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The prevalence of osteoporosis is about three times greater in people living with HIV than in the general population. Bisphosphonates are the only class of antiresorptive drugs which have proved to be safe and effective in HIV patients. However, bisphosphonates are not recommended in women of childbearing age due to an increased rate of associated neonatal complications. To the best of our knowledge no reports on the use of denosumab in HIV-infected individuals have been published so far. We describe a 38 year-old woman with HIV, osteoporosis and vertebral fractures treated with denosumab, a monoclonal antibody targeting RANKL. After four years of treatment, bone mineral density improved, no new fractures occurred, and neither HIV reactivation nor opportunistic infections were observed. We show that denosumab could be a safe and effective approach for osteoporosis in patients with HIV and could be considered in women of childbearing age.

The aim of this study was to promote the construction of a real network and a shared diagnostic and therapeutic management model between hospitals and out-of-hospital healthcare services to capture as many patients with bone fragility as possible. Starting from the analysis of the clinical competences present in the province of Pavia, the bone specialists (BSs) organized some educational events involving both general practitioners (GPs) and hospital specialists. The Fracture Liaison Service (FLS) model, the revision of Note 79, the national plan for chronicity and the health reform of the Lombardy Regional Authority supported the structure of our model, in which the roles of clinicians are well defined and based on the complexity and severity of patients. In our method the GP has a central role as clinical manager, facilitating patient management and communication between the specialists and the BS. In January 2019, the Therapeutic Care Diagnostic Path (PDTA) shared between 2 bone specialists (BSs), 9 GPs, as reference treaters, and a multidisciplinary group of 25 specialists of the Province of Pavia was defined. The strategic directions of the two largest public hospitals in Pavia have supported the PDTA, which was validated by the quality departments of the hospitals themselves. Finally, sixty GPs belonging to the network have joined the PDTA. This model is the first example of integrated management between hospitals and out-of-hospital healthcare services for the primary and secondary prevention of fragility fractures (FF), where the GPs play a pivotal role as managers and supervisors to ensure proper care to chronic patients according to their levels of severity.

Osteoporosis and fractures are common and invalidating consequences of chronic glucorticoid (GC) treatment. Reliable information regarding the epidemiology of GC induced osteoporosis (GIOP) comes exclusively from the placebo group of randomized clinical trials while observational studies are generally lacking data on the real prevalence of vertebral fractures, GC dosage and primary diagnosis. The objective of this study was to evaluate the prevalence and incidence of osteoporotic fractures and to identify their major determinants (primary disease, GC dosage, bone mineral density, risk factors, specific treatment for GIOP) in a large cohort of consecutive patients aged >21 years, on chronic treatment with GC (≥5 mg prednisone - PN - equivalent) and attending rheumatology centers located all over Italy. Glucocorticoid Induced OsTeoporosis TOol (GIOTTO) is a national multicenter cross-sectional and longitudinal observational study. 553 patients suffering from Rheumatoid Arthritis (RA), Polymyalgia Rheumatica (PMR) and Connective Tissue Diseases (CTDs) and in chronic treatment with GCs were enrolled. Osteoporotic BMD values (T score

Rheumatoid arthritis (RA) is a chronic immune-inflammatory disease associated with significant bone damage. Pathological bone remodeling in RA is primarily driven by persistent inflammation. Indeed, pro-inflammatory cytokines stimulate the differentiation of bone-resorbing osteoclasts and, in parallel, suppress osteoblast function, resulting in net loss of bone. Abating disease activity thus remains the major goal of any treatment strategy in patients with RA. Autoantibody-positive patients, however, often show a rapidly progressive destructive course of the disease, disproportionate to the level of inflammation. The epidemiological association between RA-specific autoantibodies, in particular anti-citrullinated protein autoantibodies, and poor structural outcomes has recently found mechanistic explanation in the multiple roles that B cells play in bone remodeling. In this review, we will summarize the substantial progress that has been made in deciphering how B cells and autoantibodies negatively impact on bone in the course of RA, through both inflammation-dependent and independent mechanisms.

Diffuse alveolar hemorrhage (DAH) is a rare life-threatening condition which refers to the presence of red blood cells within alveoli deriving from hemorrhage originating in the pulmonary microvasculature. It differs from alveolar filling, in which blood cells derive from localized bleeding, usually of bronchial origin. DAH may be part of diffuse alveolar injury of any origin. DAH should be considered a medical emergency due to the significant morbidity and mortality associated with respiratory failure, when secondary to impaired oxygen uptake from alveoli filled with erythrocytes. Patients with alveolar hemorrhage present with non-specific symptoms like dyspnea, cough and hemoptysis, which is not always present. They may develop acutely or insidiously over a few days. We present a case of a patient with probable Behçet’s disease complicated by pulmonary capillaritis and DAH resulting in refractory respiratory failure and death.

In rheumatic diseases, biomarkers may serve as surrogate endpoints for diagnosis, prognosis, disease activity, therapeutic response and disease outcome. In recent years a great effort has been made to identify useful tools to establish early diagnosis, prognosis and therapeutic response especially in rheumatoid arthritis (RA). In psoriatic arthritis (PsA) serological biomarkers have been frequently borrowed from RA, but this approach have sometimes lead to inappropriate choices of biomarkers and incorrect conclusions. Furthermore, the heterogeneous spectrum of articular manifestation of PsA and the variable course of the disease can make diagnosis and prognosis difficult. Recently, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) identified two key areas for biomarkers development in psoriasis and PsA: the diagnosis of the articular disease in patients with psoriasis and the evaluation of joint damage in PsA. In this review we revised the currently available and the new potential markers for PsA, such as serum, genetic, cellular and histological biomarkers, clinical and imaging data, with particular attention on the prognostic aspect in order to identify progressive disease suitable for a more aggressive treatment.

Objective: to evaluate the effectiveness of fundoscopy, electrooculography, electroretinogram and visually evoked potentials in early detection of hydroxychloroquine retinal toxicity in RA patients and to evaluate the influence of patients’ age, drug dosage, concomitant therapy (prednisone and methotrexate) and serum creatinine levels in the development of this side effect. Methods: from september to december 1999, we have enrolled 32 RA patients (13 males, 19 females) starting hydroxichlorochine treatment. The patients underwent regular ophthalmological examination (fundoscopy, electro-oculography, electro-retinogram and visually evoked potentials) every 4 months. Disease activity was evaluated every two months by clinical and routine serological examination. Results: no patients developed retinopathy during 1 year’s follow-up; fundoscopy, electrooculography, and visually evoked potentials did not vary from the baseline. On the other hand, electroretinogram showed early alterations of scotopic and photopic response; moreover a significant statistical correlation between patients’ age (more than 65 years) and b1 photopic wave increase (p < 0,05) was observed. No correlation was found between the developement of electro- retinographic alterations and hydroxychloroquine dosage, concomitant therapy and serum creatinine levels Conclusion: our data show the inefficacy of fundoscopy, electrooculography and visually evoked potentials in early detection of hydroxychloroquine retinopathy. On the other hand electroretinogram allows early detection of retinal alterations during hydroxychloroquine treatment, in patients older than 65 years.

É apresentado um caso de chagásico crônico, portador de doença de Hodgkin, tratado com imunossupressores, no qual foi observado parasitismo incomum do esôfago e do miocárdio. É dada ênfase à raridade da localização esofágica de ninhos de leishmânias na doença de Chagas crônica do adulto, bem como às dimensões do parasito e às características das formas amastigotas.An unusual case of chronic Chagas' disease is presented in which very intense parasitism was observed in the esophagus and in the myocardium. Hodgkin's disease and treatment with immunosupressants were associated findings. Emphasis is put on the rarity of the esophagic localization of leishmanial pseudocyst in the chronic Chagas' disease of the adult, on the dimensions of the pseudocyst, and on the characteristics of the amastigote forms.

Breeding from prepubertal females reduces the generation interval and increases the rate of genetic gain in animal breeding programs. Despite considerable interest in this technology, its efficiency remains too low. Reduced in vitroand in vivodevelopmental competence of oocytes derived from prepubertal animals have been reported in association with morphologic, metabolic, and biochemical differences. The objective of this study was to compare the relative transcript abundance of a panel of developmentally important genes in embryos produced in vitrofrom prepubertal lamb and adult sheep oocytes. Cumulus–oocyte complexes derived from ovaries of regularly slaughtered 1-month-old prepubertal and adult sheep were matured in vitroin TCM-199 with 10% heat-treated oestrus sheep serum (OSS), 10 μL mL-1of FSH/LH and 100 μmcysteamine, in 5% CO2in air at 38.5°C for 24 h. Matured oocytes were fertilized with frozen–thawed ram semen in SOF medium + 2% OSS for 22 h at 38.5°C and 5% CO2, 5% O2, and 90% N2atmosphere. Zygotes were cultured in SOF + AA + 0.4% BSA in 5% CO2and 5% O2up to blastocyst stage. Three groups of 10 blastocysts for each class (4 replicates) were used to quantify the relative expression of 15 genes by reverse transcription followed by real-time PCR. The relative quantification of the transcripts was performed with the 2-ddCt method (Livak and Schmittgen 2001 Methods 25, 402–408), after normalization against the β-actin expression levels. The analysis of gene expression evidenced higher relative abundance for Aquaporin 3, P34Cdc2, cyclin B, Oct4, H2A.Z, and Nanog transcripts in sheep embryos than in prepubertal-derived ones (ANOVA; P< 0.05), while interferon τ and insulin-like growth factor (IGF) 2 mRNAs were significantly more abundant in lamb-derived embryos (ANOVA; P< 0.01). No differences were observed for the remaining analyzed transcripts (BAX, IGF2R, heat shock protein 90, NaKATPase, E-cadherin, PAP, and glyceraldehyde 3-phosphate dehydrogenase). Overall, results show that embryos produced in vitrofrom prepubertal and adult oocytes display different patterns of expression at the blastocyst stage. Such difference may be related to the generally observed reduced in vitroand in vivodevelopmental competence. Increased understanding of the gene expression status during pre-implantation development may provide valuable insights into the molecular basis underlying the very early stages of life and an opportunity for optimizing in vitroembryo production systems. [ABSTRACT FROM AUTHOR]

Cryopreservation of oocytes is still an open problem because of their structural sensitivity to the cooling and freezing process. Meiotic spindle disorganization and chromosomal aberrations are frequently observed, possibly due to the alteration of molecules involved in the meiotic cell cycle regulation and spindle formation such as maturation promoting factor (MPF) and mitogen-activated protein kinase (MAPK). In this study we treated MII ovine oocytes with caffeine before vitrification and we evaluated the effect on (1) MPF and MAPK activity and (2) oocyte spontaneous or induced parthenogenetic activation. Oocytes from slaughterhouse sheep ovaries were in vitro-matured for 21 h in TCM-199 + 10% FCS + FSH, LH + cysteamine, and then incubated for 2 h with (+) or without (-) caffeine (20 mM; Sigma-Aldrich, Milan, Italy). Thereafter, MII oocytes were vitrified by equilibration with 10% ethylene glycol (EG) + 10% DMSO (30 s), exposure to 20% EG + 20% DMSO + 0.5 M sucrose (20 s), loading onto the Cryotop, and plunging into liquid nitrogen. After warming, groups of (+) and (-) oocytes were used for MPF and MAPK assays or (A) cultured in TCM-199 + 10% FCS for 24 h to evaluate spontaneous parthenogenetic activation, or (B) activated with ionomycin (5 M, 5 min; Sigma) and cultured as in A. Fresh (+) and (-) oocytes were processed as above as controls. All oocytes were stained with glycerol-Hoechst 33342 to evaluate chromatin configuration. After vitrification, similar rates of spontaneous parthenogenetic activation between (+) and (-) oocytes (12/38, 31.6% vs. 16/38, 42.1%, respectively) were observed. However, the number of oocytes with a regular chromatin configuration in the MII plate was significantly higher (P < 0.01; chi-square test) in vitrified (+) compared to (-) oocytes (22/38, 57.9% vs. 4/38, 10.5%, respectively). After incubation with ionomycin, a significantly (P < 0.05) lower proportion of activated oocytes was recorded in the (+) compared to the (-) group (19/49, 38.8% vs. 32/53, 60.4%, respectively). In the control oocytes, the treatment with caffeine significantly (P < 0.01) decreased the activation rate after ionomycin stimulation compared to that of non-caffeine-treated control oocytes (6/51, 11.8% vs. 28/46, 60.9%, respectively), but no difference in spontaneous parthenogenetic activation was found between (+) and (-) groups (6/38, 15.8% vs. 6/46, 13.0%, respectively). Analysis of MPF and MAPK activities showed that caffeine treatment significantly increased (P < 0.05; ANOVA) the levels of the 2 kinases of vitrified MII oocytes, and these values are comparable to those of MII fresh oocytes. These results show that caffeine can increase MPF and MAPK activity in vitrified ovine oocytes and thus may contribute toward maintaining a regular chromatin organization in the MII plate and toward the decrease in parthenogenetic iomomycin-induced activation. Experiments are in progress to test the efficiency of caffeine treatment to improve the development competence of vitrified MII ovine oocytes. [ABSTRACT FROM AUTHOR]

Zygote arrest 1 (ZAR1) is an ovary-specific maternal factor that plays essential roles during the oocyte-to-embryo transition. It is evolutionary conserved in vertebrates, and the protein is characterized by the presence of a homeobox zing finger domain, suggesting its role in transcription regulation. Discovered in mice (Wu et al. 2003 Nat. Genet. 33, 187-191), its expression pattern has been analyzed in oocytes and pre-implantation embryos in mice, cattle, and pig (Pennetier et al. 2004 Biol. Reprod. 71, 1359-1366; Brevini et al. 2004 Mol. Reprod. Dev. 69, 375-380; Reprod. Biol. Endocrinol. 21, 4-12). Because no information on Zar1 ortholog in the ovine species is available, the aim of this study was to assess its presence and to analyze its expression pattern in oocytes and pre-implantation embryos. Reverse transcription-polymerase chain reaction (RT-PCR) was performed in germinal vesicle (GV) and IVM metaphase II (MII) oocytes, and, following IVFC, in 2- (2C), 4- (4C), 8- (8C), and 12-16- (12C-16C) cell embryos, morulae, and blastocysts. Primers were designed on the basis of bovine and swine conserved sequences and contained an intron-spanning region. The PCR product was sequenced and the alignment, performed with BLAST (www.ncbi.nlm.nih.gov/BLAST/), confirmed its homology with the Zar1 orthologous genes present in public databases, sharing 98%, 92%, and 89% nucleotide identity with the bovine, porcine, and human sequences, respectively. Real-time PCR revealed that Zar1 is present at its highest level in the GV oocyte, has a major decrease at the MII stage (around 10-fold), remains constant in the embryo first cleavage steps (2C-4C), drops again at the 8C stage (around 30-fold), and disappears in morulae and blastocysts. Our data demonstrate that a Zar1 ortholog is present in the ovine species. Results are also in accordance with the expression patterns characterized in other mammalian species and suggest that Zar1 transcript in the ovine oocyte may be necessary for normal female reproduction in the transition from oocyte to embryonic life. [ABSTRACT FROM AUTHOR]

Suboptimal culture conditions during in vitro maturation (IVM) affect oocyte developmental competence and the viability of the resulting embryo. Three-dimensional (3D) culture systems provide a more biologically appropriate environment compared to traditional two-dimensional (2D) cultures. The aim of this study was to evaluate the effect of liquid marble (LM) microbioreactors as a 3D culture system on IVM and the subsequent embryo development of prepubertal goat oocytes. The cumulus-oocyte complexes (COCs) recovered from prepubertal goat ovaries underwent IVM in drops under oil (the 2D system and the control group) and in the 3D LM system (the LM group). After IVM, oocytes were parthenogenetically activated and cultured until the blastocyst stage. The control and LM groups showed similar rates of nuclear maturation (52.17% and 44.12%) and blastocyst formation (10.64% and 10.10%). Reactive oxygen species and glutathione levels and the density of transzonal projections (TZPs) in oocytes did not differ between groups. The LM system increased mitochondrial activity and modified the organization of these organelles in the oocyte cytoplasm compared to the control group. The LM microbioreactor demonstrated the ability to improve the mitochondrial status of the oocytes and was not harmful for oocyte IVM and subsequent embryo development. Therefore, LM could be used as a 3D cost-effective culture system for the IVM of prepubertal goat oocytes.

The challenges posed by climate change and increasing world population are stimulating renewed efforts for improving the sustainability of animal production. To meet such challenges, the contribution of genomic selection approaches, in combination with assisted reproductive technologies (ARTs), to spreading and preserving animal genetics is essential. The largest increase in genetic gain can be achieved by shortening the generation interval. This review provides an overview of the current status and progress of advanced ARTs that could be applied to reduce the generation time in both female and male of domestic ruminants. In females, the use of juvenile in vitro embryo transfer (JIVET) enables to generate offspring after the transfer of in vitro produced embryos derived from oocytes of prepubertal genetically superior donors reducing the generational interval and acceleration genetic gain. The current challenge is increasing in vitro embryo production (IVEP) from prepubertal derived oocytes which is still low and variable. The two main factors limiting IVEP success are the intrinsic quality of prepubertal oocytes and the culture systems for in vitro maturation (IVM). In males, advancements in ARTs are providing new strategies to in vitro propagate spermatogonia and differentiate them into mature sperm or even to recapitulate the whole process of spermatogenesis from embryonic stem cells. Moreover, the successful use of immature cells, such as round spermatids, for intracytoplasmic injection (ROSI) and IVEP could allow to complete the entire process in few months. However, these approaches have been successfully applied to human and mouse whereas only a few studies have been published in ruminants and results are still controversial. This is also dependent on the efficiency of ROSI that is limited by the current isolation and selection protocols of round spermatids. In conclusion, the current efforts for improving these reproductive methodologies could lead toward a significant reduction of the generational interval in livestock animals that could have a considerable impact on agriculture sustainability., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Inc.)

Mediterranean Shag ( Gulosus aristotelis desmarestii ) is a seabird endemic to the Mediterranean and Black Seas, recently included in the IUCN list of threatened Species. Most of the reproductive colonies are hosted in Sardinia and surrounding islets. Bycatch in fishing nets is one of the most significant threats for this population. Our work aimed to assess alterations in the sex ratio caused by bycatch and to study the adaptive response of the population to a skewed adult sex ratio. The sex ratio of Mediterranean Shags found drowned in the gillnets near the colonies and that of the nestlings of the Corcelli (northeast Sardinia) colony was determined using the sex-linked polymorphism of the gene Chromobox-Helicase-DNA-binding 1. The data of the shags found drowned in gillnets evidenced a high mortality rate (83.3%; p < 0.001) and a larger size of males (35% heavier than females, p < 0.05) compared to females, supporting the theory that heavier individuals are able to forage at great depths. With 64.8% of the nestlings being male, the sex ratio of nestlings was statistically different from parity ( p < 0.05). Furthermore, it was related to the brood size. In one- and two-chick broods, 73% and 70% of nestlings, respectively, were males, while in three-chick broods, only 33% were males. Our data identify the higher rate of male shags drowned in gillnets as a factor causing an alteration of the sex ratio in the Mediterranean Shag population. According to the Sex Allocation Theory, an adaptive adjustment of sex made by adult females restores the Mendelian sex ratio in the population.