Handgrip strength and health related quality of life in individuals with copd

In individuals with chronic obstructive pulmonary disease (COPD), skeletal muscle wasting and changes in muscle fiber composition limit the muscle strength with consequences on daily physical activities. In the present study we aimed to investigate about the interconnection among upper limb strength, body composition and health related quality of life (HRQoL) in patients with COPD to verify the impact of muscle mass loss on HRQoL. Twenty-six consecutive patients (69.2% male; age: 69.7±7.29 years) with COPD were included. Patients underwent pulmonary function tests. Body composition was evaluated through Bioelectrical Impedance Analysis (BIA); handgrip test was used for measure upper limb strength. St George’s Respiratory Questionnaire (SGRQ) was used to evaluate patients’ HRQoL. Upper limb muscle strength was negatively correlated with SGRQ (Pearson=-0.571; p=0.002) in particular with activity and impact domains (Pearson=-0.668; p<0.001 and Pearson =-0.461; p=0.02). Multivariate linear regression confirm that poor handgrip strength is a predictor of worse SGRQ after adjusting for gender, age, fat free mass index and inhaled corticosteroids use (p=0.012). Upper limb muscle strength and body composition are two essential tools in the multisystemic assessment of patients with COPD. © 2020, Segretariato Italiano Giovani Medici - Associazione Italiana Medici. All rights reserved

Small leucine rich proteoglycans are differently distributed in normal and pathological endometrium

BACKGROUND: During the woman's fertile period, the non-pregnant uterus is subject to constant cyclic changes. The complex mechanisms that control the balance among proliferation, differentiation, cell death and the structural remodeling of the extracellular matrix can contribute to the benign or malignant endometrial pathological state. The small leucine-rich proteoglycans (SLRPs) are important components of cell surface and extracellular matrices. MATERIALS AND METHODS: Using immunohistochemistry, we showed that the distribution patterns of SLRPs were completely modified in the pathological compared to normal endometrium. RESULTS: The expression of SLRPs was low/absent in all endometrial pathologies examined compared to normal endometrium. We observed an increase of lumican from proliferative to secretory phase of the endometrium and a decrease of fibromodulin, biglycan and decorin. In menopause endometrial tissue, the level of expression of fibromodulin, biglycan, decorin and lumican dramatically decreased. CONCLUSION: The results revealed the prominence and importance of proteoglycans in the tissue architecture and extracellular matrix organization

Localization and distribution of wolframin in human female reproductive tract

Wolframin, a transmembrane glycoprotein of endoplasmic reticulum consisting of 890 amino acids, is encoded by the WFS1 gene, mutated in the Wolfram syndrome. This pathology, also called DIDMOAD, is an autosomal recessive disorder defined by the association of diabetes mellitus, optic atrophy, and further organ abnormalities. To gain further insight into the pathogenesis of diseases associated with WFS1 mutations, we conducted an immunohistochemical study to investigate its pattern of expression in human female reproductive tract in physiologic and pathologic conditions. For this purpose, samples of physiologic and pathologic endometrium, samples of placenta throughout pregnancy in normal and diabetic pregnant women, were used. In physiologic endometrium, we observed a light increase of wolframin from proliferative to secretory phase where wolframin was localized in the glands, stroma and cells lining blood vessels. In menopause, wolframin expression increased with a glandular and stromal localization. In pathologic endometrium, we observed an increase of wolframin expression from hyperplasia to polyps until a higher expression in carcinoma tissues. In normal placenta there was a modulation of wolframin throughout pregnancy with a strong level of expression during the first trimester and a moderate level in the third trimester. In diabetic women, the wolframin expression was strongly reduced in the third trimester of gestation. In human endometrium, wolframin seems to have a role in differentiation program. Deregulation of these functions may induce the onset of several endometrial pathologies. Moreover, in normal placenta wolframin may be required to sustain normal rates of cytotrophoblast cell proliferation during the first trimester of gestation. The decrease of wolframin expression in diabetic placentae may hypothesize that this protein is directly regulated by insulin concentration also in the placenta, suggesting that this protein physiologically maintain the glucose homeostasis in this organ

Role of FAP48 in HIV-associated lipodystrophy

The introduction of highly active antiretroviral therapies (HAART) has significantly changed the clinical course of HIV disease, with prolonged survival and better quality of life for HIV infected patients. However, this successful therapeutic advance has been partially marked by the development of serious long-term side effects including metabolic alterations, cardiovascular disease, kidney impairment, bone alterations and adipose tissue redistribution. This last phenomenon is currently indicated as HIV related lipodystrophy (Barbaro, 2006). Even if some studies suggested an independent role for HIV in the development of lipodystrophic phenotype, there is a widely accepted consensus that the risk to develop fat redistribution in HIV patients has to be mostly related to antiretroviral therapy. In order to investigate new pathways involved in the development of lipodystrophy, our group performed an array screening using two identical filter arrays with cDNAlabeled probes, generated from the adipose tissue of either HIV patients affected or not affected by lipodystrophy. Among the genes selected, we focused our attention on a recently described 48 kDa protein of 417 amino acids named FAP48. Our results suggest, using 3T3-L1-FAP48 stable clone, that FAP48 over-expression results in rapid NFAT dephosphorilatyon by activating CaN and in the increase of aP2 gene transcription, a gene expressed at the last phase of the adipocyte differentiation. These data support the role of Fap48 in the activation of adipocyte differentiation through a pathway involving NFAT. Moreover we evaluated the expression of PPARγ and aP2 in 3T3-L1 FAP48pcDNA stably transfected cells treated with five antiretroviral drugs (Indinavir, Amprenavir, Efavirenz, Stavudine and Saquinavir), belonging to the three main classes of anti-HIV drugs, that were able, in our experimental model, to affect adipocyte differentiation (Esposito et al., 2009). We observed that cells treated with Saquinavir and Efavirenz, using 3T3-L1- FAP48 stable clone, are characterized by an increased expression of PPARγ and aP2, during the 6 day time course, compared with the control cells. This evidence supports the hypothesis of a protective mechanism, that in 3T3L1 cells could counteract the toxicity of Efavirenz and Saquinavir or could be activated in presence of these drugs. Drawing from our experimental results it can be then postulated that this mechanism could work trough FAP48/ FBP52/Hsp90 pathway, suggesting this complex as a potential target for novel therapeutic approaches to the HAART related lipodystrophy in patients treated with regimen including Efavirenz and Saquinavir

Role of Associated Adherent-Invasive Escherichia Coli in Crohn’s disease

Several lines of evidence suggest that adherent-invasive Escherichia coli (AIEC) strains play an important role in Crohn’s disease (CD). The objective of this study was to investigate the pathogenic role of two AIEC strains, LF82 and O83:H1, in CD patients. Organ cultures of colonic biopsies from patients were set up to assess the effects of LF82 and O83:H1 on the expression of CEACAM6, LAMP1, HLA-DR, ICAM1 by immunohistochemistry and of IL-8, IFNγ, and TNF-α genes by RT-PCR. Moreover, on Caco2 cells, we analyzed the cell cycle, the expression of MGMT and DNMT1 genes, and DNA damage induced by LF82 and O83:H1, by FACS, RT-PCR, and DAPI staining, respectively. Epithelial and lamina propria mononuclear cells (LPMNC) expression of CEACAM6 and LAMP1 were higher in biopsies cultured in the presence of both O83:H1 and LF82 than in biopsies cultured with non-pathogenic E. coli. Both AIEC strains induced increased expression of ICAM-1 on blood vessels and HLA-DR on LPMNC. We observed higher levels of TNF-α, IFN-γ, and IL-8 transcripts in biopsies cultured with both AIEC strains than in those cultured with NP. Both LF82 and O83:H1, block the cell cycle into S phase, inducing DNA damage, and modulate the expression of DNMT1 and MGMT genes. Our data suggest that LF82 and 083:H1 strains of E. coli are able to increase in CD colonic biopsies the expression of all the pro-inflammatory cytokines and all the mucosal immune markers investigated

Next Generation Molecular Diagnosis of Hereditary Spastic Paraplegias: An Italian Cross-Sectional Study

Hereditary spastic paraplegia (HSP) refers to a group of genetically heterogeneous neurodegenerative motor neuron disorders characterized by progressive age-dependent loss of corticospinal motor tract function, lower limb spasticity, and weakness. Recent clinical use of next generation sequencing (NGS) methodologies suggests that they facilitate the diagnostic approach to HSP, but the power of NGS as a first-tier diagnostic procedure is unclear. The larger-than-expected genetic heterogeneity-there are over 80 potential disease-associated genes-and frequent overlap with other clinical conditions affecting the motor system make a molecular diagnosis in HSP cumbersome and time consuming. In a single-center, cross-sectional study, spanning 4 years, 239 subjects with a clinical diagnosis of HSP underwent molecular screening of a large set of genes, using two different customized NGS panels. The latest version of our targeted sequencing panel (SpastiSure3.0) comprises 118 genes known to be associated with HSP. Using an in-house validated bioinformatics pipeline and several in silico tools to predict mutation pathogenicity, we obtained a positive diagnostic yield of 29% (70/239), whereas variants of unknown significance (VUS) were found in 86 patients (36%), and 83 cases remained unsolved. This study is among the largest screenings of consecutive HSP index cases enrolled in real-life clinical-diagnostic settings. Its results corroborate NGS as a modern, first-step procedure for molecular diagnosis of HSP. It also disclosed a significant number of new mutations in ultra-rare genes, expanding the clinical spectrum, and genetic landscape of HSP, at least in Italy

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients

Carriers of ADAMTS13 Rare Variants Are at High Risk of Life-Threatening COVID-19

Thrombosis of small and large vessels is reported as a key player in COVID-19 severity. However, host genetic determinants of this susceptibility are still unclear. Congenital Thrombotic Thrombocytopenic Purpura is a severe autosomal recessive disorder characterized by uncleaved ultra-large vWF and thrombotic microangiopathy, frequently triggered by infections. Carriers are reported to be asymptomatic. Exome analysis of about 3000 SARS-CoV-2 infected subjects of different severities, belonging to the GEN-COVID cohort, revealed the specific role of vWF cleaving enzyme ADAMTS13 (A disintegrin-like and metalloprotease with thrombospondin type 1 motif, 13). We report here that ultra-rare variants in a heterozygous state lead to a rare form of COVID-19 characterized by hyper-inflammation signs, which segregates in families as an autosomal dominant disorder conditioned by SARS-CoV-2 infection, sex, and age. This has clinical relevance due to the availability of drugs such as Caplacizumab, which inhibits vWF-platelet interaction, and Crizanlizumab, which, by inhibiting P-selectin binding to its ligands, prevents leukocyte recruitment and platelet aggregation at the site of vascular damage