Autologous micrografts and methotrexate in plantar erosive lichen planus: healing and pain control. A case report

Erosive lichen planus is an uncommon variant of lichen planus. We report a case of long-standing and refractory plantar ELPs causing disabling and opiate-resistant pain treated with 'classic' meshed skin graft combined with RigeneraVR micrografts. After approximately 9 months follow-up, no clinical recurrence or pain were observed. Erosive lichen planus (ELP) is an uncommon variant of lichen planus, involving oral cavity and genitalia and, less often plantar areas, where it usually presents with chronic erosions of the soles, along with intense, disabling pain and progressive loss of toenails. An abnormal immune cellular response (CD8+ lymphocytes and macrophages) and the consequent altered production of multiple mediators (interleukin-12, interferon-gamma, tumor necrosis factor-alpha, RANTES and MMP-9), seem to play a crucial role in the pathogenesis, although the etiology remains uncertain. From a histological point of view, ELP shows keratinocyte apoptosis, intense inflammatory response and basal epithelial keratinocytes TNF-alpha overexpression. Several therapies have been proposed, with variable and controversial results. While topical corticosteroids and topical calcineurin inhibitors are the treatments of choice for localized forms, short pulses of systemic glucocorticoids, phototherapy, and systemic immunosuppressants are recommended for generalized cases. Surgery has been reported as a possible therapeutic option in refractory and stable cases with localized lesions, either alone or with cyclosporine. Herein, we report a case of longstanding and refractory plantar ELPS causing disabling and opiate-resistant pain treated with 'classic' meshed skin graft combined with RigeneraVR micrografts

Characterization and analysis of the expression pattern of microRNAs in the grapevine Vitis vinifera

MicroRNAs are small (19-24 nt) noncoding RNAs that play an important role in the regulation of multiple cell events, inhibiting gene expression at the posttranscriptional level by binding target mRNAs that are subsequently degraded or sequestered from translation. The availability of the complete genome sequence of the grapevine (Vitis vinifera), has already permitted genome-wide predictions of microRNAs by purely computational methods. Here we integrate transcriptomic data derived from high-throughput Illumina SOLEXA and ABI SOLiD sequence tags derived from both polyA+ transcripts and isolated small RNAs with oligonucleotide array data. We are thus able to detect both mature microRNAs and to establish whether genomic loci corresponding to the pre-miRNA are expressed in various tissues. In many cases, the unambiguous alignment of sequence tags derived from polyA+ RNA to the genomic sequence allow provisional mapping of primary microRNA transcripts, a first step towards bioinformatics characterization of elements potentially regulating microRNA expression

Grapevine miRNAs : Towards A Structural And Functional Characterization.

In plants, microRNAs (miRNAs) are key post-transcriptional regulatory elements approximately 21 nt long, coded by MIRNA genes, which regulate plant architecture, nutrient homeostasis and stress response. The crucial role they play in fine tuning gene regulation clearly implies that a complete characterization of genomes structure and function cannot be attained without a deep analysis of this class of regulatory elements. Here we present the characterization of miRNA genes in grapevine, following the annotation of 140 conserved MIRNA genes (Jaillon et al., 2007). Starting from the description of their transcriptional landscape (Mica et al., 2009) we analyzed their genomic structure and interaction with putative targets. We experimentally validated primary transcript boundaries and alternative splicing events of several miRNA genes, confirming bioinformatic predictions and showing different splicing patterns and alternative transcription end points. Putative targets were identified and validated by means of 5\u2019 modified RACE experiments. We are currently focusing on target genes involved in several physiological pathways such as phenylpropanoid pathway and that, according to transcriptome analysis using oligo-chips, are up- or down-regulated in berries after light and heat stress treatments

Remote ischaemic preconditioning in coronary artery bypass surgery: a meta-analysis

Aim Randomised trials exploring remote ischaemic preconditioning (RIPC) in patients undergoing coronary artery bypass graft (CABG) surgery have yielded conflicting data regarding potential cardiovascular and renal protection, and are individually flawed by small sample size. Methods Three investigators independently searched the MEDLINE, EMBASE and Cochrane databases to identify randomised trials testing RIPC in patients undergoing CABG. Results Nine studies with 704 patients were included. Standardised mean difference of troponin I and T release showed a significant decrease ( 120.36 (95% CI 120.62 to 120.09)). This difference held true after excluding the trials with cross-clamp fibrillation, the study with off-pump CABG and studies using a flurane as anaesthetic agent ( 120.41 (95% CI 120.69 to 120.12), 120.38 (95% CI 120.70 to 120.07) and 120.37 (95% CI 120.63 to 120.12), respectively). A similar trend was also obtained for patients with multivessel disease ( 120.41 (95% CI 120.73 to 120.08)). The trials evaluating postoperative creatinine reported a non-significant reduction (0.02 (95% CI 120.09 to 0.13)). Moreover, the length of in-hospital stay was not influenced by the kind of treatment (weighted mean difference 0.27 (95% CI 120.24 to 0.79)). Conclusion RIPC reduced the release of troponin in patients undergoing CABG. Larger randomised trials are needed to clarify the presence of a causal relationship between RIPC-induced troponin release and clinical adverse events

miRNA DISCOVERY IN GRAPEVINE BY IN SILICO APPROACHES

The key role of non-coding RNAs in many different biological areas has become clear in the last ten years. microRNAs are a group of non-coding small RNAs (20-22 nt long) which are often conserved between related organisms and which are coded by specific genes called MIR genes. All the transcripts that give rise to the same miRNA are grouped in a single family. microRNAs are involved in post-transcriptional gene regulation, inducing transcript cleavage or translation inhibition, throughout sequence similarity. Target genes are associated with many different biological processes and possess no significant similarity to their respective miRNA genes, apart from the 21 nucleotide sequence. In plants, target genes are typically involved in stress response and plant development. They are broadly present in the plant kingdom; in recent years many new species have been investigated and many miRNAs have been discovered, mainly through in silico comparative genomic approaches. Here we present a double in silico approach applied to the complete sequence of the grape (Vitis vinifera L.) genome focused on the discovery of both conserved plant miRNAs and new species-specific miRNAs. Interesting comparative and phylogenetic analyses have been performed that explicit how different miRNA gene families behave during evolution, following geneexpansion or gene-loss, showing in some cases a similar genomic organization, among different species. Moreover, to further characterize these miRNAs and investigate their putative roles, a detailed target analysis has been performed. As expected targets of related families are highly conserved between species, belonging to the same functional categories. Nonetheless a further characterization of these targets and their corresponding miRNAs can clarify their role and possible involvement in plant growth and fruit development

Definition plant microRNA primary transcripts and their splicing patterns using RNAseq

Motivation. The prediction of conserved mature microRNAs and their precursor hairpins has been addressed through several computational tools, while the detection of novel and lineage specific microRNAs is typically approached through deep sequencing of small RNA species. However, a meaningful understanding of both the regulation of miRNA transcription and the potential roles of alternative splicing in posttranscriptional regulation of microRNA biogenesis require accurate, high throughput methods to describe primary microRNA transcript structure. Methods. Given that at least most primary miRNAs in plants are believed to be transcribed by RNA polymerase II, we reasoned that, despite the expected short physiological half life of such species, ultra high-throughput sequencing of cDNA should provide evidence of primary miRNA transcripts and splicing of these molecules. We tested this hypothesis using Illumina RNAseq data from the Grapevine Vitis vinifera. Reads were mapped to the genome sequence and \u201cislands\u201d of transcription including known miRNA precursors were analysed in detail. All possible canonical splice junctions within such islands were generated computationally and used as targets for mapping of RNAseq reads that did not map to the genome sequence (reads potentially covering splice junctions). Results. We show that for many microRNA precursors, convincing estimates of primary transcript coordinates can be obtained from RNAseq data. Furthermore, estimates of splicing events obtained from our approach can often be validated experimentally. Our data suggest that splicing and alternative splcing of primary miRNAs may be widespread, at least in the grapevine, and that alternative splicing may represent a mechanism of post-transcriptional regulation of miRNA biogenesis

MiRNA discovery in grapevine by in silico approaches

The key role of non-coding RNAs in many different biological areas has become clear in the last ten years. microRNAs are a group of non-coding small RNAs (20-22 nt long) which are often conserved between related organisms and which are coded by specific genes called MIR genes. All the transcripts that give rise to the same miRNA are grouped in a single family. microRNAs are involved in post-transcriptional gene regulation, inducing transcript cleavage or translation inhibition, throughout sequence similarity. Target genes are associated with many different biological processes and possess no significant similarity to their respective miRNA genes, apart from the 21 nucleotide sequence. In plants, target genes are typically involved in stress response and plant development. They are broadly present in the plant kingdom; in recent years many new species have been investigated and many miRNAs have been discovered, mainly through in silico comparative genomic approaches. Here we present a double in silico approach applied to the complete sequence of the grape (Vitis vinifera L.) genome focused on the discovery of both conserved plant miRNAs and new species-specific miRNAs. Interesting comparative and phylogenetic analyses have been performed that explicit how different miRNA gene families behave during evolution, following geneexpansion or gene-loss, showing in some cases a similar genomic organization, among different species. Moreover, to further characterize these miRNAs and investigate their putative roles, a detailed target analysis has been performed. As expected targets of related families are highly conserved between species, belonging to the same functional categories. Nonetheless a further characterization of these targets and their corresponding miRNAs can clarify their role and possible involvement in plant growth and fruit development

Characterization and analysis of the expression pattern of microRNAs in the grapevine Vitis vinifera

Motivation: MicroRNAs are small (19-24 nt) noncoding RNAs that play an important role in the regulation of multiple cell events, inhibiting gene expression at the posttranscriptional level by binding target mRNAs that are subsequently degraded or sequestered from translation. Plant microRNA genes are typically transcribed by Pol II to yield polyadenylated primary miRNAs (pri-miRNA). These undergo nuclear cleavage to produce to a stem loop intermediate (pre-miRNA) with specific thermodinamic features. Further processing yields a miRNA:miRNA* duplex with 2 nt 3\u2019 overhangs that enters a cytoplasmic ribonucleprotein complex which mediates interaction with target mRNAs. Systematic analyses of micro RNAs and their expression patterns have been performed in only a few plant model species. The availability of the complete genome sequence of the grapevine (Vitis vinifera), has already permitted genome-wide predictions of microRNAs by purely computational methods. Here we present a comprehensive analysis of expression of both mature microRNAs and their primary transcripts in the grapevine using oligonucleotide arrays and next generation sequencing technologies. Methods: We integrate tanscriptome information derived from high-throughput Illumina SOLEXA and ABI SOLiD sequence tags derived from both polyA+ transcripts and isolated small RNAs with oligonucleotide array data. We are thus able to detect both mature microRNAs and to establish whether genomic loci corresponding to the pre-miRNA are expressed in various tissues. Results: Using \u201cnext generation\u201d sequencing technologies and oligonucleotide arrays, we are able to demonstrate tissue specificity of expression of many microRNA genes and their precursor sequences. In many cases, the unambiguous alignment of sequence tags derived from polyA+ RNA to the genomic sequence allow provisional mapping of primary microRNA transcripts. It is hoped that the approach outlined here will ultimately provide insights into the regulation of processing of primary microRNAs and precursor microRNAs as well as facilitating identification of sequence elements involved in the regulation of transcription of microRNA genes

Consensus document on controversial issues in the diagnosis and treatment of prosthetic joint infections.

BACKGROUND: Joint replacement surgery has been on the increase in recent decades and prosthesis infection remains the most critical complication. Many aspects of the primary prevention and clinical management of such prosthesis infections still need to be clarified. CONTROVERSIAL ISSUES: The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group - a panel of multidisciplinary experts - was to define recommendations for the following controversial issues: (1) Is a conservative surgical approach for the management of prosthetic joint infections effective? (2) Is the one-stage or the two-stage revision for the management of prosthetic joint infections more effective? (3) What is the most effective treatment for the management of prosthetic joint infections due to methicillin-resistant staphylococci? Results are presented and discussed in detail. METHODS: A systematic literature search using the MEDLINE database for the period 1988 to 2008 of randomized controlled trials and/or non-randomized studies was performed. A matrix was created to extract evidence from original studies using the CONSORT method to evaluate randomized clinical trials and the Newcastle-Ottawa Quality Assessment Scale for case-control studies, longitudinal cohorts, and retrospective studies. The GRADE method for grading quality of evidence and strength of recommendation was applied

Breathlessness, but not cough, suggests chronic obstructive pulmonary disease in elderly smokers with stable heart failure.

Chronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD. Patients with HF and COPD were more symptomatic, but only breathlessness when walking up a hill was an independent predictor of COPD (odds ratio=1.33, p=0.0484). Interestingly, COPD-specific symptoms such as cough and phlegm were not significant. Thus, in elderly smokers with stable HF, significant breathlessness when walking up a hill is most indicative of associated COPD, and may indicate the need for further lung function evaluation