Metodi biochimici e biomolecolari applicati alla medicina clinica: rendimento della real-time TaqMan PCR per la valutazione della resistenza alla claritromicina in H.pylori e tests fecali nella diagnorstica del carcinoma colo-rettale: M2PK, calprotectina e FOBT

1) Background: The most common methods to evaluate clarithromycin resistance is the E-Test, but is time consuming. Resistance of Hp to clarithromycin is due to point mutations in the 23S rRNA. Eight different point mutations have been related to CH resistance, but the large majority of the clarithromycin resistance depends on three point mutations (A2142C, A2142G and A2143G). A novel PCR-based clarithromycin resistance assays, even on paraffin-embedded biopsy specimens, have been proposed. Aims: to assess clarithromycin resistance detecting these point mutation (E-Test as a reference method);secondly, to investigate relation with MIC values. Methods: Paraffin-embedded biopsies of patients Hp-positive were retrieved. The A2142C, A2142G and A2143G point mutations were detected by molecular analysis after DNA extraction by using a TaqMan real-time PCR. Results: The study enrolled 86 patients: 46 resistant and 40 sensible to CH. The Hp status was evaluated at endoscopy, by rapid urease test (RUT), histology and hp culture. According to real-time PCR, 37 specimens were susceptible to clarithromycin (wild type dna) whilst the remaining 49 specimens (57%) were resistant. A2143G is the most frequent mutation. A2142C always express a resistant phenotype and A2142G leads to a resitant phenotype only if homozigous. 2) Background: Colonoscopy work-load for endoscopy services is increasing due to colorectal cancer prevention. We tested a combination of faecal tests to improve accuracy and prioritize the access to colonoscopy. Methods: we tested a combination of fecal tests (FOBT, M2-PK and calprotectin) in a group of 280 patients requiring colonoscopy. Results: 47 patients had CRC and 85 had advanced adenoma/s at colonoscopy/histology. In case of single test, for CRC detection FOBT was the test with the highest specificity and PPV, M2-PK had the highest sensitivity and higher NPV. Combination was more interesting in term of PPV. And the best combination of tests was i-FOBT + M2-PK.

Origin and variability of PM10 and atmospheric radiotracers at the WMO-GAW station of Mt. Cimone (1998-2011) and in the central Po Valley

Particulate matter is one of the main atmospheric pollutants, with a great chemical-environmental relevance. Improving knowledge of the sources of particulate matter and of their apportionment is needed to handle and fulfill the legislation regarding this pollutant, to support further development of air policy as well as air pollution management. Various instruments have been used to understand the sources of particulate matter and atmospheric radiotracers at the site of Mt. Cimone (44.18° N, 10.7° E, 2165 m asl), hosting a global WMO-GAW station. Thanks to its characteristics, this location is suitable investigate the regional and long-range transport of polluted air masses on the background Southern-Europe free-troposphere. In particular, PM10 data sampled at the station in the period 1998-2011 were analyzed in the framework of the main meteorological and territorial features. A receptor model based on back trajectories was applied to study the source regions of particulate matter. Simultaneous measurements of atmospheric radionuclides Pb-210 and Be-7 acquired together with PM10 have also been analysed to acquire a better understanding of vertical and horizontal transports able to affect atmospheric composition. Seasonal variations of atmospheric radiotracers have been studied both analysing the long-term time series acquired at the measurement site as well as by means of a state-of-the-art global 3-D chemistry and transport model. Advection patterns characterizing the circulation at the site have been identified by means of clusters of back-trajectories. Finally, the results of a source apportionment study of particulate matter carried on in a midsize town of the Po Valley (actually recognised as one of the most polluted European regions) are reported. An approach exploiting different techniques, and in particular different kinds of models, successfully achieved a characterization of the processes/sources of particulate matter at the two sites, and of atmospheric radiotracers at the site of Mt. Cimone.