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Cari L, Rosati L, Leoncini G, Lusenti E, Gentili M, Nocentini G, Riccardi C, Migliorati G, Ronchetti S. Association of GILZ with MUC2, TLR2, and TLR4 in Inflammatory Bowel Disease. Int J Mol Sci 2023; 24:ijms24032235. [PMID: 36768553 PMCID: PMC9917296 DOI: 10.3390/ijms24032235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
Ulcerative colitis (UC) and Crohn's Disease (CD) are chronic relapsing inflammatory diseases that are caused by genetic, environmental, and immune factors. Treatment strategies are currently based on symptomatic control by immunosuppression. The glucocorticoid-induced leucine zipper (GILZ), a mediator of several effects of glucocorticoids, was recently found to be secreted by goblet cells and play a role in inflammatory bowel disease (IBD). This study investigates which genes GILZ is associated with in its role in intestinal barrier functions. We examined datasets from the Gene Expression Omnibus (GEO) and ArrayExpress profiles of the gut of healthy subjects (HSs), as well as UC and CD patients. The human colonic epithelial HT29 cell line was used for in vitro validation experiments. GILZ was significantly correlated with MUC2, TLR2, and TLR4. In particular, an inverse correlation was found between the GILZ and MUC2 in HS and patients with IBD, mostly in those with an active disease. Further, direct pairwise correlations for GILZ/TLR2 and GILZ/TLR4 were found in HSs and UC patients, but not in CD patients. Overall, our results reveal the crosstalk at the transcription level between the GILZ, MUC2, and TLRs in the mucosal barrier through common pathways, and they open up new perspectives in terms of mucosal healing in IBD patients.
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Affiliation(s)
- Luigi Cari
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Lucrezia Rosati
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Giuseppe Leoncini
- First Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133 Milano, Italy
| | - Eleonora Lusenti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Marco Gentili
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Giuseppe Nocentini
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Carlo Riccardi
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Graziella Migliorati
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
| | - Simona Ronchetti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, P.le L. Severi 1, 06132 Perugia, Italy
- Correspondence:
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2
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Leoncini G, Gentili M, Lusenti E, Caruso L, Calafà C, Migliorati G, Riccardi C, Villanacci V, Ronchetti S. The novel role of glucocorticoid-induced leucine zipper as a marker of mucosal healing in inflammatory bowel diseases. Pharmacol Res 2022; 182:106353. [PMID: 35835370 DOI: 10.1016/j.phrs.2022.106353] [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: 05/11/2022] [Revised: 06/22/2022] [Accepted: 07/08/2022] [Indexed: 02/07/2023]
Abstract
Glucocorticoid-induced leucin zipper (GILZ) mediates the effects of glucocorticoids in immune cells, but little is known about its role in both the gastro-intestinal (GI) mucosa and inflammatory bowel diseases (IBD) in humans. To investigate the GILZ protein expression profile in the GI tract, mucosal biopsies from 80 patients were retrospectively enrolled in this study and subdivided into three groups: 1) patients without clinical-endoscopic and histological evidence of IBD; 2) IBD patients; 3) patients with chronic atrophic gastritis (CAG) and Barrett esophagus (BE), both characterized by intestinal metaplasia (IM). GILZ expression was assessed by immunohistochemical and immunofluorescence methods. Our results showed that GILZ protein was strongly expressed in the secretory cells in healthy mucosa. GILZ expression was reduced in goblet cells in active disease, whereas it was restored in quiescent diseases. Conversely, entero-endocrine cells were not involved in such inflammation-driven dynamics, as GILZ expression remained detectable in active disease. Moreover, GILZ was expressed in IM, but was limited to CAG, and was not detected in BE. In summary, GILZ acts as a secretory protein in the GI mucosa in healthy, hyperplastic and metaplastic conditions. Its secretion by goblet cells is mostly affected by neutrophils mucosal infiltration and seems to be directly related to active mucosal inflammation in IBD. Overall, our findings suggest that GILZ is a suitable molecule to be considered as a histological marker of mucosal healing.
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Affiliation(s)
- Giuseppe Leoncini
- Pathology Unit, Department of Pathology and Laboratory Medicine, ASST del Garda Desenzano del Garda, Brescia, Italy
| | - Marco Gentili
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Eleonora Lusenti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Laura Caruso
- Pathology Unit, Department of Pathology and Laboratory Medicine, ASST del Garda Desenzano del Garda, Brescia, Italy
| | - Cristina Calafà
- Pathology Unit, Department of Pathology and Laboratory Medicine, ASST del Garda Desenzano del Garda, Brescia, Italy
| | - Graziella Migliorati
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Carlo Riccardi
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - Simona Ronchetti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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3
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Gentili M, Hidalgo-Garcia L, Vezza T, Ricci E, Migliorati G, Rodriguez-Nogales A, Riccardi C, Galvez J, Ronchetti S. A recombinant glucocorticoid-induced leucine zipper protein ameliorates symptoms of dextran sulfate sodium-induced colitis by improving intestinal permeability. FASEB J 2021; 35:e21950. [PMID: 34613638 DOI: 10.1096/fj.202100778rrrr] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022]
Abstract
Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders characterized by relapsing intestinal inflammation, but many details of pathogenesis remain to be fully unraveled. Glucocorticoid (GC)-induced leucine zipper (GILZ) is a mediator of the anti-inflammatory effects of GCs, the most powerful drugs for IBD treatment, but they cause several unwanted side effects. The fusion protein TAT-GILZ has been successfully used in some pre-clinical models of inflammatory and autoimmune diseases. To test the efficacy of TAT-GILZ for treating dextran sulfate sodium (DSS)-induced colitis and explore its impact on the gut microbiome, colitis was induced by DSS in C57BL/6J mice and treated with TAT-GILZ or dexamethasone. Various hallmarks of colitis were analyzed, including disease activity index, gut permeability, and expression of pro-inflammatory cytokines and tight junction proteins. TAT-GILZ treatment showed a therapeutic effect when administered after the onset of colitis. Its efficacy was associated with improved gut permeability, as evidenced by zonula occludens-1 and CD74 upregulation in inflamed colonic tissue. TAT-GILZ also ameliorated the changes in the gut microbiota induced by the DSS, thus potentially providing an optimal environment for colonization of the mucosa surface by beneficial bacteria. Overall, our results demonstrated for the first time that TAT-GILZ treatment proved effective after disease onset allowing restoration of gut permeability, a key pathogenic feature of colitis. Additionally, TAT-GILZ restored gut dysbiosis, thereby contributing to healing mechanisms. Interestingly, we found unprecedented effects of exogenous GILZ that did not overlap with those of GCs.
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Affiliation(s)
- Marco Gentili
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Laura Hidalgo-Garcia
- CIBER-EHD, Department of Pharmacology, ibs.GRANADA, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Teresa Vezza
- CIBER-EHD, Department of Pharmacology, ibs.GRANADA, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Erika Ricci
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Graziella Migliorati
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alba Rodriguez-Nogales
- CIBER-EHD, Department of Pharmacology, ibs.GRANADA, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Carlo Riccardi
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Julio Galvez
- CIBER-EHD, Department of Pharmacology, ibs.GRANADA, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Simona Ronchetti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Ricci E, Roselletti E, Gentili M, Sabbatini S, Perito S, Riccardi C, Migliorati G, Monari C, Ronchetti S. Glucocorticoid-Induced Leucine Zipper-Mediated TLR2 Downregulation Accounts for Reduced Neutrophil Activity Following Acute DEX Treatment. Cells 2021; 10:2228. [PMID: 34571877 PMCID: PMC8472062 DOI: 10.3390/cells10092228] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/03/2022] Open
Abstract
Glucocorticoids are the most powerful anti-inflammatory and immunosuppressive pharmacological drugs available, despite their adverse effects. Glucocorticoid-induced leucine zipper (GILZ) is a glucocorticoid-induced gene that shares several anti-inflammatory properties with glucocorticoids. Although immunosuppressive effects of glucocorticoids on neutrophils remain poorly understood, we previously demonstrated that GILZ suppresses neutrophil activation under glucocorticoid treatment. Here, we sought to explore the regulation of Toll-like receptor 2 (TLR2) by the synthetic glucocorticoid dexamethasone (DEX) on neutrophils and the associated GILZ involvement. Peripheral blood neutrophils were isolated from wild type and GILZ-knock-out (KO) mice. TLR2 was found to be downregulated by the in vivo administration of glucocorticoids in wild type but not in GILZ-KO neutrophils, suggesting the involvement of GILZ in TLR2 downregulation. Accordingly, the TLR2-associated anti-fungal activity of neutrophils was reduced by DEX treatment in wild type but not GILZ-KO neutrophils. Furthermore, GILZ did not interact with NF-κB but was found to bind with STAT5, a pivotal factor in the regulation of TLR2 expression. A similar modulation of TLR2 expression, impaired phagocytosis, and killing activity was observed in circulating human neutrophils treated in vitro with DEX. These results demonstrate that glucocorticoids reduce the ability of neutrophils to respond to infections by downregulating TLR2 via GILZ, thereby reducing critical functions.
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Affiliation(s)
- Erika Ricci
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Elena Roselletti
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Marco Gentili
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Stefano Perito
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Carlo Riccardi
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Graziella Migliorati
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
| | - Claudia Monari
- Department of Medicine and Surgery, Medical Microbiology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (S.S.); (S.P.); (C.M.)
| | - Simona Ronchetti
- Department of Medicine and Surgery, Pharmacology Division, University of Perugia, 06132 Perugia, Italy; (E.R.); (M.G.); (C.R.); (G.M.)
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Ronchetti S, Ayroldi E, Ricci E, Gentili M, Migliorati G, Riccardi C. A Glance at the Use of Glucocorticoids in Rare Inflammatory and Autoimmune Diseases: Still an Indispensable Pharmacological Tool? Front Immunol 2021; 11:613435. [PMID: 33584696 PMCID: PMC7874096 DOI: 10.3389/fimmu.2020.613435] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/04/2020] [Indexed: 12/11/2022] Open
Abstract
Since their discovery, glucocorticoids (GCs) have been used to treat almost all autoimmune and chronic inflammatory diseases, as well as allergies and some forms of malignancies, because of their immunosuppressive and anti-inflammatory effects. Although GCs provide only symptomatic relief and do not eliminate the cause of the pathology, in the majority of treatments, GCs frequently cannot be replaced by other classes of drugs. Consequently, long-term treatments cause adverse effects that may, in turn, lead to new pathologies that sometimes require the withdrawal of GC therapy. Therefore, thus far, researchers have focused their efforts on molecules that have the same efficacy as that of GCs but cause fewer adverse effects. To this end, some GC-induced proteins, such as glucocorticoid-induced leucine zipper (GILZ), have been used as drugs in mouse models of inflammatory pathologies. In this review, we focus on some important but rare autoimmune and chronic inflammatory diseases for which the biomedical research investment in new therapies is less likely. Additionally, we critically evaluate the possibility of treating such diseases with other drugs, either GC-related or unrelated.
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Affiliation(s)
- Simona Ronchetti
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Emira Ayroldi
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Erika Ricci
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Marco Gentili
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Graziella Migliorati
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Carlo Riccardi
- Pharmacology Division, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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6
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Ronchetti S, Gentili M, Ricci E, Migliorati G, Riccardi C. Glucocorticoid-Induced Leucine Zipper as a Druggable Target in Inflammatory Bowel Diseases. Inflamm Bowel Dis 2020; 26:1017-1025. [PMID: 31961437 DOI: 10.1093/ibd/izz331] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/11/2022]
Abstract
Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders with a complex pathogenesis, affecting people of all ages. They are characterized by alternating phases of clinical relapse and remission, depending on the fine balance between immune cells and the gut microbiota. The cross talk between cells of the immune system and the gut microbiota can result in either tolerance or inflammation, according to multifactorial triggers, ranging from environmental factors to genetic susceptibility. Glucocorticoid (GC) administration remains the first-line treatment for IBDs, although long-term use is limited by development of serious adverse effects. Recently, new alternative pharmacological therapies have been developed, although these are not always effective in IBD patients. There is a constant demand for effective new drug targets to guarantee total remission and improve the quality of life for IBD patients. The glucocorticoid-induced leucine zipper (GILZ) has been implicated as a promising candidate for this purpose, in view of its powerful anti-inflammatory effects that mimic those of GCs while avoiding their unwanted adverse reactions. Here we present and discuss the latest findings about the involvement of GILZ in IBDs.
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Affiliation(s)
- Simona Ronchetti
- Department of Medicine, Pharmacology Division, University of Perugia, Italy
| | - Marco Gentili
- Department of Medicine, Pharmacology Division, University of Perugia, Italy
| | - Erika Ricci
- Department of Medicine, Pharmacology Division, University of Perugia, Italy
| | | | - Carlo Riccardi
- Department of Medicine, Pharmacology Division, University of Perugia, Italy
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Rivard A, Gentili M, Koizumi N. Interactive Maps for UNOS Data Visualization. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1013] [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: 11/15/2022] Open
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Gentili M, Ronchetti S, Ricci E, Di Paola R, Gugliandolo E, Cuzzocrea S, Bereshchenko O, Migliorati G, Riccardi C. Selective CB2 inverse agonist JTE907 drives T cell differentiation towards a Treg cell phenotype and ameliorates inflammation in a mouse model of inflammatory bowel disease. Pharmacol Res 2018; 141:21-31. [PMID: 30552973 DOI: 10.1016/j.phrs.2018.12.005] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
Cannabinoids are known to possess anti-inflammatory and immunomodulatory properties, but the mechanisms involved are not fully understood. CB2 is the cannabinoid receptor that is expressed primarily on hematopoietic cells and mediates the immunoregulatory functions of cannabinoids. In order to study the effect of JTE907, a selective/inverse agonist of CB2 with anti-inflammatory properties, on the differentiation of T cell subtypes, we used an in vitro system of Th lineage-specific differentiation of naïve CD4+ T lymphocytes isolated from the mouse spleen. The results indicate that JTE907 was able to induce the differentiation of Th0 cells into the Treg cell phenotype, which was characterized by the expression of FoxP3, TGF-β and IL-10. P38 phosphorylation and STAT5A activation were found to mediate the signaling pathway triggered by JTE907 via the CB2 receptor in Th0 lymphocytes. In mice with DNBS-induced colitis, JTE907 treatment was able to induce an increase in the number of CD4+CD25+FoxP3+ cells in the lamina propria after 24 h of disease onset and reduce disease severity after 48 h. Further, longer JTE907 treatment resulted in less severe colitis even when administered orally, resulting in less body weight loss, reduction of the disease score, prevention of NF-κB activation, and reduction of the expression of adhesion molecules. Collectively, the results of this study indicate that specific signals delivered through the CB2 receptor can drive the immune response towards the Treg cell phenotype. Thus, ligands such as JTE907 may have use as potential therapeutic agents in autoimmune and inflammatory diseases.
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Affiliation(s)
- Marco Gentili
- Department of Medicine, Section of Pharmacology, University of Perugia, Italy
| | - Simona Ronchetti
- Department of Medicine, Section of Pharmacology, University of Perugia, Italy.
| | - Erika Ricci
- Department of Medicine, Section of Pharmacology, University of Perugia, Italy
| | - Rosanna Di Paola
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Enrico Gugliandolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Italy
| | - Oxana Bereshchenko
- Department of Medicine, Section of Pharmacology, University of Perugia, Italy
| | | | - Carlo Riccardi
- Department of Medicine, Section of Pharmacology, University of Perugia, Italy
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Ricci E, Ronchetti S, Gabrielli E, Pericolini E, Gentili M, Roselletti E, Vecchiarelli A, Riccardi C. GILZ restrains neutrophil activation by inhibiting the MAPK pathway. J Leukoc Biol 2018; 105:187-194. [PMID: 30371949 DOI: 10.1002/jlb.3ab0718-255r] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 07/05/2018] [Revised: 09/11/2018] [Accepted: 10/04/2018] [Indexed: 01/09/2023] Open
Abstract
Glucocorticoid-induced leucine zipper (GILZ) exerts anti-inflammatory effects on the immune cells. However, less is known about GILZ function in neutrophils. We aimed to define the specific role of GILZ in basal neutrophil activity during an inflammatory response. GILZ knockdown resulted in a persistent activation state of neutrophils, as evidenced by increased phagocytosis, killing activity, and oxidative burst in GILZ-knockout (KO) neutrophils. This enhanced response caused severe disease in a dinitrobenzene sulfonic acid (DNBS)-induced colitis model, where GILZ-KO mice had prominent granulocytic infiltrate and excessive inflammatory state. We used a Candida albicans intraperitoneal infection model to unravel the intracellular pathways affected by GILZ expression in activated neutrophils. GILZ-KO neutrophils had stronger ability to clear the infectious agent than the wild-type (WT) neutrophils, and there was more activation of the NOX2 (NADPH oxidase 2) and p47phox proteins, which are directly involved in oxidative burst. Similarly, the MAPK pathway components, that is, ERK and p38, which are involved in the oxidative burst pathway, were highly phosphorylated in GILZ-KO neutrophils. Evaluation of GILZ expression kinetics during C. albicans infection revealed down-regulation that correlated inversely with the state of neutrophil activation, which was evaluated as oxidative burst. Overall, our findings define GILZ as a regulator of neutrophil functions, as its expression contributes to limiting neutrophil activation by reducing the activation of the signaling pathways that control the basal neutrophil functions. Controlling GILZ expression could help regulate a continuous inflammatory state that can result in chronic inflammatory and autoimmune diseases.
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Affiliation(s)
- Erika Ricci
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
| | - Simona Ronchetti
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
| | - Elena Gabrielli
- Department of Medicine, Microbiology Section, University of Perugia, Perugia, Italy
| | - Eva Pericolini
- Department of Diagnostic, Clinic and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Gentili
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
| | - Elena Roselletti
- Department of Medicine, Microbiology Section, University of Perugia, Perugia, Italy
| | - Anna Vecchiarelli
- Department of Medicine, Microbiology Section, University of Perugia, Perugia, Italy
| | - Carlo Riccardi
- Department of Medicine, Section of Pharmacology, University of Perugia, Perugia, Italy
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Ricci E, Ronchetti S, Pericolini E, Gabrielli E, Cari L, Gentili M, Roselletti E, Migliorati G, Vecchiarelli A, Riccardi C. Role of the glucocorticoid-induced leucine zipper gene in dexamethasone-induced inhibition of mouse neutrophil migration via control of annexin A1 expression. FASEB J 2017; 31:3054-3065. [PMID: 28373208 DOI: 10.1096/fj.201601315r] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
The glucocorticoid-induced leucine zipper (GILZ) gene is a pivotal mediator of the anti-inflammatory effects of glucocorticoids (GCs) that are known to regulate the function of both adaptive and innate immunity cells. Our aim was to investigate the role of GILZ in GC-induced inhibition of neutrophil migration, as this role has not been investigated before. We found that GILZ expression was induced by dexamethasone (DEX), a synthetic GC, in neutrophils, and that it regulated migration of these cells into inflamed tissues under DEX treatment. Of note, inhibition of neutrophil migration was not observed in GILZ-knockout mice with peritonitis that were treated by DEX. This was because DEX was unable to up-regulate annexin A1 (Anxa1) expression in the absence of GILZ. Furthermore, we showed that GILZ mediates Anxa1 induction by GCs by transactivating Anxa1 expression at the promoter level via binding with the transcription factor, PU.1. The present findings shed light on the role of GILZ in the mechanism of induction of Anxa1 by GCs. As Anxa1 is an important protein for the resolution of inflammatory response, GILZ may represent a new pharmacologic target for treatment of inflammatory diseases.-Ricci, E., Ronchetti, S., Pericolini, E., Gabrielli, E., Cari, L., Gentili, M., Roselletti, E., Migliorati, G., Vecchiarelli, A., Riccardi, C. Role of the glucocorticoid-induced leucine zipper gene in dexamethasone-induced inhibition of mouse neutrophil migration via control of annexin A1 expression.
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Affiliation(s)
- Erika Ricci
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Simona Ronchetti
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Eva Pericolini
- Microbiology Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy.,Department of Diagnostic, Clinic, and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Gabrielli
- Microbiology Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Luigi Cari
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Marco Gentili
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Elena Roselletti
- Microbiology Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Graziella Migliorati
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - Anna Vecchiarelli
- Microbiology Section, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Carlo Riccardi
- Pharmacology Section, Department of Medicine, University of Perugia, Perugia, Italy;
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Affiliation(s)
- M. Gentili
- CEA, DEN, DER, Cadarache, 13108 Saint Paul Lez Durance, France
- Aixi Marseille Université, 13284, Marseille, France
| | - B. Fontaine
- CEA, DEN, DER, Cadarache, 13108 Saint Paul Lez Durance, France
| | - G. Rimpault
- CEA, DEN, DER, Cadarache, 13108 Saint Paul Lez Durance, France
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12
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Raab M, Gentili M, de Belly H, Thiam HR, Vargas P, Jimenez AJ, Lautenschlaeger F, Voituriez R, Lennon-Duménil AM, Manel N, Piel M. ESCRT III repairs nuclear envelope ruptures during cell migration to limit DNA damage and cell death. Science 2016; 352:359-62. [PMID: 27013426 DOI: 10.1126/science.aad7611] [Citation(s) in RCA: 590] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/25/2016] [Indexed: 12/18/2022]
Abstract
In eukaryotic cells, the nuclear envelope separates the genomic DNA from the cytoplasmic space and regulates protein trafficking between the two compartments. This barrier is only transiently dissolved during mitosis. Here, we found that it also opened at high frequency in migrating mammalian cells during interphase, which allowed nuclear proteins to leak out and cytoplasmic proteins to leak in. This transient opening was caused by nuclear deformation and was rapidly repaired in an ESCRT (endosomal sorting complexes required for transport)-dependent manner. DNA double-strand breaks coincided with nuclear envelope opening events. As a consequence, survival of cells migrating through confining environments depended on efficient nuclear envelope and DNA repair machineries. Nuclear envelope opening in migrating leukocytes could have potentially important consequences for normal and pathological immune responses.
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Affiliation(s)
- M Raab
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France. Institut Pierre-Gilles de Gennes, PSL Research University, F-75005 Paris, France
| | - M Gentili
- Institut Curie, PSL Research University, INSERM, U 932, F-75005 Paris, France
| | - H de Belly
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France
| | - H R Thiam
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France
| | - P Vargas
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France. Institut Pierre-Gilles de Gennes, PSL Research University, F-75005 Paris, France
| | - A J Jimenez
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France
| | - F Lautenschlaeger
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France
| | - Raphaël Voituriez
- Laboratoire de Physique Théorique de la Matière Condensée, CNRS UMR 7600, Université Pierre et Marie Curie, Paris, France. Laboratoire Jean Perrin, CNRS UMR 8237, Université Pierre et Marie Curie, Paris, France
| | - A M Lennon-Duménil
- Institut Curie, PSL Research University, INSERM, U 932, F-75005 Paris, France
| | - N Manel
- Institut Curie, PSL Research University, INSERM, U 932, F-75005 Paris, France
| | - M Piel
- Institut Curie, PSL Research University, CNRS, UMR 144, F-75005 Paris, France. Institut Pierre-Gilles de Gennes, PSL Research University, F-75005 Paris, France.
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Gentili M, Marinaccio PM, Galimberti C, Carnovale C, Antoniazzi S, Pozzi M, Clementi E, Viganò C, Radice S. A case of dysgraphia induced by sertraline and a review of official spontaneous adverse reaction databases. J Clin Pharm Ther 2016; 41:106-7. [PMID: 26792111 DOI: 10.1111/jcpt.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES The occurrence of dysgraphia after sertraline intake has never been reported. The objective was to describe a case of this adverse drug reaction and present a review of similar cases held in international databases with a discussion of the possible pharmacological mechanisms. CASE SUMMARY We observed a 60-year-old man who experienced resting tremors, dyskinesia and dysgraphia 2 months after a stepwise increase in sertraline dosing from 50 to 200 mg/day. WHAT IS NEW AND CONCLUSION Dysgraphia is a possible adverse drug reaction to sertraline, and we suggest that inhibition of extrapyramidal dopaminergic activity might be the pharmacological mechanism.
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Affiliation(s)
- M Gentili
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
| | - P M Marinaccio
- Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
| | - C Galimberti
- Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
| | - C Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
| | - S Antoniazzi
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy.,Scientific Direction, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Pozzi
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - E Clementi
- Scientific Institute, IRCCS E. Medea, Lecco, Italy.,Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital 'Luigi Sacco', Università di Milano, Milan, Italy
| | - C Viganò
- Psychiatry Unit, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
| | - S Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, 'Luigi Sacco' University Hospital, Università di Milano, Milan, Italy
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Kennedy S, Hu J, Kearney C, Skaat H, Gu L, Gentili M, Vandenburgh H, Mooney D. Sequential release of nanoparticle payloads from ultrasonically burstable capsules. Biomaterials 2015; 75:91-101. [PMID: 26496382 DOI: 10.1016/j.biomaterials.2015.10.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/01/2015] [Accepted: 10/05/2015] [Indexed: 12/22/2022]
Abstract
In many biomedical contexts ranging from chemotherapy to tissue engineering, it is beneficial to sequentially present bioactive payloads. Explicit control over the timing and dose of these presentations is highly desirable. Here, we present a capsule-based delivery system capable of rapidly releasing multiple payloads in response to ultrasonic signals. In vitro, these alginate capsules exhibited excellent payload retention for up to 1 week when unstimulated and delivered their entire payloads when ultrasonically stimulated for 10-100 s. Shorter exposures (10 s) were required to trigger delivery from capsules embedded in hydrogels placed in a tissue model and did not result in tissue heating or death of encapsulated cells. Different types of capsules were tuned to rupture in response to different ultrasonic stimuli, thus permitting the sequential, on-demand delivery of nanoparticle payloads. As a proof of concept, gold nanoparticles were decorated with bone morphogenetic protein-2 to demonstrate the potential bioactivity of nanoparticle payloads. These nanoparticles were not cytotoxic and induced an osteogenic response in mouse mesenchymal stem cells. This system may enable researchers and physicians to remotely regulate the timing, dose, and sequence of drug delivery on-demand, with a wide range of clinical applications ranging from tissue engineering to cancer treatment.
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Affiliation(s)
- Stephen Kennedy
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Department of Electrical, Computer, and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA; Department of Chemical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Jennifer Hu
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Cathal Kearney
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA; Department of Anatomy, Tissue Engineering Research Group and Advanced Materials and Bioengineering Research Center, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hadas Skaat
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Luo Gu
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Marco Gentili
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Herman Vandenburgh
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, RI 02912, USA; Department of Pathology and Laboratory Medicine, Brown University, Providence, RI 02912, USA
| | - David Mooney
- Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA.
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Lessiani G, Iodice P, Nicolucci E, Gentili M. Lymphatic edema of the lower limbs after orthopedic surgery: results of a randomized, open-label clinical trial with a new extended-release preparation. J BIOL REG HOMEOS AG 2015; 29:805-812. [PMID: 26753640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The lymphedema is a high interstitial protein concentration edema, caused by impaired lymphatic transport capacity. It can be primary or secondary. The secondary form may be caused by a lesion of the lymphatic vessels and/or lymph nodes during diagnostic or therapeutic procedures such as surgical interventions. Often, in clinical practice, there is lymphedema after orthopedic surgery, even in minor orthopedic surgery. Lymphedema, typically presents symptoms of swelling, pain, inflammation, and itching, and it can generate, over the years, acute disability in the affected limbs. The standard therapy is mainly represented by medical treatment, such as manual lymphatic drainage and compression with bandages and stockings. In literature it is documented that lymphedema is responsive to alpha and the gamma benzopyrones. The aim of this study was to determine the effectiveness of delayed extended-release formulation of a compound containing apha-benzo-pyrone (Coumarin), benzo-gamma-pyrone (Troxuretina) and oligomeric proanthocyanidins from Vitis vinifera (OPC), in addition to compression therapy, in the reduction of lymphatic edema after prosthetic hip and knee surgery. In the group treated, after 30 days, a reduction was observed of the edema of 4.8% in the ankle area (p less than 0.008) and 2.7% in the calf area (p less than 0.013). The control group showed no significant reduction. The treated group showed a marked reduction of all the secondary symptoms considered in the study, although variations were not significant. The results show that the compound used was effective in reducing edema after major orthopedic surgery, and consequently in alleviating some related symptoms, such as pain, itching, and burning. As an edema has extensive inflammatory components in patients with reduced mobility, the final data seems interesting, however, further investigations and a better follow-up are required.
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Affiliation(s)
- G Lessiani
- Vascular Medicine Unit, Private Hospital Villa Serena, Città SantAngelo (PE), Italy
| | - P Iodice
- Orthopedic Rehabilitation Unit, Private Hospital Villa Serena, Città SantAngelo (PE), Italy
| | - E Nicolucci
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - M Gentili
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
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16
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Brusadelli T, Carnovale C, Gentili M, Borsadoli C, Speziali A, Perrone V, Pellegrino P, Antoniazzi S, Pozzi M, Radice S, Clementi E. Throbbing headache associated with enoxaparin administration: a case report, a review of pharmacovigilance databases for similar cases and possible mechanisms. J Clin Pharm Ther 2015; 40:342-4. [PMID: 25726970 DOI: 10.1111/jcpt.12257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 01/21/2015] [Accepted: 02/05/2015] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES To date, no case of headache has been reported with enoxaparin. We present the case of a 60-years-old man, who developed enoxaparin-induced throbbing headache and discuss the possible pharmacological mechanisms. We provide an analysis of enoxaparin-induced headache in three international databases. CASE SUMMARY A few hours after the subcutaneous administration of this drug at therapeutic dose, the patient experienced throbbing headache. Rechallenge on two other separate occasions separated by several days produced the same effect although with reduced intensity when the dose was lowered. The Naranjo Algorithm indicated a 'certain' relationship. WHAT IS NEW AND CONCLUSION We report a case of throbbing headache associated with the use of enoxaparin; with the increasing use of enoxaparin, physicians who prescribe this drug should be aware of this potential ADR. We suggest that it is a heparin class-effect, and therefore, a more general caution is also appropriate.
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Affiliation(s)
- T Brusadelli
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, Università di Milano, Milan, Italy
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17
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Pellegrino P, Carnovale C, Perrone V, Salvati D, Gentili M, Brusadelli T, Antoniazzi S, Pozzi M, Radice S, Clementi E. Epidemiological analysis on two decades of hospitalisations for meningitis in the United States. Eur J Clin Microbiol Infect Dis 2014; 33:1519-24. [DOI: 10.1007/s10096-014-2102-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 03/27/2014] [Indexed: 11/29/2022]
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18
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Saumier N, Gentili M, Dupont H, Aubrun F. [Postoperative intravenous morphine titration in PACU after bariatric laparoscopic surgery]. ACTA ACUST UNITED AC 2013; 32:850-5. [PMID: 24199906 DOI: 10.1016/j.annfar.2013.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Accepted: 09/25/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is limited information available regarding intravenous (IV) morphine administration in obese patients in PACU. The aim of this study was to compare two IV morphine titration (IMT) regimen in two surgical centers. STUDY DESIGN Observational study. PATIENTS Laparoscopic bariatric surgery in one private (Saint-Grégoire Clinic) and one public (University Hospital of Amiens) surgical center. METHODS A strict and common protocol of IMT was implemented if PACU of both centers according to the recommendations of the French Society of Anaesthesia and Intensive Care. When pain score increased to>30, IMT was titrated every 5 min in 3mg increments until pain relief (VAS≤30 mm). Pain level, dose of morphine (per total and ideal body weight), effectiveness, and side events were recorded. RESULTS Data were recorded for 159 adult patients (129 women). Mean age and BMI were 42±12 yrs and 43.8±6.9 kg/m(2). Ninety-eight patients were eligible for IMT regimen but only 76 patients received IV morphine (47.8 %). Mean dose was 7.3 mg±3.5mg [1-19 mg], (60.4 μg/kg and 115.8 μg/kg). IMT was less frequent, mean dose was greater (8.6±4.2 vs 6.2±2.9 mg) and number of patients with pain relief was higher (73.7 vs 35.6 %) in the public hospital. No severe adverse events have been recorded and there was no difference in both centers regarding these events. CONCLUSION Implementation of a IMT regimen in PACU was not associated with effective pain relief after laparoscopic surgery in obese patients.
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Affiliation(s)
- N Saumier
- Pôle d'anesthésie-réanimation, CHU, place Victor-Pauchet, 80054 Amiens, France
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19
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Villevieille T, Delaunay L, Gentili M, Benhamou D. Chirurgie arthroscopique de l’épaule et complications ischémiques cérébrales. ACTA ACUST UNITED AC 2012; 31:914-8. [DOI: 10.1016/j.annfar.2012.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 08/14/2012] [Indexed: 10/27/2022]
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20
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Hugot P, Aguillon D, Musellec H, Breitel D, Gentili M. [Tracheal tube obstruction mimicking a bronchospasm]. Ann Fr Anesth Reanim 2012; 31:488-490. [PMID: 22513179 DOI: 10.1016/j.annfar.2012.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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21
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Nouette-Gaulain K, Lenfant F, Jacquet Francillon D, Belbachir A, Bournigault-Nuquet A, Choquet O, Claisse A, Dujarric F, Francon D, Gentili M, Majoufre-Lefebvre C, Marciniack B, Péan D, Yavordios PG, Leone M. [French clinical guidelines for prevention of perianaesthetic dental injuries. Short text]. Ann Fr Anesth Reanim 2012; 31:272-5. [PMID: 22366392 DOI: 10.1016/j.annfar.2012.01.003] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- K Nouette-Gaulain
- Pôle d'anesthésie-réanimation, service d'anesthésie-réanimation III, hôpital des enfants, centre hospitalier universitaire de Bordeaux, université Bordeaux Segalen, place Amélie-Raba-Léon, 33076 Bordeaux, France.
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22
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Nouette-Gaulain K, Lenfant F, Jacquet-Francillon D, Belbachir A, Bournigault-Nuquet A, Choquet O, Claisse A, Dujarric F, Francon D, Gentili M, Majoufre-Lefebvre C, Marciniack B, Péan D, Yavordios PG, Leone M. [French clinical guidelines for prevention of perianaesthetic dental injuries: long text]. Ann Fr Anesth Reanim 2012; 31:213-23. [PMID: 22377414 DOI: 10.1016/j.annfar.2012.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dental injuries represent the most common claims against the anaesthesiologists. Dental lesions are frequent complications of orotracheal intubation and major causal factors are, firstly, preexisting poor dentition, and, secondly, difficult laryngoscopy and tracheal intubation. The aim of this work was to prioritize propositions for prevention in perianaesthetic dental injury and for care in case of dental trauma. METHOD A GRADE consensus procedure consisting of three rounds was conducted. A purposively selected heterogeneous panel (n=15) of experts, comprising 10 practitioners in anesthesiology, one practitioner who is jurist and anaesthesiologist, two practitioners in maxillofacial surgery, and two practitioners in dentist surgery. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the board members. The guidelines represent the best current evidence based on literature search and professional opinion. RESULTS The entire panel completed all three rounds and 31 plus six propositions were written for adult and paediatric clinical practice in anaesthesiology, respectively. The experts highlight the interest of preoperative visit for minimizing dental injuries: the practitioner must identify risk factors for difficult intubation and ventilation, describe precisely patient's preoperative dental condition, including upper incisor most commonly involved teeth in dental trauma. Patients have to be informed by practitioner for risk dental injury and anaesthesiology staff must choose his anesthesia protocol before the induction of intubation narcosis, avoiding insufficient anaesthesia and lack of experience by the anaesthesiologist. The choice of accurate proceeding during laryngoscopy, tracheal intubation and extubation for example, can aid in the prevention of dental injury, reduce the number of claims and the cost of litigation process. DISCUSSION These guidelines delineate an approach for the prevention of perianaesthetic dental trauma and for the immediate or urgent care in case of perianaesthetic dental injury.
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Affiliation(s)
- K Nouette-Gaulain
- Pôle d'anesthésie réanimation, service d'anesthésie-réanimation III, université Bordeaux-Segalen, hôpital des enfants, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
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Abstract
BACKGROUND Spinal bupivacaine produces a complete anaesthetic block of a longer duration than ropivacaine, which leads to a potentially increased risk of failure. A combination of sufentanil to ropivacaine may improve the block's reliability. METHODS Sixty-four patients, scheduled for varicose vein stripping or the tension-free vaginal tape procedure, were allocated to receive double-blindly, spinal bupivacaine 10 mg (Group 1) or ropivacaine 10 mg without (Group 2) or with sufentanil 2.5 mcg (Group 3), 5 mcg (Group 4). Sensory block was tested with pinprick and motor block was evaluated with the Bromage scale until full recovery. The primary endpoint was to compare the duration of sensory block evaluated by regression to S2. RESULTS In comparison with bupivacaine, ropivacaine produced a shorter duration sensory block (median at 68, 90 and 120 min in groups 2, 3 and 4, respectively, vs. 150 min in Group 1) and motor block (median at 90, 98 and 120 min in groups 2, 3 and 4 vs. 180 min in Group 1). Motor blockade was significantly less important in patients receiving spinal ropivacaine (median values for the Bromage scale at 3 in groups 2, 3 and 4, vs. 1 in Group 1). Pruritus was significantly more frequent in patients receiving spinal sufentanil (Groups 3 and 4 vs. Groups 1 and 2). CONCLUSION Plain bupivacaine 10 mg has a longer recovery profile than the same dose of ropivacaine with or without sufentanil.
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Affiliation(s)
- E Marret
- Department of Anaesthesiology and Critical Care, Tenon University Hospital, University Pierre et Marie Curie, Paris, France.
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24
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Gianni W, Madaio RA, Di Cioccio L, D'Amico F, Policicchio D, Postacchini D, Franchi F, Ceci M, Benincasa E, Gentili M, Zuccaro SM. Prevalence of pain in elderly hospitalized patients. Arch Gerontol Geriatr 2009; 51:273-6. [PMID: 20031238 DOI: 10.1016/j.archger.2009.11.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2009] [Revised: 11/18/2009] [Accepted: 11/20/2009] [Indexed: 10/20/2022]
Abstract
Several studies indicate that pain, although very common in the elderly, is under-treated, because it is considered as a concomitant effect of aging. This study aimed to evaluate the prevalence of pain among patients in eight Italian geriatric hospital departments, correlated to prescribed therapy. We enrolled 387 patients in the study, 367 of whom were evaluated. Each patient's recovery, co-morbidity, pain intensity, prescribed therapy, side effects, duration of pain, and efficacy of therapy were monitored during two 15-day periods from 15 July to end of August 2008, and from 1 October to 15 November 2008. The results of this study confirmed that hypertension, cardiopathic disease, diabetes, and chronic obstructive pulmonary disease (COPD) are common pathologies, and that pain is present in 67.3% of those recovered in geriatric departments. In general, however, pain is not treated. Indeed only 49% of those with pain had any type of treatment, which was adequate for the pain intensity. In fact 74.5% of patients considered the therapy to be of low or no efficacy. These data demonstrate the presence of pain in a high percentage of elderly patients, which is either not treated, or treated inadequately. Controlling pain is essential in elderly patients in order to allow a normal life and an active role in family and society. The main conclusion is that pain is often poorly considered in the elderly, thus leading to a dangerous under-treatment. We want to underline the crucial clinical impact of such under-treatment in elderly patients.
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Affiliation(s)
- W Gianni
- Istituto Nazionale di Ricerca e Cura per Anziani I.N.R.C.A.-I.R.C.C.S., Unità Operativa di Geriatria Roma, Via Cassia 1167, I-00189 Roma, Italy.
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25
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Affiliation(s)
- P Macaire
- Département d'anesthésie-réanimation, centre clinical, Soyaux, France
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Delaunay L, Catoire P, Estèbe JP, Gentili M. [About a neuropathy...]. Ann Fr Anesth Reanim 2009; 28:173-176. [PMID: 19167184 DOI: 10.1016/j.annfar.2008.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Lucchetti L, Gentili M, Simoni F, Pavliuchenko S, Subota S, Reshetnyak V. Surface-induced nonlinearities of liquid crystals driven by an electric field. Phys Rev E Stat Nonlin Soft Matter Phys 2008; 78:061706. [PMID: 19256857 DOI: 10.1103/physreve.78.061706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Indexed: 05/27/2023]
Abstract
We report the study of the effect of a static electric field on the huge optical nonlinearity of methyl-red doped nematic liquid crystals. Experimental data are well fitted using a theoretical model that takes into account the modulation of the surface charge density due to the impinging light beam. It is demonstrated that the optical nonlinearity can be varied by orders of magnitude with application of a low voltage below the threshold of the Fredericks transition. These results confirm the previously proposed model of surface induced nonlinear effects.
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Affiliation(s)
- L Lucchetti
- Dipartimento di Fisica e Ingegneria dei Materiali e del Territorio and CNISM, Università Politecnica delle Marche, Via Brecce Bianche, 60131 Ancona, Italy.
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Müller D, Gentili M, Weigel M, Sütterlin M. Ist die Spermaqualität HIV-infizierter Männer mit Kinderwunsch durch die Antiretrovirale Therapie verschlechtert? Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Nicolini D, di Francesco F, Cautero N, De Luca S, Vecchi A, Garelli P, Martorelli G, Vincenzi P, Gentili M, Baccarani U, Adani GL, Risaliti A. Technical solutions for venous outflow reconstruction in damaged liver grafts during procurement: case reports. Transplant Proc 2008; 40:1941-3. [PMID: 18675095 DOI: 10.1016/j.transproceed.2008.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The incidence and clinical consequences of hepatic injuries (parenchymal, vascular, and biliary) due to surgical handling during multiorgan procurement are still underestimated. Surgical damage to liver grafts may lead to an increased mortality and graft dysfunction rate; therefore, multiorgan procurements require a high level of expertise and training. We report our experience in two cases of accidental venous outflow damage during liver procurement focusing on our repair strategies. In one case, a short suprahepatic inferior vena cava (IVC) was extended by a venous cuff obtained from a long infrahepatic IVC from the same liver graft. In the second case, we observed a complete transection of the middle hepatic vein during in situ splitting procedure. The damage was reconstructed by cadaveric iliac vein interposition. In both cases, liver transplantation was successfully performed without venous complication. An adequate surgical technique in liver procurement and venous reconstruction during living donor and domino liver transplantation are formidable tools to achieve successful liver transplantation with a damaged graft.
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Affiliation(s)
- D Nicolini
- Chirurgia Epatobiliopancreatica e dei Trapianti di Fegato, Rene e Pancreas, Dipartimento di Scienze Mediche e Chirurgiche, Università Politecnica delle Marche, Ancona, Italy.
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Müller D, Gentili M, Weigel M, Sütterlin M. Untersuchungen zu Spermaqualität HIV-infizierter Männer mit Kinderwunsch. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1079245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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31
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Pasqui F, Mastrodonato L, Ceccarelli F, Scrivo R, Magrini L, Riccieri V, Di Franco M, Gentili M, Valesini G, Spadaro A. [Occupational therapy in rheumatoid arthritis: short term prospective study in patients treated with anti-TNF-alpha drugs]. Reumatismo 2006; 58:191-8. [PMID: 17013435 DOI: 10.4081/reumatismo.2006.191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the effect of occupational therapy (OT) in rheumatoid arthritis (RA) patients treated with anti-TNF-alpha drugs in a short-term open controlled prospective study. METHODS 31 RA subjects [(M/F=5/26; mean age= 56 (range=28-73) years; mean disease duration= 165 (range =15-432) months], treated with anti- TNF-alpha drugs, were allocated to OT (n=15) or control (n=16) group. We evaluated at entry and 12 weeks the following outcome parameters including Health Assessment Questionnaire (HAQ), Short-Form Health Survey (SF-36), Global Health (GH), Ritchie index, number of swollen or tender joints, pain, patient and physician disease activity, Disease Activity Score (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein CRP) and the correct adherence to items regarding activity daily living (ADL). RESULTS At baseline, OT and control group had similar demographic and clinical features. After 12 weeks, the changes from baseline of main outcome parameters were not significantly different between the two groups. After 12 weeks, in 7 out of 11 items regarding ADL, the percentage of patients showing a correct adherence was significantly increased in OT group only. Moreover at the end of the study, the OT group showed a correct adherence to 8 out of 11 ADL items in an higher percentage of patients respect to the control group. CONCLUSION Our study sustains that OT improves self-management but not main parameters of disease activity or functional capacity. Nevertheless educational intervention should be considered as a useful tool in conjunction with pharmacological treatment.
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MESH Headings
- Activities of Daily Living
- Adalimumab
- Adult
- Aged
- Anti-Inflammatory Agents/administration & dosage
- Anti-Inflammatory Agents/therapeutic use
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antirheumatic Agents/administration & dosage
- Antirheumatic Agents/therapeutic use
- Arthritis, Rheumatoid/blood
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/rehabilitation
- Blood Sedimentation
- C-Reactive Protein/analysis
- Cortisone/administration & dosage
- Cortisone/therapeutic use
- Data Interpretation, Statistical
- Etanercept
- Female
- Health Status
- Health Surveys
- Humans
- Immunoglobulin G/administration & dosage
- Immunoglobulin G/therapeutic use
- Infliximab
- Male
- Middle Aged
- Occupational Therapy
- Patient Compliance
- Prospective Studies
- Receptors, Tumor Necrosis Factor/administration & dosage
- Receptors, Tumor Necrosis Factor/therapeutic use
- Socioeconomic Factors
- Surveys and Questionnaires
- Time Factors
- Treatment Outcome
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
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Affiliation(s)
- F Pasqui
- Cattedra di Reumatologia, Dip. di Clinica e Terapia Medica Applicata, Azienda Policlinico Umberto I, Università di Roma "La Sapienza", Roma, Italia
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32
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Lucchetti L, Gentili M, Simoni F. Colossal optical nonlinearity induced by a low frequency external electric field in dye-doped liquid crystals. Opt Express 2006; 14:2236-2241. [PMID: 19503559 DOI: 10.1364/oe.14.002236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report on the effects of a low-frequency electric field on the optical nonlinear response of thin dye-doped liquid crystal cells. Experimental data show that the external field allows reaching extremely high values of the optical nonlinearity without any critical control of the cell interfaces. A qualitative interpretation of the collected data, based on the light-induced modulation of the bulk voltage through surface modifications, is proposed.
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Pham-Marcou TA, Gentili M, Asehnoune K, Fletcher D, Mazoit JX. Effect of neurolytic nerve block on systemic carrageenan-induced inflammatory response in mice. Br J Anaesth 2005; 95:243-6. [PMID: 15863437 DOI: 10.1093/bja/aei150] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Local tissue inflammation caused by injury or inflammatory processes may be reduced by section or local anaesthetic block of the nerve innervating the inflamed area. METHODS Using a neurolytic nerve block, we assessed the systemic inflammatory response elicited by a local injection of carrageenan in mice. Sixty mice received a unilateral sciatic nerve block with 70% ethanol followed 5 days later by an injection of carrageenan on the ipsilateral or contralateral hind paw. Whole blood was sampled 15 h after carrageenan injection. RESULTS Fifty-six animals had a complete nerve block. Tumour necrosis factor-alpha (TNF-alpha), interleukin 1beta (IL-1beta) and interleukin 10 (IL-10) concentrations were measured in the plasma of 20 mice (10 in the ispilateral group and 10 in the contralateral group). In the remaining 36 mice (18 in each group), blood was cultured for 24 h in the presence of lipopolysaccharide or Staphylococcus aureus extract. TNF-alpha and IL-1beta production in the supernatant were, on average, 30% lower in the ispilateral group than in the contralateral group. CONCLUSION A prolonged nerve block decreases the systemic consequences of the local inflammatory reaction elicited by carrageenan injection.
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Affiliation(s)
- T A Pham-Marcou
- Laboratoire d'Anesthésie, UPRES EA 3540, Faculté de Médecine, Université de Paris-Sud, 94276 Le Kremlin Bicêtre Cedex, France
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34
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Gentili M, Deleuze A. [Spinal anesthesia and ambulatory surgery]. Ann Fr Anesth Reanim 2004; 23:443-5. [PMID: 15120799 DOI: 10.1016/j.annfar.2004.02.043] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- M Gentili
- Polyclinique Saint-Vincent, Saint Grégoire, France.
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35
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Deleuze A, Gentili M. [Postoperative pain in ORL surgery]. Ann Fr Anesth Reanim 2004; 23:78-81. [PMID: 14980332 DOI: 10.1016/j.annfar.2003.11.005] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- A Deleuze
- Clinique de l'Espérance, groupe A.-Tzank, Mougins, France.
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Affiliation(s)
- P Albaladejo
- Service d'anesthésie-réanimation, CHU de Beaujon, 92110 Clichy, France.
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37
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Lienhart A, Gentili M. [Anesthesia-resuscitation and the law: elements for understanding the guidelines of the SFAR]. Ann Fr Anesth Reanim 2002; 21:f108-21. [PMID: 12192700] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- A Lienhart
- Hôpital Saint-Antoine 75571 Paris, France
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Abstract
Endothelins (ET) are potent vasoconstrictive peptides originally isolated from vascular endothelial cells. Their biological effects are mediated through two different receptors, the endothelin-1 (ET-1)-selective endothelin receptor subtype ETA and the non-selective receptor subtype ETB. ET-1 protein has been found in human ovarian follicular fluid and ET-1 mRNA expression has been demonstrated in ovarian tissue. These findings indicate that the endothelin-system participates in the modulation of ovarian function, probably acting in an autocrine/paracrine manner. In the current study we used freshly aspirated, luteinized human granulosa cells (hGC) representing an in vitro model of the early corpus luteum. By means of RT-PCR and immunocytochemistry we investigated whether luteinized human granulosa cells express ETA and ETB receptors. Specific amplification products of ETA transcripts were detected in all samples investigated. In contrast, only after using a three-fold amount of ETB reverse transcripts we were able to demonstrate specific, but weak amplification products. In addition, immunocytochemical staining for ETA but not for ETB was found in granulosa cell preparations. The present study provides clear evidence that human granulosa cells predominantly express ETA receptor subtype mRNA and protein hinting to its possible role in follicle maturation and corpus luteum formation.
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Affiliation(s)
- M Gentili
- Department of Obstetrics and Gynaecology, University of Heidelberg, Germany.
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39
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Gentili M, Enel D, Szymskiewicz O, Mansour F, Bonnet F. Postoperative analgesia by intraarticular clonidine and neostigmine in patients undergoing knee arthroscopy. Reg Anesth Pain Med 2001; 26:342-7. [PMID: 11464354 DOI: 10.1053/rapm.2001.23461] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Clonidine and neostigmine have a central mechanism of analgesic action and are synergistic when given intrathecally. Both drugs also have a peripheral analgesic effect. The purpose of this study was to compare the analgesic effect of intraarticular clonidine and neostigmine, used separately and in combination, in patients undergoing knee arthroscopy. METHODS Eighty-four American Society of Anesthesiologists (ASA) I and II patients scheduled for meniscus repair under arthroscopy were allocated randomly in 6 groups to receive in a double-blind manner at the end of surgery 150 microg of intraarticular clonidine with subcutaneous saline, 500 microg of intraarticular neostigmine with subcutaneous saline, an intraarticular combination of 150 microg of clonidine and 500 microg of neostigmine with subcutaneous saline, 150 microg of intraarticular clonidine with 500 microg of subcutaneous neostigmine, 500 microg of intraarticular neostigmine with 150 microg of subcutaneous clonidine, or intraarticular and subcutaneous isotonic saline. Postoperative pain scores were measured on a visual analog scale (VAS) at rest and on mobilization. Paracetamol (1 g) was given as a rescue medication when pain score was greater than 40. RESULTS VAS scores at rest and on mobilization were lower in the first 5 groups compared with the intraarticular saline group (P <.05), but no significant difference was documented between the treated groups. The time to the first paracetamol administration was shorter in the saline group compared with the other groups, and the paracetamol demand was also higher in this group. Forty-five percent of the patients who had received clonidine had at least 1 episode of hypotension versus 4% of those who did not (P <.01). The incidence of bradycardia was 20% and 0%, respectively (P =.01). The incidence of nausea was not statistically different in patients who did and did not receive neostigmine (43% v. 36%, respectively). CONCLUSION Intraarticular administration of 150 microg of clonidine, 500 microg of neostigmine, or both produce postoperative analgesia, and the combination is not more effective.
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Affiliation(s)
- M Gentili
- Centre Médico-Chirurgical Saint-Vincent, Rennes, France
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40
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Weigel MM, Gentili M, Beichert M, Friese K, Sonnenberg-Schwan U. Reproductive assistance to HIV-discordant couples--the German approach. Eur J Med Res 2001; 6:259-62. [PMID: 11432794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
An estimated 35 000 Germans are infected with HIV, and 75% of these are of childbearing age. Couples with one infected partner are faced with the risk of infection of the healthy partner. By using assisted reproduction techniques (ART) and virus-free sperm it is possible to fulfil the desire for children while minimising the risk of acquisition of infection. Therefore since 1991 in Germany ART is offered to couples of HIV-positive males and seronegative females. However, established programmes in different centres were temporarily suspended due to serious doubts about the reliability and safety of the sperm preparation technique (density gradient centrifugation and swim-up). -. Since 1997 processed sperm samples are routinely tested for HIV by highly sensitive detection methods and cryopreserved. Only if the test is negative are the processed spermatozoa used for homologous insemination, in-vitro fertilization or intracytoplasmatic sperm injection. This procedure removes most medical as well as legal considerations. At present 3 reproductive units in Germany offer reproductive assistance to HIV-discordant couples, and a further 9 institutions plan to establish that procedure. From 1991 to 1999, 54 women were treated by ART. 30 pregnancies occurred and 24 children were born. So far no maternal or infant infection was observed after treatment.
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Affiliation(s)
- M M Weigel
- Universitäts-Frauenklinik, D-68135 Mannheim, Germany.
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41
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Fialdini G, Troiani R, Manfredini G, Bertolaccini P, Bonini R, Spinelli I, Lambruschi G, Piacentini G, Pietrini F, Gentili M, Barbieri L, Maneschi A, Sicari A. Sentinel Node and Radioguided Surgery in Breast Cancer of Limited Size. Preliminary Experience at ASL 1, Massa E Carrara. Tumori 2000; 86:325-6. [PMID: 11016717 DOI: 10.1177/030089160008600418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the effectiveness of sentinel node (SN) biopsy in breast cancer. Twenty-five female patients classified as T1N0 according to the TNM system of the UICC were evaluated with this procedure from April to October 1999. The day before surgery a subdermal injection of 99mTc-nanocoll within the tissue overlying the neoplastic lesion and subsequent lymphoscintigraphy were performed. In all patients the SN was detected with a radioguided probe during scintigraphy and surgery. Histological examination of the SN for detection of metastases was positive in four patients who subsequently underwent axillary dissection. In the remaining patients with normal SNs no axillary dissection was performed. The preliminary results confirm the validity of the sentinel node procedure.
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Affiliation(s)
- G Fialdini
- Department of Oncology ASL 1 Massa e Carrara, Study Group on Radioguided Surgery, Italy
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Abstract
Infiltration of the surgical wound is a classical technique for post-operative analgesia. Recent studies have suggested that local anaesthetic may be combined with other drugs such as opioids. This study has evaluated, in rat, the infiltration with morphine, bupivacaine and their combination. In all groups, the two hind paws were injected with carrageenin. The left hind paw was used as control. The vocalisation threshold to paw pressure (VTPP) of both hind paws was evaluated 2 h after induction of carrageenin inflammation (baseline value), then every 10 min until the return to baseline value after injection of analgesic drugs. The development of oedema was evaluated in both hind paws by measurement of paw circumference (PC) before, then after, carrageenin injection. All analgesic drugs were injected in the right inflamed paw diluted in 0.2 mL of normal saline. The analgesic effect of bupivacaine (0.1, 0.25 and 0.5%), morphine (25, 50 and 100 microg) and their combination (bupivacaine 0.1%/morphine 20 microg, bupivacaine 0.2%/morphine 40 microg and bupivacaine 0.4%/morphine 80 microg) was tested. The effect of naloxone on morphine induced analgesia was tested. The interaction between bupivacaine and morphine was evaluated with an isobolographic analysis. Bupivacaine produced a dose-dependent antinociceptive effect. Morphine infiltration produced a peripheral, dose-dependent analgesic effect antagonised by naloxone. This analgesic effect of morphine was associated with an anti-inflammatory effect. The isobolographic analysis revealed only additivity between bupivacaine and morphine. The infiltration with morphine offers a peripheral analgesic effect which is additive with the effect of bupivacaine. An anti-inflammatory effect of morphine participates in this peripheral analgesic effect.
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Affiliation(s)
- D Fletcher
- Université Paris sud, département d'anesthésie réanimation chirurgicale, Bicêtre, France.
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43
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Weigel M, Obermüller N, Gentili M, Gretz N, Melchert F. P-243. The cell-specific expression of the angiotensin II-receptor type 2 (AT2) and its functional significance in the mature rat ovary. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.262-a] [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: 11/12/2022] Open
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Abstract
UNLABELLED Tourniquet pain often complicates the use of the pneumatic tourniquet during surgical procedures performed under IV regional anesthesia. Clonidine-containing local anesthetic solutions have better analgesic properties than plain solutions when used for spinal, epidural, or peripheral blocks. We tested the hypothesis that the addition of clonidine may improve the quality of IV regional anesthesia, especially tourniquet tolerance. Forty patients were allocated randomly in a double-blinded, randomized study to receive 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline or clonidine (150 microg). A double-cuffed tourniquet was kept inflated until patients complained of pain, leading to release of the distal cuff. Pain at the tourniquet site, at the surgical site, and in the distal part of the arm was rated on a visual analog scale (VAS) and a verbal rating scale (VRS) every 15 min during tourniquet placement and every 15 min for 1 h after tourniquet deflation. Motor blockade, sedation, arterial pressure, and heart rate were also recorded. VAS and VRS scores were significantly lower in the clonidine group 30 and 45 min after tourniquet inflation. The tolerance for the distal tourniquet was also significantly longer in the clonidine group (median [range]: 22 [10-40] vs 10 [5-20] min; P < 0.05); motor blockade was comparable between the two groups. Pain was not different in the two groups after tourniquet release. The clonidine group experienced a higher degree of sedation. We conclude that clonidine improves tourniquet tolerance when added to a local anesthetic solution. IMPLICATIONS A 150-microg dose of clonidine added to lidocaine improved tourniquet tolerance during IV regional anesthesia.
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Affiliation(s)
- M Gentili
- Département d'Anesthésie, Clinique Saint Vincent, Saint-Grégoire-Rennet, France
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Abstract
We have investigated the relationship between the extent of spinal block and occurrence of sedation. In a first series of 43 patients, the distribution of sedation score (measured on the Ramsey scale) was related to the extent of spinal block (pinprick). In a second series of 33 patients, the relationship between sedation score and spinal block persisted after injection of midazolam 1 mg. This study confirmed that high spinal block was associated with increased sedation.
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Abstract
We report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. Aspiration test for blood and spinal fluid were both negative, as well as a test dose of 3 mL lidocaine 2%-bupivacaine 0.5%. One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.
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Affiliation(s)
- M Gentili
- Département d'anesthésie-réanimation 2, CMC Saint-Vincent, Paris, France
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47
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Gentili M, Pagni R, Gentili S, Ferretti A, Santelli F, Avenali S, Amici M, Piattellini GM, Mora D, Sichini L, De Angelis C, Camilletti GF, Dani C. [Partial liquid ventilation (PLV) in the newborn and infants: initial experiences in Italy]. Pediatr Med Chir 1998; 20:315-6. [PMID: 10068978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Partial liquid ventilation is a valid alternative ventilation strategy for the management of the respiratory distress in newborn and infant. Authors describe their first experiences in 11 children (7 newborns, 4 infants).
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Affiliation(s)
- M Gentili
- Azienda Ospedaliera G. Salesi Ancona, Dipartimento Materno-Infantile, Italia
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48
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Obermüller N, Schlamp D, Hoffmann S, Gentili M, Inagami T, Gretz N, Weigel M. Localization of the mRNA for the angiotensin II receptor subtype 2 (AT2) in follicular granulosa cells of the rat ovary by nonradioactive in situ hybridization. J Histochem Cytochem 1998; 46:865-70. [PMID: 9671437 DOI: 10.1177/002215549804600801] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The ovary is one of the organs in which an intrinsic renin-angiotensin system (RAS) has been described. Among angiotensin II receptors, the angiotensin II receptor subtype 2 (AT2) is believed to play an important role in mediating or modulating a variety of intraovarian processes. Previous studies were mainly based on ligand binding techniques using AT2 receptor-specific antagonists. Despite the recent cloning of the AT2 gene, no information is available about the exact intraovarian distribution of AT2 mRNA expression. Therefore, we analyzed ovaries from sexually mature, untreated rats by nonradioactive in situ hybridzation using an AT2-specific anti-sense RNA probe. Experiments were performed on perfusion-fixed ovaries obtained from different stages of the estrous cycle. As an important finding, strong AT2 mRNA expression could be demonstrated exclusively in follicular granulosa cells. Follicles containing AT2 mRNA-positve granulosa cells were mainly in the advanced tertiary stage of follicular development, already exhibiting features of atresia. In addition, individual collapsed, definitive atretic follicles also showed strong AT2 mRNA expression solely in granulosa cells. In corpora lutea and in other structures of the ovary, no message for the AT2 receptor could be detected under these conditions. These data may contribute to a better understanding of the effects exerted by an intraovarian RAS. (J Histochem Cytochem 46:865-870, 1998)
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Affiliation(s)
- N Obermüller
- Medical Research Center, Klinikum Mannheim, University of Heidelberg, Mannheim, Germany
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Mistrello G, Gentili M, Roncarolo D, Antoniotti P, Ottoboni F, Falagiani P. Dot immunobinding assay for detection of mite antigens in house-dust samples. J Med Entomol 1998; 35:143-147. [PMID: 9538574 DOI: 10.1093/jmedent/35.2.143] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A new test was developed specifically to detect mite antigens in house-dust. It uses a nitrocellulose dipstick spotted with specific antimite antibodies that act as a capture matrix; the same antibodies act as a detecting reagent when conjugated with colloidal dye particles. Aclotest is a 1-step assay, where a spotted dipstick is placed in a tube containing the detecting reagent and the house-dust sample. No instrumentation or previous extraction procedure of the sample is required, and the test response is visible as a colored spot, after 1 h incubation. The sensitivity and specificity of the new test were compared with those of Acarex and Der p1/Der f1 ELISA tests.
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Affiliation(s)
- G Mistrello
- Research Department, Laboratorio Farmaceutico Lofarma, Milan, Italy
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Gentili M, Senlis H, Houssel P, Monnier B, Bonnet F. Single-shot spinal anesthesia with small doses of bupivacaine. Reg Anesth 1997; 22:511-514. [PMID: 9425965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND AND OBJECTIVES The potential risks of spinal lidocaine have generated interest in an alternative local anesthetic solution. Features of anesthetic block were therefore assessed in a double-blind randomized prospective study following administration of spinal bupivacaine in small doses. METHODS Ninety patients scheduled for lower limb saphenous vein stripping were randomized to receive a 4-mL hyperbaric solution containing 4, 6, or 8 mg bupivacaine in the subarachnoid space. Sensory and motor block and hemodynamic changes were assessed at regular intervals. Patients were also questioned regarding transient radicular irritation symptoms. RESULTS The mean duration of sensory block increased with increasing dose (duration at L2: 56 +/- 27, 71 +/- 29, 79 +/- 25 minutes in groups 4, 6, and 8 mg, respectively, P < .05). Motor block was also dose dependent. The incidence of grade 3 motor block increased from 0%, to 21%, and to 53%. No patient had symptoms of transient radicular irritation. Arterial pressure and heart rate were stable throughout the study. CONCLUSION Hyperbaric bupivacaine 6-8 mg provides a suitable alternative to spinal lidocaine for surgical procedures of short duration.
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Affiliation(s)
- M Gentili
- Clinique Saint Vincent, Saint Grégoire, France
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