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Sancassiani F, Cossu G, Cantone E, Romano F, Perra A, Urban A, Pinna S, Del Giacco S, Littera R, Firinu D, Chessa L, Tramontano E, Nardi AE, Carta MG. The Stability of Social and Behavioral Rhythms and Unexpected Low Rate of Relevant Depressive Symptoms in Old Adults during the COVID-19 Pandemic. J Clin Med 2024; 13:2005. [PMID: 38610769 PMCID: PMC11012795 DOI: 10.3390/jcm13072005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/24/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The disruption of social rhythms was found to be associated with depressive disorders during the COVID-19 pandemic; lower rates of these disorders were surprisingly found in old adults. The present study aims to verify the stability of social rhythms during lockdown in a sample of elderly people. Methods: Controlled cohort study (secondary analyses) of a previous randomized-controlled trial with the first evaluation in April 2019 (T0) and then 48 weeks later (T1) during the lockdown. The regulation of social and behavioral rhythms was measured through the Brief Social Rhythms Scale (BSRS); the Patient Health Questionnaire-9 (PHQ9) was adopted to detect relevant depressive symptoms. Results: 93 elderlies (73.36 ± 4.97 years old, 50.5% females) were evaluated at T0 and T1. Neither the total score of BSRS nor any of the 10 items showed a statistically significant difference comparing the two survey periods. The frequency of relevant depressive symptoms was 5.3% at T0 and 6.4% at T1 (OR = 0.8, CI95% 0.2-24). Conclusions: Among elderlies who did not show an increased risk of depression during the lockdown, social and behavioral rhythms remained exceptionally stable during the same period. Considering previous evidence about rhythms dysregulation preceding depression, their stability may be considered a factor of resilience.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Roma, Italy;
| | - Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Antonio Urban
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
- University Hospital of Cagliari, 09124 Cagliari, Italy
| | - Samantha Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Roberto Littera
- Medical Genetics, “R. Binaghi” Hospital, 09126 Cagliari, Italy;
- AART-ODV (Association for the Advancement of Research on Transplantation), 09131 Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
| | - Enzo Tramontano
- Department of Life and Environmental Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Antonio Egidio Nardi
- Institute of Psychiatry-IPUB, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil;
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.C.); (E.C.); (A.P.); (A.U.); (S.P.); (S.D.G.); (D.F.); (L.C.); (M.G.C.)
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Sanna G, Marongiu A, Firinu D, Piras C, Palmas V, Galdiero M, Atzori L, Caria P, Campagna M, Perra A, Costanzo G, Coghe F, Littera R, Chessa L, Manzin A. Humoral responses to wild type and ancient BA.1 SARS-CoV-2 variant after heterologous priming vaccination with ChAdOx1 nCoV-19 and BNT162b2 booster dose. Clin Exp Med 2024; 24:12. [PMID: 38244064 PMCID: PMC10799790 DOI: 10.1007/s10238-023-01276-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/26/2023] [Indexed: 01/22/2024]
Abstract
Several countries have recommended a booster dose of Pfizer BNT162b2 vaccine for subjects under the age of 60, who have already received the first dose of ChAdOx1. This is due to several ChAdOx1 vaccine-associated adverse vascular events and thrombocytopenia. Neutralization assay and quantitative IgG anti-SARS-CoV-2 Spike antibody (anti-S-IgG) were conducted to investigate the long-term responses to vaccine treatment in a cohort of Sardinian participants, who have received heterologous Prime-Boost Vaccination via ChAdOx1 vector vaccine and a booster dose via BNT162b2. The obtained results were compared with those of a cohort of healthcare workers (HCW) who received homologous BNT162b2 (BNT/BNT/BNT) vaccination. One month (T2) and five months after the second and before the third dose (T3), anti-spike antibody or neutralizing titers in the subjects vaccinated with ChAdOx1-S/BNT162b2 were significantly higher than those who experienced the ChAdOx1-S/ChAdOx1-S or BNT162b2/BNT162b2 schedule. These results suggest that a ChAdOx1-S/BNT162b2 regimen provides a more robust antibody response than either of the homologous regimens. However, the anti-spike antibodies or neutralizing titers after the third injection (mRNA vaccine) of ChAdOx1-S as a second dose and BNT162b2 were not statistically different. Homologous and heterologous vaccination provided a strong antibody response. Neutralizing activities were also described against the Omicron BA.1 variant in a sub-group (40) representative of the three vaccination regimens among our cohort.
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Affiliation(s)
- Giuseppina Sanna
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy.
| | - Alessandra Marongiu
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy.
| | - Cristina Piras
- Clinical Metabolomics Unit, Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Vanessa Palmas
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Luigi Atzori
- Clinical Metabolomics Unit, Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Paola Caria
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Andrea Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Giulia Costanzo
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Ferdinando Coghe
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042, Monserrato, Italy
| | - Roberto Littera
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09100, Cagliari, Italy
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
| | - Aldo Manzin
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Cagliari, Italy
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Pasella M, Pisano F, Cannas B, Fanni A, Cocco E, Frau J, Lai F, Mocci S, Littera R, Giglio SR. Decision trees to evaluate the risk of developing multiple sclerosis. Front Neuroinform 2023; 17:1248632. [PMID: 37649987 PMCID: PMC10465164 DOI: 10.3389/fninf.2023.1248632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Multiple sclerosis (MS) is a persistent neurological condition impacting the central nervous system (CNS). The precise cause of multiple sclerosis is still uncertain; however, it is thought to arise from a blend of genetic and environmental factors. MS diagnosis includes assessing medical history, conducting neurological exams, performing magnetic resonance imaging (MRI) scans, and analyzing cerebrospinal fluid. While there is currently no cure for MS, numerous treatments exist to address symptoms, decelerate disease progression, and enhance the quality of life for individuals with MS. Methods This paper introduces a novel machine learning (ML) algorithm utilizing decision trees to address a key objective: creating a predictive tool for assessing the likelihood of MS development. It achieves this by combining prevalent demographic risk factors, specifically gender, with crucial immunogenetic risk markers, such as the alleles responsible for human leukocyte antigen (HLA) class I molecules and the killer immunoglobulin-like receptors (KIR) genes responsible for natural killer lymphocyte receptors. Results The study included 619 healthy controls and 299 patients affected by MS, all of whom originated from Sardinia. The gender feature has been disregarded due to its substantial bias in influencing the classification outcomes. By solely considering immunogenetic risk markers, the algorithm demonstrates an ability to accurately identify 73.24% of MS patients and 66.07% of individuals without the disease. Discussion Given its notable performance, this system has the potential to support clinicians in monitoring the relatives of MS patients and identifying individuals who are at an increased risk of developing the disease.
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Affiliation(s)
- Manuela Pasella
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Fabio Pisano
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Barbara Cannas
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Alessandra Fanni
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Eleonora Cocco
- Department of Medical Science and Public Health, Centro Sclerosi Multipla, University of Cagliari, Cagliari, Italy
| | - Jessica Frau
- Department of Medical Science and Public Health, Centro Sclerosi Multipla, University of Cagliari, Cagliari, Italy
| | - Francesco Lai
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services, University of Cagliari, Monserrato, Italy
| | - Roberto Littera
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Sabrina Rita Giglio
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services, University of Cagliari, Monserrato, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
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Pisano F, Cannas B, Fanni A, Pasella M, Canetto B, Giglio SR, Mocci S, Chessa L, Perra A, Littera R. Decision trees for early prediction of inadequate immune response to coronavirus infections: a pilot study on COVID-19. Front Med (Lausanne) 2023; 10:1230733. [PMID: 37601789 PMCID: PMC10433226 DOI: 10.3389/fmed.2023.1230733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Few artificial intelligence models exist to predict severe forms of COVID-19. Most rely on post-infection laboratory data, hindering early treatment for high-risk individuals. Methods This study developed a machine learning model to predict inherent risk of severe symptoms after contracting SARS-CoV-2. Using a Decision Tree trained on 153 Alpha variant patients, demographic, clinical and immunogenetic markers were considered. Model performance was assessed on Alpha and Delta variant datasets. Key risk factors included age, gender, absence of KIR2DS2 gene (alone or with HLA-C C1 group alleles), presence of 14-bp polymorphism in HLA-G gene, presence of KIR2DS5 gene, and presence of KIR telomeric region A/A. Results The model achieved 83.01% accuracy for Alpha variant and 78.57% for Delta variant, with True Positive Rates of 80.82 and 77.78%, and True Negative Rates of 85.00% and 79.17%, respectively. The model showed high sensitivity in identifying individuals at risk. Discussion The present study demonstrates the potential of AI algorithms, combined with demographic, epidemiologic, and immunogenetic data, in identifying individuals at high risk of severe COVID-19 and facilitating early treatment. Further studies are required for routine clinical integration.
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Affiliation(s)
- Fabio Pisano
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Barbara Cannas
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Alessandra Fanni
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Manuela Pasella
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | | | - Sabrina Rita Giglio
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Cagliari, Monserrato, Italy
| | - Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Cagliari, Monserrato, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Roberto Littera
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
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Carta MG, Orrù G, Littera R, Firinu D, Chessa L, Cossu G, Primavera D, Del Giacco S, Tramontano E, Manocchio N, Buonomo C, Scano A. Comparing the responses of countries and National Health Systems to the COVID-19 pandemic: a critical analysis with a case-report series. Eur Rev Med Pharmacol Sci 2023; 27:7868-7880. [PMID: 37667964 DOI: 10.26355/eurrev_202308_33442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
This review aimed to compare the different responses of countries to the pandemic, their National Health Systems, and their impact on citizens' health. This work aimed to create a narrative plot that connects different discussion points and suggests organizational solutions and strategic choices in the face of the pandemic. In particular, this work focused on public health organizations, specifically the European Union and vaccination politics. It is also based on a case report series (about the United States, Germany, Vietnam, New Zealand, Cuba, and Italy), where each country has responded differently to the pandemic in terms of political decisions such as vaccination type, information to citizens, dealings with independent experts, and other specific country factors. In comparing the various models of care systems response to the pandemic, it emerges that: we have found some (few) good practices, but without global coordination, and this is obviously not enough. It is now quite clear that there cannot be a "good answer" in a single nation. Uncoordinated local responses cannot counter a global phenomenon. The second point is that the general context must be considered from a strategic point of view. With the threat of new pandemics (but also of health disasters linked to climate change, pollution, and wars), humanity finds itself at the crossroads between investing in a "democratic" management of international bodies but without power (and at the mercy of the need for funds with consequent conflicts) or in some new leadership proposals that advocate efficiency and problem-solving (and that would probably be able to implement it) but that would place processes totally outside of the public's control.
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Affiliation(s)
- M G Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
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Mocci S, Littera R, Chessa L, Campagna M, Melis M, Ottelio CM, Piras IS, Lai S, Firinu D, Tranquilli S, Mascia A, Vacca M, Schirru D, Lecca LI, Rassu S, Cannas F, Sanna C, Carta MG, Sedda F, Giuressi E, Cipri S, Miglianti M, Perra A, Giglio S. A review of the main genetic factors influencing the course of COVID-19 in Sardinia: the role of human leukocyte antigen-G. Front Immunol 2023; 14:1138559. [PMID: 37342325 PMCID: PMC10277491 DOI: 10.3389/fimmu.2023.1138559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction A large number of risk and protective factors have been identified during the SARS-CoV-2 pandemic which may influence the outcome of COVID-19. Among these, recent studies have explored the role of HLA-G molecules and their immunomodulatory effects in COVID-19, but there are very few reports exploring the genetic basis of these manifestations. The present study aims to investigate how host genetic factors, including HLA-G gene polymorphisms and sHLA-G, can affect SARS-CoV-2 infection. Materials and Methods We compared the immune-genetic and phenotypic characteristics between COVID-19 patients (n = 381) with varying degrees of severity of the disease and 420 healthy controls from Sardinia (Italy). Results HLA-G locus analysis showed that the extended haplotype HLA-G*01:01:01:01/UTR-1 was more prevalent in both COVID-19 patients and controls. In particular, this extended haplotype was more common among patients with mild symptoms than those with severe symptoms [22.7% vs 15.7%, OR = 0.634 (95% CI 0.440 - 0.913); P = 0.016]. Furthermore, the most significant HLA-G 3'UTR polymorphism (rs371194629) shows that the HLA-G 3'UTR Del/Del genotype frequency decreases gradually from 27.6% in paucisymptomatic patients to 15.9% in patients with severe symptoms (X2 = 7.095, P = 0.029), reaching the lowest frequency (7.0%) in ICU patients (X2 = 11.257, P = 0.004). However, no significant differences were observed for the soluble HLA-G levels in patients and controls. Finally, we showed that SARS-CoV-2 infection in the Sardinian population is also influenced by other genetic factors such as β-thalassemia trait (rs11549407C>T in the HBB gene), KIR2DS2/HLA-C C1+ group combination and the HLA-B*58:01, C*07:01, DRB1*03:01 haplotype which exert a protective effect [P = 0.005, P = 0.001 and P = 0.026 respectively]. Conversely, the Neanderthal LZTFL1 gene variant (rs35044562A>G) shows a detrimental consequence on the disease course [P = 0.001]. However, by using a logistic regression model, HLA-G 3'UTR Del/Del genotype was independent from the other significant variables [ORM = 0.4 (95% CI 0.2 - 0.7), PM = 6.5 x 10-4]. Conclusion Our results reveal novel genetic variants which could potentially serve as biomarkers for disease prognosis and treatment, highlighting the importance of considering genetic factors in the management of COVID-19 patients.
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Affiliation(s)
- Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Roberto Littera
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, University Hospital, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Carla Maria Ottelio
- Anesthesia and Intensive Care Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Ignazio S. Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessia Mascia
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Isaia Lecca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefania Rassu
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Celeste Sanna
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Sedda
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Erika Giuressi
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Selene Cipri
- GeneMos-APS (Association for Social Advancement), Reggio Calabria, Italy
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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7
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Rodia R, Meloni PE, Mascia C, Balestrieri C, Ruggiero V, Serra G, Conti M, Loi M, Pes F, Onali S, Perra A, Littera R, Velluzzi F, Mariotti S, Chessa L, Boi F. Direct-acting antivirals used in HCV-related liver disease do not affect thyroid function and autoimmunity. J Endocrinol Invest 2023; 46:359-366. [PMID: 36048357 PMCID: PMC9859881 DOI: 10.1007/s40618-022-01909-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE It is well known that interferon-α (IFN-α), used for long time as the main therapy for HCV-related disease, induces thyroid alterations, but the impact of the new direct-acting antivirals (DAAs) on thyroid is not established. Aim of this prospective study was to evaluate if DAAs therapy may induce thyroid alterations. METHODS A total of 113 HCV patients, subdivided at the time of the enrollment in naïve group (n = 64) and in IFN-α group (n = 49) previously treated with pegylated interferon-α and ribavirin, were evaluated for thyroid function and autoimmunity before and after 20-32 weeks of DAAs. RESULTS Before starting DAAs, a total of 8/113 (7.1%) patients showed Hashimoto's thyroiditis (HT) all belonging to IFN-α group (8/49, 16.3%), while no HT cases were found in the naïve group. Overall, 7/113 (6.2%) patients were hypothyroid: 3/64 (4.7%) belonging to naïve group and 4/49 (8.2%) to IFN-α group. Furthermore, a total of 8/113 patients (7.1%) showed subclinical hyperthyroidism: 2/64 (3.1%) were from naïve group and 6/49 (12.2%) from IFN-α group. Interestingly, after DAAs therapy, no new cases of HT, hypothyroidism and hyperthyroidism was found in all series, while 6/11 (54.5%) patients with non-autoimmune subclinical thyroid dysfunction became euthyroid. Finally, the only association between viral genotypes and thyroid alterations was genotype 1 and hypothyroidism. CONCLUSIONS This study supports evidence that DAAs have a limited or missing influence on thyroid in patients with HCV-related diseases. Moreover, it provides preliminary evidence that subclinical non-autoimmune thyroid dysfunction may improve after HCV infection resolution obtained by DAAs.
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Affiliation(s)
- R Rodia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - P E Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Mascia
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - C Balestrieri
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - V Ruggiero
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - G Serra
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Conti
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - M Loi
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Pes
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Onali
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - A Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - R Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - F Velluzzi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - S Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - L Chessa
- Centre of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy
| | - F Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Azienda Ospedaliero-Universitaria di Cagliari, SS 554, Bivio per Sestu, 09042, Monserrato, Cagliari, Italy.
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8
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Littera R, Perra A, Miglianti M, Piras IS, Mocci S, Lai S, Melis M, Zolfino T, Balestrieri C, Conti M, Serra G, Figorilli F, Firinu D, Onali S, Matta L, Porcu C, Pes F, Fanni D, Manieli C, Vacca M, Cusano R, Trucas M, Cipri S, Tranquilli S, Rassu S, Cannas F, Carta MG, Kowalik MA, Giuressi E, Faa G, Chessa L, Giglio S. The double-sided of human leukocyte antigen-G molecules in type 1 autoimmune hepatitis. Front Immunol 2022; 13:1007647. [PMID: 36311782 PMCID: PMC9597675 DOI: 10.3389/fimmu.2022.1007647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
The immunomodulatory effects of HLA-G expression and its role in cancers, human liver infections and liver transplantation are well documented, but so far, there are only a few reports addressing autoimmune liver diseases, particularly autoimmune hepatitis (AIH).
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Affiliation(s)
- Roberto Littera
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ignazio S. Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Teresa Zolfino
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | | | - Maria Conti
- Liver Unit, University Hospital, Cagliari, Italy
| | | | - Francesco Figorilli
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Simona Onali
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Matta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Carmen Porcu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Fanni
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Cristina Manieli
- Department of Pathological Anatomy, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- Biomedical Sector, Center for Advanced Studies, Research and Development (CRS4), Cagliari, Italy
| | - Marcello Trucas
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Selene Cipri
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marta Anna Kowalik
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Gavino Faa
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, University Hospital, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Sabrina Giglio
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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9
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Carta MG, Orrù G, Peracchia A, Cossu G, Velluzzi F, Atzori L, Ferreli C, Ivan Aviles Gonzalez C, Romano F, Littera R, Puxeddu R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Scano A, Coghe F, Minerba L, Manconi M, Saba L. Differences in lethality and diffusion of Covid-19 in countries using different kinds of vaccines. J Public Health Res 2022; 11:22799036221107062. [PMID: 36105780 PMCID: PMC9465600 DOI: 10.1177/22799036221107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
To verify if lethality and diffusivity of Covid-19 correlated with percentage of
people vaccinated in different countries and whether results on these indicators
were comparable under different types of vaccines. A linear regression analysis
was conducted between vaccines/inhabitant, new cases/inhabitants and ratio
deaths/cases. A comparison between the three indicators was carried out in
countries subdivided by kind of vaccine. The proportion of
vaccinations/inhabitants correlates negatively with proportion of deaths × 100
cases (R = −3.90, p < 0.0001), but didn’t
on incidence of new cases. Countries with prevalence of mRNA vaccines were
similar to others on incidence of new cases; but a lower lethality of Sars-Cov2
was found than in countries with prevalence of viral vehicle vaccines
(F = 6.064, p = 0.0174) but didn’t against
countries with prevalence of inactivated vaccines. The higher is the proportion
of vaccine/inhabitant in a given country, the less is the fraction of infected
people who die.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Germano Orrù
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Ambra Peracchia
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Atzori
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Ferreli
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Ferdinando Romano
- Department of Hygiene and Preventive Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberto Littera
- Department of Medical Genetic, R. Binaghi Hospital of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Luigi Minerba
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Manconi
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
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10
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Aviles-Gonzalez CI, Scano A, Cossu G, Littera R, Campagna M, Deidda S, Romano F, Kalcev G, Firinu D, Meloni F, Carta MG, Del Giacco S, Restivo A, Zorcolo L, Marongiu L, Tamburini G, Maleci A, Orrù G, Chessa L, Brasesco MV. Verifying the Theory of Climate Affecting Lethality of COVID-19 by an Analysis in Two Climatic Zones of Chile. TOPHJ 2022; 15. [DOI: 10.2174/18749445-v15-e2204140] [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] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 09/22/2023]
Abstract
Introduction:
The study of seasonal influences on the COVID-19 pandemic can take advantage of the unique position of Chile and its different climatic profiles in the north-south extension. The purpose is to verify the influence of seasonal climate changes on the COVID-19 in the temperate and sub-arctic areas of Chile.
Methods:
We monitored the evolution of CFR in temperate versus sub-boreal regions, reporting from the John Hopkins University COVID-19 Center on the CFR in each province in midwinter, spring, and early summer.
Results:
CFR worsened from mid-winter to mid-spring in the temperate zone of Chile, while in the sub-boreal area the CFR improves in the same period, (Kruskal Wallis Test, p=0.004). In the temperate zone after the increase in late winter-early spring, CRF tends to stabilize; on the contrary in the sub-boreal zone, there is a more marked tendency to worsen the CFR at the same time (Kruskal Wallis Test, p=0.010). The temperate zone of Chile shows a CFR increasing until spring-like temperate Europe, unlike Europe CFR does not decrease in summer, but the mean minimum temperature in temperate Chile is lower in summer than in temperate Europe. In Patagonian, CFR remains stable or drops from winter to spring but increases in early summer.
Conclusion:
The temperate and sub-boreal zones of Chile have a markedly different CFR variation profile during the COVID-19 pandemic.
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11
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Firinu D, Fenu G, Sanna G, Costanzo GA, Perra A, Campagna M, Littera R, Locci C, Marongiu A, Cappai R, Melis M, Orrù G, Del Giacco S, Coghe F, Manzin A, Chessa L. Evaluation of humoral and cellular response to third dose of BNT162b2 mRNA COVID-19 vaccine in patients treated with B-cell depleting therapy. J Autoimmun 2022; 131:102848. [PMID: 35714496 PMCID: PMC9189114 DOI: 10.1016/j.jaut.2022.102848] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE to investigate the responses to mRNA COVID-19 vaccines in a cohort of immunosuppressed patients affected by immune-mediated inflammatory diseases (IMID). METHODS we have measured humoral and cellular immunity using quantitative IgG anti-SARS-CoV-2 Spike antibody (anti-S-IgG), neutralization assays and specific interferon-gamma (IFN-g) release assay (IGRA) before and after the third dose of BNT162b2. The response of those on anti-CD20 (n = 18) was then compared with healthy controls (HC, n = 18) and IMID naïve to anti-CD20 drugs (n = 13). RESULTS a third BNT162b2 dose is highly immunogenic in IMID patients naïve to anti-CD20, as 100% of the subjects seroconverted compared to the 55% in anti-CD20. The rate of IGRA response was of 79% in anti-CD20, 50% in IMID naïve to anti-CD20, 100% in HC. Among those who have seroconverted, IMID patients had significantly reduced anti-S-IgG and neutralization titers compared to HC, whereas no significant difference was observed when comparing anti-CD20 and HC. Furthermore, 13% of anti-CD20 and 7.7% of IMID were simultaneously negative for both neutralizing antibodies and IGRA after three doses. CONCLUSION these data draw attention to the immunogenicity of COVID-19 vaccination in treated IMID, taking specific groups into consideration for vaccination program.
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Affiliation(s)
- Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy.
| | - Giuseppe Fenu
- Department of Neuroscience, ARNAS Brotzu, 09100, Cagliari, Italy
| | - Giuseppina Sanna
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - Giulia A Costanzo
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
| | - Andrea Perra
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, 09100, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
| | - Roberto Littera
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09100, Cagliari, Italy
| | - Carlotta Locci
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
| | - Alessandra Marongiu
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - Riccardo Cappai
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042, Monserrato, Italy
| | - Maurizio Melis
- Department of Neuroscience, ARNAS Brotzu, 09100, Cagliari, Italy
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
| | - Ferdinando Coghe
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09100, Cagliari, Italy
| | - Aldo Manzin
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari. and Unit of Internal Medicine, Policlinico Universitario - AOU di Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, CA, Italy
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12
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Mocci S, Littera R, Tranquilli S, Provenzano A, Mascia A, Cannas F, Lai S, Giuressi E, Chessa L, Angioni G, Campagna M, Firinu D, Del Zompo M, La Nasa G, Perra A, Giglio S. A Protective HLA Extended Haplotype Outweighs the Major COVID-19 Risk Factor Inherited From Neanderthals in the Sardinian Population. Front Immunol 2022; 13:891147. [PMID: 35514995 PMCID: PMC9063452 DOI: 10.3389/fimmu.2022.891147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Sardinia has one of the lowest incidences of hospitalization and related mortality in Europe and yet a very high frequency of the Neanderthal risk locus variant on chromosome 3 (rs35044562), considered to be a major risk factor for a severe SARS-CoV-2 disease course. We evaluated 358 SARS-CoV-2 patients and 314 healthy Sardinian controls. One hundred and twenty patients were asymptomatic, 90 were pauci-symptomatic, 108 presented a moderate disease course and 40 were severely ill. All patients were analyzed for the Neanderthal-derived genetic variants reported as being protective (rs1156361) or causative (rs35044562) for severe illness. The β°39 C>T Thalassemia variant (rs11549407), HLA haplotypes, KIR genes, KIRs and their HLA class I ligand combinations were also investigated. Our findings revealed an increased risk for severe disease in Sardinian patients carrying the rs35044562 high risk variant [OR 5.32 (95% CI 2.53 - 12.01), p = 0.000]. Conversely, the protective effect of the HLA-A*02:01, B*18:01, DRB*03:01 three-loci extended haplotype in the Sardinian population was shown to efficiently contrast the high risk of a severe and devastating outcome of the infection predicted for carriers of the Neanderthal locus [OR 15.47 (95% CI 5.8 - 41.0), p < 0.0001]. This result suggests that the balance between risk and protective immunogenetic factors plays an important role in the evolution of COVID-19. A better understanding of these mechanisms may well turn out to be the biggest advantage in the race for the development of more efficient drugs and vaccines.
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Affiliation(s)
- Stefano Mocci
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Littera
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy.,Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Aldesia Provenzano
- Medical Genetics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Alessia Mascia
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Erika Giuressi
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Goffredo Angioni
- Structure of Infectious Diseases Unit, SS Trinità Hospital, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giorgio La Nasa
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy.,Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy.,Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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13
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Sanna G, Marongiu A, Firinu D, Piras C, Franci G, Galdiero M, Pala G, Palmas V, Angius F, Littera R, Perra A, Orrù G, Campagna M, Costanzo G, Meloni F, Coghe F, Chessa L, Manzin A. Neutralizing Antibodies Responses against SARS-CoV-2 in a Sardinian Cohort Group Up to 9 Months after BNT162b2 Vaccination. Vaccines (Basel) 2022; 10:vaccines10040531. [PMID: 35455280 PMCID: PMC9024419 DOI: 10.3390/vaccines10040531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/26/2022] [Accepted: 03/27/2022] [Indexed: 12/19/2022] Open
Abstract
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, has caused over 460 million cases of infection and over 6 million deaths worldwide. The pandemic has called for science, technology, and innovation to provide solutions and, due to an incredible scientific and financial global effort, several prophylactic and therapeutic apparatuses such as monoclonal antibodies and vaccines were developed in less than one year to address this emergency. After SARS-CoV-2 infection, serum neutralizing antibodies are produced by B cells and studies on virus-neutralizing antibodies’ kinetics are pivotal. The process of protective immunity and the duration of this kind of protection against COVID-19 remain to be clarified. We tested 136 sera from 3 groups of individuals, some of them providing multiple sequential sera (1—healthy, no previous CoV2-infected, vaccinated; 2—healthy, previous CoV2 infected, vaccinated; 3—healed, previous CoV2-infected, not vaccinated) to assess the kinetics of antibodies (Abs) neutralizing activity. We found that SARS-CoV-2 infection elicits moderate neutralizing antibody activity in most individuals; neither age nor gender appear to have any influence on Abs responses. The BNT162b2 vaccine, when administered in two doses, induces high antibodies titre endowed with potent neutralizing activity against bare SARS-CoV-2 in in vitro neutralizing assay. The residual neutralization capability and the kinetic of waning immunity were also evaluated over 9 months after the second dose in a reference group of subjects. Neutralization titre showed a decline in all subjects and the median level of S-protein IgG, over 270 days after the second vaccination dose, was below 10 AU/mL in 53% of serum tested.
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Affiliation(s)
- Giuseppina Sanna
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
- Correspondence: (G.S.); (D.F.)
| | - Alessandra Marongiu
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
- Correspondence: (G.S.); (D.F.)
| | - Cristina Piras
- Clinical Metabolomics Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy;
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Giuseppe Pala
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
| | - Vanessa Palmas
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
| | - Fabrizio Angius
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
| | - Roberto Littera
- Department of Internal Medical Sciences, Medical Genetics, “R. Binaghi” Hospital, University of Cagliari, 09126 Cagliari, Italy;
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, 09100 Cagliari, Italy
| | - Andrea Perra
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, 09100 Cagliari, Italy;
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
| | - Giulia Costanzo
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
| | - Ferdinando Coghe
- Laboratory of Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042 Monserrato, Italy;
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy; (G.O.); (M.C.); (G.C.); (F.M.); (L.C.)
| | - Aldo Manzin
- Microbiology and Virology Unit, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (A.M.); (G.P.); (V.P.); (F.A.); (A.M.)
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14
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Carta MG, Orrù G, Cossu G, Velluzzi F, Atzori L, Aviles Gonzalez CI, Romano F, Littera R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Scano A, Onali S, Kalcev G, Coghe F, Minerba L. Covid-19 vaccines work but other factors play a relevant role: a data analysis on spread and mortality in 24 countries. J Public Health Res 2022; 11. [PMID: 35322646 PMCID: PMC8996068 DOI: 10.4081/jphr.2022.2665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim was to outline a methodology to monitor the impact of vaccinations in different countries comparing at two different times within countries and between countries the frequency of new cases and Covid-19 related deaths and the percentage of vaccinations conducted. DESIGN AND METHODS The 25 countries with the largest increase in SARS-CoV-2 cases on 8 August 2021 were evaluated. In each nation was calculated the proportion of Covid-19 deaths divided per new cases x 100 and the proportion of new cases per 1.000 inhabitants on 10 January 2021 (before vaccinations' distribution) and 8 August 2021 (when large percentage of the population had been vaccinated in many countries). RESULTS The study shows that in the countries with the highest number of cases as of 8 August 2021, the proportion of vaccinations carried out in the population correlates negatively with both the proportion between Covid-19 dead people x100 infected people and with the rate of new cases. However, the proportion of vaccinations does not correlate with the differences in the two same indicators considered in the weeks observed, thus additional factors seem to play an important role. CONCLUSIONS This work indicates that mass vaccination is associated with a lower spread of the pandemic and, to greater extent, with a lowering of mortality in infected people.
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Affiliation(s)
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Fernanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari.
| | | | | | - Roberto Littera
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Stefano Del Giacco
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences, University of Cagliari.
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | | | - Simona Onali
- Department of Biomedical Sciences, University of Cagliari.
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Ferinando Coghe
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari.
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15
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Carta MG, Fornaro M, Minerba L, Pau M, Velluzzi F, Atzori L, Aviles Gonzalez CI, Romano F, Littera R, Chessa L, Firinu D, Del Giacco S, Restivo A, Deidda S, Orrù G, Scano A, Onali S, Coghe F, Kalcev G, Cossu G. Previous functional social and behavioral rhythms affect resilience to COVID-19-related stress among old adults. J Public Health Res 2022; 11. [PMID: 35299585 PMCID: PMC8973204 DOI: 10.4081/jphr.2022.2768] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Functioning of Social Behavioral Rhythms (SBRs) may affect resilience toward stressful events across different age groups. However, the impact of SBRs on the coronavirus disease of 2019 (COVID-19) in elder people is yet to ascertain, representing the aim of the present report. DESIGN AND METHODS Follow-up of a peer-reviewed randomized controlled trial on exercise on old adults (³65 years), concurrent to the onset of the pandemic-related lockdown. Post-RCT evaluations occurred after further 12 and 36 weeks since the beginning of the lockdown phase. People with Major Depressive Episode (MDE) at week-48 (follow-up endpoint) were deemed as cases, people without such condition were considered controls. MDE was ascertained using the Patient Health Questionnaire-9 (PHQ-9); SBRs functioning at week 12 onward, through the Brief Symptom Rating Scale (BSRS). RESULTS Seventy-nine individuals (53.2%, females) entered the RCT-follow-up phase. The frequency of MDE did not significantly change before versus during lockdown (OR 2.60, CI95%=0.87-9.13). People with BSRS>1 standard deviation of the whole sample score at week-12 had an inflated risk of DE during lockdown (OR=5.6, 95%CI: 1.5-21.4) compared to those with lower BSRS scores. Such odd hold after excluding individuals with MDD at week-12. The post-hoc analysis could be potentially affected by selection bias. CONCLUSIONS Overall, older adults were resilient during the first phase of the pandemic when functioning of pre-lockdown was still preserved, in contrast to the subsequent evaluations when the impairment of daily rhythms was associated with impaired reliance.
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Affiliation(s)
| | | | - Luigi Minerba
- Department of Medical Science and Public Health, University of Cagliari.
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari.
| | - Fernanda Velluzzi
- Department of Medical Science and Public Health, University of Cagliari.
| | - Laura Atzori
- Department of Medical Science and Public Health, University of Cagliari.
| | | | | | - Roberto Littera
- Unit of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari.
| | - Luchino Chessa
- Department of Medical Science and Public Health, University of Cagliari.
| | - Davide Firinu
- Department of Medical Science and Public Health, University of Cagliari.
| | - Stefano Del Giacco
- Department of Medical Science and Public Health, University of Cagliari.
| | - Angelo Restivo
- Department of Surgical Sciences, University of Cagliari.
| | - Simona Deidda
- Department of Surgical Sciences, University of Cagliari.
| | - Germano Orrù
- Department of Surgical Sciences, University of Cagliari.
| | | | - Simona Onali
- Department of Medical Science and Public Health, University of Cagliari.
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari.
| | - Goce Kalcev
- International Ph.D in Innovation Sciences and Technologies, University of Cagliari.
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari.
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16
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Firinu D, Perra A, Campagna M, Littera R, Meloni F, Sedda F, Conti M, Costanzo G, Erbi M, Usai G, Locci C, Carta MG, Cappai R, Orrù G, Del Giacco S, Coghe F, Chessa L. Evaluation of Antibody Response to Heterologous Prime-Boost Vaccination with ChAdOx1 nCoV-19 and BNT162b2: An Observational Study. Vaccines (Basel) 2021; 9:vaccines9121478. [PMID: 34960224 PMCID: PMC8704060 DOI: 10.3390/vaccines9121478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 12/12/2022] Open
Abstract
In several countries, thrombotic events after vaccination with ChAdOx1 nCoV-19 have led to heterologous messenger RNA (mRNA) boosting. We tested the antibody response to SARS-CoV-2 spike protein four weeks after heterologous priming with the ChAdOx1 (ChAd) vector vaccine followed by boosting with BNT162b2(ChAd/BNT), comparing data of homologous regimen (BNT/BNT, ChAd/ChAd) subjects positive for SARS-CoV-2 after the first dose of BNT162b2 (BNT1dose/CoV2) and convalescent COVID-19. Methods: healthy subjects naïve for SARS-CoV-2 infection were assessed for serum IgG anti-S-RBD response 21 days after priming (T1), 4 (TFULL) and 15 (T15W) weeks after booster dose. Results: The median IgG anti-S-RBD levels at TFULL of Chad/BNT group were significantly higher than the BNT/BNT group and ChAd/ChAd. Those of BNT/BNT group were significantly higher than ChAd/ChAd. IgG anti-S-RBD of BNT1dose/CoV2 group were similar to BNT/BNT, ChAd/BNT and ChAd/Chad group. The levels among COVID-19 convalescents were significantly lower than ChAd/BNT, BNT/BNT, ChAd/Chad and BNT1dose/CoV2. The proportion of subjects reaching an anti-S-RBD titer >75 AU/mL, correlated with high neutralizing titer, was 94% in ChAd/BNT and BNT/BNT, 60% in BNT1dose/CoV2, 25% in ChAd/ChAd and 4.2% in convalescents. At T15W the titer of ChAd/BNT was still significantly higher than other vaccine schedules, while the anti-S-RBD decline was reduced for ChAd/ChAd and similar for other combinations. Conclusion: Our data highlight the magnitude of IgG anti-S-RBD response in ChAd/BNT dosing, supporting the current national guidelines for heterologous boosting
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Affiliation(s)
- Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
- Correspondence: ; Tel.: +39-070-5109-6128; Fax: +39-070-5109-6227
| | - Andrea Perra
- Department of Biomedical Sciences, University of Cagliari, 09100 Cagliari, Italy; (A.P.); (F.S.)
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, 09100 Cagliari, Italy;
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Roberto Littera
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, 09100 Cagliari, Italy;
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Francesca Sedda
- Department of Biomedical Sciences, University of Cagliari, 09100 Cagliari, Italy; (A.P.); (F.S.)
| | - Maria Conti
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Giulia Costanzo
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Monica Erbi
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Gianmario Usai
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Carlotta Locci
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Riccardo Cappai
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042 Cagliari, Italy; (R.C.); (F.C.)
| | - Germano Orrù
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
| | - Ferdinando Coghe
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, 09042 Cagliari, Italy; (R.C.); (F.C.)
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, 09100 Cagliari, Italy; (M.C.); (F.M.); (M.C.); (G.C.); (M.E.); (G.U.); (C.L.); (M.G.C.); (G.O.); (S.D.G.); (L.C.)
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, 09100 Cagliari, Italy;
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17
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Firinu D, Perra A, Campagna M, Littera R, Fenu G, Meloni F, Cipri S, Sedda F, Conti M, Miglianti M, Costanzo G, Secci M, Usai G, Carta MG, Cappai R, Orrù G, Del Giacco S, Coghe F, Chessa L. Evaluation of antibody response to BNT162b2 mRNA COVID-19 vaccine in patients affected by immune-mediated inflammatory diseases up to 5 months after vaccination. Clin Exp Med 2021; 22:477-485. [PMID: 34741188 PMCID: PMC8570239 DOI: 10.1007/s10238-021-00771-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022]
Abstract
SARS-CoV-2 vaccination with mRNA product BNT162b2 elicited high immunogenicity in healthy subjects in trials. This study aims to better understand the factors that influence the humoral immune response to vaccination against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). We enrolled patients and healthy healthcare workers control group (HCW) that underwent mRNA BNT162b2 vaccination and measured the serum IgG anti-S-RBD response at booster dose (T1), one month after booster dose (T2) and up to 5 months (T3). Demographic, disease-specific and vaccination data were recorded. Vaccination response of 551 participants naïve to SARS-CoV-2 infection were included in HCW and 102 in the IMID group, analyzing separately those on anti-CD20. At T2 all naïve HCW developed anti-S-RBD-IgG, while 94% of IMID responded (p < 0.001). IMID patients had a significantly different level of IgG than HCW at both T1 (p = 0.031), T2 (p < 0.001), while there was no significant difference at T3. There were no statistically significant differences according to the IMID type or to ongoing treatment with immunosuppressants, corticosteroids or biological drugs other than anti-CD20. The proportion and magnitude of response was significantly lower in IMID treated with anti-CD20 drugs. There was a correlation with age at T1 and at T2 but not at T3, stronger in patients than in HCW. Immune response close after BNT162b2 vaccination is reduced in patients with IMID, but there is no significant difference at 5 months. The measured reduction is related to age and the disease itself rather than treatments, with the exception of anti-CD20 drugs.
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Affiliation(s)
- Davide Firinu
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy.
| | - Andrea Perra
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Roberto Littera
- Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, Cagliari, Italy.,Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Fenu
- Department of Neuroscience, A.O. Brotzu, Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Selene Cipri
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Sedda
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Conti
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Giulia Costanzo
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Marta Secci
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Gianmario Usai
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Riccardo Cappai
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, Cagliari, Italy
| | - Germano Orrù
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy
| | - Ferdinando Coghe
- Laboratory Clinical Chemical Analysis and Microbiology, University Hospital of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Department of Medical Sciences and Public Health, Policlinico Universitario - AOU di Cagliari, University of Cagliari, Azienda Ospedaliero Universitaria, SS 554-Bivio Sestu, 09042, Monserrato, Cagliari, CA, Italy.,Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., Non Profit Organisation, Cagliari, Italy
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18
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Littera R, Chessa L, Deidda S, Angioni G, Campagna M, Lai S, Melis M, Cipri S, Firinu D, Santus S, Lai A, Porcella R, Rassu S, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Ragatzu P, Vacca M, Cannas F, Alba F, Carta MG, Del Giacco S, Restivo A, Deidda S, Palimodde A, Congera P, Perra R, Orrù G, Pes F, Loi M, Murru C, Urru E, Onali S, Coghe F, Giglio S, Perra A. Natural killer-cell immunoglobulin-like receptors trigger differences in immune response to SARS-CoV-2 infection. PLoS One 2021; 16:e0255608. [PMID: 34352002 PMCID: PMC8341547 DOI: 10.1371/journal.pone.0255608] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background The diversity in the clinical course of COVID-19 has been related to differences in innate and adaptative immune response mechanisms. Natural killer (NK) lymphocytes are critical protagonists of human host defense against viral infections. It would seem that reduced circulating levels of these cells have an impact on COVID-19 progression and severity. Their activity is strongly regulated by killer-cell immuno-globulin-like receptors (KIRs) expressed on the NK cell surface. The present study’s focus was to investigate the impact of KIRs and their HLA Class I ligands on SARS-CoV-2 infection. Methods KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 396 Sardinian patients with SARS-CoV-2 infection. Comparisons were made between 2 groups of patients divided according to disease severity: 240 patients were symptomatic or paucisymptomatic (Group A), 156 hospitalized patients had severe disease (Group S). The immunogenetic characteristics of patients were also compared to a population group of 400 individuals from the same geographical areas. Results Substantial differences were obtained for KIR genes, KIR haplotypes and KIR-HLA ligand combinations when comparing patients of Group S to those of Group A. Patients in Group S had a statistically significant higher frequency of the KIR A/A haplotype compared to patients in Group A [34.6% vs 23.8%, OR = 1.7 (95% CI 1.1–2.6); P = 0.02, Pc = 0.04]. Moreover, the KIR2DS2/HLA C1 combination was poorly represented in the group of patients with severe symptoms compared to those of the asymptomatic-paucisymptomatic group [33.3% vs 50.0%, OR = 0.5 (95% CI 0.3–0.8), P = 0.001, Pc = 0.002]. Multivariate analysis confirmed that, regardless of the sex and age of the patients, the latter genetic variable correlated with a less severe disease course [ORM = 0.4 (95% CI 0.3–0.7), PM = 0.0005, PMC = 0.005]. Conclusions The KIR2DS2/HLA C1 functional unit resulted to have a strong protective effect against the adverse outcomes of COVID-19. Combined to other well known factors such as advanced age, male sex and concomitant autoimmune diseases, this marker could prove to be highly informative of the disease course and thus enable the timely intervention needed to reduce the mortality associated with the severe forms of SARS-CoV-2 infection. However, larger studies in other populations as well as experimental functional studies will be needed to confirm our findings and further pursue the effect of KIR receptors on NK cell immune-mediated response to SARS-Cov-2 infection.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Silvia Deidda
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Maurizio Melis
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Local Crisis Unit (UCL), ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Alba
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Paola Congera
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Loi
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Claudia Murru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Urru
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
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19
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Carta MG, Minerba L, Demontis R, Orrù G, Romano F, Scano A, Restivo A, Del Giacco S, Deidda S, Firinu D, Campagna M, Meloni F, Cossu G, Sancassiani F, Chessa L, Kalcev G, Littera R, Zorcolo L, Aviles-Gonzale CI, Usai P. The COVID-19 incidence in Italian regions correlates with low temperature, mobility and PM10 pollution but lethality only with low temperature. J Public Health Res 2021; 10:2303. [PMID: 34121380 PMCID: PMC8636947 DOI: 10.4081/jphr.2021.2303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim was to verify whether the density of particulate matter (PM10), the climate, and the mobility of people can influence the pandemic in the 19 regions and in the two autonomous Italian provinces as incidence rate and lethality. DESIGN AND METHODS The incidence rates per 100,000 inhabitants and the case fatality ratio (CFR) (dependent variables) in all Italian regions were calculated in January 2021 at John Hopkins University Coronavirus Center. The independent variables were: Minimum average temperatures in the same month (January) of 2020; average pollution of PM10 in the air in each region in the last year available reported on a 0-10 scale to 0 = total absence of PM10 to 10 maximum pollutions; number of places in hotels occupied per inhabitants in 2020. Linear regression and Multiple Regression Analysis were carried out. RESULTS The spread of the COVID-19 in the Italian regions seems to be related to pollution of PM10, the number of beds occupied in hotels (as an index of mobility and temperature (indirect correlation). On the contrary, the CFR correlates inversely with temperature but not with pollution. Measuring the concomitant effect of two independent variables by means of Multiple Regression Analysis, temperature and pollution show a synergistic effect on COVID-19 incidence. CONCLUSIONS The study seems to confirm the literature on the influence of temperature on the lethality of COVID-19 but adds the new results of an inverse relationship between the spread of the virus and low temperature in regions between the Mediterranean area (which includes southern Italy and Sicily and Sardinia islands) and the cold European temperate zone which includes the northern regions under the Alps. A new date also concerns the summation effect of the risk between cold weather and PM10 air pollution was found. Due to several methodic weaknesses, the study has an exploratory than conclusive relevance.
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Affiliation(s)
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Roberto Demontis
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari.
| | | | - Alessandra Scano
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari.
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Stefano Del Giacco
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences, University of Cagliari.
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Marcello Campagna
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari.
| | - Federico Meloni
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy .
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | | | - Luchino Chessa
- Center for the Study of Liver Diseases, Department of Medical Sciences, University of Cagliari .
| | - Goce Kalcev
- International Ph.D. in Innovation Sciences and Technologies, University of Cagliari.
| | - Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS), Cagliari.
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | | | - Paolo Usai
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
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20
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Carta MG, Minerba L, Demontis R, Orrù G, Romano F, Scano A, Restivo A, Del Giacco S, Deidda S, Firinu D, Campagna M, Meloni F, Cossu G, Sancassiani F, Chessa L, Kalcev G, Littera R, Zorcolo L, Aviles-Gonzale CI, Usai P. The COVID-19 incidence in Italian regions correlates with low temperature, mobility and PM10 pollution but lethality only with low temperature. J Public Health Res 2021. [PMID: 34121380 DOI: 10.4081/jphr.2021.2303.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim was to verify whether the density of particulate matter (PM10), the climate, and the mobility of people can influence the pandemic in the 19 regions and in the two autonomous Italian provinces as incidence rate and lethality. DESIGN AND METHODS The incidence rates per 100,000 inhabitants and the case fatality ratio (CFR) (dependent variables) in all Italian regions were calculated in January 2021 at John Hopkins University Coronavirus Center. The independent variables were: Minimum average temperatures in the same month (January) of 2020; average pollution of PM10 in the air in each region in the last year available reported on a 0-10 scale to 0 = total absence of PM10 to 10 maximum pollutions; number of places in hotels occupied per inhabitants in 2020. Linear regression and Multiple Regression Analysis were carried out. RESULTS The spread of the COVID-19 in the Italian regions seems to be related to pollution of PM10, the number of beds occupied in hotels (as an index of mobility and temperature (indirect correlation). On the contrary, the CFR correlates inversely with temperature but not with pollution. Measuring the concomitant effect of two independent variables by means of Multiple Regression Analysis, temperature and pollution show a synergistic effect on COVID-19 incidence. CONCLUSIONS The study seems to confirm the literature on the influence of temperature on the lethality of COVID-19 but adds the new results of an inverse relationship between the spread of the virus and low temperature in regions between the Mediterranean area (which includes southern Italy and Sicily and Sardinia islands) and the cold European temperate zone which includes the northern regions under the Alps. A new date also concerns the summation effect of the risk between cold weather and PM10 air pollution was found. Due to several methodic weaknesses, the study has an exploratory than conclusive relevance.
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Affiliation(s)
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Roberto Demontis
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari.
| | | | - Alessandra Scano
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari.
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Stefano Del Giacco
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences, University of Cagliari.
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | - Marcello Campagna
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari.
| | - Federico Meloni
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy .
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari.
| | | | - Luchino Chessa
- Center for the Study of Liver Diseases, Department of Medical Sciences, University of Cagliari .
| | - Goce Kalcev
- International Ph.D. in Innovation Sciences and Technologies, University of Cagliari.
| | - Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS), Cagliari.
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
| | | | - Paolo Usai
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari.
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21
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Porcu S, Simbula M, Marongiu MF, Perra A, Poddie D, Perseu L, Kowalik MA, Littera R, Barella S, Caria CA, Demartis FR, Ristaldi MS. Delta-globin gene expression improves sickle cell disease in a humanised mouse model. Br J Haematol 2021; 193:1228-1237. [PMID: 34046885 DOI: 10.1111/bjh.17561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/04/2021] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Abstract
Sickle cell disease (SCD) is a widespread genetic disease associated with severe disability and multi-organ damage, resulting in a reduced life expectancy. None of the existing clinical treatments provide a solution for all patients. Gene therapy and fetal haemoglobin (HbF) reactivation through genetic approaches have obtained promising, but early, results in patients. Furthermore, the search for active molecules to increase HbF is still ongoing. The delta-globin gene produces the delta-globin of haemoglobin A2 (HbA2). Although expressed at a low level, HbA2 is fully functional and could be a valid anti-sickling agent in SCD. To evaluate the therapeutic potential of a strategy aimed to over-express the delta-globin gene in vivo, we crossed transgenic mice carrying a single copy of the delta-globin gene, genetically modified to be expressed at a higher level (activated), with a humanised mouse model of SCD. The activated delta-globin gene gives rise to a consistent production of HbA2, effectively improving the SCD phenotype. For the first time in vivo, these results demonstrate the therapeutic potential of delta-globin, which could lead to novel approaches to the cure of SCD.
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Affiliation(s)
- Susanna Porcu
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | - Michela Simbula
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | - Maria F Marongiu
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | - Andrea Perra
- Unità di Oncologia e Patologia Molecolare, Dipartimento di Scienze Biomediche, University of Cagliari, Cagliari, Italy
| | - Daniela Poddie
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | - Lucia Perseu
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | - Marta A Kowalik
- Unità di Oncologia e Patologia Molecolare, Dipartimento di Scienze Biomediche, University of Cagliari, Cagliari, Italy
| | - Roberto Littera
- Struttura Complessa di Genetica Medica, Ospedale R. Binaghi, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Susanna Barella
- Ospedale Microcitemico 'A. Cao' - A.O. 'G. Brotzu', Cagliari, Italy
| | - Cristian A Caria
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
| | | | - Maria S Ristaldi
- Istituto di Ricerca Genetica e Biomedica del Consiglio Nazionale delle Ricerche (IRGB-CNR), Cagliari, Italy
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22
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Abstract
Objectives Epidemiological investigations and mathematical models have revealed that the rapid diffusion of Covid-19 can mostly be attributed to undetected infective individuals who continue to circulate and spread the disease: finding their number would be of great importance in the control of the epidemic. Methods The dynamics of an infection can be described by the SIR model, which divides the population into susceptible (S), infective I, and removed R subjects. In particular, we exploited the Kermack-McKendrick epidemic model, which can be applied when the population is much larger than the fraction of infected subjects. Results We proved that the fraction of undetected infectives, compared to the total number of infected subjects, is given by 1−1R0, where R0 is the basic reproduction number. The mean value R0=2.10 2.09-2.11 for the Covid-19 epidemic in three Italian regions yielded a percentage of undetected infectives of 52.4% (52.2%–52.6%) compared to the total number of infectives. Conclusions Our results, straightforwardly obtained from the SIR model, highlight the role of undetected carriers in the transmission and spread of the SARS-CoV-2 infection. Such evidence strongly recommends careful monitoring of the infective population and ongoing adjustment of preventive measures for disease control until a vaccine becomes available for most of the population.
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Affiliation(s)
- Maurizio Melis
- AART (Association for the Advancement of Research on Transplantation), Cagliari, Italy.
| | - Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy.
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23
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Deidda S, Tora L, Firinu D, Del Giacco S, Campagna M, Meloni F, Orrù G, Chessa L, Carta MG, Melis A, Spolverato G, Littera R, Perra A, Onali S, Zorcolo L, Restivo A. Gastrointestinal coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention, and management. Expert Rev Gastroenterol Hepatol 2021; 15:41-50. [PMID: 32955375 DOI: 10.1080/17474124.2020.1821653] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported pieces of evidence that patients with SARS-CoV-2 infection could have direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common. AREA COVERED In this article, we reviewed current-published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, the presumptive biological mechanism of GI infection, prognosis, clinical management, and public health-related concerns on the possible risk of oral-fecal transmission. EXPERT OPINION Different clues point to direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enter into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme two membrane receptor. These findings, coupled with the identification of viral RNA found in stools of patients, clearly suggest that direct involvement of the gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral-fecal route for transmission, additionally or alternatively to the main respiratory route.
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Affiliation(s)
- Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Lorena Tora
- Anahuac University, Comprehensive and Advanced Diagnostic Assessment for Cancer , Mexico City, Mexico
| | - Davide Firinu
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | | | - Marcello Campagna
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Federico Meloni
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Luchino Chessa
- Center for the Study of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Alessandra Melis
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Gaya Spolverato
- Section of Surgery, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova , Padua, Italy
| | - Roberto Littera
- Complex Structure of Medical Genetics, R.Binaghi Hospital, ASSL Cagliari , ATS Sardegna, Italy
| | - Andrea Perra
- Department of Biomedical Sciences, University of Cagliari , Cagliari, Italy
| | - Simona Onali
- Department of Biomedical Sciences, University of Cagliari , Cagliari, Italy
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
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Littera R, Campagna M, Deidda S, Angioni G, Cipri S, Melis M, Firinu D, Santus S, Lai A, Porcella R, Lai S, Rassu S, Scioscia R, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Serra M, Ragatzu P, Carta MG, Del Giacco S, Restivo A, Deidda S, Orrù S, Palimodde A, Perra R, Orrù G, Conti M, Balestrieri C, Serra G, Onali S, Marongiu F, Perra A, Chessa L. Human Leukocyte Antigen Complex and Other Immunogenetic and Clinical Factors Influence Susceptibility or Protection to SARS-CoV-2 Infection and Severity of the Disease Course. The Sardinian Experience. Front Immunol 2020. [PMID: 33343579 DOI: 10.3389/fimmu.2020.605688.pmid:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim SARS-CoV-2 infection is a world-wide public health problem. Several aspects of its pathogenesis and the related clinical consequences still need elucidation. In Italy, Sardinia has had very low numbers of infections. Taking advantage of the low genetic polymorphism in the Sardinian population, we analyzed clinical, genetic and immunogenetic factors, with particular attention to HLA class I and II molecules, to evaluate their influence on susceptibility to SARS-CoV-2 infection and the clinical outcome. Method and Materials We recruited 619 healthy Sardinian controls and 182 SARS-CoV-2 patients. Thirty-nine patients required hospital care and 143 were without symptoms, pauci-symptomatic or with mild disease. For all participants, we collected demographic and clinical data and analyzed the HLA allele and haplotype frequencies. Results Male sex and older age were more frequent in hospitalized patients, none of whom had been vaccinated during the previous seasonal flu vaccination campaignes. Compared to the group of asymptomatic or pauci-symptomatic patients, hospitalized patients also had a higher frequency of autoimmune diseases and glucose-6-phosphate-dehydrogenase (G6PDH) deficiency. None of these patients carried the beta-thalassemia trait, a relatively common finding in the Sardinian population. The extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 [OR 0.1 (95% CI 0-0.6), Pc = 0.015] was absent in all 182 patients, while the HLA-C*04:01 allele and the three-loci haplotype HLA-A*30:02, B*14:02, C*08:02 [OR 3.8 (95% CI 1.8-8.1), Pc = 0.025] were more frequently represented in patients than controls. In a comparison between in-patients and home care patients, the HLA-DRB1*08:01 allele was exclusively present in the hospitalized patients [OR > 2.5 (95% CI 2.7-220.6), Pc = 0.024]. Conclusion The data emerging from our study suggest that the extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 has a protective effect against SARS-CoV-2 infection in the Sardinian population. Genetic factors that resulted to have a negative influence on the disease course were presence of the HLA-DRB1*08:01 allele and G6PDH deficiency, but not the beta-thalassemic trait. Absence of influenza vaccination could be a predisposing factor for more severe disease.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy.,Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia Deidda
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, PO SS Trinità, ASSL Cagliari ATS Sardegna, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Maurizio Melis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Unitá di Crisi Locale (UCL) ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Rosetta Scioscia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, PO SS Trinità, ASSL Cagliari ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Serra
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Sandro Orrù
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Maria Conti
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Cinzia Balestrieri
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Giancarlo Serra
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Francesco Marongiu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy.,Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Associazione per l'Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
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25
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Littera R, Campagna M, Deidda S, Angioni G, Cipri S, Melis M, Firinu D, Santus S, Lai A, Porcella R, Lai S, Rassu S, Scioscia R, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Serra M, Ragatzu P, Carta MG, Del Giacco S, Restivo A, Deidda S, Orrù S, Palimodde A, Perra R, Orrù G, Conti M, Balestrieri C, Serra G, Onali S, Marongiu F, Perra A, Chessa L. Human Leukocyte Antigen Complex and Other Immunogenetic and Clinical Factors Influence Susceptibility or Protection to SARS-CoV-2 Infection and Severity of the Disease Course. The Sardinian Experience. Front Immunol 2020; 11:605688. [PMID: 33343579 PMCID: PMC7746644 DOI: 10.3389/fimmu.2020.605688] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022] Open
Abstract
Aim SARS-CoV-2 infection is a world-wide public health problem. Several aspects of its pathogenesis and the related clinical consequences still need elucidation. In Italy, Sardinia has had very low numbers of infections. Taking advantage of the low genetic polymorphism in the Sardinian population, we analyzed clinical, genetic and immunogenetic factors, with particular attention to HLA class I and II molecules, to evaluate their influence on susceptibility to SARS-CoV-2 infection and the clinical outcome. Method and Materials We recruited 619 healthy Sardinian controls and 182 SARS-CoV-2 patients. Thirty-nine patients required hospital care and 143 were without symptoms, pauci-symptomatic or with mild disease. For all participants, we collected demographic and clinical data and analyzed the HLA allele and haplotype frequencies. Results Male sex and older age were more frequent in hospitalized patients, none of whom had been vaccinated during the previous seasonal flu vaccination campaignes. Compared to the group of asymptomatic or pauci-symptomatic patients, hospitalized patients also had a higher frequency of autoimmune diseases and glucose-6-phosphate-dehydrogenase (G6PDH) deficiency. None of these patients carried the beta-thalassemia trait, a relatively common finding in the Sardinian population. The extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 [OR 0.1 (95% CI 0-0.6), Pc = 0.015] was absent in all 182 patients, while the HLA-C*04:01 allele and the three-loci haplotype HLA-A*30:02, B*14:02, C*08:02 [OR 3.8 (95% CI 1.8-8.1), Pc = 0.025] were more frequently represented in patients than controls. In a comparison between in-patients and home care patients, the HLA-DRB1*08:01 allele was exclusively present in the hospitalized patients [OR > 2.5 (95% CI 2.7-220.6), Pc = 0.024]. Conclusion The data emerging from our study suggest that the extended haplotype HLA-A*02:05, B*58:01, C*07:01, DRB1*03:01 has a protective effect against SARS-CoV-2 infection in the Sardinian population. Genetic factors that resulted to have a negative influence on the disease course were presence of the HLA-DRB1*08:01 allele and G6PDH deficiency, but not the beta-thalassemic trait. Absence of influenza vaccination could be a predisposing factor for more severe disease.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia Deidda
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, PO SS Trinità, ASSL Cagliari ATS Sardegna, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Maurizio Melis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Unitá di Crisi Locale (UCL) ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Area Socio-Sanitaria Locale (ASSL) Cagliari, Azienda per la Tutela della Salute (ATS) Sardegna, Italy
| | - Rosetta Scioscia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, PO SS Trinità, ASSL Cagliari ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Serra
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Sandro Orrù
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, PO SS Trinità, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Maria Conti
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Cinzia Balestrieri
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Giancarlo Serra
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Francesco Marongiu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Associazione per l’Avanzamento della Ricerca per i Trapianti O.d.V., non profit organisation, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
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Deidda S, Tora L, Firinu D, Del Giacco S, Campagna M, Meloni F, Orrù G, Chessa L, Carta MG, Melis A, Spolverato G, Littera R, Perra A, Onali S, Zorcolo L, Restivo A. Gastrointestinal coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention, and management. Expert Rev Gastroenterol Hepatol 2020. [PMID: 32955375 DOI: 10.1080/17474124.2020.1821653.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
INTRODUCTION The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported pieces of evidence that patients with SARS-CoV-2 infection could have direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common. AREA COVERED In this article, we reviewed current-published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, the presumptive biological mechanism of GI infection, prognosis, clinical management, and public health-related concerns on the possible risk of oral-fecal transmission. EXPERT OPINION Different clues point to direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enter into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme two membrane receptor. These findings, coupled with the identification of viral RNA found in stools of patients, clearly suggest that direct involvement of the gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral-fecal route for transmission, additionally or alternatively to the main respiratory route.
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Affiliation(s)
- Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Lorena Tora
- Anahuac University, Comprehensive and Advanced Diagnostic Assessment for Cancer , Mexico City, Mexico
| | - Davide Firinu
- Internal Medicine, Allergy and Clinical Immunology, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | | | - Marcello Campagna
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Federico Meloni
- Occupational Health Section, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Lab, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Luchino Chessa
- Center for the Study of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari , Cagliari, Italy
| | - Alessandra Melis
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Gaya Spolverato
- Section of Surgery, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova , Padua, Italy
| | - Roberto Littera
- Complex Structure of Medical Genetics, R.Binaghi Hospital, ASSL Cagliari , ATS Sardegna, Italy
| | - Andrea Perra
- Department of Biomedical Sciences, University of Cagliari , Cagliari, Italy
| | - Simona Onali
- Department of Biomedical Sciences, University of Cagliari , Cagliari, Italy
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari , Cagliari, Italy
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Procaccio F, Masiero L, Vespasiano F, Grossi PA, Gagliotti C, Pantosti A, Caprio M, Lombardini L, Nanni Costa A, Giacon B, Saracino A, Mancini P, Giannattasio P, Sangiorgi G, Licari M, Valeri M, Munoz Lopez M, Moschini M, Giacometti R, Panebianco A, Littera R, Butera A, Bonizzoli M, Pilati L, Dovas A, Lazzarini F, Coluccio E, Vesconi S, Ghirardini A, Puoti F, Ricci A, Di Ciaccio P. Organ donor screening for carbapenem-resistant gram-negative bacteria in Italian intensive care units: the DRIn study. Am J Transplant 2020; 20:262-273. [PMID: 31400257 DOI: 10.1111/ajt.15566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/12/2019] [Revised: 08/01/2019] [Accepted: 08/03/2019] [Indexed: 01/25/2023]
Abstract
The 759 cases of brain death declaration (BDD [Italian law, 6 hours of observation time]) that occurred in 190 Italian intensive care units (ICUs) between May and September 2012 were studied to quantify carbapenem-resistant gram-negative bacteria (CR-GN) isolated in organ donors, to evaluate adherence to national screening guidelines, and to identify risk factors for CR-GN isolation. Mandatory blood, bronchoalveolar lavage, and urine cultures were performed on the BDD day in 99% of used donors. Because results were rarely made available before transplant, >20% of transplants were performed before obtaining any microbiological information, and organs from 15 of 22 CR-GN cases were used. Two (lung-liver) of the 37 recipients died, likely because of donor-derived early CR-GN sepsis. ICU stay >3 days (odds ratio [OR] = 7.49, P = .004), fever (OR = 3.11, P = .04), age <60 years (OR = 2.80, P = .06), and positive ICU epidemiology (OR = 8.77, P = .07) were associated with CR-GN isolation. An association between single ICU and risk of CR-GN was observed, as a result of differences across ICUs (ICC = 29%; 95% confidence interval [CI] 6.5%-72%) probably related to inadequate practices of infection control. Continuous education aimed at implementing priority actions, including stewardship programs for a rational use of antimicrobials, is a priority in healthcare systems and transplant networks. Improved awareness among ICU personnel regarding the importance of early CR-GN detection and timely alert systems might facilitate decisions regarding organ suitability and eventually save recipient lives.
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Affiliation(s)
| | - Lucia Masiero
- Centro Nazionale Trapianti, Istituto Superiore di Sanità, Rome, Italy
| | | | - Paolo A Grossi
- Clinica delle Malattie Infettive e Tropicali, Università degli Studi dell'Insubria, Varese, Italy
| | - Carlo Gagliotti
- Agenzia Sanitaria e Sociale Regionale Emilia-Romagna, Bologna, Italy
| | - Annalisa Pantosti
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, Italy
| | - Mario Caprio
- Centro Nazionale Trapianti, Istituto Superiore di Sanità, Rome, Italy
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28
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Melis M, Littera R, Cocco E, Frau J, Lai S, Congeddu E, Ragatzu P, Serra M, Loi V, Maddi R, Pitzalis R, Orrù S, Chessa L, Perra A, Carcassi C. Entropy of human leukocyte antigen and killer-cell immunoglobulin-like receptor systems in immune-mediated disorders: A pilot study on multiple sclerosis. PLoS One 2019; 14:e0226615. [PMID: 31846493 PMCID: PMC6917289 DOI: 10.1371/journal.pone.0226615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/29/2019] [Indexed: 11/25/2022] Open
Abstract
Background Entropy is a thermodynamic variable statistically correlated with the disorder of a system. The hypothesis that entropy can be used to identify potentially unhealthy conditions was first suggested by Schrödinger, one of the founding fathers of quantum mechanics. Shannon later defined entropy as the quantity of information stored in a system. Shannon’s entropy has the advantage of being adaptable across a variety of disciplines, including genetic studies on complex immunogenetic systems such as the human leukocyte antigen (HLA) and killer-cell immunoglobulin-like receptor (KIR) systems. Methods In our study, entropy associated to the HLA and KIR systems was compared between a cohort of 619 Sardinian healthy controls and a group of 270 patients affected by multiple sclerosis (MS), the latter stratified into 81 patients with primary progressive multiple sclerosis (PPMS) and 189 patients with relapsing remitting multiple sclerosis (RRMS). Results The entropy associated to HLA four-loci haplotypes (A, B, C, DR) and combinations of two inhibitory KIR genes was significantly higher in patients affected by RRMS than in healthy controls. No significant differences were observed for patients with PPMS. By calculating the total HLA and KIR entropy ratio in each subject, it was possible to determine the individual risk of developing MS, particularly RRMS. Conclusions In addition to the standard statistical methods used to evaluate immunogenetic parameters associated to immune-mediated disease, the analysis of entropy measures the global disorder status deriving from these parameters. This innovative approach may represent a useful complementary tool to the risk assessment of immune-mediated disorders. Improved risk assessment is particularly important for family members of patients with MS. However, further investigation is warranted to confirm our findings and to evaluate the validity of the entropy-based method in other types of immune-mediated disorders.
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Affiliation(s)
- Maurizio Melis
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (MM); (LC)
| | - Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- * E-mail: (RL); (MM); (LC)
| | - Eleonora Cocco
- Multiple Sclerosis Center, R. Binaghi Hospital, University of Cagliari/ATS Sardegna, Cagliari, Italy
| | - Jessica Frau
- Multiple Sclerosis Center, R. Binaghi Hospital, University of Cagliari/ATS Sardegna, Cagliari, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Elena Congeddu
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Serra
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Valentina Loi
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Roberta Maddi
- Complex Structure of Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Roberta Pitzalis
- Multiple Sclerosis Center, R. Binaghi Hospital, University of Cagliari/ATS Sardegna, Cagliari, Italy
| | - Sandro Orrù
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Center for the Study of Liver Diseases, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (MM); (LC)
| | - Andrea Perra
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Carlo Carcassi
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Orrù S, Coni P, Floris A, Littera R, Carcassi C, Sogos V, Brancia C. Reduced stress granule formation and cell death in fibroblasts with the A382T mutation of TARDBP gene: evidence for loss of TDP-43 nuclear function. Hum Mol Genet 2018; 25:4473-4483. [PMID: 28172957 DOI: 10.1093/hmg/ddw276] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 12/12/2022] Open
Abstract
TAR deoxyribonucleic acid-binding protein 43 (TDP-43) is a key protein in the pathogenesis of amyoptrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD). Recent studies suggest that mutations in the TDP-43 coding gene, TARDBP, as well as variations in TDP-43 protein expression levels may disrupt the dynamics of stress granules (SGs). However, it remains unclear whether the pathogenetic effect of the TDP-43 protein is exerted at the cytoplasmic level, through direct participation to SG composition, or at nuclear level, through control of proteins essential to SG assembly. To clarify this point, we investigated the dynamics of SG formation in primary skin fibroblast cultures from the patients with ALS together with the A382T mutation and the patients with ALS and healthy controls with wild-type TDP-43. Under stress conditions induced by sodium arsenite, we found that in human fibroblasts TDP-43 did not translocate to the SGs but instead contributed to the SG formation through a regulatory effect on the G3BP1 core protein. We found that the A382T mutation caused a significant reduction in the number of SGs per cell (P < 0.01) as well as the percentage of cells that form SGs (P < 0.00001). Following stress stimuli, a significant decrease of viability was observed for cells with the TDP-43 A382T mutation (P < 0.0005).
We can therefore conclude that the A382T mutation caused a reduction in the ability of cells to respond to stress through loss of TDP-43 function in SG nucleation. The pathogenetic action revealed in our study model does not seem to be mediated by changes in the localization of the TDP-43 protein.
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Affiliation(s)
- Sandro Orrù
- Medical Genetics, Department of Medical Sciences, University of Cagliari, R. Binaghi Hospital, Cagliari, Italy
| | - Paola Coni
- Paola Coni, Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Andrea Floris
- Medical Genetics, Department of Medical Sciences, University of Cagliari, R. Binaghi Hospital, Cagliari, Italy
| | - Roberto Littera
- Regional Transplant Center, R. Binaghi Hospital, ASL Cagliari, Cagliari, Italy
| | - Carlo Carcassi
- Medical Genetics, Department of Medical Sciences, University of Cagliari, R. Binaghi Hospital, Cagliari, Italy
| | - Valeria Sogos
- Paola Coni, Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Carla Brancia
- Paola Coni, Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
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Caocci G, Greco M, Arras M, Cusano R, Orrù S, Martino B, Abruzzese E, Galimberti S, Mulas O, Trucas M, Littera R, Lai S, Carcassi C, La Nasa G. HLA-G molecules and clinical outcome in Chronic Myeloid Leukemia. Leuk Res 2017; 61:1-5. [DOI: 10.1016/j.leukres.2017.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/17/2017] [Accepted: 08/13/2017] [Indexed: 12/22/2022]
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Littera R, Piredda G, Argiolas D, Lai S, Congeddu E, Ragatzu P, Melis M, Carta E, Michittu MB, Valentini D, Cappai L, Porcella R, Alba F, Serra M, Loi V, Maddi R, Orrù S, La Nasa G, Caocci G, Cusano R, Arras M, Frongia M, Pani A, Carcassi C. KIR and their HLA Class I ligands: Two more pieces towards completing the puzzle of chronic rejection and graft loss in kidney transplantation. PLoS One 2017; 12:e0180831. [PMID: 28686681 PMCID: PMC5501603 DOI: 10.1371/journal.pone.0180831] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 05/15/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Kidney transplantation is a life-saving treatment for patients with end-stage renal disease. However, despite progress in surgical techniques and patient management, immunological rejection continues to have a negative impact on graft function and overall survival. Incompatibility between donors and recipients for human leukocyte antigens (HLA) of the major histocompatibility complex (MHC) generates a series of complex cellular and humoral immune response mechanisms that are largely responsible for rejection and loss of graft function. Within this context, a growing amount of evidence shows that alloreactive natural killer (NK) cells play a critical role in the immune response mechanisms elicited by the allograft. Killer immunoglobulin-like receptors (KIRs) are prominent mediators of NK cell alloreactivity. METHODS AND FINDINGS A cohort of 174 first cadaveric kidney allograft recipients and their donors were selected from a total cohort of 657 transplanted patients for retrospective immunogenetic analyses. Patients with HLA Class II mismatches were excluded. HLA Class I allele frequencies were compared among patients with chronic rejection, patients with stable graft function and a group of 2388 healthy controls. Activating and inhibitory KIR gene frequencies, KIR haplotypes, KIR-HLA ligand matches/mismatches and combinations of recipient KIRs and donor HLA Class I ligands were compared among patients with and without chronic rejection and a group of 221 healthy controls. Patients transplanted from donors homozygous for HLA-C1 antigens had a significantly higher risk for chronic rejection than patients transplanted from donors homozygous or heterozygous for HLA-C2 antigens or with epitopes belonging to the HLA-Bw4 ligand group. The Kaplan-Meier curves obtained by dividing the patients into 3 groups according to the presence or absence of one or both of the combinations of recipient KIRs and donor HLA ligands (rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4) showed a significantly higher cumulative incidence of chronic rejection in the group of patients completely lacking these functional units. These patients showed a progressively stronger decline in modification of diet in renal disease-estimated glomerular filtration rate. CONCLUSIONS KIR genotyping should be performed at the time of enrolment of patients on the waiting list for organ transplantation. In our study, a significantly higher risk of chronic rejection after kidney transplantation was observed when recipient (r) and donor (d) pairs completely lacked the two functional rKIR-dHLA ligand combinations rKIR2DL1/dHLA-C2 and rKIR3DL1/dHLA-Bw4. This immunogenetic profile corresponds to low levels of NK cell inhibition. Therefore, patients with this high risk profile could benefit from immunosuppressive therapy aimed at reducing NK-cell cytotoxicity.
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MESH Headings
- Adult
- Cadaver
- Case-Control Studies
- Female
- Gene Expression
- Glomerular Filtration Rate
- Graft Rejection/genetics
- Graft Rejection/immunology
- Graft Rejection/pathology
- Graft Survival/genetics
- HLA-B Antigens/genetics
- HLA-B Antigens/immunology
- HLA-C Antigens/genetics
- HLA-C Antigens/immunology
- Histocompatibility
- Humans
- Kidney Failure, Chronic/immunology
- Kidney Failure, Chronic/pathology
- Kidney Failure, Chronic/surgery
- Kidney Transplantation
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Ligands
- Male
- Middle Aged
- Receptors, KIR2DL1/genetics
- Receptors, KIR2DL1/immunology
- Receptors, KIR3DL1/genetics
- Receptors, KIR3DL1/immunology
- Transplantation, Homologous
- Unrelated Donors
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Affiliation(s)
- Roberto Littera
- Regional Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- * E-mail:
| | - Gianbenedetto Piredda
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Davide Argiolas
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Elena Congeddu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Paola Ragatzu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Maurizio Melis
- Regional Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Elisabetta Carta
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | - Maria Benigna Michittu
- Kidney Transplant Unit, Department of Renal Dieases, G. Brotzu Hospital, Cagliari, Italy
| | | | - Luisella Cappai
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Rita Porcella
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Francesco Alba
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Maria Serra
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Valentina Loi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Roberta Maddi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Sandro Orrù
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giorgio La Nasa
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Hematology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Caocci
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Hematology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- Center for Advanced Studies, Research and Development (CRS4) Biomedical Sector, "Polaris" Technology Park, Pula, Cagliari, Italy
| | - Marcella Arras
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
| | - Mauro Frongia
- Complex Structure of Urology, Kidney Transplantation and Robotic Surgery, G. Brotzu Hospital, Cagliari, Italy
| | - Antonello Pani
- Complex Structure of Nephrology and Dialysis, Department of Renal Diseases, G. Brotzu Hospital, Cagliari, Italy
| | - Carlo Carcassi
- Medical Genetics, R. Binaghi Hospital, ASSL Cagliari, ATS Sardegna, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Caocci G, Greco M, Fanni D, Senes G, Littera R, Lai S, Risso P, Carcassi C, Faa G, La Nasa G. HLA-G expression and role in advanced-stage classical Hodgkin lymphoma. Eur J Histochem 2016; 60:2606. [PMID: 27349312 PMCID: PMC4933823 DOI: 10.4081/ejh.2016.2606] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 12/17/2022] Open
Abstract
Non-classical human leucocyte antigen (HLA)-G class I molecules have an important role in tumor immune escape mechanisms. We investigated HLA-G expression in lymphonode biopsies taken from 8 controls and 20 patients with advanced-stage classical Hodgkin lymphoma (cHL), in relationship to clinical outcomes and the HLA-G 14-basepair (14-bp) deletion-insertion (del-ins) polymorphism. Lymphnode tissue sections were stained using a specific murine monoclonal HLA-G antibody. HLA-G protein expression was higher in cHL patients than controls. In the group of PET-2 positive (positron emission tomography carried out after 2 cycles of standard chemotherapy) patients with a 2-year progression-free survival rate (PFS) of 40%, we observed high HLA-G protein expression within the tumor microenvironment with low expression on Hodgkin and Reed-Sternberg (HRS) cells. Conversely, PET-2 negative patients with a PFS of 86% had higher HLA-G protein expression levels on HRS cells compared to the microenvironment. Lower expression on HRS cells was significantly associated with the HLA-G 14-bp ins/ins genotype. These preliminary data suggest that the immunohistochemical pattern of HLA-G protein expression may represent a useful tool for a tailored therapy in patients with cHL, based on the modulation of HLA-G expression in relation to achievement of negative PET-2.
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La Nasa G, Greco M, Littera R, Oppi S, Celeghini I, Caria R, Lai S, Porcella R, Martino M, Romano A, Di Raimondo F, Gallamini A, Carcassi C, Caocci G. The favorable role of homozygosity for killer immunoglobulin-like receptor (KIR) A haplotype in patients with advanced-stage classic Hodgkin lymphoma. J Hematol Oncol 2016; 9:26. [PMID: 26983546 PMCID: PMC4793496 DOI: 10.1186/s13045-016-0255-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/05/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Interim positron emission tomography after 2 cycles of ABVD (iPET-2) is a good predictor of outcome in advanced-stage classic Hodgkin lymphoma. So far, there are no other prognostic biomarkers capable of identifying chemotherapy refractory patients with comparable accuracy. Despite the considerable amount of evidence suggesting that antitumor immune surveillance is downregulated in classic Hodgkin lymphoma (cHL), few data exist on the impairment of natural killer cell function and the role of their killer immunoglobulin-like receptors (KIRs). METHODS We investigated KIR gene frequencies, KIR haplotypes, and KIR-ligand combinations in a cohort of 135 patients with advanced-stage classic Hodgkin lymphoma and 221 healthy controls. We furthermore evaluated the correlation of KIR genes and KIR haplotypes with the achievement of negative iPET-2. RESULTS In the cohort of patients, the 5-year overall survival and progression-free survival were 93.6 and 79%, respectively. Homozygosity for KIR A haplotype and the HLA-C1 KIR ligand (KIR-AA/C1C1) was significantly higher in healthy controls (15.7 vs. 4.8%, p = 0.001). The KIR-AA genotype resulted to have a significant predictive power for achieving iPET-2 negativity (p = 0.039). CONCLUSIONS Homozygosity for KIR A haplotype offers protection against classic Hodgkin lymphoma. The association found for the KIR-AA genotype and achievement of negative iPET-2 suggests that KIR-AA could be used in clinical practice to enhance the chemosensitivity predictive power of iPET-2. Our results point to the possibility of adapting treatment strategies based on the combination of KIR biomarkers and PET scan.
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Affiliation(s)
- Giorgio La Nasa
- Hematology Unit, Department of Medical Sciences "M. Aresu", University of Cagliari, Via Is Guadazzonis, 3, 09126, Cagliari, Italy. .,Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy.
| | - Marianna Greco
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Roberto Littera
- Regional Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Sara Oppi
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Ivana Celeghini
- Hematology Department and BMT Unit, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
| | - Rossella Caria
- Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Sara Lai
- Regional Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Rita Porcella
- Regional Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
| | - Massimo Martino
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera BMM, Reggio Calabria, Italy
| | - Alessandra Romano
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Andrea Gallamini
- Research, Innovation and Statistics Department, Centre Antoine Lacassagne, Nice Cedex 2, France
| | - Carlo Carcassi
- Medical Genetics, Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences "M. Aresu", University of Cagliari, Via Is Guadazzonis, 3, 09126, Cagliari, Italy.,Bone Marrow Transplant Center, R. Binaghi Hospital, ASL 8, Cagliari, Italy
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Derchi G, Balocco M, Bina P, Caruso V, D'Ascola DG, Littera R, Origa R, Cappellini MD, Forni GL. Efficacy and safety of sildenafil for the treatment of severe pulmonary hypertension in patients with hemoglobinopathies: results from a long-term follow up. Haematologica 2014; 99:e17-8. [PMID: 24497563 DOI: 10.3324/haematol.2013.095810] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Littera R, Zamboni F, Tondolo V, Fantola G, Chessa L, Orrù N, Sanna M, Valentini D, Cappai L, Mulargia M, Caocci G, Arras M, Floris A, Orrù S, La Nasa G, Carcassi C. Absence of activating killer immunoglobulin-like receptor genes combined with hepatitis C viral genotype is predictive of hepatocellular carcinoma. Hum Immunol 2013; 74:1288-94. [PMID: 23756163 DOI: 10.1016/j.humimm.2013.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 05/02/2013] [Accepted: 05/29/2013] [Indexed: 11/25/2022]
Abstract
Killer immunoglobulin-like receptors and their human leukocyte antigen class I ligands have a critical role in natural killer cell response to viral pathogens and tumors. To investigate whether killer immunoglobulin-like receptor genes could influence the chronic course of hepatitis C virus infection and/or progression to hepatocellular carcinoma we retrospectively analyzed a cohort of 228 patients transplanted for hepatitis C virus-induced cirrhotic end stage liver disease, combined or not with hepatocellular carcinoma. We found that patients completely lacking activating killer immunoglobulin-like receptor genes had a high risk of developing hepatocellular carcinoma. Hepatitis C viral genotype and viral load are other risk factors that can influence the course of chronic hepatitis C virus infection. In our study, the risk conferred by hepatitis C viral genotypes was enhanced in patients lacking activating killer immunoglobulin-like receptors. These results point to an important role for activating killer immunoglobulin-like receptors in the control of hepatitis C virus infection and progression to hepatocellular carcinoma. In clinical practice, assessment of killer immunoglobulin-like receptor and hepatitis C viral genotype combinations should allow for more accurate monitoring of patients with chronic hepatitis C virus infection.
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Affiliation(s)
- Roberto Littera
- Centro Regionale Trapianti, Ospedale R. Binaghi - ASL 8, 09126 Cagliari, Italy.
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La Nasa G, Caocci G, Littera R, Atzeni S, Vacca A, Mulas O, Langiu M, Greco M, Orrù S, Orrù N, Floris A, Carcassi C. Homozygosity for killer immunoglobin-like receptor haplotype A predicts complete molecular response to treatment with tyrosine kinase inhibitors in chronic myeloid leukemia patients. Exp Hematol 2013; 41:424-31. [PMID: 23380384 DOI: 10.1016/j.exphem.2013.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 01/28/2013] [Accepted: 01/31/2013] [Indexed: 11/29/2022]
Abstract
Several recent reports suggest a possible role for killer immunoglobulin-like receptors (KIR) in the onset of chronic myeloid leukemia (CML) and response to therapy with tyrosine kinase inhibitors (TKIs). To explore this hypothesis, we studied KIRs and their human leukocyte antigen class I ligands in 59 consecutive patients with chronic-phase CML (mean age, 53 years; range, 23-81 years) and a group of 121 healthy control participants belonging to the same ethnic group as the patients. The 2-year cumulative incidence of complete molecular response, obtained after a median of 27 months (range, 4-52 months), was 51.2%. An increased frequency of the activating receptor KIR2DS1 (pm = 0.05) and a reduced frequency of the KIR-ligand combination KIR2DS2/2DL2 absent/C1 present (pm = 0.001) were significantly associated with CML. Moreover, KIR repertoires in patients appeared to influence response to TKI therapy. Homozygosity for KIR haplotype A (pm = 0.01), a decreased frequency of the inhibitory KIR gene KIR2DL2 (pm = 0.02), and low numbers of inhibitory KIR genes (pm = 0.05) were all significantly associated with achievement of complete molecular remission. These data suggest that a decrease in properly stimulated and activated NK cells might contribute to the occurrence of CML and indicate homozygosity for KIR haplotype A as a promising immunogenetic marker of complete molecular response that could help clinicians decide whether to withdraw treatment in patients with CML.
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Affiliation(s)
- Giorgio La Nasa
- Bone Marrow Transplant Center, R. Binaghi Hospital - ASL 8, Cagliari, Italy.
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Caocci G, Efficace F, Ciotti F, Roncarolo MG, Vacca A, Piras E, Littera R, Markous RSD, Collins GS, Ciceri F, Mandelli F, Marktel S, La Nasa G. Health related quality of life in Middle Eastern children with beta-thalassemia. BMC Blood Disord 2012; 12:6. [PMID: 22726530 PMCID: PMC3496588 DOI: 10.1186/1471-2326-12-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 05/18/2012] [Indexed: 11/16/2022]
Abstract
Background Thalassemia is a common disorder worldwide with a predominant incidence in Mediterranean countries, North Africa, the Middle East, India, Central Asia, and Southeast Asia. Whilst substantial progress has been made towards the improvement of Health related quality of life (HRQoL) in western countries, scarce evidence-based data exists on HRQol of thalassemia children and adolescents living in developing countries. Methods We studied 60 thalassemia children from Middle Eastern countries with a median age of 10 years (range 5 to 17 years). HRQoL was assessed with the Pediatric Quality of Life Inventory (PedsQL) 4.0. The Questionnaire was completed at baseline by all patients and their parents. The agreement between child-self and parent-proxy HRQoL reports and the relationship between HRQoL profiles and socio-demographic and clinical factors were investigated. Results The scores of parents were generally lower than those of their children for Emotional Functioning (mean 75 vs 85; p = 0.002), Psychosocial Health Summary (mean 70.3 vs 79.1; p = 0.015) and the Total Summary Score (mean 74.3 vs 77.7 p = 0.047). HRQoL was not associated with ferritin levels, hepatomegaly or frequency of transfusions or iron chelation therapy. Multivariate analysis showed that a delayed start of iron chelation had a negative impact on total PedsQL scores of both children (p = 0.046) and their parents (p = 0.007). Conclusions The PedsQL 4.0 is a useful tool for the measurement of HRQoL in pediatric thalassemia patients. This study shows that delayed start of iron chelation has a negative impact on children’s HRQoL.
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Affiliation(s)
- Giovanni Caocci
- Centro Trapianti di Midollo Osseo, P,O, "R, Binaghi", Via Is Guadazzonis, 3, 09126, Cagliari, Italy.
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Littera R, Orrù N, Caocci G, Sanna M, Mulargia M, Piras E, Vacca A, Giardini C, Orofino MG, Visani G, Bertaina A, Giorgiani G, Locatelli F, Carcassi C, La Nasa G. Interactions between killer immunoglobulin-like receptors and their human leucocyte antigen Class I ligands influence the outcome of unrelated haematopoietic stem cell transplantation for thalassaemia: a novel predictive algorithm. Br J Haematol 2011; 156:118-28. [PMID: 22077388 DOI: 10.1111/j.1365-2141.2011.08923.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In a study conducted on 114 patients undergoing unrelated donor haematopoietic stem cell transplantation (HSCT) for thalassaemia, we observed that the lack of activating killer immunoglobulin-like receptors (KIRs) on donor natural killer (NK) cells significantly increased the risk of graft-versus-host disease (GvHD) [hazard risk (HR) 4.2, 95% confidence interval (CI) 1.7-10.1, P = 0.002] and transplantation-related mortality (HR 4.7, 95% CI 1.6-14.2, P = 0.01). The risk of GvHD furthermore increased when recipients heterozygous for HLA-C KIR ligand groups (C1/C2) were transplanted from donors completely lacking activating KIRs (HR 6.1, 95% CI 1.9-19.2, P = 0.002). We also found that the risk of rejection was highest when the recipient was homozygous for the C2 HLA-KIR ligand group and the donor carried two or more activating KIRs (HR 6.8, 95% CI 1.9-24.4, P = 0.005). By interpolating the number of donor activating KIRs with recipient HLA-C KIR ligands, we created an algorithm capable of stratifying patients according to the immunogenetic risk of complications following unrelated HSCT. In clinical practice, this predictive tool could serve as an important supplement to clinical judgement and decision-making.
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Affiliation(s)
- Roberto Littera
- Centro Regionale Trapianti, Ospedale R. Binaghi - ASL 8, Cagliari, Italy.
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Caocci G, Efficace F, Ciotti F, Roncarolo MG, Vacca A, Piras E, Littera R, Dawood Markous RS, Collins GS, Ciceri F, Mandelli F, Marktel S, La Nasa G. Prospective Assessment of Health-Related Quality of Life in Pediatric Patients with Beta-Thalassemia following Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2011; 17:861-6. [DOI: 10.1016/j.bbmt.2010.09.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 09/08/2010] [Indexed: 11/16/2022]
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Littera R, Orrù N, Vacca A, Bertaina A, Caocci G, Mulargia M, Giardini C, Piras E, Mastronuzzi A, Vinti L, Orrù S, Locatelli F, Carcassi C, Nasa GL. The role of killer immunoglobulin-like receptor haplotypes on the outcome of unrelated donor haematopoietic SCT for thalassaemia. Bone Marrow Transplant 2010; 45:1618-24. [DOI: 10.1038/bmt.2010.24] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Caocci G, Atzeni S, Orrù N, Littera R, Culurgioni F, Marongiu F, La Nasa G. Response to imatinib in a patient with chronic myeloid leukemia simultaneously expressing p190(BCR-ABL) oncoprotein and JAK2V617F mutation. Leuk Res 2009; 34:e27-9. [PMID: 19748671 DOI: 10.1016/j.leukres.2009.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 08/10/2009] [Accepted: 08/10/2009] [Indexed: 10/20/2022]
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Caocci G, Atzeni S, Orrù N, Azzena L, Martorana L, Littera R, Ledda A, La Nasa G. Gynecomastia in a male after dasatinib treatment for chronic myeloid leukemia. Leukemia 2008; 22:2127-8. [PMID: 18463676 DOI: 10.1038/leu.2008.106] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Littera R, Arras M, Ledda A, Caocci G, Tronci MB, Carcassi C, La Nasa G. Long-term efficacy and tolerance of rituximab for post-transfusional alloimmune haemolytic anaemia in a thalassaemia patient. Br J Haematol 2007; 140:114-5. [PMID: 17916104 DOI: 10.1111/j.1365-2141.2007.06858.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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La Nasa G, Littera R, Locatelli F, Lai S, Alba F, Caocci G, Lisini D, Nesci S, Vacca A, Piras E, Bernardo ME, Di Cesare-Merlone A, Orrù S, Carcassi C. The human leucocyte antigen-G 14-basepair polymorphism correlates with graft-versus-host disease in unrelated bone marrow transplantation for thalassaemia. Br J Haematol 2007; 139:284-8. [PMID: 17897304 DOI: 10.1111/j.1365-2141.2007.06779.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The presence of the 14-bp insertion polymorphism of the human leucocyte antigen (HLA)-G gene (HLA-G) promotes immune tolerance through increased synthesis of HLA-G molecules. We investigated this polymorphism in a large cohort of 53 thalassaemia patients transplanted from an unrelated donor. Sixteen patients (30.2%) homozygous for the 14-bp deletion had a higher risk of developing acute graft-versus-host disease (aGvHD) than patients homozygous for the 14-bp insertion (-14-bp/-14-bp vs +14-bp/+14-bp: Relative Risk = 15.0; 95% confidence interval 1.59-141.24; P = 0.008). Therefore, the 14-bp polymorphism could be an important predictive factor for aGvHD following bone marrow transplantation.
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Affiliation(s)
- Giorgio La Nasa
- Cattedra di Ematologia, Centro Trapianti Midollo osseo, Ospedale R. Binaghi, Dipartimento di Scienze Mediche Internistiche, University of Cagliari, Cagliari, Italy
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Littera R, Carcassi C, Masala A, Piano P, Serra P, Ortu F, Corso N, Casula B, La Nasa G, Contu L, Manconi PE. HLA-dependent hypersensitivity to nevirapine in Sardinian HIV patients. AIDS 2006; 20:1621-6. [PMID: 16868443 DOI: 10.1097/01.aids.0000238408.82947.09] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Hypersensitivity reaction to nevirapine, which in some cases can be fatal, shows a higher prevalence in Sardinia in comparison with other Italian regions. OBJECTIVE This study demonstrates that hypersensitive reaction to nevirapine in Sardinian HIV-infected patients is associated with the HLA Cw8-B14 haplotype. These two HLA class I antigens are in strong linkage disequilibrium in the Sardinian population. METHODS Forty-nine Sardinian HIV-positive patients treated with nevirapine were studied. Thirteen (26%), developed a hypersensitive reaction thus requiring the drug to be discontinued. HLA class I and II molecular typing was performed in both nevirapine-hypersensitive and nevirapine-tolerant patients. To avoid biased representation of the allele frequencies in the two groups of treated patients, molecular typing was also performed in 82 HIV-positive patients who had not been treated with nevirapine. RESULTS Considerable overlap was observed for the clinical, immunological and demographic characteristics of the 13 hypersensitive patients and 36 tolerant patients. Clinical parameters included viral load, status of HIV infection, CD4 and CD8 cell counts, hepatitis C virus/hepatitis B virus co-infections. Forty-six percent (6/13) of the nevirapine-hypersensitive subjects had the HLA-Cw8 and HLA-B14(65) antigens compared with 5% (2/36) of the nevirapine-tolerant group (P = 0.004; Pc = 0.05). CONCLUSION In agreement with other recent reports, the utility of HLA typing in HIV patients to identify genetic factors that may confer susceptibility to drug-induced hypersensitive reaction was confirmed. A careful choice of antiretroviral therapy in susceptible individuals should significantly reduce the risk of severe hypersensitive reaction.
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Affiliation(s)
- Roberto Littera
- Centro Regionale Trapianti, Ospedale 'R. Binaghi', Azienda USL no. 8, Cagliari, Italy.
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La Nasa G, Argiolu F, Giardini C, Pession A, Fagioli F, Caocci G, Vacca A, De Stefano P, Piras E, Ledda A, Piroddi A, Littera R, Nesci S, Locatelli F. Unrelated bone marrow transplantation for beta-thalassemia patients: The experience of the Italian Bone Marrow Transplant Group. Ann N Y Acad Sci 2006; 1054:186-95. [PMID: 16339665 DOI: 10.1196/annals.1345.023] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Bone marrow transplantation (BMT) remains the only potentially curative treatment for patients with thalassemia major. However, most candidates for BMT do not have a suitable family donor. In order to evaluate whether BMT from an HLA-matched unrelated volunteer donor can offer a probability of cure comparable to that obtained when the donor is a compatible sibling, we carried out a study involving 68 thalassemia patients transplanted in six Italian BMT Centers. Thirty-three males and 35 females (age range, 2-37 years; median age, 15) were transplanted from unrelated volunteer donors, all selected using high-resolution molecular typing of both HLA class I and II loci. Fourteen patients were classified in risk class 1; 16 in risk class 2; and 38 in risk class III of the Pesaro classification system. Nine patients (13%) had either primary or secondary graft failure. Fourteen patients (20%) died from transplant-related causes. Grade II-IV acute graft-versus-host disease (GVHD) developed in 24 cases (40%), and chronic GVHD in 10 cases (18%). Overall survival (OS) in the cohort of 68 patients was 79.3% (CI 67-88%), whereas the Kaplan-Meier estimates of disease-free survival (DFS) with transfusion independence was 65.8% (CI 54-77%). In the group of 30 thalassemic patients in risk classes 1 and 2, the probability of OS and DFS were 96.7% (CI 90-100%) and 80.0% (CI 65-94%), respectively, whereas in the 38 patients in class 3 OS was 65.2% (CI 49-80%) and DFS was 54.5% (CI 38-70%). These data show that when donor selection is based on stringent compatibility criteria, the results of unrelated transplantation in thalassemia patients are comparable to those obtained when the donor is a compatible sibling.
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Affiliation(s)
- Giorgio La Nasa
- Centro Trapianti Midollo Osseo, Ospedale "R. Binaghi" ASL 8, via Is Guadazzonis 3, 09126 Cagliari, Italy.
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Caocci G, Baccoli R, Ledda A, Littera R, La Nasa G. A mathematical model for the evaluation of amplitude of hemoglobin fluctuations in elderly anemic patients affected by myelodysplastic syndromes: correlation with quality of life and fatigue. Leuk Res 2006; 31:249-52. [PMID: 16814382 DOI: 10.1016/j.leukres.2006.05.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 05/15/2006] [Accepted: 05/19/2006] [Indexed: 10/24/2022]
Abstract
Therapy with RBC transfusions and rHuEPO for management of anemia in patients with myelodysplastic syndromes causes recurrent fluctuations in hemoglobin levels. The purpose of this study was to elaborate a mathematical model for the interpretation of hemoglobin fluctuations and to correlate the resulting numerical parameter (Variaglobin Index) with quality of life and fatigue. In 32 myelodysplastic patients, lower amplitude of the Variaglobin Index was found significantly correlated with a better quality of life and less fatigue. The mathematical model proposed here makes it easy to monitor anemia in myelodysplastic patients and to adjust therapy accordingly.
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Affiliation(s)
- Giovanni Caocci
- Unità operativa Centro Trapianti di Midollo Osseo, P.O. "R. Binaghi", Via Is Guadazzonis 3, 09126 Cagliari, Italy.
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La Nasa G, Littera R, Maccioni A, Ledda A, Vacca A, Contu L. Voriconazole for the treatment of disseminated nodular cutaneous aspergillosis in a patient affected by acute myeloid leukemia. ACTA ACUST UNITED AC 2004; 5:178-80. [PMID: 15048069 DOI: 10.1038/sj.thj.6200341] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report a 44-year-old patient with refractory acute myeloid leukemia who developed a rare form of disseminated cutaneous aspergillosis resulting from colonization in the deep reticular dermis of Aspergillus flavus. Diagnosis was based on cutaneous biopsy. Antifungal therapy was started with liposomal amphotericin B (L AmB). However, the lesions continued to spread and there was a marked decline in the patient's clinical condition. Consequently, L AmB was replaced with voriconazole. Response to voriconazole was excellent with regression of the skin lesions and a rapid improvement of the patient's general clinical condition.
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Affiliation(s)
- Giorgio La Nasa
- Centro Trapianti di Midollo Osseo, Centro Regionale Trapianti, Ospedale R. Binaghi, ASL n. 8, Cagliari, Sardinia, Italy.
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La Nasa G, Littera R, Cocco E, Battistini L, Marrosu MG, Contu L. Allogeneic hematopoietic stem cell transplantation in a patient affected by large granular lymphocyte leukemia and multiple sclerosis. Ann Hematol 2003; 83:403-5. [PMID: 14648027 DOI: 10.1007/s00277-003-0801-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2003] [Accepted: 09/25/2003] [Indexed: 10/26/2022]
Abstract
We describe a 57-year-old man, affected by large granular lymphocyte (LGL) leukemia and concomitant primary progressive multiple sclerosis (MS), treated with allogeneic hematopoietic stem cell transplantation (HSCT) from an HLA-identical sibling. The patient was conditioned with fludarabine, busulphan, and cyclophosphamide. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-term methotrexate. At 3 years follow-up, the patient is in complete remission of LGL with a marked improvement in neurological conditions. This is the first case of allogeneic HSCT in a patient with LGL leukemia and concomitant primary progressive MS. Allogeneic HSCT, performed in our patient to cure the lymphoproliferative disorder, improved the clinical course of MS.
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Affiliation(s)
- Giorgio La Nasa
- Centro Trapianti di Midollo Osseo, Centro Regionale Trapianti, Ospedale R. Binaghi ASL n degrees 8, Via Is Guadazzonis, 3, 09126 Cagliari, Italy.
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Littera R, La Nasa G, Derchi G, Cappellini MD, Chang CYP, Contu L. Long-term treatment with sildenafil in a thalassemic patient with pulmonary hypertension. Blood 2002; 100:1516-7. [PMID: 12184280 DOI: 10.1182/blood-2002-04-1171] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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