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Giambruno R, Zacco E, Ugolini C, Vandelli A, Mulroney L, D’Onghia M, Giuliani B, Criscuolo E, Castelli M, Clementi N, Clementi M, Mancini N, Bonaldi T, Gustincich S, Leonardi T, Tartaglia GG, Nicassio F. Unveiling the role of PUS7-mediated pseudouridylation in host protein interactions specific for the SARS-CoV-2 RNA genome. Mol Ther Nucleic Acids 2023; 34:102052. [PMID: 38028201 PMCID: PMC10630655 DOI: 10.1016/j.omtn.2023.102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive single-stranded RNA virus, engages in complex interactions with host cell proteins throughout its life cycle. While these interactions enable the host to recognize and inhibit viral replication, they also facilitate essential viral processes such as transcription, translation, and replication. Many aspects of these virus-host interactions remain poorly understood. Here, we employed the catRAPID algorithm and utilized the RNA-protein interaction detection coupled with mass spectrometry technology to predict and validate the host proteins that specifically bind to the highly structured 5' and 3' terminal regions of the SARS-CoV-2 RNA. Among the interactions identified, we prioritized pseudouridine synthase PUS7, which binds to both ends of the viral RNA. Using nanopore direct RNA sequencing, we discovered that the viral RNA undergoes extensive post-transcriptional modifications. Modified consensus regions for PUS7 were identified at both terminal regions of the SARS-CoV-2 RNA, including one in the viral transcription regulatory sequence leader. Collectively, our findings offer insights into host protein interactions with the SARS-CoV-2 UTRs and highlight the likely significance of pseudouridine synthases and other post-transcriptional modifications in the viral life cycle. This new knowledge enhances our understanding of virus-host dynamics and could inform the development of targeted therapeutic strategies.
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Affiliation(s)
- Roberto Giambruno
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
- Institute of Biomedical Technologies, National Research Council, 20090 Segrate, Italy
| | - Elsa Zacco
- Central RNA and RNA Systems Biology Labs, Centre for Human Technologies (CHT), Istituto Italiano di Tecnologia (IIT), 16152 Genova, Italy
| | - Camilla Ugolini
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, 20122 Milano, Italy
| | - Andrea Vandelli
- Central RNA and RNA Systems Biology Labs, Centre for Human Technologies (CHT), Istituto Italiano di Tecnologia (IIT), 16152 Genova, Italy
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona 08193, Spain
- Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - Logan Mulroney
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, Cambridgeshire CB10 1SD, UK
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory (EMBL), Monterotondo, RM 00015, Italy
| | - Manfredi D’Onghia
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - Bianca Giuliani
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Tiziana Bonaldi
- Department of Experimental Oncology, European Institute of Oncology IRCCS, 20139 Milano, Italy
- Department of Oncology and Hematology-Oncology, University of Milan, 20122 Milano, Italy
| | - Stefano Gustincich
- Central RNA and RNA Systems Biology Labs, Centre for Human Technologies (CHT), Istituto Italiano di Tecnologia (IIT), 16152 Genova, Italy
| | - Tommaso Leonardi
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - Gian Gaetano Tartaglia
- Central RNA and RNA Systems Biology Labs, Centre for Human Technologies (CHT), Istituto Italiano di Tecnologia (IIT), 16152 Genova, Italy
- Catalan Institution for Research and Advanced Studies, ICREA, 08010 Barcelona, Spain
| | - Francesco Nicassio
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
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2
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Noviello M, Lorentino F, Xue E, Racca S, Furnari G, Valtolina V, Campodonico E, Dvir R, Lupo-Stanghellini MT, Giglio F, Piemontese S, Clerici D, Oltolini C, Tassi E, Beretta V, Farina F, Mannina D, Ardemagni A, Vago L, Bernardi M, Corti C, Peccatori J, Clementi M, Ciceri F, Bonini C, Greco R. Human herpesvirus 6-specific T-cell immunity in allogeneic hematopoietic stem cell transplant recipients. Blood Adv 2023; 7:5446-5457. [PMID: 37067947 PMCID: PMC10515312 DOI: 10.1182/bloodadvances.2022009274] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Human herpesvirus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplant (allo-HSCT) and may lead to severe symptoms. HHV-6-specific immune responses after HSCT are largely unexplored. We conducted a prospective observational study on 208 consecutive adult patients who received allo-HSCT to investigate HHV-6 reactivations and specific immune responses. Interferon gamma-producing HHV-6-specific T cells were quantified using enzyme-linked immunospot assay (ELISpot). HHV-6 reactivation occurred in 63% of patients, at a median of 25 days from allo-HSCT. Only 40% of these presented a clinically relevant infection, defined by the presence of classical HHV-6 end-organ diseases (EODs), based on European Conference on Infections in Leukaemia (ECIL) guidelines, and other possible HHV6-related EODs. Using multivariate analysis, we identified risk factors for HHV-6 reactivation: previous allo-HSCT, posttransplant cyclophosphamide (PT-Cy), and time-dependent steroids introduction. The use of PT-Cy and steroids were associated with clinically relevant infections, whereas higher CD3+ cell counts seemed to be protective. Interestingly, circulating HHV-6-specific T cells were significantly higher in patients with reactivated virus. Moreover, HHV-6-specific T-cell responses, quantified at >4 days after the first viremia detection, predicted clinically relevant infections (P < .0001), with higher specificity (93%) and sensitivity (79%) than polyclonal CD3+ cells per μL. Overall survival and transplant-related mortality were not affected by time-dependent HHV-6 reactivation, whereas a significant association was observed between clinically relevant infections and acute graft-versus-host disease. These results shed light on the role of HHV-6 in allo-HSCT and may affect HHV-6 monitoring and treatment.
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Affiliation(s)
- Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Francesca Lorentino
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Elisabetta Xue
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Sara Racca
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | | | - Veronica Valtolina
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Edoardo Campodonico
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Roee Dvir
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | | | - Fabio Giglio
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Simona Piemontese
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Daniela Clerici
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Chiara Oltolini
- Infectious Disease Unit, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Elena Tassi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Valeria Beretta
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Francesca Farina
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Daniele Mannina
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Anna Ardemagni
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Luca Vago
- Università Vita-Salute San Raffaele, Milan, Italy
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Ospedale San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Bernardi
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Consuelo Corti
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Jacopo Peccatori
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Ospedale San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Milano, Italy
- Cell Therapy Immunomonitoring Laboratory, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Greco
- Haematology and Bone Marrow Transplant Unit, Ospedale San Raffaele Scientific Institute, Milano, Italy
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Da Prat V, Galli L, Cichero P, Castiglioni B, Oltolini C, Tassan Din C, Andolina A, Bruzzesi E, Poli A, Moro M, Mancini N, Clementi M, Tresoldi M, Castagna A, Scarpellini P, Ripa M. Antibiotic appropriateness for Gram-negative bloodstream infections: impact of infectious disease consultation. Infect Dis (Lond) 2023; 55:255-262. [PMID: 36694444 DOI: 10.1080/23744235.2023.2169345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND We investigated the role of infectious disease consultation (IDC) on therapeutic appropriateness in Gram-negative bloodstream infections (GNBSIs) in a setting with a high proportion of antibiotic resistance. Secondary outcomes were in-hospital mortality and the impact of rapid diagnostic tests (RDTs). METHODS Retrospective study on hospitalised patients with GNBSIs. Therapy was deemed appropriate if it had the narrowest spectrum considering infection and patients' characteristics. Interventional-IDC (I-IDC) group included patients with IDC-advised first appropriate or last non-appropriate therapy. Time to first appropriate therapy and survival were evaluated by Kaplan-Meier curves. Factors associated with therapy appropriateness were assessed by multivariate Cox proportional-hazard models. RESULTS 471 patients were included. High antibiotic resistance rates were detected: quinolones 45.5%, third-generation cephalosporins 37.4%, carbapenems 7.9%. I-IDC was performed in 31.6% of patients (149/471), RDTs in 70.7% (333/471). The 7-day probability of appropriate treatment was 91.9% (95% confidence interval [95%CI]: 86.4-95.8%) vs. 75.8% (95%CI: 70.9-80.4%) with and without I-IDC, respectively (p-value = 0.0495); 85.5% (95%CI: 81.3-89.1%) vs. 69.4% (95%CI: 61.3-77.2%) with and without RDTs, respectively (p-value = 0.0023). Compared to RDTs alone, the combination with I-IDC was associated with a higher proportion of appropriate therapies at day 7: 81.9% (95%CI: 76.4-86.7%) vs. 92.6% (95%CI: 86.3-96.7%). At multivariate analysis, I-IDC and RDTs were associated with time to first appropriate therapy [adjusted hazard-ratio 1.292 (95%CI: 1.014-1.647) and 1.383 (95%CI: 1.080-1.771), respectively], with no impact on mortality. CONCLUSIONS In a setting with a high proportion of antibiotic resistance, IDC and RDTs were associated with earlier prescription of appropriate therapy in GNBSIs, without impact on mortality.
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Affiliation(s)
- Valentina Da Prat
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Cichero
- Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Barbara Castiglioni
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Oltolini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Tassan Din
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Andolina
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Andrea Poli
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Moro
- Hospital Management, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Clementi
- Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Ripa
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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4
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Criscuolo E, Giuliani B, Ferrarese R, Ferrari D, Locatelli M, Clementi M, Mancini N, Clementi N. Smallpox vaccination-elicited antibodies cross-neutralize 2022-Monkeypox virus Clade II. J Med Virol 2023; 95:e28643. [PMID: 36890648 DOI: 10.1002/jmv.28643] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 12/29/2022] [Revised: 02/17/2023] [Accepted: 03/05/2023] [Indexed: 03/10/2023]
Abstract
Since early May 2022, some monkeypox virus (MPXV) infections have been reported from countries where the disease is not endemic. Within two months, the number of patients has increased extensively, becoming the most considerable MPXV outbreak described. Smallpox vaccines demonstrated high efficacy against monkeypox viruses in the past and are considered a crucial outbreak control measure. However, viruses isolated during the current outbreak carry distinct genetic variations, and the cross-neutralizing capability of antibodies remains to be assessed. Here we report that serum antibodies elicited by first-generation smallpox vaccines can neutralize the current MPXV more than 40 years after vaccine administration. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan
| | - Benedetta Giuliani
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan
| | | | | | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan.,Synlab Italia, Castenedolo (BS), Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan.,IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan.,IRCCS San Raffaele Hospital, Milan, Italy
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5
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Lai A, Bergna A, Della Ventura C, Menzo S, Bruzzone B, Sagradi F, Ceccherini-Silberstein F, Weisz A, Clementi N, Brindicci G, Vicenti I, Sasset L, Caucci S, Corvaro B, Ippoliti S, Acciarri C, De Pace V, Lanfranchi L, Bellocchi MC, Giurato G, Ferrarese R, Lagioia A, Francisci D, Colombo ML, Lazzarin S, Ogliastro M, Cappelletti MR, Iannetta M, Rizzo F, Torti C, Fumi M, d’Avenia M, Brusa S, Greco F, Menchise A, Letizia V, Vaccaro E, Santoro CR, Fraccalvieri C, Testa S, Carioti L, Rocco T, Saracino A, Cattelan A, Clementi M, Sarmati L, Riva A, Galli M, Antinori S, Zehender G. Epidemiological and Clinical Features of SARS-CoV-2 Variants Circulating between April-December 2021 in Italy. Viruses 2022; 14:v14112508. [PMID: 36423117 PMCID: PMC9699621 DOI: 10.3390/v14112508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
SARS-CoV-2 is constantly evolving, leading to new variants. We analysed data from 4400 SARS-CoV-2-positive samples in order to pursue epidemiological variant surveillance and to evaluate their impact on public health in Italy in the period of April-December 2021. The main circulating strain (76.2%) was the Delta variant, followed by the Alpha (13.3%), the Omicron (5.3%), and the Gamma variants (2.9%). The B.1.1 lineages, Eta, Beta, Iota, Mu, and Kappa variants, represented around 1% of cases. There were 48.2% of subjects who had not been vaccinated, and they had a lower median age compared to the vaccinated subjects (47 vs. 61 years). An increasing number of infections in the vaccinated subjects were observed over time, with the highest proportion in November (85.2%). The variants correlated with clinical status; the largest proportion of symptomatic patients (59.6%) was observed with the Delta variant, while subjects harbouring the Gamma variant showed the highest proportion of asymptomatic infection (21.6%), albeit also deaths (5.4%). The Omicron variant was only found in the vaccinated subjects, of which 47% had been hospitalised. The diffusivity and pathogenicity associated with the different SARS-CoV-2 variants are likely to have relevant public health implications, both at the national and international levels. Our study provides data on the rapid changes in the epidemiological landscape of the SARS-CoV-2 variants in Italy.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
- Correspondence: ; Tel.: +39-0250319775
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Carla Della Ventura
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Stefano Menzo
- Virology Unit, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60131 Ancona, Italy
| | | | - Fabio Sagradi
- Unit of Infectious Diseases, Azienda Socio Sanitaria Territoriale Cremona, 26100 Cremona, Italy
| | | | - Alessandro Weisz
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20158 Milan, Italy
| | | | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lolita Sasset
- Infectious Diseases Unit, Azienda Ospedale Università di Padova, 35128 Padova, Italy
| | - Sara Caucci
- Virology Unit, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60131 Ancona, Italy
| | - Benedetta Corvaro
- Virology Unit, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60131 Ancona, Italy
| | - Silvia Ippoliti
- Virology Unit, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60131 Ancona, Italy
| | - Carla Acciarri
- Virology Unit, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60131 Ancona, Italy
| | | | - Leonardo Lanfranchi
- Unit of Infectious Diseases, Azienda Socio Sanitaria Territoriale Cremona, 26100 Cremona, Italy
| | - Maria C. Bellocchi
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giorgio Giurato
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20158 Milan, Italy
| | | | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, Santa Maria della Misericordia Hospital, University of Perugia, 06123 Perugia, Italy
| | - Martina L. Colombo
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Samuel Lazzarin
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, 16126 Genoa, Italy
| | - Maria R. Cappelletti
- Unit of Infectious Diseases, Azienda Socio Sanitaria Territoriale Cremona, 26100 Cremona, Italy
| | - Marco Iannetta
- Infectious Disease Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesca Rizzo
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Maurizio Fumi
- UOC Patologia Clinica, AO San Pio Benevento, 82100 Benevento, Italy
| | - Morena d’Avenia
- UOSVD di Citopatologia e Screening, Department of Laboratory Medicines, 70131 Bari, Italy
| | - Stefano Brusa
- Department of Translational Medical Sciences, Università Federico II, 80138 Naples, Italy
| | - Francesca Greco
- UOC Microbiologia e Virologia, PO Cosenza, 87100 Cosenza, Italy
| | - Angela Menchise
- Microbiology and Virology Laboratory, A.O.R. San Carlo Potenza, 85100 Potenza, Italy
| | - Vittoria Letizia
- UOSD Genetics and Molecular Biology, AORN Sant’Anna e San Sebastiano di Caserta, 81100 Caserta, Italy
| | - Emilia Vaccaro
- Molecular Biology Units, AOU ‘S. Giovanni di Dio e Ruggi d’Aragona’ Università di Salerno, 84131 Salerno, Italy
| | | | | | - Sophie Testa
- Unit of Infectious Diseases, Azienda Socio Sanitaria Territoriale Cremona, 26100 Cremona, Italy
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Teresa Rocco
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, 84084 Salerno, Italy
| | | | - Annamaria Cattelan
- Infectious Diseases Unit, Azienda Ospedale Università di Padova, 35128 Padova, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20158 Milan, Italy
| | - Loredana Sarmati
- Infectious Disease Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20174 Milan, Italy
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Spagnuolo V, Voarino M, Tonelli M, Galli L, Poli A, Bruzzesi E, Racca S, Clementi N, Oltolini C, Tresoldi M, Rovere Querini P, Dagna L, Zangrillo A, Ciceri F, Clementi M, Castagna A. Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study. Drug Des Devel Ther 2022; 16:3645-3654. [PMID: 36268521 PMCID: PMC9578770 DOI: 10.2147/dddt.s369473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Evidence regarding the impact of remdesivir (RDV) on SARS-CoV-2 viral clearance (VC) is scarce. The aim of this study was to compare VC timing in hospitalized COVID-19 patients who did or did not receive RDV. Methods This was a matched-cohort study of patients hospitalized with pneumonia, a SARS-CoV-2-positive nasopharyngeal swab (NPS) at admission, and at least one NPS during follow-up. Patients who received RDV (cases) and those who did not (controls) were matched in a 1:2 ratio by age, sex, and PaO2/FiO2 (P/F) values at admission. NPSs were analyzed using real-time polymerase chain reaction. Time to VC (within 30 days after hospital discharge) was estimated using the Kaplan-Meier curve. A multivariable Cox proportional hazard model was fitted to determine factors associated with VC. Results There were 648 patients enrolled in the study (216 cases and 432 controls). VC was observed in 490 patients (75.6%), with a median time of 25 (IQR 16-34) days. Overall, time to VC was similar between cases and controls (p = 0.519). However, time to VC was different when considering both RDV treatment status and age (p = 0.007). A significant finding was also observed when considering both RDV treatment status and P/F values at admission (p = 0.007). A multivariate analysis showed that VC was associated with a younger age (aHR = 0.990, 95% CI 0.983-0.998 per every 10-year increase in age; p = 0.009) and a higher baseline P/F ratio (aHR=1.275, 95% CI 1.029-1.579; p=0.026), but not with RDV treatment status. Conclusion Time to VC was similar in cases and controls. However, there was a benefit associated with using RDV in regard to time to VC in younger patients and in those with a P/F ratio ≤200 mmHg at hospital admission.
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Affiliation(s)
- Vincenzo Spagnuolo
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy,Correspondence: Vincenzo Spagnuolo, Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy, Tel +390226437907, Fax +390226437903, Email
| | - Marta Voarino
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Tonelli
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - Elena Bruzzesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Racca
- Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Oltolini
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere Querini
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy,Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy,Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
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7
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Tassi E, Noviello M, De Simone P, Lupo-Stanghellini MT, Doglio M, Serio F, Abbati D, Beretta V, Valtolina V, Oliveira G, Racca S, Campodonico E, Ruggiero E, Clerici D, Giglio F, Lorentino F, Dvir R, Xue E, Farina F, Oltolini C, Manfredi F, Vago L, Corti C, Bernardi M, Clementi M, Brix L, Ciceri F, Peccatori J, Greco R, Bonini C. Cytomegalovirus-specific T cells restricted for shared and donor human leukocyte antigens differentially impact on Cytomegalovirus reactivation risk after allogeneichematopoietic stem cell transplantation. Haematologica 2022. [PMID: 36200418 DOI: 10.3324/haematol.2022.280685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 11/09/2022] Open
Abstract
After allogeneic hematopoietic stem cell transplantation (allo-HSCT), the emergence of circulating Cytomegalovirus(CMV)-specific T cells correlates with protection from CMV reactivation, an important risk factor for non-relapse mortality. However, functional assays measuring CMV-specific cells are time-consuming and often inaccurate at early timepoints. We report results of a prospective single-center non-interventional study which identifies the enumeration of Dextramer-positive CMV-specific lymphocytes as a reliable and early predictor of viral reactivation. We longitudinally monitored 75 consecutive patients for 1 year after allo-HSCT (n=630 samples). The presence of ≥0.5 CMV-specific CD8+ cells//L at day+45 was an independent protective factor from subsequent clinicallyrelevant reactivation in univariate(p.
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Affiliation(s)
- Elena Tassi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Maddalena Noviello
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Pantaleo De Simone
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | | | - Matteo Doglio
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Francesca Serio
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Danilo Abbati
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Valeria Beretta
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Veronica Valtolina
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute
| | - Giacomo Oliveira
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Sara Racca
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | - Edoardo Campodonico
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Eliana Ruggiero
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Daniela Clerici
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Fabio Giglio
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Francesca Lorentino
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Roee Dvir
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | - Elisabetta Xue
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Francesca Farina
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Chiara Oltolini
- Infectious Disease Unit, Ospedale San Raffaele Scientific Institute
| | - Francesco Manfredi
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano
| | - Luca Vago
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele
| | - Consuelo Corti
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Massimo Bernardi
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Massimo Clementi
- Laboratory of Clinical Microbiology and Virology, Ospedale San Raffaele Scientific Institute
| | | | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele
| | - Jacopo Peccatori
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, Ospedale San Raffaele Scientific Institute
| | - Chiara Bonini
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano, Italy; Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Ospedale San Raffaele Scientific Institute, Milano; Università Vita-Salute San Raffaele.
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8
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Ripa M, Galli L, D’Angelo A, Apruzzi L, Palumbo D, Campochiaro C, Tassan Din C, Danise A, Da Prat V, Vitali G, Brugliera L, Poli A, Monardo R, Monti G, Baccellieri D, De Cobelli F, Clementi M, Iannaccone S, Dagna L, Rovere-Querini P, Ciceri F, Tresoldi M, Zangrillo A, Scarpellini P, Castagna A. High risk of secondary infections following thrombotic complications in patients with COVID-19. Open Forum Infect Dis 2022; 9:ofac454. [PMID: 36168552 PMCID: PMC9511118 DOI: 10.1093/ofid/ofac454] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study’s primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications. Methods This was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univariable Poisson regression as the number of cases per 1000 person-days of follow-up (PDFU) with 95% confidence intervals. The cumulative incidence functions of secondary infections according to thrombotic complications were compared with Gray's method accounting for competing risk of death. A multivariable Fine-Gray model was applied to assess factors associated with risk of secondary infections. Results Overall, 109/904 patients had 176 secondary infections (IR, 10.0; 95% CI, 8.8–11.5; per 1000-PDFU). The IRs of secondary infections among patients with or without thrombotic complications were 15.0 (95% CI, 10.7–21.0) and 9.3 (95% CI, 7.9–11.0) per 1000-PDFU, respectively (P = .017). At multivariable analysis, thrombotic complications were associated with the development of secondary infections (subdistribution hazard ratio, 1.788; 95% CI, 1.018–3.140; P = .043). The etiology of secondary infections was similar in patients with and without thrombotic complications. Conclusions In patients with COVID-19, thrombotic complications were associated with a high risk of secondary infections.
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Affiliation(s)
- Marco Ripa
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
- Vita-Salute San Raffaele University , Milan , Italy
| | - Laura Galli
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Armando D’Angelo
- Coagulation Service and Thrombosis Research Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Luca Apruzzi
- Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Diego Palumbo
- Vita-Salute San Raffaele University , Milan , Italy
- Unit of Radiology, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Chiara Tassan Din
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Anna Danise
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Valentina Da Prat
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Giordano Vitali
- Internal Medicine, Diabetes and Endocrinology Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Luigia Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Andrea Poli
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Roberta Monardo
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
- Vita-Salute San Raffaele University , Milan , Italy
| | - Giacomo Monti
- Vita-Salute San Raffaele University , Milan , Italy
- Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Domenico Baccellieri
- Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Francesco De Cobelli
- Vita-Salute San Raffaele University , Milan , Italy
- Unit of Radiology, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Massimo Clementi
- Vita-Salute San Raffaele University , Milan , Italy
- Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University , Milan , Italy
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University , Milan , Italy
- Internal Medicine, Diabetes and Endocrinology Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University , Milan , Italy
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University , Milan , Italy
- Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Paolo Scarpellini
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Antonella Castagna
- Unit of Infectious and Tropical Diseases IRCCS San Raffaele Scientific Institute , Milan , Italy
- Vita-Salute San Raffaele University , Milan , Italy
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Sista F, Carandina S, Andreica A, Zulian V, Pietroletti R, Cappelli S, Balla A, Nedelcu M, Clementi M. Long-term results of laparoscopic gastric sleeve: the importance of follow-up adherence. Eur Rev Med Pharmacol Sci 2022; 26:6691-6699. [PMID: 36196719 DOI: 10.26355/eurrev_202209_29770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study was conducted to assess the long-term results of the Laparoscopic Sleeve Gastrectomy (LSG) in patients not compliant with follow-up, and in patients who completed a postoperative follow-up program. PATIENTS AND METHODS The data concerning LSG patients operated from February 2011 to December 2013 were retrospectively reviewed basing on a single center database. The patients with complete long-term follow-up were scheduled in Group A, while patients who failed to attend controls for more than two years were scheduled in Group B. Long-term results (weight loss, comorbidity improvement and late complications) were compared between the two groups. RESULTS The study population consisted of 285 patients. Of these, 101 had a complete follow-up with a mean duration of 71 ± 7.6 months (Group A). The remaining 184 patients (Group B) were not compliant with follow-up and, consequently, the mean duration of follow-up was 5.5 ± 7.3 months (p < 0.00001). A higher number of patients with insufficient weight loss was recorded in Group B with respect to Group A (78 vs. 23; p = 0.001). The number of patients with results below 25% EWL was significantly higher in Group B than in Group A (24 vs. 5; p = 0.04). In the long-term, the rate of patients with symptomatic reflux requiring medical treatment was two-fold higher in Group B than in Group A. CONCLUSIONS The adherence to a long-term follow-up plan after LSG seems to decrease the number of patients experiencing insufficient weight loss and those at risk for developing a gastro-esophageal reflux disease.
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Affiliation(s)
- F Sista
- San Salvatore Hospital, Department of Surgery, L'Aquila, Italy.
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10
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Mazzara PG, Criscuolo E, Rasponi M, Massimino L, Muggeo S, Palma C, Castelli M, Clementi M, Burioni R, Mancini N, Broccoli V, Clementi N. A Human Stem Cell-Derived Neurosensory–Epithelial Circuitry on a Chip to Model Herpes Simplex Virus Reactivation. Biomedicines 2022; 10:biomedicines10092068. [PMID: 36140168 PMCID: PMC9495731 DOI: 10.3390/biomedicines10092068] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Both emerging viruses and well-known viral pathogens endowed with neurotropism can either directly impair neuronal functions or induce physio-pathological changes by diffusing from the periphery through neurosensory–epithelial connections. However, developing a reliable and reproducible in vitro system modeling the connectivity between the different human sensory neurons and peripheral tissues is still a challenge and precludes the deepest comprehension of viral latency and reactivation at the cellular and molecular levels. This study shows a stable topographic neurosensory–epithelial connection on a chip using human stem cell-derived dorsal root ganglia (DRG) organoids. Bulk and single-cell transcriptomics showed that different combinations of key receptors for herpes simplex virus 1 (HSV-1) are expressed by each sensory neuronal cell type. This neuronal–epithelial circuitry enabled a detailed analysis of HSV infectivity, faithfully modeling its dynamics and cell type specificity. The reconstitution of an organized connectivity between human sensory neurons and keratinocytes into microfluidic chips provides a powerful in vitro platform for modeling viral latency and reactivation of human viral pathogens.
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Affiliation(s)
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Marco Rasponi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Luca Massimino
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sharon Muggeo
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Cecilia Palma
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Vania Broccoli
- Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
- National Research Council (CNR), Institute of Neuroscience, 20129 Milan, Italy
- Correspondence: (V.B.); (N.C.); Tel.: +39-022-643-4616 (V.B.); +39-022-643-3144 (N.C.)
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Correspondence: (V.B.); (N.C.); Tel.: +39-022-643-4616 (V.B.); +39-022-643-3144 (N.C.)
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Sisti S, Diotti RA, Caputo V, Libera M, Ferrarese R, Carletti S, Rizzi P, Cirillo DM, Lorenzin G, Clementi M, Mancini N, Clementi N. Identification of a novel mutation involved in colistin resistance in Klebsiella pneumoniae through Next-Generation Sequencing (NGS) based approaches. New Microbiol 2022; 45:199-209. [PMID: 35920875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
The spread of multidrug-resistant (MDR) K. pneumoniae carbapenemase-producing bacteria (KPC) is one of the most serious threats to global public health. Due to the limited antibiotic options, colis- tin often represents a therapeutic choice. In this study, we performed Whole-Genome Sequencing (WGS) by Illumina and Nanopore platforms on four colistin-resistant K. pneumoniae isolates (CoRKp) to explore the resistance profile and the mutations involved in colistin resistance. Mapping reads with reference sequence of the most com- mon genes involved in colistin resistance did not show the presence of mobile colistin resistance (mcr) genes in all CoRKp. Complete or partial deletions of mgrB gene were observed in three out of four CoRKp, while in one CoRKp the mutation V24G on phoQ was identified. Complementation assay with proper wild type genes restored colistin susceptibility, validating the role of the amino acid substitution V24G and, as already described in the literature, confirming the key role of mgrB alterations in colistin resistance. In conclusion, this study allowed the identification of the novel mutation on phoQ gene involved in colistin resistance phenotype.
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Affiliation(s)
- Sofia Sisti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta A. Diotti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Valeria Caputo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Martina Libera
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Silvia Carletti
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pierfrancesco Rizzi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Giovanni Lorenzin
- Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Criscuolo E, Giuliani B, Ferrari D, Ferrarese R, Diotti RA, Clementi M, Mancini N, Clementi N. Proper Selection of In Vitro Cell Model Affects the Characterization of the Neutralizing Antibody Response against SARS-CoV-2. Viruses 2022; 14:1232. [PMID: 35746703 PMCID: PMC9230092 DOI: 10.3390/v14061232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/01/2022] [Accepted: 06/05/2022] [Indexed: 11/26/2022] Open
Abstract
(1) Background: Our aim is the evaluation of the neutralizing activity of BNT162b2 mRNA vaccine-induced antibodies in different in vitro cellular models, as this still represents one of the surrogates of protection against SARS-CoV-2 viral variants. (2) Methods: The entry mechanisms of SARS-CoV-2 in three cell lines (Vero E6, Vero E6/TMPRSS2 and Calu-3) were evaluated with both pseudoviruses and whole virus particles. The neutralizing capability of sera collected from vaccinated subjects was characterized through cytopathic effects and Real-Time RT PCR. (3) Results: In contrast to Vero E6 and Vero E6/TMPRSS2, Calu-3 allowed the evaluation of both viral entry mechanisms, resembling what occurs during natural infection. The choice of an appropriate cellular model can decisively influence the determination of the neutralizing activity of antibodies against SARS-CoV-2 variants. Indeed, the lack of correlation between neutralizing data in Calu-3 and Vero E6 demonstrated that testing the antibody inhibitory activity by using a single cell model possibly results in an inaccurate characterization. (4) Conclusions: Cellular systems allowing only one of the two viral entry pathways may not fully reflect the neutralizing activity of vaccine-induced antibodies moving increasingly further away from possible correlates of protection from SARS-CoV-2 infection.
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Affiliation(s)
- Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
| | - Benedetta Giuliani
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
| | - Davide Ferrari
- SCVSA Department, University of Parma, 43121 Parma, Italy;
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
| | - Roberta A. Diotti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
- IRCCS Ospedale San Raffaele, 20158 Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
- IRCCS Ospedale San Raffaele, 20158 Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20158 Milan, Italy; (E.C.); (B.G.); (R.F.); (R.A.D.); (M.C.); (N.M.)
- IRCCS Ospedale San Raffaele, 20158 Milan, Italy
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De Santis M, Motta F, Isailovic N, Clementi M, Criscuolo E, Clementi N, Tonutti A, Rodolfi S, Barone E, Colapietro F, Ceribelli A, Vecellio M, Luciano N, Guidelli G, Caprioli M, Rezk C, Canziani L, Azzolini E, Germagnoli L, Mancini N, Lleo A, Selmi C. Dose-Dependent Impairment of the Immune Response to the Moderna-1273 mRNA Vaccine by Mycophenolate Mofetil in Patients with Rheumatic and Autoimmune Liver Diseases. Vaccines (Basel) 2022; 10:vaccines10050801. [PMID: 35632557 PMCID: PMC9144166 DOI: 10.3390/vaccines10050801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to evaluate the efficacy and safety of the Moderna-1273 mRNA vaccine for SARS-CoV-2 in patients with immune-mediated diseases under different treatments. Anti-trimeric spike protein antibodies were tested in 287 patients with rheumatic or autoimmune diseases (10% receiving mycophenolate mofetil, 15% low-dose glucocorticoids, 21% methotrexate, and 58% biologic/targeted synthetic drugs) at baseline and in 219 (76%) 4 weeks after the second Moderna-1273 mRNA vaccine dose. Family members or caretakers were enrolled as the controls. The neutralizing serum activity against SARS-CoV-2-G614, alpha, and beta variants in vitro and the cytotoxic T cell response to SARS-CoV-2 peptides were determined in a subgroup of patients and controls. Anti-SARS-CoV-2 antibody development, i.e., seroconversion, was observed in 69% of the mycophenolate-treated patients compared to 100% of both the patients taking other treatments and the controls (p < 0.0001). A dose-dependent impairment of the humoral response was observed in the mycophenolate-treated patients. A daily dose of >1 g at vaccination was a significant risk factor for non-seroconversion (ROC AUC 0.89, 95% CI 0.80−98, p < 0.0001). Moreover, in the seroconverted patients, a daily dose of >1 g of mycophenolate was associated with significantly lower anti-SARS-CoV-2 antibody titers, showing slightly reduced neutralizing serum activity but a comparable cytotoxic response compared to other immunosuppressants. In non-seroconverted patients treated with mycophenolate at a daily dose of >1 g, the cytotoxic activity elicited by viral peptides was also impaired. Mycophenolate treatment affects the Moderna-1273 mRNA vaccine immunogenicity in a dose-dependent manner, independent of rheumatological disease.
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Affiliation(s)
- Maria De Santis
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
| | - Francesca Motta
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
| | - Natasa Isailovic
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (M.C.); (N.C.); (N.M.)
- IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | | | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (M.C.); (N.C.); (N.M.)
- IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Antonio Tonutti
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Stefano Rodolfi
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Elisa Barone
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy
| | - Francesca Colapietro
- Division of Internal Medicine and Liver Disease, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy;
| | - Angela Ceribelli
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
| | - Matteo Vecellio
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Nicoletta Luciano
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Giacomo Guidelli
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Marta Caprioli
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Clara Rezk
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
| | - Lorenzo Canziani
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
| | - Elena Azzolini
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- Medical Direction, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy;
| | - Luca Germagnoli
- Diagnostic Laboratory, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy;
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, University Vita-Salute San Raffaele, 20132 Milan, Italy; (M.C.); (N.C.); (N.M.)
- IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Ana Lleo
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- Division of Internal Medicine and Liver Disease, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy;
| | - Carlo Selmi
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Milan, Italy; (M.D.S.); (F.M.); (N.I.); (A.C.); (M.V.); (N.L.); (G.G.); (M.C.); (L.C.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Milan, Italy; (A.T.); (S.R.); (E.B.); (C.R.); (A.L.)
- Correspondence: ; Tel.: +39-028-2245-118
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14
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Ugolini C, Mulroney L, Leger A, Castelli M, Criscuolo E, Williamson MK, Davidson AD, Almuqrin A, Giambruno R, Jain M, Frigè G, Olsen H, Tzertzinis G, Schildkraut I, Wulf MG, Corrêa IR, Ettwiller L, Clementi N, Clementi M, Mancini N, Birney E, Akeson M, Nicassio F, Matthews D, Leonardi T. Nanopore ReCappable sequencing maps SARS-CoV-2 5' capping sites and provides new insights into the structure of sgRNAs. Nucleic Acids Res 2022; 50:3475-3489. [PMID: 35244721 PMCID: PMC8989550 DOI: 10.1093/nar/gkac144] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 01/09/2023] Open
Abstract
The SARS-CoV-2 virus has a complex transcriptome characterised by multiple, nested subgenomic RNAsused to express structural and accessory proteins. Long-read sequencing technologies such as nanopore direct RNA sequencing can recover full-length transcripts, greatly simplifying the assembly of structurally complex RNAs. However, these techniques do not detect the 5' cap, thus preventing reliable identification and quantification of full-length, coding transcript models. Here we used Nanopore ReCappable Sequencing (NRCeq), a new technique that can identify capped full-length RNAs, to assemble a complete annotation of SARS-CoV-2 sgRNAs and annotate the location of capping sites across the viral genome. We obtained robust estimates of sgRNA expression across cell lines and viral isolates and identified novel canonical and non-canonical sgRNAs, including one that uses a previously un-annotated leader-to-body junction site. The data generated in this work constitute a useful resource for the scientific community and provide important insights into the mechanisms that regulate the transcription of SARS-CoV-2 sgRNAs.
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Affiliation(s)
- Camilla Ugolini
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - Logan Mulroney
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
- Biomolecular Engineering Department, UC Santa Cruz, CA 95064, USA
| | - Adrien Leger
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University; via Olgettina 58, 20132 Milan, Italy
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University; via Olgettina 58, 20132 Milan, Italy
| | - Maia Kavanagh Williamson
- School of Cellular and Molecular Medicine, Faculty of Life Sciences, University Walk, University of Bristol, Bristol BS8 1TD, UK
| | - Andrew D Davidson
- School of Cellular and Molecular Medicine, Faculty of Life Sciences, University Walk, University of Bristol, Bristol BS8 1TD, UK
| | - Abdulaziz Almuqrin
- School of Cellular and Molecular Medicine, Faculty of Life Sciences, University Walk, University of Bristol, Bristol BS8 1TD, UK
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Roberto Giambruno
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - Miten Jain
- Biomolecular Engineering Department, UC Santa Cruz, CA 95064, USA
| | - Gianmaria Frigè
- Department of Experimental Oncology, IEO European Institute of Oncology IRCCS, 20139 Milano, Italy
| | - Hugh Olsen
- Biomolecular Engineering Department, UC Santa Cruz, CA 95064, USA
| | | | | | | | | | | | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University; via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute; via Olgettina 60, 20132 Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University; via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute; via Olgettina 60, 20132 Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University; via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Scientific Institute; via Olgettina 60, 20132 Milan, Italy
| | - Ewan Birney
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Mark Akeson
- Biomolecular Engineering Department, UC Santa Cruz, CA 95064, USA
| | - Francesco Nicassio
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
| | - David A Matthews
- School of Cellular and Molecular Medicine, Faculty of Life Sciences, University Walk, University of Bristol, Bristol BS8 1TD, UK
| | - Tommaso Leonardi
- Center for Genomic Science of IIT@SEMM, Fondazione Istituto Italiano di Tecnologia, 20139 Milano, Italy
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Sista F, Clementi M, Rivkine E, Soprani A, Fiasca F, Cappelli S, Montana L, Nedelcu M, Carandina S. Gastric Bypass after multiple restrictive procedures: Roux-en-Y or One Anastomosis? A retrospective multicentric study. Eur Rev Med Pharmacol Sci 2022; 26:2075-2084. [PMID: 35363357 DOI: 10.26355/eurrev_202203_28355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE When restrictive surgery fails, conversion to more malabsorptive techniques is frequently proposed. The aim of this study is to evaluate the weight loss figures between Roux-en-Y Gastric Bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) in patients who have already undergone Multiple Restrictive Procedures (MRP). PATIENTS AND METHODS All patients who underwent conversion of Laparoscopic Sleeve Gastrectomy (LSG) to RYGB or OAGB between 2010 and 2019 were retrospectively analyzed. Only patients who had conversion for Weight Regain (WR) or Insufficient Weight Loss (IWL) after both Laparoscopic Gastric Banding (LGB) and LSG entered the study population. Finally, 44 patients underwent conversion to RYGB, and 24 patients to OAGB. RESULTS Concerning Excess Weight Loss (%EWL) at 3, 6, 12, 24 postoperative months, the results for RYGB were 33.7%, 47.95%, 61.8%, 61.8%, while for OAGB were 38.3%, 51.9%, 63.75%, 79.45%. A significant difference was recorded in favor of OAGB at 3 (p=0.03) and 24 (p=0.046) postoperative months. % EWL at 24 months in the case of IWL was 57.8% for RYGB, while for OAGB was 72.7% (p=0.047). No significant difference was found considering patients with WR (80.9% and 80.5%; p= 0.999). Patients with better results at 24 months after surgery had a significantly longer time between sleeve and bypass than those with a lower % EWL. CONCLUSIONS The results of the present study seem to show that both techniques give good results at 24 months in patients who have undergone MRP. However, OAGB shows overall better results, particularly in patients with IWL.
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Affiliation(s)
- F Sista
- Department of Surgery, Ospedale Civile San Salvatore L'Aquila, UOC di Chirurgia Epato-Bilio-Pancreatica, L'Aquila, Italy.
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Maugeri N, De Lorenzo R, Clementi N, Antonia Diotti R, Criscuolo E, Godino C, Tresoldi C, Angels For Covid-BioB Study Group B, Bonini C, Clementi M, Mancini N, Ciceri F, Rovere-Querini P, Manfredi AA. Unconventional CD147-dependent platelet activation elicited by SARS-CoV-2 in COVID-19. J Thromb Haemost 2022; 20:434-448. [PMID: 34710269 PMCID: PMC8646617 DOI: 10.1111/jth.15575] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Platelet activation and thrombotic events characterizes COVID-19. OBJECTIVES To characterize platelet activation and determine if SARS-CoV-2 induces platelet activation. PATIENTS/METHODS We investigated platelet activation in 119 COVID-19 patients at admission in a university hospital in Milan, Italy, between March 18 and May 5, 2020. Sixty-nine subjects (36 healthy donors, 26 patients with coronary artery disease, coronary artery disease, and seven patients with sepsis) served as controls. RESULTS COVID-19 patients had activated platelets, as assessed by the expression and distribution of HMGB1 and von Willebrand factor, and by the accumulation of platelet-derived (plt) extracellular vesicles (EVs) and HMGB1+ plt-EVs in the plasma. P-selectin upregulation was not detectable on the platelet surface in a fraction of patients (55%) and the concentration of soluble P-selectin in the plasma was conversely increased. The plasma concentration of HMGB1+ plt-EVs of patients at hospital admission remained in a multivariate analysis an independent predictor of the clinical outcome, as assessed using a 6-point ordinal scale (from 1 = discharged to 6 = death). Platelets interacting in vitro with SARS-CoV-2 underwent activation, which was replicated using SARS-CoV-2 pseudo-viral particles and purified recombinant SARS-CoV-2 spike protein S1 subunits. Human platelets express CD147, a putative coreceptor for SARS-CoV-2, and Spike-dependent platelet activation, aggregation and granule release, release of soluble P-selectin and HMGB1+ plt-EVs abated in the presence of anti-CD147 antibodies. CONCLUSIONS Hence, an early and intense platelet activation, which is reproduced by stimulating platelets in vitro with SARS-CoV-2, characterizes COVID-19 and could contribute to the inflammatory and hemostatic manifestations of the disease.
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Affiliation(s)
- Norma Maugeri
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Rebecca De Lorenzo
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Nicola Clementi
- Università Vita-Salute San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, "Vita-Salute" San Raffaele University, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Institute, Milan, Italy
| | - Roberta Antonia Diotti
- Laboratory of Medical Microbiology and Virology, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Medical Microbiology and Virology, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Cosmo Godino
- Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Institute, Milan, Italy
| | - Cristina Tresoldi
- Molecular Haematology Unit, IRCCS San Raffaele Institute, Milan, Italy
| | | | - Chiara Bonini
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Massimo Clementi
- Università Vita-Salute San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, "Vita-Salute" San Raffaele University, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Institute, Milan, Italy
| | - Nicasio Mancini
- Università Vita-Salute San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, "Vita-Salute" San Raffaele University, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Institute, Milan, Italy
| | - Fabio Ciceri
- Università Vita-Salute San Raffaele, Milan, Italy
- Molecular Haematology Unit, IRCCS San Raffaele Institute, Milan, Italy
- Haematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Angelo A Manfredi
- Division of Immunology, Transplantation & Infectious Diseases, IRCCS San Raffaele Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
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17
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Clementi M, Carandina S, Zulian V, Guadagni S, Cianca G, Salvatorelli A, Grasso A, Sista F. The role of antral resection in sleeve gastrectomy. An observational comparative study. Eur Rev Med Pharmacol Sci 2021; 25:7204-7210. [PMID: 34919218 DOI: 10.26355/eurrev_202112_27412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The role of antral resection (AR) in laparoscopic sleeve gastrectomy (LSG) is still a greatly debated topic in the literature. The aim of this study was to evaluate the results and complications of AR in LSG. PATIENTS AND METHODS In this observational comparative study, 101 patients who underwent LSG were divided into two groups based on the extent of antral resection: 1 cm from the pylorus (1-DP group), or 6 cm from the pylorus (6-DP group). The %EWL (%Excess weight loss), resolution of T2D (Type 2 Diabetes Mellitus) and GLP-1 were investigated 48 hours before surgery and 3, 6 and 12 months after LSG. Postoperative complications in the first 30 days after surgery were also compared between the two groups using the Clavien-Dindo (CD) score. RESULTS A significant difference in %EWL was observed at 3 and 6 months in favor of the 1-DP group (38.9% and 57.8%, respectively) compared to the 6-DP group (31.4% and 49.7%, respectively). No difference in T2D resolution was observed between two groups during the follow-up period, with similar changes in GLP-1. Statistically significant differences were found between 1-DP and 6-DP group for the reintervention rate (CD III, 7.7% and 1.9%, respectively; p = 0.02) and life-threatening complications requiring intensive care unit management (CD IV, 3.8% and 0%, respectively, p = 0.03). CONCLUSIONS In LSG, sparing the antrum is associated with a significant reduction in the rate of postoperative complications, but the metabolic and weight results are comparable to those for antrum resection.
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Affiliation(s)
- M Clementi
- Dipartimento di Scienze Cliniche Applicate e Biotecnologie, Ospedale Civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
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18
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Spagnuolo V, Voarino M, Tonelli M, Galli L, Poli A, Bruzzesi E, Racca S, Clementi N, Oltolini C, Tresoldi M, Querini PR, Dagna L, Zangrillo A, Ciceri F, Clementi M, Castagna A. 505. Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study. Open Forum Infect Dis 2021. [PMCID: PMC8644947 DOI: 10.1093/ofid/ofab466.704] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Evidence regarding the impact of remdesivir (RDV) on SARS-CoV-2 viral clearance (VC) is scarce. Aim of this study was to compare VC timing in COVID-19 patients who received RDV with those who did not. Methods Matched-cohort study conducted (25 February 2020-15 April 2021) at the IRCSS San Raffaele, Milan, Italy. The study enrolled hospitalized patients with pneumonia and a SARS-CoV-2 positive nasopharyngeal swab (NPS) at admission and at least one NPS during follow-up. Follow-up started at hospital admission and ended at the date of the first negative NPS (within 30 days after discharge). Patients who received RDV (cases) and patients who did not (controls) were matched based on age (±5 years), sex and PaO2/FiO2 (P/F; ±10 mmHg) values at admission. NPS were analyzed with RT-PCR. Results described as median (IQR) or frequency (%). Time to VC was estimated with Kaplan-Meier curve and compared with log-rank test. Results 648 patients were enrolled: 216 cases and 432 controls. Patients’ characteristics at admission are reported in Table 1. VC was observed in 490 patients (75.6%) in a median time of 25 (16-34) days. Overall, time to VC was similar in patients receiving or not receiving remdesivir (p=0.519). However, time to VC was different when considering both the use of RDV (yes vs no) and age (≤ or > 63 years), as shown in Figure 1A. A significant finding was also observed considering the use of RDV and P/F values at admission (≤ or > 200 mmHg), as reported in Figure 1B. Among the 490 patients who reached VC during follow-up, overall time to VC was similar in patients receiving or not receiving RDV (p=0.075; Figure 2A); however, RDV use was associated with a higher probability of VC in the subgroup of patients with P/F admission values ≤ 200mmHg (p=0.035; Figure 2B), in the age group 55-65 years (p=0.025; Figure 2C) and in patients with comorbidities (p=0.028). ![]()
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Time to viral clearance among the 490 patients who reached VC during follow-up. Panel A: time to VC according to RDV use. Panel B: time to VC according to RDV and P/F ratio value at admission. Panel C: time to VC according to RDV in the age group 55-65 years. Conclusion Time to viral clearance was similar in patients receiving or not receiving remdesivir; however the use of RDV was associated with a benefit on time to viral clearance in younger patients and in those with a P/F ratio at admission ≤200 mmHg. Disclosures Vincenzo Spagnuolo, MD, ViiV Healthcare (Other Financial or Material Support, Preparation of educational material) Antonella Castagna, MD, Gilead Sciences (Other Financial or Material Support, Speaking fee)Jansenn-Cilag (Other Financial or Material Support, Speaking fee)MSD (Other Financial or Material Support, Speaking fee)Theratechnologies (Other Financial or Material Support, Speaking fee)ViiV Healthcare (Other Financial or Material Support, Speaking fee)
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Affiliation(s)
- Vincenzo Spagnuolo
- Vita-Salute San Raffaele University; Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Marta Voarino
- Vita-Salute San Raffaele University, Milan, Lombardia, Italy
| | - Marco Tonelli
- Vita Salute San Raffaele University; Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Laura Galli
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Andrea Poli
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Elena Bruzzesi
- Vita-Salute San Raffaele University; Unit of Infectious Diseases, IRCCS, San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Sara Racca
- Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Nicola Clementi
- Vita Salute San Raffaele University; Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Chiara Oltolini
- Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Patrizia Rovere Querini
- Vita-Salute San Raffaele University; Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University; Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University; Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Massimo Clementi
- Vita Salute San Raffaele University; Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Lombardia, Italy
| | - Antonella Castagna
- IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milano, Lombardia, Italy
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19
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Sposito B, Broggi A, Pandolfi L, Crotta S, Clementi N, Ferrarese R, Sisti S, Criscuolo E, Spreafico R, Long JM, Ambrosi A, Liu E, Frangipane V, Saracino L, Bozzini S, Marongiu L, Facchini FA, Bottazzi A, Fossali T, Colombo R, Clementi M, Tagliabue E, Chou J, Pontiroli AE, Meloni F, Wack A, Mancini N, Zanoni I. The interferon landscape along the respiratory tract impacts the severity of COVID-19. Cell 2021; 184:4953-4968.e16. [PMID: 34492226 PMCID: PMC8373821 DOI: 10.1016/j.cell.2021.08.016] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/19/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
Severe coronavirus disease 2019 (COVID-19) is characterized by overproduction of immune mediators, but the role of interferons (IFNs) of the type I (IFN-I) or type III (IFN-III) families remains debated. We scrutinized the production of IFNs along the respiratory tract of COVID-19 patients and found that high levels of IFN-III, and to a lesser extent IFN-I, characterize the upper airways of patients with high viral burden but reduced disease risk or severity. Production of specific IFN-III, but not IFN-I, members denotes patients with a mild pathology and efficiently drives the transcription of genes that protect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In contrast, compared to subjects with other infectious or noninfectious lung pathologies, IFNs are overrepresented in the lower airways of patients with severe COVID-19 that exhibit gene pathways associated with increased apoptosis and decreased proliferation. Our data demonstrate a dynamic production of IFNs in SARS-CoV-2-infected patients and show IFNs play opposing roles at distinct anatomical sites.
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Affiliation(s)
- Benedetta Sposito
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, MA 02115, USA; Department of Biotechnology and Biosciences and Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan 20100, Italy
| | - Achille Broggi
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, MA 02115, USA.
| | - Laura Pandolfi
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy
| | - Stefania Crotta
- Immunoregulation Laboratory, The Francis Crick Institute, London NW1 1AT, UK
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy; IRCCS San Raffaele Hospital, Milan 20100, Italy
| | - Roberto Ferrarese
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy
| | - Sofia Sisti
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy
| | - Elena Criscuolo
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy
| | - Roberto Spreafico
- Institute for Quantitative and Computational Biosciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jaclyn M Long
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, MA 02115, USA
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan 20100, Italy
| | - Enju Liu
- Harvard Medical School, Boston Children's Hospital, Division of Gastroenterology, Boston, MA 02115, USA; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA 02115, USA
| | - Vanessa Frangipane
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy
| | - Laura Saracino
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy
| | - Sara Bozzini
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy
| | - Laura Marongiu
- Department of Biotechnology and Biosciences and Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan 20100, Italy
| | - Fabio A Facchini
- Department of Biotechnology and Biosciences and Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan 20100, Italy
| | - Andrea Bottazzi
- Department of Anesthesia and Critical Care Medicine, IRCCS Policlinico San Matteo Foundation, Pavia 27100, Italy
| | - Tommaso Fossali
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan 20100, Italy
| | - Riccardo Colombo
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan 20100, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy; IRCCS San Raffaele Hospital, Milan 20100, Italy
| | - Elena Tagliabue
- Value-based healthcare unit, IRCCS Multimedica, Milan 20100, Italy
| | - Janet Chou
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, MA 02115, USA
| | | | - Federica Meloni
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia 27100, Italy; Department of Internal Medicine and Pharmacology, University of Pavia, Pavia 27100, Italy
| | - Andreas Wack
- Immunoregulation Laboratory, The Francis Crick Institute, London NW1 1AT, UK
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan 20100, Italy; IRCCS San Raffaele Hospital, Milan 20100, Italy.
| | - Ivan Zanoni
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, MA 02115, USA; Harvard Medical School, Boston Children's Hospital, Division of Gastroenterology, Boston, MA 02115, USA.
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20
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Severa M, Diotti RA, Etna MP, Rizzo F, Fiore S, Ricci D, Iannetta M, Sinigaglia A, Lodi A, Mancini N, Criscuolo E, Clementi M, Andreoni M, Balducci S, Barzon L, Stefanelli P, Clementi N, Coccia EM. Differential plasmacytoid dendritic cell phenotype and type I Interferon response in asymptomatic and severe COVID-19 infection. PLoS Pathog 2021; 17:e1009878. [PMID: 34473805 PMCID: PMC8412261 DOI: 10.1371/journal.ppat.1009878] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/09/2021] [Indexed: 12/25/2022] Open
Abstract
SARS-CoV-2 fine-tunes the interferon (IFN)-induced antiviral responses, which play a key role in preventing coronavirus disease 2019 (COVID-19) progression. Indeed, critically ill patients show an impaired type I IFN response accompanied by elevated inflammatory cytokine and chemokine levels, responsible for cell and tissue damage and associated multi-organ failure. Here, the early interaction between SARS-CoV-2 and immune cells was investigated by interrogating an in vitro human peripheral blood mononuclear cell (PBMC)-based experimental model. We found that, even in absence of a productive viral replication, the virus mediates a vigorous TLR7/8-dependent production of both type I and III IFNs and inflammatory cytokines and chemokines, known to contribute to the cytokine storm observed in COVID-19. Interestingly, we observed how virus-induced type I IFN secreted by PBMC enhances anti-viral response in infected lung epithelial cells, thus, inhibiting viral replication. This type I IFN was released by plasmacytoid dendritic cells (pDC) via an ACE-2-indipendent but Neuropilin-1-dependent mechanism. Viral sensing regulates pDC phenotype by inducing cell surface expression of PD-L1 marker, a feature of type I IFN producing cells. Coherently to what observed in vitro, asymptomatic SARS-CoV-2 infected subjects displayed a similar pDC phenotype associated to a very high serum type I IFN level and induction of anti-viral IFN-stimulated genes in PBMC. Conversely, hospitalized patients with severe COVID-19 display very low frequency of circulating pDC with an inflammatory phenotype and high levels of chemokines and pro-inflammatory cytokines in serum. This study further shed light on the early events resulting from the interaction between SARS-CoV-2 and immune cells occurring in vitro and confirmed ex vivo. These observations can improve our understanding on the contribution of pDC/type I IFN axis in the regulation of the anti-viral state in asymptomatic and severe COVID-19 patients.
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Affiliation(s)
- Martina Severa
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta A. Diotti
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Marilena P. Etna
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fabiana Rizzo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Stefano Fiore
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniela Ricci
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Iannetta
- Infectious Disease Clinic, Policlinico Tor Vergata, Rome, Italy
| | | | - Alessandra Lodi
- Infectious Disease Clinic, Policlinico Tor Vergata, Rome, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, Padua, Italy
| | - Paola Stefanelli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Eliana M. Coccia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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21
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Castelli M, Baj A, Criscuolo E, Ferrarese R, Diotti RA, Sampaolo M, Novazzi F, Dalla Gasperina D, Focosi D, Ferrari D, Locatelli M, Clementi M, Clementi N, Maggi F, Mancini N. Characterization of a Lineage C.36 SARS-CoV-2 Isolate with Reduced Susceptibility to Neutralization Circulating in Lombardy, Italy. Viruses 2021; 13:v13081514. [PMID: 34452380 PMCID: PMC8402759 DOI: 10.3390/v13081514] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022] Open
Abstract
SARS-CoV-2 spike is evolving to maximize transmissibility and evade the humoral response. The massive genomic sequencing of SARS-CoV-2 isolates has led to the identification of single-point mutations and deletions, often having the recurrence of hotspots, associated with advantageous phenotypes. We report the isolation and molecular characterization of a SARS-CoV-2 strain, belonging to a lineage (C.36) not previously associated with concerning traits, which shows decreased susceptibility to vaccine sera neutralization.
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Affiliation(s)
- Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
| | - Andreina Baj
- Laboratory of Microbiology, ASST Sette Laghi, 21100 Varese, Italy; (A.B.); (F.N.)
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
| | - Roberta A. Diotti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
| | - Michela Sampaolo
- Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Federica Novazzi
- Laboratory of Microbiology, ASST Sette Laghi, 21100 Varese, Italy; (A.B.); (F.N.)
| | - Daniela Dalla Gasperina
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
- Internal Medicine Unit, ASST Sette Laghi, 21100 Varese, Italy
| | - Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, 56127 Pisa, Italy;
| | - Davide Ferrari
- SCVSA Department, University of Parma, 43121 Parma, Italy;
| | - Massimo Locatelli
- Laboratory Medicine Service, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
- Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
- Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
| | - Fabrizio Maggi
- Laboratory of Microbiology, ASST Sette Laghi, 21100 Varese, Italy; (A.B.); (F.N.)
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
- Correspondence: (F.M.); (N.M.)
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy; (M.C.); (E.C.); (R.F.); (R.A.D.); (M.C.); (N.C.)
- Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy;
- Correspondence: (F.M.); (N.M.)
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22
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Nozza S, Ferrarese R, Poli A, Galli L, Sampaolo M, Bigoloni A, Galli A, Muccini C, Spagnuolo V, Lazzarin A, Clementi M, Mancini N, Castagna A. Analysis of the faecal microbiome during analytical treatment interruption in people with chronic HIV infection and long-lasting virological suppression (APACHE study). J Antimicrob Chemother 2021; 75:2700-2702. [PMID: 32542322 DOI: 10.1093/jac/dkaa231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- S Nozza
- San Raffaele Scientific Institute, Milan, Italy
| | - R Ferrarese
- San Raffaele Scientific Institute, Milan, Italy
| | - A Poli
- San Raffaele Scientific Institute, Milan, Italy
| | - L Galli
- San Raffaele Scientific Institute, Milan, Italy
| | - M Sampaolo
- San Raffaele Scientific Institute, Milan, Italy
| | - A Bigoloni
- San Raffaele Scientific Institute, Milan, Italy
| | - A Galli
- San Raffaele Scientific Institute, Milan, Italy
| | - C Muccini
- University Vita-Salute San Raffaele, Milan, Italy
| | - V Spagnuolo
- University Vita-Salute San Raffaele, Milan, Italy
| | - A Lazzarin
- San Raffaele Scientific Institute, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - M Clementi
- San Raffaele Scientific Institute, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - N Mancini
- San Raffaele Scientific Institute, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - A Castagna
- San Raffaele Scientific Institute, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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23
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Abstract
Several viruses target the human respiratory tract, causing different clinical manifestations spanning from mild upper airway involvement to life-threatening acute respiratory distress syndrome (ARDS). As dramatically evident in the ongoing SARS-CoV-2 pandemic, the clinical picture is not always easily predictable due to the combined effect of direct viral and indirect patient-specific immune-mediated damage. In this review, we discuss the main RNA (orthomyxoviruses, paramyxoviruses, and coronaviruses) and DNA (adenoviruses, herpesviruses, and bocaviruses) viruses with respiratory tropism and their mechanisms of direct and indirect cell damage. We analyze the thin line existing between a protective immune response, capable of limiting viral replication, and an unbalanced, dysregulated immune activation often leading to the most severe complication. Our comprehension of the molecular mechanisms involved is increasing and this should pave the way for the development and clinical use of new tailored immune-based antiviral strategies.
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Affiliation(s)
- Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sreya Ghosh
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, Massachusetts, USA
| | - Maria De Santis
- Department of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Ivan Zanoni
- Harvard Medical School, Boston Children's Hospital, Division of Immunology, Boston, Massachusetts, USA
- Harvard Medical School, Boston Children's Hospital, Division of Gastroenterology, Boston, Massachusetts, USA
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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24
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Sposito B, Broggi A, Pandolfi L, Crotta S, Ferrarese R, Sisti S, Clementi N, Ambrosi A, Liu E, Frangipane V, Saracino L, Marongiu L, Facchini FA, Bottazzi A, Fossali T, Colombo R, Clementi M, Tagliabue E, Pontiroli AE, Meloni F, Wack A, Mancini N, Zanoni I. Severity of SARS-CoV-2 infection as a function of the interferon landscape across the respiratory tract of COVID-19 patients. bioRxiv 2021:2021.03.30.437173. [PMID: 33821280 PMCID: PMC8020981 DOI: 10.1101/2021.03.30.437173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The COVID-19 outbreak driven by SARS-CoV-2 has caused more than 2.5 million deaths globally, with the most severe cases characterized by over-exuberant production of immune-mediators, the nature of which is not fully understood. Interferons of the type I (IFN-I) or type III (IFN-III) families are potent antivirals, but their role in COVID-19 remains debated. Our analysis of gene and protein expression along the respiratory tract shows that IFNs, especially IFN-III, are over-represented in the lower airways of patients with severe COVID-19, while high levels of IFN-III, and to a lesser extent IFN-I, characterize the upper airways of patients with high viral burden but reduced disease risk or severity; also, IFN expression varies with abundance of the cell types that produce them. Our data point to a dynamic process of inter- and intra-family production of IFNs in COVID-19, and suggest that IFNs play opposing roles at distinct anatomical sites.
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Affiliation(s)
- Benedetta Sposito
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology, Boston, US
- Dep. of Biotechnology and Biosciences and Ph.D. program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan, Italy
| | - Achille Broggi
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology, Boston, US
| | - Laura Pandolfi
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Stefania Crotta
- Immunoregulation Laboratory, The Francis Crick Institute, London, UK
| | - Roberto Ferrarese
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Sofia Sisti
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Enju Liu
- Harvard Medical School, Boston Children’s Hospital, Division of Gastroenterology, Boston, US
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Vanessa Frangipane
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Laura Saracino
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Laura Marongiu
- Dep. of Biotechnology and Biosciences and Ph.D. program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan, Italy
| | - Fabio A Facchini
- Dep. of Biotechnology and Biosciences and Ph.D. program in Molecular and Translational Medicine (DIMET), University of Milano - Bicocca, Milan, Italy
| | - Andrea Bottazzi
- Department of Anesthesia and Critical Care Medicine, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Tommaso Fossali
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Riccardo Colombo
- Division of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Federica Meloni
- Respiratory Disease Unit IRCCS San Matteo Hospital Foundation, Pavia, Italy
- Department of Internal Medicine and Pharmacology, University of Pavia, Pavia, Italy
| | - Andreas Wack
- Immunoregulation Laboratory, The Francis Crick Institute, London, UK
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
- IRCCS San Raffaele Hospital, Milan, Italy
| | - Ivan Zanoni
- Harvard Medical School, Boston Children’s Hospital, Division of Immunology, Boston, US
- Harvard Medical School, Boston Children’s Hospital, Division of Gastroenterology, Boston, US
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25
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Velázquez-Moctezuma R, Augestad EH, Castelli M, Holmboe Olesen C, Clementi N, Clementi M, Mancini N, Prentoe J. Mechanisms of Hepatitis C Virus Escape from Vaccine-Relevant Neutralizing Antibodies. Vaccines (Basel) 2021; 9:vaccines9030291. [PMID: 33804732 PMCID: PMC8004074 DOI: 10.3390/vaccines9030291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/15/2022] Open
Abstract
Hepatitis C virus (HCV) is a major causative agent of acute and chronic hepatitis. It is estimated that 400,000 people die every year from chronic HCV infection, mostly from severe liver-related diseases such as cirrhosis and liver cancer. Although HCV was discovered more than 30 years ago, an efficient prophylactic vaccine is still missing. The HCV glycoprotein complex, E1/E2, is the principal target of neutralizing antibodies (NAbs) and, thus, is an attractive antigen for B-cell vaccine design. However, the high genetic variability of the virus necessitates the identification of conserved epitopes. Moreover, the high intrinsic mutational capacity of HCV allows the virus to continually escape broadly NAbs (bNAbs), which is likely to cause issues with vaccine-resistant variants. Several studies have assessed the barrier-to-resistance of vaccine-relevant bNAbs in vivo and in vitro. Interestingly, recent studies have suggested that escape substitutions can confer antibody resistance not only by direct modification of the epitope but indirectly through allosteric effects, which can be grouped based on the breadth of these effects on antibody susceptibility. In this review, we summarize the current understanding of HCV-specific NAbs, with a special focus on vaccine-relevant bNAbs and their targets. We highlight antibody escape studies pointing out the different methodologies and the escape mutations identified thus far. Finally, we analyze the antibody escape mechanisms of envelope protein escape substitutions and polymorphisms according to the most recent evidence in the HCV field. The accumulated knowledge in identifying bNAb epitopes as well as assessing barriers to resistance and elucidating relevant escape mechanisms may prove critical in the successful development of an HCV B-cell vaccine.
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Affiliation(s)
- Rodrigo Velázquez-Moctezuma
- Copenhagen Hepatitis C Program (CO-HEP), Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark; (R.V.-M.); (E.H.A.); (C.H.O.)
- Department of Infectious Diseases, Hvidovre Hospital, 2650 Hvidovre, Denmark
| | - Elias H. Augestad
- Copenhagen Hepatitis C Program (CO-HEP), Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark; (R.V.-M.); (E.H.A.); (C.H.O.)
- Department of Infectious Diseases, Hvidovre Hospital, 2650 Hvidovre, Denmark
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20132 Milano, Italy; (M.C.); (N.C.); (M.C.); (N.M.)
| | - Christina Holmboe Olesen
- Copenhagen Hepatitis C Program (CO-HEP), Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark; (R.V.-M.); (E.H.A.); (C.H.O.)
- Department of Infectious Diseases, Hvidovre Hospital, 2650 Hvidovre, Denmark
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20132 Milano, Italy; (M.C.); (N.C.); (M.C.); (N.M.)
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20132 Milano, Italy; (M.C.); (N.C.); (M.C.); (N.M.)
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Università “Vita-Salute” San Raffaele, 20132 Milano, Italy; (M.C.); (N.C.); (M.C.); (N.M.)
| | - Jannick Prentoe
- Copenhagen Hepatitis C Program (CO-HEP), Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark; (R.V.-M.); (E.H.A.); (C.H.O.)
- Department of Infectious Diseases, Hvidovre Hospital, 2650 Hvidovre, Denmark
- Correspondence:
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26
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Criscuolo E, Diotti RA, Ferrarese R, Alippi C, Viscardi G, Signorelli C, Mancini N, Clementi M, Clementi N. Fast inactivation of SARS-CoV-2 by UV-C and ozone exposure on different materials. Emerg Microbes Infect 2021; 10:206-210. [PMID: 33399524 PMCID: PMC7872580 DOI: 10.1080/22221751.2021.1872354] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The extremely rapid spread of the SARS-CoV-2 has already resulted in more than 1 million reported deaths of coronavirus disease 2019 (COVID-19). The ability of infectious particles to persist on environmental surfaces is potentially considered a factor for viral spreading. Therefore, limiting viral diffusion in public environments should be achieved with correct disinfection of objects, tissues, and clothes. This study proves how two widespread disinfection systems, short-wavelength ultraviolet light (UV-C) and ozone (O3), are active in vitro on different commonly used materials. The development of devices equipped with UV-C, or ozone generators, may prevent the virus from spreading in public places.
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Affiliation(s)
- Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta A Diotti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Cesare Alippi
- Dipartimento di Elettronica e Informazione, WEMSY Lab, Politecnico di Milano, Italy
| | - Gabriele Viscardi
- Dipartimento di Elettronica e Informazione, WEMSY Lab, Politecnico di Milano, Italy
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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27
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Mancini N, Clementi N, Ferrarese R, Ambrosi A, Tonelli M, Zangrillo A, Landoni G, Clementi M. Very high SARS-CoV-2 load at the emergency department presentation strongly predicts the risk of admission to the intensive care unit and death. Clin Chem Lab Med 2021; 59:e247-e250. [PMID: 33577724 DOI: 10.1515/cclm-2020-1709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Alessandro Ambrosi
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
| | - Marco Tonelli
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Alberto Zangrillo
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
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28
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Novelli L, Motta F, Ceribelli A, Guidelli GM, Luciano N, Isailovic N, Vecellio M, Caprioli M, Clementi N, Clementi M, Mancini N, Selmi C, De Santis M. A case of psoriatic arthritis triggered by SARS-CoV-2 infection. Rheumatology (Oxford) 2021; 60:e21-e23. [PMID: 33206980 PMCID: PMC7717387 DOI: 10.1093/rheumatology/keaa691] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Lucia Novelli
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Francesca Motta
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Angela Ceribelli
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Giacomo M Guidelli
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Nicoletta Luciano
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Natasa Isailovic
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Matteo Vecellio
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Center, University of Oxford
| | - Marta Caprioli
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Selmi
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Biomedical Science Department, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Maria De Santis
- Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
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29
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Spagnuolo V, Guffanti M, Galli L, Poli A, Querini PR, Ripa M, Clementi M, Scarpellini P, Lazzarin A, Tresoldi M, Dagna L, Zangrillo A, Ciceri F, Castagna A. Viral clearance after early corticosteroid treatment in patients with moderate or severe covid-19. Sci Rep 2020; 10:21291. [PMID: 33277573 PMCID: PMC7718220 DOI: 10.1038/s41598-020-78039-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to evaluate the impact of early treatment with corticosteroids on SARS-CoV-2 clearance in hospitalized COVID-19 patients. Retrospective analysis on patients admitted to the San Raffaele Hospital (Milan, Italy) with moderate/severe COVID-19 and availability of at least two nasopharyngeal swabs. The primary outcome was the time to nasopharyngeal swab negativization. A multivariable Cox model was fitted to determine factors associated with nasopharyngeal swab negativization. Of 280 patients included, 59 (21.1%) patients were treated with steroids. Differences observed between steroid users and non-users included the proportion of patients with a baseline PaO2/FiO2 ≤ 200 mmHg (45.8% vs 34.4% in steroids and non-steroids users, respectively; p = 0.023) or ≤ 100 mmHg (16.9% vs 12.7%; p = 0.027), and length of hospitalization (20 vs 14 days; p < 0.001). Time to negativization of nasopharyngeal swabs was similar in steroid and non-steroid users (p = 0.985). According to multivariate analysis, SARS-CoV-2 clearance was associated with age ≤ 70 years, a shorter duration of symptoms at admission, a baseline PaO2/FiO2 > 200 mmHg, and a lymphocyte count at admission > 1.0 × 109/L. SARS-CoV-2 clearance was not associated with corticosteroid use. Our study shows that delayed SARS-CoV-2 clearance in moderate/severe COVID-19 is associated with older age and a more severe disease, but not with an early use of corticosteroids.
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Affiliation(s)
- V Spagnuolo
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | - M Guffanti
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - L Galli
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - A Poli
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - P Rovere Querini
- Vita-Salute San Raffaele University, Milan, Italy.,Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Ripa
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - M Clementi
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - P Scarpellini
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - A Lazzarin
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
| | - M Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Dagna
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy.,Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Ciceri
- Vita-Salute San Raffaele University, Milan, Italy.,Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Castagna
- Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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30
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Mycroft-West CJ, Su D, Pagani I, Rudd TR, Elli S, Gandhi NS, Guimond SE, Miller GJ, Meneghetti MCZ, Nader HB, Li Y, Nunes QM, Procter P, Mancini N, Clementi M, Bisio A, Forsyth NR, Ferro V, Turnbull JE, Guerrini M, Fernig DG, Vicenzi E, Yates EA, Lima MA, Skidmore MA. Heparin Inhibits Cellular Invasion by SARS-CoV-2: Structural Dependence of the Interaction of the Spike S1 Receptor-Binding Domain with Heparin. Thromb Haemost 2020; 120:1700-1715. [PMID: 33368089 PMCID: PMC7869224 DOI: 10.1055/s-0040-1721319] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
The dependence of development and homeostasis in animals on the interaction of hundreds of extracellular regulatory proteins with the peri- and extracellular glycosaminoglycan heparan sulfate (HS) is exploited by many microbial pathogens as a means of adherence and invasion. Heparin, a widely used anticoagulant drug, is structurally similar to HS and is a common experimental proxy. Exogenous heparin prevents infection by a range of viruses, including S-associated coronavirus isolate HSR1. Here, we show that heparin inhibits severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) invasion of Vero cells by up to 80% at doses achievable through prophylaxis and, particularly relevant, within the range deliverable by nebulisation. Surface plasmon resonance and circular dichroism spectroscopy demonstrate that heparin and enoxaparin, a low-molecular-weight heparin which is a clinical anticoagulant, bind and induce a conformational change in the spike (S1) protein receptor-binding domain (S1 RBD) of SARS-CoV-2. A library of heparin derivatives and size-defined fragments were used to probe the structural basis of this interaction. Binding to the RBD is more strongly dependent on the presence of 2-O or 6-O sulfate groups than on N-sulfation and a hexasaccharide is the minimum size required for secondary structural changes to be induced in the RBD. It is likely that inhibition of viral infection arises from an overlap between the binding sites of heparin/HS on S1 RBD and that of the angiotensin-converting enzyme 2. The results suggest a route for the rapid development of a first-line therapeutic by repurposing heparin and its derivatives as antiviral agents against SARS-CoV-2 and other members of the Coronaviridae.
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Affiliation(s)
- Courtney J. Mycroft-West
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Dunhao Su
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Isabel Pagani
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Timothy R. Rudd
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, United Kingdom
| | - Stefano Elli
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Neha S. Gandhi
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Scott E. Guimond
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Gavin J. Miller
- School of Chemical and Physical Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Maria C. Z. Meneghetti
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Helena B. Nader
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Yong Li
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Quentin M. Nunes
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Patricia Procter
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | | | | | - Antonella Bisio
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Nicholas R. Forsyth
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Hartshill, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Vito Ferro
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Jeremy E. Turnbull
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - David G. Fernig
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Elisa Vicenzi
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edwin A. Yates
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marcelo A. Lima
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Mark A. Skidmore
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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31
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Mycroft-West CJ, Su D, Pagani I, Rudd TR, Elli S, Gandhi NS, Guimond SE, Miller GJ, Meneghetti MCZ, Nader HB, Li Y, Nunes QM, Procter P, Mancini N, Clementi M, Bisio A, Forsyth NR, Ferro V, Turnbull JE, Guerrini M, Fernig DG, Vicenzi E, Yates EA, Lima MA, Skidmore MA. Heparin Inhibits Cellular Invasion by SARS-CoV-2: Structural Dependence of the Interaction of the Spike S1 Receptor-Binding Domain with Heparin. Thromb Haemost 2020; 120:1700-1715. [PMID: 33368089 DOI: 10.1101/2020.04.28.066761] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 05/23/2023]
Abstract
The dependence of development and homeostasis in animals on the interaction of hundreds of extracellular regulatory proteins with the peri- and extracellular glycosaminoglycan heparan sulfate (HS) is exploited by many microbial pathogens as a means of adherence and invasion. Heparin, a widely used anticoagulant drug, is structurally similar to HS and is a common experimental proxy. Exogenous heparin prevents infection by a range of viruses, including S-associated coronavirus isolate HSR1. Here, we show that heparin inhibits severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) invasion of Vero cells by up to 80% at doses achievable through prophylaxis and, particularly relevant, within the range deliverable by nebulisation. Surface plasmon resonance and circular dichroism spectroscopy demonstrate that heparin and enoxaparin, a low-molecular-weight heparin which is a clinical anticoagulant, bind and induce a conformational change in the spike (S1) protein receptor-binding domain (S1 RBD) of SARS-CoV-2. A library of heparin derivatives and size-defined fragments were used to probe the structural basis of this interaction. Binding to the RBD is more strongly dependent on the presence of 2-O or 6-O sulfate groups than on N-sulfation and a hexasaccharide is the minimum size required for secondary structural changes to be induced in the RBD. It is likely that inhibition of viral infection arises from an overlap between the binding sites of heparin/HS on S1 RBD and that of the angiotensin-converting enzyme 2. The results suggest a route for the rapid development of a first-line therapeutic by repurposing heparin and its derivatives as antiviral agents against SARS-CoV-2 and other members of the Coronaviridae.
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Affiliation(s)
- Courtney J Mycroft-West
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Dunhao Su
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Isabel Pagani
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Timothy R Rudd
- Analytical and Biological Sciences Division, National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, United Kingdom
| | - Stefano Elli
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Neha S Gandhi
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Scott E Guimond
- School of Medicine, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Gavin J Miller
- School of Chemical and Physical Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Maria C Z Meneghetti
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Helena B Nader
- Biochemistry Department, Federal University of São Paulo (UNIFESP), São Paulo, SP Brazil
| | - Yong Li
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Quentin M Nunes
- Department of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Patricia Procter
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | | | | | - Antonella Bisio
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - Nicholas R Forsyth
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Hartshill, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Vito Ferro
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Jeremy E Turnbull
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marco Guerrini
- Istituto di Ricerche Chimiche e Biochimiche G. Ronzoni, Milan, Italy
| | - David G Fernig
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Elisa Vicenzi
- Viral Pathogenesis and Biosafety Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edwin A Yates
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Marcelo A Lima
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
| | - Mark A Skidmore
- Molecular and Structural Biosciences, School of Life Sciences, Keele University, Newcastle-Under-Lyme, Staffordshire, United Kingdom
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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Renzi S, Clementi M, Racca S, Mucci M, Beccaria P, Borghi G, Landoni G, Zangrillo A. Is Bordetella pertussis co-infecting SARS-CoV-2 patients? Braz J Anesthesiol 2020; 71:92-93. [PMID: 33281244 PMCID: PMC7700006 DOI: 10.1016/j.bjane.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Samuele Renzi
- The Hospital for Sick Children, Division of Haematology/Oncology, Toronto, Canada
| | - Massimo Clementi
- IRCCS San Raffaele Scientific Institute, Laboratory of Microbiology and Virology, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Racca
- IRCCS San Raffaele Scientific Institute, Laboratory of Microbiology and Virology, Milan, Italy
| | - Milena Mucci
- IRCCS San Raffaele Scientific Institute, Anesthesia and Intensive Care Department, Milan, Italy
| | - Paolo Beccaria
- IRCCS San Raffaele Scientific Institute, Anesthesia and Intensive Care Department, Milan, Italy
| | - Giovanni Borghi
- IRCCS San Raffaele Scientific Institute, Anesthesia and Intensive Care Department, Milan, Italy.
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Anesthesia and Intensive Care Department, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Anesthesia and Intensive Care Department, Milan, Italy
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Bosi E, Bosi C, Rovere Querini P, Mancini N, Calori G, Ruggeri A, Canzonieri C, Callegaro L, Clementi M, De Cobelli F, Filippi M, Bregni M. Interferon β-1a (IFNβ-1a) in COVID-19 patients (INTERCOP): study protocol for a randomized controlled trial. Trials 2020; 21:939. [PMID: 33225960 PMCID: PMC7681191 DOI: 10.1186/s13063-020-04864-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 07/24/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Pharmacological therapies of proven efficacy in coronavirus disease 2019 (COVID-19) are still lacking. We have identified IFNβ-1a as the most promising drug to be repurposed for COVID-19. The rationale relies on the evidence of IFNβ anti-viral activity in vitro against SARS-CoV-2 and animal models resembling SARS-CoV-2 infection and on a recent clinical trial where IFNβ was indicated as the key component of a successful therapeutic combination. METHODS This is a randomized, controlled, open-label, monocentric, phase II trial (INTERCOP trial). One hundred twenty-six patients with positive swab detection of SARS-CoV-2, radiological signs of pneumonia, and mild-to-moderate disease will be randomized 2:1 to IFNβ-1a in addition to standard of care vs standard of care alone. No other anti-viral drugs will be used as part of the regimens, both in the control and the intervention arms. IFNβ-1a will be administered subcutaneously at the dose of 44 mcg (equivalent to 12 million international units) three times per week, at least 48 h apart, for a total of 2 weeks. The primary outcome is the time to negative conversion of SARS-CoV-2 nasopharyngeal swabs. Secondary outcomes include improvement or worsening in a clinical severity score measured on a 7-point ordinal scale (including transfer to intensive care unit and death), oxygen- and ventilator-free days, mortality, changes in pulmonary computed tomography severity score, hospital stay duration, reduction of viral load measured on nasopharyngeal swabs, number of serious adverse events, and changes in biochemical markers of organ dysfunction. Exploratory outcomes include blood cell counts, cytokine and inflammatory profile, peripheral mRNA expression profiles of interferon-stimulated genes, and antibodies to SARS-CoV-2 and to IFNβ-1a. INTERCOP is the first study to specifically investigate the clinical benefits of IFNβ-1a in COVID-19 patients. DISCUSSION Potential implications of this trial are multifaceted: should the primary outcome be fulfilled and the treatment be safe, one may envisage that IFNβ-1a be used to reduce the infectivity of patients with mild-to moderate disease. In case IFNβ-1a reduced the duration of hospital stay and/or ameliorated the clinical status, it may become a cornerstone of COVID-19 treatment. TRIAL REGISTRATION EudraCT 2020-002458-25. Registered on May 11, 2020 ClinicalTrials.gov Identifier: NCT04449380.
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Affiliation(s)
- Emanuele Bosi
- Unit of Internal Medicine, IRCCS Ospedale San Raffaele, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
| | - Carlo Bosi
- University of Milan Medical School, Milan, Italy
| | - Patrizia Rovere Querini
- Unit of Internal Medicine, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Nicasio Mancini
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Virology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giliola Calori
- Clinical Trial Center, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Annalisa Ruggeri
- Clinical Trial Center, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | - Massimo Clementi
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Virology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco De Cobelli
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Radiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Filippi
- Vita-Salute San Raffaele University, Milan, Italy
- Unit of Neurology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Bregni
- Clinical Trial Center, IRCCS Ospedale San Raffaele, Milan, Italy
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Criscuolo E, Diotti RA, Strollo M, Rolla S, Ambrosi A, Locatelli M, Burioni R, Mancini N, Clementi M, Clementi N. Weak correlation between antibody titers and neutralizing activity in sera from SARS-CoV-2 infected subjects. J Med Virol 2020; 93:2160-2167. [PMID: 33064340 PMCID: PMC7675753 DOI: 10.1002/jmv.26605] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 07/20/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/19/2023]
Abstract
Plenty of serologic tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed so far, thus documenting the importance of evaluating the relevant features of the immune response to this viral agent. The performance of these assays is currently under investigation. Amongst them, LIAISON® SARS-CoV-2 S1/S2 IgG by DiaSorin and Elecsys Anti-SARS-CoV-2 cobas® by Roche are currently used by laboratory medicine hospital departments in Italy and many other countries. In the present study, we firstly compared two serologic tests on serum samples collected at two different time points from 46 laboratory-confirmed coronavirus disease-2019 (COVID-19) subjects. Secondly, 85 negative serum samples collected before the SARS-CoV-2 pandemic were analyzed. Thirdly, possible correlations between antibody levels and the resulting neutralizing activity against a clinical isolate of SARS-CoV-2 were evaluated. Results revealed that both tests are endowed with low sensitivity on the day of hospital admission, which increased to 97.8% and 100% for samples collected after 15 days for DiaSorin and Roche tests, respectively. The specificity evaluated for the two tests ranges from 96.5% to 100%, respectively. Importantly, a poor direct correlation between antibody titers and neutralizing activity levels was evidenced in the present study. These data further shed light on both potentials and possible limitations related to SARS-CoV-2 serology. In this context, great efforts are still necessary for investigating antibody kinetics to develop novel diagnostic algorithms. Moreover, further investigations on the role of neutralizing antibodies and their correlate of protection will be of paramount importance for the development of effective vaccines.
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Affiliation(s)
- Elena Criscuolo
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta A Diotti
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Strollo
- Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy
| | - Serena Rolla
- Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy
| | - Alessandro Ambrosi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Locatelli
- Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberto Burioni
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
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35
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Ripa M, Galli L, Poli A, Oltolini C, Spagnuolo V, Mastrangelo A, Muccini C, Monti G, De Luca G, Landoni G, Dagna L, Clementi M, Rovere Querini P, Ciceri F, Tresoldi M, Lazzarin A, Zangrillo A, Scarpellini P, Castagna A. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect 2020; 27:451-457. [PMID: 33223114 PMCID: PMC7584496 DOI: 10.1016/j.cmi.2020.10.021] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 01/08/2023]
Abstract
Objectives The aim of our study was to describe the incidence and predictive factors of secondary infections in patients with coronavirus disease 2019 (COVID-19). Methods This was a cohort study of patients hospitalized with COVID-19 at IRCCS San Raffaele Hospital between 25th February and 6th April 2020 (NCT04318366). We considered secondary bloodstream infections (BSIs) or possible lower respiratory tract infections (pLRTIs) occurring 48 hours after hospital admission until death or discharge. We calculated multivariable Fine–Gray models to assess factors associated with risk of secondary infections. Results Among 731 patients, a secondary infection was diagnosed in 68 patients (9.3%); 58/731 patients (7.9%) had at least one BSI and 22/731 patients (3.0%) at least one pLRTI. The overall 28-day cumulative incidence was 16.4% (95%CI 12.4–21.0%). Most of the BSIs were due to Gram-positive pathogens (76/106 isolates, 71.7%), specifically coagulase-negative staphylococci (53/76, 69.7%), while among Gram-negatives (23/106, 21.7%) Acinetobacter baumanii (7/23, 30.4%) and Escherichia coli (5/23, 21.7%) predominated. pLRTIs were caused mainly by Gram-negative pathogens (14/26, 53.8%). Eleven patients were diagnosed with putative invasive aspergillosis. At multivariable analysis, factors associated with secondary infections were low baseline lymphocyte count (≤0.7 versus >0.7 per 109/L, subdistribution hazard ratios (sdHRs) 1.93, 95%CI 1.11–3.35), baseline PaO2/FiO2 (per 100 points lower: sdHRs 1.56, 95%CI 1.21–2.04), and intensive-care unit (ICU) admission in the first 48 hours (sdHR 2.51, 95%CI 1.04–6.05). Conclusions Patients hospitalized with COVID-19 had a high incidence of secondary infections. At multivariable analysis, early need for ICU, respiratory failure, and severe lymphopenia were identified as risk factors for secondary infections.
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Affiliation(s)
- Marco Ripa
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Laura Galli
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Oltolini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Spagnuolo
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Giacomo Monti
- Anaesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy; Anaesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Vita-Salute San Raffaele University, Milan, Italy; Microbiology and Virology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere Querini
- Vita-Salute San Raffaele University, Milan, Italy; Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adriano Lazzarin
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy; Anaesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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36
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Rovere-Querini P, Tresoldi C, Conte C, Ruggeri A, Ghezzi S, De Lorenzo R, Di Filippo L, Farina N, Ramirez GA, Ripa M, Mancini N, Cantarelli E, Galli L, Poli A, De Cobelli F, Bonini C, Manfredi AA, Franchini S, Spessot M, Carlucci M, Dagna L, Scarpellini P, Ambrosio A, Di Napoli D, Bosi E, Tresoldi M, Lazzarin A, Landoni G, Martino G, Zangrillo A, Poli G, Castagna A, Vicenzi E, Clementi M, Ciceri F. Biobanking for COVID-19 research. Panminerva Med 2020; 64:244-252. [PMID: 33073557 DOI: 10.23736/s0031-0808.20.04168-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Biobanks are imperative infrastructures, particularly during outbreaks, when there is an obligation to acquire and share knowledge as quick as possible to allow for implementation of science-based preventive, diagnostic, prognostic and therapeutic strategies. METHODS We established a COVID-19 biobank with the aim of collecting high-quality and well-annotated human biospecimens, in the effort to understand the pathogenic mechanisms underlying COVID-19 and identify therapeutic targets (COVID-BioB, NCT04318366). Here we describe our experience and briefly review the characteristics of the biobanks for COVID-19 that have been so far established. RESULTS A total of 46,677 samples have been collected from 913 participants (63.3% males, median [IQR] age 62.2 [51.2 - 74.0] years) since the beginning of the program. Most patients (66.9%) had been admitted to hospital for COVID-19, with a median length of stay of 15.0 (9.0 - 27.0) days. A minority of patients (13.3% of the total) had been admitted for other reasons and subsequently tested positive for SARS-CoV-2. The remainder were managed at home after being seen at the Emergency Department. CONCLUSIONS Having a solid research infrastructure already in place, along with flexibility and adaptability to new requirements, allowed for the quick building of a COVID-19 biobank that will help expand and share the knowledge of SARS-CoV-2.
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Affiliation(s)
- Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy - .,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy -
| | - Cristina Tresoldi
- Molecular Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annalisa Ruggeri
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Ghezzi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Giuseppe A Ramirez
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Ripa
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Cantarelli
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco De Cobelli
- Vita-Salute San Raffaele University, Milan, Italy.,Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Angelo A Manfredi
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Franchini
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marzia Spessot
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michele Carlucci
- Emergency Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Scarpellini
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Ambrosio
- Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Di Napoli
- Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuele Bosi
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Moreno Tresoldi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adriano Lazzarin
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy.,Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianvito Martino
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy.,Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Guido Poli
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Vicenzi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Clementi
- Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
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37
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Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, Gramegna M, Yuen KY, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Kwon GC, Menezes ME, Patru MM, Singh K, Ferrari M, Najjar O, Horvath AR, Adeli K, Lippi G. IFCC Interim Guidelines on Molecular Testing of SARS-CoV-2 Infection. Clin Chem Lab Med 2020; 58:1993-2000. [PMID: 33027042 DOI: 10.1515/cclm-2020-1412] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022]
Abstract
The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection globally has relied extensively on molecular testing, contributing vitally to case identification, isolation, contact tracing, and rationalization of infection control measures during the coronavirus disease 2019 (COVID-19) pandemic. Clinical laboratories have thus needed to verify newly developed molecular tests and increase testing capacity at an unprecedented rate. As the COVID-19 pandemic continues to pose a global health threat, laboratories continue to encounter challenges in the selection, verification, and interpretation of these tests. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay verification, and (D) test interpretation and limitations for molecular testing of SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide and highlight the continued importance of laboratory medicine in our collective pandemic response.
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Affiliation(s)
- Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | | | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Virology Division, SEALS Microbiology, Prince of Wales Hospital, NSW, Randwick, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of South Africa
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Korea
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | - Andrea R Horvath
- Department of Clinical Chemistry, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Giuseppe Lippi
- University Hospital of Verona, Verona, Italy.,Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy
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38
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Thompson S, Bohn MK, Mancini N, Loh TP, Wang CB, Grimmler M, Yuen KY, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Kwon GC, Menezes ME, Patru MM, Gramegna M, Singh K, Najjar O, Ferrari M, Lippi G, Adeli K, Horvath AR. IFCC Interim Guidelines on Biochemical/Hematological Monitoring of COVID-19 Patients. Clin Chem Lab Med 2020; 58:2009-2016. [PMID: 33027044 DOI: 10.1515/cclm-2020-1414] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
Routine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.
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Affiliation(s)
- Simon Thompson
- Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Department of Virology, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of Australia
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Korea
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | | | | | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Andrea R Horvath
- Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy.,Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
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- Taskforce on COVID-19, International Federation of Clinical Chemistry (IFCC), Milan, Italy
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39
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Bohn MK, Loh TP, Wang CB, Mueller R, Koch D, Sethi S, Rawlinson WD, Clementi M, Erasmus R, Leportier M, Grimmler M, Yuen KY, Mancini N, Kwon GC, Menezes ME, Patru MM, Gramegna M, Singh K, Najjar O, Ferrari M, Horvath AR, Lippi G, Adeli K. IFCC Interim Guidelines on Serological Testing of Antibodies against SARS-CoV-2. Clin Chem Lab Med 2020; 58:2001-2008. [PMID: 33027043 DOI: 10.1515/cclm-2020-1413] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 12/16/2022]
Abstract
Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.
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Affiliation(s)
- Mary Kathryn Bohn
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Tze Ping Loh
- National University Health System, Singapore, Singapore
| | | | | | - David Koch
- Emory University School of Medicine, Atlanta, GA, USA
| | - Sunil Sethi
- National University Health System, Singapore, Singapore
| | - William D Rawlinson
- Virology Division, SEALS Microbiology, Prince of Wales Hospital, NSW, Randwick, Australia
| | | | - Rajiv Erasmus
- University of Stellenbosch, Cape Town, Western Cape, Republic of South Africa
| | | | | | - K Y Yuen
- University of Hong Kong, Hong Kong, PR China
| | | | - Gye Cheol Kwon
- Chungnam National University Hospital, Daejeon, Republic of South Africa
| | | | | | | | | | - Osama Najjar
- Allied Health Professions Ministry of Health, Palestine, Palestine
| | | | - Andrea R Horvath
- Department of Clinical Chemistry, New South Wales Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | - Khosrow Adeli
- Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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40
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Ferrarese R, Zuppardo RA, Puzzono M, Mannucci A, Amato V, Ditonno I, Patricelli MG, Raucci AR, Clementi M, Elmore U, Rosati R, Testoni PA, Mancini N, Cavestro GM. Oral and Fecal Microbiota in Lynch Syndrome. J Clin Med 2020; 9:jcm9092735. [PMID: 32847083 PMCID: PMC7563889 DOI: 10.3390/jcm9092735] [Citation(s) in RCA: 5] [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: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The role of microbiota in Lynch syndrome (LS) is still under debate. We compared oral and fecal microbiota of LS saliva and stool samples with normal healthy controls (NHC). Methods: Total DNA was purified from feces and saliva to amplify the V3–V4 region of the 16s rRNA gene. Sequences with a high-quality score and length >250 bp were used for taxonomic analysis with QIIME software. Results: Compared to NHC, LS fecal samples demonstrated a statistically significant increase of Bacteroidetes and Proteobacteria and a significant decrease of Firmicutes at the phylum level and of Ruminococcaceae at the family level. Moreover, LS oral samples exhibited a statistically significant increase of Veillonellaceae and Leptotrichiaceae and a statistically significant decrease of Pasteurellaceae. A beta-diversity index allowed differentiation of the two groups. Conclusions: A peculiar microbial signature is associated with LS, similar to that of sporadic colorectal cancer and Crohn’s disease. These data suggest a possible role of proinflammatory bacteria in tumor development in a condition of genetic predisposition, such as LS.
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Affiliation(s)
- Roberto Ferrarese
- Microbiology and Virology Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.F.); (V.A.); (M.C.); (N.M.)
| | - Raffaella Alessia Zuppardo
- Division of Experimental Oncology, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.A.Z.); (M.P.); (P.A.T.)
| | - Marta Puzzono
- Division of Experimental Oncology, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.A.Z.); (M.P.); (P.A.T.)
| | - Alessandro Mannucci
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
| | - Virginia Amato
- Microbiology and Virology Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.F.); (V.A.); (M.C.); (N.M.)
| | - Ilaria Ditonno
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
| | - Maria Grazia Patricelli
- Division of Genetics and Cell Biology and Laboratory of Clinical Molecular Biology and Cytogenetics, Unit of Genomics for Human Disease Diagnosis, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (M.G.P.); (A.R.R.)
| | - Annalisa Russo Raucci
- Division of Genetics and Cell Biology and Laboratory of Clinical Molecular Biology and Cytogenetics, Unit of Genomics for Human Disease Diagnosis, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (M.G.P.); (A.R.R.)
| | - Massimo Clementi
- Microbiology and Virology Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.F.); (V.A.); (M.C.); (N.M.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
| | - Ugo Elmore
- Department of Gastrointestinal Surgery, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Riccardo Rosati
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
- Department of Gastrointestinal Surgery, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Pier Alberto Testoni
- Division of Experimental Oncology, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.A.Z.); (M.P.); (P.A.T.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
| | - Nicasio Mancini
- Microbiology and Virology Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.F.); (V.A.); (M.C.); (N.M.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
| | - Giulia Martina Cavestro
- Division of Experimental Oncology, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Ospedale San Raffaele Scientific Institute, 20132 Milan, Italy; (R.A.Z.); (M.P.); (P.A.T.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.M.); (I.D.); (R.R.)
- Correspondence: ; Tel.: +39-022-643-5508
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41
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Clementi N, Ferrarese R, Criscuolo E, Diotti RA, Castelli M, Scagnolari C, Burioni R, Antonelli G, Clementi M, Mancini N. Interferon-β-1a Inhibition of Severe Acute Respiratory Syndrome-Coronavirus 2 In Vitro When Administered After Virus Infection. J Infect Dis 2020; 222:722-725. [PMID: 32559285 PMCID: PMC7337790 DOI: 10.1093/infdis/jiaa350] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/15/2020] [Indexed: 12/23/2022] Open
Abstract
The ongoing coronavirus disease 2019 pandemic has forced the clinical and scientific community to try drug repurposing of existing antiviral agents as a quick option against severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2). Under this scenario, interferon (IFN) β-1a, whose antiviral potential is already known, and which is a drug currently used in the clinical management of multiple sclerosis, may represent as a potential candidate. In this report, we demonstrate that IFN-β-1a was highly effective in inhibiting in vitro SARS-CoV-2 replication at clinically achievable concentration when administered after virus infection.
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Affiliation(s)
- Nicola Clementi
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Roberta Antonia Diotti
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Carolina Scagnolari
- Laboratory of Virology, Department of Molecular Medicine, and Institute Pasteur Italia-Cenci Bolognetti Foundation, Sapienza University, Rome, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Guido Antonelli
- Laboratory of Virology, Department of Molecular Medicine, and Institute Pasteur Italia-Cenci Bolognetti Foundation, Sapienza University, Rome, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Università Vita-Salute San Raffaele, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy
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42
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Lai A, Bergna A, Caucci S, Clementi N, Vicenti I, Dragoni F, Cattelan AM, Menzo S, Pan A, Callegaro A, Tagliabracci A, Caruso A, Caccuri F, Ronchiadin S, Balotta C, Zazzi M, Vaccher E, Clementi M, Galli M, Zehender G. Molecular Tracing of SARS-CoV-2 in Italy in the First Three Months of the Epidemic. Viruses 2020; 12:v12080798. [PMID: 32722343 PMCID: PMC7472216 DOI: 10.3390/v12080798] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 01/15/2023] Open
Abstract
The aim of this study is the characterization and genomic tracing by phylogenetic analyses of 59 new SARS-CoV-2 Italian isolates obtained from patients attending clinical centres in North and Central Italy until the end of April 2020. All but one of the newly-characterized genomes belonged to the lineage B.1, the most frequently identified in European countries, including Italy. Only a single sequence was found to belong to lineage B. A mean of 6 nucleotide substitutions per viral genome was observed, without significant differences between synonymous and non-synonymous mutations, indicating genetic drift as a major source for virus evolution. tMRCA estimation confirmed the probable origin of the epidemic between the end of January and the beginning of February with a rapid increase in the number of infections between the end of February and mid-March. Since early February, an effective reproduction number (Re) greater than 1 was estimated, which then increased reaching the peak of 2.3 in early March, confirming the circulation of the virus before the first COVID-19 cases were documented. Continuous use of state-of-the-art methods for molecular surveillance is warranted to trace virus circulation and evolution and inform effective prevention and containment of future SARS-CoV-2 outbreaks.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.); (M.G.); (G.Z.)
- Correspondence: ; Tel.: +39-0250319775
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.); (M.G.); (G.Z.)
| | - Sara Caucci
- Department of Biomedical Sciences and Public Health, Virology Unit, Polytechnic University of Marche, 60131 Ancona, Italy; (S.C.); (S.M.)
| | - Nicola Clementi
- Microbiology and Virology Unit, “Vita-Salute” San Raffaele University, 20132 Milan, Italy; (N.C.); (M.C.)
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (I.V.); (F.D.); (M.Z.)
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (I.V.); (F.D.); (M.Z.)
| | - Anna Maria Cattelan
- Infectious Diseases Unit, Department of Internal Medicine, Azienda Ospedaliera-Universitaria di Padova, 35128 Padua, Italy;
| | - Stefano Menzo
- Department of Biomedical Sciences and Public Health, Virology Unit, Polytechnic University of Marche, 60131 Ancona, Italy; (S.C.); (S.M.)
| | - Angelo Pan
- Infectious Diseases, ASST Cremona, 26100 Cremona, Italy;
| | - Annapaola Callegaro
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy;
| | - Adriano Tagliabracci
- Section of Legal Medicine, Universita Politecnica delle Marche, 60126 Ancona, Italy;
| | - Arnaldo Caruso
- Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy; (A.C.); (F.C.)
| | - Francesca Caccuri
- Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, 25123 Brescia, Italy; (A.C.); (F.C.)
| | | | - Claudia Balotta
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.); (M.G.); (G.Z.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (I.V.); (F.D.); (M.Z.)
| | - Emanuela Vaccher
- Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy;
| | - Massimo Clementi
- Microbiology and Virology Unit, “Vita-Salute” San Raffaele University, 20132 Milan, Italy; (N.C.); (M.C.)
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.); (M.G.); (G.Z.)
| | - Gianguglielmo Zehender
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.); (M.G.); (G.Z.)
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Clementi M, Signorelli C, Romano Spica V, Vitali M, Conti M, Vitale M. Protocols and self-checking plans for the safety of post-COVID-19 balneotherapy. Acta Biomed 2020; 91:40-49. [PMID: 32701916 PMCID: PMC8023090 DOI: 10.23750/abm.v91i9-s.10167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Indexed: 12/12/2022]
Abstract
During the COVID-19 pandemics, balneotherapic establishments were closed in Italy like in the rest of Europe. The Italian Foundation for Research in balneotherapy (FoRST) was asked to prepare a safety protocol to be proposed to the National Health Authorities to allow the establishments to restart their activity when possible, under safe conditions (the so-called Phase-2). The group of experts proposed the following hygienic and sanitary protocols of risk management for the initial reopening of the balneology settings in Italy. The plan aims to define the operating procedures to be implemented at the balneology establishments for the beginning of Phase-2 and to keep them constantly updated in the different periods that will characterize Phase-2 in relation to the trends of the disease. To this end the procedures, defined on the basis of the scientific state-of-the-art available today, will be updated and revised from time to time whenever further scientific evidence and directives from the Health Authorities make it necessary and/or useful.
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Affiliation(s)
| | - Carlo Signorelli
- San Raffaele University Vita e Salute, Milano; DiMeC Dept., University of Parma, Parma.
| | | | | | | | - Marco Vitale
- DiMeC Dept., University of Parma, Parma; Fondazione per la Ricerca Scientifica Termale (FoRST), Rome, Italy.
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Caputo V, Diotti RA, Boeri E, Hasson H, Sampaolo M, Criscuolo E, Bagaglio S, Messina E, Uberti-Foppa C, Castelli M, Burioni R, Mancini N, Clementi M, Clementi N. Detection of low-level HCV variants in DAA treated patients: comparison amongst three different NGS data analysis protocols. Virol J 2020; 17:103. [PMID: 32660499 PMCID: PMC7359454 DOI: 10.1186/s12985-020-01381-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Notwithstanding the efforts of direct-acting antivirals (DAAs) for the treatment of chronically infected hepatitis C virus (HCV) patients, concerns exist regarding the emergence of resistance-associated substitutions (RAS) related to therapy failure. Sanger sequencing is still the reference technique used for the detection of RAS and it detects viral variants present up to 15%, meaning that minority variants are undetectable, using this technique. To date, many studies are focused on the analysis of the impact of HCV low variants using next-generation sequencing (NGS) techniques, but the importance of these minority variants is still debated, and importantly, a common data analysis method is still not defined. METHODS Serum samples from four patients failing DAAs therapy were collected at baseline and failure, and amplification of NS3, NS5A and NS5B genes was performed on each sample. The genes amplified were sequenced using Sanger and NGS Illumina sequencing and the data generated were analyzed with different approaches. Three different NGS data analysis methods, two homemade in silico pipeline and one commercially available certified user-friendly software, were used to detect low-level variants. RESULTS The NGS approach allowed to infer also very-low level virus variants. Moreover, data processing allowed to generate high accuracy data which results in reduction in the error rates for each single sequence polymorphism. The results improved the detection of low-level viral variants in the HCV quasispecies of the analyzed patients, and in one patient a low-level RAS related to treatment failure was identified. Importantly, the results obtained from only two out of the three data analysis strategies were in complete agreement in terms of both detection and frequency of RAS. CONCLUSIONS These results highlight the need to find a robust NGS data analysis method to standardize NGS results for a better comprehension of the clinical role of low-level HCV variants. Based on the extreme importance of data analysis approaches for wet-data interpretation, a detailed description of the used pipelines and further standardization of the in silico analysis could allow increasing diagnostic laboratory networking to unleash true potentials of NGS.
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Affiliation(s)
- Valeria Caputo
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy
| | - Roberta Antonia Diotti
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy
| | - Enzo Boeri
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132, Milan, Italy
| | - Hamid Hasson
- Department of Infectious Diseases, San Raffaele Hospital, 20132, Milan, Italy
| | - Michela Sampaolo
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy
| | - Sabrina Bagaglio
- Department of Infectious Diseases, San Raffaele Hospital, 20132, Milan, Italy
| | - Emanuela Messina
- Department of Infectious Diseases, San Raffaele Hospital, 20132, Milan, Italy
| | | | - Matteo Castelli
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy
| | - Roberto Burioni
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy.,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132, Milan, Italy
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy.,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132, Milan, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology at "Vita-Salute" San Raffaele University, 20132, Milan, Italy. .,Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132, Milan, Italy.
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45
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Clementi N, Criscuolo E, Diotti RA, Ferrarese R, Castelli M, Dagna L, Burioni R, Clementi M, Mancini N. Combined Prophylactic and Therapeutic Use Maximizes Hydroxychloroquine Anti-SARS-CoV-2 Effects in vitro. Front Microbiol 2020; 11:1704. [PMID: 32754147 PMCID: PMC7365881 DOI: 10.3389/fmicb.2020.01704] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 04/09/2020] [Accepted: 06/29/2020] [Indexed: 12/27/2022] Open
Abstract
While the SARS-CoV-2 pandemic is heavily hitting the world, it is of extreme importance that significant in vitro observations guide the quick set up of clinical trials. In this study, we evidence that the anti-SARS-CoV2 activity of a clinically achievable hydroxychloroquine concentration is maximized only when administered before and after the infection of Vero E6 and Caco-2 cells. This suggests that only a combined prophylactic and therapeutic use of hydroxychloroquine may be effective in limiting viral replication in patients.
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Affiliation(s)
- Nicola Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elena Criscuolo
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta Antonia Diotti
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Matteo Castelli
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Burioni
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Clementi
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Microbiology and Virology, Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Clementi N, Ferrarese R, Tonelli M, Amato V, Racca S, Locatelli M, Lippi G, Silvestri G, Clementi M, Mancini N. Lower nasopharyngeal viral load during the latest phase of COVID-19 pandemic in a Northern Italy University Hospital. Clin Chem Lab Med 2020; 58:1573-1577. [PMID: 32598306 DOI: 10.1515/cclm-2020-0815] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022]
Abstract
Objectives A milder clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been anecdotally reported over the latest phase of COVID-19 pandemic in Italy. Several factors may contribute to this observation, including the effect of lockdown, social distancing, lower humidity, lower air pollution, and potential changes in the intrinsic pathogenicity of the virus. In this regard, the clinical severity of COVID-19 could be attenuated by mutations in SARS-CoV-2 genome that decrease its virulence, as well as by lower virus inocula. Methods In this pilot study, we compared the reverse transcription polymerase chain reaction (RT-PCR) amplification profile of 100 nasopharyngeal swabs consecutively collected in April, during the peak of SARS-CoV-2 epidemic, to that of 100 swabs collected using the same procedure in May. Results The mean Ct value of positive samples collected in May was significantly higher than that of samples collected in the previous period (ORF 1a/b gene: 31.85 ± 0.32 vs. 28.37 ± 0.5, p<0.001; E gene: 33.76 ± 0.38 vs. 29.79 ± 0.63, p<0.001), suggesting a lower viral load at the time of sampling. No significant differences were observed between male and females in the two periods, whilst higher viral loads were found in (i) patients over 60-years old, and (ii) patients that experienced severe COVID-19 during the early stages of the pandemic. Conclusions This pilot study prompts further investigation on the correlation between SARS-CoV-2 load and different clinical manifestation of COVID-19 during different phases of the pandemic. Laboratories should consider reporting quantitative viral load data in the molecular diagnosis of SARS-CoV-2 infection.
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Affiliation(s)
- Nicola Clementi
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
| | - Marco Tonelli
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
| | - Virginia Amato
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
| | - Sara Racca
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Massimo Locatelli
- Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Guido Silvestri
- Division of Microbiology and Immunology, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Massimo Clementi
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, University "Vita-Salute" San Raffaele, Via Olgettina 58, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, Milan, Italy
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Boeri L, Capogrosso P, Ventimiglia E, Pederzoli F, Cazzaniga W, Chierigo F, Pozzi E, Clementi M, Viganò P, Montanari E, Montorsi F, Salonia A. High-risk human papillomavirus in semen is associated with poor sperm progressive motility and a high sperm DNA fragmentation index in infertile men. Hum Reprod 2020; 34:209-217. [PMID: 30517657 DOI: 10.1093/humrep/dey348] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/07/2018] [Indexed: 01/15/2023] Open
Abstract
STUDY QUESTION Does the presence of human papillomavirus (HPV) in semen impact seminal parameters and sperm DNA quality in white European men seeking medical help for primary couple's infertility? SUMMARY ANSWER HPV seminal infections involving high-risk (HR) genotypes are associated with impaired sperm progressive motility and sperm DNA fragmentation (SDF) values. WHAT IS KNOWN ALREADY HPV is commonly present in semen samples. However, whether the presence of HPV in semen is actually associated with impaired sperm parameters and SDF values have yet to be elucidated. STUDY DESIGN, SIZE, DURATION In this cross-sectional study, complete demographic, clinical and laboratory data from 729 infertile men were analysed. PARTICIPANTS/MATERIALS, SETTING, METHODS Health-significant comorbidities were scored with the Charlson comorbidity index (CCI). Serum hormones and SDF index (measured by the sperm chromatin structure assay [SCSA]) were measured in every patient (SDF ≥30% was defined as pathological). Semen analysis was based on 2010 World Health Organisation reference criteria. Amplification by nested PCR was used to detect HPV-DNA sequences in semen samples. Descriptive statistics and linear regression models were used to test the association between the presence of HPV and clinical and seminal characteristics in the whole cohort. MAIN RESULTS AND THE ROLE OF CHANCE The overall rate of HPV positivity was 15.5% (113/729). Overall, 78/729 (10.7%) and 35/729 (4.8%) patients had HR HPV+ and low-risk HPV+, respectively. HPV16 was the most prevalent type (22.1%), followed by HPV43 (10.6%), HPV56 and HPV42 (both 8.8%). No differences were found in terms of clinical and hormonal characteristics between patients with or without seminal HPV. Sperm progressive motility was significantly lower (P = 0.01) while SDF values were higher (P = 0.005) in HPV+ men compared to those with no HPV. In particular, HR HPV+ men had lower sperm progressive motility (P = 0.007) and higher SDF values (P = 0.003) than those with a negative HPV test. Univariable analysis showed that HR HPV+ was associated with impaired sperm progressive motility (P = 0.002) and SDF values (P = 0.003). In the multivariable analysis, age, FSH levels and testicular volume were significantly associated with impaired sperm progressive motility (all P ≤ 0.04). Conversely BMI, CCI, smoking habits and HPV status were not. Only age (P = 0.02) and FSH (P = 0.01) were significantly associated with SDF, after accounting for BMI, CCI, testicular volume, smoking habits and HPV status. LIMITATIONS, REASONS FOR CAUTION Main limitations are the cross-sectional design of our study and the relatively small sample size of the subgroups. Additional limitations are the lack of a control group of normal fertile men and the lack of follow-up testing to check the clearance or the persistence of HPV in semen after a 6-12 months. WIDER IMPLICATIONS OF THE FINDINGS Overall, these observations point out the importance of an accurate investigation of seminal HPV presence in everyday clinical practice in the diagnostic work-up of infertile men. STUDY FUNDING/COMPETING INTEREST(S) No external funding was used. There are no competing interests.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Chierigo
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Massimo Clementi
- University Vita-Salute San Raffaele, Milan, Italy.,Laboratory of Microbiology and Virology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Infertility Unit, Unit of Obstetrics/Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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Ciceri F, Castagna A, Rovere-Querini P, De Cobelli F, Ruggeri A, Galli L, Conte C, De Lorenzo R, Poli A, Ambrosio A, Signorelli C, Bossi E, Fazio M, Tresoldi C, Colombo S, Monti G, Fominskiy E, Franchini S, Spessot M, Martinenghi C, Carlucci M, Beretta L, Scandroglio AM, Clementi M, Locatelli M, Tresoldi M, Scarpellini P, Martino G, Bosi E, Dagna L, Lazzarin A, Landoni G, Zangrillo A. Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy. Clin Immunol 2020; 217:108509. [PMID: 32535188 PMCID: PMC7289745 DOI: 10.1016/j.clim.2020.108509] [Citation(s) in RCA: 191] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023]
Abstract
Background National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. Methods All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. Results Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO2/FiO2 ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. Conclusion In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.
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Affiliation(s)
- Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco De Cobelli
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Laura Galli
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Poli
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Carlo Signorelli
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eleonora Bossi
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Fazio
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Giacomo Monti
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | | | | | - Luigi Beretta
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Massimo Clementi
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Gianvito Martino
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuele Bosi
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adriano Lazzarin
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Landoni
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Zangrillo
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Scientific Institute, Milan, Italy
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Boeri L, Pederzoli F, Capogrosso P, Abbate C, Alfano M, Mancini N, Clementi M, Montanari E, Montorsi F, Salonia A. Semen infections in men with primary infertility in the real-life setting. Fertil Steril 2020; 113:1174-1182. [DOI: 10.1016/j.fertnstert.2020.01.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 12/21/2022]
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Matucci-Cerinic M, Bruni C, Allanore Y, Clementi M, Dagna L, Damjanov NS, de Paulis A, Denton CP, Distler O, Fox D, Furst DE, Khanna D, Krieg T, Kuwana M, Lee EB, Li M, Pillai S, Wang Y, Zeng X, Taliani G. Systemic sclerosis and the COVID-19 pandemic: World Scleroderma Foundation preliminary advice for patient management. Ann Rheum Dis 2020; 79:724-726. [DOI: 10.1136/annrheumdis-2020-217407] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/11/2022]
Abstract
Due to the frequent presence of interstitial lung disease and widespread use of immunosuppressive treatment, systemic sclerosis (SSc) patients may be considered at risk for a more severe disease course and higher mortality when they develop Severe Acute Respiratory Syndrome - Coronavirus - 2 (SARS-CoV-2) virus infection. Therefore, with World Scleroderma Foundation endorsement, experts from different specialties including rheumatology, virology and clinical immunology gathered virtually to answer to the main practical clinical questions regarding SARS-CoV-2 infection coming from both patients and physicians. This preliminary advice is aligned with other national and international recommendations, adapted for SSc patients.
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