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Sevieri M, Mazzucchelli S, Barbieri L, Garbujo S, Carelli S, Bonizzi A, Rey F, Recordati C, Recchia M, Allevi R, Sitia L, Morasso C, Zerbi P, Prosperi D, Corsi F, Truffi M. Ferritin nanoconjugates guide trastuzumab brain delivery to promote an antitumor response in murine HER2 + breast cancer brain metastasis. Pharmacol Res 2023; 196:106934. [PMID: 37734460 DOI: 10.1016/j.phrs.2023.106934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Brain metastasis (BM) represents a clinical challenge for patients with advanced HER2 + breast cancer (BC). The monoclonal anti-HER2 antibody trastuzumab (TZ) improves survival of BC patients, but it has low central nervous system penetrance, being ineffective in treating BM. Previous studies showed that ferritin nanoparticles (HFn) may cross the blood brain barrier (BBB) through binding to the transferrin receptor 1 (TfR1). However, whether this has efficacy in promoting the trans-BBB delivery of TZ and combating BC BM was not studied yet. Here, we investigated the potential of HFn to drive TZ brain delivery and promote a targeted antitumor response in a murine model of BC BM established by stereotaxic injection of engineered BC cells overexpressing human HER2. HFn were covalently conjugated with TZ to obtain a nanoconjugate endowed with HER2 and TfR1 targeting specificity (H-TZ). H-TZ efficiently achieved TZ brain delivery upon intraperitoneal injection and triggered stable targeting of cancer cells. Treatment with H-TZ plus docetaxel significantly reduced tumor growth and shaped a protective brain microenvironment by engaging macrophage activation toward cancer cells. H-TZ-based treatment also avoided TZ-associated cardiotoxicity by preventing drug accumulation in the heart and did not induce any other major side effects when combined with docetaxel. These results provided in vivo demonstration of the pharmacological potential of H-TZ, able to tackle BC BM in combination with docetaxel. Indeed, upon systemic administration, the nanoconjugate guides TZ brain accumulation, reduces BM growth and limits side effects in off-target organs, thus showing promise for the management of HER2 + BC metastatic to the brain.
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Affiliation(s)
- Marta Sevieri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy
| | - Serena Mazzucchelli
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy
| | - Linda Barbieri
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milano, Italy
| | - Stefania Garbujo
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milano, Italy
| | - Stephana Carelli
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; Center of Functional Genomics and Rare Diseases, Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Arianna Bonizzi
- Istituti Clinici Scientifici Maugeri IRCCS, via Maugeri 4, 27100 Pavia, Italy
| | - Federica Rey
- Pediatric Clinical Research Center "Romeo ed Enrica Invernizzi", Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy; Center of Functional Genomics and Rare Diseases, Department of Pediatrics, Buzzi Children's Hospital, Milano, Italy
| | - Camilla Recordati
- Mouse and Animal Pathology Laboratory, Fondazione Unimi, viale Ortles 22/4, 20139 Milano, Italy; Dipartimento di Medicina Veterinaria e Scienze Animali, Università di Milano, via dell'Università 6, 26900 Lodi, Italy
| | - Matteo Recchia
- Mouse and Animal Pathology Laboratory, Fondazione Unimi, viale Ortles 22/4, 20139 Milano, Italy; Dipartimento di Medicina Veterinaria e Scienze Animali, Università di Milano, via dell'Università 6, 26900 Lodi, Italy
| | - Raffaele Allevi
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy
| | - Leopoldo Sitia
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy
| | - Carlo Morasso
- Istituti Clinici Scientifici Maugeri IRCCS, via Maugeri 4, 27100 Pavia, Italy
| | - Pietro Zerbi
- Anatomia Patologica, ASST Santi Paolo e Carlo, via Pio II, 3, Milano, Italy
| | - Davide Prosperi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milano, Italy
| | - Fabio Corsi
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy; Istituti Clinici Scientifici Maugeri IRCCS, via Maugeri 4, 27100 Pavia, Italy.
| | - Marta Truffi
- Istituti Clinici Scientifici Maugeri IRCCS, via Maugeri 4, 27100 Pavia, Italy.
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Guerci C, Colombo F, Goi G, Zerbi P, Pirrò B, Danelli P. Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction. Front Surg 2022; 9:876396. [PMID: 35495766 PMCID: PMC9051068 DOI: 10.3389/fsurg.2022.876396] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Intussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction. Case report A 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion. Discussion Intussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant. Conclusion We reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.
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Affiliation(s)
- Claudio Guerci
- Department of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
- *Correspondence: Claudio Guerci ;
| | - Francesco Colombo
- Department of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
- Francesco Colombo
| | - Gloria Goi
- Department of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Pietro Zerbi
- Pathology Unit, Department of Biomedical and Clinical Sciences “L. Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Barbara Pirrò
- Department of Radiology, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Piergiorgio Danelli
- Department of General Surgery, Department of Biomedical and Clinical Sciences “Luigi Sacco”, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
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3
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Grassi M, Giorgi V, Nebuloni M, Zerbi P, Gismondo MR, Salaffi F, Sarzi-Puttini P, Rimoldi SG, Manzotti A. SARS-CoV-2 in the knee joint: a cadaver study. Clin Exp Rheumatol 2022; 40:608-612. [PMID: 34665699 DOI: 10.55563/clinexprheumatol/t1m4y2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces. The aim of this post-mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus. METHODS Post-mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post-mortem nasopharyngeal swabs of all of the patients. RESULTS No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab. CONCLUSIONS Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. This makes it unlikely that these are potential sources of contagion, and suggests that SARS-CoV-2 is not directly arthritogenic.
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Affiliation(s)
- Miriam Grassi
- Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
| | - Valeria Giorgi
- Rheumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy.
| | - Manuela Nebuloni
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
| | - Pietro Zerbi
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
| | - Maria Rita Gismondo
- Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
| | - Fausto Salaffi
- Rheumatology Department, Università Politecnica delle Marche, Jesi, Italy
| | | | - Sara Giordana Rimoldi
- Microbiology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
| | - Alfonso Manzotti
- Orthopaedic and Traumatology Unit, ASST-Fatebenefratelli Luigi Sacco University Hospital, Milan, Italy
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Granata AM, Palmisano F, Fenizia C, Rossi RS, Talso M, Vanetti C, Tonello C, Romanò AL, Zerbi P, Carsana L, Trabattoni D, Nebuloni M, Gregori A. Is there a risk of virus contamination through pneumoperitoneum during laparoscopic surgery in patients with COVID-19? A cadaveric study. Minerva Urol Nephrol 2021; 74:242-244. [PMID: 34791864 DOI: 10.23736/s2724-6051.21.04614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Antonio M Granata
- Department of Urology, ASST Fatebenefratelli-Sacco, Sacco University Hospital, Milan, Italy
| | - Franco Palmisano
- Department of Urology, ASST Fatebenefratelli-Sacco, Sacco University Hospital, Milan, Italy -
| | - Claudio Fenizia
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Roberta S Rossi
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Michele Talso
- Department of Urology, ASST Fatebenefratelli-Sacco, Sacco University Hospital, Milan, Italy
| | - Claudia Vanetti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Cristina Tonello
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Ai L Romanò
- Department of Urology, ASST Fatebenefratelli-Sacco, Sacco University Hospital, Milan, Italy
| | - Pietro Zerbi
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Luca Carsana
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Manuela Nebuloni
- Pathology Unit, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli-Sacco, Sacco University Hospital, University of Milan, Milan, Italy
| | - Andrea Gregori
- Department of Urology, ASST Fatebenefratelli-Sacco, Sacco University Hospital, Milan, Italy
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Redaelli V, Bosi A, Luzi F, Cappella P, Zerbi P, Ludwig N, Di Lernia D, Roughan JV, Porcu L, Soranna D, Parati G, Calvillo L. Neuroinflammation, body temperature and behavioural changes in CD1 male mice undergoing acute restraint stress: An exploratory study. PLoS One 2021; 16:e0259938. [PMID: 34780550 PMCID: PMC8592432 DOI: 10.1371/journal.pone.0259938] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 11/01/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Animal models used to study pathologies requiring rehabilitation therapy, such as cardiovascular and neurologic disorders or oncologic disease, must be as refined and translationally relevant as possible. Sometimes, however, experimental procedures such as those involving restraint may generate undesired effects which may act as a source of bias. However, the extent to which potentially confounding effects derive from such routine procedures is currently unknown. Our study was therefore aimed at exploring possible undesirable effects of acute restraint stress, whereby animals were exposed to a brightly lit enclosed chamber (R&L) similar to those that are commonly used for substance injection. We hypothesised that this would induce a range of unwanted physiological alterations [such as neuroinflammatory response and changes in body weight and in brown adipose tissue (BAT)] and behavioural modification, and that these might be mitigated via the use of non-aversive handling methods: Tunnel Handling (NAH-T) and Mechanoceptive Handling (NAH-M)) as compared to standard Tail Handling (TH). METHODS Two indicators of physiological alterations and three potentially stress sensitive behavioural parameters were assessed. Physiological alterations were recorded via body weight changes and assessing the temperature of Brown Adipose Tissue (BAT) using infra-red thermography (IRT), and at the end of the experiment we determined the concentration of cytokines CXCL12 and CCL2 in bone marrow (BM) and activated microglia in the brain. Nest complexity scoring, automated home-cage behaviour analysis (HCS) and Elevated Plus Maze testing (EPM) were used to detect any behavioural alterations. Recordings were made before and after a 15-minute period of R&L in groups of mice handled via TH, NAH-T or NAH-M. RESULTS BAT temperature significantly decreased in all handling groups following R&L regardless of handling method. There was a difference, at the limit of significance (p = 0.06), in CXCL12 BM content among groups. CXCL12 content in BM of NAH-T animals was similar to that found in Sentinels, the less stressed group of animals. After R&L, mice undergoing NAH-T and NAH-M showed improved body-weight maintenance compared to those exposed to TH. Mice handled via NAH-M spent a significantly longer time on the open arms of the EPM. The HCS results showed that in all mice, regardless of handling method, R&L resulted in a significant reduction in walking and rearing, but not in total distance travelled. All mice also groomed more. No difference among the groups was found in Nest Score, in CCL2 BM content or in brain activated microglia. CONCLUSIONS Stress induced by a common restraint procedure caused metabolic and behavioural changes that might increase the risk of unexpected bias. In particular, the significant decrease in BAT temperature could affect the important metabolic pathways controlled by this tissue. R&L lowered the normal frequency of walking and rearing, increased grooming and probably carried a risk of low-grade neuro-inflammation. Some of the observed alterations can be mitigated by Non-aversive handlings.
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Affiliation(s)
- Veronica Redaelli
- Department of Biomedical, Surgical and Dental Sciences–One Health Unit, Università degli Studi di Milano, Milan, Italy
| | - Alice Bosi
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
| | - Fabio Luzi
- Department of Biomedical, Surgical and Dental Sciences–One Health Unit, Università degli Studi di Milano, Milan, Italy
| | | | - Pietro Zerbi
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Nicola Ludwig
- Dipartimento di Fisica, Università degli Studi di Milano, Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab, Dipartimento di psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - John Vincent Roughan
- Institute of Neuroscience, Comparative Biology Centre, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Luca Porcu
- Laboratory of Methodology for Clinical Research, Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Davide Soranna
- Biostatistics Unit, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Laura Calvillo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
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Cammarata F, Yakushkina A, Pennacchi L, Carsana L, Zerbi P, Montecamozzo G, Danelli P. Atypical primary hyperparathyroidism due to parathyroid lipoadenoma: a case report. J Surg Case Rep 2021; 2021:rjab308. [PMID: 34316347 PMCID: PMC8302074 DOI: 10.1093/jscr/rjab308] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/22/2021] [Indexed: 12/04/2022] Open
Abstract
Parathyroid lipoadenoma is a very rare cause of primary hyperparathyroidism. Preoperative imaging techniques often fail to detect such lesions, and even during surgery they can be misinterpreted just as fat tissue. A 62-year-old woman clinically monitored for primary hyperparathyroidism, with hypertension and a left nephrectomy for hydrouretheronephrosis caused by recurrent kidney stones. A neck ultrasound showed a nodule consistent with left parathyroid of 9 × 5 mm, which was not confirmed on single-photon-emission computed tomography/computed tomography (CT) scan. On surgery, a voluminous lesion with adipose appearance and texture was removed. Frozen sections and intraoperative parathyroid hormone (PTH) confirmed such lesion to be a parathyroid lipoadenoma. Parathyroid lipoadenomas are difficult to localize preoperatively. Sometimes they can be seen by ultrasound scan as hyperechoich lesion, but scintigraphy and CT often fail to identify them. Only the awareness of such lesions and the use of intraoperative PTH can avoid unnecessary extensive cervical exploration.
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Affiliation(s)
- Francesco Cammarata
- Department of General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Al'ona Yakushkina
- Department of General Surgery, Ospedale di Saronno, Saronno VA, Italy
| | - Luca Pennacchi
- Department of General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Luca Carsana
- Department of Pathology, Luigi Sacco University Hospital, Milan, Italy
| | - Pietro Zerbi
- Department of Pathology, Luigi Sacco University Hospital, Milan, Italy
| | - Giulio Montecamozzo
- Department of General Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - Piergiorgio Danelli
- Department of General Surgery, Luigi Sacco University Hospital, Milan, Italy
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Lopez G, Tonello C, Osipova G, Carsana L, Biasin M, Cappelletti G, Pellegrinelli A, Lauri E, Zerbi P, Rossi RS, Nebuloni M. Olfactory bulb SARS-CoV-2 infection is not paralleled by the presence of virus in other central nervous system areas. Neuropathol Appl Neurobiol 2021; 48:e12752. [PMID: 34297438 PMCID: PMC8447476 DOI: 10.1111/nan.12752] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Gianluca Lopez
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Pathology Unit, L. Sacco Hospital, Milan, Italy
| | | | | | | | - Mara Biasin
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Gioia Cappelletti
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | | - Eleonora Lauri
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Pietro Zerbi
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Pathology Unit, L. Sacco Hospital, Milan, Italy
| | | | - Manuela Nebuloni
- L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Pathology Unit, L. Sacco Hospital, Milan, Italy
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Grassi M, Giorgi V, Nebuloni M, Zerbi P, Gismondo MR, Salaffi F, Sarzi-Puttini P, Rimoldi SG, Manzotti A. AB0671 NO EVIDENCE OF SARS-COV-2 IN THE KNEE JOINT: A CADAVER STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Despite the considerable research efforts being made to learn more about COVID-19, little is known about the presence of SARS-CoV-2 genetic material in biological fluids other than respiratory droplets, blood, and feces 1,2. In particular, little is known about the presence of SARS-CoV-2 in the joints either post mortem3 or in vivo4. To the best of our knowledge, only Lopéz-Gonzalez et al.5 have published a description of acute arthritides occurring during hospitalisation due to COVID-19, and they did not find any SARS-CoV-2 genetic material in the patients’ synovial fluid samples.Objectives:The aim of this post mortem study was to assess the presence of SARS-CoV-2 RNA in the knee synovial fluid, synovial tissue, and bone tissue of COVID-19 patients in order to discover whether the joint is a possible route of transmission during orthopaedic surgical procedures, and clarify the possible role of SARS-CoV-2 as a directly arthritogenic virus.Methods:Post mortem synovial fluid, synovial tissue and bone tissue samples were collected from the knees of five patients who died of COVID-19 in our hospital between September and October 2020, and analysed for the presence of SARS-CoV-2 using a commercial real-time polymerase chain reaction (RT-PCR) panel. Quantitative RT-PCR was used to test post mortem nasopharyngeal swabs of all of the patients.Results:No SARS-CoV-2 RNA was detected in any of the knee samples, despite the positivity of the throat swab.Conclusion:Our findings indicate that SARS-CoV-2 was not detected in knee synovial fluid, synovial membrane or bone. Therefore, our results suggest that all healthcare professionals performing surgical procedures on the joints of COVID-19 patients are exposed to a risk of contagion due to exposure to respiratory droplets, blood and body fluids, but not to direct exposure to joint- or bone-related tissues. Furthermore, given that some case reports of arthritis in COVID-19 patients 5-8 show that it is possible that COVID-19 patients display viral-mediated arthralgias and arthritis, the absence of the virus in the knee highlighted by our study suggests that it is unlikely that SARS-CoV-2 has a direct inflammatory action on the joint, but it could induce an inflammation-related reaction, manifesting as a reactive arthritis 9.References:[1]Cheng ZJ, Shan J. 2019 Novel coronavirus: where we are and what we know. Infection. 2020;(0123456789):1-9. doi:10.1007/s15010-020-01401-y[2]Chen Y, Chen L, Deng Q, et al. The Presence of SARS-CoV-2 RNA in Feces of COVID-19 Patients. J Med Virol. April 2020. doi:10.1002/jmv.25825[3]Maiese A, Manetti AC, La Russa R, et al. Autopsy findings in COVID-19-related deaths: a literature review. Forensic Sci Med Pathol. 2020. doi:10.1007/s12024-020-00310-8[4]Baldanti F, Novazzi F, Cassaniti I, Piralla A, Di A, Bruno R. Detection of the SARS-CoV-2 in different biologic specimens from positive patients with COVID-19, in Northern Italy. Authorea. 2020. doi:10.22541/au.159724509.93056098[5]López-González M-C, Peral-Garrido ML, Calabuig I, et al. Case series of acute arthritis during COVID-19 admission. Ann Rheum Dis. 2020;0(0):annrheumdis-2020-217914. doi:10.1136/annrheumdis-2020-217914[6]Parisi S, Borrelli R, Bianchi S, Fusaro E. Viral arthritis and COVID-19. Lancet Rheumatol. 2020;2(11):e655-e657. doi:10.1016/S2665-9913(20)30348-9[7]Alivernini S, Cingolani A, Gessi M, et al. Comparative analysis of synovial inflammation after SARS-CoV-2 infection. Ann Rheum Dis. 2020;0(0):2-3. doi:10.1136/annrheumdis-2020-218315[8]Talarico R, Stagnaro C, Ferro F, Carli L, Mosca M. Symmetric peripheral polyarthritis developed during SARS-CoV-2 infection. Lancet Rheumatol. 2020;2(9):e518-e519. doi:10.1016/S2665-9913(20)30216-2[9]Di Carlo M, Tardella M, Salaffi F. Can SARS-CoV-2 induce reactive arthritis? Clin Exp Rheumatol. 2020;In press.Acknowledgements:We would like to thank the clinical staff of the Pathology Unit for their collaboration in performing the autopsies.Disclosure of Interests:None declared
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9
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Montecamozzo G, Cammarata F, Pennacchi L, Yakushkina A, Carsana L, Zerbi P, Danelli P. Thyroid metastasis from adenoid cystic carcinoma of the lung: a case report and literature review. J Surg Case Rep 2021; 2021:rjab178. [PMID: 34040752 PMCID: PMC8136885 DOI: 10.1093/jscr/rjab178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 03/11/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/14/2022] Open
Abstract
Both adenoid cystic carcinoma (ACC) and thyroid metastasis are quite peculiar clinical presentations. ACC is a malignant salivary gland-type tumour mostly found in the head and neck district, but that can arise from different organs. Due to its rarity, it can pose problems in the diagnostic and therapeutic management. A 72-year-old woman presented for a persistent non-productive cough. A computed tomography showed a lung mass. She underwent lung surgery, and the lesion was an ACC primitive of the lung. She developed hoarseness and ultrasound and cytology confirmed metastatic involvement of left thyroid lobe from ACC. A total thyroidectomy was performed, followed by radiotherapy. The present case highlights the need to be aware of possible metastatic thyroid localization of ACC originating in lower airways. This is a very rare event, and clinical and cytological findings must be carefully examined. It represents an opportunity to consider the current knowledge about ACC metastasis to thyroid.
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Affiliation(s)
- Giulio Montecamozzo
- Department of General Surgery, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Francesco Cammarata
- Department of General Surgery, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Luca Pennacchi
- Department of General Surgery, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Al'ona Yakushkina
- Department of General Surgery, Ospedale di Saronno, 21047 Saronno VA, Italy
| | - Luca Carsana
- Department of Pathology, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Pietro Zerbi
- Department of Pathology, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Piergiorgio Danelli
- Department of General Surgery, Luigi Sacco University Hospital, 20157 Milan, Italy
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10
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Truffi M, Sevieri M, Morelli L, Monieri M, Mazzucchelli S, Sorrentino L, Allevi R, Bonizzi A, Zerbi P, Marchini B, Longhi E, Sampietro GM, Colombo F, Prosperi D, Colombo M, Corsi F. Anti-MAdCAM-1-Conjugated Nanocarriers Delivering Quantum Dots Enable Specific Imaging of Inflammatory Bowel Disease. Int J Nanomedicine 2020; 15:8537-8552. [PMID: 33173291 PMCID: PMC7646444 DOI: 10.2147/ijn.s264513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Assessment of inflammatory bowel disease (IBD) currently relies on aspecific clinical signs of bowel inflammation. Specific imaging of the diseased bowel regions is still lacking. Here, we investigate mucosal addressin cell adhesion molecule 1 (MAdCAM-1) as a reliable and specific endothelial target for engineered nanoparticles delivering imaging agents to obtain an exact mapping of diseased bowel foci. Materials and Methods We generated a nanodevice composed of PLGA-PEG coupled with anti-MAdCAM-1 antibody half-chains and loaded with quantum dots (P@QD-MdC NPs). Bowel localization and systemic biodistribution of the nanoconjugate were analyzed upon injection in a murine model of chronic IBD obtained through repeated administration of dextran sulfate sodium salt. Specificity for diseased bowel regions was also assessed ex vivo in human specimens from patients with IBD. Potential for development as contrast agent in magnetic resonance imaging was assessed by preliminary study on animal model. Results Synthesized nanoparticles revealed good stability and monodispersity. Molecular targeting properties were analyzed in vitro in a cell culture model. Upon intravenous injection, P@QD-MdC NPs were localized in the bowel of colitic mice, with enhanced accumulation at 24 h post-injection compared to untargeted nanoparticles (p<0.05). Nanoparticles injection did not induce histologic lesions in non-target organs. Ex vivo exposure of human bowel specimens to P@QD-MdC NPs revealed specific recognition of the diseased regions vs uninvolved tracts (p<0.0001). After loading with appropriate contrast agent, the nanoparticles enabled localized contrast enhancement of bowel mucosa in the rectum of treated mice. Conclusion P@QD-MdC NPs efficiently detected bowel inflammation foci, accurately following the expression pattern of MAdCAM-1. Fine-tuning of this nanoconjugate with appropriate imaging agents offers a promising non-invasive tool for specific IBD diagnosis.
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Affiliation(s)
- Marta Truffi
- Nanomedicine and Molecular Imaging Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia 27100, Italy
| | - Marta Sevieri
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Lucia Morelli
- NanoBioLab, Department of Biotechnology and Biosciences, Università degli studi di Milano-Bicocca, Milano, 20126, Italy
| | - Matteo Monieri
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Serena Mazzucchelli
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Luca Sorrentino
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Raffaele Allevi
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Arianna Bonizzi
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Pietro Zerbi
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Beatrice Marchini
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Erika Longhi
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy
| | - Gianluca Matteo Sampietro
- IBD Surgery Unit, ASST Fatebenefratelli Sacco - Ospedale "Luigi Sacco" Polo Universitario, Milano, 20157, Italy
| | - Francesco Colombo
- IBD Surgery Unit, ASST Fatebenefratelli Sacco - Ospedale "Luigi Sacco" Polo Universitario, Milano, 20157, Italy
| | - Davide Prosperi
- NanoBioLab, Department of Biotechnology and Biosciences, Università degli studi di Milano-Bicocca, Milano, 20126, Italy
| | - Miriam Colombo
- NanoBioLab, Department of Biotechnology and Biosciences, Università degli studi di Milano-Bicocca, Milano, 20126, Italy
| | - Fabio Corsi
- Department of Biomedical and Clinical Sciences "Luigi Sacco, Università degli studi di Milano, Milano, 20157, Italy.,Surgery Department, Breast Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, 27100, Italy
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11
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Sonzogni A, Previtali G, Seghezzi M, Grazia Alessio M, Gianatti A, Licini L, Morotti D, Zerbi P, Carsana L, Rossi R, Lauri E, Pellegrinelli A, Nebuloni M. Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations. Liver Int 2020; 40:2110-2116. [PMID: 32654359 PMCID: PMC7404964 DOI: 10.1111/liv.14601] [Citation(s) in RCA: 189] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022]
Abstract
SARS2-CoV-2 breakout in Italy caused a huge number of severely ill patients with a serious increase in mortality. Although lungs seem to be the main target of the infection, very few information are available about liver involvement, possibly evocating a systemic disease. Post-mortem wedge liver biopsies from 48 patients died from severe pulmonary COVID-19 disease with respiratory failure were collected from two main hospitals in northern Italy. No patient had clinical symptoms of liver disease or signs of liver failure before and during hospitalization; for each of them liver function tests were available. All liver samples showed minimal inflammation features. Histological pictures compatible with vascular alterations were observed, characterized by increase in number of portal vein branches associated with lumen massive dilatation, partial or complete luminal thrombosis of portal and sinusoidal vessels, fibrosis of portal tract, focally markedly enlarged and fibrotic. SARS-CoV-2 was found in 15 of 22 samples tested by in situ hybridization method. Our preliminary results confirm the clinical impression that liver failure is not a main concern and this organ is not the target of significant inflammatory damage. Histopathological findings are highly suggestive for marked derangement of intrahepatic blood vessel network secondary to systemic changes induced by virus that could target not only lung parenchyma but also cardiovascular system, coagulation cascade and endothelial layer of blood vessels. It still remains unclear if the mentioned changes are directly related to virus infection or if SARS-CoV-2 triggers a series of reactions leading to striking vascular alterations.
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Affiliation(s)
| | - Giulia Previtali
- Department of Laboratory MedicinePapa Giovanni XXIII HospitalBergamoItaly
| | - Michela Seghezzi
- Department of Laboratory MedicinePapa Giovanni XXIII HospitalBergamoItaly
| | | | - Andrea Gianatti
- Department of PathologyPapa Giovanni XXIII HospitalBergamoItaly
| | - Lisa Licini
- Department of PathologyPapa Giovanni XXIII HospitalBergamoItaly
| | - Denise Morotti
- Department of PathologyPapa Giovanni XXIII HospitalBergamoItaly
| | - Pietro Zerbi
- Department of PathologyLuigi Sacco HospitalMilanoItaly,Department of Biomedical and Clinical SciencesUniversity of MilanMilanoItaly
| | - Luca Carsana
- Department of Biomedical and Clinical SciencesUniversity of MilanMilanoItaly
| | - Roberta Rossi
- Department of Biomedical and Clinical SciencesUniversity of MilanMilanoItaly
| | | | | | - Manuela Nebuloni
- Department of PathologyLuigi Sacco HospitalMilanoItaly,Department of Biomedical and Clinical SciencesUniversity of MilanMilanoItaly
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12
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Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, Rech R, Colombo R, Antinori S, Corbellino M, Galli M, Catena E, Tosoni A, Gianatti A, Nebuloni M. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis 2020; 20:1135-1140. [PMID: 32526193 PMCID: PMC7279758 DOI: 10.1016/s1473-3099(20)30434-5] [Citation(s) in RCA: 885] [Impact Index Per Article: 221.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND COVID-19 is characterised by respiratory symptoms, which deteriorate into respiratory failure in a substantial proportion of cases, requiring intensive care in up to a third of patients admitted to hospital. Analysis of the pathological features in the lung tissues of patients who have died with COVID-19 could help us to understand the disease pathogenesis and clinical outcomes. METHODS We systematically analysed lung tissue samples from 38 patients who died from COVID-19 in two hospitals in northern Italy between Feb 29 and March 24, 2020. The most representative areas identified at macroscopic examination were selected, and tissue blocks (median seven, range five to nine) were taken from each lung and fixed in 10% buffered formalin for at least 48 h. Tissues were assessed with use of haematoxylin and eosin staining, immunohistochemical staining for inflammatory infiltrate and cellular components (including staining with antibodies against CD68, CD3, CD45, CD61, TTF1, p40, and Ki-67), and electron microscopy to identify virion localisation. FINDINGS All cases showed features of the exudative and proliferative phases of diffuse alveolar damage, which included capillary congestion (in all cases), necrosis of pneumocytes (in all cases), hyaline membranes (in 33 cases), interstitial and intra-alveolar oedema (in 37 cases), type 2 pneumocyte hyperplasia (in all cases), squamous metaplasia with atypia (in 21 cases), and platelet-fibrin thrombi (in 33 cases). The inflammatory infiltrate, observed in all cases, was largely composed of macrophages in the alveolar lumina (in 24 cases) and lymphocytes in the interstitium (in 31 cases). Electron microscopy revealed that viral particles were predominantly located in the pneumocytes. INTERPRETATION The predominant pattern of lung lesions in patients with COVID-19 patients is diffuse alveolar damage, as described in patients infected with severe acute respiratory syndrome and Middle East respiratory syndrome coronaviruses. Hyaline membrane formation and pneumocyte atypical hyperplasia are frequent. Importantly, the presence of platelet-fibrin thrombi in small arterial vessels is consistent with coagulopathy, which appears to be common in patients with COVID-19 and should be one of the main targets of therapy. FUNDING None.
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Affiliation(s)
- Luca Carsana
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Aurelio Sonzogni
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Ahmed Nasr
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy; Department of Pathology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Pietro Zerbi
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Roberto Rech
- Department of Anaesthesiology and Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy
| | - Riccardo Colombo
- Department of Anaesthesiology and Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Corbellino
- Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Massimo Galli
- Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Emanuele Catena
- Department of Anaesthesiology and Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy
| | - Antonella Tosoni
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Andrea Gianatti
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Manuela Nebuloni
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
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13
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Antinori S, Rech R, Galimberti L, Castelli A, Angeli E, Fossali T, Bernasconi D, Covizzi A, Bonazzetti C, Torre A, Carsana L, Tonello C, Zerbi P, Nebuloni M. Invasive pulmonary aspergillosis complicating SARS-CoV-2 pneumonia: A diagnostic challenge. Travel Med Infect Dis 2020; 38:101752. [PMID: 32470620 PMCID: PMC7255262 DOI: 10.1016/j.tmaid.2020.101752] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Roberto Rech
- Intensive Care Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Laura Galimberti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Elena Angeli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Tommaso Fossali
- Intensive Care Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Davide Bernasconi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alice Covizzi
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cecilia Bonazzetti
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alessandro Torre
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Luca Carsana
- Pathology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Pietro Zerbi
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Pathology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Manuela Nebuloni
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milan, Italy; Pathology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
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14
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Gianotti R, Zerbi P, Dodiuk-Gad RP. Clinical and histopathological study of skin dermatoses in patients affected by COVID-19 infection in the Northern part of Italy. J Dermatol Sci 2020; 98:141-143. [PMID: 32381428 PMCID: PMC7190511 DOI: 10.1016/j.jdermsci.2020.04.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/19/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Raffaele Gianotti
- UOC Dermatologia, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Pietro Zerbi
- Pathology Unit Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano Milan, Italy
| | - Roni P Dodiuk-Gad
- Dermatology Department, Emek Medical Center, Afula, Israel; Bruce Rappaport Faculty of Medicine, Technion - Institute of Technology, Haifa, Israel; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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15
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Vertemati M, Rizzetto F, Cassin S, Zerbi P, Giordano A, Cariati M, Gallieni M. Clinical relevance of the left brachiocephalic vein anatomy for vascular access in dialysis patients. Clin Anat 2020; 33:1120-1129. [PMID: 31891199 DOI: 10.1002/ca.23549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/17/2019] [Accepted: 12/17/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Most hemodialysis patients start renal replacement therapy with a central venous catheter (CVC). The left internal jugular vein (LIJV) is the second-choice vein for CVC positioning, after the right IJV. However, to reach the right atrium, the CVC must pass through the left brachiocephalic vein (LBV), which also drains blood from the left arm through the subclavian vein. The purpose of this study is to describe how the anatomy of the central venous system and in particular that of the LBV affects vascular access in hemodialysis patients. MATERIALS AND METHODS Three-dimensional (3D) virtual model reconstructions of the central thoracic veins of three hemodialysis patients were obtained from contrast-enhanced computed tomography scans acquired in the venous phase. The images were exported as DICOM files and loaded on open-source software for visualizing and analyzing the medical imaging (3D Slicer, Windows version 4.8.1). RESULTS As expected, the 3D reconstructions showed that the LBV has a tortuous path with three main angulations that could be associated with external compression and stenosis. These could determine the difficulties and increased risks of venous injury during CVC placement, and an increased risk of medium to long-term catheter-associated vein thrombosis and stenosis. CONCLUSIONS The anatomical features of the LBV indicate that the path of a CVC from the LIJV to the right atrium is tortuous and can easily be complicated by vein injury, negatively affecting the creation of future arterio-venous vascular accesses in the left arm.
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Affiliation(s)
- Maurizio Vertemati
- Institute of Human Anatomy, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy.,CIMaINa (Interdisciplinary Centre for Nano structured Materials and Interfaces), Università degli Studi di Milano, Milan, Italy
| | - Francesco Rizzetto
- School of Medicine, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy
| | - Simone Cassin
- School of Medicine, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy
| | - Pietro Zerbi
- Pathology Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy
| | - Antonino Giordano
- Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo, Milan, Italy
| | - Maurizio Cariati
- Department of Radiology, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo, Milan, Italy
| | - Maurizio Gallieni
- School of Medicine, Department of Biomedical and Clinical Sciences "Luigi Sacco", Università degli Studi di Milano, Milan, Italy.,Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milan, Italy
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16
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Alfano M, Pederzoli F, Locatelli I, Ippolito S, Longhi E, Zerbi P, Ferrari M, Brendolan A, Montorsi F, Drago D, Andolfo A, Nebuloni M, Salonia A. Impaired testicular signaling of vitamin A and vitamin K contributes to the aberrant composition of the extracellular matrix in idiopathic germ cell aplasia. Fertil Steril 2019; 111:687-698. [DOI: 10.1016/j.fertnstert.2018.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 12/12/2022]
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17
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Mazzucchelli S, Andreata F, Bonizzi A, Monieri M, Bellini M, Longhi E, Ottria R, Sorrentino L, Truffi M, Prosperi D, Zerbi P, Corsi F. Abstract P1-20-04: Nanoformulation of doxorubicin inside H- ferritin nanocages allows a cardio-safe combined therapy with trastuzumab: De-escalating cardiotoxicity in HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-20-04] [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: 11/16/2022]
Abstract
Abstract
Background: HER2+ breast cancer (BC) accounts for 20-25 % of BCs and it is characterized by high aggressiveness.1 Despite the anti-HER2 monoclonal antibody Trastuzumab (TZ) has improved BC clinical outcome, it could induce severe cardiac reversible dysfunction:2 HER2 signaling is also essential for growth and survival of myocardiocytes.3 Therefore, the concurrent use of TZ with other cardiotoxic drugs as doxorubicin (DOX) is discouraged.3 Both neoadjuvant and adjuvant clinical trials have challenged the notion that TZ should be administered with anthracyclines only sequentially,4 despite pre-clinical studies demonstrated the significant enhancement of efficacy by their coadministration.5-7 Nanomedicine answers to this clinical issue with HFn-DOX: a natural protein-based DOX nanoformulation with native tumor targeting capability that displays a self-triggered nuclear delivery of DOX improving antitumor efficacy and reducing both chemoresistance and cardiotoxicity.8
Methods: HER2+ BC bearing mice have been treated 5 times twice a week with placebo, HFn-DOX (1 mg/Kg, i.v.), TZ (5 mg/Kg, i.p.) and with the combination of them. Main end-point were cardiotoxicity and anticancer efficacy. Tumor size was measured by caliper, while antitumor activity and cardiotoxicity were characterized by ICH, immunofluorescence, cytofluorimetry, TEM, mass spectrometry and western blot on resections. Statistical analyses were conducted using two-tailed Student's t-test (P< 0.05)
Results: Although single treatments with HFn-DOX or TZ display a good capability to reduce tumor progression, their combination improves antitumor potential, affecting tumor size and angiogenesis. Since the main TZ activity is the induction of the Antibody-Dependent Cell mediated Cytotoxicity, we have assessed the effect of HFn-DOX on Tumor Infiltrating Lymphocytes (TIL), revealing that both TILs enumeration and TIL activity is unaffected by HFn-DOX. On the other hand, HFn-DOX increases the induction of apoptosis, suggesting that the reduction of the tumor size observed in mice treated with the combination of TZ and HFn-DOX is attributable to the coupling of these activity. Mitochondrial morphology has been checked for cardiotoxicity. A pathological increase in mitochondria area coupled with cristae depletion has been evidenced only in mice treated with TZ alone, confirming the overall safety of the HFn-DOX formulation. Interestingly, mice treated with the TZ and HFn-DOX did not display evidences of cardiac suffering. TZ quantification in tumor and heart revealed that the combination with HFn-DOX couples the increased TZ accumulation and penetration in tumor with TZ reduction in heart, resulting in the lack of cardiotoxicity.
Conclusions: Our results suggest that a combined therapy with HFn-DOX and TZ allows an enhanced anticancer activity and reduced cardiotoxicity, with potential translational implications on the treatment of HER2+ BC patients.
[1] Nat Rev Cancer 2009; 9:463; [2] Nat. Med. 2012; 18(11):1639; [3] Cancer treatments reviews 2009; 35:633; [4] The breast 2014; 23:317; [5] Cancer Res. 1998; 58(13):2825; [6] Lancet Oncol. 2011; 12(3):236; [7] Lancet 2010; 375(9712):377. [8] Oncotarget. 2017; 8:8383.
Citation Format: Mazzucchelli S, Andreata F, Bonizzi A, Monieri M, Bellini M, Longhi E, Ottria R, Sorrentino L, Truffi M, Prosperi D, Zerbi P, Corsi F. Nanoformulation of doxorubicin inside H- ferritin nanocages allows a cardio-safe combined therapy with trastuzumab: De-escalating cardiotoxicity in HER2-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-20-04.
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Affiliation(s)
- S Mazzucchelli
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - F Andreata
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - A Bonizzi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - M Monieri
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - M Bellini
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - E Longhi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - R Ottria
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - L Sorrentino
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - M Truffi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - D Prosperi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - P Zerbi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
| | - F Corsi
- University of Milan, Department of Biomedical and Clinical Sciences "L. Sacco", Milan, Italy; University of Milan-Bicocca, Milan, Italy; ICS Maugeri Spa SB, Breast Unit, Pavia, Italy
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Wu MA, Arquati M, Zanichelli A, Perego F, Gidaro A, Suffritti C, Zerbi P, Cicardi M. Two Cases Of Peculiar Hypereosinophilic Syndrome Treated With Mepolizumab. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.892] [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: 11/30/2022]
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Ferrario L, Zerbi P, Angiolini MR, Agarossi A, Riggio E, Bondurri A, Danelli P. Leiomyomatosis peritonealis disseminata: A case report of recurrent presentation and literature review. Int J Surg Case Rep 2018; 49:25-29. [PMID: 29933173 PMCID: PMC6010956 DOI: 10.1016/j.ijscr.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/25/2018] [Accepted: 06/10/2018] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Leiomyomatosis peritonealis disseminata (LPD) is an uncommon disease featured by the presence of multiple nodules of smooth muscle cells scattered in the abdominal cavity. To date only about 150 cases have been reported in literature. We report a case of recurrent LPD after laparotomy. CASE PRESENTATION In March 2016 a 36-year-old female, with a history of multiple previous laparoscopic myomectomies, consulted her gynaecologist complaining abdominal pain; a MRI was performed and reported multiple pelvic masses, subsequently excised during laparotomy. The patient refused a total hysterectomy with bilateral salpingo-oopherectomy so a close follow-up was recommended. In November 2017 when a new MRI revealed recurrency of the disease, a second laparotomy is performed and all visible nodules are excised. The histological exam confirms LPD diagnosis. On follow-up after three months the patients is completely asymptomatic. DISCUSSION Differential diagnosis of LPD is challenging due to its similarity to carcinomatosis and to other benign abdominal disorders. Malignant transformation is rare, but it may occur, so a close follow-up is necessary. Even if there is no consensus regarding the treatment, hormonal therapy is probably the best first line approach, while surgery should be the second choice. CONCLUSIONS LPD is an uncommon but potentially severe disease. In our opinion larger studies are necessary to improve our diagnostic effectiveness and to define the best therapeutic strategy.
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Affiliation(s)
- Luca Ferrario
- Department of General Surgery, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy.
| | - Pietro Zerbi
- Department of Pathology, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
| | - Maria Rachele Angiolini
- Department of General Surgery, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
| | - Alberto Agarossi
- Department of Obstetrics and Gynecology, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
| | - Eliana Riggio
- Department of General Surgery, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
| | - Andrea Bondurri
- Department of General Surgery, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
| | - Piergiorgio Danelli
- Department of General Surgery, Department of Biomedical and Clinical Sciences "Luigi Sacco", "Luigi Sacco" University Hospital, Università degli Studi di Milano, 20157 Milan, Italy
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20
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Truffi M, Sorrentino L, Monieri M, Fociani P, Mazzucchelli S, Bonzini M, Zerbi P, Sampietro GM, Di Sabatino A, Corsi F. Inhibition of Fibroblast Activation Protein Restores a Balanced Extracellular Matrix and Reduces Fibrosis in Crohn's Disease Strictures Ex Vivo. Inflamm Bowel Dis 2018; 24:332-345. [PMID: 29361086 DOI: 10.1093/ibd/izx008] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Crohn's disease (CD) is a chronic bowel inflammation that ultimately leads to fibrosis, for which medical therapy is currently unavailable. Fibrotic strictures in CD are characterized by excessive extracellular matrix (ECM) deposition, altered balance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), and overexpression of fibroblast activation protein (FAP), a marker of active fibroblasts. Here we investigated the role of FAP-targeted therapy in ECM remodeling in CD strictures ex vivo. METHODS Bowel specimens were obtained from stenotic and nonstenotic ileal segments from 30 patients with fibrostenotic CD undergoing surgery. FAP expression was evaluated in isolated mucosal myofibroblasts by immunoblotting and flow cytometry. Bowel tissue cultures were treated with anti-FAP antibody, and soluble collagen, TIMP-1, and MMPs were measured in tissue culture supernatants by immunoblotting. Anti-FAP-treated myofibroblasts were analyzed for TIMP-1 expression by immunoblotting, for migratory potential by wound healing assay, and for apoptosis by Annexin V staining. RESULTS Myofibroblasts from stenotic CD mucosa showed upregulation of FAP expression when compared with nonstenotic mucosa. Treatment of stenotic tissues with anti-FAP antibody induced a dose-dependent decrease in collagen production, particularly affecting type I collagen. The treatment also reduced TIMP-1 production in CD strictures, without altering MMP-3 and MMP-12 secretion. Accordingly, anti-FAP treatment inhibited TIMP-1 expression in stenotic CD myofibroblasts and enhanced myofibroblast migration without affecting survival. CONCLUSIONS FAP inhibition reduced type I collagen and TIMP-1 production by CD strictures ex vivo without compromising uninvolved bowel areas. These results suggest that targeting FAP could reconstitute ECM homeostasis in fibrostenotic CD.
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Affiliation(s)
- Marta Truffi
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Luca Sorrentino
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Matteo Monieri
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Paolo Fociani
- Department of Pathology, IBD Unit, ASST Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Serena Mazzucchelli
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Matteo Bonzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Pietro Zerbi
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.,Department of Pathology, IBD Unit, ASST Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Gianluca M Sampietro
- Department of Surgery, IBD Unit, ASST Fatebenefratelli Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, St. Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Fabio Corsi
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.,Surgery Department, Breast Unit, ICS Maugeri S.p.A. SBPavia, Italy.,Nanomedicine laboratory, ICS Maugeri S.p.A. SB, Italy, Italy
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21
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Truffi M, Colombo M, Peñaranda-Avila J, Sorrentino L, Colombo F, Monieri M, Collico V, Zerbi P, Longhi E, Allevi R, Prosperi D, Corsi F. Nano-targeting of mucosal addressin cell adhesion molecule-1 identifies bowel inflammation foci in murine model. Nanomedicine (Lond) 2017. [PMID: 28621606 DOI: 10.2217/nnm-2017-0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIM We investigate MAdCAM-1 as a reliable target to detect active bowel inflammation for selective noninvasive nanodiagnostics. MATERIALS & METHODS We coupled anti-MAdCAM-1 antibodies to manganese oxide nanoparticles, and analyzed nanoconjugate biodistribution and safety in murine model of inflammatory bowel disease by imaging and histology. RESULTS Nanoparticles were stable and nontoxic. Upon administration in colitic mice, anti-MAdCAM-1 functionalized nanoparticles preferentially localized in the inflamed bowel, whereas untargeted nanoparticles were more rapidly washed out. Nanoparticles did not induce lesions in nontarget organs. CONCLUSION Anti-MAdCAM-1 functionalized nanoparticles detected active bowel inflammation foci, accurately following MAdCAM-1 expression pattern. These nanoconjugates could be a promising noninvasive imaging system for an early and accurate follow-up in patients affected by acute colitis.
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Affiliation(s)
- Marta Truffi
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy
| | - Miriam Colombo
- Department of Biotechnologies & Biosciences, NanoBioLab, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Jesus Peñaranda-Avila
- Department of Biotechnologies & Biosciences, NanoBioLab, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Luca Sorrentino
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy
| | - Francesco Colombo
- Surgery Department, IBD Unit, ASST Fatebenefratelli Sacco-Luigi Sacco University Hospital, via G. B. Grassi 74, 20157 Milan, Italy
| | - Matteo Monieri
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy
| | - Veronica Collico
- Department of Biotechnologies & Biosciences, NanoBioLab, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Pietro Zerbi
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy.,Pathology Department, ASST Fatebenefratelli Sacco-Luigi Sacco Hospital, via G. B. Grassi 74, 20157 Milan, Italy
| | - Erika Longhi
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy
| | - Raffaele Allevi
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy
| | - Davide Prosperi
- Department of Biotechnologies & Biosciences, NanoBioLab, University of Milano-Bicocca, Piazza della Scienza 2, 20126 Milan, Italy
| | - Fabio Corsi
- Department of Biomedical & Clinical Sciences 'L. Sacco', University of Milan, via G. B. Grassi 74, 20157 Milan, Italy.,Surgery Department, Breast Unit, ICS Maugeri S.p.A. SB, via S. Maugeri 10, 27100 Pavia, Italy
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Contino M, Mangini A, Lemma MG, Romagnoni C, Zerbi P, Gelpi G, Antona C. A geometric approach to aortic root surgical anatomy. Eur J Cardiothorac Surg 2015; 49:93-100. [DOI: 10.1093/ejcts/ezv059] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 01/23/2015] [Indexed: 11/13/2022] Open
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Moroni M, Ghezzi S, Baroli P, Heltai S, De Battista D, Pensieroso S, Cavarelli M, Dispinseri S, Vanni I, Pastori C, Zerbi P, Tosoni A, Vicenzi E, Nebuloni M, Wong K, Zhao H, McHugh S, Poli G, Lopalco L, Scarlatti G, Biassoni R, Mullins JI, Malnati MS, Alfano M. Spontaneous control of HIV-1 viremia in a subject with protective HLA-B plus HLA-C alleles and HLA-C associated single nucleotide polymorphisms. J Transl Med 2014; 12:335. [PMID: 25477316 PMCID: PMC4272524 DOI: 10.1186/s12967-014-0335-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Received: 08/16/2014] [Accepted: 11/20/2014] [Indexed: 01/10/2023] Open
Abstract
Introduction Understanding the mechanisms by which some individuals are able to naturally control HIV-1 infection is an important goal of AIDS research. We here describe the case of an HIV-1+ woman, CASE1, who has spontaneously controlled her viremia for the last 14 of her 20 years of infection. Methods CASE1 has been clinically monitored since 1993. Detailed immunological, virological and histological analyses were performed on samples obtained between 2009 and 2011. Results As for other Elite Controllers, CASE1 is characterized by low to undetectable levels of plasma HIV-1 RNA, peripheral blood mononuclear cell (PBMC) associated HIV-1 DNA and reduced in vitro susceptibility of target cells to HIV-1 infection. Furthermore, a slow rate of virus evolution was demonstrated in spite the lack of assumption of any antiretroviral agent. CASE1 failed to transmit HIV-1 to either her sexual male partner or to her child born by vaginal delivery. Normal values and ratios of T and B cells were observed, along with normal histology of the intestinal mucosa. Attempts to isolate HIV-1 from her PBMC and gut-derived cells were unsuccessful, despite expression of normal cell surface levels of CD4, CCRC5 and CXCR4. CASE1 did not produce detectable anti-HIV neutralizing antibodies in her serum or genital mucosal fluid although she displayed potent T cell responses against HIV-1 Gag and Nef. CASE1 also possessed multiple genetic polymorphisms, including HLA alleles (B*14, B*57, C*06 and C*08.02) and HLA-C single nucleotide polymorphisms (SNPs, rs9264942 C/C and rs67384697 del/del), that have been previously individually associated with spontaneous control of plasma viremia, maintenance of high CD4+ T cell counts and delayed disease progression. Conclusions CASE1 has controlled her HIV-1 viremia below the limit of detection in the absence of antiretroviral therapy for more than 14 years and has not shown any sign of immunologic deterioration or disease progression. Co-expression of multiple protective HLA alleles, HLA-C SNPs and strong T cell responses against HIV-1 proteins are the most likely explanation of this very benign case of spontaneous control of HIV-1 disease progression. Electronic supplementary material The online version of this article (doi:10.1186/s12967-014-0335-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marco Moroni
- Infectious Disease Unit, Busto Arsizio Public Hospital, P.le Solaro n. 3, Busto Arsizio, 21052, Varese, Italy.
| | - Silvia Ghezzi
- Viral Pathogens and Biosafety Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Paolo Baroli
- Service Lab Fleming Research, Busto Arsizio, Varese, Italy.
| | - Silvia Heltai
- Human Virology Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Davide De Battista
- Human Virology Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Simone Pensieroso
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Mariangela Cavarelli
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Stefania Dispinseri
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Irene Vanni
- Department of Translational Research, Istituto Giannina Gaslini, Genoa, Italy.
| | - Claudia Pastori
- Immunobiology of HIV Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Pietro Zerbi
- Pathology Unit, Luigi Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| | - Antonella Tosoni
- Pathology Unit, Luigi Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| | - Elisa Vicenzi
- Viral Pathogens and Biosafety Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Manuela Nebuloni
- Pathology Unit, Luigi Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
| | - Kim Wong
- Departments of Microbiology, Medicine and Laboratory Medicine, University of Washington, Seattle, WA, USA.
| | - Hong Zhao
- Departments of Microbiology, Medicine and Laboratory Medicine, University of Washington, Seattle, WA, USA.
| | - Sarah McHugh
- Departments of Microbiology, Medicine and Laboratory Medicine, University of Washington, Seattle, WA, USA.
| | - Guido Poli
- AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Via Olgettina n. 58, Milan, 20132, Italy. .,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
| | - Lucia Lopalco
- Immunobiology of HIV Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Gabriella Scarlatti
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Roberto Biassoni
- Department of Translational Research, Istituto Giannina Gaslini, Genoa, Italy.
| | - James I Mullins
- Departments of Microbiology, Medicine and Laboratory Medicine, University of Washington, Seattle, WA, USA.
| | - Mauro S Malnati
- Human Virology Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Milan, Italy.
| | - Massimo Alfano
- AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Disease, San Raffaele Scientific Institute, Via Olgettina n. 58, Milan, 20132, Italy. .,Present address; Division of Experimental Oncology, Unit of Urology, URI; IRCCS Ospedale San Raffaele, Via Olgettina n. 60, Milan, 20132, Italy.
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Tolva V, Mazzola S, Zerbi P, Casana R, Albertini M, Calvillo L, Selmin F, Cilurzo F. A successful experimental model for intimal hyperplasia prevention using a resveratrol-delivering balloon. J Vasc Surg 2014; 63:788-94. [PMID: 25446284 DOI: 10.1016/j.jvs.2014.09.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/23/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Restenosis due to intimal hyperplasia is a major clinical problem that compromises the success of angioplasty and endovascular surgery. Resveratrol (RSV) has demonstrated a beneficial effect on restenosis from angioplasty. Unfortunately, the physicochemical characteristics of RSV reduce the practicality of its immediate clinical application. This work proposes an experimental model aiming to setup an intravessel, elutable, RSV-containing compound. METHODS A 140 μg/mL RSV sterile injectable solution with a suitable viscosity for intravascular administration by drug-delivery catheter (RSV-c) was prepared. This solution was locally administered in the common iliac artery of adult male New Zealand White rabbits using a dedicated device (Genie; Acrostak, Geneva, Switzerland) after the induction of intimal hyperplasia by traumatic angioplasty. The RSV concentrations in the wall artery were determined, and the thickness of the harvested iliac arteries was measured over a 1-month period. RESULTS The Genie catheter was applied in rabbit vessels, and the local delivery resulted in an effective reduction in restenosis after plain angioplasty. Notably, RSV-c forced into the artery wall by balloon expansion might accumulate in the interstitial areas or within cells, avoiding the washout of solutions. Magnification micrographs showed intimal proliferation was significantly inhibited when RSV-c was applied. Moreover, no adverse events were documented in in vitro or in vivo studies. CONCLUSIONS RSV can be advantageously administered in the arterial walls by a drug-delivery catheter to reduce the risk of restenosis.
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Affiliation(s)
- Valerio Tolva
- Surgical Department, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Presidio Ospedaliero Capitanio, Milan, Italy; Dipartimento di Scienze della Salute, University of Milan-Bicocca, Milan, Italy.
| | - Silvia Mazzola
- Dipartimento di Scienze Veterinarie e Sanità Pubblica, Università degli Studi di Milano, Milan, Italy
| | - Pietro Zerbi
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Renato Casana
- Surgical Department, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Presidio Ospedaliero Capitanio, Milan, Italy
| | - Mariangela Albertini
- Dipartimento di Scienze Veterinarie e Sanità Pubblica, Università degli Studi di Milano, Milan, Italy
| | - Laura Calvillo
- Department and Laboratory of Cardiac Arrhtmias on Genetic Basis, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Francesca Selmin
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Milano, Milan, Italy
| | - Francesco Cilurzo
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Milano, Milan, Italy
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Maconi G, Lombardini M, Furfaro F, Bezzio C, Zerbi P, Ardizzone S. Long-term outcome of inflammatory bowel diseases with cytomegalovirus colitis: effect of antiviral treatment. Eur J Gastroenterol Hepatol 2014; 26:1146-51. [PMID: 25089547 DOI: 10.1097/meg.0000000000000175] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The role of cytomegalovirus (CMV) reactivation in the outcome of inflammatory bowel diseases (IBDs) is unclear. Uncertainties remain on the treatment of CMV infection, especially in patients with a viral load just above the normal value in the blood or with very few positive cells in colonic biopsies. This retrospective cohort study reports the long-term outcome of 38 active IBD patients with CMV infection, 13 of whom received an antiviral treatment. PATIENTS AND METHODS Thirty patients with ulcerative colitis (UC) and eight patients with Crohn's colitis with active colitis and CMV infection, diagnosed by detection of at least one CMV inclusion by histology and immunohistochemistry and/or with the CMV antigen test or the CMV DNA test, were studied. Their clinical history at 6 months and up to 1 year following hospital discharge was reviewed. Clinical remission at hospital discharge and recurrences requiring new treatments or colectomy were considered major outcomes of the study. The features of treated and untreated patients were compared using the Fisher exact test and the Student t-test. RESULTS All patients showed rare CMV inclusions, and only three had positive blood CMV PCR. Thirteen patients received antiviral treatment, whereas 25 patients did not. No patient underwent colectomy during the hospitalization. The 12-month cumulative rate of clinical relapse requiring new treatment or colectomy was 23% in patients treated with antivirals and 50% in untreated patients (P=0.165). However, in patients with UC and in those with steroid-dependent/refractory disease, antiviral treatment was associated with a significantly higher clinical remission rate at 12 months (77.8 vs. 45%, P=0.049, and 77.8 vs. 19.4%, P=0.038, respectively). CONCLUSION In IBD patients with active CMV colitis, antiviral treatment seems to have a marginal impact in the short term, during the treatment of the acute phase, but it may have some beneficial effect in maintaining remission up to 1 year of follow-up in patients with UC and steroid-dependent/refractory disease.
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Affiliation(s)
- Giovanni Maconi
- aGastroenterology Unit bPathology Unit, Department of Biomedical and Clinical Sciences, 'L. Sacco' University Hospital, Milan, Italy
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Genovese L, Zawada L, Tosoni A, Ferri A, Zerbi P, Allevi R, Nebuloni M, Alfano M. Cellular localization, invasion, and turnover are differently influenced by healthy and tumor-derived extracellular matrix. Tissue Eng Part A 2014; 20:2005-18. [PMID: 24498848 DOI: 10.1089/ten.tea.2013.0588] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The interplay between tumor cells and the microenvironment has been recognized as one of the hallmarks of cancer biology. To assess the role of extracellular matrix (ECM) in the modulation of tissue homeostasis and tumorigenesis, we developed a protocol for the purification of tissue-derived ECM using mucosae from healthy human colon, perilesional area, and colorectal carcinoma (CRC). Matched specimens were collected from the left colon of patients undergoing CRC resection surgery. ECMs were obtained from tissues that were decellularized with hypotonic solutions containing ionic and nonionic detergents, hypertonic solution, and endonuclease in the absence of denaturing agents. Mucosae-derived ECMs maintained distribution and localization of proteins and glycoproteins typical of the original tissues, and showed different three-dimensional (3D) structures among normal versus perilesional and tumor-derived stroma. The three types of ECM differentially regulated the localization and organization of seeded monocytes and cancer cells that were located and organized as in the original tissue. Specifically, healthy, perilesional, and CRC-derived ECMs sustained differentiation and polarization of cancer epithelial cells. In addition, healthy, but not perilesional and CRC-derived ECM constrained invasion of cancer cells. All three ECMs sustained turnover between cell proliferation and death up to 40 days of culture, although each ECM showed different ability in supporting cell proliferation, with tumor>perilesional>healthy-derived ECMs. Healthy-, perilesional- and CRC-derived ECM differently modulated cell homeostasis, spreading in the stroma and turnover between proliferation and death, and equally supported differentiation and polarization of cancer epithelial cells, thus highlighting the contribution of different ECMs modulating some features of tissue homeostasis and tumorigenesis. Moreover, these ECMs provide competent scaffolds useful to assess efficacy of antitumor drugs in a 3D setting that more closely recapitulates the native microenvironment. Further, ECM-based scaffolds may also be beneficial for future studies seeking prognostic and diagnostic stromal markers and targets for antineoplastic drugs.
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Affiliation(s)
- Luca Genovese
- 1 School of Medicine, Vita-Salute San Raffaele University , Milan, Italy
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Marcon G, Indaco A, Di Fede G, Suardi S, Finato N, Moretti V, Micoli S, Fociani P, Zerbi P, Pincherle A, Redaelli V, Tagliavini F, Giaccone G. Panencephalopathic Creutzfeldt-Jakob disease with distinct pattern of prion protein deposition in a patient with D178N mutation and homozygosity for valine at codon 129 of the prion protein Gene. Brain Pathol 2013; 24:148-51. [PMID: 24118545 DOI: 10.1111/bpa.12095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/02/2013] [Indexed: 11/30/2022] Open
Abstract
Prion diseases include sporadic, acquired and genetic forms linked to mutations of the prion protein (PrP) gene (PRNP). In subjects carrying the D178N PRNP mutation, distinct phenotypes can be observed, depending on the methionine/valine codon 129 polymorphism. We present here a 53-year-old woman with D178N mutation in the PRNP gene and homozygosity for valine at codon 129. The disease started at age 47 with memory deficits, progressive cognitive impairment and ataxia. The clinical picture slowly worsened to a state of akinetic mutism in about 2 years and the disease course was 6 years. The neuropathologic examination demonstrated severe diffuse cerebral atrophy with neuronal loss, spongiosis and marked myelin loss and tissue rarefaction in the hemispheric white matter, configuring panencephalopathic Creutzfeldt-Jakob disease. PrP deposition was present in the cerebral cortex, basal ganglia and cerebellum with diffuse synaptic-type pattern of immunoreactivity and clusters of countless, small PrP deposits, particularly evident in the lower cortical layers, in the striatum and in the molecular layer of the cerebellum. Western blot analysis showed the presence of type 1 PrP(Sc) (Parchi classification). These findings underline the clear-cut distinction between the neuropathological features of Creutzfeldt-Jakob disease associated with D178N PRNP mutation and those of fatal familial insomnia.
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Affiliation(s)
- Gabriella Marcon
- Department of Biological and Medical Sciences (DSMB), University of Udine, Udine, Italy
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Nebuloni M, Zawada L, Ferri A, Tosoni A, Zerbi P, Resnati M, Poli G, Genovese L, Alfano M. HIV-1 infected lymphoid organs upregulate expression and release of the cleaved form of uPAR that modulates chemotaxis and virus expression. PLoS One 2013; 8:e70606. [PMID: 23923008 PMCID: PMC3726662 DOI: 10.1371/journal.pone.0070606] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 06/21/2013] [Indexed: 11/18/2022] Open
Abstract
Cell-associated receptor for urokinase plasminogen activator (uPAR) is released as both full-length soluble uPAR (suPAR) and cleaved (c-suPAR) form that maintain ability to bind to integrins and other receptors, thus triggering and modulating cell signaling responses. Concerning HIV-1 infection, plasma levels of suPAR have been correlated with the severity of disease, levels of immune activation and ineffective immune recovery also in individuals receiving combination anti-retroviral therapy (cART). However, it is unknown whether and which suPAR forms might contribute to HIV-1 induced pathogenesis and to the related state of immune activation. In this regard, lymphoid organs represent an import site of chronic immune activation and virus persistence even in individuals receiving cART. Lymphoid organs of HIV-1(+) individuals showed an enhanced number of follicular dendritic cells, macrophages and endothelial cells expressing the cell-associated uPAR in comparison to those of uninfected individuals. In order to investigate the potential role of suPAR forms in HIV-1 infection of secondary lymphoid organs, tonsil histocultures were established from HIV-1 seronegative individuals and infected ex vivo with CCR5- and CXCR4-dependent HIV-1 strains. The levels of suPAR and c-suPAR were significantly increased in HIV-infected tonsil histocultures supernatants in comparison to autologous uninfected histocultures. Supernatants from infected and uninfected cultures before and after immunodepletion of suPAR forms were incubated with the chronically infected promonocytic U1 cell line characterized by a state of proviral latency in unstimulated conditions. In the contest of HIV-conditioned supernatants we established that c-suPAR, but not suPAR, inhibited chemotaxis and induced virus expression in U1 cells. In conclusion, lymphoid organs are an important site of production and release of both suPAR and c-suPAR, this latter form being endowed with the capacity of inhibiting chemotaxis and inducing HIV-1 expression.
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Affiliation(s)
- Manuela Nebuloni
- Pathology Unit, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Lidia Zawada
- Pathology Unit, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Angelita Ferri
- Pathology Unit, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Antonella Tosoni
- Pathology Unit, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Pietro Zerbi
- Pathology Unit, “Luigi Sacco” Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Massimo Resnati
- Molecular Genetic Unit, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, Italy
| | - Guido Poli
- Vita-Salute San Raffaele University, School of Medicine, Milan, Italy
- AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Luca Genovese
- AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Alfano
- AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
- * E-mail:
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Beretta S, Fabiano V, Mauri S, Vivaldo T, Tadini G, Zerbi P, Zuccotti GV. A case of worsening lipoatrophy in a 13 year-old girl. Pediatr Dermatol 2012; 29:363-4. [PMID: 22594337 DOI: 10.1111/j.1525-1470.2011.01629.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Silvia Beretta
- Department of Pediatrics, Ospedale Maggiore di Milano, Università degli Studi di Milano, Milan, Italy
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Moda F, Suardi S, Di Fede G, Indaco A, Limido L, Vimercati C, Ruggerone M, Campagnani I, Langeveld J, Terruzzi A, Brambilla A, Zerbi P, Fociani P, Bishop MT, Will RG, Manson JC, Giaccone G, Tagliavini F. MM2-thalamic Creutzfeldt-Jakob disease: neuropathological, biochemical and transmission studies identify a distinctive prion strain. Brain Pathol 2012; 22:662-9. [PMID: 22288561 PMCID: PMC8057639 DOI: 10.1111/j.1750-3639.2012.00572.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In Creutzfeldt-Jakob disease (CJD), molecular typing based on the size of the protease resistant core of the disease-associated prion protein (PrP(Sc) ) and the M/V polymorphism at codon 129 of the PRNP gene correlates with the clinico-pathologic subtypes. Approximately 95% of the sporadic 129MM CJD patients are characterized by cerebral deposition of type 1 PrP(Sc) and correspond to the classic clinical CJD phenotype. The rare 129MM CJD patients with type 2 PrP(Sc) are further subdivided in a cortical and a thalamic form also indicated as sporadic fatal insomnia. We observed two young patients with MM2-thalamic CJD. Main neuropathological features were diffuse, synaptic PrP immunoreactivity in the cerebral cortex and severe neuronal loss and gliosis in the thalamus and olivary nucleus. Western blot analysis showed the presence of type 2A PrP(Sc) . Challenge of transgenic mice expressing 129MM human PrP showed that MM2-thalamic sporadic CJD (sCJD) was able to transmit the disease, at variance with MM2-cortical sCJD. The affected mice showed deposition of type 2A PrP(Sc) , a scenario that is unprecedented in this mouse line. These data indicate that MM2-thalamic sCJD is caused by a prion strain distinct from the other sCJD subtypes including the MM2-cortical form.
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Affiliation(s)
- Fabio Moda
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Suardi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Antonio Indaco
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lucia Limido
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | | | - Jan Langeveld
- Central Veterinary Institute, Wageningen UR, Lelystad, The Netherlands
| | | | | | - Pietro Zerbi
- Ospedale Luigi Sacco, Università di Milano, Milan, Italy
| | - Paolo Fociani
- Ospedale Luigi Sacco, Università di Milano, Milan, Italy
| | - Matthew T. Bishop
- National Creutzfeldt‐Jakob Disease Surveillance Unit, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Robert G. Will
- National Creutzfeldt‐Jakob Disease Surveillance Unit, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Jean C. Manson
- The Roslin Institute and R(D)SVS, University of Edinburgh, Edinburgh, UK
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Mikhailova TL, Sishkova E, Poniewierka E, Zhidkov KP, Bakulin IG, Kupcinskas L, Lesniakowski K, Grinevich VB, Malecka-Panas E, Ardizzone S, D'Arienzo A, Valpiani D, Koch M, Denapiene G, Vago G, Fociani P, Zerbi P, Ceracchi M, Camerini R, Gasbarrini G. Randomised clinical trial: the efficacy and safety of propionyl-L-carnitine therapy in patients with ulcerative colitis receiving stable oral treatment. Aliment Pharmacol Ther 2011; 34:1088-97. [PMID: 21929562 DOI: 10.1111/j.1365-2036.2011.04844.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ulcerative colitis (UC) is characterised by impaired fatty-acid oxidation; l-carnitine has a key role in fatty-acid metabolism and short-chain fatty acids such as butyrate and propionate are important energy source for intestinal epithelial cells. AIM To evaluate efficacy and safety of colon-release propionyl-L-carnitine (PLC) in patients with mild-to-moderate UC receiving stable oral aminosalicylate or thiopurine therapy. METHODS In a multicentre, phase II, double-blind, parallel-group trial, patients were randomised to receive PLC 1 g/day, PLC 2 g/day or placebo. Main inclusion criteria were as follows: age 18-75; disease activity index (DAI) score 3-10 inclusive, be under oral stable treatment with aminosalicylate or thiopurine. The primary endpoint was clinical/endoscopic response, defined as a decrease in DAI score ≥ 3 points or remission, defined as a DAI score ≤ 2 with no individual sub-score > 1. RESULTS Of 121 patients who were randomised, 57 of 79 (72%) patients receiving PLC (combined 1 g and 2 g cohort) had a clinical/endoscopic response vs. 20 of 40 (50%) receiving placebo (P = 0.02). Specifically, in PLC 1 g/day group, 30 of 40 (75%) patients had clinical/endoscopic response (P = 0.02 vs. placebo) and 27 of 39 (69%) in the PLC 2 g/day group (P = 0.08 vs. placebo). Rates of remission were 22/40 (55%), 19/39 (49%), 14/40 (35%) in the PLC 1 g, PLC 2 g, and placebo groups, respectively. PLC had a similar safety profile to placebo; the most common adverse events were gastrointestinal. CONCLUSION Propionyl-L-carnitine 1 g/day should be investigated further as a co-treatment for mild-to-moderate ulcerative colitis (NCT-01026857).
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Affiliation(s)
- T L Mikhailova
- State Scientific Centre of Coloproctology, Rosmedtechnology, Moscow, Russia
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Nebuloni M, Pasqualini F, Zerbi P, Lauri E, Mantovani A, Vago L, Garlanda C. PTX3 expression in the heart tissues of patients with myocardial infarction and infectious myocarditis. Cardiovasc Pathol 2010; 20:e27-35. [PMID: 20356766 DOI: 10.1016/j.carpath.2010.02.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Revised: 01/06/2010] [Accepted: 02/25/2010] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The long pentraxin 3 is involved in innate resistance to pathogens, controlling inflammation and extracellular matrix remodeling. Moreover, pentraxin 3 plays a nonredundant role in the regulation of cardiac tissue damage in mice and, recently, it has been proposed as a new candidate marker for acute and chronic heart diseases. However, the actual localization and cellular sources of pentraxin 3 in ischemic and infectious cardiac pathology have not been carefully defined. METHODS In this study, using immunohistochemistry, we analyzed pentraxin 3 expression in the heart tissues of patients with acute myocardial infarction at different time points after the ischemic event. In addition, we studied the heart tissues of patients with infectious myocarditis (fungi, bacteria, and protozoa) and patients who died of noncardiac events with normal heart histology. RESULTS In acute myocardial infarction cases, we observed pentraxin 3 localized within and around ischemic lesions. On the contrary, no pentraxin 3 was observed in normal heart areas. In early ischemic lesions, pentraxin 3 was localized primarily in granulocytes; in more advanced acute myocardial infarction, pentraxin 3 positivity was found in the interstitium and in the cytoplasm of macrophages and the endothelium, whereas most granulocytes did not express pentraxin 3, presumably as a consequence of degranulation. In infectious myocarditis, pentraxin 3 was present and localized within and around histological lesions, associated with macrophage, endothelial cell, and, more rarely, myocardiocyte and granulocyte positivities. As observed in acute myocardial infarction patients, no pentraxin 3 staining was found in normal heart areas. CONCLUSIONS Thus, neutrophils are an early source of pentraxin 3 in acute myocardial infarction and presumably other inflammatory heart disorders. Subsequently, in acute myocardial infarction and infectious myocarditis, pentraxin 3 is produced by macrophages, the endothelium, and, to a lesser extent, myocardiocytes, and localized in the interstitium.
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Affiliation(s)
- Manuela Nebuloni
- Pathology Unit, L. Sacco Department of Clinical Sciences, L. Sacco Hospital, Università degli Studi di Milano, Milan, Italy
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Delbue S, Branchetti E, Boldorini R, Vago L, Zerbi P, Veggiani C, Tremolada S, Ferrante P. Presence and expression of JCV early gene large T Antigen in the brains of immunocompromised and immunocompetent individuals. J Med Virol 2008; 80:2147-52. [PMID: 19040292 DOI: 10.1002/jmv.21313] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
JC virus (JCV) is a polyomavirus that asymptomatically infects up to 80% of the worldwide human population and establishes latency in the kidney. In the case of host immunodeficiency, it can cause progressive multifocal leukoencephalopathy (PML), which is a fatal demyelinating disease of the central nervous system. In an attempt to understand better PML pathogenesis and JCV infection, the presence of the JCV genome and expression of the early viral protein in the brain of deceased individuals, with and without HIV infection, was investigated. Sixty autopsy samples of brain tissues were collected from 15 HIV-positive PML patients, 15 HIV-positive patients with other neurological diseases, 15 HIV-positive patients without neurological disorders, and 15 HIV-negative individuals who died from diseases unrelated to the central nervous system. By means of specific Real Time Polymerase Chain Reaction, the JCV genome was detected in 14 of 15 PML brains, three of 15 HIV-positive brains (with and without neurological diseases), and 1 of 15 HIV-negative brains. JCV genotyping was also performed. Expression of the early JCV protein T Antigen was verified by a specific immunohistochemistry assay, and it was found in the brain tissues from 12 PML cases and one case with other neurological disease. The data obtained demonstrate that infection of the brain with JCV can also be observed in the brains of HIV-negative individuals, without neurological disorders. However, viral protein expression was limited to PML brains and to one brain from a patient with other neurological disease, suggesting that JCV can also be present in the brains of patients without PML.
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Affiliation(s)
- Serena Delbue
- Department of Biomedical Sciences and Technologies, University of Milan, Milan, Italy
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Nebuloni M, Cinque P, Sidenius N, Ferri A, Lauri E, Omodeo-Zorini E, Zerbi P, Vago L. Expression of the urokinase plasminogen activator receptor (uPAR) and its ligand (uPA) in brain tissues of human immunodeficiency virus patients with opportunistic cerebral diseases. J Neurovirol 2008; 15:99-107. [PMID: 19115132 DOI: 10.1080/13550280802400692] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The urokinase plasminogen activator receptor (uPAR) and its ligand (uPA) play an important role in cell migration and extracellular proteolysis. We previously described uPAR/uPA overexpression in the cerebrospinal fluid (CSF) and brain tissues of patients with human immunodeficiency virus (HIV)-related cerebral diseases. In this study, we examined uPAR/uPA expression by immunohistochemistry (IHC) in brains of HIV patients with opportunistic cerebral lesions and in HIV-positive/negative controls. uPAR was found in macrophages/microglia with the highest levels in cytomegalovirus (CMV) encephalitis, toxoplasmosis, and lymphomas; in cryptococcosis and progressive multifocal leukoencephalopathy (PML) cases, only a few positive cells were found and no positivity was observed in controls. uPA expression was demonstrated only in a few macrophages/microglia and lymphocytes in all the cases and HIV-positive controls without different pattern of distribution; no uPA immunostaining was found in cryptococcosis and HIV-negative controls. The higher expression of uPAR/uPA in most of the opportunistic cerebral lesions supports their role in these diseases, suggesting their contribution to tissue injury.
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Affiliation(s)
- Manuela Nebuloni
- Pathology Unit, L. Sacco Department of Clinical Sciences, L. Sacco Hospital, University of Milan, via G.B. Grassi 74, Milan, Italy.
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Bargiggia S, Parente F, Ucci G, Tricomi P, Zerbi P, Vago L. Bleeding gastric metastatic melanoma. Dig Liver Dis 2008; 40:699. [PMID: 18339593 DOI: 10.1016/j.dld.2008.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Revised: 02/01/2008] [Accepted: 02/01/2008] [Indexed: 12/11/2022]
Affiliation(s)
- S Bargiggia
- Department of Gastroenterology & Endoscopy, A. Manzoni Hospital, Via dell'Eremo 9/11, Lecco 23900, Italy.
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Gazzola L, Zanini F, Zerbi P, Franzetti F, Gori A. The usefulness of PCR assay in diagnosing disseminated mycobacterial infection in AIDS patients. Eur J Clin Microbiol Infect Dis 2007; 27:163-6. [PMID: 17999096 DOI: 10.1007/s10096-007-0407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 09/29/2007] [Indexed: 12/01/2022]
Affiliation(s)
- L Gazzola
- Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Via A. di Rudinì, 8, 20142 Milan, Italy.
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Schiavini M, Angeli E, Mainini A, Zerbi P, Duca PG, Gubertini G, Vago L, Fociani P, Giorgi R, Cargnel A. Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985-2002. HIV Med 2007; 7:331-7. [PMID: 16945079 DOI: 10.1111/j.1468-1293.2006.00384.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To identify predictive factors for moderate/severe liver fibrosis and to analyse fibrosis progression in paired liver biopsies from HIV-positive patients with chronic hepatitis C virus (HCV) infection. METHODS HIV/HCV coinfected patients followed at the 2nd Department of Infectious Diseases of L. Sacco Hospital in Milan, Italy, with at least one liver biopsy specimen were retrospectively evaluated. RESULTS A total of 110 patients were enrolled in the study. In a univariate analysis, predictive factors of Ishak-Knodell stage > or =3 were a history of alcohol abuse [odds ratio (OR) 3.6, P=0.004], alanine aminotransferase level >100 IU/L at biopsy (OR 2.4, P=0.05), necro-inflammatory grade > or =9 (OR 37.14, P<0.0001) and CD4 count <350 cells/microL at nadir (OR 5.3, P=0.05). In a multivariate analysis, age >35 years (OR 3.19, P=0.04) and alcohol abuse (OR 4.36, P=0.002) remained independently associated with Ishak-Knodell stage. Paired liver biopsies were available in 36 patients; 18 showed an increase of at least one stage in the subsequent liver biopsy. Either in a univariate or in a multivariate analysis, a decrease of CD4 cell count of more than 10% between two biopsies (OR 6.85, P=0.002) was significantly associated with liver fibrosis progression. CONCLUSION Our findings highlight the relevance of encouraging a withdrawal of alcohol consumption in people with chronic HCV infection and of carrying out close follow-up of patients, especially if they are more than 35 years old. It is therefore mandatory to evaluate HIV/HCV coinfected patients for anti-HCV treatment and to increase CD4 cell count through antiretroviral therapy in order to reduce the risk of fibrosis progression and to slow the evolution of liver disease.
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Affiliation(s)
- M Schiavini
- 2nd Department of Infectious Diseases, Sacco Hospital, Milan, Italy.
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Aliberti S, Falleni M, Tarsia P, Vago G, Zerbi P, Barberis M, Valenti V, Blasi F. A 13-year-old female with shortness of breath and pleuritic chest pain. Eur Respir J 2007; 28:876-82. [PMID: 17012634 DOI: 10.1183/09031936.06.00021006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S Aliberti
- Institute of Respiratory Diseases, University of Milan, IRCCS Fondazione Policlinico-Mangiagalli-Regina Elena Milano, Milan, Italy
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Puoti G, Giaccone G, Mangieri M, Limido L, Fociani P, Zerbi P, Suardi S, Rossi G, Iussich S, Capobianco R, Di Fede G, Marcon G, Cotrufo R, Filippini G, Bugiani O, Tagliavini F. Sporadic Creutzfeldt-Jakob disease: the extent of microglia activation is dependent on the biochemical type of PrPSc. J Neuropathol Exp Neurol 2005; 64:902-9. [PMID: 16215462 DOI: 10.1097/01.jnen.0000183346.19447.55] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In prion-related encephalopathies, microglial activation occurs early and is dependent on accumulation of disease-specific forms of the prion protein (PrPSc) and may play a role in nerve cell death. Previously, we found that different types of PrPSc (i.e. type 1 and type 2) coexisted in approximately 25% of patients with sporadic Creutzfeldt-Jakob disease (CJD); and a close relationship was detected between PrPSc type, the pattern of PrP immunoreactivity, and extent of spongiform degeneration. To investigate whether microglial reaction is related to the biochemical type and deposition pattern of PrPSc, we carried out a neuropathologic and biochemical study on 26 patients with sporadic CJD, including all possible genotypes at codon 129 of the prion protein gene. By quantitative analysis, we demonstrated that strong microglial activation was associated with type 1 PrPSc and diffuse PrP immunoreactivity, whereas type 2 PrPSc and focal PrP deposits were accompanied by mild microglia reaction. These findings support the view that the phenotypic heterogeneity of sporadic CJD is largely determined by the physicochemical properties of distinct PrPSc conformers.
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Affiliation(s)
- Gianfranco Puoti
- Istituto Nazionale Neurologico Carlo Besta, Milano, and Dipartimento di Scienze Neurologiche, Seconda Università di Napoli, Napoli, Italy
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Tosoni A, Nebuloni M, Zerbi P, Vago L, Comotti C, Sessa A. Ultrastructural study of renal involvement in two females with Anderson-Fabry disease. Ultrastruct Pathol 2005; 29:203-7. [PMID: 16036875 DOI: 10.1080/01913120590951202] [Citation(s) in RCA: 7] [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: 10/25/2022]
Abstract
Anderson-Fabry disease (AFD) is a rare X-linked lipid storage disorder due to a deficient lysosomal a-galactosidase A (a-Gal) activity. In males with the classic form of the disease the enzymatic defect leads to progressive accumulation of glycosphingolipids (GL) in different organs, mainly in the kidney, heart, and brain, causing severe multisystem failure. AFD is usually mild in heterozygous females, but severe cerebrovascular, renal, and cardiac manifestations have been rarely described. The aim of this study is to describe renal involvement of mild symptomatic female carriers by ultrastructural analysis focusing to microvascular lesions, considered to be one of the major causes of systemic disease in AFD. Resin-embedded renal biopsies from 2 sisters with isolated mild proteinuria and belonging to a family group with AFD were observed by light and electron microscopy. In spite of the mild clinical symptoms, diffuse GL storages were demonstrated in all types of glomerular cells and in interstitial endothelial cells. Moreover, platelets were frequently observed in glomerular vassels, a feature coherent with a possible role of prothrombotic state, and platelet activation, in early glomerular lesions.
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Affiliation(s)
- A Tosoni
- Department of Medical Science, Pathology Unit, L. Sacco Hospital, Milan, Italy.
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Maconi G, Colombo E, Zerbi P, Sampietro GM, Fociani P, Bosani M, Cassinotti A, Casini V, Russo A, Ardizzone S, Porta M, Bianchi Porro G. Prevalence, detection rate and outcome of cytomegalovirus infection in ulcerative colitis patients requiring colonic resection. Dig Liver Dis 2005; 37:418-23. [PMID: 15893280 DOI: 10.1016/j.dld.2005.01.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Accepted: 01/21/2005] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the prevalence of cytomegalovirus infection in patients with steroid-refractory ulcerative colitis who required colonic resection, and to assess its possible association with the use of immunosuppressive and steroid treatment and outcome after colectomy. PATIENTS AND METHODS The study included surgical specimens and related pre-operative endoscopic biopsy specimens of 77 consecutive ulcerative colitis patients (34 females) who underwent colectomy because of intractable steroid-refractory ulcerative colitis (55 patients), toxic megacolon (6 patients), dysplasia or cancer (7 patients) or loss of function of the colon (9 patients). Clinical features and current and past treatments were analysed. Haematoxylin and eosin and specific immunohistochemical staining for cytomegalovirus were used to detect inclusion bodies in all specimens. RESULTS Cytomegalovirus infection was found in 15 of 55 steroid-refractory ulcerative colitis patients (27.3%) and in 2 of 22 non-refractory patients (9.1%) (p=0.123). Only six patients had positive staining for cytomegalovirus in pre-operative endoscopic biopsy specimens. Detection of cytomegalovirus inclusion in biopsy specimens was not related to the number of biopsies or to time that had elapsed since colonoscopy and index surgery. Cytomegalovirus-positive patients were more likely to be on systemic corticosteroids (p=0.03). In contrast, current use and duration of immunosuppressive treatment, number of steroid cycles since diagnosis and in the last year, as well as chronic use of steroid in the last year were not significantly related to cytomegalovirus infection. Cytomegalovirus-positive patients did not receive antiviral therapy following proctocolectomy but did not show endoscopic or histological cytomegalovirus reactivation in the ileo-anal pouch and in the remaining bowel. CONCLUSIONS Cytomegalovirus infection is frequently found in surgical specimens of patients with steroid-refractory ulcerative colitis and is more likely in patients on corticosteroid treatment. Cytomegalovirus infection is frequently unrecognised in pre-operative biopsy specimens, thus raising concerns about the accuracy of the available diagnostic tools. Unrecognised and untreated cytomegalovirus infection does not affect the outcome of ulcerative colitis patients following proctocolectomy.
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Affiliation(s)
- G Maconi
- Department of Gastroenterology, L. Sacco University Hospital, Via G.B. Grassi, 74, 20157 Milan, Italy.
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Parente F, Anderloni A, Zerbi P, Lazzaroni M, Sampietro G, Danelli P, Bianchi Porro G. Intermittent small-bowel obstruction caused by gastric adenocarcinoma in a Meckel's diverticulum. Gastrointest Endosc 2005; 61:180-3. [PMID: 15672086 DOI: 10.1016/s0016-5107(04)02450-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [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: 02/08/2023]
Affiliation(s)
- Fabrizio Parente
- Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy
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Parente F, Molteni M, Anderloni A, Lazzaroni M, Bianchi Porro G, Danelli PG, Sampietro G, Zerbi P. Carcinoid mimicking ileal Crohn's disease. Gastrointest Endosc 2005; 61:105-6. [PMID: 15672068 DOI: 10.1016/s0016-5107(04)02383-1] [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: 02/08/2023]
Affiliation(s)
- Fabrizio Parente
- Academic Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy
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Sidenius N, Nebuloni M, Sala S, Zerbi P, Price RW, Gisslen M, Hagberg L, Vago L, Lazzarin A, Blasi F, Cinque P. Expression of the urokinase plasminogen activator and its receptor in HIV-1-associated central nervous system disease. J Neuroimmunol 2004; 157:133-9. [PMID: 15579290 DOI: 10.1016/j.jneuroim.2004.08.038] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2004] [Indexed: 11/30/2022]
Abstract
The urokinase plasminogen activator (uPA) and its receptor (uPAR) play important physiological functions in extracellular proteolysis, as well as cell adhesion and migration. Through dysregulation of these functions, the uPA/uPAR system might be involved in the pathogenesis of AIDS dementia complex (ADC), and, in fact, uPAR has been found to be overexpressed in the cerebrospinal fluid (CSF) and brain tissues of patients with ADC. On the other hand, its ligand uPA has been shown to down-regulate HIV replication in vitro. In this study, we examined uPAR and uPA expression in the brain of HIV-related lesions, as well as CSF levels of soluble uPAR (suPAR), uPA, and complexes between these two molecules (suPAR/uPA) in patients with HIV infection with or without ADC. uPAR was highly expressed by macrophages in both HIV encephalitis (HIV-E) or leukoencephalopathy (HIV-LE), with a distribution exceeding that of HIV p24 antigen. In contrast, uPA was detected only on rare cells in most of the cases. Both uPA and suPAR/uPA complex concentrations were significantly correlated with CSF suPAR levels, and CSF concentrations of both markers were higher in ADC patients than controls. However, uPA levels were substantially lower than corresponding suPAR levels. Although these findings remain correlative, they add support to the hypothesis that uPAR might be an important participant in the events leading to ADC. Additionally, these findings are consistent with a model in which overexpression of uPAR and overproduction of its soluble form may promote HIV replication via binding and removal of uPA from cell surface.
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Affiliation(s)
- Nicolai Sidenius
- Molecular Genetics Unit, DIBIT, San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan, Italy
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Parente F, Anderloni A, Zerbi P, Morandi E, Trabucchi E, Bianchi Porro G. Giant bleeding stromal tumor. Gastrointest Endosc 2004; 60:100-1. [PMID: 15229437 DOI: 10.1016/s0016-5107(04)01297-0] [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: 12/10/2022]
Affiliation(s)
- Fabrizio Parente
- Division of Gastroenterology, Department of Surgery, Pathology Service, L. Sacco University Hospital, Milan, Italy
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Affiliation(s)
- Fabrizio Parente
- Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy
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Fociani P, Carsana L, Zerbi P, Ferri A, Sampietro GM, Vago G. [Histopathological differential diagnosis in inflammatory bowel diseases]. Ann Ital Chir 2003; 74:641-9. [PMID: 15206805] [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: 04/29/2023]
Abstract
In front of the suspicious diagnosis of an inflammatory bowel disease (IBD), the pathologist must have adequate and complete clinical, anamnestic, instrumental informations and, if possible, the previous histopathologic examinations. This is necessary because: the diagnosis of IBD is made with exclusion criteria, different pathologic entities may have similar macroscopic and microscopic findings and the characteristic lesions are often present in little number. The authors consider in this paper the problem of the differential diagnosis of IBD.
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Affiliation(s)
- P Fociani
- Unità Operativa di Anatomia Patologica dell'Azienda Ospedaliera L. Sacco, Milano
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Vago L, Bonetto S, Nebuloni M, Duca P, Carsana L, Zerbi P, D'Arminio-Monforte A. Pathological findings in the central nervous system of AIDS patients on assumed antiretroviral therapeutic regimens: retrospective study of 1597 autopsies. AIDS 2002; 16:1925-8. [PMID: 12351952 DOI: 10.1097/00002030-200209270-00009] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the prevalence of HIV-related central nervous system (CNS) lesions (HIV-encephalitis and/or HIV-leukoencephalopathy: HIV-E/L) with and without concomitant opportunistic diseases in a large autopsy series, and to correlate it with the changes in antiretroviral treatment that have occurred since the beginning of the epidemic. METHODS We reviewed 1597 consecutive autopsies of HIV-positive patients performed between 1984 and 2000, and divided into four time periods on the basis of the therapeutic regimens available: 1984-1987, no therapy; 1988-1994, monotherapy (zidovudine); 1995-1996, dual combination therapy with nucleoside reverse transcriptase inhibitors (NRTI); and 1997-2000, triple combination therapy including two NRTI and at least one protease inhibitor or non-NRTI. The data concerning the treatment actually received were collected only for the patients who died during the last period. The chi -test was used to assess the significance of the differences in prevalence. RESULTS The CNS of 1210 patients (76%) was affected by opportunistic diseases, HIV-related lesions or both. The prevalence of HIV-related lesions in the four periods was respectively 54%, 32%, 18% and 15%; this reduction was statistically significant (P < 0.000001). During the last period, however, differences in HIV-E/L between treated and untreated patients were not statistically significant, although there were fewer than expected cases among the treated patients (six instead of eight) and more than expected among the untreated patients (10 instead of eight). CONCLUSIONS These neuropathological data from a large autopsy series confirm clinical observations concerning the efficacy of antiretroviral treatment in reducing the frequency of HIV-related CNS lesions in AIDS patients.
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Affiliation(s)
- Luca Vago
- Pathology Unit, Department of Clinical Sciences L. Sacco, University of Milan, Italy
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Abstract
We evaluate cellular prion protein (PrP(C)) immunoreactivity (IR) in Alzheimer's, Parkinson's, diffuse Lewy body, and motor neuron diseases (MND), progressive supranuclear palsy, and multiple system atrophy. We use immunohistochemistry for PrP, including five monoclonal antibodies against different epitopes and three different pretreatments, alpha-synuclein, phosphorylated tau, beta-amyloid, and ubiquitin. Disease-specific inclusions are devoid of PrP(C) IR. Using double immunofluorescence and confocal laser microscopy we observe focal overlapping of PrP(C) with tau and with alpha-synuclein in early, but not in fully developed inclusions. However, PrP(C) IR neurons may contain abnormal tau or alpha-synuclein aggregates. Additionally, we observe a loss of PrP(C) IR in anterior horn neurons in MND. Our results suggest that expression of PrP(C) reflects a general response to cellular stress rather than specific co-operation in aggregation of other proteins.
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Affiliation(s)
- Gabor G Kovacs
- Institute of Neurology, University of Vienna, and Austrian Reference Centre for Human Prion Diseases, AKH 4J, Währinger Gürtel 18-20, PO Box 48, A-1097 Vienna, Austria
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Zerbi P, Schønau A, Bonetto S, Gori A, Costanzi G, Duca P, Vago L. Amplified in situ hybridization with peptide nucleic acid probes for differentiation of Mycobacterium tuberculosis complex and nontuberculous Mycobacterium species on formalin-fixed, paraffin-embedded archival biopsy and autopsy samples. Am J Clin Pathol 2001; 116:770-5. [PMID: 11710696 DOI: 10.1309/k7xc-0vxf-ke10-0ufh] [Citation(s) in RCA: 15] [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: 10/26/2022] Open
Abstract
The aim of this study was to evaluate sensitivity and specificity of in situ hybridization (ISH) using peptide nucleic acid (PNA) probes and tyramide-based amplification for the differentiation between Mycobacterium tuberculosis (MTB) and mycobacteria other than tuberculosis (MOTT) on formalin-fixed, paraffin-embedded tissue samples. We performed ISH simultaneously with both probes on 86 specimens from different organs: 70 obtained at autopsy and 16 by biopsy, all with a histologic evidence of mycobacterial infection confirmed by Ziehl-Neelsen-positive staining. Taking culture as the "gold standard," the sensitivity and the specificity of the MTB probe were 100% (41/41) and 95% (38/40), respectively. In only 2 cases ISH failed to identify mycobacteria. Culture results were not available in 3 cases. We propose ISH as a relatively simple and rapid method to differentiate mycobacteria on formalin-fixed, paraffin-embedded specimens (it is more specific than usual histologic stains) and as an alternative to polymerase chain reaction, allowing the morphologic evaluation of positive bacilli.
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Affiliation(s)
- P Zerbi
- Pathology Unit, Institute of Biomedical Sciences, L. Sacco University of Milan, Italy
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