Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Riluzole Attenuates L-DOPA-Induced Abnormal Involuntary Movements Through Decreasing CREB1 Activity

Chronic administration of L-DOPA, the first-line treatment of dystonic symptoms in childhood or in Parkinson's disease, often leads to the development of abnormal involuntary movements (AIMs), which represent an important clinical problem. Although it is known that Riluzole attenuates L-DOPA-induced AIMs, the molecular mechanisms underlying this effect are not understood. Therefore, we studied the behavior and performed RNA sequencing of the striatum in three groups of rats that all received a unilateral lesion with 6-hydroxydopamine in their medial forebrain bundle, followed by the administration of saline, L-DOPA, or L-DOPA combined with Riluzole. First, we provide evidence that Riluzole attenuates AIMs in this rat model. Subsequently, analysis of the transcriptomics data revealed that Riluzole is predicted to reduce the activity of CREB1, a transcription factor that regulates the expression of multiple proteins that interact in a molecular landscape involved in apoptosis. Although this mechanism underlying the beneficial effect of Riluzole on AIMs needs to be confirmed, it provides clues towards novel or existing compounds for the treatment of AIMs that modulate the activity of CREB1 and, hence, its downstream targets

Altered dopaminergic regulation of the dorsal striatum is able to induce tic-like movements in juvenile rats

<div><p>Motor tics are sudden, repetitive, involuntary movements representing the hallmark behaviors of the neurodevelopmental disease Tourette’s syndrome (TS). The primary cause of TS remains unclear. The initial observation that dopaminergic antagonists alleviate tics led to the development of a dopaminergic theory of TS etiology which is supported by <i>post mortem</i> and in vivo studies indicating that non-physiological activation of the striatum could generate tics. The striatum controls movement execution through the balanced activity of dopamine receptor D1 and D2-expressing medium spiny neurons of the direct and indirect pathway, respectively. Different neurotransmitters can activate or repress striatal activity and among them, dopamine plays a major role. In this study we introduced a chronic dopaminergic alteration in juvenile rats, in order to modify the delicate balance between direct and indirect pathway. This manipulation was done in the dorsal striatum, that had been associated with tic-like movements generation in animal models. The results were movements resembling tics, which were categorized and scored according to a newly developed rating scale and were reduced by clonidine and riluzole treatment. Finally, <i>post mortem</i> analyses revealed altered RNA expression of dopaminergic receptors D1 and D2, suggesting an imbalanced dopaminergic regulation of medium spiny neuron activity as being causally related to the observed phenotype.</p></div

Average frequency scores of the body parts involved in tic-like movements.

<p>Average frequency scores of limb, neck, mouth movements and complex tic-like movements during the phase of maximal abnormal motor manifestation (60-120min after quinpirole administration) on dorsal striatum-lesioned rats (A) or sham-lesioned rats (B).</p

Time course of tic-like movements score in aDS and cDS.

<p>Tic-like movements score is taken every 30 min after quinpirole administration and is calculated as the total of number of body parts + average frequency + complexity + impairment scores. Significant difference is indicated as ****p<0.001.</p

Total cell density in the lesioned area at PND25 and PND50.

<p>The total cell density in the area that had been interested by the lesion was calculated as number of nuclear staining-positive cells/ um^<b>2</b> of tissue in 18 samples taken from rats sacrificed after the lesion at PND25 or at PND50 after phenotype validation. Significant difference is indicated as **p<0.01, ****p<0.001.</p

Percentage of DRD1 and DRD2 positive cells in DS.

<p>The number of positive cells for DRD1 RNA and nuclear staining (A) or DRD2 RNA and nuclear staining (B) in the lesioned and in the corresponding area on the control side of PND25 and PND50 rats is reported in percentages of the total number of nuclear staining-positive cells. Significant total difference is indicated as ****p<0.001, **p<0.01, *p<0.05.</p

<i>In situ</i> hybridization reveals DrD2 RNA expression in aDS and cDS of 6-OHDA lesioned rats, evaluated at PND25 and PND50.

<p>In all panels, red dots result from a chromogenic reaction indicating the presence of the target RNA, while blue dots represent the nuclear marker; aDS PND25 (top left), cDS PND25 (bottom left), aDS PND50 (top right), cDS PND50 (bottom right). The orange circle approximately indicates the area taken into account for quantitative analysis.</p

Time course of tic-like movements score after clonidine and riluzole administration.

<p>Clonidine (0.05 mg/kg IP) was administered together with quinpirole (A). Riluzole (6mg/kg IP) was administered 60min after quinpirole (indicated by an arrow) (B). Significant reduction of phenotype score compared to the score obtained during quinpirole treatment by the same animals is indicated as *p<0.05, **p<0.01.</p