Cross talk: the microbiota and neurodevelopmental disorders

Humans evolved within a microbial ecosystem resulting in an interlinked physiology. The gut microbiota can signal to the brain via the immune system, the vagus nerve or other host-microbe interactions facilitated by gut hormones, regulation of tryptophan metabolism and microbial metabolites such as short chain fatty acids (SCFA), to influence brain development, function and behavior. Emerging evidence suggests that the gut microbiota may play a role in shaping cognitive networks encompassing emotional and social domains in neurodevelopmental disorders. Drawing upon pre-clinical and clinical evidence, we review the potential role of the gut microbiota in the origins and development of social and emotional domains related to Autism spectrum disorders (ASD) and schizophrenia. Small preliminary clinical studies have demonstrated gut microbiota alterations in both ASD and schizophrenia compared to healthy controls. However, we await the further development of mechanistic insights, together with large scale longitudinal clinical trials, that encompass a systems level dimensional approach, to investigate whether promising pre-clinical and initial clinical findings lead to clinical relevance

The role of the gut microbiome in the development of schizophrenia

Schizophrenia is a heterogeneous neurodevelopmental disorder involving the convergence of a complex and dynamic bidirectional interaction of genetic expression and the accumulation of prenatal and postnatal environmental risk factors. The development of the neural circuitry underlying social, cognitive and emotional domains requires precise regulation from molecular signalling pathways, especially during critical periods or “windows”, when the brain is particularly sensitive to the influence of environmental input signalling. Many of the brain regions involved, and the molecular substrates sub-serving these domains are responsive to life-long microbiota-gut-brain (MGB) axis signalling. This intricate microbial signalling system communicates with the brain via the vagus nerve, immune system, enteric nervous system, enteroendocrine signalling and production of microbial metabolites, such as short-chain fatty acids. Preclinical data has demonstrated that MGB axis signalling influences neurotransmission, neurogenesis, myelination, dendrite formation and blood brain barrier development, and modulates cognitive function and behaviour patterns, such as, social interaction, stress management and locomotor activity. Furthermore, preliminary clinical studies suggest altered gut microbiota profiles in schizophrenia. Unravelling MGB axis signalling in the context of an evolving dimensional framework in schizophrenia may provide a more complete understanding of the neurobiological architecture of this complex condition and offers the possibility of translational interventions

Case report: lenvatinib in neoadjuvant setting in a patient affected by invasive poorly differentiated thyroid carcinoma

We report a case of an elderly woman presenting with a huge cervical mass invading the tracheal lumen. Diagnosed as invasive poorly differentiated thyroid cancer, after an endotracheal biopsy, stenting and radiotherapy, it was judged eligible for total thyroidectomy, but surgery was delayed due to pulmonary thromboembolism. The patient was therefore treated with lenvatinib with a neoadjuvant intent until hemodynamic stability was obtained. Thyroidectomy and radioiodine therapy were then performed and the postdose scan revealed an area of modest uptake in the anterior part of the neck. The patient is now in a good clinical status and she continues her follow-up program without any adjuvant therapy

Mid-life microbiota crises: middle age is associated with pervasive neuroimmune alterations that are reversed by targeting the gut microbiome

Male middle age is a transitional period where many physiological and psychological changes occur leading to cognitive and behavioural alterations, and a deterioration of brain function. However, the mechanisms underpinning such changes are unclear. The gut microbiome has been implicated as a key mediator in the communication between the gut and the brain, and in the regulation of brain homeostasis, including brain immune cell function. Thus, we tested whether targeting the gut microbiome by prebiotic supplementation may alter microglia activation and brain function in ageing. Male young adult (8 weeks) and middle-aged (10 months) C57BL/6 mice received diet enriched with a prebiotic (10% oligofructose-enriched inulin) or control chow for 14 weeks. Prebiotic supplementation differentially altered the gut microbiota profile in young and middle-aged mice with changes correlating with faecal metabolites. Functionally, this translated into a reversal of stress-induced immune priming in middle-aged mice. In addition, a reduction in ageing-induced infiltration of Ly-6Chi monocytes into the brain coupled with a reversal in ageing-related increases in a subset of activated microglia (Ly-6C+) was observed. Taken together, these data highlight a potential pathway by which targeting the gut microbiome with prebiotics can modulate the peripheral immune response and alter neuroinflammation in middle age. Our data highlight a novel strategy for the amelioration of age-related neuroinflammatory pathologies and brain function

Acromegaly is associated with increased cancer risk: A survey in Italy

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 \uc2\ub1 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk

Notulae to the Italian native vascular flora: 8

In this contribution, new data concerning the distribution of native vascular flora in Italy are presented. It includes new records, confirmations, exclusions, and status changes to the Italian administrative regions for taxa in the genera Ajuga, Chamaemelum, Clematis, Convolvulus, Cytisus, Deschampsia, Eleocharis, Epipactis, Euphorbia, Groenlandia, Hedera, Hieracium, Hydrocharis, Jacobaea, Juncus, Klasea, Lagurus, Leersia, Linum, Nerium, Onopordum, Persicaria, Phlomis, Polypogon, Potamogeton, Securigera, Sedum, Soleirolia, Stachys, Umbilicus, Valerianella, and Vinca. Nomenclatural and distribution updates, published elsewhere, and corrigenda are provided as Suppl. material 1

The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

To compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019

From youth to old age: therapeutic potential of microbiota interventions in the gut-brain-axis

There is a growing recognition of the involvement of the gut microbiota in the regulation of certain physiological and metabolic parameters across the life cycle of animals. A greater understanding of the microbiota changes throughout the life cycle may provide a novel therapeutic target for treating various age-related disorders from autism in childhood to dementia in old age. The increase in the elderly population with a rapid rise in dementia, cardiovascular and metabolic disease, leads to the growing demand for new interventions to decelerate the senescent decline. However, if the microbiota is to become a therapeutic target a far greater understanding of the structural changes which take place throughout the lifespan is required. In this thesis, we focus attention on microbiota-targeted interventions in young, middle age and old animals. The studies examine behaviour, physiology, and metabolism, exploring effects both in the periphery and in the brain, across a range of treatments from prebiotics to polyphenols. We highlight the physiological differences between the various age groups. Intestinal permeability and neuronal plasticity were the only modifiable parameters in the elderly. In younger animal prebiotics impact metabolism and inflammation. Polyphenols rich diets (grape pomace and rafuma) significantly alter intestinal permeability reversing the damage to the intestinal barrier due to ageing. The effect was not directly linked to changes in microbial diversity of the gut and did not significantly ameliorate the impaired immune system of the aged animals’ intestine or hippocampus. Only a significant increase in the number of dendritic cells emerged in conjunction with a reduced level of TNF-α in the blood. Neither did the polyphenols reverse some of the behavioural deficits associated with ageing. Cumulatively, these data show the specific effect of polyphenols in the elderly. We next investigated whether inulin, the most widely studied prebiotics, could improve host metabolism in middle-aged mice. We tested 52 metabolic markers involved in hypothalamic-pituitary-adrenal (HPA) axis regulation, cholesterol and glucose homeostasis and immune regulation. Interestingly, the liver, the brain and the mesenteric fat did not show any modification in middle-age animals. Inulin had a greater impact in young animals and stimulated the lipid and glucose metabolism, increasing the level of Sirtuin1, a fundamental metabolic sensor, without impacting transcriptional factor changes in the liver. The study also uncovered a range of changes in the HPA. In fact, inulin decreased the level of the glucocorticoids receptors (Nr3c1) and corticotropin-releasing hormone (Crhr1) receptors in the amygdala of young mice. In an attempt to understand the mechanisms through which microbiota-targeted interventions exert the anti-aging effects, we used a model of premature ageing (ApoE deficient mice). The effect of two different strains of lactobacillus (L.reuteri and L.mucosae) and two prebiotics derived from plants (plant sterol esters and oat b- glucan) were examined. Neural plasticity was restored in the Prefrontal cortex after 24 weeks of prebiotic administration and the level of claudin 5 increased in the hippocampus following consumption of L. mucosae. Overall, these results provide novel insights regarding the impact of a portfolio of microbiota-targeted interventions on age-related alterations in physiology and brain function and suggest the importance of using target-specific therapeutic options during particular time windows for maximum gain