Publications by authors named "Elisabetta Bertoni"
Risk and Protective Factors for Gastrointestinal Symptoms associated with Antibiotic Treatment in Children: A Population Study.
Pediatr Gastroenterol Hepatol Nutr
January 2020
Article Synopsis
- The study aimed to understand the incidence and risk factors related to gastrointestinal symptoms, specifically antibiotic-associated diarrhea (AAD), in children undergoing antibiotic treatment.
- Of the 289 children studied, AAD occurred in 20.4% of cases, particularly affecting those under 3 years old and with certain infections or previous episodes of AAD.
- Probiotic supplementation was found to significantly decrease the occurrence of AAD and abdominal pain among the participants.
Article Synopsis
- The study focused on evaluating the effectiveness of the cow's milk-related symptom score (CoMiSS) in diagnosing cow's milk allergy (CMA) in infants, particularly when dealing with non-IgE-mediated symptoms.
- Researchers enrolled 47 infants with gastrointestinal issues who were put on a cow's milk-free diet (CMFD) and measured their CoMiSS scores compared to 94 healthy controls.
- Results indicated that a higher CoMiSS score was associated with a better response to the CMFD, with a cut-off score of 9 demonstrating 84% sensitivity and 85% specificity for identifying infants who could benefit from dietary changes.
Article Synopsis
- The VALIGA study analyzed the use of the Oxford Classification for immunoglobulin A nephropathy (IgAN) in 1147 patients across 13 European countries, focusing on biopsy scoring and its impact on treatment decisions.
- The findings revealed that local pathologists tended to report more lesions than central pathologists, and variability in scoring was noted, particularly for mesangial hypercellularity and endocapillary hypercellularity.
- Ultimately, the study highlighted discrepancies in pathology assessments affecting treatment choices and clinical outcomes, suggesting that central reviews could offer more reliable evaluations for certain lesions.
Complement related kidney diseases: Recurrence after transplantation.
World J Transplant
December 2016
Article Synopsis
- The recurrence of renal diseases like atypical hemolytic uremic syndrome (HUS) and C3 glomerulopathy is a major cause of kidney graft loss after transplantation due to genetic or autoimmune factors affecting the complement system, making them difficult to manage post-surgery.
- Early diagnosis is crucial for the successful treatment of recurring diseases in transplant patients, who should be cautiously evaluated for transplantation due to the genetic risks involved, particularly in living donor situations.
- Complement inhibitors, especially eculizumab, show promise for preventing and treating recurrence, but their long-term effectiveness and optimal dosing remain uncertain, with some patients resistant to this treatment and others undergoing trials for alternative therapies.
Article Synopsis
- - Ischemia/reperfusion injury occurs after kidney transplantation and significantly affects both short-term and long-term outcomes for the graft, leading to problems like delayed graft function and chronic dysfunction.
- - This injury triggers an inflammatory response influenced by cellular changes, energy metabolism issues, and various forms of cell death, including apoptosis, necrosis, and a newer form called necroptosis.
- - Understanding the mechanisms behind ischemia/reperfusion injury is crucial for developing strategies to prevent or treat it, ultimately improving kidney transplant success rates.
Article Synopsis
- - The text discusses the role of the complement cascade in various renal diseases and its significance in renal transplantation, highlighting a shift towards understanding these conditions through their underlying mechanisms rather than just their symptoms.
- - It categorizes renal issues into those caused by complement over-activation and dysregulation, affecting disease progression and outcomes in transplantation.
- - The authors identify potential therapeutic targets within the complement cascade, noting that while only the anti-C5 monoclonal antibody is currently available, ongoing research is exploring other components for future treatments.
Article Synopsis
- * Key topics include donor activity, immunosuppressive therapies, tolerance, and complications like infections and cancers following transplantation.
- * The study highlights trends in organ transplantation numbers and survival rates, and examines challenges such as organ preservation, ischemia-reperfusion injuries, and antibody-mediated rejection, as well as new and existing drugs in clinical trials.
Article Synopsis
- Allo-antibodies, especially donor-specific ones, significantly contribute to both early and late graft dysfunction in kidney transplants, with specific antibodies against Human Leukocyte Antigens (HLA) being pivotal to renal injury.
- New diagnostic techniques like solid-phase assays and Luminex have improved the detection of these antibodies in patients, while also identifying signs of complement activation in biopsied tissues.
- The understanding of chronic renal injury has shifted from solely blaming calcineurin inhibitors to recognizing the role of alloantibodies, leading to an increased focus on developing new therapeutic approaches to manage antibody-induced damage, though many promising drugs are still in early clinical trials.
Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations.
World J Nephrol
August 2013
Article Synopsis
- * Complement proteins play a significant role in all types of thrombotic microangiopathy, including typical HUS, atypical HUS, and thrombotic thrombocytopenic purpura (TTP), with certain secondary HUS forms linked to complement gene abnormalities.
- * Treatment options for HUS include traditional therapies like plasma therapy and kidney transplants, alongside emerging treatments such as the monoclonal antibody eculizumab, which shows promise for atypical HUS and potentially for typical HUS and TTP
Is it time to give up with calcineurin inhibitors in kidney transplantation?
World J Transplant
June 2013
Article Synopsis
- - Calcineurin inhibitors (CNIs) are essential for immunosuppressive treatment in organ transplants but can lead to serious side effects, especially chronic nephrotoxicity, prompting efforts to reduce their dosage or find alternatives.
- - Research indicates that poor long-term transplant outcomes might be due to CNIs' nephrotoxicity or their failure to effectively manage B-cell mediated rejection.
- - Promising new drugs, like co-stimulation blockers, may replace CNIs, showing similar effectiveness with better kidney function and fewer negative side effects, while also avoiding the development of harmful antibodies.
Article Synopsis
- - The review highlights the increasing number of patients needing kidney retransplants, emphasizing challenges in finding suitable organs mainly due to clinical and immunological issues.
- - Immunological complications, particularly anti-HLA antibodies, make it tough for patients, who often become hyperimmunized, complicating the cross-match process for transplantation.
- - The authors explore various immunosuppressive strategies, new allocation methods like acceptable mismatch and paired kidney exchange programs, and promising emerging drugs aimed at improving desensitization for better transplant outcomes.
Article Synopsis
- - The study investigates how endothelial dysfunction influences cardiovascular complications in renal transplant recipients (RTRs), focusing on the connection between endothelial response and levels of parathyroid hormone (PTH) and progenitor cells. - In a comparison of 120 RTRs with healthy subjects, results indicated that RTRs had a significantly lower endothelial response (measured by reactive hyperemia index) and fewer endothelial progenitor cells (EPCs), alongside higher PTH levels. - The findings suggest that alterations in endothelial function and reduced EPCs, along with increased PTH levels in RTRs, may help assess cardiovascular risk in these patients more effectively.
Article Synopsis
- Cytomegalovirus (CMV) is a significant opportunistic virus in renal transplant recipients, typically infecting them after the first month post-transplant.
- CMV can manifest in different forms: primary infections, reinfections, or reactivations of existing latent infections.
- A case study highlights a rare instance of CMV skin ulcers in the perineal area without systemic symptoms and a negative PCR result, emphasizing the varied presentations of CMV disease in renal transplant patients.
Article Synopsis
- * Results showed that the everolimus group had a significantly lower rate of delayed graft function (DGF) and better one-year graft survival rates, along with lower CsA dosage and higher kidney function (eGFR) at one year.
- * While everolimus patients had some slight disadvantages, such as more proteinuria and slightly lower hemoglobin levels, the overall findings suggest that everolimus therapy could be more beneficial than EC-MPS therapy in terms
Article Synopsis
- * Common treatments include methods like cryotherapy, bleomycin injections, electrocoagulation, and topical agents, though these can lead to pain and potential scarring.
- * A case is presented where a wart on the right index finger was effectively treated using a topical form of activated vitamin D.
Article Synopsis
- * mTOR plays a significant role in various cellular processes, including angiogenesis (formation of new blood vessels), nutrient uptake, and metabolism; when mTOR pathways are deregulated, it can increase cancer risk due to factors like overactive growth signals.
- * Clinical trials have shown that targeting mTOR and its associated pathways not only helps prevent cancer in transplant patients but can also reduce tumor size and progression in those already diagnosed.
Article Synopsis
- Renal transplant recipients (RTRs) have a higher risk of cardiovascular issues, prompting a study to evaluate reticulated platelets (RP), platelet reactivity, and von Willebrand factor (vWF) levels in these patients.
- The study involved 150 RTRs (some on acetylsalicylic acid, ASA, and some not) and 60 healthy controls, measuring RP percentages, platelet function via aggregometry, and vWF levels.
- Findings indicated that RTRs had significantly higher RP and vWF levels compared to controls, with those not on ASA showing greater platelet reactivity, suggesting increased platelet turnover and cardiovascular risk in RTRs.
Article Synopsis
- - The study aimed to assess if higher doses of the drug everolimus (EVL) could allow for a reduced dosage of cyclosporine A (CsA) in kidney transplant patients, potentially lowering the risk of kidney dysfunction.
- - Two groups of new kidney transplant recipients were compared: one received standard EVL levels with lower CsA, and the other received higher EVL levels with very low CsA. The main outcomes measured were kidney function (creatinine clearance) and rates of acute rejection after 6 months.
- - Results showed that while there was better graft survival in the higher EVL group, overall kidney function and rejection rates at 6 and 12 months did not differ significantly between the two
Article Synopsis
- The study focuses on the significance of CXCL9 levels in predicting acute rejection (AR) and outcomes in kidney transplant patients.
- Analyzed data from 252 patients revealed that those with higher CXCL9 levels experienced significantly lower 5-year survival rates (73.3%) compared to lower levels (97.7%).
- The research highlights CXCL9 as a strong indicator of graft loss risk, suggesting that measuring its levels could help tailor immunosuppressive therapies for at-risk patients.
Article Synopsis
- The authors discuss the role of mTOR inhibitors in cancer treatment, highlighting mTOR as a critical kinase regulating cell growth and proliferation through various signals from nutrients and growth factors.
- The mTOR pathway connects to several processes like angiogenesis, nutrient uptake, and protein synthesis, and its dysregulation—common in cancers—leads to increased tumor growth and survival.
- Targeting mTOR and the associated deregulated pathways offers a promising strategy for enhancing anticancer effects, with evidence supporting its efficacy in transplant patients and those recovering from cancer.
Article Synopsis
- The study focuses on the epidemiology, characteristics, and outcomes of patients receiving preemptive kidney transplants from living donors.
- It compares these outcomes to those from deceased donor transplants and living donor transplants after dialysis has started, highlighting the advantages of preemptive transplants.
- Preemptive transplants lead to better results due to fewer dialysis-related issues, resulting in less delayed graft function, lower acute rejection rates, and improved graft and patient survival.
Article Synopsis
- The study investigates proteinuria linked to mTOR inhibitors, specifically Everolimus, in renal transplant patients, highlighting a lack of understanding about its causes and mechanisms.
- Among the patients treated with Everolimus, 39% developed significant proteinuria, with certain urinary proteins correlating with the degree of protein loss.
- Proteomic analysis revealed significant increases in various urinary proteins associated with kidney damage when using Everolimus, indicating that the treatment can lead to serious renal alterations visible in urine tests.
Article Synopsis
- * There is a growing need to explore urinary biomarkers related to protein fragments, which may enhance our understanding of certain kidney conditions like nephrotic syndrome and focal segmental glomerulosclerosis.
- * Current research focuses on characterizing albumin protein fragments and developing new techniques, such as 2-D nondenaturing electrophoresis, to improve the analysis of proteases that contribute to kidney diseases.
Article Synopsis
- * Data from over 10,000 patients show that GFR at 1 year is the strongest indicator of GFR at 5 years, with factors like acute rejection affecting GFR primarily during the first year.
- * The research emphasizes the importance of ongoing observational studies to understand how early transplant conditions impact long-term kidney performance.