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Carducci AL, Agodi A, Ancona C, Angelini P, Bagordo F, Barbone F, Birbaum L, Carreri V, Casuccio A, Conti A, Conversano M, De Donno A, De Giglio O, Desiante F, Di Pietro A, Dogliotti E, Donato F, Fara GM, Fiore M, Forastiere F, Giammanco G, Izzotti A, Montagna MT, Oliveri Conti G, Petronio MG, Sciacca S, Signorelli C, Testai E, Verani M, Vinceti M, Vitale F, Ferrante M, Adani G, Berghella L, Calia C, Calzolari R, Canale A, Castiglione D, Conti A, Copat C, Cristaldi A, Cuffari G, Coronel Vargas G, De Vita E, De Nard F, Federigi I, Filippini T, Grasso A, Leonardi N, Letzgus M, Lo Bianco G, Mazzucco W, Nicolosi I, Orlandi P, Paladino G, Pizzo S, Pousis C, Raffo M, Rivolta S, Scarpitta F, Trani G, Triggiano F, Tumbarello A, Vecchio V, Zuccarello P, Vassallo M. Impact of the environment on the health: From theory to practice. Environ Res 2021; 194:110517. [PMID: 33271142 DOI: 10.1016/j.envres.2020.110517] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
The Erice 56 Charter titled "Impact of the environment on the health: from theory to practice" was unanimously approved at the end of the 56th course of the "International School of Epidemiology and Preventive Medicine G. D'Alessandro" held from 3rd to November 7, 2019 in Erice - Sicily (Italy) and promoted by the Study Group of "Environment and Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health. The course, that included lectures, open discussions and guided working groups, was aimed to provide a general training on epidemiological and toxicological aspects of the environmental health impact, to be used by public health professionals for risk assessment, without forgetting the risk communications. At the end of the course 12 key points were agreed among teachers and students: they underlined the need of specific training and research, in the perspective of "One Health" and "Global Health", also facing emerging scientific and methodological issues and focusing on communication towards stakeholders. This Discussion highlight the need to improve knowledge of Health and Environment topic in all sectors of health and environmental prevention and management.
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Affiliation(s)
- A L Carducci
- Department of Biology, University of Pisa, Italy
| | - A Agodi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Ancona
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Italy
| | - F Bagordo
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - F Barbone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - L Birbaum
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - V Carreri
- Past-President of Italian Society of Hygiene (SItI), Italy
| | - A Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - M Conversano
- Department of Public Health, ASL, Taranto, Italy
| | - A De Donno
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - O De Giglio
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - F Desiante
- Department of Prevention, Local Health Authority of Taranto, Taranto, Italy
| | - A Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - E Dogliotti
- Department of Environmental and Health. Istituto Superiore di Sanità. Rome, Italy
| | - F Donato
- Department of Medical and Surgical Specialties, Radiological Sciences, And Public Health, University of Brescia, Italy
| | - G M Fara
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - M Fiore
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - F Forastiere
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - G Giammanco
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - A Izzotti
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M T Montagna
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - G Oliveri Conti
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M G Petronio
- Health and Environment-Department of Prevention, Local Health Authority-Empoli, Florence, Italy
| | - S Sciacca
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Signorelli
- University Vita-Salute San Raffaele, Milan, Italy
| | - E Testai
- Istituto Superiore di Sanità, Environment & Health Dept., Rome, Italy
| | - M Verani
- Department of Biology, University of Pisa, Italy
| | - M Vinceti
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - M Ferrante
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy.
| | - G Adani
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - L Berghella
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Calia
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - R Calzolari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - A Canale
- Department of Biology, University of Pisa, Italy
| | - D Castiglione
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - C Copat
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Cristaldi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - G Cuffari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - G Coronel Vargas
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - E De Vita
- Department of Biology, University of Pisa, Italy
| | | | - I Federigi
- Department of Biology, University of Pisa, Italy
| | - T Filippini
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - A Grasso
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - N Leonardi
- University Center for the Protection and Management of Natural Environments and Agrosystems (CUTGANA), University of Catania, Italy
| | | | | | - W Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - I Nicolosi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Orlandi
- Local Health Authority of Rome, Italy
| | - G Paladino
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - S Pizzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - C Pousis
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - M Raffo
- Local Health Authority of Rome, Italy
| | | | - F Scarpitta
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - G Trani
- Central Health Department of the Friuli Venezia Giulia Region, Trieste, Italy
| | - F Triggiano
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | | | - V Vecchio
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Zuccarello
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M Vassallo
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
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Molinaro A, Orlandi P, Niccolai F, Agretti P, De Marco G, Ferrarini E, Di Cosmo C, Vitti P, Piaggi P, Di Desidero T, Bocci G, Tonacchera M. Genetic interaction analysis of VEGF-A rs3025039 and VEGFR-2 rs2071559 identifies a genetic profile at higher risk to develop nodular goiter. J Endocrinol Invest 2020; 43:149-155. [PMID: 31376092 DOI: 10.1007/s40618-019-01092-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/29/2019] [Indexed: 12/16/2022]
Abstract
CONTEXT Nodular goiter in patients from areas of iodine deficiency is due to the growth of follicular and endothelial cells, involving different vascular-related growth factors in its pathogenesis. OBJECTIVE The aim of our study was to examine the association of known single polymorphisms of vascular endothelial growth factor-A [VEGF-A], VEGF receptor-2 [VEGFR-2] and hypoxia-inducible factor-1α [HIF-1α] genes or their genetic interactions with the risk of nodular goiter development. PATIENTS AND METHODS 116 normal subjects, without any thyroid disease, and 108 subjects with nodular goiter [subjects with goiter and at least one thyroid nodule of > 1 cm of maximum size and in absence of signs of autoimmunity] were selected from a homogeneous population living in a mild iodine deficiency geographic area. Analyses were performed on germline DNA obtained from blood samples and VEGF-A rs3025039, VEGFR-2 rs2071559, and HIF-1αrs11549465 SNPs were investigated by real-time PCR technique. The multifactor dimensionality reduction [MDR] methodology was applied to investigate the genetic interaction between SNPs. Hardy-Weinberg equilibrium was performed. RESULTS None of the studied polymorphisms were individually associated with a higher risk to develop nodular goiter [P > 0.05]. The combination of the VEGF-A rs3025039 and VEGFR-2 rs2071559 polymorphisms had the highest accuracy of 0.58 [P = 0.018] and the interaction of some genotypes was significantly associated with the risk of nodular goiter development. CONCLUSIONS Our results support a genetic interaction between the VEGF-A rs3025039 and VEGFR-2 rs2071559 polymorphisms as a predictor of the risk to develop nodular goiter in subjects coming from an area with mild iodine deficiency.
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Affiliation(s)
- A Molinaro
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy
| | - P Orlandi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - F Niccolai
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - P Agretti
- Laboratory of Chemistry and Endocrinology, University Hospital of Pisa, Pisa, Italy
| | - G De Marco
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy
| | - E Ferrarini
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy
| | - C Di Cosmo
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy
| | - P Vitti
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy
| | - P Piaggi
- Department of Energy and Systems Engineering, University of Pisa, Pisa, Italy
| | - T Di Desidero
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Tonacchera
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Via Paradisa 2, Cisanello, 56124, Pisa, Italy.
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ANDERSON A, Orlandi P, Wang X, Xie D, Yang W, Feldman H. SAT-175 TRAJECTORIES OF KIDNEY FUNCTION AND THEIR PREDICTORS: FINDINGS FROM THE CHRONIC RENAL INSUFFICIENCY COHORT (CRIC) STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fornaro L, Vivaldi C, Orlandi P, Musettini G, Pecora I, Gentile D, Catanese S, Lencioni M, Salani F, Pasquini G, Massa V, Di Desidero T, Falcone A, Vasile E, Bocci G. Longitudinal evaluation of angiogenesis-related circulating biomarkers during second-line treatment with paclitaxel and ramucirumab in advanced gastroesophageal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cantarella M, Pasqualetti F, Gonnelli A, Orlandi P, Giuliani D, Delishaj D, Montrone S, Coraggio G, Lombardo E, Simeon V, Di Desiderio T, Fioravanti A, Fabrini M, Danesi R, Guarini S, Paiar F, Bocci G. PO-0630: The role of mc4r gene polymorphisms in gbm patients treated with concomitant radio-chemotherapy. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cantarella M, Gonnelli A, Molinari A, Orlandi P, Di Desiderio T, Simeon V, Lombardi G, Pasqualetti F, Paiar F, Bocci G. P01.26 rs489693 Melacortin receptor gene polymorphism is associated with the progression-free survival of glioblastoma patients treated with concomitant radio-chemotherapy. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Di Paolo A, Orlandi P, Di Desidero T, Danesi R, Bocci G. Simultaneous, but not consecutive combination with folinate salts potentiates 5-fluorouracil antitumor activity in vitro. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30301-5] [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: 10/20/2022]
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Lambertini L, Paci G, Morittu V, Vignola G, Orlandi P, Zaghini G, Formigoni A. Consequences of behaviour on productive performances of rabbits reared in pens. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2005.2s.550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Awah N, Balogun H, Achidi E, Mariuba LA, Nogueira PA, Orlandi P, Troye-Blomberg M, Gysin J, Berzins K. Antibodies to the Plasmodium falciparum rhoptry protein RAP-2/RSP-2 in relation to anaemia in Cameroonian children. Parasite Immunol 2011; 33:104-15. [PMID: 21226723 DOI: 10.1111/j.1365-3024.2010.01259.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies have implicated reactive antibodies to the low molecular weight rhoptry-associated proteins (RAP-1, RAP-2/RSP-2 and RAP-3) in erythroid cell destruction during Plasmodium falciparum infection. In this pilot study, the frequency, specificity and functional capacity of naturally acquired anti-RAP-2/RSP-2 antibodies were investigated in the sera of anaemic and nonanaemic malaria-infected Cameroonian children. All sera recognized RAP-2/RSP-2 by FACS, irrespective of the clinical status of the subjects. However, the anaemic children showed higher levels of IgG antibodies than the nonanaemic group, while both groups showed similar levels of IgM antibodies. Only few individuals had detectable levels of RAP-2/RSP-2-specific IgG1 and IgG3 subclass antibodies, while no IgG2 and IgG4 subclass antibodies were detected in these subjects. By ELISA, the anaemic group tended to show higher levels of antibodies to RAP-2/RSP-2 regarding all antibody classes tested, except for IgG4 and IgE. Unexpectedly, sera from the nonanaemic group activated complement to a greater extent than those from the anaemic group. These results need to be confirmed in extended studies but indicate that the effector functions of the RAP-2/RSP-2-reactive antibodies may be more important than their amounts. Such antibodies could play a role in both immunity and pathogenesis during P. falciparum infection.
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Affiliation(s)
- N Awah
- Department of Immunology, Wenner-Gren Institute, Stockholm University, Stockholm, Sweden.
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Loupakis F, Cremolini C, Fioravanti A, Orlandi P, Salvatore L, Masi G, Di Desidero T, Canu B, Schirripa M, Frumento P, Di Paolo A, Danesi R, Falcone A, Bocci G. Pharmacodynamic and pharmacogenetic angiogenesis-related markers of first-line FOLFOXIRI plus bevacizumab schedule in metastatic colorectal cancer. Br J Cancer 2011; 104:1262-9. [PMID: 21407216 PMCID: PMC3078596 DOI: 10.1038/bjc.2011.85] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: The identification of molecular and genetic markers to predict or monitor the efficacy of bevacizumab (BV) represents a key issue in the treatment of metastatic colorectal cancer (mCRC). Methods: Plasma levels of vascular endothelial growth factor (VEGF), placental growth factor (PlGF), soluble VEGF receptor 2 (sVEGFR-2) and thrombospondin-1 (TSP-1) were assessed by ELISA assay at different time points in a cohort of 25 patients enroled in a phase II trial of GONO-FOLFOXIRI plus BV as first-line treatment of mCRC. VEGF: −2578A/C, −1498C/T, −1154A/G, −634C/G and 936C/T; and VEGFR-2: −604A/G, +1192C/T and +1719A/T, polymorphisms were assessed in a total of 54 patients. Results: Treatment with GONO-FOLFOXIRI plus BV determined a prolonged and significant reduction in plasma free, biologically active VEGF concentration. Interestingly, VEGF concentrations remained lower than at baseline also at the time of PD. Conversely, PlGF levels increased during the treatment if compared with baseline, suggesting a possible role in tumour resistance; moreover, sVEGFR-2 increased at the time of PD, as well as TSP-1. No association of assessed polymorphisms with outcome was found. Conclusion: Our study suggested the possible mechanisms of resistance to combined therapy in those patients with a progressive disease to be tested in ongoing phase III randomised studies.
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Affiliation(s)
- F Loupakis
- Unit of Medical Oncology, Department of Oncology, Transplants and New Technologies in Medicine, Azienda Ospedaliero-Universitaria Pisana and University of Pisa, Via Roma, 67, Pisa, 56126, Italy
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Cremolini C, Loupakis F, Salvatore L, Schirripa M, Fioravanti A, Orlandi P, Di Desidero T, Danesi R, Falcone A, Bocci G. Exploratory analysis of circulating pro- and antiangiogenic factors in metastatic colorectal cancer (mCRC) patients, treated with GONO-FOLFOXIRI plus bevacizumab (BV). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Baldi G, Bocci G, Barletta M, Fioravanti A, Loupakis F, Orlandi P, Allegrini G, Danesi R, Del Tacca M, Falcone A. 3067 POSTER Irinotecan Metronomic Chemotherapy (MC) in patients with diagnosis of metastatic colorectal cancer (MCRC): clinical, pharmacodynamic (PD) and pharmacokinetic (PK) evaluation. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70995-3] [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: 10/22/2022] Open
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Bocci G, Culler MD, Fioravanti A, Orlandi P, Fasciani A, Colucci R, Taylor JE, Sadat D, Danesi R, Del Tacca M. In vitro antiangiogenic activity of selective somatostatin subtype-1 receptor agonists. Eur J Clin Invest 2007; 37:700-8. [PMID: 17696959 DOI: 10.1111/j.1365-2362.2007.01848.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Endothelial cells of human blood vessels (arteries and veins) show high levels of somatostatin subtype-1 receptor (sst(1)). The aim of the present study is to investigate the inhibitory effects of novel somatostatin analogs, highly selective for human sst(1), on in vitro angiogenesis and their modulation of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2) expression. MATERIALS AND METHODS Somatostatin analogs BIM-23745 and BIM-23926 were tested for their ability to prevent proliferation and migration of human endothelial HMEC-1 cells, to modulate VEGF and VEGFR-2 expression and to inhibit sprouting of microvessels from cultured human placental vessel explants in fibrin matrix for 28 days. RESULTS The somatostatin sst(1 )receptor-selective agonists, BIM-23745 and BIM-23926 showed a suppression of endothelial proliferation (e.g. 10(-6) M BIM-23475, 40.0 +/- 2.1% vs. 100% of controls; 10(-7) M BIM-23926, 55.3 +/- 3.3% vs. 100% of controls), migration (e.g. 10(-7) M BIM-23475, 35.0 +/- 1.56% vs. 100% of controls; 10(-7) M BIM-23926, 53.7 +/- 1.77% vs. 100% of controls) and microvessel sprouting (e.g. 10(-8) M BIM-23475, 42.8 +/- 5.6% vs. 100% of controls; 10(-7) M BIM-23926, 17.2 +/- 11.8% vs. 100% of controls). A small but significant percentage of cells exposed to BIM-23745 and BIM-23926 for 24 h and for 72 h presented typical apoptotic morphology. Moreover, both the analogs significantly inhibit VEGF and VEGFR-2 gene expression in endothelial cells grown for 144 h in a fibrin matrix and the VEGF secretion in conditioned media. CONCLUSIONS The inhibition of endothelial activities suggests potential therapeutic utility for administration of somatostatin sst(1 )receptor-selective agonists in the proliferative diseases involving angiogenesis.
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Affiliation(s)
- G Bocci
- University of Pisa, Pisa, Italy.
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14
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Antonucci S, Orlandi P, Mattei PA, Amato F. Airway obstruction during arthroscopic shoulder surgery: anesthesia for the patient or for the surgeon? Minerva Anestesiol 2006; 72:995-1000. [PMID: 17235266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Two cases of airway obstruction as a result of oedema of laryngeal structures which arose during protracted arthroscopic shoulder surgery, in which single-shot interscalene blocks had been performed, are reported. In these 2 cases, the complexity of the pathologies and the fact that the surgeons were at the beginning of their surgical experience are the most likely causes of the conditions which led to tracheal compression from extra-articular leakage of fluid. Therefore, we recommend a combined peripheral block and general anaesthesia with tracheal intubation for procedures performed by surgeons without an adequate experience and on obese patients, patients placed in a lateral decubitus, or procedures in which difficulties are expected. The advantages of regional anaesthesia with a constant control of the airways are underlined.
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Affiliation(s)
- S Antonucci
- Department of Anesthesia and Intensive Care Medicine, SS. Trinità Hospital, Popoli (PE), Italy
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15
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Loupakis F, Bocci G, Allegrini G, Cerri E, Barletta MT, Masi G, Fioravanti A, Orlandi P, Del Tacca M, Falcone A. Metronomic chemotherapy (MC) with irinotecan (CPT-11) in patients with diagnosis of metastatic colorectal cancer (MCRC): clinical and pharmacodynamic evaluation. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
13111 Background: Preclinical studies have demonstrated that the frequent administration of low doses of cytotoxic drugs over prolonged periods of time (MC) reduces tumour cell growth through inhibition of angiogenesis. The antitumor effect of a MC with cyclophosphamide is due to an increase of thrombospondin-1 (TSP-1) plasma level, an endogenous inhibitor of angiogenesis. Methods: An exploratory study was conducted to assess the feasibility, the activity and the optimal metronomic dose of CPT-11 when administered as protracted continuous infusion (c.i.) in pretreated MCRC. A pharmacodynamic evaluation of anti- and pro-angiogenic factors, such as TSP-1 and vascular endothelial growth factor (VEGF), was performed. Weekly blood samples were taken. Three different CPT-11 dose levels have been evaluated: 1.4, 2.8 and 4.2 mg/sqm/day; 25%, 50% and 75% of the maximum CPT-11 tolerated dose in c.i. (5.6 mg/sqm/day), respectively. Results: Between Apr 04 and May 05 20 patients have been enrolled. Patients characteristics were: M/F = 11/9, median age = 71 years (range 51–79); PS 0/1/2 = 8/11/1; sites of metastasis: single/multiple = 7/13; median of previous lines of chemotherapy: 3 (range 1–5). No toxicities of grade >1 NCI scale have been observed. No objective responses were observed, but 4 patients (20%) had a stable disease with a median duration of 14 weeks (range 11–20). TSP-1 plasma levels significantly increased after one week and remained higher than the baseline for more than 8 weeks (120.1±10.3% vs. 100% of day 0). VEGF levels did not significantly change during the CPT-11 infusion. No statistical differences have been found for TSP-1 and VEGF concentrations among the three dose levels. Conclusions: CPT-11 metronomic chemotherapy is feasible. Plasma TSP-1 markedly increased during metronomic CPT-11 administration, suggesting a modulation of the angiogenic process in cancer patients. Supported by A.I.R.C. [Table: see text]
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Affiliation(s)
- F. Loupakis
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - G. Bocci
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - G. Allegrini
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - E. Cerri
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - M. T. Barletta
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - G. Masi
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - A. Fioravanti
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - P. Orlandi
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - M. Del Tacca
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
| | - A. Falcone
- Ospedale Civile, Livorno, Italy; Divisione di Farmacologia e Chemioterapia, Pisa, Italy; Università degli Studi, Pisa, Italy
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Orlandi P, Barbara C, Bocci G, Fioravanti A, Di Paolo A, Del Tacca M, Danesi R. Idarubicin and idarubicinol effects on breast cancer multicellular spheroids. J Chemother 2006; 17:663-7. [PMID: 16433198 DOI: 10.1179/joc.2005.17.6.663] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [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: 10/31/2022]
Abstract
Despite extensive preclinical evaluation in several experimental models, no studies have determined the effect of idarubicin and its metabolite idarubicinol on multicellular spheroids, a model which mimics the microregions of solid tumors. The principal aim of the present study was to investigate the in vitro cytotoxicity of idarubicin and its metabolite idarubicinol on MCF-7 breast cancer cells growing as monolayers or multicellular spheroids and to evaluate the influence of the length of exposure on the cytotoxic effect of both drugs. Cytoxicity was evaluated on monolayer and spheroid cultures exposed to idarubicin and idarubicinol 0.01-1000 ng/ml for 24 h or treated for 6, 12, 24 and 48 h to 100 ng/ml of both drugs. The IC50 of idarubicin and idarubicinol were 3.3+/-0.4 and 3.6+/-0.7 ng/ml, respectively, on MCF-7 monolayers and 7.9+/-1.1 and 5.3+/-0.7 ng/ml in multicellular spheroids, respectively. The antiproliferative effects of 100 ng/ml idarubicin and idarubicinol on MCF-7 spheroids was characterized by a marked time-dependence, which was less evident on MCF-7 growing as monolayer. In conclusion, the present experimental data demonstrate, for the first time, that idarubicin and idarubicinol have significant cytotoxic activity against multicellular spheroids, comparable to the antiproliferative effects on monolayer cells. In contrast, spheroids displayed substantial resistance after short exposure times that was not present in the two dimensional cultures.
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Affiliation(s)
- P Orlandi
- Division of Pharmacology and Chemotherapy, Department of Internal Medicine, University of Pisa, Pisa, Italy
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17
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Bocci G, Fioravanti A, Orlandi P, Bernardini N, Collecchi P, Del Tacca M, Danesi R. Fluvastatin synergistically enhances the antiproliferative effect of gemcitabine in human pancreatic cancer MIAPaCa-2 cells. Br J Cancer 2005; 93:319-30. [PMID: 16052215 PMCID: PMC2361561 DOI: 10.1038/sj.bjc.6602720] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The new combination between the nucleoside analogue gemcitabine and the cholesterol-lowering drug fluvastatin was investigated in vitro and in vivo on the human pancreatic tumour cell line MIAPaCa-2. The present study demonstrates that fluvastatin inhibits proliferation, induces apoptosis in pancreatic cancer cells harbouring a p21ras mutation at codon 12 and synergistically potentiates the cytotoxic effect of gemcitabine. The pharmacologic activities of fluvastatin are prevented by administration of mevalonic acid, suggesting that the shown inhibition of geranyl-geranylation and farnesylation of cellular proteins, including p21rhoA and p21ras, plays a major role in its anticancer effect. Fluvastatin treatment also indirectly inhibits the phosphorylation of p42ERK2/mitogen-activated protein kinase, the cellular effector of ras and other signal transduction peptides. Moreover, fluvastatin administration significantly increases the expression of the deoxycytidine kinase, the enzyme required for the activation of gemcitabine, and simultaneously reduces the 5′-nucleotidase, responsible for deactivation of gemcitabine, suggesting a possible additional role of these enzymes in the enhanced cytotoxic activity of gemcitabine. Finally, a significant in vivo antitumour effect on MIAPaCa-2 xenografts was observed with the simultaneous combination of fluvastatin and gemcitabine, resulting in an almost complete suppression and a marked delay in relapse of tumour growth. In conclusion, the combination of fluvastatin and gemcitabine is an effective cytotoxic, proapoptotic treatment in vitro and in vivo against MIAPaCa-2 cells by a mechanism of action mediated, at least in part, by the inhibition of p21ras and rhoA prenylation. The obtained experimental findings might constitute the basis for a novel translational research in humans.
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Affiliation(s)
- G Bocci
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - A Fioravanti
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - P Orlandi
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - N Bernardini
- Department of Human Morphology and Applied Biology, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - P Collecchi
- Division of Pathological Anatomy, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - M Del Tacca
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy
| | - R Danesi
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy
- Division of Pharmacology and Chemotherapy, University of Pisa, Via Roma, I-56126 Pisa, Italy. E-mail:
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18
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Abstract
The main topic of this article is B cell development and differentiation, with a special focus on the mechanisms and molecules that regulate the expression of humoral immunity. Molecular epidemiological analysis was performed on the genes responsible for the X-linked agammaglobulinemia (XLA) phenotype of the majority of Italian patients and their distinct mutations were characterized. Mutations in Bruton's tyrosine kinase (BTK), a member of Tec Family of protein tyrosine kinases, have been found to be mainly responsible for XLA disease. The exact function of BTK in signal transduction is not yet known; thus, the specific role of BTK in receptor-dependent calcium signaling and the pro-antiapoptotic regulatory activity was addressed by transfecting RAMOS-1, a BTK-deficient human Burkitt's/B cell leukemia line with wild-type and mutant constructs. This work may provide clues about critical sites in the molecule and give support for gene therapy as a potential successful approach to XLA. Another aspect of this research is the identification and dissection of the molecular events that are likely to be directly related to the ability to express various isotypes of immunoglobulin with differing function and certain B cell immunodeficiency, mainly common variable disease and non-X-linked hyperIgM. B cell development and maturation steps in different compartments of the immune system are tracked by the analysis of cell-surface molecules and components of the signal transduction pathways, i.e. CD40, CD30, CD27, CD38, CD22 and CD24. A few components involved in B cell development, maturation and differentiation and their specific functional role are at least partially known, but these are far from fitting into an understandable pathway at present.
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Affiliation(s)
- V Moschese
- Department of Pediatrics, Laboratory of Pediatric Immunology and Biotechnology, University of Tor Vergata, Cattedra di Pediatria, Rome, Italy
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19
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20
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Gagliardi MC, Finocchi A, Orlandi P, Cursi L, Cancrini C, Moschese V, Miyawaki T, Rossi P. Bruton's tyrosine kinase defect in dendritic cells from X-linked agammaglobulinaemia patients does not influence their differentiation, maturation and antigen-presenting cell function. Clin Exp Immunol 2003; 133:115-22. [PMID: 12823285 PMCID: PMC1808743 DOI: 10.1046/j.1365-2249.2003.t01-1-02178.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2003] [Indexed: 11/20/2022] Open
Abstract
X-linked agammaglobulinaemia (XLA) is a primary immunodeficiency disease characterized by very low levels or even absence of circulating antibodies. The immunological defect is caused by deletions or mutations of Bruton's tyrosine kinase gene (Btk), whose product is critically involved in the maturation of pre-B lymphocytes into mature B cells. Btk is expressed not only in B lymphocytes but also in cells of the myeloid lineage, including dendritic cells (DC). These cells are professional antigen presenting cells (APC) that play a fundamental role in the induction and regulation of T-cell responses. In this study, we analysed differentiation, maturation, and antigen-presenting function of DC derived from XLA patients (XLA-DC) as compared to DC from age-matched healthy subjects (healthy-DC). We found that XLA-DC normally differentiate from monocyte precursors and mature in response to lipopolysaccharide (LPS) as assessed by de novo expression of CD83, up-regulation of MHC class II, B7.1 and B7.2 molecules as well as interleukin (IL)-12 and IL-10 production. In addition, we demonstrated that LPS stimulated XLA-DC acquire the ability to prime naïve T cells and to polarize them toward a Th1 phenotype, as observed in DC from healthy donors stimulated in the same conditions. In conclusion, these data indicate that Btk defect is not involved in DC differentiation and maturation, and that XLA-DC can act as fully competent antigen presenting cells in T cell-mediated immune responses.
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Affiliation(s)
- M C Gagliardi
- Division of Immunology and Infectious Diseases, Children's Hospital Bambino Gesù, Department of Paediatrics, University of Rome Tor Vergata, Rome, Italy.
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21
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Iervese G, Spina T, Mascitelli G, Acquarola P, Orlandi P, Bosco G. [Bilateral stenosis of the innominate veins in oncological patient]. Minerva Anestesiol 2002; 68:631-4. [PMID: 12244296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Oncologic diseases frequently need a central venous catheterization to improve pharmacological administration safety and patient's comfort. We report a case of a woman affected by acute myelocytic leukemia with a bilateral stenosis of the innominate veins, likely of thrombotic nature, diagnosed during central venous catheterization. These events, as that occurred to our patient, are usually caused by hypercoagulability inducted by oncologic diseases, sepsis, antithrombin III deficiency, catheters materials and repeated catheterizations. Although the treatment, based on local thrombolysis, systemic heparinization, and surgery to repair venous obstruction, is effective, the prevention of such events is fundamental. It can be achieved with catheters of particular characteristics and appropriate management techniques. Finally it is underlined that in oncology patients, before catheterization, especially when the objective examination is negative, radiological methodologies and in particular ultrasonography are an important aid to establish the presence or absence of thrombosis in internal jugular, subclavian and innominate veins.
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Affiliation(s)
- G Iervese
- Servizio di Anestesia e Rianimazione, Ospedale Civile S. Spirito, Pescara, Italy
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22
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Sarwal MM, Yorgin PD, Alexander S, Millan MT, Belson A, Belanger N, Granucci L, Major C, Costaglio C, Sanchez J, Orlandi P, Salvatierra O. Promising early outcomes with a novel, complete steroid avoidance immunosuppression protocol in pediatric renal transplantation. Transplantation 2001; 72:13-21. [PMID: 11468528 DOI: 10.1097/00007890-200107150-00006] [Citation(s) in RCA: 183] [Impact Index Per Article: 8.0] [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: 01/18/2023]
Abstract
BACKGROUND Corticosteroids have been a cornerstone of immunosuppression for four decades despite their adverse side effects. Past attempts at steroid withdrawal in pediatric renal transplantation have had little success. This study tests the hypothesis that a complete steroid-free immunosuppressive protocol avoids steroid dependency for suppression of the immune response with its accompanying risk of acute rejection on steroid withdrawal. METHODS An open labeled prospective study of complete steroid avoidance immunosuppressive protocol was undertaken in 10 unsensitized pediatric recipients (ages 5-21 years; mean 14.4 years) of first renal allografts. Steroids were substituted with extended daclizumab use, in combination with tacrolimus and mycophenolate mofetil. Protocol biopsies were performed in the steroid-free group at 0, 1, 3, 6, and 12 months posttransplantation. Clinical outcomes were compared to a steroid-based group of 37 matched historical controls. RESULTS Graft and patient survival was 100% in both groups. Clinical acute rejection was absent in the steroid-free group at a mean follow-up time of 9 months (range 3-13.7 months). Protocol biopsies in the steroid-free group (includes 10 patients at 3 months, 7 at 6 months, and 4 at 12 months) revealed only two instances of mild (Banff 1A) subclinical rejection (reversed by only a nominal increase in immunosuppression) and no chronic rejection. At 6 months the steroid-free group had no hypertension requiring treatment (P=0.003), no hypercholesterolemia (P=0.007), and essentially no body disfigurement (P=0.0001). Serum creatinines, Schwartz GFR, and mean delta height Z scores trended better in the steroid-free group. In the steroid-free group, one patient had cytomegalovirus disease at 1 month and three had easily treated herpes simplex stomatitis, but with no significant increase in bacterial infections or rehospitalizations over the steroid-based group. The steroid-free group was more anemic early posttransplantation (P=0.004), suggesting an early role of steroids in erythrogenesis; erythropoietin use normalized hematocrits by 6 months. CONCLUSIONS Complete steroid-free immunosuppression is efficacious and safe in this selected group of children with no early clinical acute rejection episodes. This protocol avoids the morbid side effects of steroids without increasing infection, and may play a future critical role in avoiding noncompliance, although optimizing renal function and growth.
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Affiliation(s)
- M M Sarwal
- Department of Surgery, Stanford University Medical Center, 703 Welch Road, Suite H-5, Palo Alto, CA 94304, USA
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Rosafio T, Cichella C, Vetrugno L, Ballone E, Orlandi P, Scesi M. Chain of survival: differences in early access and early CPR between policemen and high-school students. Resuscitation 2001; 49:25-31. [PMID: 11334688 DOI: 10.1016/s0300-9572(00)00341-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/17/2022]
Abstract
Immediate activation of the emergency medical service (EMS) and cardiopulmonary resuscitation (CPR) increases the incidence of return of spontaneous circulation and the number discharged from hospital. The American Heart Association (AHA) and the European Resuscitation Council describe CPR as an ordinate sequence of eight steps. The objectives of this study were to assess the general knowledge of EMS and CPR and to analyse the retention of the CPR steps 2 months after a Basic Life Support (BLS)-course conducted according to AHA standards. We studied two populations from the same geographical area, law enforcement agents (LEA), since they are often the first to intervene, and high school students (HSS) since they are more likely to participate in such courses. HSS were more responsive and receptive than LEA. In order to increase the retention of the sequence of CPR steps, the number of steps should be reduced and refresher courses should be included in training programmes. Early access and early CPR are still not completely effective in the geographical area studied.
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Affiliation(s)
- T Rosafio
- Emergency Department, SS. Annunziata Hospital, Chieti, Italy
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24
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Millan MT, Sarwal MM, Lemley KV, Yorgin P, Orlandi P, So S, Alexander S, Salvatierra O. A 100% 2-year graft survival can be attained in high-risk 15-kg or smaller infant recipients of kidney allografts. Arch Surg 2000; 135:1063-8; discussion 1068-9. [PMID: 10982511 DOI: 10.1001/archsurg.135.9.1063] [Citation(s) in RCA: 32] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Infants make up the most high-risk, difficult to care for subgroup undergoing kidney transplantation, with the lowest 1- and 2-year graft survival rates of any other age group. The principal causes of graft loss have been graft thrombosis, primary nonfunction, technical error, and irreversible acute rejection. HYPOTHESIS Infants undergoing kidney transplantation can achieve near 100% graft survival at 2 years following surgery, despite their very high-risk status. DESIGN Analysis of 45 consecutive kidney transplants performed in patients weighing less than or equal to 15 kg during an 8-year period beginning August 1991. Patients included complex referrals from throughout the United States and all received transplants and were cared for by the same pediatric kidney transplantation team. RESULTS Mean weight at transplantation was 11. 2 kg. Renal failure was due to congenital or urologic causes in the majority (53%) of cases. Size-discrepant adult-sized kidney grafts were transplanted in 80% of patients; 64% received live-donor grafts; 78% were receiving dialysis prior to transplantation; and 27% had extremely small bladders (<20 cm(3)) requiring modification of the ureteral implantation. Excluding 1 transplant-unrelated death, graft and patient survival at 2 years was 100%. Eight-year patient and graft survival rates (for our combined live and cadaver donor series) were 89.6% and 84.6%, respectively. This compares favorably with much lower graft survival in low-risk adult recipients. Delayed graft function occurred in only 1 patient (2%). Rate of incidence of rejection was 9.3% within 2 years of transplantation and the overall rejection rate was 15.5%. No graft was lost to vascular thrombosis, primary nonfunction, technical error, or acute rejection. The mean creatinine level was 53.04 micromol/L (0.6 mg/dL) and 61.9 micromol/L (0.7 mg/dL) at 1 and 2 years, respectively, and 88.4 micromol/L (1.0 mg/dL) at 3, 4, and 5 years after transplantation. CONCLUSION One hundred percent 2-year and excellent 8-year graft survival rates can be achieved in what has historically been the highest-risk and most difficult to care for patient subgroup undergoing kidney transplantation.
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Affiliation(s)
- M T Millan
- Stanford University Medical Center, 750 Welch Rd, Suite 319, Palo Alto, CA 94304, USA.
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25
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Moschese V, Orlandi P, Plebani A, Arvanitidis K, Fiorini M, Speletas M, Mella P, Ritis K, Sideras P, Finocchi A, Livadiotti S, Rossi P. X-chromosome inactivation and mutation pattern in the Bruton's tyrosine kinase gene in patients with X-linked agammaglobulinemia. Italian XLA Collaborative Group. Mol Med 2000; 6:104-13. [PMID: 10859027 PMCID: PMC1949935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The diagnosis of X-linked agammaglobulinemia (XLA) is not always clearcut. Not all XLA conform to the classic phenotype and less than 50% of affected boys have a family history of immunodeficiency. Mutations in the gene for Bruton's tyrosine kinase (BTK) are responsible for the majority of agammaglobulinemia cases. However, a certain proportion of patients may have mutations involving other genes, although they show with an XLA phenotype. We performed BTK gene mutation analysis in 37 males with presumed XLA and analyzed the pattern of X-chromosome inactivation (XCI) in 31 mothers to evaluate the relevance of these approaches to diagnosis and genetic counseling. MATERIALS AND METHODS Twenty affected males with a sporadic occurrence and 17 familial cases belonging to nine families were enrolled within the framework of the Italian Multicenter Clinical Study on XLA. We used non-isotopic RNase cleavage assay (NIRCA), followed by cDNA sequence determination to screen for BTK mutations and X-chromosome inactivation analysis for carrier detection. RESULTS Using the cDNA-based approach, the identification of BTK gene abnormalities confirmed the clinical diagnosis of XLA in 31 of 37 affected infants. Missense was the most frequent mutational event and the kinase domain was mostly involved. In addition, nine novel mutations were identified. In sporadic cases, BTK gene abnormalities were identified in 9 out of 10 patients whose mothers had a nonrandom pattern of XCI and in 5 out of 6 patients whose mother had a random pattern of XCI. With the exception of one family, all patients with a familial occurrence and born to mothers with a nonrandom pattern of XCI had mutations of the BTK gene. CONCLUSIONS Our findings indicate that in sporadic cases BTK gene sequencing is the only reliable tool for a definitive diagnosis of XLA and support XCI as the first diagnostic tool in the mothers of affected males in multiple generations. Furthermore, our molecular analysis confirms that 10-20% of BTK-unaltered patients have disorders caused by defects in other genes.
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Affiliation(s)
- V Moschese
- Department of Pediatrics, University of Rome Tor Vergata, School of Medicine, Children's Hospital Bambino Gesù, Italy.
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Barbanti M, Costa C, Garbarino L, Orlandi P, Sacchi N. [The Italian Registry of Bone Marrow Donors]. Ann Ist Super Sanita 2000; 35:13-20. [PMID: 10645640] [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: 02/15/2023]
Abstract
Following a synthetic statement of the scientific, genetic and practical assumptions of the bone marrow transplantation (BMT) from marrow unrelated donor (MUD), which, in turn, have represented the basis for the establishment of the Italian Bone Marrow Donor Registry (IBMDR), the paper reports the registry activity on 30 November 1998. At that date, Italian volunteers were 232,876, number which put the IBMDR as the fourth registry all over the world and as the third in Europe. The mean age of the donors is 34 years, and this means that IBMDR is one of the youngest among international registries. Using Italian donors, 426 BMT, altogether, have been performed, (248 for Italian patients and 178 for foreign patients). Donor search activations performed by national and international transplant centres have been, at the same date, 5729 (1821 for Italian patients and 3908 for foreign patients). Operating standards and guidelines for all centres participating in the IBMDR are reported in this issue.
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Affiliation(s)
- M Barbanti
- Laboratorio di Tipizzazione Tissutale e Istocompatibilità, E.O. Ospedali Galliera, Genova
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Orlandi P, Ritis K, Moschese V, Angelini F, Arvanitidis K, Speletas M, Sideras P, Plebani A, Rossi P. Identification of nine novel mutations in the Bruton's tyrosine kinase gene in X-linked agammaglobulinaemia patients. Hum Mutat 2000; 15:117. [PMID: 10612838 DOI: 10.1002/(sici)1098-1004(200001)15:1<117::aid-humu26>3.0.co;2-h] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mutations in the Bruton's tyrosine kinase (BTK ) gene are responsible for X-linked Agammaglobulinemia (XLA), an immunodeficiency caused by a block in B cell differentiation. Non Isotopic RNAse Cleavage Assay (NIRCA), followed by sequencing was used to screen for BTK mutations in 11 Italian XLA patients. Nine novel mutations were identified: 6 missense (Y39S, L512P, L512Q, R544G, S578Y, E589K), one non-sense (Q260X), one frameshift (1599-1602del GCGC) and one in-frame insertion (2037-2038insTTTTAG), that represents the first case of premature stop codon introduction in the BTK coding frame. These data support the high molecular heterogeneity of BTK gene in XLA disease and provide new insight to the diagnosis and to the role of BTK domain in XLA and in B cell signal transduction and development. Hum Mutat 15:117, 2000.
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Affiliation(s)
- P Orlandi
- Dept. of Pediatrics, Division of Immunology and Infectious Diseases, Children's Hospital "Bambino Gesu", University of Rome Tor Vergata, Rome, Italy.
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Romiti ML, Colognesi C, Cancrini C, Mas A, Berrino M, Salvatori F, Orlandi P, Jansson M, Palomba E, Plebani A, Bertran JM, Hernandez M, de Martino M, Amoroso A, Tovo PA, Rossi P, Espanol T, Scarlatti G. Prognostic value of a CCR5 defective allele in pediatric HIV-1 infection. Mol Med 2000; 6:28-36. [PMID: 10803406 PMCID: PMC1949908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND A deletion of 32 base pairs in the CCR5 gene (delta32 CCR5) has been linked to resistance to HIV-1 infection in exposed adults and to the delay of disease progression in infected adults. MATERIALS AND METHODS To determine the role of delta32 CCR5 in disease progression of HIV-1 infected children born to seropositive mothers, we studied a polymerase chain reaction in 301 HIV-1 infected, 262 HIV-1 exposed-uninfected and 47 HIV-1 unexposed-uninfected children of Spanish and Italian origin. Infected children were further divided into two groups according to their rate of HIV-1 disease progression: rapid progressors who developed severe clinical and/or immunological conditions within the second year of life, and delayed progressors with any other evolution of disease. Among the latter were the long-term, non-progressors (LTNP) who presented with mild or no symptoms of HIV-1 infection above 8 years of age. Viral phenotype was studied for 45 delayed progressors. RESULTS No correlation was found between delta32 CCR5 and mother-to-child transmission of HIV-1. However, the frequency of the deletion was substantially higher in LTNP, compared with delayed (p = 0.019) and rapid progressors (p = 0.0003). In children carrying the delta32 CCRS mutation, the presence of MT-2 tropic virus isolate was associated with a severe immune suppression (p = 0.028); whereas, the presence of MT-2 negative viruses correlated with LTNP (p = 0.010). CONCLUSIONS Given the rapidity and simplicity of the assay, the delta32 CCR5 mutation may be a useful predictive marker to identify children with delayed disease progression who, consequently, may not require immediate antiretroviral treatment.
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Affiliation(s)
- M L Romiti
- Division of Immunology and Infectious Diseases, Children's Hospital Bambino Gesù, University of Rome Tor Vergata, Italy
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Salvatierra O, Singh T, Shifrin R, Conley S, Alexander S, Tanney D, Lemley K, Sarwal M, Mackie F, Alfrey E, Orlandi P, Zarins C, Herfkens R. Transplantation of adult-sized kidneys into infants induces major blood flow changes. Transplant Proc 1999; 31:236-7. [PMID: 10083090 DOI: 10.1016/s0041-1345(98)01517-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- O Salvatierra
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA
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30
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Attanasio R, Oppizzi G, Lodrini S, Dallabonzana D, Barausse M, Orlandi P, DaRe N, Cozzi R. Neurosurgery restores late GH rise after glucose-induced suppression in cured acromegalics. Eur J Endocrinol 1999; 140:23-8. [PMID: 10037247 DOI: 10.1530/eje.0.1400023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE AND DESIGN A decrease of GH levels below 2 microg/l after an oral glucose tolerance test (OGTT) is still currently accepted as the gold standard for assessing cure in surgically treated acromegaly. Whether glucose-induced suppression of GH is accompanied by a restoration of normal GH late rebound has not yet been evaluated in this disease. In order to assess the restoration of normal GH regulation after removal of a pituitary adenoma, we have evaluated GH changes after an OGTT in a series of selected acromegalic patients (transsphenoidal surgery and lack of pituitary failure). METHODS Twenty-nine patients (13 male, 16 female, age range 27-70 years) entered the study. Their neuroradiological imaging before neurosurgery showed microadenoma in 7, intrasellar macroadenoma in 8 and macroadenoma with extrasellar extension in 14. Plasma GH levels were assayed up to 300 min after glucose administration (75 g p.o.) and IGF-I on basal samples. RESULTS Basal GH levels were below 5 microg/l in 20 patients and below 2 microg/l in 5 of these. Normal age-adjusted IGF-I levels were observed in 12 patients. GH values were suppressed below 2 microg/l during an OGTT in 13 patients, and below 1 microg/l in 7 of these. In 9 patients out of these 13, a marked rise in GH levels occurred after nadir. Baseline and nadir GH values of these 9 patients were not different from the corresponding values of the other 4 patients without OGTT-induced late GH peaks. CONCLUSIONS GH rebound after GH nadir occurs in acromegalic patients considered as cured on the basis of OGTT-induced GH suppression and/or IGF-I normalization. The restoration of this physiological response could be regarded as a marker of recovered/preserved integrity of the hypothalamic-pituitary axis. Even though the reason for this GH rebound has not yet been elucidated (GHRH discharge?/end of somatostatin inhibition?), the lack of late GH peak in the patients regarded as cured by the usual criteria could be due to injury to the pituitary stalk caused by the adenoma or by surgical manipulation.
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Affiliation(s)
- R Attanasio
- Department of Endocrinology, Niguarda Hospital, Milan, Italy
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31
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Principi N, Marchisio P, Esposito S, Rossi P, Gattinara GC, Galli L, Gabiano C, Zuccotti GV, Orlandi P. Zidovudine therapy and HIV type 1 mutations in children with symptomatic HIV type 1 infection: effect of switching to didanosine or zidovudine plus didanosine therapy. Italian Multicenter Study Group on HIV Mutations in Children. AIDS Res Hum Retroviruses 1998; 14:1653-9. [PMID: 9870319 DOI: 10.1089/aid.1998.14.1653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Type and prevalence of zidovudine (ZDV) resistance mutations in HIV-1-infected children in clinically stable condition and on ZDV monotherapy were analyzed to evaluate the effect of switching to didanosine (ddI) monotherapy or to ZDV plus ddI on the pattern of mutations and on the clinical outcome. Monthly clinical and laboratory controls for HIV-1 infection status were performed; at enrollment and every 4 to 6 months after treatment randomization mutant proviral sequences were evaluated in all the children, whereas viral burden was performed only in a small subgroup of patients randomly selected in each of the three treatment groups. ZDV resistance-associated proviral DNA mutations were defined as low-level resistance (LLR) mutations or medium/high-level resistance (MHLR) mutations; clinical outcome was considered as stable or deteriorating. Results showed that at entry into the study the duration of ZDV therapy was significantly correlated with the presence of mutations, and that the level of resistance given by mutations was associated with the severity both of symptoms and immunodeficiency. After randomization to treatment, in patients with mutations that confer LLR a better clinical outcome with ddI monotherapy than with ZDV plus ddI and ZDV alone was observed in the subsequent 6 months, whereas in patients with mutations that confer MHLR no significant difference among the three treatment groups was found. Data showed also that levels of viral burden at the time of changing therapy are related to clinical outcome if measured by plasma viral load. These results suggest that genotypic resistance assays, together with viral load, may prove useful for rational treatment decisions both at the start of therapy and with failure.
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Affiliation(s)
- N Principi
- Pediatric Department 4, University of Milan, Italy.
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32
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Orlandi P, Cancrini C, Scaccia S, Romiti ML, Livadiotti S, Gattinara GC, Angelini F, Cox S, Rossi P. Analysis of HIV-1 reverse transcriptase gene mutations in infected children treated with zidovudine. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 19:230-7. [PMID: 9803964 DOI: 10.1097/00042560-199811010-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prolonged treatment with antiretroviral agents directed against reverse transcription (RT) in patients with HIV-1 infection results in the emergence of virus variants with reduced sensitivity containing mutations in the HIV-1 RT gene. Development of zidovudine (ZDV)-related mutations was studied in a cohort of 24 vertically infected pediatric patients receiving ZDV therapy. Monthly clinical and immunologic evaluation was accompanied by direct sequencing of the HIV-1 RT gene every 4 months. A correlation was observed between the emergence of mutations and the duration of therapy. Mutation at codon 41 was found only in the presence of mutation at codon 215. The presence of the mutations Met41-->Leu and Thr215-->Tyr/Phe did not appear to be related to disease progression. These findings suggest that the mere presence of mutations in the HIV-1 RT gene alone during ZDV monotherapy is not a reliable prognostic marker in the absence of other clinical and virologic information.
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Affiliation(s)
- P Orlandi
- Division of Immunology and Infectious Diseases, Children's Hospital Bambino Gesú, University of Rome Tor Vergata, Italy
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33
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Cozzi R, Attanasio R, Barausse M, Dallabonzana D, Orlandi P, Da Re N, Branca V, Oppizzi G, Gelli D. Cabergoline in acromegaly: a renewed role for dopamine agonist treatment? Eur J Endocrinol 1998; 139:516-21. [PMID: 9849816 DOI: 10.1530/eje.0.1390516] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE AND DESIGN Eighteen active acromegalics entered a prospective open study with cabergoline (CAB), a dopaminergic drug much more potent than bromocriptine (Br). METHODS CAB was administered for 6 months at doses ranging between 0.5 mg twice weekly and 0.5 mg/day. Clinical-anamnestic characteristics of the patients were: (i) sensitivity to dopamine agonist drugs (10 patients); (ii) resistance to somatostatin analogs (SAs) (8 patients): (iii) intolerance to SA (3 patients). In 2 patients marked hyperprolactinemia was present. RESULTS Basal GH was 6.6 microg/l (2.2-50) (median (range)), and on treatment it was 3.5 microg/l (1.2-34) (P=0.013). The corresponding IGF-I values were 720 microg/l (410-1438) and 375 microg/l (167-1260) respectively (P=0.00001). Individual GH levels decreased below 2 microg/l in 5 patients, and between 2 and 5 microg/l in another 5 patients. IGF-I levels were suppressed below 50% of baseline in 8 patients and normal age-adjusted IGF-I values were reached in 5 patients (27% of the series). The retrospective comparison with previous chronic treatment with Br in the 10 suitable patients showed a greater effectiveness of CAB (IGF-I decrease on CAB treatment, 46.8%, on Br treatment, 31%, P=0.02). Adenoma shrank in the 3 patients whose pituitary imaging was repeated during CAB. CONCLUSIONS These results envisage that CAB may represent a worthy therapeutic tool in acromegalic patients, inducing a degree of IGF-I and GH suppression comparable to SAs, administered by the oral route and much less expensive.
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Affiliation(s)
- R Cozzi
- Division of Endocrinology, Ospedale Niguarda, Milano, Italy
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34
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Salvatierra O, Singh T, Shifrin R, Conley S, Alexander S, Tanney D, Lemley K, Sarwal M, Mackie F, Alfrey E, Orlandi P, Zarins C, Herfkens R. Successful transplantation of adult-sized kidneys into infants requires maintenance of high aortic blood flow. Transplantation 1998; 66:819-23. [PMID: 9798687 DOI: 10.1097/00007890-199810150-00001] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nationally, results of renal transplantation in infants are inferior to those in older children and adults. Within the infant group, best results are obtained with adult-sized kidneys (ASKs) rather than size-compatible pediatric kidneys. However, transplantation of ASKs into infants has an increased risk of acute tubular necrosis and graft loss from vascular thrombosis and primary nonfunction. The aim of this study was to define and understand the hemodynamic changes induced by ASK transplantation, so that outcomes of transplantation in infants can be improved. METHODS Nine hemodynamically stable and optimally hydrated infants were studied under a controlled sedation with cine phase-contrast magnetic resonance at three time periods: before transplantation, 8-12 days after transplantation, and 4-6 months after transplantation. Cross-sectional images of both the infant aorta and the adult transplant renal artery were obtained and blood flow was quantitated. Renal volumes were also obtained, and expected renal artery blood flow based on early posttransplant volume was calculated. In addition, renal artery blood flow was determined in 10 in situ native adult kidneys prior to donor nephrectomy. Supplemental nasogastric or gastrostomy tube feeding was carried out during the blood flow study period to optimize intravascular volume. RESULTS Mean infant aortic blood flows were 331+/-148 ml/min before transplantation, 761+/-272 ml/ min at 8-12 days after transplantation (P=0.0006 with pretransplant flow), and 665+/-138 ml/min at 4-6 months after transplantation (P=0.0001 with pretransplant flow). Mean transplanted renal artery flows were 385+/-158 ml/min at 8-12 days and 296+/-113 ml/min at 4-6 months after transplantation. Transplanted renal artery flows were less than prenephrectomy in situ donor renal artery blood flow (618+/-130 ml/min; P=0.02 and P=0.0003) and expected normal renal artery blood flow (666+/-87 ml/min; P=0.003 and P=0.001) at both 8-12 days and 4-6 months after transplantation. A 26% reduction in renal volume (P=0.003) occurred between the two postoperative time periods, and this paralleled the decrease in posttransplant renal artery flow. One-year graft and patient survival in the nine infants was 100%. The mean serum creatinine levels at 3, 6, and 12 months were 0.43+/-0.10, 0.48+/-0.15, and 0.49+/-0.16 mg/dl. CONCLUSIONS This study is the first to quantitatively document the blood flow changes occurring after ASK transplantation in infants. There was a greater than two-fold increase in aortic blood flow after ASK transplantation, and this increase was sustained for at least 4 months and appeared to be driven by the blood flow demand of the ASK. However, actual posttransplant renal artery blood flow was significantly less than normal renal artery flow. Our study suggests that aggressive intravascular volume maintenance may be necessary to achieve and maintain optimum aortic blood flow, so as not to further compromise posttransplant renal artery flow and to avoid low-flow states that could induce acute tubular necrosis, vascular thrombosis, or primary nonfunction.
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Affiliation(s)
- O Salvatierra
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California 94304, USA
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35
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Oppizzi G, Cozzi R, Dallabonzana D, Orlandi P, Benini Z, Petroncini M, Attanasio R, Milella M, Banfi G, Possa M. Scintigraphic imaging of pituitary adenomas: an in vivo evaluation of somatostatin receptors. J Endocrinol Invest 1998; 21:512-9. [PMID: 9801992 DOI: 10.1007/bf03347337] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED We have performed pituitary scintigraphy with the somatostatin (SS) analog pentetreotidean by (111In-P) in patients with GH-secreting adenoma or with "clinically non functioning" adenoma (NFA) to evaluate the presence and the functionality of SS receptors (SS-R). 111In-P pituitary accumulation was expressed as Activity Ratio (AR): the ratio between the uptake of radioactivity by the adenoma and that of the normal brain tissue. In subjects without pituitary disease, AR ranged from 1.6 to 2.2 and a value lower than 2.2 was thus arbitrarily considered as normal. In 15 out of the 17 patients with GH-secreting adenoma, an accumulation of the radioligand was shown. Median AR was 3.8 (range 1-6.9; in 14 AR were greater that 2.2) and ARs were directly correlated (r = 0.54; p < 0.05) with the suppressibility of plasma GH levels by octreotide (OC) acute administration. In two patients who repeated scintigraphy during chronic OC treatment, AR values were reduced. In all the 22 patients with NFA an accumulation of 111In-P at the pituitary level was observed and median AR was 3.0 (range 1.5-20; in 14 greater that 2.2). In vitro autoradiography of surgical specimens in 6 NFA patients revealed SS-R in 4 cases with high scintigraphic AR and negative results in two cases with low AR. Scintiscan was repeated during chronic OC treatment in 5 patients with high score: AR decreased in one patient, increased in three, and did not change in the other patient. No changes in tumor size were shown in any of these patients. A total of 8 patients (3 GH secreting and 5 NFA) had "normal" AR values. CONCLUSIONS In acromegaly scintigraphy with 111In-P visualizes functioning pituitary SS-R coupled to intracellular events that control hormonal hypersecretion and tumor growth. In contrast, in spite of the positivity of 111In-P imaging in most patients with NFA, their receptors might have a defect in the coupling-transduction process, as they are not inhibited by OC treatment and no tumor shrinkage is observed.
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Affiliation(s)
- G Oppizzi
- Medicina Nucleare Niguarda Hospital, Milano, Italy
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36
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Ritis K, Speletas M, Tsironidou V, Pardali E, Kanariou M, Moschese V, Orlandi P, Skordala M, Rossi P, Kartalis G, Bourikas G, Sideras P. Absence of Bruton's tyrosine kinase (Btk) mutations in patients with acute myeloid leukaemia. Br J Haematol 1998; 102:1241-8. [PMID: 9753052 DOI: 10.1046/j.1365-2141.1998.00914.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/20/2022]
Abstract
Bruton's tyrosine kinase (Btk) is a non-receptor protein tyrosine kinase (PTK) that is expressed in all haemopoietic lineages except mature T cells and plasma cells. Despite the broad range of expression. mutations that inactivate this molecule affect primarily the development of the B-cell lineage. As a PTK, Btk could potentially be involved directly or indirectly in the processes that relate to the malignant transformation of all the cell lineages where this molecule is expressed. Previous studies have failed to demonstrate mutations in patients with B-cell origin acute lymphoblastic leukaemia (ALL). We have utilized a recently developed method that enables the rapid and convenient detection of mutations at the cDNA level, namely, the non-isotopic RNase cleavage assay (NIRCA) to analyse Btk sequences from 27 patients with different types of acute myeloid leukaemia (AML). The only alteration that we observed was a polymorphism at position 2031. This polymorphism has already been seen in previous studies. Furthermore, using the same methodology, we identified the Btk mutations in six XLA (X-linked agammaglobulinaemia) patients. Our results, although they do not exclude the involvement of Btk mutations in the development or progression of some type of AML, nevertheless suggest that such mutations do not constitute a major co-factor in the development of myeloid malignancies.
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Affiliation(s)
- K Ritis
- Department of Applied Cell and Molecular Biology, Umeå University, Sweden
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37
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Visco-Comandini U, Yun Z, Paganelli R, Orlandi P, Salotti A, Johansson B, Vahlne A, Sönnerborg A. HIV-1 nef mutations and clinical long-term nonprogression. A molecular epidemiology study. J Hum Virol 1998; 1:320-7. [PMID: 10195259] [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: 02/11/2023]
Abstract
OBJECTIVES To analyze HIV-1 nef gene mutations in a cohort of Italian and Swedish long-term nonprogressors (LTNP) and to investigate whether particular amino acid substitutions are associated with LTNP. STUDY DESIGN/METHODS nef alleles from 21 LTNP and 8 progressor controls were amplified by polymerase chain reaction (PCR) and sequenced. The amino acid sequences were compared with the previously reported sequences of 16 North American LTNP and of 28 patients with progressive infection. RESULTS An untruncated intact open reading frame was observed as major sequence in all LTNP and controls. None of the amino acid substitutions in known biologically functional sites was linked to LTNP. A valine/isoleucine at the variable position 11 was associated with both European (P = .0001) and American (P = .001) LTNP. The interpatient nef variation was lower among European LTNP (P = .002) than in European progressor controls. CONCLUSIONS Nef amino acid heterogeneity is lower among LTNP, probably reflecting the lower HIV-1 replication rate. Nef gene defects appear uncommon in both Swedish and Italian LTNP, although the presence of a valine/isoleucine at position 11 is statistically associated with a lower probability to progress to disease.
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Affiliation(s)
- U Visco-Comandini
- Department of Immunology, Microbiology, Pathology and Infectious Diseases, Karolinska Institute, Huddinge Hospital, Sweden.
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Halapi E, Leitner T, Jansson M, Scarlatti G, Orlandi P, Plebani A, Romiti L, Albert J, Wigzell H, Rossi P. Correlation between HIV sequence evolution, specific immune response and clinical outcome in vertically infected infants. AIDS 1997; 11:1709-17. [PMID: 9386805 DOI: 10.1097/00002030-199714000-00007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate sequence evolution in relation to different rates of disease progression in infants infected with HIV-1. DESIGN Variability in the gp120 V3 region was analysed in HIV-1-infected children with different clinical courses, slow progression (n = 2) versus progressive disease (n = 3). METHODS Cloning and sequencing of virus-derived DNA from uncultured peripheral blood mononuclear cells was performed at two to three timepoints from birth and up to the fifth year of life. Sequence variability was estimated by calculating the genetic distance and the proportion and ratio of synonymous and non-synonymous nucleotide substitutions over time. RESULTS Genetic distances were significantly shorter in children with fast progression to disease, a predominance of synonymous nucleotide substitutions also being detected at later timepoints. Conversely, a preferential accumulation of non-synonymous nucleotide substitutions was apparent in children with slow disease progression. Furthermore, a positive correlation between a decreased ratio of synonymous/non-synonymous nucleotide substitutions and the ability of children's sera to react with synthetic peptides representing the autologous virus sequence was determined. CONCLUSION Data suggest that an antigenically more diverse virus population emerges in infected children with slower progression to disease as a result of a stronger immune pressure.
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Affiliation(s)
- E Halapi
- Microbiology and Tumorbiology Centre, Karolinska Institute, Stockholm, Sweden
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Cozzi R, Attanasio R, Oppizzi G, Orlandi P, Giustina A, Lodrini S, Da Re N, Dallabonzana D. Effects of tamoxifen on GH and IGF-I levels in acromegaly. J Endocrinol Invest 1997; 20:445-51. [PMID: 9364247 DOI: 10.1007/bf03348000] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Tamoxifen (TAM), a non steroid partially competitive antagonist to the estrogen receptors, has been reported to decrease plasma GH and IGF-I levels both in vitro and in vivo. These data prompted us to evaluate GH and IGF-I changes in acromegaly after acute and chronic TAM administration. Nineteen acromegalic patients (6 M, 13 F, aged 30-70 years) were studied in a prospective open study. Acute TAM test (20 mg po) did not induce any significant change in GH and IGF-I levels. Chronic TAM treatment (20 mg/day for a month and 40 mg/day for another month) induced a transient increase in GH levels (from 9 [3-139] micrograms/l [median, range] to 12 [3-188] micrograms/l, p = 0.0025) and a persistent decrease in IGF-I levels (from 785 [500-1200] micrograms/l to 553 [209-1420] micrograms/l, p = 0.0034). Individual IGF-I values decreased in 13 patients and reached the normal range in 4 of them. At TAM withdrawal hormonal levels increased up to pretreatment values. There was no correlation between GH and IGF-I changes and results were not influenced by age, sex or gonadal status. In this setting it is likely that the observed decrease in plasma IGF-I levels is dependent on TAM activity at the hepatic level.
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Affiliation(s)
- R Cozzi
- Divisione di Endocrinologia, Ospedale Niguarda, Italy
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40
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Jansson M, Orlandi P, Scarlatti G, Moschese V, Romiti ML, Cancrini C, Mancia L, Livadiotti S, Castelli-Gattinara G, Rossi P, Halapi E. Role of immunity in maternal-infant HIV-1 transmission. Acta Paediatr Suppl 1997; 421:39-45. [PMID: 9240856 DOI: 10.1111/j.1651-2227.1997.tb18318.x] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Factors influencing human immunodeficiency virus type 1 (HIV-1) mother-to-child transmission include both immunological and virological parameters: higher viral loads have been associated with clinical stage of HIV-1-infected individuals as well as higher risk of mother-to-child transmission. Furthermore, we have shown that transmitting mothers more frequently harbour HIV-1 isolates with rapid/high syncytium-inducing (SI) biological phenotype than non-transmitting mothers do. Genetically homogeneous virus populations have been found in HIV-1-infected children at birth, in contrast to the heterogeneous virus populations often found in their infected mothers. This observation suggests that a few virus variants are transmitted or initially are replicating in the child. By comparing the HIV-1 gp120 V3 region of sequentially obtained samples from infected children with samples obtained from their mothers at delivery we found, however, that multiple variants of HIV-1 with different outgrowth kinetics can be transmitted. In addition, we have obtained results indicating an impaired ability of the immune response to adapt to the sequence evolution of HIV-1 in transmitting mothers, as assessed by measuring serum reactivities to peptides representing selected yet closely related V3 sequences. By analysing the presence of antibodies in maternal serum at delivery, which neutralize autologous isolates as well as other primary virus isolates, we have indications that a protective immunity in HIV-1 mother-to-child transmission might exist. Immunotherapy has been assessed in infected adult individuals by passive immunization with a variety of HIV-1-specific antibody products. Data from these studies indicated a differential response to therapy according to the stage of the disease. Active vaccine strategies, including envelope glycoproteins, pursued so far in seronegative adult subjects have shown limitations because broadly neutralizing antibodies, such as can be found in infected individuals, have not been evoked. Further investigations are therefore needed to give support for the potential use of either passive and/or active immunization for the prevention of HIV-1 mother-to-child transmission.
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Affiliation(s)
- M Jansson
- Microbiology and Tumorbiology Center, Karolinska Institute, Stockholm, Sweden
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41
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Pepe G, Bué C, Orlandi P, Meloni GF, Modiano G. Are the SSTR alleles stable enough to be considered monophyletic and hence reliable anthropogenetic markers? Linkage disequilibrium study on the (ACT)n COL1A2 SSTR. Hum Biol 1995; 67:703-15. [PMID: 8543285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An extremely low production rate of a polymorphic allele (formally called the mutation rate)--a prerequisite for using the allele as a marker (particularly for anthropogenetic purposes where the alleles must be assumed to be monophyletic)--cannot be taken for granted for alleles of highly polymorphic VNTRs, but a low production rate can be used to identify alleles produced by a single nucleotide substitution. This property was indirectly tested for the (ACT)n COL1A2 (of type I collagen) microsatellite SSTR (degree of heterozygosity H = 0.72) by searching for linkage disequilibria between the SSTR's four common alleles (n = 6, 8, 9, or 10) and three RFLPs of the same gene. A strong linkage disequilibrium between at least three of the four SSTR alleles and two of the three closely linked RFLPs has been demonstrated in a Sardinian population (Italy), a finding that suggests a low production rate of these alleles. Thus it seems that this highly polymorphic system and, by a reasonable extrapolation, other VNTRs with a comparable degree of heterozygosity may be valuable anthropogenetic markers, at least in distinguishing subgroups of a major ethnic group.
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Affiliation(s)
- G Pepe
- Department of Biology, University of Rome Tor Vergata, Italy
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Attanasio R, Cozzi R, Oppizzi G, Dallabonzana D, Chiodini I, Benini Z, Orlandi P, Liuzzi A, Chiodini PG. Persistence of somatostatinergic tone in acromegaly. Eur J Endocrinol 1995; 132:27-31. [PMID: 7850006 DOI: 10.1530/eje.0.1320027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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] [Indexed: 01/27/2023]
Abstract
It is a matter of debate whether hypothalamic somatostatin (SRIH) secretion in acromegaly is preserved and still regulated by the physiological feedback mechanisms of growth hormone (GH) and insulin-like growth factor I. To gather further information on this, the reproducibility of plasma GH changes induced by growth hormone-releasing hormone (GHRH) administration was evaluated in 15 acromegalic patients. There was a highly significant correlation between the peak/basal ratio (P/B) GH response in the 15 patients administered GHRH on two separate occasions (r = 0.99, p < 0.001). The test was performed also before and after the administration of drugs able to inhibit or stimulate hypothalamic SRIH release, by activating (pyridostigmine) or inhibiting (pirenzepine) cholinergic pathways, respectively. The GHRH-induced GH response (P/B = 2, range 1.1-26.1) was increased significantly by pyridostigmine pretreatment in 30 patients (P/B = 2.6, range 1.3-34.8; p = 0.0045). In nine out of 30 patients an increase of greater than 2 SD of within-subject GHRH variability was observed in response to GHRH plus pyridostigmine when compared to GHRH alone. An inverse correlation (r = -0.37, p < 0.05) was observed between GH response to GHRH alone and after pyridostigmine pretreatment. On the contrary, no change of GHRH-induced GH response was observed in 12 patients after pirenzepine pretreatment (P/B = 1.9, range 1.1-5 and P/B = 2, range 1.3-6 without and after pirenzepine pretreatment, respectively). These data suggest that in acromegaly the somatostatinergic tone does not seem to fluctuate, and that it can be inhibited often by cholinergic pathway activation but not increased further by cholinergic suppression.
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Affiliation(s)
- R Attanasio
- Division of Endocrinology, Ospedale Niguarda, Milano, Italy
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Ghigi G, Salizzoni E, Orlandi P, Battista G, Bercovich E, Rusconi R, Manferrari F. [Congenital mullerian prostatic cyst: percutaneous treatment]. Radiol Med 1994; 88:513-5. [PMID: 7997634] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- G Ghigi
- Istituto di Radiologia, Università di Bologna
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Pepe G, Bue C, Orlandi P, Ena F, Meloni T, Modiano G. COL1A2 gene (alpha 2 gene of type I collagen) at the haplotype level as a new valuable anthropogenetic marker: a study on Sardinians. Hum Biol 1994; 66:613-23. [PMID: 7916321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sardinians, a population with many distinct anthropogenetic features, has been studied for the COLIA1 and COLIA2 genes at the DNA level for two purposes: to look for new RFLPs (restriction fragment length polymorphisms) and to study the distribution of three known COLIA2 RFLPs (EcoRI, RsaI, MspI) at both the allele and the haplotype levels. None of the eleven enzyme-probe systems examined led to the discovery of a new polymorphism. The following frequency q was found for the less common allele of the three RFLPs: EcoRI, q(+) = 0.178 +/- 0.031; RsaI, q(-) = 0.316 +/- 0.038; MspI, q(-) = 0.046 +/- 0.017. EcoRI turned out to be the most discriminant of the three polymorphisms because the frequency of the (+) allele in Sardinians was about half that estimated for a large homogeneous white sample (0.18 +/- 0.03 vs. 0.30 +/- 0.01). So far as the haplotype level is concerned, the sample is made up of triplets (parents and child). Therefore all the haplotype frequencies and delta values (degrees of disequilibrium, D) were obtained by direct counting of the unambiguously identified haplotypes rather than being based on their maximum-likelihood estimates. This together with their analytical and detailed presentation makes these data comparable with future findings, provided that the two data sets are presented in a comparable way. At this level the three RFLPs are efficient in distinguishing Sardinians from Calabrians (southern Italy) but not from the central Italian population. The present results, besides adding a further discriminative criterion between Sardinians and Italians (and whites on the whole), identify the complex COLIA2 locus as a valuable anthropogenetic marker.
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Affiliation(s)
- G Pepe
- Dipartimento di Biologia, Università di Roma Tor Vergata, Italy
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al-Uzri A, Conley SB, Orlandi P, So S, Salvatierra O. Aggressive early cyclosporine therapy is desirable in pediatric renal transplantation. Transplant Proc 1994; 26:88-90. [PMID: 8109036] [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: 01/28/2023]
Affiliation(s)
- A al-Uzri
- Department of Transplantation, California Pacific Medical Center, San Francisco 94115
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46
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Liuzzi A, Oppizzi G, Cozzi R, Dallabonzana D, Petroncini M, Orlandi P, Chiodini PG. GH regulation in acromegaly. J Pediatr Endocrinol Metab 1993; 6:339-43. [PMID: 7921003 DOI: 10.1515/jpem.1993.6.3-4.339] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- A Liuzzi
- Divisione di Endocrinologia, Ospedale Niguarda, Milano, Italy
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Chiodini PG, Attanasio R, Cozzi R, Dallabonzana D, Oppizzi G, Orlandi P, Strada S, Liuzzi A. CV 205-502 in acromegaly. Acta Endocrinol (Copenh) 1993; 128:389-93. [PMID: 8100375 DOI: 10.1530/acta.0.1280389] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In a series of acromegalic patients the effects of CV 205-502, a new long-acting dopamine-agonist drug, on growth hormone (GH), insulin-like growth factor I (IGF-I) and prolactin (PRL) levels were evaluated in an open study. After acute administration of CV 205-502 (0.0375 mg, po) in 12 patients. GH levels did not change, whereas PRL values significantly decreased and remained suppressed for 24 h. In the 14 patients who underwent chronic CV 205-502 treatment (at daily doses of 0.150-0.600 mg/day given at bedtime or b.i.d. for up to 12 months). GH and IGF-I levels fell significantly from 60 +/- 17 (mean +/- SEM) micrograms/l to 28 +/- 10 micrograms/l and from 1127 +/- 84 micrograms/l to 738 +/- 57 micrograms/l, respectively (p < 0.05). A retrospective comparison with the results obtained for the same patients during a previous chronic bromocriptine treatment (at daily doses of 5-20 mg given t.i.d. or q.i.d.) did not show any significant difference in the suppression of GH levels between the two treatments; no bromocriptine-resistant patient was CV 205-502 sensitive, even at the highest CV 205-502 dose used. We conclude that in acromegaly chronic treatment with this new dopaminergic drug has a GH- and PRL-lowering effect that is similar to but more prolonged than that of bromocriptine, and normal or near-normal GH and IGF-I levels may be obtained in a few patients with b.i.d. administration. However, no GH-lowering effect is observed in bromocriptine-resistant patients.
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Affiliation(s)
- P G Chiodini
- Division of Endocrinology, Ospedale Niguarda, Milan, Italy
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Attanasio R, Orlandi P, Dallabonzana D, Lodrini A, Ferrari M, Maccagnano E, Verde G, Cozzi R, Liuzzi A, Chiodini PG. Doxorubicin for acromegaly: a case report. J Endocrinol Invest 1991; 14:493-7. [PMID: 1774445 DOI: 10.1007/bf03346849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We report the case of an acromegalic woman, aged 35 years, with a huge GH-secreting tumor, repeatedly treated with neurosurgery and radiotherapy, not responsive to bromocriptine (Br) and octreotide (SMS), whose clinical picture evolved to coma due to endocranic hypertension. Since remnant size was too large to be further treated by surgery, chemotherapy with doxorubicin (DOX) (100 mg i.v. every three weeks up to 0.5 mg/m2 over 7 months) was started. Treatment was followed by a rapid improvement of clinical picture with resumption out of coma, progressive decline of GH levels (from 800 ng/ml to 15 ng/ml) and a slight shrinkage of tumor. No side effects were observed during DOX administration. We suggest that in those few acromegalic patients resistant both to SMS and Br, and with poor prognosis, DOX may be effectively used.
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Affiliation(s)
- R Attanasio
- Division of Endocrinology, Ospedale Niguarda, Milano, Italy
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50
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Chiodini PG, Attanasio R, Liuzzi A, Cozzi R, Orlandi P, De Palo C, Dallabonzana D, Girotti F, Testa D. Prolactin response to growth hormone-releasing hormone during chronic thyrotropin-releasing hormone infusion in the treatment of amyotrophic lateral sclerosis. J Endocrinol Invest 1990; 13:631-6. [PMID: 2125610 DOI: 10.1007/bf03349584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In six patients suffering from amyotrophic lateral sclerosis we evaluated changes of T4, T3, TSH, PRL, and GH during treatment by continuous iv infusion of TRH for at least 15 days. No clinical improvement was detected. A significant rise of thyroid hormone levels was observed, as well as an upward trend of basal TSH levels and no change of basal PRL and GH levels. TRH acute test-induced TSH and PRL responses became blunted. Treatment provoked also the onset of a responsiveness of PRL to GHRH. The reduced TSH and PRL responses to acute TRH test during treatment could be explained by a down-regulation of TRH pituitary receptors. On the contrary, the onset of PRL responsiveness to GHRH is at present without a satisfactory explanation.
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Affiliation(s)
- P G Chiodini
- Divisione di Endocrinologia, Ospedale Niguarda, Milano, Italy
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