Identification of a molecular signature as potential biomarker in blood of symptomatic and asymptomatic patients with carotid atherosclerosis

Background and Objectives: Carotid revascularization to prevent future vascular events is reasonable in patients with high-grade carotid stenosis. Currently, several biomarkers to predict carotid plaque development and progression have been investigated, among which microRNAs (miRs) are promising tools for the diagnosis of atherosclerosis. Methods and Results: A total of 49 participants were included in the study, divided into two main populations: Population 1 comprising symptomatic and asymptomatic inpatients, and Population 2 comprising asymptomatic outpatients. The study consisted of two main phases: a preliminary discovery phase and a validation phase, applying different techniques. MiR-profiles were performed on plasma and plaque tissue samples obtained from 4 symptomatic and 4 asymptomatic inpatients. MiRs emerging from profiling comparisons, i.e. miR-126-5p, miR-134-5p, miR-145-5p, miR-151a-5p, miR-34b, miR-451a, miR-720 and miR-1271-5p, were subjected to validation through RT-qPCR analysis in the total cohort of donors. Comparing asymptomatic and symptomatic inpatients, significant differences were reported in the expression levels of c-miRs for miR-126-5p and miR-1271-5p in blood, being more expressed in symptomatic subjects. In contrast, simultaneous evaluation of the selected miRs in plaque tissue samples did not confirm data obtained by the miR profiling, and no significant differences were observed. Using Receiver-Operating Characteristic (ROC) analysis, a circulating molecular signature (mir-126-5p, miR-1271-5p, albumin, C-reactive protein, and monocytes) was identified, allowing the distinction of the two groups in Population 1 (AUC = 0.795). Conclusions: Data emerging from this thesis suggest that c-miRs (i.e. miR-126-5p, miR-1271-5p) combined with selected haemato-biochemical parameters (albumin, C-reactive protein, and monocytes) produced a good molecular 'signature' to distinguish asymptomatic and symptomatic inpatients. C-miRs in blood do not necessarily reflect the expression levels of the same miRs in carotid plaque tissues since different mechanism can influence their expression.

New methodologies in organocatalysis: from discovery to application and mechanistic

This PhD thesis deals with three different topics: i) sulfoxonium ylides, ii) donor-acceptor cyclopropanes, and iii) desymmetrization reactions. Catalysis, and in more detail organocatalysis, is the fil rouge linking the three subjects of study. The main focus treated during this doctorate period is the reactivity of sulfoxonium ylides, and in particular stabilized sulfoxonium ylides. Special attention has been dedicated to the behavior of these particular substrates under asymmetric and non-asymmetric reaction conditions. Moreover, also similarities and differences with the related, less stable, sulfonium ylides were fully analyzed, both experimentally and from a theoretical point of view. Two different reactions were developed in full. One conducted under acidic reaction conditions and the second one exploiting the asymmetric aminocatalysis. Subsequently, the reactivity of donor-acceptor cyclopropanes was studied. After different attempts in the development of a new catalytic methodology based on these substrates, a non-conventional reactivity conducted under phase transfer catalysis was discovered and optimized. In particular, a chemodivergent reaction depending on the reaction conditions was developed. Finally, during the period spent abroad, a preliminary study of a desymmetrization reaction was carried out. The studied reaction is based on an asymmetric elimination reaction conducted under asymmetric phosphoric acid catalysis. In summary, this PhD thesis shows the versatility of different organocatalytic methodologies when applied to different reactions and substrates.