Rosalia Arsena
University of Palermo
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Featured researches published by Rosalia Arsena.
Nephrology Dialysis Transplantation | 2008
Santina Cottone; Giuseppe Mulè; Marco Guarneri; Alessandro Palermo; Maria Carmela Lorito; Raffaella Riccobene; Rosalia Arsena; Francesco Vaccaro; Anna Vadalà; Emilio Nardi; Paola Cusimano; Giovanni Cerasola
BACKGROUNDnHypertension and additional non-traditional risk factors can damage the kidney directly and by promoting atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate a large part of the effects of risk factors on the kidney. We hypothesized that in hypertensive patients (HT), oxidative stress, measured as 8-ISO-prostaglandin F2alpha (8-ISO-PGF2alpha), should raise paralleling decreasing renal function and should correlate with estimated glomerular filtration rate (eGFR).nnnMETHODSnIn 626 HT with renal function ranging from stages 1 to 5 and 100 healthy controls, plasma levels of 8-ISO-PGF2alpha, high-sensitivity C-reactive protein (CRP), transforming growth factor-beta (TGF-beta) and endothelin-1 (ET-1) were measured. GFR was estimated by the Modification of Diet in Renal Disease study equation.nnnRESULTSnWhen HT were stratified according to renal function stages, 8-ISO-PGF2alpha, CRP, TGF-beta and ET-1 increased progressively and significantly with decreasing eGFR. The multiple regression analysis, considering eGFR as a dependent variable, showed that 8-ISO-PGF2alpha (beta = -0.361, P < 0.000001), ET-1 (beta = -0.197, P < 0.0001) and TGF-beta (beta = -0.170, P < 0.0004) correlated independently with eGFR. All biomarkers were good predictors of eGFR <60 ml/min/1.73 m(2) [receiver-operator-curve (ROC) areas]. ET-1 was shown to be the best predictor with a ROC area = 0.938; with a threshold of 4 pg/ml, 91% sensitivity and 85% specificity were observed, whereas 8-ISO had a ROC area = 0.931, and for a threshold of 329 pg/ml, sensitivity and specificity were 89%, respectively. In contrast, CRP showed the lower predictive value with a ROC area = 0.917; with a threshold of 2.52 mg/l, an 87% sensitivity and an 83% specificity were obtained.nnnCONCLUSIONSnOur findings are a clear-cut demonstration of a strong and negative correlation of both oxidative stress and ET-1 with renal function stages in HT. ET-1 and 8-isoprostane are predictive of eGFR.
Clinical Nephrology | 2007
Santina Cottone; Emilio Nardi; Giuseppe Mulè; Anna Vadalà; Maria Carmela Lorito; Raffaella Riccobene; Alessandro Palermo; Rosalia Arsena; Marco Guarneri; Giovanni Cerasola
AIMSnLeft ventricular hypertrophy (LVH) is a predictor for cardiovascular mortality, and it is considered to be a surrogate marker of preclinical cardiovascular disease. This study aimed at evaluating whether fetuin-A plasma levels are decreased in patients with moderate chronic kidney disease (CKD) and their linkage to plasma concentrations of hs-C-reactive protein (CRP), cardiotrophyn-1 (CT-1), tumor necrosis factor-ac (TNF-alpha), propeptide of collagen Type I (PIP) and to LVH.nnnMATERIAL AND METHODSnWe enrolled 64 moderate CKD and 55 essential hypertensives (EH) with normal renal function as controls. All the patients underwent an echocardiographic examination; plasma samples were obtained to measure routine clinical parameters and the molecules listed above (measured by ELISA).nnnRESULTSnAmong CKD there were 30/64 patients with LVH, and in EH group 14/55 subjects had LVH. Fetuin A was reduced in CKD when compared with EH (p < 0.0001). The comparison between CKD having LVH with those without LVH showed significant differences in plasma levels of fetuin-A (p < 0.002), TNF-alpha (p < 0.01) and hs-CRP (p < 0.001), CT-1 and PIP (p < 0.002). CKD with LVH had lower values of fetuin-A (p < 0.001), and higher values of hs-CRP (p < 0.001) TNF-alpha (p < 0.001), CT-1 (p < 0.001) and PIP (p < 0.001) than EH with LVH. The multivariate analysis of correlation demonstrated that in CKD patients hs-CRP (beta 0.42, p < 0.00006), and systolic blood pressure (beta 0.29, p < 0.02) were independent predictors of LV mass index. The relationship between LV mass index and fetuin-A did not reach statistical significance.nnnCONCLUSIONSnFor the first time in moderate CKD patients, we demonstrate that fetuin-A is decreased and relates to LVH depending on C-reactive protein.
Nephrology | 2010
Giovanni Cerasola; Emilio Nardi; Giuseppe Mulè; Alessandro Palermo; Paola Cusimano; Marco Guarneri; Rosalia Arsena; Gaia Giammarresi; Anna Carola Foraci; Santina Cottone
Aim:u2003 Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular (CV) morbidity and mortality. The aim of the present study was to evaluate the relationship between LV mass and mild‐to‐moderate renal dysfunction in a group of non‐diabetic hypertensives, free of CV diseases, participating in the Renal Dysfunction in Hypertension (REDHY) study.
Journal of Human Hypertension | 2007
Santina Cottone; Giuseppe Mulè; Emilio Nardi; Maria Carmela Lorito; Marco Guarneri; Rosalia Arsena; Chiara Briolotta; Anna Vadalà; Giovanni Cerasola
We hypothesized that in essential hypertensive patients (EHs), plasma levels of pro-atherogenic adhesion molecules would be increased and related with urine albumin excretion (UAE). Thus, this study was aimed at evaluating biochemical markers of endothelial activation and their relationship with UAE in a group of patients with uncomplicated EH. In basal condition soluble forms of adhesion molecules intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1, as well as 24-h UAE were assayed. One hundred patients with essential hypertension and no diabetes or ultrasonographic evidence of atherosclerosis were included in the study. Seventy normotensive healthy subjects served as controls. EHs were first studied overall, than were divided into two subgroups: those with UAE ⩾20u2009mcg/min MAUs and those with UAE <20u2009mcg/min (non-MAUs). ICAM-1 (P<0.001) and VCAM-1 (P<0.0001) plasma concentrations were higher in EHs than in controls. Microalbuminuric EHs had greater levels of adhesion molecules than non-MAUs (ICAM-1 P=0.04; VCAM-1 P=0.02, respectively). In EHs UAE was correlated with ICAM-1 (r=0.29, P=0.003), and VCAM-1 (r=0.30, P=0.002). These associations were confirmed in multiple regression models (P=0.02 for both ICAM-1 and VCAM-1) including, along with adhesion molecules, age, body mass index and blood pressures. Our findings show that in essential hypertension there is a very early activation of endothelial adhesion molecules favouring atherosclerosis.
Journal of Hypertension | 2007
Santina Cottone; Giuseppe Mulè; Emilio Nardi; Anna Vadalà; Maria Carmela Lorito; Marco Guarneri; Rosalia Arsena; Alessandro Palermo; Giovanni Cerasola
Background Oxidant stress is implicated in the pathogenesis of atherosclerosis in cardiovascular diseases. Our aim was to test oxidative stress, as 8-iso-prostaglandin F2α (8-iso-PGF2α), and its relationship with inflammation markers C-reactive protein (CRP) and tumour necrosis factor-α (TNFα), and endothelial activation assayed as soluble intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in essential hypertension. Methods In 216 essential hypertensive patients and 55 healthy control individuals, plasma levels of high-sensitivity CRP and TNFα, 8-iso-PGF2α, ICAM-1 and VCAM-1 were measured in basal conditions. Moreover, basal and 24-h ambulatory blood pressure monitoring measurements were obtained. Results Essential hypertensive patients showed higher levels of 8-iso-PGF2α (P < 0.0001), high-sensitivity CRP, TNFα, ICAM-1 and VCAM-1 (P < 0.001, respectively) than control individuals. In control individuals, 8-iso-PGF2α correlated only with high-sensitivity CRP (P < 0.001). In essential hypertensive patients, 8-iso-PGF2α correlated with high-sensitivity CRP (P < 0.000001), TNFα (P < 0.0001), ICAM-1 (P < 0.000001), VCAM-1 (P < 0.0001) and blood pressure. The multiple regression analysis considering 8-iso-PGF2α as the dependent variable showed that in essential hypertensive patients the independent predictors of 8-iso-PGF2α were ICAM-1, high-sensitivity CRP (P < 0.00001, respectively), and TNFα (P = 0.028). Conclusion Our findings demonstrate that oxidant stress is increased in essential hypertension, and relates to inflammation and endothelial activation. Factors other than blood pressure are stronger predictors of oxidant stress.
Transplant International | 2007
Santina Cottone; Alessandro Palermo; Francesco Vaccaro; Giuseppe Mulè; Marco Guarneri; Rosalia Arsena; Anna Vadalà; Giovanni Cerasola
The aim of this study was to investigate the relationships between inflammation and adhesion molecules in long‐term kidney transplantation. We measured serum concentrations of tumor necrosis factor‐alpha (TNFα) and intercellular and vascular cell adhesion molecules (ICAM‐1 and VCAM‐1) in 35 renal transplant recipients (mean age of transplantation 5u2003±u20033u2003years) and in 35 chronic renal insufficiency (CRI) patients; twenty‐six healthy subjects were enrolled as controls. Transplanted showed higher values than controls of TNFα (Pu2003<u20030.0001), ICAM‐1 (Pu2003<u20030.0001), and VCAM‐1 (Pu2003<u20030.0001). CRI group as well exhibited higher concentrations than controls of TNFα (Pu2003<u20030.0001), ICAM‐1 (Pu2003<u20030.0001), and VCAM‐1 (Pu2003<u20030.0001). Transplanted and CRI patients had similar blood pressure and renal function levels, and TNFα, ICAM‐1, and VCAM‐1 were not significantly different in the two groups. In transplanted group ICAM‐1, VCAM‐1, and TNFα correlated negatively and independently with glomerular filtration rate (GFR) –Pu2003<u20030.00001 for all. TNFα as well correlated with ICAM‐1 and VCAM‐1 (Pu2003<u20030.001, respectively). In CRI group, TNFα correlated with serum creatinine, ICAM‐1, and VCAM‐1 (Pu2003=u20030.01 for all). In conclusion, in long‐term renal transplantation, the level of kidney function and both inflammation and endothelial activation are closely related. In fact, the multiple regression analysis demonstrated that the level of kidney insufficiency and the levels of the studied molecules were independently associated.
Journal of Human Hypertension | 2010
Giovanni Cerasola; Giuseppe Mulè; Emilio Nardi; Paolo Cusimano; Antonio Palermo; Rosalia Arsena; Maria Francesca Guarneri; Calogero Geraci; Santina Cottone
Our study was aimed to assess the clinical correlates of different degrees of renal dysfunction in a wide group of non-diabetic hypertensive patients, free from cardiovascular (CV) complications and known renal diseases, participating to the REDHY (REnal Dysfunction in HYpertension) study. A total of 1856 hypertensive subjects (mean age: 47±14 years), attending our hypertension centre, were evaluated. The glomerular filtration rate (GFR) was estimated by the simplified Modification of Diet in Renal Disease Study prediction equation. A 24-h urine sample was collected to determine albumin excretion rate (AER). Albuminuria was defined as an AER greater than 20u2009μgu2009min−1. We used the classification proposed by the US National Kidney Foundations guidelines for chronic kidney disease (CKD) to define the stages of renal function impairment. In multiple logistic regression analysis, the probability of having stage 1 and stage 2 CKD was significantly higher in subjects with greater values of systolic blood pressure (SBP) and with larger waist circumference. SBP was also positively related to stage 3 CKD. Stage 3 and stages 4–5 CKD were inversely associated with waist circumference and directly associated with serum uric acid. Age was inversely related to stage 1 CKD and directly related to stage 3 CKD. The factors associated with milder forms of kidney dysfunction are, in part, different from those associated with more advanced stages of renal function impairment.
Hypertension Research | 2013
Marco Guarneri; Calogero Geraci; Francesca Incalcaterra; Rosalia Arsena; Giuseppe Mulè; Francesco Vaccaro; Clelia Luna; Giovanni Cerasola; Santina Cottone
The intima-media thickness (IMT) is considered as a surrogate marker for atherosclerotic disease. The aim of this study was to analyze the relationship of carotid IMT with fetuin-A in patients with essential hypertension (EH) and normal renal function. The plasma levels of fetuin-A, interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α) and the biomarker of oxidative stress 8-iso-PGF2alpha were assayed in samples from 105 untreated EH patients. Carotid IMT measurements were also performed. EH was studied overall and after dividing in EH with IMT ⩾ and <0.9u2009mm. All of the biomarkers were significantly different between the two subgroups, in particular, the fetuin-A level was lower in the patients with an IMT ⩾0.9u2009mm. In the overall group, the linear analysis of correlation demonstrated that the IMT was significantly inversely correlated with the fetuin-A level (r=−0.40, P<0.0001) and directly with TNF-α (r=0.39, P<0.0001), IL-6 (r=0.38, P<0.0001) and 8-iso-PGF2alpha (r=0.356, P<0.0003). The multiple regression analysis performed that assigned IMT as a dependent variable showed that fetuin-A (β=−0.268, P<0.0001) was independently correlated with the IMT. Receiver-operator curves demonstrated that fetuin-A levels have a predictive power of IMT>0.9u2009mm (AUC (area under the curve) 0.738, P<0.0001). Our results suggest that in EH, fetuin-A is associated with the IMT independently of oxidative stress and renal function, thus predicting increases in the IMT.
Journal of Human Hypertension | 2015
Santina Cottone; Laura Guarino; Rosalia Arsena; Concetta Scazzone; Francesca Tornese; Marco Guarneri; Chiara Guglielmo; Antonino Bono; Giuseppe Mulè
Several studies analyzed 25-hydroxyvitamin D (25[OH]D) and blood pressure (BP) relationship with mixed results. Moreover, a relationship between the risk of hypertension and vitamin D receptor (VDR) gene polymorphisms, FokI and BsmI, was reported. This study was aimed to analyze these relationships in essential hypertensive (EH) patients. Seventy-one EH patients, 18–75 years old, were enrolled. Patients underwent clinical BP, 24-h ambulatory BP monitoring, 25[OH]D and plasma renin activity (PRA) evaluations. FokI and BsmI VDR polymorphisms were analyzed and compared with those of 72 healthy controls. In EH patients, the median 25[OH]D levels were lower than 30u2009ngu2009ml−1. We found a significant negative correlation between 25[OH]D and 24-h systolic BP (r=−0.277, P=0.043). This correlation persisted in backward stepwise multivariate analyses (β=−0.337; P=0.022), after adjustment for age, gender, body mass index, glomerular filtration rate, and PRA. We did not observe statistically significant correlation between 25[OH]D and PRA. We compared the allelic frequencies and genotype distribution between patients and controls, and FokI and BsmI VDR polymorphisms were not associated either with hypertensive status or with PRA. Further wide studies are needed to clarify this relationship.
Journal of Hypertension | 2010
Marco Guarneri; Raffaella Riccobene; Rosalia Arsena; C. Altieri; Francesca Tornese; A Previti; Laura Guarino; Giovanni Cerasola; Santina Cottone
Objectives: Hypertension is characterized by a synergy between oxidative stress, inflammation and endothelial dysfunction. Endothelial dysfunction plays an important role in the patho-physiology of high blood pressure, of atherosclerosis and cardiovascular diseases. In the last decade, a technique for non-invasive assessment of flow mediated vasodilation (FMD) of the brachial artery, an endothelium dependent function, which assesses endothelial function in vivo was developed. The purpose of our study was to analyze the relationship between endothelial dysfunction, assessed by FMD, and biomarkers of endothelial dysfunction (ET-1, ICAM-1, VCAM-1), and inflammation (TNF-α) in patients with hypertension having chronic renal failure (CRF). Methods: Have been enrolled 50 subjects with hypertension (HT), with various degrees of kidney function (CRF II-IV), and 50 healthy control subjects. In all subjects plasma concentrations of ET-1, ICAM-1, VCAM-1, E-SEL and TNF-á were determined. In hypertensive subjects the analysis of endothelial function was carried out by FMD. Results: Overall, the results showed in HT plasma levels of ET-1, ICAM-1, VCAM-1, E-SEL and TNF-α significantly higher (p < 0.001) than in control subjects. The average value of FMD% as assessed in the group of hypertensive subjects was of 4.57 ± 1.08. The linear correlation analysis showed in hypertensive subjects, negative correlations and statistically significant of FMD% with ET-1, ICAM-1, VCAM-1, E-SEL, and TNF-α (p < 0.05 respectively). The analysis of correlation between FMD% and glomerular filtrate rate, as estimated by the MDRD study equation at 4 variables, was not statistically significant. Conclusions: Our study confirms, in hypertensive patients with different degrees of renal function, the presence of endothelial activation characterized by increased serum concentrations of adhesion molecules and markers of inflammation. These results are associated with reduced endothelium-dependent vasodilatation, regardless of the degree of renal function.