Sebastiano Gangemi

Autism and social robotics: A systematic review.

Social robotics could be a promising method for Autism Spectrum Disorders (ASD) treatment. The aim of this article is to carry out a systematic literature review of the studies on this topic that were published in the last 10 years. We tried to address the following questions: can social robots be a useful tool in autism therapy? We followed the PRISMA guidelines, and the protocol was registered within PROSPERO database (CRD42015016158). We found many positive implications in the use of social robots in therapy as for example: ASD subjects often performed better with a robot partner rather than a human partner; sometimes, ASD patients had, toward robots, behaviors that TD patients had toward human agents; ASDs had a lot of social behaviors toward robots; during robotic sessions, ASDs showed reduced repetitive and stereotyped behaviors and, social robots manage to improve spontaneous language during therapy sessions. Therefore, robots provide therapists and researchers a means to connect with autistic subjects in an easier way, but studies in this area are still insufficient. It is necessary to clarify whether sex, intelligence quotient, and age of participants affect the outcome of therapy and whether any beneficial effects only occur during the robotic session or if they are still observable outside the clinical/experimental context. Autism Res 2016, 9: 165–183.

IL-33/ST2 axis controls Th2/IL-31 and Th17 immune response in allergic airway diseases.

IL-33 targeting ST2 receptor (T1/ST2), expressed on Th2 cell surface, regulates the production of cytokines like IL-17A and IL-31. We studied the role of IL-33/ST2 axis in IL-31 and IL-17A production in patients with allergic rhinitis (AR) and with concomitant allergic asthma and rhinitis (AAR). 20 healthy control subjects (HC), 14 AR and 17 AAR subjects were recruited and blood samples collected. IL-33, soluble ST2 (sST2), IL-17A and IL-31 plasma concentrations were measured by ELISA method. T1/ST2, IL-31 and IL-17A cellular expression were studied in peripheral blood mononuclear cells (PBMC) from HC, AR and AAR (n=6 for each group) by flow-cytometry. In vitro, we also evaluated the effect of beclomethasone dipropionate (BDP) on T1/ST2, IL-31 and IL-17A expression in CD3(+)T-cells from PBMC of AAR (n=6). Plasma levels of IL-33, IL-31 and IL-17A were significantly higher and sST2 was lower in patients with AR and AAR than in HC. IL-31 and IL-17A intracellular levels significantly increased, whereas T1/ST2 expression was significantly lower, in CD3(+)T-cells from AR and AAR compared to HC. Positive correlations were observed between plasmatic components of IL-33/ST2 axis and IL-31 in both AR and AAR and IL-17A in AAR. In vitro IL-31 and IL-17A intracellular levels decreased after BDP treatment, whereas T1/ST2 expression increased in cultured CD3(+)T-cells obtained from AAR. IL-33/ST2 axis is involved in Th2/IL-31 and Th17 immune response during the progression of allergic airway disease. In vitro BDP is able to control Th2/IL-31 and Th17 immune response in PBMC from allergic patients.

Interleukin-23 serum levels in patients affected by peripheral arterial disease.

OBJECTIVES To clarify whether interleukin (IL)-23 is involved in peripheral arterial disease (PAD). DESIGN AND METHODS We evaluated IL-23 serum levels, in 29 patients suffering from lower extremity PAD and in 30 healthy subjects. RESULTS IL-23 serum levels were higher during the three times (T0, T1 and T2) compared to the control group, although only statistically significant for T0 and T2: T0 (15.83 ± 22.08 vs. 8.08 ± 8.62 pg ml, p=0.026), T1 (16.10 ± 23.71 vs. 8.08 ± 8.62 pg/ml, p=0.101), T2 (15.06 ± 16.72 vs. 8.08 ± 8.62 pg/ml, p=0.005). CONCLUSION For the first time, our data gives us reason to believe there is an involvement of IL-23 in PAD.

Increased serum levels of advanced oxidation protein products and glycation end products in subjects exposed to low-dose benzene

Simple aromatic hydrocarbon benzene occurs naturally in crude oil and petroleum. Benzene has been internationally recognised as a haematotoxin and carcinogen. The involvement of oxidative stress is a major susceptibility factors for benzene hematotoxicity in humans. Advanced oxidation protein products (AOPPs) and advanced glycation end products (AGEs) are modified structures which can serve as markers of oxidative stress. The aim of this study is to assess modification of circulating AOPPs and AGEs, as early markers of oxidative stress, in subjects exposed to low dose of benzene. Furthermore the genetic polymorphism of glutathione-S-transferase (GST) may be related to health effects of benzene exposure, in fact both genotype T1 (GSTT1) and M1 (GSTM1) are involved in the detoxification of benzene oxide. The study was performed on 54 workers oil refinery employees. A group of 32 healthy age-matched subjects was included as controls. The AOPPs serum levels in oil refinery employees were higher in a statistically significant way than those measured in controls, but there were no significant changes in serum AGE levels between both groups. However, GST polymorphisms had not influence on serum levels of both biomarkers, so demonstrating that production of circulating AGEs and AOPPs in benzene parity-exposed workers levels is not dependent by GST genotypes. We can conclude that, in this condition, AOPPs are more sensitive marker of low benzene exposure than AGEs.

Healthy centenarians show high levels of circulating interleukin-22 (IL-22)

Aging is characterized by a progressive alteration of homeostatic mechanisms modulated by environmental and genetic factors. It is associated with a pro-inflammatory status. In centenarians, an increase of pro-inflammatory cytokine production balanced by anti-inflammatory immune response that would promote longevity is observed. Cytokine dysregulation is believed to play a key role in the proposed remodeling of the immune-inflammatory responses accompanying old age. IL-22 is a pro-inflammatory cytokine belonging to the IL-10 family and represents an important effector molecule of activated T helper (Th)-22, Th-1, and Th-17 cells. We recruited 17 healthy centenarians (4 males, 13 females, range 100-105 years). All ultralongeval subjects were living at home or in a nursing home. Sixteen healthy, sex-matched individuals (4 males, 12 females, range 60-95 years) were also recruited as controls. Centenarians displayed significantly higher circulating IL-22 levels compared to control population (45.7±66.9 pg/ml versus 11.1±6.5 pg/ml; p=0.031). Its well known that IL-22 is a pro-inflammatory cytokine produced by activated T lymphocytes and NK cells. IL-22 stimulates the production of acute phase reactants and promotes the antimicrobial defense. The results of the present study show, for the first time, that there is an increase of IL-22 in healthy centenarians. This pro-inflammatory condition probably is protective against infection, promoting the longevity of these subjects.

Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature

Omalizumab is recombinant humanized monoclonal antibody to immunoglobulin E. Guidelines for the treatment of chronic idiopathic urticaria (also known as chronic spontaneous urticaria) recommend the use of omalizumab as third‐line therapy in addition to high doses of histamine receptor type 1 (H1) antihistamines when they are unsuccessful as first‐ and second‐line therapy. We performed a systematic review of the literature to identify studies that evaluated the efficacy of omalizumab for the treatment of chronic idiopathic urticaria, in both controlled and real‐world settings, to assess its potential role as a preferred therapy. The PubMed, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences Literature), and Google Scholar databases were searched between January 1, 2000, and November 21, 2016. The search was limited to articles published in peer‐reviewed journals in the English language, and 29 studies were included in this review. Omalizumab 300 mg administered every 4 weeks appears to be the most effective and safe dosage, with a rapid response time, for the treatment of chronic idiopathic urticaria, with few minor adverse effects, and appears to be safe in the offspring of pregnant patients who received the drug. However, as published studies of omalizumab are sparse, future studies are warranted. When findings are confirmed in larger studies, due to its efficacy, safety, and increased benefit/cost ratio, omalizumab could become the preferred method of treatment for chronic idiopathic urticaria in patients unresponsive to H1 antihistamines.

Anticancer Potential of Citrus Juices and Their Extracts: A Systematic Review of Both Preclinical and Clinical Studies

Background: During the last decades, a huge body of evidence has been accumulated suggesting that Citrus fruits and their juices might have a role in preventing many diseases including cancer. Objective: To summarize the numerous evidences on the potential of Citrus juices and their extracts as anticancer agents. Data sources: A systematic review of articles written in English using MEDLINE (1946-present), EMBASE (1974-present) and Web of Sciences (1970-present) was performed independently by two reviewers. Search terms included Citrus, Citrus aurantifolia, Citrus sinensis, Citrus paradisi, Citrus fruits, Citrus fruits extract, cancer, neoplasm, neoplasia, tumor, metastasis, carcinogenesis, proliferation. The last search was performed on March 16th, 2017. Study selection: Study selection and systematic review were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Prior to the beginning of the review, Authors defined a checklist for inclusion criteria, thus including articles which meet the following: (i) published on peer-reviewed scientific journals; (ii) Citrus juice used alone; (iii) extracts derived from Citrus juice; (iii) for preclinical studies, an exposure time to Citrus juices and their extracts more than 24 h. Reviews, meta-analyses, conference abstracts and book chapters were excluded. Data extraction: Three reviewers independently performed the extraction of articles. Data synthesis: 22 papers met our inclusion criteria and were eligible for inclusion in the final review. According to the kind of study, the selected ones were further divided in preclinical (n = 20) and observational (n = 2) studies. Conclusion: The studies discussed in this review strongly corroborate the role of Citrus juices and their derivatives as potential resource against cancer.

Interleukin-10 involvement in exposure to low dose of benzene

Objective: To establish if serum levels of interleukin-10 (IL-10) in subjects exposed to benzene are connected with age, working years, and employment age. Methods: We evaluated serum levels of IL-10 in 51 employees working in oil refinery (group A) and in 16 office workers who resided in the same area (group B). Results: There was no statistically significant difference between serum concentrations of IL-10 in groups A and B. There was a statistically significant dependent relationship in group A between age, working years, and serum concentration of IL-10. There was a statistically significant and positive dependent relationship in group A between serum concentration of IL-10 and employment age. Conclusions: The role played by IL-10 in benzene immune suppression may be relevant and attention should be directed toward assessment of age, working years, and employment age in benzene-exposed populations.

Different serum levels of interleukin-23 in patients affected by peripheral arterial disease

Recently, we demonstrated the involvement of interleukin (IL)-23 in peripheral arterial disease (PAD). IL-23 is mainly involved in the generation of a new subset of effector T cells (Th17) that could be characterised by the ability to produce a unique set of inflammatory cytokines, such as IL-17A, IL-17F, IL-6 and tumour necrosis factor-a, that play an important role in vascular inflammation. We showed that serum levels of this cytokine are higher in three times in connection with surgical treatment (T0: 24 h before, T1: 24 h after, T2: five days after) in patients with lower extremity PAD stage IV compared to controls. Afterwards, we retrospectively analysed whether IL23 has a univocal behaviour in PAD patients or is influenced by its initial values. Therefore, we divided the 29 patients of the previous study into two subgroups: group A (14 patients) with IL-23 levels at T0 8 pg/ml. The cut-off value was established following the controls mean value (8.08 8.62 pg/ml). Data were presented as mean standard deviation (SD). Differences between two paired groups were analysed by the Wilcoxon test and between more than two paired groups by Friedman test. Relationship between variables was evaluated with the ANOVA linear regression which identified the dependent variable in IL-23 and the independent variables in parameters such as age, sex, allergy, smoking, diabetes, hypertension, ischemic heart disease, autoimmune diseases, chronic renal failure and dialysis and use of drugs. Statistical significance was set at p< 0.05. IL-23 serum levels in group A at three times (T01⁄4 3.65 2.23 pg/ml; T11⁄4 6.05 2.5 pg/ml; T21⁄4 8.22 2.77 pg/ml) (Figure 1) showed a statistically significant progressive increase (p< 0.0001) that we did not find in group B (T01⁄4 27.20 26.14 pg/ml; T11⁄4 25.49 30.37 pg/ml; T21⁄4 21.44 21.49 pg/ml; p1⁄4 0.627) (Figure 2). Specifically in group A, both between T0-T1 and T1-T2, the IL-23 serum levels increased in 13 of 14 patients (p1⁄4 0.001 and p1⁄4 0.003, respectively). In group B, both between T0-T1 and T1-T2, the IL-23 serum levels increased in seven of 15 patients (p1⁄4 0.650 and p1⁄4 0.496, respectively). Using ANOVA linear regression, we did not find a relationship between IL-23 serum levels and parameters such as age, sex, allergy, smoking, diabetes, hypertension, ischemic heart disease, autoimmune diseases, chronic renal failure and dialysis. It was also evaluated whether the use of drugs could influence IL-23 serum levels. The linear regression showed no relationship. In another study, Jiang et al. reported increased serum IL-23 levels in patients with Behcet disease after cataract surgery; the cytokine levels did not consistently change in a control group of uncomplicated cataract patients after surgery. The authors hypothesised an underlying inflammation and immune hypersensitivity reaction in patients with Behcet disease that is provoked by the cataract trauma. Our study shows that the increasing IL-23 levels after surgery is influenced by initial levels of this

A systematic review of the association between allergic asthma and autism

INTRODUCTION Autism Spectrum Disorder represents a burdensome condition in early childhood, with a number of risk factors proposed to explain its pathogenesis, most of which without a reliable scientific basis. Allergic asthma is likely to be one of the possible comorbilities of autism. EVIDENCE ACQUISITION In this paper, the relationship between autism and allergic asthma was analyzed through a systematic literature review, conducted according to the PRISMA Guidelines. The review was performed on PubMed and Science Direct database and covered the period January 1, 2004-July 9, 2016. The search was limited to articles published in peer-reviewed journals. The obtained results were sorted by relevance and the most significant case-control, epidemiological and nationwide-based works associating autism and allergic asthma in humans were selected. EVIDENCE SYNTHESIS A slight correlation between these conditions has been found in more than a half studies selected, suggesting a possible association between the two diseases. Small sample sizes of some works and some methodological limitations rise uncertainty about this link. CONCLUSIONS Autism Spectrum Disorder and asthma could be associated conditions, as evidenced by the higher prevalence of asthma in autistic children with respect to typically developed controls, with also a verisimilar biological basis. Despite that, future studies are required to provide more reliable data, also by employing animal models, to better clarify this, still unsure, relationship. Methods for study selection and inclusion criteria were specified in advance and documented in PROSPERO protocol #CRD42014012851.