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Biomedical subjects

G Sacco

Publications and source records attributed to G Sacco.

At least 19 recordsLinked to original sources

Comparison of doxorubicin- and MEN 10755-induced long-term progressive cardiotoxicity in the rat.

The delayed functional cardiotoxic effects of repeated treatment with the new disaccharide anthracycline MEN 10755 and doxorubicin (1.5 mg/kg, i.v., once a week for 5 consecutive weeks) were investigated in the rat. Changes were assessed (2 days and 4 and 13 weeks after the last treatment) in ECG morphology, hemodynamics, in vivo left ventricular contractile responses to beta-adrenergic stimulation, and histopathology of both atria and ventricles. Doxorubicin induced significant and progressive prolongation of the QalphaT interval starting 2 days after suspension of treatment. At 4 and 13 weeks after the last treatment, the ECG showed a further progressive and significant impairment. MEN 10755 induced alterations similar in nature but of lesser severity compared with doxorubicin. In addition, MEN 10755-induced prolongation of the QalphaT interval was not progressive, being similar at 4 and 13 weeks after the last treatment. Although the hemodynamics were only slightly affected by both anthracyclines, a nearly complete ablation of isoprenaline-induced enhancement of ventricular function was observed 4 and 13 weeks after the last treatment with doxorubicin, whereas only mild, if any, reduction was detected in rats receiving MEN 10755. Histopathologic investigations indicated that both anthracyclines produced qualitatively similar alterations in ventricular myocytes. However, only with doxorubicin did these changes show a progression with a further significant worsening at 13 weeks as compared with 4 weeks after the last treatment. In addition, atrial lesions were evident in doxorubicin-treated rats, but not in rats receiving MEN 10755. In conclusion, an equimyelotoxic regimen of MEN 10755 produced, as compared with doxorubicin, lesser ECG alterations, smaller impairment of the ventricular response to adrenergic stimulation, and less severe myocyte lesions. Unlike doxorubicin, the histologic and functional cardiotoxic effects induced by MEN 10755 were not progressive. Further investigations are warranted to define the pharmacodynamic and/or pharmacokinetic mechanism(s) underlying the different cardiotoxic profile exhibited by the two anthracyclines.

Animals↗

Long-term evaluation of T-cell subsets and T-cell function after HAART in advanced stage HIV-1 disease.

OBJECTIVES: Evaluation of immunological reconstitution after 2 years of highly active antiretroviral therapy (HAART) in AIDS patients. DESIGN: Previous data showed the effectiveness of HAART but conflicting evidence of immune reconstitution has been found in severely immunocompromised patients. Therefore, T-cell subsets and functions were analysed during 24 months of HAART in 21 AIDS patients (mean baseline CD4 cell count, 20 x 10(6)/l). METHODS: Subjects were tested at baseline and after 4, 12 and 24 months of therapy for clinical symptoms and the following investigations were carried out: plasma HIV RNA, T-cell subsets and lymphoproliferative responses to mitogens (phytohaemagglutinin, anti-CD3), and recall antigens (Candida mannoprotein, tetanus toxoid and recombinant glycoprotein 160). RESULTS: Increase in body weight, improvement of Karnofsky's score and reduction of opportunistic infections were observed. All patients showed an initial increase in the CD4 memory subset, whereas naive CD4 cells consistently increased only after 1 year. The magnitude of immune recovery was stronger in patients showing a significant reduction in viral load. However seven out of 21 patients who did not reach a sustained suppression of viral load showed also an increase in T-cell subsets. The majority of patients recovered lymphoproliferative responses to mitogens, whereas only four subjects showed a functional response to Candida mannoprotein. No patients showed a response to HIV recombinant glycoprotein 160 or tetanus toxoid. CONCLUSIONS: The immune recovery observed is slower and not complete in severely immunocompromised patients. Our data suggest that HAART may be continued also in the absence of a significant HIV RNA decrease if alternative drugs are not available.

Adult↗

Clinical and immunologic response without decrease in virus load in patients with AIDS after 24 months of highly active antiretroviral therapy.

This study reports an analysis of clinical, virological, and immunologic outcomes in a cohort of 77 multidrug-experienced AIDS patients during 24 months of highly active antiretroviral therapy (HAART). Our results have shown a reduced risk of AIDS complications, prolonged survival, and immunologic benefit even in the absence of sustained virus suppression. The degree of immunodepression, the risk factors for HIV-1 infection, the use of 2 drugs instead of 3, and a change in protease inhibitor were independently correlated with virological failure. In the majority of studied patients, an increase in CD4+ T cells was observed after HAART. However, the increase was more pronounced in patients who showed a decrease in virus load than in those who did not. Moreover, we observed an absence of relapses among patients who permanently discontinued prophylaxis for Cytomegalovirus retinitis and atypical mycobacterial infections. Peripheral lipodystrophy developed in the majority of patients, regardless of treatment used and virological outcome.

AIDS-Related Opportunistic Infections↗

Hepatitis C virus infection in Italian patients with hypogammaglobulinemia.

We investigated the presence of hepatitis C virus (HCV) infection in 58 patients with humoral immunodeficiencies. Forty-three of these patients had common variable immunodeficiency (CVI), 2 had sporadic hyperimmunoglobulin M (HIM) syndrome, 2 had immunoglobulin G subclass deficiency, 4 had ataxia-telangiectasia (AT), and 7 had X-linked agammaglobulinemia (XLA). Patients with late-onset hypogammaglobulinemia (those with CVI, HIM, or immunoglobulin G subclass deficiency) had a 38.2% prevalence of HCV infection. In patients with XLA or AT, HCV infection was not detectable. Most of the HCV-infected patients had persistent viremia, with histologic findings of chronic hepatitis. Although patients positive for HCV ribonucleic acid (RNA) had received several lots of immunoglobulin, we were unable to detect any correlation between the time that alanine aminotransferase levels increased and the time that intravenous immunoglobulin therapy was given, except in one patient with CVI. Moreover, we found no differences in the number of blood transfusions, surgical procedures, or administrations of intravenous or intramuscular immunoglobulin between HCV RNA-positive and HCV RNA-negative groups. We concluded that: (1) the incidence of HCV infection in patients with hypogammaglobulinemia is much higher than that reported in the Italian general population; (2) although patients with hypogammaglobulinemia have persistent viremia, they do not show an aggressive course of HCV disease, nor does hepatocarcinoma develop; and (3) intravenous immunoglobulins are only one of several possible causes of HCV transmission in patients with humoral immunodeficiencies.

Adult↗

Hepatitis C virus infection in hypogammaglobulinemic patients receiving long-term replacement therapy with intravenous immunoglobulin.

BACKGROUND: Hepatitis C virus (HCV) seroconversion and viremia have been reported in patients treated with intravenous immunoglobulin (IVIG). STUDY DESIGN AND METHODS: A prevalence study was conducted to evaluate the rate of HCV infection in patients undergoing long-term treatment with IVIG. Fifty-four patients with congenital or acquired hypogammaglobulinemia treated with IVIG at 300 to 400 mg per kg every 14 to 21 days for a mean of 6.6 years were enrolled for clinical and biochemical examination. The type of IVIG preparation (type 1 only, type 2 only, or other products) administered to each patient was recorded. Antibodies to HCV were measured by enzyme-linked immunosorbent assay and immunoblotting; HCV RNA was detected by nested polymerase chain reaction. RESULTS: Anti-HCV was detected in 31 patients (57.4%) and HCV RNA was found in 5 patients (9.2%), all of whom were anti-HCV-positive. Abnormal alanine aminotransferase (ALT) levels were found in 10 patients (18.5%). Circulating HCV RNA (p = 0.01) and elevated ALT (p = 0.01) correlated significantly with anti-HCV positivity. Moreover, the rates of anti-HCV positivity and of ALT elevation were significantly higher among patients treated with type 1 IVIG and other products than among those receiving type 2 IVIG (p < 0.001 and p = 0.05, respectively). CONCLUSION: Anti-HCV positivity and viremia were frequently observed. The significant correlation between the detection of HCV RNA, the elevation of ALT, and positivity for anti-HCV suggests HCV infection. Exclusion of anti-HCV-positive donors and of anti-HCV-positive IVIG lots should improve the safety of IVIG.

Adolescent↗

Subclinical coeliac disease: an anthropometric assessment.

OBJECTIVES: To evaluate the prevalence of malnutrition in patients with untreated coeliac disease (CD) according to their pattern of presentation, and the effect of gluten-free diet (GFD) upon nutritional status. DESIGN: Cohort prospective study. SETTING: All subjects were seen at the outpatient 'malabsorption' clinic of the Department of Medical Pathology I, University of Bologna (referral centre), Bologna. SUBJECTS: Eighty consecutive patients with CD (48 with classical and 32 with subclinical presentation), 15 patients with dermatitis herpetiformis (DH) and 40 healthy volunteers (members of the hospital staff). MAIN OUTCOME MEASURES: The nutritional status was evaluated by anthropometric measurements (percentage of ideal body weight for height and sex, percentage of standard triceps skinfold thickness and percentage of ideal arm-muscle circumference). RESULTS: The overall prevalence of malnutrition in our series of CD patients was 53%. Prevalence of malnutrition (actual body weight less than 90% of the ideal) was significantly higher in classical coeliacs (67%) than in subclinical ones (31%, P < 0.002), in patients with DH (13%, P < 0.0003) and in healthy volunteers (13%, P < 0.0001). At diagnosis, percentage values of ideal body weight, triceps skinfold thickness and arm-muscle circumference were significantly lower (P < 0.0001, P < 0.0002 and P < 0.0003, respectively) in classical coeliacs (84.5 +/- 10.6, 71.2 +/- 28.1 and 87.1 +/- 10.8, respectively) than in subclinical coeliacs (95.5 +/- 9.1, 105.6 +/- 41.0 and 94.8 +/- 10.6, respectively). After GFD, 33% of classical and only 3% of subclinical coeliacs were still malnourished. CONCLUSIONS: Prevalence of malnutrition in CD is lower than was previously thought. CD patients with classical presentation may require a longer period of GFD to achieve a significant improvement of their nutritional status, with respect to those with subclinical presentation, probably because of a greater extent of intestinal damage. Finally, a careful evaluation of dietary habits is usually sufficient to identify incomplete adherence to GFD as the reason for nonimprovement of the nutritional status in patients with CD.

Adult↗

Fibroblast-derived factors preserve viability in vitro of mononuclear cells isolated from subjects with HIV-1 infection.

OBJECTIVE: Peripheral blood mononuclear cells (PBMC) from HIV-infected subjects have an increased mortality rate (MR) when incubated in vitro for 3 days in a culture medium. We have previously shown that fibroblast-conditioned medium (FCM) can preserve viability, without significant activation, of human lymphocytes in vitro. We therefore tested the ability of two FCM and other factors to reduce spontaneous MR in HIV-positive PBMC. METHODS: PBMC were cultured for 3 days in control medium and medium supplemented with FCM or recombinant cytokines [interleukin (IL)-2, IL-6, IL-7, granulocyte macrophage colony-stimulating factor]. Cells viable at day 3 were counted in a cytofluorimeter after staining with ethidium bromide. DNA was extracted from the cultures and evaluated for the presence of low molecular weight fragmentation. RESULTS: The MR of PBMC from 51 HIV-positive subjects and from 21 healthy controls were 30.1 and 9.5%, respectively (P < 0.0001). The MR was higher in 40 patients with a CD4+ lymphocyte count < 400 x 10(6)/l than in subjects with a count > 400 x 10(6)/l (32.84 versus 20.96%; P = 0.047). IL-2 and FCM significantly reduced MR in HIV-positive subjects (MR: 17.8 and 20.4%; P: < 0.001 and 0.005, respectively). This effect was more evident in subjects with a CD4+ lymphocyte count < 400 x 10(6)/l and in subjects with negative p24 antigenaemia. Cellular proliferation accounts for increased survival in IL-2-supplemented cultures but not in those with FCM. DNA was extracted from fresh PBMC and cells cultured for 3 days for 22 HIV-positive cases. DNA degradation was documented and bands related to an apoptotic mechanism of death observed, especially in subjects with more advanced disease. CONCLUSIONS: Our data suggest that FCM inhibits accelerated cell death in vitro of PBMC isolated from HIV-positive patients.

Adult↗

Clinical course of Crohn's disease in Italy.

The clinical course of Crohn's disease in 131 patients was studied for a mean period of 4.2 +/- 3.2 years. The clinical activity of the disease, expressed as percentage of patients per year in an active phase, is high in the first year (70.2 percent) and progressively decreases during subsequent years (25 percent after seven years). The percentage of patients who needed steroid treatment is high during the first year (68 percent) and falls to 19 percent after seven years. An operative risk rate of 54 percent was registered, with a probability of reoperation equal to 34 percent. Clinical relapse after the first surgery occurred in 70 percent of cases. The registered mortality was 6.9 percent, with a ratio of 6 to 1 between observed and expected mortality. In conclusion, the disease, while showing a tendency to reduce its activity over the years, is burdened by a risk of surgery and mortality which progressively increases with time.

Adult↗

The primary structure of the cytotoxin alpha-sarcin.

The primary structure of the cytotoxin alpha-sarcin was determined. Eighteen of the 19 tryptic peptides were purified; the other peptide has arginine only. The complete sequence of 17 of the peptides was determined; the sequence of the remaining peptide was determined in part. The sequence of the 39 NH2-terminal residues was obtained by automated Edman degradation. The carboxyl-terminal amino acids were identified after carboxypeptidase treatment. The assignment of the amino acids in the tryptic peptides was confirmed and their alignment established from the sequence of the secondary tryptic peptides obtained after cleavage of citraconylated alpha-sarcin, from the sequence of a 2-(2-nitrophenylsulfenyl)-3-methyl-3'-bromoindolenine peptide, from the sequence of a chymotryptic peptide, and from the sequence of a peptide obtained with Staphylococcus aureus V8 protease. alpha-Sarcin contains 150 amino acid residues; the molecular weight is 16,987. There are disulfide bridges between cysteine residues at positions 6 and 148 and between residues 76 and 132.

Amino Acid Sequence↗

Human phosphoglucomutase locus 1: red cell enzymatic activities associated with common isoelectric focusing phenotypes.

Human phosphoglucomutase activity has been determined in red blood cells obtained from 348 unrelated subjects. The mean activities attributed to the four common PGM1 alleles, expressed as micromoles of G6P produced per gram of Hb per hour were 53 for PGMa31, 60 for PGMa11, 61 for PGMa41 and 72 for PGMa21. The relative amount of variation associated with the electrophoretic polymorphism was estimated as 24%.

Alleles↗

[Evaluation of hematometric parameters and plasma ferritin levels in patients treated with ferritin-containing preparations].

Ferritin has been administered in immediately bioavailable solution form, and in solid form, with exclusively duodenal bioavailability, to two groups of patients suffering from sideropenic dyserythropoietic anaemia. The results obtained point to a significant stimulating action on erythropoiesis documented by the increase in reticulocytes and red cells. This increase is certainly relatable to the increase of available iron and to its incorporation in the erythrocytes, as demonstrated by the increase in ferritinaemia, sideraemia, haemoglobin and mean corpuscular haemoglocbin concentration. The data obtained showed the bioavailable fluid form to be more active than the solid.

Anemia, Hypochromic↗

Cellular events in growth and germination of giant conidia of Neurospora crassa.

During growth of conidia in 3.22 M ethylene glycol the increase in the number of the nuclei is proportional to the increase in volume only in the phase of maximum growth rate and is lower in the preceding and in the following periods of growth. DNA synthesis similarly initiates later and decreases faster than protein synthesis. The dilution of ethylene glycol is followed by the germination of giant conidia, which is characterized by the absence of a lag phase, a high degree of synchrony and the formation of more than one germ tube per conidium. The number of germ tubes is dependent on the volume reached by conidia at the end of the treatment and does not increase with time. The resuming of DNA synthesis after germination is preceded by a sharp increase in protein synthesis and the division of almost half of the nuclei and shows a synchronized pattern. Results are discussed in the light of models of growth proposed for eukaryotic cells.

DNA, Fungal↗

A comparative electrophysiological and histological study of sensory conduction velocity and Meissner corpuscles of the median nerve in pneumatic tool workers.

The sensory conduction velocity of the median nerve has been determined according to the technique described by Buchthal and Rosenfalck in 32 pneumatic tool workers and in 32 normal controls of the same age group. In each worker and in 8 normals of the same age group the Meissner corpuscles of the skin of the thumb of the side investigated were studied according to the technique described by Ridley and Dickens et al. The only relevant electrophysiological finding was represented by a decreased amplitude of the evoked response of the median nerve at the wrist, probably pointing to some degree of distal axonal degeneration. As to the histological findings, no significant variations from normal were found in the Meissner corpuscles of the workers. A trend towards a quantitative reduction of the corpuscles in those subjects who showed a decreased amplitude of the evoked response did not reach the level of significance.

Adult↗