Publications by authors named "Pignata C"

Background: Activated Phosphoinositide 3-Kinase (PI3K) δ Syndrome (APDS), an inborn error of immunity due to upregulation of the PI3K pathway, leads to recurrent infections and immune dysregulation (lymphoproliferation and autoimmunity).

Methods: Clinical and genetic data of 28 APDS patients from 25 unrelated families were collected from fifteen Italian centers.

Results: Patients were genetically confirmed with APDS-1 (n = 20) or APDS-2 (n = 8), with pathogenic mutations in the PIK3CD or PIK3R1 genes.

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Background: Inborn errors of immunity (IEIs) are more than 500 different rare congenital disorders of the immune system characterized by susceptibility to infections and immune dysregulation. The significant overlap of the clinical features among the different forms may lead to diagnostic delay. High throughput sequencing techniques may allow a timely genetic definition.

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Background: An equitable immunization coverage to "leave no one behind" is one of the World Health Organization Sustainable Development Goals. However, disparities in vaccination coverage exist. The present study aims to investigate vaccine attitude of non-European parents living in Italy and those factors affecting vaccine uptake and equity.

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  • * A study was conducted on a wastewater treatment plant (WWTP) to evaluate the presence of ARB, antibiotic resistance genes (ARGs), and pathogenic bacteria, finding significant levels at all treatment stages, especially sulfamethoxazole-resistant bacteria and the sulII gene.
  • * The results noted a decrease in these bacteria during treatment but still found them in the effluent intended for reuse, highlighting the link between heavy metals and ARB, which calls for better monitoring and interventions to protect public health when reusing wastewater in agriculture.
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Introduction: Ataxia telangiectasia (AT) is a rare disorder characterized by neurodegeneration, combined immunodeficiency, a predisposition to malignancies, and high clinical variability. Profiling of microRNAs (miRNAs) may offer insights into the underlying mechanisms of complex rare human diseases, as miRNAs play a role in various biological functions including proliferation, differentiation, and DNA repair. In this study, we investigate the differential expression of miRNAs in samples from AT patients to identify miRNA patterns and analyze how these patterns are related to the disease.

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Immunodeficiency, Centromeric instability and Facial anomalies (ICF) syndrome is a rare genetic disorder characterized by variable immunodeficiency. More than half of the affected individuals show mild to severe intellectual disability at early onset. This disorder is genetically heterogeneous and is the causative gene of the subtype 2, accounting for about 30% of the ICF cases.

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  • Activated phosphoinositide 3-kinase (PI3Kδ) Syndrome (APDS) is a rare inborn error of immunity that leads to increased infection risk and immune dysfunction, making diagnosis challenging due to its variable symptoms that overlap with other disorders.
  • Currently, there are no established treatment protocols for APDS; management mainly focuses on alleviating symptoms through therapies like immunoglobulin replacement and antimicrobial prophylaxis, while hematopoietic stem cell transplantation is used in select cases with uncertain outcomes.
  • The review highlights the importance of understanding APDS for better diagnosis and treatment strategies, as newer targeted therapies, such as PI3Kδ inhibitors, are on the horizon for more effective patient management.
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  • Kabuki Syndrome (KS) is a genetic disorder that can affect multiple systems in the body, leading to immunological issues like higher infection risk and autoimmune responses.
  • A study involving 39 KS patients revealed that many had congenital heart defects and a notable percentage suffered from autoimmune cytopenia, which was linked to thymectomy.
  • The findings indicated that a significant number of patients had low immunoglobulin levels, increasing the need for immunoglobulin therapy, while certain immune cell abnormalities were also noted, highlighting the complexity of KS-related immunological challenges.
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Background And Aims: X lymphoproliferative syndrome type 1 (XLP1) is a rare inborn error of immunity due to mutations of , encoding for slam-associated protein (SAP). The clinical phenotype includes severe mononucleosis, hemophagocytic lymphohistiocytosis (HLH), and B-cell lymphomas.

Methods: We report the case of a child affected with XLP1 who presented with an incomplete HLH, triggered by Epstein-Barr virus (EBV) and treated with rituximab, involving orbits and paranasal sinuses.

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Wiskott-Aldrich syndrome (WAS) is a multifaceted monogenic disorder with a broad disease spectrum and variable disease severity and a variety of treatment options including allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT). No reliable biomarker exists to predict disease course and outcome for individual patients. A total of 577 patients with a WAS variant from 26 countries and a median follow-up of 8.

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  • The CDC and ACIP endorse COVID-19 vaccination for patients with inborn errors of immunity (IEI), but there's limited knowledge on its safety and impact on infection severity in these patients.
  • A study involving a registry of 1,245 IEI patients across 24 countries was conducted to gather data on vaccination frequency, safety, and effectiveness, revealing that 64.7% were vaccinated, primarily with mRNA vaccines.
  • Results showed that vaccinated patients had significantly lower hospitalization and ICU admission rates when infected with COVID-19, indicating that vaccination is both safe and effective in reducing the severity of the disease in IEI patients.
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Initially described as a triad of immunodeficiency, congenital heart defects and hypoparathyroidism, 22q11.2 deletion syndrome (22q11.2DS) now encompasses a great amount of abnormalities involving different systems.

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  • - The study investigates the relationship between X-linked chronic granulomatous disease (X-CGD), a genetic condition marked by recurrent infections, and regulatory T cells (Tregs) which help manage immune responses.
  • - Researchers found that adult X-CGD patients had increased and activated Tregs in their blood, linked to the activation of conventional CD4+ T cells (Tconvs) that produce higher levels of TNF.
  • - The activation of these T cells resulted in an increase of reactive oxygen species (ROS) not from the NOX2 pathway but from cellular metabolism, suggesting that Treg expansion is a response to overall immune activation in X-CGD patients.
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Background: Urban air pollution is recognized as a critical problem for public health and is classified as a carcinogen for humans. A great number of studies have focused on the monitoring of urban air mutagenicity. One of the best-known and applied methods for assessing mutagenicity is the Ames test, a bacterial reverse mutation test.

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Purpose: Inborn errors of immunity (IEI) represent a heterogeneous group of rare genetically determined diseases. In some cases, patients present with complex or atypical phenotypes, not fulfilling the accepted diagnostic criteria for IEI and, thus, at high risk of misdiagnosis or diagnostic delay. This study aimed to validate a platform that, through the opinion of immunologist experts, improves the diagnostic process and the level of care of patients with atypical/complex IEI.

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GATA2 deficiency is a rare disorder encompassing a broadly variable phenotype and its clinical picture is continuously evolving. Since it was first described in 2011, up to 500 patients have been reported. Here, we describe a cohort of 31 Italian patients (26 families) with molecular diagnosis of GATA2 deficiency.

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Background And Aims: Wiskott-Aldrich syndrome (WAS) is an X-linked recessive primary immunodeficiency disorder characterized by severe eczema, recurrent infections, and micro-thrombocytopenia. Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for patients with classic form. The risk of developing post-transplant tumors appears to be higher in patients with WAS than in other inborn errors of immunity (IEIs), but the actual incidence is not well defined, due to the scarcity of published data.

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Background: Unclassified primary antibody deficiency (unPAD) is a relatively novel inborn error of immunity (IEI) condition that can vary with time to more defined entities. Since long-term follow-up (FU) studies are scarce, we aimed to provide insight into the evolutionary clinical and immunological scenario of unPAD children to adulthood and identification of biomarkers of primary immune deficiency (PID) persistence.

Methods: A total of 23 pediatric unPAD patients underwent clinical and immunological FU for a mean time of 14 years (range 3-32 years, median 16 years).

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Since many waterborne diseases are caused by human pathogenic viruses, virus monitoring of drinking water (DW) and DW sources is crucial for public health. Therefore, the aim of this review was to describe the occurrence of human pathogenic viruses in DW and DW sources; the occurrence of two viruses proposed as novel indicators of human faecal contamination (Pepper mild mottle virus and Tobacco mosaic virus) was also reported. This research was focused on articles that assessed viral occurrence using molecular methods in the surface water used for DW production (SW-D), groundwater used for DW production (GW-D), DW and bottled-DW (BW).

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Background/objectives: Ataxia telangiectasia (A-T) is a multiorgan disorder with increased vulnerability to cancer. Despite this increased cancer risk, there are no widely accepted guidelines for cancer surveillance in people affected by A-T. We aimed to understand the current international practice regarding cancer surveillance in A-T and agreed-upon approaches to develop cancer surveillance in A-T.

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Job's syndrome, or autosomal dominant hyperimmunoglobulin E syndrome (AD-HIES, STAT3-Dominant Negative), is a rare inborn error of immunity (IEI) with multi-organ involvement and long-life post-infective damage. Longitudinal registries are of primary importance in improving our knowledge of the natural history and management of these rare disorders. This study aimed to describe the natural history of 30 Italian patients with AD-HIES recorded in the Italian network for primary immunodeficiency (IPINet) registry.

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Article Synopsis
  • * The connection between immune dysregulation and immunodeficiency can be attributed to various underlying mechanisms.
  • * This review discusses how understanding these mechanisms has led to the development of specific treatments aimed at addressing immune dysregulation in patients with IEI.
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  • Patients with X-linked recessive deficiency of TLR7, a crucial immune sensor, struggle to recognize SARS-CoV-2 and produce necessary type I interferons, leading to severe pneumonia cases.
  • A study included 22 unvaccinated individuals with MyD88 or IRAK-4 deficiencies from multiple countries, primarily affecting children and young adults, with a significant portion requiring hospitalization.
  • The findings highlight that these genetic deficiencies, previously linked to bacterial infections, also significantly increase vulnerability to hypoxemic pneumonia caused by COVID-19, especially as patients age.
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This study investigates the antibiotic resistance fate in the urban water cycle, evaluating the dynamics of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) in three different full-scale wastewater treatment plants (WWTPs) and two drinking water treatment plants (DWTPs) located in the same geographical area (North-West of Italy). ARB (tetracycline-, ampicillin-, and sulfonamide-resistant bacteria) were quantified by plate counting and the abundances of selected ARGs (i.e.

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Primary Immunodeficiencies (PID) are a group of rare congenital disorders of the immune system. Autoimmune cytopenia (AIC) represents the most common autoimmune manifestation in PID patients. Treatment of AIC in PID patients can be really challenging, since they are often chronic, relapsing and refractory to first line therapies, thus requiring a broad variety of alternative therapeutic options.

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