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Zappa M, Grossi S, Pignatti P, Pini L, Centis R, Migliori GB, Ardesi F, Sotgiu G, Corsico AG, Spanevello A, Visca D. Alpha-1 deficiency in severe asthma patients. Int J Tuberc Lung Dis 2024; 28:225-230. [PMID: 38659141 DOI: 10.5588/ijtld.23.0493] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Alpha-1 antitrypsin (AAT) deficiency, an autosomal co-dominant condition, decreases protein concentration and activity at both serum and tissue levels. Few studies investigated whether the type of SERPINA1 gene phenotype in patients with severe asthma can influence symptoms and disease control during follow-up.OBJECTIVE To assess whether the presence of a non-MM genotype of SERPINA1 in patients with severe asthma is associated with disease control, systemic and airway inflammation, lung function and comorbidities prevalence compared to severe asthma patients with a homozygous genotype (MM).METHODS Asthmatic patients belonging to Global Initiative for Asthma (GINA) step 5 were retrospectively analysed in an Italian reference asthma clinic. We collected clinical, biological and functional variables at baseline and for the three following years.RESULTS Out of 73 patients enrolled, 14 (19.18%) were non-MM and 59 (80.8%) were MM. Asthmatics with non-MM genotype had lower serum AAT concentration (P = 0.004) and higher emphysema prevalence than the MM group (P = 0.003) at baseline. During follow up, only MM patients showed a significant improvement of both ACQ-6 score (P < 0.0001) and eosinophilic systemic inflammation (P < 0.0001).CONCLUSIONS Our findings emphasise the importance of a screening for AAT deficiency in severe asthma, as alleles mutation may influence patient's follow-up..
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Affiliation(s)
- M Zappa
- Department of Medicine and Surgery, University of Insubria, Varese
| | - S Grossi
- Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Tradate
| | - P Pignatti
- Allergy and Immunology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia
| | - L Pini
- Department of Clinical and Experimental Sciences, University of Brescia
| | - R Centis
- Clinical Epidemiology of Respiratory Diseases Service, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - G B Migliori
- Clinical Epidemiology of Respiratory Diseases Service, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate
| | - F Ardesi
- Department of Medicine and Surgery, University of Insubria, Varese
| | - G Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Pharmacological Sciences, University of Sassari, Sassari
| | - A G Corsico
- Department of Internal Medicine and Therapeutics, University of Pavia, Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo-University of Pavia, Pavia, Italy
| | - A Spanevello
- Department of Medicine and Surgery, University of Insubria, Varese, Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Tradate
| | - D Visca
- Department of Medicine and Surgery, University of Insubria, Varese, Department of Medicine and Cardiopulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Tradate
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Gatta E, Maltese V, Cimino E, Cavadini M, Anelli V, Di Lodovico E, Piovani E, Zammarchi I, Gozzoli G, Agosti B, Pirola I, Delbarba A, Girelli A, Buoso C, Bambini F, Alfieri D, Bremi W, Facondo P, Lupo R, Bezzi F, Fredi M, Mazzola AM, Gandossi E, Saullo M, Marini F, Licini M, Pezzaioli LC, Pini L, Franceschini F, Ricci C, Cappelli C. Evaluation of a large set of patients with Autoimmune Polyglandular Syndrome from a single reference centre in context of different classifications. J Endocrinol Invest 2024; 47:857-864. [PMID: 37752372 DOI: 10.1007/s40618-023-02200-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To characterize patients with APS and to propose a new approach for their follow-up. Query ID="Q1" Text="Please check the given names and familynames." METHODS Monocentric observational retrospective study enrolling patients referred to the Outpatients clinic of the Units of Endocrinology, Diabetology, Gastroenterology, Rheumatology and Clinical Immunology of our Hospital for Autoimmune diseases. RESULTS Among 9852 patients, 1174 (11.9%) [869 (73.9%) female] were diagnosed with APS. In 254 subjects, the diagnosis was made at first clinical evaluation (Group 1), all the other patients were diagnosed with a mean latency of 11.3 ± 10.6 years (Group 2). Group 1 and 2 were comparable for age at diagnosis (35.7 ± 16.3 vs. 40.4 ± 16.6 yrs, p = .698), but different in male/female ratio (81/173 vs 226/696, p = .019). In Group 2, 50% of patients developed the syndrome within 8 years of follow-up. A significant difference was found after subdividing the first clinical manifestation into the different outpatient clinic to which they referred (8.7 ± 8.0 vs. 13.4 ± 11.6 vs. 19.8 ± 8.7 vs. 7.4 ± 8.1 for endocrine, diabetic, rheumatologic, and gastroenterological diseases, respectively, p < .001). CONCLUSIONS We described a large series of patients affected by APS according to splitters and lumpers. We propose a flowchart tailored for each specialist outpatient clinic taking care of the patients. Finally, we recommend regular reproductive system assessment due to the non-negligible risk of developing premature ovarian failure.
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Affiliation(s)
- E Gatta
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Maltese
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Cimino
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Cavadini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - V Anelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - E Di Lodovico
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - E Piovani
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - I Zammarchi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - G Gozzoli
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - B Agosti
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - I Pirola
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - A Delbarba
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - A Girelli
- UOC Medicina Generale ad Indirizzo Metabolico e Diabetologico, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Buoso
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - F Bambini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - D Alfieri
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - W Bremi
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - P Facondo
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - R Lupo
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Bezzi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - M Fredi
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - A M Mazzola
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - E Gandossi
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Saullo
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - F Marini
- Sindacato Unico Medicina Ambulatoriale Italiana e Professionalità dell'Area Sanitaria-SUMAI, Trade Union Organisation, Brescia, Italy
| | - M Licini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L C Pezzaioli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy
| | - L Pini
- Department of Clinical and Experimental Sciences, Respiratory Medicine Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - F Franceschini
- Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Ricci
- Department of Clinical and Experimental Sciences, Gastroenterology Unit, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
| | - C Cappelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili no 1, 25100, Brescia, Italy.
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Guenoun D, Wirth T, Roche D, Michel CP, Daudé P, Ogier AC, Chagnaud C, Mattei JP, Pini L, Guye M, Ollivier M, Bendahan D, Guis S. Ultra-high field magnetic resonance imaging of the quadriceps tendon enthesis in healthy subjects. Surg Radiol Anat 2023:10.1007/s00276-023-03175-y. [PMID: 37277665 DOI: 10.1007/s00276-023-03175-y] [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: 02/10/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE Although enthesitis is a hallmark of several rheumatologic conditions, current imaging methods are still unable to characterize entheses changes because of the corresponding short transverse relaxation times (T2). A growing number of MR studies have used Ultra-High Field (UHF) MRI in order to assess low-T2 tissues e.g., tendon but never in humans. The purpose of the present study was to assess in vivo the enthesis of the quadriceps tendon in healthy subjects using UHF MRI. METHODS Eleven healthy subjects volunteered in an osteoarthritis imaging study. The inclusion criteria were: no knee trauma, Lequesne index = 0, less than 3 h of sport activities per week, and Kellgren and Lawrence grade = 0. 3D MR images were acquired at 7 T using GRE sequences and a T2* mapping. Regions of interest i.e., trabecular bone, subchondral bone, enthesis, and tendon body were identified, and T2* values were quantified and compared. RESULTS Quadriceps tendon enthesis was visible as a hyper-intense signal. The largest and the lowest T2* values were quantified in the subchondral bone region and the tendon body respectively. T2* value within subchondral bone was significantly higher than T2* value within the enthesis. T2* in subchondral bone region was significantly higher than the whole tendon body T2*. CONCLUSION A T2* gradient was observed along the axis from the enthesis toward the tendon body. It illustrates different water biophysical properties. These results provide normative values which could be used in the field of inflammatory rheumatologic diseases and mechanical disorders affecting the tendon.
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Affiliation(s)
- Daphne Guenoun
- Institute for Locomotion, Department of Radiology, APHM, Sainte-Marguerite Hospital, 270 Bd Sainte Marguerite, 13009, Marseille, France.
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France.
| | - Theo Wirth
- Service de Rhumatologie, AP-HM, Marseille, France
- Aix-Marseille Université, Marseille, France
- Inserm UMRs1097, Arthrites Autoimmunes, Marseille, France
| | - Damien Roche
- Service de Rhumatologie, AP-HM, Marseille, France
| | - Constance P Michel
- Aix-Marseille Université, Marseille, France
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
| | - Pierre Daudé
- Aix-Marseille Université, Marseille, France
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
| | - Augustin C Ogier
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
- Service de Radiologie, Hôpital de La Conception, AP-HM, Aix-Marseille Université, Marseille, France
| | - Christophe Chagnaud
- Aix-Marseille Université, Marseille, France
- Service de Radiologie, Hôpital de La Conception, AP-HM, Aix-Marseille Université, Marseille, France
- Aix Marseille Université, Université de Toulon, CNRS, LIS, Marseille, France
| | - Jean Pierre Mattei
- Service de Rhumatologie, AP-HM, Marseille, France
- Aix-Marseille Université, Marseille, France
| | - Lauriane Pini
- Aix-Marseille Université, Marseille, France
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
| | - Maxime Guye
- Aix-Marseille Université, Marseille, France
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
| | - Matthieu Ollivier
- Aix-Marseille Université, Marseille, France
- Department of Orthopedics and Traumatology, Institute of Movement and Locomotion, St. Marguerite Hospital, 270 Boulevard Sainte Marguerite, BP 29, 13274, Marseille, France
| | - David Bendahan
- Aix-Marseille Université, Marseille, France
- CRMBM-CEMEREM, UMR CNRS 7339, Marseille, France
| | - Sandrine Guis
- Service de Rhumatologie, AP-HM, Marseille, France
- Aix-Marseille Université, Marseille, France
- Inserm UMRs1097, Arthrites Autoimmunes, Marseille, France
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Bentatou Z, Troalen T, Bernard M, Guye M, Pini L, Bartoli A, Jacquier A, Kober F, Rapacchi S. Simultaneous multi-slice T1 mapping using MOLLI with blipped CAIPIRINHA bSSFP. Magn Reson Imaging 2023; 95:90-102. [PMID: 32304799 DOI: 10.1016/j.mri.2020.03.006] [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: 01/10/2020] [Revised: 03/02/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study evaluates the possibility for replacing conventional 3 slices, 3 breath-holds MOLLI cardiac T1 mapping with single breath-hold 3 simultaneous multi-slice (SMS3) T1 mapping using blipped-CAIPIRINHA SMS-bSSFP MOLLI sequence. As a major drawback, SMS-bSSFP presents unique artefacts arising from side-lobe slice excitations that are explained by imperfect RF modulation rendering and bSSFP low flip angle enhancement. Amplitude-only RF modulation (AM) is proposed to reduce these artefacts in SMS-MOLLI compared to conventional Wong multi-band RF modulation (WM). MATERIALS AND METHODS Phantoms and ten healthy volunteers were imaged at 1.5 T using a modified blipped-CAIPIRINHA SMS-bSSFP MOLLI sequence with 3 simultaneous slices. WM-SMS3 and AM-SMS3 were compared to conventional single-slice (SMS1) MOLLI. First, SNR degradation and T1 accuracy were measured in phantoms. Second, artefacts from side-lobe excitations were evaluated in a phantom designed to reproduce fat presence near the heart. Third, the occurrence of these artefacts was observed in volunteers, and their impact on T1 quantification was compared between WM-SMS3 and AM-SMS3 with conventional MOLLI as a reference. RESULTS In the phantom, larger slice gaps and slice thicknesses yielded higher SNR. There was no significant difference of T1 values between conventional MOLLI and SMS3-MOLLI (both WM and AM). Positive banding artefacts were identified from fat neighbouring the targeted FOV due to side-lobe excitations from WM and the unique bSSFP signal profile. AM RF pulses reduced these artefacts by 38%. In healthy volunteers, AM-SMS3-MOLLI showed similar artefact reduction compared to WM-SMS3-MOLLI (3 ± 2 vs 5 ± 3 corrupted LV segments out of 16). In-vivo native T1 values obtained from conventional MOLLI and AM-SMS3-MOLLI were equivalent in LV myocardium (SMS1-T1 = 935.5 ± 36.1 ms; AM-SMS3-T1 = 933.8 ± 50.2 ms; P = 0.436) and LV blood pool (SMS1-T1 = 1475.4 ± 35.9 ms; AM-SMS3-T1 = 1452.5 ± 70.3 ms; P = 0.515). Identically, no differences were found between SMS1 and SMS3 postcontrast T1 values in the myocardium (SMS1-T1 = 556.0 ± 19.7 ms; SMS3-T1 = 521.3 ± 28.1 ms; P = 0.626) and the blood (SMS1-T1 = 478 ± 65.1 ms; AM-SMS3-T1 = 447.8 ± 81.5; P = 0.085). CONCLUSIONS Compared to WM RF modulation, AM SMS-bSSFP MOLLI was able to reduce side-lobe artefacts considerably, providing promising results to image the three levels of the heart in a single breath hold. However, few artefacts remained even using AM-SMS-bSSFP due to residual RF imperfections. The proposed blipped-CAIPIRINHA MOLLI T1 mapping sequence provides accurate in vivo T1 quantification in line with those obtained with a single slice acquisition.
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Affiliation(s)
- Zakarya Bentatou
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France; Siemens Healthcare SAS, Saint-Denis, France.
| | | | | | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Lauriane Pini
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
| | - Axel Bartoli
- APHM, Hôpital Universitaire Timone, Service de Radiologie, Marseille, France.
| | - Alexis Jacquier
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, Service de Radiologie, Marseille, France.
| | - Frank Kober
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.
| | - Stanislas Rapacchi
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France.
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Levi G, Rocchetti C, Mei F, Stella GM, Lettieri S, Lococo F, Taccari F, Seguiti C, Fantoni M, Natali F, Candoli P, Bortolotto C, Pinelli V, Mondoni M, Carlucci P, Fabbri A, Trezzi M, Vannucchi L, Bonifazi M, Porcarelli F, Gasparini S, Sica G, Valente T, Biondini D, Damin M, Liani V, Tamburrini M, Sorino C, Mezzasalma F, Scaramozzino MU, Pini L, Bezzi M, Marchetti GP. Diagnostic role of internal mammary lymph node involvement in tuberculous pleurisy: a multicenter study. Pulmonology 2022:S2531-0437(22)00022-8. [PMID: 35190300 DOI: 10.1016/j.pulmoe.2022.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Diagnosis of tuberculous pleurisy (TP) may be challenging and it often requires pleural biopsy. A tool able to increase pre-test probability of TP may be helpful to guide diagnostic work-up and enlargement of internal mammary lymph node (IMLN) has been suggested to play a potential role. The aim of the present investigation was to assess role of IMLN involvement in TP in a multi-centric case-control study, by comparing its prevalence and test performance to those observed in patients with infectious, non-tuberculous pleurisy (NTIP), and in controls free from respiratory diseases (CP). METHODS A total of 419 patients, from 14 Pulmonology Units across Italy were enrolled (127 patients affected by TP, 163 affected by NTIP and 129 CP). Prevalence, accuracy and predictive values of ipsilateral IMLN involvement between cases and control groups were assessed, as well as concordance between chest computed tomography (CT scan) and thoracic ultrasound (TUS) measurements. RESULTS The prevalence of ipsilateral IMLN involvement in TP was significantly higher than that observed in NTIP and CP groups (respectively 77.2%, 39.3% and 14.7%). Results on test performance, stratified by age, revealed a high positive predictive value in patients aged ≤50 years, while a high negative predictive value in patients aged >50 years. The comparison between CT scan and ultrasound showed moderate agreement (Kappa=0.502). CONCLUSIONS Evaluation of IMLN involvement plays a relevant role in assessing the pre-test probability of TP. Considering the increasing global prevalence of mycobacterial infections, a tool able to guide diagnostic work-up of suspected TP is crucial, especially where local sources are limited.
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Affiliation(s)
- G Levi
- Interventional Pulmonology Unit, ASST Spedali Civili, Brescia, Italy; Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy.
| | - C Rocchetti
- Interventional Pulmonology Unit, ASST Spedali Civili, Brescia, Italy; Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
| | - F Mei
- Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy; Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - G M Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - S Lettieri
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - F Lococo
- Thoracic Unit, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - F Taccari
- Infectious Diseases Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - C Seguiti
- Security and Bioethics department, Catholic University of the Sacred Heart, Rome, Italy; Security and Bioethics department, Catholic University of the Sacred Heart, Rome, Italy
| | - M Fantoni
- Security and Bioethics department, Catholic University of the Sacred Heart, Rome, Italy; Security and Bioethics department, Catholic University of the Sacred Heart, Rome, Italy
| | - F Natali
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi IRCCS, Bologna, Italy
| | - P Candoli
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi IRCCS, Bologna, Italy
| | - C Bortolotto
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - V Pinelli
- Pneumology Division, ASL5 Spezzino, Italy
| | - M Mondoni
- Respiratory Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - P Carlucci
- Respiratory Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - A Fabbri
- Pneumology Unit, Azienda USL Toscana Centro, Pistoia, Italy
| | - M Trezzi
- Infectious Diseases Unit, Azienda USL Toscana Centro, Pistoia, Italy
| | - L Vannucchi
- Department of Radiology, Azienda USL Toscana Centro, Pistoia, Italy
| | - M Bonifazi
- Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy; Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - F Porcarelli
- Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy; Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - S Gasparini
- Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy; Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy
| | - G Sica
- Radiology Unit, Azienda Ospedali dei Colli, Monaldi Hospital, Napoli, Italy
| | - T Valente
- Radiology Unit, Azienda Ospedali dei Colli, Monaldi Hospital, Napoli, Italy
| | - D Biondini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - M Damin
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - V Liani
- Pulmonology Unit, AO Friuli Occidentale, Pordenone, Italy
| | - M Tamburrini
- Pulmonology Unit, AO Friuli Occidentale, Pordenone, Italy
| | - C Sorino
- Division of Pulmonology, Sant'Anna Hospital, Como, Italy; University of Insubria, Faculty of Medicine and Surgery, Varese, Italy
| | - F Mezzasalma
- Diagnostic and Interventional Bronchoscopy Unit, Cardio-Thoracic and Vascular Department, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS, Siena, Italy
| | - M U Scaramozzino
- Complex structure Pneumology unit, Civil hospital - Regional centre of excellence for immunoallergological diseases, Locri, Italy
| | - L Pini
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy; Respiratory Medicine Unit, ASST Spedali Civili, Brescia, Italy
| | - M Bezzi
- Interventional Pulmonology Unit, ASST Spedali Civili, Brescia, Italy
| | - G P Marchetti
- Pulmonology Unit, ASST Spedali Civili, Brescia, Italy
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Pini L, Magri R, Perger E, Levi G, Zambelli L, Giordani J, Ciarfaglia M, Tantucci C. Phenotyping OSAH patients during wakefulness. Sleep Breath 2022; 26:1801-1807. [PMID: 35023036 DOI: 10.1007/s11325-021-02551-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Although currently there are simplified methods to measure the pathophysiological traits that stimulate the occurrence and maintenance of obstructive sleep apnea-hypopnea (OSAH), they remain difficult to implement in routine practice. This pilot study aimed to find a simpler daytime approach to obtain a meaningful, similar pathophysiological phenotypic profile in patients with OSAH. METHODS After obtaining diagnostic polygraphy from a group of consecutive patients with OSAH, we performed the dial-down CPAP technique during nocturnal polysomnography and used it as reference method. This allowed assessment of upper airway collapsibility, loop gain (LG), arousal threshold (AT), and upper airway muscle gain (UAG). We compared these results with a daytime protocol based on negative expiratory pressure (NEP) technique for evaluating upper airway collapsibility and UAG, on maximal voluntary apnea for LG, and on clinical predictors for AT. RESULTS Of 15 patients studied, 13 patients with OSAH accurately completed the two procedures. There were strong (all r2 > 0.75) and significant (all p < 0.001) correlations for each phenotypic trait between the measurements obtained through the reference method and those achieved during wakefulness. CONCLUSION It is possible to phenotype patients with OSAH from a pathophysiological point of view while they are awake. Using this approach, cutoff values corresponding to those usually adopted using the reference method can be identified to detect abnormal traits, achieving profiles similar to those obtained through the dial-down CPAP technique.
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Affiliation(s)
- L Pini
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy. .,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - R Magri
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - E Perger
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - G Levi
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - L Zambelli
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - J Giordani
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - M Ciarfaglia
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - C Tantucci
- Respiratory Medicine Unit, ASST-Spedali Civili di Brescia, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Baucher G, Rasoanandrianina H, Levy S, Pini L, Troude L, Roche PH, Callot V. T1 Mapping for Microstructural Assessment of the Cervical Spinal Cord in the Evaluation of Patients with Degenerative Cervical Myelopathy. AJNR Am J Neuroradiol 2021; 42:1348-1357. [PMID: 33985954 DOI: 10.3174/ajnr.a7157] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 02/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although current radiologic evaluation of degenerative cervical myelopathy by conventional MR imaging accurately demonstrates spondylosis or degenerative disc disease causing spinal cord dysfunction, conventional MR imaging still fails to provide satisfactory anatomic and clinical correlations. In this context, we assessed the potential value of quantitative cervical spinal cord T1 mapping regarding the evaluation of patients with degenerative cervical myelopathy. MATERIALS AND METHODS Twenty patients diagnosed with mild and moderate-to-severe degenerative cervical myelopathy and 10 healthy subjects were enrolled in a multiparametric MR imaging protocol. Cervical spinal cord T1 mapping was performed with the MP2RAGE sequence procedure. Retrieved data were processed and analyzed regarding the global spinal cord and white and anterior gray matter on the basis of the clinical severity and the spinal canal stenosis grading. RESULTS Noncompressed levels in healthy controls demonstrated significantly lower T1 values than noncompressed, mild, moderate, and severe stenotic levels in patients. Concerning the entire spinal cord T1 mapping, patients with moderate-to-severe degenerative cervical myelopathy had higher T1 values compared with healthy controls. Regarding the specific levels, patients with moderate-to-severe degenerative cervical myelopathy demonstrated a T1 value increase at C1, C7, and the level of maximal compression compared with healthy controls. Patients with mild degenerative cervical myelopathy had lower T1 values than those with moderate-to-severe degenerative cervical myelopathy at the level of maximal compression. Analyses of white and anterior gray matter confirmed similar results. Strong negative correlations between individual modified Japanese Orthopaedic Association scores and T1 values were also observed. CONCLUSIONS In this preliminary study, 3D-MP2RAGE T1 mapping demonstrated increased T1 values in the pathology tissue samples, with diffuse medullary alterations in all patients with degenerative cervical myelopathy, especially relevant at C1 (nonstenotic level) and at the maximal compression level. Encouraging correlations observed with the modified Japanese Orthopaedic Association score make this novel approach a potential quantitative biomarker related to clinical severity in degenerative cervical myelopathy. Nevertheless, patients with mild degenerative cervical myelopathy demonstrated nonsignificant results compared with healthy controls and should now be studied in multicenter studies with larger patient populations.
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Affiliation(s)
- G Baucher
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - H Rasoanandrianina
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - S Levy
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - L Pini
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
| | - L Troude
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
| | - P-H Roche
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - V Callot
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
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Gaborit B, Ancel P, Abdullah AE, Maurice F, Abdesselam I, Calen A, Soghomonian A, Houssays M, Varlet I, Eisinger M, Lasbleiz A, Peiretti F, Bornet CE, Lefur Y, Pini L, Rapacchi S, Bernard M, Resseguier N, Darmon P, Kober F, Dutour A. Effect of empagliflozin on ectopic fat stores and myocardial energetics in type 2 diabetes: the EMPACEF study. Cardiovasc Diabetol 2021; 20:57. [PMID: 33648515 PMCID: PMC7919089 DOI: 10.1186/s12933-021-01237-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/01/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Empagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that has demonstrated cardiovascular and renal protection in patients with type 2 diabetes (T2D). We hypothesized that empaglifozin (EMPA) could modulate ectopic fat stores and myocardial energetics in high-fat-high-sucrose (HFHS) diet mice and in type 2 diabetics (T2D). METHODS C57BL/6 HFHS mice (n = 24) and T2D subjects (n = 56) were randomly assigned to 12 weeks of treatment with EMPA (30 mg/kg in mice, 10 mg/day in humans) or with placebo. A 4.7 T or 3 T MRI with 1H-MRS evaluation-myocardial fat (primary endpoint) and liver fat content (LFC)-were performed at baseline and at 12 weeks. In humans, standard cardiac MRI was coupled with myocardial energetics (PCr/ATP) measured with 31P-MRS. Subcutaneous (SAT) abdominal, visceral (VAT), epicardial and pancreatic fat were also evaluated. The primary efficacy endpoint was the change in epicardial fat volume between EMPA and placebo from baseline to 12 weeks. Secondary endpoints were the differences in PCr/ATP ratio, myocardial, liver and pancreatic fat content, SAT and VAT between groups at 12 weeks. RESULTS In mice fed HFHS, EMPA significantly improved glucose tolerance and increased blood ketone bodies (KB) and β-hydroxybutyrate levels (p < 0.05) compared to placebo. Mice fed HFHS had increased myocardial and liver fat content compared to standard diet mice. EMPA significantly attenuated liver fat content by 55%, (p < 0.001) but had no effect on myocardial fat. In the human study, all the 56 patients had normal LV function with mean LVEF = 63.4 ± 7.9%. Compared to placebo, T2D patients treated with EMPA significantly lost weight (- 2.6 kg [- 1.2; - 3.7]) and improved their HbA1c by 0.88 ± 0.74%. Hematocrit and EPO levels were significantly increased in the EMPA group compared to placebo (p < 0.0001, p = 0.041). EMPA significantly increased glycosuria and plasma KB levels compared to placebo (p < 0.0001, p = 0.012, respectively), and significantly reduced liver fat content (- 27 ± 23 vs. - 2 ± 24%, p = 0.0005) and visceral fat (- 7.8% [- 15.3; - 5.6] vs. - 0.1% [- 1.1;6.5], p = 0.043), but had no effect on myocardial or epicardial fat. At 12 weeks, no significant change was observed in the myocardial PCr/ATP (p = 0.57 between groups). CONCLUSIONS EMPA effectively reduced liver fat in mice and humans without changing epicardial, myocardial fat or myocardial energetics, rebutting the thrifty substrate hypothesis for cardiovascular protection of SGLT2 inhibitors. Trial registration NCT, NCT03118336. Registered 18 April 2017, https://clinicaltrials.gov/ct2/show/NCT03118336.
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Affiliation(s)
- B Gaborit
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France
| | - P Ancel
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - A E Abdullah
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France
| | - F Maurice
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - I Abdesselam
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A Calen
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A Soghomonian
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France
| | - M Houssays
- Assistance-Publique Hôpitaux de Marseille, Medical Evaluation Department, CIC-CPCET, 13005, Marseille, France
| | - I Varlet
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - M Eisinger
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France
| | - A Lasbleiz
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - F Peiretti
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
| | - C E Bornet
- Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, 13385, Marseille, France
| | - Y Lefur
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - L Pini
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - S Rapacchi
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - M Bernard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - N Resseguier
- Support Unit for Clinical Research and Economic Evaluation, Assistance Publique-Hôpitaux de Marseille, 13385, Marseille, France
- Aix-Marseille Univ, EA 3279 CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - P Darmon
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France
| | - F Kober
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A Dutour
- Aix Marseille Univ, INSERM, INRAE, C2VN, Marseille, France.
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle ENDO, APHM, Hôpital Nord, Chemin Des Bourrely, 13915, Marseille cedex 20, France.
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Pini L, Youssov K, Sambataro F, Bachoud‐Levi A, Vallesi A, Jacquemot C. Striatal connectivity in pre‐manifest Huntington’s disease is differentially affected by disease burden. Eur J Neurol 2020; 27:2147-2157. [DOI: 10.1111/ene.14423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/25/2020] [Indexed: 11/26/2022]
Affiliation(s)
- L. Pini
- Department of Neuroscience & Padova Neuroscience Center University of Padova Padova Italy
| | - K. Youssov
- Département d'Études Cognitives École Normale Supérieure PSL University ParisFrance
- Faculté de Santé Université Paris‐Est Créteil CréteilFrance
- Inserm U955 Equipe E01 NeuroPsychologie Interventionnelle Institut Mondor de Recherche Biomédicale CréteilFrance
- Centre de référence Maladie de Huntington Service de Neurologie Hôpital Henri Mondor, AP‐HP Créteil France
| | - F. Sambataro
- Department of Neuroscience & Padova Neuroscience Center University of Padova Padova Italy
| | - A.‐C. Bachoud‐Levi
- Département d'Études Cognitives École Normale Supérieure PSL University ParisFrance
- Faculté de Santé Université Paris‐Est Créteil CréteilFrance
- Inserm U955 Equipe E01 NeuroPsychologie Interventionnelle Institut Mondor de Recherche Biomédicale CréteilFrance
- Centre de référence Maladie de Huntington Service de Neurologie Hôpital Henri Mondor, AP‐HP Créteil France
| | - A. Vallesi
- Department of Neuroscience & Padova Neuroscience Center University of Padova Padova Italy
- Brain Imaging and Neural Dynamics Research Group IRCCS San Camillo Hospital Venice Italy
| | - C. Jacquemot
- Département d'Études Cognitives École Normale Supérieure PSL University ParisFrance
- Faculté de Santé Université Paris‐Est Créteil CréteilFrance
- Inserm U955 Equipe E01 NeuroPsychologie Interventionnelle Institut Mondor de Recherche Biomédicale CréteilFrance
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Roche D, Michel C, Daudé P, Le Troter A, Chagnaud C, Mattei JP, Pini L, Guye M, Bendahan D, Guis S. AB1098 STRUCTURAL ELEMENTS OF THE KNEE ENTHESES ASSESSED IN HEALTHY SUBJECTS WITH ULTRA HIGH FIELD MRI (150 MICRONS). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Fibrocartilaginous enthesis is composed of different histological zones which are commonly referred to the tendon distal extremity (a lamellar tissue with a low cell density, collagen and connective tissue), the fibrocartilaginous zone (with chondrocytes), a progressively mineralized zone and the bone. The MRI visualization of the water content of entheses is challenging given the very short relation time so that entheses has been very poorly assessed using MRI (1).Objectives:The main objective of the study was to assess the structural elements of the knee enthesis based on the quantitative T2* measurements using Ultra High Field (UHF) MRI.Methods:Twelve healthy subjects without any osteoarticular pathology were included in the study after they provided their informed consent. 3D gradient echo sequence with a 4.3 ms echo time and T2* mapping were performed. The lateral internal, external and crossed ligaments, patellar and quadricipital tendons were assessed. T2* measurements were performed specifically on the quadricipital tendon.Results:The quadricipital tendon and the bone trabeculation could be visualized on the UHF MR image. The T2* mapping analysis illustrated a large value (16.4 ± 4 ms) for the subchondral bone and much lower values for the trabecular bone (11 ± 4.5 ms) and the different zones of the keen entheses (7.7 ± 1.9 ms).Conclusion:Based on T2* measurements performed using UHF MRI, the different structural elements of the knee entheses were distinguished. This quantitative stratification could be used to assess changes in pathological conditions such as SpA and trauma.References:[1]Benjamin M, Bydder GM. Magnetic resonance imaging of entheses using ultrashort TE (UTE) pulse sequences. Journal of magnetic resonance imaging: JMRI. 2007;25(2):381-9.Disclosure of Interests:None declared
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Pini L, Giordani J, Concoreggi C, Gardini G, Raffetti E, Pini A, Levi G, Pedroni L, Ciarfaglia M, Magri R, Tantucci C. EVALUATING THE EMERGENCY DEPARTMENT ADMISSION AND HOSPITALIZATION TREND FOR COPD EXACERBATION AND TIME-DEPENDENT PARTICULATE MATTER EXPOSURE. Chest 2020. [DOI: 10.1016/j.chest.2020.05.378] [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: 10/24/2022] Open
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Bas J, Ogier AC, Le Troter A, Delmont E, Leporq B, Pini L, Guye M, Parlanti A, Lefebvre MN, Bendahan D, Attarian S. Fat fraction distribution in lower limb muscles of patients with CMT1A: A quantitative MRI study. Neurology 2020; 94:e1480-e1487. [PMID: 31980579 DOI: 10.1212/wnl.0000000000009013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/10/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To quantitatively describe the MRI fat infiltration pattern of muscle degeneration in Charcot-Marie-Tooth (CMT) type 1A (CMT1A) disease and to look for correlations with clinical variables. METHODS MRI fat fraction was assessed in lower-limb musculature of patients with CMT1A and healthy controls. More particularly, 14 muscle compartments were selected at leg and thigh levels and for proximal, distal, and medial slices. Muscle fat infiltration profile was determined quantitatively in each muscle compartment and along the entire volume of acquisition to determine a length-dependent gradient of fat infiltration. Clinical impairment was evaluated with muscle strength measurements and CMT Examination Scores (CMTESs). RESULTS A total of 16 patients with CMT1A were enrolled and compared to 11 healthy controls. Patients with CMT1A showed a larger muscle fat fraction at leg and thigh levels with a proximal-to-distal gradient. At the leg level, the largest fat infiltration was quantified in the anterior and lateral compartments. CMTES was correlated with fat fraction, especially in the anterior compartment of leg muscles. Strength of plantar flexion was also correlated with fat fraction of the posterior compartments of leg muscles. CONCLUSION On the basis of quantitative MRI measurements combined with a dedicated segmentation method, muscle fat infiltration quantified in patients with CMT1A disclosed a length-dependent peroneal-type pattern of fat infiltration and was correlated to main clinical variables. Quantification of fat fraction at different levels of the leg anterior compartment might be of interest in future clinical trials.
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Affiliation(s)
- Joachim Bas
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Augustin C Ogier
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Arnaud Le Troter
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Emilien Delmont
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Benjamin Leporq
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Lauriane Pini
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Maxime Guye
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Amandine Parlanti
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Marie-Noëlle Lefebvre
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - David Bendahan
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France
| | - Shahram Attarian
- From the Reference Center for Neuromuscular Diseases and ALS (J.B., E.D., A.P., S.A.) and CIC-CPCET (M.-N.L.), La Timone University Hospital, Aix-Marseille University; Aix-Marseille University (A.C.O., A.L.T., L.P., M.G., D.B.), CNRS, Center for Magnetic Resonance in Biology and Medicine; Aix-Marseille University (E.D.), UMR 7286, Medicine Faculty; Aix-Marseille University (S.A.), Inserm, GMGF; Aix Marseille University (A.C.O.), Université de Toulon, CNRS, LIS, Marseille; Université de Lyon (B.L.); and CREATIS CNRS UMR 5220 (B.L.), Inserm U1206, INSA-Lyon, UCBL Lyon 1, France.
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13
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Maurice F, Dutour A, Vincentelli C, Abdesselam I, Bernard M, Dufour H, Lefur Y, Graillon T, Kober F, Cristofari P, Jouve E, Pini L, Fernandez R, Chagnaud C, Brue T, Castinetti F, Gaborit B. Active cushing syndrome patients have increased ectopic fat deposition and bone marrow fat content compared to cured patients and healthy subjects: a pilot 1H-MRS study. Eur J Endocrinol 2018; 179:307-317. [PMID: 30108093 DOI: 10.1530/eje-18-0318] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Glucocorticoid excess is one of the most important causes of bone disorders. Bone marrow fat (BMF) has been identified as a l new mediator of bone metabolism. Cushing syndrome (CS), is a main regulator of adipose tissue distribution but its impact on BMF is unknown. The objective of the study was to evaluate the effect of chronic hypercortisolism on BMF. DESIGN This was a cross-sectional study. Seventeen active and seventeen cured ACTH-dependent CS patients along with seventeen controls (matched with the active group for age and sex) were included. METHODS the BMF content of the femoral neck and L3 vertebrae were measured by 1H-MRS on a 3-Tesla wide-bore magnet. BMD was evaluated in patients using dual-energy X-ray absorptiometry. RESULTS Active CS patients had higher BMF content both in the femur (82.5±2.6%) and vertebrae (70.1±5.1%) compared to the controls (70.8±3.6%, p=0.013 and 49.0±3.7% p=0.005, respectively). In cured CS patients (average remission time of 43 months), BMF content was not different from controls at both sites (72.3±2.9% (femur) and 46.7%±5.3% (L3)). BMF content was positively correlated with age, fasting plasma glucose, HbA1c, triglycerides and visceral adipose tissue in the whole cohort and negatively correlated with BMD values in the CS patients . CONCLUSIONS Accumulation of BMF is induced by hypercortisolism. In remission patients BMF reached values of controls. Further studies are needed to determine whether this increase in marrow adiposity in CS is associated with bone loss.
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Affiliation(s)
- F Maurice
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
- Department of Endocrinology, Pôle ENDO, APHM, Marseille, France
| | - A Dutour
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
- Department of Endocrinology, Pôle ENDO, APHM, Marseille, France
| | - C Vincentelli
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
- Department of Endocrinology, Pôle ENDO, APHM, Marseille, France
| | - I Abdesselam
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - M Bernard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - H Dufour
- Department of Neurosurgery, APHM, CHU Timone, Marseille, France
| | - Y Lefur
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - T Graillon
- Department of Neurosurgery, APHM, CHU Timone, Marseille, France
| | - F Kober
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | | | - E Jouve
- Medical Evaluation Department, Assistance-Publique Hôpitaux de Marseille, CIC-CPCET, Marseille, France
| | - L Pini
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - R Fernandez
- Radiology Department, Conception Hospital, Marseille, France
| | - C Chagnaud
- Radiology Department, Conception Hospital, Marseille, France
| | - T Brue
- Aix-Marseille Univ, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Assistance Publique - Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Centre de Référence des Maladies Rares Hypophysaires HYPO, Marseille, France
| | - F Castinetti
- Aix-Marseille Univ, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Assistance Publique - Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Centre de Référence des Maladies Rares Hypophysaires HYPO, Marseille, France
| | - B Gaborit
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
- Department of Endocrinology, Pôle ENDO, APHM, Marseille, France
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14
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Fouré A, Pini L, Rappacchi S, Ogier AC, Mattei JC, Bydder M, Guye M, Bendahan D. Ultrahigh-Field Multimodal MRI Assessment of Muscle Damage. J Magn Reson Imaging 2018; 49:904-906. [DOI: 10.1002/jmri.26222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/24/2018] [Indexed: 01/03/2023] Open
Affiliation(s)
- Alexandre Fouré
- Aix-Marseille University CNRS, CRMBM; Marseille France
- APHM, Hôpital Universitaire Timone, CEMEREM; Marseille France
- Laboratoire Interuniversitaire de Biologie de la Motricité; Université Claude Bernard Lyon 1; Villeurbanne France
| | - Lauriane Pini
- Aix-Marseille University CNRS, CRMBM; Marseille France
- APHM, Hôpital Universitaire Timone, CEMEREM; Marseille France
| | | | - Augustin C. Ogier
- Aix-Marseille University, Université de Toulon, CNRS, LIS; Marseille France
| | - Jean-Camille Mattei
- Aix-Marseille University CNRS, CRMBM; Marseille France
- APHM, Hôpital Universitaire Timone, CEMEREM; Marseille France
- APHM, Hôpital Nord, Service d'Orthopédie; Marseille France
| | - Mark Bydder
- Aix-Marseille University CNRS, CRMBM; Marseille France
- APHM, Hôpital Universitaire Timone, CEMEREM; Marseille France
- University of California, David Geffen School of Medicine; Department of Radiological Sciences; Los Angeles California USA
| | - Maxime Guye
- Aix-Marseille University CNRS, CRMBM; Marseille France
- APHM, Hôpital Universitaire Timone, CEMEREM; Marseille France
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15
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Donadieu M, Le Fur Y, Maarouf A, Gherib S, Ridley B, Pini L, Rapacchi S, Confort-Gouny S, Guye M, Schad LR, Maudsley AA, Pelletier J, Audoin B, Zaaraoui W, Ranjeva JP. Metabolic counterparts of sodium accumulation in multiple sclerosis: A whole brain 23Na-MRI and fast 1H-MRSI study. Mult Scler 2017; 25:39-47. [DOI: 10.1177/1352458517736146] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Increase of brain total sodium concentrations (TSC) is present in multiple sclerosis (MS), but its pathological involvement has not been assessed yet. Objective: To determine in vivo the metabolic counterpart of brain sodium accumulation. Materials/methods: Whole brain 23Na-MR imaging and 3D-1H-EPSI data were collected in 21 relapsing-remitting multiple sclerosis (RRMS) patients and 20 volunteers. Metabolites and sodium levels were extracted from several regions of grey matter (GM), normal-appearing white matter (NAWM) and white matter (WM) T2 lesions. Metabolic and ionic levels expressed as Z-scores have been averaged over the different compartments and used to explain sodium accumulations through stepwise regression models. Results: MS patients showed significant 23Na accumulations with lower choline and glutamate–glutamine (Glx) levels in GM; 23Na accumulations with lower N-acetyl aspartate (NAA), Glx levels and higher Myo-Inositol (m-Ins) in NAWM; and higher 23Na, m-Ins levels with lower NAA in WM T2 lesions. Regression models showed associations of TSC increase with reduced NAA in GM, NAWM and T2 lesions, as well as higher total-creatine, and smaller decrease of m-Ins in T2 lesions. GM Glx levels were associated with clinical scores. Conclusion: Increase of TSC in RRMS is mainly related to neuronal mitochondrial dysfunction while dysfunction of neuro-glial interactions within GM is linked to clinical scores.
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Affiliation(s)
- Maxime Donadieu
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France/Siemens Healthineers, Saint-Denis, France
| | - Yann Le Fur
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Adil Maarouf
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France/APHM, Timone University Hospital, Department of Neurology, Marseille, FranceCNRS, CRMBM UMR 7339, Medical School of Marseille, Aix-Marseille University, Marseille, France/AP-HM, CHU Timone, Department of Imaging, CEMEREM, Marseille, France/AP-HM, CHU Timone, Pole de Neurosciences Cliniques, Department of Neurology, Marseille, France
| | - Soraya Gherib
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Ben Ridley
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Lauriane Pini
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Stanislas Rapacchi
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Sylviane Confort-Gouny
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Maxime Guye
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Mannheim University Hospital, Heidelberg University, Mannheim, Germany
| | - Andrew A Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, FL, USA
| | - Jean Pelletier
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France/APHM, Timone University Hospital, Department of Neurology, Marseille, FranceCNRS, CRMBM UMR 7339, Medical School of Marseille, Aix-Marseille University, Marseille, France/AP-HM, CHU Timone, Department of Imaging, CEMEREM, Marseille, France/AP-HM, CHU Timone, Pole de Neurosciences Cliniques, Department of Neurology, Marseille, France
| | - Bertrand Audoin
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France/APHM, Timone University Hospital, Department of Neurology, Marseille, FranceCNRS, CRMBM UMR 7339, Medical School of Marseille, Aix-Marseille University, Marseille, France/AP-HM, CHU Timone, Department of Imaging, CEMEREM, Marseille, France/AP-HM, CHU Timone, Pole de Neurosciences Cliniques, Department of Neurology, Marseille, France
| | - Wafaa Zaaraoui
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
| | - Jean-Philippe Ranjeva
- Aix-Marseille University, CNRS, CRMBM, APHM, Marseille, France/Timone University Hospital, CEMEREM, Marseille, France
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Quadri F, Boni E, Pini L, Bottone D, Venturoli N, Corda L, Tantucci C. Exercise tolerance in obstructive sleep apnea-hypopnea (OSAH), before and after CPAP treatment: Effects of autonomic dysfunction improvement. Respir Physiol Neurobiol 2016; 236:51-56. [PMID: 27840271 DOI: 10.1016/j.resp.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 06/13/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obstructive sleep apnea hypopnea (OSAH) is associated with decreased exercise tolerance and autonomic abnormalities and represents a risk for cardiovascular diseases. The aim of the study was to evaluate the effects of CPAP on cardiovascular autonomic abnormalities and exercise performance in patients with OSAH without changes in lifestyle and body weight during treatment. METHODS Twelve overweight subjects with OSAH underwent anthropometric measures, autonomic cardiovascular and incremental symptom-limited cardio-respiratory exercise tests before and after two months of treatment with CPAP. RESULTS Lower frequency component of power spectrum of heart rate variability (59.5±24.2 msec2 vs 43.2±25.9 msec2; p<0.05) and improvements of maximal workload (99.3±13.5 vs 108.3±16.8%pred.; p<0.05) and peak oxygen consumption (95.3±7.6 vs 105.5±7.9%pred.; p<0.05) were observed in these patients after CPAP, being their BMI unchanged. CONCLUSIONS CPAP-induced decrease of sympathetic hyperactivity is associated with better tolerance to the effort in OSAH patients that did not change their BMI and lifestyle, suggesting that OSAH limits per se the exercise capacity.
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Affiliation(s)
- F Quadri
- Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - E Boni
- Division of Internal Medicine, Spedali Civili of Brescia, P.zza Spedali Civili, 1, Brescia, Italy.
| | - L Pini
- Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - D Bottone
- Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - N Venturoli
- Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - L Corda
- Division of Internal Medicine, Spedali Civili of Brescia, P.zza Spedali Civili, 1, Brescia, Italy.
| | - C Tantucci
- Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
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17
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Gatta D, Aliprandi G, Pini L, Zanardini A, Fredi M, Tantucci C. Dynamic pulmonary hyperinflation and low grade systemic inflammation in stable COPD patients. Eur Rev Med Pharmacol Sci 2011; 15:1068-1073. [PMID: 22013730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVES It is increasingly recognized that a low grade of systemic inflammation occurs in patients with advanced chronic obstructive pulmonary disease (COPD). C-reactive protein (CRP), a marker of systemic chronic inflammatory response, has been related with decreased survival in large cohorts of COPD patients. The aim of the study was to assess if resting dynamic pulmonary hyperinflation (DH) is linked to the presence of systemic inflammation in COPD. MATERIALS AND METHODS In a 12-month retrospective study involving 55 out-patients with COPD (FEV1 59+/- 23% pred.) examined in stable conditions, inspiratory capacity (IC) was measured at rest and considered as index of DH when lower than 80% predicted. Simultaneously, CRP (by immuno-turbidometry) and white blood cells (WBC), uric acid and alpha-1 globulins were measured in the venous blood in the morning before eating. RESULTS CRP was significantly increased in the COPD patients with IC < 80% pred. (n = 35; IC = 61 + 14% pred.) as compared with that measured in COPD patients with IC > 80% pred. (n = 20; IC = 97 + 13% pred.), amounting to 0.70 +/- 0.59 vs 0.29 +/- 0.28 mg/dl, respectively (p < 0.01). CRP was inversely related to IC (% pred.) (r = 0.45, p < 0.01). WBC, serum uric acid (an endogenous danger signal), and albumin and alfa-1 globulins were not different between the two groups. DISCUSSION These results show that the IC reduction is associated with higher serum levels of CRP in stable COPD patients, suggesting a potential role of dynamic pulmonary hyperinflation on development and maintenance of low grade systemic inflammation in COPD.
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Affiliation(s)
- D Gatta
- Unit of Respiratory Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
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18
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Dottorini ML, Bruni B, Peccini F, Bottini P, Pini L, Donato F, Casucci G, Tantucci C. Skin prick-test reactivity to aeroallergens and allergic symptoms in an urban population of central Italy: a longitudinal study. Clin Exp Allergy 2007; 37:188-96. [PMID: 17250691 DOI: 10.1111/j.1365-2222.2007.02652.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cross-sectional studies report an increasing prevalence of allergic diseases, such as rhinitis and asthma. Not thoroughly known, instead, is the natural history of allergic sensitization and the progress of the allergic disease-related symptoms. AIM The purpose of this study was to evaluate longitudinally the skin reactivity for the most common aeroallergens and the allergic symptoms in an urban population living in Perugia, a town of central Italy with a low-level of air pollution exposure. METHODS In the 1998-1999 period 788 subjects were tested for skin reactivity to a panel of aeroallergens and underwent the administration of a questionnaire. These same subjects were part of a cohort of 1200 subjects who participated in a previous epidemiological study performed in 1984-1985 using the same tools. Subjects were aged between 14 and 64 years at the time of the first survey. RESULTS In the present survey 196 subjects (24.9%) had skin reactivity to at least one aeroallergen, while in the previous survey 143 subjects (18.1%) had skin prick-test reactivity. The increase of the skin reactivity between the two observations was highly significant (P<0.001) and was mainly observed in subjects <40-years old. The greatest increment in skin reactivity was seen to Dermatophagoides pteronyssinus (house dust mite) allergen. Data obtained from questionnaires showed that subjects who declared allergic symptoms increased from 341 (43.3%) to 380 (48.2%). However, the increase was significant (P<0.01) only in subjects who had a positive association between allergic symptoms and prick-test reactivity and was greater for rhino-conjunctivitis than for asthma-related symptoms. CONCLUSIONS In a cohort of urban population of the centre of Italy, exposed to a low and stable level of air pollution, the sensitization to common aeroallergens increased with time, mostly in people <40-years of age. The greatest increment was found for indoor allergens such as Dermatophagoides pteronysimus. A significant increase in allergic symptoms, mainly related to rhino-conjunctivitis, was observed only in the presence of positive prick test.
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Affiliation(s)
- M L Dottorini
- Dipartimento di Medicina Interna e Scienze Endocrino Metaboliche (DiMISEM), Università di Perugia, Perugia, Italy.
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19
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Dottorini ML, Bruni B, Peccini F, Bottini P, Pini L, Donato F, Casucci G, Tantucci C. Skin prick-test reactivity to aeroallergens and allergic symptoms in an urban population of central Italy: a longitudinal study. Clin Exp Allergy 2007. [PMID: 17250691 DOI: 10.1111/j.1365‐2222.2007.02652.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cross-sectional studies report an increasing prevalence of allergic diseases, such as rhinitis and asthma. Not thoroughly known, instead, is the natural history of allergic sensitization and the progress of the allergic disease-related symptoms. AIM The purpose of this study was to evaluate longitudinally the skin reactivity for the most common aeroallergens and the allergic symptoms in an urban population living in Perugia, a town of central Italy with a low-level of air pollution exposure. METHODS In the 1998-1999 period 788 subjects were tested for skin reactivity to a panel of aeroallergens and underwent the administration of a questionnaire. These same subjects were part of a cohort of 1200 subjects who participated in a previous epidemiological study performed in 1984-1985 using the same tools. Subjects were aged between 14 and 64 years at the time of the first survey. RESULTS In the present survey 196 subjects (24.9%) had skin reactivity to at least one aeroallergen, while in the previous survey 143 subjects (18.1%) had skin prick-test reactivity. The increase of the skin reactivity between the two observations was highly significant (P<0.001) and was mainly observed in subjects <40-years old. The greatest increment in skin reactivity was seen to Dermatophagoides pteronyssinus (house dust mite) allergen. Data obtained from questionnaires showed that subjects who declared allergic symptoms increased from 341 (43.3%) to 380 (48.2%). However, the increase was significant (P<0.01) only in subjects who had a positive association between allergic symptoms and prick-test reactivity and was greater for rhino-conjunctivitis than for asthma-related symptoms. CONCLUSIONS In a cohort of urban population of the centre of Italy, exposed to a low and stable level of air pollution, the sensitization to common aeroallergens increased with time, mostly in people <40-years of age. The greatest increment was found for indoor allergens such as Dermatophagoides pteronysimus. A significant increase in allergic symptoms, mainly related to rhino-conjunctivitis, was observed only in the presence of positive prick test.
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Affiliation(s)
- M L Dottorini
- Dipartimento di Medicina Interna e Scienze Endocrino Metaboliche (DiMISEM), Università di Perugia, Perugia, Italy.
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Pini L, Hamid Q, Shannon J, Lemelin L, Olivenstein R, Ernst P, Lemière C, Martin JG, Ludwig MS. Differences in proteoglycan deposition in the airways of moderate and severe asthmatics. Eur Respir J 2006; 29:71-7. [PMID: 17050562 DOI: 10.1183/09031936.00047905] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Excess deposition of proteoglycans (PGs) has been described in the subepithelial layer of the asthmatic airway wall. However, less is known about deposition in the airway smooth muscle (ASM) layer, and whether the pattern of deposition is altered depending upon disease severity. Endobronchial biopsies were performed in patients with severe or moderate asthma (defined using American Thoracic Society criteria) and in control subjects. Biopsies were immunostained for the PGs biglycan, lumican, versican and decorin. PG deposition was measured in the subepithelial and ASM layers, the former by calculating the area of positive staining, and the latter by determining the percentage area stained using point counting. Immunostaining for PGs was prominent in biopsies from both moderate and severe asthmatics, compared with control subjects. While there was no difference in the amount of PG in the subepithelial layer between the two asthmatic groups, the percentage area of biglycan and lumican staining in the ASM layer was significantly greater in moderate versus severe asthmatics. Differences in the deposition of proteoglycans within the airway smooth muscle layer of moderate versus severe asthmatics potentially impact on the functional behaviour of the airway smooth muscle in these two groups of patients.
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Affiliation(s)
- L Pini
- Meakins-Christie Laboratories, Montreal Chest Institute, McGill University Hospital Centre, Université de Montréal, Montreal, QC, Canada
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21
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Venkatesan N, Pini L, Ludwig MS. Changes in Smad expression and subcellular localization in bleomycin-induced pulmonary fibrosis. Am J Physiol Lung Cell Mol Physiol 2004; 287:L1342-7. [PMID: 15333293 DOI: 10.1152/ajplung.00035.2004] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [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: 02/03/2023] Open
Abstract
Administration of bleomycin (BM) produces inflammation and fibrosis of the lung in humans and experimental animals. The molecular defects by which BM induces these pathological effects have not been studied in detail. We studied the expression of Smad family proteins, key molecules involved in mediating transforming growth factor (TGF)-β signaling from the cell membrane to the nucleus, during the early and late phases of BM-induced fibrogenesis. Pulmonary fibrosis was induced in male Sprague-Dawley rats by a single intratracheal injection (1.5 units) of BM. Control rats received saline. Rats were killed at 3, 5, 7, 14, and 28 days after BM, cytosolic and nuclear proteins were extracted and isolated from lung tissues, and Smad proteins were probed with specific antibodies. In BM-exposed lung tissue, compared with control, Smad3 decreased persistently in the cytosol and increased transiently in the nucleus. There was a persistent increase in phosphorylation and nuclear accumulation of Smad2/3. Smad4 was increased transiently in both the cytosol and nucleus. A significant and progressive decrease in the expression of Smad7, the endogenous inhibitor of TGF-β/Smad signaling, was observed after BM instillation. Collectively, our results indicate that an imbalance between agonistic Smads2–4 and antagonistic Smad7 may result in the unchecked activation of an autocrine TGF-β loop, which contributes to the pathogenesis of BM-induced pulmonary fibrosis.
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Affiliation(s)
- N Venkatesan
- Meakins Christie Laboratories, McGill University Hospital Center, Montreal, Quebec, Canada H2X 2P2
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22
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Ferrari E, Mirani M, Barili L, Falvo F, Solerte SB, Cravello L, Pini L, Magri F. COGNITIVE AND AFFECTIVE DISORDERS IN THE ELDERLY: A NEUROENDOCRINE STUDY. Arch Gerontol Geriatr 2004:171-82. [PMID: 15207411 DOI: 10.1016/j.archger.2004.04.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Both in physiological and pathological brain aging, cognitive and affective disorders usually keep up with significant morphological and metabolic changes of brain areas possibly involved in the control of mood, learning and memory, as well as in the modulation of the hypothalamo-pituitary-adrenal (HPA) axis. The aim of this work was to study the circadian rhythm of serum cortisol and dehydroepiandrosterone (DHEAS) in 25 old demented patients and 10 old unipolar depressed patients, compared with 21 old and 13 young controls. The circadian profile of serum cortisol was clearly flattened in elderly subjects,both healthy and demented, in comparison to young controls, with significantly higher cortisol levels at nighttime. The occurrence of minor depression was associated with a further increase of the cortisol mean levels in old demented subjects, but not in the healthy ones. The trend towards the increase of the nocturnal cortisol levels was also evident in old subjects with major depression. The decline of DHEAS secretory pattern was clearly age related,being additive factors to both dementia and major depression. No significant influence of minor depression on DHEAS secretion was found. The cortisol/DHEAS molar ratio,considered as a good index of the brain steroidal milieu, progressively increased with aging and exhibited a further increase related to the occurrence of senile dementia or minor depressive symptoms. The value of the same ratio was higher in elderly subjects with major depression, than in age-matched healthy controls. In conclusion, the occurrence of major depression or even only of depressive symptoms seems to amplify the changes of the adrenal steroidal secretory pattern, already present in physiological aging.
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Affiliation(s)
- E Ferrari
- Department of Internal Medicine and Medical Therapy, University of Pavia, I -27100 Pavia, Italy.
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23
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Boni E, Corda L, Franchini D, Chiroli P, Damiani GP, Pini L, Grassi V, Tantucci C. Volume effect and exertional dyspnoea after bronchodilator in patients with COPD with and without expiratory flow limitation at rest. Thorax 2002; 57:528-32. [PMID: 12037229 PMCID: PMC1746351 DOI: 10.1136/thorax.57.6.528] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A study was undertaken to investigate whether bronchodilators are associated with less breathlessness at rest and during light exercise in patients with moderate to severe chronic obstructive pulmonary disease (COPD) with resting tidal expiratory flow limitation (EFL; flow limited (FL)) compared with those without EFL (non-flow limited (NFL)). METHODS Twenty subjects (13 men) of mean (SD) age 65 (8) years (range 43-77) suffering from COPD with forced expiratory volume in 1 second (FEV(1)) 47 (18)% predicted were studied before and after inhalation of salbutamol (400 microg). Routine pulmonary function tests were performed in the seated position at rest. EFL was assessed by the negative expiratory pressure (NEP) method and changes in end expiratory lung volume (EELV) were inferred from variations in inspiratory capacity (IC). Dyspnoea was measured using the Borg scale at rest and at the end of a 6 minute steady state exercise test at 33% of the maximal predicted workload. RESULTS EFL occurred in 11 patients. Following salbutamol IC did not change in NFL patients but increased by 24% (95% CI 15 to 33) in FL patients (p<0.001). Maximal inspiratory pressure (PImax) improved at EELV from 45 (95% CI 26 to 63) to 55 (95% CI 31 to 79) cm H(2)O (p<0.05) in FL patients after salbutamol but remained unchanged in NFL patients. The workload performed during exercise amounted to 34 (95% CI 27 to 41) and 31 (95% CI 21 to 40) watts (NS) for patients without and with EFL, respectively. After salbutamol, dyspnoea did not change either at rest or during exercise in the NFL patients, but decreased from 0.3 (95% CI -0.1 to 0.8) to 0.1 (95% CI -0.1 to 0.4) at rest (NS) and from 3.7 (95% CI 1.7 to 5.7) to 2.6 (95% CI 1.1 to 4.0) at the end of exercise (p<0.01) in FL patients. CONCLUSIONS Patients with COPD with EFL may experience less breathlessness after a bronchodilator, at least during light exercise, than those without EFL. This beneficial effect, which is closely related to an increase in IC at rest, occurs even in the absence of a significant improvement in FEV(1) and is associated with a greater PImax.
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Affiliation(s)
- E Boni
- Cattedra di Medicina I, Università di Brescia, Italy
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24
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Abstract
Glomerulonephritis occurring in association with alpha(1)-antitrypsin deficiency has been sporadically reported in the literature but it is assumed to be a rare and poorly investigated disease. The complete pathologic pattern of glomerular lesions has not yet been established. The aim of our work was to investigate the correlation between the extent of antiprotease deficiency and the expression of nephropathy evaluated in two groups of patients (47 heterozygotic subjects with the PiMZ phenotype and 12 homozygotic subjects with the PiZZ phenotype) by a noninvasive approach with urinalyses and proteinuria measurement. No statistical differences between proteinuria in the two groups were observed suggesting that nephropathy is not a direct and single expression of the protein deficiency.
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Affiliation(s)
- A Montanelli
- Department of Clinical Pathology, Ospedale Maggiore of Crema, Italy.
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25
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Malerba M, Clini E, Cremona G, Radaeli A, Bianchi L, Corda L, Pini L, Ricciardolo F, Grassi V, Ambrosino N, Ricclardolo F. Exhaled nitric oxide in patients with PiZZ phenotype-related alpha1-anti-trypsin deficiency. Respir Med 2001; 95:520-5. [PMID: 11421511 DOI: 10.1053/rmed.2001.1082] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
There is no report of exhaled NO (eNO) in subjects with different phenotypes of alpha1-anti-trypsin (AAT) deficiency. Exhaled nitric oxide was evaluated by means of single-breath chemiluminescence analysis (fractional exhaled concentration at the plateau level [plFE(NO)]) in 40 patients with AAT deficiency. Patients were divided according to the protease inhibitor (Pi) phenotype: PiMZ/MS, n = 25; PiSZ n = 6; PiZZ, n = 9. Nineteen healthy subjects served as controls. Levels of eNO in PiZZ patients were also compared with those of subjects, without AAT deficiency (PiMM), matched for diagnosis, sex, age, smoking habit and forced expiratory volume in 1 sec (FEV1). In AAT deficiency subjects airway hyper-responsiveness to methacholine (PD20 FEV1) was also assessed. plFE(NO) was significantly lower in the PiZZ group (4.5+/-1.4 ppb) than in matched PiMM subjects (8.2+/-3.8 ppb), in healthy controls (9.3+/-2.8 ppb) and in patients of other phenotypes. Dynamic lung volumes and DL(CO) were significantly lower in PiZZ than in other AAT-deficient patients. Bronchial hyper-responsiveness was not different among AAT phenotypes. These results suggest that eNO may be significantly reduced in PiZZ as compared to healthy control subjects and to AAT subjects with other phenotypes, independent of the level of airway obstruction. Whether, at least potentially, eNO may be considered as an early marker of lung involvement in AAT deficiency must be confirmed with studies on larger number of subjects.
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Affiliation(s)
- M Malerba
- Institute of Internal Medicine University of Brescia, Italy
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26
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Malerba M, Clini E, Radaeli A, Corda L, Pini L, Ceriani L, Grassi V. Exhaled nitric oxide in patients with alpha 1 antitrypsin (AAT) deficiency. Monaldi Arch Chest Dis 2001; 56:175-6. [PMID: 11499313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Affiliation(s)
- M Malerba
- Institute of Internal Medicine, University of Brescia, Italy.
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27
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Pini L, Corda L, Malerba M, Montanelli A, Favagrossa GM, Terzi A, Marcobruni N, Magoni M, Franchini D, Radaeli A, Tantucci C, Grassi V. [Alpha 1-antitrypsin deficiency: the Brescia clinical study]. Recenti Prog Med 2000; 91:352-61. [PMID: 10932919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
In a longitudinal clinical study, two hundred subjects have been evaluated in order to identify alpha 1-antitrypsin deficiency patients. According to their serum alpha 1-antitrypsin levels, they have been divided into three groups: 25 patients with severe deficiency (with both pathological alleles--ZZ, SZ or Z and rare deficiency allele--and, if clinically suggested, to be treated with augmentation therapy), 92 patients with intermediate deficiency (with one pathological allele, to be followed up in order to evaluate the risk to develop deficiency related disease) and 63 healthy subjects (normal alleles MM). They performed lung function test (including cardiopulmonary exercise test and methacholine bronchial challenge) chest X-ray and high resolution computed tomography, blood tests. Severe deficiency patients also performed perfusional lung scan to detect early disorders of blood flow, evaluation of arterial blood gases and liver echotomography. Expiratory flow limitation, the prevalence of vascular disease, the amount of urine elastin products and correlations between the amount of nitric oxide exhaled and bronchial hyperresponsiveness have been also investigated. The study showed that in Brescia county the deficiency is more common than expected and that evaluation of liver and vessels might be as useful as lung function tests. In addition, beneficial effect on local system has been observed. The longitudinal study might permit to detect early organ damage and to eliminate additive risk factors.
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Corda L, Pini L, Malerba M, Grassi V. [Severe alpha 1-antitrypsin deficiency: cross sectional clinical study]. Ann Ital Med Int 2000; 15:125-31. [PMID: 10920502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The aim of this study was to investigate a group of severe alpha 1-antitrypsin deficient subjects. Of the 20 subjects detected, 7 were classified as Index Cases (discovered because they were symptomatic and had pulmonary emphysema or liver disease), while 13 were classified as Non-Index Cases (asymptomatic and discovered because they were relatives of Index Cases or because of the absence of alpha 1 band in serum electrophoresis). They underwent pulmonary function tests, determination of arterial blood gases, lung high resolution computed tomography and lung perfusion scan. All Index Cases were with the ZZ phenotype, indicating a major risk of developing related pulmonary emphysema or liver disease; most Index Cases (71%) were ex-smokers, while among the Non-Index Cases, 46% were smokers or ex-smokers, suggesting that smoking might be the main cofactor in the development of emphysema. Index Cases were older (statistical significance) and mostly male as compared with Non-Index Cases. A statistical significance was observed between the two groups for several lung function parameters (forced expiratory volume in one second, Tiffenau index, residual volume, diffusing capacity of the lung for carbon monoxide, arterial oxygen tension) as a result of a pathological impairment in Index Cases. This underdiagnosed condition merits more attention in order to prevent its complications and to get a better understanding about its diagnosis and management.
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Affiliation(s)
- L Corda
- Spedali Civili e Cattedra di Medicina Interna, Università degli Studi di Brescia.
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Barillari G, Iorio E, Catanese B, Pini L. A study of the absorption and tolerance of ibuprofen guaiacol ester in man after repeated oral administration. Boll Chim Farm 1982; 121:626-31. [PMID: 7184507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Catanese B, Barillari G, Iorio E, Pini L. Studies on the oral absorption of ibuprofen guaiacol-ester in man. Boll Chim Farm 1982; 121:567-72. [PMID: 7183325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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31
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Benassi L, Cacciatore A, Pini L, Salvadori B. [16-substituted steroids in the fetus and newborn in pregnancies complicated by toxemias]. Minerva Med 1979; 70:2983-4. [PMID: 158717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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32
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Tamba M, Pini L, Badiello R. Radiation chemical evidence for differences in the amino-acid composition of yeast and horse-liver alcohol dehydrogenases. Int J Radiat Biol Relat Stud Phys Chem Med 1978; 33:95-101. [PMID: 342432 DOI: 10.1080/09553007714551541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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33
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Benassi L, Cacciatore A, Pini L, Salvadori B. 16-substituted steroids in in the fetus and newborn infant in pregnancies complicated by EPH-gestosis. Panminerva Med 1977; 19:437-8. [PMID: 609479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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34
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Salvadori B, Benassi L, Merialdi A, Coppola F, Pini L, Cacciatore A. Feto-neonatal hormonology in premature delivery. J Steroid Biochem 1977; 8:385-6. [PMID: 599914 DOI: 10.1016/0022-4731(77)90238-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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