1
|
Ciarambino T, Crispino P, Buono P, Giordano V, Trama U, Iodice V, Leoncini L, Giordano M. Efficacy and Safety of Vaccinations in Geriatric Patients: A Literature Review. Vaccines (Basel) 2023; 11:1412. [PMID: 37766089 PMCID: PMC10537287 DOI: 10.3390/vaccines11091412] [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: 08/01/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
With the progressive lengthening of the average age of the population, especially in some countries such as Italy, vaccination of the elderly is a fixed point on which most of the public health efforts are concentrating as epidemic infectious diseases, especially those of the winter, have a major impact on the progression of severe disease, hospitalization, and death. The protection of the elderly against acute infectious diseases should not only limit mortality but also have a positive impact on the fragility of these people in terms of less disability and fewer care needs. However, vaccination of the elderly population differs in efficacy and safety compared to that of other population categories since aging and the consequent loss of efficiency of the immune system lead to a reduction in the immunogenicity of vaccines without achieving a lasting antibody coverage. There are various strategies to avoid the failure of immunization by vaccines such as resorting to supplementary doses with adjuvant vaccines, increasing the dosage of the antigen used, or choosing to inoculate the serum relying on various routes of administration of the vaccine. Vaccination in the elderly is also an important factor in light of growing antibiotic resistance because it can indirectly contribute to combating antibiotic resistance, reducing theoretically the use of those agents. Furthermore, vaccination in old age reduces mortality from infectious diseases preventable with vaccines and reduces the same rate of resistance to antibiotics. Given the importance and complexity of the topic, in this review, we will deal with the main aspects of vaccination in the elderly and how it can influence mortality and healthcare costs, especially in those countries where population aging is more evident. Therefore, we conducted a systematic literature search in PubMed to identify all types of studies published up to 31 May 2023 that examined the association between vaccination and the elderly. Data extraction and quality assessment were conducted by two reviewers (PC and TC) who independently extracted the following data and assessed the quality of each study.
Collapse
Affiliation(s)
- Tiziana Ciarambino
- Internal Medicine Department, Hospital of Marcianise, ASL Caserta, 81031 Caserta, Italy
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | - Pietro Crispino
- Internal Medicine Department, Hospital of Latina, ASL Latina, 04100 Latina, Italy;
| | - Pietro Buono
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | | | - Ugo Trama
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | - Vincenzo Iodice
- ASL Caserta, Direttore Sanitario Aziendale, 81100 Caserta, Italy
| | - Laura Leoncini
- ASL Caserta, Direttore Sanitario, P.O. Marcianise, 81025 Marcianise, Italy
| | - Mauro Giordano
- Department of Advanced Medical and Surgical Science, University of Campania, L. Vanvitelli, 81100 Naples, Italy;
| |
Collapse
|
2
|
Motta M, Zanocco M, Rondinella A, Iodice V, Sin A, Fedrizzi L, Andreatta F. Inhibitive effect of 8-hydroxyquinoline on corrosion of gray cast iron in automotive braking systems. Electrochim Acta 2023. [DOI: 10.1016/j.electacta.2023.142221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
|
3
|
Fusco FM, Pisaturo M, Iodice V, Bellopede R, Tambaro O, Parrella G, Di Flumeri G, Viglietti R, Pisapia R, Carleo MA, Boccardi M, Atripaldi L, Chignoli B, Maturo N, Rescigno C, Esposito V, Dell'Aversano R, Sangiovanni V, Punzi R. COVID-19 among healthcare workers in a specialist infectious diseases setting in Naples, Southern Italy: results of a cross-sectional surveillance study. J Hosp Infect 2020; 105:596-600. [PMID: 32565367 PMCID: PMC7301109 DOI: 10.1016/j.jhin.2020.06.021] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [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: 05/05/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023]
Abstract
A coronavirus disease 2019 (COVID-19) surveillance study was performed in March–April 2020 among asymptomatic healthcare workers (HCWs) at a specialist infectious diseases hospital in Naples, Italy. All HCWs underwent two rounds of molecular and serological testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). One hundred and fifteen HCWs were tested; of these, two cases of infection were identified by reverse transcriptase polymerase chain reaction and two HCWs were SARS-CoV-2 immunoglobulin G seropositive. The overall prevalence of current or probable previous infection was 3.4%. The infection rate among HCWs was reasonably low. Most of the infected HCWs had been asymptomatic for the preceding 30 days, which supports the need for periodic screening of HCWs for COVID-19.
Collapse
Affiliation(s)
- F M Fusco
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy.
| | - M Pisaturo
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Iodice
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Bellopede
- UOC Pronto Soccorso Infettivologico ed Accettazione, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - O Tambaro
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - G Parrella
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - G Di Flumeri
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Viglietti
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Pisapia
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - M A Carleo
- UOC Immunodeficienze e Malattie Infettive di Genere, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - M Boccardi
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - L Atripaldi
- UOC Microbiologia e Virologia, AORN Ospedali dei Colli, P.O. Monaldi, Naples, Italy
| | - B Chignoli
- UOSD Medicina del Lavoro, AORN Ospedali dei Colli, Naples, Italy
| | - N Maturo
- UOC Pronto Soccorso Infettivologico ed Accettazione, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - C Rescigno
- UOC Malattie Infettive ad Indirizzo Neurologico, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Esposito
- UOC Immunodeficienze e Malattie Infettive di Genere, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Dell'Aversano
- UOC Direzione Medica di Ospedale, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - V Sangiovanni
- UOC Infezioni Sistemiche e dell'Immunodepresso, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| | - R Punzi
- UOC Malattie Infettive ed Urgenze Infettivologiche, AORN Ospedali dei Colli, P.O. 'D. Cotugno', Naples, Italy
| |
Collapse
|
4
|
Vichayanrat E, Low DA, Iodice V, Stuebner E, Hagen EM, Mathias CJ. Twenty-four-hour ambulatory blood pressure and heart rate profiles in diagnosing orthostatic hypotension in Parkinson's disease and multiple system atrophy. Eur J Neurol 2016; 24:90-97. [DOI: 10.1111/ene.13135] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 08/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E. Vichayanrat
- Autonomic Unit; National Hospital for Neurology and Neurosurgery (NHNN); London UK
- Autonomic and Neurovascular Medicine Unit; Faculty of Medicine; Imperial College London at St Mary's Hospital; London UK
| | - D. A. Low
- Autonomic and Neurovascular Medicine Unit; Faculty of Medicine; Imperial College London at St Mary's Hospital; London UK
- Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - V. Iodice
- Autonomic Unit; National Hospital for Neurology and Neurosurgery (NHNN); London UK
- Autonomic and Neurovascular Medicine Unit; Faculty of Medicine; Imperial College London at St Mary's Hospital; London UK
| | - E. Stuebner
- Clinic for Neurology and Clinical Neurophysiology; Centre of Research in Clinical Medicine (ZFKM); Helios clinic Wuppertal; University of Witten/Herdecke; Wuppertal Germany
| | - E. M. Hagen
- Autonomic and Neurovascular Medicine Unit; Faculty of Medicine; Imperial College London at St Mary's Hospital; London UK
| | - C. J. Mathias
- Autonomic Unit; National Hospital for Neurology and Neurosurgery (NHNN); London UK
- Autonomic and Neurovascular Medicine Unit; Faculty of Medicine; Imperial College London at St Mary's Hospital; London UK
| |
Collapse
|
5
|
Carr AS, Pelayo-Negro AL, Evans MR, Laurà M, Blake J, Stancanelli C, Iodice V, Wechalekar AD, Whelan CJ, Gillmore JD, Hawkins PN, Reilly MM. A study of the neuropathy associated with transthyretin amyloidosis (ATTR) in the UK. J Neurol Neurosurg Psychiatry 2016; 87:620-7. [PMID: 26243339 DOI: 10.1136/jnnp-2015-310907] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/08/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hereditary transthyretin amyloidosis (ATTR) is usually characterised by a progressive peripheral and autonomic neuropathy often with associated cardiac failure and is due to dominantly inherited transthyretin mutations causing accelerated amyloid deposition. The UK population is unique in that the majority of patients have the T60A missense mutation in ATTR where tyrosine is replaced by adenine at position 60. This has been traced to a single founder mutation from north-west Ireland. The neuropathy phenotype is less well described than the cardiac manifestations in this group. METHODS We present the findings from an observational cohort study of patients with ATTR attending the National Hospital Inherited Neuropathy Clinic between 2009 and 2013. Detailed clinical neurological and electrophysiological data were collected on all patients alongside correlating autonomic and cardiac assessments. Follow-up data were available on a subset. RESULTS Forty-four patients with genetically confirmed ATTR were assessed; 37 were symptomatic; mean age at onset=62 years, range=38-75 years; 75.7% male. T60A was the most common mutation (17/37), followed by V30M (5/37). A severe, rapidly progressive, predominantly length dependent axonal sensorimotor neuropathy was the predominant phenotype. T60A patients were distinguished by earlier and more frequent association with carpal tunnel syndrome; a predominance of negative sensory symptoms at onset; significant vibration deficits; and a non-length dependent progression of motor deficit. Progression of the neuropathy was observed over a relatively short follow-up period (2 years) in 20 patients with evidence of clinically measurable annual change in Medical Research Council (MRC) sum score (-1.5 points per year) and Charcot Marie Tooth Neuropathy Score (CMTNS:2.7 points per year), and a congruent trend in the electrophysiological measures used. CONCLUSION The description of the ATTR neuropathy phenotype, especially in the T60A patients, should aid early diagnosis as well as contribute to the understanding of its natural history.
Collapse
Affiliation(s)
- A S Carr
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - A L Pelayo-Negro
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK Department of Neurology, University Hospital "Marqués de Valdecilla", Santander, Spain
| | - M Rb Evans
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - M Laurà
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| | - J Blake
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK Department of Clinical Neurophysiology, Norfolk and Norwich University Hospital, Norwich, UK
| | - C Stancanelli
- Autonomic unit, National Hospital of Neurology and Neurosurgery, London, UK
| | - V Iodice
- Autonomic unit, National Hospital of Neurology and Neurosurgery, London, UK
| | - A D Wechalekar
- National Amyloidosis Centre, University College London Medical School, Royal Free Campus, London, UK
| | - C J Whelan
- National Amyloidosis Centre, University College London Medical School, Royal Free Campus, London, UK
| | - J D Gillmore
- National Amyloidosis Centre, University College London Medical School, Royal Free Campus, London, UK
| | - P N Hawkins
- National Amyloidosis Centre, University College London Medical School, Royal Free Campus, London, UK
| | - M M Reilly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK
| |
Collapse
|
6
|
Jones R, Vichayanrat E, Ingle G, Watson L, Lang B, Iodice V. Autoimmune autonomic ganglionopathy in a patient with ovarian teratoma. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
7
|
Ponnusamy V, Owens A, Iodice V, Mathias C. Orthostatic Intolerance and Autonomic Dysfunction following Bariatric Surgery: A case series and review of the literature. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Navarro-Otano J, Ingle G, Iodice V, Vichayanrat E, Mason L, Bleasdale-Barr K, Watson L, Hagen E. Autonomic involvement in Holmes-Adie-Ross spectrum. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Iodice V, Low D, Mathias C. Diagnosing PoTS: Additional investigations beyond the HUT and standing tests. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Hagen E, Navarro-Otano J, Iodice V, Vichayanrat E, Mason L, Bleasdale-Barr K, Ingle G. 24 Hour Blood pressure monitoring profile in Holmes-Adie-Ross spectrum. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
de Stefano G, Scognamiglio U, Iodice V, Farella N, Simeone E, Montesarchio V. Efficacy and safety of combined sequential treatment with radiofrequency ablation and sorafenib in patients with hepatocellular carcinoma in intermediate stage ineligible for tace: a prospective randomized open study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
12
|
Scognamiglio U, De Stefano G, Iodice V, Farella N, Montesarchio V, Simeone E, Chirianni A. The role of CEUS in the differential diagnosis of superficial lymphadenopathy: preliminary results of a prospective study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv348.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
13
|
Ahmed RM, Iodice V, Daveson N, Kiernan MC, Piguet O, Hodges JR. Autonomic dysregulation in frontotemporal dementia. J Neurol Neurosurg Psychiatry 2015; 86:1048-9. [PMID: 25550415 DOI: 10.1136/jnnp-2014-309424] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/08/2014] [Indexed: 11/03/2022]
Affiliation(s)
- R M Ahmed
- Neuroscience Research Australia, Sydney, New South Wales, Australia Prince of Wales Clinical School, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, the University of New South Wales, Sydney, New South Wales, Australia
| | - V Iodice
- Department of Autonomic Medicine, National Hospital for Neurology and Neurosurgery, London, UK
| | - N Daveson
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - M C Kiernan
- Neuroscience Research Australia, Sydney, New South Wales, Australia Sydney Medical School, Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - O Piguet
- Neuroscience Research Australia, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, the University of New South Wales, Sydney, New South Wales, Australia School of Medical Sciences, the University of New South Wales, Sydney, New South Wales, Australia
| | - J R Hodges
- Neuroscience Research Australia, Sydney, New South Wales, Australia ARC Centre of Excellence in Cognition and its Disorders, the University of New South Wales, Sydney, New South Wales, Australia School of Medical Sciences, the University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
14
|
Galli F, Iodice V, Lauri C, Signore A. New approaches to image thyroid cancer cells and microenvironment. Q J Nucl Med Mol Imaging 2015; 59:184-196. [PMID: 25737425] [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: 06/04/2023]
Abstract
Poorly differentiated thyroid cancer (PDTC) and undifferentiated thyroid cancer (UDTC) are still life-threatening pathologies, because of the lack of well-established diagnostic and therapeutic approaches. In the past, many attempts have been made to develop radiopharmaceutical to diagnose or treat radioactive iodine (RAI)-refractory metastases or recurrences, with limited results. Indeed, it was not possible to find a specific and overexpressed marker to be used as target of radiopharmaceuticals or targeted therapies. Nowadays, with novel advances in the field of tumor microenvironment, many new markers are available to be used as suitable targets for targeted therapies interfering with signalling pathways of cells involved in the mechanisms that favour tumor growth and metastatization. This opened new perspective in the use of radiopharmaceuticals targeting components of tumor microenvironment for early diagnosis, pre-operative staging or therapy planning and follow up with targeted drugs. In the present review we present the state of novel approaches to image thyroid cancer and its microenvironment, focusing on RAI-refractory thyroid cancer as a real clinical problem to be solved.
Collapse
Affiliation(s)
- F Galli
- Nuclear Medicine Unit, Department of Medical‑Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy -
| | | | | | | |
Collapse
|
15
|
Iodice V, Laganà B, Lauri C, Capriotti G, Germano V, D'Amelio R, Picchianti Diamanti A. Imaging B lymphocytes in autoimmune inflammatory diseases. Q J Nucl Med Mol Imaging 2014; 58:258-268. [PMID: 25265247] [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: 06/03/2023]
Abstract
B cells arise from stem cells precursor and develop through a tightly regulated and selective process that lead to the generation of different B cell populations such as transitional, mature, memory and plasma cells. These B cell subsets can be identified using flow cytometry by the expression of specific surface antigens. The growing knowledge of the pivotal role played by B cells in the development and progression of autoimmune diseases combined with the advances in monoclonal antibody technology, led in the last years to the generation of different biological agents targeting B cells. In this context, nuclear medicine can offer the possibility to use a panel of biologic radiopharmaceuticals for molecular imaging of inflammatory diseases. Radiopharmaceuticals bind to their targets with high affinity and specificity and have an excellent imaging diagnostic potential for the evaluation of disease activity, selection and monitoring of immune therapies. Several molecules have been radiolabelled for the imaging of T lymphocytes whereas, by now, the anti CD20 rituximab is the only biological therapy targeting B cells that demonstrated to be efficiently radiolabelled and used to detect inflammation in autoimmune patients.
Collapse
Affiliation(s)
- V Iodice
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy -
| | | | | | | | | | | | | |
Collapse
|
16
|
Eccles J, Iodice V, Dowell N, Owens A, Hughes L, Skipper S, Lycette Y, Humphries K, Harrison N, Mathias C, Critchley H. JOINT HYPERMOBILITY AND AUTONOMIC HYPERACTIVITY: RELEVANCE TO NEURODEVELOPMENTAL DISORDERS. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-308883.9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
17
|
Iodice V, Laganà B, Lauri C, Capriotti G, Germano V, D'Amelio R, Picchianti Diamanti A. Imaging B lymphocytes in autoimmune inflammatory diseases. Q J Nucl Med Mol Imaging 2014:R39Y9999N00A140081. [PMID: 24809276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
B cells arise from stem cells precursor and develop through a tightly regulated and selective process that lead to the generation of different B cell populations such as transitional, mature, memory and plasmacells. These B cell subsets can be identified using flow cytometry by the expression of specific surface antigens. The growing knowledge of the pivotal role played by B cells in the development and progression of autoimmune diseases combined with the advances in monoclonal antibody technology, led in the last years to the generation of different biological agents targeting B cells. In this context, nuclear medicine can offer the possibility to use a panel of biologic radiopharmaceuticals for molecular imaging of inflammatory diseases. Radiopharmaceuticals bind to their targets with high affinity and specificity and have an excellent imaging diagnostic potential for the evaluation of disease activity, selection and monitoring of immune therapies. Several molecules have been radiolabelled for the imaging of T lymphocytes whereas, by now, the anti CD20 Rituximab is the only biological therapy targeting B cells that demonstrated to be efficiently radiolabelled and used to detect inflammation in autoimmune patients.
Collapse
Affiliation(s)
- V Iodice
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Facultyof Medicine and Psychology, "Sapienza" University, Rome, Italy -
| | | | | | | | | | | | | |
Collapse
|
18
|
Vichayanrat E, Low D, Nilsen K, Iodice V, Mathias C. Cardiovascular autonomic and olfactory dysfunction in patients with Parkinson’s Disease. Auton Neurosci 2013. [DOI: 10.1016/j.autneu.2013.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
19
|
Iodice V, Low D, Mathias C. The effects of the somatostatin analogue, octreotide, on orthostasis before and after food ingestion, in the Postural Tachycardia Syndrome. Auton Neurosci 2011. [DOI: 10.1016/j.autneu.2011.05.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Coppola N, Masiello A, Tonziello G, Pisapia R, Pisaturo M, Sagnelli C, Messina V, Iodice V, Sagnelli E. Factors affecting the changes in molecular epidemiology of acute hepatitis B in a Southern Italian area. J Viral Hepat 2010; 17:493-500. [PMID: 19780943 DOI: 10.1111/j.1365-2893.2009.01201.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To explore changes in molecular epidemiology of acute viral hepatitis B (AVH-B), hepatitis B virus (HBV) genotypes were determined by direct sequencing of the Pre-S-S region in 123 consecutive patients, with AVH-B observed in Naples or its surroundings in the last decade (group AVH-B) and in 123 HBV chronic carriers [chronic carrier of HBV (CC-B) group] from the same areas, who had been hepatitis B surface antigen-positive for more than 10 years. Genotype D was less frequently detected in patients with AVH-B than in those in the CC-B group (76.4%vs 97.5%, P < 0.0001). In the AVH-B group, intravenous drug addiction (IVDA) was the prevalent risk factor (55.3%) for acquiring HBV in the 94 patients with HBV genotype D, but it was rarely recorded (6.9%) in the 29 patients with genotypes non-D (P < 0.0001); unsafe sexual intercourse was prevalent in patients with genotype non-D (72.3%) and less frequent in those with genotype D (28.8%, P < 0.005). In the AVH-B group, the prevalence of non-D genotypes increased during the observation period from 11.1% in 1999-2003 to 41.1% in 2004-2008 (P < 0.0005), paralleling the increase in the prevalence of patients with unsafe sexual intercourse; similarly, the progressive decrease in IVDA paralleled the decrease in the prevalence of genotype D (from 88.3% in 1999-2003 to 11.7% in 2004-2008). The prevalence of HBV non-D genotypes recorded in the last 10 years in AVH-B in this area shows a progressive increase, most probably because of recent changes in HBV epidemiology, namely, the HBV mass vaccination campaign and increased immigration from areas with high HBV endemicity.
Collapse
Affiliation(s)
- N Coppola
- Department of Public Medicine, Section of Infectious Diseases, 2nd University of Naples, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
BACKGROUND Autoimmune autonomic ganglionopathy is characterized by impairment of multiple autonomic domains of which sudomotor function is among the most common. Many patients with this disorder have difficulties with thermoregulation and anhidrosis. Our objective was to characterize the distribution and severity of sudomotor dysfunction in this disorder. METHODS Sudomotor function was analyzed in a cohort of 21 patients with ganglionic alpha3 nicotinic acetylcholine receptor (nAChR) antibody positive autoimmune autonomic ganglionopathy. Standard measurements of sudomotor function were used including the Thermoregulatory Sweat Test and Quantitative Sudomotor Axon Reflex Test. RESULTS The clinical presentation in all patients was characterized by widespread sudomotor dysfunction. Sudomotor impairment was predominantly postganglionic in 17 of the 21 patients studied. Higher ganglionic alpha3 nAChR antibody levels resulted in progressive postganglionic predominant dysfunction (postganglionic, r = 0.637, p = 0.002; mixed ganglionic, r = 0.709, p < 0.001). The pattern of anhidrosis on Thermoregulatory Sweat Testing was consistent with a ganglionopathy in the majority of patients (14 of 21) and a distal pattern in a minority of patients (8 of 21). These patterns of anhidrosis coupled with increasing postganglionic dysfunction in a proximal to distal pattern (foot > distal leg > proximal leg > forearm) indicate lesions at both the ganglia and distal axon of the postganglionic sudomotor sympathetic neuron. CONCLUSIONS Our data characterize the unique sudomotor dysfunction in autoimmune autonomic ganglionopathy as widespread, predominantly postganglionic, and a result of lesions at both the ganglia and distal axon. This study provides important support to the hypothesis that this disorder represents a ganglionic neuropathy.
Collapse
Affiliation(s)
- K Kimpinski
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | | | | | | | |
Collapse
|
22
|
Iodice V, Kimpinski K, Vernino S, Sandroni P, Fealey RD, Low PA. Efficacy of immunotherapy in seropositive and seronegative putative autoimmune autonomic ganglionopathy. Neurology 2009; 72:2002-8. [PMID: 19506222 DOI: 10.1212/wnl.0b013e3181a92b52] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of immunotherapy in the treatment of patients with seropositive and seronegative putative autoimmune autonomic ganglionopathy (AAG) using validated autonomic function tests and instruments. BACKGROUND AAG is an immune-mediated disorder characterized by prominent and selective involvement of autonomic nerve fibers or ganglia. Treatment with i.v. immunoglobulin (IVIg) or plasma exchange (PE) has been reported to be effective in single case reports. METHODS We studied six patients, four with seropositive and two with seronegative putative AAG, who underwent autonomic function tests and completed two validated questionnaires, to assess autonomic symptoms before and after immunomodulatory treatment. Patients were treated with standard doses of IVIg, PE, or immunosuppressants in a specific sequential therapy protocol depending on clinical response. RESULTS Of the six patients (all women, mean ages 49.3 +/- 10.6 years), four patients were ganglionic (alpha3) AChR autoantibody positive and two were autoantibody negative. All patients showed clinical improvement after treatment. Sudomotor function assessed by quantitative sudomotor axon reflex test and thermoregulatory sweat test improved in four patients after treatment. CONCLUSIONS Immunomodulatory treatment can be effective in both seropositive and seronegative putative autoimmune autonomic ganglionopathy. Plasma exchange or combined therapy with immunosuppressive agents should be considered in patients who do not benefit from i.v. immunoglobulin alone.
Collapse
Affiliation(s)
- V Iodice
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | | | | | | | | | | |
Collapse
|