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Simoncelli E, Colafrancesco S, Spinelli FR, Gattamelata A, Giardina F, Truglia S, Garufi C, Izzo R, Cantarini L, Frediani B, Conticini E, Grazzini S, Priori R, Conti F. POS1266 MULTICENTER RETROSPECTIVE STUDY EVALUATING THE SAFETY OF ANTI-SARS-CoV-2 VACCINE IN A COHORT OF PATIENTS WITH SYSTEMIC VASCULITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVaccinations against SARS-CoV-2 represent a fundamental tool in controlling the pandemic. To date, data on the safety of anti-SARS-CoV-2 vaccines in patients with rare rheumatic diseases, such as systemic vasculitis, are limited.ObjectivesIn this study we aimed at evaluating the safety of anti-SARS-CoV-2 vaccines in a multicentric cohort of patients with systemic vasculitis.MethodsPatients with systemic vasculitis from two Rheumatology centres who had received anti-SARS-CoV-2 vaccine were retrospectively examined. The primary outcome was to evaluate, in this multi-centric cohort, the occurence of a disease flare after the administration of the vaccine, defined as development of clinical manifestations related to vasculitis with a concomitant increase in serum inflammatory markers. As a secondary outcome we aimed at evaluating, in a monocentric cohort of patients with vasculitis, the occurrence of adverse events (AEs) following vaccine administration compared to healthy controls (HC).ResultsWe examined 111 patients with systemic vasculitis (n=69 female, n=42 male), with a mean age of 64.3 (± 13) years. Sixty had ANCA-associated vasculitis (AAV), fourty-two had Giant-Cell Arterities (GCA), five had Periarteritis Nodosa, four had Takayasu’s arteritis. One-hundred and five patients received a mRNA vaccine and six a viral vector one. A disease flare occurred in only 2 patients (1.8%) after the first dose of a mRNA vaccine: both had AAV (microscopic poliangioitis) and developed a pulmunary disease flare (respiratory failure requiring hospitalization and treatment with high-dose glucocorticoids). Of note, one of these patients had multiple previous comorbidities, including a severe COPD. Multivaried analysis, adjusted for age and sex, performed in a single monocentric cohort of patients with systemic vasculitis [n=60 (39 AAV, 21 GCA), 37 female, 23 male, mean age 71 (± 12.5) years] demonstrated a statistically significant higher frequency of AEs in vasculitis patients compared to HC (p=0.015) after the first dose of vaccination. No significant differences in the frequency of AEs in vasculitis patients compared to HC after the second dose were detected. All the AEs were mild in both groups (malaise was the most frequently reported); no serious AEs were reported.ConclusionOur data show a very low incidence of disease flares after the administration of anti-SARS-CoV-2 vaccines in patients with systemic vasculitis. Patients with systemic vasculitis seem more prone to develop mild AEs after the first dose of the vaccine. Taken together, this data suggest a good risk profile for anti-SARS-CoV-2 vaccine in patients with systemic vasculitis.Disclosure of InterestsNone declared
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Colafrancesco S, Barbati C, Priori R, Giardina F, Gattamelata A, Izzo R, Cerbelli B, Giordano C, Scarpa S, Fusconi M, Spinelli FR, Cavalli G, Alessandri C, Conti F. OP0236 JAK-STAT INHIBITION RESTORES EPITHELIAL CELLS’ HOMEOSTASIS IN PRIMARY SJOGREN’S SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAlthough salivary gland epithelial cells (SGECs) are key players in the pathogenesis of autoimmune epithelitis that characterizes primary Sjӧgren’s Syndrome (pSS), the mechanisms sustaining SGECs activation in pSS remain largely undetermined. Therefore, therapeutic strategies to counteract SGECs activation in pSS are also lacking. In previous studies, we revealed that maladaptive autophagy sustains survival and pro-inflammatory activation of SGECs in pSS (1).ObjectivesTo determine the therapeutic potential of JAK/STAT inhibition with baricitinib to restore homeostatic regulation of SGECs in pSS, by reducing autophagy, survival, and expression of adhesion molecules.MethodsPrimary SGECs were isolated from minor salivary glands (SG) of large cohort of patients with pSS or sicca syndrome and subjected to mechanistic and functional studies including flow-cytometry, immunoblotting, and immunofluorescence to assess autophagy (autophagic-flux, LC3IIB, p62, LC3B+/LAMP1+ staining), apoptosis (annexin V/PI, Caspase-3) and activation (ICAM, VCAM). Focus score and germinal centers were determined in homologous SG biopsies to assess correlations of findings with histological disease severity. Primary SGECs of patients with pSS were treated with Baricitinib (1 mM) for 24 prior to assessment of autophagy, apoptosis and activation.ResultsSGECs from pSS patients (n=29) exhibited increased autophagy (as determined by autophagic-flux p=0.001; LC3IIB p=0.02; p62 p=0.064; LC3IIB/LAMP1+ staining), increased expression of anti-apoptotic molecules (Bcl2 p=0.006), and reduced apoptosis (Annexin-V/PI p=0.002, Caspase-3 p=0.057) compared to sicca (n=16). Induction of autophagy in pSS SGECs correlated with histologic disease severity. Treatment of pSS SGECs with baricitinib ex vivo suppressed autophagy, increased apoptosis, and reduced expression of adhesion molecules.ConclusionSGECs in the inflammatory milieu of pSS are characterized by induction of autophagy and pro-survival mechanisms, and by expression of adhesion molecules. These changes correlate with SG infiltration with immune cells and with histologic disease severity. Among clinically available therapies, the JAK/STAT inhibitor baricitinib effectively reduced autophagy, countered the state of maladaptive activation of SGECs, and restored epithelial cell homeostasis. Transcriptomics and metabolomics studies are ongoing to dissect the specific mechanisms responsible for these beneficial effects.References[1]Colafrancesco S, et al. Maladaptive autophagy in the pathogenesis of autoimmune epithelitis in Sjӧgren’s Syndrome. Arthritis Rheumatol 2021.Disclosure of InterestsSerena Colafrancesco Speakers bureau: NovartisSobi, Grant/research support from: Eli Lilly, cristiana barbati: None declared, Roberta Priori: None declared, Federico Giardina: None declared, angelica gattamelata: None declared, raffaella izzo: None declared, Bruna Cerbelli: None declared, Carla Giordano: None declared, Susanna Scarpa: None declared, Massimo Fusconi: None declared, Francesca Romana Spinelli Speakers bureau: Eli LillyPfizerAbbvie, Giulio Cavalli: None declared, cristiano alessandri: None declared, Fabrizio Conti: None declared
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Giardina F, Curcio G, Gioia C, Izzo R, Simoncelli E, Gattamelata A, Colafrancesco S, Mastromanno L, Villa M, Iannuccelli C, Di Franco M, Conti F, Priori R. AB1487 VALIDATION AND CULTURAL ADAPTATION OF THE QUALISEX QUESTIONNAIRE IN WOMEN WITH SJÖGREN’S SYNDROME IN ITALY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe quality of sexual life (QSL) is a complex and multimodal experience influenced by endogenous and external factors, including age, gender, and cultural environment. Rheumatic diseases, with their burden of pain, fatigue, organ damage, and disability, can severely impair sexual life and this is true also for Sjögren’s Syndrome, where simple tools to assess the QSL in everyday clinical practice are needed.ObjectivesTo translate ad adapt into Italian the Qualisex, a new brief questionnaire originally created for Rheumatoid Arthritis patients, for women with primary Sjögren’s Syndrome (pSS) and evaluate the impact of the disease on their sexuality.MethodsConsecutive sexually active pSS (according to ACR/EULAR 2016 criteria) patients aged >18 were asked to participate in this study approved by the local bioethics committee. With the permission of the developer, the French original version of the Qualisex questionnaire (consisting of 10 items, the higher the score, the greater the negative impact of the disease on the QSL) was translated and adapted into Italian according to current guidelines. In the absence of a gold standard assessment for sexuality in pSS, face and content validity was assessed cross-sectionally by correlations with other disease aspects such as anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS), EULAR SS patient-reported index (ESSPRI), and quality of the relationship. As a measure of reliability, internal consistency was assessed through Cronbach’s Alpha coefficient. A Cronbach’s value >0.7 is generally regarded as satisfactory. The feasibility of the scale was indirectly assessed through missing data. To assess the factorial structure of the Italian version of the questionnaire an Exploratory Factor Analysis (EFA) was carried out. Moreover we also assessed the level of redundancy by means of intra-item correlation of the Qualisex questionnaire. ESSDAI (EULAR Sjögren’s Syndrome Disease Activity Index), and SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed as well. Analyses were carried out with IBM SPSS Statistics for Macintosh, version 22.0 (IBM Corp., Armonk, NY, USA).Results40 sexually active women with pSS and a median age of 53 (IQR 45.25-57.25) were enrolled. The EFA showed that the model with a single factor appeared to be highly significant (Chi235= 2943.10; p<0.05); the average inter-item correlation was found to be 0.392 (Min -0.479; Max 0.834) which is an acceptable value as for redundancy. There were no missing answers. Cronbach’s alpha coefficient resulted to be 0.86 which indicates an adequate internal consistency. The median Qualisex score was 4.65 (IQR 2.13–6.2). As far as correlations, age (Rho=0.39; p<0.05), menopause (Rho=0.41; p<0.05), relationship quality (Rho=0.55; p<0.05), anxiety (HADS-A; Rho=0.38; p<0.05), and depression (HADS-D; Rho=0.47; p<0.05) appeared to be positively correlated with Qualisex score. Also, a positive correlation with ESSPRI (Rho=0.43; p<0.05), and drug use (Rho=0.37; p<0.05) was demonstrated. On the contrary no significant correlation was found with education (Rho=-0.07; p=0.64), systemic disease activity (Rho=0.14; p=0.39), and damage (Rho=0.06; p=0,74).ConclusionThe Italian version of the Qualisex questionnaire is a valid, reliable and useful tool to assess the quality of sexual life in pSS. QSL in pSS women has an inverse relationship with age, menopause, drug use, ESSPRI, mood disorders, and dissatisfaction with the partner, while, as previously reported, no correlation was found with disease activity, damage, and educational status. This further highlights the impact of subjective symptoms such as dryness, pain, fatigue, and the overall psychological well-being on patients’ life. Thus, it is critical for the physician to consider patients’ perspective.Disclosure of InterestsNone declared
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Izzo R, Colafrancesco S, Pinto A, Gattamelata A, Giardina F, Claudia F, Donini LM, Priori R. AB0317 ADHERENCE TO MEDITERRANEAN DIET AND NUTRITIONAL STATE IN ITALIAN WOMEN WITH ISOLATED SJÖGREN’S SYNDROME. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The Mediterranean Diet (MD) has anti-inflammatory and immunomodulatory effects1,2 suggesting a protective role in rheumatic diseases. There is limited knowledge about the eating habits and the nutritional state in patients with isolated Sjögren Syndrome (SS) living within the Mediterranean area.Objectives:assessment of adherence to the MD and analysis of the nutritional state in women with SS and their correlations with the clinical, laboratory and histological data of the disease.Methods:patients classified as isolated SS according to AECG criteria 20023 who had undergone to minor salivary gland biopsy during the previous twelve months were consecutively enrolled during follow-up visits. The adherence to the MD was assessed by the Med Diet (MDiet)4 which includes eleven groups of foods; to each group is assigned a value ranging between 0 and 5 based on the frequency of monthly intake. The total score spans from 0 (poor adherence) to 55 (maximum adherence). The level of physical activity was measured by the 6-minutes walking test (6MWT) and by the International Physical Activity Questionnaire (IPAQ). Systemic disease activity was evaluated with the EULAR SS disease activity index (ESSDAI); EULAR SS patient-reported index (ESSPRI) was calculated as well. A subgroup of patients was asked to fill a daily food diary processed with FOOD CONS software which allows to study in detail their eating habits. Nutritional state, muscle strength and basal metabolic rate were assessed. Alcoholism or drug abuse, diabetes mellitus, specific dietary models, treatment with drugs and/or food supplements with anti-inflammatory and/or antioxidant activity were considered exclusion criteria. Multivariate linear regression was performed with R project for Statistical Computing.Results:N= 40 N= 26Age, median (range) 53 (25-80) 33 (25-71)BMI, median (range) 21 (19-29.3) 25.1 (19-33.7)MedDiet score, median (range) 33 (26-43) 33 (23-40)ESSDAI, median (range) 2 (0-16) 1 (0-16)ESSPRI, median (range) 6 (0-8.6) 5.3 (1.6-9)ESSPRI dryness, median (range) 6 (0-10) 6 (2-10)Focus score, median (range) 2.5 (0-9.6) 1.7 (0.8-6.24)ASM kg, median (range) - 16.8 (13.3-21.7)IPAQ meters, median (range) - 1386 (99-11865)6MWT meters, median (range) - 595 (536-680)BMI, body mass index; ASM appendicular skeletal mass; IPAQ International Physical Activity Questionnaire; 6MWT, six minute walking test.MDiet was administered to 40 female SS outpatients. Even if not reaching significativity, patients with a higher focus score in their MSG have a lower value of MDiet score (p = 0.058, r = -1.00). The MDiet score is not associated with ESSDAI (p = 0.85, r 0.02), but only with lower serum levels of C3 (p = 0.004, r = - 0.08).In 26 patients, daily food questionnaire shows that their diet consists of 43% of carbohydrates while fats represent 40% of total energy intake, the remaining 17% daily energy comes from proteins. Fat consumption is higher compared to the levels of energy and nutrient intake for the Italian population5. Six patients had a reduction in muscle mass; sarcopenia is not associated to ESSDAI (p = 0.610).The MDiet score and the amount eaten of polyunsaturated fatty acids (PUFA) were reduced in patients with high value of subscale dryness of ESSPRI (p = 0.057, r -1.21; p =0.610, r -1.00).Conclusion:This study highlights a lower degree of glandular lymphocytic infiltration (expressed as focus score) in minor salivary glands in patients following MD, so its anti-inflammatory role of seems to be confirmed. SS patients have an unbalanced diet because of a higher intake of fat foods, likely for their lubricating effect. Despite the absence of correlation with objective parameters, the increased dryness in patients with a reduced intake of PUFA arouses our interest in a future study including omega-3 supplementation.References:[1]Schwingshackl L et al., Nutr Metab Cardiovasc Dis 2014[2]Mena MP et al., Am J Clin Nutr. 2009[3]Vitali C et al, ARD 2002[4]Panagiotakos D et al., J Med Food 2007[5]LARN 2014Disclosure of Interests:None declared
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De Marco M, Mancusi C, Canciello G, Losi M, Trimarco B, De Luca N, De Simone G, Izzo R. Increased carotid cross-sectional area is a marker of organ damage in young hypertensive patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Common Carotid artery (CA) cross sectional area (CCSA) is strictly related to vessel remodelling stimulated by mechanical stress due to arterial hypertension. Accordingly, increased CCSA might represent an early marker of vascular target organ damage independently of presence of atherosclerotic plaque.
Purpose
To assess early correlates and prognostic impact of CCSA in a large population of young treated HTN patients.
Methods
We selected 970 hypertensive patients, 18 to 40 years old (mean age 34±5 yrs; 30% women) of the Campania Salute Network registry with available CA ultrasound and follow-up data, free of overt cardiovascular (CV) disease. CCSA was computed as:
CCSA = π [(CAd/2 + IMT)2 – (CAd/2)2]
where CAd = CA diameter and IMT = mean intima media thickness. Participants were compared by CCSA tertiles.
Results
Compared to the lowest and intermediate tertiles, patients in the highest tertile were more often male, smokers, older, and had higher body mass index (BMI), diastolic blood pressure (BP), higher fasting glucose, triglycerides, LDL cholesterol and uric acid, with lower level of HDL cholesterol. They also exhibited higher left ventricular mass index and IMT and had more often carotid atherosclerotic plaque (all p<0.05). During a median follow-up of 45 months, 22 incident composite CV events occurred. In Cox-Regression analyses, adjusting for the above covariates, presence of carotid plaque and classes of antihypertensive medications, increased CCSA was significantly associated with increased CV risk (HR 1.08/mm2; 95% CI 1.02–1.13; p<0.01).
Conclusions
In a population of young hypertensive patients, increased CCSA is related to metabolic and atherosclerotic disease and is associated with increased CV risk, also independently of overt carotid plaque.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M De Marco
- AORN Ospedali dei Colli - CTO Hospital, Naples, Italy
| | - C Mancusi
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - G Canciello
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - M.G Losi
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - B Trimarco
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - N De Luca
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - G De Simone
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
| | - R Izzo
- Federico II University Hospital, Department of Translational Medical Sciences, Naples, Italy
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Losi M, Grieco F, Canciello G, Mancusi C, Izzo R, Manzi M, De Luca N, Trimarco B, De Simone G, Barbato E. HFpEF score discriminates severity of cardiovascular profile in asymptomatic treated hypertensive patients: the campania salute network. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The heart failure with preserved ejection fraction (HFpEF) score is easy to use and potentially useful to discriminate HFpEF from noncardiac causes of dyspnea. HFpEF score may be expressed also as probability to have HFpEF.
Purpose
We investigated whether a high HFpEF score can identify specific cardiovascular (CV) profile in treated hypertensive patients even without dyspnea.
Methods
From September to December 2019, we consecutively enrolled treated hypertensive patients without dyspnea, with normal left ventricular (LV) ejection fraction (>50%), and chronic kidney disease of no more than stage III. In addition to standard echocardiographic parameters we evaluated: 1) inappropriate LV mass, identified as a percent of predicted LV mass >128%, 2) myocardial energetic efficiency as the ratio of stroke volume to heart rate normalized by LV mass (MEEi), and 3) an estimate of arterial stiffness, i.e. the ratio of pulse pressure and stroke index (by allometric normalization by height), as previously reported. The probability of HFpEF was calculated from the HFpEF score, using body mass index, pulmonary systolic pressure, mitral E/E' ratio, age, and history or evidence of atrial fibrillation.
Results
188 patients with complete data were analyzed (42% women, age 61±14 years, 9% diabetic). Patients were then divided into 3 groups according to HFpEF probability tertiles and compared by ANOVA and trend analysis (Table 1).
Conclusions
Probability of HFpEF using HFpEF score and non-standard echocardiographic parameters identify worse CV profile in treated hypertensive patients without dyspnea.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M.A Losi
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - F Grieco
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - G Canciello
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - C Mancusi
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - R Izzo
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - M.V Manzi
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - N De Luca
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - B Trimarco
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - G De Simone
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - E Barbato
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
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Giardina F, Izzo R, Gattamelata A, Colafrancesco S, Conti F, Priori R. COVID-19 in Italian Sjögren's syndrome patients: a monocentric study. Rheumatol Int 2020; 41:235-236. [PMID: 33070254 PMCID: PMC7568843 DOI: 10.1007/s00296-020-04722-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/03/2020] [Indexed: 11/18/2022]
Affiliation(s)
- F Giardina
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy.
| | - R Izzo
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - A Gattamelata
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - S Colafrancesco
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - F Conti
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy
| | - R Priori
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Rheumatology Unit, Sapienza University of Rome, 00161, Rome, Italy.,UniCamillus, Saint Camillus International University of Health Sciences, 00131, Rome, Italy
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Celia AI, Colafrancesco S, Gattamelata A, Izzo R, Giardina F, Mastromanno L, Priori R. THU0258 SJOGREN’S SYNDROME WITH AND WITHOUT AND AUTOIMMUNE THYROIDITIS: IS THERE ANY DIFFERENCE? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Sjögren’s syndrome (SS) is a systemic autoimmune disease mainly affecting exocrine glands and characterized by a progressive lymphocytic infiltration of salivary and lacrimal glands with consequent loss of function and development of sicca symptoms. Autoimmune thyroiditis (AT) is the most frequent autoimmune disease associated with SS and detectable in about 10 - 30% of cases1. Interestingly, patients with concomitant SS and AT seem to display a more attenuated phenotype compared to patients with solely SS. It is also noteworthy that up to 30% of patients with AT experience sicca symptoms without a clear diagnosis SS2. At the light of these evidences, it is unclear whether SS and AT represent two distinct nosological entities or different expressions of the same pathology.Objectives:Aim of this study is to evaluate the prevalence of AT in a large monocentric cohort of patients with SS and to define its clinical and laboratory characteristics compared to isolated SS.Methods:Consecutive patients with SS (AECG criteria) referring to our “Sjögren Clinic” (Sapienza University of Rome) were enrolled and divided in two groups: SS with AT (group 1) and SS without AT (group 2). Group 1 was further divided in two subgroups depending on the presence (1a) or absence (1b) of anti Ro/SSA antibodies. The following clinical and laboratory data were retrospectively collected for all patients: concomitant celiac disease, arthralgia, lung involvement, purpura, lymphoma, presence of ANA, anti-Ro/SSA, anti-La/SSB, rheumatoid factor, cryoglobulins, leukopenia and hypergammaglobulinaemia. These characteristics were compared between the following groups: group 1, group 2, group 1a and 1b. For statistic Chi Square and Fisher’s test analysis were performed.Results:Six-hundred and three SS patients were enrolled (group 1 n=135; group 2 n=381; group 1a n=96; group 1b n=39). The prevalence of AT was 135/603 (22.3%). When comparing SS patients with or without AT (group 1 vs group 2) the frequency of rheumatoid factor was significantly higher in group 2 compared to group 1 (p=0.006). No case of lymphoma was recorded in group 1 while 14 cases of lymphoma were ascertained in group 2 (p=0,08). Conversely, celiac disease was higher in group 1 compared to group 2 (p=0.01). No other differences between these groups were identified. Stratifying SS patients with AT according to the presence (group 1a) or not (group 1b) of anti Ro/SSA antibodies, ANA, rheumatoid factor and hypergammaglobulinemia were significantly more positive in group 1a compared to group 1b (p=0.0002, p=0.002, p=0.02, respectively); no clinical differences were identified.Conclusion:In this study, we confirm the presence of a less aggressive disease in patients with SS and AT compared to solely SS. The higher prevalence of rheumatoid factor and lymphoma occurrence in SS without AT, strictly suggest a more severe phenotype in this subset. Although is known that in SS patients with anti Ro/SSA+ antibodies and RF there is a more aggressive disease, in SS with AT the presence or absence of such autoantibodies do not seems to associate with any difference in clinical severity. Follow up studies are presently being carried out in order to provide conformation of a less sever phenotype and a better disease outcome in patients with associated SS and AT.References:[1]Jara, L.J., Navarro, C., Brito-Zerón, M.P. et al. Thyroid disease in Sjögren’s syndrome. Clin Rheumatol 26, 1601–1606 (2007)[2]Vera D. Milic, Goran Radunovic, Ivan Boricic, Sanja Ognjanovic, Radmila Petrovic, Marija Radak-Perovic, Nada Vujasinovic-Stupar, Nemanja Damjanov, High prevalence of autoimmune thyroid disease in subjects with sicca symptoms without Sjögren’s syndrome, Rheumatology, Volume 52, Issue 4, April 2013, Pages 754–755.Disclosure of Interests:None declared
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Giardina F, Curcio G, Izzo R, Colafrancesco S, Gattamelata A, Mastromanno L, Valesini G, Priori R. THU0266 RESILIENCE IN WOMEN WITH PRIMARY SJÖGREN’S SYNDROME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Resilience is the ability to react positively to stressful life events, a multidimensional feature that varies in relation to context, time, age, sex, culture and personal experience, appearing among the most important traits in patients suffering from rheumatic diseases1. Several studies focus on patients with RA and SLE and the role of resilience in the respective clinical manifestations, as well as in the development of anxiety and depression2,3. Conversely, the data available regarding patients with primary Sjögren’s Syndrome (pSS) are limited.Objectives:To assess, in women with pSS (classified according to the criteria of Vitali et al.4), the relationship between resilience and anxiety, depression, health, fatigue, physical activity and quality of life in relation to disease activity and duration and in consideration of demographic, job and cultural characteristics.Methods:74 female patients with pSS afferent to the dedicated clinic of the University Hospital Policlinico Umberto I of Rome were recruited. Resilience was assessed by administering the Italian validated version of the Resilience Scale (RS-14)5consisting of 14 items, each of which is assigned a score from 1 to 7, with a range from 14 to 98. Higher scores relate to greater resilience. ESSDAI (EULAR Sjögren’s syndrome disease activity index), ESSPRI (EULAR Sjogren’s Syndrome Patient Reported Index), SSDDI (Sjogren’s Syndrome Disease Damage Index) were assessed and EuroQol / GH EQ VAS (visual analogue scale), HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assesment Scale), IPAQ (International Physical Activity Questionnaire), FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) questionnaires were submitted. Educational qualifications and job were also considered. The statistical analysis was carried out by means of Spearman’s correlation.Results:No relationship was found between resilience, systemic disease activity, disease duration, patient-reported symptoms and damage. Furthermore, no apparent link was found between socio-demographic characteristics, employment and resilience. Conversely, an inverse relationship was found between resilience and mood disorders (p=0.0379), with greater resilience associated with a better perception of quality of life (p=0.0232) and general health (p=0.0002), mainly mental (p=0.0001) than physical (p=0.0035), as well as less fatigue (p=0.0079) and more phyisically active lifestyle (p=0.0012)Conclusion:For the first time, the role of resilience in women with pSS in relation to their disease and other individual parameters was assessed. The most resilient patients are less depressed and show better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue and a more active lyfestile, while there was no relation between resilience value, active disease and socio-demographic features.References:[1]Rojas M. et al., Resilience in women with autoimmune rheumatic diseases, Joint Bone Spine (2017).[2]Sílvia Fernanda Cal et al., Resilience in systemic lupus erythematosus, Psychology, Health & Medicine (2013), 18:5, 558-563.[3]NeiLi Xu et al., Associations of perceived social support and positive psychological resources with fatigue symptom in patients with rheumatoid arthritis.PLoS One. 2017; 12(3).[4]Vitali C, et al. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61:554-558.[5]Camilla Callegari et al., Reliability and validity of the Italian version of the 14-item Resilience Scale, Psychology Research and Behavior Management 2016:9 277–284.Disclosure of Interests:None declared
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Mancusi C, Izzo R, Losi MA, Barbato E, Trimarco V, Morisco C, Canciello G, Manzi MV, Rozza F, De Luca N, De Simone G, Trimarco B. P5457Assessment of carotid cross sectional area in hypertensive patients: phenotyping and prognostic validation in the campania salute network. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Increased intima media thickness (IMT) of common carotid artery (CA) is considered the hallmark of vascular hypertension-mediated target organ damage, even though vessel remodeling due to mechanical stress can be accompanied also by changes in diameter.
Purpose
We developed a method computing both diameter and IMT of CA, and assessed correlates and prognostic impact of carotid cross sectional area (CCSA) in a large registry of treated hypertensive patients.
Methods
We selected 7049 hypertensive patients of the Campania Salute Network registry free of overt cardiovascular (CV) disease and with available CA ultrasound (54±11 yrs; 57% male). CCSA was computed as:
π × [((CA diameter + 2 × (mean IMT)) / 2)]2 − π × [((CA diameter) / 2)]2.
Results
CCSA was considered high if >90th percentile of the sex-specific distribution (>48 mm2 in men and >41 mm2 in women). Higher CCSA correlated with older age, male sex, higher pulse pressure (PP), higher total and LDL cholesterol and presence of diabetes (p<0.01 for all). During a median follow-up of 45 months (IQR 19–92), 324 incident composite major and minor CV events occurred. In Cox regression analysis high CCSA was associated with more than 100% increased risk of incident CV events (p<0.0001, figure), independently of the effect of older age, male sex, PP>60mmHg, presence of left ventricular hypertrophy (LVH), carotid plaque (CP), and less anti-RAS therapy (p<0.05 for all).
Conclusions
In treated hypertensive patients, increased CCSA is associated with worse metabolic and lipid profile and predict incident CV events, independently of high PP, presence of LVH and CP.
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Affiliation(s)
- C Mancusi
- Federico II UNiversity of Naples, Naples, Italy
| | - R Izzo
- Federico II UNiversity of Naples, Naples, Italy
| | - M A Losi
- Federico II UNiversity of Naples, Naples, Italy
| | - E Barbato
- Federico II UNiversity of Naples, Naples, Italy
| | - V Trimarco
- Federico II UNiversity of Naples, Naples, Italy
| | - C Morisco
- Federico II UNiversity of Naples, Naples, Italy
| | - G Canciello
- Federico II UNiversity of Naples, Naples, Italy
| | - M V Manzi
- Federico II UNiversity of Naples, Naples, Italy
| | - F Rozza
- Federico II UNiversity of Naples, Naples, Italy
| | - N De Luca
- Federico II UNiversity of Naples, Naples, Italy
| | - G De Simone
- Federico II UNiversity of Naples, Naples, Italy
| | - B Trimarco
- Federico II UNiversity of Naples, Naples, Italy
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Lønnebakken MT, Mancusi C, Losi MA, Gerdts E, Izzo R, Manzi MV, De Luca N, de Simone G, Trimarco B. Weight loss facilitates reduction of left ventricular mass in obese hypertensive patients: The Campania Salute Network. Nutr Metab Cardiovasc Dis 2019; 29:185-190. [PMID: 30559043 DOI: 10.1016/j.numecd.2018.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Reduction of left ventricular mass index (LVMi) during antihypertensive treatment is less likely to occur in obese subjects. The aim of the study was to assess whether weight loss influences reduction of LVMi in treated, obese, hypertensive patients. METHODS AND RESULTS From the Campania Salute Network registry, we identified 1546 obese hypertensive patients (50 ± 9 years, 43% women) with more than 12 months follow-up. Echocardiographic reduction of LVMi was considered as achievement of normal values (<47 g/m2.7 in women or <50 g/m2.7 in men) or a reduction of ≥10% during follow-up. Weight loss was considered as ≥5% reduction in body weight, and occurred in 403 patients (26%) during a median follow-up of 50 months (IQrange:31-93). Median weight loss was 8.6% (IQrange:6.5-12). Patients with weight loss had higher baseline body mass index (p < 0.05), while there was no difference in age, sex, duration of hypertension, prevalence of diabetes, metabolic syndrome and average blood pressure during follow-up. During follow-up, 152 patients (9.8%) exhibited reduction of LVMi. Reduction of LVMi was more frequent (12.9% vs 9.1%, p < 0.030) in patients losing weight than in those who did not. In logistic regression analysis, weight loss was associated with reduction of left ventricular mass index (OR 1.51 [95%CI 1.02-2.23], p = 0.039), independent of significant associations with younger age, lower average systolic blood pressure during follow-up, longer follow-up time and higher LVMi at baseline. CONCLUSION In treated obese hypertensive patients, weight loss during follow-up promotes significant reduction of LVMi, independent of baseline characteristics and blood pressure control.
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Affiliation(s)
- M T Lønnebakken
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - C Mancusi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy
| | - M A Losi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy
| | - E Gerdts
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - R Izzo
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Translational Medical Science Federico II University Hospital, Naples, Italy
| | - M V Manzi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy
| | - N De Luca
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy
| | - G de Simone
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy.
| | - B Trimarco
- Hypertension Research Center, Federico II University Hospital, Naples, Italy; Department of Advanced Biomedical Sciences, Naples, Italy
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Mancusi C, Izzo R, Ferrara LA, Rozza F, Losi MA, Canciello G, Pepe M, de Luca N, Trimarco B, de Simone G. Is increased uric acid a risk factor or a defensive response? The Campania Salute Network. Nutr Metab Cardiovasc Dis 2018; 28:839-846. [PMID: 29898822 DOI: 10.1016/j.numecd.2018.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 04/15/2018] [Accepted: 04/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Circulating uric acid (UA) is positively associated with body mass index (BMI), blood glucose, blood pressure (BP), markers of inflammation, and altered lipid profile. UA has also anti-oxidative properties which might be beneficial for cardiovascular (CV) system. It is still debated whether or not UA is independently associated with increased CV morbidity and/or mortality. METHODS AND RESULTS We studied prognostic impact of UA in 8833 hypertensive adults (mean age 53 ± 12 yrs, 3857 women) from the Campania Salute Network, without prevalent CV disease and more than stage 3 CKD. We calculated standardized UA Z-score, adjusted for age, sex, glomerular filtration rate, and BMI. Low and high UA and UA Z-score quartiles were compared to the 2 middle quartiles assumed to be "normal". Prevalence of obesity and diabetes was higher in low and high than in normal UA Z-score group (all p < 0.001). Systolic BP, left ventricular mass, carotid intima thickness were significantly higher and ejection fraction was reduced in the presence of high UA Z-score (all p < 0.001). Over 33-months average follow-up, incident major CV end-points (MACE) were not significantly different among low, normal and high UA or UA Z-score. In the latter analysis, however, incident MACE tended to be more frequent in the low than the high UA Z-score. Despite the results of multivariable analyses, the effect of less aggressive therapy in low UA Z-score cannot be excluded with certainty. CONCLUSION In treated hypertensive patients, high levels of UA normalized for major biological determinants do not independently predict CV outcome. CLINICALTRIALS. GOV IDENTIFIER NCT02211365.
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Affiliation(s)
- C Mancusi
- Hypertension Research Center, Italy; Department of Advanced Biomedical Sciences, Italy
| | - R Izzo
- Hypertension Research Center, Italy; Department of Translational Medical Sciences, Federico II University Hospital, Italy
| | | | - F Rozza
- Hypertension Research Center, Italy; Department of Advanced Biomedical Sciences, Italy
| | - M A Losi
- Hypertension Research Center, Italy; Department of Advanced Biomedical Sciences, Italy
| | | | - M Pepe
- Casa di Cura "San Michele", Maddaloni, Italy
| | - N de Luca
- Hypertension Research Center, Italy; Department of Translational Medical Sciences, Federico II University Hospital, Italy
| | - B Trimarco
- Hypertension Research Center, Italy; Department of Advanced Biomedical Sciences, Italy
| | - G de Simone
- Hypertension Research Center, Italy; Department of Translational Medical Sciences, Federico II University Hospital, Italy.
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Ilardi F, Gargiulo G, Schiattarella GG, Giugliano G, Paolillo R, Menafra G, De Angelis E, Franzone A, Stabile E, Perrino C, Cirillo P, Morisco C, Izzo R, Trimarco V, Esposito G. 4058Effects of selective and nonselective beta-blockers on platelet aggregation in patients with acute coronary syndrome: the PLATE-BLOCK study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Ilardi
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - G Gargiulo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - G G Schiattarella
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - G Giugliano
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Paolillo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - G Menafra
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - E De Angelis
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - A Franzone
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - E Stabile
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - C Perrino
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - P Cirillo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - C Morisco
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - R Izzo
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
| | - V Trimarco
- Federico II University Hospital, Hypertension Research Center, Naples, Italy
| | - G Esposito
- Federico II University Hospital, Advanced Biomedical Sciences, Naples, Italy
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Mancusi C, Losi MA, Izzo R, Canciello G, De Stefano G, Albano G, De Luca N, Trimarco B, De Simone G. 3024Incident Cardiovascular events among hypertensive patients with optimally controlled blood pressure: the Campania Salute Network. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Mancusi
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - M A Losi
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - R Izzo
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - G Canciello
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - G De Stefano
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - G Albano
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - N De Luca
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - B Trimarco
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
| | - G De Simone
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
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Losi MA, Izzo R, Mancusi C, Wang W, Roman MJ, Lee ET, Howard BH, Devereux RB, De Simone G. P3192Depressed myocardial energetic efficiency is associated with increased risk of incident heart failure: the strong heart study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Losi
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - R Izzo
- Federico II University Hospital, Department of Translational Medicine, Naples, Italy
| | - C Mancusi
- Federico II University of Naples, Advanced Biomedical Sciences, Naples, Italy
| | - W Wang
- University of Oklahoma, Oklahoma City, United States of America
| | - M J Roman
- Weill Cornell Medical College, New York, United States of America
| | - E T Lee
- University of Oklahoma, Oklahoma City, United States of America
| | - B H Howard
- Medstar Research Institute, Washington, United States of America
| | - R B Devereux
- Weill Cornell Medical College, New York, United States of America
| | - G De Simone
- Federico II University of Naples, Hypertension Research Center, Naples, Italy
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Izzo R, Bevivino G, De Simone V, Sedda S, Monteleone I, Marafini I, Di Giovangiulio M, Rizzo A, Franzè E, Colantoni A, Ortenzi A, Monteleone G. Knockdown of Smad7 With a Specific Antisense Oligonucleotide Attenuates Colitis and Colitis-Driven Colonic Fibrosis in Mice. Inflamm Bowel Dis 2018; 24:1213-1224. [PMID: 29668937 DOI: 10.1093/ibd/izy062] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND In Crohn's disease (CD), the pathogenic immune response is associated with high Smad7, an inhibitor of TGF-β1 signaling. Smad7 knockdown with Mongersen, a specific antisense oligonucleotide-containing compound, restores TGF-β1 activity leading to inhibition of inflammatory signals and associates with clinical benefit in CD patients. As TGF-β1 is pro-fibrogenic, it remains unclear whether Mongersen-induced Smad7 inhibition increases the risk of intestinal fibrosis. We assessed the impact of Smad7 inhibition on the course of colitis-driven intestinal fibrosis in mice. METHODS BALB/c mice were rectally treated with increasing doses of trinitrobenzene sulfonic acid (TNBS) for 8 or 12 weeks. The effect of oral Smad7 antisense or control oligonucleotide, administered to mice starting from week 5 or week 8, respectively, on mucosal inflammation and colitis-associated colonic fibrosis was assessed. Mucosal samples were analyzed for Smad7 by immunoblotting and immunohistochemistry, TGF-β1 by enzyme-linked immunosorbent assay, and collagen by immunohistochemistry. RESULTS TNBS-induced chronic colitis was associated with colonic deposition of collagen I and fibrosis, which were evident at week 8 and became more pronounced at week 12. TNBS treatment enhanced Smad7 in both colonic epithelial and lamina propria mononuclear cells. Colitic mice treated with Smad7 antisense oligonucleotide exhibited reduced signs of colitis, less collagen deposition, and diminished fibrosis. These findings were associated with diminished synthesis of TGF-β1 and reduced p-Smad3 protein expression. CONCLUSION Attenuation of colitis with Smad7 antisense oligonucleotide limits development of colonic fibrosis.
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Affiliation(s)
- Roberta Izzo
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Gerolamo Bevivino
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Veronica De Simone
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Silvia Sedda
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Ivan Monteleone
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy.,Dipartimento di Biomedicina e Prevenzione, Università Tor Vergata, Rome, Italy
| | - Irene Marafini
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | | | - Angelamaria Rizzo
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Eleonora Franzè
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Alfredo Colantoni
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Angela Ortenzi
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
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Imparato LI, Viggiano A, Pergola V, Carella C, Abbate FG, Canciello G, Mongiello F, Koci E, Mancusi C, De Simone G, Losi MA, Izzo R, De Luca N, Trimarco B, Rapacciuolo A. P400CHA2DS2-VASc score and dilated left atrial volume index predict incident atrial fibrillation in hypertensive patients. Europace 2018. [DOI: 10.1093/europace/euy015.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L I Imparato
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Viggiano
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - V Pergola
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Carella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - F G Abbate
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G Canciello
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - F Mongiello
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - E Koci
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Mancusi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - G De Simone
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M A Losi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Izzo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - N De Luca
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - B Trimarco
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Rapacciuolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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Trimarco V, Battistoni A, Tocci G, Coluccia R, Manzi MV, Izzo R, Volpe M. Single blind, multicentre, randomized, controlled trial testing the effects of a novel nutraceutical compound on plasma lipid and cardiovascular risk factors: Results of the interim analysis. Nutr Metab Cardiovasc Dis 2017; 27:850-857. [PMID: 28965797 DOI: 10.1016/j.numecd.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/14/2017] [Accepted: 08/07/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS The clustering of high levels of LDL cholesterol (LDL-C) and other risk factors represents a predisposing condition for atherosclerotic disease development. Cardiovascular prevention is based on effective control of these conditions. In adult subjects with mild hypercholesterolemia we compared in the real life the effects of a new combination of nutraceuticals on lipid and glucose metabolism and blood pressure with those of an established nutraceutical combination. METHOD AND RESULTS This multicenter, controlled, randomized, single-blind trial was designed to compare the effect of Armolipid Plus® versus that of LopiGLIK® on lipid and glucose levels and blood pressure (BP) in subjects with mild hypercholesterolemia not on statin therapy. Primary outcome was the proportion of subjects achieving therapeutic targets of LDL-C (<130 mg/dl); secondary outcomes were the effects on HDL-C, glycated haemoglobin and insulin levels. Data from an overall sample of 359 adult individuals (age 55.2 ± 11.1 years, women 57.7%, LDL-C 157.3 ± 22.6 mg/dl, HDL-C 50.7 ± 13.0 mg/dl) are reported. 72% of subjects treated with LopiGLIK® and 43% treated with Armolipid Plus® achieved the primary endpoint (p < 0.0001). Both treatments reduced plasma levels of total and LDL-C and triglycerides (p < 0.001 for all comparisons). The treatments also reduced systolic and diastolic blood pressure, plasma levels of glycated haemoglobin, insulin and HOMA index. The changes induced by LopiGLIK® in all these metabolic parameters were greater than those obtained with Armolipid Plus®. CONCLUSIONS The present analysis shows that LopiGLIK® may represent a more effective tool for clinical management of CV risk factors in subjects with mild hypercholesterolemia.
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Affiliation(s)
- V Trimarco
- Hypertension Research Center, Federico II University, Naples, Italy; Department of Neurosciences, Federico II University, Naples, Italy
| | - A Battistoni
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - G Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | | | - M V Manzi
- Hypertension Research Center, Federico II University, Naples, Italy
| | - R Izzo
- Hypertension Research Center, Federico II University, Naples, Italy.
| | - M Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
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Mancusi C, Losi M, Izzo R, Gerdts E, Canciello G, De Stefano G, De Luca N, Trimarco B, De Simone G. 288Prognostic impact of increase arterial stiffness in hypertensive patients: the Campania Salute Network. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Izzo R, Losi MA, Galderisi M, Mancusi C, Canciello G, D'Amato A, De Luca N, Trimarco B, De Simone G. 5032Aortic Root Dilatation is associated with incident CV events in a population of treated hypertensive patients: the Campania Salute Network. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Losi M, Mancusi C, Izzo R, Canciello G, D'Amato A, De Luca N, Trimarco B, De Simone G. 1237Left atrial dilatation: a target organ damage in arterial hypertension. The Campania Salute Network. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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D'Amato A, Losi M, Izzo R, Mancusi C, Canciello G, De Luca N, Trimarco B, De Simone G. P465Target organ damage and thresholds of systolic blood pressure control: the Campania Salute Network. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Gerdts E, Izzo R, Mancusi C, Losi M, Manzi M, Canciello G, De Luca N, Trimarco B, De Simone G. 2897Sex difference in cardiovascular risk is offset by presence of left ventricular hypertrophy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.2897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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24
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Mancusi C, Losi MA, Izzo R, Canciello G, Manzi MV, Sforza A, De Luca N, Trimarco B, de Simone G. Effect of diabetes and metabolic syndrome on myocardial mechano-energetic efficiency in hypertensive patients. The Campania Salute Network. J Hum Hypertens 2016; 31:395-399. [PMID: 28032631 DOI: 10.1038/jhh.2016.88] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 10/11/2016] [Accepted: 11/14/2016] [Indexed: 01/16/2023]
Abstract
Reduced myocardial mechano-energetic efficiency (MEE), estimated as stroke volume/heart rate ratio per g of left ventricular (LV) mass (LVM), and expressed in μl s-1 g-1 (MEEi), is a strong predictor of cardiovascular (CV) events, independently of LV hypertrophy and other confounders, including type II diabetes (DM). Decreased MEEi is more frequent in patients with diabetes. In the present analysis we evaluated the interrelation among MEEi, DM and metabolic syndrome (MetS) in the setting of arterial hypertension. Hypertensive patients from the Campania Salute Network, free of prevalent CV disease and with ejection fraction >50% (n=12 503), were analysed. Coexistence of MetS and DM was ordinally categorized into 4 groups: 8235 patients with neither MetS nor DM (MetS-/DM-); 502 without MetS and with DM (MetS-/DM+); 3045 with MetS and without DM (MetS+/DM-); and 721 with MetS and DM (MetS+/DM+). After controlling for sex, systolic blood pressure, body mass index, relative wall thickness (RWT), antihypertensive medications and type of antidiabetic therapy, MEEi was 333 μl s-1 g-1 in MetS-/DM-, 328 in MetS-/DM+, 326 in MetS+/DM- and 319 in MetS+/DM+ (P for trend <0.0001). In pairwise comparisons (Sidak-adjusted), all conditions, except MetS-/DM+, were significantly different from MetS-/DM- (all P<0.02). No statistical difference was detected between MetS-/DM+ and MetS+/DM-. Both MetS and DM are associated with decreased MEEi in hypertensive patients, independently to each other, but the reduction is statistically less evident for MetS-/DM+. MetS+/DM+ patients have the lowest levels of MEEi, consistent with the alterations of energy supply associated with the combination of insulin resistance with insulin deficiency.
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Affiliation(s)
- C Mancusi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - M A Losi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - R Izzo
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - G Canciello
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - M V Manzi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - A Sforza
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - N De Luca
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - B Trimarco
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Medical Bioscience, Federico II University Hospital, Naples, Italy
| | - G de Simone
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
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Sedda S, De Simone V, Marafini I, Bevivino G, Izzo R, Paoluzi OA, Colantoni A, Ortenzi A, Giuffrida P, Corazza GR, Vanoli A, Di Sabatino A, Pallone F, Monteleone G. High Smad7 sustains inflammatory cytokine response in refractory coeliac disease. Immunology 2016; 150:356-363. [PMID: 27861825 DOI: 10.1111/imm.12690] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 09/14/2016] [Revised: 11/02/2016] [Accepted: 11/07/2016] [Indexed: 12/20/2022] Open
Abstract
Refractory coeliac disease (RCD) is a form of coeliac disease (CD) resistant to gluten-free diet and associated with elevated risk of complications. Many effector cytokines over-produced in the gut of patients with RCD are supposed to amplify the tissue-destructive immune response, but it remains unclear if the RCD-associated mucosal inflammation is sustained by defects in counter-regulatory mechanisms. The aim of the present study was to determine whether RCD-related inflammation is marked by high Smad7, an intracellular inhibitor of transforming growth factor-β1 (TGF-β1 ) activity. Smad7 was evaluated in duodenal biopsy samples of patients with RCD, patients with active CD, patients with inactive CD and healthy controls by Western blotting, immunohistochemistry and real-time PCR. In the same samples, TGF-β1 and phosphorylated (p)-Smad2/3 were evaluated by ELISA and immunohistochemistry, respectively. Pro-inflammatory cytokine expression was evaluated in RCD samples cultured with Smad7 sense or antisense oligonucleotide. Smad7 protein, but not RNA, expression was increased in RCD compared with active and inactive CD patients and healthy controls and this was associated with defective TGF-β1 signalling, as marked by diminished p-Smad2/3 expression. TGF-β1 protein content did not differ among groups. Knockdown of Smad7 in RCD biopsy samples reduced interleukin-6 and tumour necrosis factor-α expression. In conclusion, in RCD, high Smad7 associates with defective TGF-β1 signalling and sustains inflammatory cytokine production. These results indicate a novel mechanism by which the mucosal cytokine response is amplified in RCD and suggest that targeting Smad7 can be therapeutically useful in RCD.
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Affiliation(s)
- Silvia Sedda
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Veronica De Simone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Irene Marafini
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Gerolamo Bevivino
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Izzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo Giuffrida
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Gino R Corazza
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Alessandro Vanoli
- Department of Molecular Medicine, San Matteo Hospital, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Francesco Pallone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Izzo R, Diano AA, Lavanga A, Vassallo P, Muto M. Posterior Fossa Arteriovenous Pial Fistula: Diagnostic and Endovascular Therapeutic Features. Neuroradiol J 2016; 19:783-6. [DOI: 10.1177/197140090601900615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 11/26/2006] [Indexed: 11/17/2022] Open
Abstract
Intracranial arteriovenous fistulas (AVFs) are rare vascular cerebral lesions composed of one or more corticalpial arterial feeders directly connected with a single draining vein. They differ from the other AV malformations in that they lack a nidus and are located outside the dural leaflets. Because of high flow and pressure AVFs have a high risk of hemorrhage and if untreated cause death in up to 63% of cases. Treatment can be endovascular or microneurosurgical. We describe an infant with hydrocephalus and raised intracranial pressure and MRI findings of a single dilated venous vessel with a proximal varix in the perimedullary spaces confirmed by CT angiography and DSA that found a single artery-single vein fistula we successfully occluded with GDC coils.
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Affiliation(s)
- R. Izzo
- A. Cardarelli National Hospital, Neuroradiology Unit; Naples, Italy
| | - A. Alvaro Diano
- A. Cardarelli National Hospital, Neuroradiology Unit; Naples, Italy
| | - A. Lavanga
- A. Cardarelli National Hospital, Neuroradiology Unit; Naples, Italy
| | - P. Vassallo
- A. Cardarelli National Hospital, Neuroradiology Unit; Naples, Italy
| | - M. Muto
- A. Cardarelli National Hospital, Neuroradiology Unit; Naples, Italy
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27
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Muto M, Izzo R, Diano A, Galasso L. L'insuccesso terapeutico nel trattamento con O2-O3 intradiscale-intraforaminale nei conflitti disco-radicolari. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/19714009030160s130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M. Muto
- UO Neuroradiologia, AORN Cardarelli; Napoli
| | - R. Izzo
- UO Neuroradiologia, AORN Cardarelli; Napoli
| | - A. Diano
- UO Neuroradiologia, AORN Cardarelli; Napoli
| | - L. Galasso
- UO Neuroradiologia, AORN Cardarelli; Napoli
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Abstract
Biomechanics of the spine is a vast area of research that has generated numerous studiesin recent years on the part of doctors (mainly orthopaedic surgeons), bioengineers and physicists. This paper is a short introduction to some of the topics of major interest in spine biomechanics. The first topic is the development of the spine with a “mechanical” explanation of the physiological curvatures. As the spine is a multiarticular complex structure, understanding the mechanism responsible for its dynamics requires in-depth knowledge of the spine's basic components: the vertebrae and their architecture, the intervertebral joints, the ligaments and muscles. A short morphofunctional description of each of these anatomical parts is given mentioning their biomechanical features. Of particular interest, in relation to spinal trauma, is the architecture of the cancellous bone of the vertebrae responsible for most resistance to compressive weight loads. This specific characteristic is gradually lost over the years either due to disease or to a progressive resorption of the horizontal lamellae and thinning of the vertical columns typical of osteoporosis. Numerous studies have been conducted in vivo and in vitro to shed light on the mechanisms leading to particular traumatic lesions or degenerative arthrosis. These have given rise to various theories formulated to account for the distribution of loads and strength in the elements making up the functional spinal unit. These theories include the old “two vertical columns” theory, subsequently replaced by the “three columns theory”, and the latest “four columns” model which divides the spine longitudinally depending on carrying strength. The latest theory was formulated in the wake of in vivo CT studies using an axial loading device which allows axial loads to be applied even though patients are in a supine position. A short mention is made of the possible biomechanical applications of neuroradiological techniques, namely cine-MR scans, which allow detailed study of the ligaments, muscles and disc, especially the cervical spine under dynamic conditions. Lastly, the controversial concept of spinal stability and instability is discussed. Further studies are necessary to establish appropriate criteria for treatment of traumatic or degenerative lesions since an impairment to spine statics can result in permanent neurological damage.
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Abstract
The goal of this paper was to evaluate the different causes of non-discal radiculopathies and to determine the different sensitivity and specificity of CT and MR. We reviewed 450 patients with non-discal radiculopathy; CT was performed in all patients while MR was done only in 95 cases. MR was obtained only in case of polyradiculopathy, or if there was a discrepancy between clinical evaluation and CT findings or when sphincteral symptoms were present. The most frequent cause of non-discal radiculopathy was degenerative disk disease associated with facet joint abnormality and secondary central and lateral spinal canal stenosis. Other causes were neoplastic lesions, traumas, malformations, inflammatory processes and vascular abnormality. CT was more sensitive and specific in degenerative disc disease while MR was better at evaluating other pathology. CT still represents a satisfactory technique in evaluating patients with non-discal radiculopathy; MR must be also performed in case of discrepancy between clinical evaluation and CT findings. Directly MR examination should be reserved for patients presenting sphincteral symptoms.
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Affiliation(s)
| | | | | | | | - I. Aprile
- Servizio di Neuroradiologia, Osp. S. Maria della Misericordia; Udine
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30
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Izzo R, Figliuzzi MM, Monteleone G. Sphingosine-1-phosphate receptor: a novel therapeutic target in ulcerative colitis. Expert Rev Clin Immunol 2016; 12:1137-1139. [DOI: 10.1080/1744666x.2016.1217774] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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De Simone V, Bevivino G, Sedda S, Izzo R, Fantini MC, Monteleone G. Abstract 5159: Smad7 knockdown in colon cancer cells activates protein kinase RNA-associated eIF2α pathway thereby leading to cell death. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-5159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Up-regulation of Smad7, an inhibitor of TGF-β1, occurs in sporadic colorectal cancer (CRC). Knockdown of Smad7 with a specific antisense oligonucleotide (AS) leads to activation of eIF2α, an attenuator of protein synthesis, and arrest of CRC cells in the S phase of the cell cycle with the downstream effect of inducing cell death.
Aim. To investigate the mechanisms by which Smad7 knockdown activates eIF2α.
Methods. Phosphorylation of eIF2α was evaluated in CRC cell lines (i.e. HCT116 and DLD-1) either untreated or treated with Smad7 sense (S) or AS by Western blotting (WB) and immunofluorescence (IF). Expression of ATF4 and CHOP, two downstream targets of EIF2α, were evaluated by IF and activation of PKR, GCN2 and PERK, up-stream kinases that induce eIF2α phosphorylation, was assessed by WB. Wild type or PKR-deficient CRC cells treated with Smad7 AS were monitored for eIF2α activation and induction of death. Finally, we assessed whether enhanced phosphorylation of eIF2α seen in cells treated with Smad7 AS was also associated with reduced interaction between eIF2α and PP1, a phosphatase that normally dephosphorylates eIF2α.
Results. Smad7 knockdown increased ATF4 and CHOP expression thus confirming previous data showing activation of eIF2α phosphorylation in CRC cells treated with Smad7 AS. Among kinases that induce eIF2α phosphorylation, only PKR was activated by Smad7 knockdown. Consistently, silencing of PKR reduced but did not abolish Smad7 AS-induced eIF2α phosphorylation and cell death, thus suggesting the existence of further mechanisms that control eIF2α phosphorylation in Smad7-deficient cells. Indeed, in CRC cells, Smad7 interacted with PP1 and Smad7 knockdown reduced association of PP1 with eIF2α.
Conclusions
Data show that Smad7 is involved in CRC cell survival and suggest that Smad7 is a valid target for therapeutic intervention in CRC.
Citation Format: Veronica De Simone, Gerolamo Bevivino, Silvia Sedda, Roberta Izzo, Massimo Claudio Fantini, Giovanni Monteleone. Smad7 knockdown in colon cancer cells activates protein kinase RNA-associated eIF2α pathway thereby leading to cell death. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5159.
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Abstract
INTRODUCTION Management of patients with active ulcerative colitis (UC), one of the most frequent inflammatory bowel diseases in human beings, is mainly based on the use of mesalamine and corticosteroids. Since in the long-term, these two drugs may be ineffective in nearly one third of the patients, immunosuppressants and/or biologics are needed to control disease activity. AREAS COVERED The marked activation of JAK/STAT molecules in inflamed mucosa of UC patients and the demonstration that UC-associated mucosal injury is driven by soluble factors that signal through JAK/STAT pathways led to investigation of JAK inhibitors for the treatment of active UC. Tofacitinib, an oral inhibitor of the cytokine-driven JAK-STAT signalling cascade, has recently been proposed for the treatment of moderate-to-severe UC. Phase 2 study showed the efficacy of tofacitinib to induce clinical and endoscopic improvement/remission and the safety profile of the drug. Herein the authors review this compound. EXPERT OPINION The results obtained from clinical trials with tofacitinib suggest that this drug could be a new treatment option for patients with moderate to severe UC. However, further experimentation is needed to assess the efficacy of this drug in selected subgroups of patients as well as to maintain remission and to determine the long-term safety profile of the drug.
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Affiliation(s)
- Roberta Izzo
- a Department of Systems Medicine , University of Rome 'Tor Vergata' , Rome , Italy
| | - Gerolamo Bevivino
- a Department of Systems Medicine , University of Rome 'Tor Vergata' , Rome , Italy
| | - Giovanni Monteleone
- a Department of Systems Medicine , University of Rome 'Tor Vergata' , Rome , Italy
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Dinallo V, Di Fusco D, Izzo R, Monteleone G. Therapy implications for the role of IL-21 in lupus. Expert Rev Clin Immunol 2016; 12:487-8. [DOI: 10.1586/1744666x.2016.1152183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Castaldo R, Melillo P, Izzo R, De Luca N, Pecchia L. Fall Prediction in Hypertensive Patients via Short-Term HRV Analysis. IEEE J Biomed Health Inform 2016; 21:399-406. [PMID: 28113874 DOI: 10.1109/jbhi.2016.2543960] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Falls are a major problem of later life having severe consequences on quality of life and a significant burden in occidental countries. Many technological solutions have been proposed to assess the risk or to predict falls and the majority is based on accelerometers and gyroscopes. However, very little was done for identifying first time fallers, which are very difficult to recognize. This paper presents a metamodel predicting falls using short term Heart Rate Variability (HRV) analysis acquired at the baseline. About 170 hypertensive patients (age: 72 ± 8 years, 56 female) were investigated, of which 34 fell once in the 3 months after the baseline assessment. This study is focused on hypertensive patients, which were considered as convenient pragmatic sample, as they undergo regular outpatient visits, during which short term Electrocardiogram (ECG) can be easily recorded without significant increase of healthcare costs. For each subject, 11 consecutive excerpts of 5 min each (55 min) were extracted from ECGs recorded between 10:30 and 12:30 and analysed. Linear and nonlinear HRV features were extracted and averaged among the 11 excerpts, which were, then, considered for the statistical and data mining analysis. The best predictive metamodel was based on Multinomial Naïve Bayes, which enabled to predict first-time fallers with sensitivity, specificity, and accuracy rates of 72%, 61%, and 68%, respectively.
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Monteleone I, Zorzi F, Marafini I, Di Fusco D, Dinallo V, Caruso R, Izzo R, Franzè E, Colantoni A, Pallone F, Monteleone G. Aryl hydrocarbon receptor-driven signals inhibit collagen synthesis in the gut. Eur J Immunol 2016; 46:1047-57. [PMID: 26786786 DOI: 10.1002/eji.201445228] [Citation(s) in RCA: 32] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/10/2015] [Accepted: 01/14/2016] [Indexed: 12/11/2022]
Abstract
Fibrostrictures (FS) are a major complication of Crohn's disease (CD). Pathogenesis of FS is not fully understood, but activation of fibroblasts and excessive collagen deposition are crucial in the development of FS. Here, we investigated the role of aryl hydrocarbon receptor (AhR) in intestinal fibrosis. AhR RNA and protein expression were evaluated in intestinal fibroblasts of CD patients and controls. CD fibroblasts were stimulated with TGF-β1 or TNF-α in the presence or absence of the AhR activator Ficz, an AhR antagonist CH223191, or a specific AhR-silencing RNA. In CD fibroblasts, TGF-β1 and TNF-α increased Col1A1, Col3A1 and α-SMA transcripts and collagen secretion and this effect was reduced by Ficz and upregulated by CH22319. TGF-β1 or TNF-α induced activation of p38 and ERK1/2 MAP kinases was decreased by Ficz and increased by CH223191. The inhibitory effect of Ficz on Map kinase activation and collagen induction was abolished by AhR silencing. To assess the role of AhR in vivo, mice with trinitrobenzene-sulfonic-acid induced colonic fibrosis were given Ficz or CH223191. Mice given either Ficz or CH223191 produced less or more collagen respectively as compared with control mice. Our results indicate that AhR is a negative regulator of profibrotic signals in the gut.
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Affiliation(s)
- Ivan Monteleone
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Francesca Zorzi
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Irene Marafini
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Davide Di Fusco
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Vincenzo Dinallo
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Roberta Caruso
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Roberta Izzo
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Eleonora Franzè
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Alfredo Colantoni
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Francesco Pallone
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
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Franzè E, Marafini I, De Simone V, Monteleone I, Caprioli F, Colantoni A, Ortenzi A, Crescenzi F, Izzo R, Sica G, Sileri P, Rossi P, Pallone F, Monteleone G. Interleukin-34 Induces Cc-chemokine Ligand 20 in Gut Epithelial Cells. J Crohns Colitis 2016; 10:87-94. [PMID: 26449789 DOI: 10.1093/ecco-jcc/jjv181] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/25/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIM Production of chemokines by intestinal epithelial cells is a key step in the amplification of the destructive immune-inflammatory response in patients with inflammatory bowel diseases [IBD]. In this study, we examined whether intestinal epithelial cells express macrophage colony-stimulating factor receptor 1 [M-CSFR-1], the functional receptor of interleukin-34 [IL-34], a cytokine that is over-produced in IBD and supposed to sustain inflammatory pathways. METHODS M-CSFR-1 expression was evaluated in intestinal samples of IBD patients, controls, and colon epithelial cell lines by real-time polymerase chain reaction [PCR], immunohistochemistry, and western blotting. DLD-1 cells were stimulated with IL-34 in the presence or absence of MAP kinase inhibitors, chemokine induction was assessed by real-time PCR and enzyme-linked immunosorbent assay [ELISA], and mitogen-activated protein (MAP) kinase activation was monitored by western blotting. The effect of a neutralising IL-34 antibody on CC chemokine ligand (CCL) 20 synthesis was tested in ex vivo organ cultures of IBD mucosal explants. RESULTS Enhanced expression of M-CSFR-1 RNA transcripts was seen in inflamed mucosa of IBD patients as compared with controls. Immunohistochemical analysis confirmed up-regulation of M-CSFR-1 in IBD and showed that both epithelial and lamina propria mononuclear cells expressed this receptor. Stimulation of DLD-1 with IL-34 increased CCL20 production through an ERK1/2-dependent mechanism. Consistently, treatment of IBD explants with anti-IL-34 reduced CCL20 production. CONCLUSIONS These data show that intestinal epithelial cells are a target of IL-34 and suggest that this cytokine contributes to mediating the cross-talk between epithelial cells and immune cells in IBD.
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Affiliation(s)
- Eleonora Franzè
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Irene Marafini
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Veronica De Simone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Ivan Monteleone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Flavio Caprioli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Francesca Crescenzi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Roberta Izzo
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Giuseppe Sica
- Department of Surgery, University of Rome 'TOR VERGATA', Rome, Italy
| | - PierPaolo Sileri
- Department of Surgery, University of Rome 'TOR VERGATA', Rome, Italy
| | - Piero Rossi
- Department of Surgery, University of Rome 'TOR VERGATA', Rome, Italy
| | - Francesco Pallone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
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Colunga Blanco S, Gonzalez Matos C, Angelis A, Dinis PG, Chinali M, Toth A, Andreassi MG, Rodriguez Munoz D, Reid AB, Park JH, Shetye A, Novo G, De Marchi SF, Cikes M, Smarz K, Illatopa V, Peluso D, Wellnhofer E, De La Rosa Riestra A, Sattarzadeh Badkoubeh R, Mandour Ali M, Azoz A, Pontone G, Krljanac G, Acar R, Nucifora G, Sirtautas A, Roos ST, Qasem MS, Marini C, Fabiani I, Gillis K, Bandera F, Borowiec A, Lim YJ, Chalbia TE, Santos M, Gao SA, Zilberszac R, Farrag AAM, Palmiero G, Aruta P, De Diego Soler O, Fasano D, Tamborini G, Ancona F, Raafat DM, Marchel M, De Gregorio C, Gommans DHF, Godinho AR, Mielczarek M, Bandera F, Kubik M, Cho JY, Tarando F, Lourenco Marmelo BF, Reis L, Domingues K, Krestjyaninov MV, Mesquita J, Ikonomidis I, Ferferieva V, Peluso D, Peluso D, King GJ, D'ascenzi F, Ferrera Duran C, Sormani P, Gonzalez Fernandez O, Tereshina O, Cambronero Cortinas E, Kupczynska K, Carvalho JF, Shivalkar B, Aghamohammadzadeh R, Cifra B, Cifra B, Bandera F, Kuznetsov VA, Van Zalen JJ, Kochanowski J, Goebel B, Ladeiras-Lopes R, Goebel B, Karvandi M, Karvandi M, Alonso Salinas G, Unkun T, Ranjbar S, Hubert A, Enescu OA, Liccardo M, Cameli M, Ako E, Lembo M, Goffredo C, Enache R, Novo G, Wdowiak-Okrojek K, Nemes A, Nemes A, Di Salvo G, Capotosto L, Caravaca P, Maceira Gonzalez AM, Iriart X, Jug B, Garcia Campos A, Capin Sampedro E, Corros Vicente C, Martin Fernandez M, Leon Arguero V, Fidalgo Arguelles A, Velasco Alonso E, Lopez Iglesias F, De La Hera Galarza JM, Chaparro-Munoz M, Recio-Mayoral A, Vlachopoulos C, Ioakeimidis N, Felekos I, Abdelrasoul M, Aznaouridis K, Chrysohoou C, Rousakis G, Aggeli K, Tousoulis D, Faustino AC, Paiva L, Fernandes A, Costa M, Cachulo MC, Goncalves L, Emma F, Rinelli G, Esposito C, Franceschini A, Doyon A, Raimondi F, Schaefer F, Pongiglione G, Mateucci MC, Vago H, Juhasz C, Janosa C, Oprea V, Balint OH, Temesvari A, Simor T, Kadar K, Merkely B, Bruno RM, Borghini A, Stea F, Gargani L, Mercuri A, Sicari R, Picano E, Lozano Granero C, Carbonell San Roman A, Moya Mur JL, Fernandez-Golfin C, Moreno Planas J, Fernandez Santos S, Casas Rojo E, Hernandez-Madrid A, Zamorano Gomez JL, Pearce K, Gamlin W, Miller C, Schmitt M, Seong IW, Kim KH, Kim MJ, Jung HO, Sohn IS, Park SM, Cho GY, Choi JO, Park SW, Nazir SA, Khan JN, Singh A, Kanagala P, Squire I, Mccann GP, Di Lisi D, Meschisi MC, Brunco V, Badalamenti G, Bronte E, Russo A, Novo S, Von Tscharner M, Urheim S, Aakhus S, Seiler C, Schmalholz S, Biering-Sorensen T, Cheng S, Oparil S, Izzo J, Pitt B, Solomon SD, Zaborska B, Jaxa-Chamiec T, Tysarowski M, Budaj A, Cordova F, Aguirre O, Sanabria S, Ortega J, Romeo G, Perazzolo Marra M, Tona F, Famoso G, Pigatto E, Cozzi F, Iliceto S, Badano LP, Kriatselis C, Gerds-Li JH, Kropf M, Pieske B, Graefe M, Martinez Santos P, Batlle Lopez E, Vilacosta I, Sanchez Sauce B, Espana Barrio E, Jimenez Valtierra J, Campuzano Ruiz R, Alonso Bello J, Martin Rios MD, Farrashi M, Abtahi H, Sadeghi H, Sadeghipour P, Tavoosi A, Abdel Rahman TA, Mohamed LA, Maghraby HM, Kora IM, Abdel Hameed FR, Ali MN, Al Shehri A, Youssef A, Gad A, Alsharqi M, Alsaikhan L, Andreini D, Rota C, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Solbiati A, Guaricci AI, Pepi M, Trifunovic D, Sobic Saranovic D, Savic L, Grozdic Milojevic I, Asanin M, Srdic M, Petrovic M, Zlaic N, Mrdovic I, Dogan C, Izci S, Gecmen C, Unkun T, Cap M, Erdogan E, Onal C, Yilmaz F, Ozdemir N, Muser D, Tioni C, Zanuttini D, Morocutti G, Spedicato L, Bernardi G, Proclemer A, Pranevicius R, Zapustas N, Briedis K, Valuckiene Z, Jurkevicius R, Juffermans LJM, Enait V, Van Royen N, Van Rossum AC, Kamp O, Khalaf HASSEN, Hitham SAKER, Osama AS, Abazid RAMI, Guall RAHIM, Durdan SHAFAT, Mohammed ZYAD, Stella S, Rosa I, Ancona F, Spartera M, Italia L, Latib A, Colombo A, Margonato A, Agricola E, Scatena C, Mazzanti C, Conte L, Pugliese N, Barletta V, Bortolotti U, Naccarato AG, Di Bello V, Bala G, Roosens B, Hernot S, Remory I, Droogmans S, Cosyns B, Generati G, Labate V, Donghi V, Pellegrino M, Carbone F, Alfonzetti E, Guazzi M, Dabrowski R, Kowalik I, Firek B, Chwyczko T, Szwed H, Kawamura A, Kawano S, Zaroui A, Ben Said R, Ben Halima M, Kheder N, Farhati A, Mourali S, Mechmech R, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Polte CL, Lagerstrand K, Johnsson ÅA, Janulewicz M, Bech-Hanssen O, Gabriel H, Wisser W, Maurer G, Rosenhek R, El Aroussy W, Abdel Ghany M, Al Adeeb K, Ascione L, Carlomagno G, Sordelli C, Ferro A, Ascione R, Severino S, Caso P, Muraru D, Janei C, Haertel Miglioranza M, Cavalli G, Romeo G, Peluso D, Cucchini U, Iliceto S, Badano L, Armario Bel X, Garcia-Garcia C, Ferrer Sistach E, Rueda Sobella F, Oliveras Vila T, Labata Salvador C, Serra Flores J, Lopez-Ayerbe J, Bayes-Genis A, Conte E, Gonella A, Morena L, Civelli D, Losardo L, Margaria F, Riva L, Tanga M, Carminati C, Muratori M, Gripari P, Ghulam Ali S, Fusini L, Vignati C, Bartorelli AL, Alamanni F, Pepi M, Rosa I, Stella S, Marini C, Spartera M, Latib A, Montorfano M, Colombo A, Margonato A, Agricola E, Ismaiel A, Ali N, Amry S, Serafin A, Kochanowski J, Filipiak KJ, Opolski G, Speranza G, Ando' G, Magaudda L, Cramer GE, Bakker J, Michels M, Dieker HJ, Fouraux MA, Marcelis CLM, Timmermans J, Brouwer MA, Kofflard MJM, Vasconcelos M, Araujo V, Almeida P, Sousa C, Macedo F, Cardoso JS, Maciel MJ, Voilliot D, Huttin O, Venner C, Olivier A, Villemin T, Deballon R, Manenti V, Juilliere Y, Selton-Suty C, Generati G, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Dabrowska-Kugacka A, Dorniak K, Lewicka E, Szalewska D, Kutniewska-Kubik M, Raczak G, Kim KH, Yoon HJ, Park HJ, Ahn Y, Jeong MH, Cho JG, Park JC, Kim JH, Galli E, Habib G, Schnell F, Lederlin M, Daubert JC, Mabo P, Donal E, Faria R, Magalhaes P, Marques N, Domingues K, Lourenco C, Almeida AR, Teles L, Picarra B, Azevedo O, Lourenco C, Oliveira M, Magalhaes P, Domingues K, Marmelo B, Almeida A, Picarra B, Faria R, Marques N, Bento D, Lourenco C, Magalhaes P, Cruz I, Marmelo B, Reis L, Picarra B, Faria R, Azevedo O, Gimaev RH, Melnikova MA, Olezov NV, Ruzov VI, Goncalves P, Almeida MS, Branco P, Carvalho MS, Dores H, Gaspar MA, Sousa H, Andrade MJ, Mendes M, Makavos G, Varoudi M, Papadavid E, Andreadou I, Gravanis K, Liarakos N, Pavlidis G, Rigopoulos D, Lekakis J, Deluyker D, Bito V, Pigatto E, Romeo G, Muraru D, Cozzi F, Punzi L, Iliceto S, Badano LP, Pigatto E, Romeo G, Muraru D, Cozzi F, Iliceto S, Badano LP, Neilan T, Coen K, Gannon S, Bennet K, Clarke JG, Solari M, Cameli M, Focardi M, Corrado D, Bonifazi M, Henein M, Mondillo S, Gomez-Escalonilla C, De Agustin A, Egido J, Islas F, Simal P, Gomez De Diego JJ, Luaces M, Macaya C, Perez De Isla L, Zancanella M, Rusconi C, Musca F, Santambrogio G, De Chiara B, Vallerio P, Cairoli R, Giannattasio G, Moreo A, Alvarez Ortega C, Mori Junco R, Caro Codon J, Meras Colunga P, Ponz De Antonio I, Lopez Fernandez T, Valbuena Lopez S, Moreno Yanguela M, Lopez-Sendon JL, Surkova E, Bonanad-Lozano C, Lopez-Lereu MP, Monmeneu-Menadas JV, Gavara J, De Dios E, Paya-Chaume A, Escribano-Alarcon D, Chorro-Gasco FJ, Bodi-Peris V, Michalski BW, Miskowiec D, Kasprzak JD, Lipiec P, Morgado G, Caldeira D, Cruz I, Joao I, Almeida AR, Lopes L, Fazendas P, Cotrim C, Pereira H, De Block C, Buys D, Salgado R, Vrints C, Van Gaal L, Mctear C, Irwin RB, Dragulescu A, Friedberg M, Mertens L, Dragulescu A, Friedberg M, Mertens L, Carbone F, Generati G, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Krinochkin DV, Yaroslavskaya EI, Zaharova EH, Pushkarev GS, Sugihara C, Patel NR, Sulke AN, Lloyd GW, Piatkowski R, Scislo P, Grabowski M, Marchel M, Opolski G, Roland H, Hamadanchi A, Otto S, Jung C, Lauten A, Figulla HC, Poerner TC, Sampaio F, Fonseca P, Fontes-Carvalho R, Pinho M, Campos AS, Castro P, Fonseca C, Ribeiro J, Gama V, Heck R, Hamdanchi A, Otto S, Jung C, Lauten A, Figulla HR, Poerner TC, Ranjbar S, Ghaffaripour Jahromi M, Ranjbar S, Hinojar R, Fernandez Golfin C, Esteban A, Pascual-Izco M, Garcia-Martin A, Casas Rojo E, Jimenez-Nacher JJ, Zamorano JL, Gecmen C, Cap M, Izci S, Erdogan E, Onal C, Acar R, Bakal RB, Kaymaz C, Ozdemir N, Karvandi M, Ghaffaripour Jahromi M, Galand V, Schnell F, Matelot D, Martins R, Leclercq C, Carre F, Suran BC, Margulescu AD, Rimbas RC, Siliste C, Vinereanu D, Nocerino P, Urso AC, Borrino A, Carbone C, Follero P, Ciardiello C, Prato L, Salzano G, Marino F, Ruspetti A, Sparla S, Di Tommaso C, Loiacono F, Focardi M, D'ascenzi F, Henein M, Mondillo S, Porter J, Walker M, Lo Iudice F, Esposito R, Santoro C, Cocozza S, Izzo R, De Luca N, De Simone G, Trimarco B, Galderisi M, Gervasi F, Patti G, Mega S, Bono M, Di Sciascio G, Buture A, Badea R, Platon P, Ghiorghiu I, Jurcut R, Coman IM, Popescu BA, Ginghina C, Lunetta M, Spoto MS, Lo Vi AM, Pensabene G, Meschisi MC, Carita P, Coppola G, Novo S, Assennato P, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Havasi K, Domsik P, Kalapos A, Forster T, Piros GA, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Bulbul Z, Issa Z, Al Sehly A, Pergola V, Oufi S, Conde Y, Cimino E, Rinaldi E, Ashurov R, Ricci S, Pergolini M, Vitarelli A, Lujan Valencia JE, Chaparro M, Garcia-Guerrero A, Cristo Ropero MJ, Izquierdo Bajo A, Madrona L, Recio-Mayoral A, Monmeneu JV, Igual B, Lopez Lereu P, Garcia MP, Selmi W, Jalal Z, Thambo JB, Kosuta D, Fras Z. Poster session 5The imaging examinationP1097Correlation between visual and quantitative assessment of left ventricle: intra- and inter-observer agreementP1099Incremental prognostic value of late gadolinium-enhanced by cardiac magnetic resonance in patients with heart failureAnatomy and physiology of the heart and great vesselsP1100Left ventricular geometry and diastolic performance in erectile dysfunction patients; a topic of differential arterial stiffness influenceAssessment of diameters, volumes and massP1101Impact of the percutaneous closure of atrial septal defect on the right heart "remodeling"P1102Left Ventricular Mass Indexation in Infants, Children and Adolescents: a Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical PracticeP1103Impact of trabecules while quantifying cardiac magnetic resonance exams in patients with systemic right ventricleP1104Detection of subclinical atherosclerosis by carotid intima-media thickness: correlation with leukocytes telomere shorteningAssessments of haemodynamicsP1105Flow redirection towards the left ventricular outflow tract: vortex formation is not affected by variations in atrio-ventricular delayAssessment of systolic functionP1106Reproducibility and feasibility of cardiac MRI feature tracking in Fabry diseaseP1107Normal left ventricular strain values by two-dimensional strain echocardiography; result of normal (normal echocardiographic dimensions and functions in korean people) studyP1108Test-retest repeatability of global strain following st-elevation myocardial infarction - a comparison of tagging and feature trackingP1109Cardiotoxicity induced by tyrosine kinase inhibitors in patients with gastrointestinal stromal tumors (GIST)P1110Finite strain ellipses for the analysis of left ventricular principal strain directions using 3d speckle tracking echocardiographyP1111Antihypertensive therapy reduces time to peak longitudinal strainP1112Right ventricular systolic function as a marker of prognosis after inferior myocardial infarction - 5-year follow-upP1113Is artery pulmonary dilatation related with right but also early left ventricle dysfunction in pulmonary artery hypertension?P1114Right ventricular mechanics changes according to pressure overload increasing, a 2D-speckle tracking echocardiographic evaluationAssessment of diastolic functionP1115Paired comparison of left atrial strain from P-wave to P-wave and R-wave to R-waveP1116Diagnostic role of Tissue Doppler Imaging echocardiographic criteria in obese heart failure with preserved ejection fraction patientsP1117Evaluation of diastolic function of right ventricle in idiopathic pulmonary arterial hypertensionP1118Severity and predictors of diastolic dysfunction in a non-hypertensive non-ischemic cohort of Egyptian patients with documented systemic autoimmune disease; pilot reportP1119correlation between ST segment shift and cardiac diastolic function in patients with acute myocardial infarctionIschemic heart diseaseP1120Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)P1121Utility of transmural myocardial mechanic for early infarct size prediction after primary percutaneous coronary intervention in STEMI patientsP1122Progressive Improvements of the echocardiographic deformation parameters in ST Elevation Myocardial Infarction after five years follow-upP1123Long-term prognostic value of left ventricular dyssynchrony as assessed by cardiac magnetic resonance feature-tracking imaging after a first st-segment elevation myocardial infarctionP1124Differences in mitral annulus remodeling in acute anterior ST elevation and acute inferior ST elevation myocardial infarctionP1125Reduction of microvascular injury using a novel theragnostic ultrasound strategy: a first in men feasibility and safety studyP1126Impact of focused echocardiography in clinical decision of patient presented with st elevation myocardial infarction underwent primary angioplastyHeart valve DiseasesP1127Aortic valve area calculation in aortic stenosis: a comparison among conventional and 3D-transesophageal echocardiography and computed tomographyP1128Myocardial fibrosis and microRNA-21 expression in patients with severe aortic valve stenosis and preserved ejection fraction: a 2D speckle tracking echocardiography, tissutal and plasmatic studyP1129Quantification of calcium amount in a new experimental model: a comparison between calibrated integrated backscatter of ultrasound and computed tomographyP1130Altered diffusion capacity in aortic stenosis: role of the right heartP1131Osteoprotegerin predicts all-cause mortality in calcific aortic stenosis patients with preserved left ventricle ejection fraction in long term observationP1132Mitral regurgitation as a risk factor for pulmonary hypertension in patients with aortic stenosisP1133The relationship between the level of plasma B-type natriuretic peptide and mitral stenosisP1134Aortic regurgitation, left ventricle mechanics and vascular load: a single centre 2d derived-speckle tracking studyP1135Feasibility and reproducibility issues limit the usefulness of quantitative colour Doppler parameters in the assessment of chronic aortic and mitral regurgitation severityP1136Predictors of postoperative outcome in degenerative mitral regurgitationP1137Left ventricular mechanical dyssynchrony in patients with severe mitral regurgitation of rheumatic etiology; three dimensional echocardiography studyP1138Functional mitral regurgitation and left atrial dysfunction concur in determining pulmonary hypertension and functional status in subjects with left ventricular systolic dysfunctionP11393D echocardiography allows more effective quantitative assessment of the severity of functional tricuspid regurgitation than conventional 2D/Doppler echocardiographyP1140Prosthetic valve thrombosis: still a severe disease? 10-years experience in a university hospitalP1141Validity of echocardiography in the hospital course of patients with feverP1142Do baseline 3DTEE characteristics of mitral valve apparatus predict long term result in patients undergoing percutaneous valve repair for degenerative regurgitation?P1143Influence of baseline aortic regurgitation on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP1144Prevalence of echocardiography detected significant valvular regurge in subclinical rheumatic carditis in assiut childrenCardiomyopathiesP1145Can we early detect left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy using global longitudinal strain assessment?P1146Prevalence of isolated papillary muscle hypertrophy in young competitive athletesP1147Troponin release after exercise in patients with hypertrophic cardiomyopathy: associations with clinical and mr imaging characteristicsP1148Atrial fibrillation in hypertrophic cardiomyopathy: can we score the risk?P1149Impact of hypertrophy on multiple layer longitudinal deformation in hypertrophy cardiomyopathy and cardiac amyloidosis compared to controlsP1150Functional evaluation in hypertrophic cardiomyopathy combining cardiopulmonary exercise testing combined with exercise-echocardiographyP1151Refinement of the old diagnostic criteria of left ventricular noncompaction cardiomyopathy (LVNC) based on cardiac magnetic resonance (CMR)P1152Differences of clinical characteristics and outcomes between acute myocarditis with preserved and reduced left ventricular systolic functionP1153Value of longitudinal strain for distinguishing left ventricular non-compaction from idiopathic dilated cardiomyopathyP1154Speed of recovery of left ventricular function is not related to the prognosis of Takotsubo cardiomyopathy. A Portuguese multicentre studyP1155Predictors of in-hospital left ventricular systolic function recovery after admission with takotsubo cardiomyopathy. Portuguese multicentre studyP1156Mid-ventricular takotsubo detected by initial echocardiogram associates with recurrence of takotsubo cardiomyopathy - a portuguese multicentre studySystemic diseases and other conditionsP1157Relations between left ventricle remodelling and expression of angiotensin 2 AT2R1 geneP1158Impact of renal denervation on long-term blood pressure variability and surrogate markers of target organ damage in individuals with drug-resistant arterial hypertensionP1159Greater improvement of coronary artery function, left ventricular deformation and twisting by IL12/23 compared to TNF-a inhibition in psoriasisP1160Advanced glycation end products play a role in adverse LV remodeling following MIP1161Incidence of subclinical myocardial dysfunction in patients with systemic sclerosis and normal left ventricular systolic and diastolic functionP1162Left atrial remodeling and dysfunction occur early in patients with systemic sclerosis and normal left ventricular functionP1163Intrinsic vortex formation : a unique performance indicatorP1164P-wave morphology is unaffected by training-induced biatrial dilatation: a prospective, longitudinal study in healthy athletesP1165Usefulness of transthoracic echocardiography in diagnosis of young patients with ischemic strokeP1166Primary cardiac lymphoma: role of echocardiography in the clinical managementP1167Abnormal echocardiographic findings in cancer patients before chemotherapyMasses, tumors and sources of embolismP1168Three-dimensional transesophageal echocardiography of the left atrial appendage reduces rate of postpone electrical cardioversionP1169Detection of ventricular thrombus by cmr after reperfused st-segment elevation myocardial infarction correlated with echocardiographyP1170Clinical and transthoracic echocardiographic predictors of left atrial appendage thrombus in patients with atrial fibrillationStress echocardiographyP1171Pharmacological stress echocardiography complications: a 4-year single center experienceP1172Myocardial functional and perfusion reserve in type I diabetesP1173Feasibility of incorporating 3D Dobutamine stress echocardiography into routine clinical practiceP1174Right ventricular isovolumic acceleration at rest and during exercise in children after heart transplantP1175Right ventricular systolic and diastolic response to exercise in children after heart transplant -a bicycle exercise studyP1176Determinants of functional capacity in heart failure patients with reduced ejection fractionP1177Handgrip stress echocardiography with emotional component compared to conventional isometric exercise in coronary artery disease diagnosisP1178The relationship between resting transthoracic echocardiography and exercise capacity in patients with paroxysmal atrial fibrillationP1179Correlation between NT-proBNP and selected echocardiography parameters at rest and after exercise in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatmentReal-time three-dimensional TEEP1180Vena contracta area for severity grading in functional and degenerative mitral regurgitation: A study based on transesophageal 3D colour Doppler in 419 patientsP1181Proximal flow convergence by 3D echocardiography in the evaluation of mitral valve area in rheumatic mitral stenosisP1182Quantification of valve dimensions by transesophageal 3D echocardiography in patients with functional and degenerative mitral regurgitationTissue Doppler and speckle trackingP1183Automatic calculation of left ventricular volume changes over a cardiac cycle from echocardiography images by nonlinear dimensionality reductionP1184Effect of the mitral valve repairs on the left ventricular blood flow formationP1185Quantification of left atrial strain using cardiovascular magnetic resonance. a comparison between hypertrophic cardiomyopathy and healthy controlsP1186The role of early systolic lengthening in patients with non-ST elevation acute coronary syndrome and its relation to syntax scoreP1187Different standard two dimensional strain methods to quantity left ventricular mechanicsP1188Atrial function and electrocardiography caracteristics in sportsmen with or without paroxysmal atrial fibrillationP1189Right ventricular outflow premature contractions induce regional left ventricular dysfunctionP1190Ultrasound guided venous access for pacemaker and defibrillators. Randomized TrialP1191Atrial function analysis correlates with symptoms and quality of life of heart failure patientsP1192The use of tissue doppler echocardiography in myocardial iron overload in patients with thalassaemia majorP1193Independent association between pulse pressure and left ventricular global longitudinal strainP1194Global and regional longitudinal strain identifies the presence of coronary artery disease in patients with suspected reduction of coronary flow reserve and absence of wall motion abnormalitiesP1195Prognostic value of invasive and noninvasive parameters of right ventricular function in patients with pulmonary arterial hypertension receiving specific vasodilator therapyP1196Myocardial deformation analysis to improve arrhythmic risk stratificationP1197Quantitative assessment of regional systolic and diastolic function parameters for detecting prior transient ischemia in normokinetic segmentsP1198Left atrial function in patients with corrected tetralogy of Fallot - a three-dimensional speckle-tracking echocardiographic studyP1199Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiographyP1200Acute angulation of the aortic arch late after the arterial switch operation for transposition of the great arteries: impact on cardiac mechanicsP1201Circumferential deformation of the ascending thoracic aorta in hypertensive patients by three-dimensional speckle tracking echocardiographyCardiac Magnetic ResonanceP1202The incremental value of cardiac magnetic resonance on diagnosis myocardial infarction and non-obstructed coronary arteriesP1204Reference ranges of global and regional myocardial T1 values derived from MOLLI and shMOLLI at 3TComputed Tomography & Nuclear CardiologyP1205Deformation of the left atrial appendage after percutaneous closure with the Amplatzer cardiac plugP1206Prognostic impact of non-obstructive coronary artery disease on coronary computed tomographic angiography: A single-center study. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fabbrocini G, Izzo R, Faggiano A, Del Prete M, Donnarumma M, Marasca C, Marciello F, Savastano R, Monfrecola G, Colao A. Low glycaemic diet and metformin therapy: a new approach in male subjects with acne resistant to common treatments. Clin Exp Dermatol 2015; 41:38-42. [DOI: 10.1111/ced.12673] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- G. Fabbrocini
- Department of Clinical Medicine and Surgery; Section of Clinical Dermatology; University of Naples Federico II; Naples Italy
| | - R. Izzo
- Department of Clinical Medicine and Surgery; Section of Clinical Dermatology; University of Naples Federico II; Naples Italy
| | - A. Faggiano
- Department of Molecular and Clinical Endocrinology and Oncology; University of Naples Federico II; Naples Italy
| | - M. Del Prete
- Department of Molecular and Clinical Endocrinology and Oncology; University of Naples Federico II; Naples Italy
| | - M. Donnarumma
- Department of Clinical Medicine and Surgery; Section of Clinical Dermatology; University of Naples Federico II; Naples Italy
| | - C. Marasca
- Department of Clinical Medicine and Surgery; Section of Clinical Dermatology; University of Naples Federico II; Naples Italy
| | - F. Marciello
- Department of Molecular and Clinical Endocrinology and Oncology; University of Naples Federico II; Naples Italy
| | | | - G. Monfrecola
- Department of Clinical Medicine and Surgery; Section of Clinical Dermatology; University of Naples Federico II; Naples Italy
| | - A. Colao
- Department of Molecular and Clinical Endocrinology and Oncology; University of Naples Federico II; Naples Italy
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Abstract
The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic pain, much more difficult to treat. The clinical assessment of pain source can be a challenge because of the complex anatomy and function of the spine; the advanced imaging methods are often not sufficient for a definitive diagnosis because similar findings could be present in either asymptomatic and symptomatic subjects: a clinical correlation is always mandatory and the therapy cannot rely uniquely upon any imaging abnormalities. Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. Special attention will be done to the discogenic pain, actually considered as the most frequent cause of chronic low back pain.
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Affiliation(s)
- R Izzo
- Neuroradiology Department, A. Cardarelli Hospital, Naples, Italy.
| | - T Popolizio
- Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg), Italy.
| | - P D'Aprile
- Neuroradiology Department, San Paolo Hospital, Bari, Italy.
| | - M Muto
- Neuroradiology Department, A. Cardarelli Hospital, Napoli, Italy.
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Fabbrocini G, De Vita V, Izzo R, Monfrecola G. The use of skin needling for the delivery of a eutectic mixture of local anesthetics. GIORN ITAL DERMAT V 2014; 149:581-585. [PMID: 25213385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The use of skin needling is believed to aid the transdermal delivery of drugs, even if it is mostly used for skin collagen induction. The aim of this paper was to use skin needling, combined with a local anesthetic EMLA (eutectic mixture of lidocaine and prilocaine), as a way to enhance transdermal drug penetration and optimize the analgesic effects of common local anesthesia. METHODS We recruited 15 patients. For each patient of our study we defined a skin area of 3 cm2 from two forearms: on one side, we used skin needling first and immediately thereafter applied the EMLA in occlusion for 60 minutes; on the other one, we only applied EMLA in occlusion for 60 minutes. Then, pain was induced in each patient's forearm by introducing a 27 G needle into the skin 4 mm deep three times. Lastly, pain sensation measures were registered and a middle value was calculated. RESULTS When skin needling is used in conjunction with EMLA applied in occlusion for 60 minutes on skin forearms, the level of pain sensation registered was significantly reduced on a Visual Analogue Scale compared to the application of EMLA alone. CONCLUSION The use of skin needling can improve the transdermal delivery of an emulsion-like eutectic mixture of local anesthetics (EMLA) and can introduce the use of this method for delivering topical molecules in dermatology.
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Affiliation(s)
- G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy -
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Di Fusco D, Izzo R, Figliuzzi MM, Pallone F, Monteleone G. IL-21 as a therapeutic target in inflammatory disorders. Expert Opin Ther Targets 2014; 18:1329-38. [DOI: 10.1517/14728222.2014.945426] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Fabbrocini G, Cameli N, Lorenzi S, De Padova MP, Marasca C, Izzo R, Monfrecola G. A dietary supplement to reduce side effects of oral isotretinoin therapy in acne patients. GIORN ITAL DERMAT V 2014; 149:441-445. [PMID: 25068233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The purpose of the study was to analyze the potential capacity of a dietary supplement, based on gamma linolenic acid, vitamin E, vitamin C, beta-carotene, coenzyme Q10 and Vitis Vitifera, to reduce side effects, in particular the dry skin, erythema and desquamation, due to treatment with oral isotretinoin, and evaluate the ability of the product to increase adherence to therapy in patients with acne. METHODS Forty-eight patients with nodular acne (32 females and 16 males) were randomly divided into 2 groups: 24 received isotretinoin therapy (20-30 mg/day) for 6 months associated to dietary supplement (twice a day), while the other 24 patients received only isotretinoin (20-30 mg/day) for 6 months. For all patients the degree of acne severity, through GAGS (Global Acne Grading System), the sebum production by Sebutape, the hydration by Corneometer and the erythema by Mexameter, were measured. We have also evaluated the adherence to treatment, asking to patients how many days a week they follow the therapy. RESULTS Patients treated with dietary supplement had lower side effects, with a less degree of erythema and dryness, and greater degree of hydration; a greater adherence to therapy was also reported. CONCLUSION Thanks to antioxidant and moisturizing properties, the dietary supplement containing gamma linolenic acid, vitamin E, vitamin C, betacarotene, coenzyme Q10 and Vitis Vitifera, can be considered a useful supplement in the treatment and prevention of dry skin associated with the use of oral isotretinoin.
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Affiliation(s)
- G Fabbrocini
- Section of Clinical Dermatology Allergology and Venereology, Department of Clinical Medicine and Surgery University of Naples Federico II, Naples, Italy -
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Izzo R, de Simone G, Trimarco V, Giudice R, De Marco M, Di Renzo G, De Luca N, Trimarco B. Primary prevention with statins and incident diabetes in hypertensive patients at high cardiovascular risk. Nutr Metab Cardiovasc Dis 2013; 23:1101-1106. [PMID: 23419735 DOI: 10.1016/j.numecd.2012.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 10/25/2012] [Accepted: 11/01/2012] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND AIMS The ESC/ESH guidelines for arterial hypertension recommend using statins for patients with high cardiovascular (CV) risk for both secondary and primary prevention. A recent meta-analysis, combining previous studies on statins, concluded that they are associated with a 9% increased risk of incident type 2 diabetes mellitus (DM). There is no information on whether statins increase incidence of DM in primary prevention. METHOD AND RESULTS We evaluated risk of incident DM in relation to statin prescription in 4750 hypertensive, non-diabetic outpatients (age 58.57 ± 9.0 yrs, 42.3% women), from the CampaniaSalute Network, without chronic kidney disease more than grade 3, free of prevalent CV disease and with at least 12 months of follow-up. DM was defined according to ADA criteria. At the end of follow-up period (55.78 ± 42.5 months), 676 patients (14%) were on statins. These patients were older (62.54 ± 7.3 vs 57.91 ± 9.1 yrs; p < 0.0001), more often female (49% vs 41.2%; p = 0.0001), with higher initial total cholesterol (217.93 ± 44.3 vs 205.29 ± 36.6 mg/dl), non-HDL cholesterol (167.16 ± 44.5 vs 155.18 ± 36.7 mg/dl) and triglycerides (150.69 ± 85.2 vs 130.98 ± 72.0 mg/dl; all p < 0.0001) than patients no taking statins, without other differences in clinical and laboratory characteristics. At the end of follow-up, prevalence of DM was 18.1% among patients on statins and 7.2% among those without lipid-lowering therapy (p < 0.0001). However, incident DM was 10.2% in patients on statins and 8.7% in those free of statin therapy (NS). CONCLUSION In real-life outpatient environment, statin prescription for primary prevention is not associated with increased risk of incident DM.
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Affiliation(s)
- R Izzo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
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de Simone G, Izzo R, De Luca N, Gerdts E. Left ventricular geometry in obesity: Is it what we expect? Nutr Metab Cardiovasc Dis 2013; 23:905-912. [PMID: 24095148 DOI: 10.1016/j.numecd.2013.06.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 06/17/2013] [Accepted: 06/27/2013] [Indexed: 02/04/2023]
Abstract
Obesity is characterized by the disproportionate growth of the components of body size, including adipose tissue and lean body mass. Left ventricular (LV) hypertrophy often develops, due to the coexistence of hemodynamic (cardiac workload) and non-hemodynamic components (including body composition and activity of visceral fat). While the hypertrophy of cardiomyocytes is produced by the hemodynamic load, through sarcomeric replication, there is a parallel growth of non-muscular myocardial components, including interstitial fat infiltration and accumulation of triglycerides in the contractile elements, which are thought to influence LV geometric pattern. Thus, pure intervention on hemodynamic load is unlikely to result in effective reduction of LV hypertrophy in obese. We review pathophysiology and prevalence of LV hypertrophy in obesity, with specific attention to LV geometric abnormalities and relations with body size.
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Affiliation(s)
- G de Simone
- The Hypertension Center, Department of Translational Medical Sciences, Federico II University Hospital, via S. Pansini 5 bld 1, 80131 Naples, Italy.
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Izzo R, De Simone G, Trimarco V, Gerdts E, Giudice R, Manzi MV, Falomi E, De Luca N, Trimarco B. Hypertensive target organ damage predicts incident diabetes mellitus. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.2889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Casalnuovo G, Gerdts E, Simone GD, Izzo R, Marco MD, Giudice R, Trimarco B, Luca ND. Arterial stiffness is associated with carotid atherosclerosis in hypertensive patients (the Campania Salute Network). Am J Hypertens 2012; 25:739-45. [PMID: 22513830 DOI: 10.1038/ajh.2012.38] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Pulse pressure/stroke volume indexed to height(2.04) (PP/SVi) is a validated measure of arterial stiffness, but its relation to carotid atherosclerosis is unknown. METHODS Clinical, echocardiographic, and carotid ultrasound data from 6,209 hypertensive patients without prevalent cardiovascular (CV) disease in the Campania Salute Network were analyzed. The population was grouped into tertiles of PP/SVi. From carotid ultrasound, peak and mean intima-media thickness (IMT) and presence of carotid plaques in the common and internal carotid arteries were reported. RESULTS Increasing PP/SVi tertile was associated with a parallel increase in age, blood pressure, total serum cholesterol and the number of antihypertensive drugs used (all P < 0.01). Higher PP/SVi was also associated with greater peak and mean IMT (all P < 0.01), also when adjusting for age, gender, blood pressure, lipid profile, and diabetes mellitus (all P < 0.01). Similarly, compared to the lower PP/SVi tertile, the multiple adjusted prevalence ratio of carotid plaque was 7 (95% confidence interval (CI) 1-13, P < 0.03) in the middle tertile and 21 (95% CI 15-28, P < 0.0001) in the upper tertile, independently of confounders. CONCLUSION In treated hypertensive patients participating in the Campania Salute Network, higher PP/SVi is associated with carotid atherosclerosis independent of well-known clinical confounders.
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Capua MD, Minno MNDD, Guida A, Loffredo M, Cuccaro C, Coppola A, Izzo R, Palmieri NM, Crispo A, Cerbone AM, Minno GD. Coronary artery disease, cerebral non-fatal ischemic stroke in retinal vein occlusion: an 8-yr follow-up. Nutr Metab Cardiovasc Dis 2012; 22:23-27. [PMID: 20674314 DOI: 10.1016/j.numecd.2010.03.008] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 02/04/2010] [Accepted: 03/22/2010] [Indexed: 11/26/2022]
Abstract
Forty-five consecutive subjects (26M, 19F; mean age 54 ± 14 yrs) with a diagnosed retinal vein occlusion (RVO), were followed-up for 8 yrs. As many as 145 sex-age- and blood pressure-matched individuals (78M, 67F; mean age 54.4 ± 13.5 yrs), that did not experience any vascular event, served as controls. At the time of the RVO, controls and subjects did not differ as to hypercholesterolemia, hypertrigliceridemia, diabetes mellitus, smoking habits, inherited/acquired thrombophilia. At the follow-up completion, they differed as to statin consumption (p = 0.016). During the 8-yrs follow-up, in the control population, 11 out of 145 (7.6%) subjects had experienced a major vascular event (8 coronary artery disease; 3 cerebral non-fatal ischemic stroke). In contrast, of the 45 subjects with a history of RVO, as many as 10 (22.2%) had experienced a major vascular event: 4 coronary artery disease; 4 cerebral non-fatal ischemic stroke; 2 cardiovascular + cerebrovascular event (p = 0.012). A prolonged antiplatelet treatment, prior to the major vascular event, was found in 5/45 cases (11.1%) vs 23/145 (15.9%) controls (p = 0.63). In contrast, a long-lasting administration of anti-hypertensive drugs, to achieve a control of blood pressure, was found in 83.4% of controls and only in 46.7% of cases (p < 0.0001). In conclusion, in a 8-yr follow-up, coronary artery disease and/or non-fatal ischemic stroke were more common in subjects with a history of RVO than in a large setting of subjects comparable for cardiovascular risk factors. These data also argue for RVO as a vascular disease in which aggressive anti-hypertensive therapy to prevent stroke and/or myocardial infarction is needed.
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Affiliation(s)
- M Di Capua
- Dept. of Clinical and Experimental Medicine, Regional Reference Centre for Coagulation Disease, Federico II University, Via Pansini 5, Naples, Italy.
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Tarchoune I, Sgherri C, Izzo R, Lachaal M, Ouerghi Z, Navari-Izzo F. Antioxidative responses of Ocimum basilicum to sodium chloride or sodium sulphate salinization. Plant Physiol Biochem 2010; 48:772-7. [PMID: 20580239 DOI: 10.1016/j.plaphy.2010.05.006] [Citation(s) in RCA: 28] [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] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 05/25/2010] [Accepted: 05/26/2010] [Indexed: 05/25/2023]
Abstract
Soils and ground water in nature are dominated by chloride and sulphate salts. There have been several studies concerning NaCl salinity, however, little is known about the Na(2)SO(4) one. The effects on antioxidative activities of chloride or sodium sulphate in terms of the same Na(+) equivalents (25 mM Na(2)SO(4) and 50 mM NaCl) were studied on 30 day-old plants of Ocimum basilicum L., variety Genovese subjected to 15 and 30 days of treatment. Growth, thiobarbituric acid reactive substances (TBARS), relative ion leakage ratio (RLR), hydrogen peroxide (H(2)O(2)), ascorbate and glutathione contents as well as the activities of ascorbate peroxidase (APX, EC 1.11.1.11); glutathione reductase (GR, EC 1.6.4.2) and peroxidases (POD, EC 1.11.1.7) were determined. In leaves, growth was more depressed by 25 mM Na(2)SO(4) than 50 mM NaCl. The higher sensitivity of basil to Na(2)SO(4) was associated with an enhanced accumulation of H(2)O(2), an inhibition of APX, GR and POD activities (with the exception of POD under the 30-day-treatment) and a lower regeneration of reduced ascorbate (AsA) and reduced glutathione (GSH). However, the changes in the antioxidant metabolism were enough to limit oxidative damage, explaining the fact that RLR and TBARS levels were unchanged under both Na(2)SO(4) and NaCl treatment. Moreover, for both salts the 30-day-treatment reduced H(2)O(2) accumulation, unchanged RLR and TBARS levels, and enhanced the levels of antioxidants and antioxidative enzymes, thus achieving an adaptation mechanism against reactive oxygen species.
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Affiliation(s)
- I Tarchoune
- Physiologie et Biochimie de la Tolérance au Sel des Plantes, Faculté des Sciences de Tunis, Campus Universitaire, 1060 Tunis, Tunisia.
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Guarnieri G, Lavanga A, Granato F, Vassallo P, Cavaliere C, Capobianco E, Izzo R, Ambrosanio G, Muto M. Endovascular treatment of a fusiform cerebral aneurysm by stenting alone. Two case reports and literature review. Neuroradiol J 2010; 23:368-75. [PMID: 24148601 DOI: 10.1177/197140091002300320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 04/04/2010] [Indexed: 11/16/2022] Open
Abstract
This paper illustrates two cases of stent-in-stenting treatment of unruptured, symptomatic, fusiform intracerebral aneurysms. Two unruptured symptomatic fusiform intracerebral aneurysms were treated by the stent-in-stent only technique. The first patient, a 35-year-old woman, had a partially thrombosed fusiform aneurysm in the left carotid siphon with the chief complaint of headache and left ophthalmoplegia. The second patient, a 60-year-old man, had a symptomatic fusiform aneurysm of the left V4 with recurrent transient ischemic attacks. No cervical trauma or infection was present in either patient. A CT, CTA and DSA were performed on hospital admission. Both patients were previously premedicated with Clopidrogel + ASA for five days before treatment. By DSA, both patients were treated under general anesthesia with a heparin protocol plus ASA (500mg) at stent placement. A double stent-in stent was placed in both patients. Post-intervention medical therapy was clopridogel and ASA for three months, then aspirin (100mg) daily for six months. CTA and DSA were performed at six and 12 months. Both stents were positioned without any difficulty and could be navigated within cerebral arteries without any exchange procedure, and thanks to their retractability, they were accurately positioned. No bleeding at post-treatment CT was noted. At 12 months follow-up, a complete disappearance of the aneurysm and preservation of the parent vessel was observed for both patients. No procedure-related complication occurred. No intra-stent stenosis or intimal hyperplasia was observed. Stenting for fusiform aneurysms is a safe procedure without complications. Medical therapy pre-post procedure associated with follow-up is necessary to prevent/establish the incidence of occlusion.
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Affiliation(s)
- G Guarnieri
- Neuroradiology Service, Cardarelli Hospital; Naples, Italy -
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Guarnieri G, Ambrosanio G, Vassallo P, Granato F, Setola FR, Greco B, Izzo R, Muto M. Combined Percutaneous and Endovascular Treatment of Symptomatic Aneurysmal Bone Cyst of the Spine: Clinical Six Months. Follow-up of Six Cases. Neuroradiol J 2010; 23:74-84. [PMID: 24148337 DOI: 10.1177/197140091002300113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 12/22/2009] [Indexed: 11/16/2022] Open
Abstract
We describe the usefulness of endovascular and direct percutaneous treatment as a therapy option for aneurysmal bone cysts (ABCs) of the spine. From January 2007 to December 2008, we treated six consecutive patients with symptomatic ABCs resistant to continuous medical management or with acute clinical onset of paraparesis at cervical, thoracic and lumbar spine level. Two patients were treated after emergency laminectomy. All patients were studied with an MRI protocol and multidetector CT with MPR reconstructions followed by angiographic control before treatment. The procedure was performed under general anaesthesia for all patients. Under CT or fluoroscopy guidance, percutaneous treatment was performed either by direct injection of Glubran(®) diluted at 30% with Lipiodol(®) only, or combined with endovascular treatment by Onyx® injection. Clinical and X-ray follow-up was performed at three and six months. Combined endovascular and percutaneous treatment for ABCs was successful and led to an excellent outcome in five out of six patients with clinical improvement. There were no periprocedural or subsequent clinical complications and the glue resulted in successful selective permanent occlusion with intralesional penetration. Direct sclerotherapy resulted in immediate thrombosis of the malformation with no progression of symptoms. Complete healing was observed in five out of six aggressive lesions. No major complications were noted. At six month follow-up the symptoms had completely resolved and X-ray control showed a partial or total sclerotic reaction of the lesion with stable clinical results (no partial or clinical abnormalities). One patient had a recurrence of the ABC with spinal cord cervical clinical symptomatology. Combined endovascular and percutaneous treatment or direct percutaneous sclerotherapy with glue alone are important, safe, effective therapy options for symptomatic aneurysmal bone cyst. Results are stable and confirmed by clinical and X-ray follow-up six months after treatment.
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Affiliation(s)
- G Guarnieri
- Neuroradiology Service, A. Cardarelli Hospital; Naples, Italy -
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