Publications by authors named "Gualano G"

Objective: Cysteamine, a drug approved to treat cystinosis, has been proposed as a host-directed therapy for (Mtb) and SARS-CoV-2. The impact of cysteamine on the immune responses has not been fully investigated. We aimed to evaluate the immunomodulatory effects of cysteamine on peripheral blood mononuclear cells (PBMCs) using the purified protein derivative (PPD) as a recall antigen, and an unspecific stimulus as staphylococcal enterotoxin B (SEB).

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Background: Tuberculosis (TB) remains a Global Health challenge, with diagnostic delays contributing significantly to its spread. This study investigates the differences in diagnostic delays between native and migrant TB patients in Italy, examining patient-related diagnostic delay (PDD), health system-related diagnostic delay (HDD), and total diagnostic delay (TDD).

Methods: We conducted a retrospective, multicenter, cross-sectional study of TB cases in 10 Italian hospitals from 2018 to 2023.

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Background: Identifying stage-specific antigens is essential for developing tuberculosis (TB) diagnostics and vaccines. In a low TB endemic country, we characterized, the Mycobacterium tuberculosis (Mtb)-specific immune response to a pool of Mtb-derived epitopes (ATB116), demonstrated as associated with TB disease.

Methods: In this prospective observational cross-sectional study, we enrolled healthy donors (HD), subjects with TB disease, and TB infection (TBI) at baseline and therapy completion.

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The treatment of non-tuberculous mycobacterial (NTM) infections is challenging because of the difficulty in obtaining phenotypic (pDST) and/or molecular (mDST) drug susceptibility testing and the need of a multi-drug regimen. : The objective was to describe the in vitro susceptibility patterns of various NTM species through an analysis of susceptibility results obtained on isolates collected between 2018 and 2023. Species identification and mutations in or genes (mDST) were identified by a line probe assay, while the pDST was performed by broth microdilution and interpreted according to CLSI criteria.

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Article Synopsis
  • A comprehensive study analyzed 468 cases of idiosyncratic drug-induced liver injury (DILI) in Latin America over a decade, revealing key demographic details such as a predominance of women (62%) and a mean age of 49 years.
  • The analysis found that hepatocellular injury was the most common (62%), with significant occurrences of jaundice (60%) and hospitalization (42%), while 4.1% of cases resulted in fatal outcomes.
  • The study highlights a rising incidence of liver injuries linked to herbal and dietary supplements, as well as specific drugs like nimesulide and nitrofurantoin, suggesting the need for public health initiatives to educate on the risks associated with these medications.
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  • Study aimed to find Mycobacterium tuberculosis (Mtb) DNA in blood cells of TB patients and those with TB infection in Italy.
  • Research involved 57 TB patients, 41 with TB infection, and 39 controls, using advanced DNA detection methods on blood samples.
  • Results showed low levels of Mtb DNA in various groups, highlighting a potential link between CD34 cells and Mtb, which could aid in understanding TB and developing new diagnostic tools.
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Over the past years, Tuberculosis (TB) control strategies have been effective in reducing drug-resistant (DR) TB globally; however, a wider implementation of new diagnostic strategies, such as Whole genome sequencing (WGS), would be critical for further improvement. The aim of this study, based on WGS of (MTB) strains isolated in a TB referral center over 6 years, was to evaluate the efficacy of this methodology in improving therapy guidance for clinicians and in improving the understanding of the epidemiology of TB transmission. WGS was performed in addition to pDST on 1001 strains consecutively isolated between January 2016 and December 2021; the results allowed us to improve the quality of data on resistance and to identify possible clusters of transmission.

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Background: Non-tuberculous mycobacteria (NTM) are generally free-living organism, widely distributed in the environment, with sporadic potential to infect. In recent years, there has been a significant increase in the global incidence of NTM-related disease, spanning across all continents and an increased mortality after the diagnosis has been reported. The decisions on whether to treat or not and which drugs to use are complex and require a multidisciplinary approach as well as patients' involvement in the decision process.

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In Italy, tuberculosis (TB) incidence in the last decade has remained constant at under 10 cases/100,000 inhabitants. In the Philippines, TB annual incidence is greater than 500 cases/100,000 inhabitants. Omalizumab is a humanized anti-IgE monoclonal antibody approved for the treatment of chronic spontaneous urticaria.

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  • Drug-induced liver injury (DILI) from antituberculosis treatment can affect 2-28% of patients, and this study analyzes clinical cases of suspected DILI using liver biopsy.
  • A retrospective study was conducted on 10 tuberculosis patients at the "Lazzaro Spallanzani" Institute from 2017 to 2022, focusing on liver damage indicators.
  • Findings indicated that 50% of biopsies confirmed DILI, with various liver injury types identified, highlighting the importance of liver biopsy as a diagnostic tool while weighing its benefits and risks.
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Introduction: IFN-γ release assays (IGRAs) are one of the referral tests for diagnosing tuberculosis infection (TBI). To improve IGRAs accuracy, several markers have been investigated. Patients with immune-mediated inflammatory diseases (IMID), taking biological drugs, have a higher risk to progress to TB-disease compared to the general population.

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  • This global study investigates the long-term outcomes of patients with tuberculosis (TB) and COVID-19, highlighting a lack of prior longitudinal data on this combined condition.
  • Data was collected from 788 patients across 31 countries from March 2020 to September 2022, showing a mortality rate of 10.8% during the study period.
  • Key factors influencing mortality included older age, HIV infection, and the need for invasive ventilation, with patients suffering from both diseases experiencing significantly lower survival rates compared to those with only one of the diseases.
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Objectives: To characterize the plasma immune profile of patients with tuberculosis (TB)-COVID-19 compared with COVID-19, TB, or healthy controls and to evaluate in vitro the specific responses to SARS-CoV-2 and Mycobacterium tuberculosis (Mtb)-antigens.

Methods: We enrolled 119 subjects: 14 TB-COVID-19, 47 COVID-19, 38 TB, and 20 controls. The plasmatic levels of 27 immune factors were measured at baseline using a multiplex assay.

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Objective: Several therapies with immune-modulatory functions have been proposed to reduce the overwhelmed inflammation associated with COVID-19. Here we investigated the impact of IL-10 in COVID-19, through the assessment of the effects of exogenous IL-10 on SARS-CoV-2-specific-response using a whole-blood platform.

Methods: Two cohorts were evaluated: in "study population A", plasma levels of 27 immune factors were measured by a multiplex (Luminex) assay in 39 hospitalized "COVID-19 patients" and 29 "NO COVID-19 controls" all unvaccinated.

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  • The study explores the effectiveness of noninvasive ventilation (NIV) in adult patients with Acute Respiratory Distress Syndrome (ARDS) caused by COVID-19, revealing a significant rate of NIV failure and mortality risks based on ARDS severity.
  • Out of 307 ARDS patients hospitalized, 224 received NIV, with 37.5% experiencing failure, particularly higher in moderate and severe cases compared to mild ARDS.
  • The research indicates that starting NIV in mild ARDS patients may enhance its effectiveness and decrease the risk of mortality, suggesting a potential benefit in early intervention for these patients.
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Objective: To better define the immunopathogenesis of COVID-19, the present study aims to characterize the early immune responses to SARS-CoV-2 infection in household contacts of COVID-19 cases. In particular, innate, T- and B-cell specific responses were evaluated over time.

Methods: Household contacts of COVID-19 cases screened for SARS-CoV-2 infection by nasopharyngeal swab for surveillance purposes were enrolled (T0, n=42).

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Respiratory infectious diseases (rIDs) remain among the most significant causes of morbidity and mortality worldwide, and, in the era of COVID-19, they have come into major focus in the scientific world and global health approaches [...

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Objectives: In this study, we aimed to characterize the SARS-CoV-2-specific T cell response detected by the QuantiFERON SARS-CoV-2 research use only assay in terms of accuracy and T cell subsets involved compared with a homemade interferon (IFN)-γ release assay (IGRA).

Methods: We evaluated T cell response by the standardized QuantiFERON SARS-CoV-2 tubes (antigen [Ag]1 and Ag2) and a homemade IGRA quantifying IFN-γ response to SARS-CoV-2 spike peptides (homemade-IGRA-SPIKE test). We evaluated the T cell subsets mediating the specific response using flow cytometry.

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Article Synopsis
  • - This study analyzed lockdown measures and tuberculosis trends in 24 countries during the first year of the COVID-19 pandemic.
  • - Several countries imposed various restrictions, including mask mandates and travel limitations, resulting in multiple lockdowns and partial reopenings.
  • - While national lockdowns helped control COVID-19, they also led to a decrease in cases of active and latent tuberculosis, indicating a complex relationship between the pandemic and tuberculosis health indicators.
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Objectives: We assessed vaccination-induced antibody and cellular responses against spike from the ancestral strain and from the delta (δ) SARS-CoV-2 variant in patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressive therapy in comparison with immunocompetent subjects.

Methods: We enrolled patients with IMID and immunocompetent subjects who completed the vaccination schedule within 4-6 months from the first dose. The interferon (IFN)-γ-response to spike peptides that were derived from the ancestral and the δ SARS-CoV-2 were measured by ELISA.

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Vitamin D plays a crucial role in many infectious diseases, such as tuberculosis (TB), that remains one of the world's top infectious killers with 1.5 million deaths from TB in 2021. Vitamin D suppresses the replication of in vitro and showed a promising role in TB management as a result of its connection with oxidative balance.

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Pulmonary thromboembolism (PTE) has been associated with tuberculosis (TB), but the true incidence is unknown. The aim of our study was to retrospectively evaluate the PTE prevalence in TB patients hospitalized at the National Institute for Infectious Diseases L. Spallanzani during the January 2016-December 2021 period.

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