Pro‑differentiating compounds for human intervertebral disc cells are present in Violina pumpkin leaf extracts

The intervertebral disc degeneration (IDD) is closely associated with inflammation, oxidative stress and loss of the discogenic phenotype which current therapies are unable to reverse. Here, the effects of acetone extract from Violina pumpkin (Cucurbita moschata) leaves on degenerated intervertebral disc (IVD) cells was investigated. IVD cells were isolated from degenerated disc tissue of patients undergoing spinal surgery, and exposed to acetone extract and three major thin layer chromatography subfractions. We found that the cells benefit from exposure in particular to subfraction 7 consisting almost entirely of p-Coumaric acid. Subfraction 7-treated cells showed a significant increase of discogenic transcription factors (SOX9, TRPS1), extracellular matrix components (aggrecan, collagen type II), cellular homeostasis and stress response regulators (FOXO3a, Nrf2, SOD2, SIRT1). Migratory ability and the expression of OCT4, two important markers related to the presence and activity of stem cells also increased. Moreover, subfraction 7 counteractes H2O2-triggered cell damage preventing in particular the increase of the pro-inflammatory and antichondrogenic microRNA, miR-221. This strengthens the hypothesis that adequate stimuli can support resident cells to repopulate the degenerate IVD and restart the anabolic machinery. Taken together, the data we obtained contribute to the discovery of molecules potentially effective in slowing the progression of IDD, a disease for which there is currently no effective treatment. Moreover, the enhancement of a part of plant, the pumpkin leaves, considered a waste product in the Western world, demonstrating that it contains substances with potential beneficial effects on human health

A recurrent F8 mutation (c.6046C>T) causing hemophilia A in 8% of northern Italian patients : evidence for a founder effect

Hemophilia A is a heterogeneous hemorrhagic disorder caused by a large number of mutations. Recurrent mutations are rare, except intron 22 and intron 1 inversions. The substitution of a cytosine to a thymine at nucleotide 6046 in F8 gene was identified in a group of Italian patients affected by hemophilia A from a specific region of Northern Italy with a prevalence of 7.6%. This F8 variant was the second most frequent mutation in our cohort, after the intron 22 inversion. The identification of the same mutation in a restricted population gets to suppose the existence of a founder effect. Intragenic and extragenic polymorphic markers were tested to assess this assumption. A peculiar haplotype in linkage disequilibrium with this recurrent mutation (c.6046C>T) was identified in 71% of patients, supporting a founder effect. This distinctive haplotype was not identified in a control group (Fisher's exact test, P\ua0<\ua00.0001), coming from the same geographic region. These data strongly suggested the presence of a founder effect, supporting the existence of a single mutation event. Using DMLE+2.3 software and the mathematical approach described by Bengtsson and Thomson, the inferred age of this mutation is supposed to be about 2325\ua0years (95% CI: 904-5081) ago

Are all cases of paediatric essential thrombocythaemia really myeloproliferative neoplasms? Analysis of a large cohort

Sporadic essential thrombocythaemia (ET) is rare in paediatrics, and the diagnostic and clinical approach to paediatric cases cannot be simply copied from experience with adults. Here, we assessed 89 children with a clinical diagnosis of ET and found that 23 patients (258%) had a clonal disease. The JAK2 V617F mutation was identified in 14 children, 1 child had the MPL W515L mutation, and 6 had CALR mutations. The monoclonal X-chromosome inactivation pattern was seen in six patients (two with JAK2 V617F and two with CALR mutations). The other 66 patients (742%) had persistent thrombocytosis with no clonality. There were no clinical or haematological differences between the clonal and non-clonal patients. The relative proportion of ET-specific mutations in the clonal children was much the same as in adults. The higher prevalence of nonclonal cases suggests that some patients may not have myeloproliferative neoplasms, with significant implications for their treatment

Acute chest syndrome in children with sickle cell disease: Data from a national AIEOP cohort identify priority areas of intervention in a hub-and-spoke system

: Acute chest syndrome (ACS) is a frequent cause of hospitalization in sickle cell disease (SCD). Despite advances in acute care, many settings still lack knowledge about ACS best practices. After the AIEOP Guidelines were published in 2012, suggesting standardized management in Italy, a retrospective study was performed to assess the diagnostic and therapeutic pathways of ACS in children. From 2013 to 2018, 208 ACS episodes were presented by 122/583 kids in 11 centres. 73 were male, mean age 10.9 years, 85% African, 92% HbSS or Sβ°. In our hub-and-spoke system, a good adherence to Guidelines was documented, but discrepancies between reference centres and general hospitals were noted. Improvement is needed for timely transfer to reference centres, use of incentive spirometry, oxygen therapy and pain management