Prevalencia de esofagitis eosinofílica: estudio multicéntrico en población pediátrica evaluada en 36 centros de gastroenterología de América Latina

Introducción y objetivo: La esofagitis eosinofílica es una enfermedad crónica, mediada inmunológicamente, descrita en series y publicaciones alrededor del mundo. En los últimos 20 años diversos estudios han intentado evaluar la incidencia y prevalencia de la enfermedad. El objetivo del presente trabajo es estimar la prevalencia de esofagitis eosinofílica en un grupo de niños atendidos en 36 centros de gastroenterología pediátrica de 10 países latinoamericanos. Materiales y métodos: A través de un protocolo multicéntrico, observacional y transversal se estimó la prevalencia de período de esofagitis eosinofílica entre los niños atendidos en consulta externa y sometidos a endoscopia superior diagnóstica por cualquier motivo en 36 centros de 10 países latinoamericanos durante un período de 3 meses. Resultados: Entre abril y junio de 2016 108 casos de esofagitis eosinofílica fueron evaluados. Asimismo, un promedio de 29,253 consultas ambulatorias y 4,152 endoscopias superiores de carácter diagnóstico fueron realizadas en los 36 centros participantes. La tasa de prevalencia de esofagitis eosinofílica en la población estudiada (n = 29,253) fue de 3,69 casos × 1,000 (IC 95%: 3.04 a 4.44) y entre los niños sometidos a endoscopia superior de rutina (n = 4,152) fue de 26 x 1,000 (IC 95%: 22.6 a 29.4). Conclusión: La tasa general de prevalencia de período de esofagitis eosinofílica en un grupo de niños evaluados en 36 centros latinoamericanos de gastroenterología pediátrica resultó de 3,69 × 1,000, y entre aquellos sometidos a endoscopia fue de 26 × 1,000. La prevalencia mostró una importante variabilidad entre los países y centros participantes. Este es el primer estudio de prevalencia de esofagitis eosinofílica pediátrica en Latinoamérica. Abstract: Introduction and objective: Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries. Materials and methods: A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame. Results: Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n = 29,253) was 3.69 cases × 1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n = 4,152), it was 26 x 1,000 (95% CI: 22.6 to 29.4). Conclusions: The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69 × 1,000, and in the children that underwent endoscopy, it was 26 × 1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America. Palabras clave: Esofagitis, Eosinofílica, Niños, Prevalencia, Latinoamérica, Keywords: Esophagitis, Eosinophilic, Children, Prevalence, Latin Americ

Il cibo dalla Costituzione alle pratiche educative nel quadro delle politiche per la sostenibilit\ue0

Il cibo, anche a seguito di recenti contenziosi, sta assumendo sempre pi\uf9 una rilevanza costituzionalistica. Oltre a tutelare il diritto al sostentamento, la Costituzione ne presidia la libert\ue0 di scelta, che trova ancoraggio nelle libert\ue0 personali, di coscienza e religiosa. Il cibo \ue8 altres\uec connesso al diritto alla salute: da questo punto di vista, emerge il problema costituzionale del costo del cibo salubre, che non dovrebbe produrre disuguaglianze. Le questioni vanno inquadrate considerando i diritti delle generazioni future, a cui l\u2019attuale comunit\ue0 sociale \ue8 legata dal dovere di solidariet\ue0. In questo contesto, si colloca l\u2019educazione alimentare, riconosciuta nei programmi dell\u2019Agenda 2030 dell\u2019Onu e nelle Linee Guida per l\u2019Educazione Alimentare del Miur, in cui prende forma un\u2019idea di azione globale integrata fra tutti i soggetti chiamati a promuovere corrette abitudini sul cibo. Tuttavia, su questo versante, recenti studi hanno evidenziato alcune debolezze nella cooperazione per programmi comuni e unitari verso un\u2019educazione alimentare promossa sul piano nazionale

Educazione alimentare e obiettivi di sviluppo sostenibile

Il contributo affronta il tema dell’educazione alimentare, unendo la prospettiva costituzionalistica a quella sociologica. Il diritto costituzionale garantisce libertà e diritti fondamentali che, direttamente o indirettamente, coinvolgono anche la dimensione alimentare. Dagli obiettivi di sviluppo sostenibile elaborati in ambito Onu nel 2005 e confluiti nell’Agenda 2030 emerge la necessità di rendere i sistemi alimentari capaci di crescita economica, nel rispetto dell’ambiente, degli interessi sociali coinvolti e dei diritti delle future generazioni. L’approccio olistico al cibo che emerge si traduce, nella sfera educativa, in linee guida per un’educazione alimentare di qualità in chiave sostenibile. Anche alla luce dei cambiamenti emersi a seguito della pandemia da Covid-19, si evidenziano criticità che richiedono una riflessione e prospettano la necessità di pratiche maggiormente integrate, nell’ottica della responsabilità intergenerazionale e delle dimensioni etica e culturale del cibo.The paper focuses on food education both from legal and sociological perspectives. Constitutional law guarantees fundamental rights and freedoms which, directly or indirectly, involve food. Different Sustainable Development Goals in UN 2030 Agenda concern food, considering economic growth, environmental protection, and social interests. This holistic approach to food is translated, in the educational ambit, by IT-Minister guidelines which consider sustainability. Anyway the Covid-19 pandemic caused social and economical changements; critical issues highlight the need of more integrated approach, taking into account the rights of future generation and also the ethical and cultural dimensions of food

An alternative strategy to synthesize PNA and DNA magnetic conjugates forming nanoparticle assembly based on PNA/DNA duplexes

In this paper we report an alternative approach to synthesize PNA and DNA magnetic nanoconjugates. Chemical modifications were introduced on the 130 nm dextran-magnetite particles to obtain poly-functionalized particles containing reversible bonds sensitive to the cellular environment and suitable for the direct introduction of unmodified oligomers. Due to the polyvalent nature of the nanoparticles, when the complementary PNA and DNA nanoconjugates were mixed together, the resulting duplex structures bring to a nanoparticle assembly driven by W-C base pairs. The formation of the nanoparticle assembly was investigated by optical spectroscopy (UV, FTIR), scanning and transmission electron microscopies and by the analysis of the macroscopic behaviour of the nanoparticle-conjugates in aqueous solution with and without magnetic field application. Furthermore, serum stability assays revealed an increased enzymatic resistance in FCS of the PNA/DNA nanoconjugate duplex with respect to the unconjugated duplex. The described nanosystem could be extended to other duplex structures, possibly involving aptameric sequences of biomedical relevance, and could be very useful in order to obtain high local concentration at the target site of both the duplex and the magnetic nanoparticles in biotechnological applications. © 2010 The Royal Society of Chemistry

PNA-based artificial nucleases as Antisense and Anti-MiRNA Oligonucleotide agents

Because of its interesting chemical, physical and biological properties, Peptide Nucleic Acid (PNA) has attracted major attention in molecular biology, for diagnostics purposes and development of biosensors. PNAs have become candidates for gene therapeutic drugs in ANTISENSE (AO) strategy with favorable in vivo biochemical properties. Recently, antisense PNA oligonucleotides have been described in anti-miRNA approach (AMO). We propose PNA-based nucleases as AO and AMO agents. We report the design, synthesis and characterization of two kinds of artificial nucleases composed of a PEG-PNA-PEG domain conjugated to HGG·Cu (A) and DETA (B) as well known cleavage sites. Qualitative (MALDI-TOF) and quantitative (HTS) assays were planned to study nuclease activity of constructs A and B on RNA-3'-FAM target sequence. The results have highlighted the best performance of nuclease B and the relevance of the PEG spacer, in particular for conjugate A, in terms of efficiency of the cleavage, suggesting that conjugates A and B also act as potential antisense and anti-miRNA agents

New solid-phase approach to obtain 3'-derivatized oligonucleotides

The solid-phase synthesis of 3'-derivatized oligonucleotides, by using a support which links the first nucleoside-3'-phosphate through the nucleobase, is reported. Following this procedure, the marking molecules can easily incorporated in satisfactory yields at the 3'-phosphate terminus either before or after the chain assembly

1-Substituted 2'-deoxyinosine analogues

The base 2-carbon of 2′,3′-di-O-acetyl-2′-deoxyinosine is strongly activated towards nucleophilic attack when either the 4-nitrophenyl or 2,4-dinitrophenyl group is attached to its N-1 position (product 1 or 2). 1-(ω-Aminoalkyl)- and 1-(ω-hydroxyalkyl)-2′-deoxyinosine derivatives 5, 8-10 have been efficiently synthesized by a rearrangement of the purine ring upon treatment of compound 1 or 2 with the appropriate α,ω-diamine or α,ω-hydroxyamine. Moreover 1-amino-2′-deoxyinosine 11 and 1-hydroxy-2′-deoxyinosine 13 have been easily prepared in high yields by reaction of substrate 1 or 2, respectively, with hydrazine or hydroxylamine

PNA-DNA chimeras forming quadruplex structures

H-NMR, CD, and UV spectroscopy have been used to investigate the structure of PNA/DNA chimeras forming quadruplex structures. In particular, we synthesized 5′TGGG3′-t (1) and 5′TGG3′-gt (2), where lower and upper case letters indicate PNA and DNA residues, respectively. CD spectrum and all NMR data of (1) are typical of quadruplexes involving four parallel strands. UV melting profile of (1) indicates that its thermal stability is quite similar to that observed for the reference structure [d(TGGGT)]4. 1H-NMR spectrum for 5′TGG3′_gt (2) shows that this oligonucleotide is not able to fold into a single, well-defined species

Facile preparation of cyclic oligoribonucleotides

A convenient solid-phase synthesis of small cyclic oligoribonucleotides based on elongation of the chain by phosphoramidite chemistry, and successive cyclization of the linear fragments by a phosphotriester approach is described