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Bellone F, Morace C, Impalà G, Viola A, Gullo AL, Cinquegrani M, Fries W, Sardella A, Scolaro M, Basile G, Squadrito G, Mandraffino G. Quality of Life (QoL) in Patients with Chronic Inflammatory Bowel Diseases: How Much Better with Biological Drugs? J Pers Med 2023; 13:947. [PMID: 37373936 DOI: 10.3390/jpm13060947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic and disabling diseases that affect patient health-related quality of life (HRQoL). IBD patients are frequently exposed to high levels of stress and psychological distress. Biological drugs have been proven to reduce inflammation, hospitalization, and most of the complications that characterize IBDs; their potential contribution to patients' HRQoL remains to be explored. AIM To evaluate and compare any change in the HRQoL and markers of inflammation in IBD patients undergoing biological drugs (infliximab or vedolizumab). MATERIAL AND METHODS A prospective observational study was conducted on a cohort of IBD patients, aged >18 years, who were prescribed with infliximab or vedolizumab. Demographic and disease-related data at baseline were collected. Standard hematological and clinical biochemistry parameters, including C-reactive protein (CRP), white blood cells count (WBC), erythrocytes sedimentation rate (ESR), and α1 and α2 globulins were measured after a 12-h fast at baseline (T0), after 6 weeks (T1), and at 14 weeks (T2) of biological treatment. Steroid use, disease activity as measured by the Harvey-Bradshaw index (HBI) and partial Mayo score (pMS) for the CD and UC, respectively, were also recorded at each timepoint. The Short Form 36 Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT-F), and Work Productivity and Activity Impairment-General Health Questionnaire (WPAI:GH) were administered to each patient at baseline, T1, and T2 to address the study aims. RESULTS Fifty eligible consecutive patients (52% with CD and 48% with UC) were included in the study. Twenty-two patients received infliximab and twenty-eight received vedolizumab. We noted a significant reduction in the CRP, WBC, α1, and α2 globulins from T0 to T2 (p = 0.046, p = 0.002, p = 0.008, and p = 0.002, respectively). Participants showed a significant decrease in steroid administration during the observation period. A significant reduction in the HBI of CD patients at all three timepoints and a similarly significant decrease in the pMS of UC patients from baseline to T1 were recorded. Statistically significant changes were observed in all questionnaires during follow-up as well as an overall improvement in the HRQoL. The interdependence analysis carried out between the biomarkers and the scores of the individual subscales showed a significant correlation between the variation (Δ) of the CRP, Hb, MCH, and MCV with physical and emotional dimensions of the SF-36 and FACIT-F tools; work productivity loss expressed by some of the WPAI:GH items negatively correlated with the ΔWBC and positively with the ΔMCV, ΔMCH, and Δ α1 globulins. A sub-analysis according to the type of treatment showed that patients receiving infliximab experienced a more pronounced improvement in their HRQoL (according to both SF-36 and FACIT-F) compared with patients receiving vedolizumab. CONCLUSIONS Both infliximab and vedolizumab played an important role in contributing to the improvement of the HRQoL in IBD patients by also reducing inflammation and, consequently, steroid use in patients with an active disease. HRQoL, being one of the treatment goals, should also be assessed when taking charge of IBD patients to assess their clinical response and remission. The specific correlation between the biomarkers of inflammation and life's spheres, as well as their possible role as clinical markers of HRQoL, should be further investigated.
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Affiliation(s)
- Federica Bellone
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Carmela Morace
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Giulia Impalà
- Unit of Anaesthesia and Intensive Care, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Anna Viola
- IBD Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS Garibaldi Hospital, 95124 Catania, Italy
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Walter Fries
- IBD Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Mariangela Scolaro
- UOC Cardiologia/Utic Ospedale G. Fogliani Milazzo Asp 5, 98123 Messina, Italy
| | - Giorgio Basile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Giovanni Squadrito
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
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Lofrumento F, Mandraffino G, Trimarchi G, Mancinelli A, Restelli D, De Sarro R, Sinicropi D, Cinquegrani M, Cusma-Piccione M, Manganaro R, Recupero A, Di Bella G, Zito C, Carerj S. Relationship between Pulse Wave Velocity and Myocardial Work in untreated hypertensive patients with preserved LVEF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Hemodynamic interaction between left ventricular (LV) and arterial system is a key determinant of cardiovascular performance. The non-invasive carotid-femoral Pulse Wave Velocity (PWV), obtained with applanation tonometry, is considered the most precise way of estimating arterial stiffness. The LV myocardial work (MW), based on non-invasive LV pressure-strain loop (PSL), is a new promising tool to assess LV function.
Purpose
The aim of the study was to evaluate the correlation between PWV and MW parameters in a population of non-hypertensive and newly diagnosed untreated hypertensive people.
Material and methods
50 people (M=30), divided in hypertensive (group 1: n=25, 40±8 years) and non-hypertensive (group 2: n=25, 38±9 years), were prospectively enrolled. All underwent conventional transthoracic echocardiography and at the same day carotid femoral PWV was calculated with applanation tonometry (SphygmoCor® XCEL). MW parameters were obtained using 2D Speckle-tracking technique.
Results
Comparing the two groups, PWV and Global Work Wasted (GWW) were significantly higher in the hypertensives group (9.44±2.4 vs 7.56±1.1; p=0.001 and 130±2.5 vs 80.60±1.5, p=0.002), as shown in Figure 1, whereas Global Work Efficiency (GWE) and Global Work Constructive (GWC) were significantly lower (94±2.5 vs 95.8±1.2, p=0.003 and 2393±20 vs 2166±18, p=0.02). We found a linear and positive correlation of PWV with GWW (r=0.315, p=0.026), as seen in Figure 2, and a linear and negative correlation of PWV with GWE (r=−0.315, p=0.026).
Conclusion
This study highlights the role of PWV and MW evaluation in hypertensives. Higher PWV and GWW could be considered as red flags of myocardial damage suggesting the need of an early appropriate antihypertensive therapy.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): University Ospital G. Martino - Messina
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Affiliation(s)
- F Lofrumento
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - G Mandraffino
- U.O. Polyclinic G. Martino, Internal Medicine Unit , Messina , Italy
| | - G Trimarchi
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - A Mancinelli
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - D Restelli
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - R De Sarro
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - D Sinicropi
- U.O. Polyclinic G. Martino, Internal Medicine Unit , Messina , Italy
| | - M Cinquegrani
- U.O. Polyclinic G. Martino, Internal Medicine Unit , Messina , Italy
| | | | - R Manganaro
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - A Recupero
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - G Di Bella
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - C Zito
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
| | - S Carerj
- U.O. Polyclinic G. Martino, Cardiology Unit , Messina , Italy
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Toscano A, Cinquegrani M, Scuruchi M, Di Pino A, Piro S, Ferrara V, Morace C, Lo Gullo A, Imbalzano E, Purrello F, Squadrito G, Scicali R, Mandraffino G. PCSK9 Plasma Levels Are Associated with Mechanical Vascular Impairment in Familial Hypercholesterolemia Subjects without a History of Atherosclerotic Cardiovascular Disease: Results of Six-Month Add-On PCSK9 Inhibitor Therapy. Biomolecules 2022; 12:biom12040562. [PMID: 35454151 PMCID: PMC9033040 DOI: 10.3390/biom12040562] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Proprotein convertase subtilisin/kexin type-9 (PCSK9) is a key regulator of low-density lipoprotein (LDL) metabolism involved in the degradation of the low-density lipoprotein receptor (LDLR) through complex mechanisms. The PCSK9 plasma levels change according to lipid lowering therapy (LLT). Few data exist regarding the role of PCSK9 in vascular damage. We aimed to evaluate the impact of PCSK9 plasma levels on pulse wave velocity (PWV) and the effect of PCSK9 inhibitors (PCSK9-i) on circulating PCSK9 and PWV in a cohort of heterozygous familial hypercholesterolemia (HeFH) subjects. In a previous step, HeFH patients were enrolled and LLT was prescribed according to guidelines. Biochemical analyses and PWV assessment were performed at baseline (T0), after 6 months of high-efficacy statin plus ezetimibe (T1) and after 6 months of PCSK9-i (T2). The PCSK9 levels were evaluated in 26 selected HeFH subjects at the three time points and 26 healthy subjects served as controls for the reference value for PCSK9 plasma levels. The PWV values decreased at each time point in HeFH subjects after LLT starting (8.61 ± 2.4 m/s, −8.7%; p < 0.001 vs. baseline at T1, and 7.9 ± 2.1 m/s, −9.3%; p < 0.001 vs. both T1 and baseline) and it was correlated to PCSK9 (r = 0.411, p = 0.03). The PCSK9 levels increased on statin/EZE therapy (+42.8% at T1) while it decreased after PCSK9-i was started (−34.4% at T2). We noted a significant relationship between PCSK9 levels and PWV changes at T1 and T2. In conclusion, PCSK9 levels were associated with baseline PWV values in HeFH subjects; moreover, we found that PCSK9 level variations seemed to be correlated with PWV changes on LLT. A longer observation time and wider sample size are needed to assess the potential role of PCSK9 plasma levels on the vascular function and remodelling, and to clarify the effects of PCSK9-i in these pathways.
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Affiliation(s)
- Arianna Toscano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Michele Scuruchi
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Viviana Ferrara
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Carmela Morace
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS Garibaldi Hospital, 95122 Catania, Italy;
| | - Egidio Imbalzano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
| | - Giovanni Squadrito
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (A.D.P.); (S.P.); (V.F.); (F.P.)
- Correspondence:
| | - Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine Lipid Center, University of Messina, 98122 Messina, Italy; (A.T.); (M.C.); (M.S.); (C.M.); (E.I.); (G.S.); (G.M.)
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Mandraffino G, Lo Gullo A, Cinquegrani M, D’Ascola A, Sinicropi D, Imbalzano E, Blando G, Campo GM, Morace C, Giuffrida C, Campo S, Squadrito G, Scuruchi M. Expression and Change of miRs 145, 221 and 222 in Hypertensive Subjects Treated with Enalapril, Losartan or Olmesartan. Biomedicines 2021; 9:biomedicines9080860. [PMID: 34440064 PMCID: PMC8389596 DOI: 10.3390/biomedicines9080860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
miR profile could be associated to CV risk, and also to prognosis/outcome in response to therapeutic approach. We aimed to evaluate if anti-hypertensive drugs enalapril, losartan or olmesartan have effects on monocyte miR profile in essential hypertensives without target organ involvement. For this purpose, 82 hypertensives and 49 controls were included; we evaluated SBP/DBP, lipid profile, glucose, CRP, fibrinogen, arterial stiffness indices (PWV; AIx), and cIMT at baseline (T0) and after 24 weeks of treatment (T1). Subjects with LDL-C ≥ 160 mg/dL, TG ≥ 200 mg/dL, BMI ≥ 30, and other additional CV risk factors were excluded. Patients who were prescribed to receive once-a-day enalapril 20 mg, losartan 100 mg or olmesartan 20 mg were eligible for the study. At T1, we found a significant improvement of SBP (-18.5%), DBP (-18%), HDL-C and LDL-C (+3% and -5.42%), glucose (-2.15%), BMI (-3.23%), fibrinogen (-11%), CRP (-17.5%,), AIx (-49.1%) PWV (-32.2%), and monocyte miR expression (miR-221: -28.4%; miR-222: -36%; miR-145: +41.7%) with respect to baseline. miR profile was compared to control subjects at baseline and at T1. We found some little difference in the behaviour of the three treatments on some variables: olmesartan was the most effective in reducing fibrinogen, DBP, CRP, and AIx (-13.1%, -19.3%, -21.4%, and -56.8%, respectively). Enalapril was the drug more significantly increasing the expression of miR-145. In conclusion, enalapril, losartan and olmesartan are effective in improving mechanical and humoral factors associated to AS and atherogenesis. These drugs appear to be able to modify miRs 221/222 and miR-145 expression in drug-naïve hypertensives, making it closer to that of control subjects; additionally, this provides a good blood pressure compensation, contributing to slow the progression of vascular damage.
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Affiliation(s)
- Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
- Lipid Center, Internal Medicine Unit, University of Messina, 98122 Messina, Italy;
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
- Correspondence: (G.M.); (A.L.G.)
| | - Alberto Lo Gullo
- IRCCS Neurolesi Bonino Pulejo, 98123 Messina, Italy;
- Correspondence: (G.M.); (A.L.G.)
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Angela D’Ascola
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
| | - Davide Sinicropi
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Egidio Imbalzano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Giuseppe Blando
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Giuseppe Maurizio Campo
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
| | - Carmela Morace
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | | | - Salvatore Campo
- Laboratory of Molecular Biology, Department of Biomedical and Dental Sciences and Morphofunctional Images, University of Messina, 98122 Messina, Italy;
| | - Giovanni Squadrito
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Michele Scuruchi
- Lipid Center, Internal Medicine Unit, University of Messina, 98122 Messina, Italy;
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
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Oreto L, Vita GL, Mandraffino G, Carerj S, Calabrò MP, Manganaro R, Cusmà-Piccione M, Todaro MC, Sframeli M, Cinquegrani M, Toscano A, Vita G, Messina S, Zito C. Impaired myocardial strain in early stage of Duchenne muscular dystrophy: its relation with age and motor performance. Acta Myol 2020; 39:191-199. [PMID: 33458574 PMCID: PMC7783425 DOI: 10.36185/2532-1900-022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 01/02/2023]
Abstract
Duchenne muscular dystrophy (DMD) is complicated by an early and progressive left ventricular (LV) dysfunction. Despite the reduction of ejection fraction (EF) usually manifests in the second decade, subtle alterations in LV mechanics can be detected earlier. Longitudinal and circumferential LV deformation, evaluated by speckle tracking echocardiography (STE), are considered sensitive markers of early dysfunction. We retrospectively examined clinical and echocardiographic data of 32 DMD children with preserved LV function. According to the median age, patients were then divided into younger and older than 9 years, and compared to 24 age-matched healthy subjects. Six-minute-walk test (6MWT), North Star Ambulatory Assessment (NSAA), and a comprehensive cardiac evaluation were performed. Although EF was within the normal range, DMD patients had significantly lower values than healthy controls, and the same occurred for the remaining conventional systolic and diastolic indices. Global longitudinal strain (GLS) was reduced in all patients (older and younger, both p < 0.001). Global circumferential strain (GCS) was reduced only in older patients (< 0.001). Both GLS and GCS worsened with age in DMD patients (GLS p = 0.005; GCS p = 0.024). GLS was significantly worse in the apical segments and in the postero-lateral wall. GCS in the antero-septal, anterior and antero-lateral segments was significantly reduced in older patients, with a prevalent involvement of the sole septal wall in the younger boys. 6MWT appeared to be correlated inversely to GLS and directly to EF. A longitudinal evaluation should be scheduled in DMD boys to assess the global cardiac performance over time and to evaluate the impact of therapies.
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Affiliation(s)
- Lilia Oreto
- Mediterranean Pediatric Cardiologic Centre, S. Vincenzo Hospital, Taormina - "Bambin Gesù", Rome, Italy.,Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gian Luca Vita
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina University Hospital, Messina, Italy
| | - Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Scipione Carerj
- Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Pia Calabrò
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age, University of Messina, Italy
| | - Roberta Manganaro
- Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maurizio Cusmà-Piccione
- Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Chiara Todaro
- Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Cardiology Unit, Papardo Hospital, Messina, Italy
| | - Maria Sframeli
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina University Hospital, Messina, Italy
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonio Toscano
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giuseppe Vita
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina University Hospital, Messina, Italy.,Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Sonia Messina
- Nemo Sud Clinical Centre for Neuromuscular Disorders, Messina University Hospital, Messina, Italy.,Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Concetta Zito
- Cardiology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Lo Gullo A, Sinicropi D, Cinquegrani M, Savarino F, Giuffrida C, Squadrito G, Mandraffino G. THU0353 ENDOCAN AND CIRCULATING PROGENITOR CELLS IN SYSTEMIC SCLEROSIS: ASSOCIATION WITH PULMONARY HYPERTENSION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic sclerosis (SSc) is characterized by early vascular involvement and by varying degrees of fibrosis in skin, lungs, and other tissues. Vascular manifestations include Raynaud’s phenomenon, digital ulcers, and pulmonary hypertension (PAH). The prevalence of PAH is 7.85–13% in SSc and it is the second most common cause of mortality in SSc. Circulating CD34+ cell number is associated to cardiovascular health status in several chronic conditions, including inflammatory disease. CD34+ cell number was found inconstantly reduced in SSc. Endocan is a proteoglycan expressed by endothelial cells likely interacting with white blood cells, recently suggested as a marker of vascular stress.Objectives:to evaluate CD34+ cell number and endocan as a markers od cardiovascular involvement in SSc.Methods:Standard transthoracic echocardiography, Rodnan skin score were performed. Vitamin D levels, CD34+ cell number, markers of inflammation, red blood cells distribution width (RDW) and Endocan plasma levels were also determined.Results:37 female SSc patients (11 diffuse/26 limited) and 35 matched healthy controls (HC) were enrolled. CD34+ cell count was lower as compared to controls (2.3±0.73 vs 2.9±0.6; p<0.001), CRP and ESR were significantly higher in SSc patients than controls. Vitamin D3 was lower in SSc patients with respect to controls (18±4.5 vs 27.26±10.98; p<0.001), Rodnan skin score was 28.89±10.24. Endocan was two times greater than controls and serum endocan levels were higher in patients with diffuse Ssc as compared with limited ones. We found no correlation between Endocan and: Rodnan skin score, ESR, fibrinogen; we found a trend of correlation between Endocan and Vitamin D levels (r= -0.315), RDW (r= 0.310), CRP (r= 0.310), but statistical significance was not reached likely due to the small sample size. We found an association of PAPs with Endocan levels (rho= 0.442, p<0.01) and CD34+ count (-0.349, p<0.05. A significant correlation was also found between Endocan and CD34+ cell number (rho= -0.605, p<0.01).Conclusion:In our study population, we found a significant correlation between CD34+ cell number and Endocan plasma levels and PAPs; Endocan and CD34+ progenitor cells might be suggested as potential marker of pulmonary arterial hypertension in SSc patients.References:[1]Lo Gullo et al. Atherosclerosis 2018Disclosure of Interests:Alberto Lo Gullo Speakers bureau: bayer, Davide Sinicropi: None declared, Mara Cinquegrani: None declared, Francesca Savarino: None declared, Clemente Giuffrida: None declared, Giovanni Squadrito: None declared, Giuseppe Mandraffino: None declared
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Mandraffino G, Scicali R, Rodríguez-Carrio J, Savarino F, Mamone F, Scuruchi M, Cinquegrani M, Imbalzano E, Di Pino A, Piro S, Rabuazzo AM, Squadrito G, Purrello F, Saitta A. Arterial stiffness improvement after adding on PCSK9 inhibitors or ezetimibe to high-intensity statins in patients with familial hypercholesterolemia: A Two-Lipid Center Real-World Experience. J Clin Lipidol 2020; 14:231-240. [PMID: 32111581 DOI: 10.1016/j.jacl.2020.01.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 10/11/2019] [Revised: 12/29/2019] [Accepted: 01/28/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is characterized by increased cardiovascular risk; despite-high intensity statins, only few patients with FH achieve the recommended low-density lipoprotein cholesterol (LDL-C) targets. OBJECTIVE We aimed to evaluate the effectiveness of six-month add-on therapy with proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9-i) or ezetimibe on lipid profile and pulse wave velocity (PWV) in patients with FH. METHODS In this observational study, we evaluated 98 genetically confirmed patients with FH with an LDL-C off-target despite high-intensity statins with or without ezetimibe; of these, 53 patients (statin plus ezetimibe) added PCSK9-i (PCSK9-i group) and 45 (statin only) added ezetimibe (EZE group) per applicable guidelines and reimbursement rules. All patients obtained biochemical analysis and PWV evaluation at baseline and after six months of optimized treatment. RESULTS After 6 months of add-on therapy, most patients achieving LDL-C targets were in the PCSK9-i group (77.3% PCSK9-i group vs 37.8% EZE group, P < .001). The PCSK9-i group achieved both a greater LDL-C and PWV reduction than the EZE group [-51% vs -22.8%, P < .001 and -15% vs -8.5%, P < .01, respectively]. In a linear regression analysis, we showed a coefficient (r) of 0.334 for the relationship between ΔPWV and ΔLDL (P < .05); moreover, in an exploratory analysis, the relationship appeared to be stronger in patients with FH without cardiovascular events (r = 0.422, P < .01). CONCLUSIONS Lipid and PWV profiles in patients with FH significantly improved after addition of PCSK9-i or ezetimibe to high-intensity statin therapy; moreover, ΔPWV was associated with ΔLDL. Our results are consistent with a beneficial role of these novel therapies in FH subjects.
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Affiliation(s)
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Javier Rodríguez-Carrio
- Department of Functional Biology, Area of Immunology, Faculty of Medicine, University of Oviedo, Oviedo, Spain; Area of Metabolism, Instituto de Investigación Sanitaria Del Principado de Asturias (ISPA), Oviedo, Spain; Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, RED in REN Del ISCIII, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Francesca Savarino
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Federica Mamone
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Michele Scuruchi
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Maria Cinquegrani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Salvatore Piro
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | | | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Francesco Purrello
- Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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8
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Carruba G, Cocciadiferro L, Di Cristina A, Granata OM, Dolcemascolo C, Campisi I, Zarcone M, Cinquegrani M, Traina A. Nutrition, aging and cancer: lessons from dietary intervention studies. Immun Ageing 2016; 13:13. [PMID: 27057203 PMCID: PMC4823849 DOI: 10.1186/s12979-016-0069-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 03/30/2016] [Indexed: 11/10/2022]
Abstract
There is convincing epidemiological and clinical evidence that, independent of aging, lifestyle and, notably, nutrition are associated with development or progression of major human cancers, including breast, prostate, colorectal tumors, and an increasingly large collection of diet-related cancers. Mechanisms underlying this association are mostly related to the distinct epigenetic effects of different dietary patterns. In this context, Mediterranean diet has been reported to significantly reduce mortality rates for various chronic illnesses, including cardiovascular diseases, neurodegenerative diseases and cancer. Although many observational studies have supported this evidence, dietary intervention studies using a Mediterranean dietary pattern or its selected food components are still limited and affected by a rather large variability in characteristics of study subjects, type and length of intervention, selected end-points and statistical analysis. Here we review data of two of our intervention studies, the MeDiet study and the DiMeSa project, aimed at assessing the effects of traditional Mediterranean diet and/or its component(s) on a large panel of both plasma and urine biomarkers. Both published and unpublished results are presented and discussed.
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Affiliation(s)
- Giuseppe Carruba
- Division of Research and Internationalization, ARNAS-Civico Di Cristina e Benfratelli, Palermo, Italy
| | | | | | - Orazia M Granata
- Clinical Pathology, "G. DI Cristina" Pediatric Hospital ARNAS-Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Cecilia Dolcemascolo
- Division of Research and Internationalization, ARNAS-Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Ildegarda Campisi
- Division of Research and Internationalization, ARNAS-Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Maurizio Zarcone
- Division of Research and Internationalization, ARNAS-Civico Di Cristina e Benfratelli, Palermo, Italy
| | | | - Adele Traina
- The Diana Project, National Cancer Institute, Milan, Italy
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9
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Cutroneo G, Bruschetta D, Trimarchi F, Cacciola A, Cinquegrani M, Duca A, Rizzo G, Alati E, Gaeta M, Milardi D. In Vivo CT Direct Volume Rendering: A Three-Dimensional Anatomical Description of the Heart. Pol J Radiol 2016; 81:21-8. [PMID: 26858778 PMCID: PMC4727493 DOI: 10.12659/pjr.895476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 07/27/2015] [Accepted: 08/17/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Since cardiac anatomy continues to play an important role in the practice of medicine and in the development of medical devices, the study of the heart in three dimensions is particularly useful to understand its real structure, function and proper location in the body. MATERIAL/METHODS This study demonstrates a fine use of direct volume rendering, processing the data set images obtained by Computed Tomography (CT) of the heart of 5 subjects with age range between 18 and 42 years (2 male, 3 female), with no history of any overt cardiac disease. The cardiac structure in CT images was first extracted from the thorax by marking manually the regions of interest on the computer, and then it was stacked to create new volumetric data. RESULTS The use of a specific algorithm allowed us to observe with a good perception of depth the heart and the skeleton of the thorax at the same time. Besides, in all examined subjects, it was possible to depict its structure and its position within the body and to study the integrity of papillary muscles, the fibrous tissue of cardiac valve and chordae tendineae and the course of coronary arteries. CONCLUSIONS Our results demonstrated that one of the greatest advantages of algorithmic modifications of direct volume rendering parameters is that this method provides much necessary information in a single radiologic study. It implies a better accuracy in the study of the heart, being complementary to other diagnostic methods and facilitating the therapeutic plans.
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Affiliation(s)
- Giuseppina Cutroneo
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Daniele Bruschetta
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Fabio Trimarchi
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Alberto Cacciola
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Maria Cinquegrani
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Antonio Duca
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Giuseppina Rizzo
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Emanuela Alati
- Division of Cardiac Surgery, Ospedale Vita e Salute, San Raffaele, Milano, Italy
| | - Michele Gaeta
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy; IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
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10
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Mandraffino G, Imbalzano E, Mamone F, Aragona C, Lo Gullo A, D'Ascola A, Alibrandi A, Cinquegrani A, Mormina E, Versace A, Basile G, Sardo M, Cinquegrani M, Carerj S, Saitta A. Biglycan expression in current cigarette smokers: A possible link between active smoking and atherogenesis. Atherosclerosis 2014; 237:471-9. [DOI: 10.1016/j.atherosclerosis.2014.10.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/16/2014] [Accepted: 10/17/2014] [Indexed: 01/31/2023]
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11
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Lo Gullo A, Mandraffino G, Sardo A, D’Ascola A, Imbalzano E, Saitta C, Cinquegrani M, Lo Gullo R, Bagnato G, Bagnato G, Saitta A. AB0147 Oxidative stress and flogosis: The role of endothelial progenitor cells in rheumathoid arthtritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.147] [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: 11/04/2022]
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12
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Lo Gullo A, Mandraffino G, Sardo MA, Mamone F, Mandraffino R, Saitta C, Lo Gullo R, Versace AG, Cinquegrani M, Saitta A. AB0075 Toll-like receptor 3 and interleukine 1b expression in circulating progenitor cells isolated from patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2398] [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: 11/03/2022]
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13
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Bagnato G, Bitto A, Pizzino G, Irrera N, Sangari D, Cinquegrani M, Roberts WN, Matucci Cerinic M, Squadrito F, Altavilla D, Bagnato G, Saitta A. Simvastatin attenuates the development of pulmonary and cutaneous fibrosis in a murine model of systemic sclerosis. Rheumatology (Oxford) 2013; 52:1377-86. [DOI: 10.1093/rheumatology/ket144] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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14
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Sardo MA, Castaldo M, Cinquegrani M, Bonaiuto M, Maesano A, Schepis F, Zema MC, Campo GM, Squadrito F, Saitta A. Effects of simvastatin treatment on sICAM-1 and sE-selectin levels in hypercholesterolemic subjects. Atherosclerosis 2001; 155:143-7. [PMID: 11223435 DOI: 10.1016/s0021-9150(00)00520-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study was performed to determine whether the levels of soluble intercellular adhesion molecule-1 (sICAM-l) and soluble endothelial molecule-1 (sE-selectin) were elevated in subjects with hypercholesterolemia who presented with no other risk factors or evidence of atherosclerosis. The effects of administration of an HMG-CoA reductase inhibitor on the serum levels of these molecules were also examined. Forty hypercholesterolemic subjects (HCh) (19 males and 21 females), without hypertension or cardiovascular disease, received placebo for 4 weeks. The patients were then randomized in two groups; 20 of them (simvastatin group) were treated with simvastatin (20 mg/day) and the other 20 (placebo group) continued placebo administration. After 12 and 24 weeks of either simvastatin or placebo treatment, sICAM-1 and sE-selectin levels were measured. The same parameters were measured in 20 control subjects (C) with normal cholesterol levels, matched for sex and age. HCh had sICAM-1 basal values higher than C (352.4+/-57.9 ng/ml versus 114.9+/-89.6 ng/ml; P<0.001); however, sE-selectin basal values were not different in the two groups. No correlation was observed between HCh sICAM-1 levels and cholesterol levels (total and low-density lipoprotein). Furthermore, cholesterol-lowering treatment with simvastatin did not significantly diminish sICAM-1 levels. Our findings would support the hypothesis that patients with isolated hypercholesterolemia and without clinical atherosclerosis may be silent carriers of arterial subendothelial inflammation, expressed as an increase of sICAM-1.
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Affiliation(s)
- M A Sardo
- Department of Internal Medicine, University of Messina, Via Camiciotti 82, 98123, Messina, Italy.
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15
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Schepis F, Cammà C, Niceforo D, Magnano A, Pallio S, Cinquegrani M, D'amico G, Pasta L, Craxì A, Saitta A, Raimondo G. Which patients with cirrhosis should undergo endoscopic screening for esophageal varices detection? Hepatology 2001; 33:333-8. [PMID: 11172334 DOI: 10.1053/jhep.2001.21410] [Citation(s) in RCA: 203] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Our aims were to develop a noninvasive predictive tool to identify cirrhotic patients with esophageal varices and to evaluate whether portal Doppler ultrasonographic parameters may improve the value of other predictors. One hundred forty-three consecutive compensated cirrhotic patients underwent upper gastrointestinal endoscopy. Fourteen clinical, biochemical, ultrasonographic, and Doppler ultrasonographic parameters of each patient were also recorded. Esophageal varices were detected in 63 of the 143 patients examined (44%; 95% confidence interval [CI] 36.2-52.6). Medium and large esophageal varices were observed in 28 subjects (44%; 95% CI 31.4-58.4). Using stepwise logistic regression, presence of esophageal varices was independently predicted by prothrombin activity less than 70% (odds ratio [OR]: 5.83; 95% CI: 2.6-12.8), ultrasonographic portal vein diameter greater than 13 mm (OR: 2.92; 95% CI: 1.3-6.4), and platelet count less than 100 x 10(9)/L (OR: 2.83; 95% CI: 1.27-6.28). Variables included in the model were used to generate a simple incremental rule to evaluate each individual patient. The discriminating ability of the prediction rule was relevant (area under the curve: 0.80) and did not change by replacing ultrasonographic portal vein diameter with congestion index of portal vein. We concluded that compensated cirrhotic patients should be screened by upper gastrointestinal endoscopy when prothrombin activity less than 70%, platelet count less than 100 x 10(9)/L, and ultrasonographic portal vein diameter greater than 13 mm are observed, whereas those without any of these predictors should not undergo endoscopy. The contribution provided by portal Doppler ultrasonographic parameters does not appear of practical utility.
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Affiliation(s)
- F Schepis
- Dipartimento di Medicina Interna e Terapia Medica, Policlinico Universitario, Messina, Italy
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16
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Woehlck H, Cinquegrani M, Connolly L. Is coronary artery disease equivalent to ischemia? Anesthesiology 2001; 94:161-2. [PMID: 11135736 DOI: 10.1097/00000542-200101000-00027] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Giofré MR, Meduri G, Pallio S, Calandra S, Magnano A, Niceforo D, Cinquegrani M, di Leo V, Mazzon E, Sturniolo GC, Longo G, Fries W. Gastric permeability to sucrose is increased in portal hypertensive gastropathy. Eur J Gastroenterol Hepatol 2000; 12:529-33. [PMID: 10833096 DOI: 10.1097/00042737-200012050-00009] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Portal hypertensive gastropathy (PHG) is frequently found among patients with hepatic cirrhosis and at present the only way to detect and follow PHG is via endoscopy. OBJECTIVE To assess gastric and intestinal permeability and investigate its relationship to endoscopic findings and indices of portal hypertension and hepatic function. DESIGN AND METHODS Thirty-one non-diabetic patients with hepatic cirrhosis and PHG (PHG+) were studied and compared with 17 cirrhotic patients without PHG (PHG-). All patients underwent endoscopy for the assessment of PHG and Helicobacter pylori status, ultrasound determination of the diameters of spleen and portal vein, and, subsequently, an oral load of sucrose, lactulose, and mannitol. Sugar concentrations were determined in 6-h urine specimens and expressed as a percentage of the orally administered dose or as lactulose/mannitol ratio. RESULTS The urinary sucrose excretion was significantly elevated in patients with PHG compared to those without (PHG+, 0.20% +/- 0.03; PHG-, 0.07% +/- 0.01; P< 0.001). No difference was found for the small intestinal probes lactulose and mannitol. Gastric sucrose permeability correlated positively with the endoscopic lesion score (P < 0.001), but not with other parameters of portal hypertension or hepatic function. H. pylori status did not influence gastric permeability. The sensitivity of this test reached 100% for PHG scores > 2. CONCLUSIONS Gastric permeability to sucrose is increased in patients with PHG, independently of the presence of H. pylori. Sucrose permeability may be useful for the follow-up of patients with PHG.
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Affiliation(s)
- M R Giofré
- Gastroenterologia, Università di Messina, Italy
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18
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Saitta A, Castaldo M, Sardo A, Saitta MN, Cinquegrani M, Bonaiuto M, D'Arrigo P, Zema M, Squadrito F. Effects of fluvastatin treatment on red blood cell Na+ transport systems in hypercholesterolemic subjects. J Cardiovasc Pharmacol 2000; 35:376-82. [PMID: 10710121 DOI: 10.1097/00005344-200003000-00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study was performed to ascertain the effects of short-term cholesterol-lowering therapy with fluvastatin on red blood cells Na+ transport systems. Forty familial hypercholesterolemic subjects (FH; 19 men and 21 women) without hypertension or cardiovascular disease were given a placebo for 4 weeks, and then randomized in two groups. Twenty (fluvastatin group) were given fluvastatin (40 mg/day), and the other 20 (placebo group) continued placebo administration. After the placebo period and after 4 and 12 weeks of placebo or fluvastatin treatment, we measured Na+/K+ pump activity, Na+/K+ cotransport (Na+/K+ Ct), Na+/Li+ countertransport (Na+/Li+ Cnt), passive Na+ permeability (Na+PP), and internal Na+ content (Na+i). The same parameters were measured in 23 control subjects (C) with normal cholesterolemic values, who were matched for sex and age. FH had higher Na+/Li+ Cnt values than C (193.2 +/- 59.4 vs. 139.8 +/- 48.7 microM cells/h; p < 0.01), an increase in Na(+)PP (0.034 +/- 0.012/h vs. 0.018 +/- 0.004/h; p < 0.001), and higher Na(+)i (7.5 +/- 1.5 vs. 6.2 +/- 0.9 mM cells; p < 0.001). In hypercholesterolemic subjects, Na(+)i values were correlated with cholesterol (total and LDL) and apo B levels, whereas an inverse correlation was found for HDL-c and apo AI levels. Reduced total and LDL cholesterol and apo B levels after fluvastatin treatment caused a decrease in both Na(+)/Li(+) Cnt (from 186.1 +/- 60.5 to 125.1 +/- 34.0 microM cells/h; p < 0.001) and Na(+) PP (from 0.035 +/- 0.013/h to 0.02 +/- 0.016/h; p < 0.01), and an increase in Na+/K+ pump activity (from 1,549.0 +/- 507.7 to 1,894.2 +/- 536.2 microM cells/h; p < 0.04), with a significant reduction in the internal Na+ content (from 7.5 +/- 1.6 to 5.8 +/- 2.4 mM cells; p < 0.001). Our findings show that hypercholesterolemia affects red blood cell Na+ transport systems, with an increase in Na+/Li+Cnt, Na+PP, and the internal Na+ content. Cholesterol-lowering treatment with fluvastatin influences Na+ transport systems and reduces the internal Na+ content. This might also be responsible for the greater vascular reactivity observed in hypercholesterolemic patients, and its amelioration after a reduction in cholesterol levels.
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Affiliation(s)
- A Saitta
- Department of Internal Medicine and Medical Therapeutics, University of Messina, Italy.
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19
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Sardo A, Campo S, Russo G, Maesano A, Castaldo M, Gravina M, Zema M, Bonaiuto M, Cinquegrani M, Nicocia G, Loddo S, Saitta A. C21 Frequence of FDP in a hypercholesterolemic population from east sicily. Atherosclerosis 1999. [DOI: 10.1016/s0021-9150(99)90124-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Blandino A, Mazziotti S, Figuera M, Cinquegrani M, Pandolfo I. [Arterioportal fistula caused by liver biopsy demonstrated with magnetic resonance angiography. Report of a case]. Radiol Med 1999; 97:537-9. [PMID: 10478215] [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: 02/13/2023]
Affiliation(s)
- A Blandino
- Istituto di Scienze Radiologiche, Università degli Studi, Messina
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21
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Saitta A, Castaldo M, Sardo A, Cinquegrani M, Bonaiuto M, Zema M, Gravina M, Mangano C. [Elevated levels of lipoprotein(a) are present in subjects with early ischemic cardiopathy and with a familial history of ischemic cardiopathy]. Minerva Med 1999; 90:151-8. [PMID: 10780189] [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: 02/16/2023]
Abstract
BACKGROUND Elevated levels of lipoprotein(a) are associated with a greater risk of atherothrombotic cardiovascular diseases. Since the Lp(a) levels are genetically determined and fairly stable in the course of life and a family history appears to be an independent risk factor of cardiovascular diseases, we evaluated the behavior of Lp(a) levels in patients with early events of coronary heart disease (CHD) and also in subjects with positive family history of ischemic heart diseases. METHODS The levels of lipoprotein (a) [Lp(a)] were measured in 254 subjects, 138 males and 116 females with an average age of 48.6 +/- 13.8 years (range 20-76 years). Diabetic subjects, females submitted to oestrogen treatment and those already in treatment with hypolipidaemic drugs were excluded from the study. Forty of the 254 patients (15.7%), 27 males and 13 females, had CHD (29 a previous myocardial infarction and 11 a stable angina). A positive family history for CHD was considered present (102 of the 254 patients) if one or more first degree relatives had angina or myocardial infarction before the age of 60 years in men and 65 in women. RESULTS The levels of Lp(a) were higher (p < 0.01) in women (25.1 +/- 28.3 mg/dl) compared to men (17.6 +/- 18.4 mg/dl), without differences in relation to age. The Lp(a) plasmatic levels were not correlated with age, body mass index, total cholesterol, LDL and HDL, triglycerides, apo B, apo AI, fibrinogen and there were no differences in Lp(a) levels in presence or absence of other known cardiovascular risk factors such as hypertension and smoking. The Lp(a) levels were not different between subjects with CHD (28.15 +/- 31.7 mg/dl) and controls (20.3 +/- 22.8 mg/dl). The subjects with CHD were older and had higher levels of fibrinogen and a significantly greater prevalence of hypertension and family history of CHD. Fifteen of the 40 subjects with CHD had an early onset of CHD (before 50 years of age) and only in such patients the Lp(a) levels were significantly greater compared to controls (35.8 +/- 33.2 mg/dl vs 20.3 +/- 22.8 of the controls, p < 0.01), independently of other variables (age, BMI, smoking, hypertension, cholesterol, triglycerides, HDL-c, LDL-c, fibrinogen). Furthermore the Lp(a) plasmatic levels were higher in subjects with a family history of CHD (28.3 +/- 27.6 mg/dl vs 16.3 +/- 18.6 mg/dl of the subjects without a family history of CHD, p < 0.01) even if they had or not had a previous coronary ischemic event. CONCLUSIONS Such data confirm the importance of high levels of Lp(a) above all for the early events of CHD and for the subjects with a family history of CHD, which could be expression of a greater predisposition for cardiovascular events.
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Affiliation(s)
- A Saitta
- Dipartimento di Medicina Interna e Terapia Medica, Università degli Studi, Messina
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22
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Saitta A, Sardo A, Bonaiuto M, Giordano G, Imbalzano E, Castaldo M, Cinquegrani M, D'Arrigo D, Campo GM, Squadrito F. Effects of picotamide on release of endothelin-1, thromboxane and prostacycline after treadmill stress in patients with peripheral artery disease. Angiology 1998; 49:879-84. [PMID: 9822043 DOI: 10.1177/000331979804901102] [Citation(s) in RCA: 3] [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: 02/05/2023]
Abstract
To assess the effects of picotamide, an antithromboxane receptor and antithromboxane synthase drug, on vascular function and endothelin-1 release, 20 patients with peripheral arterial disease, without hypertension or diabetes mellitus, receiving placebo and picotamide (900 mg/day) were studied. The modifications of vascular parameters were evaluated by arterial distensibility index and postischemic hyperemia test (postischemic perfusion index and recovery time). Endothelin-1, prostacycline, and thromboxane B2 were determined under resting conditions and after treadmill test. Picotamide treatment caused a decrease of resting thromboxane B2 and endothelin-1 concentrations, produced an improvement of the vascular function as seen by the increase of vascular parameters reported, and attenuated the ischemic treadmill-induced increase of thromboxane B2, but not of endothelin-1. These data confirm that the picotamide improved vascular flow by the reduction of thromboxane-mediated effects, reduced resting endothelin-1 levels, but did not attenuate endothelin-1 concentrations induced by the treadmill stress.
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Affiliation(s)
- A Saitta
- Department of Internal Medicine and Medical Therapeutics, University of Messina, Italy
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23
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Saitta A, Saitta MN, Bonaiuto M, Castaldo M, Sardo A, Imbalzano E, Cinquegrani M, Squadrito F, Hannaert PA. Erythrocyte passive potassium flux is increased in patients with ischemic coronary disease (ICD) and in subjects with family history of ICD. Angiology 1998; 49:549-55. [PMID: 9671854 DOI: 10.1177/000331979804900705] [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
BACKGROUND It has been proposed that ischemic coronary disease (ICD) associated potassium loss could be due to modifications of potassium permeability. We investigated whether a positive family history of ICD can influence this parameter. We have compared potassium permeability in erythrocytes from ICD patients and from positive family history subjects (FICD) with control subjects. METHODS All patients and subjects were carefully selected for the absence of hypertension and dysmetabolic pathologies. ICD group: 24 patients (19 males, 5 females; ages 43 to 69) all affected by ischemic coronary disease, under no drug treatment; FICD group: 18 subjects (all males, ages 27 to 42) with a verified positive ICD family history, without hypertensive family history and cardiovascular pathology; control group: 16 subjects (11 males, 5 females; ages 28 to 48) without positive family history of ICD. Passive potassium efflux (PPE) was spectrophotometrically measured in K-free medium containing ouabain and bumetanide. The kinetic constant was calculated by dividing PPE by the erythrocyte potassium concentration. RESULTS No statistically significant differences were noted between the intracellular potassium content of the three groups. However, (1) the passive potassium permeability of the ICD group was significantly higher (kK=0.055 +/- 0.021 h(-1), n=24) than that of the control group (kK=0.023 +/- 0.008 h(-1), n= 16; p<0.00001), (2) the FICD group was higher (kK=0.036 +/- 0.012 h(-1), n=18) than the control group (p<0.001), and (3) the ICD group was higher than the FICD group (p<0.001). CONCLUSIONS Our results suggest an inheritability of ICD, paralleling the familial aggregation of the pathology. Erythrocyte potassium permeability could represent an early marker of ischemic coronary disease and be used as a prophylactic tool.
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Affiliation(s)
- A Saitta
- Department of Internal Medicine, School of Medicine, University of Messina, Italy
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24
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Saitta A, Sardo A, Castaldo M, Bonaiuto M, Cinquegrani M, Maesano C, Russo G, Gravina M, Mangano C, Zema M, Campo G, Squadrito F. Expression of E-selectin and ICAM-1 in hypercholesterolemia: Effects of simvastatin treatment. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)80001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Saitta A, Saitta MN, Messina A, Bonaiuto M, Cinquegrani M, Squadrito G, Castaldo M, Sardo A, Imbalzano E, Squadrito F. [Effects of adrenergic stimulation on transmembrane transport of Na+ in patients with essential hypertension]. Minerva Med 1997; 88:275-82. [PMID: 9304069] [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: 02/05/2023]
Abstract
BACKGROUND It has been studied whether an adrenergic stimulation induced by the cold pressor test (CPT) could influence the behaviour of the transmembrane transport systems of sodium in hypertensive subjects compared to a normotensive control population. MATERIALS AND METHODS Twenty-two hypertensive subjects (average age 43.2 +/- 5.7 years), with normal weight, without signs of cardiovascular and metabolic diseases, underwent the cold pressor test. The dynamic behaviour of sodium erythrocytic transport systems and plasmatic norepinephrine was evaluated basally, at the third minute during the cold pressor test and 20 minutes after the end of the test. The same test was carried out in a control population made up of 20 normotensive subjects (average age 41.9 +/- 4.8 years), selected on the basis of the absence of any cardiovascular or metabolic pathology and without family history of arterial hypertension. RESULTS The cold pressor test did not cause significant changes in the sodium transmembrane transport systems in normotensive subjects, while in the hypertensive subjects a significant reduction was observed, during the test, in the total efflux of sodium and in the sodium/potassium pump, respectively from 2636 +/- 296 mumol/l/red blood cells/hr to 2032 +/- 178 mumol/l/red blood cells/hr (p < 0.0001) and from 2156 +/- 149 mumol/l/red blood cells/hr to 1610 +/- 101 mumol/l/red blood cells/hr (p < 0.0001); the intraerythrocytic sodium increased from 6.5 +/- 1.0 mmol/l/cells to 7.2 +/- 1.1 mmol/l/cells (p < 0.04) and the passive permeability decreased from 0.039 +/- 0.004 hr-1 to 0.018 +/- 0.006 hr-1 (p < 0.0001). During cold pressor test the increase in the plasma norepinephrine levels was correlated to the reduction in the total efflux of sodium (r = -0.60; p < 0.003) and in the sodium/potassium pump (r = -0.59; p < 0.003) only in hypertensive subjects. CONCLUSIONS Our data show that an adrenergic stimulation, induced by the cold pressor test, is able to significantly influence the behaviour of transmembrane fluxes of sodium in hypertensive subjects, and it causes an inhibitory effect on the sodium/potassium pump and an increase in the intraerythrocytic sodium. Such data show the existence in hypertensive subjects of an interrelationship between adrenergic activity and sodium transport systems that could cooperate in causing and/or in maintaining the hypertensive syndrome.
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Affiliation(s)
- A Saitta
- Dipartimento di Medicina Interna e Terapia Medica, Università degli Studi, Messina
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26
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Saitta A, Saitta MN, Bonaiuto M, Castaldo M, Sardo A, Messina A, Cinquegrani M, Squadrito G, Campo GM, Squadrito F. [Effect of beta blockade on the erythrocyte transport of Na+: evaluation during stimulation by cold pressure test in patients with essential hypertension]. Clin Ter 1997; 148:237-47. [PMID: 9377859 DOI: pmid/9377859] [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: 02/07/2023]
Abstract
Several studies have shown in essential hypertension alterations of the transmembrane red blood cells sodium fluxes, as an involvement, especially in the early phases, also of the adrenergic system. In this study we evaluated the behaviour of red blood cells fluxes of sodium before, during and after the cold pressor test, a method used also to evoke an adrenergic stimulation, in twenty hypertensive subjects, 14 males and 6 females, with an average age of 43.2 +/- 5.7 years, with normal weight and without cardiovascular complications and metabolic diseases. The behaviour of the Na+ total efflux (Na+ TE), of the Na+/K+ pump, of the Na+K+ cotransport (Na+/K+ CT), of the Na+/Li+ counter transport (Na+/Li+ Cnt), of the Na+ passive permeability (Na+ PP), of the intracellular Na+ (I Na+) and of the plasmatic noradrenaline (NE) was evaluated basally, at the third minute during cold pressor test (CPT) and 20 minutes after the end of the test. The test, which the same method, was repeated after a 30 day treatment with propranolol at the dose of 240 mg/day in three daily administrations. The beta-blockade caused, besides the reduction of both the systolic and diastolic pressure values, a significant increase in the Na+/K+ CT (from 248 +/- 41 to 314 +/- 71 mmol/l/cells/h, p < 0.001) and a decrease in the Na+ PP (from 0.039 +/- 0.004 to 0.023 +/- 0.007 hr-1, p < 0.00001), probably directed towards the reduction of the accumulation of intracellular Na+, that could compete, among the other mechanisms, with the anti-hypertensive action of the beta-blockers. The CPT caused, before the beta-blockade, a significant depression of the Na+/K+ pump (from 2057 +/- 149 to 1610 +/- 101 mmol/l/cells/h, p < 0.00001) and of the Na+ TE (from 2640 +/- 397 to 2032 +/- 179 mmol/l/cells/h, p < 0.00001) inversely correlated to the levels of NE (r = -0.60, p < 0.003), with a consequent increase in I Na+ (from 6.2 +/- 0.6 to 7.5 +/- 1.5 mmol/l/cells, p < 0.001), showing how the adrenergic activation in hypertensive subjects is able to interfere with the systems of transmembrane transport with an inhibitory attitude, that is expressed by an increase in the levels of I Na+. The beta-blockade was able to outweigh the depression of the Na+/K+ pump (from 1843 +/- 584 to 1728 +/- 640 mmol/l/cells/h, p: ns) and the reduction of the Na+ TE, preventing the accumulation of I Na+ (from 6.3 +/- 1.6 to 6.6 +/- 1.3 mmol/l/cells, p: ns). Such data show an increased susceptibility of the Na+ transport systems to the adrenergic stimuli in hypertensive subjects with a tendency to favor the accumulation of I Na+ and that the beta-blockade is able to antagonize the effects, with a maintenance of the intracellular levels of Na+.
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Affiliation(s)
- A Saitta
- Dipartimento di Medicina Interna e Terapia Medica, Università degli Studi di Messina
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27
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Saitta A, Saitta MN, Messina A, Bonaiuto M, Castaldo M, Cinquegrani M, Imbalzano E, Mangano C, Giordano G, Vollero G, Sardo A, Totaro S. [Transmembrane sodium transport systems in various forms of hyperlipoproteinemia]. Minerva Med 1996; 87:449-54. [PMID: 8992406] [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: 02/03/2023]
Abstract
The possible interrelationships between the erythrocytic transport systems of Na+ (Na+/K+ pump, Na+/K+ cotransport, Na+/Li+ countertransport, Na+ passive permeability) and the plasmatic lipids (cholesterol, triglycerides, HDL, LDL, apoprotein A1, apoprotein B) were studied in 42 normotensive subjects with different forms of hyperlipoproteinaemia and with a negative familiarity for arterial hypertension. In subjects with hypercholesterolaemia (hyperlipoproteinaemia II A and II B) an elevated activity of the Na+/K+ pump was noticed, while in subjects with hypertriglyceridaemia (type IV) an increase in Na+ passive permeability and Na+/Li+ countertransport with a lower level of intraerythrocytic Na+ was shown. A negative correlation was observed between the total efflux of Na+ and Na+/K+ pump and the levels of cholesterol (r = -0.43, p < 0.04 and r = -0.41, p < 0.05) and the apoprotein B/A ratio (r = 0.42, p < 0.05 and r = -0.50, p < 0.01). A negative correlation was also noticed between the Na+/K+ pump and the levels of apoprotein B (r = -0.41, p < 0.05). The Na+/K+ cotransport appeared inversely correlated with the levels of HDL cholesterol (r = -0.42, p < 0.05), while the Na+ passive permeability was negatively correlated with the levels of LDL (r = -0.43, p < 0.04) and positively correlated with the plasmatic triglycerides (r = +0.54, p < 0.01). Such data show that the plasmatic lipids can influence the systems of transmembrane ionic transport of Na+ and play an important role also this way, in cardiovascular pathology.
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Affiliation(s)
- A Saitta
- Cattedra di Terapia Medica, Università degli Studi, Messina
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28
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Bagnato GF, Mileto A, Gulli S, Oriti S, Di Cesare E, Cinquegrani M, Bonaiuto M, Saitta A, Purello D'Ambrosio F. Acute cardiovascular effects of salmeterol in subjects with stable bronchial asthma. Monaldi Arch Chest Dis 1996; 51:275-8. [PMID: 8909010] [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: 02/03/2023] Open
Abstract
The airway response and cardiovascular effects of salmeterol (SM) and salbutamol (SB) given as a single dose from metered-dose inhalers were studied in 10 patients with mild asthma. In a double-blind, randomized, cross-over, placebo-controlled study, the subjects received SM 100 micrograms (four puffs, 25 micrograms per actuation), SB 200 micrograms (four puffs, 50 micrograms per actuation) or placebo (P) (four puffs). SM caused a greater and longer lasting increase of peak expiratory flow rate (PEFR) value than SB and P. There was no significant difference either with P or the study drugs in heart rate, PR interval, QT interval corrected for heart rate (QTc), incidence of ventricular and supraventricular ectopics, and in echocardiogram evaluation. These findings show that at dosages based on those used in clinical practice salmeterol causes cardiovascular effects comparable to those induced by salbutamol and confirm the favourable cardiac safety profile of this drug.
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Affiliation(s)
- G F Bagnato
- Dept of Internal Medicine, University of Messina, Italy
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29
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Saitta A, Bonaiuto M, Giordano G, Saitta MN, Castaldo M, Cinquegrani M, Squadrito G, Canale P, Altavilla D, Campo GM, Caputi AP, Squadrito F. Effects of cloricromene on the levels of endothelin and on the microcirculatory function in peripheral atherosclerotic arteriopathies. Pharmacology 1996; 52:8-15. [PMID: 8966205 DOI: 10.1159/000139355] [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: 02/05/2023]
Abstract
The effects of cloricromene on plasma endothelin-1 (ET-1) levels and on microcirculatory function in 9 patients with peripheral atherosclerotic arteriopathy (PAA) and in healthy control subjects were studied. ET-1 levels and microcirculatory function were evaluated both under basal conditions and 30, 60, and 90 min after acute administration of cloricromene (30 mg i.v.). PAA patients had significantly increased levels of ET-1 and impaired vascular parameters (studied by means of Winsor's Index, Gosling's Index, postischemic perfusion index and recovery time) when compared to control subjects. The acute administration of cloricromene (30 mg i.v.) did not change plasma ET-1 both in control subjects and in patients with PAA. In contrast, cloricromene produced a significant improvement in the postischemic perfusion index and in recovery time in arteriopathic patients. Control subjects and patients with PAA also underwent a cold pressor test (CPT) under basal conditions and (72 h later) 30 min after an acute intravenous administration of cloricromene (30 mg i.v.). CPT caused a higher increase in ET-1 in the patients with PAA compared to the control group, and a reduction in the vascular flow at the femoral level, while the pretreatment with cloricromene prevented both the increase in the levels of ET-1 and the reduction of the femoral vascular flow observed after the cold stimulus in patients with PAA. Our data show that cloricromene, besides ameliorating the microcirculatory function, is able to interfere with dynamic mechanisms, such as those induced by the CPT, capable of stimulating the release of ET-1 at the vascular level.
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Affiliation(s)
- A Saitta
- Medical Therapeutics, University of Messina, Italy
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30
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Saitta A, Bonaiuto M, Mileto A, Squadrito F, Campo GM, Altavilla D, Giordano G, Squadrito G, Totaro S, Cinquegrani M. Effects of gallopamil on epinephrine and norepinephrine plasmatic levels and on TxB2 and beta-tg release in patients with coronary artery disease during adrenergic stimulus with cold pressor test. Pharmacol Res 1995; 32:49-55. [PMID: 8668647 DOI: 10.1016/s1043-6618(95)80008-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We investigated the effect of gallopamil administration during a cold pressor test (CPT) in 18 patients suffering from chronic angina (CA) and in 21 healthy subjects. CA patients showed increased basal levels of beta-thromboglobulin and thromboxane B2 compared to control patients and normal plasma levels of catecholamines. CPT caused plasma catecholamines, beta-thromboglobulin and TxB2 levels to rise. This rise was greater in CA patients than in control patients. Administration of gallopamil (50 mg kg-1 three times a day for 30 days) reduced plasma levels of catecholamines, beta-thromboglobulin and TxB2 blood concentrations either under basal conditions or after CPT. Our data suggest that gallopamil is able to modulate the response induced by adrenergic stress.
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Affiliation(s)
- A Saitta
- Department of Internal Medicine and Medical Therapeutics, University of Messina, Italy
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31
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Saitta A, Bonaiuto M, Mileto A, Oriti S, Cinquegrani M, Giordano G, Fodale P, Saitta M, Squadrito F. [Evaluation of the anti-arrhythmic action of propafenone treatment and its influence on left ventricular function]. Clin Ter 1993; 142:351-60. [PMID: 8330479] [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: 01/29/2023]
Abstract
Twelve patients (9 males, 3 females, mean age 59.2 +/- 7.0 years) with hyperkinetic ventricular arrhythmias were treated for 30 days with 150 mg propafenone three times daily; the daily dosage was raised to 900 mg in non responders (< 85% reduction of ectopic ventricular beats/h). A 24-hour ECGD and mono- and bidimensional echocardiography were carried out at baseline, after 30 days on 450 mg, 30 days on 900 mg propafenone, and one week after drug withdrawal. Propafenone treatment was found to reduce significantly ectopic ventricular beats, especially with the higher dosage (44.9% reduction under 450 mg; 88.8% reduction under 900 mg). At the lower dosage, 25% of patients responded, under the higher dosage 88.9%; the latter dosage also induced a significant reduction of Lown class. Propafenone treatment was also accompanied by a reduction of maximum and mean heart rate, and by a lengthened PR interval which was almost always within the normal range, without changes of QTc. The two months of propafenone treatment did not induce significant changes of cardiac volume or left ventricular function; on the contrary, at the end of the treatment period an increase, albeit not a significant one, of the ejection fraction and a shortening of the circumference inversely proportional to the reduction in ectopic ventricular beats could be noted. In conclusion, propafenone was found to have a valid antiarrhythmic effect, especially at the 900 mg/day dosage without interfering with left ventricular function which was even found to improve under chronic treatment, probably as a result of improved compliance thanks to the reduction of ventricular ectopic beats.
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Affiliation(s)
- A Saitta
- Istituto di Medicina Interna, Università degli Studi di Messina
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32
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Saitta A, Bonaiuto M, Mileto A, Oriti S, Fodale P, Giordano G, Cinquegrani M, Squadrito G. [Changes in the QT interval caused by autonomic cardiovascular involvement in diabetes mellitus]. Minerva Med 1991; 82:545-51. [PMID: 1945002] [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: 12/29/2022]
Abstract
The aim of the study was to assess the role of altered autonomic regulation on changes in the QT interval. Fifty-three diabetic patients, comprising 32 men and 21 women with a mean age of 49.4 +/- 15.9 years (range 13-73 years), underwent sympathetic and parasympathetic stimulatory tests (changes in heart rate between clino- and orthostatism, lying to standing, while deep breathing, Valsalva's manoeuvre, changes of arterial pressure related to posture) to study cardiovascular reflexes. Patients who were positive for at least two of the tests were considered to be affected by autonomic neuropathy. Ten non-diabetic age-matched subjects (44.8 +/- 14.8 years) with no cardiovascular diseases were included in the study as a control group. The QTc interval was measured in basal conditions and during sympathetic and parasympathetic stimulatory tests, in clino- and orthostatism, during deep breathing and Valsalva's manoeuvre. A significantly greater QTc interval (p less than 0.05) was found in neuropathic patients compared to controls and non-neuropathic patients both in basal conditions and following stimulatory tests at the lowest heart rate (phase IV of Valsalva's manoeuvre and slow exhalation during deep breathing), while at a higher heart rate (orthostatism, L-S, deep inhalation during deep breathing, phase II of Valsalva's manoeuvre) there was no difference in QTc between controls, and neuropathic and non-neuropathic patients due to a lesser extension of the QTc in neuropathic patients. This difference appears to be the expression of autonomic dysregulation in neuropathic patients, given the lack of correlation with diabetes or duration of disease, and is only conditioned by the presence or absence of autonomopathic damage. Among other causes, the observed extension of the QT interval might therefore justify the increased frequency of sudden death in diabetic patients with cardiovascular autonomic neuropathy.
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Affiliation(s)
- A Saitta
- Istituto di Medicina Interna, Università di Messina
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33
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Peluso G, Ambrosio L, Cinquegrani M, Nicolais L, Tajana G. Macrophage activation induced by different carbon fiber-epoxy resin composites. J Biomed Mater Res 1991; 25:637-49. [PMID: 1869579 DOI: 10.1002/jbm.820250507] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The activation of cells by interaction with solid surfaces is important in many settings, including the response of tissue to implanted materials. However, few comprehensive studies of both cell migration and activation have been performed so that the connection between these events and immunological activation against foreign material is not well understood. In the present study, synthesis and expression of Ia antigens by peritoneal exudate macrophages after implantation of different carbon fiber composites in the rat peritoneal cavity have been investigated in order to determine whether the type of material implanted affected the composition of Ia-bearing cells of the exudate. The results have confirmed the low level of expression of Ia on resident peritoneal macrophages; while we have found that macrophages, harvested after implantation, express a different amount of Ia related to the different cure cycles of the composite material used.
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Affiliation(s)
- G Peluso
- Institute of Protein Biochemistry and Enzymology-CNR, Naples, Italy
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Peluso G, Ambrosio L, Cinquegrani M, Nicolais L, Saiello S, Tajana G. Rat peritoneal immune response to carbon fibre reinforced epoxy composite implants. Biomaterials 1991; 12:231-5. [PMID: 1878458 DOI: 10.1016/0142-9612(91)90205-o] [Citation(s) in RCA: 17] [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: 12/29/2022]
Abstract
The aim of this paper was to evaluate the histocompatibility of differently cured carbon fibre reinforced epoxy composites, studying their potential to induce an intolerance reaction in neighbouring tissues after peritoneal implantation in the rat. According to the microscopic and scanning electron microscope findings, the inductive capacity to generate connective tissue and cellular reaction was greatest in the partially cured material compared to the fully cured material. In addition, only the partially cured material implants appeared totally coated by macrophages at various stages of activation. The differences in the cellular reactions and scar tissue deposition in the interstices of these two composites are probably related to the chemical surface properties rather than to the structural characteristics of the materials.
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Affiliation(s)
- G Peluso
- Institute of Protein Biochemistry and Enzimology - CNR, Naples, Italy
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35
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Peluso G, Ranieri M, Ambrosio L, Cinquegrani M, Nicolais L, Tajana G. Biocompatibility of two different cured polyepoxy composites. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0267-6605(91)90016-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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36
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Saitta A, Bonaiuto M, Mileto A, Oriti S, Campo S, Giordano G, Cinquegrani M, Saitta MN, Fodale P. [Clinical-instrumental evaluation of the effects of quinapril treatment in mild-to-moderate hypertension]. Clin Ter 1990; 134:289-99. [PMID: 2149311] [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: 12/30/2022]
Abstract
Eleven patients with uncomplicated mild-to-moderate hypertension (diastolic pressure 95-115 mmHg) were treated for four weeks with daily single quinapril doses of 20-40 mg. Already during the second week a significant reduction in blood pressure was observed without increase of heart rate; 27.3% of patients responded to the lower dose (diastolic blood pressure [90 mmHg], and 54.6% responded to the higher dose. Drug treatment led to reduced pressure increase in response to cold stimulation without influencing the adrenergic response both in basal conditions and after cold pressor test. The drug brought about peripheral vasodilatation as shown by increased perfusion index during Doppler ultrasound examination, and improved arterial reactivity with increased perfusion index and reduced recovery time after ischemia. The reduction of angiotensin and aldosterone plasma levels during treatment was not correlated to diminished blood pressure values, indicating that the antihypertensive effect can occur via pathways different from ACE inhibition. Tolerance was excellent as shown both by clinical and laboratory evidence.
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Affiliation(s)
- A Saitta
- Istituto di Medicina Interna, Università degli Studi di Messina
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37
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Buemi M, Marino D, Giacobbe MS, Squadrito F, Cinquegrani M, Frisina N. Effects of calmodulin and calcium channel blockers on the Ca2+ induced outflow of K+ in intact red blood cells of patients with essential hypertension. Riv Eur Sci Med Farmacol 1989; 11:69-75. [PMID: 2508196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The correlation between the alterations of free intracellular calcium concentrations and the essential arterial hypertension has been largely investigated. Calmodulin, a cytoplasmic protein with low molecular weight, is one of the factors known to be able to affect the activity of calcium-dependent enzymes. The authors have investigated the effect of calcium and calmodulin on the plasmatic membrane of intact erythrocytes in a group of patients with essential arterial hypertension. To this purpose, the ionophor A23187, propranolol at low concentrations and a few calcium channel blocking drugs, alone or associated with calmodulin have been used. The results demonstrate that calmodulin, capable of blocking calcium outside the cell, can exert its effect only when propranolol is also present in the erythrocytes of normotensive but not in the hypertensive patients. The authors discuss some pathogenetic hypotheses.
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38
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Saitta A, Bonaiuto M, Lanzafame F, Mileto A, Pernice F, Cinquegrani M, Mazza G, Micali G, Pangallo A, Fodale P. [Evaluation of apoproteins A and B, lipoproteins and plasma lipids during treatment with bezafibrate in various forms of hyperlipoproteinemia]. Clin Ter 1988; 124:373-81. [PMID: 2974348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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39
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Bonaiuto M, Mileto A, Lanzafame F, Cinquegrani M, Giordano G, Pangallo A, Saitta A. [Evaluation by an ergometric test of the effects of diltiazem in patients with stable angina]. Minerva Cardioangiol 1986; 34:541-6. [PMID: 3808345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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40
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Saitta A, Cinquegrani M, Nania G, Pangallo A, Rulli N, Squadrito F, Totaro S, Squadrito G. [Dyslipoproteinemia and vascular injury]. Cardiologia 1983; 28:695-720. [PMID: 6687212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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