Cambiamenti dello scenario epidemiologico e clinico dell'epatocarcinoma in Italia nell'ultimo ventennio

Background & Aims: This study investigates whether the aetiologic changes in liver disease and the improved management of hepatocellular carcinoma (HCC) have modified the clinical scenario of this tumour over the last 20 years in Italy. Methods: Retrospective study based on the analysis of the ITA.LI.CA (Italian Liver Cancer) database including 3027 HCC patients managed in 11 centres. Patients were divided into 3 groups according to the period of HCC diagnosis: 1987–1996 (year of the ‘‘Milano criteria’’ publication), 1997–2001 (year of release of the EASL guidelines for HCC), and 2002–2008. Results: The significant changes were: (1) progressive patient ageing; (2) increasing prevalence of HCV infection until 2001, with a subsequent decrease, when the alcoholic aetiology increased; (3) liver function improvement, until 2001; (4) increasing ‘‘incidental’’ at the expense of ‘‘symptomatic’’ diagnoses, until 2001; (5) unchanged prevalence of tumours diagnosed during surveillance (around 50%), with an increasing use of the 6- month schedule; (6) favourable HCC ‘‘stage migration’’, until 2001; (7) increasing use of percutaneous ablation; (8) improving survival, until 2001. Conclusions: Over the last 20 years, several aetiologic and clinical features regarding HCC have changed. The survival improvement observed until 2001 was due to an increasing number of tumours diagnosed in early stages and in a background of compensated cirrhosis, and a growing and better use of locoregional treatments. However, the prevalence of early cancers and survival did not increase further in the last years, a result inciting national policies aimed at implementing surveillance programmes for at risk patients.

Kiwifruit bud release from dormancy: effect of exogenous cytokinins

A new formulate containing citokinins, that is commercialized as Cytokin, has been introduced as dormancy breaking agents. During a three-years study, Cytokin was applied at different concentrations and application times in two producing areas of the Emilia-Romagna region to verify its efficacy as a DBA. Cytokin application increased the bud break and showed a lateral flower thinning effect. Moreover, treated vines showed an earlier and more uniform flowering as compared to control ones. Results obtained on the productive performance revealed a constant positive effect in the fruit fresh weight at harvest. Moreover, Cytokin did not cause any phytotoxicity even at the highest concentrations. Starting from the field observation, which suggested the involvement of cytokinins in kiwifruit bud release from dormancy, 6-BA was applied in open field condition and molecular and histological analyses were carried out in kiwifruit buds collected starting from the endo dormant period up to complete bud break to compare the natural occurring situation to the one induced by exogenous cytokinin application. In details, molecular analyses were set up on to verify the expression of genes involved in the reactivation of cell cycle: cyclin D3, histone H4, cyclin-dependent kinase B, as well as of others which are known to be up regulated during bud release in other species, i.e.isopenteniltransferases (IPTs), which catalyze the first step in the CK biosynthesis, and sucrose synthase 1 and A, which are involved in the sugar supplied. Moreover, histological analyses of the cell division rate in kiwifruit bud apical meristems were performed. These analyses showed a reactivation of the cell divisions during bud release and changes in the expression level of the investigated genes.

Biomimetic Scaffolds for the Controlled Release of Bioactive Molecules for Tissue Engineering Applications

The temporospatial controlled delivery of growth factors is crucial to trigger the desired healing mechanisms in target tissues. The uncontrolled release of growth factors has been demonstrated to cause severe side effects in its surrounding tissues. Thus, the first working hypothesis was to tune and optimize a newly developed multiscale delivery platform based on a nanostructured silicon particle core (pSi) and a poly (dl-lactide-co-glycolide) acid (PLGA) outer shell. In a murine subcutaneous model, the platform was demonstrated to be fully tunable for the temporal and spatial control release of the payload. Secondly, a multiscale approach was followed in a multicompartment collagen scaffold, to selectively integrate different sets of PLGA-pSi loaded with different reporter proteins. The spatial confinement of the microspheres allowed the release of the reporter proteins in each of the layers of the scaffold. Finally, the staged and zero-order release kinetics enabled the temporal biochemical patterning of the scaffold. The last step of this PhD project was to test if by fully embedding PLGA microspheres in a highly structured and fibrous collagen-based scaffold (camouflaging), it was possible to prevent their early detection and clearance by macrophages. It was further studied whether such a camouflaging strategy was efficient in reducing the production of key inflammatory molecules, while preserving the release kinetics of the payload of the PLGA microspheres. Results demonstrated that the camouflaging allowed for a 10-fold decrease in the number of PLGA microspheres internalized by macrophages, suggesting that the 3D scaffold operated by cloaking the PLGA microspheres. When the production of key inflammatory cytokines induced by the scaffold was assessed, macrophages' response to the PLGA microspheres-integrated scaffolds resulted in a response similar to that observed in the control (not functionalized scaffold) and the release kinetic of a reporter protein was preserved.