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Non-invasive investigation in patients with inflammatory joint disease

World Journal of Gastroenterology 2009年第20期15卷 2463-2468页

作者： Elisabetta dal Pont renata d’incà Antonino Caruso Giacomo Carlo Sturniolo department of Surgical and Gastro-enterological Sciences University of Padova

Gut inflammation can occur in 30%-60% of patients with ***, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint *** are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract.A number of blood tests, *** sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut ***, it would be useful to have a marker capable of separately identifying gut *** proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation:they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal *** the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of *** short, noninvasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease.

关键词：关节病侵入性患者炎症

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Relevance of fecal calprotectin and lactoferrin in the postoperative management of inflammatory bowel diseases

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World Journal of Gastrointestinal Surgery 2016年第3期8卷 193-201页

作者： Roberta Caccaro Imerio Angriman renata d'incà department of Surgery Oncology and Gastroenterology Gastroenterology Section University Hospital of Padua department of Surgery Oncology and Gastroenterology Surgery Section University Hospital of Padua

The role of fecal lactoferrin and calprotectin has been extensively studied in many areas of inflammatory bowel disease(IBd) patients' management. The postoperative setting in both Crohn's disease(Cd) and ulcerative colitis(UC) patients has been less investigated although few promising results come from small, crosssectional studies. Therefore, the current post-operative management still requires endoscopy 6-12 mo after intestinal resection for Cd in order to exclude endoscopic recurrence and plan the therapeutic strategy. In patients who underwent restorative proctocolectomy, endoscopy is required whenever symptoms includes the possibility of pouchitis. There is emerging evidence that fecal calprotectin and lactoferrin are useful surrogate markers of inflammation in the post-operative setting, they correlate with the presence and severity of endoscopic recurrence according to Rutgeerts' score and possibly predict the subsequent clinical recurrence and response to therapy in Cd patients. Similarly, fecal markers show a good correlation with the presence of pouchitis, as confirmed by endoscopy in operated UC patients. Fecal calprotectin seems to be able to predict the short-term development of pouchitis in asymptomatic patients and to vary according to response to medical treatment. The possibility of both fecal markers to used in the routine clinical practice for monitoring IBd patients in the postoperative setting should be confirmed in multicentric clinical trial with large sample set. An algorithm that can predict the optimal use and timing of fecal markers testing, the effective need and timing of endoscopy and the cost-effectiveness of these as a strategy of care would be of great interest.

关键词： Calprotectin Lactoferrin Fecal markers Inflammatory bowel disease Post-operative Surgery Crohn’s disease Ulcerative colitis

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Glucose transporter expression in the human colon

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World Journal of Gastroenterology 2018年第7期24卷 775-793页

作者： Flavia Merigo Alessandro Brandolese Sonia Facchin Silvia Missaggia Paolo Bernardi Federico Boschi renata d’incà Edoardo Vincenzo Savarino Andrea Sbarbati Giacomo Carlo Sturniolo department of Neuroscience Biomedicine and Movement Human Anatomy and Histology Section University of Verona department of Medicine Gastroen-terology Section University of Verona department of Surgery Oncology and Gastroenterology Gastroenterology Section University Hospital of Padua department of Computer Science University of Verona

AIM To investigate by immunostaining glucose transporter expression in human colorectal mucosa in controls and patients with inflammatory bowel disease(IBd). METHOdS Colorectal samples were obtained from patients undergoing lower endoscopic colonoscopy or rectosigmoidoscopy. Patients diagnosed with ulcerativecolitis(n = 18) or Crohn's disease(n = 10) and scheduled for diagnostic colonoscopy were enrolled. Patients who underwent colonoscopy for prevention screening of colorectal cancer or were followed-up after polypectomy or had a history of lower gastrointestinal symptoms were designated as the control group(CTRL, n = 16). Inflammatory status of the mucosa at the sampling site was evaluated histologically and/or endoscopically. A total of 147 biopsies of colorectal mucosa were collected and processed for immunohistochemistry analysis. The expression of GLUT2, SGLT1, and GLUT5 glucose transporters was investigated using immunoperoxidase labeling. To compare immunoreactivity of GLUT5 and LYVE-1, which is a marker for lymphatic vessel endothelium, doublelabeled confocal microscopy was used. RESULTS Immunohistochemical analysis revealed that GLUT2, SGLT1, and GLUT5 were expressed only in short epithelial portions of the large intestinal mucosa. No important differences were observed in glucose transporter expression between the samples obtained from the different portions of the colorectal tract and between the different patient groups. Unexpectedly, GLUT5 expression was also identified in vessels, mainly concentrated in specific areas where the vessels were clustered. Immunostaining with LYVE-1 and GLUT5 antibodies revealed that GLUT5-immunoreactive(-IR) clusters of vessels were concentrated in areas internal to those that were LYVE-1 positive. GLUT5 and LYVE-1 did not appear to be colocalized but rather showed a close topographical relationship on the endothelium. Based on their LYVE-1 expression, GLUT5-IR vessels were identified as lymphatic. Both inflamed and nonin

关键词： Ulcerative colitis Colon Crohn’s disease Glucose transporter LYVE-1,Immunohistochemistry

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Could mammalian inorganic polyphosphate be a crucial signaling molecule in neurological disorders?

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Neural Regeneration Research 2024年第4期19卷 701-702页

作者： renata Torres da Costa Maria E.Solesio Rutgers University Department of BiologyCamdenNJUSA

Since the early stages of life on earth,cellular metabolism has evolved to adapt to fluctuations in nutrient and oxygen *** this context,mammals,which are probably the organisms that show one of the highest levels of metabolic complexity,have developed an elegant system that uses constant and rechargeable energy sources of modulate their *** homeostasis is especially important in the central nervous system,as neurons and other cells in the brain are highly susceptible to fluctuations in nutrients and oxygen availability.

关键词： metabolism homeostasis neurological

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Noninfectious interstitial lung disease during infliximab therapy:Case report and literature review

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World Journal of Gastroenterology 2013年第32期19卷 5377-5380页

作者： Roberta Caccaro Edoardo Savarino renata d'incà Giacomo Carlo Sturniolo department of Surgical Oncological and Gastroenterological SciencesGastroenterology SectionUniversity of Padova

Pulmonary abnormalities are not frequently encountered in patients with inflammatory bowel ***,lung toxicity can be induced by conventional medications used to maintain remission,and similar evidence is also emerging for *** present the case of a young woman affected by colonic Crohn’s disease who was treated with oral mesalamine and became steroid-dependent and refractory to azathioprine and *** was referred to our clinic with a severe relapse and was treated with infliximab,an antitumor necrosis factor α(TNF-α)antibody,to induce *** an initial benefit,with decreases in bowel movements,rectal bleeding and C-reactive protein levels,she experienced shortness of breath after the *** interstitial lung disease was *** mesalamine and infliximab were discontinued,and steroids were introduced with slow but progressive improvement of symptoms,radiology and functional *** represents a rare case of interstitial lung disease associated with infliximab therapy and the effect of drug withdrawal on these lung *** the increasing use of anti-TNF-α therapies and the increasing reports of pulmonary abnormalities in patients with inflammatory bowel diseases,this case underlines the importance of a careful evaluation of respiratory symptoms in patients undergoing infliximab therapy.

关键词： Interstitial lung disease Crohn’s disease Infliximab Mesalamine drug-induced toxicity

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替度鲁肽用于正接受肠内营养支持的克罗恩病合并短肠综合征患者的疗效:跳出传统思维

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Gastroenterology Report 2019年第6期7卷 459-460,I0003页

作者： Brigida Barberio Giacomo Carlo Sturniolo renata d’incà Fabio Farinati Maria Assunta Bigotto Matteo Ghisa Greta Lorenzon Edoardo Savarino department of Surgery Oncology and GastroenterologyUniversity of PaduaPaduaItaly department of Pharmaceutical Sciences University of PaduaPaduaItaly

Introduction Short bowel syndrome(SBS)is a disorder characterized by malabsorption due to the absence or resection of a long small intestine tract,with an incidence of 2 per million of *** adults,SBS is defined as less than 200 cm without colon and less than 50 cm with residual colon in continuity[1].The causes of SBS in adult patients are different,but the most frequent one(33.3%of the cases)is the need for surgery in patients with Crohn’s disease(Cd)[2].

关键词：克罗恩病肠内营养支持短肠综合征 intestine

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5-ASA colonic mucosal concentrations resulting from different pharmaceutical formulations in ulcerative colitis

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World Journal of Gastroenterology 2013年第34期19卷 5665-5670页

作者： renata d’incà Martina Paccagnella Romilda Cardin Surajit Pathak Vincenzo Baldo Maria Cecilia Giron Giacomo Carlo Sturniolo department of Surgical Oncological and Gastroenterological SciencesUniversity of Padua department of Environmental Medicine and Public Health Institute of HygieneUniversity of Padua department of Pharmacology and Anaesthesiology University of Florence

AIM:To compare the mucosal concentrations of 5-aminosalicylic acid(5-ASA)resulting from different pharmaceutical formulations and analyse the influence of inflammation on the mucosal ***:The study included 130 inflammatory bowel disease(IBd)patients receiving 5-ASA as pH-dependent-release formulations(73 patients),time-dependent-release formulations(11 patients),or pro-drugs(18patients).In addition,28 patients were receiving topical treatment(2-4 g/d)with pH-dependent-release *** biopsies were obtained from the sigmoid region during the *** 5-ASA concentrations(ng/mg)were measured in tissue homogenatesusing high-pressure liquid chromatography with electrochemical *** t test and Mann-Whitney test,when appropriate,were used for statistical ***:Patients receiving pH-dependent-release formulations showed significantly higher mucosal concentrations of 5-ASA(51.75±5.72 ng/mg)compared with patients receiving pro-drugs(33.35±5.78 ng/mg,P=0.01)or time-dependent-release formulations(38.24±5.53 ng/mg,P=0.04).Patients with endoscopic remission had significantly higher mucosal concentrations of5-ASA than patients with active disease(60.14±7.95ng/mg vs 35.66±5.68 ng/mg,P=0.02).Similar results were obtained when we compared patients with the histological appearance of remission and patients with active histological inflammation(67.53±9.22 ng/mg vs 35.53±5.63 ng/mg,Pdetected in patients treated with both oral and topical treatments in combination compared with patients who received oral treatment with pH-dependent-release formulations alone(72.33±11.23 ng/mg vs 51.75±5.72 ng/mg,P=0.03).CONCLUSION:IBd patients showed significant variability in mucosal 5-ASA concentrations depending on the type of formulation,and the highest mean concentration was achieved using pH-dependent-release formulations.

关键词： 5-aminosalicylic acid Inflammatory bowel diseases Mucosal concentration

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Granulo-monocyto apheresis is more effective in mild ulcerative colitis than in moderate to severe disease

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World Journal of Gastroenterology 2014年第45期20卷 17155-17162页

作者： Chiara de Cassan Edoardo Savarino Piero Marson Tiziana Tison Giorgia Hatem Giacomo Carlo Sturniolo renata d'incà division of Gastroenterology Department of Surgery Oncology and Gastroenterology University of Padua Apheresis Unit Blood Transfusion Service University of Padua

AIM:To evaluate whether the effectiveness of Granulomonocyto apheresis(GMA),a technique that consists of the extracorporeal removal of granulocytes and monocytes from the peripheral blood,might vary according to the severity of ulcerative colitis(UC)in patients with mild to moderate-severe disease UC ***:We retrospectively reviewed prospectively collected data of patients undergoing GMA at our inflammatory bowel disease centre who had at least a 6 mo of *** demographics,clinical and laboratory data were extracted from the patients’charts and electronic *** severity of UC was scored according to the Modified Truelove Witts Severity Index(MTWSI).A clinical response was defined as a decrease from baseline of≥2 points or a value of MTWSI≤2 ***:A total of 41(24 males/17 females;meanage 47 years)patients were included in the *** GMA cycle completion,21/28(75%)of mild UC patients showed a clinical response compared with 7/13(54%)of patients with moderate to severe disease(P=0.27).At 6-mo,14/28(50%)of the mild UC patients maintained a clinical response compared with 2/13(15%)of the patients with moderate to severe disease(P=0.04).After the GMA cycle completion and during the 6-mo follow up period,13/16(81%)and 9/16(56%)of mild UC patients with intolerance,resistance and contraindications to immunosuppressants and/or biologics showed a clinical response compared with 2/6(33%)and 0/6(0%)of patients with moderate to severe disease activity with these characteristics(P=0.05and P=0.04,respectively).CONCLUSION:Patients with mild UC benefit from GMA more than patients with moderate to severe disease in the short-term *** should be considered a valid therapeutic option in cases of contraindications to immunosuppressants,corticosteroids and/or biologics.

关键词： Ulcerative colitis Granulo-monocyto-apher-esis Inf

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Persistence of high Cd40 and Cd40L expression after restorative proctocolectomy for ulcerative colitis

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World Journal of Gastroenterology 2005年第34期11卷 5303-5308页

作者： Lino Polese Imerio Angriman Giuseppe de Franchis Attilio Cecchetto Giacomo C.Sturniolo renata d'incà Marco Scarpa Cesare Ruffolo Lorenzo Norberto Mauro Frego davide F d'Amico department of Gastroenterological and Surgical Sciences. Surgical Unit University of Padova Italy department of Laboratory Medicine University of Padova Italy department of Pathology University of Padova Italy department of Gastroenterological and Surgical Sciences Gastroenterological Unit University of Padova Italy

AIM: To focus on the role of Cd40 and Cd40L in their ***: We analyzed by immunohistochemistry the Cd40 and Cd40L expression in the pouch mucosa of 28 patients who had undergone RPC for UC, in the terminal ileum of 6 patients with UC and 11 healthy subjects. We also examined by flow cytometry the expression of Cd40 by B lymphocytes and monocytes in the peripheral blood of 20 pouch patients, 15 UC patients and 11 healthy ***: Ileal pouch mucosa leukocytes presented a significantly higher expression of Cd40 and Cd40L as compared to controls. This alteration correlated with pouchitis, but was also present in the healthy pouch and in the terminal ileum of UC patients. Cd40 expression of peripheral B lymphocytes was significantly higher in patients with UC and pouch, respect to controls. increased Cd40 levels in blood B cells of pouch patients correlatedwith the presence of spondyloarthropathy, but not with pouchitis, or inflammatory ***: High Cd40 expression in the ileal pouch mucosa could be implied in the pathogenesis of pouchitis following proctocolectomy for UC, whereas its increased levels on peripheral blood B lymphocytes are associated with the presence of extraintestinal manifestations.

关键词： Cd40 Cd40L 基因表达大肠炎滋补剂

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Appropriateness of Amikacin dose Prescription, Monitoring and Safety during Hospitalization as an Impact of Clinical Pharmacologist Intervention, in the Israeli Regional Hospital

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Journal of Biosciences and Medicines 2024年第3期12卷 337-354页

作者： renata Shihmanter Olga Lazar Lidia Arcavi Clinical Pharmacology Unit Kaplan Medical Center Rehovot and Hebrew University Hadassah Medical School Jerusalem Israel department of Medicine Kaplan Medical Center Rehovot and Hebrew University Hadassah Medical School Jerusalem Israel

Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TdM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TdM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p d the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TdM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.

关键词： Amikacin Therapeutic drug Monitoring Appropriate Clinical Pharmacologist Safety Adverse Effects

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