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Carobbio degli Angeli, Italy

Iaccarino L.,University of Padua | Ghirardello A.,University of Padua | Zen M.,University of Padua | Villalta D.,Hospital S. Maria Degli Angeli | And 3 more authors.
Reumatismo | Year: 2012

This study evaluated some cytokines involved in the Th1-Th2 shift during pregnancy in patients with systemic lupus erythematosus (SLE) and healthy women. Twenty-seven consecutive successful pregnancies in 26 SLE patients and 28 pregnancies in 28 matched healthy subjects, as controls, were enrolled and prospectively studied. Sera obtained at first and third trimesters of pregnancy were tested for IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12p70, INF-γ, and TNF-α with a highly sensitive, multiplexed sandwich ELISA (SearchLight Human Inflammatory Cytokine Array). Statistics were performed by SPSS package. IL-8 serum levels were higher in the first (P<0.0001) and third (P=0.003) trimesters of pregnancy in SLE patients compared with controls, INF-γ serum levels in the third trimester (P=0.009), and IL-10 serum levels in the first and third trimesters (P=0.055 and P<0.0001, respectively). IL-2 (r=0.524 P=0.010), IL-12 (r=0.549 P=0.007), IFN-γ (r=0.492 P=0.017), and IL-6 (r=0.515 P=0.020) serum levels correlated with disease activity in SLE patients in the first trimester of pregnancy. Cytokine profile was similar in patients with and without lupus nephritis both in the first and in the third trimesters of pregnancy. IL-8 serum levels were lower in patients with a previous diagnosis of antiphospholipid antibody syndrome compared with those without, both in the first and in the third trimesters of pregnancy. In SLE patients, a lower than expected decrease in Th1 cytokine serum levels was observed in the third trimester of gestation which could contribute to a lower Th2 cytokine polarization during pregnancy. Source


Doria A.,University of Padua | Cutolo M.,University of Genoa | Ghirardello A.,University of Padua | Zen M.,University of Padua | And 5 more authors.
Arthritis Research and Therapy | Year: 2012

Introduction: The aim of this study was to evaluate an extensive panel of cytokines involved in immune regulation during pregnancy in patients with systemic lupus erythematosus (SLE) and in healthy women.Methods: A total of 47 consecutive successful pregnancies in 46 SLE patients and 56 pregnancies in 56 matched healthy subjects, as controls, were prospectively studied. Serum interleukin (IL)-1-α, IL-1-β, IL-2, IL-6, IL-8, IL-10, IL-12p70, interferon (INF)-γ and tumor necrosis factor (TNF)-α were detected in sera obtained at the first and third trimester of pregnancy by a highly sensitive, multiplexed sandwich ELISA.Results: Medians (pg/ml) of serum levels of most helper T (Th)1-type cytokines were significantly lower in the third trimester compared with those observed in the first trimester of pregnancy in healthy women: INF-γ 2.0 vs 3.4, TNF-α 10.2 vs 11.5, IL-1-α 0.9 vs 1.1, IL-1-β 0.6 vs 1.0, IL-2 3.0 vs 3.5, and IL-12p70 4.9 vs 5.6 (P-values < 0.02 for all). By contrast, only the IL-1-α serum levels were lower in the third trimester compared with the first trimester in SLE patients (P = 0.006). IFN-γ/IL-6 and IFN-γ/IL-10 ratios were higher in controls than in SLE (P = 0.002, and P = 0.001, respectively); moreover, they were significantly reduced in the third compared to the first trimester of pregnancy in healthy women, but not in SLE.Conclusions: In SLE patients, Th1/Th2 cytokine serum level ratio does not decrease during pregnancy progression as much as in healthy pregnant women. This could account for the observation of a low frequency of disease flares in the third trimester of gestation. © 2012 Doria et al.; licensee BioMed Central Ltd. Source


Ghirardello A.,University of Padua | Villalta D.,Hospital S. Maria Degli Angeli | Morozzi G.,University of Siena | Afeltra A.,Biomedical University of Rome | And 13 more authors.
Clinical and Experimental Rheumatology | Year: 2011

Objective: An Italian multicentre study was promoted in order to assess the accuracy of four anti-double-stranded DNA (dsDNA) antibody assays for SLE diagnosis and monitoring. Methods: Two hundred and twenty-three patients with established SLE according to ACR classification criteria were enrolled from 9 centres. They included 59 patients at first evaluation (disease duration <12 months) and 164 with longer disease duration (median disease duration 120 months). The sera from 55 healthy subjects and 161 patients with rheumatic, infectious or neoplastic diseases were tested as controls. SLE activity was measured by ECLAM score. Anti-dsDNA antibodies were detected in serum by means of FarrzymeTM assay, fluoroenzymeimmunoassay (EliATM), Crithidia luciliae indirect immunofluorescence (CLIFT) or Farr radioimmunoassay (Farr). Cut-off values of quantitative assays were chosen by ROC curves analysis. Statistics were conducted by SPSS software package. Results: Sensitivity for SLE diagnosis ranged between 66% with Farrzyme to 95% with Farr, with about 90% specificity for all the methods tested. Farrzyme assay was more specific than the others towards patients with non-SLE connective tissue disease. The four methods were moderately concordant and correlated among them, all showing a positive association with active disease, renal or haematologic involvement, and a negative association with central nervous system disease. Whatever the assay used, anti-dsDNA antibody levels correlated with disease activity with r correlation coefficients ranging from 0.336 to 0.425 (p<0.0001). Conclusion: The diagnostic accuracy for SLE of evaluated anti-dsDNA antibody assays is comparable and potentially improvable especially in terms of specificity. The clinical adherence of the assays confirms the value of anti-dsDNA antibody for SLE monitoring. © Clinical and Experimental Rheumatology 2011. Source


Carrubba S.L.,Cervello | Todaro M.,Messina University | Zito C.,Messina University | Antonini-Canterin F.,Hospital S. Maria Degli Angeli | And 9 more authors.
Journal of Cardiovascular Echography | Year: 2013

Context: Metabolic syndrome (MS) is a cluster of interrelated common clinical disorders, including obesity, insulin resistance, glucose intolerance, hypertension and dyslipidemia, associated with a greater risk of atherosclerotic cardiovascular disease than any of its individual components. Although MS is associated with increased cardiovascular risk (CVR), its relationship with heart failure (HF) and left ventricular (LV) dysfunction is not fully understood. Aims: We sought to determine whether MS is associated to LV systolic and diastolic dysfunction in a sample of patients with MS and no symptoms for HF. Subjects and Methods: We enrolled 6422 consecutive asymptomatic patients admitted to echo-lab for a routine echocardiogram. We calculated LV systolic and diastolic function, by Simpson biplane method and validated Doppler parameters, respectively. MS was diagnosed if three or more CVR factors were found. Results: LV systolic function was evaluated in 6175 patients (96.2%). In the group of patients without MS (n = 5630), the prevalence of systolic dysfunction was 10.8% (n = 607) while in the group of patients with MS (n = 545) it was 12.5% (n = 87), (RR1.57; CI 95% 1.2-2.0; P < 0.001). Diastolic function was evaluated in 3936 patients (61.3%). In the group of patients without MS (n = 3566) the prevalence of diastolic dysfunction was 33.3% (n = 1187), while in patients with MS (n = 370) it was 45.7% (n = 169), (RR1.68; CI95% 1.3-2.0; P < 0.001). After adjustment for age and gender, MS proved to be an independent predictor of LV systolic and diastolic dysfunction. Conclusions: Our data show that asymptomatic LV systolic and diastolic dysfunction, is correlated with MS and demonstrate that echocardiography is a useful tool to detect patients at high risk for HF. Echocardiography in asymptomatic patients with MS may lead to a therapy initiation at early stages to prevent future cardiovascular events and HF. Source

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