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1.
J Crohns Colitis ; 11(8): 942-953, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28333239

RESUMO

BACKGROUND AND AIMS: An increased risk of small bowel carcinoma [SBC] has been reported in coeliac disease [CD] and Crohn's disease [CrD]. We explored clinico-pathological, molecular, and prognostic features of CD-associated SBC [CD-SBC] and CrD-associated SBC [CrD-SBC] in comparison with sporadic SBC [spo-SBC]. METHODS: A total of 76 patients undergoing surgical resection for non-familial SBC [26 CD-SBC, 25 CrD-SBC, 25 spo-SBC] were retrospectively enrolled to investigate patients' survival and histological and molecular features including microsatellite instability [MSI] and KRAS/NRAS, BRAF, PIK3CA, TP53, HER2 gene alterations. RESULTS: CD-SBC showed a significantly better sex-, age-, and stage-adjusted overall and cancer-specific survival than CrD-SBC, whereas no significant difference was found between spo-SBC and either CD-SBC or CrD-SBC. CD-SBC exhibited a significantly higher rate of MSI and median tumour-infiltrating lymphocytes [TIL] than CrD-SBC and spo-SBC. Among the whole SBC series, both MSI─which was the result of MLH1 promoter methylation in all but one cases─and high TIL density were associated with improved survival at univariable and stage-inclusive multivariable analysis. However, only TILs retained prognostic power when clinical subgroups were added to the multivariable model. KRAS mutation and HER2 amplification were detected in 30% and 7% of cases, respectively, without prognostic implications. CONCLUSIONS: In comparison with CrD-SBC, CD-SBC patients harbour MSI and high TILs more frequently and show better outcome. This seems mainly due to their higher TIL density, which at multivariable analysis showed an independent prognostic value. MSI/TIL status, KRAS mutations and HER2 amplification might help in stratifying patients for targeted anti-cancer therapy.


Assuntos
Doença Celíaca/complicações , Neoplasias do Colo/etiologia , Doença de Crohn/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Celíaca/diagnóstico , Doença Celíaca/genética , Doença Celíaca/patologia , Criança , Classe I de Fosfatidilinositol 3-Quinases/genética , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Doença de Crohn/diagnóstico , Doença de Crohn/genética , Doença de Crohn/patologia , Humanos , Masculino , Instabilidade de Microssatélites , Pessoa de Meia-Idade , Prognóstico , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Receptor ErbB-2/genética , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Proteína Supressora de Tumor p53/genética , Adulto Jovem
2.
J Immunol Res ; 2015: 501361, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26090492

RESUMO

The term "microbiota" means genetic inheritance associated with microbiota, which is about 100 times larger than the guest. The tolerance of the resident bacterial flora is an important key element of immune cell function. A key role in the interaction between the host and the microbiota is played by Paneth cell, which is able to synthesize and secrete proteins and antimicrobial peptides, such as α/ß defensins, cathelicidin, 14 ß-glycosidases, C-type lectins, and ribonuclease, in response to various stimuli. Recent studies found probiotics able to preserve intestinal homeostasis by downmodulating the immune response and inducing the development of T regulatory cells. Specific probiotic strain, as well as probiotic-driven metabolic products called "postbiotics," has been recently recognized and it is able to influence innate immunity. New therapeutic approaches based on probiotics are now available, and further treatments based on postbiotics will come in the future.


Assuntos
Imunidade Inata/efeitos dos fármacos , Imunidade Inata/imunologia , Microbiota/efeitos dos fármacos , Microbiota/imunologia , Celulas de Paneth/imunologia , Celulas de Paneth/microbiologia , Probióticos/farmacologia , Animais , Humanos , Celulas de Paneth/efeitos dos fármacos
3.
Support Care Cancer ; 20(8): 1919-28, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22314972

RESUMO

PURPOSE: There is little information about the nutritional status of cancer outpatients because the practice of nutritional screening is rarely performed. This study aims to define the pattern of scores of nutritional risk in 1,453 outpatients and factors associated with a high nutrition risk score, to facilitate the identification of such patients by the oncologists. METHODS: We prospectively screened the nutritional status of cancer outpatients according to the NRS-2002 score which combines indicators of malnutrition and of severity of the disease (1-3 points, respectively). A score ≥ 3 indicates "nutritional risk". The association of the nutritional scores with some patient/tumour/therapy-related variables was investigated through univariable and multivariable linear regression models. RESULTS: Thirty-two percent of outpatients were at nutritional risk. Primary tumour site, Eastern Cooperative Oncology Group score and presence of anorexia or fatigue were significantly associated with the nutrition risk score. Depending on the combination of these variables, it was possible to estimate different probabilities of nutritional risk. CONCLUSIONS: The frequency of a relevant nutritional risk was higher than expected considering the favourably selected population. The nutritional risk was associated with common clinical variables which are usually recorded in the charts and could easily alert the oncologist on the need of a further nutritional assessment or a nutritional support.


Assuntos
Distúrbios Nutricionais/etiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Idoso , Feminino , Humanos , Itália/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Distúrbios Nutricionais/epidemiologia , Estado Nutricional , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença
4.
J Invest Dermatol ; 128(8): 1920-4, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18323783

RESUMO

The enhancer DNase-hypersensitive region 1,2 (HS1,2), a member of the Ig heavy-chain 3' regulatory region (3'RR) cluster, is active in human B cells transfected with reporter genes and in mouse is activated in late maturation. HS1,2-A contains binding sites for several transcription factors. There are four known alleles, that is, (*)1, (*)2, (*)3, and (*)4, which differ in their lengths in transcription factor binding. We showed that in celiac disease the frequency of the (*)2 allele is increased. Both dermatitis herpetiformis (DH) and psoriasis can be associated with different frequencies with celiac disease. Thus, we further investigate the frequency of allele (*)2 in DH, plaque psoriatic, and psoriatic arthritis patients. HS1,2-A allele frequencies were investigated in 37 DH, 61 plaque psoriatic, 28 psoriatic arthritis patients, and 265 healthy donors, age- and sex-matched, from the same geographical area. The frequency of the (*)2 allele changes from 0.39 in controls to 0.63 in DH, 0.59 in plaque psoriasis and 0.75 in psoriatic arthritis (P between 10(-4)-10(-5)). Our data evidence an increased frequency of the (*)2 allele of HS1,2-A in these cutaneous immune-related disorders. We suggest a related genetic predisposition in these pathogeneses.


Assuntos
Alelos , Artrite Psoriásica/genética , Dermatite Herpetiforme/genética , Elementos Facilitadores Genéticos/genética , Frequência do Gene/genética , Cadeias Pesadas de Imunoglobulinas/genética , Psoríase/genética , Adulto , Sequência de Bases , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular
5.
Int J Cardiol ; 116(2): e34-8, 2007 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-17070606

RESUMO

We report the case of a young anorexic woman who suffered a sudden loss of consciousness with convulsions, diagnosed as epilepsy associated with a migrational disorder, as documented at MRI. Standard 12-lead ECG showed a prolonged QT interval. Biochemical tests revealed a severe hypokalemia. Continuous 24-h ECG recording detected a ventricular tachycardia in torsades de pointes inducing a syncopal convulsive attack that seemed to be related to oral Cisapride assumption for dyspepsia. Discontinuation of cisapride and normalization of kalemia caused disappearance of both ECG abnormalities and loss of consciousness episodes. Syncope is a condition often misdiagnosed as epileptic seizures.


Assuntos
Anorexia/complicações , Convulsões/complicações , Convulsões/diagnóstico , Síncope/complicações , Síncope/diagnóstico , Adulto , Cisaprida/efeitos adversos , Cisaprida/uso terapêutico , Diagnóstico Diferencial , Dispepsia/tratamento farmacológico , Epilepsia/diagnóstico , Feminino , Fármacos Gastrointestinais/efeitos adversos , Fármacos Gastrointestinais/uso terapêutico , Humanos , Convulsões/induzido quimicamente , Síncope/induzido quimicamente , Taquicardia Ventricular/induzido quimicamente
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