CD20-related signaling pathway is differently activated in normal and dystrophic circulating CD133(+) stem cells.

Among the heterogeneous population of circulating hematopoietic and endothelial progenitors, we identified a subpopulation of CD133(+) cells displaying myogenic properties. Unexpectedly, we observed the expression of the B-cell marker CD20 in blood-derived CD133(+) stem cells. The CD20 antigen plays a role in the modulation of intracellular calcium homeostasis through signaling pathways activation. Several observations suggest that an increase in intracellular calcium concentration ([Ca(2+)](i)) could be involved in the etiology of the Duchenne muscular dystrophy (DMD). Here, we show that a CD20-related signaling pathway able to induce an increase in [Ca(2+)](i) is differently activated after brain derived neurotrophic factor (BDNF) stimulation of normal and dystrophic blood-derived CD133(+) stem cells, supporting the assumption of a "CD20-related calcium impairment" affecting dystrophic cells. Presented findings represent the starting point toward the expansion of knowledge on pathways involved in the pathology of DMD and in the behavior of dystrophic blood-derived CD133(+) stem cells.

[Quality system and training of the occupational physician: a referral macromodel]. / Sistema qualità e formazione del medico del lavoro: un macromodello di riferimento.

The progressive changes in society, in the working environment and in organization are leading to changes in the role of the occupational physician. This process requires a continuing renewal of the training curricula of the University Schools of Occupational Medicine. The revised curricula provide more appropriate guidance by setting learning objectives (knowledge an occupational physician should have in each formative area) and training objectives (experience an occupational physician should have). These changes require a new approach in delivering a successful teaching-learning service. A Quality System (QS) for training is a management tool aimed at identifying the training products required by the complex customer system (society, institutions, students, firms). A QS anticipates customers' needs and satisfies them; it guarantees the quality of the results by monitoring resources, activities and processes that directly influence the quality of the service/training product. The system is mainly based on the development and exploitation of the internal expertise and on the innovative approach by the customer-oriented structures. The system is also based on innovation of methods (methods of planning, delivering and evaluating) and on rationalization of the processes and the connected procedures of training tools, professional abilities, training and managerial documentation. Therefore, although all Specialization Schools share the same mission, i.e. training of the Specialist in occupational medicine, each School should adopt a Quality Policy in accordance with strategic choices made by the School in relation to its specific, history, values, perceived vision and situation of the market.