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1. The long-term spectral changes of eta Carinae: are they caused by a dissipating occulter as indicated by CMFGEN models?

Author

Damineli, A., Hillier, D. J., Navarete, F., Moffat, A. F. J., Weigelt, G., Corcoran, M. F., Gull, T. R., Richardson, N. D., Ho, T. P., Madura, T. I., Espinoza-Galeas, D., Hartman, H., Morris, P., Pickett, C. S., Stevens, I. R., Russell, C. M. P., Hamaguchi, K., Jablonski, F. J., Teodoro, M., McGee, P., Cacella, P., Heathcote, B., Harrison, K., Johnston, M., Bohlsen, T., and Di Scala, G.

Subjects
Astrophysics - Solar and Stellar Astrophysics, Astrophysics - Astrophysics of Galaxies
Abstract

Eta Carinae ($\eta$\,Car) exhibits a unique set of P Cygni profiles with both broad and narrow components. Over many decades, the spectrum has changed -- there has been an increase in observed continuum fluxes and a decrease in FeII and HI emission line equivalent widths. The spectrum is evolving towards that of a P Cygni star such as P~Cygni itself and HDE~316285. The spectral evolution has been attributed to intrinsic variations such as a decrease in the mass-loss rate of the primary star or differential evolution in a latitudinal-dependent stellar wind. However intrinsic wind changes conflict with three observational results: the steady long-term bolometric luminosity; the repeating X-ray light curve over the binary period; and the constancy of the dust-scattered spectrum from the Homunculus. We extend previous work that showed a secular strengthening of P~Cygni absorptions by adding more orbital cycles to overcome temporary instabilities and by examining more atomic transitions. {\sc cmfgen} modeling of the primary wind shows that a time-decreasing mass-loss rate is not the best explanation for the observations. However, models with a `small' dissipating absorber in our line-of-site can explain both the increase in brightness and changes in the emission and P Cygni absorption profiles. If the spectral evolution is caused by the dissipating circumstellar medium, and not by intrinsic changes in the binary, the dynamical timescale to recover from the Great Eruption is much less than a century, different from previous suggestions., Comment: 71 pages, 8 figures, 4 long tables, to appear on ApJ

Published
2022

2. Pulsations, eruptions, and evolution of four yellow hypergiants

Author

van Genderen, A. M., Lobel, A., Nieuwenhuijzen, H., Henry, G. W., de Jager, C., Blown, E., Di Scala, G., and van Ballegoij, E. J.

Subjects
Astrophysics - Solar and Stellar Astrophysics
Abstract

We aim to explore the variable photometric and stellar properties of four yellow hypergiants (YHGs), HR8752, HR 5171A, $\rho$ Cas, and HD 179821, and their pulsations of hundreds of days, and long-term variations (LTVs) of years. We tackled multi-colour and visual photometric data sets, looked for photometric indications betraying eruptions or enhanced mass-loss episodes, calculated stellar properties mainly using a published temperature calibration, and investigated the nature of LTVs and their influence on quasi-periods and stellar properties. The $BV$ photometry revealed a high-opacity layer in the atmospheres. When the temperature rises the mass loss increases as well, consequently, as the density of the high-opacity layer. As a result, the absorption in $B$ and $V$ grow. The absorption in $B$, presumably of the order of one to a few 0\fm1, is always higher than in $V$. This difference renders redder and variable $(B-V)$ colour indexes, but the absorption law is unknown. This property of YHGs is unpredictable and explains why spectroscopic temperatures are always higher than photometric ones. We propose shorter distances for $\rho$ Cas and HR 5171A than the accepted ones. Therefore, a correction to decrease the blue luminescence of HR 5171A by polycyclic aromatic hydrocarbon (PAH) molecules is necessary, and HR 5171A would no longer be a member of the cluster Gum48d. HR 5171A is only subject to one source of light variation, not by two as the literature suggests. Eruptive episodes of YHGs prefer relatively cool circumstances when a red evolutionary loop (RL) has shifted the star to the red on the HR diagram. After the eruption, a blue loop evolution (BL) is triggered lasting one to a few decades. The reddening episode of HR 5171A between 1960 and 1974 was most likely due to a red loop evolution, and the reddening after the 1975 eruption was likely due to a shell ejection., Comment: 28 pages, 18 figures, Accepted for Astronomy and Astrophysics

Published
2019
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3. A new bright eclipsing hot subdwarf binary from the ASAS and SuperWASP surveys

Author

Schaffenroth, V., Geier, S., Drechsel, H., Heber, U., Wils, P., Oestensen, R. H., Maxted, P. F. L., and di Scala, G.

Subjects
Astrophysics - Solar and Stellar Astrophysics
Abstract

We report the discovery of a bright (V=11.6 mag) eclipsing hot subdwarf binary of spectral type B with a late main sequence companion from the All Sky Automated Survey (ASAS 102322-3737.0). Such systems are called HW Vir stars after the prototype. The lightcurve shows a grazing eclipse and a strong reflection effect. An orbital period of P=0.13927 d, an inclination of i=65.86{\deg}, a mass ratio q=0.34, a radial velocity semiamplitude K_1=81.0 kms^-1, and other parameters are derived from a combined spectroscopic and photometric analysis. The short period can only be explained by a common envelope origin of the system. The atmospheric parameters (T_eff=28400 K, log g=5.60) are consistent with a core helium-burning star located on the extreme horizontal branch. In agreement with that we derived the most likely sdB mass to be M_sdB=0.46M_sun, close to the canonical mass of such objects. The companion is a late M-dwarf with a mass of M_comp=0.16 M_sun. ASAS 102322-3737.0 is the third brightest of only 12 known HW Virginis systems, which makes it an ideal target for detailed spectroscopic studies and long term photometric monitoring to search for period variations, e.g. caused by a substellar companion.

Published
2013
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4. AB0667 CHARACTERIZING ULTRASOUND-PROVEN ENTHESITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS: PREVALENCE AND IDENTIFICATION OF DISEASE SUBSET WITH LESS FREQUENT RENAL INVOLVEMENT

Author

Fagni, F., primary, Bettiol, A., additional, Silvestri, E., additional, Fedi, R., additional, Palermo, A., additional, Urban, M. L., additional, Mazzotta, R., additional, Malandrino, D., additional, Bello, F., additional, Mattioli, I., additional, Simon, D., additional, Di Scala, G., additional, Schett, G., additional, Prisco, D., additional, and Emmi, G., additional

Published
2023
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5. Erratum: Management of adult-onset Still's disease with interleukin-1 inhibitors: Evidence- And consensus-based statements by a panel of Italian experts (Arthritis Res Ther (2019) 21:275 DOI: 10.1186/s13075-019-2021-9)

Author

Colafrancesco, S., Manara, M., Bortoluzzi, A., Serban, T., Bianchi, G., Cantarini, L., Ciccia, F., Dagna, L., Govoni, M., Montecucco, C., Priori, R., Ravelli, A., Sfriso, P., Sinigaglia, L., Alivernini, S., Baldissera, E., Bartoloni, E., Berti, A., Bugatti, S., Camellino, D., Cammelli, D., Caporali, R., Caso, F., Cavallaro, E., Cavalli, G., Colaci, M., Costa, L., Di Scala, G., Emmi, G., Frassi, M., Gerli, R., Giacomelli, R., Gremese, E., Iannone, F., Lapadula, G., Leveghi, L., Lopalco, G., Manna, R., Marotto, D., Mathieu, A., Neri, R., Patisso, I., Piga, M., Punzi, L., Romano, M., Ruscitti, P., Salvarani, C., Scarpa, R., Scrivo, R., Talarico, R., Verrecchia, E., Viapiana, O., Vitale, A., AOSD Consensus Group: Alivernini S, Vitiello G., Baldissera, E, Bartoloni, E, Berti, A, Bugatti, S, Camellino, D, Cammelli, D, Caporali, R, Caso, F, Cavallaro, E, Cavalli, G, Colaci, M, Costa, L, di Scala, G, Emmi, G, and Frassi, M

Published
2020

6. Clinical profile and evolution of patients with juvenile-onset Behçet’s syndrome over a 25-year period: insights from the AIDA network

Author

Sota, J, Rigante, Donato, Lopalco, G, Emmi, G, Gentileschi, S, Gaggiano, C, Ciarcia, L, Berlengiero, V, Mourabi, M, Ricco, N, Barneschi, S, Tosi, Gm, Frediani, B, Tarsia, M, di Scala, G, Vitale, A, Iannone, F, Fabiani, C, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Sota, J, Rigante, Donato, Lopalco, G, Emmi, G, Gentileschi, S, Gaggiano, C, Ciarcia, L, Berlengiero, V, Mourabi, M, Ricco, N, Barneschi, S, Tosi, Gm, Frediani, B, Tarsia, M, di Scala, G, Vitale, A, Iannone, F, Fabiani, C, Cantarini, L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Behçet’s syndrome (BS) represents an understudied topic in pediatrics: the main aims of our study were to characterize demographic and clinical features of a cohort of BS patients with juvenile-onset managed in three tertiary referral centers in Italy, evaluate their evolution in the long-term, and detect any potential differences with BS patients having an adult-onset. Medical records of 64 juvenile-onset and 332 adult-onset BS followed-up over a 2-year period were retrospectively analyzed and compared. Mean age ± SD of first symptom-appearance was 10.92 ± 4.34 years with a female-to-male ratio of 1.06:1. Mucocutaneous signs were the most frequent initial manifestations, followed by uveitis. Throughout the disease course, genital aphthae (76.56%) and pseudofolliculitis (40.63%) prevailed among the mucocutaneous signs, while major organ involvement was represented by gastrointestinal and ocular involvement (43.75 and 34.38%, respectively). No significant differences emerged for both mucocutaneous signs and specific major organ involvement between juvenile-onset and adult BS patients. After excluding nonspecific abdominal pain, juvenile-onset BS patients were less frequently characterized by the development of major organ involvement (p = 0.027). Logistic regression detected the juvenile-onset as a variable associated with reduced risk of long-term major organ involvement (OR 0.495 [0.263–0.932], p = 0.029). In our cohort, juvenile-onset BS resembled the clinical spectrum of adult-onset patients. Pediatric patients with a full-blown disease at onset showed a more frequent mucocutaneous involvement. In addition, patients with juvenile-onset seemed to develop less frequently major organ involvement and had an overall less severe disease course.

Published
2021

7. Risk of acute arterial and venous thromboembolic events in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Author

Bettiol, A., Sinico, R. A., Schiavon, F., Monti, S., Bozzolo, E. P., Franceschini, F., Govoni, M., Lunardi, C., Guida, G., Lopalco, G., Paolazzi, G., Vacca, A., Gregorini, G., Leccese, P., Piga, M., Conti, F., Fraticelli, P., Quartuccio, L., Alberici, F., Salvarani, C., Bettio, S., Negrini, S., Selmi, C., Sciascia, S., Moroni, G., Colla, L., Manno, C., Urban, M. L., Vannacci, A., Pozzi, M. R., Fabbrini, P., Polti, S., Felicetti, M., Marchi, M. R., Padoan, R., Delvino, P., Caporali, R., Montecucco, C., Dagna, L., Cariddi, A., Toniati, P., Tamanini, S., Furini, F., Bortoluzzi, A., Tinazzi, E., Delfino, L., Badiu, I., Rolla, G., Venerito, V., Iannone, F., Berti, A., Bortolotti, R., Racanelli, V., Jeannin, G., Padula, A., Cauli, A., Priori, R., Gabrielli, A., Bond, M., Tedesco, M., Pazzola, G., Tomietto, P., Pellecchio, M., Marvisi, C., Maritati, F., Palmisano, A., Dejaco, C., Willeit, J., Kiechl, S., Olivotto, I., Willeit, P., Prisco, D., Vaglio, A., Emmi, G., Bargagli, E., Becatti, M., Beccalli, M., Bello, F., Bozzao, F., Canti, V., Cassia, M. A., Cassone, G., Catanoso, M., Chieco-Bianchi, F., Clari, R., Coladonato, L., De Santis, M., Di Scala, G., Fagni, F., Fenaroli, P., Fiorillo, C., Floris, A., Fornaro, M., Galli, E., Generali, E., Giliberti, M., Lascaro, N., Leccese, I., Mattioli, I., Olivieri, B., Osti, N., Peyronel, F., Radin, M., Righetti, G., Salvati, S., Silvestri, E., Susca, N., Tamburini, C., Taurisano, G., Trezzi, B., Trivioli, G., Bettiol, A, Sinico, R, Schiavon, F, Monti, S, Bozzolo, E, Franceschini, F, Govoni, M, Lunardi, C, Guida, G, Lopalco, G, Paolazzi, G, Vacca, A, Gregorini, G, Leccese, P, Piga, M, Conti, F, Fraticelli, P, Quartuccio, L, Alberici, F, Salvarani, C, Bettio, S, Negrini, S, Selmi, C, Sciascia, S, Moroni, G, Colla, L, Manno, C, Urban, M, Vannacci, A, Pozzi, M, Fabbrini, P, Polti, S, Felicetti, M, Marchi, M, Padoan, R, Delvino, P, Caporali, R, Montecucco, C, Dagna, L, Cariddi, A, Toniati, P, Tamanini, S, Furini, F, Bortoluzzi, A, Tinazzi, E, Delfino, L, Badiu, I, Rolla, G, Venerito, V, Iannone, F, Berti, A, Bortolotti, R, Racanelli, V, Jeannin, G, Padula, A, Cauli, A, Priori, R, Gabrielli, A, Bond, M, Tedesco, M, Pazzola, G, Tomietto, P, Pellecchio, M, Marvisi, C, Maritati, F, Palmisano, A, Dejaco, C, Willeit, J, Kiechl, S, Olivotto, I, Willeit, P, Prisco, D, Vaglio, A, and Emmi, G

Subjects
Pulmonary and Respiratory Medicine, Burden of disease, Humans, Churg-Strauss Syndrome, Granulomatosis with Polyangiitis, Venous Thromboembolism, Venous Thrombosis, Churg-strauss syndrome, Criminology, NO, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Vascular inflammation, business.industry, Conflict of interest, Cytoplasmic antibody, medicine.disease, 030228 respiratory system, Wegener granulomatosis, arterial and venous thromboembolic events, Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss syndrome), Organ involvement, business, Production team
Abstract

Eosinophilic Granulomatosis with Polyangiitis (EGPA, Churg-Strauss syndrome) is a rare anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) characterised by respiratory manifestations and systemic organ involvement [1]. Particularly, cardiac manifestations occur in 40–60% of patients, representing the leading cause of mortality [2]. Recent reports suggest that venous thromboembolic events might also represent a consistent burden of disease [3, 4], as already known for the other AAVs [5–7], possibly due to eosinophil-mediated vascular inflammation [5]. Nevertheless, the occurrence of arterial and venous thrombotic events (AVTE) has never been systematically explored in EGPA. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Alessandra Bettiol Conflict of interest: Renato Alberto Sinico Conflict of interest: Franco Schiavon Conflict of interest: Sara Monti Conflict of interest: Enrica Paola Bozzolo Conflict of interest: Franco Franceschini Conflict of interest: Marcello Govoni Conflict of interest: Claudio Lunardi Conflict of interest: Giuseppe Guida Conflict of interest: Giuseppe Lopalco Conflict of interest: Giuseppe Paolazzi Conflict of interest: Angelo Vacca Conflict of interest: Gina Gregorini Conflict of interest: Pietro Leccese Conflict of interest: Matteo Piga Conflict of interest: Fabrizio Conti Conflict of interest: Paolo Fraticelli Conflict of interest: Luca Quartuccio Conflict of interest: Federico Alberici Conflict of interest: Carlo Salvarani Conflict of interest: Silvano Bettio Conflict of interest: Simone Negrini Conflict of interest: Carlo Selmi Conflict of interest: Savino Sciascia Conflict of interest: Gabriella Moroni Conflict of interest: Loredana Colla Conflict of interest: Carlo Manno Conflict of interest: Maria Letizia Urban Conflict of interest: Alfredo Vannacci Conflict of interest: Maria Rosa Pozzi Conflict of interest: Paolo Fabbrini Conflict of interest: Stefano Polti Conflict of interest: Mara Felicetti Conflict of interest: Maria Rita Marchi Conflict of interest: Roberto Padoan Conflict of interest: Paolo Delvino Conflict of interest: Roberto Caporali Conflict of interest: Carlomaurizio Montecucco Conflict of interest: Lorenzo Dagna Conflict of interest: Adriana Cariddi Conflict of interest: Paola Toniati Conflict of interest: Dr. Tamanini reports other from Glaxo Smith Kline, outside the submitted work. Conflict of interest: Federica Furini Conflict of interest: Alessandra Bortoluzzi Conflict of interest: Elisa Tinazzi Conflict of interest: Lorenzo Delfino Conflict of interest: Iuliana Badiu Conflict of interest: Giovanni Rolla Conflict of interest: Vincenzo Venerito Conflict of interest: Florenzo Iannone Conflict of interest: Alvise Berti Conflict of interest: Roberto Bortolotti Conflict of interest: Vito Racanelli Conflict of interest: Guido Jeannin Conflict of interest: Angela Padula Conflict of interest: Alberto Cauli Conflict of interest: Roberta Priori Conflict of interest: Armando Gabrielli Conflict of interest: Milena Bond Conflict of interest: Martina Tedesco Conflict of interest: Giulia Pazzola Conflict of interest: Paola Tomietto Conflict of interest: Marco Pellecchio Conflict of interest: Chiara Marvisi Conflict of interest: Federica Maritati Conflict of interest: Alessandra Palmisano Conflict of interest: Christian Dejaco Conflict of interest: Johann Willeit Conflict of interest: Stefan Kiechl Conflict of interest: Iacopo Olivotto Conflict of interest: Peter Willeit Conflict of interest: Domenico Prisco Conflict of interest: Augusto Vaglio Conflict of interest: Giacomo Emmi

Published
2020

9. Adalimumab effectively controls both anterior and posterior noninfectious uveitis associated with systemic inflammatory diseases: focus on Behçet’s syndrome

Author

Silvestri, E., Bitossi, A., Bettiol, A., Emmi, G., Urban, M. L., Mattioli, I., Di Scala, G., Bacherini, D., Lopalco, G., Venerito, V., Iannone, F., Vitale, A., Tosi, G. M., Rizzo, S., Fabiani, C., Cantarini, L., Virgili, G., Vannozzi, L., and Prisco, D.

Subjects
eye diseases, Adalimumab, Anterior uveitis, Behçet’s syndrome, Macular edema, Ocular relapses, Uveitis
Published
2020

10. Erratum. management of adult-onset still's disease with interleukin-1 inhibitors. evidence- and consensus-based statements by a panel of Italian experts

Author

Colafrancesco, S., Manara, M., Bortoluzzi, A., Serban, T., Bianchi, G., Cantarini, L., Ciccia, F., Dagna, L., Govoni, M., Montecucco, C., Priori, R., Ravelli, A., Sfriso, P., Sinigaglia, L., Alivernini, S., Baldissera, E., Bartoloni, E., Berti, A., Bugatti, S., Camellino, D., Cammelli, D., Caporali, R., Caso, F., Cavallaro, E., Cavalli, G., Colaci, M., Costa, L., Di Scala, G., Emmi, G., Frassi, M., Gerli, R., Giacomelli, R., Gremese, E., Iannone, F., Lapadula, G., Leveghi, L., Lopalco, G., Manna, R., Marotto, D., Mathieu, A., Neri, R., Patisso, I., Piga, M., Punzi, L., Romano, M., Ruscitti, P., Salvarani, C., Scarpa, R., Scrivo, R., Talarico, R., Verrecchia, E., Viapiana, O., Vitale, A., and Vitiello, G.

Subjects
030203 arthritis & rheumatology, 0301 basic medicine, medicine.medical_specialty, Pediatrics, Adult-onset Still's disease, lcsh:Diseases of the musculoskeletal system, business.industry, Published Erratum, MEDLINE, Interleukin, Rheumatology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Internal medicine, medicine, lcsh:RC925-935, business
Abstract

Following publication of the original article [1], it was brought to our attention that the AOSD Consensus Group was incorrectly tagged and therefore not searchable. The publishers apologize for this error.

Published
2020

11. Long-term effectiveness of secukinumab in patients with axial spondyloarthritis

Author

Gentileschi, S, Rigante, Donato, Sota, J, Lopalco, G, Giannotta, Mg, Emmi, G, Di Scala, G, Iannone, F, Fabiani, C, Frediani, B, Cantarini, L, Rigante D (ORCID:0000-0001-7032-7779), Gentileschi, S, Rigante, Donato, Sota, J, Lopalco, G, Giannotta, Mg, Emmi, G, Di Scala, G, Iannone, F, Fabiani, C, Frediani, B, Cantarini, L, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Objectives. The primary aim of our study was to evaluate long-term efficacy of secukinumab (SCK) in patients with axial spondyloarthritis (axSpA); secondary aims were to evaluate drug retention rate and to identify differences in the clinical and laboratory assessment according to axSpA clinical features, dosage administered, and biologic treatment lines. Patients and Methods. We collected clinical, demographical, and treatment data from 39 patients affected by axSpA consecutively treated with SCK. Laboratory assessment was based on inflammation parameters; clinical assessment was performed with the Ankylosing Spondylitis Disease Activity Score- (ASDAS-) CRP and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Data were recorded at baseline and every 3 months for the first year and then every 6 months in the second year. Results. Twelve males and 27 females were enrolled; both BASDAI and ASDAS-CRP showed a statistically significant reduction during the observation period (p < 0:0001 and p < 0:0001, respectively). C-reactive protein significantly decreased (p = 0:006), with significant reduction at the post hoc analysis between baseline and both 6-month evaluation (p = 0:02) and 24-month visit (p = 0:036). No statistical significance was observed in BASDAI and ASDAS-CRP improvement (p = 0:482 and p = 0:164, respectively) between different dosages administered. No significant differences emerged in the BASDAI and ASDAS-CRP variations between biologic-naïve patients and subjects previously failing to tumour necrosis factor (TNF) inhibitors (p = 0:53 and p = 0:148, respectively). At the end of our observation, 7 out of 39 patients discontinued SCK. The global retention rate at the end of the study period was 78.2%, without any significant differences between biologic-naïve and anti-TNF-failure patients (p = 0:619) or between subjects administered with different SCK dosages (p = 0:614). No adverse events were reported. Conclusions. In our cohort, SCK

Published
2020

17. Real-world effectiveness of apremilast in multirefractory mucosal involvement of Behçet’s disease

Author

Lopalco, G, Venerito, V, Leccese, P, Emmi, G, Cantarini, L, Lascaro, N, Di Scala, G, Fabiani, C, Rigante, Donato, Iannone, F, Rigante D (ORCID:0000-0001-7032-7779), Lopalco, G, Venerito, V, Leccese, P, Emmi, G, Cantarini, L, Lascaro, N, Di Scala, G, Fabiani, C, Rigante, Donato, Iannone, F, and Rigante D (ORCID:0000-0001-7032-7779)

Abstract

Relapsing oral and genital ulcers (OGUs) represent the stigmata of Behçet’s disease (BD) and may be very painful, affecting both quality of life and relationships. A wide number of topical and immunosuppressive drugs can be used to treat ulcers [1], but failures are commonly reported. The efficacy of the phosphodiesterase-4 inhibitor apremilast has been proven in OGUs of BD in two randomized clinical trials (RCT) [2, 3], whereas only two case reports are available until now [4, 5]. We aimed at evaluating the real-world effectiveness of apremilast in BD patients with OGUs refractory to conventional and/or biologic treatments. We retrospectively evaluated patients classified as BD, according to International Criteria for BD [6] and International Study Group [7] criteria, who underwent apremilast (30 mg twice daily) for multirefractory OGUs from November 2017 to January 2019. The number of OGUs was assessed at baseline and either at 3 and 6 months. Pain from ulcers and BD activity were evaluated via 100-mm visual-analogue scale (VAS) and BD Current Activity Form (BDCAF). We also recorded the number of oral and genital ulcer flares both in the 4 weeks prior to apremilast start and throughout the observation period (Table 1 and Supplementary Table 2). The occurrence of adverse events was also reported. Paired t-test or Wilcoxon matched-pair signed rank test were used for statistical analysis. The off-label use of apremilast was approved by the Hospital Ethics Committee in compliance with the Declaration of Helsinki. All patients provided a written informed consent. Thirteen patients (females 9/13) with disease duration (mean ± SD) of 154 ± 167 months were analysed (Table 1). At 3 months, (data from 12/13 patients) active OGUs were significantly less (p=0.02 for both) than baseline (Table 2). Three patients stopped the treatment due to diarrhoea. At 6 months, active oral ulcers and oral relapses were still lower than baseline (p=0.03 for both), whereas only a positive tr

Published
2019

19. Prompt Clinical Response to Secukinumab in Patients with Axial Spondyloarthritis: Real Life Observational Data from Three Italian Referral Centers

Author

Gentileschi, S., Vitale, A., Rigante, D., Lopalco, G., Emmi, G., Orlando, I., Di Scala, G., Sota, J., Fabiani, C., Frediani, B., Galeazzi, M., Giovanni Lapadula, Iannone, F., and Cantarini, L.

Subjects
Adult, Male, secukinumab, Antibodies, Monoclonal, Blood Sedimentation, Middle Aged, Antibodies, Monoclonal, Humanized, Severity of Illness Index, C-Reactive Protein, Treatment Outcome, interleukin (IL)-17, Italy, axial spondyloarthritis (axSpA), seronegative arthritis, Humans, Female, Spondylitis, Ankylosing, Referral and Consultation, Aged
Abstract

Clinical research is needed to identify patients with axial spondyloarthritis (axSpA) who are more likely to be responsive to interleukin (IL)-17 inhibition.To evaluate short-term efficacy of secukinumab in the management of axSpA.Twenty-one patients (7 males, 14 females) with axSpA were consecutively treated with secukinumab. Laboratory and clinical assessments were based on erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Data were recorded at baseline and at a 3 month follow-up visit.The study was comprised of 21 patients. Both BASDAI and ASDAS-CRP showed a statistically significant reduction between the baseline and the 3 month visit (P0.0001 and P = 0.0005, respectively). During the laboratory assessment, ESR showed a significant decrease (P = 0.008) while CRP improvement did not reach statistical significance (P = 0.213). No statistical significance was observed between patients treated with secukinumab 150 mg vs. 300 mg in BASDAI (P=0.99), ASDAS-CRP (P = 0.69), ESR (P = 0.54), and CRP (P = 0.56). No significant differences emerged between the BASDAI (P = 0.15), ASDAS-CRP (P = 0.09), and CRP (P = 0.15) rates in biologic-naïve patients and those previously failing tumor necrosis factor-α inhibition. Conversely, ESR decrease was significantly higher in the biologic-naïve subgroup (P = 0.01). No adverse events were reported.Secukinumab has proven remarkable short-term effectiveness, regardless of the biologic treatment line. A dosage of 150 mg proved to be appropriate in the clinical and laboratory management of axSpA.

Published
2018

25. PROMPT CLINICAL RESPONSE TO SECUKINUMAB IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: REAL-LIFE OBSERVATIONAL DATA FROM THREE ITALIAN REFERRAL CENTERS

Author

Gentileschi, S, Vitale, A, Rigante, Donato, Lopalco, G, Emmi, G, Orlando, I, di Scala, G, Sota, J, Fabiani, C, Frediani, B, Galeazzi, M, Lapadula, G, Iannone, F, Cantarini, L, Rigante, D (ORCID:0000-0001-7032-7779), Gentileschi, S, Vitale, A, Rigante, Donato, Lopalco, G, Emmi, G, Orlando, I, di Scala, G, Sota, J, Fabiani, C, Frediani, B, Galeazzi, M, Lapadula, G, Iannone, F, Cantarini, L, and Rigante, D (ORCID:0000-0001-7032-7779)

Abstract

The use of sekunimab in patients with spondyloarthritides is herein discussed

Published
2018

27. AB0836 Drug retention rate of the first tnf inhibitor in radiographic and non radiographic axial spondyloarthritis: data from a multicenter study

Author

Lopalco, G., primary, Venerito, V., additional, Cantarini, L., additional, Emmi, G., additional, Salaffi, F., additional, Tafuri, S., additional, Bianchi, F.P., additional, Di Carlo, M., additional, Gentileschi, S., additional, Di Scala, G., additional, Nivuori, M., additional, Perniola, S., additional, Fornaro, M., additional, Anelli, M.G., additional, Cacciapaglia, F., additional, Scioscia, C., additional, Fabiani, C., additional, Galeazzi, M., additional, Lapadula, G., additional, and Iannone, F., additional

Published
2018
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31. Behçet's syndrome as a tool to dissect the mechanisms of thrombo‐inflammation: clinical and pathogenetic aspects.

Author

Becatti, M., Emmi, G., Bettiol, A., Silvestri, E., Di Scala, G., Taddei, N., Prisco, D., and Fiorillo, C.

Subjects
BLOOD platelet aggregation, SYNDROMES, INFLAMMATION, REACTIVE oxygen species, THROMBOSIS
Abstract

Summary: Behçet's syndrome (BS) is a complex disease with different organ involvement. The vascular one is the most intriguing, considering the existence of a specific group of patients suffering from recurrent vascular events involving the venous and, more rarely, the arterial vessels. Several clinical clues suggest the inflammatory nature of thrombosis in BS, especially of the venous involvement, thus BS is considered a model of inflammation‐induced thrombosis. Unique among other inflammatory conditions, venous involvement (together with the arterial one) is currently treated with immunosuppressants, rather than with anti‐coagulants. Although many in‐vitro studies have suggested the different roles of the multiple players involved in clot formation, in‐vivo models are crucial to study this process in a physiological context. At present, no clear mechanisms describing the pathophysiology of thrombo‐inflammation in BS exist. Recently, we focused our attention on BS patients as a human in‐vivo model of inflammation‐induced thrombosis to investigate a new mechanism of clot formation. Indeed, fibrinogen displays a critical role not only in inflammatory processes, but also in clot formation, both in the fibrin network and in platelet aggregation. Reactive oxygen species (ROS)‐derived modifications represent the main post‐translational fibrinogen alterations responsible for structural and functional changes. Recent data have revealed that neutrophils (pivotal in the pathogenetic mechanisms leading to BS damage) promote fibrinogen oxidation and thrombus formation in BS. Altogether, these new findings may help understand the pathogenetic bases of inflammation‐induced thrombosis and, more importantly, may suggest potential targets for innovative therapeutic approaches. Thrombotic events in BS are sustained by an inflammatory process rather than a thrombophilic state. Reactive oxygen species (ROS)‐derived modifications represent the main post‐translational fibrinogen alterations responsible for structural and functional changes. Neutrophils (pivotal in the pathogenetic mechanisms leading to BS damage) promote fibrinogen oxidation and thrombus formation in BS. [ABSTRACT FROM AUTHOR]

Published
2019
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32. INVOLVEMENT OF HYPOTHALAMUS AUTOIMMUNITY IN PATIENTS WITH AUTOIMMUNE HYPOPITUITARISM: ROLE OF ANTIBODIES TO HYPOTHALAMIC CELLS

Author

De Bellis, A, Sinisi, Aa, Pane, E, Dello Iacovo, A, Bellastella, G, Di Scala, G, Falorni, A, Giavoli, C, Gasco, V, Giordano, R, Ambrosio, Mr, Colao, A, Bizzarro, A, Bellastella, A, Italian Autoimmune Hypophysitis Network Group Arvat, E, Beck Peccoz, P, Betterle, C, Cannavo', Salvatore, Chiovato, L, Delvecchio, M, De Marinis, L, Degli Uberti, E, Ghigo, E, Maghnie, M, Mantero, F, Persani, L, Rotondi, M, Spada, A, Zatelli, M. C., DE BELLIS, Annamaria, Sinisi, Aa, Pane, E, Dello Iacovo, A, Bellastella, Giuseppe, Di Scala, G, Falorni, A, Giavoli, C, Gasco, V, Giordano, R, Ambrosio, Mr, Colao, A, Bizzarro, Antonio, and Bellastella, A.

Subjects
Adult, Male, medicine.medical_specialty, anticorpi anti-ipotalamo, Corticotropin-Releasing Hormone, Hypophysitis, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Context (language use), Hypopituitarism, Immunofluorescence, medicine.disease_cause, Biochemistry, Autoimmune Diseases, sindrome poliendocrina autoimmune, Autoimmunity, NO, Cohort Studies, Anticorpi anti-ipofisi, Endocrinology, Adrenocorticotropic Hormone, Antibody Specificity, Seroepidemiologic Studies, Internal medicine, medicine, Humans, antibodies, hypothalamus, health care economics and organizations, Autoantibodies, diabete insipido centrale, Subclinical infection, medicine.diagnostic_test, Human Growth Hormone, business.industry, Biochemistry (medical), medicine.disease, hypophysitis, Diabetes Insipidus, Neurogenic, Cross-Sectional Studies, Diabetes insipidus, Immunology, Autoimmune hypophysitis, Female, business
Abstract

Antipituitary antibodies (APA) but not antihypothalamus antibodies (AHA) are usually searched for in autoimmune hypopituitarism.Our objective was to search for AHA and characterize their hypothalamic target in patients with autoimmune hypopituitarism to clarify, on the basis of the cells stained by these antibodies, the occurrence of autoimmune subclinical/clinical central diabetes insipidus (CDI) and/or possible joint hypothalamic contribution to their hypopituitarism.We conducted a cross-sectional cohort study.Ninety-five APA-positive patients with autoimmune hypopituitarism, 60 without (group 1) and 35 with (group 2) lymphocytic hypophysitis, were studied in comparison with 20 patients with postsurgical hypopituitarism and 50 normal subjects.AHA by immunofluorescence and posterior pituitary function were evaluated; then AHA-positive sera were retested by double immunofluorescence to identify the hypothalamic cells targeted by AHA.AHA were detected at high titer in 12 patients in group 1 and in eight patients in group 2. They immunostained arginine vasopressin (AVP)-secreting cells in nine of 12 in group 1 and in four of eight in group 2. All AVP cell antibody-positive patients presented with subclinical/clinical CDI; in contrast, four patients with GH/ACTH deficiency but with APA staining only GH-secreting cells showed AHA targeting CRH- secreting cells.The occurrence of CDI in patients with lymphocytic hypophysitis seems due to an autoimmune hypothalamic involvement rather than an expansion of the pituitary inflammatory process. To search for AVP antibody in these patients may help to identify those of them prone to develop an autoimmune CDI. The detection of AHA targeting CRH-secreting cells in some patients with GH/ACTH deficiency but with APA targeting only GH-secreting cells indicates that an autoimmune aggression to hypothalamus is jointly responsible for their hypopituitarism.

Published
2012

33. Italian autoimmune hypophysitis network group.Involvement of hypothalamus autoimmunity in patients with autoimmune hypopituitarism:role of antibodies to hypothalamic cells

Author

De Bellis A, Sinisi AA, Pane E, Dello Iacovo A, bellastella G, di Scala G, Falorni A, Giavoli C, Gasco V, Giordano R, Ambrosio MR, Bizzarro A, Bellastella A., COLAO, ANNAMARIA, De Bellis, A, Sinisi, Aa, Pane, E, Dello Iacovo, A, Bellastella, G, di Scala, G, Falorni, A, Giavoli, C, Gasco, V, Giordano, R, Ambrosio, Mr, Colao, Annamaria, Bizzarro, A, and Bellastella, A.

Abstract

Antipituitary antibodies (APA) but not antihypothalamus antibodies (AHA) are usually searched for in autoimmune hypopituitarism.Our objective was to search for AHA and characterize their hypothalamic target in patients with autoimmune hypopituitarism to clarify, on the basis of the cells stained by these antibodies, the occurrence of autoimmune subclinical/clinical central diabetes insipidus (CDI) and/or possible joint hypothalamic contribution to their hypopituitarism.We conducted a cross-sectional cohort study. Ninety-five APA-positive patients with autoimmune hypopituitarism, 60 without (group 1) and 35 with (group 2) lymphocytic hypophysitis, were studied in comparison with 20 patients with postsurgical hypopituitarism and 50 normal subjects. AHA by immunofluorescence and posterior pituitary function were evaluated; then AHA-positive sera were retested by double immunofluorescence to identify the hypothalamic cells targeted by AHA. AHA were detected at high titer in 12 patients in group 1 and in eight patients in group 2. They immunostained arginine vasopressin (AVP)-secreting cells in nine of 12 in group 1 and in four of eight in group 2. All AVP cell antibody-positive patients presented with subclinical/clinical CDI; in contrast, four patients with GH/ACTH deficiency but with APA staining only GH-secreting cells showed AHA targeting CRH- secreting cells. The occurrence of CDI in patients with lymphocytic hypophysitis seems due to an autoimmune hypothalamic involvement rather than an expansion of the pituitary inflammatory process. To search for AVP antibody in these patients may help to identify those of them prone to develop an autoimmune CDI. The detection of AHA targeting CRH-secreting cells in some patients with GH/ACTH deficiency but with APA targeting only GH-secreting cells indicates that an autoimmune aggression to hypothalamus is jointly responsible for their hypopituitarism.

Published
2012

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