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1. Long-term use of inhaled glucocorticoids in patients with stable chronic obstructive pulmonary disease and risk of bone fractures: a narrative review of the literature

Author

Caramori G, Ruggeri P, Arpinelli F, Salvi L, and Girbino G

Subjects
COPD, inhaled corticosteroids, osteoporosis, fracture risk, Diseases of the respiratory system, RC705-779
Abstract

Gaetano Caramori,1 Paolo Ruggeri,1 Fabio Arpinelli,2 Laura Salvi,2 Giuseppe Girbino11Unità Operativa Complessa di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy; 2Direzione Medica, GSK, Verona, ItalyAbstract: Patients with chronic obstructive pulmonary disease (COPD) demonstrate a greater osteoporosis prevalence than the general population. This osteoporosis risk may be enhanced by treatment with inhaled corticosteroids (ICSs), which are recommended for COPD management when combined with long-acting bronchodilators, but may also be associated with reduced bone mineral density (BMD). We conducted a narrative literature review reporting results of randomized controlled trials (RCTs) of an ICS versus placebo over a treatment period of at least 12 months, with the aim of providing further insight into the link between bone fractures and ICS therapy. As of 16 October 2017, we identified 17 RCTs for inclusion. The ICSs studied were budesonide (six studies), fluticasone propionate (five studies), mometasone furoate (three studies), beclomethasone dipropionate, triamcinolone acetonide, and fluticasone furoate (one each). We found no difference in the number of bone fractures among patients receiving ICSs versus placebo across the six identified RCTs reporting fracture data. BMD data were available for subsets of patients in few studies, and baseline BMD data were rare; where these data were given, they were reported for treatment groups without stratification for factors known to affect BMD. Risk factors for reduced BMD and fractures, such as smoking and physical activity, were also often not reported. Furthermore, a standardized definition of the term “fracture” was not employed across these studies. The exact relationship between long-term ICS use and bone fracture incidence in patients with stable COPD remains unclear in light of our review. We have, however, identified several limiting factors in existing studies that may form the basis of future RCTs designed specifically to explore this relationship.Keywords: COPD, inhaled corticosteroids, osteoporosis, fracture risk

Published
2019

2. Early management of COPD: where are we now and where do we go from here? A Delphi consensus project

Author

Di Marco F, Balbo P, de Blasio F, Cardaci V, Crimi N, Girbino G, Pelaia G, Pirina P, Roversi P, Santus P, Scichilone N, Vatrella A, Pasqualetti P, and Carone M

Subjects
Italy, bronchodilator therapy, respiratory symptoms, dyspnoea, Diseases of the respiratory system, RC705-779
Abstract

Fabiano Di Marco,1 Piero Balbo,2 Francesco de Blasio,3 Vittorio Cardaci,4 Nunzio Crimi,5 Giuseppe Girbino,6 Girolamo Pelaia,7 Pietro Pirina,8 Pietro Roversi,9 Pierachille Santus,10,11 Nicola Scichilone,12 Alessandro Vatrella,13 Patrizio Pasqualetti,14 Mauro Carone15 1Department of Health Sciences, University of Milan, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy; 2SC Malattie dell’Apparato Respiratorio, AOU Maggiore della Carità, Novara, Italy; 3Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center S.p.A. Private Hospital, Department of Medicine and Health Sciences “V Tiberio”, University of Molise, Campobasso, Italy; 4Unit of Pulmonary Rehabilitation, IRCCS “San Raffaele Pisana”, Rome, Italy; 5Unità Operativa Complessa di Pneumologia e Allergologia, Policlinico Rodolico Vittorio Emanuele, Università di Catania, Catania, Italy; 6Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy; 7Department of Medical and Surgical Sciences, Unit of Respiratory Diseases, University Magna Graecia of Catanzaro, Catanzaro, Italy; 8Respiratory Unit, AOU Sassari, Sassari, Italy; 9Azienda Ospedaliera Universitaria, Policlinico di Modena, Modena, Italy; 10Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 11Division of Respiratory Diseases “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 12Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), University of Palermo, Palermo, Italy; 13Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy; 14Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Rome, Italy; 15Istituti Clinici Scientifici Maugeri, IRCCS di Cassano delle Murge, Cassano delle Murge (BA), Italy Purpose: There is a lack of consensus on the most appropriate early diagnostic strategy, criteria for early access to treatment and follow-up approach for patients with COPD. Materials and methods: A Delphi consensus project investigated the early management of COPD. We formulated two questionnaires for completion by pneumologists in Italy. Results: A total of 207 specialists completed questionnaire 1 and 184 of them questionnaire 2, between November 2016 and October 2017. Early diagnosis of COPD was considered uncommon for 93.2% of the expert panel. Regardless of the definition of “early diagnosis” – a diagnosis made before the clinical manifestation of the disease for most responders (60.4%) – experts were confident of the positive effects of early disease management, which they consider is effective in modifying the natural history of the disease. Lack of awareness of the disease was considered the first limiting factor to early COPD management for 78% of respondents. The most effective steps to reduce functional decline were considered to be smoking cessation, followed by long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA), LAMA, LABA, and finally inhaled corticosteroid/LABA (P

Published
2019

3. Early management of COPD: Where are we now and where do we go from here? a delphi consensus project

Author

Di Marco F., Balbo P., de Blasio F., Cardaci V., Crimi N., Girbino G., Pelaia G., Pirina P., Roversi P., Santus P., Scichilone N., Vatrella A., Pasqualetti P., Carone M., Di Marco F., Balbo P., de Blasio F., Cardaci V., Crimi N., Girbino G., Pelaia G., Pirina P., Roversi P., Santus P., Scichilone N., Vatrella A., Pasqualetti P., and Carone M.

Subjects
Adrenergic beta-2 Receptor Agonist, Pulmonary and Respiratory Medicine, drug combinations, practice guidelines as topic, Consensu, Predictive Value of Test, bronchodilator therapy, dyspnea, italy, respiratory symptoms, adrenal cortex hormones, adrenergic beta-2 receptor agonists, adult, bronchodilator agents, consensus, delphi technique, early diagnosis, early medical intervention, evidence-based medicine, female, humans, male, middle aged, muscarinic antagonists, predictive value of tests, pulmonary disease, chronic obstructive, surveys and questionnaires, treatment outcome, Settore MED/10 - Malattie Dell'Apparato Respiratorio, International Journal of Chronic Obstructive Pulmonary Disease, dyspnoea, Adrenal Cortex Hormone, Pulmonary Disease, Chronic Obstructive, Drug Combination, Early Diagnosi, Surveys and Questionnaire, Bronchodilator Agent, Original Research, lcsh:RC705-779, Health Policy, Environmental and Occupational Health, lcsh:Diseases of the respiratory system, Bronchodilator therapy, Dyspnea, Italy, Respiratory symptoms, Public Health, Environmental and Occupational Health, Muscarinic Antagonist, Respiratory symptom, Public Health, Human
Abstract

Fabiano Di Marco,1 Piero Balbo,2 Francesco de Blasio,3 Vittorio Cardaci,4 Nunzio Crimi,5 Giuseppe Girbino,6 Girolamo Pelaia,7 Pietro Pirina,8 Pietro Roversi,9 Pierachille Santus,10,11 Nicola Scichilone,12 Alessandro Vatrella,13 Patrizio Pasqualetti,14 Mauro Carone15 1Department of Health Sciences, University of Milan, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy; 2SC Malattie dell’Apparato Respiratorio, AOU Maggiore della Carità, Novara, Italy; 3Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center S.p.A. Private Hospital, Department of Medicine and Health Sciences “V Tiberio”, University of Molise, Campobasso, Italy; 4Unit of Pulmonary Rehabilitation, IRCCS “San Raffaele Pisana”, Rome, Italy; 5Unità Operativa Complessa di Pneumologia e Allergologia, Policlinico Rodolico Vittorio Emanuele, Università di Catania, Catania, Italy; 6Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy; 7Department of Medical and Surgical Sciences, Unit of Respiratory Diseases, University Magna Graecia of Catanzaro, Catanzaro, Italy; 8Respiratory Unit, AOU Sassari, Sassari, Italy; 9Azienda Ospedaliera Universitaria, Policlinico di Modena, Modena, Italy; 10Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 11Division of Respiratory Diseases “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 12Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), University of Palermo, Palermo, Italy; 13Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy; 14Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Rome, Italy; 15Istituti Clinici Scientifici Maugeri, IRCCS di Cassano delle Murge, Cassano delle Murge (BA), Italy Purpose: There is a lack of consensus on the most appropriate early diagnostic strategy, criteria for early access to treatment and follow-up approach for patients with COPD. Materials and methods: A Delphi consensus project investigated the early management of COPD. We formulated two questionnaires for completion by pneumologists in Italy. Results: A total of 207 specialists completed questionnaire 1 and 184 of them questionnaire 2, between November 2016 and October 2017. Early diagnosis of COPD was considered uncommon for 93.2% of the expert panel. Regardless of the definition of “early diagnosis” – a diagnosis made before the clinical manifestation of the disease for most responders (60.4%) – experts were confident of the positive effects of early disease management, which they consider is effective in modifying the natural history of the disease. Lack of awareness of the disease was considered the first limiting factor to early COPD management for 78% of respondents. The most effective steps to reduce functional decline were considered to be smoking cessation, followed by long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA), LAMA, LABA, and finally inhaled corticosteroid/LABA(P

Published
2019

5. Is early detection of late-onset Pompe disease a pneumologist's affair? A lesson from an Italian screening study

Author

Confalonieri M, Vitacca M, Scala R, Polverino M, Sabato E, Crescimanno G, Ceriana P, Antonaglia C, Siciliano G, Ring N, Zacchigna S, Salton F, Vianello A, Mattei A, De Michele F, Triolo L, Culla G, Canessa P, Girbino G, Lusuardi M, Perretta E, De Michelis C, Renda T., Confalonieri, Marco, Vitacca, Michele, Scala, Raffaele, Polverino, Mario, Sabato, Eugenio, Crescimanno, Grazia, Ceriana, Piero, Antonaglia, Caterina, Siciliano, Gabriele, Ring, Nadja, Zacchigna, Serena, Salton, Francesco, and Vianello, Andrea

Subjects
Adult, Lung Diseases, Male, 0301 basic medicine, medicine.medical_specialty, Biopsy, Maximal Respiratory Pressures, lcsh:Medicine, Late onset, Disease, 030105 genetics & heredity, Acute respiratory failure, Late Onset Disorders, 03 medical and health sciences, FEV1/FVC ratio, 0302 clinical medicine, Internal medicine, Diagnosis, Pulmonary Medicine, medicine, Humans, Pharmacology (medical), Respiratory system, Letter to the Editor, Genetics (clinical), Aged, Glycogen Storage Disease Type II, business.industry, Muscles, lcsh:R, Muscle weakness, alpha-Glucosidases, General Medicine, Middle Aged, Dried blood spot, Late-onset Pompe disease, Respiratory high dependency care unit, Noninvasive ventilation, Early Diagnosis, Italy, Respiratory failure, Female, Dried Blood Spot Testing, medicine.symptom, business, 030217 neurology & neurosurgery, Diagnosi
Abstract

Background Late-onset Pompe disease (LOPD) is a recessive disease caused by α-glucosidase (GAA) deficiency, leading to progressive muscle weakness and/or respiratory failure in children and adults. Respiratory derangement can be the first indication of LOPD, but the diagnosis may be difficult for pneumologists. We hypothesize that assessing the GAA activity in suspected patients by a dried blood spot (DBS) may help the diagnosis of LOPD in the pneumological setting. Population and methods We performed a multicenter DBS survey of patients with suspected LOPD according to a predefined clinical algorithm. From February 2015 to December 2017, 140 patients (57 ± 16 yrs., 80 males) were recruited in 19 Italian pneumological units. The DBS test was performed by a drop of blood collected on absorbent paper. Patients with GAA activity

Published
2019
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6. Autoimmunity and COPD: Clinical Implications

Author

Caramori, G, Ruggeri, P, Di Stefano, A, Mumby, S, Girbino, G, Adcock, IM, Kirkham, P, Medical Research Council (MRC), Wellcome Trust, and British Heart Foundation

Subjects
Respiratory System, PATHOGENESIS, Autoimmunity, EMPHYSEMA, mAbs, OBSTRUCTIVE PULMONARY-DISEASE, MECHANISMS, Pulmonary Disease, Chronic Obstructive, Autoantibody, Critical Care Medicine, General & Internal Medicine, Humans, SYSTEMIC-LUPUS-ERYTHEMATOSUS, Autoantibodies, BALT, Science & Technology, 1103 Clinical Sciences, CELL-ACTIVATING FACTOR, respiratory tract diseases, T-CELLS, Disease Progression, MONOCLONAL-ANTIBODIES, ADCC, BALT, Autoantibody, Autoimmunity, mAbs, ADCC, Life Sciences & Biomedicine, LUNG, Biomarkers
Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Long term cigarette smoking is the cause of more than 90% of COPD in Westernized countries. However, only a fraction of chronic heavy smokers develop symptomatic COPD by the age of 80 years. COPD is characterized by an abnormal immune response in the lower airways and its progression is associated with infiltration of the lung by innate and adaptive inflammatory immune cells that form lymphoid follicles. There is growing evidence that both cellular- and antibody-mediated autoimmunity has a fundamental role in the pathogenesis of stable COPD. In particular, carbonyl-modified proteins may help to drive autoimmunity in COPD and to cause the characteristic small airways abnormalities and even contribute to the pathogenesis of pulmonary emphysema. Although direct, indirect, and circumstantial evidence of a role for autoimmunity in stable COPD patients has been identified, no cause-and-effect relationship between autoimmunity and the mechanisms of COPD has been firmly established in man. As such the potential contribution of an autoimmune response to the pathogenesis of COPD exacerbation is still being investigated and represents an area of active research. Many drugs targeting autoimmune responses are already available and the results of controlled clinical trials are awaited with great interest. The potential for measuring specific serum autoantibodies as biomarkers to predict clinical phenotypes or progression of stable COPD is promising.

Published
2018

7. TGF-β signalling pathways in different compartments of the lower airways of stable COPD patients

Author

Di Stefano, A, Sangiorgi, C, Gnemmi, I, Casolari, P, Brun, P, Ricciardolo, FL, Contoli, M, Papi, A, Maniscalco, P, Ruggeri, P, Girbino, G, Cappello, F, Pavlides, S, Guo, Y, Chung, KF, Barnes, PJ, Adcock, IM, Balbi, B, Caramori, G, Wellcome Trust, and National Institute for Health Research

Subjects
TGF-β, TGFβ, BAMBI, autoimmunity, Respiratory System, CTGF, 1103 Clinical Sciences, respiratory system, airway inflammation, SMAD, respiratory tract diseases
Abstract

BACKGROUND: The expression and localization of transforming growth factor-beta (TGF-β) pathway proteins in different compartments of the lower airways of stable COPD patients is unclear. OBJECTIVE: To determine TGF-β pathway protein expression in patients with stable COPD. METHODS: The expression and localization of TGF-β pathway components was measured in the bronchial mucosa and peripheral lung of patients with stable COPD (n=44), control smokers with normal lung function (n=24) and control non-smoking subjects (n=11) using immunohistochemistry. RESULTS: TGF-β1, TGF-β3 and CCN2 expression were significantly decreased in the bronchiolar epithelium, with TGF-β1 also decreased in alveolar macrophages, of stable COPD patients compared to control smokers with normal lung function. TGF-β3 expression was increased in the bronchial lamina propria of both control smokers with normal lung function and mild/moderate stable COPD compared to control non-smokers and correlated significantly with pack-years. However, TGF-β3+ cells decreased in severe/very severe COPD compared to control smokers. LTBP-1 expression was increased in the bronchial lamina propria in stable COPD of all severities compared with control smokers with normal lung function. BAMBI expression in the bronchial mucosa was significantly increased in stable COPD of all severities compared to control subjects. No other significant differences were observed between groups for all the other molecules studied either in the bronchial mucosa and peripheral lung. CONCLUSION: Expression of TGF-βs and their regulatory proteins is distinct within different lower airway compartments in stable COPD. Selective reduction in TGF-β1 and enhanced BAMBI expression may be associated with the increase in autoimmunity in COPD.

Published
2017

15. IS OLEA POLLINOSIS INCREASING? : 142

Author

Fiorello, G., Stillittano, M., Salmeri, V., Morabito, M., Sapiente, V., Mazza, R., Colletti, F., Vastola, M. B., and Girbino, G.

Published
1997

28. CLOSE CORRELATION BETWEEN ANXIETY; DEPRESSION; AND ASTHMA CONTROL

Author

DI MARCO F, VERGA M, SANTUS P, GIOVANNELLI F, BUSATTO P, NERI M, GIRBINO G, CENTANNI S, RESPIR MED, BONINI, Sergio, DI MARCO, F, Verga, M, Santus, P, Giovannelli, F, Busatto, P, Neri, M, Girbino, G, Bonini, Sergio, Centanni, S, and Respir, Med

Published
2009

29. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

Author

BUSSE WW, PEDERSEN S, PAUWELS RA, TAN WC, CHEN YZ, LAMM CJ, Eckmayr J, Riedler J, Wurzinger G, Ott G, Zarkovic J, Schulheim A, Götz M, Schinko H, Thomüller I, de Backer W, van Bever H, Verleden G, de Boeck C, Aumann J, Vincken W, Dab I, de Vuyst P, de Jonghe M, Casimir G, Joos G, de Baets F, Bogaerts Y, Halloy JL, Bartsch P, Thiriaux J, Pohunek P, Rybníćek O, Skopková O, Pavelková L, Broź P, Ohnutková E, Novotná B, Baly J, Krćmová I, Kuralová Z, Koćí T, Honomichlová H, Kaśák V, Panzner P, Vondra V, Némećková J, Seberová E, Sykora T, Vít P, Turzíková J, Sörensen T, Neldam S, Peter J, Kludt J, Hansen UB, Knudsen T, Schultz PJ, Rost D, Jensen F, Kinnula V, Saarelainen P, Eho Remes M, Valovirta E, Venho KK, Kokko E, Järvinen M, Toljamo T, Taivainen A, Kava T, Herrala J, Kuusela AL, Nordgren P, Syvänen P, Godard P, Rufin P, Anton M, Aubert JP, Grosclaude M, Brambilla C, Archaud P, Racineux JL, Muir JF, Albertini M, Le Roux P, Simmons A, Bartuschka B, von Berg A, Bergmann V, Berns J, Bisping Arnold A, Blum HC, Garanin G, Brückner OJ, Burbach P, Sudhoff H, Feldmann M, Schmoller T, Wozny HW, Galaske R, Huptas M, Kaecke J, Köcher V, Laule Peschel M, Lohr E, Goldberg J, Drescher T, Reeh W, Rabe U, Rehn L, Scheffler NK, Steinmetz KO, Stutz PM, Weber HH, Uhde C, Ullner R, Vehar H, Krohn EU, Orosz M, Devai A, Uhereczky G, Rajkay K, Gönczi F, Györi E, Dobra G, Puha K, Sztancsik Z, Gömöri K, Dolinay T, Bittera I, Palinkasi S, Cseke Z, Bisits M, Bjämer D, Holme JI, Langhammer A, Hunstad K, Holmboe JH, Grangård E, Solberg DA, Grönneröd TA, Salkowitsch MB, Oymar K, Iversen K, Szczeklik A, Chyrek Borowska S, Mincewicz G, Malaczynska T, Latos T, Obtulowicz K, Emeryk A, Gorski P, Nowak D, Szmidt M, Alkiewicz J, Ziolo G, Spychalski L, Chmielewska Szewczyk D, Nowacka K, Pirozynski M, Prokurat H, Boznanski A, Malolepszy J, Rogala E, Kozielski J, Eriksson UL, Wahlestedt H, Selberg M, Larsson R, Rignér K, Alm B, Aronsson M, Winnergård I, Lagerwall M, Martinsons U, Berlin L, Rydberg B, Weston D, Johnson ME, Barrett C, Siafakas N, Mantzourani E, Orphanidou D, Trakopoulos G, Tzannes S, Kotsovoulou V, Dimadi M, Amfilochiou A, Priftis K, Papageorgiou Saxoni F, Christaki P, Tsanakas I, Paraskevi M, Bousmoukilia S, Spiropoulos K, Anthrakopoulos M, Roussos C, Bentur Alkouby L, Heimer D, Tal A, Horowitz I, Soferman R, Katz Y, Stav D, Weiler Z, Bibi H, Rottem M, Mandelberg A, Geller C, Roizin H, Weiler Ravell D, Kramer MR, Schwartz Y, Rossi A, Foresi A, Giuntini C, Bisetti A, Scoditti S, Tranfa C, Zacchello F, Giovannini M, Boner A, Fabbri LM, Girbino G, Barberio G, Cacciari E, Montefort S, Parascandalo R, Pato R, de Lourdes Chieira M, Moreira C, Chieira DS, Brito U, Borges FD, Marques AC, Figueiredo MM, Dias F, de Almeida AB, Cesar Ramos J, Valente MJ, Pereira JD, Nunes C, Riberio MF, Marques A, Carvalho MQ, de Azevedo MV, de Almeida AR, Pinto JA, Matos Mde F, Afonso A, Dos Santos JM, Fernandez CV, Agustin IC, Bejarano JM, Santos AA, Font ET, Huet EH, Lorente TL, Pujol MM, Munoz AP, Aineto PS, Forns SB, Areu JB, Casan P, Garcia JM, Rodriguez AV, Segura PA, Gil RS, Ciscar CP, Garcia JF, Jimenez TV, Gonzalez JI, Andres FQ, Bueno TA, Baticon CO, Miguel CR, Garcia FD, Hernando HV, Vina AL, Matia RA, Cumplido AS, Andueza MC, Cabra MS, Navarro PL, Rodriguez FA, Li JH, Landry D, O'Keefe D, Muram BF, Conter HS, Tweel D, Peters SD, Adelglass J, Baker JW, Berger WE, Bernstein DI, Blake KV, Amelong P, Casale TB, Charous BL, Chervinsky P, Condemi JJ, Cook D, Creticos PS, de Graff AC Jr, Smith T, Ellis MH, Grossman J, Halverson PC, Galant S, Hollingsworth H, Jackson C, Jacobs RL, Welch M, Kraemer MJ, Leflein J, Lemanske RF, Liebhaber MI, Lockey R, Kelly B, Mendelson L, Nayak A, Pearlman DS, Ruff M, Schwartz B, Scott MB, Shapiro GG, Silk HJ, Skoner DP, Stoloff S, Swamy KN, Atkins FM, Szefler SJ, Vandewalker M, Wald J, Weinstein SF, Wong DA, Wu F, Goldstein S, Murthy KC, Dolmann A, Gene R, Casas JC, Piovano C, Segal E, Balanzat AM, Taborda J, Truganti A, Teper A, Garrood J, Patel MJ, Hogan C, Russel G, Zhu YJ, Cao L, Liu SY, Miao JZ, Ding DJ, Yao WZ, Liu YN, Chen P, Kong SQ, Pang L, Sun B, Li ZM, Li GS, Chen PL, Zhu Q, Zhang TX, Wang XH, Wei S, Deng WW, Zhou X, Ji YY, Luo WT, Li Q, Zhu HR, Sheng JY, Ma JY, Zhang DP, Ji CZ, Xia XR, Zhang ZY, Yin KS, Yiang J, Li Y, Tang PW, Liu FG, Wang HP, Zhong NS, Rong ZS, Tang YC, Lin CY, Liu JS, Liu HZ, Cai DM, Yang JC, Ma QF, Mangunnegoro H, Wijono CA, Tobing NH, Rahajoe NN, Sugito, Surjanto E, Hisyam B, Alsagaff H, Santosa G, Kim YY, Park CS, Kim MK, Cho YJ, Choi DC, Jee YK, Mohan J, Yogeswery S, Wong SL, Kuan GL, Koh CT, Quah BS, de Bruyne J, Liam CK, Avila MM, Cuevas F, Chavaje N, Topete LA, Badillo I, Ponce M, Merida JC, Espinosa AG, Ledezma JM, García JA, Morales GG, Gomez JM, Martinez FJ, Ramos JE, Dorantes JR, Gonzalez CC, Vera JG, Bayardo RG, Melendez AP, Loyola CB, Suárez MA, de Guia T, Balgos A, Bautista N, Realiza T, Diaz D, Yu C, Mendoza Wi JA, Juaneza R, Bigornia R, Mansukhani P, Cacanindin DN, Wah LB, Hon YK, Yau OY, Moh CO, Tang WY, Dippenaar YD, Kirsten DL, Maraschin EF, Ossip MS, Visser SS, Mouton WL, Mercer M, Cassim KM, Macleod AH, Bateman ED, Leaver R, Morison A, Nel H, von Delft KH, Vermeulen JH, Weinberg EG, Lund RJ, Weber HC, Kuo SH, Kuo HP, Wang JL, Hsiue TR, Wang JH, Ching CD, Vangveeravong M, Pothiratana C, Trakultivakorn M, Kongpanichkul A, Thamanavat B, Fuangtong R, Suntornlohanakul S, Youngchaiyud P, Teeratakulpisarn J, Boonsawat W, Viriyachaiyo V, Direkwattanachai C, Visitsunthorn N., MIRAGLIA DEL GIUDICE, Michele, Busse, Ww, Pedersen, S, Pauwels, Ra, Tan, Wc, Chen, Yz, Lamm, Cj, Eckmayr, J, Riedler, J, Wurzinger, G, Ott, G, Zarkovic, J, Schulheim, A, Götz, M, Schinko, H, Thomüller, I, de Backer, W, van Bever, H, Verleden, G, de Boeck, C, Aumann, J, Vincken, W, Dab, I, de Vuyst, P, de Jonghe, M, Casimir, G, Joos, G, de Baets, F, Bogaerts, Y, Halloy, Jl, Bartsch, P, Thiriaux, J, Pohunek, P, Rybníćek, O, Skopková, O, Pavelková, L, Broź, P, Ohnutková, E, Novotná, B, Baly, J, Krćmová, I, Kuralová, Z, Koćí, T, Honomichlová, H, Kaśák, V, Panzner, P, Vondra, V, Némećková, J, Seberová, E, Sykora, T, Vít, P, Turzíková, J, Sörensen, T, Neldam, S, Peter, J, Kludt, J, Hansen, Ub, Knudsen, T, Schultz, Pj, Rost, D, Jensen, F, Kinnula, V, Saarelainen, P, Eho Remes, M, Valovirta, E, Venho, Kk, Kokko, E, Järvinen, M, Toljamo, T, Taivainen, A, Kava, T, Herrala, J, Kuusela, Al, Nordgren, P, Syvänen, P, Godard, P, Rufin, P, Anton, M, Aubert, Jp, Grosclaude, M, Brambilla, C, Archaud, P, Racineux, Jl, Muir, Jf, Albertini, M, Le Roux, P, Simmons, A, Bartuschka, B, von Berg, A, Bergmann, V, Berns, J, Bisping Arnold, A, Blum, Hc, Garanin, G, Brückner, Oj, Burbach, P, Sudhoff, H, Feldmann, M, Schmoller, T, Wozny, Hw, Galaske, R, Huptas, M, Kaecke, J, Köcher, V, Laule Peschel, M, Lohr, E, Goldberg, J, Drescher, T, Reeh, W, Rabe, U, Rehn, L, Scheffler, Nk, Steinmetz, Ko, Stutz, Pm, Weber, Hh, Uhde, C, Ullner, R, Vehar, H, Krohn, Eu, Orosz, M, Devai, A, Uhereczky, G, 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Published
2008

46. Imbalance of serum cytokine network in sarcoid patients: index of sarcoidosis relapse?

Author

Francesca Salmeri, Sofo, V., Andò, F. G., Vastola, M. B., Crosca, S., Bitto, A., Gaeta, M., and Girbino, G.

Subjects
Adult, Male, Sarcoidosis, Middle Aged, Peptidyl-Dipeptidase A, Cytokine network, Th1/Th2 cells, Receptors, Tumor Necrosis Factor, Respiratory Function Tests, Cytokines, Humans, Female, Biomarkers, Chemokine CCL2, Aged
Abstract

The follow-up of sarcoidosis is usually performed by invasive tools such as thoracic biopsy, supported by Broncho-Alveolar Lavage (BAL), Gallium-scintigraphy and Gadolinium Magnetic Resonance Imaging (Gd-MRI) to evaluate the degree of disease. Its pathogenesis can be ascribed to an accumulation of cells due to the disregulation of the immune system which involves Th1/Th2 cells as well as the soluble factors they generate. We evaluated serum cytokine and membrane marker levels (cytokine network) in sarcoid patients in order to study the correlation with the disease activity, in particular with the occurrence of sarcoidosis relapses.Seven sarcoid patients clinically stable without therapy, at different stages, were enrolled in our study. Cytokine and membrane marker serum values were measured monthly for 24 months, after a six-month period of run-in, by ELISA assay and MoAb indirect immunofluorescence, respectively.In some patients at the first and second stages of the disease we observed MCP-1 and inflammatory cytokine peaks and, moreover, MCP-1 values were increased before other cytokine values. After three subsequent increases of these parameters were observed, according to our personal experience, Gadolinium-MRI confirmed the presence of an increase of the lesion and therefore our hypothesis of sarcoidosis relapse. Only one patient at stage III showed constantly elevated values of fibro-angiogenic cytokines and membrane receptors of the TNF receptor family.Cytokine network monitoring could be a non-invasive means of following up the clinical course of sarcoidosis.

Published
2003

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