Publications by authors named "Fabiana Zingone"

Crohn's disease (CD) is a chronic, complex inflammatory disorder of the gastrointestinal tract that presents significant therapeutic challenges. Despite the availability of a wide range of treatments, many patients experience primary non-response, secondary loss of response, or adverse events, limiting the overall effectiveness of current therapies. Clinical trials often report response rates below 60%, partly due to stringent inclusion criteria.

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Background: Freezing donor fecal microbiota has improved fecal microbiota transplantation (FMT) for recurrent C. difficile infection (CDI), achieving short-term effectiveness similar to fresh-samples. Research shows frozen fecal matter remains effective for up to 12-months at -80 °C.

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Article Synopsis
  • Pouchitis is an inflammatory disease that can affect ileal pouches, potentially leading to pouch failure, and this study looks into the effects of a specific probiotic strain, DG®, on this condition.
  • In a randomized trial with 52 patients post-restorative proctocolectomy, participants received either DG® or a placebo for 8 weeks, during which researchers monitored inflammatory cytokine levels in the pouch mucosa at multiple points.
  • Results showed that the group receiving DG® had significantly reduced levels of inflammatory cytokines after 8 weeks compared to their baseline, indicating the probiotic may positively influence the pouch microenvironment.
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Background: Gastroenterologists still raise concerns about adopting a non-biopsy strategy for diagnosing celiac disease (CeD) in adults.

Aim: To assess the performance of the concurrent detection of two autoantibodies targeting two independent antigens, tissue transglutaminase (tTG) and deamidated gliadin peptides (DGP).

Methods: This prospective, multicenter, binational study collected consecutive patients with a high pre-test probability for CeD.

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  • Therapeutic drug monitoring (TDM) for anti-tumor necrosis factor (anti-TNF) treatments in inflammatory bowel disease (IBD) can improve treatment outcomes and manage failures more cost-effectively, but slow lab results hinder its widespread use.
  • *To address this issue, point-of-care technology tests (POCTs) offer rapid results at the patient's location, allowing for faster treatment decisions compared to the current standard method, the ELISA assay.
  • *This study evaluated a new POCT method (ProciseDx) against the standard ELISA method for measuring drug levels in IBD patients and found a strong correlation between the two, suggesting the POCT could be a practical alternative in clinical settings.*
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Crohn's disease (CD) is a complex, chronic inflammatory bowel disease characterized by unpredictable flare-ups and periods of remission. Despite advances in treatment, CD remains a significant health burden, leading to substantial direct healthcare costs and out-of-pocket expenses for patients, especially in the first-year post-diagnosis. The impact of CD on patients' quality of life is profound, with significant reductions in physical, emotional, and social well-being.

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Background: Data on resilience, the ability to recover from adversity, in coeliac disease (CeD) are lacking.

Aim: To assess the degree of resilience in patients with CeD on a gluten-free diet (GFD), and its association with clinical features, sociodemographic factors, psychological morbidity, and quality of life (QOL).

Methods: A cross-sectional multicentre Italian study was conducted on adult CeD patients between May 2022 and April 2023.

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Background & Aim: Patients with inflammatory bowel disease (IBD) may experience symptoms of sexual dysfunction (SD). However, the magnitude of this problem remains uncertain. Therefore, we performed a systematic review and meta-analysis to assess the prevalence of SD in adult patients with IBD.

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Inflammatory bowels diseases (IBD) are high risk conditions for colorectal cancer (CRC). The discovery of IBD and CRC noninvasive protein/peptide biomarkers using saliva and feces was the aim of this study involving 20 controls, 25 IBD (12 Crohn's Disease-CD), 37 CRC. By untargeted proteomic (LTQ-Orbitrap/MS), a total of 152 proteins were identified in saliva.

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Article Synopsis
  • The study aimed to analyze the clinical characteristics and gastric tumor risk in patients with autoimmune gastritis (AIG) across eight Italian hospitals, focusing on those with and without Helicobacter pylori infection.
  • A total of 1,598 AIG patients were assessed; findings indicated that those who were H. pylori-naive had a higher tendency for certain autoimmune conditions and significant family health history.
  • The overall incidence of gastric adenocarcinoma was low, but a notable percentage developed type 1 gastric neuroendocrine neoplasm (gNEN), especially in patients presenting with vitamin B12/iron deficiencies, suggesting these individuals should receive closer monitoring.
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The gastrointestinal tract is home to trillions of diverse microorganisms collectively known as the gut microbiota, which play a pivotal role in breaking down undigested foods, such as dietary fibers. Through the fermentation of these food components, short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate are produced, offering numerous health benefits to the host. The production and absorption of these SCFAs occur through various mechanisms within the human intestine, contingent upon the types of dietary fibers reaching the gut and the specific microorganisms engaged in fermentation.

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Background: Inflammatory bowel diseases (IBDs) have a peak incidence between the second and fourth decades of life and can affect women's reproductive life.

Objectives: Our study aimed to assess the impact of IBD on the reproductive life of female patients with this condition.

Design: Cross-sectional study.

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Background: Many women grow up dreaming of becoming doctors, preferring specialties that allow more focus on time outside the hospital and on family life. Nowadays, specialties, like gastroenterology, have still a significant gender gap.

Methods: Based on this known discrepancy, a web-based questionnaire was designed by the Young Component of the Scientific Committee of the Federation of Italian Scientific Societies of Digestive Diseases 2023 (FISMAD) to examine the current situation of female gastroenterologists in Italy.

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Ustekinumab (UST) has demonstrated effectiveness in treating patients with Crohn's disease. Monitoring treatment response can improve disease management and reduce healthcare costs. We investigated whether UST trough levels (TLs), serum IL22, and Oncostatin M (OSM) levels could be early indicators of non-response by analysing their correlation with clinical and biochemical outcomes in CD.

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The present document constitutes Part 2 of the EoETALY Consensus Statements guideline on the diagnosis and management of eosinophilic esophagitis (EoE) developed by experts in the field of EoE across Italy (i.e., EoETALY Consensus Group).

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Article Synopsis
  • - Celiac disease (CeD) is a chronic condition triggered by gluten in those genetically prone, affecting about 1% of the population, yet it remains often overlooked despite increasing awareness.
  • - Proactively testing high-risk individuals with serology is the best method for identifying undiagnosed CeD, particularly among those with autoimmune diseases or conditions that might mimic CeD symptoms.
  • - Recommended screening for CeD includes patients with various specific conditions, and if they undergo upper endoscopy, biopsies should be taken to confirm or rule out the disease.
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  • * A group of Italian experts in EoE conducted a Delphi process to create updated management guidelines, which include the latest evidence and improve upon previous guidelines from the Italian Society of Gastroenterology (SIGE).
  • * The new guidelines are split into two parts covering topics like the definition and diagnosis of EoE, as well as treatment and follow-up, and they have been endorsed by several Italian medical societies and incorporated feedback from patient associations.
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The low FODMAP (fermentable oligosaccharide, disaccharide, monosaccharide, and polyol) diet is a beneficial therapeutic approach for patients with irritable bowel syndrome (IBS). However, how the low FODMAP diet works is still not completely understood. These mechanisms encompass not only traditionally known factors such as luminal distension induced by gas and water but also recent evidence on the role of FOMAPs in the modulation of visceral hypersensitivity, increases in intestinal permeability, the induction of microbiota changes, and the production of short-chain fatty acids (SCFAs), as well as metabolomics and alterations in motility.

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Primary sclerosing cholangitis (PSC) is a rare liver disorder characterized by biliary ducts inflammation, fibrosis and consequently chronic cholestasis, which progressively lead to liver cirrhosis. The main feature of PSC is the frequent association with inflammatory bowel disease (IBD), with an estimated prevalence of around 70% of the cases. This strong relationship seems due to the presence of shared pathogenetic mechanisms, which seem to involve the intestinal barrier function, the human gut microbiota and the immune innated and adaptative response to antigens derived from the bowel.

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Background: Recent studies showed that early surgery for Crohn's disease leads to a lower recurrence rate. However, the underlying mechanism is unknown.

Objective: The study aims to analyze the innate immunity microenvironment in ileal mucosa according to the duration of Crohn's disease.

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MicroRNAs (miRNAs) are small, non-coding RNA molecules involved in regulating gene expression. Many studies, mostly conducted on pediatric patients, suggested that oxidative stress and several miRNAs may play an important role in coeliac disease (CeD) pathogenesis. However, the interplay between oxidative stress and miRNA regulatory functions in CeD remains to be clarified.

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Celiac disease (CeD) is a chronic autoimmune disorder triggered by the ingestion of gluten, affecting around 1% of the global population. It is a multifactorial disease involving both genetics and environmental factors. Nowadays, the only available treatment for CeD is a life-long gluten-free diet (GFD), which can cause a significant burden for patients, since symptoms and mucosal injury can persist despite apparent compliance with a GFD.

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Coeliac disease (CeD) is an immunological disease triggered by the consumption of gluten contained in food in individuals with a genetic predisposition. Diagnosis is based on the presence of small bowel mucosal atrophy and circulating autoantibodies (anti-type 2 transglutaminase antibodies). After diagnosis, patients follow a strict, life-long gluten-free diet.

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Background & Aims: Multiple colorectal adenomas (MCRAs) can result from APC (AFAP) or biallelic MUTYH (MAP) mutations, but most patients are wild type and referred to as non-APC/MUTYH polyposis (NAMP). We aim to examine the risk of colorectal cancer (CRC) and the role of endoscopy in managing patients with MCRAs, with a specific focus on clinical features and genotype.

Methods: Records of MRCAs between 2000 and 2022 were retrospectively analysed.

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