[Vaccines for the treatment of drug addiction]. / Vaccini contro la dipendenza da sostanze psicoattive.

The treatment of drug addiction is a very wide-ranging sector within modern medicine. The use of immunotherapy in this context represents an innovative approach. The purpose of this paper is to illustrate, through a literature review, the main avenues of research and the results obtained with immunotherapy in the treatment of drug addiction.

[Immunotherapeutic approach for the prevention and treatment of chronic diseases]. / Approccio immunoterapeutico per la prevenzione e la terapia delle malattie cronico-degenerative.

Alzheimer disease, diabetes and cardiovascular diseases are among the leading causes of morbidity and mortality worldwide. Different immunotherapeutic approaches for prevention and treatment of these diseases are currently object of several researches. In this paper, recent trials describing active and passive immunotherapy for the management of these pathologies are discussed. The recent immunotherapeutic and preventive approaches for the treatment of Alzheimer's disease are based on the use of ß-amyloid peptides and to tau-based immunization strategies but new possibility are explored. Immunotherapeutic vaccine against angiotensin II showed promising results for the management of hypertension. Heath shock proteins and ß2-glycoprotein I have been tested to reduce atherosclerosis. Insulin agonists were used for preventing type 1 diabetes in mouse; IL-1ß was effective in experimental type 2 diabetes. Research in the field of immunological approach to treatment and prevention of chronic diseases is promising even if the present results have been obtained mainly in animal models.

[Therapeutic cancer vaccines: only hope or concrete opportunity for the future?]. / Vaccini terapeutici contro il cancro: solo speranza o concreta prospettiva per il futuro?

In the recent years, research in the field of anti-tumour therapeutic vaccines showed a rapid development. Many studies regarding different types of cancers are presently on going. In the trials various immunological approaches are applied and studied in combination with standard therapies. Results are controversial and anti-tumor vaccines are not licensed in the European Union and only one is commercialized in US. Before these vaccines can be considered a valid therapeutic alternative it is necessary that the characteristics of the candidate patients are clearly identified and that clinical efficacy, length of protection and safety are well documented. Moreover a correct evaluation of socio-economic and public health aspects should be available.

[Epidemiology and prevention of hepatitis A and B in developing countries]. / Attualità in epidemiologia e prevenzione delle epatiti A e B nei Paesi in via di sviluppo.

Viral hepatitis A and B are serious public health problems all over the world. Effective prophylactic measures and improvement in the hygienic and sanitary conditions have considerably modified the diseases trend, characterized by high prevalence levels in developing countries. In this paper the epidemiology of hepatitis A and B is reviewed, focused on endemic areas, on the basis of data collected from local and international studies in order to evaluate prevention strategies for both local population and travelers.

[Active immunoprophylaxis to reduce clinical impact of Herpes Zoster and its complications]. / Prospettive dell'immunoprofilassi attiva nella riduzione dell'impatto dell'Herpes Zoster e delle sue complicanze.

Herpes Zoster is a painful cutaneous eruption caused by reactivation of Varicella Zoster Virus, years after primary infection. Approximately one third of the population, and more than 50% of persons older than 80, will present zoster in their lifetime. Zoster complications, particularly postherpetic neuralgia, are common and result in worsening health status and quality of life, with high direct and indirect costs. Licensed zoster vaccine, available in Italy in a next future, is efficacious in preventing virus reactivation and particularly in reducing complications.

[Persistence of protection induced by hepatitis B vaccine.]. / Persistenza della protezione indotta dal vaccino anti-epatite B.

Universal mass vaccination against hepatitis B virus in infants and adolescents, together with targeted prophylaxis for risk groups, is recommended since almost twenty years all over the world to prevent infection and related diseases. Safety and effectiveness of the vaccine have been clearly demonstrated while unambiguous data about long term protection and need of booster administration are not yet available, especially for high risk subjects like health care workers and dialysis patients. By means of new vaccines and new adjuvants better results could be obtained in a next future.

[Invasive pneumococcal diseases in children and surveillance systems in Italy]. / Malattie invasive da pneumococco nell'infanzia e sistemi di sorveglianza in Italia.

Streptococcus pneumoniae is the causative agent of invasive diseases and of localized infections in children and older people. World and European epidemiological data show differences in disease incidences and in prevalences of pathogenic serotypes. Epidemiology changed after the introduction of conjugate vaccines for infants even if the still inadequate surveillance systems do not allow a comparison of the data. In this paper the Italian available epidemiological data and surveillance systems are rewied considering problems related to the emergence of new or drug-resistant strains and the advantages awaited from the new vaccines.

[Hepatitis A and Hepatitis B: present immunization strategies]. / Epatiti A e B: quali aggiornamenti sulle strategie vaccinali?

The most recent data on the epidemiology of hepatitis A and B and on the immunization strategies are presented and discussed. In Italy Hepatitis A vaccine is recommended for risk groups, while a wide strategy is implemented against hepatitis B in order to reach the elimination of the disease.

Hepatitis B: Epidemiology and prevention in developing countries.

Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.

Nucleotide correlation between HAV isolates from human patients and environmental samples.

Hepatitis A disease is endemic in Albania even though records from the Medical Authority show outbreaks involving only limited numbers of people. In the city of Lac, 200 people became ill following an outbreak of hepatitis A started on November 2002. The age distribution of the cases shows a peak in the age group 5-9 (43.5%) followed by the age group 10-14 (28%) and the age group 1-4 (18%). No cases were recorded in the age group 0-1. Drinking water and sewage samples were collected, using electropositive cartridges, during the outbreak. Rotavirus was identified by RT-PCR in two out of five drinking water samples; however, all the samples tested negative for HAV and astrovirus. Rotavirus was also identified in three out of five sewage samples from which four were HAV positive. HAV-RNA was identified in 28 (62.2%) out of 45 IgM anti-HAV positive sera collected during the outbreak. Genotype IA was expressed from all the amplified samples. Sequence analysis of the overlapping VP1-2A region shows 97-99% homology with three Italian strains IT-SCH-00, IT-ZAM-01, and IT-CAP-00 and one Spanish strain (Sa 30/06/95), whereas the phylogenetic tree built from the 168 bp sequence of the VP1-2A shows four clusters, one including 24 out of 28 RT-PCR positive sera. Considering the deduced amino acid sequence, only one substitution was identified and reported previously for genotype IB.