Publications by authors named "Caccavale R"

Objective: A pathogenetic role of CD8+ T lymphocytes in radiographic axial spondyloarthritis (r-axSpA) and other spondyloarthritis (SpA) is sustained by genome-wide association studies (GWAS) and by the expansion of public T cell clonotypes in the target tissues. This study investigates the migration of CD8+ T cells, along with their phenotype and functions in patients with r-axSpA and psoriatic arthritis (PsA).

Methods: Peripheral blood CD8+ and CD4+ T cells were isolated from r-axSpA (n= 128), PsA (n= 60) and rheumatoid arthritis (RA, n= 74) patients and healthy donors (HD, n= 79).

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The treatment landscape for Rheumatoid Arthritis (RA) has evolved significantly with the introduction of Janus kinase inhibitors (JAKi), such as Tofacitinib (TOFA), which offer a new therapeutic option for patients who have failed or are intolerant to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Safety concerns, particularly related to cardiovascular and cancer risks, prompted a need for additional investigation in real-world clinical settings. This study aimed to evaluate the long-term effectiveness and predictors of response to TOFA in two subpopulations of RA patients, categorized by differing cardiovascular risk profiles.

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Background: Upadacitinib (UPA) is a selective, reversible Janus kinase inhibitor (JAKi) approved for the treatment of RA. However, there is still no solid evidence on the long-term efficacy of UPA in treated patients. The purpose of this study was to determine the efficacy of UPA to obtain remission or low disease activity (LDA) in a series of UPA patients in patients with RA after 6 and 12 months of treatment in a real-world setting.

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Article Synopsis
  • The Janus kinase inhibitors (JAKi) like tofacitinib, baricitinib, upadacitinib, and filgotinib are effective in treating rheumatoid arthritis but faced safety concerns from the FDA and EMA, particularly about serious adverse events (SAEs) such as thrombosis and cancer.
  • The study aimed to analyze the impact of the EMA's first two safety warnings on how rheumatologists in Italy prescribed JAKi from July 2019 to June 2022, using data from 29 rheumatology centers.
  • Results showed a significant reduction (32%) in JAKi prescriptions after the first warning, with a smaller decrease (16%) observed after the second warning, although there
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Fibromyalgia (FM) is a chronic disease characterized by widespread musculoskeletal pain of unknown etiology. The condition is commonly associated with other symptoms, including fatigue, sleep disturbances, cognitive impairment, and depression. For this reason, FM is also referred to as FM syndrome.

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Giant cell arteritis (GCA) is a noninfectious granulomatous vasculitis of unknown etiology affecting individuals older than 50 years. Two forms of GCA have been identified: a cranial form involving the medium-caliber temporal artery causing temporal arteritis (TA) and an extracranial form involving the large vessels, mainly the thoracic aorta and its branches. GCA generally affects individuals with a genetic predisposition, but several epigenetic (micro)environmental factors are often critical for the onset of this vasculitis.

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Article Synopsis
  • The study compared the safety and effectiveness of etanercept and adalimumab biosimilars (SB4 and ABP501) with their original versions among patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis in Italy from 2017 to 2020.
  • Out of 891 patients, safety profiles were similar; however, biosimilars had higher discontinuation rates due to ineffectiveness, with retention rates at 24 months being 76.5% for biosimilars compared to 81.1% for originators.
  • The findings suggest biosimilars are a viable, safe, and more affordable treatment option, offering
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The human leukocyte antigen (HLA)-B*27 family of alleles is strongly associated with ankylosing spondylitis (AS), a chronic inflammatory disorder affecting the axial and peripheral joints, yet some HLA-B*27 variants not associated with AS have been shown. Since no major differences in the ligandome of associated compared to not-associated alleles have emerged, a plausible hypothesis is that the quantity rather than the quality of the presented epitopes makes the difference. In addition, the Endoplasmic Reticulum AminoPeptidases (ERAPs) 1 and 2, playing a crucial role in shaping the HLA class I epitopes, act as strong AS susceptibility factors, suggesting that an altered peptidome might be responsible for the activation of pathogenic CD8+ T cells.

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: Tofacitinib (TOFA) was the first Janus kinase inhibitor (JAKi) to be approved for the treatment of rheumatoid arthritis (RA). However, data on the retention rate of TOFA therapy are still far from definitive. : The goal of this study is to add new real-world data on the TOFA retention rate in a cohort of RA patients followed for a long period of time.

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Introduction: Enthesitis and dactylitis are difficult-to-treat features of psoriatic arthritis (PsA), leading to disability and affecting quality of life.

Objective: The aim of this study is to evaluate enthesitis (using the Leed enthesitis index (LEI)) and dactylitis at 6 and 12 months in patients treated with apremilast.

Methods: Patients affected by PsA from fifteen Italian rheumatological referral centers were screened.

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Sanitizing railway stations is a relevant issue, primarily due to the recent evolution of the Covid-19 pandemic. In this work, we propose a multi-robot approach to sanitize railway stations based on a distributed Deep Q-Learning technique. The proposed framework relies on anonymous data from existing WiFi networks to dynamically estimate crowded areas within the station and to develop a heatmap of prioritized areas to be sanitized.

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Article Synopsis
  • Systemic lupus erythematosus (SLE) is a serious autoimmune disease that predominantly affects women and can cause damage to multiple organs, sometimes leading to life-threatening conditions.
  • The disease is distinguished by the presence of autoantibodies that form immune complexes, leading to inflammation and organ damage, and its pathogenesis involves both innate and adaptive immune responses.
  • Recent advancements have led to the development of targeted therapies that aim for personalized treatment, but these new drugs are currently meant to complement traditional, often toxic therapies while researchers continue to explore future treatment possibilities that could potentially cure SLE.
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  • * Data was collected from 15 Italian rheumatology centers, tracking patients' disease activity at the start, after 6 months, and after 12 months of treatment.
  • * Results showed that around 42.7% of patients reached low disease activity or remission at 6 months, increasing to 54.9% by 12 months, with baseline DAPSA scores being the only factor significantly linked to achieving these outcomes.
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Axial spondyloarthritis (axSpA) is a chronic inflammatory disease involving the spine, peripheral joints, and entheses. This condition causes stiffness, pain, and significant limitation of movement. In recent years, several effective therapies have become available based on the use of biologics that selectively block cytokines involved in the pathogenesis of the disease, such as tumor necrosis factor-α (TNFα), interleukin (IL)-17, and IL-23.

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T-helper 17 (Th17) cells represent a subpopulation of CD4+ T lymphocytes that play an essential role in defense against pathogens. Th17 cells are distinguished from Th1 and Th2 cells by their ability to produce members of the interleukin-17 (IL-17) family, namely IL-17A and IL-17F. IL-17 in turn induces several target cells to synthesize and release cytokines, chemokines, and metalloproteinases, thereby amplifying the inflammatory cascade.

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: Interleukin-17 (IL-17) is a cytokine family consisting of six members and five specific receptors. IL-17A was the first member to be identified in 1993. Since then, several studies have elucidated that IL-17 has predominantly pro-inflammatory activity and that its production is involved in both the defense against pathogens and the genesis of autoimmune processes.

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Background: Most of the recent literature regarding rotator cuff tear etiology identifies in peripheral microcirculation disorders the probable main cause of tissue degeneration, and consequently of tendon rupture. Nailfold capillaroscopy is a practical and inexpensive diagnostic technique used to evaluate the health status of peripheral microcirculation, and recently, its use has found other indications in addition to that of diagnosing connective tissue diseases and Raynaud phenomenon. We verified the possible indirect contribution of nailfold capillaroscopy in the identification of peripheral microcirculation disturbances in a group of patients with rotator cuff tear and whether these possible alterations could be related to rotator cuff tear size.

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Background: Tubulointerstitial nephritis and uveitis syndrome (TINU) is a rare disorder typically characterized by sudden-onset non-granulomatous anterior uveitis associated with tubulointerstitial nephritis (TIN). However, the prevalence and clinical features of TINU are still a matter of debate. To add information about TINU, we describe here the clinical features of a series of patients affected by TINU in a retrospective study.

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Objective: There are few real-world setting studies focused on apremilast effectiveness (i.e., retention rate) in psoriatic arthritis (PsA).

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Article Synopsis
  • - Juvenile idiopathic arthritis (JIA) is a common condition in children that can lead to uveitis, an eye inflammation that often goes unnoticed until it's advanced, causing serious vision issues.
  • - Initial treatment usually involves topical steroids; however, more severe cases may need stronger therapies like systemic corticosteroids, which can have long-term side effects such as growth issues and eye complications.
  • - The review discusses different immunosuppressive treatments, including anti-TNF biologics and newer options targeting CTLA-4 and IL-6R, along with the potential of JAK inhibitors for patients who don't respond to standard treatments.
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Article Synopsis
  • - The study investigates the clinical outcomes of patients with autoimmune arthritis receiving either the original adalimumab or its biosimilar, ABP 501, and analyzes data from treatments provided between January 2003 and December 2020.
  • - A total of 1,046 patients were categorized into three groups: those naive to the original adalimumab (oADA), those naive to ABP 501 (bADA), and those who switched from oADA to ABP 501 (sADA).
  • - The 18-month retention rates for the three groups were similar, with slight variations: 81.5% for oADA, 84.0% for bADA, and 88.0
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We evaluated the 3-year drug survival and efficacy of the biosimilar SB4/Benepali in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients, previously treated with etanercept (ETA). Drug survival rate was calculated using the Kaplan-Meier method and Cox proportional hazard models were developed to examine predictors of SB4 discontinuation. 236 patients (120 RA, 80 PsA and 36 AS), aged 60.

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In social and service robotics, complex collaborative tasks are expected to be executed while interacting with humans in a natural and fluent manner. In this scenario, the robotic system is typically provided with structured tasks to be accomplished, but must also continuously adapt to human activities, commands, and interventions. We propose to tackle these issues by exploiting the concept of cognitive control, introduced in cognitive psychology and neuroscience to describe the executive mechanisms needed to support adaptive responses and complex goal-directed behaviors.

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Background: Secukinumab (SEC) is effective for ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomized trials, but real-life data are lacking.

Research Design And Methods: Real-life, prospective observational study on 169 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 130 PsA, 77%).

Results: Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes like VAS-pain.

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Here, we developed an unbiased, functional target-discovery platform to identify immunogenic proteins from primary non-small cell lung cancer (NSCLC) cells that had been induced to apoptosis by cisplatin (CDDP) treatment in vitro, as compared with their live counterparts. Among the multitude of proteins identified, some of them were represented as fragmented proteins in apoptotic tumor cells, and acted as non-mutated neoantigens (NM-neoAgs). Indeed, only the fragmented proteins elicited effective multi-specific CD4 and CD8 T cell responses, upon a chemotherapy protocol including CDDP.

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