Autophagic process is sexually different in VSMCs from human male and female neonates

Sex has largely been neglected in cellular studies. Autophagy is a sophisticatedly reg- ulated homeostatic mechanism, which ensures cell’s constituent turnover. Under physiological conditions, autophagy levels are usually low (constitutive autophagy), but can be induced by numerous cellular stresses such as starvation. The influence of sex on autophagy has been studied either in vitro or in vivo, and previous our findings demonstrated the existence of sex differences in rat heart and HUVECs. Vascular smooth muscle cells (VSMCs) are a good experimental model for studying the physiopatholo- gy of the cardiovascular system, in which autophagy plays an important physiological role. Therefore, we investigated the occurrence of sexual dimorphism in constitutive and starvation-induced autophagy between the VSMCs obtained from human umbilical cord arteries (HUASMCs) of male (MHUASMCs) and female (FHUASMCs) neonates. HUASMCs were isolated from the umbilical cord of healthy and normal weight male and female neonates. The expression of oestrogen receptor (ER-α and ER-β) and the primary molecules involved in autophagic process [the mammalian target of rapamycin (mTOR), beclin-1 and microtubule-associated protein 1 light chain 3 (LC3)] were analysed by western blotting. Both cell types expressed both isoforms of the oestrogen receptor (ER): ER-β was higher expressed in the MHUASMCs than the FHUASMCs while ER-α was similarly expressed in both sexes. The level of constitutive autophagy, measured as LC3II/I ratio was higher in FHUASMCs than in MHUASMCs, while male cells had an higher expression of Beclin-1, indicating that constitutive autophagy was at least partly beclin-1-independent. mTOR activity, a regulator of autophagy, did not vary between the sexes, indicating that the observed differences could not be attributed to this central pathway. Starvation promoted autophagy in both MHUASMCs and FHUASMCs, but the increase was more pro- nounced in FHUASMCs. Our results show that sex-differences start in utero and are parameter-specific, suggesting that HUASMCs of both sexes are necessary in in vitro studies to elevate the quality and translational value of research results. The observed differences in the autophagic process could help to emeliorate our knowledge on sex-differences observed in cardiovascular diseases

RESTORE Survey on the Public Perception of Advanced Therapies and ATMPs in Europe — Why the European Union Should Invest More!

Advanced therapy medicinal products (ATMPs) are potential game changers in modern medical care with an anticipated major impact for patients and society. They are a new drug class often referred to as "living drugs," and are based on complex components such as vectors, cells and even tissues. The production of such ATMPs involves innovative biotechnological methods. In this survey, we have assessed the perception of European citizens regarding ATMPs and health care in Europe, in relation to other important topics, such as safety and security, data protection, climate friendly energy supply, migration, and others. A crucial question was to determine to what extent European citizens wish to support public funding of innovations in healthcare and reimbursement strategies for ATMPs. To answer this, we conducted an online survey in 13 European countries (representative of 85.3% of the entire EU population including the UK in 2020), surveying a total of 7,062 European citizens. The survey was representative with respect to adult age groups and gender in each country. Healthcare had the highest ranking among important societal topics. We found that 83% of the surveyed EU citizens were in support of more public funding of technologies in the field of ATMPs. Interestingly, 74% of respondents are in support of cross-border healthcare for patients with rare diseases to receive ATMP treatments and 61% support the reimbursement of very expensive ATMPs within the European health care system despite the current lack of long-term efficacy data. In conclusion, healthcare is a top ranking issue for European Citizens, who additionally support funding of new technologies to enable the wider application of ATMPs in Europe

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic

Endometriosis in adolescence

Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies provide new options, in particular the use of serological markers

Thrombophlebitis and bilateral visual loss and in Behçet’s disease

Purpose: To describe an unusual case of Behçet’s disease characterized by bilateral ocular involvement and thrombophlebitis in the right leg. Methods: A 37-year-old man was referred with a two-month history of progressive, severe visual loss in both eyes. He had had thrombophlebitis in his right leg following an insect bite a month before. Visual acuity was R.E.: light perception and L.E.: 20/400. Fundus examination disclosed bilateral papillitis and retinal vasculitis and a macular pucker in the right eye. Results: Fluorescein angiography showed occlusive arteritis with periphlebitis in both eyes. TC and MR imaging and laboratory tests for toxoplasmosis, Lyme disease, syphilis, HIV, HSV, and Rickettsia conorii infection were negative. Conversely, ESR, PCR and HLA-B51 were found to be positive. Treatment with systemic steroids produced no improvement. Conclusions: Ocular Behçet’s disease is occasionally not associated with the classic systemic signs, such as oral aphtous lesions, skin lesions, and genital lesions. In this report, the retinal lesions followed an episode of thrombophlebitis caused by an insect bite.</br