Mindfulness-based stress reduction in patients with interstitial lung diseases: a pilot, single-centre observational study on safety and efficacy

open11siBackground Chronic, progressive respiratory symptoms are associated with great psychological and emotional impact in patients suffering from interstitial lung disease (ILD). This single-centre pilot study evaluated for the first time the safety, feasibility and efficacy of a Mindfulness Based Stress Reduction Program (MBSR) in a group of patients with ILD. Methods Prospective observational study set in a university hospital ILD outpatient clinic. Nineteen patients with different ILDs were recruited 2 months prior to the start of the 8-week MBSR program and followed up for 12 months. Primary outcomes were program safety and feasibility, while secondary outcomes were changes in moods and stress (assessed by Profile Of Mood State (POMS) and Perceived Stress Scale (PSS) questionnaires), symptoms (Shortness Of Breath (SOB) and Cough And Sputum Assessment (CASA-Q) questionnaires), lung function and exercise tolerance at 12 months. Results Two patients (10.5%) dropped out in the observational period before the start of the MBSR intervention because of non-respiratory causes. All 17 patients who entered the 8-week MBSR program managed to complete it with an adherence average of eight sessions of nine. No adverse events related to the mindfulness training were reported. Statistically significant improvements in the POMS total score and in several individual items of POMS and PSS were observed throughout the study. However, respiratory questionnaire scores, lung function and exercise tolerance did not show a significant difference over time. Conclusions An MBSR program appears to be safe and feasible in patients with ILD, and might affect perceived moods and stress producing a positive and lasting improvement in several stress-related negative domains. These findings pave the way to larger (possibly multicentre), randomised, controlled confirmatory trials.openSgalla, Giacomo; Cerri, Stefania; Ferrari, Roberto; Ricchieri, Maria Pia; Poletti, Stefano; Ori, Margherita; Garuti, Martina; Montanari, Gloria; Luppi, Fabrizio; Petropulacos, Kyriakoula; Richeldi, LucaSgalla, Giacomo; Cerri, Stefania; Ferrari, Roberto; Ricchieri, Maria Pia; Poletti, Stefano; Ori, Margherita; Garuti, Martina; Montanari, Gloria; Luppi, Fabrizio; Petropulacos, Kyriakoula; Richeldi, Luc

Monocyte-macrophage differentiation of acute myeloid leukemia cell lines by small molecules identified through interrogation of the Connectivity Map database

The transcription factor C/EBPα is required for granulocytic differentiation of normal myeloid progenitors and is frequently inactivated in acute myeloid leukemia (AML) cells. Ectopic expression of C/EBPα in AML cells suppresses proliferation and induces differentiation suggesting that restoring C/EBPα expression/activity in AML cells could be therapeutically useful. Unfortunately, current approaches of gene or protein delivery in leukemic cells are unsatisfactory. However, "drug repurposing" is becoming a very attractive strategy to identify potential new uses for existing drugs. In this study, we assessed the biological effects of candidate C/EBPα-mimetics identified by interrogation of the Connectivity Map database. We found that amantadine, an antiviral and anti-Parkinson agent, induced a monocyte-macrophage-like differentiation of HL60, U937, Kasumi-1 myeloid leukemia cell lines, as indicated by morphology and differentiation antigen expression, when used in combination with suboptimal concentration of all trans retinoic acid (ATRA) or Vit D3. The effect of amantadine depends, in part, on increased activity of the vitamin D receptor (VDR), since it induced VDR expression and amantadine-dependent monocyte-macrophage differentiation of HL60 cells was blocked by expression of dominant-negative VDR. These results reveal a new function for amantadine and support the concept that screening of the Connectivity Map database can identify small molecules that mimic the effect of transcription factors required for myelo-monocytic differentiation

Morbidity and Mortality in Patients with Idiopathic Pulmonary Fibrosis Undergoing Diagnostic Surgical Lung Biopsy

Morbidity and Mortality In Patients With Idiopathic Pulmonary Fibrosis Undergoing Diagnostic Surgical Lung Biopsy.Previous studies have shown conflicting results about safety of surgical lung biopsy (SLB) in usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) patients. Study design: we performed a retrospective analysis of all patients who underwent SLB between 2003 and 2013 at the University Hospital of Modena (Italy), to assess morbidity and mortality among patients with UIP/IPF , as compared to patients with other diffuse parenchymal lung diseases (non UIP/IPF). Results: we analyzed 73 patients with (n=29) and without (n=44) UIP/IPF, in which medical history, histology, and survival status were collected. UIP/IPF was diagnosed according to international guidelines. In 59 patients lung biopsy was performed via video-assisted thoracoscopy; in 14 patients thoracotomy was conducted. No intraoperative complications were observed. Postoperative complications were not significantly different between groups and consisted of fever (n=1 in UIP/IPF group; n=4 in non-UIP/IPF group), pneumothorax (n=1 in non-UIP/IPF), pleural effusion (n=1 in non-UIP/IPF), and acute exacerbation (n=1 in both groups, who died). There was no 30-day, 60-day and 90-day mortality. Conclusions: we conclude that surgical lung biopsy can be safely performed in patients with suspected UIP/IPF

Levels of circulating endothelial cells are low in idiopathic pulmonary fibrosis and are further reduced by anti-fibrotic treatments

Background: It has been suggested that circulating fibrocytes and endothelial cells actively participate in the intense remodelling of the pulmonary vasculature in patients with idiopathic pulmonary fibrosis (IPF). Indeed, fibrotic areas exist that have fewer blood vessels, whereas adjacent non-fibrotic tissue is highly vascularized. The number of circulating endothelial cells (CEC) and endothelial progenitor cells (EPC) might reflect the balance between vascular injury and repair. Thus, fibrocytes as well as endothelial cells could potentially be used as biomarkers of disease progression and treatment outcome. Methods: Peripheral blood samples were collected from 67 patients with a multidisciplinary diagnosis of IPF and from 45 age-matched and sex-matched healthy volunteers. Buffy coat was isolated according to standard procedures and at least 20 million cells were stained with different monoclonal antibodies for the detection of CEC, EPC and circulating fibrocytes. For the detection of CEC and EPC, cells were stained with anti-CD45, anti-CD34, anti-CD133, anti-CD14, anti-CD309 and with the viability probe Far-Red LIVE/DEAD. For the detection of circulating fibrocytes, cells were first stained with LIVE/DEAD and the following monoclonal antibodies: anti-CD3, anti-CD19, anti-CD45, anti-CD34 and anti-CD14, then cells were fixed, permeabilized and stained with fluorochrome-conjugated anti-collagen I monoclonal antibodies. Results: Patients with IPF displayed almost undetectable levels of circulating fibrocytes, low levels of CEC, and normal levels of EPC. Patients treated with nintedanib displayed higher levels of CEC, but lower levels of endothelial cells expressing CD309 (the type II receptor for vascular endothelial growth factor). Treatment with both nintedanib and pirfenidone reduced the percentage of CEC and circulating fibrocytes. Conclusions: Levels of CEC were reduced in patients with IPF as compared to healthy individuals. The anti-fibrotic treatments nintedanib and pirfenidone further reduced CEC levels. These findings might help explain the mechanism of action of these drugs and should be explored as predictive biomarkers in IPF

La pubblicità e la traduzione del messaggio pubblicitario: problemi e strategie traduttivi.

L’idea di realizzare questo lavoro di ricerca sulla traduzione nell’ambito pubblicitario sorge da un interesse nell’analisi del linguaggio della pubblicità, sia nelle sue componenti psicologiche e persuasive che in quelle linguistiche. La pubblicità è oggi uno dei principali motori dell’economia, un canale di comunicazione diffuso in maniera sempre più capillare ed uno strumento estetico ed ideologico di massa, che condiziona il modo di guardare le cose in maniera decisiva. Con la globalizzazione e la necessità di esportare i prodotti di ogni paese a livello mondiale, ha assunto un’importanza fondamentale la traduzione degli annunci di promozione di questi prodotti finalizzata alla localizzazione dei messaggi pubblicitari, in contrasto alla tendenza alla globalizzazione linguistica. Questo lavoro si propone di analizzare proprio questo contrasto tra la necessità di adattare il testo al paese e alla cultura del destinatario e, d’altra parte, l’internazionalizzazione e standardizzazione dei messaggi, la situazione in cui questo contrasto sorge ed il modo in cui viene risolto. Partendo dalla descrizione delle origini del termine “pubblicità” nel tentativo di definirne il concetto, passando attraverso la descrizione dei suoi obiettivi e funzioni e descrivendo il processo persuasivo ed i diversi modi in cui la pubblicità può essere classificata, vengono spiegate le strategie traduttive del messaggio pubblicitario, le situazioni particolari in cui tali strategie sono applicate ed i loro fini. Vengono descritte le tecniche di traduzione applicate al nome del marchio, il modo in cui i riferimenti culturali presenti nell’annuncio vengono adattati ai diversi paesi e le tecniche traduttive adattate al mezzo di comunicazione e ai vari recettori. In seguito si descrive l’importanza della forza appellativa ed espressiva di ogni testo e della struttura testuale nella traduzione degli annunci e il modo in cui vengono adattati gli elementi grafici e la grafia durante la traduzione, terminando con alcuni esempi concreti di errori di traduzione di annunci pubblicitari