Laboratory of Clinical Pathology

Siracusa, Italy

Laboratory of Clinical Pathology

Siracusa, Italy
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Bizzaro N.,S Antonio Hospital | Bizzaro N.,Laboratory of Clinical Pathology | Tozzoli R.,Civic Hospital | Villalta D.,S Maria Degli Angeli Hospital | And 2 more authors.
Clinical Reviews in Allergy and Immunology | Year: 2012

Celiac disease (CD) is a gluten-dependent immune-mediated disease with a prevalence in the general population estimated between 0.3% and 1.2%. Large-scale epidemiological studies have shown that only 10-20% of cases of CD are identified on the basis of clinical findings and that laboratory tests are crucial to identify subjects with subtle or atypical symptoms. The correct choice and clinical use of these diagnostic tools may enable accurate diagnosis and early recognition of silent CD cases. In this review, we have considered some relevant aspects related to the laboratory diagnosis of CD and, more extensively, of gluten intolerance, such as the best combination of tests for early and accurate diagnosis, the diagnostic role of new tests for detecting antibodies against neoepitopes produced by the transglutaminase-gliadin complex, the forms of non-celiac gluten intolerance (gluten sensitivity), and the use and significance of measuring cytokines in CD. © Springer Science+Business Media, LLC 2010.


Ram M.,Zabludowicz Center for Autoimmune Disease | Barzilai O.,Zabludowicz Center for Autoimmune Disease | Shapira Y.,Zabludowicz Center for Autoimmune Disease | Anaya J.-M.,University of Medellín | And 8 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2013

Background: The pathogenesis of autoimmunity is presumed to be a complex process including genetic predisposition, hormonal balance and environmental factors such as infectious agents . Helicobacter pylori , a common bacterial infectious agent has been associated with a variety of autoimmune disorders. However, this bacteria is also thought to play a protective role in the development of multiple sclerosis (MS), systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD). We tested various links between anti- H. pylori (anti-HP) antibodies and a wide profile of autoimmune diseases and autoantibodies. Methods: A total of 1290 patients diagnosed with 14 different autoimmune diseases from two geographical areas (Europe and Latin America) and two groups of healthy matching controls (n = 385) were screened for the presence of H. pylori IgG antibodies by " pylori detect " kit. In parallel, a large profile belonging to three groups of autoantibodies was tested in all sera (anti-nuclear antibodies, autoantibodies associated with thrombophilia and gastrointestinal diseases). Results: Our data demonstrate associations between anti-HP antibodies and anti-phospholipid syndrome, giant cell arteritis, systemic sclerosis and primary biliary cirrhosis. Our data also support a previously known negative association between the prevalence of anti-HP antibodies and IBD. Additionally, links were made between seropositivity to H. pylori and the presence of anti-nuclear antibodies, dsDNA, anti-Ro and some thrombophiliaassociated antibodies, as well as negative associations with gastrointestinal-associated antibodies. Conclusions: Whether these links are epiphenomenal or H. pylori does play a causative role in the autoimmune diseases remains uncertain. The negative associations could possibly support the notion that in susceptible individuals infections may protect from the development of autoimmune diseases.


de Sales Santos I.M.,Federal University of Piauí | da Rocha Tome A.,State University of Ceará | Feitosa C.M.,Federal University of Piauí | de Souza G.F.,Laboratory of Clinical Pathology | And 3 more authors.
Pharmacology Biochemistry and Behavior | Year: 2010

In the present study we investigated the effects of lipoic acid (LA) on δ-aminolevulinic dehydratase (δ-ALA-D) and Na+, K+-ATPase activities in rat brain after seizures induction by pilocarpine. Wistar rats were treated with 0.9% saline (i.p., control group), lipoic acid (10mg/kg, i.p., LA group), pilocarpine (400mg/kg, i.p., pilocarpine group), or the combination of LA (10mg/kg, i.p.) with pilocarpine (400mg/kg, i.p.), 30min before administration of LA (LA plus pilocarpine group). After the treatments all groups were observed for 1h. The enzyme activities (δ-ALA-D and Na+, K+-ATPase) were measured using spectrophotometric methods, and the results were compared with that obtained from saline and pilocarpine-treated animals. Neuroprotective effects of LA against seizures were evaluated based on those enzyme activities. The pilocarpine group showed a reduction in δ-ALA-D and Na+, K+-ATPase activities after seizures. In turn, LA plus pilocarpine abolished the appearance of seizures and reversed the decreased in δ-ALA-D and Na+, K+-ATPase activities produced by seizures, when compared to the pilocarpine seizing group. The results from the present study demonstrate that preadministration of LA abolished seizure episodes induced by pilocarpine in rat, probably by increasing δ-ALA-D and Na+, K+-ATPase activities in rat brain during seizures. © 2009 Elsevier Inc.


Tozzoli R.,Beata Vergine delle Grazie Hospital | Kodermaz G.,Beata Vergine delle Grazie Hospital | Perosa A.R.,Beata Vergine delle Grazie Hospital | Tampoia M.,University of Bari | And 3 more authors.
Autoimmunity Reviews | Year: 2010

Autoimmune thyroid diseases (AITD) can be associated with autoimmune gastritis (AIG), but the frequency of this association is poorly characterized. We performed a prospective study to: a) characterize the frequency of parietal cell (PCA) and intrinsic factor (IFA) autoantibodies in AITD patients; b) evaluate the development of histologically- and functionally-proven AIG after five years and to assess the predictive role of PCA for AIG at baseline; and c) analyze the trend of PCA levels in the course of the disease. We studied 208 consecutive adult patients affected by AITD (166 Hashimoto's thyroiditis, 42 Graves' disease). PCA, IFA and plasma gastrin levels were measured with ELISA methods at baseline and after 5. years. At baseline, 51/208 (24.5%) AITD patients were positive for PCA and 10/208 (4.8%) for IFA. 25 out of 54 PCA/IFA-positive AITD patients (all without gastric or haematologic symptoms) agreed to participate in the follow-up study. After 5. years, 6 (24%) of these 25 patients showed a histologically proven AIG, with lymphocytic infiltration and/or atrophy of body gastric mucosa. The trend analysis of PCA concentration showed that autoantibody levels rise progressively over time, reach a peak level and then fall, according to the progressive destruction of gastric mucosa and to the disappearance of the target autoantigen (proton pump). The presence of PCA predicts the development of autoimmune gastritis in AITD patients. Antibody levels measured with a sensitive quantitative immunometric method are useful for early diagnosis and early treatment of the disease. © 2010 Elsevier B.V.


De Freitas R.M.,Federal University of Piauí | De Oliveira Silva F.,Federal University of Ceará | Saldanha G.B.,Laboratory of Clinical Pathology | Jordan J.,University of Castilla - La Mancha
Fundamental and Clinical Pharmacology | Year: 2011

This study was aimed at investigating the anticonvulsant activity of lipoic acid (LA) against pilocarpine-induced seizures as well as the effects of this metabolic antioxidant on the hippocampal extracellular concentrations of amino acid neurotransmitters glutamate, aspartate, glycine and glutamate and γ-aminobutyric acid (GABA). In vivo microdialysis demonstrated that an intraperitoneal administration of pilocarpine induced a pronounced increment of hippocampal glutamate and aspartate concentrations, whereas no significant change was observed in the levels of glycine or GABA. LA (10, 20 or 30mg/kg) pretreatment completely blocked pilocarpine-evoked increases in extracellular glutamate and aspartate concentrations. Significant reductions in hippocampal GABA and glycine concentrations were also observed although not as pronounced as those shown by glutamate and aspartate. Based on the finding that LA protected rats against pilocarpine-induced seizures, it could be suggested that the reduction in inhibitory amino acid neurotransmitters levels was comparatively minor and offset by a more pronounced reduction in glutamate and aspartate extracellular concentrations. Therefore, the fact that LA could drastically reduce pilocarpine-induced increases in glutamate and aspartate should account, at least partly, for its anticonvulsant activity observed in pilocarpine-induced seizure in rats. © 2010 The Authors Fundamental and Clinical Pharmacology © 2010 Société Française de Pharmacologie et de Thérapeutique.


Tozzoli R.,Laboratory of Clinical Pathology | Bizzaro N.,S Antonio Hospital
Autoimmunity Reviews | Year: 2012

The objective of this review is to analyze the causes of the increasing interest of laboratory medicine in the definition and characterization of a new sub-discipline, laboratory autoimmunology, concerning the development and the clinical use of tests for measuring circulating autoantibodies and the study of autoimmune serological reactions. The laboratory autoimmunologist's task includes knowledge of the range of technical solutions available to identify the different types of autoantibodies and provide laboratory consult for improving utilization of laboratory results. Along with the figure of the laboratory autoimmunologist, the position of clinical autoimmunologist not only has been proposed but has already found its first concrete applications. This is a specialist with a wide knowledge of those symptoms and diagnostic procedures necessary to identify autoimmune diseases, and who is familiar with the range of therapies available to treat various diseases. Cooperation between the two autoimmunology specialists will lead to a more up-to-date and efficient management of autoimmune patients. © 2012 Elsevier B.V..


Moretti M.,Laboratory of Clinical Pathology | Sisti D.,Urbino University | Rocchi M.B.,Urbino University | Delprete E.,Laboratory of Clinical Pathology
Clinica Chimica Acta | Year: 2011

Background: Clinical Laboratory and Standards Institute (CLSI) published EP17-A guideline, recommending new definitions for low end performances: Limit of Blank (LoB), Limit of Detection (LoD) and Limit of Quantitation (LoQ). The aim of this study was to determine LoB, LoD and LoQ by applying EP17-A to Hybritech and World Health Organization (WHO) calibrated Access Total PSA assays, and verify the correlation between results generated by the same reagent with both calibrations, particularly at low end concentrations. Methods: According to EP17-A, serum pools of anonymous routine patient samples residuals were analyzed on a UniCelDxI800 with the chemiluminescent Access®Hybritech®TotalPSA assay. Results: LoB: 0.0046μg/L Hybritech, 0.005μg/L WHO calibration; LoD: 0.014μg/L Hybritech, 0.015μg/L WHO; LoQ at 20% coefficient of variation (CV%) 0.0414μg/L Hybritech, 0.034μg/L WHO. Regression Hybritech y=0.2398×+4.2017 (R 2=0.9515); WHO y=0.2248×+3.4335 (R 2=0.9596) with no statistical difference. Comparison between Hybritech and WHO at low PSA levels indicated an excellent Pearson's and intraclass correlation (r=0.999, p<0.001; ICC=0.974, p<0.001). Conclusions: Our results show that the Access Total PSA assay is suitable for prostate cancer recurrence and PSA velocity evaluation; Hybritech and WHO calibrated values can both be used for clinical purposes even at low levels. © 2011 Elsevier B.V.


Colombo C.,Cystic Fibrosis Center | Faelli N.,Cystic Fibrosis Center | Tirelli A.S.,Laboratory of Clinical Pathology | Fortunato F.,University of Foggia | And 6 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2011

Cystic Fibrosis (CF) lung disease is characterized by high levels of cytokines and chemokines in the airways, producing chronic inflammation. Non-invasive biomarkers, which are also specific for the inflammatory and immune responses, are urgently needed to identify exacerbations and evaluate therapeutic efficacy. The aim of this study is to evaluate the association of sputum and exhaled breath condensate (EBC) biomarker changes with clinical exacerbation and response to therapy. We studied the simultaneous presence and concentration of twelve cytokines and growth factors (EGF, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IFN-γ, MCP-1, TNF-α and VEGF) by a multi-parametric biochip array in sputum and EBC of 24 CF patients before, after 6 and 15 days of therapy, and 15 days after the end of treatment for an acute exacerbation. Correlations with functional respiratory tests (FEV1, FVC) and the systemic marker C-reactive protein (CRP) were looked for. In sputum, before therapy, VEGF and IL-1β levels positively correlated with the respiratory function and CRP. Sputum IL-1α, IL-1β IL-4, IL-10, TNF-α, and VEGF significantly decreased, while EGF increased, during therapy. IL-8 and IL-4 levels negatively correlated with the respiratory function at 15 and 30 days from the start of therapy, respectively. IL-4, IL-6, IL-10 and TNF-α positively correlated with CRP during therapy. Although some EBC biomarkers correlated with respiratory function and CRP, no significant associations with these clinical parameters were found. Sputum IL-1β and VEGF might be considered biomarkers of an acute exacerbation in CF patients. A panel of sputum cytokines and growth factors may better describe the response to intravenous antibiotic treatment of CF than one single systemic marker. Copyright © by BIOLIFE, s.a.s.


Giani M.,Pediatric Nephrology and Dialysis Unit | Mastrangelo A.,Pediatric Nephrology and Dialysis Unit | Villa R.,Pediatric Nephrology and Dialysis Unit | Turolo S.,Laboratory of Clinical Pathology | And 4 more authors.
Pediatric Nephrology | Year: 2013

Background: Alport syndrome (AS) is a progressive hereditary glomerular disease. Recent data indicate that aldosterone promotes fibrosis mediated by the transforming growth factor-β1 (TGF-β1) pathway, which may worsen proteinuria. Spironolactone (SP) antagonizes aldosterone and this study aimed to evaluate the efficacy of SP in reducing proteinuria and urinary TGF-β1 excretion in proteinuric AS patients. Methods: The study involved ten children with AS, normal renal function, and persistent proteinuria (>6 months; uPr/uCr ratio >1). SP 25 mg once a day for 6 months was added to existing ACE inhibitor treatment with or without angiotensin-II receptor blockade. Urine and blood samples were examined monthly. Urinary TGF-β1 levels were measured twice before and three times during SP treatment. Plasma renin activity (PRA) and serum aldosterone levels were also measured. In eight patients, uProt/uCreat was also assessed after 9 months and 12 months of SP treatment. Results: After beginning SP therapy, all patients showed significant decrease in mean uProt/uCreat ratio (1.77 ± 0.8 to 0.86 ± 0.6; p < 0.001) and mean urinary TGF-β1 levels (104 ± 54 to 41 ± 20 pg/mgCreatinine; p < 0.01), beginning after 30 days of treatment and remaining stable throughout SP administration. PRA remain unchanged, and mean serum aldosterone increased from 105 ± 72 pg/ml to 303 ± 156 pg/ml (p < 0.001). The only side effect was gynecomastia in an obese boy. After 1 year of therapy, mean uProt/uCreat remains low (0.82 ± 0.48). Conclusions: Addition of SP to ACE-I treatment with or without angiotensin II receptor blokers (ARB) significantly reduced proteinuria. This was mediated by decreased urinary TGF-β1 levels and not associated with major side effects. © 2013 IPNA.


Roscia G.,University of Siena | Falciani C.,University of Siena | Bracci L.,University of Siena | Bracci L.,Laboratory of Clinical Pathology | And 2 more authors.
Current Protein and Peptide Science | Year: 2013

The increasing frequency of multidrug-resistant bacteria and a recent slowing in the development of new antimicrobial agents place mankind in a state of emergency with regard to the threat of new bacterial infections. Antibacterial peptides (AMPs) are considered an important class of molecules to develop against bacteria. AMPs have been known for many years but very few have yet been extensively used in clinical practice, mainly because of their general toxicity and manufacturing cost. Now, thanks to new technologies for screening and development, interest in these molecules has grown. Many new AMPs have been discovered and some are under evaluation for the development of new antibacterial therapeutics. Here we review the major AMPs currently used in clinical practice and others in the phase of preclinical and clinical development. © 2013 Bentham Science Publishers.

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