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Diagnosis of male infertility is essentially based on the evaluation of semen quality (sperm concentration, motility, viability, and morphology). However, there is a lack of knowledge about possible molecules used as candidates for the early identification of male infertility risk. Calprotectin is a biological marker for inflammation, measured prevalently in stool specimens, widely used to discriminate between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), and for the subsequent monitoring of gastrointestinal diseases' development. Would it be possible to use calprotectin determination to identify also male infertility risk?Cross-sectional pilot study investigated calprotectin concentration in the seminal fluid of 45 men (range: 23-51 yrs) that were under evaluation for semen quality at our Center for Reproductive Medicine. Calprotectin concentration was determined with a commercially available immuno-chromatographic test and successfully detected in 37 of the 45 analyzed men (age: 37.38 ± 6.59). A correlation with semen quality (concentration, motility, morphology) was assessed.Higher calprotectin concentration seemed to indicate a better quality of the seminal fluid. Normozoospermic subjects (Group A) had on average a calprotectin value of 0.215 ± 0.162 µg/ml (mean ± SD), while subjects with at least one of the semen parameters below reference values (Group B) showed lower calprotectin concentration (mean ± SD: 0.126 ± 0.068, p-value 0.05). A significant difference was clearly evident between calprotectin concentration measured in seminal fluids with physiological sperm morphology (≥4%) as compared with teratozoospermic samples (4%) (p-value 0.05). Indeed, the developed ROC curves showed a good diagnostic accuracy (around 67 %) using calprotectin concentration (threshold value: 0.121 μg/ml) as a preliminary test to discriminate subjects with and without abnormal semen parameters, especially morphology.Calprotectin determination in the seminal fluid may be proposed as a biological marker for preliminary screening in male subjects at risk of infertility due to one or more alterations of semen quality.

Summary Background and aims Non-Celiac Gluten Sensitivity (NCGS) is a recently proposed clinical condition causing both intestinal and extra-intestinal symptoms, without gastrointestinal lesions, which improve on avoiding gluten intake, in the absence of celiac disease and wheat allergy. The prevalence of this condition is still a matter of debate, in part due to the very recent introduction of an accepted diagnostic test, a double-blind, placebo controlled gluten challenge. However, this is a lengthy and cumbersome procedure, theoretically burdened by a significant reduction of patient compliance. ALCAT 5 is an automated in vitro test evaluating the toxic effect of gluten on neutrophils by the exposure of these cells to a gluten-containing extract of gluten-containing cereals. The test is very simple to perform, the results are rapidly obtained, and might represent, if sufficiently accurate, a promising alternative to diagnose gluten intolerance. The aim of this study was the comparison of ALCAT 5 results with those of a double-blind, placebo-controlled, gluten challenge, in a group of patients with clinically-suspected NCGS. Methods Twenty-five patients (M/F 3/22, mean age 32 ± 4 yrs) with severe functional abdominal pain and bloating, who had previously undergone the ALCAT 5 test, were enrolled. All the subjects reported their symptoms on a gluten-containing diet and considered gluten the causal agent. Following the Salerno Experts’ Criteria, they underwent a double-blind, placebo controlled trial with gluten vs placebo. A mean value during gluten ingestion >30% of the value during placebo was considered as indicative of gluten sensitivity. Results After blinded administration of gluten, 13 out of 25 (52%) patients showed an increase in the severity of abdominal pain, and 11 out of 25 (44%) showed an increase in the severity of abdominal bloating. Considering these two symptoms together, in 16 patients out of 25 (64%), blinded gluten administration induced an increase of abdominal pain and/or bloating. The ALCAT 5 test proved to be positive in 20 and negative in 5 patients. In sixteen patients out of 25 the result of ALCAT 5 agreed with the double-blind trial (64%). In particular, both tests were positive in 14 patients and negative in 2. Conclusions In this subgroup of patients, ALCAT 5 could be used to support the clinical suspicion of the presence of NCGS and to address these patients to a blinded gluten challenge.

Background A few studies have outlined a possible relationship between an increased body mass index and allergic rhinitis. A single study reported that males with seasonal allergic rhinitis (SAR), evaluated outside the pollen season, had increased serum adiponectin levels. Objective The aim of this preliminary study was to evaluate the serum adiponectin levels in a cohort of SAR normo-weight patients evaluated during the pollen season, comparing them with SAR patients evaluated out of pollen season and a group of healthy controls. Methods The study included 137 subjects; 62 SAR patients evaluated in their pollen season, while symptomatic, 41 SAR patients studied out their pollen season, while they were without symptoms, and 34 normal subjects. All subjects were consecutively evaluated. All of them were normo-weight. A skin prick test and blood sampling for assessing serum adiponectin levels were performed in all subjects. Results After analysing genders separately, symptomatic male patients had significantly higher levels than both symptomless and normal males ( p = 0.0041 and 0.0001 respectively), symptomatic female patients showed significantly higher levels than both symptomless and normal females ( p = 0.0001 and 0.0071 respectively). Conclusion This study provides the preliminary evidence that adiponectin serum levels might depend on allergen exposure in SAR normo-weight patients.

Several studies have outlined a possible relationship between an increased body mass index (BMI) and respiratory allergic diseases, such as asthma and rhinitis. Very recently, it has been demonstrated that serum adipokines, such as leptin and adiponectin, may be increased in patients with allergic rhinitis. The aim of the study was to evaluate the serum leptin and adiponectin levels in a cohort of patients with pollen-induced allergic rhinitis, before and after a single preseasonal course of sublingual immunotherapy (SLIT). A total of 41 patients (22 male and 19 female, median age 39 years) with AR due to pollen allergy, along with 34 normal subjects, were included in the study. Blood sampling for assessing serum adipokines, immunoglobulin E (IgE) levels, and eosinophils were performed in all subjects before and after the SLIT course. An increasing trend of both adipokines was observed after SLIT, albeit without statistical significance and with gender difference. Leptin was significantly related to some clinical parameters and peripheral eosinophil counts. Conversely, adinopectin showed an inverse significant correlation with peripheral eosinophils counts but only for men. In conclusion, the results of this preliminary study show that a single preseasonal SLIT course does not induce significant modifications in serum adipokines levels but induces only a slight increase.

We treated with thalidomide seven patients with primary MDS and observed reduction of the transfusion requirement in three cases and reduction of bone marrow blasts in one case. The apoptotic rate of bone marrow cells diminished significantly from a mean of 43.8% to a mean of 17.5%, whereas the proliferative activity did not change. Plasma TNF-α, bFGF, IL-1β levels decreased variably, whereas VEGF levels tended to increase. Matrix metalloproteinases 2 and 9 expression decreased in bone marrow cells of responders. A reduction of CD4 cells and an increase of NK cells was observed in the peripheral blood. Thus, thalidomide may produce a fairly good hematological improvement in erythroid series in MDS, with complex biological mechanisms.

Allergic rhinitis (AR) is characterized by an inflammatory reaction sustained by Th2 polarization, whereas systemic lupus erythematosus (SLE) is a typical autoimmune disorder. Vascular endothelial growth factor (VEGF) is a critical mediator of inflammation. The aim of this study was to compare serum VEGF levels in three groups of subjects: 40 normal subjects, 40 allergic patients, evaluated before and after specific immunotherapy, and 40 patients with inactive SLE. Patients who were allergic before immunotherapy had the lowest VEGF serum levels, which significantly increased after treatment; SLE patients had the highest VEGF serum levels. This comparative study provides evidence that serum VEGF levels depend on the type of immune response: they are high in autoimmune disease and low in Th2-polarized allergic reaction. The relevance of this phenomenon is further apparent, as it is also observed in patients with inactive disease.