RESUMO
The information regarding the probability of finding a matched unrelated donor (MUD) within a relatively short time is crucial for the success of hematopoietic stem cell transplantation (HSCT), particularly in patients with malignancies. In this study, we retrospectively analyzed 315 Italian patients who started a search for a MUD, in order to assess the distribution of human leukocyte antigen (HLA) alleles and haplotypes in this population of patients and to evaluate the probability of finding a donor. Comparing two groups of patients based on whether or not a 10/10 HLA-matched donor was available, we found that patients who had a fully-matched MUD possessed at least one frequent haplotype more often than the others (45.6% vs 14.3%; P = 0.000003). In addition, analysis of data pertaining to the HLA class I alleles distribution showed that, in the first group of patients, less common alleles were under-represented (20.2% vs 40.0%; P = 0.006). Therefore, the presence of less frequent alleles represents a negative factor for the search for a potential compatible donor being successful, whereas the presence of one frequent haplotype represents a positive predictive factor. Antigenic differences between patient and donor observed at C and DQB1 loci, were mostly represented by particular B/C or DRB1/DQB1 allelic associations. Thus, having a particular B or DRB1 allele, linked to multiple C or DQB1 alleles, respectively, might be considered to be associated with a lower probability of a successful search. Taken together, these data may help determine in advance the probability of finding a suitable unrelated donor for an Italian patient.
Assuntos
Seleção do Doador , Antígenos HLA/genética , Transplante de Células-Tronco Hematopoéticas , Doadores de Tecidos , Alelos , Frequência do Gene/genética , Loci Gênicos/genética , Haplótipos/genética , Humanos , Itália , Doadores não RelacionadosRESUMO
BACKGROUND: Although peripheral neuropathies (PN) have been described in patients with Parkinson's disease (PD) treated with oral dopaminergic therapies, anecdotal reports of subacute severe PN have been reported during treatment with enteral levodopa/carbidopa infusion (Duodopa). AIM OF THE STUDY: We prospectively assessed clinical and electrophysiological data of 15 consecutive patients with PD treated with Duodopa for a mean follow-up of 9 months. METHODS: Nerve conduction studies and a clinical evaluation with a standardized battery of peripheral neuropathy scales were performed at baseline and after a mean follow-up of 9 months. RESULTS: At baseline, mild signs of PN were observed in three subjects, and vitamin B12 serum levels were found to correlate with the amplitude of sural sensory action potentials. Follow-up data were available for 10/15 subjects: one patient developed a subacute sensory-motor PN and three subjects with pre-existing PN showed a moderate worsening of electrophysiological and clinical features. Subclinical electrophysiological alterations of peripheral nerves were observed in two subjects. No significant changes were observed in vitamin B12, folate, homocysteine and methylmalonic acid levels. CONCLUSIONS: In this consecutive series of patients treated with Duodopa, we observed one subacute sensory-motor PN and few length-dependent alterations of peripheral nerves, similar to those described during oral levodopa treatment.
Assuntos
Antiparkinsonianos/efeitos adversos , Carbidopa/efeitos adversos , Levodopa/efeitos adversos , Condução Nervosa/efeitos dos fármacos , Transtornos Parkinsonianos/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Potenciais de Ação/efeitos dos fármacos , Idoso , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/farmacologia , Antiparkinsonianos/uso terapêutico , Carbidopa/administração & dosagem , Carbidopa/farmacologia , Carbidopa/uso terapêutico , Combinação de Medicamentos , Feminino , Seguimentos , Géis , Humanos , Absorção Intestinal/efeitos dos fármacos , Levodopa/administração & dosagem , Levodopa/farmacologia , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Transtornos Parkinsonianos/sangue , Doenças do Sistema Nervoso Periférico/sangue , Estudos Prospectivos , Tempo de Reação/efeitos dos fármacos , Vitamina B 12/sangue , Deficiência de Vitamina B 12/sangue , Deficiência de Vitamina B 12/induzido quimicamenteRESUMO
The novel HLA-DPA1*01:130 allele differs from HLA-DPA1*01:03:01:03 by one nucleotide substitution in Exon 3.
Assuntos
Cadeias alfa de HLA-DP , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Alelos , Teste de Histocompatibilidade , Cadeias alfa de HLA-DP/genéticaRESUMO
The novel allele HLA-DQB1*04:09 differs from DQB1*04:02:01 by three nonsynonymous nucleotide substitutions in exon 2.
Assuntos
Alelos , Cadeias beta de HLA-DQ/genética , Polimorfismo de Nucleotídeo Único , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Sequência de Bases , Éxons , Teste de Histocompatibilidade , Humanos , Itália , Dados de Sequência Molecular , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Alinhamento de Sequência , Análise de Sequência de DNARESUMO
BACKGROUND: The aim of the survey was to estimate the prevalence, duration and exclusivity of breastfeeding (AS) in the province of Rieti, using standardized indicators, for further assessment. METHODS: this is an observational prospective study, through questionnaires self-administered to parents of children receiving the first two vaccinations mandatores. The survey was conducted in the outpatient paediatric vaccine clinics and attended by parents of 198 children born in 2010, who carried out the vaccinations required by law in the first six months of life. The main outcome measures were the prevalence of exclusive breastfeeding (AE), predominant breastfeeding (AP), partial breastfeeding (AC) and with formula feeding only (not AS) after three and six months in postpartum. Have been also studied a number of factors that may affect the ability of the mothers to breastfeed and its continuation. RESULTS: At 3 months of age, the proportion of infants who were being breastfed was 65.5%, (AE 39.7%, AP 11.7%, 14.1% AC), while, after 5 months in postpartum the proportion of any AS was 51.7% ( AE 18.5%, AP 15.6% and 17.9% AC). Based on the regression model, significant associations were observed between AS complete at the 3rd and 5th month, and natural delivery (OR 2.6, respectively, and OR 1.9); having breastfed her son during the first 48 hours of birth was associated with increased prevalence of AS at 3rd month (OR 3.5), but it was not significant associated at the 5th month. Pre-term birth reduces significantly the probability of BF (OR 0.3) at the first vaccination. The use of pacifiers has been associated with reduced prevalence and early discontinuation of BF (respectively, OR 0.2 at 3rd month and OR 0.3 at 5th month). CONCLUSION: The survey confirms the need to assist the new mothers in the postpartum to promote the practice of exclusive breastfeeding and its continuation. The identification of specific risk groups, such as women who have caesarean delivery or who started late lactation, allows health professionals to act with greater awareness and achieve greater efficiency in interventions.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Lactente , Itália , Masculino , Estudos Prospectivos , Inquéritos e Questionários , Fatores de TempoRESUMO
DQB1*05:304 allele was identical to DQB1*05:02:01 except for a single nucleotide substitution.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Nucleotídeos , Humanos , Sequência de Bases , Alelos , Cadeias beta de HLA-DQ/genéticaRESUMO
The novel HLA-C allele C*06:58 shows one nucleotide change from C*06:02:01:01 at nt 366 from G to A, resulting in an amino acid change at codon 98 of exon 3 from Met to Ile.
Assuntos
Alelos , Substituição de Aminoácidos , Éxons/genética , Antígenos HLA-C/genética , Família , Feminino , Humanos , Itália , Masculino , Análise de Sequência de DNARESUMO
The new allele shows one nucleotide change from C*07:02:01:01 at 351 nt from C to A, resulting in an amino acid change at codon 93 of exon 3 from H to Q.
Assuntos
Alelos , Éxons/genética , Antígenos HLA-C/genética , Mutação/genética , Sequência de Aminoácidos , Sondas de DNA de HLA/genética , Transplante de Células-Tronco Hematopoéticas , Teste de Histocompatibilidade , Humanos , Itália , Dados de Sequência Molecular , Polimorfismo de Nucleotídeo Único , Análise de Sequência de DNA , Doadores de TecidosRESUMO
Polymorphisms in the 3' untranslated region (3'UTR) of HLA-G, an important player in immunological tolerance, could be involved in post-transcriptional expression control, and their association with different clinical immune-related conditions including autoimmunity and transplantation is of mounting interest. Most studies have focused on a 14 base pair (bp) insertion/deletion (ins/del), while additional single-nucleotide polymorphisms (SNPs) in the HLA-G 3'UTR have been described but not extensively investigated for their clinical relevance. Here we have comparatively studied the association between 3'UTR haplotypes of HLA-G, or the 14 bp ins/del, with clinical outcome of HLA-identical sibling hematopoietic stem cell transplantation (HSCT) in 147 Middle Eastern beta-thalassemia patients. Sequence based typing of 3'UTR HLA-G polymorphisms in the patients and in 102 healthy Italian blood donors showed strong linkage disequilibrium between the 14 bp ins/del and five 3'UTR SNPs, which together could be arranged into eight distinct haplotypes based on expectation-maximization studies, with four predominant haplotypes (UTRs1-4). After HSCT, we found a moderate though not significant association between the presence of UTR-2 in double dose and protection from acute graft versus host disease (hazard ratio (HR) 0.45, 95% confidence intervals (CI): 0.14-1.45; P = 0.18), an effect that was also seen when the corresponding 14 bp ins/ins genotype was considered alone (HR 0.42, 95% CI: 0.16-1.06; P = 0.07). No association was found with rejection or survival. Taken together, our data show that there is no apparent added value of considering entire 3'UTR HLA-G haplotypes for risk prediction after allogeneic HSCT for beta-thalassemia.
Assuntos
Regiões 3' não Traduzidas/genética , Doença Enxerto-Hospedeiro/genética , Antígenos HLA-G/genética , Transplante de Células-Tronco Hematopoéticas , Talassemia beta/genética , Regiões 3' não Traduzidas/imunologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Genótipo , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/imunologia , Haplótipos/genética , Haplótipos/imunologia , Humanos , Tolerância Imunológica , Itália , Desequilíbrio de Ligação , Masculino , Mutagênese Insercional , Polimorfismo Genético , Deleção de Sequência , Irmãos , Transplante Homólogo , Resultado do Tratamento , Talassemia beta/imunologia , Talassemia beta/terapiaRESUMO
Human leukocyte antigen (HLA) class I sequence-based typing (SBT) for hematopoietic unrelated donor searching in an Italian Caucasian patient showed the presence of a novel HLA-A allele defined as A*31:48. HLA-A*31:48 has one nucleotide change from A*31:01:02 at nt 727 from C to T, resulting in an amino acid change at codon 219 of exon 4 from Arg to Trp.
Assuntos
Alelos , Substituição de Aminoácidos , Antígenos HLA-A/genética , Mutação de Sentido Incorreto , Adulto , Anemia Aplástica/genética , Anemia Aplástica/terapia , Feminino , HumanosRESUMO
The study of human leukocyte antigen (HLA), allele and haplotype frequencies within populations provides an important source of information for anthropological investigation, organ and hematopoietic stem-cell transplantation purposes as well as disease association studies. As of today, there are no data available in the literature on the HLA structure of the Maldivian population. Altogether 106 families were studied. We used the parents of each family (212 unrelated individuals) to analyze the frequencies of HLA class I and class II allele groups and haplotypes.
Assuntos
Antígenos HLA/genética , Alelos , Análise Mutacional de DNA , Família , Frequência do Gene , Predisposição Genética para Doença , Genética Populacional , Haplótipos , Teste de Histocompatibilidade , Humanos , Ilhas do Oceano Índico , Desequilíbrio de Ligação , Análise de Sequência de DNA , Talassemia/genéticaRESUMO
BACKGROUND: Nail psoriasis occurs in up to half of psoriatic patients and can lead to significant physical impairment and pain. To date, patients and clinicians are actually dissatisfied by current therapeutic approaches. OBJECTIVE: Our main aim is to evaluate Infliximab efficacy in nail psoriasis. METHODS: We performed an open-label and uncontrolled retrospective study considering all psoriatic patients presenting recalcitrant nail involvement and receiving Infliximab in our Department during the period between January 2008 and March 2009. We calculated nail psoriasis severity index (NAPSI) score at 0, 14, 22 and 38 weeks and percentage of patients achieving NAPSI-50,-75,-90 at 14, 22 and 38 weeks. RESULTS: We observed a rapid nail improvement in most cases after 22 weeks of Infliximab therapy, but a complete nail clearing was reached in only five (10.4%) patients. We don't have a follow-up longer than 38 weeks to assess long-term efficacy of this treatment in nail psoriasis. CONCLUSIONS: Infliximab, in our experience, has proved to be effective in reducing nail lesions and, in some cases, even clearing them. Our data demonstrate long-term efficacy of this biological agent in nail psoriasis.
Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Doenças da Unha/tratamento farmacológico , Psoríase/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Infliximab , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Intense pulsed light (IPL) treatment is one of the most effective procedures for patients with non-aesthetic vascular lesions in addition to signs of skin photoageing, and it has been reported as very successful in the treatment of telangiectasias, spider nevi, erythrosis, and above all, rosacea and poikiloderma. Its use is based on the principle of selective photothermolysis, which exploits the haemoglobin absorption peak among its range of wavelengths. OBJECTIVE: The aim of this study is to assess the efficacy and safety of intense pulsed light in treating non-aesthetic vascular skin lesions, especially with regard to poikiloderma of Civatte and rosacea. METHODS: A total of eighty-five patients, 64 women and 21 men, with 63 non-aesthetic vascular lesions (28 Poikiloderma of Civatte and 35 rosacea), 22 pigmented lesions (UV-related hyperpigmentation of solar lentigo-type) and four precancerous lesions (actinic keratosis, AKs), were treated repeatedly with IPL for 2 years. The patients received a mean of five treatments (range 4-6) at 3-weekly intervals. They were evaluated via clinical observations and professional photographs were taken before each treatment and after 2 weeks, 4 weeks, 3 months, 6 months and 12 months. The outcome of the IPL treatments was evaluated by four independent dermatologists, who were not informed about the study protocol, and who assessed the performance of IPL by dividing the results into four categories: no results, slight improvement, moderate improvement and marked improvement. RESULTS: All the patients showed improvements in their overall lesions: 72 lesions (80.9%) achieved a marked improvement, 14 lesions (15.7%) achieved a moderate improvement and three lesions (3.4%) achieved a slight improvement. The results of the 63 non-aesthetic vascular lesions in Rosacea and Poikiloderma of Civatte were: 51 with a marked improvement, 10 with moderate improvement, whereas only two lesions achieved a slight improvement. The improvement of all four actinic keratoses was marked whereas the 22 pigmented lesions obtained a marked improvement in 17 cases, a moderate improvement in four cases and a slight improvement in one case. No undesirable effects were observed. CONCLUSIONS: Our study confirms how by minimizing side-effects, time and costs, IPL can be effective and safe for the treatment of non-aesthetic facial and neck vascular lesions.
Assuntos
Face , Pescoço , Fototerapia , Dermatopatias/terapia , Doenças Vasculares/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Resultado do TratamentoAssuntos
Alelos , Éxons , Antígenos HLA-B/genética , Mieloma Múltiplo/genética , Mutação Puntual , Sequência de Bases , Códon , Família , Antígenos HLA-B/imunologia , Teste de Histocompatibilidade , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Mieloma Múltiplo/imunologia , Mieloma Múltiplo/terapia , Alinhamento de Sequência , Análise de Sequência de DNARESUMO
New allele B*0769 showed one nucleotide difference with B*0732 at codon 272 (TTC-->TGC).
Assuntos
Alelos , Antígenos HLA-B/genética , Núcleo Familiar , Adolescente , Sequência de Aminoácidos , Substituição de Aminoácidos , Sequência de Bases , Cisteína/metabolismo , Primers do DNA/genética , Éxons , Variação Genética , Antígeno HLA-B7 , Haplótipos , Teste de Histocompatibilidade/métodos , Humanos , Irã (Geográfico) , Masculino , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Homologia de Sequência do Ácido Nucleico , Terminologia como AssuntoRESUMO
Minimally ablative fractional laser devices have gained acceptance as a preferred method for skin resurfacing. Notable improvements in facial rhytides, photodamage, acne scarring, and skin laxity have been reported. The aim of the present work was to compare how different CO(2) laser fluences, by modulating the secretory pathway of cytokines, are able to influence the wound-healing process, and how these fluences are associated with different clinical results. Eighteen patients, all with photodamaged skin, were treated using a fractional CO(2) laser (SmartXide DOT, Deka M.E.L.A., Florence, Italy) with varying laser fluences (2.07, 2.77, and 4.15 J/cm(2)). An immunocytochemical study was performed at defined end points in order to obtain information about specific cytokines of the microenvironment before and after treatment. The secretory pathway of cytokines changed depending on the re-epithelization and the different laser fluences. Different but significant improvements in wrinkles, skin texture, and hyperpigmentation were definitely obtained when using 2.07, 2.77, and 4.15 J/cm(2), indicating fractional CO(2) laser as a valuable tool in photorejuvenation with good clinical results, rapid downtime, and an excellent safety profile.
Assuntos
Técnicas Cosméticas/instrumentação , Terapia a Laser/métodos , Envelhecimento da Pele/fisiologia , Pele/efeitos da radiação , Dióxido de Carbono , Fator de Crescimento Epidérmico/metabolismo , Feminino , Fator 2 de Crescimento de Fibroblastos/metabolismo , Humanos , Imuno-Histoquímica , Terapia a Laser/instrumentação , Lasers de Gás , Pessoa de Meia-Idade , Fator de Crescimento Derivado de Plaquetas/metabolismo , Rejuvenescimento , Pele/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Vimentina/metabolismo , Cicatrização/fisiologia , Cicatrização/efeitos da radiaçãoRESUMO
Rituximab is a chimeric monoclonal antibody currently used for the treatment of non-Hodgkin lymphoma that targets the transmembrane protein CD20 of B cells. Recently it has also been used for the treatment of several autoimmune diseases, including skin disorders such as Paraneoplastic Pemphigus, Pemphigus Vulgaris, Pemphigus Foliaceus, Mucosal pemphigoid, Bullous pemphigoid, Epidermolysis bullosa acquisita, Systemic lupus erythematous and Dermatomyositis. Frequently all these conditions required intolerably high doses of corticosteroids and additional immunosoppressants, which can increase the risk of severe adverse events. Therefore, new therapeutic options are needed for such patients. The intent of the authors in this review is to provide the reader with a panoramic view of the studies reported to date.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Fatores Imunológicos/uso terapêutico , Dermatopatias/tratamento farmacológico , Anticorpos Monoclonais Murinos , Humanos , RituximabRESUMO
Basal cell carcinoma is the most common skin tumor in humans which can be removed in a variety of ways (depending on the type of the lesion, the affected area, and depth of the lesion). Laser therapy offers another option to the traditional methods of treatment; thus, the purpose of this work is to valuate the efficacy of dye laser in a selected group of patients affected by superficial basal cell carcinoma. We suggest that the success of pulse dye laser treatment lies in the fact that as all tumors, basal cell carcinomas contain an increased number of dilated blood vessels. Twenty patients (eight males and 12 females) with superficial basal cell carcinoma were given five treatments with a flashlamp-pumped pulse dye laser every 20 days. The clinical follow up was 12-24 months after the fifth treatment. A complete response was obtained in 16 patients out of 20. Three recurrences and one no response was observed during the study. Pulse dye laser is effective and safe in the treatment of superficial basal cell carcinoma.
Assuntos
Carcinoma Basocelular/cirurgia , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade , Neoplasias Cutâneas/cirurgia , Idoso , Carcinoma Basocelular/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Resultado do Tratamento , CicatrizaçãoRESUMO
HLA-A*02:653 differs from A*02:01:01:01 by a C to T substitution in exon 2.