Espressione e ruolo funzionale di interleuchina-33 e del suo recettore, ST2, nelle malattie infiammatorie croniche intestinali

IL-33 is a novel member of the IL-1 family and ligand for the IL-1 receptor-related protein, ST2. Recent evidence suggests that the IL-33/ST2 axis plays a critical role in several autoimmune and inflammatory disorders; however, its role in inflammatory bowel disease (IBD) has not been clearly defined. We characterized IL-33 and ST2 expression and modulation following conventional anti-TNF therapy in Crohn’s disease and ulcerative colitis (UC) patients, and investigated the role of IL-33 in SAMP1/YitFc (SAMP) mice, a mixed Th1/Th2 model of IBD. Our results showed a specific increase of mucosal IL-33 in active UC, localized primarily to intestinal epithelial cells (IEC) and colonic inflammatory infiltrates. Importantly, increased expression of full-length IL-33, representing the most bioactive form, was detected in UC epithelium, while elevated levels of cleaved IL-33 were present in IBD serum. ST2 isoforms were differentially modulated in UC epithelium and sST2, a soluble decoy receptor with anti-inflammatory properties, was also elevated in IBD serum. Infliximab (anti-TNF) treatment of UC decreased circulating IL-33 and increased sST2, while stimulation of HT-29 IEC confirmed IL-33 and sST2 regulation by TNF. Similarly, IL-33 significantly increased and correlated with disease severity, and potently induced IL-5, IL-6 and IL-17 from mucosal immune cells in SAMP mice. Taken together, the IL-33/ST2 system plays an important role in IBD and experimental colitis, is modulated by anti-TNF therapy, and may represent a specific biomarker for active UC.

Ruolo di interleuchina-33 sull'espressione di geni profibrotici e sull'ipertrofia dei miofibroblasti nella fibrosi intestinale

Background: Intestinal fibrosis is a serious complication of IBD, with more than a third of Crohn’s disease (CD) patients developing a fibrostenosing phenotype with formation of strictures that will require surgical intervention. Remarkably, SAMP1/YitFc (SAMP) mice, a spontaneous model of CD, develop gut fibrosis; similar to IBD patients, the pathophysiology of SAMP fibrosis is unknown. IL-33 is a member of the IL-1 cytokine family and increased expression is associated with IBD. Emerging evidence suggests its potential role in liver and cutaneous fibrosis, as well as myofibroblast-associated colonic ulcerations . Aim: The aim of this study was to evaluate the role of IL-33 as a potential mediator of profibrotic events leading to intestinal fibrosis and possible stricture formation. Methods: A detailed histologic time course study, with collagen-specific Masson trichrome staining and IHC for ST2 (IL-33 receptor), was performed on SAMP and control AKR (parental strain) mice. qRT-PCR was done on full-thickness ilea for the profibrogenic genes, collagen (coll)-1, coll-3, connective tissue growth factor (CTGF) and insulin-like growth factor 1 (IGF-1). Exogenous IL-33 (33 μg/kg, i.p.) or vehicle was administered daily for 7d to SAMP and AKR mice (N=6/exp group), and ileal tissues evaluated as above. Finally, microarray analysis was performed on full-thickness ilea from SAMP and AKR mice, and IL-33 stimulated subepithelial myofibroblasts (SEMFs). Results: SAMP mice displayed ileal skip lesions with randomly distributed strictures, preceded by typical pre-stricture dilations of the ileum. Ileal wall was visibly thickened with hypertrophy of the serosa, muscularis mucosa, muscularis propria, within which intense collagen deposition was observed, and inflammatory infiltrates in segments showing strictures. Interestingly, intense ST2 staining was present within the inflamed lamina propria of SAMP, notably localized to SEMFs. Fibrosis was first observed at 20 wks, and reached its peak by 50 wks of age. mRNA expression of coll-1 (4.74±0.69-fold; P=0.001), coll-3 (4.92±1.05-fold; P=0.01), IGF1 (12.9±3.45; P=0.006), and CTGF (3.29±0.69; P=0.004) was dramatically elevated in SAMP vs. AKR ilea. IL-33 treatment of AKR mice induced a marked increase in muscle fiber/myofibroblast cellularity and hypertrophy of the muscularis propria (4.13±0.74-fold; P<0.0001), and mRNA expression of coll-1 (5.16±0.89-fold; P=0.0009), coll-3 (1.97±0.14-fold; P=0.01), IGF-1 (9.32±2.27-fold; P=0.004), and CTGF (1.43±0.31-fold; P=0.006) vs. vehicle controls. Microarray data from SAMP ilea and IL-33-treated SEMFs confirmed these trends, displaying a global increase in profibrogenic gene expression. Conclusion: These data suggest an important role for IL-33 in intestinal fibrosis, and may represent a potential target for the treatment of IBD-associated fibrosis and stricture formation.

Mappaggio fine di un QTL principale per la resa in granella sul cromosoma 3B di frumento duro

In durum wheat, two major QTL for grain yield (Qyld.idw-2B and Qyld.idw-3B) and related traits were identified in a recombinant population derived from Kofa and Svevo (Maccaferri et al. 2008). To further investigate the genetic and physiological basis of allelic variation for this important trait, the fine mapping of Qyld.idw-2B e Qyld.idw-3B was done during the PhD. In this regard, new molecular markers were added to increase the map resolution in the target interval. For Qyld.idw-2B region COS markers derived from the synteny between wheat and rice/ sorghum /brachypodiu genomes were screened. While for Qyld.idw-3B region SSR, ISBP and COS markers obtained from BAC end-sequences and BAC sequences generated during the construction of the 3B physical map (Paux et al., 2008) were screened. In the RIL population a final map resolution of 2,8 markers/cM for Qyld.idw-2B and 0,6 markers/cM for Qyld.idw-3B were obtained. Eighteen pairs of near-isogenic lines (NILs) for Qyld.idw-3B were obtained from F4:5 heterogeneous inbred families. In order to confirm the phenotypic effect of the QTL all pairs were evaluated in field trials (2010 and 2011) for all traits. Three pairs of NILs, with contrasted haplotypes at the target region, were crossed to produce a large F2 population (ca. 7,500 plants in total) that was screened for the identification of recombinants. A total of 233 homozygous F4:5 segmental isolines were obtained and the phenotypic and genotypic characterization of these materials were done. A fine mapping for Qyld.idw-3B was obtained and the QTL peak was identified in a interval of 0,4 cM. All markers were anchored to the Chinese Spring physical map of chr. 3B, which allowed us to identify the BAC Contigs spanning the QTL region and to assign the QTL peak to Contig 954. Sequencing of this contig has revealed the presence of 42 genes.

Pathogenic role of IL-33-mediated eosinophil infiltration and function in experimental inflammatory bowel disease

IL-33/ST2 axis is known to promote Th2 immune responses and has been linked to several autoimmune and inflammatory disorders, including inflammatory bowel disease (IBD), and recent evidences show that it can regulate eosinophils (EOS) infiltration and function. Based also on the well documented relationship between EOS and IBD, we assessed the role of IL-33-mediated eosinophilia and ileal inflammation in SAMP1/YitFc (SAMP) murine model of Th1/Th2 chronic enteritis, and we found that IL-33 is related to inflammation progression and EOS infiltration as well as IL-5 and eotaxins increase. Administering IL-33 to SAMP and AKR mice augmented eosinophilia, eotaxins mRNA expression and Th2 molecules production, whereas blockade of ST2 and/or typical EOS molecules, such as IL-5 and CCR3, resulted in a marked decrease of inflammation, EOS infiltration, IL-5 and eotaxins mRNA expression and Th2 cytokines production. Human data supported mice’s showing an increased colocalization of IL-33 and EOS in the colon mucosa of UC patients, as well as an augmented IL-5 and eotaxins mRNA expression, when compared to non-UC. Lastly we analyzed SAMP raised in germ free (GF) condition to see the microbiota effect on IL-33 expression and Th2 responses leading to chronic intestinal inflammation. We found a remarkable decrease in ileal IL-33 and Th2 cytokines mRNA expression as well as EOS infiltration in GF versus normal SAMP with comparable inflammatory scores. Moreover, EOS depletion in normal SAMP didn’t affect IL-33 mRNA expression. These data demonstrate a pathogenic role of IL-33-mediated eosinophilia in chronic intestinal inflammation, and that blockade of IL-33 and/or downstream EOS activation may represent a novel therapeutic modality to treat patients with IBD. Also they highlight the gut microbiota role in IL-33 production, and the following EOS infiltration in the intestinal mucosa, confirming that the microbiota is essential in mounting potent Th2 response leading to chronic ileitis in SAMP.

The "Orthoplastic" combined surgical approach to open tibia fractures: a multicentric prospective outcome study

Introduction: Open fractures of the leg represent a severe trauma. The combined approach, shared between plastic and orthopaedic surgeons, is considered to be important, although this multidisciplinary treatment is not routinely performed. Aim of this study was to verify whether the orthoplastic treatment is of any advantage over the traditional simply orthopedic treatment, through a multicentric inclusion of these unfrequent injuries into a prospective study. Material and methods: The following trauma centres were involved: Rizzoli Orthopaedic Institute/University of Bologna (leading centre) and Maggiore Hospital (Bologna, Italy), Frenchay Hospital (Bristol, United Kingdom), Jinnah Hospital (Lahore, Pakistan). All patients consecutively hospitalized in the mentioned centres between January 2012 and December 2013 due to tibial open fractures were included in the study and prospectively followed up to December 2014. Demographics and other clinical features were recorded, including the type of treatment (orthopaedic or orthoplastic). The considered outcome measures included duration of hospitalization, time for bone union and soft tissue closure, Enneking score at 3, 6 and 12 months, the incidence of osteomyelitis and other complications. Results: A total of 164 patients were included in the study. Out of them 68% were treated with an orthoplastic approach, whereas 32% received a purely orthopedic treatment. All considered outcome measures showed to be improved by the orthoplastic approach, compared to the orthopaedic one: time for soft tissue closure (2 versus 25 weeks), duration of hospital stay (22 versus 55 days), time for bone union (6 versus 8.5 months) , number of additional operations (0.6 versus 1.2) and functional recovery of the limb at 12 months (27 versus 19, Enneking’s score). All results were statistically significant. Conclusion: The combined orthoplastic approach to the treatment of open tibia fractures, in particular for high grade injuries (Gustilo 3B), is proven to improve the outcome of these severe injuries.