Variazione dei markers di attivata coagulazione indotta dalla terapia infusionale con Infliximab in pazienti affetti da malattie infiammatorie croniche intestinali

INTRODUCTION: A relationship between inflammatory response and coagulation is suggested by many observations. In particular, pro-inflammatory cytokines, such as TNFalpha, promote the activation of coagulation and reduce the production of anticoagulant molecules. It is known that inflammatory bowel diseases show a prothrombotic state and a condition of hypercoagulability. Aim of our study was to evaluate whether anti-TNFalpha therapy induces changes in the levels of coagulation activation markers in IBD patients. MATERIALS AND METHODS: We analyzed 48 plasma samples obtained before and 1 hour after 24 infliximab infusions (5 mg/kg) in 9 IBD patients (5 men and 4 women; mean age: 47.6+17.6 years; 4 Crohn's disease, 4 Ulcerative Colitis,1 Indeterminate Colitis). F1+2 and D-dymer levels were measured in each sample using ELISA methods.The data were statistically analyzed by means of Wilcoxon matched paired test. RESULTS: Median F1+2 levels were markdely reduced 1 hour after anti-TNFα infusion (median pre-infusion levels were 247.0 pmol/L and median post-infusion levels were 185.3 pmol/L) (p<0.002). Median D-dymer levels were also significantly reduced, from 485.2 ng/mL to 427.6 ng/mL (p< 0.001). These modifications were more evident in patients naive for infliximab therapy (p<0.02 for F1+2 and p<0.02 for D-dymer) and in Crohn's disease compared with Ulcerative Colitis patients (p=0.01 for F1+2 and p<0.007 for D-dymer).CONCLUSIONS: Infusion of infliximab significantly reduces the activation of coagulation cascade in IBD patients. This effect is early enough to suggest a direct effect of infliximab on the coagulation cascade and a possible new anti-inflammatory mechanism of action of this molecule.

Ricerca di contaminanti in tessuti animali e in alimenti destinati all'uomo.

La contaminazione chimica rappresenta uno dei rischi principali per la sicurezza alimentare e può arrecare anche gravi danni alla salute umana. Rientrano in questa tesi di dottorato tre famiglie di contaminanti: Micotossine, Metalli e Insetticidi. La ricerca di aflatossina B1 è stata effettuata su 90 confezioni di farina, sia biologici sia convenzionali. La presenza della micotossina è stata rilevata solo nelle farine di mais. Solo un campione di produzione convenzionale ha superato il limite di 2 ppb definito per legge. Il dato di maggior rilievo è stato che il quantitativo di 5 grammi di campionamento si è dimostrato non rappresentativo sul totale della confezione commerciale di farina. Più attendibile si è invece dimostrato un campionamento di 20 grammi. L’aflatossina M1 è stata ricercata in 58 campioni di latte di cui 35 sono risultati positivi. Tuttavia, i livelli riscontrati erano costantemente inferiori al limite previsto per legge. Sono stati sottoposti a estrazione e purificazione, e analizzati con metodica HPLC-FL per la ricerca di Ocratossina A, 114 campioni di bile, 35 campioni di plasma, 40 campioni di rene prelevati da polli in Giordania. Le analisi hanno fornito risultati costantemente negativi. Sono stati analizzati 72 campioni (30 di muscolo, 29 di fegato e 13 di rene) prelevati da 30 bovini nel macello di Irbid (Giordania), di età compresa tra 8 e 30 mesi e provenienti da allevamenti diversi, per la ricerca di 13 elementi essenziali e non essenziali. In questo studio nessun campione supera i livelli massimi stabiliti dalla normativa europea per quanto riguarda gli elementi considerati. Infine, sono stati analizzati 37 campioni di latte ovino e 31 campioni di latte bovino, prelevati in Giordania in diversi allevamenti, per la ricerca di 4 neonicotinoidi (imidacloprid, acetamiprid, thiamethoxam e thiacloprid). I campioni, analizzati con sistema HPLC/MS/MS, sono risultati costantemente negativi ai quattro neonicotinoidi ricercati.

Functional relationship of colorectal cancer-associated glycans with malignant phenotype and transcriptome changes

Glycosyltransferases ST6GAL1 and B4GALNT2 (and their cognate antigens Sia6LacNAc and Sda, respectively) are associated with colorectal cancer (CRC) but it is not fully clear their biological and clinical significance. We explored the clinical relevance of both glycosyltransferases by interrogating The Cancer Genome Atlas (TCGA) database while the phenotypic/transcriptomic effects of ST6GAL1/B4GALNT2 overexpression were studied in genetically modified CRC cell lines. Transcriptomic data from CRC patients in TCGA database suggested a moderate impact of ST6GAL1 on CRC progression, although it was not possible to define a clear role for this glycosyltransferase. Transcriptomic analysis of ST6GAL1-transduced cell lines revealed a much deeper effect of ST6GAL1 on gene expression in SW948 than in SW48. The overexpression of ST6GAL1 induced opposite effects on soft agar growth and wound healing in both cell lines. These results indicate that the impact of a cancer-associated glycosyltransferase change on phenotype/transcriptome can be extremely variable, depending on the molecular context of the tumor cell. On the contrary, transcriptomic analysis of B4GALNT2-modified cell lines together with TCGA database survey demonstrated a strong impact of B4GALNT2 on the transcriptional activity of CRC cells, in particular its association with a better prognosis. We suggest an anti-tumoral role of B4GALNT2 in CRC. We also investigated the glycan changes related to ST6GAL1/B4GALNT2 expression in a small cohort of tissues/plasma as well as the N-glycomic profile of CRC, normal and polyp tissues. We found an increase of ST6GAL1 activity in CRC and inflammatory bowel disease plasma samples comparing with plasma from healthy donors. A different Sda protein carrier pattern was observed between healthy donors and CRC plasma samples. β-arrestin 1 is a possible candidate as Sda carrier protein in plasma samples although future validation studies are needed. The alterations found in the N-glycan pattern highlight the importance of N-glycome as a molecular signature in cancer.

Evaluation of the theranostic use of miRNAs in correlation to the radiopharmaceutical 64CuCl2 in glioblastoma

B:Glioblastoma multiforme(GBM) is one of the most prevalent and aggressive malignant primary brain tumors in adult patients. 64CuCl2 is an innovative radiopharmaceutical investigated as theranostic agent in GBM patients. The therapeutic scheme is still under evaluation, therefore the research focused on the possibility of radioresistance development. The actors responsible for modulating radioresistance could be miRNAs, thus their potential use was investigated both in radioresistant cell lines and in GBM patients plasma samples. M:Radioresistant cell lines were generated by exposing U87MG, U373MG lines to increasing doses of radiation for 32 weeks. Cell membrane permeability alterations and DNA damage were assessed to characterize the lines. Moreover, 64Cu cell incorporation and subcellular distribution were investigated measuring gamma-radiation emission. miRNA expression was evaluated: in parental and radioresistant cell lines, both in cell pellet and media exosomes; in plasma samples of GBM patients using TaqMan Array MicroRNA Cards. R:Radioresistant lines exhibited reduction in membrane permeability and in DNA DSBs indicating the capability to skip the drug killing effect. Cell uptake assays showed internalization of 64Cu both in the sensitive and radioresistant lines. Radioresistant lines showed a different miRNA expression profile compared to the parental lines. 5 miRNAs were selected as possible biomarkers of response to treatment (miR-339-3p, miR-133b, miR-103a-3p, miR-32-5p, miR-335-5p) and 6 miRNAs as possible predictive biomarkers of response to treatment (let-7e-5p, miR-15a-5p, miR-29c-3p, miR-495, miR-146b-5p, miR-199a-5p). miR-32-5p was selected as possible molecule to be used to restore 64CuCl2 responsiveness in the radioresistant cell lines. C: This is the first study describing the development and characterization of 64CuCl2 radioresistant cell lines useful to implement the approach for dosimetric analysis to avoid radioresistance uprising. miRNAs could bring to a better understanding of 64CuCl2 treatment, becoming a useful tool both in detection of treatment response and both as molecule that could restore responsiveness to 64CuCl2 treatment.

Study on NGF and VEGF during the equine perinatal period

Part 1 of the study aims to: evaluate NGF and VEGF levels obtained at parturition from mare, foal and umbilical cord vein plasma, as well as in amniotic fluid; evaluate NGF and VEGF content in plasma of healthy foals during the first 72 h of life; evaluate NGF and VEGF levels at parturition in relation to selected mares’ and foals’ clinical parameters; evaluate the relationship between the two trophic factors and thyroid hormone levels in the first 72 h of life; assess mRNA expression of NGF, VEGF and BDNF and their cell surface receptors in the placenta. Part 2 aims to clinically characterize a population of foals spontaneously affected by Neonatal Encephalopathy (NE), and then to: evaluate NGF and VEGF levels in plasma samples obtained in the affected population at parturition from mare’s jugular vein, umbilical cord vein and foal’s jugular vein, as well as in amniotic fluid; evaluate NGF and VEGF content in plasma of foals affected by NE during the first 72 h of life/hospitalization; evaluate NGF and VEGF levels at birth/admission in relation to selected mares’ and foals’ clinical parameters; evaluate the relationship between the two trophic factors and thyroid hormone levels in the first 72 h of life/hospitalization; assess the mRNA expression of NGF, VEGF and BDNF, and their cell surface receptors, in the placenta of mares that delivered affected foals. The close relationship between the two trophic factors in foal plasma over time and their fine expression in placental tissues under physiological conditions appear to be key regulators of fetal development and adaptation. Their less pronounced decrease in compromised foals compared to healthy ones, their relationship with thyroid hormones over time, and the reduced expression of NGF and BDNF in placental tissues, could be key regulators in the mechanisms of NE.

Liquid biopsy for prostate cancer molecular characterization: homologous recombination system and genomic profile

Pathogenic aberrations in homologous recombination DNA repair (HRR) genes occur in approximately 1 to 4 men with advanced prostate cancer (PCa). Treatment with PARP inhibitors (PARPi) has recently been introduced for metastatic castration-resistant PCa patients, increasing clinicians' interest in the molecular characterization of all PCa patients. The limitations of using old, low-quality tumor tissue for genetic analysis, which is very common for PCa, can be overcome by using liquid biopsy as an alternative biomarker source. In this study, we aimed to evaluate the detection of molecular alterations in HRR genes on liquid biopsy compared with tumor tissue from PCa patients. Secondarily, we explored the genomic instability score (GIS), and a broader range of gene alterations for in-depth characterization of the PCa cohort. Plasma samples were collected from 63 patients with PCa. Sophia Homologous Recombination Solution (targeting 16 HRR genes) and shallow whole genome sequencing (sWGS) were used for genomic analysis of tissue DNA and circulating tumor DNA (ct). A total of 33 alterations (mainly on TP53, ATM, CHEK2, CDK12, and BRCA1/2) were identified in 28,5% of PCa plasma patients. By integrating the mutational and sWGS data, the HRR status of PCa patients was determined and a concordance agreement of 85,7% was identified with tumor tissue. A median GIS of 15 was obtained, reaching a score of 63 in 2 samples with double alterations, BRCA1 and TP53. We explored the PCa mutation landscape, and the most significant enriched pathways identified were the sphingosine 1-phosphate (S1P) receptor signaling and the PI3K-AKT-mTOR pathway. HRR analysis on FFPE and liquid biopsy samples show high concordance, demonstrating that the noninvasive ctDNA-enriched plasma can be an optimal alternative source for molecular SNV and CNV analysis. In addition, the evaluation of GIS and pathway interaction should be considered for more comprehensive molecular characterization in PCa patients.

Development of Original Analytical Methods for the Determination of Drugs of Abuse in Biological Samples

Drug abuse is a major global problem which has a strong impact not only on the single individual but also on the entire society. Among the different strategies that can be used to address this issue an important role is played by identification of abusers and proper medical treatment. This kind of therapy should be carefully monitored in order to discourage improper use of the medication and to tailor the dose according to the specific needs of the patient. Hence, reliable analytical methods are needed to reveal drug intake and to support physicians in the pharmacological management of drug dependence. In the present Ph.D. thesis original analytical methods for the determination of drugs with a potential for abuse and of substances used in the pharmacological treatment of drug addiction are presented. In particular, the work has been focused on the analysis of ketamine, naloxone and long-acting opioids (buprenorphine and methadone), oxycodone, disulfiram and bupropion in human plasma and in dried blood spots. The developed methods are based on the use of high performance liquid chromatography (HPLC) coupled to various kinds of detectors (mass spectrometer, coulometric detector, diode array detector). For biological sample pre-treatment different techniques have been exploited, namely solid phase extraction and microextraction by packed sorbent. All the presented methods have been validated according to official guidelines with good results and some of these have been successfully applied to the therapeutic drug monitoring of patients under treatment for drug abuse.