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Barbieri E, Giordano M, Sorgente G, Borgia G, Improta M, Colonna M, Crisci V, Fattorusso V, Barbieri F, Buonocore G, De Bernardo G. Use and Efficacy of I-Gel in Complicated Intubations in Newborn Infants: A Review of Case Reports in the Literature. Curr Pediatr Rev 2024; 20:CPR-EPUB-140048. [PMID: 38685776 DOI: 10.2174/0115733963295361240426064436] [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: 11/27/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Current guidelines for neonatal resuscitation suggest the use of a laryngeal mask when ventilation with both facemask and endotracheal tube has failed in newborns weighing >2000 g or delivered ≥ 34 weeks of gestation age. Paediatric I-gel® is one of the latest supraglottic airway management devices suitable for children and newborns. I-gel® use was effective in guaranteeing adequate ventilation in patients with anatomic abnormalities in case of respiratory impairment or during surgical procedures after the induction of anaesthesia. OBJECTIVE The purpose of our review was to evaluate the use and efficacy of I-gel® in case of complicated intubations. METHODS In July 2023, two authors of this paper independently conducted searches of the MEDLINE, Web of Science, and Scopus databases without imposing any time constraints or other restrictions. Three case reports were included, each describing the use of I-gel® device in difficult intubations in newborns with anatomical abnormalities. RESULTS No difficulties were reported in the insertion of the device, which was placed even by inexperienced clinicians. CONCLUSION The data collected highlighted the possibility of using I-gel® not only as a rescue device after attempted and failed endotracheal placement but also as a first choice in selected patients. Studies on larger cohorts would be needed. Further research involving larger patient cohorts of multicentre NICUs is necessary to confirm the use of laryngeal masks in neonates weighing less than 2000 grams.
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Affiliation(s)
- Emiliano Barbieri
- Division of Pediatrics, Department of Transaltional Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Maurizio Giordano
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Sorgente
- Division of Pediatrics, Department of Transaltional Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giulia Borgia
- Division of Pediatrics, Department of Transaltional Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Marta Improta
- Division of Pediatrics, Department of Transaltional Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Monica Colonna
- Department of Woman and Child, Ospedale "Buon Consiglio Fatebenefratelli", Naples, Italy
| | - Valeria Crisci
- Department of Medicine and Surgery, "Scuola Medica Salernitana", Section of Pediatrics, University of Salerno, Salerno, Italy
| | - Valentina Fattorusso
- Department of Woman and Child, Ospedale "Buon Consiglio Fatebenefratelli", Naples, Italy
| | - Flavia Barbieri
- Department of Woman and Child, Ospedale "Buon Consiglio Fatebenefratelli", Naples, Italy
| | - Giuseppe Buonocore
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Giuseppe De Bernardo
- Department of Woman and Child, Ospedale "Buon Consiglio Fatebenefratelli", Naples, Italy
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2
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Garavelli S, Bruzzaniti S, Tagliabue E, Di Silvestre D, Prattichizzo F, Mozzillo E, Fattorusso V, La Sala L, Ceriello A, Puca AA, Mauri P, Strollo R, Marigliano M, Maffeis C, Petrelli A, Bosi E, Franzese A, Galgani M, Matarese G, de Candia P. Plasma circulating miR-23~27~24 clusters correlate with the immunometabolic derangement and predict C-peptide loss in children with type 1 diabetes. Diabetologia 2020; 63:2699-2712. [PMID: 32728892 DOI: 10.1007/s00125-020-05237-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS We aimed to analyse the association between plasma circulating microRNAs (miRNAs) and the immunometabolic profile in children with type 1 diabetes and to identify a composite signature of miRNAs/immunometabolic factors able to predict type 1 diabetes progression. METHODS Plasma samples were obtained from children at diagnosis of type 1 diabetes (n = 88) and at 12 (n = 32) and 24 (n = 30) months after disease onset and from healthy control children with similar sex and age distribution (n = 47). We quantified 60 robustly expressed plasma circulating miRNAs by quantitative RT-PCR and nine plasma immunometabolic factors with a recognised role at the interface of metabolic and immune alterations in type 1 diabetes. Based on fasting C-peptide loss over time, children with type 1 diabetes were stratified into the following groups: those who had lost >90% of C-peptide compared with diagnosis level; those who had lost <10% of C-peptide; those showing an intermediate C-peptide loss. To evaluate the modulation of plasma circulating miRNAs during the course of type 1 diabetes, logistic regression models were implemented and the correlation between miRNAs and immunometabolic factors was also assessed. Results were then validated in an independent cohort of children with recent-onset type 1 diabetes (n = 18). The prognostic value of the identified plasma signature was tested by a neural network-based model. RESULTS Plasma circulating miR-23~27~24 clusters (miR-23a-3p, miR-23b-3p, miR-24-3p, miR-27a-3p and miR-27b-3p) were upmodulated upon type 1 diabetes progression, showed positive correlation with osteoprotegerin (OPG) and were negatively correlated with soluble CD40 ligand, resistin, myeloperoxidase and soluble TNF receptor in children with type 1 diabetes but not in healthy children. The combination of plasma circulating miR-23a-3p, miR-23b-3p, miR-24-3p, miR-27b-3p and OPG, quantified at disease onset, showed a significant capability to predict the decline in insulin secretion 12 months after disease diagnosis in two independent cohorts of children with type 1 diabetes. CONCLUSIONS/INTERPRETATIONS We have pinpointed a novel miR-23a-3p/miR-23b-3p/miR-24-3p/miR-27b-3p/OPG plasma signature that may be developed into a novel blood-based method to better stratify patients with type 1 diabetes and predict C-peptide loss.
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Affiliation(s)
- Silvia Garavelli
- IRCCS MultiMedica, via G. Fantoli 16/15, 20138, Milan, Italy
- Institute for Endocrinology and Experimental Oncology 'G. Salvatore', C.N.R, via Pansini 5, 80131, Naples, Italy
| | - Sara Bruzzaniti
- Institute for Endocrinology and Experimental Oncology 'G. Salvatore', C.N.R, via Pansini 5, 80131, Naples, Italy
- Department of Biology, University of Naples 'Federico II', Naples, Italy
| | - Elena Tagliabue
- IRCCS MultiMedica, via G. Fantoli 16/15, 20138, Milan, Italy
| | | | | | - Enza Mozzillo
- Centre of Paediatric Diabetology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy
| | - Valentina Fattorusso
- Centre of Paediatric Diabetology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy
| | - Lucia La Sala
- IRCCS MultiMedica, via G. Fantoli 16/15, 20138, Milan, Italy
| | | | - Annibale A Puca
- IRCCS MultiMedica, via G. Fantoli 16/15, 20138, Milan, Italy
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - Pierluigi Mauri
- Institute of Biomedical Technologies, C. N. R, Segrate, Milan, Italy
| | - Rocky Strollo
- Department of Medicine, Unit of Endocrinology & Diabetes, Università Campus Bio-Medico, Rome, Italy
| | - Marco Marigliano
- Paediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Claudio Maffeis
- Paediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Alessandra Petrelli
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Emanuele Bosi
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Adriana Franzese
- Centre of Paediatric Diabetology, Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy
| | - Mario Galgani
- Institute for Endocrinology and Experimental Oncology 'G. Salvatore', C.N.R, via Pansini 5, 80131, Naples, Italy.
- Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II', via Pansini 5, 80131, Naples, Italy.
| | - Giuseppe Matarese
- Institute for Endocrinology and Experimental Oncology 'G. Salvatore', C.N.R, via Pansini 5, 80131, Naples, Italy.
- Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II', via Pansini 5, 80131, Naples, Italy.
| | - Paola de Candia
- IRCCS MultiMedica, via G. Fantoli 16/15, 20138, Milan, Italy.
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3
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Bruzzaniti S, Cirillo E, Prencipe R, Giardino G, Lepore MT, Garziano F, Perna F, Procaccini C, Mascolo L, Pagano C, Fattorusso V, Mozzillo E, Bifulco M, Matarese G, Franzese A, Pignata C, Galgani M. CD4 + T Cell Defects in a Mulibrey Patient With Specific TRIM37 Mutations. Front Immunol 2020; 11:1742. [PMID: 33042106 PMCID: PMC7530177 DOI: 10.3389/fimmu.2020.01742] [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: 05/18/2020] [Accepted: 06/30/2020] [Indexed: 01/10/2023] Open
Abstract
Mulibrey (muscle-liver-brain-eye) syndrome (MUL) is an autosomal recessive disorder caused by mutations in the TRIpartite motif (TRIM)37 gene, encoding for TRIM37 a member of the TRIM E3 ubiquitin ligase protein family. MUL patients are characterized by growth retardation, dysmorphic features, and a wide range of abnormalities affecting different organs. However, T-cell abnormalities have not been observed in MUL subjects, to date. Here we described the immunological features of a MUL child carrying recently identified TRIM37 mutations, a 17q22 deletion of maternal origin combined with a TRIM37 variant of paternal origin. Here we found quantitative and functional defects in CD4+ T cells from this MUL case. Low levels of TRIM37 protein were specifically detected in CD4+ T cells of MUL patient and associated with their altered proliferation and cytokine production. Of note, both CD4+ and CD8+ T lymphocytes of MUL child displayed an effector memory phenotype compared with healthy children. This clinical case research highlighted the possible role of TRIM37 in the control of immune cell number and function, especially in CD4+ T cells. Finally, this study may contribute to the novel mechanistic studies aim of identifying, in depth, the role of the TRIM37 protein in the immune system.
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Affiliation(s)
- Sara Bruzzaniti
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy.,Dipartimento di Biologia, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Emilia Cirillo
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Rosaria Prencipe
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Giuliana Giardino
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Maria Teresa Lepore
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy
| | | | - Francesco Perna
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Claudio Procaccini
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy.,Unità di Neuroimmunologia, Fondazione Santa Lucia, Rome, Italy
| | - Luigi Mascolo
- Divisione di Farmacologia, Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Cristina Pagano
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Valentina Fattorusso
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Enza Mozzillo
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Maurizio Bifulco
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Giuseppe Matarese
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Adriana Franzese
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Claudio Pignata
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Mario Galgani
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II", Naples, Italy
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4
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Casertano A, De Matteis A, Mozzillo E, Rosanio FM, Buono P, Fattorusso V, Franzese A. Diagnosis of congenital Hyperinsulinism can occur not only in infancy but also in later age: a new flow chart from a single center experience. Ital J Pediatr 2020; 46:131. [PMID: 32928245 PMCID: PMC7490857 DOI: 10.1186/s13052-020-00894-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Congenital Hyperinsulinism typically occurs with a neonatal hypoglycemia but can appear even in childhood or in adolescence with different types of glucose metabolism derangements. Current diagnostic algorithms don't take into account cases with a late presentation. PATIENTS AND METHODS Clinical and laboratory data of twenty-two subjects diagnosed at Federico II University of Naples have been described: patients have been divided according to the molecular defect into channel defects, metabolic defects and unidentified molecular defects. A particular focus has been made on three cases with a late presentation. RESULTS AND CONCLUSIONS Late presentation cases may not be identified by previous diagnostic algorithms. Consequently, it seems appropriate to design a new flow-chart starting from the age of presentation, also considering that late presentation cases can show glucose metabolism derangements other than hypoglycaemic crises such as diabetes, glucose intolerance, postprandial hypoglycaemia and gestational diabetes.
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Affiliation(s)
- Alberto Casertano
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Arianna De Matteis
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Francesco Maria Rosanio
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Pietro Buono
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Valentina Fattorusso
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
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5
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Terrazzano G, Bruzzaniti S, Rubino V, Santopaolo M, Palatucci AT, Giovazzino A, La Rocca C, de Candia P, Puca A, Perna F, Procaccini C, De Rosa V, Porcellini C, De Simone S, Fattorusso V, Porcellini A, Mozzillo E, Troncone R, Franzese A, Ludvigsson J, Matarese G, Ruggiero G, Galgani M. T1D progression is associated with loss of CD3 +CD56 + regulatory T cells that control CD8 + T cell effector functions. Nat Metab 2020; 2:142-152. [PMID: 32500117 PMCID: PMC7272221 DOI: 10.1038/s42255-020-0173-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An unresolved issue in autoimmunity is the lack of surrogate biomarkers of immunological self-tolerance for disease monitoring. Here, we show that peripheral frequency of a regulatory T cell population, characterized by the co-expression of CD3 and CD56 molecules (TR3-56), is reduced in subjects with new-onset type 1 diabetes (T1D). In three independent T1D cohorts, we find that low frequency of circulating TR3-56 cells is associated with reduced β-cell function and with the presence of diabetic ketoacidosis. As autoreactive CD8+ T cells mediate disruption of insulin-producing β-cells1-3, we demonstrate that TR3-56 cells can suppress CD8+ T cell functions in vitro by reducing levels of intracellular reactive oxygen species. The suppressive function, phenotype and transcriptional signature of TR3-56 cells are also altered in T1D children. Together, our findings indicate that TR3-56 cells constitute a regulatory cell population that controls CD8+ effector functions, whose peripheral frequency may represent a traceable biomarker for monitoring immunological self-tolerance in T1D.
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Affiliation(s)
- Giuseppe Terrazzano
- Dipartimento di Scienze, Università degli Studi di Potenza, Potenza, Italy
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Sara Bruzzaniti
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
- Dipartimento di Biologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Valentina Rubino
- Dipartimento di Scienze, Università degli Studi di Potenza, Potenza, Italy
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Marianna Santopaolo
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
| | | | - Angela Giovazzino
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Claudia La Rocca
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Paola de Candia
- Istituto di Ricovero e Cura a Carattere Scientifico MultiMedica, Milan, Italy
| | - Annibale Puca
- Istituto di Ricovero e Cura a Carattere Scientifico MultiMedica, Milan, Italy
| | - Francesco Perna
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Claudio Procaccini
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
- Unità di Neuroimmunologia, Fondazione Santa Lucia, Rome, Italy
| | - Veronica De Rosa
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
- Unità di Neuroimmunologia, Fondazione Santa Lucia, Rome, Italy
| | - Chiara Porcellini
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Salvatore De Simone
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Valentina Fattorusso
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Antonio Porcellini
- Dipartimento di Biologia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Enza Mozzillo
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Riccardo Troncone
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Disease, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Adriana Franzese
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Johnny Ludvigsson
- Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University and Crown Princess Victoria Children's Hospital, Linköping, Sweden
| | - Giuseppe Matarese
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy.
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy.
| | - Giuseppina Ruggiero
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy.
| | - Mario Galgani
- Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale G. Salvatore, Consiglio Nazionale delle Ricerche, Naples, Italy.
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Naples, Italy.
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6
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Garavelli S, Bruzzaniti S, Tagliabue E, Prattichizzo F, Di Silvestre D, Perna F, La Sala L, Ceriello A, Mozzillo E, Fattorusso V, Mauri P, Puca AA, Franzese A, Matarese G, Galgani M, de Candia P. Blood Co-Circulating Extracellular microRNAs and Immune Cell Subsets Associate with Type 1 Diabetes Severity. Int J Mol Sci 2020; 21:ijms21020477. [PMID: 31940853 PMCID: PMC7013659 DOI: 10.3390/ijms21020477] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 12/17/2022] Open
Abstract
Immune cell subsets and microRNAs have been independently proposed as type 1 diabetes (T1D) diagnostic and/or prognostic biomarkers. Here, we aimed to analyze the relationships between peripheral blood circulating immune cell subsets, plasmatic microRNAs, and T1D. Blood samples were obtained from both children with T1D at diagnosis and age-sex matched healthy controls. Then, immunophenotype assessed by flow cytometry was coupled with the quantification of 60 plasmatic microRNAs by quantitative RT-PCR. The associations between immune cell frequency, plasmatic microRNAs, and the parameters of pancreatic loss, glycemic control, and diabetic ketoacidosis were assessed by logistic regression models and correlation analyses. We found that the increase in specific plasmatic microRNAs was associated with T1D disease onset (let-7c-5p, let-7d-5p, let-7f-5p, let-7i-5p, miR-146a-5p, miR-423-3p, and miR-423-5p), serum C-peptide concentration (miR-142-5p and miR-29c-3p), glycated hemoglobin (miR-26a-5p and miR-223-3p) and the presence of ketoacidosis (miR-29c-3p) more strongly than the evaluated immune cell subset frequency. Some of these plasmatic microRNAs were shown to positively correlate with numbers of blood circulating B lymphocytes (miR-142-5p) and CD4+CD45RO+ (miR-146a-5p and miR-223-3p) and CD4+CD25+ cells (miR-423-3p and miR-223-3p) in children with T1D but not in healthy controls, suggesting a disease-specific microRNA association with immune dysregulation in T1D. In conclusion, our results suggest that, while blood co-circulating extracellular microRNAs and immune cell subsets may be biologically linked, microRNAs may better provide powerful information about T1D onset and severity.
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Affiliation(s)
- Silvia Garavelli
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
| | - Sara Bruzzaniti
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Dipartimento di Biologia, Università degli Studi di Napoli “Federico II”, 80126 Naples, Italy
| | - Elena Tagliabue
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
| | - Francesco Prattichizzo
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
| | - Dario Di Silvestre
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche (ITB-CNR), 20090 Segrate (MI), Italy; (D.D.S.); (P.M.)
| | - Francesco Perna
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy;
| | - Lucia La Sala
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
| | - Antonio Ceriello
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
| | - Enza Mozzillo
- Centro Regionale di Diabetologia Pediatrica, Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy or (E.M.); (V.F.); (A.F.)
| | - Valentina Fattorusso
- Centro Regionale di Diabetologia Pediatrica, Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy or (E.M.); (V.F.); (A.F.)
| | - Pierluigi Mauri
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche (ITB-CNR), 20090 Segrate (MI), Italy; (D.D.S.); (P.M.)
| | - Annibale A. Puca
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
- Dipartimento di Medicina, Chirurgia e Odontoiatria ”Scuola Medica Salernitana”, Università di Salerno, Via S. Allende, 84081 Baronissi (SA), Italy
| | - Adriana Franzese
- Centro Regionale di Diabetologia Pediatrica, Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy or (E.M.); (V.F.); (A.F.)
| | - Giuseppe Matarese
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy
- Correspondence: (G.M.); or (M.G.); (P.d.C.); Tel.: +39-08-1746-4580 (G.M.); +39-08-1746-4596 (M.G.); +39-02-5540-6534 (P.d.C.)
| | - Mario Galgani
- Istituto per l’Endocrinologia e l’Oncologia Sperimentale “G. Salvatore”, Consiglio Nazionale delle Ricerche, 80131 Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli “Federico II”, 80131 Naples, Italy
- Correspondence: (G.M.); or (M.G.); (P.d.C.); Tel.: +39-08-1746-4580 (G.M.); +39-08-1746-4596 (M.G.); +39-02-5540-6534 (P.d.C.)
| | - Paola de Candia
- IRCCS MultiMedica, 20138 Milan, Italy; (S.G.); (E.T.); (F.P.); (L.L.S.); (A.C.); (A.A.P.)
- Correspondence: (G.M.); or (M.G.); (P.d.C.); Tel.: +39-08-1746-4580 (G.M.); +39-08-1746-4596 (M.G.); +39-02-5540-6534 (P.d.C.)
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Palmieri VV, Lonero A, Bocchini S, Cassano G, Convertino A, Corica D, Crinò A, Fattorusso V, Ferraris S, Fintini D, Franzese A, Grugni G, Iughetti L, Lia R, Macchi F, Madeo SF, Matarazzo P, Nosetti L, Osimani S, Pajno R, Patti G, Pellegrin MC, Perri A, Ragusa L, Rutigliano I, Sacco M, Salvatoni A, Scarano E, Stagi S, Tornese G, Trifirò G, Wasniewska M, Fischetto R, Giordano P, Licenziati MR, Delvecchio M. Uniparental disomy and pretreatment IGF-1 may predict elevated IGF-1 levels in Prader-Willi patients on GH treatment. Growth Horm IGF Res 2019; 48-49:9-15. [PMID: 31487604 DOI: 10.1016/j.ghir.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/09/2019] [Accepted: 08/26/2019] [Indexed: 10/26/2022]
Abstract
Pediatric patients with Prader-Willi syndrome (PWS) can be treated with recombinant human GH (rhGH). These patients are highly sensitive to rhGH and the standard doses suggested by the international guidelines often result in IGF-1 above the normal range. We aimed to evaluate 1 the proper rhGH dose to optimize auxological outcomes and to avoid potential overtreatment, and 2 which patients are more sensitive to rhGH. In this multicenter real-life study, we recruited 215 patients with PWS older than 1 year, on rhGH at least for 6 months, from Italian Centers for PWS care. We collected auxological parameters, rhGH dose, IGF-1 at recruitment and (when available) at start of treatment. The rhGH dose was 4.3 (0.7/8.4) mg/m2/week. At recruitment, IGF-1 was normal in 72.1% and elevated in 27.9% of the patients. In the group of 115 patients with IGF-1 available at start of rhGH, normal pretreatment IGF-1 and uniparental disomy were associated with elevated IGF-1 during the therapy. No difference in height and growth velocity was found between patients treated with the highest and the lowest range dose. The rhGH dose prescribed in Italy seems lower than the recommended one. Normal pretreatment IGF-1 and uniparental disomy are risk factors for elevated IGF-1. The latter seems to be associated with higher sensitivity to GH. In case of these risk factors, we recommend a more accurate titration of the dose to avoid overtreatment and its potential side effects.
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Affiliation(s)
- Viviana Valeria Palmieri
- Department of Biomedicine and Human Oncology, Pediatric Section, University A. Moro, Bari, Italy
| | | | - Sarah Bocchini
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Hospital, Roma, Italy
| | - Gilda Cassano
- Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessio Convertino
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Hospital, Roma, Italy
| | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Italy
| | - Antonio Crinò
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Hospital, Roma, Italy
| | | | - Silvio Ferraris
- Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, University of Torino, Torino, Italy
| | - Danilo Fintini
- Reference Center for Prader-Willi syndrome, Bambino Gesù Hospital, Research Hospital, Roma, Italy
| | - Adriana Franzese
- Department of Translational Sciences, University Federico II, Naples, Italy
| | - Graziano Grugni
- Division of Auxology, Italian Auxological Institute, Research Institute, Piancavallo, Verbania, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Francesca Macchi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Simona Filomena Madeo
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Patrizia Matarazzo
- Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, University of Torino, Torino, Italy
| | - Luana Nosetti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Sara Osimani
- Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta Pajno
- Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppa Patti
- Department of Pediatrics, Giannina Gaslini Institute, Genoa, Italy
| | | | - Annamaria Perri
- Rare Diseases Unit Pediatric Department, University of Bologna, Bologna, Italy
| | | | - Irene Rutigliano
- Department of Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Michele Sacco
- Department of Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | | | - Emanuela Scarano
- Rare Diseases Unit Pediatric Department, University of Bologna, Bologna, Italy
| | - Stefano Stagi
- Anna Meyer Children's University Hospital, Florence, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Italy
| | - Rita Fischetto
- Metabolic Diseases, Clinical Genetics and Diabetology Unit, Giovanni XXIII Children's Hospital, Bari, Italy
| | - Paola Giordano
- Department of Biomedicine and Human Oncology, Pediatric Section, University A. Moro, Bari, Italy
| | - Maria Rosaria Licenziati
- Obesity and Endocrine disease Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maurizio Delvecchio
- Metabolic Diseases, Clinical Genetics and Diabetology Unit, Giovanni XXIII Children's Hospital, Bari, Italy.
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8
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Di Bonito P, Mozzillo E, Esposito M, Rosanio FM, Casertano A, Fattorusso V, Franzese A. Non-albuminuric reduced eGFR phenotype in children and adolescents with type 1 diabetes. Diabetes Res Clin Pract 2019; 155:107781. [PMID: 31279959 DOI: 10.1016/j.diabres.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 11/16/2022]
Abstract
AIMS To analyze the factors associated with non-albuminuric reduced estimated glomerular filtration rate (NAeGFR-) phenotype in young people with type 1 diabetes (T1DM). METHODS In this cross-sectional study were enrolled 140 outpatient diabetic children (age 7-18 years), consecutively observed in the period 2016-2017. Eighteen subjects with microalbuminuria (defined as albumin excretion rate ≥ 30 mg/24 h) were excluded. Fasting HbA1c, uric acid (UA), neutrophils and lymphocytes count were recorded. Estimated glomerular filtration rate (eGFR) was calculated using the Schwartz's bed-side formula and reduced eGFR was defined by a value <90 mL/min/1.73 m2. RESULTS Out of 122 subjects analyzed, 76 (62%) showed normal eGFR and 46 (38%) showed NAeGFR- phenotype. They were characterized by higher prevalence of male sex (57% vs 33%, p = 0.010), autoimmune diseases (26% vs 12%, p = 0.043), high UA levels (4.0 ± 0.9 vs 3.3 ± 0.9 mg/dl, p < 0.0001) and high Neutrophils/Lymphocytes ratio (1.5 [1.2-2.0] vs 1.3 [1.0-1.8], p = 0.023). CONCLUSIONS In our population, the prevalence on NAeGFR- phenotype is 38% and it is associated with male sex, high levels of UA, presence of other autoimmune diseases and low-grade inflammation. It should encourage pediatricians to monitor early both eGFR and UA in order to intercept diabetic youth more likely prone to develop progressive renal impairment.
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Affiliation(s)
- Procolo Di Bonito
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy; Department of Internal Medicine "S. Maria delle Grazie" Hospital, Pozzuoli (Naples), Italy
| | - Enza Mozzillo
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
| | - Maria Esposito
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Francesco Maria Rosanio
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Alberto Casertano
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Valentina Fattorusso
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Adriana Franzese
- Pediatric Diabetes Unit, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy
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Abstract
PURPOSE OF REVIEW Non-diabetic hyperglycemia (NDHY) is a pathological condition that is not yet well known. The aim of this review is to examine approaches for management of this condition. RECENT FINDINGS While it is well known that persistent hyperglycemia in diabetes affects immune response and risk for diabetes-related micro- and macrovascular complications, little is known about the biological effects of transient NDHY, particularly in the pediatric age group. Stress HY (SHY) is typically defined as blood glucose > 8.33 mmol/L (150 mg/dL) during physical stress, resolving spontaneously after dissipation of acute illness in patients without known diabetes. Based on the literature and clinical practice, two situations can be classified: (1) SHY1, which occurs during severe and prolonged illness and under serious life-threatening conditions, mainly in emergency situations and in resuscitation areas; and (2) SHY2, which occurs during acute illness, mainly in non-life-threatening conditions. Furthermore, (NDHY) among pediatric patients can be induced by drugs; the most frequent conditions are secondary to (1) steroid therapy and (2) antineoplastic/immunosuppressive therapy.
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Affiliation(s)
- Valentina Fattorusso
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Rosa Nugnes
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Alberto Casertano
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy.
| | - Adriana Franzese
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
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10
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Fattorusso V, Casale A, Raia V, Mozzillo E, Franzese A. Long-Term Follow-Up in a Girl with Cystic Fibrosis and Diabetes Since the First Year of Life. Diabetes Ther 2017; 8:1187-1190. [PMID: 28770464 PMCID: PMC5630546 DOI: 10.1007/s13300-017-0289-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Indexed: 11/25/2022] Open
Abstract
Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF). Recently, more attention has been paid to early glucose metabolism derangements (GMDs). The subject of this report is a female patient, affected by CF since 3 months of age. She presented with intermittent diabetes during early childhood. At the age of 10 years, oral glucose tolerance test (OGTT) was performed and showed glucose intolerance (IGT) status; glargine insulin therapy was started. At the age of 13 years, CF-related diabetes with fasting hyperglycemia occurred, so rapid insulin at meals was added. During the following year, clinical and nutritional status improved. Stable clinical conditions were observed in the following 3 years. This is the first case of very long-term follow-up concerning a CF patient with GMDs. Our case confirms the importance of paying attention to early GMDs in very young CF patients and seems to suggest that earlier therapy could ameliorate CF natural history.
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Affiliation(s)
- Valentina Fattorusso
- Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy.
| | - Alida Casale
- Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy
| | - Valeria Raia
- Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy
| | - Enza Mozzillo
- Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy
| | - Adriana Franzese
- Section of Pediatrics, Department of Translational Medical Science (DISMET), University of Naples Federico II, Naples, Italy
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11
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Di Costanzo L, Fattorusso V, Mozzillo E, Patrì A, Di Caprio R, De Nitto E, Balato N, Franzese A. Psoriasis in children with type 1 diabetes: A new comorbidity to be considered? Acta Diabetol 2017; 54:803-804. [PMID: 28500467 DOI: 10.1007/s00592-017-1000-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 04/02/2017] [Accepted: 04/27/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Luisa Di Costanzo
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Valentina Fattorusso
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy.
| | - Enza Mozzillo
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Angela Patrì
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Roberta Di Caprio
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Elena De Nitto
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Nicola Balato
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Adriana Franzese
- Department of Translational Medical Science (DISMET), Section of Pediatrics, University of Naples Federico II, Naples, Italy
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12
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Mozzillo E, Cozzolino C, Genesio R, Melis D, Frisso G, Orrico A, Lombardo B, Fattorusso V, Discepolo V, Della Casa R, Simonelli F, Nitsch L, Salvatore F, Franzese A. Mulibrey nanism: Two novel mutations in a child identified by Array CGH and DNA sequencing. Am J Med Genet A 2016; 170:2196-9. [PMID: 27256967 DOI: 10.1002/ajmg.a.37770] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 12/30/2015] [Accepted: 05/16/2016] [Indexed: 02/02/2023]
Abstract
In childhood, several rare genetic diseases have overlapping symptoms and signs, including those regarding growth alterations, thus the differential diagnosis is sometimes difficult. The proband, aged 3 years, was suspected to have Silver-Russel syndrome because of intrauterine growth retardation, postnatal growth retardation, typical facial dysmorphic features, macrocephaly, body asymmetry, and bilateral fifth finger clinodactyly. Other features were left atrial and ventricular enlargement and patent foramen ovale. Total X-ray skeleton showed hypoplasia of the twelfth rib bilaterally and of the coccyx, slender long bones with thick cortex, and narrow medullary channels. The genetic investigation did not confirm Silver-Russel syndrome. At the age of 5 the patient developed an additional sign: hepatomegaly. Array CGH revealed a 147 kb deletion (involving TRIM 37 and SKA2 genes) on one allele of chromosome 17, inherited from his mother. These results suggested Mulibrey nanism. The clinical features were found to fit this hypothesis. Sequencing of the TRIM 37 gene showed a single base change at a splicing locus, inherited from his father that provoked a truncated protein. The combined use of Array CGH and DNA sequencing confirmed diagnosis of Mulibrey nanism. The large deletion involving the SKA2 gene, along with the increased frequency of malignant tumours in mulibrey patients, suggests closed monitoring for cancer of our patient and his mother. Array CGH should be performed as first tier test in all infants with multiple anomalies. The clinician should reconsider the clinical features when the genetics suggests this. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | | | - Rita Genesio
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Daniela Melis
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Giulia Frisso
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Ada Orrico
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Barbara Lombardo
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Valentina Fattorusso
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Valentina Discepolo
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Roberto Della Casa
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy
| | - Lucio Nitsch
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Francesco Salvatore
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,IRCCS-Fondazione SDN, Naples, Italy
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples, Italy
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13
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Mozzillo E, D'Amico A, Fattorusso V, Carotenuto B, Buono P, De Nitto E, Falco M, Franzese A. Cerebral Accidents in Pediatric Diabetic Ketoacidosis: Different Complications and Different Evolutions. Horm Res Paediatr 2016; 84:139-44. [PMID: 26138370 DOI: 10.1159/000382016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/27/2015] [Indexed: 11/19/2022] Open
Abstract
Diabetic ketoacidosis (DKA) may be associated with neurologic complications: the most common is cerebral edema while the risk of venous and arterial stroke is rare. There is a pathogenetic link between DKA, hypercoagulability and stroke, whose risk is underestimated by clinicians. Our cases present a wide spectrum of cerebral accidents during DKA, the first one being diffuse cerebral edema, the second one venous stroke after 5 days of DKA resolution, while the third one multifocal edema suspected to be extrapontine myelinolysis although without electrolyte imbalance. Our cases suggest that DKA requires very accurate treatment, particularly at an early age, and it can be complicated by cerebral accidents even with appropriate medical care.
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Affiliation(s)
- Enza Mozzillo
- Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetology, University of Naples Federico II, Naples, Italy
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14
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Franzese A, Mozzillo E, Fattorusso V, Raia V, Valerio G. Screening of glucose metabolism derangements in pediatric cystic fibrosis patients: how, when, why. Acta Diabetol 2015; 52:633-8. [PMID: 25863781 DOI: 10.1007/s00592-015-0743-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/14/2015] [Indexed: 10/23/2022]
Abstract
Diabetes mellitus is the most common comorbidity in cystic fibrosis (CF), occurring in a variable number of children and adolescents. Glucose metabolism derangements (GMDs) are responsible for a negative impact on the general health status of CF patients. Screening of GMDs is important since the youngest age and should be performed by means of OGTT, including its intermediate times, that could detect other non-traditional GMDs. Insulin treatment, administered before overt diabetes, could be beneficial in reducing the number of pulmonary infections, in improving both pulmonary function and nutritional status. Early screening of GMDs in pediatric age can exert an important preventing role regarding all aspects of health status of patients with CF.
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Affiliation(s)
- Adriana Franzese
- Department of Medical and Translational Medical Sciences, Section of Pediatrics, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy,
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15
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Mozzillo E, Melis D, Falco M, Fattorusso V, Taurisano R, Flanagan SE, Ellard S, Franzese A. Thiamine responsive megaloblastic anemia: a novel SLC19A2 compound heterozygous mutation in two siblings. Pediatr Diabetes 2013; 14:384-7. [PMID: 23289844 DOI: 10.1111/j.1399-5448.2012.00921.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 04/26/2012] [Revised: 07/12/2012] [Accepted: 08/02/2012] [Indexed: 01/19/2023] Open
Abstract
Thiamine responsive megaloblastic anemia (TRMA) is an autosomal recessive disease caused by loss of function mutations in the SLC19A2 gene. TRMA is characterized by anemia, deafness, and diabetes. In some cases, optic atrophy or more rarely retinitis pigmentosa is noted. We now report two sisters, the eldest of which presented to a different hospital during childhood with sensorineural deafness, which was treated with a hearing prosthesis, insulin requiring diabetes, retinitis pigmentosa, optic atrophy, and macrocytic anemia. These features initially suggested a clinical diagnosis of Wolfram syndrome (WS). Therapy with thiamine was initiated which resulted in the resolution of the anemia. The younger sister, who was affected with sensorineural deafness, was referred to our hospital for non-autoimmune diabetes. She was found to have macrocytosis and ocular abnormalities. Because a diagnosis of TRMA was suspected, therapy with insulin and thiamine was started. Sequencing analysis of the SLC19A2 gene identified a compound heterozygous mutation p.Y81X/p.L457X (c.242insA/c.1370delT) in both sisters. Non-autoimmune diabetes associated with deafness and macrocytosis, without anemia, suggests a diagnosis of TRMA. Patients clinically diagnosed with WS with anemia and/or macrocytosis should be reevaluated for TRMA.
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Affiliation(s)
- Enza Mozzillo
- Department of Pediatrics, Federico II University of Naples, Naples, Italy.
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16
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Fattorusso V, Raia V, Mozzillo E, Natale C, De Nitto E, Amato N, De Gregorio F, Franzese A, Casale A. 66 Effects of a 3-year therapy with glargine among pediatric patients with cystic fibrosis and early glucose derangements. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60208-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mozzillo E, Raia V, Fattorusso V, Falco M, Sepe A, De Gregorio F, Nugnes R, Valerio G, Franzese A. Glucose derangements in very young children with cystic fibrosis and pancreatic insufficiency. Diabetes Care 2012; 35:e78. [PMID: 23093689 PMCID: PMC3476927 DOI: 10.2337/dc12-0459] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Enza Mozzillo
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
- School of Movement Sciences (DiSiST), “Parthenope” University of Naples, Naples, Italy
| | - Valeria Raia
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Valentina Fattorusso
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Mariateresa Falco
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Angela Sepe
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Fabiola De Gregorio
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Rosa Nugnes
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
| | - Giuliana Valerio
- School of Movement Sciences (DiSiST), “Parthenope” University of Naples, Naples, Italy
| | - Adriana Franzese
- From the Department of Pediatrics, Federico II University of Naples, Naples, Italy; and the
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Camarca ME, Mozzillo E, Nugnes R, Zito E, Falco M, Fattorusso V, Mobilia S, Buono P, Valerio G, Troncone R, Franzese A. Celiac disease in type 1 diabetes mellitus. Ital J Pediatr 2012; 38:10. [PMID: 22449104 PMCID: PMC3348012 DOI: 10.1186/1824-7288-38-10] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 03/26/2012] [Indexed: 02/07/2023] Open
Abstract
Celiac Disease (CD) occurs in patients with Type 1 Diabetes (T1D) ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD). In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD) on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients.
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Affiliation(s)
| | - Enza Mozzillo
- Department of Paediatrics, "Federico II" University, Naples, Italy
- School of Movement Sciences (DiSIST)- Parthenope University, Naples, Italy
| | - Rosa Nugnes
- Department of Paediatrics, "Federico II" University, Naples, Italy
- Department of Cellular and Molecular Pathology "L. Califano", "Federico II" University, Naples, Italy
| | - Eugenio Zito
- Department of Paediatrics, "Federico II" University, Naples, Italy
| | | | | | - Sara Mobilia
- Department of Paediatrics, "Federico II" University, Naples, Italy
| | - Pietro Buono
- Department of Paediatrics, "Federico II" University, Naples, Italy
| | - Giuliana Valerio
- School of Movement Sciences (DiSIST)- Parthenope University, Naples, Italy
| | | | - Adriana Franzese
- Department of Paediatrics, "Federico II" University, Naples, Italy
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Fattorusso V, Ritter O. Aperçu statistique sur quelques variations constitutionnelles du système cardio-vasculaire. Cardiology 2008. [DOI: 10.1159/000164835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fattorusso V. Contribution à l'étude du ramollissement cérébral. Eur Neurol 2008. [DOI: 10.1159/000148381] [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: 11/19/2022]
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Fattorusso V. The importance of drug therapy for modern health care. Acta Pharm Suec 1973; 10:359-70. [PMID: 4587802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Fattorusso V. [Technic of dialysis and renal transplantation]. Presse Med (1893) 1967; 75:337-9. [PMID: 5334272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Fattorusso V. [Treatment of the classic attack of pulmonary tuberculosis in adults]. Presse Med (1893) 1966; 74:2211-4. [PMID: 5924406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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