Publications by authors named "Vecchi A"

Article Synopsis
  • Atrial fibrillation (AF) significantly increases the risk of stroke due to thrombus formation in the left atrial appendage (LAA), which can have varied morphologies impacting blood flow dynamics.
  • The study used advanced non-Newtonian computational fluid dynamics (CFD) models to analyze blood viscosity in the LAA, confirming that fibrinogen levels substantially influence this viscosity across different patient groups, particularly in AF patients with Covid-19.
  • Gaussian process emulators (GPEs) showed promise for predicting blood viscosity in the LAA quickly and effectively, with the chicken wing morphology displaying the highest viscosity levels among the LAA types analyzed.
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Introduction: The lymphatic system is a multifaceted regulator of tissue homeostasis and an integral part of immune responses. Previous studies had shown that subsets of lymphatic endothelial cells (LEC) express , an essential component of humoral innate immunity and tissue homeostasis.

Methods: In the present study using whole-mount imaging and image-based morphometric quantifications, -targeted mice and functional analysis, we investigated the involvement of PTX3 in shaping and function of the lymphatic vasculature.

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  • The study aimed to assess disease activity, muscle strength, and functional abilities in newly diagnosed juvenile dermatomyositis (JDM) patients over a 2-year period.
  • A total of 96 JDM patients were evaluated at diagnosis and at 6, 12, 18, and 24 months using various clinical assessment tools, showing significant improvements in some areas, particularly in the first 6 months.
  • Despite overall improvement in disease activity scores, some measures like childhood myositis and disability indices showed no significant progress, indicating ongoing functional impairment.
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  • * MDCT is crucial for obtaining detailed anatomical information before procedures, aiding in clinical decision-making, and improving patient outcomes while minimizing complications.
  • * Key innovations in MDCT, including advanced analytics, patient-specific modeling, and the integration of technologies like 3D printing and artificial intelligence, are transforming patient care for heart valve interventions.
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Accurate prenatal diagnosis of coarctation of the aorta (CoA) is challenging due to high false positive rate burden and poorly understood aetiology. Despite associations with abnormal blood flow dynamics, fetal arch anatomy changes and alterations in tissue properties, its underlying mechanisms remain a longstanding subject of debate hindering diagnosis in utero. This study leverages computational fluid dynamics (CFD) simulations and statistical shape modelling to investigate the interplay between fetal arch anatomy and blood flow alterations in CoA.

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Objective: Selected populations of patients with chronic hepatitis B (CHB) may benefit from a combined use of pegylated interferon-alpha (pegIFN-α) and nucleos(t)ides (NUCs). The aim of our study was to assess the immunomodulatory effect of pegIFN-α on T and natural killer (NK) cell responses in NUC-suppressed patients to identify cellular and/or serological parameters to predict better T cell-restoring effect and better control of infection in response to pegIFN-α for a tailored application of IFN-α add-on.

Design: 53 HBeAg-negative NUC-treated patients with CHB were randomised at a 1:1 ratio to receive pegIFN-α-2a for 48 weeks, or to continue NUC therapy and then followed up for at least 6 months maintaining NUCs.

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Article Synopsis
  • * Researchers created PeptiVAX, a novel vaccine platform using PeptiCRAd technology, which targets broader T-cell responses by focusing on conserved regions across coronaviruses instead of just the SPIKE protein.
  • * Initial tests in human immune cells and mice showed that PeptiVAX effectively stimulated specific T-cell responses, suggesting it could be a fast and flexible solution for enhancing vaccine efficacy against SARS-CoV-2.
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NK cells infiltrating Hepatocellular Carcinoma (HCC) may express residency markers such as Integrin Subunit Alpha 1 (CD49a) that have been associated with nurturing functions in the decidua, and characterized by the production of angiogenic factors as well as loss of cytotoxicity. CIBERSORT, a computational analysis method for quantifying cell fractions from bulk tissue gene expression profiles, was used to estimate the infiltrating immune cell composition of the tumor microenvironment from gene expression profiles of a large cohort of 225 HCCs in the public GEO database. Decidual-like CD49a+ NK cells, in addition to another 22 immune cell populations, were characterized and thoroughly investigated so that HCC cell heterogeneity in a large cohort of 225 HCCs from the public GEO database could be studied.

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  • Accurate velocity reconstruction is crucial for evaluating coronary artery disease, and this study introduces a Gaussian process method to enhance the accuracy of velocity profiles using limited data from positron emission particle tracking (PEPT).
  • Various anatomical models were tested, including a narrowed tube and patient-specific coronary arteries, to assess how factors like tracer particle quantity and detection time impact flow reconstruction accuracy.
  • The results showed that while PEPT and kriging effectively estimated maximum velocities, especially at peak flow, they tended to overestimate area-averaged velocity in cases with higher stenosis, with reconstruction errors ranging from 13.4% to 161% depending on the severity of occlusion.
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The natural history of hepatitis B virus (HBV) infection is closely dependent on the dynamic interplay between the host immune response and viral replication. Spontaneous HBV clearance in acute self-limited infection is the result of an adequate and efficient antiviral immune response. Instead, it is widely recognized that in chronic HBV infection, immunologic dysfunction contributes to viral persistence.

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Monitoring antigen-specific T cell frequency and function is essential to assess the host immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we present a FluoroSpot assay for concurrently detecting ex vivo antiviral cytokine production by SARS-CoV-2-specific T cells following peptide stimulation. We then detail intracellular cytokine staining by flow cytometry to further validate the FluoroSpot assay results and define the specific T cell subpopulations.

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Communication between clinicians and patients and communication within clinical teams is widely recognized as a tool through which improved patient outcomes can be achieved. As emerging technologies, there is a notable lack of commentary on the role of immersive virtual reality (VR) and augmented reality (AR) in enhancing medical communication. This scoping review aims to map the current landscape of literature on this topic and highlights gaps in the evidence to inform future endeavors.

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Article Synopsis
  • - Humoral immunity, which relies on antibodies, struggles against SARS-CoV-2 mutants, while CD8 T cells show more resistance to mutation effects.
  • - Analysis of spike variant peptides reveals that mutations can either inhibit or enhance CD8 T cell responses in vaccinated and recovered individuals.
  • - The emergence of new T cell function enhancing epitopes may improve antiviral protection and inform the future development of more effective COVID-19 vaccines.
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Background & Aims: In chronic HBV infection, elevated reactive oxygen species levels derived from dysfunctional mitochondria can cause increased protein oxidation and DNA damage in exhausted virus-specific CD8 T cells. The aim of this study was to understand how these defects are mechanistically interconnected to further elucidate T cell exhaustion pathogenesis and, doing so, to devise novel T cell-based therapies.

Methods: DNA damage and repair mechanisms, including parylation, CD38 expression, and telomere length were studied in HBV-specific CD8 T cells from chronic HBV patients.

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Atrial fibrillation (AF) underlies almost one third of all ischaemic strokes, with the left atrial appendage (LAA) identified as the primary thromboembolic source. Current stroke risk stratification approaches, such as the CHADS-VASc score, rely mostly on clinical comorbidities, rather than thrombogenic mechanisms such as blood stasis, hypercoagulability and endothelial dysfunction-known as Virchow's triad. While detection of AF-related thrombi is possible using established cardiac imaging techniques, such as transoesophageal echocardiography, there is a growing need to reliably assess AF-patient thrombogenicity prior to thrombus formation.

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Objective: Exhausted hepatitis B virus (HBV)-specific CD8 T cells in chronic HBV infection are broadly heterogeneous. Characterisation of their functional impairment may allow to distinguish patients with different capacity to control infection and reconstitute antiviral function.

Design: HBV dextramer+CD8 T cells were analysed ex vivo for coexpression of checkpoint/differentiation markers, transcription factors and cytokines in 35 patients with HLA-A2+chronic hepatitis B (CHB) and in 29 control HBsAg negative CHB patients who seroconverted after NUC treatment or spontaneously.

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Article Synopsis
  • Transcatheter mitral valve replacement is a less invasive option for older patients with severe mitral annulus calcification (MAC), who face high risks of complications like heart failure and valve failure post-surgery.
  • The study utilized Computational Fluid Dynamics (CFD) and image processing to analyze how these procedures affect blood flow dynamics in patients with severe MAC, generating personalized models based on CT scans.
  • Simulation results indicated increased pressure gradients and potential for thrombosis due to restricted blood flow post-implantation, emphasizing CFD's utility in assessing procedural outcomes.
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Therapeutic interventions are being developed for Huntington's disease (HD), a hallmark of which is mutant huntingtin protein (mHTT) aggregates. Following the advancement to human testing of two [C]-PET ligands for aggregated mHTT, attributes for further optimization were identified. We replaced the pyridazinone ring of CHDI-180 with a pyrimidine ring and minimized off-target binding using brain homogenate derived from Alzheimer's disease patients.

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Several microRNAs and long noncoding RNAs contribute to pulmonary arterial hypertension (PAH) pathogenesis by impairing nitric oxide production, enhancing proliferation and migration and decreasing apoptosis of smooth muscle cells, and promoting endothelial-to-mesenchymal transition in pulmonary arteries. These noncoding RNAs (ncRNAs) could serve as both biomarkers and therapeutic targets for PAH. Nonetheless, the knowledge about their role in PAH is still incomplete.

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Neonatal coarctation of the aorta (CoA) is a common congenital heart defect. Its antenatal diagnosis remains challenging, and its pathophysiology is poorly understood. We present a novel statistical shape modeling (SSM) pipeline to study the role and predictive value of arch shape in CoA in utero.

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Article Synopsis
  • * A study involving 80 patients with AHF-pEF revealed that those with APE had higher blood pressure and certain biomarkers, but similar LV volumes and ejection fraction compared to those with peHF, with distinct differences in wall thickness and function.
  • * At discharge, both groups saw reductions in specific measurements like pulse pressure/stroke volume and pulmonary artery pressures, with no significant differences remaining between them, although LV ejection fraction and some functions remained unchanged.
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To estimate the prognostic value of stress echo (SE) with the assessment of coronary flow velocity reserve (CFVR) and heart rate reserve (HRR) in patients admitted for chest pain with non-diagnostic EKG, negative troponin, and without inducible regional wall motion abnormalities (RWMA). 658 patients (age 67 ± 12 years) admitted to our Emergency Department with chest pain, non-diagnostic EKG, and negative serial troponin underwent dipyridamole (0.84 mg/kg in 6') SE with simultaneous assessment of RWMA, CFVR in the left anterior descending artery, and HRR as peak/rest heart rate.

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Current treatment for chronic HBV infection is mainly based on nucleos(t)ide analogues, that in most cases need to be administered for a patient's lifetime. There is therefore a pressing need to develop new therapeutic strategies to shorten antiviral treatments. A severe dysfunction of virus-specific T cell responses contributes to virus persistence; hence, immune-modulation to reconstitute an efficient host antiviral response is considered a potential approach for HBV cure.

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Pancreatic resection still represents the only curative option for patients affected by pancreatic ductal adenocarcinoma (PDAC). However, the association with modern chemotherapy regimens is a key factor in improving the inauspicious oncological outcome. The benefit of neoadjuvant treatment (NAT) for borderline resectable/locally advanced PDAC has been demonstrated; this evidence raises the question of whether even resectable PDAC should undergo NAT rather than upfront surgery.

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