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1. Policy implementation and priorities to create healthy food environments using the Healthy Food Environment Policy Index (Food-EPI): A pooled level analysis across eleven European countries

Author

Pineda, Elisa, Poelman, Maartje P., Aaspõllu, Anu, Bica, Margarida, Bouzas, Cristina, Carrano, Elena, De Miguel-Etayo, Pilar, Djojosoeparto, Sanne, Blenkuš, Mojca Gabrijelčič, Graca, Pedro, Geffert, Karin, Hebestreit, Antje, Helldan, Anni, Henjum, Sigrun, Huseby, Camilla Sanne, Gregório, Maria João, Kamphuis, Carlijn, Laatikainen, Tiina, Løvhaug, Anne Lene, Leydon, Clarissa, Luszczynska, Aleksandra, Mäki, Päivi, Martínez, J. Alfredo, Raulio, Susanna, Romaniuk, Piotr, Roos, Gun, Salvador, Clara, Sassi, Franco, Silano, Marco, Sotlar, Ingrid, Specchia, Maria Lucia, de Arriaga, Miguel Telo, Terragni, Laura, Torheim, Liv Elin, Tur, Josep A., von Philipsborn, Peter, Harrington, Janas M., Vandevijvere, Stefanie, Leerstoel de Wit, Social Policy and Public Health, Leerstoel de Wit, Social Policy and Public Health, and Faculdade de Ciências da Nutrição e Alimentação

Subjects
Non-communicable diseases (NCDs), Health Policy, Health sciences, Medical and Health sciences, Obesity, Public health policies, Healthy food environment policy index (Food-EPI), Food environments, Europe, Ciências médicas e da saúde, Healthy food environment policy index, Food-EPI, Oncology, Medical and Health sciences, Internal Medicine, Consumptie en Gezonde Leefstijl, Ciências da Saúde, Ciências médicas e da saúde, Non-communicable diseases, Consumption and Healthy Lifestyles, Settore MED/42 - IGIENE GENERALE E APPLICATA
Abstract

Background: Food environments have been recognised as highly influential on population diets. Government policies have great potential to create healthy food environments to promote healthy diets. This study aimed to evaluate food environment policy implementation in European countries and identify priority actions for governments to create healthy food environments. Methods: The Healthy Food Environment Policy Index (Food-EPI) was used to evaluate the level of food environment policy and infrastructure support implementation in Estonia, Finland, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Slovenia, and Spain in 20192021. Evidence of implementation of food environment policies was compiled in each country and validated by government officials. National experts evaluated the implementation of policies and identified priority recommendations. Findings: Finland had the highest proportion (32%, n = 7/22) of policies shaping food environments with a high level of implementation. Slovenia and Poland had the highest proportion of policies rated at very low implementation (42%, n = 10/24 and 36%, n = 9/25 respectively). Policies regarding food provision, promotion, retail, funding, monitoring, and health in all policies were identified as the most important gaps across the European countries. Experts recommended immediate action on setting standards for nutrients of concern in processed foods, improvement of school food environments, fruit and vegetable subsidies, unhealthy food and beverage taxation, and restrictions on unhealthy food marketing to children. Interpretation: Immediate implementation of policies and infrastructure support that prioritize action towards healthy food environments is urgently required to tackle the burden of obesity and diet-related non-communicable diseases in Europe. Funding: This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 774548 and from the Joint Programming Initiative A Healthy Diet for a Healthy Life. (c) 2022 The Author(s)

Published
2022

2. Turmeric (Curcuma longa L.) food supplements and hepatotoxicity: an integrated evaluation approach

Author

Menniti-Ippolito, Francesca, Ippoliti, Ilaria, Pastorelli, Augusto Alberto, Altieri, Ilaria, Scalise, Francesco, De Santis, Barbara, Debegnach, Francesca, Brera, Carlo, Pacifici, Roberta, Pichini, Simona, Pellegrini, Manuela, Rotolo, Maria Concetta, Graziano, Silvia, Palazzino, Giovanna, Multari, Giuseppina, Gallo, Francesca Romana, Neri, Bruno, Giannetti, Luigi, Russo, Katia, Fedrizzi, Giorgio, Bonan, Stefania, Mazzanti, Gabriela, Moro, Paola Angela, Salvi, Emanuela, Firenzuoli, Fabio, Valeri, Andrea, Moretti, Ugo, Traversa, Giuseppe, Silano, Marco, Stacchini, Paolo, and Boniglia, Concetta

Subjects
Adult, Male, Plant Extracts, Curcuma longa, food supplements, adverse reactions, food safety, chemical analyses, Middle Aged, food supplements, food safety, chemical analyses, Curcuma, Italy, Dietary Supplements, Humans, Female, adverse reactions, Chemical and Drug Induced Liver Injury, Curcuma longa, Aged
Abstract

Turmeric is the common name for the rhizome of Curcuma longa L. In the recent years, food supplements containing turmeric have been marketed and widely used by an increasing number of consumers. Spontaneous reports of suspected adverse reactions to food supplements are collected within the Phytovigilance system.An ad hoc multidisciplinary group investigated the suspected cases of hepatotoxicity reported to the Italian Phytovigilance system associated with the assumption of turmeric food supplements with the methodology specific to pharmacovigilance as well as for the evaluation of the quality and safety of food supplements.A cluster of 28 spontaneous reports of acute hepatitis, mostly with cholestasis, associated with turmeric products were sent to the Italian Phytovigilance system in the first six months of 2019. In all cases, except one, the causality assessment was at least possible. The suspected products were collected and analysed for the presence of drugs, heavy metals, aflatoxins, pesticides, synthetic dyes and pyrrolizidine alkaloids.On the basis of the results of all the activities performed by multidisciplinary group, regulatory intervention was taken. This study highlights the importance of developing an integrated evaluation approach for the evaluation of the adverse effects associated with the use of food supplements.

Published
2020

3. Low risk of colon cancer in patients with celiac disease

Author

Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, GR, Sandri, G, Giorgetti, G, Caio, G, Lo Perfido, S, Perri F, Festa V, Pelli MA, Cavalletti ML, Segato S, Curzio M, Pennazio M, Rossini FP, Picarelli A, Pera A, Ercole E, Passaleva MT, Barbato M, Usai P, Dore MF, Chilovi F, Piazzi L, Zancanella L, Boarino V, Ferrari A., GRECO, LUIGI, AURICCHIO, SALVATORE, Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Greco, Luigi, Auricchio, Salvatore, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, Gr, Sandri, G, Giorgetti, G, Caio, G, Lo, Perfido, S, Perri, F, Festa, V, Pelli, Ma, Cavalletti, Ml, Segato, S, Curzio, M, Pennazio, M, Rossini, Fp, Picarelli, A, Pera, A, Ercole, E, Passaleva, Mt, Barbato, M, Usai, P, Dore, Mf, Chilovi, F, Piazzi, L, Zancanella, L, Boarino, V, Ferrari, A., Volta U, Vincentini O, Quintarelli F, Felli C, Silano M, and Collaborating Centres of the Italian Registry of the Complications of Celiac Disease

Subjects
Male, Colorectal cancer, COLON CANCER, Disease, Gastroenterology, Colon carcinoma, Retrospective Studie, Medicine, Child, Colonic Neoplasm, education.field_of_study, Medicine (all), Incidence, Celiac disease, Gluten-free diet, Adolescent, Adult, Carcinoma, Celiac Disease, Child, Preschool, Colonic Neoplasms, Diet, Gluten-Free, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Italy, Middle Aged, Patient Compliance, Retrospective Studies, Risk Assessment, Young Adult, Population study, Human, Cohort study, medicine.medical_specialty, Population, Follow-Up Studie, NO, Internal medicine, In patient, Preschool, education, business.industry, Newborn, medicine.disease, digestive system diseases, Diet, Standardized mortality ratio, Gluten-Free, Celiac disease, colon carcinoma, gluten-free diet, business
Abstract

Objective. Celiac disease (CD) has strongly been established as associated with some site-specific gastrointestinal malignancies. On the contrary, according to the few reports available, the risk of colon carcinoma in CD patients has been described similar to that of general population. In this cohort study, we describe the risk of colon carcinoma in a group of Italian celiac patients. Materials and methods. The study population included all CD patients diagnosed at the Collaborating Centers of the Italian Registry of CD between 1st January 1982 and 31st December 2006. Upon diagnosis of CD and upon at every subsequent clinical control, the Collaborating Centers filled in a validated form for each CD patient reporting information about demographic data, possible occurrence of a neoplasm and adherence to a gluten-free diet. Results. Out of 1757 celiac patients enrolled, 6 developed a colon carcinoma during the follow-up period (mean: 18.1 years). The standardized incidence ratio (SIR) resulted 0.29 (95% CI = 0.07–0.45). Stratifying the risk for the dietary gluten intake, the SIR dropped to 0.07 (95% CI = 0.009–0.27) for CD patients with a strict adherence to a gluten-free diet. Conclusion. We confirm the previous finding that there is low risk to develop a colon cancer in celiac patients.

Published
2014

4. Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease

Author

Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Santini, D., F. , Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., GRECO, LUIGI, AURICCHIO, SALVATORE, Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Greco, Luigi, Auricchio, Salvatore, Santini, D., F., Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.

Subjects
Male, Time Factors, Lymphoma, Physiology, Gastroenterology, Coeliac disease, Celiac disease, Enteropathy-associated T-cell lymphoma, Gluten-free diet, Child, chemistry.chemical_classification, Settore BIO/12, Middle Aged, Child, Preschool, Gluten-free diet, Enteropathy-associated T-cell lymphoma, Female, Human, Adult, medicine.medical_specialty, Intestinal Neoplasm, Glutens, Adolescent, Time Factor, Diet therapy, Malignancy, Lymphoma, T-Cell, Follow-Up Studie, Celiac disease, Celiac Disease, Follow-Up Studies, Humans, Infant, Intestinal Neoplasms, Patient Compliance, Stomach Neoplasms, Stomach Neoplasm, Internal medicine, medicine, Risk factor, Preschool, business.industry, nutritional and metabolic diseases, medicine.disease, T-Cell, Gluten, digestive system diseases, chemistry, Gluten free, business
Abstract

Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9-12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac disease and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02-0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X(2 )= 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.

Published
2008

5. Delayed diagnosis of coeliac disease increases cancer risk

Author

Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, L., Auricchio, S., Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna-Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, Luigi, Auricchio, Salvatore, Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.

Subjects
Registrie, tumors, Adult, Male, Risk, medicine.medical_specialty, Time Factors, Time Factor, Delayed diagnosis, Gastroenterology, Coeliac disease, Internal medicine, Neoplasms, medicine, Neoplasm, Humans, Age Factor, In patient, Registries, lcsh:RC799-869, Coeliac disease, neoplasm, tumors, Age Factors, Celiac Disease, Female, Middle Aged, business.industry, Medicine (all), Settore BIO/12, Cancer, General Medicine, Hepatology, medicine.disease, Population study, lcsh:Diseases of the digestive system. Gastroenterology, Cancer risk, business, neoplasm, Human, Research Article
Abstract

Background The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease. Methods The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005. Results The SIR for all cancers resulted to be 1.3; 95% CI = 1.0–1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9–7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5–51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7–25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3–4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not. Conclusion Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.

Published
2007

7. Anti-transglutaminase antibodies from celiac patients are responsible for trophoblast damage via apoptosis in vitro

Author

Di Simone, Nicoletta, Silano, Marco, Castellani, Roberta, Di Nicuolo, Fiorella, D'Alessio, Maria Clara, Franceschi, Francesco, Tritarelli, Alessandra, Leone, Antonio Maria, Tersigni, Chiara, Gasbarrini, Giovanni Battista, Silveri, Nicolò, Caruso, Alessandro, and Gasbarrini, Antonio

Subjects
Settore MED/40 - GINECOLOGIA E OSTETRICIA, anti-tissue tranglutaminase antibodies, trophoblast
Published
2010

8. PD-L1 in small bowel adenocarcinoma is associated with etiology and tumor-infiltrating lymphocytes, in addition to microsatellite instability

Author

Giovanni Arpa, Gabriella Nesi, Catherine Klersy, Carolina Ciacci, Antonietta D'Errico, Anna D'Odorico, Marco Paulli, Gino Roberto Corazza, Fausto Sessa, Valeria Barresi, Vittorio Perfetti, Federica Grillo, Vincenzo Canzonieri, Renato Cannizzaro, Roberto Fiocca, Stefano Ferrero, Luca Reggiani Bonetti, Deborah Malvi, Giovanni Latella, Paolo Pedrazzoli, Antonio Calabrò, Roberto De Giorgio, Alessandra Viglio, Fernando Rizzello, Flavio Caprioli, Roberto Caronna, Daniela Furlan, Antonino Giulio Giannone, Marco Silano, Maurizio Vecchi, Michele Martino, Francesco Tonelli, Laura Cantoro, Antonio Di Sabatino, Maria D'Armiento, Enrico Solcia, Paolo Giuffrida, Gianluca M. Sampietro, Ada Maria Florena, Giovanni Monteleone, Livia Biancone, Claudia Mescoli, G. Solina, Andrea Pietrabissa, Umberto Volta, Renata D'Incà, Ombretta Luinetti, Vincenzo Villanacci, Luca Elli, Massimo Rugge, Maria Cristina Macciomei, Paolo Fociani, Marco Astegiano, Rachele Ciccocioppo, Fabiana Zingone, Claudio Papi, Giacomo Caio, G. Sandri, Barbara Oreggia, Alessandro Vanoli, Aroldo Rizzo, Elena Biletta, Augusto Orlandi, Gilberto Poggioli, Antonio Ciardi, Marco Vincenzo Lenti, Paolo Usai, Erica Quaquarini, Donatella Santini, Sandro Ardizzone, Giuffrida, Paolo, Arpa, Giovanni, Grillo, Federica, Klersy, Catherine, Sampietro, Gianluca, Ardizzone, Sandro, Fociani, Paolo, Fiocca, Roberto, Latella, Giovanni, Sessa, Fausto, D'Errico, Antonietta, Malvi, Deborah, Mescoli, Claudia, Rugge, Massimo, Nesi, Gabriella, Ferrero, Stefano, Furlan, Daniela, Poggioli, Gilberto, Rizzello, Fernando, Macciomei, Maria C, Santini, Donatella, Volta, Umberto, De Giorgio, Roberto, Caio, Giacomo, Calabrò, Antonio, Ciacci, Carolina, D'Armiento, Maria, Rizzo, Aroldo, Solina, Gaspare, Martino, Michele, Tonelli, Francesco, Villanacci, Vincenzo, Cannizzaro, Renato, Canzonieri, Vincenzo, Florena, Ada M, Biancone, Livia, Monteleone, Giovanni, Caronna, Roberto, Ciardi, Antonio, Elli, Luca, Caprioli, Flavio, Vecchi, Maurizio, D'Incà, Renata, Zingone, Fabiana, D'Odorico, Anna, Lenti, Marco Vincenzo, Oreggia, Barbara, Reggiani Bonetti, Luca, Astegiano, Marco, Biletta, Elena, Cantoro, Laura, Giannone, Antonino G, Orlandi, Augusto, Papi, Claudio, Perfetti, Vittorio, Quaquarini, Erica, Sandri, Giancarlo, Silano, Marco, Usai, Paolo, Barresi, Valeria, Ciccocioppo, Rachele, Luinetti, Ombretta, Pedrazzoli, Paolo, Pietrabissa, Andrea, Viglio, Alessandra, Paulli, Marco, Corazza, Gino R, Solcia, Enrico, Vanoli, Alessandro, Di Sabatino, Antonio, Giuffrida P., Arpa G., Grillo F., Klersy C., Sampietro G., Ardizzone S., Fociani P., Fiocca R., Latella G., Sessa F., D'Errico A., Malvi D., Mescoli C., Rugge M., Nesi G., Ferrero S., Furlan D., Poggioli G., Rizzello F., Macciomei M.C., Santini D., Volta U., De Giorgio R., Caio G., Calabro A., Ciacci C., D'Armiento M., Rizzo A., Solina G., Martino M., Tonelli F., Villanacci V., Cannizzaro R., Canzonieri V., Florena A.M., Biancone L., Monteleone G., Caronna R., Ciardi A., Elli L., Caprioli F., Vecchi M., D'Inca R., Zingone F., D'Odorico A., Lenti M.V., Oreggia B., Reggiani Bonetti L., Astegiano M., Biletta E., Cantoro L., Giannone A.G., Orlandi A., Papi C., Perfetti V., Quaquarini E., Sandri G., Silano M., Usai P., Barresi V., Ciccocioppo R., Luinetti O., Pedrazzoli P., Pietrabissa A., Viglio A., Paulli M., Corazza G.R., Solcia E., Vanoli A., Di Sabatino A., Giuffrida, P., Arpa, G., Grillo, F., Klersy, C., Sampietro, G., Ardizzone, S., Fociani, P., Fiocca, R., Latella, G., Sessa, F., D'Errico, A., Malvi, D., Mescoli, C., Rugge, M., Nesi, G., Ferrero, S., Furlan, D., Poggioli, G., Rizzello, F., Macciomei, M. C., Santini, D., Volta, U., De Giorgio, R., Caio, G., Calabro, A., Ciacci, C., D'Armiento, M., Rizzo, A., Solina, G., Martino, M., Tonelli, F., Villanacci, V., Cannizzaro, R., Canzonieri, V., Florena, A. M., Biancone, L., Monteleone, G., Caronna, R., Ciardi, A., Elli, L., Caprioli, F., Vecchi, M., D'Inca, R., Zingone, F., D'Odorico, A., Lenti, M. V., Oreggia, B., Reggiani Bonetti, L., Astegiano, M., Biletta, E., Cantoro, L., Giannone, A. G., Orlandi, A., Papi, C., Perfetti, V., Quaquarini, E., Sandri, G., Silano, M., Usai, P., Barresi, V., Ciccocioppo, R., Luinetti, O., Pedrazzoli, P., Pietrabissa, A., Viglio, A., Paulli, M., Corazza, G. R., Solcia, E., Vanoli, A., Di Sabatino, A., and Vincenzo Lenti, Marco

Subjects
0301 basic medicine, Male, PD-L1 - small bowel adenocarcinoma - tumor-infiltrating lymphocytes - microsatellite instability, Pathology, BLOCKADE, Colorectal cancer, Lymphocyte, Small bowel adenocarcinoma, Gastroenterology, B7-H1 Antigen, Settore MED/12, 0302 clinical medicine, Crohn Disease, Intestine, Small, small bowel adenocarcinoma, Small bowel adenocarcinomas, MEDULLARY CARCINOMA, MORPHOLOGY, EXPRESSION, CANCER, biology, microsatelliteinstability, Middle Aged, medicine.anatomical_structure, Medullary carcinoma, tumor infiltrating lymphocytes, 030220 oncology & carcinogenesis, tumor-infiltrating lymphocytes, Adenocarcinoma, Female, Microsatellite Instability, PD-L1, Adult, medicine.medical_specialty, small bowel adenocarcinoma, tumor-infiltrating lymphocytes, microsatelliteinstability, Settore MED/08 - Anatomia Patologica, PD-L1, small bowel adenocarcinoma, NO, Pathology and Forensic Medicine, 03 medical and health sciences, Lymphocytes, Tumor-Infiltrating, Internal medicine, expression, Intestinal Neoplasms, Biomarkers, Tumor, medicine, Humans, PD-L1 in small bowel adenocarcinoma, MSI-H, Small bowel adenocarcinoma, expression, microsatellite instability, biomarkers, Aged, Retrospective Studies, business.industry, Tumor-infiltrating lymphocytes, biomarkers, Cancer, Correction, Microsatellite instability, medicine.disease, Celiac Disease, 030104 developmental biology, biology.protein, Etiology, business
Abstract

Small bowel adenocarcinomas (SBAs) are often associated with poor prognosis and have limited therapeutic options. Programmed cell death protein-1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway blockade is an effective treatment in many microsatellite instability-high (MSI-H) solid tumors. We aimed at investigating PD-L1 and PD-1 expression in non-hereditary, non-ampullary SBAs, associated with celiac disease (CeD), Crohn’s disease (CrD), or sporadic, recruited through the Small Bowel Cancer Italian Consortium. We assessed PD-L1 and PD-1 by immunohistochemistry in a series of 121 surgically resected SBAs, including 34 CeD-SBAs, 49 CrD-SBAs, and 38 sporadic SBAs. PD-L1 and PD-1 expression was correlated with several clinico-pathological features, such as the etiology, microsatellite instability status, and tumor-infiltrating lymphocyte (TIL) density. The prevalence of PD-L1 positivity according to combined positive score (CPS) was 26% in the whole cohort of SBAs, with significantly (p = 0.001) higher percentage (35%) in both CeD-SBAs and CrD-SBAs in comparison with sporadic SBAs (5%). CPS ≥ 1 SBAs were significantly (p = 0.013) more frequent in MSI-H cases (41%) than in non-MSI-H ones (18%); however, 15 CPS ≥ 1 microsatellite stable SBAs were also identified. CPS ≥ 1 SBAs showed higher TIL and PD-1+ immune cell density, more frequently medullary histotype, as well as a better outcome in comparison with CPS < 1 cases. This study demonstrates an increased proportion of PD-L1+ cases in both CeD-SBAs and CrD-SBAs in comparison with sporadic SBAs. In addition, the identification of a subset of PD-L1+ microsatellite stable SBAs supports the need to ascertain additional biomarkers of response to immune checkpoint inhibitors along with MSI-H.

Published
2020

9. Small Bowel Carcinomas in Coeliac or Crohn’s Disease: Clinico-pathological, Molecular, and Prognostic Features. A Study From the Small Bowel Cancer Italian Consortium

Author

Claudia Mescoli, Michele Martino, Fausto Sessa, Massimo Rugge, Ombretta Luinetti, Gabriella Nesi, Vincenzo Canzonieri, Alessandro Vanoli, Luca Reggiani Bonetti, Ada Maria Florena, Giovanni Monteleone, Daniela Furlan, Umberto Volta, Paolo Fociani, Vincenzo Villanacci, Antonino Giulio Giannone, Marco Silano, Antonio Di Sabatino, Antonio Maccioni, Paolo Usai, G. Solina, Vittorio Perfetti, Federica Grillo, Maria Cristina Macciomei, Rachele Manca, Stefano Ferrero, Renato Cannizzaro, Aroldo Rizzo, Livia Biancone, Luca Elli, Claudio Papi, Giacomo Caio, Giovanni Latella, Antonio Calabrò, Roberta Cerutti, Marianna Salemme, Paolo Giuffrida, Gianluca M. Sampietro, Gino Roberto Corazza, Paola Migliora, Donatella Santini, Sandro Ardizzone, Augusto Orlandi, Francesco Tonelli, Antonio Ciardi, Catherine Klersy, Carolina Ciacci, Davide Trapani, Renata D'Incà, Francesco Paolo D'Armiento, Marco Paulli, Marco Astegiano, Roberto Caronna, Roberto Fiocca, Luigi Michele Coppola, Paola Alberizzi, Enrico Solcia, Giuseppe Santeusanio, G. Sandri, Roberta Riboni, Vanoli, Alessandro, Sabatino, Antonio Di, Furlan, Daniela, Klersy, Catherine, Grillo, Federica, Fiocca, Roberto, Mescoli, Claudia, Rugge, Massimo, Nesi, Gabriella, Fociani, Paolo, Sampietro, Gianluca, Ardizzone, Sandro, Luinetti, Ombretta, Calabrò, Antonio, Tonelli, Francesco, Volta, Umberto, Santini, Donatella, Caio, Giacomo, Giuffrida, Paolo, Elli, Luca, Ferrero, Stefano, Latella, Giovanni, Ciardi, Antonio, Caronna, Roberto, Solina, Gaspare, Rizzo, Aroldo, Ciacci, Carolina, D'Armiento, FRANCESCO PAOLO, Salemme, Marianna, Villanacci, Vincenzo, Cannizzaro, Renato, Canzonieri, Vincenzo, Bonetti, Luca Reggiani, Biancone, Livia, Monteleone, Giovanni, Orlandi, Augusto, Santeusanio, Giuseppe, Macciomei, Maria C, D'Incà, Renata, Perfetti, Vittorio, Sandri, Giancarlo, Silano, Marco, Florena, Ada M, Giannone, Antonino G, Papi, Claudio, Coppola, Luigi, Usai, Paolo, Maccioni, Antonio, Astegiano, Marco, Migliora, Paola, Manca, Rachele, Martino, Michele, Trapani, Davide, Cerutti, Roberta, Alberizzi, Paola, Riboni, Roberta, Sessa, Fausto, Paulli, Marco, Solcia, Enrico, Corazza, Gino R., Di Sabatino, Antonio, D’Armiento, Francesco P., Reggiani Bonetti, Luca, Macciomei, Maria C., D’Incà, Renata, Florena, Ada M., Giannone, Antonino G., Vanoli A., Di Sabatino A., Furlan D., Klersy C., Grillo F., Fiocca R., Mescoli C., Rugge M., Nesi G., Fociani P., Sampietro G., Ardizzone S., Luinetti O., Calabro A., Tonelli F., Volta U., Santini D., Caio G., Giuffrida P., Elli L., Ferrero S., Latella G., Ciardi A., Caronna R., Solina G., Rizzo A., Ciacci C., D'Armiento F.P., Salemme M., Villanacci V., Cannizzaro R., Canzonieri V., Bonetti L.R., Biancone L., Monteleone G., Orlandi A., Santeusanio G., Macciomei M.C., D'Inca R., Perfetti V., Sandri G., Silano M., Florena A.M., Giannone A.G., Papi C., Coppola L., Usai P., Maccioni A., Astegiano M., Migliora P., Manca R., Martino M., Trapani D., Cerutti R., Alberizzi P., Riboni R., Sessa F., Paulli M., Solcia E., and Corazza G.R.

Subjects
Male, 0301 basic medicine, Neuroblastoma RAS viral oncogene homolog, Oncology, Survival, Receptor, ErbB-2, Colorectal cancer, medicine.disease_cause, Inflammatory bowel disease, tumour-infiltrating lymphocyte, ErbB-2, 0302 clinical medicine, Crohn Disease, Retrospective Studie, Risk Factors, 80 and over, Child, Class I Phosphatidylinositol 3-Kinase, Aged, 80 and over, Colonic Neoplasm, Settore MED/12 - Gastroenterologia, Crohn's disease, MLH1 methylation, Tumour-infiltrating lymphocytes, Gastroenterology, General Medicine, Middle Aged, Prognosis, Microsatellite instability, MLH1 promoter methylation, 030220 oncology & carcinogenesis, Colonic Neoplasms, Survival Analysi, KRAS, Human, Receptor, Adult, Proto-Oncogene Proteins B-raf, medicine.medical_specialty, Prognosi, Class I Phosphatidylinositol 3-Kinases, Settore MED/08 - Anatomia Patologica, NO, Proto-Oncogene Proteins p21(ras), Young Adult, 03 medical and health sciences, Internal medicine, medicine, Carcinoma, Humans, inflammatory bowel disease, microsatellite instability, survival, tumour-infiltrating lymphocytes, neoplasms, Aged, Retrospective Studies, Celiac Disease, Microsatellite Instability, Survival Analysis, Tumor Suppressor Protein p53, business.industry, Tumour-infiltrating lymphocyte, Risk Factor, Cancer, medicine.disease, eye diseases, digestive system diseases, 030104 developmental biology, business
Abstract

Background and aims An increased risk of small bowel carcinoma [SBC] has been reported in coeliac disease [CD] and Crohn's disease [CrD]. We explored clinico-pathological, molecular, and prognostic features of CD-associated SBC [CD-SBC] and CrD-associated SBC [CrD-SBC] in comparison with sporadic SBC [spo-SBC]. Methods A total of 76 patients undergoing surgical resection for non-familial SBC [26 CD-SBC, 25 CrD-SBC, 25 spo-SBC] were retrospectively enrolled to investigate patients' survival and histological and molecular features including microsatellite instability [MSI] and KRAS/NRAS, BRAF, PIK3CA, TP53, HER2 gene alterations. Results CD-SBC showed a significantly better sex-, age-, and stage-adjusted overall and cancer-specific survival than CrD-SBC, whereas no significant difference was found between spo-SBC and either CD-SBC or CrD-SBC. CD-SBC exhibited a significantly higher rate of MSI and median tumour-infiltrating lymphocytes [TIL] than CrD-SBC and spo-SBC. Among the whole SBC series, both MSI─which was the result of MLH1 promoter methylation in all but one cases─and high TIL density were associated with improved survival at univariable and stage-inclusive multivariable analysis. However, only TILs retained prognostic power when clinical subgroups were added to the multivariable model. KRAS mutation and HER2 amplification were detected in 30% and 7% of cases, respectively, without prognostic implications. Conclusions In comparison with CrD-SBC, CD-SBC patients harbour MSI and high TILs more frequently and show better outcome. This seems mainly due to their higher TIL density, which at multivariable analysis showed an independent prognostic value. MSI/TIL status, KRAS mutations and HER2 amplification might help in stratifying patients for targeted anti-cancer therapy.

Published
2017

10. La diagnosi e il follow-up della celiachia

Author

Catassi, C., Copparoni, R., Corazza, G. R., Stefano, S., Ruocco, G., Silano, M., Troncone, R., Alessandro Ventura, Catassi, Carlo, Copparoni, Roberto, Corazza, Gino Roberto, De Stefano, Simona, Ruocco, Giuseppe, Silano, Marco, Troncone, Riccardo, and Ventura, Alessandro

Subjects
Pediatric, Celiac Disease, Pediatrics
Abstract

Il presente documento è stato realizzato dal Tavolo Tecnico* del Ministero della Salute in materia di diagnosi di celiachia e rappresenta il riferimento tecnico delle nuove linee guida diagnostico-terapeutiche sulla celiachia approvate dalla conferenza stato-regioni, pubblicate sulla Gazzetta Ufficiale il 16 agosto 2015 e divulgate dal Ministero della Salute (http://www.salute.gov.it/imgs/C_17_pubblicazioni_ 2463_allegato.pdf).

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