Combined antiretroviral therapy reduces hyperimmunoglobulinemia in HIV-1 infected children

Objective: To evaluate the effect of combined antiretroviral therapy on serum immunoglobulin (Ig) levels in HIV-1 perinatally infected children. Methods: Data from 1250 children recorded by the Italian Register for HIV Infection in Children from 1985 to 2002 were analysed. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using means and standard deviations of normal population for each age period. Combined antiretroviral therapy has become widespread in Italy since 1996, thus differences in Ig z-scores between the periods 1985-1995 and 1996-2002 were analysed. Data according to type of therapeutic regimen were also analysed. Results: Between the two periods 1985-1995 and 1996-2002, significant (P < 0.0001) decreases in IgG (6.29 ± 4.72 versus 4.44 ± 4.33), IgM (9.25 ± 13.32 versus 5.61 ± 7.93), and IgA (10.25 ± 15.68 versus 6.48 ± 11.56) z-scores, together with a parallel significant (P < 0.0001) increase in CD4 T-lymphocyte percentages, were found. These decreases were confirmed regardless of whether the children were receiving intravenous Ig or not. Ig z-scores were significantly higher in children receiving mono-therapy than in those receiving double-combined therapy (IgC, P < 0.0001; IgM, P = 0.003; IgA, P = 0.031) and in the latter children than in those receiving three or more drugs (P < 0.0001 for all z-scores). Ig z-scores correlated inversely with CD4 T-lymphocyte percentages and, directly, with viral loads. Conclusions: Our data show that in HIV-1 infected children combined antiretroviral therapy leads to reduction of hyperimmunoglobulinemia which parallels restoration of CD4 T-lymphocyte percentage and viral load decrease, which it turn probably reflects improved B-lymphocyte functions. © 2004 Lippincott Williams & Wilkins

I rachitismi ipofosfatemici

I rachitismi ipofosfatemici rappresentano forme rare di rachitismo trasmesse geneticamente che negli ultimi anni sono state meglio caratterizzate da una diagnosi molecolare. Le recenti acquisizioni sulla regolazione del metabolismo fosfo-calcico hanno evidenziato come il fattore di crescita fibroblastico 23 (fibrobast growth factor 23, FGF23) svolga un ruolo centrale nella patogenesi dei rachitismi ipofosfatemici: infatti, livelli elevati di FGF23 determinano l’ipofosfatemia che porta all’instaurarsi delle lesioni rachitiche. Esistono diverse forme di rachitismo ipofosfatemico in cui i livelli di FGF23 sono elevati o inappropriatamente normali per l’ipofosfatemia: il rachitismo ipofosfatemico X-linked dovuto a mutazione inattivante del gene PHEX, la forma autosomico dominante dovuta a mutazione attivante del gene FGF23, le forme autosomiche recessive (tipo 1 e tipo 2) dovute a mutazione dei geni DMP1 e ENPP1, rispettivamente. Esiste inoltre una forma di rachitismo ipofosfatemico ereditario con ipercalciuria, un disordine autosomico recessivo caratterizzato da una mutazione del gene SLC34A3 in cui la fosfaturia consegue ad un difetto primitivo renale, per cui i livelli di FGF23 sono ridotti o ai limiti bassi della norma. Nonostante la diagnosi di queste forme genetiche di rachitismo rimanga essenzialmente clinica, la diagnosi genetica può dare importanti informazioni sul tipo di rachitismo ipofosfatemico, sulla prognosi e sulla terapia. Inoltre, una più precisa identificazione dei meccanismi molecolari alla base delle singole patologie potrà, in un prossimo futuro, identificare nuovi target terapeutici

Differences in escape response of fish in protected and fished Mediterranean rocky reefs

In both protected and fished rocky reefs in the southern Adriatic Sea, the behaviour of the sea breams Diplodus sargus and D. vulgaris (both targeted by spear-fishing) in the presence of divers was found to be mostly negative (i.e. escape response). However, at protected reefs sea breams frequently swam into the closest shelters, whereas in fished reefs they mostly escaped in open water. This study suggests that spear-fishing may alter the escape response of fish from natural predators and that marine reserves may re-establish natural behaviour patterns

Usefulness of phalangeal quantitative ultrasound in identifying reduced bone mineral status and increased fracture risk in adolescents with Turner syndrome.

OBJECTIVE. Bone health is a major concern in patients with Turner syndrome (TS). There are few studies assessing bone mineral status in TS adolescents and none have reported a clear relationship with the risk of fracture. We assessed bone mineral status at three different skeletal sites by two different densitometric techniques in a group of TS adolescents. DESIGN. In 24 TS adolescents (17.1±3.1 years) we evaluated lumbar and femoral volumetric bone mineral density (vBMD) with dual energy X-ray absorptiometry (DXA), amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) with phalangeal quantitative ultrasound (QUS). RESULTS. Mean lumbar vBMD Z-score was normal, while mean femoral vBMD, ADSoS and BTT Z-score were reduced. 8/24 (33.3%) and 13/24 (54.2%) girls had AD-SoS and BTT ≤-2 Z-score, respectively, while lumbar vBMD and femoral vBMD were ≤-2 Z-score only in 2/24 (8.4%) and 1/24 (4.2%) patients. Overall, we documented 15 fractures (three pathological) in 8 girls. Patients who reported at least one fracture had lower AD-SoS and BTT Z-score values than fracture-free girls. The presence of a value of BTT ≤-2.0 Z-score was associated with a significant OR of positive history of fracture of 11.67 (χ2=5.906, p =0.015, C.I. 95% 1.14-119.54). Lumbar and femoral vBMD were not related to fracture risk. CONCLUSIONS. TS adolescents may have impaired bone mineral status in skeletal sites with predominant cortical bone. Phalangeal QUS represents a useful method to identify subjects with increased fracture risk

A greener procedure for the synthesis of [Bu4N]2-cis -[Ru(4-carboxy-4′-carboxylate-2,2′-bipyridine)2(NCS)2] (N719), a benchmark dye for DSSC applications

none6noA previously reported protocol for the synthesis of the commercial dye [Bu4N]2[Ru(4-carboxy-4′-carboxylate-2,2′-bipyridine)2(NCS)2] (N719) was thoroughly optimized in terms of the amount of input materials needed, reaction times and temperatures achieving significant reductions in all the three synthetic steps. This optimization allowed a 81% reduction of the Sheldon's E factor of the overall process.noneVierucci, S.; Muzzioli, S.; Righi, P.; Borzatta, V.; Gorni, G.; Zama, I.Vierucci, S.; Muzzioli, S.; Righi, P.; Borzatta, V.; Gorni, G.; Zama, I