Peripheral arterial disease and diabetes: effects on endothelial progenitor cell differentiation and nitric oxide metabolism

In the recent years it is emerged that peripheral arterial disease (PAD) has become a growing health problem in Western countries. This is a progressive manifestation of atherothrombotic vascular disease, which results into the narrowing of the blood vessels of the lower limbs and, as final consequence, in critical leg ischemia. PAD often occurs along with other cardiovascular risk factors, including diabetes mellitus (DM), low-grade inflammation, hypertension, and lipid disorders. Patients with DM have an increased risk of developing PAD, and that risk increases with the duration of DM. Moreover, there is a growing population of patients identified with insulin resistance (IR), impaired glucose tolerance, and obesity, a pathological condition known as “metabolic syndrome”, which presents increased cardiovascular risk. Atherosclerosis is the earliest symptom of PAD and is a dynamic and progressive disease arising from the combination of endothelial dysfunction and inflammation. Endothelial dysfunction is a broad term that implies diminished production or availability of nitric oxide (NO) and/or an imbalance in the relative contribution of endothelium-derived relaxing factors. The secretion of these agents is considerably reduced in association with the major risks of atherosclerosis, especially hyperglycaemia and diabetes, and a reduced vascular repair has been observed in response to wound healing and to ischemia. Neovascularization does not only rely on the proliferation of local endothelial cells, but also involves bone marrow-derived stem cells, referred to as endothelial progenitor cells (EPCs), since they exhibit endothelial surface markers and properties. They can promote postnatal vasculogenesis by homing to, differentiating into an endothelial phenotype, proliferating and incorporating into new vessels. Consequently, EPCs are critical to endothelium maintenance and repair and their dysfunction contributes to vascular disease. The aim of this study has been the characterization of EPCs from healthy peripheral blood, in terms of proliferation, differentiation and function. Given the importance of NO in neovascularization and homing process, it has been investigated the expression of NO synthase (NOS) isoforms, eNOS, nNOS and iNOS, and the effects of their inhibition on EPC function. Moreover, it has been examined the expression of NADPH oxidase (Nox) isoforms which are the principal source of ROS in the cell. In fact, a number of evidences showed the correlation between ROS and NO metabolism, since oxidative stress causes NOS inactivation via enzyme uncoupling. In particular, it has been studied the expression of Nox2 and Nox4, constitutively expressed in endothelium, and Nox1. The second part of this research was focused on the study of EPCs under pathological conditions. Firstly, EPCs isolated from healthy subject were cultured in a hyperglycaemic medium, in order to evaluate the effects of high glucose concentration on EPCs. Secondly, EPCs were isolated from the peripheral blood of patients affected with PAD, both diabetic or not, and it was assessed their capacity to proliferate, differentiate, and to participate to neovasculogenesis. Furthermore, it was investigated the expression of NOS and Nox in these cells. Mononuclear cells isolated from peripheral blood of healthy patients, if cultured under differentiating conditions, differentiate into EPCs. These cells are not able to form capillary-like structures ex novo, but participate to vasculogenesis by incorporation into the new vessels formed by mature endothelial cells, such as HUVECs. With respect to NOS expression, these cells have high levels of iNOS, the inducible isoform of NOS, 3-4 fold higher than in HUVECs. While the endothelial isoform, eNOS, is poorly expressed in EPCs. The higher iNOS expression could be a form of compensation of lower eNOS levels. Under hyperglycaemic conditions, both iNOS and eNOS expression are enhanced compared to control EPCs, as resulted from experimental studies in animal models. In patients affected with PAD, the EPCs may act in different ways. Non-diabetic patients and diabetic patients with a higher vascular damage, evidenced by a higher number of circulating endothelial cells (CECs), show a reduced proliferation and ability to participate to vasculogenesis. On the other hand, diabetic patients with lower CEC number have proliferative and vasculogenic capacity more similar to healthy EPCs. eNOS levels in both patient types are equivalent to those of control, while iNOS expression is enhanced. Interestingly, nNOS is not detected in diabetic patients, analogously to other cell types in diabetics, which show a reduced or no nNOS expression. Concerning Nox expression, EPCs present higher levels of both Nox1 and Nox2, in comparison with HUVECs, while Nox4 is poorly expressed, probably because of uncompleted differentiation into an endothelial phenotype. Nox1 is more expressed in PAD patients, diabetic or not, than in controls, suggesting an increased ROS production. Nox2, instead, is lower in patients than in controls. Being Nox2 involved in cellular response to VEGF, its reduced expression can be referable to impaired vasculogenic potential of PAD patients.

Pollination ecology and reproductive success in isolated populations of flowering plants: Primula apennina Widmer, Dictamnus albus L. and Convolvulus lineatus L.

This research focuses on reproductive biology and pollination ecology of entomophilous angiosperms, with particular concern to reproductive success in small and isolated populations of species that occur at their distribution limits or are endemic. I considered three perennial herbs as model species: Primula apennina Widmer, Dictamnus albus L. and Convolvulus lineatus L. I carried out field work on natural populations and performed laboratory analyses on specific critical aspects (resource allocation, pollen viability, stigmatic receptivity, physiological self-incompatibility, seed viability), through which I analysed different aspects related to plant fitness, such as production of viable seed, demographic structure of populations, type and efficiency of plant-pollinator system, and limiting factors.

Polysulfurated aromatic compounds: preparation and photophysical properties

The aim of this thesis was the synthesis and photophysical characterization of some new polysulfurated aromatic compounds: this class of molecules can offer intriguing properties, potentially useful for the construction of new materials for optoelectronic devices. Two main families of compounds have been synthesized: the first is represented by a series of small molecular asterisks, with peripheral aromatic units, showing luminescence in solid phase or in highly rigid conditions. All compounds with peripheral substituents display an AIE behavior (Aggregation Induced Emission) with radiative deactivation of the triplet states. Taking inspiration from these smaller asterisks, a larger molecule with the same geometry has been designed, decorated with terpyridyl moieties as the outermost units: this compound shows great affinity for the coordination of several transition metal ions, changing luminescence properties after the interaction with zinc ions. With the same intentions, a tetrasulfurated pyrene-core molecule with terpyridyl external units has been synthesized and isolated: this ligand exhibits good coordination capabilities towards transition metal ions, giving rise to luminescent nanoaggregates upon addition of zinc(II), characterized by DLS and AFM microscopy. In addition a NIR emission is recorded after coordination of neodymium(III), showing evidence of an intramolecular energy transfer process.

Nuove tecniche per l'allevamento massale di Ditteri del genere Coenosia Meigen

The species of the genus Coenosia Meigen are polyphagous predators both in the larval and in the adult stage. In Europe five Coenosia species of the ‘tigrina group’ are naturally present in greenhouses, where they can establish for long periods. As their wide preys range includes important pests of protected crops, as Aleyrodidae, Sciaridae and Agromyzidae, Coenosia species are considered promising potential biological control agents. A method for rearing Coenosia species in vivo was developed for the first time in 1993 in Germany, where C. attenuata, C. strigipes and C. humilis were bred on Bradysia paupera (Diptera Sciaridae), reared on Fusarium spp. cultivated on wood fibre. Although this method was partially simplified afterwards, it is still too complex and expensive for a mass production. This research aimed at simplifying this rearing procedure and making it cheaper, in the perspective of an eventual mass production. Studies on potential preys were conducted, to determine their suitability for C. attenuata larvae and adults and to develop rearing methods. Biology and rearing methods of Bradysia paupera Tuomikoski, Scatella stagnalis Fallén and Drosophila melanogaster Meigen (Diptera: Sciaridae, Ephydridae, Drosophilidae) were compared. B. paupera resulted the most suitable prey for rearing C. attenuata in vivo. The Sciarid fly was effectively reared on damp coconut fibre with fresh Agaricus bisporus (J.E. Lange) Pilát, thus simplifying the existing method. After preliminary trials with different potential preys, attempts to rear C. attenuata in vivo on B. paupera and D. melanogaster were made. The best results were obtained with B. paupera, reared on coconut fibre and A. bisporus, but the method needs further improvement. Trials of in vitro rearing of C. attenuata were also made: as no specific diet for Coenosia species is reported in literature, different potentially suitable media were tested. Among these, a specific diet for Diptera Tachinidae resulted a good starting point for further studies and improvements. The biology of C. attenuata adults captured in greenhouses was also studied, by observing both groups and isolated individuals. Data on lifespan, daily number of preys per adult, daily number of laid eggs and hatching rate were recorded, and the effects of different foods on these parameters were analyzed. The following foods were compared: D. melanogaster adults only, as preys for C. attenuata; D. melanogaster adults and a water-honey solution; the water-honey solution only. Honey resulted an effective food integration for C. attenuata, increasing lifespan and the number of egg laying females. It is possible that in greenhouses Coenosia adults complete the preys diet with nectar and/or honeydew. Moreover, the integration with honey reduced the daily preys consumption. This may allow to prevent cannibalism among Coenosia adults in the rearing conditions, where high population densities are required. A survey of the Coenosia species naturally present in Lombardy greenhouses was conducted. The species C. attenuata, C. strigipes, C. tigrina and C. atra were detected. C. attenuata resulted the most common, recorded in most greenhouses and for consecutive years. Besides, the presence of potential preys, weeds and the crops were recorded in each greenhouse. Nevertheless, it is difficult to determine the relation between these parameters and the presence of Coenosia species.

Anomalie cerebellari fetali: confronto tra ecografia e risonanza magnetica prenatale e follow up a distanza

Cerebellar malformation are increasingly diagnosed in utero. To assess the effectiveness of ultrasound and fetal magnetic resonance in the antenatal prediction of long term neurodevelopmental delay. STUDY DESIGN: We collected 105 cases of cerebellum malformation in the period 2000-2010 in Bologna and Bari University. Classification included cystic anomalies of posterior fossa and cerebellar hypoplasia. RESULTS: The greater group included Blake’s pouch cysts and mega cisterna magna cases (58/105). These cases seemed to have a good prognosis with a good outcome both in association with other anomalies and isolated. In cases of Dandy Walker malformation, vermis hypoplasia and cerebellum hypoplasia there were few survivors, so it was so difficult to outline some conclusion for child outcome. Despite great neuroimaging advances, in our study, ultrasound and MR reached a similar sensitivity (62-63%) for the diagnosis of posterior fossa anomalies, but the number of MR was lower compared with ultrasonography. CONCLUSION: Ultrasonography remains the screening method of choice for evaluation of cerebellum anatomy but probably MR imaging can improve some details expecially in the third trimester. Despite the data on Dandy Walker, vermis hypoplasia and cerebellum hypoplasia were conflicting and uncertain, for Blake and mega cisterna magna we can considered a rather good outcome.

Solving the cooling flow problem through mechanical AGN feedback

A fundamental gap in the current understanding of collapsed structures in the universe concerns the thermodynamical evolution of the ordinary, baryonic component. Unopposed radiative cooling of plasma would lead to the cooling catastrophe, a massive inflow of condensing gas toward the centre of galaxies, groups and clusters. The last generation of multiwavelength observations has radically changed our view on baryons, suggesting that the heating linked to the active galactic nucleus (AGN) may be the balancing counterpart of cooling. In this Thesis, I investigate the engine of the heating regulated by the central black hole. I argue that the mechanical feedback, based on massive subrelativistic outflows, is the key to solving the cooling flow problem, i.e. dramatically quenching the cooling rates for several billion years without destroying the cool-core structure. Using an upgraded version of the parallel 3D hydrodynamic code FLASH, I show that anisotropic AGN outflows can further reproduce fundamental observed features, such as buoyant bubbles, cocoon shocks, sonic ripples, metals dredge-up, and subsonic turbulence. The latter is an essential ingredient to drive nonlinear thermal instabilities, which cause cold gas condensation, a residual of the quenched cooling flow and, later, fuel for the AGN feedback engine. The self-regulated outflows are systematically tested on the scales of massive clusters, groups and isolated elliptical galaxies: in lighter less bound objects the feedback needs to be gentler and less efficient, in order to avoid drastic overheating. In this Thesis, I describe in depth the complex hydrodynamics, involving the coupling of the feedback energy to that of the surrounding hot medium. Finally, I present the merits and flaws of all the proposed models, with a critical eye toward observational concordance.

La cardiomiopatia aritmogena come causa di scompenso cardiaco e trapianto di cuore

Scopo dello studio: la cardiomiopatia aritmogena (CA) è conosciuta come causa di morte improvvisa, la sua relazione con lo scompenso cardiaco (SC) è stata scarsamente indagata. Scopo dello studio è la definizione della prevalenza e incidenza dello SC, nonché della fisiopatologia e delle basi morfologiche che conducono i pazienti con CA a SC e trapianto di cuore. Metodi: abbiamo analizzato retrospettivamente 64 pazienti con diagnosi di CA e confrontato i dati clinici e strumentali dei pazienti con e senza SC (NYHA III-IV). Abbiamo analizzato i cuori espiantati dei pazienti sottoposti a trapianto presso i centri di Bologna e Padova. Risultati: la prevalenza dello SC alla prima osservazione era del 14% e l’incidenza del 2,3% anno-persona. Sedici pazienti (23%) sono stati sottoposti a trapianto. I pazienti con SC erano più giovani all’esordio dei sintomi (46±16 versus 37±12 anni, p=0.04); il ventricolo destro (VD) era più dilatato e ipocinetico all’ecocardiogramma (RVOT 41±6 versus 37±7 mm, p=0.03; diametro telediastolico VD 38±11 versus 28±8 mm, p=0.0001; frazione di accorciamento 23%±7 versus 32%±11, p= 0.002). Il ventricolo sinistro (VS) era lievemente più dilatato (75±29 ml/m2 versus 60±19, p= 0.0017) e globalmente più ipocinetico (frazione di eiezione = 35%±14 versus 57%±12, p= 0.001). Il profilo emodinamico dei pazienti sottoposti a trapianto era caratterizzato da un basso indice cardiaco (1.8±0.2 l/min/m2) con pressione capillare e polmonare tendenzialmente normale (12±8 mmHg e 26±10 mmHg). L’analisi dettagliata dei 36 cuori dei pazienti trapiantati ha mostrato sostituzione fibro-adiposa transmurale nel VD e aree di fibrosi nel VS. Conclusioni: Nella CA lo SC può essere l’unico sintomo alla presentazione e condurre a trapianto un rilevante sottogruppo di pazienti. Chi sviluppa SC è più giovane, ha un interessamento del VD più severo accanto a un costante interessamento del VS, solo lievemente dilatato e ipocinetico, con sostituzione prevalentemente fibrosa.

A step forwards in immunomodulation and immunetolerance knowledge. HLA-G expression in co-cultures of peripheral blood mononuclear cells and stem cells after in vitro NGAL stimulation

NGAL (Neutrophil Gelatinase-associated Lipocalin ) is a protein of lipocalin superfamily. Recent literature focused on its biomarkers function in several pathological condition (acute and chronic kidney damage, autoimmune disease, malignancy). NGAL biological role is not well elucidated. Several are the demonstration of its bacteriostatic role. Recent papers have indeed highlight NGAL role in NFkB modulation. The aim of this study is to understand whether NGAL may exert a role in the activation (modulation) of T cell response through the regulation of HLA-G complex, a mediator of tolerance. From 8 healthy donors we obtained peripheral blood mononuclear cells (PBMCs) and we isolated by centrifugation on a Ficoll gradient. Cells were then treated with four concentrations of NGAL (40-320 ng/ml) with or without iron. We performed flow cytometry analysis and ELISA test. NGAL increased the HLA-G expression on CD4+ T cells, with an increasing corresponding to the dose. Iron effect is not of unique interpretation. NGAL adiction affects regulatory T cells increasing in vitro expansion of CD4+ CD25+ FoxP3+ cells. Neutralizing antibody against NGAL decreased HLA-G expression and reduced significantly CD4+ CD25+ FoxP3+ cells percentage. In conclusion, we provided in vitro evidence of NGAL involvement in cellular immunity. The potential role of NGAL as an immunomodulatory molecule has been evaluated: it has been shown that NGAL plays a pivotal role in the induction of immune tolerance up regulating HLA-G and T regulatory cells expression in healthy donors. As potential future scenario we highlight the in vivo role of NGAL in immunology and immunomodulation, and its possible relationship with immunosuppressive therapy efficacy, tolerance induction in transplant patients, and/or in other immunological disorders.