Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where Antonio Tursi is active.

Publication


Featured researches published by Antonio Tursi.


The American Journal of Gastroenterology | 2010

Treatment of Relapsing Mild-to-Moderate Ulcerative Colitis With the Probiotic VSL#3 as Adjunctive to a Standard Pharmaceutical Treatment: A Double-Blind, Randomized, Placebo-Controlled Study

Antonio Tursi; G. Brandimarte; Alfredo Papa; A. Giglio; Walter Elisei; Gian Marco Giorgetti; Giacomo Forti; Sergio Morini; Cesare Hassan; Maria Antonietta Pistoia; S. Rodinò; Teresa D'Amico; Ladislava Sebkova; N. Saccà; Emilio Di Giulio; Francesco Luzza; Maria Imeneo; Tiziana Larussa; Salvatore Di Rosa; Vito Annese; Silvio Danese; Antonio Gasbarrini

OBJECTIVES:VSL#3 is a high-potency probiotic mixture that has been used successfully in the treatment of pouchitis. The primary end point of the study was to assess the effects of supplementation with VSL#3 in patients affected by relapsing ulcerative colitis (UC) who are already under treatment with 5-aminosalicylic acid (ASA) and/or immunosuppressants at stable doses.METHODS:A total of 144 consecutive patients were randomly treated for 8 weeks with VSL#3 at a dose of 3,600 billion CFU/day (71 patients) or with placebo (73 patients).RESULTS:In all, 65 patients in the VSL#3 group and 66 patients in the placebo group completed the study. The decrease in ulcerative colitis disease activity index (UCDAI) scores of 50% or more was higher in the VSL#3 group than in the placebo group (63.1 vs. 40.8; per protocol (PP) P=0.010, confidence interval (CI)95% 0.51–0.74; intention to treat (ITT) P=0.031, CI95% 0.47–0.69). Significant results with VSL#3 were recorded in an improvement of three points or more in the UCDAI score (60.5% vs. 41.4%; PP P=0.017, CI95% 0.51–0.74; ITT P=0.046, CI95% 0.47–0.69) and in rectal bleeding (PP P=0.014, CI95% 0.46–0.70; ITT P=0.036, CI95% 0.41–0.65), whereas stool frequency (PP P=0.202, CI95% 0.39–0.63; ITT P=0.229, CI95% 0.35–0.57), physicians rate of disease activity (PP P=0.088, CI95% 0.34–0.58; ITT P=0.168, CI95% 0.31–0.53), and endoscopic scores (PP P=0.086, CI95% 0.74–0.92; ITT P=0.366, CI95% 0.66–0.86) did not show statistical differences. Remission was higher in the VSL#3 group than in the placebo group (47.7% vs. 32.4%; PP P=0.069, CI95% 0.36–0.60; ITT P=0.132, CI95% 0.33–0.56). Eight patients on VSL#3 (11.2%) and nine patients on placebo (12.3%) reported mild side effects.CONCLUSIONS:VSL#3 supplementation is safe and able to reduce UCDAI scores in patients affected by relapsing mild-to-moderate UC who are under treatment with 5-ASA and/or immunosuppressants. Moreover, VSL#3 improves rectal bleeding and seems to reinduce remission in relapsing UC patients after 8 weeks of treatment, although these parameters do not reach statistical significance.


The American Journal of Gastroenterology | 2003

High Prevalence of Small Intestinal Bacterial Overgrowth in Celiac Patients With Persistence of Gastrointestinal Symptoms After Gluten Withdrawal

Antonio Tursi; G. Brandimarte; GianMarco Giorgetti

OBJECTIVE:Celiac disease is a gluten-sensitive enteropathy with a broad spectrum of clinical manifestation, and most celiac patients respond to a gluten-free diet (GFD). However, in some rare cases celiacs continue to experience GI symptoms after GFD, despite optimal adherence to diet. The aim of our study was to evaluate the causes of persistence of GI symptoms in a series of consecutive celiac patients fully compliant to GFD.METHODS:We studied 15 celiac patients (five men, 10 women, mean age 36.5 yr, range 24–59 yr) who continued to experience GI symptoms after at least 6–8 months of GFD (even if of less severity). Antigliadin antibody (AGA) test, antiendomysial antibody (EMA) test, and sorbitol H2-breath test (H2-BT), as well as esophagogastroduodenoscopy (EGD) with histological evaluation, were performed before starting GFD. Bioptic samples were obtained from the second duodenal portion during EGD, and histopathology was expressed according to the Marsh classification. To investigate the causes of persistence of GI symptoms in these patients, we performed AGA and EMA tests, stool examination, EGD with histological examination of small bowel mucosa, and sorbitol-, lactose-, and lactulose H2-breath tests.RESULTS:Histology improved in all patients after 6–8 months of GFD; therefore, refractory celiac disease could be excluded. One patient with Marsh II lesions was fully compliant to his diet but had mistakenly taken an antibiotic containing gluten. Two patients showed lactose malabsorption, one patient showed Giardia lamblia and one patient Ascaris lumbricoides infestation, and 10 patients showed small intestinal bacterial overgrowth (SIBO) by lactulose H2-BT. We prescribed a diet without milk or fresh milk–derived foods to the patient with lactose malabsorption; we treated the patients with parasite infestation with mebendazole 500 mg/day for 3 days for 2 consecutive wk; and we treated the patients with SIBO with rifaximin 800 mg/day for 1 wk. The patients were re-evaluated 1 month after the end of drug treatment (or after starting lactose-free diet); at this visit all patients were symptom-free.CONCLUSIONS:This study showed that SIBO affects most celiacs with persistence of GI symptoms after gluten withdrawal.


Journal of Clinical Gastroenterology | 2003

Prevalence of antitissue transglutaminase antibodies in different degrees of intestinal damage in celiac disease.

Antonio Tursi; G. Brandimarte; Gian Marco Giorgetti

Goals Although anti-tissue transglutaminase antibodies (anti-tTG) are effective for celiac disease (CD) routine laboratory screening, there are no studies evaluating correlation between degree of intestinal damage and positivity to anti-tTG. Since recent studies showed that anti-gliadin (AGA) and anti-endomysium (EMA) antibodies are ineffective in diagnosing mild gluten-sensitive enteropathy, the aim of this study was to evaluate the prevalence of anti-tTG in different degrees of intestinal damage of celiac patients and whether there is a correlation between serum value of anti-tTG and the degree of histologic damage. Study We studied 119 consecutive adult patients affected by CD (47 men and 72 women; mean age, 28 years; range, 22–51 years). All patients were stratified for histologic damage according to Marsh classification, and in all of them an anti-tTG evaluation was performed. Results Marsh I lesions were present in 13 patients (10.92%), Marsh II in 24 anti-tTG (20.16%), Marsh IIIa in 27 anti-tTG (22.68%), Marsh IIIb in 31 anti-tTG (26.05%) and Marsh IIIc in 24 anti-tTG (20.16%). Anti-tTG positivity was ranging from 1 of 13 anti-tTG (7.69%) in Marsh I lesions to 23 of 24 anti-tTG (95.83%) in Marsh IIIc lesions respectively (P < 0.005), while mean serum value of anti-tTG ranged from 3.61 (range, 0.7–9.2) UA/mL in Marsh I lesions to 7.3 (range, 1–25.1), 18.5 (range, 1.8–56.2), 36 (range, 3.7–83.5) and 74.95 (range, 6.5–257) UA/mL in Marsh II, IIIb and IIIc lesions respectively (P < 0.005). Conclusions Our study showed that anti-tTG prevalence and their mean serum value was higher in celiacs with severe enteropathy (Marsh IIIb-c lesions) than in those showing slight enteropathy (Marsh I-IIIa). So, serologic tests without histologic evaluation may underestimate the real prevalence of CD and there is the risk of delaying the diagnosis of CD in patients who run an increased risk of deficiencies, non-malignant conditions and malignancy.


The American Journal of Gastroenterology | 2001

Low prevalence of antigliadin and anti-endomysium antibodies in subclinical/silent celiac disease.

Antonio Tursi; G. Brandimarte; GianMarco Giorgetti; Andrea Gigliobianco; Domenico Lombardi; Giovanni Gasbarrini

OBJECTIVE:Endomysial antibodies (EMA) are a well-known hallmark of celiac disease, but some recent studies showed that the prevalence of these antibodies in clinical practice is lower than expected. The aim of our study was to determine the prevalence of antigliadin (AGA) and EMA antibodies on a consecutive series of subclinical/silent celiac patients.METHODS:We studied 115 consecutive patients with subclinical (92 patients) or silent (23 patients) forms of celiac disease. AGA and EMA were screened in all patients. Histopathology of celiac disease was expressed according to the Marsh classification.RESULTS:The overall AGA in subclinical form were positive in 77% (14 of 18) of patients with partial villous atrophy (VA), in 84% (21 of 25) of patients with subtotal VA, and in 90% (27 of 30) of patients with total VA, whereas EMA were positive in 88.88% (16 of 18) of patients with partial VA, in 92% (23 of 25) of patients with subtotal VA, and 96.66% (29 of 30) of patients with total VA. On the other hand, AGA were positive in 0% (zero of two) of patients with Marsh I and in 30% (three of 10) of patients with Marsh II, whereas EMA were positive in 0% (zero of two) of patients with Marsh I and in 40% (four of 10) of patients with Marsh II (Marsh I–IIIa vs Marsh IIIb–c, p = < 0.005 in overall AGA-positive patients and p = < 0.0001 in EMA-positive patients). At the same time the overall AGA in silent form were positive in 60% (three of five) of patients with partial VA, in 66.66% (four of six) of patients with subtotal VA, and in 77.77% (seven of nine) of patients with total VA, whereas EMA were positive in 80% (four of five) of patients with partial VA, in 83.33% (five of six) of patients with subtotal VA, and in 88.88% (eight of nine) of patients with total VA. On the other hand, overall AGA were positive in 0% of patients with both Marsh I (zero of one) and Marsh II (zero of two), as well as EMA were positive in 0% with both Marsh I (zero of one) and Marsh II (zero of two) (Marsh I–IIIa vs Marsh IIIb–c, p = < 0.001 in overall AGA-positive patients and p = < 0.007 in EMA-positive patients).CONCLUSIONS:At this time small bowel biopsy seems to be the only correct procedure to diagnose a case of suspected celiac disease, especially in patients with mild symptoms or suspected for celiac disease, because they belong to high-risk groups.


Journal of Clinical Gastroenterology | 2006

Mesalazine and/or Lactobacillus casei in Preventing Recurrence of Symptomatic Uncomplicated Diverticular Disease of the Colon A Prospective, Randomized, Open-label Study

Antonio Tursi; Giovanni Brandimarte; Gian Marco Giorgetti; W. Elisei

Goals To investigate the effectiveness and safety of mesalazine, with or without Lactobacillus casei, in preventing recurrence of symptomatic diverticular disease of the colon. Background Both mesalazine and probiotics showed recently their effectiveness in obtaining remission of symptomatic uncomplicated diverticular disease of the colon. Consistent data are not available on the optimal therapy to prevent recurrence of symptomatic diverticular disease of the colon. Study Multicenter, prospective, randomized, open-label study. Ninety consecutive patients (36 men, 54 women, mean age 67.5 y, range 39 to 84 y), previously affected by symptomatic uncomplicated diverticular disease of the colon (remission obtained with rifaximin 800 mg/d plus mesalazine 2.4 g/d for 10 d, followed by mesalazine 1.6 g/d for 8 wk), were enrolled in a 12-month follow-up. The following symptoms were assessed at entry and through follow-up by using a quantitative scale: (1) constipation, (2) diarrhea, (3) abdominal pain, (4) rectal bleeding, and (5) mucus with the stools. After recruitment, the patients were randomly assigned to one of the following 3 groups: mesalazine 1.6 g/d (group M), L. casei DG 16 billion/d for 15 d/mo (group L); mesalazine 1.6 g/d+L. casei DG 16 billion/d for 15 d/mo (group LM). Results Eighty-five patients completed the study (94.5%): 2 patients (2.22%, 1 of group M and 1 of group LM) were withdrawn from the study for protocol violation and 1 (1.11%) for hospital admission due to acute pulmonary disease (group L); 2 patients (2.22%) were lost to follow-up. Seventy-five patients (88.2%) were symptom free after the 12th month of treatment (overall symptomatic score: (0): 23/27 patients of group M [on intention to treat: 76.7% confidence interval (CI 95%: 61.5 to 91.8)], 23/29 of group L [on intention to treat: 76.7% (CI 95%: 61.5 to 91.8)], 29/29 of group LM [on intention to treat: 96% (CI 95%: 94.2 to 100)] (P<0.05). Only 10 patients (11.1%) showed recurrence of symptoms (overall symptomatic score: 68). Conclusions Both mesalazine and L. casei DG seem to be effective in preventing recurrence of symptomatic uncomplicated diverticular disease of the colon, but their association seems to be more promising in this field.


Journal of Clinical Gastroenterology | 2003

Lack of usefulness of anti-transglutaminase antibodies in assessing histologic recovery after gluten-free diet in celiac disease.

Antonio Tursi; G. Brandimarte; Gian Marco Giorgetti

Gluten-free diet (GFD) plays a key role in the treatment of celiac disease (CD), but it is difficult to evaluate the effect of GFD on the improvement of villous architecture using sensitive, non-invasive tests. Aim of this study is to evaluate anti-transglutaminase (tTG) antibodies in the follow-up of CD to detect histologic recovery. We studied 42 consecutive patients with CD. In all the patients anti-tTG antibodies (evaluated by the enzyme linked immunosorbent assay method) and EGDscopy with multiple bioptic samples before GFD and then 6, 12, and 18 months after GFD were evaluated. For comparison, a sorbitol H2-breath test (H2-BT) and anti-endomysium (EMA) antibodies test were carried out concomitantly. Anti-tTG results were positive in 36 of 42 patients before GFD (80.95%), while they were positive in 11 of 34 (32.35%), 1 of 17 (5.88%), and 0 of 6 (0%) of patients with a persistence in histologic lesions 6, 12, and 18 months of GFD respectively, without any correlation with persistence of histologic lesions (P = NS). Also EMA failed to show correlation with improvement of histologic lesions. They were positive in 31 of 42 patients before GFD (73.80%), while they were positive in 18 of 34 (52.94%), 3 of 17 (17.64%), and 0 of 6 (0%) cases 6, 12, and 18 months of GFD respectively (P = NS). Regarding sorbitol H2-BT, it was positive in 40 of 42 (95.24%) patients before GFD, while it was positive in 31 of 34 (91.17%), 13 of 17 (76.47%), and 4 of 6 (50%) of patients with a persistence in histologic lesions 6, 12, and then 18 months after GFD starting (see Fig. 2, infra). So, anti-tTG and EMA were ineffective in assessing the histologic recovery at each follow-up visit (P = NS), while sorbitol H2-BT seems more effective than anti-tTG and EMA in this field (P < 0.0001 sorbitol H2-BT versus anti-tTG and versus EMA at 18 months after gluten withdrawal). Thirty-eight of 42 (90.47%) patients adhered to a strict GFD. Four patients were found to have occasional dietary transgression, and in all we noted a progressive decreasing of anti-tTG after 6 months of GFD and negative anti-tTG after 12 months of GFD, but sorbitol H2-BT persisted being positive during the entire follow-up. Intestinal damage persisted during the follow-up, despite anti-tTG and EMA negativity, and worsened in the presence of dietary lapses. Anti-tTG does not seem effective to assess histologic recovery in the follow-up of celiac patients after they have started GFD due to its poor correlation with histologic damage. FIGURE 2. Correlation between histologic lesions, sorbitol H2-BT, EMA and, anti-tTG throughout the follow-up (number of patients).


Journal of Clinical Gastroenterology | 2008

Assessment and grading of mucosal inflammation in colonic diverticular disease

Antonio Tursi; Giovanni Brandimarte; W. Elisei; Gian Marco Giorgetti; Cosimo Damiano Inchingolo; Silvio Danese; Fabio Aiello

Goal The aim of this study was to assess and grade the mucosal inflammatory infiltrate in different degrees of diverticular disease (DD) and to compare them with healthy matched controls. Background Mucosal inflammation in colonic DD has never been investigated. In particular, it is unknown whether inflammation may be found in every degree of DD. Materials and Methods Thirty consecutive patients with a new endoscopic diagnosis of DD (10 with asymptomatic diverticulosis, 10 with symptomatic uncomplicated DD, and 10 with acute uncomplicated diverticulitis) and 10 healthy controls were studied. Results A neutrophilic inflammatory infiltrate was found only in acute uncomplicated diverticulitis (overall score, 26). The mean lymphocytic cell density was significantly higher in symptomatic DD (median lymphocytic density, 7) and acute uncomplicated diverticulitis (median lymphocytic density, 11). Subdividing the patients according to different degrees of DD, we found higher lymphocytic cell density even in asymptomatic diverticulosis (median lymphocytic density, 6.5) than healthy controls (median lymphocytic density, 4; P<0.02). Conclusions We found an increased inflammatory infiltrate in DD according to the degree of the disease and higher than healthy controls. Moreover, also asymptomatic diverticulosis shows higher inflammatory cell density than controls.


Inflammatory Bowel Diseases | 2005

High prevalence of celiac disease among patients affected by Crohn's disease.

Antonio Tursi; Gian Marco Giorgetti; Giovanni Brandimarte; W. Elisei

Background: Recent literature has shown a correlation between Crohns disease (CD) and celiac disease, but a prospective study has not been performed. Our aim was to evaluate the prevalence of celiac disease in a consecutive series of patients affected by CD, in whom the disease was diagnosed for the first time. Methods: From January to December 2004, we diagnosed 27 patients affected by CD (13 men and 14 women; mean age, 32.3 yrs; range, 16‐69 yrs). In all patients, we performed antigliadin, antiendomysium, and antitransglutaminase antibody tests, and the sorbitol H2 breath test evaluation. In case of antibodies and/or sorbitol positivity, esophagogastroduodenoscopy was performed for a small bowel biopsy. Results: Antigliadin, antiendomysium, and antitransglutaminase antibody tests were positive in 8/27 (29.63%), 4/27 (14.81%), and 5/27 (18.52%) patients, respectively, whereas the sorbitol H2 breath test was positive in 11/27 (40.74%) patients: all of them underwent esophagogastroduodenoscopy. Nine of 11 patients showed signs of duodenal endoscopic damage, and 5/9 (55.55%) showed histologic features of celiac disease (18.52% of overall CD population studied): 2 showed Marsh IIIc lesions (1 patient affected by ileal CD and 1 affected by ileo‐colonic CD), 2 showed Marsh IIIb lesions (all of them affected by ileo‐colonic CD), 1 showed a Marsh IIIa lesion (1 patient affected by colonic CD). Conclusions: Prevalence of celiac disease seems to be high among patients affected by CD, and this finding should be kept in mind at the time of the first diagnosis of CD; a gluten‐free diet should be promptly started.


Alimentary Pharmacology & Therapeutics | 2013

Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease – a double-blind, randomised, placebo-controlled study

Antonio Tursi; Giovanni Brandimarte; Walter Elisei; Marcello Picchio; G. Forti; G. Pianese; S. Rodino; T. D'Amico; N. Sacca; Piero Portincasa; E. Capezzuto; R. Lattanzio; A. Spadaccini; S. Fiorella; F. Polimeni; N. Polimeni; V. Stoppino; G. Stoppino; GianMarco Giorgetti; F. Aiello; Silvio Danese

Placebo‐controlled studies in maintaining remission of symptomatic uncomplicated diverticular disease (SUDD) of the colon are lacking.


Journal of Clinical Gastroenterology | 1996

Role of Dental Plaque in the Transmission of helicobacter Pylori Infection

Giovanni Cammarota; Antonio Tursi; Massimo Montalto; Alfredo Papa; Graziamaria Veneto; Sabrina Bernardi; Antonia Boari; Vittorio Colizzi; Giuseppe Fedeli; Giovanni Gasbarrini

With regard to the role of dental plaque in the transmission of Helicobacter pylori infection, data from the literature vary greatly, owing to differences in sample collection and H. pylori-detecting techniques. Using the polymerase chain reaction (PCR), we have determined the incidence of H. pylori colonization in the dental plaque of 31 consecutive patients who underwent gastroscopy. The patients were divided into two groups on the basis of H. pylori infection, determined by Giemsa stain and the rapid urease test: group A made up of 21 H. pylori-positive patients and group B with 10 H. pylori-negative patients. Our PCR assay of dental plaque samples proved negative in all group A subjects but was positive in only one patient in group B. In our study, we found that H. pylori had a low prevalence (3.2%) in the oral cavity, with no significant relationship between gastric mucosa and dental plaque colonization. More comprehensive studies are needed to determine whether dental plaque is an important reservoir in the epidemiology of H. pylori-induced gastric disease.

Collaboration


Dive into the Antonio Tursi's collaboration.

Top Co-Authors

Avatar

Marcello Picchio

Sapienza University of Rome

View shared research outputs
Top Co-Authors

Avatar

Walter Elisei

Sapienza University of Rome

View shared research outputs
Top Co-Authors

Avatar

Alfredo Papa

The Catholic University of America

View shared research outputs
Top Co-Authors

Avatar

Giovanni Cammarota

Catholic University of the Sacred Heart

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Giovanni Gasbarrini

The Catholic University of America

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar
Researchain Logo
Decentralizing Knowledge