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Torri F, Balzano E, Melandro F, Maremmani P, Bertini P, Lo Pane P, Masini M, Rotondo MI, Babboni S, Del Turco S, Antonelli S, De Tata V, Biancofiore G, Guarracino F, Paolicchi A, De Simone P, Basta G, Ghinolfi D. Sequential Normothermic Regional Perfusion and End-ischemic Ex Situ Machine Perfusion Allow the Safe Use of Very Old DCD Donors in Liver Transplantation. Transplantation 2024:00007890-990000000-00686. [PMID: 38467592 DOI: 10.1097/tp.0000000000004963] [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: 03/13/2024]
Abstract
BACKGROUND In Italy, 20 min of continuous, flat-line electrocardiogram are required for death declaration. Despite prolonged warm ischemia time, Italian centers reported good outcomes in controlled donation after circulatory death (cDCD) liver transplantation by combining normothermic regional and end-ischemic machine perfusion (MP). The aim of this study was to evaluate the safety and feasibility of the use of septuagenarian and octogenarian cDCD donors with this approach. METHODS All cDCD older than 70 y were evaluated during normothermic regional perfusion and then randomly assigned to dual hypothermic or normothermic MP. RESULTS In the period from April 2021 to December 2022, 17 cDCD older than 70 y were considered. In 6 cases (35%), the graft was not considered suitable for liver transplantation, whereas 11 (65%) were evaluated and eventually transplanted. The median donor age was 82 y, being 8 (73%) older than 80. Median functional warm ischemia and no-flow time were 36 and 28 min, respectively. Grafts were randomly assigned to ex situ dual hypothermic oxygenated MP in 6 cases (55%) and normothermic MP in 5 (45%). None was discarded during MP. There were no cases of primary nonfunction, 1 case of postreperfusion syndrome (9%) and 2 cases (18%) of early allograft dysfunction. At a median follow-up of 8 mo, no vascular complications or ischemic cholangiopathy were reported. No major differences were found in terms of postoperative hospitalization or complications based on the type of MP. CONCLUSIONS The implementation of sequential normothermic regional and end-ischemic MP allows the safe use of very old donation after circulatory death donors.
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Affiliation(s)
- Francesco Torri
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
| | - Emanuele Balzano
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
| | - Paolo Maremmani
- Department of Anesthesia and Critical Care Medicine, University of Pisa Hospital, Pisa, Italy
| | - Pietro Bertini
- Department of Anesthesia and Critical Care Medicine, University of Pisa Hospital, Pisa, Italy
| | - Paolo Lo Pane
- Local Transplant Authority AUSL 6-Area Vasta Nord-Ovest, Livorno, Italy
| | - Matilde Masini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Hospital, Pisa, Italy
| | | | - Serena Babboni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Stefano Antonelli
- Local Transplant Authority, Gabriele Monasterio Fundation, Del Cuore Hospital, Massa, Italy
| | - Vincenzo De Tata
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Hospital, Pisa, Italy
| | | | - Fabio Guarracino
- Department of Anesthesia and Critical Care Medicine, University of Pisa Hospital, Pisa, Italy
| | - Aldo Paolicchi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa Hospital, Pisa, Italy
| | - Paolo De Simone
- Department of Endocrine and Metabolic Surgery and Transplantation, University of Pisa, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
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Basta G, Melandro F, Babboni S, Del Turco S, Ndreu R, Torri F, Martinelli C, Silvestrini B, Peris A, Lazzeri C, Guarracino F, Morganti R, Maremmani P, Bertini P, De Simone P, Ghinolfi D. An extensive evaluation of hepatic markers of damage and regeneration in controlled and uncontrolled donation after circulatory death. Liver Transpl 2023; 29:813-826. [PMID: 36879554 DOI: 10.1097/lvt.0000000000000122] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023]
Abstract
Livers from donations after circulatory death (DCDs) are very sensitive to ischemia/reperfusion injury and thus need careful reconditioning, such as normothermic regional perfusion (NRP). So far, its impact on DCDs has not been thoroughly investigated. This pilot cohort study aimed to explore the NRP impact on liver function by evaluating dynamic changes of circulating markers and hepatic gene expression in 9 uncontrolled DCDs (uDCDs) and 10 controlled DCDs. At NRP start, controlled DCDs had lower plasma levels of inflammatory and liver damage markers, including α-glutathione s-transferase, sorbitol-dehydrogenase, malate dehydrogenase 1, liver-type arginase-1, and keratin-18, but higher levels of osteopontin, sFas, flavin mononucleotide, and succinate than uDCDs. During 4-hour NRP, some damage and inflammatory markers increased in both groups, while IL-6, HGF, and osteopontin increased only in uDCDs. At the NRP end, the tissue expression of early transcriptional regulators, apoptosis, and autophagy mediators was higher in uDCDs than in controlled DCDs. In conclusion, despite initial differences in liver damage biomarkers, the uDCD group was characterized by a major gene expression of regenerative and repair factors after the NRP procedure. Correlative analysis among circulating/tissue biomarkers and the tissue congestion/necrosis degree revealed new potential candidate biomarkers.
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Affiliation(s)
- Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Serena Babboni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Rudina Ndreu
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Francesco Torri
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Caterina Martinelli
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | | | - Adriano Peris
- Tuscany Regional Transplant Authority, Centro Regionale Allocazione Organi e Tessuti (CRAOT), Florence, Italy
| | - Chiara Lazzeri
- Tuscany Regional Transplant Authority, Centro Regionale Allocazione Organi e Tessuti (CRAOT), Florence, Italy
| | - Fabio Guarracino
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Riccardo Morganti
- Division of Medical Statistics, University of Pisa Medical School Hospital, Pisa, Italy
| | - Paolo Maremmani
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Pietro Bertini
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Paolo De Simone
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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Petroni D, Fabbri C, Babboni S, Menichetti L, Basta G, Del Turco S. Extracellular Vesicles and Intercellular Communication: Challenges for In Vivo Molecular Imaging and Tracking. Pharmaceutics 2023; 15:1639. [PMID: 37376087 DOI: 10.3390/pharmaceutics15061639] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/17/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Extracellular vesicles (EVs) are a heterogeneous class of cell-derived membrane vesicles released by various cell types that serve as mediators of intercellular signaling. When released into circulation, EVs may convey their cargo and serve as intermediaries for intracellular communication, reaching nearby cells and possibly also distant organs. In cardiovascular biology, EVs released by activated or apoptotic endothelial cells (EC-EVs) disseminate biological information at short and long distances, contributing to the development and progression of cardiovascular disease and related disorders. The significance of EC-EVs as mediators of cell-cell communication has advanced, but a thorough knowledge of the role that intercommunication plays in healthy and vascular disease is still lacking. Most data on EVs derive from in vitro studies, but there are still little reliable data available on biodistribution and specific homing EVs in vivo tissues. Molecular imaging techniques for EVs are crucial to monitoring in vivo biodistribution and the homing of EVs and their communication networks both in basal and pathological circumstances. This narrative review provides an overview of EC-EVs, trying to highlight their role as messengers of cell-cell interaction in vascular homeostasis and disease, and describes emerging applications of various imaging modalities for EVs visualization in vivo.
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Affiliation(s)
- Debora Petroni
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
| | - Costanza Fabbri
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy
| | - Serena Babboni
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
| | - Luca Menichetti
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Via Moruzzi 1, 56124 Pisa, Italy
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Mazzone A, Del Turco S, Trianni G, Quadrelli P, Marotta M, Bastiani L, Gasbarri T, D'Agostino A, Mariani M, Basta G, Foffa I, Sbrana S, Vassalle C, Ravani M, Solinas M, Berti S. The Positive Impact of Early Frailty Levels on Mortality in Elderly Patients with Severe Aortic Stenosis Undergoing Transcatheter/Surgical Aortic Valve Replacement. J Cardiovasc Dev Dis 2023; 10:jcdd10050212. [PMID: 37233180 DOI: 10.3390/jcdd10050212] [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: 03/08/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Background: Frailty is highly common in older patients (pts) undergoing transcatheter aortic valve replacement (TAVR), and it is associated with poor outcomes. The selection of patients who can benefit from this procedure is necessary and challenging. The aim of the present study is to evaluate outcomes in older severe aortic valve stenosis (AS) pts, selected by a multidisciplinary approach for surgical, clinical, and geriatric risk and referred to treatment, according to frailty levels. Methods: A total of 109 pts (83 ± 5 years; females, 68%) with AS were classified by Fried's score in pre-frail, early frail, and frail and underwent surgical aortic valve replacement SAVR/TAVR, balloon aortic valvuloplasty, or medical therapy. We evaluated geriatric, clinical, and surgical features and detected periprocedural complications. The outcome was all-cause mortality. Results: Increasing frailty was associated with the worst clinical, surgical, geriatric conditions. By using Kaplan-Meier analysis, the survival rate was higher in pre-frail and TAVR groups (p < 0.001) (median follow-up = 20 months). By using the Cox regression model, frailty (p = 0.004), heart failure (p = 0.007), EF% (p = 0.043), albumin (p = 0.018) were associated with all-cause mortality. Conclusions: According to tailored frailty management, elderly AS pts with early frailty levels seem to be the most suitable candidates for TAVR/SAVR for positive outcomes because advanced frailty would make each treatment futile or palliative.
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Affiliation(s)
- Annamaria Mazzone
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | | | - Giuseppe Trianni
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Paola Quadrelli
- Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Marco Marotta
- Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Luca Bastiani
- CNR Institute of Clinical Physiology, 56124 Pisa, Italy
| | - Tommaso Gasbarri
- Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Andreina D'Agostino
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Massimiliano Mariani
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | | | - Ilenia Foffa
- CNR Institute of Clinical Physiology, 54100 Massa, Italy
| | | | | | - Marcello Ravani
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Marco Solinas
- Adult Cardiosurgery Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy
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Ghinolfi D, Melandro F, Torri F, Esposito M, Bindi M, Biancofiore G, Basta G, Del Turco S, Lazzeri C, Rotondo MI, Peris A, De Simone P. The role of sequential normothermic regional perfusion and end-ischemic normothermic machine perfusion in liver transplantation from very extended uncontrolled donation after cardiocirculatory death. Artif Organs 2023; 47:432-440. [PMID: 36461895 DOI: 10.1111/aor.14468] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 07/07/2022] [Revised: 09/19/2022] [Accepted: 11/09/2022] [Indexed: 12/04/2022]
Abstract
The use of pre-procurement normothermic regional perfusion (NRP) allowed us to implement controlled DCD liver transplantation with results comparable to brain death donors, but the use of uncontrolled DCD is declining due to logistic challenges and the high incidence of post-transplant complications. In Italy, the mandatory stand-off period of 20 min for DCD donors has driven the combined use of NRP and ex-situ machine perfusion with the intent to counterbalance the negative impact of prolonged warm ischemia. Organ viability during NRP is based on duration of warm ischemia, regional perfusion flow, lactate, transaminases values and histology, and those used in Italy are the widest worldwide. However, this evaluation can be difficult, especially when the acute damage is particularly severe. The use of ex-situ NRP could provide a safe organ evaluation. In the period from 06/2020 to 06/2022, all DCD grafts exceeding NRP viability criteria at a single center were eventually evaluated using ex-situ normothermic machine perfusion. Machine perfusion viability criteria were based on lactate clearance, irrespectively to bile production, unless 1-h transaminases perfusate level were not exceeding 5000 IU/L. Three cases of uncontrolled DCD grafts in excess of NRP viability criteria underwent ex-situ graft evaluation. Two matched ex-situ normothermic machine perfusion viability criteria and were successfully transplanted. Both recipients are doing well after 26 and 5 months after surgery with no signs of ischemic cholangiopathy. This experience suggests that the sequential use of NRP and normothermic machine perfusion may further expand the boundaries of organ viability in uncontrolled DCD liver transplantation.
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Affiliation(s)
- Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Francesco Torri
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
| | - Massimo Esposito
- Department of Anesthesia, University Hospital of Pisa, Pisa, Italy
| | - Maria Bindi
- Department of Anesthesia, University Hospital of Pisa, Pisa, Italy
| | | | - Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Chiara Lazzeri
- CRAOT, Regional Authority for Organ and Tissue Allocation, Careggi Hospital (Centro Regionale per l'Allocazione di Organi e Tessuti), Florence, Italy
| | | | - Adriano Peris
- OTT, Regional Transplant Authority of Tuscany (Organizzazione Toscana Trapianti), Florence, Italy
| | - Paolo De Simone
- Division of Hepatic Surgery and Liver Transplantation, University Hospital of Pisa, Pisa, Italy
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Del Turco S, Bastiani L, Minichilli F, Landi P, Basta G, Pingitore A, Vassalle C. Interaction of Uric Acid and Neutrophil-to-Lymphocyte Ratio for Cardiometabolic Risk Stratification and Prognosis in Coronary Artery Disease Patients. Antioxidants (Basel) 2022; 11:2163. [PMID: 36358534 PMCID: PMC9686877 DOI: 10.3390/antiox11112163] [Citation(s) in RCA: 4] [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: 08/30/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 12/02/2023] Open
Abstract
Oxidative stress and inflammation are key factors in cardiometabolic diseases. We set out to evaluate the relationship between serum uric acid (UA) and the neutrophil-to-lymphocyte ratio (NLR) with cardiometabolic risk factors in coronary artery disease (CAD) patients, and their additive and multiplicative interactive effects on outcomes (cardiac death/CD and hard events (HE)-death plus reinfarction). A total of 2712 patients (67 ± 11 years, 1960 males) who underwent coronary angiography was retrospectively analyzed and categorized into no-CAD patients (n =806), stable-CAD patients (n =1545), and patients with acute myocardial infarction (AMI) (n =361). UA and NLR were reciprocally correlated and associated with cardiometabolic risk factors. During a mean follow-up period of 27 ± 20 months, 99-3.6% deaths, and 213-7.8% HE were registered. The Kaplan-Meier survival estimates showed significantly worse outcomes in patients with elevated UA or NLR levels. Multivariate Cox regression analysis demonstrated that NLR independently predicted CD and HE. There was no multiplicative interaction between UA and NLR; however, the use of measures of additive interaction evidenced a positive additive interaction between UA and NLR for CD and HE. Although it is clear that correlation does not imply causation, the coexistence of NRL and UA appears to have a synergistic effect, providing further information for the risk stratification of CAD patients.
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Affiliation(s)
- Serena Del Turco
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Luca Bastiani
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Fabrizio Minichilli
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Patrizia Landi
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | | | - Cristina Vassalle
- Fondazione CNR-Regione Toscana Gabriele Monasterio, 56124 Pisa, Italy
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7
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Del Turco S, Cappello V, Tapeinos C, Moscardini A, Sabatino L, Battaglini M, Melandro F, Torri F, Martinelli C, Babboni S, Silvestrini B, Morganti R, Gemmi M, De Simone P, Martins PN, Crocetti L, Peris A, Campani D, Basta G, Ciofani G, Ghinolfi D. Cerium oxide nanoparticles administration during machine perfusion of discarded human livers: A pilot study. Liver Transpl 2022; 28:1173-1185. [PMID: 35100468 DOI: 10.1002/lt.26421] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/10/2022] [Accepted: 01/20/2022] [Indexed: 01/13/2023]
Abstract
The combined approach of ex situ normothermic machine perfusion (NMP) and nanotechnology represents a strategy to mitigate ischemia/reperfusion injury in liver transplantation (LT). We evaluated the uptake, distribution, and efficacy of antioxidant cerium oxide nanoparticles (nanoceria) during normothermic perfusion of discarded human livers. A total of 9 discarded human liver grafts were randomized in 2 groups and underwent 4 h of NMP: 5 grafts were treated with nanoceria conjugated with albumin (Alb-NC; 50 µg/ml) and compared with 4 untreated grafts. The intracellular uptake of nanoceria was analyzed by electron microscopy (EM) and inductively coupled plasma-mass spectrometry (ICP-MS). The antioxidant activity of Alb-NC was assayed in liver biopsies by glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) assay, telomere length, and 4977-bp common mitochondrial DNA deletion (mtDNA4977 deletion). The cytokine profile was evaluated in perfusate samples. EM and ICP-MS confirmed Alb-NC internalization, rescue of mitochondrial phenotype, decrease of lipid droplet peroxidation, and lipofuscin granules in the treated grafts. Alb-NC exerted an antioxidant activity by increasing GSH levels (percentage change: +94% ± 25%; p = 0.01), SOD (+17% ± 4%; p = 0.02), and CAT activity (51% ± 23%; p = 0.03), reducing the occurrence of mtDNA4977 deletion (-67.2% ± 11%; p = 0.03), but did not affect cytokine release. Alb-NC during ex situ perfusion decreased oxidative stress, upregulating graft antioxidant defense. They could be a tool to improve quality grafts during NMP and represent an antioxidant strategy aimed at protecting the graft against reperfusion injury during LT.
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Affiliation(s)
- Serena Del Turco
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Valentina Cappello
- Center for Materials Interfaces, Electron Crystallography, Istituto Italiano di Tecnologia, Pontedera, Italy
| | - Christos Tapeinos
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Pontedera, Italy
| | - Aldo Moscardini
- National Enterprise for nanoScience and nanoTechnology, Scuola Normale Superiore, Pisa, Italy
| | - Laura Sabatino
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Matteo Battaglini
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Pontedera, Italy
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Francesco Torri
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Caterina Martinelli
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Serena Babboni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Beatrice Silvestrini
- Division of Interventional Radiology, University of Pisa Medical School Hospital, Pisa, Italy
| | | | - Mauro Gemmi
- Center for Materials Interfaces, Electron Crystallography, Istituto Italiano di Tecnologia, Pontedera, Italy
| | - Paolo De Simone
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Paulo N Martins
- Department of Surgery, Division of Transplantation, University of Massachusetts, Worcester, Massachusetts, USA
| | - Laura Crocetti
- Division of Interventional Radiology, University of Pisa Medical School Hospital, Pisa, Italy
| | - Adriano Peris
- Regional Transplant Authority of Tuscany, Florence, Italy
| | - Daniela Campani
- Division of Pathology, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Gianni Ciofani
- Smart Bio-Interfaces, Istituto Italiano di Tecnologia, Pontedera, Italy
| | - Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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8
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Melandro F, Basta G, Torri F, Biancofiore G, Del Turco S, Orlando F, Guarracino F, Maremmani P, Lazzeri C, Peris A, De Simone P, Ghinolfi D. Normothermic regional perfusion in liver transplantation from donation after cardiocirculatory death: Technical, biochemical, and regulatory aspects and review of literature. Artif Organs 2022; 46:1727-1740. [PMID: 35733227 DOI: 10.1111/aor.14330] [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: 01/07/2022] [Revised: 03/21/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Organs from donation after circulatory death (DCD) are increasingly used for liver transplantation, due to the persisting organ shortage and waiting list mortality. However, the use of DCD grafts is still limited by the inferior graft survival rate and the increased risk of primary non-function and biliary complications when compared to brain death donors' grafts. METHODS Abdominal normothermic regional perfusion with extracorporeal membrane oxygenation (ECMO) is an in situ preservation strategy. which may mitigate ischemia-reperfusion injuries. and has been proposed to restore blood perfusion after the determination of death thus optimizing liver function before implantation. RESULTS In this systematic review, we highlighted the clinical evidence supporting the use of normothermic regional perfusion in DCD liver underlying the pathophysiological mechanisms, and technical, logistic, and regulatory aspects. CONCLUSIONS Despite the lack of properly designed, prospective, randomized trials, the current available data suggest beneficial effects of normothermic regional perfusion on clinical outcomes after liver transplantation.
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Affiliation(s)
- Fabio Melandro
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Francesco Torri
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giandomenico Biancofiore
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy.,Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Francesco Orlando
- Hepatobiliary Surgery and Liver Transplant Center Hospital A. Cardarelli, Naples, Italy
| | - Fabio Guarracino
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Paolo Maremmani
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Chiara Lazzeri
- Tuscany Regional Transplant Authority, Centro Regionale Allocazione Organi e Tessuti (CRAOT), Florence, Italy
| | - Adriano Peris
- Tuscany Regional Transplant Authority, Centro Regionale Allocazione Organi e Tessuti (CRAOT), Florence, Italy
| | - Paolo De Simone
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy.,Department of Surgical, Medical, Biochemical Pathology and Intensive Care, University of Pisa, Pisa, Italy
| | - Davide Ghinolfi
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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Vecoli C, Basta G, Borghini A, Gaggini M, Del Turco S, Mercuri A, Gastaldelli A, Andreassi MG. Advanced glycation end products, leukocyte telomere length, and mitochondrial DNA copy number in patients with coronary artery disease and alterations of glucose homeostasis: From the GENOCOR study. Nutr Metab Cardiovasc Dis 2022; 32:1236-1244. [PMID: 35260310 DOI: 10.1016/j.numecd.2022.01.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIM Alterations of glucose homeostasis can increase advanced glycation end products (AGEs) that exacerbate vascular inflammatory disease and may increase vascular senescence and aging. This study examined the relationships between carboxymethyl-lysine (CML) and soluble receptor for AGEs (sRAGE) with leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNAcn), as cell aging biomarkers, in patients with established coronary artery disease (CAD). METHODS AND RESULTS We studied 459 patients with CAD further categorized as having normal glucose homeostasis (NG, n = 253), pre-diabetes (preT2D, n = 85), or diabetes (T2D, n = 121). All patients were followed up for the occurrence of major adverse cardiovascular events (MACEs). Plasma concentrations of sRAGE and CML were measured by ELISA. mtDNAcn and LTL were measured by qRT-PCR. CML levels were significantly higher in patients with preT2D (p < 0.007) or T2D (p < 0.003) compared with those with NG. mtDNAcn resulted lower in T2D vs preT2D (p = 0.04). At multivariate Cox proportional hazard analysis, short LTL (HR: 2.89; 95% CI: 1.11-10.1; p = 0.04) and high levels of sRAGE (HR: 2.20; 95% CI: 1.01-5.14; p = 0.04) were associated with an increased risk for MACEs in patients with preT2D and T2D, respectively. T2D patients with both short LTL and high sRAGE levels had the highest risk of MACEs (HR: 3.11; 95% CI: 1.11-9.92; p = 0.04). CONCLUSIONS High levels of sRAGE and short LTL were associated with an increased risk of MACEs, especially in patients with diabetes, supporting the usefulness of both biomarkers of glycemic impairment and aging in predicting cardiovascular outcomes in patients with CAD.
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Pignolo L, Servidio R, Basta G, Carozzo S, Tonin P, Calabrò RS, Cerasa A. The Route of Motor Recovery in Stroke Patients Driven by Exoskeleton-Robot-Assisted Therapy: A Path-Analysis. Med Sci (Basel) 2021; 9:medsci9040064. [PMID: 34842770 PMCID: PMC8628926 DOI: 10.3390/medsci9040064] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Exoskeleton-robot-assisted therapy is known to positively affect the recovery of arm functions in stroke patients. However, there is a lack of evidence regarding which variables might favor a better outcome and how this can be modulated by other factors. Methods: In this within-subject study, we evaluated the efficacy of a robot-assisted rehabilitation system in the recovery of upper limb functions. We performed a path analysis using a structural equation modeling approach in a large sample of 102 stroke patients (age 63.6 ± 13.1 years; 61% men) in the post-acute phase. They underwent 7 weeks of bilateral arm training assisted by an exoskeleton robot combined with a conventional treatment (consisting of simple physical activity together with occupational therapy). The upper extremity section of the Fugl–Meyer (FM-UE) scale at admission was used as a predictor of outcome, whereas age, gender, side of the lesion, days from the event, pain scale, duration of treatment, and number of sessions as mediators. Results: FM-UE at admission was a direct predictor of outcome, as measured by the motricity index of the contralateral upper limb and trunk control test, without any other mediating factors. Age, gender, days from the event, side of lesion, and pain scales were independently associated with outcomes. Conclusions: To the best of our knowledge, this is the first study assessing the relationship between clinical variables and outcomes induced by robot-assisted rehabilitation with a path-analysis model. We define a new route for motor recovery of stroke patients driven by exoskeleton-robot-assisted therapy, highlighting the role of FM-UE at admission as a useful predictor of outcome, although other variables need to be considered in the time-course of disease.
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Affiliation(s)
- Loris Pignolo
- S’Anna Institute, 88900 Crotone, Italy; (G.B.); (S.C.); (P.T.); (A.C.)
- Correspondence:
| | - Rocco Servidio
- Department of Cultures, Education and Society, University of Calabria, 87036 Rende, Italy;
| | - Giuseppina Basta
- S’Anna Institute, 88900 Crotone, Italy; (G.B.); (S.C.); (P.T.); (A.C.)
| | - Simone Carozzo
- S’Anna Institute, 88900 Crotone, Italy; (G.B.); (S.C.); (P.T.); (A.C.)
| | - Paolo Tonin
- S’Anna Institute, 88900 Crotone, Italy; (G.B.); (S.C.); (P.T.); (A.C.)
| | | | - Antonio Cerasa
- S’Anna Institute, 88900 Crotone, Italy; (G.B.); (S.C.); (P.T.); (A.C.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Rende, Italy
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11
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Ragusa R, Di Molfetta A, Del Turco S, Basta G, Rizzo M, Mercatanti A, Pitto L, Amodeo A, Trivella M, Caselli C. Cardiac miRNAs were involved in the regulation of pathophysiological mechanisms underlying HF in pediatric patients after ventricular assist device implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
VAD use in heart failure (HF) children have undergone rapid progress in the last three decades through pump technological innovation and improvement of perioperative care. Studies in HF adults showed that VAD put native heart at rest and lead to molecular changes in cardiac muscle, including at microRNA (miRNA) level. However, little is known on changes induced by VAD implant in cardiac miRNA expression and their putative targets in HF children.
Purpose
The aims of this study were to evaluate: 1) modification of miRNA expression in cardiac muscle from HF children after VAD support; 2) the putative targets of selected miRNAs by in silico analysis; 2) the role of the identify miRNAs on putative targets by in vitro study.
Methods
Cardiac biopsies were collected from HF children at the moment of VAD implant [n=8; 20 (7.5–64.5) months, 2 males; 19 (15.75–32.25) LVEF%] and at the time of heart transplant after VAD support [n=5; 32 (5–204) months; 4 males; 13.5 (10–18) LVEF%]. Cardiac miRNA expression was evaluated by NGS. The potential miRNA targets were identified by bioinformatics analyses and their cardiac expression by real-time PCR was evaluated. HL-1 cell line was used for testing the regulatory role of selected miRNA on predicted targets by miRNA mimic transfection study.
Results
At NGS, 465 miRNA were found on average in each sample and the cardiac expression levels of miR19a-3p, miR-1246 and miR-199b-5p decreased in HF children after VAD support compared to pre-implant (Fig. 1A-B). In silico analysis showed that more than 5000 potential gene targets regulated by miR-19a-3p, miR-1246 and miR-199b-5p. Among them, adiponectin receptors (AdipoR1, AdipoR2, T-CAD) were identified as common targets for 3 miRNAs. Real-time PCR data showed that levels of all adiponectin receptors increased significantly whilst the expression of 3 miRNAs decreased after VAD support (Fig. 1C). Moreover, AdipoR2 and T-CAD were inversely related to miRNA levels (Fig. 1D). In vitro studies confirmed the regulatory role of miR-1246 and miR-199b-5p on AdipoR2 (Fig. 1E-F), whilst only miR-199b-5p reduced the expression of T-CAD (Fig. 1G). Finally, AdipoR1 expression levels are not modified compared to control by miRNAs mimic transfection (data not shown).
Conclusion
In HF children the use of VAD could modify the expression of several miRNAs potentially involved in the regulation of several pathophysiological mechanisms underlying HF. Specifically, the reductions of miR-1246, mir-19a-3p, miR-199b-5p were associated with an increase of the adiponectin receptors AdipoR2 and T-CAD mRNA, suggesting the existence of a miRNAs related fine tuning of the adiponectin system at cardiac tissue level by VAD implant, able to favour the protective effect of adiponectin in HF cardiac muscle.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): FP7-ICT-2009 Project, Grant Agreement 24863 Figure 1
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Affiliation(s)
- R Ragusa
- National Council of Research, Pisa, Italy
| | - A Di Molfetta
- Bambino Gesu Children's Hospital, Department of Cardiothoracic surgery, Rome, Italy
| | | | - G Basta
- National Council of Research, Pisa, Italy
| | - M Rizzo
- Institute of Clinical Physiology, CNR, Tuscan Tumour Institute, Florence, Italy, Pisa, Italy
| | | | - L Pitto
- National Council of Research, Pisa, Italy
| | - A Amodeo
- Bambino Gesu Children's Hospital, Department of Cardiothoracic surgery, Rome, Italy
| | | | - C Caselli
- National Council of Research, Pisa, Italy. Fondazione Toscana Gabriele Monasterio, Pisa, Italy, Pisa, Italy
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Ragusa R, Di Molfetta A, Del Turco S, Cabiati M, Del Ry S, Basta G, Mercatanti A, Pitto L, Amodeo A, Trivella MG, Rizzo M, Caselli C. Epigenetic Regulation of Cardiac Troponin Genes in Pediatric Patients with Heart Failure Supported by Ventricular Assist Device. Biomedicines 2021; 9:biomedicines9101409. [PMID: 34680526 PMCID: PMC8533380 DOI: 10.3390/biomedicines9101409] [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: 09/13/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/16/2022] Open
Abstract
Ventricular Assist Device (VAD) therapy is considered as a part of standard care for end-stage Heart Failure (HF) children unresponsive to medical management, but the potential role of miRNAs in response to VAD therapy on molecular pathways underlying LV remodeling and cardiac function in HF is unknown. The aims of this study were to evaluate the effects of VAD on miRNA expression profile in cardiac tissue obtained from HF children, to determine the putative miRNA targets by an in-silico analysis as well as to verify the changes of predicated miRNA target in the same cardiac samples. The regulatory role of selected miRNAs on predicted targets was evaluated by a dedicated in vitro study. miRNA profile was determined in cardiac samples obtained from 13 HF children [median: 29 months; 19 LVEF%; 9 Kg] by NGS before VAD implant (pre-VAD) and at the moment of heart transplant (Post-VAD). Only hsa-miR-199b-5p, hsa-miR-19a-3p, hsa-miR-1246 were differentially expressed at post-VAD when compared to pre-VAD, and validated by real-time PCR. Putative targets of the selected miRNAs were involved in regulation of sarcomere genes, such as cardiac troponin (cTns) complex. The expression levels of fetal ad adult isoforms of cTns resulted significantly higher after VAD in cardiac tissue of HF pediatric patients when compared with HF adults. An in vitro study confirmed a down-regulatory effect of hsa-miR-19a-3p on cTnC expression. The effect of VAD on sarcomere organization through cTn isoform expression may be epigenetically regulated, suggesting for miRNAs a potential role as therapeutic targets to improve heart function in HF pediatric patients.
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Affiliation(s)
- Rosetta Ragusa
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
- Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Arianna Di Molfetta
- Departement of Cardiothoracic Surgery, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy; (A.D.M.); (A.A.)
| | - Serena Del Turco
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Manuela Cabiati
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Silvia Del Ry
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Alberto Mercatanti
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Letizia Pitto
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Antonio Amodeo
- Departement of Cardiothoracic Surgery, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy; (A.D.M.); (A.A.)
| | - Maria Giovanna Trivella
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Milena Rizzo
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
| | - Chiara Caselli
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (R.R.); (S.D.T.); (M.C.); (S.D.R.); (G.B.); (A.M.); (L.P.); (M.G.T.); (M.R.)
- Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050-3153551; Fax: +39-050-3152166
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Ghinolfi D, Melandro F, Torri F, Martinelli C, Cappello V, Babboni S, Silvestrini B, De Simone P, Basta G, Del Turco S. Extended criteria grafts and emerging therapeutics strategy in liver transplantation. The unstable balance between damage and repair. Transplant Rev (Orlando) 2021; 35:100639. [PMID: 34303259 DOI: 10.1016/j.trre.2021.100639] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 02/07/2023]
Abstract
Due to increasing demand for donor organs, "extended criteria" donors are increasingly considered for liver transplantation, including elderly donors and donors after cardiac death. The grafts of this subgroup of donors share a major risk to develop significant features of ischemia reperfusion injury, that may eventually lead to graft failure. Ex-situ machine perfusion technology has gained much interest in liver transplantation, because represents both a useful tool for improving graft quality before transplantation and a platform for the delivery of therapeutics directly to the organ. In this review, we survey ongoing clinical evidences supporting the use of elderly and DCD donors in liver transplantation, and the underlying mechanistic aspects of liver aging and ischemia reperfusion injury that influence graft quality and transplant outcome. Finally, we highlight evidences in the field of new therapeutics to test in MP in the context of recent findings of basic and translational research.
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Affiliation(s)
- Davide Ghinolfi
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy.
| | - Fabio Melandro
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Francesco Torri
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Caterina Martinelli
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Valentina Cappello
- Center for Nanotechnology Innovation@NEST, Istituto Italiano di Tecnologia, Piazza S. Silvestro 12, 56127 Pisa, Italy
| | - Serena Babboni
- Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi 1, 56124 Pisa, Italy
| | - Beatrice Silvestrini
- Department of Surgical, Medical, Molecular Pathology, and Critical Area, University of Pisa, 56122 Pisa, Italy.
| | - Paolo De Simone
- Division of Hepatic Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi 1, 56124 Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, CNR San Cataldo Research Area, via Moruzzi 1, 56124 Pisa, Italy.
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14
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Vianello A, Del Turco S, Babboni S, Silvestrini B, Ragusa R, Caselli C, Melani L, Fanucci L, Basta G. The Fight against COVID-19 on the Multi-Protease Front and Surroundings: Could an Early Therapeutic Approach with Repositioning Drugs Prevent the Disease Severity? Biomedicines 2021; 9:710. [PMID: 34201505 PMCID: PMC8301470 DOI: 10.3390/biomedicines9070710] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 12/15/2022] Open
Abstract
The interaction between the membrane spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the transmembrane angiotensin-converting enzyme 2 (ACE2) receptor of the human epithelial host cell is the first step of infection, which has a critical role for viral pathogenesis of the current coronavirus disease-2019 (COVID-19) pandemic. Following the binding between S1 subunit and ACE2 receptor, different serine proteases, including TMPRSS2 and furin, trigger and participate in the fusion of the viral envelope with the host cell membrane. On the basis of the high virulence and pathogenicity of SARS-CoV-2, other receptors have been found involved for viral binding and invasiveness of host cells. This review comprehensively discusses the mechanisms underlying the binding of SARS-CoV2 to ACE2 and putative alternative receptors, and the role of potential co-receptors and proteases in the early stages of SARS-CoV-2 infection. Given the short therapeutic time window within which to act to avoid the devastating evolution of the disease, we focused on potential therapeutic treatments-selected mainly among repurposing drugs-able to counteract the invasive front of proteases and mild inflammatory conditions, in order to prevent severe infection. Using existing approved drugs has the advantage of rapidly proceeding to clinical trials, low cost and, consequently, immediate and worldwide availability.
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Affiliation(s)
- Annamaria Vianello
- Department of Information Engineering, Telemedicine Section, University of Pisa, 56122 Pisa, Italy; (A.V.); (L.F.)
| | - Serena Del Turco
- Council of National Research (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (S.B.); (R.R.); (C.C.)
| | - Serena Babboni
- Council of National Research (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (S.B.); (R.R.); (C.C.)
| | - Beatrice Silvestrini
- Department of Surgical, Medical, Molecular Pathology, and Critical Area, University of Pisa, 56122 Pisa, Italy;
| | - Rosetta Ragusa
- Council of National Research (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (S.B.); (R.R.); (C.C.)
| | - Chiara Caselli
- Council of National Research (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (S.B.); (R.R.); (C.C.)
| | - Luca Melani
- Department of Territorial Medicine, ASL Toscana Nord-Ovest, 56121 Pisa, Italy;
| | - Luca Fanucci
- Department of Information Engineering, Telemedicine Section, University of Pisa, 56122 Pisa, Italy; (A.V.); (L.F.)
| | - Giuseppina Basta
- Council of National Research (CNR), Institute of Clinical Physiology, 56124 Pisa, Italy; (S.B.); (R.R.); (C.C.)
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15
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Ragusa R, Basta G, Neglia D, De Caterina R, Del Turco S, Caselli C. PCSK9 and atherosclerosis: Looking beyond LDL regulation. Eur J Clin Invest 2021; 51:e13459. [PMID: 33236356 DOI: 10.1111/eci.13459] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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] [Received: 09/15/2020] [Revised: 11/03/2020] [Accepted: 11/21/2020] [Indexed: 12/14/2022]
Abstract
Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) is involved in cholesterol homeostasis. After binding to the complex low-density lipoprotein (LDL)-receptor, PCSK9 induces its intracellular degradation, thus reducing serum LDL clearance. In addition to the well-known activity on the hepatic LDL receptor-mediated pathway, PCSK9 has been, however, associated with vascular inflammation in atherogenesis. Indeed, PCSK9 is expressed by various cell types that are involved in atherosclerosis (e.g. endothelial cells, smooth muscle cells and macrophages) and is detected inside human atherosclerotic plaques. We here analyse the biology of PCSK9 and its possible involvement in molecular processes involved in atherosclerosis, beyond the regulation of circulating LDL cholesterol levels.
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Affiliation(s)
- Rosetta Ragusa
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Institute of Clinical Physiology, CNR, Pisa, Italy
| | | | - Danilo Neglia
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.,Institute of Clinical Physiology, CNR, Pisa, Italy.,Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Raffaele De Caterina
- Fondazione Toscana G. Monasterio, Pisa, Italy.,Cardiovascular Division, Pisa University Hospital, University of Pisa, Pisa, Italy
| | | | - Chiara Caselli
- Institute of Clinical Physiology, CNR, Pisa, Italy.,Fondazione Toscana G. Monasterio, Pisa, Italy
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16
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Affiliation(s)
- Giuseppina Basta
- Institute of Clinical Physiology, National Research Council (CNR), San Cataldo Research Area, Via Moruzzi, 1, Pisa 56124, Italy.
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Abdel-Shafy EA, Abdel-Wahhab MA, Abdollahi M, Abdurahman NH, Adefegha SA, Adeyemi WJ, Agus HH, Alabi QK, Alara OR, Alarcón Yaquetto DE, Al-Hady DA, Ali SA, Al-Talhi T, Alvarenga MOP, Aly HF, Al-Yasi HMM, Anadón A, Aragão WAB, Ares I, Arici MA, Arriaga-Alba M, Arumugam T, Atalar MN, Aydin Y, Ayhllon-Osorio CA, Basta G, Battal A, Bittencourt LO, Boşgelmez İİ, Butanda-Ochoa A, CAM I, Capanoglu E, Catalkaya G, Cervelli T, Ceylan FD, Chemelo VDS, Chen Y, Chuturgoon AA, Colle D, Costa ACO, Del Turco S, Diab AEAA, Dludla PV, Dogan A, Eiró LG, Eken A, El-Megharbel SM, El-Nekeety AA, Erkan M, Farina M, Feng Y, Fernandes RM, Ferreira MKM, Fett R, Flampouri E, Ghazi T, Gobouri AA, Gonzaga LV, Gonzales GF, Graciela KA, Grzelak A, Guldiken B, Hamza RZ, Han Q, Hassani S, Heidari R, Hernández-Muñoz R, Ibrahim NA, Ilhan M, J T, Juanita B, Kechrid Z, Khiari M, Klibet F, KOC U, Kovács M, Kowalczyk T, Krishnaiah D, Kronberg MF, Kruszewski M, Lima LADO, Lima RR, López-Vargas MR, Louw J, Malekirad AA, Martínez MA, Martínez-Larrañaga MR, Marzouki L, Mazibuko-Mbeje SE, Mehrzad J, Merzouk AS, Merzouk H, Mézes M, Miranda GHN, Molehin OR, Momtaz S, Montero-Montoya R, Munarriz ER, Mxinwa V, Nascimento PC, Nkambule BB, Nyambuya TM, Ommati MM, Orlando P, Orta Yilmaz B, Ozkan G, Pang J, Patel VB, Paz Aparicio VM, Preedy VR, Puty B, Rajendram R, Ralston NV, Raymond LJ, Ren J, Rossen A, Rtibi K, Sak K, Schulz M, Sebai H, Serrano-Contreras JI, Sheik Abdul N, Silvestri S, Silvia LA, Sitarek P, Skała E, Şlencu BG, Śliwiński T, Sun R, Szabó A, Terpilowska S, Tiano L, Torres-Santiago G, Tuncok Y, Türkan F, Wang N, Wang S, Xu C, Xu F, Yildizbayrak N, Zepeda-Vallejo LG, Zhang C, Zhang Y, Zheng Y. Contributors. Toxicology 2021. [DOI: 10.1016/b978-0-12-819092-0.09990-8] [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]
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Del Turco S, Vianello A, Ragusa R, Caselli C, Basta G. COVID-19 and cardiovascular consequences: Is the endothelial dysfunction the hardest challenge? Thromb Res 2020; 196:143-151. [PMID: 32871306 PMCID: PMC7451195 DOI: 10.1016/j.thromres.2020.08.039] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 05/30/2020] [Revised: 08/17/2020] [Accepted: 08/26/2020] [Indexed: 12/22/2022]
Abstract
A Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has become a pandemic disease named Coronavirus Disease-19 (COVID-19) of epochal dimension. The clinical spectrum of COVID-19 is wide, ranging from asymptomatic forms to severe pneumonia, sepsis and multiple organ dysfunction syndromes resulting in poor outcomes. Among the various consequences of severe COVID-19, cardiovascular (CV) collapse appears the most serious and potentially lethal. On the other hand, pre-existent CV comorbidities are also associated with higher mortality. The most reliable hypothetical pathogenetic mechanism for CV complications and cardiac injury in severe COVID-19 patients appears to be a sustained endothelial dysfunction, caused by the interplay of inflammation and coagulation. In this review, we survey papers addressing issues related to severe COVID-19, characterized by enhanced lung microvascular loss, hypercytokinemia, hypoxemia and thrombosis. We discuss about how the virus-induced downregulation of the angiotensin converting enzyme-2 (ACE2) receptor, used to enter the host cell, could affect the renin-angiotensin system, attempting to clarify the doubts about the use of ACE inhibitors and Angiotensin-II receptor blockers in COVID-19 patients. Finally, we point out how the delicate and physiological homeostatic function of the endothelium, which turns into a disastrous battlefield of the complex interaction between "cytokine and coagulative storms", can be irreparably compromised and result in systemic inflammatory complications.
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Affiliation(s)
- Serena Del Turco
- Institute of Clinical Physiology, CNR, San Cataldo Research Area, Via Moruzzi, 1, 56124 Pisa, Italy.
| | - Annamaria Vianello
- Department of Information Engineering, Telemedicine Section, University of Pisa, Italy
| | - Rosetta Ragusa
- Institute of Clinical Physiology, CNR, San Cataldo Research Area, Via Moruzzi, 1, 56124 Pisa, Italy
| | - Chiara Caselli
- Institute of Clinical Physiology, CNR, San Cataldo Research Area, Via Moruzzi, 1, 56124 Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR, San Cataldo Research Area, Via Moruzzi, 1, 56124 Pisa, Italy.
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Ragusa R, Di Molfetta A, Del Turco S, Basta G, Cabiati M, Del Ry S, Amodeo A, Trivella M, Caselli C. Changes in circulating levels and cardiac expression of adiponectin system in children with heart failure after Ventricular Assist Device support. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Ventricular Assist Device (VAD) is increasingly used as bridge to transplantation for the treatment adult and pediatric patients with end-stage Heart Failure (HF). Unloading of heart by VAD can lead to significant molecular, structural and functional changes of cardiac muscle in HF adult patients, including an improvement of the inflammatory process. Adiponectin (ADN), an anti-inflammatory adipokine, exerts anti-hypertrophic, anti-fibrotic and anti-apoptotic effects after binding to AdipoR1, AdipoR2 and T-CAD receptors. There is an apparently paradoxical increase of ADN levels in HF adult patients, probably due ADN resistance. VAD treatment leads to an increased cardiac expression of ADN receptors in HF adults. However, little is known about the role of ADN in HF children and the effects of VAD support on ADN system in these patients.
Purpose
The aims of this study were to evaluate: 1) the circulating ADN levels from HF children and a control group of healthy children; 2) the effects of VAD treatment both on circulating levels of ADN and on the cardiac expression of ADN system in pediatric patients with HF.
Methods
Circulating levels of ADN were measured in plasma samples collected from 8 HF children [age:57±33 (mean±SD) months; 2 males; 14.2±13.5 weight; 29±8 LVEF%] before and at 4 hrs, 1, 3, 7, 14 and 30 days after VAD implant. The ADN levels of paediatric patients at baseline were compared with a group of 107 [58±7 months; 67 males] healthy children. Expression levels of AdipoR1, AdipoR2, T-CAD were determined by real-time PCR in cardiac biopsies collected from HF children at the time of VAD implant (Pre-VAD) and at the time of heart transplantation (Post-VAD).
Results
Circulating levels of ADN were significantly higher in HF compared to healthy children (Figure 1A). In HF children, plasma ADN decreased significantly in early post-operative time-course (up to 3 days Post-VAD implant) and returned to pre-operative levels in 1 month (Figure 1B). In cardiac biopsies, mRNA expression of AdipoR1, AdipoR2, T-CAD increased significantly after VAD treatment compared to Pre-VAD (Figure 2A–C).
Conclusion
In pediatric patients, high circulating levels of ADN were associated with presence of HF and were modified by VAD implant, but remained significantly abnormal. On the other hand, an increased cardiac mRNA expression of ADN receptors was observed after VAD. These results could suggest the existence of a fine tuning of the ADN system at cardiac tissue level, able to mitigate plasma abnormality and favour the cardio-protective effect of ADN.
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): SensorART-A Remote Controlled Sensorized ARTificial Heart Enabling Patients Empowerment and New Therapy Approaches
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Affiliation(s)
- R Ragusa
- National Council of Research, Pisa, Italy
| | - A Di Molfetta
- Bambino Gesu Children's Hospital, Department of Cardiothoracic surgery, Rome, Italy
| | | | - G Basta
- National Council of Research, Pisa, Italy
| | - M Cabiati
- National Council of Research, Pisa, Italy
| | - S Del Ry
- National Council of Research, Pisa, Italy
| | - A Amodeo
- Bambino Gesu Children's Hospital, Department of Cardiothoracic surgery, Rome, Italy
| | | | - C Caselli
- National Council of Research, Pisa, Italy
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Pignolo L, Basta G, Carozzo S, Bilotta M, Todaro MR, Serra S, Ciancarelli I, Tonin P, Cerasa A. A body-weight-supported visual feedback system for gait recovering in stroke patients: A randomized controlled study. Gait Posture 2020; 82:287-293. [PMID: 33002839 DOI: 10.1016/j.gaitpost.2020.09.020] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to determine the effectiveness of a novel body-weight-supported (BWS) gait training system with visual feedback, called Copernicus® (Rehalife, Italy). This computerized device provides comfortable, regular and repeatable locomotion in hemiplegic patients. Through visual real-time monitoring of gait parameters, patients are trained to transfer weight loading alternately on both feet. DESIGN A single-blind, randomized controlled study. A single center used a computer-generated randomization code to allocate treatments. SETTING Intensive rehabilitation unit (IRU) at the Institute S. Anna (Italy). PARTICIPANTS 63 first-ever stroke patients (39 men, age: 66.1 ± 9.6 years; 61.6 % with left-sided lesion) randomly distributed into three demographically/clinically matched groups. TREATMENTS All groups were treated five times a week for 2 -h sessions for six consecutive weeks. The first group ("control") underwent a conventional physical therapy; the second group performed advanced BWS gait training sessions without visual feedback (Experimental VF- group); whereas the third group used BWS with visual feedback stimulation (Experimental VF+ group). MAIN OUTCOME MEASURES Absolute changes were recorded using conventional clinical scales and kinematic measurement of static gait balance from baseline to follow-up. RESULTS Significant interaction Group*Time effects scales (F2,126 = 5.1, p-level = 0.005, η²p = 0.25; F2,126 = 4.7, p-level = 0.007, η²p = 0.19; respectively) were detected in the Functional Independence Measure and Tinetti-Balance scales. Post hoc analysis demonstrated that the recovery of motor functioning was greater for the VF + group with respect to other groups (all p's ≤ 0.001). A similar pattern of findings was also obtained with a stabilometric analysis, demonstrating a better clinical improvement in static balance after VF + treatment. CONCLUSION The proposed advanced rehabilitation system with visual feedback was more effective in improving gait recovery with respect to conventional and high-tech therapies without a sensor feedback.
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Affiliation(s)
| | | | | | | | | | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | | | - Antonio Cerasa
- S. Anna Institute, 88900, Crotone, Italy; Institute for Biomedical Research and Innovation, National Research Council, (IRIB-CNR), 87050, Mangone, CS, Italy.
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Cabiati M, Gaggini M, DE Simone P, Basta G, Gastaldelli A, Del Ry S. Assessment of RANKL/RANK/osteoprotegerin system expression in patients with hepatocellular carcinoma. Minerva Endocrinol (Torino) 2020; 46:367-369. [PMID: 32623844 DOI: 10.23736/s2724-6507.20.03163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Manuela Cabiati
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Melania Gaggini
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Paolo DE Simone
- Department of Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Silvia Del Ry
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy -
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Cabiati M, Gaggini M, DE Simone P, Basta G, Gastaldelli A, Del Ry S. Assessment of RANKL/RANK/osteoprotegerin system expression in patients with hepatocellular carcinoma. Minerva Endocrinol (Torino) 2020. [PMID: 32623844 DOI: 10.23736/s0391-1977.20.03163-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Manuela Cabiati
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Melania Gaggini
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Paolo DE Simone
- Department of Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy
| | - Silvia Del Ry
- Institute of Clinical Physiology, Italian Research Council (CNR), Pisa, Italy -
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Vassalle C, Del Turco S, Sabatino L, Basta G, Maltinti M, Sbrana F, Ndreu R, Mastorci F, Pingitore A. New inflammatory and oxidative stress-based biomarker changes in response to a half-marathon in recreational athletes. J Sports Med Phys Fitness 2020; 60:1390-1395. [PMID: 32536110 DOI: 10.23736/s0022-4707.20.10738-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Modulation of oxidative stress/inflammation during exercise may have both positive and negative health effects, depending by a number of factors (e.g. training status, and exercise type, intensity and duration) and the oxidative stress or inflammation-related biomarkers considered, which may reflect different levels of the oxidative stress/inflammatory multi entities. The aim of this study was to evaluate oxidative stress and inflammatory multi-biomarker panel in response to a half-marathon during early and delayed recovery. METHODS Blood samples (baseline, postrace within 20 min after the race end, and 24 h and 48 h after the run) from runners (N.=31, 20 males, mean age 47±6 years) were assessed for reactive oxygen species (ROM assay) and total antioxidant capacity (OXY test), leukocyte telomere length (LTL), procoagulant activity of circulating microparticles (MP-PCA), inflammatory parameters obtained by hemocrome, and irisin. RESULTS A significant decrease for OXY (from 375±71 to 280±66, 239±54, 239±45 µmolHClO/mL) after the half-marathon and during recovery was observed. A reduction for ROMs was also evidenced respect to baseline (from 328±46 to 301±39, 290±56, 320±55 AU). Instead, MP-PCA increased after the race (from 6.2±6 to 10.5±6, 7±4.3 and 5.8±2.1 nmol/L), whereas the other biomarkers did not significantly change. CONCLUSIONS The oxidant counterpart did not increase in response to the half-marathon, likely counteracted by antioxidants, which appeared greatly worn out. MP-PCA and WBC increase, always within the normality range, may represent an adaptation to regular chronic endurance training. In any case, antioxidant supply could be considered and tailored for each athlete in this exercise setting.
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Affiliation(s)
- Cristina Vassalle
- G. Monasterio Foundation, Institute of Clinical Physiology, CNR-Regione Toscana San Cataldo Research Area, Pisa, Italy -
| | - Serena Del Turco
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Laura Sabatino
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Maristella Maltinti
- G. Monasterio Foundation, Institute of Clinical Physiology, CNR-Regione Toscana San Cataldo Research Area, Pisa, Italy
| | - Francesco Sbrana
- G. Monasterio Foundation, Institute of Clinical Physiology, CNR-Regione Toscana San Cataldo Research Area, Pisa, Italy
| | - Rudina Ndreu
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
| | - Francesca Mastorci
- Institute of Clinical Physiology, CNR San Cataldo Research Area, Pisa, Italy
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Basta G, Del Turco S, Caselli C, Melani L, Vianello A. [It's world war at CoViD-19. The first battle on the front of the viral invasion against the exitus for interstitial pneumonia was decisive.]. Recenti Prog Med 2020; 111:238-252. [PMID: 32319446 DOI: 10.1701/3347.33187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
An outbreak of a new coronavirus originating from Wuhan (China), responsible for a severe acute respiratory syndrome (SARS), called SARS-CoV-2, is causing a pandemic disease called CoViD-19 (Coronavirus Disease-19), although strict containment measures and restrictions on individual travel have been taken everywhere to hinder the spread of the virus. The clinical spectrum of this infection includes, in order of lesser to greater severity, asymptomatic viremia, paucisymptomatic forms, clinical conditions characterized by respiratory failure that needs mechanical ventilation and support in an intensive care unit, systemic manifestations of infection, septic shock, and multiple organ dysfunction syndromes. There is currently no vaccine to prevent CoViD-19, but the international scientific community is intensely focused on finding a vaccine that will prevent SARS-CoV-2 transmission. In the meanwhile, to prevent hospitals from risking collapse, it is crucial to stratify patients at high risk of poor lung progression, to find effective monitoring strategies, even at home, for the positive patients and/or those highly at risk of positivity of CoViD-19. Starting from the pathogenetic mechanisms involved in the development of this infection up to the clinical characteristics of the infected patients, in this review we tried to focus on the crucial points of the infection in combination with the appropriateness of the medical intervention. We aim to offer indications of therapeutic intervention that are timely and, as far as possible, effective, targeted to the individual patient in relation to age, clinical condition and comorbidities. An early diagnosis associated with an appropriate therapeutic action in the initial stages of the disease can reduce the progression of CoViD-19 towards interstitial pneumonia, thus interfering with the number of transfers to intensive care and lethality of the pandemic in progress.
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Affiliation(s)
| | | | | | - Luca Melani
- Associazione territoriale di Medicina Generale (AFT 2) ASL Toscana Nord Ovest, Pisa
| | - Annamaria Vianello
- Dipartimento di Ingegneria dell'Informazione, Sezione di Telemedicina, Università di Pisa
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Del Turco S, Basta G, Mazzone A. Different inflammatory profile in young and elderly STEMI patients undergoing primary percutaneous coronary intervention (PPCI): Its influence on no-reflow and mortality. Int J Cardiol 2020; 298:17. [PMID: 31901263 DOI: 10.1016/j.ijcard.2019.08.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/27/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Serena Del Turco
- Institute of Clinical Physiology, CNR G. Moruzzi, 1, 56124 Pisa, Italy.
| | - Giuseppina Basta
- Institute of Clinical Physiology, CNR G. Moruzzi, 1, 56124 Pisa, Italy
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Del Turco S, Quattrini L, Colucci R, Gaggini M, La Motta C, Basta G. A 2,3-diphenylpyrido[1,2- a] pyrimidin-4-one derivative inhibits specific angiogenic factors induced by TNF-α. Saudi Pharm J 2019; 27:1174-1181. [PMID: 31885477 PMCID: PMC6921196 DOI: 10.1016/j.jsps.2019.09.014] [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: 02/07/2019] [Accepted: 09/28/2019] [Indexed: 11/30/2022] Open
Abstract
Low-grade chronic inflammation is a key process of angiogenesis in tumour progression. We investigated whether a synthetic analogue of apigenin, the 2-(3,4-dimethoxyphenyl)-3-phenyl-4H-pyrido[1,2-a] pyrimidin-4-one (called DB103), interfered with the mechanisms involved in the angiogenic process induced by the inflammatory cytokine tumour necrosis factor (TNFα). In endothelial cells, DB103 but not apigenin reduced the TNFα-induced oxidative stress. DB103 inhibited the activation of ERK1/2 but not JNK, p38 and Akt kinases, while apigenin was not so selective because it inhibited essentially all examined kinases. Similarly, apigenin inhibited the TNFα-induced transcription factors CREB, STAT3, STAT5 and NF-κB, while DB103 acted only on NF-κB. DB103 inhibited the induced-release of angiogenic factors such as monocyte chemotactic protein-1, interleukin-6 (IL-6) and angiopoietin-2 but not IL-8, while apigenin reduced the IL-6 and IL-8 release. DB103 revealed a better ability than apigenin to modulate proangiogenic responses induced by an inflammatory microenvironment.
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Affiliation(s)
- Serena Del Turco
- CNR Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy
| | - Luca Quattrini
- Department of Pharmacy, University of Pisa, Via Bonanno, 6, 56126 Pisa, Italy
| | - Rocchina Colucci
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Largo Meneghetti 2, 35131 Padova, Italy
| | - Melania Gaggini
- CNR Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy
| | - Concettina La Motta
- Department of Pharmacy, University of Pisa, Via Bonanno, 6, 56126 Pisa, Italy
| | - Giuseppina Basta
- CNR Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy
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Pignolo L, Serra S, Basta G, Carozzo S, Arcuri F, Pignataro LM, Ciancarelli I, Tonin P, Cerasa A. Data on a new neurorehabilitation approach targeting functional recovery in stroke patients. Data Brief 2019; 27:104685. [PMID: 31737755 PMCID: PMC6849111 DOI: 10.1016/j.dib.2019.104685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/23/2019] [Accepted: 10/11/2019] [Indexed: 11/28/2022] Open
Abstract
Robotic-assisted devices are known to positively affect the recovery of one specific motor effector after stroke. However, it has widely been reported that the functional status of patients is only partially ameliorated after application of this kind of advanced treatment. Here, data about the effect of a new rehabilitation approach has been described in a large population of stroke patients. We sought to validate an integrated rehabilitation system for stroke (IRSS) patients, which is composed of a set of robotic-assisted tools aimed at recovering the entire body. We evaluated the motor recovery in 84 stroke patients equally divided into experimental and control groups to assess the difference between IRSS approach and conventional rehabilitation treatment. We found that IRSS induced a significant improvement as measured by functional neurological scales, such as the barthel index and functional independence measure. The data provided in this article will assist therapists and physicians working for developing new rehabilitation protocols more focused on a holistic functional recovery approach. The data are available at Mendeley Data, https://doi.org/10.17632/wptmgm7zk2.1.
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Affiliation(s)
- Loris Pignolo
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
| | - Sebastiano Serra
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
| | - Giuseppina Basta
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
| | - Simone Carozzo
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
| | - Francesco Arcuri
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
| | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Nova Salus S.r.l., L'Aquila, Italy
| | - Paolo Tonin
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Nova Salus S.r.l., L'Aquila, Italy
| | - Antonio Cerasa
- S. Anna Institute, Research in Advanced Neurorehabilitation (RAN), 88900, Crotone, Italy
- IBFM, National Research Council, 88100, Catanzaro, Italy
- Corresponding author. Neuroimaging Unit, IBFM-CNR, 88100, Catanzaro, Italy.
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Caselli C, Ragusa R, Del Turco S, Basta G, Saraste A, Knuuti J, De Caterina R, Neglia D. P6191Proprotein convertase subtilisin/kexin type 9 (PCSK9) plasma levels are associated with the metabolic syndrome in patients with stable coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
PCSK9 is a key regulator of serum LDL-cholesterol levels. The relation of PCSK9 with other components of cardiovascular and coronary artery disease (CAD) risk is still debated.
Purpose
To evaluate the association of PCSK9 plasma levels with cardiovascular and coronary risk profile, in patients with symptoms of suspected stable CAD enrolled in the EVINCI study.
Methods
PCSK9 was measured in 522 patients (60.4±8.8 years, 318 males) with symptoms of stable CAD Individual risk was characterized by clinical and bio-humoral variables, including lipid/glucose/inflammatory profiles. Obstructive CAD was firstly ruled-in by multimodality non-invasive imaging and, subsequently, assessed by invasive coronary angiography.
Results
Patients were divided into groups according to PCSK9 quartiles: I (<138 ng/mL), II-III (138–264 ng/mL), and IV (>264 ng/mL) (Table). The prevalence of obstructive CAD at invasive angiography and statin treatment did not differ among groups. Compared with patients in quartile IV, patients in quartile I, had a higher prevalence of metabolic syndrome and higher values of body mass index. Among biomarkers, all cholesterol lipoproteins levels progressively increased from quartile I to IV, while insulin and HOMA index values decreased (Table). At multivariable analyses adjusted for medical treatment, the only clinical or bio-humoral variables independently associated with PCSK9 levels were presence of the metabolic syndrome (Coeff. −0.195, SE 0.05, p<0.0001) and HDL cholesterol levels (Coeff. 0.444, SE 0.06, p<0.0001), respectively.
Table 1 Clinical Variables Quartile I Quartile II–III Quartile IV Biomarkers Quartile I Quartile II–III Quartile IV <138 ng/L 138–264 ng/L >264 ng/L <138 ng/L 138–264 ng/L >264 ng/L (n=130) (n=261) (n=131) (n=130) (n=261) (n=131) Age, years 61±9 60±9 61±8 Glucose, mg/dL 110±30 117±41 109±29 Male gender 86 (66) 161 (62) 71 (55) Insulin, mUI/mL 13.3±12.5* 11.3±10.1 10.3±10.1 Family history 38 (29)# 86 (33) 58 (44) HOMA index 3.9±4.5* 3.5±4.1 2.9±3.3 Hypertension 78 (60) 164 (63) 88 (67) Tryglicerides, mg/dL 128±86 128±87 118±68 Hypercholesterolemia 72 (55) 158 (61) 81 (62) Total cholesterol, mg/dL 171±43* 181±45 203±55 Diabetes mellitus 43 (33) 91 (35) 37 (28) LDL, mg/dL 99±36* 104±38 119±45 Metabolic Syndrome 45 (35)# 72 (28) 19 (15) HDL, mg/dL 46±13* 52±15 61±19 BMI, kg/m2 28.02±4.00* 28.03±4.25 26.95±4.56 Total/HDL cholesterol 3.8±1.2* 3.7±1.2 3.5±1.1 Significant CAD at ICA 18 (14) 46 (18) 24 (18) hs-CRP, mg/dL 0.41±0.61 0.39±1.38 0.41±0.83 Statins treatment 68 (52) 143 (55) 58 (44) Interleukin 6, ng/L 1.60±2.75 1.30±2.49 1.30±1.68 Chi square test: #p<0.05. ANOVA: I vs. IV Quartile: *p<0.05.
Conclusion
In patients with stable CAD, low plasma levels of PCSK9 are associated with the prevalence of metabolic syndrome and its individual components, including, in particular, HDL cholesterol.
Acknowledgement/Funding
AMGEN grant, EU FP7-CP-FP506 2007 project (grant agreement no. 222915)
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - R Ragusa
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - S Del Turco
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - G Basta
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - J Knuuti
- University of Turku, Turku, Finland
| | | | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Del Turco S, Basta G, De Caterina AR, Sbrana S, Paradossi U, Taddei A, Trianni G, Ravani M, Palmieri C, Berti S, Mazzone A. Different inflammatory profile in young and elderly STEMI patients undergoing primary percutaneous coronary intervention (PPCI): Its influence on no-reflow and mortality. Int J Cardiol 2019; 290:34-39. [DOI: 10.1016/j.ijcard.2019.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/12/2019] [Accepted: 05/02/2019] [Indexed: 12/31/2022]
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Cabiati M, Gaggini M, De Simone P, Filipponi F, Basta G, Gastaldelli A, Del Ry S. Osteoprotegerin as optimal target for the screening of patients with hepatocellular carcinoma at higher risk of mortality. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.282] [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]
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Del Turco S, Ciofani G, Cappello V, Parlanti P, Gemmi M, Caselli C, Ragusa R, Papa A, Battaglia D, Sabatino L, Basta G, Mattoli V. Effects of cerium oxide nanoparticles on hemostasis: Coagulation, platelets, and vascular endothelial cells. J Biomed Mater Res A 2019; 107:1551-1562. [DOI: 10.1002/jbm.a.36669] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/14/2019] [Accepted: 02/21/2019] [Indexed: 01/18/2023]
Affiliation(s)
- Serena Del Turco
- Institute of Clinical PhysiologyCNR San Cataldo Research Area Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Gianni Ciofani
- Smart Bio‐InterfacesFondazione Istituto Italiano di Tecnologia Pontedera (Pisa), Viale Rinaldo Piaggio 34, 56025 Italy
- Department of Mechanical and Aerospace EngineeringPolitecnico di Torino Torino, Corso Duca degli Abruzzi 24, 10129 Italy
| | - Valentina Cappello
- Center for Nanotechnology Innovation@NESTFondazione Istituto Italiano di Tecnologia Pisa, Piazza San Silvestro 12, 56127 Italy
| | - Paola Parlanti
- Center for Nanotechnology Innovation@NESTFondazione Istituto Italiano di Tecnologia Pisa, Piazza San Silvestro 12, 56127 Italy
| | - Mauro Gemmi
- Center for Nanotechnology Innovation@NESTFondazione Istituto Italiano di Tecnologia Pisa, Piazza San Silvestro 12, 56127 Italy
| | - Chiara Caselli
- Institute of Clinical PhysiologyCNR San Cataldo Research Area Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Rosetta Ragusa
- Scuola Superiore Sant'Anna Pisa, Piazza Martiri della Libertà 33, 56127 Italy
| | - Angela Papa
- Department of Laboratory MedicineCNR Fondazione Toscana Gabriele Monasterio Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Debora Battaglia
- Department of Laboratory MedicineCNR Fondazione Toscana Gabriele Monasterio Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Laura Sabatino
- Institute of Clinical PhysiologyCNR San Cataldo Research Area Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Giuseppina Basta
- Institute of Clinical PhysiologyCNR San Cataldo Research Area Pisa, Via Giuseppe Moruzzi 1, 56124 Italy
| | - Virgilio Mattoli
- Center of MicroBioRobotics @SSSAFondazione Istituto Italiano di Tecnologia Pontedera (Pisa), Viale Rinaldo Piaggio 34, 56025 Italy
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Cerasa A, Arcuri F, Pignataro LM, Serra S, Messina D, Carozzo S, Biafora A, Ceraudo C, Abbruzzino L, Pignolo L, Basta G, Tonin P. The cooking therapy for cognitive rehabilitation of cerebellar damage: A case report and a review of the literature. J Clin Neurosci 2018; 59:357-361. [PMID: 30337124 DOI: 10.1016/j.jocn.2018.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/26/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND IMPORTANCE The therapeutic approach for cerebellar damages heavily relies on neurorehabilitation since there are no medications that may improve clinical symptoms mainly those related to cognitive dysfunctions. Nevertheless, neurorehabilitation programs tailored to cerebellar damages have never been validated. Here we describe a new rehabilitation approach based on cooking training (CT). The idea that cooking may stimulate cerebellar activity relies on previous evidence demonstrating the beneficial effect on the executive functions as well as in promoting neural plasticity within the cerebellum. Indeed, CT requires motor/mental coordination, thinking flexibly, planning, implementing strategies, shifting and self-monitoring behaviors, all functions drastically affected in cerebellar disorders. CASE DESCRIPTION A 68-year-old male stroke patient with isolated right cerebellar ischemia in the posterior cerebellum characterized by mild executive dysfunctions. After intensive six weekly two-hour sessions, we found that CT was effective in improving some cognitive abilities in a context of mild motor impairment. In particular, deficits in the execution of the Symbol digit modality test and Wisconsin card-sorting test were recovered. CONCLUSION The comparison of our data with those reported in previous studies confirmed the Schmahmann's hypothesis on the effectiveness of neurorehabilitation approaches in cerebellar patients acting as external timekeeping of conscious thoughts.
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Affiliation(s)
- Antonio Cerasa
- IBFM, National Research Council, 88100 Catanzaro, Italy; S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy.
| | - Francesco Arcuri
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | | | | | - Demetrio Messina
- Department of Neurology, "S. Giovanni di Dio" Hospital, Largo Bologna, 88900 Crotone, Italy
| | - Simone Carozzo
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Antonio Biafora
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Caterina Ceraudo
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Luca Abbruzzino
- Cooking Soon Association, Loc. Garga 9 San Giovanni in Fiore, 87055 Cosenza, Italy
| | - Loris Pignolo
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Giuseppina Basta
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
| | - Paolo Tonin
- S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), 88900 Crotone, Italy
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Del Turco S, Sbrana S, Basta G, Paradossi U, Trianni G, De Caterina AR, Rizza A, Ravani M, Palmieri C, Berti S, Mazzone A. P5549Different inflammatory profile in young and elderly STEMI patients undergoing primary percutaneous coronary intervention (PPCI): its influence on no-reflow. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Del Turco
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - S Sbrana
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - G Basta
- Institute of Clinical Physiology of CNR, Pisa, Italy
| | - U Paradossi
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - G Trianni
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - A R De Caterina
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - A Rizza
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - M Ravani
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - C Palmieri
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - S Berti
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
| | - A Mazzone
- Gabriele Monasterio Foundation-CNR Region Toscana, Pisa, Italy
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Mazzone A, Scalese M, Paradossi U, Del Turco S, Botto N, De Caterina A, Trianni G, Ravani M, Rizza A, Molinaro S, Palmieri C, Berti S, Basta G. How to predict new-onset atrial fibrillation in STEMI patients treated by primary percutaneous coronary intervention: The ALBO score. Vascul Pharmacol 2018. [DOI: 10.1016/j.vph.2017.12.044] [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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Mazzone A, Scalese M, Paradossi U, Del Turco S, Botto N, De Caterina A, Trianni G, Ravani M, Rizza A, Molinaro S, Palmieri C, Berti S, Basta G. Development and validation of a risk stratification score for new-onset atrial fibrillation in STEMI patients undergoing primary percutaneous coronary intervention. Int J Clin Pract 2018; 72:e13087. [PMID: 29665154 DOI: 10.1111/ijcp.13087] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/20/2018] [Indexed: 12/26/2022] Open
Abstract
AIM New-onset atrial fibrillation (NOAF) is a complication not infrequent in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) and has been associated with worse in-hospital and long-term prognosis. We aimed to develop and validate a risk score based on common clinical risk factors and routine blood biomarkers to assess the early incidence of NOAF post-pPCI, before discharge. METHODS The risk score for NOAF occurrence during hospitalisation (about 5 days) was developed in a cohort of 1135 consecutive STEMI patients undergoing pPCI while was externally validated in a temporal cohort of 771 STEMI patients. Biomarkers and clinical variables significantly contributing to predicting NOAF were assessed by multivariate Cox-regression analysis. RESULTS Independent predictors of NOAF were age ≥80 years (6.97 [3.40-14.30], hazard ratio [95% CI], P < .001), leukocyte count > 9.68 × 103 /μL (2.65 [1.57-4.48], P < .001), brain natriuretic peptide (BNP) > 80 ng/L (2.37 [1.13-4.95], P = .02) and obesity (2.07 [1.09-3.92], P = .03). By summing the hazard ratios of these predictors we derived the ALBO (acronym derived from: Age, Leucocyte, BNP and Obesity) risk score which yielded high C-statistics in both the derivation (0.734 [0.675-0.793], P < .001) and validation cohort (0.76 [0.688-0.831], P < .001). In both cohorts, using Kaplan-Meier risk analysis, the ALBO score identified a tertile of patients at highest risk (ALBO >4 points), with percentages of NOAF incidence of 30.8% and 27.4% in the derivation and validation cohort, respectively. CONCLUSION The ALBO risk score, comprising biomarkers and clinical variables that can be assessed in hospital setting, could help to identify high-risk patients for NOAF after pPCI so that a prompter action can be taken.
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Affiliation(s)
| | | | | | | | - Nicoletta Botto
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
| | | | | | - Marcello Ravani
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
| | - Antonio Rizza
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
| | | | | | - Sergio Berti
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
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Brunetti P, Basta G, Faloerni A, Calcinaro F, Pietropaolo M, Calafiore R. Immunoprotection of Pancreatic Islet Grafts within Artificial Microcapsules. Int J Artif Organs 2018. [DOI: 10.1177/039139889101401208] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To circumvent pancreatic islet graft-directed immune destruction we enveloped porcine islets within highly biocompatible and selectively permeable algin/polyaminoacid microcapsules. These special microspheres were deposited between the inner (permeable) and the outer (impermeable) layers of an artificial, coaxial vascular prosthesis, directly anastomized to blood vessels. Five dogs with spontaneous, insulin-dependent diabetes received microencapsulated porcine islets in arterio-vein iliac prosthesis by-passes. One showed complete and the remainder partial, sustained reversal of hyperglycemia. Microencapsulation may be a potential solution to immunological problems related to islet transplantation.
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Affiliation(s)
- P. Brunetti
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
| | - G. Basta
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
| | - A. Faloerni
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
| | - F. Calcinaro
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
| | - M. Pietropaolo
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
| | - R. Calafiore
- Istituto di Patologia Speciale Medica, Università di Perugia e Consorzio Interuniversitario per il Trapianto d'Organo, Perugia - Italy
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Vassalle C, Masotti S, Lubrano V, Basta G, Prontera C, Di Cecco P, Del Turco S, Sabatino L, Pingitore A. Traditional and new candidate cardiac biomarkers assessed before, early, and late after half marathon in trained subjects. Eur J Appl Physiol 2017; 118:411-417. [DOI: 10.1007/s00421-017-3783-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
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Massaro M, Basta G, Lazzerini G, Carluccio M, Bosetti F, Solaini G, Visioli F, Paolicchi A, De Caterina R. Quenching of Intracellular ROS Generation as a Mechanism for Oleate-Induced Reduction of Endothelial Activation and Early Atherogenesis. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613207] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryWe previously showed that the exposure of vascular endothelium to oleate results in reduced endothelial activation. We now investigate possible mechanisms for this effect in relation to generation of reactive oxygen species (ROS). We stimulated several types of endothelial cells with cytokines or lipopolysaccharide, with or without preincubation with 10-100 µmol/L oleate. Oleate preincubation reduced VCAM-1 expression in all cell types, as well as macrophage-colony stimulating factor release. We simultaneously measured the concentration of intracellular glutathione (GSH), the activity of GSH-related antioxidant enzymes and the production of intracellular ROS. Stimulation of endothelial cells caused a decrease of GSH and an increase in intracellular ROS. The addition of oleate before stimulation, prevented the depletion of GSH and partially prevented stimuli-induced increase of intracellular ROS. This occurred without any change in the activity of GSH-related antioxidant enzymes, superoxide dismutase and catalase. Furthermore, in a cell-free superoxide anion-generating system, oleate quenched the generation of ROS. These results indicate that oleate may exert direct vascular atheroprotective effects by inhibiting endothelial activation through a quenching of stimuli-induced increase in ROS.
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Abstract
SummaryIf delivered at elevated intensity, ultrasound potentiates enzymatic clot dissolution; however, an elevated acoustic intensity damages vascular wall and favors reocclusion. This study’s aim was to investigate whether exposure to high-frequency, lowintensity ultrasound generated by a diagnostic scanner enhances enzymatic thrombolysis, and if this effect differs in clots from blood of normal subjects and of patients with coronary artery disease (CAD). Venous blood samples were drawn from 10 healthy volunteers and from 10 CAD patients on chronic medical treatment, which also included aspirin. Each sample generated 2 radiolabelled clots, which were positioned in 2 in vitro models filled with human plasma recirculating at 37°. One clot was exposed to acetyl salicylic acid (60 μg/ml), tissue plasminogen activator (3 μg/ml) and heparin (1 IU/ml), while the other was exposed to the same medications plus ultrasound (2.5 MHz, mechanical index = 1.0) for 3 hours. Enzymatic thrombolysis was measured as solubilization of radiolabel. Normal subjects and patients did not significantly differ as to coagulation parameters, weight, volume and density of the clots, and fibrinolytic activity (p = 0.794). Ultrasound exposure did not influence thrombolysis in clots of normal subjects (p = 0.367), while it enhanced the dissolution of clots of CAD patients (p = 0.013). The enhancement was equal to 51% at 5 minutes, 32% at 15 minutes, 27% at 30 minutes, 20% at 1 hour and 19% at 3 hours (p < 0.05). Diagnostic ultrasound enhances enzymatic dissolution of clots generated from the blood of CAD patients, likely due to chronic treatment and in particular to aspirin.
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Turco SD, Basta G, Lazzerini G, Evangelista M, Rainaldi G, Tanganelli P, Camera M, Tremoli E, Caterina RD. Parallel decrease of tissue factor surface exposure and increase of tissue factor microparticle release by the n-3 fatty acid docosahexaenoate in endothelial cells. Thromb Haemost 2017. [DOI: 10.1160/th06-07-0402] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryTissue factor (TF) is expressed on the endothelium in response to inflammatory mediators, giving endothelial cells a pro-thrombotic phenotype. Since fish-derived n-3 fatty acids (FA) have been associated with reduced incidence of myocardial infarction, we investigated the endothelial effects of the most abundant n-3 FA, docosahexaenoate (DHA), on TF expression. Human umbilical vein endothelial cells were pre-incubated with DHA (or stearate and arachidonate as controls) for 48–72 hours, and then stimulated with bacterial lipopolysaccharide (LPS) or tumor necrosis factor-α. Pre-incubation of endothelial cells with DHA (but not stearate or arachidonate) concentration-dependently reduced surface protein exposure, independent of TF mRNA or total protein expression regulation. Conversely, DHA treatment in conjunction with activating stimuli, induced the release of endothelial TF-exposing microparticles from endothelial cells,quantitatively accounting for the decreasedTF cell surface exposure. In conclusion,DHA treatment, with a time-course consistent with its incorporation in membrane phospholipids, increases the release of TF-exposing microparticles from endothelial cells, accounting for decreased endothelial cell TF surface exposure, thus potentially modifying the overall endothelial control of microparticle-related effects.
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Cabiati M, Gaggini M, Cesare MM, Caselli C, De Simone P, Filipponi F, Basta G, Gastaldelli A, Del Ry S. Osteopontin in hepatocellular carcinoma: A possible biomarker for diagnosis and follow-up. Cytokine 2017; 99:59-65. [PMID: 28711012 DOI: 10.1016/j.cyto.2017.07.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/16/2017] [Accepted: 07/06/2017] [Indexed: 02/08/2023]
Abstract
Recently osteopontin (OPN), a protein of the extracellular matrix, has generated in hepatocellular carcinoma (HCC) a significant interest as a prognostic factor. Aim of this study was to confirm, in liver tissues of subjects with HCV-positive HCC undergoing liver transplantation (RL, n=10) and of donors (DL, n=14), the increase of OPN plasma and tissue concentration, the OPN splicing isoforms expression profiling together with those of thrombin, and to evaluate a possible association between OPN measurements. Their association with Notch-1, IV-Collagen-7s domain, IL-6 and TNF-α were also evaluated. Real-Time PCR experiments and immunometric assay were performed. mRNA expression resulted higher in RL than in DL for all analyzed genes and several correlations were found between them. The more relevant association were between OPN-a and OPN-b (p<0.0001), between thrombin and OPN-a (p=0.007), between 7s-collagen and OPN isoforms (p<0.05) and between Notch-1 with OPN-c (p=0.004). Both OPN plasma and liver tissue extract concentrations were assessed confirming the trend observed at the mRNA level. An important association was found between OPN plasma and protein (p<0.0001, r=0.96) even splitting patients in DL (p<0.0001, r=0.93) and RL (p<0.0001, r=0.96). A reduction of OPN plasma levels was found at 6months after transplantation. Considering MELD score as liver disease severity, the mRNA expression of our markers as well as of OPN plasma and tissue concentrations resulted increased as a function of clinical severity. Our results might be considered a useful starting point to validate OPN as a prognostic and diagnostic marker of HCC.
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Affiliation(s)
| | | | | | | | - Paolo De Simone
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Franco Filipponi
- Hepatobiliary Surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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Luca G, Calvitti M, Nastruzzi C, Macchiarulo G, Becchetti E, Neri LM, Capitani S, Basta G, Brunetti P, Calafiore R, Cameron DF. Effects of Simulated Microgravity on the Morphology and Function of Neonatal Porcine Cell Clusters Cultured with and without Sertoli Cells. Cell Transplant 2017; 15:55-65. [PMID: 16700330 DOI: 10.3727/000000006783982223] [Citation(s) in RCA: 9] [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] [Indexed: 11/24/2022] Open
Abstract
Human islet allografts are well known to induce full and sustained remission of hyperglycemia, with complete normalization of key metabolic parameters. Nevertheless, acquiring human islets, even from cadaveric human donor pancreases, remains a significant impediment to successful transplantation therapy for diabetes. To overcome this difficulty, neonatal porcine cell clusters (NPCCs) have been considered for human islet substitutes because they are easily obtained by collagenase digestion of the neonatal piglet pancreas. Currently, the major hurdle in using NPCCs for xenograft is the delay (time lag) in achieving the posttransplant normalization of blood glucose levels in animal diabetic recipients. The present work is the first attempt to evaluate whether incubation of NPCCs in simulated microgravity, in the presence or absence of Sertoli cells (SC), may reduce the maturation time lag of β-cells by differentiation acceleration in vitro, thereby expediting production, viability, and acquisition of functional competence of pretransplantation β-cell-enriched islets. Following a 3-day incubation period, NPCCs maintained in conventional culture, NPCCs incubated in simulated microgravity in the HARV biochamber, and NPCCs plus co-incubated SC in simulated microgravity were examined for viability, morphology, and insulin secretion. Results show that NPCCs grown alone in the HARV biochamber are superior in quality, both in terms of viability and functional competence, when compared to other culture pretreatment protocols. This finding strongly suggests that NPCC pretreatment in simulated microgravity may enhance the transplantation success of NPCCs in the diabetic recipient.
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Affiliation(s)
- G Luca
- Department of Internal Medicine and Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy
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Gaggini M, Cabiati M, Del Turco S, Navarra T, De Simone P, Filipponi F, Del Ry S, Gastaldelli A, Basta G. Increased FNDC5/Irisin expression in human hepatocellular carcinoma. Peptides 2017; 88:62-66. [PMID: 28012856 DOI: 10.1016/j.peptides.2016.12.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/20/2016] [Accepted: 12/20/2016] [Indexed: 01/12/2023]
Abstract
The fibronectin type III domain containing 5 (FNDC5)/Irisin, a novel energy-regulating hormone, is associated with lipid and carbohydrate metabolism. It is produced in low amounts by normal hepatic tissue, while in human hepatocellular carcinoma (HCC), in which aberrant de novo lipogenesis (DNL) occurs, the hepatic expression of FNDC5/Irisin is still unknown. The gene expression of FNDC5/Irisin, associated to key regulators of DNL, inflammation and cancer progression was evaluated in liver tissue of 18 patients with HCC undergoing liver transplantation and of 18 deceased donors. Hepatic mRNA expression of FNDC5/Irisin and stearoyl-CoA desaturase (SCD-1), main enzymatic regulator of DNL, were significantly higher in HCC patients than in donors (p<0.0001 and p=0.015, respectively). The hepatic mRNA expression of the neurogenic locus notch homolog protein 1 (NOTCH1) tended to be higher in HCC patients than in donors (p=0.06). Only in HCC patients, hepatic FNDC5/Irisin strongly correlated with the transcription factor sterol regulatory element-binding factor 1, SCD-1, NOTCH1, tumor necrosis factor-α and Interleukin-6 mRNA expression. Further, in HCC patients, FNDC5/Irisin mRNA tended to correlate to plasma lipid profile namely triglycerides, palmitic/linoleic acid and polyunsaturated fatty acid/saturated fatty acid ratios. In conclusion, HCC-liver tissue over-expressed FNDC5/Irisin in association with gene expression of mediators involved in lipogenesis, inflammation and cancer, suggesting a possible protective role of the hormone from the liver damage.
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Affiliation(s)
| | | | | | | | - Paolo De Simone
- Hepatobiliary surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Franco Filipponi
- Hepatobiliary surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
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Basta G, Chatzianagnostou K, Paradossi U, Botto N, Del Turco S, Taddei A, Berti S, Mazzone A. The prognostic impact of objective nutritional indices in elderly patients with ST-elevation myocardial infarction undergoing primary coronary intervention. Int J Cardiol 2016; 221:987-92. [PMID: 27441479 DOI: 10.1016/j.ijcard.2016.07.039] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/04/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND The prognostic impact of nutritional status in ST-elevation myocardial infarction (STEMI) patients is poorly understood. METHODS We used the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) score on outcomes of 945 patients with acute STEMI undergoing primary percutaneous coronary intervention with stent. RESULTS During a median follow-up of 2years (1-3.3years, interquartile range), 56 patients (5.9%) died for all-cause of death. In the dead group, the CONUT and PNI scores were more severe than in the alive group. Elderly patients (≥71years) had nutritional indices more serious than patients <71years. In the whole population of the study, both CONUT and PNI correlated with clinical markers of poor prognosis such as brain natriuretic peptide (BNP), creatinine and liver enzymes. Kaplan-Meier curves revealed that the patients with severe CONUT but not patients with severe PNI index had the highest event rate for all-cause death, with a log-rank of p<0.001. The Cox proportional hazard analyses showed that, contrary to PNI score, the CONUT score was associated with increased risk of all-cause death for both unadjusted model and age- and sex-adjusted model, while in a full-adjusted model the best predictors were age and BNP. CONCLUSIONS In STEMI patients, the nutritional status evaluated by the CONUT score, in addition to other comorbidities, can affect the prognosis in elderly patients. These results suggest a personalized nutritional treatment as well as an accurate assessment of the appropriateness of lipid-lowering treatment after coronary revascularization.
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Affiliation(s)
- Giuseppina Basta
- CNR, Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy.
| | | | | | - Nicoletta Botto
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
| | - Serena Del Turco
- CNR, Institute of Clinical Physiology, Via G. Moruzzi, 1, 56124 Pisa, Italy
| | | | - Sergio Berti
- Fondazione G. Monasterio CNR-Regione Toscana Pisa, Massa, Italy
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Del Turco S, Basta G. Can Dietary Polyphenols Prevent the Formation of Toxic Compounds from Maillard Reaction? Curr Drug Metab 2016; 17:598-607. [DOI: 10.2174/1389200217666160308130906] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/25/2016] [Accepted: 03/07/2016] [Indexed: 11/22/2022]
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Pignolo L, Lucca LF, Basta G, Serra S, Pugliese ME, Sannita WG, Dolce G. A new treatment in the rehabilitation of the paretic upper limb after stroke: the ARAMIS prototype and treatment protocol. Ann Ist Super Sanita 2016; 52:301-308. [PMID: 27364408 DOI: 10.4415/ann_16_02_25] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND In recent years, as part of the rehabilitation of post stroke patients, the use of robotic technologies to improve recovery of upper limb has become more widespread. The Automatic Recovery Arm Motility Integrated System (ARAMIS) is a concept robot and prototype designed to promote the functional interaction of the arms in the neurorehabilitation of the paretic upper limb. Two computer-controlled, symmetric and interacting exoskeletons compensate for the inadequate strength and accuracy of the paretic arm and the effect of gravity during rehabilitation. Rehabilitation is possible in 3 different modalities; asynchronous, synchronous and active-assisted. OBJECTIVES To compare the effectiveness of robotic rehabilitation by an exoskeleton prototype system with traditional rehabilitation in motor and functional recovery of the upper limb after stroke. METHODS Case-control study, 52 patients enrolled in the study, 28 cases (women: 8, age: 65 ± 10 yrs) treated with ARAMIS and 24 controls (women: 11, age: 69 ± 7 yrs) with conventional rehabilitation. Motor impairment assessed before and after treatment with Fugl-Meyer scale and Motricity Index, level of disability assessed with the Functional Independence Measure. A questionnaire was also administered to assess the patient's tolerance to robotic therapy. RESULTS After 28 ± 4 sessions over a 54 ± 3.6-day period, the patients treated by ARAMIS had an improvement on the Fugl-Meyer scale (global score from 43 ± 18 to 73 ± 29; p < 0.00001), Motricity Index scale (p < 0.004) and Functional Independence Measure (p < 0.001). A lesser degree of improvement was achieved using conventional rehabilitation, the Fugl-Meyer global score of the control group improved from 41 ± 13 to 58 ± 16 (p < 0.006) and the motor function item from 9.4 ± 4.1 to 14.9 ± 5.8 (p < 0.023). CONCLUSIONS Motor improvement was greater at the wrist and hand than at shoulder and elbow level in patients treated by ARAMIS and controls, but it was significantly greater in ARAMIS-treated patients than in controls. The results indicate a greater efficacy of ARAMIS compared to conventional rehabilitation.
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Affiliation(s)
- Loris Pignolo
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
| | - Lucia F Lucca
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
| | - Giuseppina Basta
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
| | - Sebastiano Serra
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
| | - Maria E Pugliese
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
| | - Walter G Sannita
- Dipartimento di Neuroscienze, Oftalmologia e Genetica, Università degli Studi di Genova, Genoa, Italy
| | - Giuliano Dolce
- RAN, Ricerca Avanzata in Neuroriabilitazione, Istituto S. Anna, Crotone, Italy
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Basta G, Montanucci P, Calafiore R. Islet transplantation versus stem cells for the cell therapy of type 1 diabetes mellitus. MINERVA ENDOCRINOL 2015; 40:267-282. [PMID: 26398188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pancreatic islet cell transplantation has represented the mainstay of cell therapy for the potential, final cure of type 1 diabetes mellitus (T1D), along the past two decades. Unfortunately, the restricted availability of cadaveric human donor pancreases coupled with heavy side effects of the recipient's general immunosuppression, have severely crippled progress of this approach into clinical trials. Only a few excellence centers, worldwide, have thus far accrued still quite marginal clinical success. In an attempt to overcome the limits of islet transplantation new technologies for use of several stem cell lineages are being under investigation, with initial experimental evidence of success. Essentially, the actual lines of research involve attempts to either activate native endogenous stem cells that replace diseased/dead cells, by a cell regeneration process, or condition other stem cells to acquire the functional properties of the targeted cells to be substituted (i.e., beta-cell-like elements associated with insulin secretory competence). A wide array of stem cells may fulfill this task, from embryonic (whose use still faces strong ethical barriers), to adult, to induced pluripotent stem cells. Mesenchymal adult stem cells, retrievable from many different sites, including adipose tissue, bone marrow and post-partum umbilical cord Wharton Jelly, seem to couple plastic to immunoregulatory properties that might greatly help progress for the disease cure.
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Affiliation(s)
- G Basta
- Section of Cardiovascular, Endocrine and Metabolic Clinical Physiology and Laboratory for Endocrine, Cell Transplants and Biohybrid Organs, Department of Medicine, University of Perugia, Perugia, Italy -
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Navarra T, De Simone P, Del Turco S, Filipponi F, Basta G. Involvement of the receptor for advanced glycation end products in liver transplantation. Ann Hepatol 2015; 14:190-7. [PMID: 25671828] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Receptor for advanced glycation end products (RAGE) blockade by a soluble form of RAGE (sRAGE) appears to be protective against hepatocellular death and necrosis after I/R injury. Little is known about the role of the hepatic RAGE, its ligands, and the plasma levels of sRAGE in liver transplantation (LT). MATERIAL AND METHODS This was a prospective study on patients (n = 28) undergoing deceased donor LT. RAGE ligands [the N(epsilon)-carboxy-methyl-lysine (CML) adduct and the high-mobility group box 1 (HMGB1) protein] and sRAGE levels were measured in donors at the time of organ procurement, while in recipients they were tested before surgery (baseline), after graft reperfusion, and on day 1 and 7 posttransplantation. Donors and recipients liver biopsies were collected to assess the transcriptional expression of the full-length RAGE and of its truncated isoform, the endogenous secreted RAGE (esRAGE). RESULTS At baseline, CML levels were higher in LT recipients than in donors (p = 0.02), decreased immediately after graft reperfusion (p < 0.0001) and returned to baseline values on day 7. Baseline HMGB1 levels (3.8 ± 2.3 ng/mL) increased after graft reperfusion (39.9±18 ng/mL, p < 0.0001), and returned to baseline values within day 1, while circulating sRAGE decreased significantly on day 7 (p < 0.0001). The graft esRAGE mRNA expression was inversely associated with bilirubin on day 7 (β = -0.62, p = 0.005). CONCLUSIONS Early on after LT, there is accumulation of CML and a rapid increase of HMGB1 concurrent with a remarkable decline in circulating sRAGE. The RAGE-ligand axis may also be involved in early graft dysfunction.
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Affiliation(s)
- Teresa Navarra
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Paolo De Simone
- Hepatobiliary surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Serena Del Turco
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Franco Filipponi
- Hepatobiliary surgery and Liver Transplantation, University of Pisa Medical School Hospital, Pisa, Italy
| | - Giuseppina Basta
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
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Daniele G, Gaggini M, Comassi M, Bianchi C, Basta G, Dardano A, Miccoli R, Mari A, Gastaldelli A, Del Prato S. Glucose Metabolism in High-Risk Subjects for Type 2 Diabetes Carrying the rs7903146 TCF7L2 Gene Variant. J Clin Endocrinol Metab 2015; 100:E1160-7. [PMID: 26046964 DOI: 10.1210/jc.2015-1172] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The mechanisms responsible for contribution of variants in the gene TFC7L2 to the risk for type 2 diabetes (T2DM) remains far from being completely understood, and available studies have generated nonunivocal results. OBJECTIVE We investigated the postprandial glucose metabolism in subjects at risk for T2DM carrying the TCF7L2 risk allele. DESIGN, SETTING, AND PARTICIPANTS Twenty-three subjects carrying the risk-conferring TCF7L2 genotypes (11 TT and 12 CT at rs7901346) and 13 subjects with wild-type genotype (CC) underwent a standard mixed-meal test (MMT) in combination with stable isotope tracers. OUTCOME MEASUREMENTS We evaluated endogenous and exogenous glucose fluxes and hormonal responses. RESULTS Fasting plasma glucose, insulin, C-peptide, glycated hemoglobin, endogenous glucose production, and plasma glucose clearance were similar in the three groups, whereas plasma glucagon levels were lower in both CT and TT than in CC (64 ± 20, 63 ± 18 and 90 ± 29 pg/mL, respectively; both P = .01). In response to the MMT, TT subjects had lower plasma glucose levels than CC subjects [mean area under the time-concentration curve (AUC) 6.1 ± 3.9 vs 7.1 ± 12.0 mmol/L, P = .04] and lower insulin secretion rate (mean AUC 385 ± 95 vs 530 ± 159 pmol/m(2) · min, P = .02). Initial (0-60 min) rate of appearance (Ra) of oral glucose was lower in TT compared with CT/CC (AUC 2.7 ± 1.1 vs 3.8 ± 1.2 μmol/kg · min, P = .02) with no difference among the three groups in endogenous glucose production. The AUC0-60min for Ra of exogenous glucose (Raex) was positively correlated with the plasma glucose AUC0-60min. Total Raex AUC0-120min was correlated with total AUC0-120min of plasma glucose (r = 0.45, P < .01). Plasma glucagon-like peptide-1 and glucose-dependent insulinotropic peptide levels in response to the MMT were not affected by genotype. CONCLUSIONS In subjects at risk for T2DM, the TCF7L2 polymorphisms were associated with reduced Raex into systemic circulation, causing reduced postprandial blood glucose increase and, in turn, lower insulin secretion rate with no impairment in β-cell function. The reduced Raex is likely due to greater glucose retention in the splanchnic area.
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Affiliation(s)
- Giuseppe Daniele
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Melania Gaggini
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Mario Comassi
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Cristina Bianchi
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Giuseppina Basta
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Angela Dardano
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Roberto Miccoli
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Andrea Mari
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Amalia Gastaldelli
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine (G.D., M.C., C.B., A.D., R.M., S.D.P.), University of Pisa, and Institute of Clinical Physiology (M.G., G.B., A.G.), 56124 Pisa, Italy; and Metabolic Unit (A.M.), Institute of Neuroscience, National Research Council, Corso Stati Uniti 4, 35127 Padova, Italy
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