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1.
Chemistry ; 29(24): e202203990, 2023 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-36734519

RESUMEN

A combined experimental and theoretical study has been carried out on 4-fluoro-threonine, the only naturally occurring fluorinated amino acid. Fluorination of the methyl group significantly increases the conformational complexity with respect to the parent amino acid threonine. The conformational landscape has been characterized in great detail, with special attention given to the inter-conversion pathways between different conformers. This led to the identification of 13 stable low-energy minima. The equilibrium population of so many conformers produces a very complicated and congested rotational spectrum that could be assigned through a strategy that combines several levels of quantum chemical calculations with the principles of machine learning. Twelve conformers out of 13 could be experimentally characterized. The results obtained from the analysis of the intra-molecular interactions can be exploited to accurately model fluorine-substitution effects in biomolecules.

2.
Eur Arch Otorhinolaryngol ; 278(3): 781-789, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32656673

RESUMEN

PURPOSE: The need for prolonged invasive mechanical ventilation in COVID-19 patients is placing the otorhinolaryngologist in front of an increasing request for tracheostomy. Nowadays, there is uncertainty regarding the timing of tracheostomy, the prognosis of these patients and the safety of healthcare workers. The aim of this study is to evaluate the efficacy and safety of tracheostomy placement in patients with COVID-19. METHODS: A retrospective cohort study on 23 COVID 19 patients, to analyse the timing of tracheostomy, the risk factors associated with in-hospital death and the infection of the involved health care workers. Early tracheostomy was defined as ≤ 10 days and late ones > 10 days. RESULTS: The mortality rate of COVID-19 patients admitted to ICU that underwent tracheostomy was 18%. The overall mortality of patients admitted to ICU was 53%. The univariate analysis revealed that early tracheostomy, SOFA score > 6, and D-dimer level > 4 were significantly associated with a greater risk of death. At the multivariate analysis SOFA score > 6 and D-dimer level > 4 resulted as significant factors for a higher risk of death. No health care workers associated with tracheostomy are confirmed to be infected by SARS-CoV2. CONCLUSION: We suggest to wait at least 14 days to perform tracheostomy. In patients with SOFA score > 6 and D dimer > 4, tracheostomy should not be performed or should be postponed. Optimized procedures and enhanced personal protective equipment can make the tracheostomy safe and beneficial in COVID-19 patients.


Asunto(s)
COVID-19 , Traqueostomía , Adulto , Anciano , Anciano de 80 o más Años , Brotes de Enfermedades , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , ARN Viral , Respiración Artificial , Estudios Retrospectivos , SARS-CoV-2
3.
Nutr Metab Cardiovasc Dis ; 20(10): 727-33, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19822409

RESUMEN

BACKGROUND AND AIMS: A blood glucose (BG) fall after an oral glucose load has never been described previously at a population level. This study was aimed at looking for a plasma glucose trend after an oral glucose load for possible blood glucose fall if any, and for its impact on coronary mortality at a population level. METHODS AND RESULTS: In subjects from an unselected general population, BG and insulin were detected before and 1 and 2h after a 75-g oral glucose load for insulin sensitivity and ß-cell function determination. Blood pressure, blood examinations and left ventricular mass were measured, and mortality was monitored for 18.8±7.7 years. According to discriminant analysis, the population was stratified into cluster 0 (1-h BG < fasting BG; n=497) and cluster 1 (1-h BG ≥ fasting BG; n=1733). To avoid any interference of age and sex, statistical analysis was limited to two age-gender-matched cohorts of 490 subjects from each cluster (n=940). Subjects in cluster 0 showed significantly higher insulin sensitivity and ß-cell function, lower visceral adiposity and lower blood pressure values. Adjusted coronary mortality was 8 times lower in cluster 0 than 1 (p<0.001). The relative risk of belonging to cluster 1 was 5.40 (95% CI 2.22-13.1). CONCLUSION: It seems that two clusters exist in the general population with respect to their response to an oral glucose load, independent of age and gender. Subjects who respond with a BG decrease could represent a privileged sub-population, where insulin sensitivity and ß-cell function are better, some risk factors are less prevalent, and coronary mortality is lower.


Asunto(s)
Glucemia/metabolismo , Índice Glucémico , Insulina/sangre , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Presión Sanguínea , Análisis por Conglomerados , Enfermedad Coronaria/mortalidad , Enfermedad Coronaria/prevención & control , Femenino , Estudios de Seguimiento , Prueba de Tolerancia a la Glucosa , Humanos , Resistencia a la Insulina , Masculino , Síndrome Metabólico/complicaciones , Persona de Mediana Edad , Obesidad/complicaciones , Factores de Riesgo , Adulto Joven
4.
Ann N Y Acad Sci ; 1051: 148-55, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16126954

RESUMEN

Antibodies to gangliosides and Purkinje cells have been reported in patients with celiac disease (CD) with neuropathy and ataxia, respectively. Whether these antibodies are pathogenic is not clear. The response of neurological symptoms and antibody titers to a gluten-free diet is still controversial. The objective of our study was to assess whether neurological manifestations in CD patients correlate with antibody titers and a gluten-free diet.Thirty-five CD patients (9 males, 26 females, mean age 37.1 +/- 12.6 yrs) were followed prospectively. At initial evaluation, 23 were on a gluten-free diet, 12 were not. At recruitment and during follow-up, patients underwent neurological and electrophysiological evaluation. IgG, IgM, and IgA anti-ganglioside antibodies were assayed by ELISA; anti-neuronal antibodies were assessed by immunohistochemistry and Western blot. Four patients, all males, had electrophysiological evidence of neuropathy; three had been on a gluten-free diet for several months, and one was newly diagnosed. One had reduced tendon reflexes; another complained of distal paresthesias. With regard to anti-ganglioside antibodies, three patients had a moderate increase in antibodies without symptoms or signs of neuropathy. No patients had ataxia or cerebellar dysfunction, although in four patients reactivity to neuronal antigens was found. In 17 patients, an electrophysiological follow-up (mean duration of follow-up, 9 months) showed no changes. In conclusion, the preliminary results of this prospective study indicate that neuropathy, usually subclinical, may accompany CD. Antibody titers do not seem to correlate with neurological symptoms/signs or diet. Ongoing follow-up will help confirm these data and clarify the role, if any, of antibodies in neurological involvement in CD.


Asunto(s)
Autoinmunidad , Enfermedad Celíaca/complicaciones , Gangliósidos/inmunología , Enfermedades del Sistema Nervioso/etiología , Neuronas/inmunología , Adulto , Enfermedad Celíaca/inmunología , Enfermedad Celíaca/fisiopatología , Femenino , Glútenes/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
5.
J Gastroenterol ; 34(3): 345-50, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10433010

RESUMEN

The correlation between therapeutic response and liver fibrogenesis was studied in serum and liver specimens taken from 31 patients treated with alpha-interferon (IFN) (14 sustained responders and 17 non-responders) for chronic hepatitis C. Serum samples, collected before therapy, and at further 6-month intervals over 2 years, were tested for markers of liver neofibrogenesis. Serum N-terminal procollagen III peptide (PIIINP) displayed a significant and persistent decrease (P < 0.05) in sustained responders but not in non-responders; significantly lowered (P < 0.05) mean levels of C-terminal procollagen I peptide (PICP) were transiently observed in both patient groups, apparently as a result of IFN administration. Serum laminin (Lam) levels remained unchanged. One year after the cessation of treatment, liver biopsy re-testing showed an improvement in necro-inflammatory scores only in sustained responders, with the histological fibrosis scores remaining unaltered in both groups. IFN treatment seemed to exert an influence on serum levels of markers of hepatic connective tissue turnover even in patients that did not respond to therapy, while no effect was observed on preexistent liver fibrosis.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/sangre , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Cirrosis Hepática/patología , Fragmentos de Péptidos/sangre , Procolágeno/sangre , Adulto , Análisis de Varianza , Biomarcadores/sangre , Biopsia con Aguja , Femenino , Hepatitis C Crónica/patología , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Sensibilidad y Especificidad , Resultado del Tratamiento
6.
Dig Liver Dis ; 36(5): 337-41, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15191203

RESUMEN

UNLABELLED: Coeliac disease is an autoimmune enteropathy characterized by an enhanced permeability of the intestinal epithelial barrier. In epithelial cells paracellular permeability is regulated by intercellular tight junction. The cytoplasmic protein ZO-1 interacts directly with F-actin and plays a pivotal role in the structural and functional organization of tight junction. AIM: The aim of this study was to investigate the expression and localization of ZO-1 in the intestinal mucosa of coeliac patients. PATIENTS AND METHODS: Twenty patients with active coeliac disease, seven of whom underwent a repeat biopsy following a gluten-free diet and 27 control subjects, were studied. In all subjects, three biopsies were obtained from distal duodenum during upper gastrointestinal endoscopy. ZO-1 protein localization and levels were detected by immunofluorescence followed by confocal microscopy analysis and immunoblotting. ZO-1 mRNA expression was assessed by RT-PCR. F-actin distribution was also investigated. RESULTS: In patients with active coeliac disease, both ZO-1 protein levels and mRNA were clearly reduced. Cytoskeletal organization was disrupted with F-actin staining concentrated at the subcortical and basal surface regions. Abnormalities in ZO-1 expression and actin organization were reversed after a gluten-free diet. CONCLUSIONS: In active coeliac disease, ZO-1 protein expression is downregulated at the transcriptional level in association with F-actin redistribution. These changes are completely reversed after a gluten-free diet and could contribute to the increased intestinal paracellular permeability observed in this disorder.


Asunto(s)
Enfermedad Celíaca/dietoterapia , Enfermedad Celíaca/metabolismo , Regulación hacia Abajo , Proteínas de la Membrana/metabolismo , Fosfoproteínas/metabolismo , Transcripción Genética , Actinas/metabolismo , Adolescente , Adulto , Western Blotting , Estudios de Casos y Controles , Enfermedad Celíaca/genética , Niño , Dieta con Restricción de Proteínas , Duodeno/metabolismo , Duodeno/patología , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Masculino , Proteínas de la Membrana/genética , Microscopía Confocal , Persona de Mediana Edad , Fosfoproteínas/genética , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Proteína de la Zonula Occludens-1
7.
J Agric Food Chem ; 49(11): 5668-73, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11714375

RESUMEN

The effect of baking and digestion on the allergenicity of wheat flour proteins has been studied. Pooled sera of patients suffering from food allergy to wheat products were tested for IgE binding to the proteins of the wheat dough and of the bread crumb and crust, before and after being in vitro digested. During in vitro digestion, the IgE binding protein components of the unheated dough tended to disappear, whereas a permanence of IgE recognition was evident for both the bread crumb and crust. This indicates that the baking process increases the resistance of the potential allergens of the wheat flour to proteolytic digestion, allowing them to reach the gastrointestinal tract, where they can elicit the immunological response. Therefore, the effects of baking must be carefully considered in studying food allergies to wheat products.


Asunto(s)
Pan , Culinaria , Digestión , Hipersensibilidad al Trigo , Electroforesis en Gel de Poliacrilamida , Humanos , Inmunoglobulina E/sangre , Técnicas In Vitro , Proteínas de Plantas/metabolismo , Unión Proteica
8.
Minerva Gastroenterol Dietol ; 40(1): 1-9, 1994 Mar.
Artículo en Italiano | MEDLINE | ID: mdl-8204699

RESUMEN

Allergic mechanisms have been shown to induce gastric and intestinal damage in animal models. It has been demonstrated that people allergic to food may complain of gastrointestinal disorders. Furthermore food allergens can induce gastric mucosal damage in sensitized people. Little is known as regards allergic mechanisms underlying "peptic" ulcers although there are reports suggesting that some forms of gastric and duodenal ulcer may be caused by allergy. AIM. Of the study was to evidence if IgE specific to food and inhalants are localized in gastric and duodenal mucosa and if the in vitro incubation of gastric and duodenal biopsies with specific allergens, stimulate mast-cell mediators. MATERIALS AND METHODS. Twenty-one patients affected by gastric/duodenal ulcers (14 with high total IgE serum levels) and 16 controls were studied. All patients were submitted to upper digestive endoscopy and biopsies were taken from gastric fundus, body and antrum and duodenal bulb. Specific IgE to food and inhalant allergens were tested after homogenization of biopsies, using commercial kits. In 3 selected patients, 3 biopsies from gastric fundus and 3 from duodenal bulb were taken. After incubation of mucosal of mucosal biopsies with allergens (wheat, lactoalbumin, Parietaria J. pollen), the release of histamine and tryptase was measured. The release of Pepsinogen A was measured in the same conditions, as control. RESULTS. Specific IgE to food and inhalants allergens have been found in 164/586 tests (27.9%) of "peptic" ulcer patients and in 17/430 tests (4%) of controls. The duodenal bulb resulted the site in which most frequently IgE have been found. The release of histamine and tryptase has been stimulated only in 1/6 tests by incubation of biopsies with specific allergens in patients with specific IgE. PG-A release has been always stimulated by incubation of gastric biopsies, but not duodenal biopsies, with all tested allergens. DISCUSSION AND CONCLUSION. Specific IgE may be localized in gastric and duodenal mucosa of patients with "peptic" ulcer and/or food allergy. This event is linked to high total IgE serum levels and in a lesser extent, intestinal parasitosis, it is not strictly correlated with specific IgE in the serum and it regards both food and inhalant allergens. No relevant effects were observed after incubation of specific allergens with gastric or duodenal mucosa biopsies containing specific IgE. The possibility that higher allergens concentration stimulate mediator release from mast cells should be investigated. A defect of the gastric or duodenal epithelial barrier which permit a passage way for proteins with subsequent IgE production in the submucosa, appears to be the cause of localization of specific IgE in stomach and duodenum.


Asunto(s)
Especificidad de Anticuerpos , Úlcera Duodenal/inmunología , Duodeno/inmunología , Mucosa Gástrica/inmunología , Inmunoglobulina E/análisis , Mucosa Intestinal/inmunología , Úlcera Gástrica/inmunología , Adulto , Anciano , Biopsia , Úlcera Duodenal/etiología , Úlcera Duodenal/patología , Duodeno/patología , Endoscopía del Sistema Digestivo , Femenino , Mucosa Gástrica/patología , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Úlcera Gástrica/etiología , Úlcera Gástrica/patología
9.
Minerva Med ; 74(28-29): 1739-43, 1983 Jul 14.
Artículo en Italiano | MEDLINE | ID: mdl-6408533

RESUMEN

In 35 patients with chronic pancreatitis, C3, C4, s-immunoglobulins, circulating immunocomplexes and T-lymphocytes were assessed in order to verify whether an immunological role may be postulated in the pathogenesis and/or in the maintenance of the disease. A significant increase of serum IgM together with normal values of C3 and C4 and without circulating immunocomplexes was found. A significant decrease in the total number of lymphocytes as well as in the number and percentage of T-lymphocytes was also documented. These results suggest a possible involvement of immunological (humoral and cellular) processes in maintaining the chronic pancreatic damage.


Asunto(s)
Inmunoglobulinas/análisis , Pancreatitis/inmunología , Adulto , Complejo Antígeno-Anticuerpo/análisis , Enfermedad Crónica , Complemento C3/análisis , Complemento C4/análisis , Femenino , Humanos , Inmunodifusión , Masculino , Persona de Mediana Edad , Formación de Roseta , Linfocitos T/inmunología
10.
Ann Ital Med Int ; 13(3): 152-6, 1998.
Artículo en Italiano | MEDLINE | ID: mdl-9859571

RESUMEN

Recurrent aphthous stomatitis is a frequently occurring disorder which may be a clinical feature of systemic disease. For many other patients, it is a tedious problem often having no known cause. The aim of this study was to verify if immune responses to common foods and/or viruses are involved in the etiopathogenesis of recurrent aphthous stomatitis. Sixteen patients with this disorder were studied by measurement of immunoglobulin classes (IgG, IgA, IgM), blood lymphocyte subpopulations, blood circulating immune complexes, and complement fractions (C3 and C4). Intradermal skin tests for common food and inhalant allergens were performed in all cases. In 5 patients with positive skin tests, serum specific IgE were tested for the same allergens by radioallergosorbent test. Skin patch tests for dental material were performed in all cases. Oral mucosal biopsies and/or cytology samples were taken in 10 cases for histopathological evaluation and in situ hybridization for Papillomavirus, Cytomegalovirus, Herpes simplex virus I and II, Epstein Barr virus. In 13 patients, lymphocyte subpopulations were altered, with a reduced CD4/CD8 ratio. No other alterations of serum immunological parameters were observed. Skin patch tests for dental material were negative in all cases, while skin tests for food allergens were positive in 5 cases (not confirmed by radioallergosorbent test or food challenge tests). Virus antigen and DNA were not found in mucosal specimens, although one patient was positive for Epstein Barr virus DNA by in situ hybridization. An alteration of the CD4/CD8 ratio was demonstrated in most of the patients with recurrent aphthous stomatitis, although immune responses to food and/or dental material and/or common viruses did not seem to be involved in the etiopathogenesis of this disorder.


Asunto(s)
Anticuerpos Antivirales/análisis , Materiales Dentales/efectos adversos , Hipersensibilidad a los Alimentos/complicaciones , Inmunoglobulinas/análisis , Estomatitis Aftosa/inmunología , Adulto , Proteínas del Sistema Complemento/análisis , Femenino , Humanos , Masculino , Recurrencia , Pruebas Cutáneas , Estomatitis Aftosa/etiología
11.
Minerva Chir ; 59(3): 301-5, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15252398

RESUMEN

Colonic diverticular disease is a benign condition typical of the Western world, but it is not rare for even the 1st episode of diverticulitis to carry potentially fatal complications. The evolution of a peridiverticular process generally poses problems for medical treatment and exposes patients to repeated episodes of diverticulitis, making surgical treatment necessary in approximately 30% of symptomatic patients. One of the most worrying complications of diverticulosis is internal fistula. The most common types of fistula are colovesical and colovaginal, against which the uterus can act as an important protective factor. The symptoms and the clinical and instrumental management of patients with diverticular fistulas are much the same as for patients with episodes of acute diverticulitis. Staging of the disease (according to Hinchey) should be done promptly so that the necessary action can be taken prior to surgery, implementing total parenteral nutrition (TPN), nasogastric aspiration and broad-spectrum antibiotic treatment. The best surgical approach to adopt in patients with diverticulitis complicated by fistula is still not entirely clear, though the 3-step strategy is currently tending to be abandoned due to its high morbidity and mortality rates. There is a widespread conviction, however, that the 2-step strategy (Hartmann, or resection with protective stomy) and the 1-step alternative should be reserved, respectively, for patients in Hinchey stages 3, 4 and 1, 2 with a situation of attenuated local inflammation. The 1-step approach seems to be safe and effective. This report describes a case of colovaginal fistula in a patient with colonic diverticulosis who had recently undergone hysterectomy, but who, unlike such cases in the past, was treated in a single step using a laparoscopic technique.


Asunto(s)
Enfermedades del Colon/cirugía , Divertículo/cirugía , Fístula Intestinal/cirugía , Laparoscopía , Fístula Vaginal/cirugía , Enfermedades del Colon/complicaciones , Enfermedades del Colon/diagnóstico por imagen , Diverticulitis/cirugía , Divertículo/complicaciones , Divertículo/diagnóstico por imagen , Femenino , Humanos , Histerectomía Vaginal/efectos adversos , Fístula Intestinal/diagnóstico por imagen , Fístula Intestinal/etiología , Persona de Mediana Edad , Radiografía , Enfermedades del Sigmoide/diagnóstico por imagen , Enfermedades del Sigmoide/etiología , Enfermedades del Sigmoide/cirugía , Resultado del Tratamiento , Fístula Vaginal/diagnóstico por imagen , Fístula Vaginal/etiología
12.
Artículo en Inglés | MEDLINE | ID: mdl-6906161

RESUMEN

Some considerations of the vascular events occurring the uvea during the course of glaucoma are reported and a mathematical model is adopted to clarify the interdependence between intraocular pressure, rate of blood flow, blood pressure gradient, and the number of unobstructed capillary vessels in the uveal membrane. By means of this mathematical model the physiopathological vascular cause of the rise in intraocular pressure is confirmed (also independently of an obstacle to aqueous outflow), and the clinical implications in relation to visual sensory impairment are emphasized.


Asunto(s)
Glaucoma/fisiopatología , Presión Intraocular , Capilares/fisiopatología , Ojo/irrigación sanguínea , Hemodinámica , Humanos , Matemática , Modelos Biológicos , Flujo Sanguíneo Regional
13.
J Clin Lab Anal ; 9(4): 230-3, 1995.
Artículo en Inglés | MEDLINE | ID: mdl-7562239

RESUMEN

A low-molecular-weight form of human chorionic gonadotropin (hCG), urinary gonadotropin peptide (UGP), has been isolated from the urine of pregnant women and of patients with cancer, mainly of gynecological origin. The clinical value of UGP measurement in gynecological diseases is under investigation but a preliminary study is necessary in order to ascertain whether there is a circadian rhythm in UGP production, to clarify the best way to express the results, and to establish the cutoff and decisional values. In our work we demonstrated a significant correlation between the UGP output and the UGP excretion normalized for urinary creatinine. A very significant agreement was even found in 24-hr urine collections and UGP concentration of a single morning specimen from the same patients. No evident circadian rhythm was found, although some patients presented morning levels of UGP higher than in other collections. UGP postmenopausal levels were higher than premenopausal. The cutoff level, adopting the 95.0 percentile, was 200 pmol/mol creatinine.


Asunto(s)
Biomarcadores de Tumor/orina , Gonadotropina Coriónica Humana de Subunidad beta/orina , Enfermedades de los Genitales Femeninos/orina , Fragmentos de Péptidos/orina , Adolescente , Adulto , Anciano , Ritmo Circadiano , Creatinina/orina , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia , Embarazo , Premenopausia , Sensibilidad y Especificidad , Manejo de Especímenes
14.
Ital J Gastroenterol ; 28(3): 160-2, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8789827

RESUMEN

Gastric ectopias in the upper oesophagus and hypopharynx are relatively rare and often misinterpreted. They may become symptomatic due to the onset of a fistula involving adjacent structures in the neck. This case report describes a 20-year-old patient with swallowing difficulties and laterocervical pain, with a diagnosis of fistula of the pyriform sinus due to secernent gastric mucosal ectopia. The significance of this case lies in the fact that accurate aetiopathogenic study and careful differential diagnostic procedures enabled the proper identification of this rare upper oesophageal pathology, which is often misdiagnosed due to the technical difficulties involved in conventional endoscopy of the digestive tract.


Asunto(s)
Esófago de Barrett/complicaciones , Fístula/etiología , Enfermedades Faríngeas/etiología , Adulto , Esófago de Barrett/diagnóstico , Fístula/diagnóstico , Fístula/cirugía , Humanos , Masculino , Enfermedades Faríngeas/diagnóstico , Enfermedades Faríngeas/cirugía
15.
Am J Gastroenterol ; 94(7): 1892-7, 1999 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10406255

RESUMEN

OBJECTIVE: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with clinical signs typical of "intestinal" food allergies or intolerance. The aim of this study was to characterize the clinical features of IBS patients suspected of suffering from adverse reactions to food. METHODS: The study involved 128 consecutive IBS patients divided into four groups according to their main symptom on presentation at our outpatient clinic. A detailed medical history was recorded, paying particular attention to any allergies and reported intolerance to food. Each patient was screened for allergies; intestinal permeability tests was performed in randomly selected patients from different groups. Findings were analyzed using the chi2 test. RESULTS: Adverse reactions to one or more foods were reported by 80 patients (62.5%); skin prick tests (SPT) were positive in 67 patients (52.3%) with no significant differences between patients complaining of different symptoms. Patients who reported a food intolerance had more positive SPTs than those who did not (47 of 80 [58.7%] vs 20 of 48 [41.7%]); this difference was not statistically significant, although it suggests a trend (p < 0.0610). There was little consistency between the specific foods reported to cause intolerance and those resulting from the tests (11 of 80 patients, 13.7%). The intestinal permeability test was normal in 29 of 33 patients (87.9%). CONCLUSIONS: More than 50% of IBS patients were found sensitized to some food or inhalant without any typical clinical signs. Patients were unable to identify potentially offending foods. The lack of a correlation between SPT results and reported food allergies needs further investigation to clarify the pathophysiology and improve the diagnosis of intestinal food allergies.


Asunto(s)
Enfermedades Funcionales del Colon/inmunología , Hipersensibilidad a los Alimentos/diagnóstico , Adolescente , Adulto , Anciano , Alérgenos , Enfermedades Funcionales del Colon/complicaciones , Enfermedades Funcionales del Colon/diagnóstico , Femenino , Alimentos/efectos adversos , Hipersensibilidad a los Alimentos/complicaciones , Humanos , Absorción Intestinal , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Pruebas Cutáneas
16.
Gut ; 29(1): 94-100, 1988 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-2830177

RESUMEN

Gastric cell c-AMP stimulating antibodies (GCS-Ab) were studied in 30 patients with duodenal ulcer (DU) disease. Semipurified immunoglobulin (Ig) preparations from 13/30 patients stimulated c-AMP production in parietal cell enriched gastric cell suspensions obtained from male guinea pig stomachs. Maximum stimulation (varying between 260 and 547%) was reached after four hours incubation with 2 and 4 mg/ml Ig concentrations. The 13 patients with gastric cell stimulating antibodies (GCS-Ab), all male patients, developed the disease at a younger age (nine of 13 under the age of 30), had a longer duration of symptoms (mean 18.4 years), and had a higher incidence of DU in their families (61%). Eight of 13 (61%) in the GCS-Ab+ group did not respond to anti-H2-R drugs, whereas in the negative patients only three of 17 (18%) were classified as 'non-responders'. Remarkably few conventional autoantibodies were detected in our series. Gastric cell stimulating antibodies are a new addition to the growing list of receptor antibodies in human diseases and the described in vitro test should provide an easier tool for screening large populations.


Asunto(s)
Autoanticuerpos/inmunología , AMP Cíclico/análisis , Úlcera Duodenal/inmunología , Mucosa Gástrica/metabolismo , Adulto , Anciano , Animales , Bioensayo , Relación Dosis-Respuesta Inmunológica , Femenino , Cobayas , Humanos , Masculino , Persona de Mediana Edad , Células Parietales Gástricas/metabolismo
17.
Ital J Gastroenterol Hepatol ; 30(1): 71-6, 1998 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9615270

RESUMEN

AIMS: Interferon alpha has been reported to enhance autoantibody production and to increase the risk of autoimmunity particularly against thyroid tissue. We designed a study with the following aims: 1) to assess the incidence of organ- and non-organ-specific autoantibodies during Interferon treatment; 2) to evaluate whether these autoantibodies have any clinical relevance; 3) to establish whether the development of autoimmune disorders can be related to a genetic predisposition. METHODS: A panel of 5 non-organ-specific and 6 organ-specific autoantibodies was evaluated in serum samples collected before treatment and then at 3 and 12 months in 47 patients enrolled in a treatment protocol with a 2b-recombinant Interferon (3 MU, 3 times a week for 12 months). In the second part of the study we explored genetic predisposition for autoimmune disorders in 31 patients by DNA-HLA class II typing using Restriction Fragment Length Polymorphism (RFPL). RESULTS: Non-organ-specific autoantibodies were absent in all patients before and after Interferon. During follow-up 6 patients showed an increment in thyroid microsomal antibody titres; 3 of these also developed thyroglobulin autoantibodies; 3 of the 6 patients developed persistent hypothyroidism; a fourth had a transient subclinical hypothyroidism and a fifth had a transient subclinical hyperthyroidism. Two patients with initial positivity for ICA and PCA maintained their reactivity during treatment without impairment of the respective target organs. Eight out of 39 initially negative patients developed one or more organ-specific autoantibodies during follow-up. One of these developed a persistent hypothyroidism, and another developed insulin-dependent diabetes. HLA-typing did not reveal any particular allele frequency in patients with thyroid antibody positivity as compared with those without autoantibodies and controls. Moreover, four of the 6 patients positive for islet-cell antibodies were carrying the non-Asp 57 allele which is considered a marker of a genetic predisposition for insulin-dependent diabetes. CONCLUSIONS: These findings suggest that, besides the thyroid gland, pancreatic beta-cells could be a target of autoimmunity during Interferon-treatment for chronic HCV hepatitis. A genetic predisposition may be important, though insufficient alone, in the development of Interferon-induced autoimmune phenomena.


Asunto(s)
Antivirales/uso terapéutico , Autoanticuerpos/análisis , Enfermedades Autoinmunes/genética , Hepatitis C Crónica/terapia , Antígenos de Histocompatibilidad Clase II/genética , Interferón-alfa/uso terapéutico , Adolescente , Adulto , Enfermedades Autoinmunes/inmunología , Autoinmunidad , Niño , Preescolar , ADN/análisis , Electroforesis en Gel de Poliacrilamida , Femenino , Estudios de Seguimiento , Hepatitis C/inmunología , Anticuerpos contra la Hepatitis C/análisis , Hepatitis C Crónica/inmunología , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Interferón alfa-2 , Islotes Pancreáticos/inmunología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Estudios Prospectivos , Proteínas Recombinantes , Tiroglobulina/inmunología , Glándula Tiroides/inmunología
18.
Ital J Gastroenterol ; 23(2): 81-5, 1991 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-1747509

RESUMEN

Eosinophilic Gastroenteritis (EG) is a poorly understood disorder defined by eosinophilic infiltration of the bowel wall, eosinophilia and gastrointestinal symptoms. The disease's aetiology, course and treatment are not well known. We report two atypical cases of EG: one involving the mucosal layer and another involving the serosal and muscularis layer. The first shows how EG may present with a long history of episodes of intestinal obstruction and malabsorption and how the disease could take a severe course and may be unresponsive to treatment. The second case shows EG presenting as acute abdomen and which subsequently became asymptomatic without therapy, regardless of the fact that peripheral eosinophilia remained present. This case raises the problem of how to treat an asymptomatic patient, what parameters should be considered in order to assess the progress of the disease and the indications for treatment.


Asunto(s)
Eosinofilia/patología , Gastroenteritis/patología , Adulto , Eosinofilia/tratamiento farmacológico , Femenino , Gastroenteritis/tratamiento farmacológico , Humanos , Absorción Intestinal , Mucosa Intestinal/patología , Persona de Mediana Edad , Prednisona/uso terapéutico , Pronóstico , Resultado del Tratamiento
19.
Ital J Gastroenterol ; 26(1): 7-11, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-7912969

RESUMEN

The prevalence of high total IgE serum levels was evaluated in 232 consecutive patients suffering from peptic ulcer. Twenty-one percent of the patients presented total IgE serum levels above 200 KU/L compared with the 5% found in a healthy control population (p < 0.004). Similar prevalence was found in gastric and/or duodenal ulcers. No significant differences in the duration of the disease, smoking habits, familiarity for peptic ulcer, symptomatology and frequency of complications were observed between patients with high and with normal total IgE serum levels. Gastric function studies (gastric acid secretion, serum pepsinogen and gastrin levels) did not show any significant differences between the two groups. The incidence of Helicobacter pylori infection was 65% in patients with normal IgE levels and 75% in those with high IgE levels (p: n.s.). The response to treatment with full dose of H2-receptor antagonists was comparable in both groups (91.25% and 90.7% of ulcer healing after 6-8 weeks of treatment). A relapse of the ulcer after 6 months of maintenance therapy (half dose of H2-receptor antagonists) was observed in 39.5% of the patients with ulcer and high total IgE serum as against the 11.9% observed in patients with normal IgE (p < 0.001). These data lend further support to the hypothesis of an underlying immuno-allergic reaction in some forms of gastric or duodenal ulcer.


Asunto(s)
Inmunoglobulina E/sangre , Úlcera Péptica/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Úlcera Duodenal/sangre , Úlcera Duodenal/complicaciones , Úlcera Duodenal/tratamiento farmacológico , Úlcera Duodenal/inmunología , Úlcera Duodenal/microbiología , Femenino , Estudios de Seguimiento , Hipersensibilidad a los Alimentos/complicaciones , Ácido Gástrico/metabolismo , Gastrinas/sangre , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica/complicaciones , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/inmunología , Úlcera Péptica/microbiología , Prevalencia , Prostaglandinas A/sangre , Recurrencia , Úlcera Gástrica/sangre , Úlcera Gástrica/complicaciones , Úlcera Gástrica/tratamiento farmacológico , Úlcera Gástrica/inmunología , Úlcera Gástrica/microbiología , Resultado del Tratamiento
20.
Minerva Pediatr ; 50(5): 157-61, 1998 May.
Artículo en Italiano | MEDLINE | ID: mdl-9842212

RESUMEN

BACKGROUND: Cord blood IgE levels have been studied as a possible marker of allergy in infants but few studies are available in our Region. The aim of this paper was to test IgE levels in cord blood of 60 consecutive newborns in a restricted area of Veneto, to correlate cord blood IgE levels with family history of allergy and to verify the risk of contamination from mother's blood. METHODS: Cord blood was obtained from 60 consecutive newborns. Immunoglobulin levels (IgG, IgA, IgM, and IgE) were measured in cord blood of newborns and in serum of all mothers. Family history for allergy was previously investigated from the mothers. RESULTS: IgE were detectable in cord blood of 5 newborns but only 2 of them had positive family history for allergy which was pointed out in 11/60. In one of these cases the contamination of sample from mother's blood was postulated. IgG levels in newborn cord blood were higher than in mothers' blood and it was not related with IgE levels or other investigated factors. CONCLUSIONS: Only 6.6% of newborns in a restricted area of Veneto region have detectable IgE in cord blood whereas 18.3% of them have positive family history for allergy. Measurable levels of IgE in cord blood are not related with positive family history of allergy and are rarely influenced by mothers' blood contamination.


Asunto(s)
Sangre Fetal/inmunología , Hipersensibilidad/inmunología , Inmunoglobulina E/sangre , Adulto , Femenino , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina A/inmunología , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Recién Nacido , Italia
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