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Battaglini M, Marino A, Montorsi M, Carmignani A, Ceccarelli MC, Ciofani G. Nanomaterials as Microglia Modulators in the Treatment of Central Nervous System Disorders. Adv Healthc Mater 2024; 13:e2304180. [PMID: 38112345 DOI: 10.1002/adhm.202304180] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Indexed: 12/21/2023]
Abstract
Microglia play a pivotal role in the central nervous system (CNS) homeostasis, acting as housekeepers and defenders of the surrounding environment. These cells can elicit their functions by shifting into two main phenotypes: pro-inflammatory classical phenotype, M1, and anti-inflammatory alternative phenotype, M2. Despite their pivotal role in CNS homeostasis, microglia phenotypes can influence the development and progression of several CNS disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, ischemic stroke, traumatic brain injuries, and even brain cancer. It is thus clear that the possibility of modulating microglia activation has gained attention as a therapeutic tool against many CNS pathologies. Nanomaterials are an unprecedented tool for manipulating microglia responses, in particular, to specifically target microglia and elicit an in situ immunomodulation activity. This review focuses the discussion on two main aspects: analyzing the possibility of using nanomaterials to stimulate a pro-inflammatory response of microglia against brain cancer and introducing nanostructures able to foster an anti-inflammatory response for treating neurodegenerative disorders. The final aim is to stimulate the analysis of the development of new microglia nano-immunomodulators, paving the way for innovative and effective therapeutic approaches for the treatment of CNS disorders.
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Affiliation(s)
- Matteo Battaglini
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
| | - Attilio Marino
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
| | - Margherita Montorsi
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
- Scuola Superiore Sant'Anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
| | - Alessio Carmignani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
- Scuola Superiore Sant'Anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
| | - Maria Cristina Ceccarelli
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
- Scuola Superiore Sant'Anna, The BioRobotics Institute, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
| | - Gianni Ciofani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, 56025, Italy
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Carmignani A, Battaglini M, Marino A, Pignatelli F, Ciofani G. Drug-Loaded Polydopamine Nanoparticles for Chemo/Photothermal Therapy against Colorectal Cancer Cells. ACS Appl Bio Mater 2024; 7:2205-2217. [PMID: 38489294 DOI: 10.1021/acsabm.3c01203] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Colorectal cancer (CRC) is a common and deadly malignancy, ranking second in terms of mortality and third in terms of incidence on a global scale. The survival rates for CRC patients are unsatisfactory primarily because of the absence of highly effective clinical strategies. The efficacy of existing CRC treatments, such as chemotherapy (CT), is constrained by issues such as drug resistance and damage to healthy tissues. Alternative approaches such as photothermal therapy (PTT), while offering advantages over traditional therapies, suffer instead from a low efficiency in killing tumor cells when used alone. In this context, nanostructures can efficiently contribute to a selective and targeted treatment. Here, we combined CT and PTT by developing a nanoplatform based on polydopamine nanoparticles (PDNPs), selected for their biocompatibility, drug-carrying capabilities, and ability to produce heat upon exposure to near-infrared (NIR) irradiation. As a chemotherapy drug, sorafenib has been selected, a multikinase inhibitor already approved for clinical use. By encapsulating sorafenib in polydopamine nanoparticles (Sor-PDNPs), we were able to successfully improve the drug stability in physiological media and the consequent uptake by CRC cells, thereby increasing its therapeutic effects. Upon NIR stimulus, Sor-PDNPs can induce a temperature increment of about 10 °C, encompassing both PTT and triggering a localized and massive drug release. Sor-PDNPs were tested on healthy colon cells, showing minimal adverse outcomes; conversely, they demonstrated excellent efficacy against CRC cells, with a strong capability to hinder cancer cell proliferation and induce apoptosis. Obtained findings pave the way to new synergistic chemo-photothermal approaches, maximizing the therapeutic outcomes against CRC while minimizing side effects on healthy cells.
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Affiliation(s)
- Alessio Carmignani
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
- Scuola Superiore Sant'Anna, The Biorobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Matteo Battaglini
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Attilio Marino
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Francesca Pignatelli
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Gianni Ciofani
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
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Marino A, Battaglini M, Carmignani A, Pignatelli F, De Pasquale D, Tricinci O, Ciofani G. Magnetic self-assembly of 3D multicellular microscaffolds: A biomimetic brain tumor-on-a-chip for drug delivery and selectivity testing. APL Bioeng 2023; 7:036103. [PMID: 37521177 PMCID: PMC10375466 DOI: 10.1063/5.0155037] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
In recent years, the need for highly predictive brain cancer models to test new anticancer compounds and experimental therapeutic approaches has significantly increased. Realistic in vitro brain tumor-on-a-chip platforms would allow a more accurate selection of valid candidate drugs and nanomedicines, therefore alleviating the economic and ethical issues of unsuccessful studies in vivo. Here, we present a multi-functional self-assembled brain tumor-on-a-chip model characterized by 3D glioma cultures interfaced both to nonmalignant brain cells of the peritumoral niche and to a 3D-real-scale blood-brain barrier (BBB) microfluidic system. This platform allowed us to screen multiple features, such as BBB crossing capabilities, apoptotic efficacy against GBM cells, and side effects on nonmalignant brain cells of a promising anticancer drug, nutlin-3a, which is fundamental for the treatment of brain cancer.
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Affiliation(s)
- Attilio Marino
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Matteo Battaglini
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | | | - Francesca Pignatelli
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Daniele De Pasquale
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Omar Tricinci
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Gianni Ciofani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
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Nica V, Marino A, Pucci C, Şen Ö, Emanet M, De Pasquale D, Carmignani A, Petretto A, Bartolucci M, Lauciello S, Brescia R, de Boni F, Prato M, Marras S, Drago F, Hammad M, Segets D, Ciofani G. Cell-Membrane-Coated and Cell-Penetrating Peptide-Conjugated Trimagnetic Nanoparticles for Targeted Magnetic Hyperthermia of Prostate Cancer Cells. ACS Appl Mater Interfaces 2023. [PMID: 37312240 DOI: 10.1021/acsami.3c07248] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Prostate malignancy represents the second leading cause of cancer-specific death among the male population worldwide. Herein, enhanced intracellular magnetic fluid hyperthermia is applied in vitro to treat prostate cancer (PCa) cells with minimum invasiveness and toxicity and highly specific targeting. We designed and optimized novel shape-anisotropic magnetic core-shell-shell nanoparticles (i.e., trimagnetic nanoparticles - TMNPs) with significant magnetothermal conversion following an exchange coupling effect to an external alternating magnetic field (AMF). The functional properties of the best candidate in terms of heating efficiency (i.e., Fe3O4@Mn0.5Zn0.5Fe2O4@CoFe2O4) were exploited following surface decoration with PCa cell membranes (CM) and/or LN1 cell-penetrating peptide (CPP). We demonstrated that the combination of biomimetic dual CM-CPP targeting and AMF responsiveness significantly induces caspase 9-mediated apoptosis of PCa cells. Furthermore, a downregulation of the cell cycle progression markers and a decrease of the migration rate in surviving cells were observed in response to the TMNP-assisted magnetic hyperthermia, suggesting a reduction in cancer cell aggressiveness.
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Affiliation(s)
- Valentin Nica
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Attilio Marino
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Carlotta Pucci
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Özlem Şen
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Melis Emanet
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Daniele De Pasquale
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Alessio Carmignani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
- Sant'Anna School of Advanced Studies, The Biorobotics Institute, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Andrea Petretto
- IRCCS Istituto Giannina Gaslini, Core Facilities-Clinical Proteomics and Metabolomics, Via Gerolamo Gaslini 5, 16147 Genova, Italy
| | - Martina Bartolucci
- IRCCS Istituto Giannina Gaslini, Core Facilities-Clinical Proteomics and Metabolomics, Via Gerolamo Gaslini 5, 16147 Genova, Italy
| | - Simone Lauciello
- Istituto Italiano di Tecnologia, Electron Microscopy Facility, Via Morego 30, 16163 Genova, Italy
| | - Rosaria Brescia
- Istituto Italiano di Tecnologia, Electron Microscopy Facility, Via Morego 30, 16163 Genova, Italy
| | - Francesco de Boni
- Istituto Italiano di Tecnologia, Materials Characterization Facility, Via Morego 30, 16163 Genova, Italy
| | - Mirko Prato
- Istituto Italiano di Tecnologia, Materials Characterization Facility, Via Morego 30, 16163 Genova, Italy
| | - Sergio Marras
- Istituto Italiano di Tecnologia, Materials Characterization Facility, Via Morego 30, 16163 Genova, Italy
| | - Filippo Drago
- Istituto Italiano di Tecnologia, Electron Microscopy Facility, Via Morego 30, 16163 Genova, Italy
| | - Mohaned Hammad
- University of Duisburg-Essen, Particle Science and Technology - Institute for Combustion and Gas Dynamics (IVG-PST), Carl-Benz Strasse 199, 47057 Duisburg, Germany
| | - Doris Segets
- University of Duisburg-Essen, Particle Science and Technology - Institute for Combustion and Gas Dynamics (IVG-PST), Carl-Benz Strasse 199, 47057 Duisburg, Germany
| | - Gianni Ciofani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
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Egil AC, Carmignani A, Battaglini M, Sengul BS, Acar E, Ciofani G, Ozaydin Ince G. Dual stimuli-responsive nanocarriers via a facile batch emulsion method for controlled release of Rose Bengal. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103547] [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: 10/17/2022]
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Battaglini M, Carmignani A, Martinelli C, Colica J, Marino A, Doccini S, Mollo V, Santoro F, Bartolucci M, Petretto A, Santorelli FM, Ciofani G. In vitro study of polydopamine nanoparticles as protective antioxidant agents in fibroblasts derived from ARSACS patients. Biomater Sci 2022; 10:3770-3792. [DOI: 10.1039/d2bm00729k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Reactive oxygen species (ROS) are active molecules involved in several biological functions. When the production of ROS is not counterbalanced by the action of protective antioxidant mechanisms present in living...
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Battaglini M, Marino A, Carmignani A, Tapeinos C, Cauda V, Ancona A, Garino N, Vighetto V, La Rosa G, Sinibaldi E, Ciofani G. Polydopamine Nanoparticles as an Organic and Biodegradable Multitasking Tool for Neuroprotection and Remote Neuronal Stimulation. ACS Appl Mater Interfaces 2020; 12:35782-35798. [PMID: 32693584 PMCID: PMC8009471 DOI: 10.1021/acsami.0c05497] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Oxidative stress represents a common issue in most neurological diseases, causing severe impairments of neuronal cell physiological activity that ultimately lead to neuron loss of function and cellular death. In this work, lipid-coated polydopamine nanoparticles (L-PDNPs) are proposed both as antioxidant and neuroprotective agents, and as a photothermal conversion platform able to stimulate neuronal activity. L-PDNPs showed the ability to counteract reactive oxygen species (ROS) accumulation in differentiated SH-SY5Y, prevented mitochondrial ROS-induced dysfunctions and stimulated neurite outgrowth. Moreover, for the first time in the literature, the photothermal conversion capacity of L-PDNPs was used to increase the intracellular temperature of neuron-like cells through near-infrared (NIR) laser stimulation, and this phenomenon was thoroughly investigated using a fluorescent temperature-sensitive dye and modeled from a mathematical point of view. It was also demonstrated that the increment in temperature caused by the NIR stimulation of L-PDNPs was able to produce a Ca2+ influx in differentiated SH-SY5Y, being, to the best of our knowledge, the first example of organic nanostructures used in such an approach. This work could pave the way to new and exciting applications of polydopamine-based and of other NIR-responsive antioxidant nanomaterials in neuronal research.
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Affiliation(s)
- Matteo Battaglini
- Smart
Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
- The
Biorobotics Institute, Scuola Superiore Sant’Anna, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Attilio Marino
- Smart
Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Alessio Carmignani
- Smart
Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Christos Tapeinos
- Smart
Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Valentina Cauda
- Department
of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Andrea Ancona
- Department
of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Nadia Garino
- Department
of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Veronica Vighetto
- Department
of Applied Science and Technology, Politecnico di Torino, Corso Duca Degli Abruzzi 24, 10129 Torino, Italy
| | - Gabriele La Rosa
- Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
| | - Edoardo Sinibaldi
- Bioinspired
Soft Robotics, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
| | - Gianni Ciofani
- Smart
Bio-Interfaces, Istituto Italiano di Tecnologia, Viale Rinaldo Piaggio 34, 56025 Pontedera, Italy
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Fruzzetti F, Paoletti AM, Lombardo M, Carmignani A, Genazzani AR. Attitudes of Italian women concerning suppression of menstruation with oral contraceptives. EUR J CONTRACEP REPR 2008; 13:153-7. [PMID: 18465477 DOI: 10.1080/13625180701800672] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Perceptions of menstruation vary according to culture and religion. This study addresses attitudes of Italian women towards changes in menstrual frequency induced by oral contraceptives (OCs) administered in an extended regimen. METHODS Three-hundred-and-fifty healthy women of reproductive age were enrolled in three test areas in Italy. Participants completed a standardized questionnaire. One-hundred-and-ten men, aged 21-54 years, accompanying their partners to the gynaecological consultation were also given a questionnaire to get to know their opinion about the extended use of OCs by their partner. RESULTS Only 32% of Italian women prefer to bleed monthly. The preferred frequencies in all age groups were 3-monthly (23.7%) or never (26%). Of the OC-users, 57.2% preferred to bleed less than once a month: 26% wished to bleed every 3 months, and 21.2% once a year. Among men, 58.1% considered an extended OC regimen to be acceptable. CONCLUSIONS About 60% of Italian women with spontaneous or OC-driven cycles prefer to bleed less than monthly. This fact should be kept in mind by physicians when prescribing OCs.
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Affiliation(s)
- F Fruzzetti
- Department of Obstetrics and Gynaecology, University of Pisa, Pisa, Italy.
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Mosca M, Strigini F, Doria A, Pratesi F, Tani C, Iaccarino L, Chimenti D, Carmignani A, Cecchi M, Zampieri S, Ghirardello A, Migliorini P, Bombardieri S. Anti-C1q antibodies in pregnant patients with systemic lupus erythematosus. Clin Exp Rheumatol 2007; 25:449-52. [PMID: 17631743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To study anti-C1q antibodies in pregnant patients with systemic lupus erythematosus (SLE) and to evaluate their prognostic significance for the occurrence of disease flares or pregnancy complications. METHODS Twenty-one pregnancies in 19 SLE patients prospectively followed were analyzed. Disease activity was evaluated on the basis of the physician's intention to treat and a modified version of the ECLAM index. Anti-C1q and anti-dsDNA antibodies were detected in the sera by an ELISA assay. Antinuclear antibodies, anti-ENA antibodies, anticardiolipin antibodies and lupus anticoagulant were also performed. RESULTS In all the patients the disease was inactive at the beginning of the pregnancy. Four flares of disease activity were observed in 4 pregnancies (19%) and obstetric complications were encountered in 7 pregnancies (43%). Anti-C1q antibodies were positive in 4 (19%) pregnancies and anti-dsDNA antibodies in 8 (38%). The presence of anti-phospholipid antibodies at the first assessment was correlated with the occurrence of obstetric complications (p<0.05). The presence of anti-C1q and anti-dsDNA antibodies at the first assessment had no prognostic significance for the occurrence of flares or obstetric complications during the course of pregnancy. Although the small number of patients studied did not allow for statistically significant analysis, flares appeared to be more likely to occur in patients presenting with anti-dsDNA or anti-C1q antibodies during pregnancy compared to patients with no changes in these antibody titers (43% vs 8% respectively). CONCLUSIONS The presence of anti-C1q and anti-dsDNA antibodies does not seem to be prognostic for the occurrence of flares during pregnancy. Further studies are warranted to explore this possibility.
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Affiliation(s)
- M Mosca
- Rheumatology Unit, Department of Internal Medicine, University of Pisa, Italy.
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Mandolfino T, Canciglia A, D'Alfonso M, Carmignani A. Infrainguinal revascularization based on duplex ultrasound arterial mapping. INT ANGIOL 2006; 25:256-60. [PMID: 16878073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
AIM Recent reports have advocated duplex ultrasound arterial mapping (DUAM) as the sole preoperative imaging modality for planning infrainguinal revascularization. This study reports the outcome of arterial revascularization procedures for chronic limb ischemia based on DUAM. METHODS From January 2002 to December 2004, 253 patients (175 men, 78 women) underwent infrainguinal revascularization based on DUAM. The indications for surgery were severe claudication (11%), rest pain (15%), gangrene (40%), non-healing ulcer (34%). Preoperative evaluation consisted of DUAM alone in 208 cases (82%) or a combination of DUAM and contrast arteriography (CA) in 30 (12%) and intraoperative angiography or direct exploration in 15 (6%). DUAM allowed imaging from the distal aorta to the pedal arteries and the selection of inflow and outflow bypass anastomosis sites. CA was deemed necessary due to technical difficulties or medico-legal reasons. RESULTS DUAM procedure time averaged 90+30 min. Proximal anastomosis was located in common femoral arteries in 202 cases, popliteal in 51. Distal anastomosis was to the tibial arteries in 144 cases and pedal arteries in 109. Primary patency was 89% and 67% at 12 and 36 months. Secondary patency was 93% and 82% at 12 and 36 months. CONCLUSIONS This experience shows that DUAM may be a safe alternative to CA for patients with chronic limb ischemia. Adequate training and experience is necessary to utilize this technique as the sole preoperative imaging modality for planning infrainguinal revascularization.
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Affiliation(s)
- T Mandolfino
- Unit and Specializing School of Vascular Surgery,University of Messina, Messina, Italy.
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Mosca M, Strigini F, Carmignani A, D'ascanio A, Genazzani AR, Bombardieri S. Pregnant patient with dermatomyositis successfully treated with intravenous immunoglobulin therapy. ACTA ACUST UNITED AC 2005; 53:119-21. [PMID: 15696574 DOI: 10.1002/art.20913] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M Mosca
- University of Pisa, Pisa, Italy.
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Magno C, Galì A, Inferrera A, Macrì A, Carmignani A, Famulari C. Pneumaturia in a patient with ectopic vas deferens opening in the bladder and agenesis of the ipsilateral seminal vesicle. Case report. Urol Int 2003; 70:324-6. [PMID: 12740500 DOI: 10.1159/000070144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2000] [Accepted: 11/06/2001] [Indexed: 11/19/2022]
Abstract
Ectopia of the vas deferens (EVD) combined with agenesis of the seminal vesicle, is a rare congenital abnormality. We describe a case of EVD with agenesis of the ipsilateral seminal vesicle, presenting with pneumaturia and frequent urinary tract infection.
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Affiliation(s)
- C Magno
- Urology Unit, University Hospital, University of Messina, Italy.
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Strigini FAL, Carmignani A, Cosio S, Giusti G, Gadducci A. Is reduction in size pathognomonic of functional ovarian cysts? Ultrasound Obstet Gynecol 2003; 21:622-624. [PMID: 12808685 DOI: 10.1002/uog.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Affiliation(s)
- F A L Strigini
- Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
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Mosca M, Neri R, Strigini F, Carmignani A, Totti D, Tavoni A, Bombardieri S. Pregnancy outcome in patients with undifferentiated connective tissue disease: a preliminary study on 25 pregnancies. Lupus 2002; 11:304-7. [PMID: 12090565 DOI: 10.1191/0961203302lu187oa] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [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: 11/05/2022]
Abstract
Undifferentiated connective tissue disease (UCTD) is a group of systemic autoimmune conditions not fulfilling the classification criteria for a definite connective tissue disease (CTD). While an average of 20% of UCTD patients develop a defined CTD during follow-up, the remaining patients maintain an undefined disease. Since pregnancy is considered to be an important factor that may alter the course of autoimmune diseases, we examined 25 pregnancies in 20 UCTD patients being followed at our unit in order to evaluate: (i) the pregnancy outcome; (ii) whether pregnancy is associated with flares of disease activity; and (iii) whether pregnancy may be a trigger for the development of a defined CTD. Twenty-two pregnancies (88%) were successfully brought to term, while the remaining three (12%) ended in an abortion in the first trimester. Obstetric complications were observed in six out of the 22 successful pregnancies (27%). Six patients (24%) experienced a disease flare during pregnancy or puerperium, one of whom presented a major flare and developed systemic lupus erythematosus. In the other five patients the manifestations at flare were mild and included arthritis, fever and skin rash. The incidence of flares in a control population of non-pregnant UCTD patients over a period of 1 year was 7%. Although UCTD is a mild condition, the risk of flares during pregnancy appears increased and therefore careful monitoring is as necessary as in other CTD patients. Further prospective studies will be necessary to confirm these preliminary observations.
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Affiliation(s)
- M Mosca
- Department of Internal Medicine, University of Pisa, Italy.
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Strigini FA, Cioni G, Canapicchi R, Nardini V, Capriello P, Carmignani A. Fetal intracranial hemorrhage: is minor maternal trauma a possible pathogenetic factor? Ultrasound Obstet Gynecol 2001; 18:335-342. [PMID: 11778992 DOI: 10.1046/j.0960-7692.2001.00486.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The occurrence of fetal intracranial hemorrhage before labor has been repeatedly observed. The aim of this study was to evaluate the sonographic appearance of fetal intracranial hemorrhage in relation to its location. Possible causative factors were also evaluated. DESIGN Five consecutive cases of fetal intracranial hemorrhage were identified at a single ultrasound unit between 1996 and 1999. In utero magnetic resonance imaging was also performed in four of these cases. Autopsy was performed after pregnancy termination or intrauterine fetal death (one case of each), and neurological follow-up was initiated in the three surviving infants. RESULTS Hydrocephaly was the predominant sonographic finding associated with intraventricular or subependymal hemorrhage; sonography provided the correct diagnosis in the former (two cases), whereas magnetic resonance imaging was necessary in the latter. Massive intraparenchymal hemorrhage was depicted as an irregular echoic mass, whereas extradural hemorrhage had a cystic appearance. History of minor maternal physical trauma without maternal or placental injury was elicited in all cases. Ultrasound examinations performed before or shortly after the trauma were available in all cases and showed normal fetal anatomy. CONCLUSIONS The sonographic appearance of fetal intracranial hemorrhage is variable, depending on its location. Even though sonography detected an intracranial anomaly in all cases, magnetic resonance imaging was necessary to establish the hemorrhagic nature of isolated subependymal and extradural hemorrhage. The similarity of histories involving minor maternal physical trauma in all cases, together with the absence of any known factor predisposing to fetal hemorrhage, may suggest that trauma is at least a contributing factor to the pathogenesis of fetal intracranial hemorrhage.
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Affiliation(s)
- F A Strigini
- Division of Obstetrics and Gynecology, University of Pisa, Italy.
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Anastasi G, Magno C, Carmignani A, Inferrera A, Petrelli A, Broccio G. [Validity of PSA density of the transition zone in the diagnosis of prostate cancer]. Arch Ital Urol Androl 2000; 72:190-3. [PMID: 11221034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
One hundred four patients (mean age 70.6 years) with prostatic specific antigen (PSA) values between 4 and 10 ng/ml (average 7.9 ng/ml), and with no suspects for neoplasia by digital rectal examination (DRE) and transrectal ultrasound (TRUS) were studied. In all patients PSA density for the entire prostate (PSAD) and PSA density for the transition zone (PSAT) were calculated. TRUS was performed using a 5 MHz probe. Prostate and transition zone volumes were obtained by ellipsoid formula. Aim of the study was to evaluate the PSAT predictivity for prostate cancer compared to the PSAD. Sixteen out of 104 patients (15.4%) had histologically confirmed prostate cancer, and 88 (84.6%) had benign prostatic hyperplasia. When cut-off for PSAD was 0.15 ng/ml/cc, specificity and sensitivity were respectively 75% and 68% with positive and negative predictive values of 54% and 17%; when cut-off for PSAT was 0.34% ng/ml/cc, sensitivity and specificity were respectively 100% and 68% with positive and negative predictive values of 60% and 18%. Our results, according to the literature data, suggest that PSAT seems to have a higher predictivity for prostate cancer than PSAD, providing an optimization for the employ of prostatic biopsy, especially for those patients with PSA values between 4 and 10 ng/ml.
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Affiliation(s)
- G Anastasi
- Divisione di Urologia, Azienda Policlinico Universitario, Università degli Studi di Messina
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Galimberti S, Papineschi F, Carmignani A, Testi R, Fazzi R, Petrini M. Arsenic and all-trans retinoic acid as induction therapy before autograft in a case of relapsed resistant secondary acute promyelocytic leukemia. Bone Marrow Transplant 1999; 24:345-8. [PMID: 10455379 DOI: 10.1038/sj.bmt.1701875] [Citation(s) in RCA: 15] [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: 11/09/2022]
Abstract
Arsenic trioxide has recently been reported to be successful in the treatment of promyelocytic leukemia. Several concerns about the use of this toxic agent are currently reducing its potential clinical use even in severely ill patients. In this report we describe the results achieved by As2O3 with all-trans retinoic acid in a patient suffering from secondary, relapsed, resistant promyelocytic leukemia. Several complications, including sepsis and an extensive area of skin necrosis, did not allow us to treat the patient further with chemotherapy. With As2O3 and ATRA therapy, the patient obtained a complete molecular remission without any significant toxicity and, subsequently, it was possible to perform a bone marrow autograft in a state of complete remission.
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Davini I, Becagli P, Pani M, Trippoli S, Peverini D, Messori A, Carmignani A. Cost-effectiveness of neoadjuvant multimodal therapy in patients with esophageal adenocarcinoma. Oncol Rep 1997; 4:1033-7. [PMID: 21590190 DOI: 10.3892/or.4.5.1033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We conducted an incremental cost-effectiveness analysis to evaluate an adjuvant multimodal therapy (chemotherapy + radiotherapy) in patients with esophageal adenocarcinoma undergoing surgery. We utilized the clinical data of a published controlled trial comparing preoperative chemotherapy + radiotherapy versus surgery alone. Information on costs was derived from local data and verified against reported values. Multimodal treatment was found to improve life expectancy by 196.9 discounted years every 100 subjects (survival gain of about 2 years per patient). Costs of this neoadjuvant therapy were estimated as $780,010 per 100 patients. Our cost-effectiveness analysis showed that the cost per life year gained was $3,961 for the multimodal therapy in comparison with surgery alone. The pharmacoeconomic profile of this therapeutic modality compares favorably with previous economic data calculated for other types of health care intervention.
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Affiliation(s)
- I Davini
- AZIENDA OSPED CAREGGI,DRUG INFORMAT CTR,PHARMACEUT SERV,I-50134 FLORENCE,ITALY
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