Federica Albicini

The course of asthma in young adults: A population-based nine-year follow-up on asthma remission and control

Background Only few longitudinal studies on the course of asthma among adults have been carried out. Objective The aim of the present prospective study, carried out between 2000 and 2009 in Italy, is to assess asthma remission and control in adults with asthma, as well as their determinants. Methods All the subjects with current asthma (21–47 years) identified in 2000 in the Italian Study on Asthma in Young Adults in 6 Italian centres were followed up. Asthma remission was assessed at follow-up in 2008–2009 (n = 214), asthma control at baseline and follow-up. Asthma remission and control were related to potential determinants by a binomial logistic and a multinomial logistic model. Separate models for remission were used for men and women. Results The estimate of the proportion of subjects who were in remission was 29.7% (95%CI: 14.4%;44.9%). Men who were not under control at baseline had a very low probability of being in remission at follow-up (OR = 0.06; 95%CI:0.01;0.33) when compared to women (OR = 0.40; 95%CI:0.17;0.94). The estimates of the proportion of subjects who were under control, partial control or who were not under control in our sample were 26.3% (95%CI: 21.2;31.3%), 51.6% (95%CI: 44.6;58.7%) and 22.1% (95%CI: 16.6;27.6%), respectively. Female gender, increasing age, the presence of chronic cough and phlegm and partial or absent asthma control at baseline increased the risk of uncontrolled asthma at follow-up. Conclusion Asthma remission was achieved in nearly 1/3 of the subjects with active asthma in the Italian adult population, whereas the proportion of the subjects with controlled asthma among the remaining subjects was still low.

The rapid FEV1 decline in chronic obstructive pulmonary disease is associated with predominant emphysema: A longitudinal study

Abstract Background: Early identification of patients with COPD and prone to more rapid decline in lung function is of particular interest from both a prognostic and therapeutic point of view. The aim of this study was to identify the clinical, functional and imaging characteristics associated with the rapid FEV1 decline in COPD. Methods: Between 2001 and 2005, 131 outpatients with moderate COPD in stable condition under maximum inhaled therapy underwent clinical interview, pulmonary function tests and HRCT imaging of the chest and were followed for at least 3 years. Results: Twenty-six percent of patients had emphysema detected visually using HRCT. The FEV1 decline was 42 ± 66 mL/y in the total sample, 88 ± 76 mL/y among rapid decliners and 6 ± 54 mL/y among the other patients. In the univariable analysis, the decline of FEV1 was positively associated with pack-years (p < 0.05), emphysema at HRCT (p < 0.001), RV (p < 0.05), FRC (p < 0.05), FEV1 (p < 0.01) at baseline and with number of hospitalizations per year (p < 0.05) during the follow-up. Using multivariable analysis, the presence of emphysema proved to be an independent prognostic factor of rapid decline (p = 0.001). When emphysema was replaced by RV, the model still remained significant. Conclusions: The rapid decline in lung function may be identified by the presence of emphysema at HRCT or increased RV in patients with a long smoking history.

Evaluation of the anti-proliferative activity of three new pyrazole compounds in sensitive and resistant tumor cell lines

BACKGROUND In previous papers we demonstrated that the activity of short heteroretinoids as anti-proliferative and pro-apoptotic compounds was deeply linked to their heterocyclic moiety and that ionone-derived 1,5-pyrazoles had the highest anti-proliferative activity in our preliminary experiments. We then demonstrated the high and pharmacologically significant anti-proliferative and apoptotic activities of the pyrazole compounds 2-(1-(4-chlorophenyl)-1H-pyrazol-5-yl)-5-methoxyphenol (EN12-4), 5-methoxy-2-(1-(pyridin-2-yl)-1H-pyrazol-5-yl)phenol (EN12-2A) and 2-(5-(4-methoxyphenyl)-1H-pyrazol-1-yl)pyridine (EN7-2) establishing, especially for EN12-2A, a possible mechanism of action involving the cell microtubular system. METHODS Here, the anti-proliferative activity of these pyrazole compounds was analyzed in vitro by the MTT assay in six drug-resistant cell lines, five of which were selected after exposure to increasing concentrations of cisplatin (L1210/DDP), doxorubicin (A2780/DX3), 5-fluorouracil (HCT-8/5FU), taxol (A549/T24) and etoposide (MCF-7/VP), and one was obtained by transfection of the ABCG2 membrane transporter (HEK-293/R2). RESULTS Our data show that these compounds have a similar anti-proliferative activity in nearly all resistant and sensitive cell lines, demonstrating their ability to overcome the most common mechanisms of drug resistance with two exceptions regarding the MCF-7/VP cell line over-expressing the ABCC1 (MRP1) transporter, and the MDR1 over-expressing A2780/DX3 cells, with a calculated RI = 3.2 for EN12-2A, relative to their sensitive cellular counterpart. On the other hand, the taxol-resistant A549/T24 cell line showed a significantly increased sensitivity to our compounds. CONCLUSIONS Our data suggest that our pyrazole compounds are able to overcome in vitro the most common drug-resistance mechanisms demonstrating a significant anti-proliferative activity and confirming a mechanism of action involving the depolymerization of microtubules.

Response of renal parenchyma and interstitium of Rana snk. esculenta to environmental pollution.

The mesonephroi of two groups of Rana esculenta collected from two rice fields near Pavia, one relatively unpolluted and one polluted, were morphologically and histochemically investigated. Light and electron microscopy analyses were performed and certain enzyme activities studied (succinic dehydrogenase, SDH, alkaline phosphatase, AlkPase, acid phosphatase, AcPase, catalase, CAT, and NOS-related nicotinamide adenine dinucleotide phosphatase, NOS/NADPHd). The expression of the inducible NOS (iNOS) was evaluated through immunohistochemistry. In the renal parenchyma of the polluted group some structural modifications, mainly in the glomeruli and the proximal tubule epithelium, were observed. Peritubular inflammatory foci in most polluted samples were often found to be in combination with parasitic cysts. However, no necrotic processes were found in the renal parenchyma. Compared to controls, the histochemical studies on contaminated frogs evidenced an increase of the AcPase, NOS and CAT activities, and of the iNOS immunoexpression as well. All the results showed a good correspondence between the biomarkers responses and the environmental stress conditions. Overall, we can state that studying the sub-lethal effects of contamination in amphibians naturally exposed to toxicants has shown to be significant for the assessment of site-specific risk and potential hazards behind the phenomenon of progressive amphibian decline.

Il coinvolgimento polmonare nei pazienti affetti da sindrome di Marfan

Il coinvolgimento polmonare non e considerato una delle principali caratteristiche della sindrome di Marfan. Grazie ai sostanziali progressi nei trattamenti, l’aspettativa di vita di questi pazienti e migliorata determinando cambiamenti nei differenti organi. L’obiettivo e quello di valutare il coinvolgimento polmonare in tutti i pazienti valutando l’esame clinico e i test di funzionalita polmonare. La storia clinica, la spirometria, la capacita diffusiva furono stati valutati nei 64 pazienti. Nessuno dei pazienti riportava sintomi respiratori cronici. Il 14% ha riportato un precedente pneumotorace e 3 blebs. Il 45% aveva moderate o severe anormalita della gabbia toracica. Il 23% ha subito interventi cardiotoracici. Due dei 19 pazienti che hanno eseguito la TC torace risultavano avere l’enfisema; 7 avevano blebs. Solo il 37% dei pazienti aveva un pattern di funzionalita polmonare normale; il 19% mostrava un pattern restrittivo e il 44% un pattern ostruttivo o una diminuzione isolata della DLCO o un’isolata iperinflazione. In assenza di precoci sintomi respiratori, anormalita della funzione polmonare dovrebbero essere individuate. I nostri risultati supportano l’importanza della determinazione dei volumi polmonari per identificare i pazienti in cui e importante un’attenta valutazione della TC torace.