INDIETRO

 

Journal of BIOLOGICAL REGULATORS

& Homeostatic Agents


Vol.22 N°4

BONE AND MAXILLOFACIAL ABNORMALITIES IN THALASSEMIA: A REVIEW OF

THE LITERATURE

 

R. DI MATTEO1, F. LIUZZA2, P.F. MANICONE3, L. RAFFAELLI3, D. BERARDI4,

G. PERFETTI4 and G. MACCAURO5

 

1Emergency Department, Aurelia Hospital, Rome; 2Department of Orthopaedics and Traumatology,

Aurelia Hospital, Rome; 3Institute of Clinical Dentistry, Catholic University, Rome; 4Department of

Stomatology and Oral Sciences, University of Chieti-Pescara, Chieti; 5Department of Orthopaedics

and Traumatology, Catholic University, Rome, Italy

 

Thalassemia is an inherited blood disorder due to an imbalanced globin chain synthesis leading

to anaemia that requires regular blood transfusions and iron-chelating therapy. Of all organ failures

secondary to iron deposit, and all the complications, heart failure still represents the first cause of

death. Osteopenia and osteoporosis can be considered important causes of morbidity in a population

whose lifespan is getting longer, with a strong impact on their quality of life. Authors have reported

mainly bone, oral and maxillofacial abnormalities and relative complications, especially in terms of

traumatic risk, in patients affected by thalassemia. As examples, this study reports bone modifications

in three clinical cases; one of these was also complicated with a femoral fracture, surgically treated with the same criteria of metastatic femoral bone disease. More research on this topic is necessary for the prevention of several complications caused by this disease, and to carefully plan dental or traumatologic operations.

JBRHA 2008;22:211-216

 

 

IMMUNITY, AUTOIMMUNITY AND AUTOIMMUNE DISEASES IN OLDER PEOPLE

 

E. ROSATO and F. SALSANO

 

Department of Clinical Immunology and Allergy, Sapienza University of Rome, Rome, Italy

 

Immunosenescence is defined as all the changes occurring in the immune system in the aged.

Recent studies suggest that in older patients the immune system undergoes a functional remodelling.

Two contrasting phenomena coexist in immunosenescence: the decreasing of immune response and

the autoantibody production. Possible consequences are an increase of autoimmune phenomenon,

neoplasia incidence, and predisposition to infections. The study of autoimmune manifestations in the

elderly population should be considered as a priority for future medical research because of the increase in life expectancy, especially in developed countries. This review analyzes the clinical expression of systemic autoimmune diseases in older patients.

JBRHA 2008;22:217-224

 

 

 

EFFECT OF MODIFIED ALKALINE SUPPLEMENTATION ON BONE METABOLIC

TURNOVER IN RATS

 

D.H. CHUI, F. MAROTTA1, T. LIU, E. MINELLI1, H. YADAV3, P. SIGNORELLI2,

A. LORENZETTI2 and S. JAIN4

 

Neuroscience Research Institute, Peking University, Beijing, China; 1WHO Center for Biotech &

Trad. Medicine, University of Milano, Italy; 2G.A.I.A. Age-Management Foundation, Pavia, Italy;

3Regenerative Biological Section, National Institute of Diabetes & Digestive & Kidney Diseases,

NIH, Bethesda, USA; 4Department of Food Science and Human Nutrition, University of Illinois,

Urbana, IL USA

 

This study aims to determine the effects of a high protein diet and alkaline supplementation on bone

metabolic turnover in rats. Eight-week-old male Sprague-Dawley rats were investigated by bone status,

including bone mineral density (BMD) and biomechanical markers from blood and urine. Thirty rats

were randomly divided into three groups and treated for 8 weeks as follows: baseline control group (n. 10, C), high-protein supplemented diet group (n. 10, chronic acidosis, CA group) and supplemented chronic acidosis (n.10, SCA). Diet-treated rats were fed an acidic high-protein diet and the supplementation consisted in a modified alkaline formula (Basenpulver, Named, Italy). At the end of the experimental period, the rats were sacrificed, blood samples were drawn and femur and tibia were removed for analysis of bone mineral density (BMD) by dual energy X-ray absorptiometry (DEXA). In the CA group, 24-hour urinary calcium (Ca) and phosphorus (P) excretion were increased 2.1-fold (p<0.05 vs normal diet controls) as well as kidney weight. However, serum Ca and P concentration, as well as urinary Dpd excretion were not significantly changed. Femural and tibial BMD was significantly decreased in the CA group (p<0.05), but alkaline supplementation prevented such phenomenon (p<0.05 vs CA). These results suggest that blood Ca and P concentrations in chronic acidosis condition during the 12-week supplementation might be maintained by hypercalciuria and hyperphosphaturia at the expenses of bone structure. However, modified alkaline supplementation is able to prevent such derangements.

JBRHA 2008;22:225-231

 

 

 

INFLUENCE OF BODY MASS INDEX, COMORBIDITIES AND PRIOR SYSTEMIC

THERAPIES ON THE RESPONSE OF PSORIASIS TO ADALIMUMAB: AN

EXPLORATORY ANALYSIS FROM THE APHRODITE DATA

 

N. CASSANO, A. GALLUCCIO1, C. DE SIMONE2, F. LOCONSOLE,

S.D. MASSIMINO3, A. PLUMARI3, S. DATTOLA4, A. PUGLISI GUERRA5,

L. DONATO6, F. CANTORESI7, O. DE PITÀ8, G. FENIZI9, V. ALTAMURA10,

M. CONGEDO11, R. PELLICANO12 and G.A. VENA

 

2nd Dermatology Clinic, University of Bari; 1Unit of Dermatology, Fatebenefratelli Hospital,

Benevento; 2Dermatology Clinic, Sacro Cuore University, Rome; 3Dermatology Unit, Garibaldi

Hospital, Catania; 4Dermatology Unit, Melito Porto Salvo, Reggio Calabria; 5Dermatology Unit,

Papardo Hospital, Messina; 6Dermatology Unit, Crotone Hospital, Crotone; 7Dermatology Clinic,

Sapienza University, Rome; 8Istituto Dermopatico dell’Immacolata, IRCCS, Rome; 9Dermatology

Unit, Ospedali Riuniti, Foggia; 10Dermatology Unit, Perrino Hospital, Brindisi; 11Dermatology

Unit, Fazzi Hospital, Lecce; 12Dermatology Unit, Ospedale Casa Sollievo della Sofferenza, IRCCS,

S. Giovanni Rotondo, Foggia, Italy

 

Adalimumab is a fully human monoclonal antibody directed against tumor necrosis factor (TNF)-

alpha, which is effective for the treatment of psoriasis and psoriatic arthritis (PsA). The aim of this

study is to determine whether the response of psoriasis to adalimumab treatment might be influenced

by certain particular factors, such as body mass index (BMI), history of biologic therapy, blood

hypertension and metabolic comorbidities. For this reason, an exploratory analysis was conducted on

144 patients with psoriasis and concomitant PsA treated with adalimumab 40 mg every other week,

evaluating the influence of such factors on the Psoriasis Area and Severity Index (PASI) response rate at week 12. Our preliminary results suggest that the response rate at week 12, in terms of both PASI-50 and PASI-75, appeared to be independent of the presence of hypertension and/or metabolic comorbidities. The PASI-50 response was observed more frequently in patients with BMI less than 30 as compared to obese patients (79% vs 58%, p = 0.02). Previous use of anti-TNF biologics did not appear to affect per se the rate of responders, although it was associated with a lower PASI-75 rate among responders.

JBRHA 2008;22:232-238

 

 

 

RELATION BETWEEN PSYCHONEUROENDOCRINE PROFILE IN STRESSFUL

CONDITIONS AND ANTIBODIES TO HERPESVIRUS 6 AND 7

 

R. VIVOLI, S. ROVESTI, P. BORELLA and C. CERMELLI

 

Department of Public Health Sciences, University of Modena and Reggio Emilia, Modena, Italy

 

The aim of the present study is to evaluate whether the individual susceptibility to infectious disease

is influenced by the psychological profile of cadets exposed to stressful events associated with military

lifestyle in academy and if the neuroendocrine responses to stressful events is related with humoral

immunity estimated by measuring antibody titres to human herpesvirus (HHV-6)7 (HHV-7) and to what extent it is influenced by personality traits. It has been observed that cadets with lower psychoaptitude scores (1-2) have a significant higher susceptibility to infectious disease (χ2=7.95; p=0.019) compared to subjects with higher scores. A positive relationship between cortisol and antibody titers to HHV-6 (r=0.304; p=0.024) it has been found. It can be interesting to observe that antibody titers on HHV-6 are also related to psychoaptitude profile (r=0.239; p=0.044). The antibody titers to HHV-7 are negatively related to the 5 scales of BFQ and in particular with subdimension Co (cordiality) of BFQ (r=0.401; p=0.002). The survey carried out on over 1,500 cadets of the Military Academy of Modena shows that the susceptibility to infectious diseases during the first six months of admission to the Academy seem to be influenced by the psychoaptitudinal profile. The finding of a positive relationship between serum cortisol and antibody vs HHV-6 suggests that the impairment of the immune system linked to circulatory cortisol levels may induce a reactivation of a latent herpesvirus 6 with related increase of antibody titers.

JBRHA 2008;22:239-245

 

 

 

 

EVALUATION OF MAGNETIC RESONANCE SIGNAL MODIFICATION INDUCED BY

HYALURONIC ACID THERAPY IN CHONDROMALACIA PATELLAE:

A PRELIMINARY STUDY

 

N. MAGARELLI, D. PALMIERI1, L. OTTAVIANO2, M. SAVASTANO3, M. BARBATO4,

A. LEONE, A. MAGGIALETTI5, F.P. CIAMPA1 and L. BONOMO

 

Department of Radiology, Cattolica University, School of Medicine, Policlinico Agostino Gemelli,

Rome; 1Department of Orthopaedics and Traumatology, “S. Spirito” Hospital, Pescara; 2Department of D.M.S.I., Section of Forensic Medicine, “G. d’Annunzio” University, Chieti;

3Department of Radiology, “G. d’Annunzio” University, Chieti; 4Department of Orthopaedic and

Traumatology, “G. Bernabeo” Hospital, Ortona; 5Radiology Service, L. Bonomo Hospital, Andria, Italy

 

Hyaluronic Acid (HA) is an alternative method for the treatment of osteoarthritis (OA), which acts

on pain through a double action: anti-inflammatory and synovial fluid (SF) visco-supplementation.

Magnetic Resonance Imaging (MRI), utilizing specific sequences, is a valid method for studying the

initial phase of chondral damage. The analysis of the data, obtained through the intensity of values taken by positioning Region of Interest (ROIs) within the lesion, determining the differences before and after treatment with HA injected into the knee. The results obtained after six months and one year from the injection were statistically different in respect to those taken before, immediately and after three months of treatment. MRI represents a valid tool to evaluate the grade of chondromalacia patellae and also to follow the cartilage modification induced by HA therapy.

JBRHA 2008;22:247-252

 

 

 

 

UPGRADED DIAGNOSTIC VALUE OF GEN-PROBE PACE 2 ASSAY FOR DETECTION

OF CHLAMYDIA TRACHOMATIS INFECTION

 

I. ROBUFFO, P. FAZII1, A. RULLI2, M. DI NICOLA3, E. TONIATO4, M. DI RIENZO,

L. COSENTINO1, A. GAMBI2, M.L. CASTELLANI5 and S. MARTINOTTI4,6

 

Istituto di Genetica Molecolare, CNR, Sezione di Chieti, Chieti; 1Laboratorio Analisi Chimico-

Cliniche e Microbiologia, P.O. “Spirito Santo”, Pescara; 2Laboratorio Analisi Chimico-Cliniche

e Microbiologia, Ospedale Clinicizzato “SS Annunziata”,Chieti; 3Dipartimento di Scienze

Biomediche, Laboratorio di Biostatistica, Università “G. d’Annunzio”, Chieti; 4Dipartimento di

Oncologia e Neuroscienze, Patologia Generale, Università “G. d’Annunzio”, Chieti; 5Department

of Medicine and Science of Ageing, University of Chieti, Chieti; 6Center of Excellence on Aging,

CRC, G. d’Annunzio Foundation, University of Chieti, Chieti, Italy

 

In this study, we evaluate the performance of a nucleic acid amplification assay, COBAS AMPLICOR

(Roche Molecular systems) (PCR), compared to non-amplified DNA probe assay PACE2 (Gen-Probe

Inc.) for the detection of C. trachomatis in a total of 2,916 samples (2,114 females and 802 males)

consecutively collected in two different clinical pathology laboratories, over a period of three years. In

the females, the endocervical swabs showed a similar range of detection when using the two different

methods: out of 1,581 females processed with PACE 2, 1.4% (2005), 0.9% (2006), 0.5% (2007), resulted positive for C. trachomatis; out of 533 females processed with PCR, 1.3% (2005), 1.5% (2006) and 1.2% (2007), resulted positive. However, in the male subjects we found an increased positivity of Chlamydia detection on urethral swabs by using PACE 2: 4.8% (2005), 1.9% (2006) and 2.9% (2007), compared to urine specimen processed by PCR: 1% (2005), 1.4% (2006) and 0% (2007). Even if PCR should be considered a most promising tool for routine diagnosis of Chlamydia infection, Gen Probe allowed us to better identify Chlamydia trachomatis (in 4.8% of urethral swabs compared to urine) leading to a hypothesis that extracellular EB forms of Chlamydia could be absent in urine in persistent infectious.

JBRHA 2008;22:253-261

 

 

 

 

PERIODIC FEVER AS THE ONLY PRESENTING SYMPTOM OF MULTIPLE

MYELOMA IN A YOUNG MAN

 

C. TRAKATELLI, E. KINTIRAKI, J. KORATZIS1, L. GAMVRILI,

V. KOTSIS and M. SION

 

Third Department of Internal Medicine, Papageorgiou Hospital, Aristotelian University of

Thessaloniki, Thessaloniki; 1Department of Hematology, Papageorgiou Hospital, Thessaloniki, Greece

 

We describe a 30-year-old male patient presenting with periodic fever. The patient underwent a series

of laboratory tests, X-rays and CT scans. Quantitative immunoglobulin showed IgG 3210.00mg/bl, IgA

20.00mg/dl and IgM 27.70mg/dl. Serum protein electrophoresis revealed a peak with a broad gamma

band. Immunofixation revealed an immunoglobulin G -λ monoclonal component. A bone marrow biopsy established the presence of multiple myeloma. To our knowledge, a periodic 24-hour-lasting fever as the only presenting symptom of multiple myeloma has never been reported.

JBRHA 2008;22:263-265

 

 

BRONCHODILATION TEST IN ALLERGIC ADOLESCENTS

 

G.L. MARSEGLIA, A. MARCHI, D. CAIMMI, S. CAIMMI, M. DI GIOACCHINO1

and G. CIPRANDI2

 

Dipartimento di Scienze Pediatriche, Università di Pavia, Fondazione IRCCS Policlinico San

Matteo, Pavia; 1Allergy Related Disease Unit, “G. d’Annunzio University” Foundation, Chieti;

2Dipartimento di Medicina Interna, A.O.U. San Martino, Genova, Italy

 

This study highlights the close link between upper and lower airways and the relevance of

bronchodilation test in patients presenting with moderate-severe persistent allergic rhinitis and mild

persistent asthma.

JBRHA 2008;22:267-270

 

 

TWO-YEAR FOLLOW-UP IN AN EARLY RHEUMATOID ARTHRITIS PATIENT

TREATED WITH ETANERCEPT: RADIOLOGICAL INVOLVEMENT DESPITE

CLINICAL REMISSION

 

B. LAGANÀ, A. PICCHIANTI DIAMANTI, V. GERMANO, G. ARGENTO1,

C. FERLITO and R. D’AMELIO

 

Department of Medical Sciences, “Sapienza” University of Rome, 2nd School of Medicine, S.

Andrea University Hospital, Rome; 2Division of Radiology, “Sapienza” University of Rome, 2nd

School of Medicine, S. Andrea University Hospital, Rome, Italy

 

This case report describes an excellent clinical and radiological response in an eRA patient treated

with Etanercept; however, it indicates that joint damage may progress, despite a sustained clinical

remission, after Etanercept suspension.

JBRHA 2008;22:271-273