1
|
Arzilli C, Annunziata M, Ernst CM, Peruzzi M, Macucci C, Pochesci S, Nassi N. Inter-hospital cardiorespiratory telemonitoring of newborns and infants: a wellworking example of a hub and spoke network. Ital J Pediatr 2023; 49:5. [PMID: 36635722 PMCID: PMC9837930 DOI: 10.1186/s13052-022-01407-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/29/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Patients who experience cardiorespiratory events usually have to be moved to specialized centers to perform cardiorespiratory studies. To avoid the transfer of these patients to specialized centers, a network has been created based on an interchange system, where the recordings were uploaded in unspecialized centers (spokes) and downloaded by the Sleep Disorders Breathing (SDB) Center (hub) to be analyzed. METHODS The inter-hospital network was established in November 2008. Initially only 3 non-tertiary hospitals in the Tuscany Region joined the network. Currently, 12 Tuscany hospitals are included. RESULTS From November 2008 to December 2020, 625 recordings were collected belonging to 422 infants. No recurrent life-threatening episode or infant death occurred in the study population and none of the infants needed to be readmitted or be moved to a tertiary center, except infants who underwent home monitoring. The discharge diagnoses belong to the following categories: apnoea, respiratory problem of the newborn, syncope, gastroesophageal reflux, altered consciousness, transient loss of consciousness and cyanosis. CONCLUSIONS This study shows that the inter-hospital network is an efficient system that allows accurate and safe management of infants at risk for apnoea, bradycardia, and hypoxemia to remain in unspecialized centers, avoiding unnecessary transfers of patients and over - hospitalizations.
Collapse
Affiliation(s)
- Cinzia Arzilli
- grid.413181.e0000 0004 1757 8562Meyer Children’s Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139 Italy
| | - Monica Annunziata
- grid.413181.e0000 0004 1757 8562Meyer Children’s Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139 Italy
| | - Carola-Maria Ernst
- grid.413181.e0000 0004 1757 8562Meyer Children’s Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139 Italy
| | - Marta Peruzzi
- grid.413181.e0000 0004 1757 8562Meyer Children’s Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139 Italy
| | - Chiara Macucci
- grid.8404.80000 0004 1757 2304Department of Paediatrics, Meyer Children’s Hospital, University of Florence, Florence, Italy
| | - Saverio Pochesci
- grid.8404.80000 0004 1757 2304Department of Paediatrics, Meyer Children’s Hospital, University of Florence, Florence, Italy
| | - Niccolò Nassi
- grid.413181.e0000 0004 1757 8562Meyer Children’s Hospital IRCCS, Sleep Disorder Breathing and SIDS Center, Viale Pieraccini, 24, Florence, 50139 Italy
| |
Collapse
|
2
|
Peruzzi M, Ramazzotti M, Damiano R, Vasarri M, la Marca G, Arzilli C, Piumelli R, Nassi N, Degl'Innocenti D. Urinary Biomarkers as a Proxy for Congenital Central Hypoventilation Syndrome Patient Follow-Up. Antioxidants (Basel) 2022; 11:antiox11050929. [PMID: 35624794 PMCID: PMC9138029 DOI: 10.3390/antiox11050929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/25/2022] [Accepted: 05/06/2022] [Indexed: 12/25/2022] Open
Abstract
Congenital Central Hypoventilation Syndrome (CCHS) is a rare genetic disorder of the autonomic nervous system and in particular of the respiratory control during sleep. No drug therapy is, to date, available; therefore, the survival of these patients depends on lifelong ventilatory support during sleep. Reactive oxygen species (ROS)-induced oxidative stress is a recognized risk factor involved in the pathogenesis of several chronic diseases. Therefore, monitoring systemic oxidative stress could provide important insights into CCHS outcomes. Because ROS-induced oxidative products are excreted as stable metabolites in urine, we performed an HPLC-MS/MS analysis for the quantitative determination of the three main representative oxidative biomarkers (i.e., diY, MDA, and 8-OHdG) in the urine of CCHS patients. Higher levels of urinary MDA were found in CCHS patients compared with age-matched control subjects. The noteworthy finding is the identification of urinary MDA as relevant biomarker of systemic oxidative status in CCHS patients. This study is a concise and smart communication about the impact that oxidative stress has in CCHS, and suggests the monitoring of urinary MDA levels as a useful tool for the management of these patients.
Collapse
Affiliation(s)
- Marta Peruzzi
- Sleep Breathing Disorders and SIDS Centre, A. Meyer Children’s Hospital, 50134 Florence, Italy; (M.P.); (C.A.); (R.P.); (N.N.)
| | - Matteo Ramazzotti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (M.R.); (R.D.); (M.V.); (G.l.M.)
| | - Roberta Damiano
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (M.R.); (R.D.); (M.V.); (G.l.M.)
- Newborn Screening, Biochemistry and Pharmacology Laboratory, A. Meyer Children’s Hospital, 50134 Florence, Italy
| | - Marzia Vasarri
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (M.R.); (R.D.); (M.V.); (G.l.M.)
| | - Giancarlo la Marca
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (M.R.); (R.D.); (M.V.); (G.l.M.)
- Newborn Screening, Biochemistry and Pharmacology Laboratory, A. Meyer Children’s Hospital, 50134 Florence, Italy
| | - Cinzia Arzilli
- Sleep Breathing Disorders and SIDS Centre, A. Meyer Children’s Hospital, 50134 Florence, Italy; (M.P.); (C.A.); (R.P.); (N.N.)
| | - Raffaele Piumelli
- Sleep Breathing Disorders and SIDS Centre, A. Meyer Children’s Hospital, 50134 Florence, Italy; (M.P.); (C.A.); (R.P.); (N.N.)
| | - Niccolò Nassi
- Sleep Breathing Disorders and SIDS Centre, A. Meyer Children’s Hospital, 50134 Florence, Italy; (M.P.); (C.A.); (R.P.); (N.N.)
| | - Donatella Degl'Innocenti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy; (M.R.); (R.D.); (M.V.); (G.l.M.)
- Correspondence:
| |
Collapse
|
3
|
Cuadros Gamboa AL, Benfante R, Nizzardo M, Bachetti T, Pelucchi P, Melzi V, Arzilli C, Peruzzi M, Reinbold RA, Cardani S, Morrone A, Guerrini R, Zucchi I, Corti S, Ceccherini I, Piumelli R, Nassi N, Di Lascio S, Fornasari D. Generation of two hiPSC lines (UMILi027-A and UMILi028-A) from early and late-onset Congenital Central hypoventilation Syndrome (CCHS) patients carrying a polyalanine expansion mutation in the PHOX2B gene. Stem Cell Res 2022; 61:102781. [DOI: 10.1016/j.scr.2022.102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022] Open
|
4
|
Piumelli R, Nassi N, Buccoliero A, Occhini R, Nardini V, Toti P, Salvatori C, Peruzzi M, Arzilli C. The multiagency approach to Sudden Unexpected Infant Deaths (SUID): eleven years' experience in the Tuscany Region. Ital J Pediatr 2020; 46:99. [PMID: 32690066 PMCID: PMC7372863 DOI: 10.1186/s13052-020-00867-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background The Sudden Unexpected Infant Death Syndrome (SUID) is one of the leading causes of mortality in the first year of life. The aim of this work was the retrospective evaluation of the incidence of SUID and the effectiveness of the multiagency approach to this phenomenon in the Tuscany Region. Methods Data were obtained from the regional registry of SUID cases in the period 2009–2019. The registry contains both sudden unexpected deaths in the first week of life (Sudden Unexpected Early Neonatal Deaths - SUEND), and those occurring after the first week up to 1 year of age (SUID). Results In this timeframe a total of 73 sudden unexpected deaths occurred in our region; 32 were Unexplained (i.e. Sudden Infant Death Syndrome - SIDS), 24 Explained, 10 Undetermined, and 7 SUEND. Autopsies were performed in 91% of cases, and in 95% of these by three groups of selected pathologists according to our protocol. We found a low incidence of SUID (0.21 ‰), and SIDS deaths accounted for 0.1‰ of live births (48% of cases) with a high prevalence of infants of non-Italian ethnicity (38% of cases). Bereaved families were able to receive psychological support from mental health professionals and have contact with the family association, Seeds for SIDS. Audits were organized when post-mortem examinations were not carried out or carried out incorrectly in procedural terms, and when the diagnosis was particularly uncertain. Conclusions This paper first provides data on SUID mortality based on complete post-mortems in an Italian region. According to these findings we can state that our approach is effective both in terms of correctly performed autopsies and support for bereaved families. Future efforts are necessary to further reduce the incidence of SUID especially among non- Italian infants. An improvement action is also recommended for ensuring a more accurate and consistent picture of the circumstances of death. The final approval of the National Protocol for the management of SUID cases is therefore strongly advocated in order to improve surveillance in this specific field and abolish disparities among the Italian regions.
Collapse
Affiliation(s)
- Raffaele Piumelli
- Sleep Breathing Disorders and SIDS Centre, Meyer Children's Hospital, Florence, Italy.
| | - Niccolò Nassi
- Sleep Breathing Disorders and SIDS Centre, Meyer Children's Hospital, Florence, Italy
| | | | | | | | - Paolo Toti
- Pathology Unit, University of Siena, Siena, Italy
| | - Cristina Salvatori
- Sleep Breathing Disorders and SIDS Centre, Meyer Children's Hospital, Florence, Italy
| | - Marta Peruzzi
- Sleep Breathing Disorders and SIDS Centre, Meyer Children's Hospital, Florence, Italy
| | - Cinzia Arzilli
- Sleep Breathing Disorders and SIDS Centre, Meyer Children's Hospital, Florence, Italy
| |
Collapse
|
5
|
Piumelli R, Arzilli C, Nassi N, Peruzzi M, Ernst CM, Salvatori C. Can we still do something-and what? - for a seemingly missing syndrome?: "Yes we can". Ital J Pediatr 2019; 45:132. [PMID: 31665038 PMCID: PMC6820974 DOI: 10.1186/s13052-019-0735-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/14/2019] [Indexed: 11/29/2022] Open
Abstract
In this letter, the authors compare the incidence of SUDI and SIDS in the Tuscany Region to the incidence reported by Campi and Bonati in their paper “Can we still do something-and what?- for a seemingly missing syndrome?” that was recently published in this journal. The Tuscany data are directly gathered from the autopsies while the others from the death certificates that are often not reilable, thus causing an understimation of the phenomenon. The real picture of the extent of SIDS is crucial to evaluate the effectiveness of back to sleep campaigns.
Collapse
Affiliation(s)
- Raffaele Piumelli
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Viale Pieraccini, 24 50139, Florence, Italy.
| | - Cinzia Arzilli
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Viale Pieraccini, 24 50139, Florence, Italy
| | - Niccolò Nassi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Viale Pieraccini, 24 50139, Florence, Italy
| | - Marta Peruzzi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Viale Pieraccini, 24 50139, Florence, Italy
| | - Carola-Maria Ernst
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Viale Pieraccini, 24 50139, Florence, Italy
| | - Cristina Salvatori
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| |
Collapse
|
6
|
Degl'Innocenti D, Becatti M, Peruzzi M, Fiorillo C, Ramazzotti M, Nassi N, Arzilli C, Piumelli R. Systemic oxidative stress in congenital central hypoventilation syndrome. Eur Respir J 2018; 52:13993003.01497-2018. [PMID: 30209197 DOI: 10.1183/13993003.01497-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/29/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Donatella Degl'Innocenti
- Dept of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,These authors contributed equally
| | - Matteo Becatti
- Dept of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,These authors contributed equally
| | - Marta Peruzzi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Florence, Italy
| | - Claudia Fiorillo
- Dept of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Matteo Ramazzotti
- Dept of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Niccolò Nassi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Florence, Italy
| | - Cinzia Arzilli
- Dept of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Raffaele Piumelli
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Florence, Italy
| |
Collapse
|
7
|
Piumelli R, Davanzo R, Nassi N, Salvatore S, Arzilli C, Peruzzi M, Agosti M, Palmieri A, Paglietti MG, Nosetti L, Pomo R, De Luca F, Rimini A, De Masi S, Costabel S, Cavarretta V, Cremante A, Cardinale F, Cutrera R. Apparent Life-Threatening Events (ALTE): Italian guidelines. Ital J Pediatr 2017; 43:111. [PMID: 29233182 PMCID: PMC5728046 DOI: 10.1186/s13052-017-0429-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/22/2017] [Indexed: 02/07/2023] Open
Abstract
Five years after the first edition, we have revised and updated the guidelines, re-examining the queries and relative recommendations, expanding the issues addressed with the introduction of a new entity, recently proposed by the American Academy of Pediatrics: BRUE, an acronym for Brief Resolved Unexplained Events. In this manuscript we will use the term BRUE only to refer to mild, idiopathic cases rather than simply replace the acronym ALTE per se.In our guidelines the acronym ALTE is used for severe cases that are unexplainable after the first and second level examinations.Although the term ALTE can be used to describe the common symptoms at the onset, whenever the aetiology is ascertained, the final diagnosis may be better specified as seizures, gastroesophageal reflux, infection, arrhythmia, etc. Lastly, we have addressed the emerging problem of the so-called Sudden Unexpected Postnatal Collapse (SUPC), that might be considered as a severe ALTE occurring in the first week of life.
Collapse
Affiliation(s)
- Raffaele Piumelli
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Firenze, Italy.
| | - Riccardo Davanzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Niccolò Nassi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Firenze, Italy
| | | | - Cinzia Arzilli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Firenze, Italy
| | - Marta Peruzzi
- Sleep Breathing Disorders and SIDS Center, Meyer Children's Hospital, Firenze, Italy
| | - Massimo Agosti
- Neonatal Intensive Care Unit, Del Ponte Hospital, Varese, Italy
| | - Antonella Palmieri
- SIDS Center, Pediatric Emergency Department, "G. Gaslini" Children's Hospital, Genova, Italy
| | - Maria Giovanna Paglietti
- Pneumology Unit - University Hospital Pediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Luana Nosetti
- Paediatric Department, University of Insubria, Varese, Italy
| | - Raffaele Pomo
- SIDS/ALTE Center, Buccheri la Ferla Hospital, Palermo, Italy
| | | | | | | | - Simona Costabel
- Emergency Department of Paediatrics, G. Gaslini Children's Hospital, Genova, Italy
| | | | - Anna Cremante
- National Neurological Institute IRCCS C, Mondino, Pavia, Italy
| | | | - Renato Cutrera
- Pneumology Unit - University Hospital Pediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| |
Collapse
|
8
|
Piumelli R, Nassi N, Liccioli G, Ernst CM, Donzelli G. Telemonitoring for infants at risk of apnoea, bradycardia and hypoxaemia: transmission of data improves the family compliance during home monitoring. J Telemed Telecare 2012; 18:344-7. [PMID: 22933479 DOI: 10.1258/jtt.2012.120405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We evaluated the compliance of families using telemonitoring and families using conventional home monitoring in infants at risk of apnoea, bradycardia and hypoxaemia. Families who used the telemedicine system could perform the remote data transmission from their home. Families who used the conventional system had to come to the regional centre to download the cardiorespiratory traces captured by the monitor. A total of 175 patients examined at the Regional Centre for Sudden Infant Death Syndrome (SIDS) in Florence were included in the 5-year study. Good compliance was defined as an average daily use of 10 hours or more; insufficient compliance was defined as an average daily use of less than 10 hours. The Centre analysed 612 data downloads, 339 from the telemedicine system and 273 from the conventional system. This represented a total of 105,061 hours of data during 12,862 days of home monitoring. The compliance of families who used the telemedicine system was significantly higher than that of families who used the conventional system. Of the 105 families who used the conventional system, 50 (48%) were good compliers. Of the 70 families who used the telemedicine system, 49 (70%) were good compliers. Telemedicine was associated with a significant improvement in the compliance of families using cardiorespiratory monitors.
Collapse
Affiliation(s)
- Raffaele Piumelli
- Meyer Children's Hospital, Viale Pieraccini 24, I-50132 Florence, Italy
| | | | | | | | | |
Collapse
|
9
|
Becatti M, Taddei N, Cecchi C, Nassi N, Nassi PA, Fiorillo C. SIRT1 modulates MAPK pathways in ischemic-reperfused cardiomyocytes. Cell Mol Life Sci 2012; 69:2245-60. [PMID: 22311064 DOI: 10.1007/s00018-012-0925-5] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 12/21/2011] [Accepted: 01/19/2012] [Indexed: 02/07/2023]
Abstract
SIRT1, an ubiquitous NAD(+)-dependent deacetylase that plays a role in biological processes such as longevity and stress response, is significantly activated in response to reactive oxygen species (ROS) production. Resveratrol (Resv), an important activator of SIRT1, has been shown to exert major health benefits in diseases associated with oxidative stress. In ischemia-reperfusion (IR) injury, a major role has been attributed to the mitogen-activated protein kinase (MAPK) pathway, which is upregulated in response to a variety of stress stimuli, including oxidative stress. In neonatal rat ventricular cardiomyocytes subjected to simulated IR, the effect of Resv-induced SIRT1 activation and the relationships with the MAPK pathway were investigated. Resv-induced SIRT1 overexpression protected cardiomyocytes from oxidative injury, mitochondrial dysfunction, and cell death induced by IR. For the first time, we demonstrate that SIRT1 overexpression positively affects the MAPK pathway-via Akt/ASK1 signaling-by reducing p38 and JNK phosphorylation and increasing ERK phosphorylation. These results reveal a new protective mechanism elicited by Resv-induced SIRT1 activation in IR tissues and suggest novel potential therapeutic targets to manage IR-induced cardiac dysfunction.
Collapse
Affiliation(s)
- Matteo Becatti
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| | | | | | | | | | | |
Collapse
|
10
|
Fiorillo C, Becatti M, Attanasio M, Lucarini L, Nassi N, Evangelisti L, Porciani M, Nassi P, Gensini G, Abbate R, Pepe G. Evidence for oxidative stress in plasma of patients with Marfan syndrome. Int J Cardiol 2010; 145:544-6. [DOI: 10.1016/j.ijcard.2010.04.077] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 04/19/2010] [Accepted: 04/20/2010] [Indexed: 12/01/2022]
|
11
|
Nassi N, Daniotti M, Agostiniani S, Lombardi E, Favilli S, Donzelli GP. Sildenafil as “first line therapy” in pulmonary persistent hypertension of the newborn? J Matern Fetal Neonatal Med 2010; 23 Suppl 3:104-5. [DOI: 10.3109/14767058.2010.512199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
12
|
Borchi E, Parri M, Papucci L, Becatti M, Nassi N, Nassi P, Nediani C. Role of NADPH oxidase in H9c2 cardiac muscle cells exposed to simulated ischaemia-reperfusion. J Cell Mol Med 2010; 13:2724-2735. [PMID: 18754815 DOI: 10.1111/j.1582-4934.2008.00485.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Oxidative stress is associated with several cardiovascular pathologies, including hypertension, cardiac hypertrophy and heart failure. Although oxidative stress is also increased after ischaemia-reperfusion (I/R), little is known about the role and the activation mechanisms, in cardiac myocytes under these conditions, of NADPH oxidase, a superoxide-producing enzyme. We found that rat cardiac muscle cells (H9c2) subjected to an in vitro simulated ischaemia (substrate-free medium plus hypoxia) followed by 'reperfusion', displayed increased reactive oxygen species (ROS) production attributable to a parallel increase of NADPH oxidase activity. Our investigation on mechanisms responsible for NADPH oxidase activation showed a contribution of both the increase of NOX2 expression and p47(phox) translocation to the membrane. We also found that the increase of NADPH oxidase activity was associated with higher levels of lipid peroxidation, the activation of redox-sensitive kinases, in particular ERK and JNK, and with cell death. Diphenyleneiodonium (DPI), a flavoprotein inhibitor used as NADPH oxidase inhibitor, prevented I/R-induced ROS formation in treated cells, together with the related lipoperoxidative damage, and JNK phosphorylation without affecting ERK activation, resulting in protection against cell death. Our results provide evidence that NADPH oxidase is a key enzyme involved in I/R-induced oxidant generation and suggest it can be a possible target in cardioprotective strategies against I/R injury, a condition of great importance in human pathology.
Collapse
Affiliation(s)
- Elisabetta Borchi
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| | - Matteo Parri
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| | - Laura Papucci
- Department of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Matteo Becatti
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| | - Niccolò Nassi
- Department of Pediatrics, University of Florence, Florence, Italy
| | - Paolo Nassi
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| | - Chiara Nediani
- Department of Biochemical Sciences, University of Florence, Florence, Italy
| |
Collapse
|
13
|
Piumelli R, Di Pietro P, Longhi L, Donzelli G, Cutrera R, Nespoli L, Magnani C, Nassi N, Becherucci P, Chiappini E, Lapi F, Vannacci A, Mari F, Nosetti L, Rimini A, Salvatore S, Paglietti MG, Palmieri A, Pomo R, Vitale A, Dalla Casa P, De Angelis GL, Macchiarini A, Nonnis-Marzano F, Pisani F, Podestà A. [Assistential-diagnostic guidelines: apparent life-threatening events (ALTE)]. Minerva Pediatr 2009; 61:891-893. [PMID: 19935585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
14
|
Abstract
BACKGROUND Although oxidative stress-related diseases mostly affect neonates with extremely low birthweight, healthy preterm newborns might also be at risk of oxidative damages. The aim of the present study was to verify this possibility. METHODS Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), erythrocyte glutathione peroxidase (GSHPx) and superoxide dismutase (SOD), plasma and erythrocyte concentrations of selenium, zinc and copper were measured until 100 days of life in 30 preterm infants with mean +/- SD birthweight and gestational age of 1605 +/- 122 g and 34.5 +/- 0.5 weeks. The control group included 30 term infants with birthweight 3123 158 g and gestational age 39.6 0.7 weeks. RESULTS Throughout the study period urinary 8-OHdG, taken as a marker of oxidative stress, was significantly higher in the preterm than in the term group. Up until 20 days of life, GSHPx activity was significantly lower in the preterm than in the term infants but this was not associated with any apparent selenium deficiency. Conversely, up until 100 days, preterm infants had significantly reduced SOD levels that appeared to reflect a shortage of the elements needed for this enzyme's activity, notably copper, the plasma concentrations of which were constantly and significantly below the control values. CONCLUSION The nutritional status of the elements related to the anti-oxidant enzymes, especially zinc and copper, should be carefully assessed in preterm infants, even if their birthweight is not extremely low.
Collapse
Affiliation(s)
- Niccolò Nassi
- Department of Paediatrics, University of Florence, Florence, Italy. .it
| | | | | | | | | |
Collapse
|
15
|
Fiorillo C, Becatti M, Pensalfini A, Cecchi C, Lanzilao L, Donzelli G, Nassi N, Giannini L, Borchi E, Nassi P. Curcumin protects cardiac cells against ischemia-reperfusion injury: effects on oxidative stress, NF-kappaB, and JNK pathways. Free Radic Biol Med 2008; 45:839-46. [PMID: 18638545 DOI: 10.1016/j.freeradbiomed.2008.06.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Accepted: 06/06/2008] [Indexed: 11/20/2022]
Abstract
In this study we explored the effects of curcumin in cardiac cells subjected to a protocol simulating ischemia-reperfusion (IR). Curcumin (10 microM) was administered before ischemia (pretreatment) or at the moment of reperfusion (posttreatment) and its effects were compared to those produced by a reference antioxidant (Trolox) with an equal antioxidant capacity. IR cardiac cells showed clear signs of oxidative stress, impaired mitochondrial activity, and a marked development of both necrotic and apoptotic processes; at the same time, increases in NF-kappaB nuclear translocation and JNK phosphorylation were observed. Curcumin pretreatment was revealed to be the most effective in attenuating all these modifications and, in particular, in reducing the death of IR cells. This confirms that the protective effect of curcumin is not related simply to its antioxidant properties but involves other mechanisms, notably interactions in the NF-kappaB and JNK pathways. These findings suggest that curcumin administration, in particular before the hypoxic challenge, represents a promising approach to protecting cardiac cells against IR injury. In this scenario our results point out the importance of the chronology for the outcome of the treatment and provide a differential valuation of the degree of protection that curcumin can exert by its antioxidant activity or by other mechanisms.
Collapse
Affiliation(s)
- Claudia Fiorillo
- Department of Biochemical Sciences University of Florence, 50134 Florence, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Nassi N, Piumelli R, Lombardi E, Landini L, Donzelli G, de Martino M. Comparison between pulse oximetry and transthoracic impedance alarm traces during home monitoring. Arch Dis Child 2008; 93:126-32. [PMID: 17893118 DOI: 10.1136/adc.2007.118513] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare transthoracic impedance (TTI/ECG) and pulse oximetry alarm traces detected during home monitoring in infants at risk of apnoea, bradycardia and hypoxaemia. STUDY DESIGN A retrospective evaluation of the monitor downloads of 67 infants who had undergone either TTI/ECG or pulse oximetry home monitoring using a device which can detect both parameters. METHODS The patients were categorised as: apparent life-threatening events (n = 39), preterm infants (n = 21) and miscellaneous (n = 7). TTI/ECG and pulse oximetry alarm traces were scored as either true or false alarms. Classification criteria were based on visual analysis of the impedance and plethysmographic waveforms captured by the memory monitor every time alarm thresholds were violated. RESULTS 5242 alarms occurred over 3452 days of monitoring: 4562 (87%) were false and 680 (13%) true. The mean duration of monitoring was 51 days (range 5-220 days). There were 2982 TTI/ECG false alarms (65% of the total) and 1580 pulse oximetry false alarms (35%) (p = 0.0042). Of the 680 true alarms, 507 (74%) were desaturations not attributable to central apnoea and 173 (26%) were true TTI/ECG alarms (p = 0.0013). CONCLUSIONS Comparison of pulse oximetry and TTI/ECG alarm traces shows that true events were mostly attributable to desaturations, while false alarms were mainly provoked by TTI/ECG. The total number of false alarms is lower than reported in other studies using TTI/ECG only, thus indicating that monitoring using both pulse oximetry and TTI/ECG is suitable for home use. When the combination of both techniques is not feasible or not required, we recommend the use of motion resistant pulse oximetry alone.
Collapse
Affiliation(s)
- N Nassi
- Department of Pediatrics, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | | | | | | | | | | |
Collapse
|
17
|
Fiorillo C, Ponziani V, Giannini L, Cecchi C, Celli A, Nassi N, Lanzilao L, Caporale R, Nassi P. Protective effects of the PARP-1 inhibitor PJ34 in hypoxic-reoxygenated cardiomyoblasts. Cell Mol Life Sci 2007; 63:3061-71. [PMID: 17131054 DOI: 10.1007/s00018-006-6345-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To clarify the role of poly(ADP-ribose)polymerase-1 (PARP-1) in myocardial ischemia-reperfusion injury, we explored some effects of PJ34, a highly specific inhibitor of this enzyme, in hypoxic-reoxygenated (HR) H9c2 cardiomyoblasts. Compared to the control, HR cells showed signs of oxidative stress, marked PARP-1 activation, NAD(+) and ATP depletion and impaired mitochondrial activity. HR cardiomyoblasts were affected by both necrosis and apoptosis, the latter involving the nuclear translocation of apoptosis-inducing factor. In HR cardiomyoblasts treated with PJ34, oxidative stress and PARP-1 activity were decreased, and NAD(+) and ATP depletion, as well as mitochondrial impairment, were attenuated. Above all, PJ34 treatment improved the survival of HR cells; not only was necrosis significantly diminished, but apoptosis was also reduced and shifted from a caspase-independent to a caspase-dependent pathway. These results suggest that PARP-1 modulation by a selective inhibitor such as PJ34 may represent a promising approach to limit myocardial damage due to post-ischemic reperfusion.
Collapse
Affiliation(s)
- C Fiorillo
- Dipartimento di Scienze Biochimiche, Università di Firenze, Viale Morgagni 50, 50134, Firenze, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Fiorillo C, Nediani C, Ponziani V, Giannini L, Celli A, Nassi N, Formigli L, Perna AM, Nassi P. Cardiac volume overload rapidly induces oxidative stress-mediated myocyte apoptosis and hypertrophy. Biochim Biophys Acta Mol Basis Dis 2005; 1741:173-82. [PMID: 15894467 DOI: 10.1016/j.bbadis.2005.03.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Revised: 02/17/2005] [Accepted: 03/21/2005] [Indexed: 10/25/2022]
Abstract
Oxidative stress stimulates both growth and apoptosis in cardiac myocytes in vitro. We investigated the role of oxidative stress in the initial phases of cardiac remodeling induced in an animal model by volume overload. As plausible candidates for a connection between oxidative stress and cardiomyocyte apoptosis or hypertrophy, we explored the behaviour of two MAPKs, specifically JNK and ERK. At 48 h of overload, the greatest increase in oxidative stress coincided with a peak of cardiomyocyte apoptosis. This was possibly induced through the mitochondrial metabolism, as evidenced by the release of cytochrome c and a significant increase in the active forms of caspase-9 and -3, but not caspase-8. Oxidative stress markers significantly decreased at 96 h of overload, combined with a marked attenuation of apoptosis and the appearance of hypertrophy. The highest levels of JNK and the lowest levels of ERK phosphorylation were observed at 48 h of overload. Conversely, a sharp increase in ERK phosphorylation was detected at 96 h of overload coinciding with the hypertrophic response. Together these results show that oxidative stress is an early and transient event in myocardial volume overload. They suggest that oxidative stress mediates amplitude dependent apoptotic and hypertrophic responses in cardiomyocytes through the selective activation of, respectively, JNK and ERK.
Collapse
Affiliation(s)
- C Fiorillo
- Department of Biochemical Sciences, Viale Morgagni 50, 50134 Florence, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Fiorillo C, Ponziani V, Giannini L, Cecchi C, Celli A, Nediani C, Perna AM, Liguori P, Nassi N, Formigli L, Tani A, Nassi P. Beneficial effects of poly (ADP-ribose) polymerase inhibition against the reperfusion injury in heart transplantation. Free Radic Res 2003; 37:331-9. [PMID: 12688429 DOI: 10.1080/1071576021000055262] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated the effect of 3-aminobenzamide (3-AB), an inhibitor of the nuclear enzyme poly(ADP-ribose) polymerase (PARP), against early ischemia/reperfusion (IR) injury in heart transplantation. In our experimental model, rat heart subjected to heterotopic transplantation, low temperature global ischemia (2 h) was followed by an in vivo reperfusion (60 min). In these conditions, and in the absence of 3-AB treatment, clear signs of oxidative stress, such as lipid peroxidation, increase in protein carbonyls and DNA strand breaks, were evident; PARP was markedly activated in concomitance with a significant NAD+ and ATP depletion. The results of microscopic observations (nuclear clearings, plasma membrane discontinuity), and the observed rise in the serum levels of heart damage markers, suggested the development of necrotic processes while, conversely, no typical sign of apoptosis was evident. Compared to the effects observed in untreated IR heart, the administration of 3-AB (10 mg/kg to the donor and to the recipient animal), but not that of its inactive analogue 3-aminobenzoic acid, significantly modified the above parameters: the levels of oxidative stress markers were significantly reduced; PARP activation was markedly inhibited and this matched a significant rise in NAD+ and ATP levels. PARP inhibition also caused a reduced release of the cardiospecific damage markers and attenuated morphological cardiomyocyte alterations, save that, in this condition, we noted the appearance of typical apoptotic markers: activation of caspase-3, oligonucleosomal DNA fragmentation, ISEL positive nuclei. Possible mechanisms for these effects are discussed, in any case the present results indicate that PARP inhibition has an overall beneficial effect against myocardial reperfusion injury, mainly due to prevention of energy depletion. In this context, the signs of apoptosis observed under 3-AB treatment might be ascribed to the maintenance of sufficient intracellular energy levels. These latter allow irreversible damages triggered during the ischemic phase to proceed towards apoptosis instead of towards necrosis, as it appears to happen when the energetic pools are depleted by high PARP activity.
Collapse
Affiliation(s)
- Claudia Fiorillo
- Dipartimento di Scienze Biochimiche, Università di Firenze, viale Morgagni 50, 50134, Fireze, Italia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Fiorillo C, Pace S, Ponziani V, Nediani C, Perna AM, Liguori P, Cecchi C, Nassi N, Donzelli GP, Formigli L, Nassi P. Poly(ADP-ribose) polymerase activation and cell injury in the course of rat heart heterotopic transplantation. Free Radic Res 2002; 36:79-87. [PMID: 11999706 DOI: 10.1080/10715760210168] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Free radicals and other reactive species generated during reperfusion of ischemic tissues may cause DNA damage and, consequently, the activation of the nuclear enzyme poly(ADP-ribose) polymerase (PARP). An excessive PARP activation may result in a depletion of intracellular NAD+ and ATP, hence cell suffering and, ultimately, cell death. The present study is aimed at clarifying the role of PARP in a heart transplantation procedure and the contribution of myocyte necrosis and/or apoptosis to this process. In our experimental model, rat heart subjected to heterotopic transplantation, low temperature global ischemia (2 h) was followed by an in vivo reperfusion (30 or 60 min). Under these conditions clear signs of oxidative stress, such as lipoperoxidation and DNA strand breaks, were evident. In addition to a marked activation, accompanied by a significant NAD+ and ATP depletion, PARP protein levels significantly increased after 60 min of reperfusion. Ultrastructural analysis showed nuclear clearings, intracellular oedema and plasma membrane discontinuity. Other relevant observations were the absence of typical signs of apoptosis like caspase-3 activation and PARP cleavage, random DNA fragmentation, rise in serum levels of heart damage markers. Our results suggest that during heart transplantation, the activation of PARP, causing energy depletion, results in myocardial cell injury whose dominant feature, at least in our experimental model, is necrosis rather than apoptosis.
Collapse
Affiliation(s)
- Claudia Fiorillo
- Dipartimento di Scienze Biochimiche, Università di Firenze, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Delle Sedie PF, Nassi N. [Epidemiological aspects of tuberculosis and activities of the Antitubercular Provincial Association in the province of Pisa in the 5-year period 1963-67]. Lotta Tuberc 1968; 38:Suppl:209-24. [PMID: 5253525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
22
|
Delle Sedie PF, Nassi N. [Current clinical pictures of pulmonary tuberculosis ascertained by mass photofluorographic investigation]. Lotta Tuberc 1965; 35:717-27. [PMID: 5218847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
23
|
Delle Sedie PF, Nassi N, Zerboni R. [Intestinal parasitism in particular categories of athletes (bicycle racers)]. MED SPORT 1965; 5:465-9. [PMID: 5842419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|