Publications by authors named "Marco Cappa"

Laminopathies represent a wide range of genetic disorders caused by mutations in gene-encoding proteins of the nuclear lamina. Altered nuclear mechanics have been associated with laminopathies, given the key role of nuclear lamins as mechanosensitive proteins involved in the mechanotransduction process. To shed light on the nuclear partners cooperating with altered lamins, we focused on Src tyrosine kinase, known to phosphorylate proteins of the nuclear lamina.

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Organized sports are governed by specific rules which aim to create or preserve fair play. An unfair advantage can be obtained by the use of specific substances or methods, also referred to as doping. The World Anti-Doping Agency (WADA) leads the international doping-free sport movement and annually publishes the List of Prohibited Substances and Methods (List), that is used by most sport federations and organizations around the world.

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  • - Growth hormone deficiency (GHD) is a common issue in kids and teens who have surgery for tumors affecting the hypothalamus and pituitary gland, often resulting from the tumor itself or damage from treatment.
  • - Managing brain tumor patients is very complicated, needing a team of experts to carefully decide on the best treatment plan, including when to start or stop growth hormone replacement therapy (GH-rT).
  • - While there’s evidence showing GH-rT is generally safe, there is still ongoing debate about its use and timing in these patients to ensure the best outcomes and quality of life.
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  • * A study on a 16-year-old female patient with APS3A/B used whole-exome sequencing to uncover two genetic variants in the TIM-3 protein that may affect her autoimmune response and overall health.
  • * Additional analyses revealed that, despite similar TIM-3 fluorescence levels to healthy donors, the patient exhibited decreased TIM-3 expression, and unique mutations were found in her compared to a cohort of APS patients, highlighting the potential for new genetic insights in APS classification.
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: Adrenoleukodystrophy (X-ALD) is a metabolic disorder caused by dysfunctional peroxisomal beta-oxidation of very-long-chain fatty acids (VLCFAs). A VLCFA-restricted Mediterranean diet has been proposed for patients and carriers to reduce daily VLCFA intake. : We retrospectively evaluated plasma VLCFAs in a cohort of 36 patients and 20 carriers at baseline and after 1 year of restricted diet.

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  • - Cushing's syndrome (CS) is caused by too much cortisol in the body, either from external glucocorticoid-related treatments or from the body producing it excessively, with childhood cases mostly stemming from medication use rather than natural causes.
  • - The most frequent type of endogenous CS in kids is due to pituitary tumors that release ACTH, with adrenal-related causes being less common but still significant, especially in early childhood.
  • - Diagnosing CS can be challenging due to its gradual onset and subtle symptoms; key signs include changes in facial appearance, weight gain, and growth issues, and accurate diagnosis usually requires multiple tests to confirm hypercortisolism.
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Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing reversible comorbidities, optimizing nutrition, and ensuring metabolic control.

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Introduction: Growth patterns in Noonan syndrome (NS) remain relatively unknown. The objective of this study was to provide growth reference curves for patients with NS and identify correlations between their growth, genotype, and clinical features.

Methods: This was a 15-year-long, monocentric, observational, retrospective, non-interventional study.

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  • Lipodystrophy syndromes are rare and often misdiagnosed diseases that can lead to serious metabolic issues and organ damage if not detected early.
  • The Rapid Action Plan was created through expert consultations to provide guidelines for clinicians who may not have much experience with these conditions.
  • The plan includes tools for diagnosis, discusses the importance of history and tests, and offers recommendations for screening, monitoring, and treatment to help improve patient outcomes.
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  • - Silver-Russell syndrome (SRS) is a rare genetic disorder characterized by symptoms like intrauterine growth retardation, poor development after birth, a triangular face, and feeding issues, with diagnosis based on clinical features.
  • - Genetic abnormalities are found in about 60% of SRS patients, primarily on chromosomes 7 or 11, while the cause remains unknown for around 40% of cases, termed idiopathic SRS.
  • - A new genetic variant was identified in a child with severe growth issues linked to SRS, highlighting the effectiveness of targeted exome sequencing, and long-term growth hormone treatment was found to improve the child's height.
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  • * The duplication modifies the normal gene arrangement, leading to increased hormone production and causing gigantism due to a new regulatory domain (neo-TAD) that disrupts typical genetic control.
  • * The case study of a female patient highlights the challenges in diagnosing and treating X-LAG, showcasing the use of advanced medical techniques and surgical interventions to achieve hormone regulation in affected children.
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  • - Autoimmune polyglandular syndromes (APS) are divided into four types, with APS1 linked to specific gene mutations, while the genetic factors for APS2-4 are not fully understood.
  • - A study examining 74 APS patients identified six Single Nucleotide Polymorphisms (SNPs) in a specific gene promoter, with most of these SNPs affecting the stability of the nucleic acid structure.
  • - The findings suggest a potential link between promoter polymorphisms and APS susceptibility, particularly in APS1, APS3, and APS4, but further research with larger groups is needed to confirm this association.
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Context: In the last decade the Sanger method of DNA sequencing has been replaced by next-generation sequencing (NGS). NGS is valuable in conditions characterized by high genetic heterogeneity such as neonatal diabetes mellitus (NDM).

Objective: To compare results of genetic analysis of patients with NDM and congenital severe insulin resistance (c.

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Vitamin B12 (or cobalamin) is an essential vitamin for DNA synthesis, fatty acid and protein metabolism as well as other metabolic pathways fundamental to the integrity of cells and tissues in humans. It is derived from the diet and mostly stored in the liver. Its deficiency has been associated with metabolic derangements, i.

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X-linked adrenoleukodystrophy (X-ALD; OMIM:300100) is a progressive neurodegenerative disorder caused by a congenital defect in the ATP-binding cassette transporters sub-family D member 1 gene (ABCD1) producing adrenoleukodystrophy protein (ALDP). According to population studies, X-ALD has an estimated birth prevalence of 1 in 17.000 subjects (considering both hemizygous males and heterozygous females), and there is no evidence that this prevalence varies among regions or ethnic groups.

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No data are available on insulin clearance (Cl) trends during the pubertal transition. The aim of this study was to investigate in 973 youths with obesity whether Cl in fasting and post-oral glucose challenge (OGTT) conditions varies at the pubertal transition in relation to the severity of obesity and the presence of steatosis liver disease (SLD). The severity of obesity was graded according to the Centers for Disease Control.

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Objective: Single Large Scale Mitochondrial DNA Deletions (SLSMDs), Pearson Syndrome (PS) and Kearns-Sayre Syndrome (KSS), are systemic diseases with multiple endocrine abnormalities. The adrenocortical function has not been systematically investigated with a few anecdotal reports of overt adrenal insufficiency (AI). The study aimed to assess the adrenocortical function in a large cohort of SLSMDs.

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Introduction: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome is a rare monogenic disease determined by biallelic mutations in gene, which encodes a transcription factor essential for central immune tolerance. Classic diagnosis is determined by the presence of two of the main APECED clinical diseases: chronic mucocutaneous candidiasis, chronic hypoparathyroidism, and Addison's disease. Non-endocrine autoimmunity, involving the liver, intestine, eyes, and kidneys, is generally reported in a minority of European patients, while American APECED patients have a higher tendency of developing organ-specific non-endocrine manifestations early in life.

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Objective: An evidence-based pubertal induction scheme in hypogonadal girls is still to be established. Interestingly, literature data report a suboptimal uterine longitudinal diameter (ULD) in >50% of treated hypogonadal women, negatively influencing their pregnancy outcomes. This study aims to investigate auxological and uterine outcomes of pubertal induction in girls in the light of underlying diagnosis and therapeutic schemes used.

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Prader-Willi syndrome (PWS) is a rare genetic disorder resulting from lack of expression of the paternally derived chromosome 15q11-13, associated with several complications, including pubertal disorders, short stature, hyperphagia, obesity, glucose metabolism abnormalities, scoliosis, obstructive sleep apnea syndrome (OSAS) and behavioral problems. We report the case of a girl affected by PWS who presented at the age of 5.9 with premature pubarche, accelerated linear growth and advanced bone age (BA).

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Objective: Since the outbreak of COVID-19 pandemic, several centers of pediatric endocrinology worldwide have observed a significant increase in the number of girls presenting with precocious or early puberty. We aimed to compare the incidence rates of female precocious puberty before and during the different phases of COVID-19 pandemic.

Methods: We have retrospectively analyzed all the consultations recorded in the outpatient clinic database of the Endocrinology Unit of Bambino Gesù Children's Hospital, Rome, Italy, from the lockdown start in March 2020 up to September 2020, in comparison with the consultations recorded in the same months of 2019, 2021 and 2022.

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Background: Despite the optimization of replacement therapy, adrenal crises still represent life-threatening emergencies in many children with adrenal insufficiency.

Objective: We summarized current standards of clinical practice for adrenal crisis and investigated the prevalence of suspected/incipient adrenal crisis, in relation to different treatment modalities, in a group of children with adrenal insufficiency.

Results: Fifty-one children were investigated.

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Adrenal insufficiency (AI) is a severe endocrine disorder characterized by insufficient glucocorticoid (GC) and/or mineralocorticoid (MC) secretion by the adrenal glands, due to impaired adrenal function (primary adrenal insufficiency, PAI) or to insufficient adrenal stimulation by pituitary ACTH (secondary adrenal insufficiency, SAI) or tertiary adrenal insufficiency due to hypothalamic dysfunction. In this review, we describe rare genetic causes of PAI with isolated GC or combined GC and MC deficiencies and we also describe rare syndromes of isolated MC deficiency. In children, the most frequent cause of PAI is congenital adrenal hyperplasia (CAH), a group of adrenal disorders related to steroidogenic enzyme deficiencies, which will not be included in this review.

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Inherited retinal degeneration (IRD) represents a clinically variable and genetically heterogeneous group of disorders characterized by photoreceptor dysfunction. These diseases typically present with progressive severe vision loss and variable onset, ranging from birth to adulthood. Genomic sequencing has allowed to identify novel IRD-related genes, most of which encode proteins contributing to photoreceptor-cilia biogenesis and/or function.

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