Expanding the therapeutic potential of neuro(active)steroids: a promising strategy for hyperdopaminergic behavioral phenotypes

Imbalances in dopamine activity significantly contribute to the pathophysiology of several neuropsychiatric disorders, including addiction, ADHD, schizophrenia, impulse control disorders, and Parkinson's Disease. Neuro (active)steroids, comprising endogenous steroids that finely modulate neuronal activity, are considered crucial regulators of brain function and behavior, with implications in various physiological processes and pathological conditions. Specifically, subclasses of Neuro(active)steroids belonging to the 5 alpha alpha reductase pathway are prominently involved in brain disorders characterized by dopaminergic signaling imbalances. This review highlights the neuromodulatory effects of Neuro(active)steroids on the dopamine system and related aberrant behavioral phenotypes. We critically appraise the role of pregnenolone, progesterone, and allopregnanolone on dopamine signaling. Additionally, we discuss the impact of pharmacological interventions targeting 5 alpha alpha reductase activity in neuropsychiatric conditions characterized by excessive activation of the dopaminergic system, ranging from psychotic (endo)phenotypes and motor complications to decision-making problems and addiction

Mitochondrial DNA methylation is associated with Mediterranean diet adherence in a population of older adults with overweight and obesity.

AbstractIntroductionAdherence to the Mediterranean dietary pattern (MeDiet) and adiposity, respectively, decreases and increases the risk of multiple common age-related diseases through several mechanisms including inflammation, reactive oxygen species (ROS) production in the mitochondria, and DNA methylation. For example, adverse changes in platelets from obese and overweight adults include hyperaggregability and increased ROS. Since platelets are anuclear, their prothrombotic function is fully orchestrated by the mitochondria and the only DNA present is the mitochondrial DNA (mtDNA). In this study, we tested the hypothesis that MeDiet influences patterns of mtDNA methylation in platelets from older adults with greater adiposity.Material and methodsWe selected 134 participants with overweight or obesity (mean BMI = 35.5 ± 5.1 and age = 62 ± 10 years) from the "Susceptibility to particle health effects, miRNA and exosomes"(SPEHRE) Study. Dietary intake was assessed using a food frequency questionnaire and MeDiet adherence was calculated using the MeDiet Score described by Martínez-González et al.(2012). MtDNA was extracted from platelets, linearized, bisulfite converted and DNA methylation was quantified by pyrosequencing at 13 CpG in seven genes that encode for tRNAs (MT-TF and MT-TL1), regulatory regions (D-Loop and MT-OLR), and subunits of the electron-transport-chain (MT-CO1, MT-CO2, and MT-CO3).ResultsIn these participants, MeDiet score ranged from 3 to 12 (mean = 6.5), with higher scores reflecting greater MeDiet adherence. Regression analysis showed that higher MeDiet score was associated with lower D-loop (β = -0.031, P = 0.019) and higher MT-CO2 CpG1 (β = 0.040, P = 0.023) methylation. No associations were found between MeDiet Score and methylation level at MT-CO1(2 CpGs), MT-CO2(CpG2), MT-CO3(2 CpGs), MT-TL1(2 CpGs), MT-TF(CpG1), MT-OLR(3 CpGs).In addition, there was no association between mtDNA methylation and BMI.DiscussionThe D-loop is critical for mitochondrial function since it initiates mtDNA replication and transcription. Increased D-loop methylation has been associated with reduced mitochondrial functionality, and insulin resistance. Our results suggest that higher adherence to MeDiet lowers D-loop methylation which may protect against obesity-related comorbidities (e.g. insulin resistance).Higher MeDiet scores are associated with MT-CO2 CpG1 hypermethylation. MT-CO2 encodes for a subunit of the Cytochrome-C-oxidase, a highly regulated enzyme involved in the oxidative metabolism. MT-CO2 demethylation, induced by Valproic-Acid administration, has been reported to be associated with increased ROS production. Our results suggest a possible role of MeDiet in mitochondrial ROS regulation via methylation of MT-CO2.For the first time, we observed associations between MeDiet adherence and mtDNA methylation. Validation of these findings in independent cohorts is required

Chronic hepatitis in man and in dog: a comparative update.

Chronic hepatitis is a frequent pathologic condition encountered in both dogs and humans; however, in the latter etiologic factors are usually searched and found that allow targeted therapeutic approaches, whereas in dogs this is less frequent. This review will take into consideration chronic hepatitis in dogs, and discuss differences and similarities between the two species with respect to this disease

Generation of Induced Pluripotent Stem Cells from Patients with Duchenne Muscular Dystrophy and their induction to Neurons

Duchenne muscular dystrophy (DMD) is an X-linked recessive disease characterized by deficient expression of the cytoskeletal protein dystrophin. DMD has been associated with intellectual disability and mental retardation (MR) and is present in about a third of all patients. Loss of Dp71, the major dystrophin-gene product in brain, and the dystrophin associated proteins (DAPs) are thought to contribute to severity of MR, but the specific function of the neural dystrophin proteins are poorly understood for a limited access to DMD patients brain tissue (1). Differentiation of induced Pluripotent Stem Cells (iPSCs) provides an opportunity to generate an unlimited supply of living neurons genetically identical to those present in patients. In this study we obtained DMD-iPSCs from peripheral blood mononuclear cells of DMD patients with cognitive impairment and we performed morphological (fluorescence and electron microscopy), molecular (Western Blot and Real Time PCR) and functional (electrophysiology) characterization both of iPSC-derived Neural Stem Cells (NSCs) and the differentiated neurons. Preliminary data showed a reduction of Dp71 and DAPs proteins, including the AQP4, potassium channel Kir4.1, α- and β-dystroglycan (α/βDG) and α-syntrophin (αSyn), both at transcriptional and traductional level, coupled with membrane dys-arrangment in DMD-iPSCs compared with healthy iPSCs. Moreover, we demonstrated that the neurons obtained from the differentiation of iPSCs derived from DMD patient showed after confocal analysis, altered cytoskeleton and reduction in Dp71expression, and by single-cell imaging experiments and electrophysiology, altered intracellular calcium homeostasis, in analogy with what shown in the dystrophic mdx mouse neurons (2). Overall these results showed that the Dp71 and DAPs alterations affect also the neural precursor as well as the differentiated neurons in DMD patients, so suggesting a key role in the pathogenesis of neurocognitive deficits in DMD disease

Sensitivity and specificity of in vivo COVID-19 screening by detection dogs: Results of the C19-Screendog multicenter study

Trained dogs can recognize the volatile organic compounds contained in biological samples of patients with COVID-19 infection. We assessed the sensitivity and specificity of in vivo SARS-CoV- 2 screening by trained dogs. We recruited five dog-handler dyads. In the operant conditioning phase, the dogs were taught to distinguish between positive and negative sweat samples collected from volunteers’ underarms in polymeric tubes. The conditioning was validated by tests involving 16 positive and 48 negative samples held or worn in such a way that the samples were invisible to the dog and handler. In the screening phase the dogs were led by their handlers to a drive-through facility for in vivo screening of volunteers who had just received a nasopharyngeal swab from nursing staff. Each volunteer who had already swabbed was subsequently tested by two dogs, whose responses were recorded as positive, negative, or inconclusive. The dogs’ behavior was constantly monitored for attentiveness and wellbeing. All the dogs passed the conditioning phase, their responses showing a sensitivity of 83-100% and a specificity of 94-100%. The in vivo screening phase involved 1251 subjects, of whom 205 had a COVID-19 positive swab and two dogs per each subject to be screened. Screeningsensitivity and specificity were respectively 91.6-97.6% and 96.3-100% when only one dog was involved, whereas combined screening by two dogs provided a higher sensitivity. Dog wellbeing was also analysed: monitoring of stress and fatigue suggested that the screening activity did not adversely impact the dogs’ wellbeing. This work, by screening a large number of subjects, strengthen recent findings that trained dogs can discriminate between COVID-19 infected and healthy human subjects and introduce two novel research aspects: i) assessement of signs of fatigue and stress in dogs during training and testing, and ii) combining screening by two dogs to improve detection sensitivity and specificity. Using some precautions to reduce the risk of infection and spillover, in vivo COVID-19 screening by a dog-handler dyad can be suitable to quickly screen large numbers of people: it is rapid, non- invasiveand economical, since it does not involve actual sampling, lab resources or waste management, and is suitable to screen large numbers of people

Temporary dense seismic network during the 2016 Central Italy seismic emergency for microzonation studies

In August 2016, a magnitude 6.0 earthquake struck Central Italy, starting a devastating seismic sequence, aggravated by other two events of magnitude 5.9 and 6.5, respectively. After the first mainshock, four Italian institutions installed a dense temporary network of 50 seismic stations in an area of 260 km2. The network was registered in the International Federation of Digital Seismograph Networks with the code 3A and quoted with a Digital Object Identifier ( https://doi.org/10.13127/SD/ku7Xm12Yy9 ). Raw data were converted into the standard binary miniSEED format, and organized in a structured archive. Then, data quality and completeness were checked, and all the relevant information was used for creating the metadata volumes. Finally, the 99 Gb of continuous seismic data and metadata were uploaded into the INGV node of the European Integrated Data Archive repository. Their use was regulated by a Memorandum of Understanding between the institutions. After an embargo period, the data are now available for many different seismological studies.Publishedid 1825T. Sismologia, geofisica e geologia per l'ingegneria sismicaJCR Journa

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription