achalasia is a rare esophageal motility disorder of unknown etiology. With the ageing of the general population, treatment in elderly patients has become increasingly common; however, the gold standard treatment in this population remains unclear. The aim of this study was to evaluate the outcomes of laparoscopic Heller-Dor myotomy (LHM) in geriatric patients. MATERIAL AND METHODS In this study, consecutive achalasia patients undergoing LHM at the University Hospital 'Federico II' of Naples from November 2018 to November 2022 were prospectively enrolled. Patients were divided into two groups based on their age at intervention: elderly (≥70 years) and younger (<70 years). The two study groups were compared by minimizing the different distribution of covariates through a propensity score matching analysis (PSM). RESULTS In both populations, there was a significant improvement in terms of manometric parameters and symptoms after surgery. After applying one-on-one PSM, we obtained a total population of 48 achalasia patients divided into two groups (24 patients each). No significant differences were found in terms of demographic characteristics as well as preoperative and intraoperative variables between two groups. At 12 months from surgery, integrated relaxation pressure (IRP) was significantly lower in patients ≥ 70 years (p = 0.032), while younger patients scored significantly less at the post-operative Eckardt score (p = 0.047). CONCLUSIONS Laparoscopic Heller-Dor myotomy is a safe and effective treatment even in elderly patients with rapid post-operative recovery, improvement of symptoms and manometric parameters.
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Affiliation(s)
- Giuseppe Palomba
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marianna Capuano
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Francesca Pegoraro
- Division of Hepato-Biliary-Pancreatic, Minimally Invasive and Robotic Surgery and Kidney Transplantation, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Raffaele Basile
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Eleonora Effice
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Domenico De Palma
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giovanni Aprea
- Division of Endoscopic Surgery, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Palenca I, Seguella L, Zilli A, Basili Franzin S, Del Re A, Pepi F, Troiani A, Pesce M, Rurgo S, De Palma FDE, Luglio G, Tropeano FP, Sarnelli G, Esposito G. Intrarectal Administration of Adelmidrol plus Hyaluronic Acid Gel Ameliorates Experimental Colitis in Mice and Inhibits Pro-Inflammatory Response in Ex Vivo Cultured Biopsies Derived from Ulcerative Colitis-Affected Patients. Int J Mol Sci 2023; 25:165. [PMID: 38203336 PMCID: PMC10778920 DOI: 10.3390/ijms25010165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Improving clinical outcomes and delaying disease recrudescence in Ulcerative Colitis (UC) patients is crucial for clinicians. In addition to traditional and new pharmacological therapies that utilize biological drugs, the development of medical devices that can ameliorate UC and facilitate the remission phase should not be overlooked. Drug-based therapy requires time to be personalized and to evaluate the benefit/risk ratio. However, the increasing number of diagnosed UC cases worldwide necessitates the exploration of new strategies to enhance clinical outcomes. By incorporating medical devices alongside pharmacological treatments, clinicians can provide additional support to UC patients, potentially improving their condition and slowing down the recurrence of symptoms. Chemically identified as an azelaic acid derivative and palmitoylethanolamide (PEA) analog, adelmidrol is a potent anti-inflammatory and antioxidant compound. In this study, we aimed to evaluate the effect of an intrarectal administration of 2% adelmidrol (Ade) and 0.1% hyaluronic acid (HA) gel formulation in both the acute and resolution phase of a mouse model of colitis induced via DNBS enema. We also investigated its activity in cultured human colon biopsies isolated from UC patients in the remission phase at follow-up when exposed in vitro to a cytomix challenge. Simultaneously, with its capacity to effectively alleviate chronic painful inflammatory cystitis when administered intravesically to urological patients such as Vessilen, the intrarectal administration of Ade/HA gel has shown remarkable potential in improving the course of colitis. This treatment approach has demonstrated a reduction in the histological damage score and an increase in the expression of ZO-1 and occludin tight junctions in both in vivo studies and human specimens. By acting independently on endogenous PEA levels and without any noticeable systemic absorption, the effectiveness of Ade/HA gel is reliant on a local antioxidant mechanism that functions as a "barrier effect" in the inflamed gut. Building on the findings of this preliminary study, we are confident that the Ade/HA gel medical device holds promise as a valuable adjunct in supporting traditional anti-UC therapies.
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Affiliation(s)
- Irene Palenca
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Luisa Seguella
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Aurora Zilli
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Silvia Basili Franzin
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Alessandro Del Re
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
| | - Federico Pepi
- Department of Chemistry and Drug Technologies, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy; (F.P.); (A.T.)
| | - Anna Troiani
- Department of Chemistry and Drug Technologies, Sapienza University of Rome, P.le Aldo Moro 5, 00185 Rome, Italy; (F.P.); (A.T.)
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Fatima Domenica Elisa De Palma
- Department of Molecular Medicine and Medical Biotechnologies, Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, 80131 Naples, Italy;
| | - Gaetano Luglio
- Endoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, Italy; (G.L.); (F.P.T.)
| | - Francesca Paola Tropeano
- Endoscopic Surgery Unit, Department of Medical and Surgical Gastrointestinal Disease, Federico II University of Naples, 80131 Naples, Italy; (G.L.); (F.P.T.)
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (I.P.); (A.Z.); (S.B.F.); (A.D.R.); (G.E.)
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Carmel M, Cohen DL, Hijazi B, Azzam N, Khoury T, Pagliaro M, Pesce M, Mari A. Chicago Classification Version 4.0 Improves Stratification of Ineffective Esophageal Motility Patients into Clinically Meaningful Subtypes: A Two-Center International Study. Dysphagia 2023:10.1007/s00455-023-10628-4. [PMID: 37934251 DOI: 10.1007/s00455-023-10628-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
The 4th iteration of the Chicago Classification (CC v4.0) for esophageal motility disorders offers more restrictive criteria for the diagnosis of Ineffective Esophageal Motility (IEM) compared to version 3.0 (CC v3.0). In light of the updated criteria for IEM, we aimed to characterize and compare the patients who retained their IEM diagnosis to those who were reclassified as normal motility, and to evaluate the clinical impact of the newly introduced CC v4.0. We performed a retrospective case-control study. We included all individuals who underwent a high-resolution manometry (HRM) between 2020 and 2021 at two centers. Consecutive studies reported as IEM according to the CC v3.0 were reanalyzed according to the CC v4.0. We compared demographics, clinical, manometry, and pH-monitoring parameters. Out of 452 manometry studies, 154 (34%) met criteria for IEM as per the CC v3.0 (CC v3.0 IEM group). Of those, 39 (25%) studies were reclassified as normal studies according to the CC v4.0 (CC v4.0 normal group), while the remaining 115 studies (25% of the overall cohort) retained an IEM diagnosis (CC v4.0 IEM group). The CC v4.0 normal group had more recovered contractions during solid swallows (p = 0.01), less ineffective swallows (p = 0.04), and lower acid exposure time (p = 0.02) compared to the CC4.0 IEM group. Under CC v4.0 criteria, fewer patients are diagnosed with IEM. Those diagnosed with IEM had worse esophageal function and higher acid burden. Though further studies are needed to confirm these findings, our results indicate that CC v4.0 criteria restrict the IEM diagnosis to a more clinically meaningful population.
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Affiliation(s)
- Moshe Carmel
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel.
- Gastroenterology Department, Nazareth EMMS Hospital, Nazareth, Israel.
| | - Daniel L Cohen
- The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Basem Hijazi
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
| | - Narges Azzam
- Gastroenterology Department, Nazareth EMMS Hospital, Nazareth, Israel
| | - Tawfik Khoury
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
- Gastroenterology Department, Nazareth EMMS Hospital, Nazareth, Israel
| | - Marta Pagliaro
- Department of Clinical Medicine and Surgery, University of Naples "Federico II" Naples, 80131, Naples, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples "Federico II" Naples, 80131, Naples, Italy
| | - Amir Mari
- Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
- Gastroenterology Department, Nazareth EMMS Hospital, Nazareth, Israel
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8
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Pesce M, Pagliaro M, Sarnelli G, Sweis R. Modern Achalasia: Diagnosis, Classification, and Treatment. J Neurogastroenterol Motil 2023; 29:419-427. [PMID: 37814432 PMCID: PMC10577462 DOI: 10.5056/jnm23125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 10/11/2023] Open
Abstract
Achalasia is a major esophageal motor disorder featured by the altered relaxation of the esophagogastric junction in the absence of effective peristaltic activity. As a consequence of the esophageal outflow obstruction, achalasia patients present with clinical symptoms of dysphagia, chest pain, weight loss, and regurgitation of indigested food. Other less specific symptoms can also present including heartburn, chronic cough, and aspiration pneumonia. The delay in diagnosis, particularly when the presenting symptoms mimic those of gastroesophageal reflux disease, may be as long as several years. The widespread use of high-resolution manometry has permitted earlier detection and uncovered achalasia phenotypes which can have prognostic and therapeutic implications. Other tools have also emerged to help define achalasia severity and which can be used as objective measures of response to therapy including the timed barium esophagogram and the functional lumen imaging probe. Such diagnostic innovations, along with the increased awareness by clinicians and patients due to the availability of alternative therapeutic approaches (laparoscopic and robotic Heller myotomy, and peroral endoscopic myotomy) have radically changed the natural history of the disorder. Herein, we report the most recent advances in the diagnosis, classification, and management of esophageal achalasia and underline the still-grey areas that needs to be addressed by future research to reach the goal of personalizing treatment.
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Affiliation(s)
- Marcella Pesce
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | - Marta Pagliaro
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | - Giovanni Sarnelli
- Department of clinical medicine and surgery, University of Naples Federico II, Naples, Italy
| | - Rami Sweis
- GI Physiology Unit, University College London Hospital, London, UK
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9
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Mongelli A, Panunzi S, Nesta M, Gottardi Zamperla M, Atlante S, Barbi V, Mongiardini V, Ferraro F, De Martino S, Cis L, Re A, Maltese S, Bachetti T, La Rovere MT, Martelli F, Pesce M, Nanni S, Massetti M, Pontecorvi A, Farsetti A, Gaetano C. Distinguishable DNA methylation defines a cardiac-specific epigenetic clock. Clin Epigenetics 2023; 15:53. [PMID: 36991505 PMCID: PMC10053964 DOI: 10.1186/s13148-023-01467-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/18/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The present study investigates whether epigenetic differences emerge in the heart of patients undergoing cardiac surgery for an aortic valvular replacement (AVR) or coronary artery bypass graft (CABG). An algorithm is also established to determine how the pathophysiological condition might influence the human biological cardiac age. RESULTS Blood samples and cardiac auricles were collected from patients who underwent cardiac procedures: 94 AVR and 289 CABG. The CpGs from three independent blood-derived biological clocks were selected to design a new blood- and the first cardiac-specific clocks. Specifically, 31 CpGs from six age-related genes, ELOVL2, EDARADD, ITGA2B, ASPA, PDE4C, and FHL2, were used to construct the tissue-tailored clocks. The best-fitting variables were combined to define new cardiac- and blood-tailored clocks validated through neural network analysis and elastic regression. In addition, telomere length (TL) was measured by qPCR. These new methods revealed a similarity between chronological and biological age in the blood and heart; the average TL was significantly higher in the heart than in the blood. In addition, the cardiac clock discriminated well between AVR and CABG and was sensitive to cardiovascular risk factors such as obesity and smoking. Moreover, the cardiac-specific clock identified an AVR patient's subgroup whose accelerated bioage correlated with the altered ventricular parameters, including left ventricular diastolic and systolic volume. CONCLUSION This study reports on applying a method to evaluate the cardiac biological age revealing epigenetic features that separate subgroups of AVR and CABG.
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Affiliation(s)
- A Mongelli
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
- Center for Translational and Experimental Cardiology (CTEC), University of Zurich, 8952, Schlieren, Switzerland
| | - S Panunzi
- National Research Council (CNR)-IASI, 00185, Rome, Italy
| | - M Nesta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - M Gottardi Zamperla
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - S Atlante
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - V Barbi
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - V Mongiardini
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
- Molecular Medicine, Istituto Italiano di Tecnologia, Genoa, Italy
| | - F Ferraro
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - S De Martino
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - L Cis
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Re
- National Research Council (CNR)-IASI, 00185, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - S Maltese
- National Research Council (CNR)-IRIB, 90146, Palermo, Italy
| | - T Bachetti
- Direzione Scientifica Centrale ICS Maugeri IRCCS, Pavia, Italy
| | - M T La Rovere
- Dipartimento di Cardiologia ICS Maugeri and Direzione Scientifica ICS Maugeri Montescano IRCCS, Pavia, Italy
| | - F Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - M Pesce
- Unità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino IRCCS, 20138, Milan, Italy
| | - S Nanni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - M Massetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Pontecorvi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Farsetti
- National Research Council (CNR)-IASI, 00185, Rome, Italy.
| | - C Gaetano
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy.
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10
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Sarnelli G, Del Re A, Pesce M, Lu J, Esposito G, Sanseverino W, Corpetti C, Basili Franzin S, Seguella L, Palenca I, Rurgo S, De Palma FDE, Zilli A, Esposito G. Oral Immunization with Escherichia coli Nissle 1917 Expressing SARS-CoV-2 Spike Protein Induces Mucosal and Systemic Antibody Responses in Mice. Biomolecules 2023; 13:biom13030569. [PMID: 36979504 PMCID: PMC10046078 DOI: 10.3390/biom13030569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
As of October 2022, the COVID-19 pandemic continues to pose a major public health conundrum, with increased rates of symptomatic infections in vaccinated individuals. An ideal vaccine candidate for the prevention of outbreaks should be rapidly scalable, easy to administer, and able to elicit a potent mucosal immunity. Towards this aim, we proposed an engineered Escherichia coli (E. coli) Nissle 1917 (EcN) strain with SARS-CoV-2 spike protein (SP)-coding plasmid, which was able to expose SP on its cellular surface by a hybridization with the adhesin involved in diffuse adherence 1 (AIDA1). In this study, we presented the effectiveness of a 16-week intragastrically administered, engineered EcN in producing specific systemic and mucosal immunoglobulins against SARS-CoV-2 SP in mice. We observed a time-dependent increase in anti-SARS-CoV-2 SP IgG antibodies in the sera at week 4, with a titre that more than doubled by week 12 and a stable circulating titre by week 16 (+309% and +325% vs. control; both p < 0.001). A parallel rise in mucosal IgA antibody titre in stools, measured via intestinal and bronchoalveolar lavage fluids of the treated mice, reached a plateau by week 12 and until the end of the immunization protocol (+300, +47, and +150%, at week 16; all p < 0.001 vs. controls). If confirmed in animal models of infection, our data indicated that the engineered EcN may be a potential candidate as an oral vaccine against COVID-19. It is safe, inexpensive, and, most importantly, able to stimulate the production of both systemic and mucosal anti-SARS-CoV-2 spike-protein antibodies.
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Affiliation(s)
- Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, 80138 Naples, Italy
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), 80100 Naples, Italy
| | - Alessandro Del Re
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, 80138 Naples, Italy
| | - Jie Lu
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), 80100 Naples, Italy
- Department of Anatomy and Cell Biology, China Medical University, Shenyang 110122, China
| | - Giovanni Esposito
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), 80100 Naples, Italy
- Department of Molecular Medicine and Medical Biotechnologies, Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, 80131 Naples, Italy
| | - Walter Sanseverino
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), 80100 Naples, Italy
| | - Chiara Corpetti
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Basili Franzin
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Irene Palenca
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, 80138 Naples, Italy
| | - Fatima Domenica Elisa De Palma
- Department of Molecular Medicine and Medical Biotechnologies, Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, 80131 Naples, Italy
| | - Aurora Zilli
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Esposito
- Nextbiomics S.R.L. (Società a Responsabilità Limitata), 80100 Naples, Italy
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, 00185 Rome, Italy
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11
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Vertaldi S, D’Amore A, Manigrasso M, Anoldo P, Chini A, Maione F, Pesce M, Sarnelli G, De Palma GD, Milone M. Robotic Surgery and Functional Esophageal Disorders: A Systematic Review and Meta-Analysis. J Pers Med 2023; 13:jpm13020231. [PMID: 36836465 PMCID: PMC9966072 DOI: 10.3390/jpm13020231] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/07/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
The functional disease of the esophago-gastric junction (EGJ) is one of the most common health problems. It often happens that patients suffering from GERD need surgical management. The laparoscopic fundoplication has been considered the gold standard surgical treatment for functional diseases of the EGJ. The aim of our meta-analysis is to investigate functional outcomes after robotic fundoplication compared with conventional laparoscopic fundoplication. A prospective search of online databases was performed by two independent reviewers using the search string "robotic and laparoscopic fundoplication", including all the articles from 1996 to December 2021. The risk of bias within each study was assessed with the Cochrane ROBINS-I and RoB 2.0 tools. Statistical analysis was performed using Review Manager version 5.4. In addition, sixteen studies were included in the final analysis, involving only four RCTs. The primary endpoints were functional outcomes after laparoscopic (LF) and robotic fundoplication (RF). No significant differences between the two groups were found in 30-day readmission rates (p = 0.73), persistence of symptomatology at follow-up (p = 0.60), recurrence (p = 0.36), and reoperation (p = 0.81). The laparoscopic fundoplication represents the gold standard treatment for the functional disease of the EGJ. According to our results, the robotic approach seems to be safe and feasible as well. Further randomized controlled studies are required to better evaluate the advantages of robotic fundoplication.
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Affiliation(s)
- Sara Vertaldi
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-340-86-03-360
| | - Anna D’Amore
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Michele Manigrasso
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Pietro Anoldo
- Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
| | - Alessia Chini
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Maione
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
| | | | - Marco Milone
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy
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12
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Milillo C, Falcone L, Di Carlo P, Aruffo E, Del Boccio P, Cufaro MC, Patruno A, Pesce M, Ballerini P. Ozone effect on the inflammatory and proteomic profile of human macrophages and airway epithelial cells. Respir Physiol Neurobiol 2023; 307:103979. [PMID: 36243292 DOI: 10.1016/j.resp.2022.103979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/15/2022]
Abstract
Ozone (O3) is one of the most harmful urban pollutants, but its biological mechanisms have not been fully elucidated yet. Human bronchial epithelial cells (HBEpC) and human macrophage cells (differentiated human monocytic cell line) were exposed to O3 at the concentration of 240 μg/m3 (120 ppb), corresponding to the European Union alert threshold. Cell viability, reactive oxygen species (ROS) production, and pro-inflammatory cytokines release (IL-8 and TNF-α) were evaluated. Results indicated that O3 exposure increases ROS production in both cell types and enhances cytokines release in macrophages. O3 stimulated IL-8 and TNF-α in HBEpC when the cells were pretreated with Lipopolysaccharide, used to mimic a pre-existing inflammatory condition. Proteomics analysis revealed that, in HBEpC, O3 caused the up-regulation of aldo-keto reductase family 1 member B10, a recognized critical protein in lung carcinogenesis. In conclusion, our results show that 120 ppb O3 can lead to potential damage to human health suggesting the need for a revision of the actual alert levels.
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Affiliation(s)
- C Milillo
- Department of Innovative Technologies in Medicine & Dentistry, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - L Falcone
- Department of Innovative Technologies in Medicine & Dentistry, University G. d'Annunzio, 66100 Chieti, Italy
| | - P Di Carlo
- Department of Innovative Technologies in Medicine & Dentistry, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - E Aruffo
- Department of Innovative Technologies in Medicine & Dentistry, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - P Del Boccio
- Department of Pharmacy, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - M C Cufaro
- Department of Pharmacy, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - A Patruno
- Department of Medicine and Aging Sciences, University G. d'Annunzio, 66100 Chieti, Italy
| | - M Pesce
- Department of Medicine and Aging Sciences, University G. d'Annunzio, 66100 Chieti, Italy.
| | - P Ballerini
- Department of Innovative Technologies in Medicine & Dentistry, University G. d'Annunzio, 66100 Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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13
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Sivero L, Maione F, Chini A, Volpe S, Maione R, Pesce M, Palomba G, Vitale R, Gennarelli N, Sivero S. Percutaneous endoscopic jejunostomy (PEJ) in patients with dumping syndrome: Evaluation of our center on a series of clinical cases. Clinical Nutrition Open Science 2022. [DOI: 10.1016/j.nutos.2022.08.005] [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: 02/07/2023] Open
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14
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Budani MC, Gallorini M, Elsallabi O, Pino V, La Fratta I, Pesce M, Ricciotti E, Tiboni GM, Patruno A. Cigarette smoke is associated with up-regulation of inducible NOS and COX-2 protein expression and activity in granulosa cells of women undergoing in vitro fertilization. Reprod Toxicol 2022; 113:128-135. [PMID: 36049621 DOI: 10.1016/j.reprotox.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/03/2022] [Accepted: 08/26/2022] [Indexed: 11/20/2022]
Abstract
Cigarette smoke exposure represents a well-established ovotoxic exogenous stress, but the molecular mechanisms underlying of this effect are still unclear. Cigarette smoke upregulates inflammatory genes in the female reproductive organs, therefore an abnormal inflammation response may contribute to the impairment of female fertility. In this study we investigated for the first time the effect of cigarette smoke exposure on NOS and COX expression and activity and on their transcription factors (CREB and NF-kB) in human GCs and on the release of NO and PGE2 in the FF in smoking and non-smoking patients undergoing IVF treatment. In addition, correlation analysis between AMH serum levels, an index of ovarian reserve, and smoking exposure or iNOS and COX-2 protein expression levels were performed using a Pearson correlation method. Cigarette smoke exposure resulted in a significant increase of iNOS and COX-2 protein expression together with an increase of iNOS activity and PGE2 levels. pNF-kB and pCREB protein expression were upregulated in the GCs of smokers compared to non-smokers. The habit of smoking was negatively correlated with serum AMH levels, and positively correlated with iNOS and COX-2 protein expression levels. The data presented in the current study revealed a novel molecular mechanism underlying the toxic effects of cigarette smoke on fertility. Additional pathways mediating the effects of cigarette smoke exposure in human GCs cannot be excluded and should be investigated in future studies.
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Affiliation(s)
- M C Budani
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - M Gallorini
- Department of Pharmacy, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - O Elsallabi
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy; Department of Biosciences and Nutrition, Karolinska Institutet, SE-141 57 Huddinge, Sweden
| | - V Pino
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - I La Fratta
- Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - M Pesce
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - E Ricciotti
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - G M Tiboni
- Department of Medical, Oral and Biotechnological Sciences, University 'G. d'Annunzio' of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - A Patruno
- Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy.
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15
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Polese B, Izzo L, Mancino N, Pesce M, Rurgo S, Tricarico MC, Lombardi S, De Conno B, Sarnelli G, Ritieni A. Effect of Dewaxed Coffee on Gastroesophageal Symptoms in Patients with GERD: A Randomized Pilot Study. Nutrients 2022; 14:nu14122510. [PMID: 35745239 PMCID: PMC9231412 DOI: 10.3390/nu14122510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Gastroesophageal Reflux Disease (GERD) is multifactorial pathogenesis characterized by the abnormal reflux of stomach contents into the esophagus. Symptoms are worse after the ingestion of certain foods, such as coffee. Hence, a randomized pilot study conducted on 40 Italian subjects was assessed to verify the effect of standard (SC) and dewaxed coffee (DC) consumption on gastroesophageal reflux symptoms and quality of life in patients with gastrointestinal diseases. The assessment of patient diaries highlighted a significant percentage reduction of symptoms frequency when consuming DC and a significant increase in both heartburn-free and regurgitation-free days. Consequentially, patients had a significant increase of antacid-free days during the DC assumption. Moreover, the polyphenolic profile of coffee pods was ascertained through UHPLC-Q-Orbitrap HRMS analysis. Chlorogenic acids (CGAs) were the most abundant investigated compounds with a concentration level ranging between 7.316 (DC) and 6.721 mg/g (SC). Apart from CGAs, caffeine was quantified at a concentration level of 5.691 mg/g and 11.091 for DC and SC, respectively. While still preliminary, data obtained from the present pilot study provide promising evidence for the efficacy of DC consumption in patients with GERD. Therefore, this treatment might represent a feasible way to make coffee more digestible and better tolerated.
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Affiliation(s)
- Barbara Polese
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Luana Izzo
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
- Correspondence: ; Tel.: +39-081-678116
| | - Nicola Mancino
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Marcella Pesce
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Sara Rurgo
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | | | - Sonia Lombardi
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
| | - Barbara De Conno
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
| | - Giovanni Sarnelli
- Digestive and Nutritional Pathophysiology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy; (B.P.); (N.M.); (M.P.); (S.R.); (B.D.C.); (G.S.)
- United Nations Educational, Scientific and Cultural Organization Chair on Health Education and Sustainable Development, University of Naples “Federico II”, 80131 Naples, Italy
| | - Alberto Ritieni
- Food Lab, Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy; (S.L.); (A.R.)
- United Nations Educational, Scientific and Cultural Organization Chair on Health Education and Sustainable Development, University of Naples “Federico II”, 80131 Naples, Italy
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Rurgo S, Vaino V, Andreozzi M, Pagliaro M, Senneca P, Di Giorgio G, Efficie E, Sarnelli G, Pesce M. Predictors of abdominal pain severity in patients with constipation-prevalent irritable bowel syndrome. J Basic Clin Physiol Pharmacol 2022; 33:665-671. [PMID: 35659327 DOI: 10.1515/jbcpp-2022-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Symptoms of irritable bowel syndrome (IBS) have been associated to altered colonic motility and sensation. Smoking affects pain perception and is a risk factor in the development of post-infectious IBS, but its effect on abdominal pain and colonic transit remains to be elucidated in IBS. METHODS Forty patients with IBS-C and 28 with IBS-M were selected based on Rome IV criteria. Colonic transit time was studied and smoking habit was recorded. Presence of mild or severe abdominal pain and the prevalent pain characteristics (diffuse or localized, chronic or acute, with cramps or gradually distending) were recorded. Data were analyzed by univariate and stepwise multiple logistic regression analysis to verify the risk association between pain and all other variables. RESULTS IBS-C patients had a longer transit time in the right colon and scored more chronic pain than IBS-M patients. When severity of abdominal pain was used as discriminating factor, a significant number of subjects reporting severe pain were males and smokers (16/30 vs. 4/38 and 20/30 vs. 4/38, both ƿ<0.001). Multivariate analysis confirmed that smoking was an independent factor associated with severe abdominal pain (OR 14.3, CI 2-99, p=0.007). Smoking was not associated with colonic transit times and colonic transit was not associated with IBS symptoms' severity (both ƿ=N.S.). CONCLUSIONS Smoking was the only factor independently associated with severe abdominal pain. As smoking does not seem to affect colonic transit time, we suggest that smoking may influence visceral perception and symptoms severity in IBS patients.
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Affiliation(s)
- Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Viviana Vaino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Marta Andreozzi
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Marta Pagliaro
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Piera Senneca
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Gianmarco Di Giorgio
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Eleonora Efficie
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy
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Del Re A, Palenca I, Seguella L, Pesce M, Corpetti C, Steardo L, Rurgo S, Sarnelli G, Esposito G. Oral Adelmidrol Administration Up-Regulates Palmitoylethanolamide Production in Mice Colon and Duodenum through a PPAR-γ Independent Action. Metabolites 2022; 12:metabo12050457. [PMID: 35629962 PMCID: PMC9144287 DOI: 10.3390/metabo12050457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Adelmidrol is a promising palmitoylethanolamide (PEA) analog which displayed up-and-coming anti-inflammatory properties in several inflammatory conditions. Recent studies demonstrated that Adelmidrol is an in vitro enhancer of PEA endogenous production, through the so called “entourage” effect. The present study investigated the ability of Adelmidrol (1 and 10 mg/Kg per os) to increase the endogenous level of PEA in the duodenum and colon of mice after 21-day oral administration in the presence and absence of PPAR-γ inhibitor (1 mg/kg). The level of PEA was analyzed by HPLC-MS. The expression of PEA-related enzymatic machinery was evaluated by western blot and RT-PCR analysis. Our findings demonstrated that Adelmidrol significantly increased PEA levels in the duodenum and colon in a dose/time-dependent manner. We also revealed that Adelmidrol up regulated the enzymatic machinery responsible for PEA metabolism and catabolism. Interestingly, the use of the selective irreversible PPAR-γ antagonist did not affect either PEA intestinal levels or expression/transcription of PEA metabolic enzymes following Adelmidrol administration. The “entourage effect” with Adelmidrol as an enhancer of PEA was thus PPAR-γ-independent. The findings suggest that Adelmidrol can maximize a PEA therapeutic-based approach in several intestinal morbidities.
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Affiliation(s)
- Alessandro Del Re
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Piazzale AldoMoro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (L.S.); (C.C.)
| | - Irene Palenca
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Piazzale AldoMoro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (L.S.); (C.C.)
| | - Luisa Seguella
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Piazzale AldoMoro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (L.S.); (C.C.)
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Chiara Corpetti
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Piazzale AldoMoro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (L.S.); (C.C.)
| | - Luca Steardo
- Department of Psychiatry, Giustino Fortunato University, 82100 Benevento, Italy;
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology V. Erspamer, Sapienza University of Rome, Piazzale AldoMoro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (L.S.); (C.C.)
- Correspondence: ; Tel.: +39-06-4991-2948
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18
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Pesce M, Seguella L, Del Re A, Lu J, Palenca I, Corpetti C, Rurgo S, Sanseverino W, Sarnelli G, Esposito G. Next-Generation Probiotics for Inflammatory Bowel Disease. Int J Mol Sci 2022; 23:ijms23105466. [PMID: 35628274 PMCID: PMC9141965 DOI: 10.3390/ijms23105466] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/22/2022] Open
Abstract
Engineered probiotics represent a cutting-edge therapy in intestinal inflammatory disease (IBD). Genetically modified bacteria have provided a new strategy to release therapeutically operative molecules in the intestine and have grown into promising new therapies for IBD. Current IBD treatments, such as corticosteroids and immunosuppressants, are associated with relevant side effects and a significant proportion of patients are dependent on these therapies, thus exposing them to the risk of relevant long-term side effects. Discovering new and effective therapeutic strategies is a worldwide goal in this research field and engineered probiotics could potentially provide a viable solution. This review aims at describing the proceeding of bacterial engineering and how genetically modified probiotics may represent a promising new biotechnological approach in IBD treatment.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | - Luisa Seguella
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (C.C.); (G.E.)
- Correspondence: ; Tel.: +39-06-4991-2948
| | - Alessandro Del Re
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (C.C.); (G.E.)
| | - Jie Lu
- Department of Anatomy and Cell Biology, China Medical University, Shenyang 110122, China;
| | - Irene Palenca
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (C.C.); (G.E.)
| | - Chiara Corpetti
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (C.C.); (G.E.)
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
| | | | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy; (M.P.); (S.R.); (G.S.)
- Nextbiomics S.r.l., 80100 Naples, Italy;
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy; (A.D.R.); (I.P.); (C.C.); (G.E.)
- Nextbiomics S.r.l., 80100 Naples, Italy;
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Salomè S, Mansi G, Lambiase CV, Barone M, Piro V, Pesce M, Sarnelli G, Raimondi F, Capasso L. Impact of psychological distress and psychophysical wellbeing on posttraumatic symptoms in parents of preterm infants after NICU discharge. Ital J Pediatr 2022; 48:13. [PMID: 35073953 PMCID: PMC8785440 DOI: 10.1186/s13052-022-01202-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/30/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Backgorund
Parents after Neonatal Intensive Care Unit (NICU) hospitalization of preterm infant may develop psychopathological symptoms.
The aim of the study was to determine how parental stress and psychophysical wellbeing affect posttraumatic symptoms (PTTS) in parents during the first year after NICU discharge. Moreover, this study aimed to explore any gender-specific difference in psychological distress among mothers and fathers.
Methods
Prospective study design from September 2018 to September 2019. 20 pairs of parents of preterm infants admitted to a tertiary-level NICU were enrolled. Primary outcome was evaluation of PTTS in parents of preterm infants at one year after NICU discharge through Impact of Event Scale- Revised. Secondary outcomes were: impact of parental stress, psychophysical wellbeing, anxiety and depression respectively through Parental Stressor Scale: NICU, Short Form Health Survey-36(SF-36), Self-rating Anxiety Scale and Self-rating Depression Scale.
Results
Mothers experienced higher rates of PTTS than fathers across the first year after NICU discharge (55% vs 20%). Maternal avoidance symptoms were associated with perception of their own infant look. Emotional aspects linked to maternal role predicted 36,8% of their hyperarousal symptoms. Maternal PTTS severity was predicted by their social functioning. Paternal mental health was associated both with maternal and paternal intrusive symptoms.. Maternal stress was associated with paternal avoidance symptoms. Paternal mental health predicted their hyperarousal symptoms (40%) and PTSD severity (52%).
Conclusions
Parents who experienced NICU hospitalization of their own infant are at heightened risk to develop psychopathological symptoms. According to our initial hypothesis, investigating parental psychophysical wellbeing, through SF-36, originally provides a valuable support to detect parents at higher risk to develop posttraumatic outcomes across the first year after NICU discharge. In addition, paternal depression deserves to be taken into account since hospitalization as it could impact paternal PTSD development. Finally, these findings provide an initial evidence of gender-related patterns in PTSD development and psychological distress among mothers and fathers across the first year of their infant.
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Pesce M, Puoti MG, Rybak A, Andreozzi M, Bruzzese E, Sarnelli G, Borrelli O. Pharmacological interventions for pediatric irritable bowel syndrome. Expert Opin Pharmacother 2021; 23:91-103. [PMID: 34523358 DOI: 10.1080/14656566.2021.1976753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Irritable bowel syndrome is a common functional gastrointestinal disorder in children, characterized by recurrent abdominal pain associated with altered bowel habits in terms of both frequency and consistency. According to change in stool consistency it is categorized into 4 subtypes. From the etiological perspective, it is a combination of factors takes part in symptoms' generation, the overall treatment response rate is often unsatisfactory if a multidisciplinary is not pursued. AREAS COVERED The aim of this manuscript is to summarize the current pharmacotherapy in pediatric irritable bowel syndrome in order to aid clinicians in treating this challenging disorder. EXPERT OPINION Most evidence involving pediatric populations rely on open label or retrospective studies and/or are not specifically designed for irritable bowel syndrome but tend to generalize their results to mixed populations of children with functional gastrointestinal disorders. A high placebo response rate combined with poor patients' selection could account for the overall weak evidence supporting the use of pharmacological agents in pediatric irritable bowel syndrome. Given the multifaceted nature of the disorder, multidisciplinary approaches combining pharmacotherapy with alternative treatments is highly recommendable.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, University "Federico Ii" of Naples, Naples, Italy
| | - Maria Giovanna Puoti
- Division of Neurogastroenterology & Motility, Department of Paediatric Gastroenterology, Great Ormond Street Hospital for children, London, UK
| | - Anna Rybak
- Division of Neurogastroenterology & Motility, Department of Paediatric Gastroenterology, Great Ormond Street Hospital for children, London, UK
| | - Marta Andreozzi
- Department of Clinical Medicine and Surgery, University "Federico Ii" of Naples, Naples, Italy
| | - Eugenia Bruzzese
- Department of Translational Medical Science, University "Federico Ii" of Naples, Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University "Federico Ii" of Naples, Naples, Italy
| | - Osvaldo Borrelli
- Division of Neurogastroenterology & Motility, Department of Paediatric Gastroenterology, Great Ormond Street Hospital for children, London, UK
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21
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Corpetti C, Del Re A, Seguella L, Palenca I, Rurgo S, De Conno B, Pesce M, Sarnelli G, Esposito G. Cannabidiol inhibits SARS-Cov-2 spike (S) protein-induced cytotoxicity and inflammation through a PPARγ-dependent TLR4/NLRP3/Caspase-1 signaling suppression in Caco-2 cell line. Phytother Res 2021; 35:6893-6903. [PMID: 34643000 PMCID: PMC8662250 DOI: 10.1002/ptr.7302] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022]
Abstract
Given the abundancy of angiotensin converting enzyme 2 (ACE‐2) receptors density, beyond the lung, the intestine is considered as an alternative site of infection and replication for severe acute respiratory syndrome by coronavirus type 2 (SARS‐CoV‐2). Cannabidiol (CBD) has recently been proposed in the management of coronavirus disease 2019 (COVID‐19) respiratory symptoms because of its anti‐inflammatory and immunomodulatory activity exerted in the lung. In this study, we demonstrated the in vitro PPAR‐γ‐dependent efficacy of CBD (10−9‐10−7 M) in preventing epithelial damage and hyperinflammatory response triggered by SARS‐CoV‐2 spike protein (SP) in a Caco‐2 cells. Immunoblot analysis revealed that CBD was able to reduce all the analyzed proinflammatory markers triggered by SP incubation, such as tool‐like receptor 4 (TLR‐4), ACE‐2, family members of Ras homologues A‐GTPase (RhoA‐GTPase), inflammasome complex (NLRP3), and Caspase‐1. CBD caused a parallel inhibition of interleukin 1 beta (IL‐1β), IL‐6, tumor necrosis factor alpha (TNF‐α), and IL‐18 by enzyme‐linked immunosorbent assay (ELISA) assay. By immunofluorescence analysis, we observed increased expression of tight‐junction proteins and restoration of transepithelial electrical resistance (TEER) following CBD treatment, as well as the rescue of fluorescein isothiocyanate (FITC)–dextran permeability induced by SP. Our data indicate, in conclusion, that CBD is a powerful inhibitor of SP protein enterotoxicity in vitro.
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Affiliation(s)
- Chiara Corpetti
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Alessandro Del Re
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Department of Physiology, Michigan State University, East Lansing, Michigan, USA
| | - Irene Palenca
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Barbara De Conno
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
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22
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Greco A, Garoffolo G, Chiesa E, Riva F, Dorati R, Modena T, Conti B, Pesce M, Genta I. Nanotechnology, a booster for the multitarget drug verteporfin. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2021.102562] [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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23
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Larese Filon F, Pesce M, Paulo M, Loney T, Modenese A, John S, Kezic S, Macan J. Incidence of occupational contact dermatitis in healthcare workers: a systematic review. J Eur Acad Dermatol Venereol 2021; 35:1285-1289. [PMID: 33336403 PMCID: PMC8248138 DOI: 10.1111/jdv.17096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/11/2020] [Indexed: 11/07/2022]
Abstract
Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/MEDLINE (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term 'incidence of contact dermatitis in HCWs' according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohorts; 10 register-based) with follow-up periods between 1987 and 2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10 000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10 000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.
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Affiliation(s)
- F. Larese Filon
- Clinical Unit of Occupational MedicineUniversity of TriesteTriesteItaly
| | - M. Pesce
- Clinical Unit of Occupational MedicineUniversity of TriesteTriesteItaly
| | - M.S. Paulo
- Institute of Public HealthCollege of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUAE
| | - T. Loney
- College of MedicineMohammed Bin Rashid University of Medicine and Health SciencesDubaiUAE
| | - A. Modenese
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena & Reggio EmiliaModenaItaly
| | - S.M. John
- Department DermatologyEnvironmental MedicineHealth TheoryUniversity of OsnabrückOsnabrückGermany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm)University of OsnabrückOsnabrückGermany
| | - S. Kezic
- Coronel Institute of Occupational HealthDepartment of Public and Occupational HealthAmsterdam UMCAmsterdamThe Netherlands
| | - J. Macan
- Institute for Medical Research and Occupational HealthZagrebCroatia
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Pesce M, Seguella L, Cassarano S, Aurino L, Sanseverino W, Lu J, Corpetti C, Del Re A, Vincenzi M, Sarnelli G, Esposito G. Phytotherapics in COVID19: Why palmitoylethanolamide? Phytother Res 2021; 35:2514-2522. [PMID: 33296131 DOI: 10.1002/ptr.6978] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
At present, googling the search terms "COVID-19" and "Functional foods" yields nearly 500,000,000 hits, witnessing the growing interest of the scientific community and the general public in the role of nutrition and nutraceuticals during the COVID-19 pandemic. Many compounds have been proposed as phytotherapics in the prevention and/or treatment of COVID-19. The extensive interest of the general public and the enormous social media coverage on this topic urges the scientific community to address the question of whether which nutraceuticals can actually be employed in preventing and treating this newly described coronavirus-related disease. Recently, the Canadian biotech pharma company "FSD Pharma" received the green light from the Food and Drug Administration to design a proof-of-concept study evaluating the effects of ultramicronized palmitoylethanolamide (PEA) in COVID-19 patients. The story of PEA as a nutraceutical to prevent and treat infectious diseases dates back to the 1970s where the molecule was branded under the name Impulsin and was used for its immunomodulatory properties in influenza virus infection. The present paper aims at analyzing the potential of PEA as a nutraceutical and the previous evidence suggesting its anti-inflammatory and immunomodulatory properties in infectious and respiratory diseases and how these could translate to COVID-19 care.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Sara Cassarano
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Laura Aurino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Jie Lu
- Department of Human Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang City, China
| | - Chiara Corpetti
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Alessandro Del Re
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Martina Vincenzi
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
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Esposito G, Corpetti C, Pesce M, Seguella L, Annunziata G, Del Re A, Vincenzi M, Lattanzi R, Lu J, Sanseverino W, Sarnelli G. A Palmitoylethanolamide Producing Lactobacillus paracasei Improves Clostridium difficile Toxin A-Induced Colitis. Front Pharmacol 2021; 12:639728. [PMID: 33986673 PMCID: PMC8111445 DOI: 10.3389/fphar.2021.639728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/01/2021] [Indexed: 01/05/2023] Open
Abstract
Genetically engineered probiotics, able to in situ deliver therapeutically active compounds while restoring gut eubiosis, could represent an attractive therapeutic alternative in Clostridium difficile infection (CDI). Palmitoylethanolamide is an endogenous lipid able to exert immunomodulatory activities and restore epithelial barrier integrity in human models of colitis, by binding the peroxisome proliferator–activated receptor-α (PPARα). The aim of this study was to explore the efficacy of a newly designed PEA-producing probiotic (pNAPE-LP) in a mice model of C. difficile toxin A (TcdA)-induced colitis. The human N-acyl-phosphatidylethanolamine-specific phospholipase D (NAPE-PLD), a key enzyme involved in the synthesis of PEA, was cloned and expressed in a Lactobacillus paracasei that was intragastrically administered to mice 7 days prior the induction of the colitis. Bacteria carrying the empty vector served as negative controls (pLP).In the presence of palmitate, pNAPE-LP was able to significantly increase PEA production by 27,900%, in a time- and concentration-dependent fashion. Mice treated with pNAPE-LP showed a significant improvement of colitis in terms of histological damage score, macrophage count, and myeloperoxidase levels (−53, −82, and −70.4%, respectively). This was paralleled by a significant decrease both in the expression of toll-like receptor-4 (−71%), phospho-p38 mitogen-activated protein kinase (−72%), hypoxia-inducible factor-1-alpha (−53%), p50 (−74%), and p65 (−60%) and in the plasmatic levels of interleukin-6 (−86%), nitric oxide (−59%), and vascular endothelial growth factor (−71%). Finally, tight junction protein expression was significantly improved by pNAPE-LP treatment as witnessed by the rescue of zonula occludens-1 (+304%), Ras homolog family member A-GTP (+649%), and occludin expression (+160%). These protective effects were mediated by the specific release of PEA by the engineered probiotic as they were abolished in PPARα knockout mice and in wild-type mice treated with pLP. Herein, we demonstrated that pNAPE-LP has therapeutic potential in CDI by inhibiting colonic inflammation and restoring tight junction protein expression in mice, paving the way to next generation probiotics as a promising strategy in CDI prevention.
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Affiliation(s)
- Giuseppe Esposito
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy.,Nextbiomics S.r.l., Naples, Italy
| | - Chiara Corpetti
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Giuseppe Annunziata
- Department of Pharmacy, Faculty of Pharmacy, University Federico II, Naples, Italy
| | - Alessandro Del Re
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Martina Vincenzi
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Roberta Lattanzi
- Department of Physiology and Pharmacology, "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Jie Lu
- Department of Human Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | | | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Section of Gastroenterology, University Federico II, Naples, Italy.,Nextbiomics S.r.l., Naples, Italy.,UNESCO Chair Staff Member, University of Naples "Federico II", Naples, Italy
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26
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Esposito G, Pesce M, Seguella L, Lu J, Corpetti C, Del Re A, De Palma FDE, Esposito G, Sanseverino W, Sarnelli G. Engineered Lactobacillus paracasei Producing Palmitoylethanolamide (PEA) Prevents Colitis in Mice. Int J Mol Sci 2021; 22:ijms22062945. [PMID: 33799405 PMCID: PMC7999950 DOI: 10.3390/ijms22062945] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 11/16/2022] Open
Abstract
Palmitoylethanolamide (PEA) is an N-acylethanolamide produced on-demand by the enzyme N-acylphosphatidylethanolamine-preferring phospholipase D (NAPE-PLD). Being a key member of the larger family of bioactive autacoid local injury antagonist amides (ALIAmides), PEA significantly improves the clinical and histopathological stigmata in models of ulcerative colitis (UC). Despite its safety profile, high PEA doses are required in vivo to exert its therapeutic activity; therefore, PEA has been tested only in animals or human biopsy samples, to date. To overcome these limitations, we developed an NAPE-PLD-expressing Lactobacillus paracasei F19 (pNAPE-LP), able to produce PEA under the boost of ultra-low palmitate supply, and investigated its therapeutic potential in a murine model of UC. The coadministration of pNAPE-LP and palmitate led to a time-dependent release of PEA, resulting in a significant amelioration of the clinical and histological damage score, with a significantly reduced neutrophil infiltration, lower expression and release of pro-inflammatory cytokines and oxidative stress markers, and a markedly improved epithelial barrier integrity. We concluded that pNAPE-LP with ultra-low palmitate supply stands as a new method to increase the in situ intestinal delivery of PEA and as a new therapeutic able of controlling intestinal inflammation in inflammatory bowel disease.
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Affiliation(s)
- Giuseppe Esposito
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (G.E.); (L.S.); (C.C.); (A.D.R.)
- Nextbiomics S.R.L., 80100 Naples, Italy;
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Luisa Seguella
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (G.E.); (L.S.); (C.C.); (A.D.R.)
| | - Jie Lu
- Department of Anatomy and Cell Biology, China Medical University, Shenyang City, Liaoning 110122, China;
| | - Chiara Corpetti
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (G.E.); (L.S.); (C.C.); (A.D.R.)
| | - Alessandro Del Re
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (G.E.); (L.S.); (C.C.); (A.D.R.)
| | - Fatima Domenica Elisa De Palma
- CEINGE-Biotecnologie Avanzate s.c.a r.l., Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy;
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | | | - Giovanni Sarnelli
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (G.E.); (L.S.); (C.C.); (A.D.R.)
- Nextbiomics S.R.L., 80100 Naples, Italy;
- UNESCO Chair Staff Member, University of Naples “Federico II”, 80100 Naples, Italy
- Correspondence: ; Tel.: +39-0817463488
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Abstract
Achalasia is a rare esophageal motility disorder characterized by the incomplete
relaxation of the lower esophageal sphincter (LES) and impaired peristaltic
activity. The advent of high-resolution manometry (HRM) and the rapidly evolving
role of therapeutic endoscopy have revolutionized the approach to the diagnosis
and management of achalasia patients in the last decade. With advances in HRM
technology and methodology, fluoroscopy and EndoFlip, achalasia can be
differentiated into therapeutically meaningful phenotypes with a high degree of
accuracy. Further, the newest treatment option, per-oral endoscopic myotomy
(POEM), has become a staple therapy following the last 10 years of experience,
and recent randomized trials appear to show no difference between POEM, graded
pneumatic dilatation and surgical Heller myotomy in terms of short- and
long-term efficacy or complication rate. On the other hand, how treatment
outcomes are measured as well as the risk of reflux following therapy remain
areas of contention. This review aims to summarize the recent advancements in
achalasia testing and therapy, describes the recent randomized clinical trials
as well as their potential setbacks, and touches on the future of personalizing
achalasia treatment.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, University "Federico II" of Naples, Naples, Italy
| | - Rami Sweis
- University College London Hospital, GI Services, 235 Euston Rd, London, NW1 2BU, UK
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Musella M, Vitiello A, Berardi G, Velotti N, Pesce M, Sarnelli G. Evaluation of reflux following sleeve gastrectomy and one anastomosis gastric bypass: 1-year results from a randomized open-label controlled trial. Surg Endosc 2020; 35:6777-6785. [PMID: 33269429 PMCID: PMC8599401 DOI: 10.1007/s00464-020-08182-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023]
Abstract
Background Recent reports have demonstrated that de novo reflux and worsening of pre-existing symptoms occur after SG; concerns are still expressed about the risk of symptomatic biliary reflux gastritis and oesophagitis. The aim of our study was to investigate and compare the rate of postoperative acid and non-acid reflux following Mini-/One anastomosis gastric bypass (MGB/OAGB) and laparoscopic sleeve gastrectomy (LSG). Study design A prospective randomized open-label, controlled trial registered on clinicaltrial.gov (NCT number: NCT02987673) has been carried out to evaluate esophagogastric junction exposure to reflux in the first year after MGB/OAGB and LSG using high impedance manometry, endoscopy, and a validated questionnaire. Results A total of 58 individuals were eventually enrolled in this trial and represented the per-protocol population (n = 28 MGB/OAGB, n = 30 LSG). No difference was found between the two groups in terms of demographic characteristics, PAGI-SYM score, acid exposure time percent of the esophagus (AET%), esophagitis, and other HRiM and MII-pH data at baseline. Comparing MII-pH outcomes of the two groups, AET% resulted significantly higher after LSG at 12 months. Endoscopic findings showed a significant increase of esophagitis ≥ B in the LSG group after 1 year; postoperative esophagitis ≥ B resulted also significantly worsened after LSG when compared to MGB/OAGB. Conclusion Since AET% and rate of esophagitis are significantly higher after LSG when compared to MGB/OAGB, this procedure should be preferred in case of preoperative subclinical reflux or low grade (A) esophagitis.
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Affiliation(s)
- Mario Musella
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
| | - Antonio Vitiello
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Berardi
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
| | - Nunzio Velotti
- Advanced Biomedical Sciences Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
| | - Marcella Pesce
- Clinical Medicine and Surgery Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanni Sarnelli
- Clinical Medicine and Surgery Department, Naples “Federico II” University, AOU “Federico II” - Via S. Pansini 5, 80131 Naples, Italy
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Esposito G, Pesce M, Seguella L, Sanseverino W, Lu J, Corpetti C, Sarnelli G. The potential of cannabidiol in the COVID-19 pandemic. Br J Pharmacol 2020; 177:4967-4970. [PMID: 32519753 PMCID: PMC7300643 DOI: 10.1111/bph.15157] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022] Open
Abstract
Identifying drugs effective in the new coronavirus disease 2019 (COVID-19) is crucial, pending a vaccine against SARS-CoV2. We suggest the hypothesis that cannabidiol (CBD), a non-psychotropic phytocannabinoid, has the potential to limit the severity and progression of the disease for several reasons:- (a) High-cannabidiol Cannabis sativa extracts are able to down-regulate the expression of the two key receptors for SARS-CoV2 in several models of human epithelia, (b) cannabidiol exerts a wide range of immunomodulatory and anti-inflammatory effects and it can mitigate the uncontrolled cytokine production responsible for acute lung injury, (c) being a PPARγ agonist, it can display a direct antiviral activity and (d) PPARγ agonists are regulators of fibroblast/myofibroblast activation and can inhibit the development of pulmonary fibrosis, thus ameliorating lung function in recovered patients. We hope our hypothesis, corroborated by preclinical evidence, will inspire further targeted studies to test cannabidiol as a support drug against the COVID-19 pandemic. LINKED ARTICLES: This article is part of a themed issue on The Pharmacology of COVID-19. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.21/issuetoc.
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Affiliation(s)
- Giuseppe Esposito
- Department of Physiology and Pharmacology “V. Erspamer”Sapienza University of RomeRomeItaly
| | - Marcella Pesce
- Department of Clinical Medicine and SurgeryUniversity of Naples “Federico II”NaplesItaly
| | - Luisa Seguella
- Department of Physiology and Pharmacology “V. Erspamer”Sapienza University of RomeRomeItaly
| | | | - Jie Lu
- Department of Human Anatomy, College of Basic Medical SciencesChina Medical UniversityShenyangChina
| | - Chiara Corpetti
- Department of Physiology and Pharmacology “V. Erspamer”Sapienza University of RomeRomeItaly
| | - Giovanni Sarnelli
- Department of Clinical Medicine and SurgeryUniversity of Naples “Federico II”NaplesItaly
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Sarnelli G, Pesce M, Seguella L, Lu J, Efficie E, Tack J, Elisa De Palma FD, D’Alessandro A, Esposito G. Impaired Duodenal Palmitoylethanolamide Release Underlies Acid-Induced Mast Cell Activation in Functional Dyspepsia. Cell Mol Gastroenterol Hepatol 2020; 11:841-855. [PMID: 33065341 PMCID: PMC7858681 DOI: 10.1016/j.jcmgh.2020.10.001] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Acid hypersensitivity is claimed to be a symptomatic trigger in functional dyspepsia (FD); however, the neuroimmune pathway(s) and the mediators involved in this process have not been investigated systematically. Palmitoylethanolamide (PEA) is an endogenous compound, able to modulate nociception and inflammation, but its role in FD has not been assessed. METHODS Duodenal biopsy specimens from FD and control subjects, and peroxisome proliferator-activated receptor-α (PPARα) null mice were cultured at a pH of 3.0 and 7.4. Mast cell (MC) number, the release of their mediators, and the expression of transient receptor potential vanilloid receptor (TRPV)1 and TRPV4, were evaluated. All measurements also were performed in the presence of a selective blocker of neuronal action potential (tetradotoxin). FD and control biopsy specimens in acidified medium also were incubated in the presence of different PEA concentrations, alone or combined with a selective PPARα or PPAR-γ antagonist. RESULTS An acid-induced increase in MC density and the release of their mediators were observed in both dyspeptic patients and controls; however, this response was amplified significantly in FD. This effect was mediated by submucosal nerve fibers and up-regulation of TRPV1 and TRPV4 receptors because pretreatment with tetradotoxin significantly reduced MC infiltration. The acid-induced endogenous release of PEA was impaired in FD and its exogenous administration counteracts MC activation and TRPV up-regulation. CONCLUSIONS Duodenal acid exposure initiates a cascade of neuronal-mediated events culminating in MC activation and TRPV overexpression. These phenomena are consequences of an impaired release of endogenous PEA. PEA might be regarded as an attractive therapeutic strategy for the treatment of FD.
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Affiliation(s)
- Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, Naples, Italy,United Nations Educational, Scientific and Cultural Organization Chair, University of Naples "Federico II," Naples, Italy,Correspondence Address correspondence to: Giovanni Sarnelli, MD, PhD, Department of Clinical Medicine and Surgery, University of Naples "Federico II," Via Pansini 5 80131, Naples, Italy. fax: (39) 0817463892.
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, Naples, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Jie Lu
- Department of Human Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang City, Liaoning, China
| | | | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Fatima Domenica Elisa De Palma
- Centro Ingegneria Genetica-Biotecnologie Avanzate s.c.a rl, Department of Molecular Medicine and Medical Biotechnologies, Naples, Italy
| | | | - Giuseppe Esposito
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
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31
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Giglio S, De Nunzio C, Cirombella R, Stoppacciaro A, Pesce M, Omar F, Volinia S, Baldassarre G, Tubaro A, Croce C, Vecchione A. Micro-RNAs as minimally invasive biomarkers for diagnosis, staging and outcome prediction in prostate cancer patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35402-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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32
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Pietrangeli P, Corpetti C, Seguella L, Del Re A, Pesce M, Vincenzi M, Lori C, Annunziata G, Mateescu MA, Sarnelli G, Esposito G, Marcocci L. Lathyrus sativus diamine oxidase reduces Clostridium difficile toxin A-induced toxicity in Caco-2 cells by rescuing RhoA-GTPase and inhibiting pp38-MAPK/NF-κB/HIF-1α activation. Phytother Res 2020; 35:415-423. [PMID: 32914548 DOI: 10.1002/ptr.6814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022]
Abstract
Clostridium difficile toxin A (TcdA) impairs the intestinal epithelial barrier, increasing the mucosa permeability and triggering a robust inflammatory response. Lathyrus sativus diamino oxidase (LSAO) is a nutraceutical compound successfully used in various gastrointestinal dysfunctions. Here, we evaluated the LSAO (0.004-0.4 μM) ability to counter TcdA-induced (30 ng/mL) toxicity and damage in Caco-2 cells, investigating its possible mechanism of action. LSAO has improved the transepithelial electrical resistance (TEER) score and increased cell viability in TcdA-treated cells, significantly rescuing the protein expression of Ras homolog family members, A-GTPase (RhoA-GTPase), occludin, and zonula occludens-1 (ZO-1). LSAO has also exhibited an anti-apoptotic effect by inhibiting the TcdA-induced expression of Bcl-2-associated X protein (Bax), p50 nuclear factor-kappa-B (p50), p65nuclear factor-kappa-B (p65), and hypoxia-inducible transcription factor-1 alpha (HIF-1α), and the release of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) in the cell milieu. Our data showed that LSAO exerts a protective effect on TcdA-induced toxicity in Caco-2 cells, placing itself as an interesting nutraceutical to supplement the current treatment of the Clostridium difficile infections.
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Affiliation(s)
- Paola Pietrangeli
- Department of Biochemical Sciences "A. Rossi Fanelli", Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
| | - Chiara Corpetti
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Alessandro Del Re
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, section of Gastroenterology, University Federico II, Naples, Italy
| | - Martina Vincenzi
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Chiara Lori
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Mircea A Mateescu
- Department of Chemistry and Centre CERMO-FC, Université du Québec à Montreal, CP8888 Branch A, Montreal (Québec), Montreal, Québec, Canada
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, section of Gastroenterology, University Federico II, Naples, Italy
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Lucia Marcocci
- Department of Biochemical Sciences "A. Rossi Fanelli", Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
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Falcone L, Aruffo E, Di Carlo P, Del Boccio P, Cufaro MC, Pesce M, Patruno A, Ballerini P. Ozone effect on inflammatory and proteomic profile of human macrophages and airway epithelial cells. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.102] [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: 11/13/2022] Open
Abstract
Abstract
Background
Reactive oxygen species (ROS) and oxidative stress in the respiratory system are involved in lung inflammation and tumorigenesis. Ozone (O3) is one of the main components of air pollution in urban areas able to act as strong pro-oxidant agent, however its effects on human health is still poorly investigated. In this study the effect of O3 has been evaluated in THP-1 monocytes differentiated into macrophages with PMA and in HBEpC (primary human bronchial epithelial) cells, two model systems for in vitro studies and translational research.
Methods
Cell viability, ROS and pro-inflammatory cytokines like interleukin-8(IL-8) and tumor necrosis factor(TNF-α) have been tested in the above-mentioned cell lines not exposed to any kind of pollution (basal condition-b.c.) or exposed to O3 at a concentration of 120 ppb. In HBEpC a labelfree shotgun proteomics analysis has been also performed in the same conditions.
Results
Ozone significantly increased the production of IL-8 and TNF-α in THP-1 whereas no changes were shown in HBEpC. In both cell lines lipopolysaccharide(LPS) caused an increase of IL-8 and TNF-α production in b.c. and O3 treatment potentiated this effect. Ozone exposure increased ROS formation in a time dependent manner in both cell lines and in THP-1 cells a decrease in catalase activity was also shown. Finally, according to these data, functional proteomics analysis revealed that in HBEpC exposure to O3 many differential proteins are related to oxidative stress and inflammation.
Conclusions
Our results indicate that O3, at levels that can be reached in urban areas, causes an increase of pro-inflammatory agents either per se or potentiating the effect of immune response stimulators in cell models of human macrophages and human airway epithelial cells. Interestingly, the proteomic analysis showed that besides the dysregulated proteins, O3 induced the expression of AKR1D1 and AKR1B10, proteins recognized to play a significant role in cancer development.
Key messages
This study adds new pieces of information on the association between O3 exposure and detrimental effects on respiratory system. This study suggests the need for further research on the mechanisms involved and for a continued monitoring/re-evaluation of air pollution standards aimed at safeguarding human health.
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Affiliation(s)
- L Falcone
- Department of Psychological, Health and Territorial Sciences, University, Chieti, Italy
- Centre for Advanced Studies and Technology, University, Chieti, Italy
| | - E Aruffo
- Department of Psychological, Health and Territorial Sciences, University, Chieti, Italy
- Centre for Advanced Studies and Technology, University, Chieti, Italy
| | - P Di Carlo
- Department of Psychological, Health and Territorial Sciences, University, Chieti, Italy
- Centre for Advanced Studies and Technology, University, Chieti, Italy
| | - P Del Boccio
- Centre for Advanced Studies and Technology, University, Chieti, Italy
- Department of Pharmacy, University, Chieti, Italy
| | - M C Cufaro
- Centre for Advanced Studies and Technology, University, Chieti, Italy
- Department of Pharmacy, University, Chieti, Italy
| | - M Pesce
- Department of Medicine and Science of Aging, University, Chieti, Italy
| | - A Patruno
- Department of Medicine and Science of Aging, University, Chieti, Italy
| | - P Ballerini
- Centre for Advanced Studies and Technology, University, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, University, Chieti, Italy
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34
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Esposito G, Pesce M, Seguella L, Sanseverino W, Lu J, Sarnelli G. Can the enteric nervous system be an alternative entrance door in SARS-CoV2 neuroinvasion? Brain Behav Immun 2020; 87:93-94. [PMID: 32335192 PMCID: PMC7179488 DOI: 10.1016/j.bbi.2020.04.060] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Giuseppe Esposito
- Department of Physiology and Pharmacology, Sapienza University of Rome, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology, Sapienza University of Rome, Italy
| | | | - Jie Lu
- Department of Human Anatomy, College of Basic Medical Sciences, China Medical University, Shenyang City, Liaoning, China
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
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Pesce M, Cargiolli M, Cassarano S, Polese B, De Conno B, Aurino L, Mancino N, Sarnelli G. Diet and functional dyspepsia: Clinical correlates and therapeutic perspectives. World J Gastroenterol 2020; 26:456-465. [PMID: 32089623 PMCID: PMC7015717 DOI: 10.3748/wjg.v26.i5.456] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/24/2019] [Accepted: 01/18/2020] [Indexed: 02/06/2023] Open
Abstract
Hypervigilance and symptoms anticipation, visceral hypersensitivity and gastroduodenal sensorimotor abnormalities account for the varied clinical presentation of functional dyspepsia (FD) patients. Many patients recognize meals as the main triggering factor; thus, dietary manipulations often represent the first-line management strategy in this cohort of patients. Nonetheless, scarce quality evidence has been produced regarding the relationship between specific foods and/or macronutrients and the onset of FD symptoms, resulting in non-standardized nutritional approaches. Most dietary advises are indeed empirical and often lead to exclusion diets, reinforcing in patients the perception of “being intolerant” to food and self-perpetuating some of the very mechanisms underlying dyspepsia physiopathology (i.e., hypervigilance and symptom anticipation). Clinicians are often uncertain regarding the contribution of specific foods to dyspepsia physiopathology and dedicated professionals (i.e., dietitians) are only available in tertiary referral settings. This in turn, can result in nutritionally unbalanced diets and could even encourage restrictive eating behaviors in severe dyspepsia. In this review, we aim at evaluating the relationship between dietary habits, macronutrients and specific foods in determining FD symptoms. We will provide an overview of the evidence-based nutritional approach that should be pursued in these patients, providing clinicians with a valuable tool in standardizing nutritional advises and discouraging patients from engaging into indiscriminate food exclusions.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
- GI Physiology Unit, University College London Hospital, London NW1 2BU, United Kingdom
| | - Martina Cargiolli
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Sara Cassarano
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Barbara Polese
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Barbara De Conno
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Laura Aurino
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Nicola Mancino
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, Naples 80131, Italy
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Seguella L, Rinaldi F, Marianecci C, Capuano R, Pesce M, Annunziata G, Casano F, Bassotti G, Sidoni A, Milone M, Aprea G, de Palma GD, Carafa M, Pesce M, Esposito G, Sarnelli G. Pentamidine niosomes thwart S100B effects in human colon carcinoma biopsies favouring wtp53 rescue. J Cell Mol Med 2020; 24:3053-3063. [PMID: 32022398 PMCID: PMC7077541 DOI: 10.1111/jcmm.14943] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/06/2019] [Accepted: 11/29/2019] [Indexed: 01/09/2023] Open
Abstract
S100B protein bridges chronic mucosal inflammation and colorectal cancer given its ability to activate NF-kappaB transcription via RAGE signalling and sequestrate pro-apoptotic wtp53. Being an S100B inhibitor, pentamidine antagonizes S100B-wtp53 interaction, restoring wtp53-mediated pro-apoptotic control in cancer cells in several types of tumours. The expression of S100B, pro-inflammatory molecules and wtp53 protein was evaluated in human biopsies deriving from controls, ulcerative colitis and colon cancer patients at baseline (a) and (b) following S100B targeting with niosomal PENtamidine VEhiculation (PENVE), to maximize drug permeabilization in the tissue. Cultured biopsies underwent immunoblot, EMSA, ELISA and biochemical assays for S100B and related pro-inflammatory/pro-apoptotic proteins. Exogenous S100B (0.005-5 μmol/L) alone, or in the presence of PENVE (0.005-5 μmol/L), was tested in control biopsies while PENVE (5 μmol/L) was evaluated on control, peritumoral, ulcerative colitis and colon cancer biopsies. Our data show that S100B level progressively increases in control, peritumoral, ulcerative colitis and colon cancer enabling a pro-inflammatory/angiogenic and antiapoptotic environment, featured by iNOS, VEGF and IL-6 up-regulation and wtp53 and Bax inhibition. PENVE inhibited S100B activity, reducing its capability to activate RAGE/phosphor-p38 MAPK/NF-kappaB and favouring its disengagement with wtp53. PENVE blocks S100B activity and rescues wtp53 expression determining pro-apoptotic control in colon cancer, suggesting pentamidine as a potential anticancer drug.
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Affiliation(s)
- Luisa Seguella
- Department of Physiology and Pharmacology, "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Federica Rinaldi
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia (ITT), Rome, Italy
| | - Carlotta Marianecci
- Department of Drug Chemistry and Technology, Sapienza University of Rome, Rome, Italy
| | - Riccardo Capuano
- Department of Physiology and Pharmacology, "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Mirella Pesce
- Department of Physiology and Pharmacology, "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Fabrizio Casano
- Department of Physiology and Pharmacology, "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy
| | - Angelo Sidoni
- Pathology Section, Department of Experimental Medicine, University of Perugia School of Medicine, Perugia, Italy
| | - Marco Milone
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giovanni Aprea
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Maria Carafa
- Department of Drug Chemistry and Technology, Sapienza University of Rome, Rome, Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology, "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
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Milone M, Manigrasso M, Vertaldi S, Velotti N, Aprea G, Maione F, Gennarelli N, De Simone G, De Conno B, Pesce M, Sarnelli G, De Palma GD. Robotic versus laparoscopic approach to treat symptomatic achalasia: systematic review with meta-analysis. Dis Esophagus 2019; 32:1-8. [PMID: 31274153 DOI: 10.1093/dote/doz062] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 04/01/2019] [Revised: 05/09/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
Minimally invasive Heller myotomy is considered the gold standard surgical approach for symptomatic achalasia because it is a safe and effective procedure. Over the last years, several studies comparing the laparoscopic and robotic approach for Heller myotomy have been published. Although the robotic approach appears to have some advantages over standard laparoscopy, data on this topic are still controversial and no definite conclusions have been drawn. This metanalysis has been designed to systematically evaluate and compare the effectiveness and safety of the robot-assisted Heller myotomy as compared to the standard laparoscopic approach. According to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic search on both laparoscopic and robotic Heller myotomy was performed in all the major electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search string: (achalasia OR Dor) AND robotic. Six articles were included in the final analysis. A metaregression analysis was performed to assess the possible effects of demographic variables (age, gender, body mass indes (BMI)) and previous abdominal surgery or endoscopic intervention on the analyzed outcomes. No statistical difference was observed in operative times (mean difference (MD) = 20.79, P = 0.19, 95% confidence interval (CI) -10.05,51,62), estimated blood loss (MD = -17.10, P = 0.13, 95% CI -40.48,5.08), conversion rate to open surgery (risk difference (RD) = -0.01, P = 0.33, 95% CI -0.05,0.02), length of hospital stay (MD = -0.73, P = 0.15, 95% CI -1.71,0.25) and long-term recurrence (odds ratio (OR) = 0.59, P = 0.45, 95% CI 0.15,2.33). On the contrary, the robotic approach was found to be associated with a significantly significant lower rate of intraoperative esophageal perforations (OR = 0.13, P < 0.001, 95% CI 0.04, 0.45). Our results suggest that the robotic approach is safer than the laparoscopic Heller myotomy, encouraging the use of robot-assisted surgery. However, our analysis is limited because of the exiguous number of comparative studies and because most of the included studies were statistically underpowered, given the small sample size. Moreover, a high degree of heterogeneity was observed in most of published studies. Taking in consideration the additional costs of robot-assisted procedures, larger Randomized Controlled Trials (RCTs) are advocated to confirm the safety and effectiveness of the robotic approach, and its advantages over standard laparoscopic surgery. In conclusion, well-designed prospective trials and RCTs with homogeneous parameters are needed to draw definitive conclusions about the best surgical approach to pursue in treating symptomatic achalasia.
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Affiliation(s)
- M Milone
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - M Manigrasso
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - S Vertaldi
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - N Velotti
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - G Aprea
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - F Maione
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - N Gennarelli
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - G De Simone
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - B De Conno
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - M Pesce
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy.,Division of Gastroenterology, Department of GI Physiology, University College London Hospitals, London, England, UK
| | - G Sarnelli
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
| | - G D De Palma
- Department of Clinical Medcine and Surgery, Federico II University, Naples, Italy
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Pesce M, Amadeo F, Salvi M, Pagani F, Angelini F, Messina E, Agrifoglio M, Molinari F, Chimenti I, Morbiducci U. P5382Geometry and strain sensing dictate YAP-dependent evolution of human cardiac stromal cells toward myofibroblasts in the cardiosphere organoid model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0342] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac stromal cells are the most abundant cell type present in the heart, where they have an important homeostatic function in matrix renewal and electromechanical coupling. We have shown that YAP transcription factor (a component of the Hippo pathway) is important for the proliferation of these cells and, potentially, pathologic cardiac matrix stiffening in heart failure.
Purpose
Given the role of Hippo pathway in cell mechanosensation, we assessed the conditions for activation of the YAP-dependent transcriptional pathway related to geometry/strain sensing using human “cardiosphere”-derived cells.
Methods
Human cardiospheres (C-Sp) and C-Sp-derived cells (CDCs) were obtained from fragments of atrial appendages of patients admitted for AoC bypass. C-Sps and CDCs were cultured using published methods. To analyze cell/nuclear geometry in 2D/3D culture, we employed an adapting thresholding algorithm allowing segmentation of cell membrane/nuclei shape and the relative abundance of nuclear/cytoplasmic fluorescence intensities from z-stacked confocal immunofluorescence images. Inhibitors of signaling cascades converging onto actin cytoskeleton polymerization or of YAP/TEADs interaction were used to assess YAP target genes transcription.
Results
Previous results showed stiffness sensitivity of YAP nuclear translocation process. Namely, CDCs plated onto stiff (E >50kPa) culture plates exhibited high ratios of nuclear/cytoplasmic YAP, as compared to cells plated on substrates with lower stiffness (E ∼ 10kPa). Analogously, cells with a stretched cytoplasm/nuclear shape in the border regions of the 3D organoids exhibited a higher YAP nuclear localization level and expression of fibrotic markers compared with cells with a more round geometry in the center of the spheres. To uncouple the cytoskeleton tensioning-dependent YAP nuclear shuttling, we treated CDCs plated onto stiff substrates with blebbistatin and Y27632. This showed a fully reversible YAP relocation from the nucleus to the cytoplasm and a reversion of canonical target genes (CYR61, ANKRD1 and CTGF) expression. In parallel, a “softening” process of the nucleus, likely due to release from cytoskeleton traction forces, was observed by confocal imaging along the cellular z-axis. Interestingly, use of Verteporfin, a drug directly interfering with the interaction of YAP/TAZ complex with TEADs DNA binding proteins showed reversion of pro-fibrotic YAP targets independent of high cytoskeleton tensioning.
Conclusions
These results establish, for the first time, a deterministic relationship between pro-pathologic evolution of human adult cardiac stromal cells and activation of mechanosensing-dependent pathways. They also provide quantitative criteria for interpreting fibrotic evolution of the heart based on modifications of myocardial architecture and mechanical compliance, as well as the ability of the cells to generate tension forces affecting the nuclear structure.
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Affiliation(s)
- M Pesce
- Cardiology Center Monzino IRCCS, Unità di Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - F Amadeo
- Cardiology Center Monzino IRCCS, Unità di Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - M Salvi
- Politecnico di Torino, Turin, Italy
| | - F Pagani
- Sapienza University of Rome, Rome, Italy
| | - F Angelini
- Sapienza University of Rome, Rome, Italy
| | - E Messina
- Sapienza University of Rome, Rome, Italy
| | | | | | - I Chimenti
- Sapienza University of Rome, Rome, Italy
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Pesce M, Krishnan U, Saliakellis E, Lopez R, Lindley KJ, Thapar N, Borrelli O. Is There a Role for pH Impedance Monitoring in Identifying Eosinophilic Esophagitis in Children with Esophageal Atresia? J Pediatr 2019; 210:134-140. [PMID: 31036410 DOI: 10.1016/j.jpeds.2019.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/18/2018] [Revised: 01/28/2019] [Accepted: 03/12/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate clinical, endoscopic, and pH-impedance measures in a cohort of children with esophageal atresia and concomitant eosinophilic esophagitis (EoE) and compared it with disease-matched controls, to identify predictive factors for the development of EoE and esophageal stricture. STUDY DESIGN We reviewed 63 patients with esophageal atresia assessed for refractory upper gastrointestinal symptoms between January 2015 and September 2017 at 2 tertiary referral centers. All patients underwent upper gastrointestinal endoscopy and pH-impedance monitoring. Based on esophageal histology, patients were classified as (1) esophageal atresia without evidence of esophagitis; (2) esophageal atresia with evidence of esophagitis (including esophageal eosinophilia not meeting the criteria for EoE); (3) esophageal atresia with concomitant EoE. Age and sex matched patients with gastroesophageal reflux disease were used as disease controls. RESULTS The presence of atopy and peripheral eosinophilia at baseline were significantly associated with EoE (P < .05). Although there was a tendency toward an increased number of strictures in patients with esophageal atresia-EoE, this did not reach statistical significance (P = .06). Higher esophageal acid exposure time and lower baseline impedance values were significantly associated with eosinophilic infiltration (P < .05 and P < .01, respectively). Using logistic regression analysis, the presence of mucosal eosinophilia was the most predictive factor for stricture formation (P < .05). CONCLUSIONS A history of atopy and the presence of peripheral eosinophilia in patients with esophageal atresia are predictive factors for the development of EoE, which in turn is a predictive factor for stricture occurrence. Higher esophageal acid exposure time and lower baseline impedance are associated with esophageal eosinophilic infiltration, suggesting their value in selecting which patients with esophageal atresia should undergo endoscopic examination.
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Affiliation(s)
- Marcella Pesce
- Department of Medicine and Surgery, University Federico II, Naples, Italy; Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, United Kingdom
| | - Usha Krishnan
- Department of Pediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Efstratios Saliakellis
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, United Kingdom
| | - Robert Lopez
- Department of Pediatric Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Keith J Lindley
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, United Kingdom
| | - Nikhil Thapar
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, United Kingdom; Stem Cells and Regenerative Medicine, UCL Institute of Child Health, London, United Kingdom
| | - Osvaldo Borrelli
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London, United Kingdom; Stem Cells and Regenerative Medicine, UCL Institute of Child Health, London, United Kingdom.
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40
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Pietrangeli P, Seguella L, Annunziata G, Casano F, Capuano R, Pesce M, De Conno B, Gigli S, Sarnelli G, Pesce M, Mateescu MA, Esposito G, Marcocci L. Lathyrus sativus
diamine oxidase counteracts histamine‐induced cell proliferation, migration and pro‐angiogenic mediators release in human colon adenocarcinoma cell line Caco‐2. Phytother Res 2019; 33:1878-1887. [DOI: 10.1002/ptr.6378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Paola Pietrangeli
- Department of Biochemical Sciences“A. Rossi Fanelli”‐ Sapienza University of Rome Rome Italy
| | - Luisa Seguella
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Giuseppe Annunziata
- Department of Pharmacy, Faculty of PharmacyUniversity Federico II Naples Italy
| | - Fabrizio Casano
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Riccardo Capuano
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Mirella Pesce
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Barbara De Conno
- Department of Clinical Medicine and Surgery, section of GastroenterologyUniversity Federico II Naples Italy
| | - Stefano Gigli
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, section of GastroenterologyUniversity Federico II Naples Italy
| | - Marcella Pesce
- Department of Clinical Medicine and Surgery, section of GastroenterologyUniversity Federico II Naples Italy
| | | | - Giuseppe Esposito
- Department of Physiology and Pharmacology“V.Erspamer”‐ Sapienza University of Rome Rome Italy
| | - Lucia Marcocci
- Department of Biochemical Sciences“A. Rossi Fanelli”‐ Sapienza University of Rome Rome Italy
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Pesce M, Magee C, Holloway RH, Gyawali CP, Roman S, Pioche M, Savarino E, Quader F, Sarnelli G, Sanagapalli S, Bredenoord AJ, Sweis R. The treatment of achalasia patients with esophageal varices: an international study. United European Gastroenterol J 2019; 7:565-572. [PMID: 31065374 DOI: 10.1177/2050640619838114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/22/2019] [Indexed: 01/10/2023] Open
Abstract
Background Treatment options for achalasia include endoscopic and surgical techniques that carry the risk of esophageal bleeding and perforation. The rare coexistence of esophageal varices has only been anecdotally described and treatment is presumed to carry additional risk. Methods Experience from physicians/surgeons treating this rare combination of disorders was sought through the International Manometry Working Group. Results Fourteen patients with achalasia and varices from seven international centers were collected (mean age 61 ± 9 years). Five patients were treated with botulinum toxin injections (BTI), four had dilation, three received peroral endoscopic myotomy (POEM), one had POEM then dilation, and one patient underwent BTI followed by Heller's myotomy. Variceal eradication preceded achalasia treatment in three patients. All patients experienced a significant symptomatic improvement (median Eckardt score 7 vs 1; p < 0.0001) at 6 months follow-up, with treatment outcomes resembling those of 20 non-cirrhotic achalasia patients who underwent similar therapy. No patients had recorded complications of bleeding or perforation. Conclusion This study shows an excellent short-term symptomatic response in patients with esophageal achalasia and varices and demonstrates that the therapeutic outcomes and complications, other than transient encephalopathy in both patients who had a portosystemic shunt, did not differ to disease-matched patients without varices.
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Affiliation(s)
- M Pesce
- Department of Gastroenterology, Department of GI Physiology, University College London Hospitals, London, UK.,University of Naples "Federico II", Naples, Italy
| | - C Magee
- Department of Gastroenterology, Department of GI Physiology, University College London Hospitals, London, UK
| | | | - C P Gyawali
- Division of Gastroenterology, Washington University, St Louis, MO, USA
| | - S Roman
- Department of Gastroenterology, Digestive Physiology, Hospices Civils de Lyon and Lyon University, Lyon, France
| | - M Pioche
- Department of Gastroenterology, Digestive Physiology, Hospices Civils de Lyon and Lyon University, Lyon, France
| | | | - F Quader
- Division of Gastroenterology, Washington University, St Louis, MO, USA
| | - G Sarnelli
- University of Naples "Federico II", Naples, Italy
| | - S Sanagapalli
- Department of Gastroenterology, Department of GI Physiology, University College London Hospitals, London, UK.,St. Vincent's Hospital Sydney, Sydney, Australia
| | - A J Bredenoord
- Division of Gastroenterology and Hepatology, Amsterdam Medical Centre, Amsterdam, Netherlands
| | - R Sweis
- Department of Gastroenterology, Department of GI Physiology, University College London Hospitals, London, UK
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Abstract
Achalasia is a chronic idiopathic disease characterized by the absence of esophageal body peristalsis and by defective lower esophageal sphincter (LES) relaxation. The incidence rate ranges from 1.07 to up to 2.8 new cases per year per 100,000 population. Presenting symptoms include dysphagia, regurgitation, vomiting, and weight loss. The diagnosis of achalasia has undergone a revolution in the last decade due to the advent of high-resolution manometry (HRM) and the consequent development of the Chicago Classification. Recent progress has allowed achalasia to be more precisely diagnosed and to be categorized into three subtypes, based on the prevalent manometric features of the esophageal peristalsis. Treatment options are pharmacotherapy, endoscopic management (Botox injection or pneumatic dilation), and surgery, e.g. laparoscopic Heller myotomy (LHM). More recently, a new endoscopic technique, per oral endoscopic myotomy (POEM), has developed as a less invasive approach alternative to the traditional LHM. Since the first POEM procedure was performed in 2008, increasing evidence is accumulating regarding its efficacy and safety profiles. Currently, POEM is being introduced as a reasonable therapeutic option, though randomized controlled trails are still lacking. The current review sheds light onto the diagnosis and management of achalasia, with special focus on the recent advances of HRM and POEM.
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Affiliation(s)
- Amir Mari
- Gastroenterology Institute, Nazareth EMMS Hospital, Nazareth, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- GI Physiology Unit, University College London Hospital, London, United Kingdom
| | - Kalp Patel
- GI Physiology Unit, University College London Hospital, London, United Kingdom
| | - Mahmud Mahamid
- Gastroenterology Institute, Nazareth EMMS Hospital, Nazareth, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Tawfik Khoury
- Gastroenterology Institute, Nazareth EMMS Hospital, Nazareth, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Marcella Pesce
- GI Physiology Unit, University College London Hospital, London, United Kingdom
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Rinaldi F, Seguella L, Gigli S, Hanieh PN, Del Favero E, Cantù L, Pesce M, Sarnelli G, Marianecci C, Esposito G, Carafa M. inPentasomes: An innovative nose-to-brain pentamidine delivery blunts MPTP parkinsonism in mice. J Control Release 2018; 294:17-26. [PMID: 30529726 DOI: 10.1016/j.jconrel.2018.12.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/19/2022]
Abstract
Preclinical and clinical evidences have demonstrated that astroglial-derived S100B protein is a key element in neuroinflammation underlying the pathogenesis of Parkinson's disease (PD), so much as that S100B inhibitors have been proposed as promising candidates for PD targeted therapy. Pentamidine, an old-developed antiprotozoal drug, currently used for pneumocystis carinii is one of the most potent inhibitors of S100B activity, but despite this effect, is limited by its low capability to cross blood brain barrier (BBB). To overcome this problem, we developed a non-invasive intranasal delivery system, chitosan coated niosomes with entrapped pentamidine (inPentasomes), in the attempt to provide a novel pharmacological approach to ameliorate parkinsonism induced by subchronic MPTP administration in C57BL-6 J mice. inPentasomes, prepared by evaporation method was administered daily by intranasal route in subchronic MPTP-intoxicated rodents and resulted in a dose-dependent manner (0.001-0.004 mg/kg) capable for a significant Tyrosine Hydroxylase (TH) positive neuronal density rescue in both striatum and substantia nigra of parkinsonian mice. In parallel, inPentasomes significantly decreased the extent of glial-related neuroinflammation through the reduction of specific gliotic markers (Iba-1, GFAP, COX-2, iNOS) with consequent PGE2 and NO2- release reduction, in nigrostriatal system. inPentasomes-mediated S100B inhibition resulted in a RAGE/NF-κB pathway downstream inhibition in the nigrostriatal circuit, causing a marked amelioration of motor performances in intoxicated mice. On the basis of our results, chitosan coated niosomes loaded with pentamidine, the inPentasome system, self-candidates as a promising new intranasal approach to mitigate parkinsonism in humans and possibly paves the way for a possible clinical repositioning of pentamidine as anti-PD drug.
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Affiliation(s)
- F Rinaldi
- Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia (ITT), Rome, Italy
| | - L Seguella
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - S Gigli
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - P N Hanieh
- Department of Drug Chemistry and Technology, Sapienza University of Rome, Rome, Italy
| | - E Del Favero
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Italy
| | - L Cantù
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Italy
| | - M Pesce
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - G Sarnelli
- Department of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy
| | - C Marianecci
- Department of Drug Chemistry and Technology, Sapienza University of Rome, Rome, Italy.
| | - G Esposito
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - M Carafa
- Department of Drug Chemistry and Technology, Sapienza University of Rome, Rome, Italy
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Abstract
The bewildering complexity of the enteric nervous system makes it susceptible to develop a wide array of motility disorders, collectively called enteric neuropathies. These gastrointestinal conditions are among the most challenging to manage, mainly given poor characterization of their etiopathophysiology and outcomes. Not surprisingly, therefore, targeted or curative therapies for enteric neuropathies are lacking and management is largely symptomatic. Nonetheless, recent advances in neurogastroenterology have witnessed improvements in established strategies, such as intestinal transplantation and the emergence of new treatments including novel drugs, electrical pacing, and manipulation of fecal microbiota, as well as stem cell and gene therapy.
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Affiliation(s)
- Marcella Pesce
- Neurogastroenterology and Motility Unit, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London WC1N 3JH, UK; Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Via Pansini 5, Naples 80131, Italy
| | - Osvaldo Borrelli
- Neurogastroenterology and Motility Unit, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Efstratios Saliakellis
- Neurogastroenterology and Motility Unit, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Nikhil Thapar
- Neurogastroenterology and Motility Unit, Department of Pediatric Gastroenterology, Great Ormond Street Hospital, London WC1N 3JH, UK; Stem Cells and Regenerative Medicine, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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45
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Pesce M, Esposito G, Sarnelli G. Endocannabinoids in the treatment of gasytrointestinal inflammation and symptoms. Curr Opin Pharmacol 2018; 43:81-86. [PMID: 30218940 DOI: 10.1016/j.coph.2018.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/22/2018] [Indexed: 01/02/2023]
Abstract
The evolving policies regarding the use of therapeutic Cannabis have steadily increased the public interest in its use as a complementary and alternative medicine in several disorders, including inflammatory bowel disease. Endocannabinoids represent both an appealing therapeutic strategy and a captivating scientific dilemma. Results from clinical trials have to be carefully interpreted owing to possible reporting-biases related to cannabinoids psychotropic effects. Moreover, discriminating between symptomatic improvement and the real gain on the underlying inflammatory process is often challenging. This review summarizes the advances and latest discovery in this ever-changing field of investigation, highlighting the main limitations in the current use of these drugs in clinical practice and the possible future perspectives to overcome these flaws.
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Affiliation(s)
- Marcella Pesce
- Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy; GI Physiology Unit, University College London Hospital, London, UK
| | - Giuseppe Esposito
- Department of Physiology and Pharmacology, `Vittorio Erspamer', La Sapienza University of Rome, Rome, Italy
| | - Giovanni Sarnelli
- Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.
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46
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Pesce M, Salvi M, Amadeo F, Angelini F, Chimenti I, Agrifoglio M, Molinari F, Santoro R, Messina E, Morbiducci U. P4225YAP-based position sensing in myofibroblast evolution of cardiac stromal cells in human cardiospheres. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4225] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Pesce
- Cardiology Center Monzino IRCCS, Unità di Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - M Salvi
- Politecnico di Torino, Turin, Italy
| | - F Amadeo
- Cardiology Center Monzino IRCCS, Unità di Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - F Angelini
- Sapienza University of Rome, Rome, Italy
| | - I Chimenti
- Sapienza University of Rome, Rome, Italy
| | | | | | - R Santoro
- Cardiology Center Monzino IRCCS, Unità di Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - E Messina
- Sapienza University of Rome, Rome, Italy
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47
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Ruiter MS, Garoffolo G, Piola M, Agrifoglio M, Zanobini M, Saccu C, Zoli S, Soncini M, Banfi C, Fiore GB, Pesce M. P6546Thrombospondin-1 is involved in human saphenous vein graft remodelling in response to coronary hemodynamic conditions. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6546] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M S Ruiter
- Cardiology Center Monzino IRCCS, Unit of Tissue Engineering, Milan, Italy
| | - G Garoffolo
- Cardiology Center Monzino IRCCS, Unit of Tissue Engineering, Milan, Italy
| | - M Piola
- Milan Polytechnic, Department of Electronics, Informatics and Bioengineering, Milan, Italy
| | - M Agrifoglio
- University of Milan, Department of Clinical Science and Community Health, Milan, Italy
| | - M Zanobini
- Cardiology Center Monzino IRCCS, Department of Cardiovascular Surgery, Milan, Italy
| | - C Saccu
- Cardiology Center Monzino IRCCS, Department of Cardiovascular Surgery, Milan, Italy
| | - S Zoli
- Cardiology Center Monzino IRCCS, Department of Cardiovascular Surgery, Milan, Italy
| | - M Soncini
- Milan Polytechnic, Department of Electronics, Informatics and Bioengineering, Milan, Italy
| | - C Banfi
- Cardiology Center Monzino IRCCS, Unit of Proteomics, Milan, Italy
| | - G B Fiore
- Milan Polytechnic, Department of Electronics, Informatics and Bioengineering, Milan, Italy
| | - M Pesce
- Cardiology Center Monzino IRCCS, Unit of Tissue Engineering, Milan, Italy
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48
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Garoffolo G, Vono R, Carrara M, Zoli S, Saccu C, Martelli F, Spinetti G, Madeddu P, Pesce M. P3771YAP-dependent signalling predisposes pathologic evolution of human saphenous vein progenitors by altered mechano-perception in vein bypass failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3771] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Garoffolo
- Cardiology Center Monzino IRCCS, Unità Ingegneria Tissutale Cardiovascolare, Milan, Italy
| | - R Vono
- IRCCS Multimedica of Milan, Laboratory of Cardiovascular Research, Milan, Italy
| | - M Carrara
- IRCCS, Policlinico San Donato, Molecular Cardiology Laboratory, San Donato Milanese, Italy
| | - S Zoli
- Cardiology Center Monzino IRCCS, Division of Vascular Surgery, Milan, Italy
| | - C Saccu
- Cardiology Center Monzino IRCCS, Division of Vascular Surgery, Milan, Italy
| | - F Martelli
- IRCCS, Policlinico San Donato, Molecular Cardiology Laboratory, San Donato Milanese, Italy
| | - G Spinetti
- IRCCS Multimedica of Milan, Laboratory of Cardiovascular Research, Milan, Italy
| | - P Madeddu
- Bristol Heart Institute, Bristol, United Kingdom
| | - M Pesce
- Cardiology Center Monzino IRCCS, Unità Ingegneria Tissutale Cardiovascolare, Milan, Italy
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Pesce M, Critto A, Torresan S, Giubilato E, Santini M, Zirino A, Ouyang W, Marcomini A. Modelling climate change impacts on nutrients and primary production in coastal waters. Sci Total Environ 2018; 628-629:919-937. [PMID: 30045581 DOI: 10.1016/j.scitotenv.2018.02.131] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 06/08/2023]
Abstract
There is high confidence that the anthropogenic increase of atmospheric greenhouse gases (GHGs) is causing modifications in the Earth's climate. Coastal waterbodies such as estuaries, bays and lagoons are among those most affected by the ongoing changes in climate. Being located at the land-sea interface, such waterbodies are subjected to the combined changes in the physical-chemical processes of atmosphere, upstream land and coastal waters. Particularly, climate change is expected to alter phytoplankton communities by changing their environmental drivers (especially climate-related), thus exacerbating the symptoms of eutrophication events, such as hypoxia, harmful algal blooms (HAB) and loss of habitat. A better understanding of the links between climate-related drivers and phytoplankton is therefore necessary for projecting climate change impacts on aquatic ecosystems. Here we present the case study of the Zero river basin in Italy, one of the main contributors of freshwater and nutrient to the salt-marsh Palude di Cona, a coastal waterbody belonging to the lagoon of Venice. To project the impacts of climate change on freshwater inputs, nutrient loadings and their effects on the phytoplankton community of the receiving waterbody, we formulated and applied an integrated modelling approach made of: climate simulations derived by coupling a General Circulation Model (GCM) and a Regional Climate Model (RCM) under alternative emission scenarios, the hydrological model Soil and Water Assessment Tool (SWAT) and the ecological model AQUATOX. Climate projections point out an increase of precipitations in the winter period and a decrease in the summer months, while temperature shows a significant increase over the whole year. Water discharge and nutrient loads simulated by SWAT show a tendency to increase (decrease) in the winter (summer) period. AQUATOX projects changes in the concentration of nutrients in the salt-marsh Palude di Cona, and variations in the biomass and species of the phytoplankton community.
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Affiliation(s)
- M Pesce
- University Ca' Foscari of Venice, Italy
| | - A Critto
- University Ca' Foscari of Venice, Italy; Centro Euro-Mediterraneo sui Cambiamenti Climatici, Italy.
| | - S Torresan
- University Ca' Foscari of Venice, Italy; Centro Euro-Mediterraneo sui Cambiamenti Climatici, Italy
| | | | - M Santini
- Centro Euro-Mediterraneo sui Cambiamenti Climatici, Italy
| | - A Zirino
- Scripps Institution of Oceanography, CA, USA
| | - W Ouyang
- Beijing Normal University, China
| | - A Marcomini
- University Ca' Foscari of Venice, Italy; Centro Euro-Mediterraneo sui Cambiamenti Climatici, Italy
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50
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Bruzzese E, Pesce M, Sarnelli G, Guarino A. Pharmacokinetic drug evaluation of rifaximin for treatment of diarrhea-predominant irritable bowel syndrome. Expert Opin Drug Metab Toxicol 2018; 14:753-760. [PMID: 29897844 DOI: 10.1080/17425255.2018.1488964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Rifaximin is a poorly absorbable antibiotic with a broad-spectrum activity against both Gram-negative and -positive bacteria. It is active in the small intestine due to its high bile solubility, whereas in the aqueous environment of the colon, it shows limited efficacy against highly susceptible bacteria. These unique pharmacokinetic properties limit its systemic effects and can correct gut microflora imbalances. Thus, rifaximin has become a major therapeutic agent in several gastrointestinal diseases in which an imbalance in gut microflora may play a role, including diarrhea predominant irritable bowel syndrome (IBS-D). Area covered: This is an up-to-date review focusing on the efficacy of rifaximin in the treatment of IBS-D in both adult and pediatric populations. We will review the pharmacokinetic properties of rifaximin, including its absorption in health and disease, mechanisms of action, and interactions with other drugs. Expert opinion: Given its safety profile and its negligible absorption, rifaximin is a suitable treatment for IBS-D, in both adults and children. The possibility of modulating gut microbiota composition without side effects has made this drug an appealing therapeutic agent in highly prevalent gastrointestinal diseases. However, to date, monitoring for the development of resistant bacterial strains during long-term rifaximin use is still lacking.
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Affiliation(s)
- Eugenia Bruzzese
- a Department of Translational Medical Science , 'Federico II' University of Naples 80131 , Naples , Italy
| | - Marcella Pesce
- b Department of Clinical Medicine and Surgery , 'Federico II' University of Naples 80131 , Naples , Italy.,c Division of Neurogastroenterology & Motility, Department of Pediatric Gastroenterology , Great Ormond Street , Hospital, London , UK
| | - Giovanni Sarnelli
- b Department of Clinical Medicine and Surgery , 'Federico II' University of Naples 80131 , Naples , Italy
| | - Alfredo Guarino
- a Department of Translational Medical Science , 'Federico II' University of Naples 80131 , Naples , Italy
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