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Cytomegalovirus-specific cell-mediated immunity (CMV-CMI) in actively infected healthy immunocompetent hosts has been poorly investigated. Conversely, correlates of maternal protective immunity for the fetus after primary infection in pregnancy continue to be studied. The kinetics and magnitude of CMV-specific CMI in immunocompetent primary CMV-infected adults are described. A literature review on CMV-CMI in primarily infected pregnant women and its correlation to the risk of vertical virus transmission is included. Immunological measurements after infection were performed by enzyme-linked ImmunoSPOT assay enumerating IFN-γ secreting CMV-specific T cells, at a single cell level, upon in vitro stimulation with viral antigens. Simultaneously, serological and virological profiles of infected patients were investigated. Patients displayed mild-to-moderate clinical and laboratory profiles for infection, and all showed positive EliSpot results in the early stage of infection (<20 days after onset). The virus-CMI was strong in the majority of patients (58.8%) in which the lowest CMV-DNAemia levels (<300 copies/mL) were detected. Significantly higher viral loads were observed in patients with weak CMV-CMI at the same time-point post-infection (up to 15,104 copies/mL; p < 0.001). T cell response magnitudes to IE-1 and pp65-UL83 peptides were overlapping and stable over time. In these case series, the early presence of CMV-CMI was probably pivotal in controlling viral replication and led to spontaneous viral clearance.
Angela Chiereghin; Gabriella Verucchi; Tiziana Lazzarotto. CMV-Specific Cell-Mediated Immunity in Immunocompetent Adults with Primary CMV Infection: A Case Series and Review of the Literature. Viruses 2021, 13, 816 .
AMA StyleAngela Chiereghin, Gabriella Verucchi, Tiziana Lazzarotto. CMV-Specific Cell-Mediated Immunity in Immunocompetent Adults with Primary CMV Infection: A Case Series and Review of the Literature. Viruses. 2021; 13 (5):816.
Chicago/Turabian StyleAngela Chiereghin; Gabriella Verucchi; Tiziana Lazzarotto. 2021. "CMV-Specific Cell-Mediated Immunity in Immunocompetent Adults with Primary CMV Infection: A Case Series and Review of the Literature." Viruses 13, no. 5: 816.
Despite the effectiveness of the currently available antiviral drugs in treating cytomegalovirus (CMV) infection, high rates of adverse effects are associated with their use. Moreover, a problem of increasing importance is the emergence of drug-resistant CMV infection. Here, we describe the first case of off-label use of letermovir (LMV) as preemptive antiviral therapy, in a pediatric allogeneic peripheral blood stem cell transplant recipient with ganciclovir-resistant CMV infection who was intolerant to foscarnet and unable to achieve viral clearance after seven doses of cidofovir. After the administration of LMV, a gradual reduction in viral load was observed and within 6 weeks of LMV treatment, after more than 6 months of positive CMV-DNAemia, the patient cleared the infection. No adverse effects associated with LMV were observed during treatment. In this pediatric study case, the off-label use of LMV for the treatment of CMV infection has been well tolerated and proved to be effective in leading to the suppression of viral replication.
Angela Chiereghin; Tamara Belotti; Eva Caterina Borgatti; Nicola Fraccascia; Giulia Piccirilli; Maura Fois; Michele Borghi; Gabriele Turello; Liliana Gabrielli; Riccardo Masetti; Arcangelo Prete; Stefano Fanti; Tiziana Lazzarotto. Off-Label Use of Letermovir as Preemptive Anti-Cytomegalovirus Therapy in a Pediatric Allogeneic Peripheral Blood Stem Cell Transplant. Infection and Drug Resistance 2021, ume 14, 1185 -1190.
AMA StyleAngela Chiereghin, Tamara Belotti, Eva Caterina Borgatti, Nicola Fraccascia, Giulia Piccirilli, Maura Fois, Michele Borghi, Gabriele Turello, Liliana Gabrielli, Riccardo Masetti, Arcangelo Prete, Stefano Fanti, Tiziana Lazzarotto. Off-Label Use of Letermovir as Preemptive Anti-Cytomegalovirus Therapy in a Pediatric Allogeneic Peripheral Blood Stem Cell Transplant. Infection and Drug Resistance. 2021; ume 14 ():1185-1190.
Chicago/Turabian StyleAngela Chiereghin; Tamara Belotti; Eva Caterina Borgatti; Nicola Fraccascia; Giulia Piccirilli; Maura Fois; Michele Borghi; Gabriele Turello; Liliana Gabrielli; Riccardo Masetti; Arcangelo Prete; Stefano Fanti; Tiziana Lazzarotto. 2021. "Off-Label Use of Letermovir as Preemptive Anti-Cytomegalovirus Therapy in a Pediatric Allogeneic Peripheral Blood Stem Cell Transplant." Infection and Drug Resistance ume 14, no. : 1185-1190.
M. Lanari; A. Chiereghin; G.B. Biserni; A. Rocca; M.C. Re; T. Lazzarotto. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. Clinical Microbiology and Infection 2020, 26, 1130 -1132.
AMA StyleM. Lanari, A. Chiereghin, G.B. Biserni, A. Rocca, M.C. Re, T. Lazzarotto. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. Clinical Microbiology and Infection. 2020; 26 (9):1130-1132.
Chicago/Turabian StyleM. Lanari; A. Chiereghin; G.B. Biserni; A. Rocca; M.C. Re; T. Lazzarotto. 2020. "Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise." Clinical Microbiology and Infection 26, no. 9: 1130-1132.
M. Lanari; A. Chiereghin; G.B. Biserni; A. Rocca; M.C. Re; T. Lazzarotto. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. 2020, 1 .
AMA StyleM. Lanari, A. Chiereghin, G.B. Biserni, A. Rocca, M.C. Re, T. Lazzarotto. Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise. . 2020; ():1.
Chicago/Turabian StyleM. Lanari; A. Chiereghin; G.B. Biserni; A. Rocca; M.C. Re; T. Lazzarotto. 2020. "Children and SARS-CoV-2 infection: innocent bystanders…until proven otherwise." , no. : 1.
Hyperechogenic bowel (HB) is a nonspecific ultrasound finding that can be associated with human cytomegalovirus (CMV) congenital infection. In this study, we investigated HB pathophysiology in CMV-infected fetuses. We examined small and large intestine as well as pancreas in 8 fetuses at 22 weeks of gestation with congenital CMV infection. Ultrasound findings showed 4 fetuses with HB and 4 without. As negative group, 4 fetuses without CMV infection and without HB were studied. Immunohistochemistry for CMV, lymphocytic infiltrate, B-cell leukemia/lymphoma-2 (bcl-2), CD-117, cystic fibrosis transmembrane regulator (CFTR) were performed. HB fetuses showed multiple and sequential CMV-positive ganglion cells of Auerbach’s myenteric plexus. In the ganglia, bcl-2 was weakly expressed representing a reduced neuronal functionality. CD-117 revealed a regular distribution of Cajal cells, the pacemakers of intestinal contractility. Pancreas showed normal CFTR staining, indicating a preserved exocrine secretion, thus unlikely a contributory factor in HB. In CMV-infected fetuses without HB, CMV-positive cells were scatteredly found in ganglion cells and bcl-2 was strongly expressed. Intestinal CD-117 and pancreatic CFTR expression were similar to fetuses with HB. In conclusion, fetal CMV infection of the bowel may lead to peristalsis impairment (paralytic ileus) due to intestinal plexus involvement, which at ultrasound appeared as HB.
Liliana Gabrielli; Maria P. Bonasoni; Angela Chiereghin; Giulia Piccirilli; Eva C. Borgatti; Giuliana Simonazzi; Nunzio C. M. Salfi; Ione Tamagnini; Tiziana Lazzarotto. Pathophysiology of Hyperechogenic Bowel in Congenitally Human Cytomegalovirus Infected Fetuses. Microorganisms 2020, 8, 779 .
AMA StyleLiliana Gabrielli, Maria P. Bonasoni, Angela Chiereghin, Giulia Piccirilli, Eva C. Borgatti, Giuliana Simonazzi, Nunzio C. M. Salfi, Ione Tamagnini, Tiziana Lazzarotto. Pathophysiology of Hyperechogenic Bowel in Congenitally Human Cytomegalovirus Infected Fetuses. Microorganisms. 2020; 8 (5):779.
Chicago/Turabian StyleLiliana Gabrielli; Maria P. Bonasoni; Angela Chiereghin; Giulia Piccirilli; Eva C. Borgatti; Giuliana Simonazzi; Nunzio C. M. Salfi; Ione Tamagnini; Tiziana Lazzarotto. 2020. "Pathophysiology of Hyperechogenic Bowel in Congenitally Human Cytomegalovirus Infected Fetuses." Microorganisms 8, no. 5: 779.
Currently, no consensus has been reached on the optimal blood compartment to be used for surveillance of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) DNAemia. Although several comparative studies have been performed correlating CMV and EBV DNA loads in whole blood (WB) vs plasma, to our knowledge, no studies have ever analyzed the kinetics of both viruses in the two blood compartments. In this retrospective non-interventional multicenter cohort study the kinetics of CMV and EBV DNA in 121 hematopoietic stem cell transplant recipients (HSCTR) have been investigated by analyzing in parallel 569 and 351 paired samples from 80 and 58 sequential episodes of CMV and EBV DNAemia, respectively. Unlike previous studies, a single automated molecular method, CE marked and FDA approved for use in quantifying CMV and EBV DNA in both plasma and WB was used. Furthermore, the complete viral replication kinetics of all episodes (including both the ascending and the descending phase of the active infection) was examined in each patient. The previously observed overall correlation between CMV DNA levels in WB and plasma was confirmed (Spearman's r = .85; P < .001). However, though WB and plasma CMV DNAemia reached peak simultaneously, in the ascending phase the median CMV DNA levels in plasma were about 1 log lower than WB. Furthermore, in patients who received pre-emptive therapy, CMV DNA showed a delayed decrease in plasma as compared to WB. A lower correlation between EBV DNA levels in plasma versus WB was shown (Spearman's r = .61; P < .001). EBV DNA kinetics was not consistent in the two blood compartments, mostly due to the lower positivity in plasma. Indeed, in 19% of episodes EBV DNA was negative at the time of EBV DNA peak in WB. Our results suggest a preferential use of WB for surveillance of CMV and EBV infection in HSCTR.
Tiziana Lazzarotto; Angela Chiereghin; Antonio Piralla; Giulia Piccirilli; Alessia Girello; Giulia Campanini; Liliana Gabrielli; Cristina Costa; Arcangelo Prete; Francesca Bonifazi; Alessandro Busca; Roberto Cairoli; Anna Amelia Colombo; Marco Zecca; Francesca Sidoti; Gabriele Bianco; Pierpaolo Paba; Carlo Federico Perno; Rossana Cavallo; Fausto Baldanti. Cytomegalovirus and Epstein-Barr Virus DNA Kinetics in Whole Blood and Plasma of Allogeneic Hematopoietic Stem Cell Transplantation Recipients. Biology of Blood and Marrow Transplantation 2018, 24, 1699 -1706.
AMA StyleTiziana Lazzarotto, Angela Chiereghin, Antonio Piralla, Giulia Piccirilli, Alessia Girello, Giulia Campanini, Liliana Gabrielli, Cristina Costa, Arcangelo Prete, Francesca Bonifazi, Alessandro Busca, Roberto Cairoli, Anna Amelia Colombo, Marco Zecca, Francesca Sidoti, Gabriele Bianco, Pierpaolo Paba, Carlo Federico Perno, Rossana Cavallo, Fausto Baldanti. Cytomegalovirus and Epstein-Barr Virus DNA Kinetics in Whole Blood and Plasma of Allogeneic Hematopoietic Stem Cell Transplantation Recipients. Biology of Blood and Marrow Transplantation. 2018; 24 (8):1699-1706.
Chicago/Turabian StyleTiziana Lazzarotto; Angela Chiereghin; Antonio Piralla; Giulia Piccirilli; Alessia Girello; Giulia Campanini; Liliana Gabrielli; Cristina Costa; Arcangelo Prete; Francesca Bonifazi; Alessandro Busca; Roberto Cairoli; Anna Amelia Colombo; Marco Zecca; Francesca Sidoti; Gabriele Bianco; Pierpaolo Paba; Carlo Federico Perno; Rossana Cavallo; Fausto Baldanti. 2018. "Cytomegalovirus and Epstein-Barr Virus DNA Kinetics in Whole Blood and Plasma of Allogeneic Hematopoietic Stem Cell Transplantation Recipients." Biology of Blood and Marrow Transplantation 24, no. 8: 1699-1706.
Chronic graft-versus-host disease (cGVHD) is a major complication after stem cell transplantation (HSCT). Several randomized studies already demonstrated that anti-T lymphoglobulin (ATLG) is effective in preventing GVHD after myeloablative unrelated and HLA-identical sibling transplants. However, the issue of doses and the potential increase of relapses still remain unsolved. Here we report data on 190 patients with acute leukemia and myelodysplastic syndrome who underwent an unrelated HSCT with low-dose ATLG (15 to 30 mg/kg) given at an earlier timing (days –6 to –2). HSCT was performed from HLA 10/10 (n = 62, 33%), 9/10 (n = 91, 48%), 8/10 (n = 30, 16%), and <8/10 (n = 7, 4%) identical unrelated donor. Peripheral blood was the stem cell source in 42% (n = 80). Median follow-up was 51 months. Grades II to IV and III to IV acute GVHD were 26% and 9%, respectively, and 2-year overall and moderate to severe cGVHD were 23% and 14%, respectively. The 3-year incidences of relapse and nonrelapse mortality were 26% and 18%, respectively. The rates of 3-year overall survival (OS), disease-free survival (DFS), and GVHD-free and relapse-free survival (GRFS) were 60%, 56% and 44%, respectively. Factors such as younger donor, good performance status, and early disease were associated with better outcome in terms of OS, DFS, and GRFS. Our data indicate that doses of ATLG lower that those used in randomized clinical trials can be used for GVHD prevention, even in the adult setting, without clear increases in relapse and infections; these findings need to be further validated by a prospective randomized study.
Francesca Bonifazi; Jacopo Olivieri; Mariarosaria Sessa; Elisa Dan; Barbara Sinigaglia; Simonetta Rizzi; Maria Rosa Motta; Andrea Bontadini; Francesca Ulbar; Valeria Giudice; Cristina Papayannidis; Antonio Curti; Angela Chiereghin; Tiziana Lazzarotto; Michele Cavo; Mario Arpinati. Low-Dose Anti-T Lymphoglobulin as Prophylaxis for Graft-versus-Host Disease in Unrelated Donor Transplantations for Acute Leukemias and Myelodysplastic Syndromes. Biology of Blood and Marrow Transplantation 2018, 24, 2450 -2458.
AMA StyleFrancesca Bonifazi, Jacopo Olivieri, Mariarosaria Sessa, Elisa Dan, Barbara Sinigaglia, Simonetta Rizzi, Maria Rosa Motta, Andrea Bontadini, Francesca Ulbar, Valeria Giudice, Cristina Papayannidis, Antonio Curti, Angela Chiereghin, Tiziana Lazzarotto, Michele Cavo, Mario Arpinati. Low-Dose Anti-T Lymphoglobulin as Prophylaxis for Graft-versus-Host Disease in Unrelated Donor Transplantations for Acute Leukemias and Myelodysplastic Syndromes. Biology of Blood and Marrow Transplantation. 2018; 24 (12):2450-2458.
Chicago/Turabian StyleFrancesca Bonifazi; Jacopo Olivieri; Mariarosaria Sessa; Elisa Dan; Barbara Sinigaglia; Simonetta Rizzi; Maria Rosa Motta; Andrea Bontadini; Francesca Ulbar; Valeria Giudice; Cristina Papayannidis; Antonio Curti; Angela Chiereghin; Tiziana Lazzarotto; Michele Cavo; Mario Arpinati. 2018. "Low-Dose Anti-T Lymphoglobulin as Prophylaxis for Graft-versus-Host Disease in Unrelated Donor Transplantations for Acute Leukemias and Myelodysplastic Syndromes." Biology of Blood and Marrow Transplantation 24, no. 12: 2450-2458.
Background: The Congenital Human Cytomegalovirus Infection Prevention (CHIP) study, a randomized, blinded, placebo-controlled trial, demonstrated that the efficacy of hyperimmune globulin (HIG) was not different from that of placebo regarding transmission of cytomegalovirus (CMV) from mothers to newborns. Our aim was to analyze histologically HIG effects on placentas collected for the CHIP study. Materials and Methods: Virological and histological analyses were performed on 40 placentas from transmitter and nontransmitter HIG-treated and untreated mothers by assessing the number of CMV-positive cells, tissue viral load, tissue damage, and compensatory mechanisms. Results: The HIG and placebo groups showed no significant differences in the number of CMV-positive cells (median number in 10 fields at 10 high-power fields: 2.5 vs. 2, p = 0.969) and viral load (median load: 5 copies/5 ng vs. 10.5 copies/5 ng, p = 0.874). Regarding histological examination, the scores of parameters related to tissue damage and hypoxic parenchymal compensation were higher in transmitters except for chorangiosis, with statistically significant differences observed for chronic villitis (p = 0.007), calcification (p = 0.011), and the total score of tissue damage (p < 0.001). The HIG and placebo groups showed no significant differences for all tissue damage and compensation parameters and overall scores. Discussion: HIGs are not able to reduce placental viral load and histological damage, which was significantly associated only with infection.
Liliana Gabrielli; Maria Paola Bonasoni; Maria P. Foschini; Enrico M. Silini; Arsenio Spinillo; Maria Grazia Revello; Angela Chiereghin; Giulia Piccirilli; Evangelia Petrisli; Gabriele Turello; Giuliana Simonazzi; Dino Gibertoni; Tiziana Lazzarotto. Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection. Fetal Diagnosis and Therapy 2018, 45, 111 -117.
AMA StyleLiliana Gabrielli, Maria Paola Bonasoni, Maria P. Foschini, Enrico M. Silini, Arsenio Spinillo, Maria Grazia Revello, Angela Chiereghin, Giulia Piccirilli, Evangelia Petrisli, Gabriele Turello, Giuliana Simonazzi, Dino Gibertoni, Tiziana Lazzarotto. Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection. Fetal Diagnosis and Therapy. 2018; 45 (2):111-117.
Chicago/Turabian StyleLiliana Gabrielli; Maria Paola Bonasoni; Maria P. Foschini; Enrico M. Silini; Arsenio Spinillo; Maria Grazia Revello; Angela Chiereghin; Giulia Piccirilli; Evangelia Petrisli; Gabriele Turello; Giuliana Simonazzi; Dino Gibertoni; Tiziana Lazzarotto. 2018. "Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection." Fetal Diagnosis and Therapy 45, no. 2: 111-117.
Giulia Piccirilli; Angela Chiereghin; Liliana Gabrielli; Maddalena Giannella; Diego Squarzoni; Gabriele Turello; Silvia Felici; Caterina Vocale; Roberta Zuntini; Dino Gibertoni; Alberto Enrico Maraolo; Simone Ambretti; Tiziana Lazzarotto. Infectious meningitis/encephalitis: evaluation of a rapid and fully automated multiplex PCR in the microbiological diagnostic workup. The new microbiologica 2018, 41, 118 -125.
AMA StyleGiulia Piccirilli, Angela Chiereghin, Liliana Gabrielli, Maddalena Giannella, Diego Squarzoni, Gabriele Turello, Silvia Felici, Caterina Vocale, Roberta Zuntini, Dino Gibertoni, Alberto Enrico Maraolo, Simone Ambretti, Tiziana Lazzarotto. Infectious meningitis/encephalitis: evaluation of a rapid and fully automated multiplex PCR in the microbiological diagnostic workup. The new microbiologica. 2018; 41 (2):118-125.
Chicago/Turabian StyleGiulia Piccirilli; Angela Chiereghin; Liliana Gabrielli; Maddalena Giannella; Diego Squarzoni; Gabriele Turello; Silvia Felici; Caterina Vocale; Roberta Zuntini; Dino Gibertoni; Alberto Enrico Maraolo; Simone Ambretti; Tiziana Lazzarotto. 2018. "Infectious meningitis/encephalitis: evaluation of a rapid and fully automated multiplex PCR in the microbiological diagnostic workup." The new microbiologica 41, no. 2: 118-125.
The clinical utility of the QuantiFERON-CMV (QFN-CMV) assay in heart transplant recipients was assessed. Forty-four cytomegalovirus (CMV)-seropositive patients were enrolled: 17 received antiviral prophylaxis, and 27 were managed preemptively. CMV-DNAemia monitoring was performed by the use of a quantitative real-time PCR assay. The QFN-CMV assay was retrospectively performed on blood samples collected at five posttransplant time points. A higher proportion of patients with an indeterminate QFN-CMV result after the suspension of prophylaxis than of patients who showed a global T-cell responsiveness developed CMV infection ( P = 0.036). Patients who reconstituted a CMV-specific response following the first CMV-DNAemia-positive result (42.9%) showed a median CMV-DNAemia peak 1 log of magnitude lower than that seen with patients with indeterminate results, and all controlled viral replication spontaneously. The 25% of patients with an indeterminate result developed CMV disease. In the preemptive strategy group, no differences in the development of subsequent infection, magnitude of viral load, and viral control were observed on the basis of QFN-CMV measurements performed before and after the first CMV-DNAemia-positive result. Considering both CMV prevention strategies, viral relapse was associated with the failure to reconstitute CMV-specific cell-mediated immunity (CMI) after the resolution of the first episode of CMV infection ( P = 0.032). QFN-CMV measurements can be a useful tool for identifying patients (i) at higher risk of developing infection after discontinuing antiviral prophylaxis, (ii) with late CMV infection who would benefit from appropriate antiviral interventions, and (iii) at higher risk of viral relapses. QFN-CMV measurements taken within 1 month posttransplantation (early period) are not revealing.
Angela Chiereghin; Luciano Potena; Laura Borgese; Dino Gibertoni; Diego Squarzoni; Gabriele Turello; Evangelia Petrisli; Giulia Piccirilli; Liliana Gabrielli; Francesco Grigioni; Tiziana Lazzarotto. Monitoring of Cytomegalovirus (CMV)-Specific Cell-Mediated Immunity in Heart Transplant Recipients: Clinical Utility of the QuantiFERON-CMV Assay for Management of Posttransplant CMV Infection. Journal of Clinical Microbiology 2018, 56, 1 .
AMA StyleAngela Chiereghin, Luciano Potena, Laura Borgese, Dino Gibertoni, Diego Squarzoni, Gabriele Turello, Evangelia Petrisli, Giulia Piccirilli, Liliana Gabrielli, Francesco Grigioni, Tiziana Lazzarotto. Monitoring of Cytomegalovirus (CMV)-Specific Cell-Mediated Immunity in Heart Transplant Recipients: Clinical Utility of the QuantiFERON-CMV Assay for Management of Posttransplant CMV Infection. Journal of Clinical Microbiology. 2018; 56 (4):1.
Chicago/Turabian StyleAngela Chiereghin; Luciano Potena; Laura Borgese; Dino Gibertoni; Diego Squarzoni; Gabriele Turello; Evangelia Petrisli; Giulia Piccirilli; Liliana Gabrielli; Francesco Grigioni; Tiziana Lazzarotto. 2018. "Monitoring of Cytomegalovirus (CMV)-Specific Cell-Mediated Immunity in Heart Transplant Recipients: Clinical Utility of the QuantiFERON-CMV Assay for Management of Posttransplant CMV Infection." Journal of Clinical Microbiology 56, no. 4: 1.
Clinical evaluation of the Elecsys(®) CMV IgM, IgG, IgG Avidity and COBAS AmpliPrep/COBAS TaqMan CMV (COBAS CMV) assays (Roche Diagnostics AG) in the diagnosis and prognosis of congenital CMV infection was performed. In this study, 150 preselected clinical samples (50 primary infection sera, 50 amniotic fluid [AF] and 50 newborn urine) were processed using Roche serological/molecular CMV-specific tests. Results were compared with those obtained by routine assays (comparator assays). The Elecsys(®) CMV IgM and IgG assays showed a perfect agreement (100%) with the comparator assays. Using the combination of the Elecsys(®) CMV IgM and IgG Avidity assays results, a primary infection was identified in 100% of cases. Inappropriate avidity CMV IgG values in two samples with very low IgG values (<6 AU/mL) were observed. COBAS CMV assay showed an agreement equal to 98% and 100% with comparator assays by processing AF and urine samples, respectively. Among AF with quantitative results, Lin's concordance correlation was 0.933 and comparator-COBAS CMV assays gave CMV-DNA loads differing by <0.5 log10 DNA. Finally, higher CMV-DNA levels in AF samples were associated with a symptomatic outcome (p=0.003). The Roche CMV-specific assays compared well with the comparator assays, thus providing to be suitable for clinical use.
Angela Chiereghin; Claudia Pavia; Liliana Gabrielli; Giulia Piccirilli; Diego Squarzoni; Gabriele Turello; Dino Gibertoni; Giuliana Simonazzi; Maria Grazia Capretti; Marcello Lanari; Tiziana Lazzarotto. Clinical evaluation of the new Roche platform of serological and molecular cytomegalovirus-specific assays in the diagnosis and prognosis of congenital cytomegalovirus infection. Journal of Virological Methods 2017, 248, 250 -254.
AMA StyleAngela Chiereghin, Claudia Pavia, Liliana Gabrielli, Giulia Piccirilli, Diego Squarzoni, Gabriele Turello, Dino Gibertoni, Giuliana Simonazzi, Maria Grazia Capretti, Marcello Lanari, Tiziana Lazzarotto. Clinical evaluation of the new Roche platform of serological and molecular cytomegalovirus-specific assays in the diagnosis and prognosis of congenital cytomegalovirus infection. Journal of Virological Methods. 2017; 248 ():250-254.
Chicago/Turabian StyleAngela Chiereghin; Claudia Pavia; Liliana Gabrielli; Giulia Piccirilli; Diego Squarzoni; Gabriele Turello; Dino Gibertoni; Giuliana Simonazzi; Maria Grazia Capretti; Marcello Lanari; Tiziana Lazzarotto. 2017. "Clinical evaluation of the new Roche platform of serological and molecular cytomegalovirus-specific assays in the diagnosis and prognosis of congenital cytomegalovirus infection." Journal of Virological Methods 248, no. : 250-254.
We performed serological and molecular pretransplant screening in solid organ transplant (SOT) donors and recipients in north-central Italy and a surveillance program for human herpes virus 8 (HHV8) infection after transplant, aiming to establish an optimal management of HHV8 infection in SOT recipients. For pretransplant HHV8 screening in both donors and recipients, 6 serological (4 indirect immunofluorescent assays (IFA) and 2 enzyme-linked immunosorbent assays (ELISA) - both HHV8 lytic and latent antigen-based) and 2 molecular assays were used. A reference standard to identify HHV8-positive patients was defined by at least 2 positive assays. All transplant patients at risk to develop HHV8-related disease underwent virological posttransplant monitoring by quantitative real-time PCR assay. HHV8 seroprevalence was 4% (10/249) in donors and 18% (93/517) in organ recipients. The best performance was obtained by 2 lytic antigen-based IFAs that showed almost perfect agreement to the reference standard (0.943 and 0.931 Cohen’s kappa). HHV8-DNA was detected in 6.8% and 2.9% of HHV8-seropositive donor samples by in-house nested PCR and quantitative real-time PCR assays, respectively. After transplant, 3 out of 12 (25%) HHV8-mismatch patients (seropositive donor/seronegative recipient) developed a primary infection, 1 of whom developed a lethal nonmalignant illness. Two out of 93 HHV8-seropositive recipients (2.1%) had viral replication in posttransplant period, 1 of whom developed Kaposi’s sarcoma. Serological assays, specifically lytic IFAs, were the best methodological approach to identify HHV8-infected SOT donors and recipients. A very low incidence (1.9%) of posttransplant HHV8-related disease was observed.
Angela Chiereghin; Patrizia Barozzi; Evangelia Petrisli; Giulia Piccirilli; Liliana Gabrielli; Giovanni Riva; Leonardo Potenza; Gianni Cappelli; Nicola De Ruvo; Irene Libri; Umberto Maggiore; Maria Cristina Morelli; Luciano Potena; Paola Todeschini; Dino Gibertoni; Manuel Labanti; Gabriela Sangiorgi; Gaetano La Manna; Antonio Daniele Pinna; Mario Luppi; Tiziana Lazzarotto. Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact After Transplantation. Transplantation 2017, 101, 1935 -1944.
AMA StyleAngela Chiereghin, Patrizia Barozzi, Evangelia Petrisli, Giulia Piccirilli, Liliana Gabrielli, Giovanni Riva, Leonardo Potenza, Gianni Cappelli, Nicola De Ruvo, Irene Libri, Umberto Maggiore, Maria Cristina Morelli, Luciano Potena, Paola Todeschini, Dino Gibertoni, Manuel Labanti, Gabriela Sangiorgi, Gaetano La Manna, Antonio Daniele Pinna, Mario Luppi, Tiziana Lazzarotto. Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact After Transplantation. Transplantation. 2017; 101 (8):1935-1944.
Chicago/Turabian StyleAngela Chiereghin; Patrizia Barozzi; Evangelia Petrisli; Giulia Piccirilli; Liliana Gabrielli; Giovanni Riva; Leonardo Potenza; Gianni Cappelli; Nicola De Ruvo; Irene Libri; Umberto Maggiore; Maria Cristina Morelli; Luciano Potena; Paola Todeschini; Dino Gibertoni; Manuel Labanti; Gabriela Sangiorgi; Gaetano La Manna; Antonio Daniele Pinna; Mario Luppi; Tiziana Lazzarotto. 2017. "Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact After Transplantation." Transplantation 101, no. 8: 1935-1944.
Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young (<5 years of age) children, causing approximately 250.000 deaths worldwide, mostly in developing countries. Differences on nucleotide sequences of VP7 (G-type) and VP4 (P-type) genes are the basis for the binary RVA nomenclature. Although at least 32 G-types and 47 P-types of rotavirus are presently known, most RVA infections in humans worldwide are related to five major G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8] and G9P[8]. Hospital-acquired viral infections are a major concern for public health. Among them, AGE is one of the most common and may severely affect susceptible children admitted for other causes. During RVA gastroenteritis surveillance in Italy in 2012-14, a total of 2341 RVA-positive fecal samples were collected from children hospitalized with AGE, and RVA strains were genotyped following standard EuroRotaNet protocols. Most of strains analyzed belonged to the five major human genotypes and 118/2341 (5.0%) were reported to be hospital-acquired. Comparison of the distributions of the RVA genotypes circulating in community or associated to nosocomial infections showed a different distribution of genotypes circulating inside the hospital wards, with respect to those observed in the community.G1P[8] and G9P[8] RVA strains were detected frequently, whereas G12P[8] caused a single big nosocomial outbreak. This study was performed to provide the hospitals of the Italian surveillance network with update information on RVA AGE useful to implement guidelines for preventing RVA AGE and optimizing the management of patients in hospital wards.
Giovanni Ianiro; Roberto Delogu; Lucia Fiore; Marina Monini; Franco M. Ruggeri; E. Pagani; L. Moroder; Sandro Binda; Laura Pellegrinelli; A. Mignacca; R. Bruno; A. Vuolo; F. Zanella; G. Bordignon; P. Pietrosemoli; T. Lazzarotto; Angela Chiereghin; A. Marigliano; B. Camilloni; Cristina Russo; R. Graffeo; M. Labianca; P. Castiglia. Group A rotavirus genotypes in hospital-acquired gastroenteritis in Italy, 2012–14. Journal of Hospital Infection 2017, 96, 262 -267.
AMA StyleGiovanni Ianiro, Roberto Delogu, Lucia Fiore, Marina Monini, Franco M. Ruggeri, E. Pagani, L. Moroder, Sandro Binda, Laura Pellegrinelli, A. Mignacca, R. Bruno, A. Vuolo, F. Zanella, G. Bordignon, P. Pietrosemoli, T. Lazzarotto, Angela Chiereghin, A. Marigliano, B. Camilloni, Cristina Russo, R. Graffeo, M. Labianca, P. Castiglia. Group A rotavirus genotypes in hospital-acquired gastroenteritis in Italy, 2012–14. Journal of Hospital Infection. 2017; 96 (3):262-267.
Chicago/Turabian StyleGiovanni Ianiro; Roberto Delogu; Lucia Fiore; Marina Monini; Franco M. Ruggeri; E. Pagani; L. Moroder; Sandro Binda; Laura Pellegrinelli; A. Mignacca; R. Bruno; A. Vuolo; F. Zanella; G. Bordignon; P. Pietrosemoli; T. Lazzarotto; Angela Chiereghin; A. Marigliano; B. Camilloni; Cristina Russo; R. Graffeo; M. Labianca; P. Castiglia. 2017. "Group A rotavirus genotypes in hospital-acquired gastroenteritis in Italy, 2012–14." Journal of Hospital Infection 96, no. 3: 262-267.
Background. The neonatal immune system is not fully developed at birth; newborns have adequate lymphocytes counts but these cells lack function.Objective. To assess the activity of T-cells and the influence of the main perinatal factors in very preterm infants (birth weight < 1500 g).Design. Blood samples from 59 preterm infants (21/59 were dizygotic twins) were collected at birth and at 30 days of life to measure CD4+ T-cell activity using the ImmuKnow™ assay. Fifteen healthy adults were included as a control group.Results. CD4+ T-cell activity was lower in VLBW infants compared with adults (p<0.001). Twins showed lower immune activity compared to singletons (p=0.005). Infants born vaginally showed higher CD4+ T-cell activity compared to those born by C-section (p=0.031); infants born after prolonged Premature Rupture of Membranes (pPROM) showed higher CD4+ T-cell activity at birth (p=0.002) compared to infants born without pPROM. Low CD4+ T-cell activity at birth is associated with necrotizing enterocolitis (NEC) in the first week of life (p=0.049).Conclusions. Preterm infants show a lack in CD4+ T-cell activity at birth. Perinatal factors such as intrauterine inflammation, mode of delivery, and zygosity can influence the adaptive immune activation capacity at birth and can contribute to exposing these infants to serious complications such as NEC.
Giulia Aquilano; Maria Grazia Capretti; Francesca Nanni; Luigi Corvaglia; Arianna Aceti; Liliana Gabrielli; Angela Chiereghin; Giacomo Faldella; Tiziana Lazzarotto. Altered Intracellular ATP Production by Activated CD4+ T-Cells in Very Preterm Infants. Journal of Immunology Research 2016, 2016, 1 -8.
AMA StyleGiulia Aquilano, Maria Grazia Capretti, Francesca Nanni, Luigi Corvaglia, Arianna Aceti, Liliana Gabrielli, Angela Chiereghin, Giacomo Faldella, Tiziana Lazzarotto. Altered Intracellular ATP Production by Activated CD4+ T-Cells in Very Preterm Infants. Journal of Immunology Research. 2016; 2016 ():1-8.
Chicago/Turabian StyleGiulia Aquilano; Maria Grazia Capretti; Francesca Nanni; Luigi Corvaglia; Arianna Aceti; Liliana Gabrielli; Angela Chiereghin; Giacomo Faldella; Tiziana Lazzarotto. 2016. "Altered Intracellular ATP Production by Activated CD4+ T-Cells in Very Preterm Infants." Journal of Immunology Research 2016, no. : 1-8.
Infections continue to be one of the leading causes of morbidity and mortality in liver transplant recipients. We retrospectively reviewed the symptomatic infectious episodes that occurred during the first year post-transplant to determine time of onset, causative pathogens and cell-mediated immunity response patterns. Ninety-eight of the 202 (48.5%) recipients enrolled developed at least one infectious episode. The total number of infectious episodes was 135: 77 (57.1%) bacterial, 45 (33.3%) viral and 13 (9.6%) fungal. The most frequently isolated bacteria were Escherichia coli (21 isolates) and Klebsiella pneumoniae (19 isolates). Overall, extended-spectrum beta lactamase-producing and methicillin-resistant organisms were responsible for 29 (29/77; 37.7%) infectious episodes. Members of the herpes virus group, in particular cytomegalovirus (34/45 viral infections, 75.5%), were detected. Candida species (9 isolates) followed by Aspergillus species (4 isolates) were isolated. The majority of infections (63%) occurred during the early post-transplant phase (<1 month), whereas only 8/135 episodes (5.9%) were detected after the sixth month (late phase). Significantly lower median ImmuKnow(®) intracellular ATP values in patients who developed bacterial and fungal infections compared to infection-free patients were observed (P < 0.0001 and P = 0.0016, respectively), whereas patients who developed a viral infection had a median intracellular ATP level not statistically different compared to uninfected patients (P = 0.4). Our findings confirm that bacteria are responsible for the majority of symptomatic infections and occur more frequently during the first month post-transplant. The ImmuKnow(®) measurements can be a useful tool for identifying patients at high risk of developing infection, particularly of fungal and bacterial etiology.
Angela Chiereghin; Evangelia Petrisli; Matteo Ravaioli; Maria Cristina Morelli; Gabriele Turello; Diego Squarzoni; Giulia Piccirilli; Simone Ambretti; Liliana Gabrielli; Antonio Daniele Pinna; Maria Paola Landini; Tiziana Lazzarotto. Infectious agents after liver transplant: etiology, timeline and patients’ cell-mediated immunity responses. Medical Microbiology and Immunology 2016, 206, 63 -71.
AMA StyleAngela Chiereghin, Evangelia Petrisli, Matteo Ravaioli, Maria Cristina Morelli, Gabriele Turello, Diego Squarzoni, Giulia Piccirilli, Simone Ambretti, Liliana Gabrielli, Antonio Daniele Pinna, Maria Paola Landini, Tiziana Lazzarotto. Infectious agents after liver transplant: etiology, timeline and patients’ cell-mediated immunity responses. Medical Microbiology and Immunology. 2016; 206 (1):63-71.
Chicago/Turabian StyleAngela Chiereghin; Evangelia Petrisli; Matteo Ravaioli; Maria Cristina Morelli; Gabriele Turello; Diego Squarzoni; Giulia Piccirilli; Simone Ambretti; Liliana Gabrielli; Antonio Daniele Pinna; Maria Paola Landini; Tiziana Lazzarotto. 2016. "Infectious agents after liver transplant: etiology, timeline and patients’ cell-mediated immunity responses." Medical Microbiology and Immunology 206, no. 1: 63-71.
Background and aim: Quantification of cytomegalovirus (CMV) DNAemia is essential in clinical management of post-transplant infection. We evaluated the performances of two quantitative real-time polymerase chain reaction (PCR) assays. Materials and Methods: 114 serial whole blood samples collected from 14 actively infected transplant recipients were processed by Abbott RealTime CMV PCR kit (Abbott Molecular) and CMV ELITe MGB™ kit (ELITech Group). The Quality Control for Molecular Diagnostics human CMV panels was also tested. Results: Sixteen (14%) samples resulted negative and 59 (51.7%) positive with a quantitative result for both assays. In the 59 samples, the coefficient of correlation was 0.856. Bland-Altman analysis showed a mean difference of <0.11 log10 copies/mL (standard deviation=0.38 log10 copies/mL). The assays gave CMV-DNA loads differing by 1 log10 DNA copies/mL in 57 samples (96.6%) and by <0.5 log10 DNA copies/mL in 48 samples (81.3%). Eleven (9.6%) samples were positive with a quantitative result with Abbott and negative with ELITech. Sixteen (14%) positive samples with a quantitative result for Abbott resulted positive but below the lower limit of quantification (LLQ) for ELITech. Twelve (10.5%) samples resulted negative with ELITech and positive but below the LLQ with Abbott. No samples were positive with ELITech and negative with Abbott. Conclusions: The assays showed a good correlation between CMVDNA levels detected and variation in CMV-DNA <0.5 log10 was observed in the majority of the samples. The viral load kinetic profiles of the assays were overlapping in all patients, but Abbott showed higher sensitivity in samples containing lower amount of DNA. The clinical value of this greater sensitivity requires further investigation.
Angela Chiereghin; Giulia Piccirilli; Gabriele Turello; Diego Squarzoni; Claudia Pavia; Liliana Gabrielli; Maria Paola Landini; Tiziana Lazzarotto. Monitoring of cytomegalovirus (CMV) infection in solid organ transplant recipients: quantitation of CMV DNAemia by two real-time polymerase chain reaction assays. Microbiologia Medica 2016, 31, 1 .
AMA StyleAngela Chiereghin, Giulia Piccirilli, Gabriele Turello, Diego Squarzoni, Claudia Pavia, Liliana Gabrielli, Maria Paola Landini, Tiziana Lazzarotto. Monitoring of cytomegalovirus (CMV) infection in solid organ transplant recipients: quantitation of CMV DNAemia by two real-time polymerase chain reaction assays. Microbiologia Medica. 2016; 31 (3):1.
Chicago/Turabian StyleAngela Chiereghin; Giulia Piccirilli; Gabriele Turello; Diego Squarzoni; Claudia Pavia; Liliana Gabrielli; Maria Paola Landini; Tiziana Lazzarotto. 2016. "Monitoring of cytomegalovirus (CMV) infection in solid organ transplant recipients: quantitation of CMV DNAemia by two real-time polymerase chain reaction assays." Microbiologia Medica 31, no. 3: 1.
Human leukocyte antigen-G (HLA-G) is a nonclassical HLA class I antigen that is expressed during pregnancy contributing to maternal-fetal tolerance. HLA-G can be expressed as membrane-bound and soluble forms. HLA-G expression increases strongly during viral infections such as congenital human cytomegalovirus (HCMV) infections, with functional consequences in immunoregulation. In this work we investigated the expression of soluble (s)HLA-G and beta-2 microglobulin (component of HLA) molecules in correlation with the risk of transmission and severity of congenital HCMV infection. We analyzed 182 blood samples from 130 pregnant women and 52 nonpregnant women and 56 amniotic fluid samples from women experiencing primary HCMV infection. The median levels of sHLA-G in maternal serum of women with primary HCMV infection were higher in comparison with nonprimary and uninfected pregnant women ( p < 0.001 ). AF from HCMV symptomatic fetuses presented higher sHLA-G levels in comparison with infected asymptomatic fetuses ( p < 0.001 ), presence of HLA-G free-heavy chain, and a concentration gradient from amniotic fluid to maternal blood. No significant statistical difference of beta-2 microglobulin median levels was observed between all different groups. Our results suggest the determination of sHLA-G molecules in both maternal blood and amniotic fluid as a promising biomarker of diagnosis of maternal HCMV primary infection and fetal HCMV disease.
Roberta Rizzo; Liliana Gabrielli; Daria Bortolotti; Valentina Gentili; Giulia Piccirilli; Angela Chiereghin; Claudia Pavia; Silvia Bolzani; Brunella Guerra; Giuliana Simonazzi; Francesca Cervi; Maria Grazia Capretti; Enrico Fainardi; Dario Di Luca; Maria Paola Landini; Tiziana Lazzarotto. Study of Soluble HLA-G in Congenital Human Cytomegalovirus Infection. Journal of Immunology Research 2016, 2016, 1 -9.
AMA StyleRoberta Rizzo, Liliana Gabrielli, Daria Bortolotti, Valentina Gentili, Giulia Piccirilli, Angela Chiereghin, Claudia Pavia, Silvia Bolzani, Brunella Guerra, Giuliana Simonazzi, Francesca Cervi, Maria Grazia Capretti, Enrico Fainardi, Dario Di Luca, Maria Paola Landini, Tiziana Lazzarotto. Study of Soluble HLA-G in Congenital Human Cytomegalovirus Infection. Journal of Immunology Research. 2016; 2016 ():1-9.
Chicago/Turabian StyleRoberta Rizzo; Liliana Gabrielli; Daria Bortolotti; Valentina Gentili; Giulia Piccirilli; Angela Chiereghin; Claudia Pavia; Silvia Bolzani; Brunella Guerra; Giuliana Simonazzi; Francesca Cervi; Maria Grazia Capretti; Enrico Fainardi; Dario Di Luca; Maria Paola Landini; Tiziana Lazzarotto. 2016. "Study of Soluble HLA-G in Congenital Human Cytomegalovirus Infection." Journal of Immunology Research 2016, no. : 1-9.
Salivary glands are a site of human cytomegalovirus (CMV) replication, latency, and persistence. Prolonged secretion of virus in saliva for months following a primary infection contribute to horizontal transmission. In order to better understand the early effects of CMV on salivary glands and the mechanisms of viral persistent replication, submandibular glands of six CMV congenitally infected fetuses at 21 weeks gestation were studied. Three fetuses at the same gestational age from CMV‐seronegative women were compared as negative controls. Tissue viral load and the type of inflammatory infiltrate were evaluated. Moreover, development and branching of salivary glands, the number of myoepithelial cells, cellular proliferation, and expression of secretory proteins of the saliva (Gross Cystic Disease Fluid Protein‐15 and lysozyme) were studied. A low viral load and rare CMV‐positive cells associated with T CD8 cytotoxic lymphocytes were observed. Branching was impaired with a decrease in terminal acinar structures, the number of myoepithelial cells, and cellular proliferation were reduced. In addition, a compromised secretion of defense proteins involved in the oral humoral immunity was observed. These findings suggest that CMV may affect salivary glands, impairing structure development and secretion of defense proteins, probably responsible for the prolonged viral shedding in saliva. J. Med. Virol. 89:318–323, 2017.
Liliana Gabrielli; Maria Paola Bonasoni; Angela Chiereghin; Giulia Piccirilli; Donatella Santini; Claudia Pavia; Gabriele Turello; Diego Squarzoni; Tiziana Lazzarotto. Salivary glands and human congenital cytomegalovirus infection: What happens in early fetal life? Journal of Medical Virology 2016, 89, 318 -323.
AMA StyleLiliana Gabrielli, Maria Paola Bonasoni, Angela Chiereghin, Giulia Piccirilli, Donatella Santini, Claudia Pavia, Gabriele Turello, Diego Squarzoni, Tiziana Lazzarotto. Salivary glands and human congenital cytomegalovirus infection: What happens in early fetal life? Journal of Medical Virology. 2016; 89 (2):318-323.
Chicago/Turabian StyleLiliana Gabrielli; Maria Paola Bonasoni; Angela Chiereghin; Giulia Piccirilli; Donatella Santini; Claudia Pavia; Gabriele Turello; Diego Squarzoni; Tiziana Lazzarotto. 2016. "Salivary glands and human congenital cytomegalovirus infection: What happens in early fetal life?" Journal of Medical Virology 89, no. 2: 318-323.
Laboratory diagnosis of measles virus (MV) infection and genetic characterization of circulating MV play an essential role in measles surveillance, allowing proper interventions to interrupt endemic transmission. We describe results obtained using serological and molecular methods to confirm MV infection among suspected cases reported in a large region in the north of Italy during 2010-2014 and the genotyping of the MV strains detected. Three hundred seventy-two samples (361 urine and 11 oral fluids) were tested for MV-RNA detection. In 281 cases, the serological results for MV-IgM detection were also available. A total of 276 cases were classified as confirmed measles and MV-RNA detection resulted positive for 239/276 cases. Nucleotide sequence analysis revealed sporadic cases of genotypes D9 and different circulations of endemic MV strains (D8, D4 and B3). This data suggests that there is still an unvaccinated part of the population maintaining the endemic circulation of MV in Italy.
Giulia Piccirilli; Angela Chiereghin; Maria Grazia Pascucci; Gabriella Frasca; Roberta Zuntini; Simona Ferrari; Liliana Gabrielli; Maria Paola Landini; Tiziana Lazzarotto. Molecular detection and genetic characterization of circulating measles virus in northern Italy. Journal of Clinical Virology 2016, 81, 34 -42.
AMA StyleGiulia Piccirilli, Angela Chiereghin, Maria Grazia Pascucci, Gabriella Frasca, Roberta Zuntini, Simona Ferrari, Liliana Gabrielli, Maria Paola Landini, Tiziana Lazzarotto. Molecular detection and genetic characterization of circulating measles virus in northern Italy. Journal of Clinical Virology. 2016; 81 ():34-42.
Chicago/Turabian StyleGiulia Piccirilli; Angela Chiereghin; Maria Grazia Pascucci; Gabriella Frasca; Roberta Zuntini; Simona Ferrari; Liliana Gabrielli; Maria Paola Landini; Tiziana Lazzarotto. 2016. "Molecular detection and genetic characterization of circulating measles virus in northern Italy." Journal of Clinical Virology 81, no. : 34-42.
Epstein-Barr virus-related post-transplant lymphoproliferative disorder (EBV-PTLD) is an uncommon, but frequently fatal, complication after allogeneic hematopoietic stem cell transplant. Prospective post-transplant virological and immunological monitoring allowed to successfully manage a patient who developed both polymorphic and monomorphic, "diffuse large B-cell lymphoma like", as an EBV-PTLD, 65days after allogeneic bone marrow transplant. Early detection of significant increase in EBV DNA level in patient's peripheral blood (peak of viral load equal to 119,039copies/mL whole blood, +56day after transplant) led to administration of pre-emptive anti-CD20 monoclonal antibody (rituximab) and close clinical monitoring. After one week, physical exam revealed laterocervical adenopathy. Histopathologic features, immunohistochemical characterization and in situ hybridization study allowed to establish a diagnosis of EBV-related PTLD. Immunological monitoring showed no EBV-specific T-cell responses during EBV replication, thus potentially explaining the occurrence of high EBV load with subsequent PTLD development. A total of four doses of anti-CD20 monoclonal antibody were administered and at the end of the treatment, EBV infection was cleared and imaging technique showed complete disease remission. In conclusion, the early use of anti-CD20 monoclonal antibody proved to be a safe and effective treatment strategy for EBV-PTLD. Moreover, combined virological-immunological monitoring of EBV infection may more accurately assess patients at higher risk for EBV-PTLD.
Angela Chiereghin; Clara Bertuzzi; Giulia Piccirilli; Liliana Gabrielli; Diego Squarzoni; Gabriele Turello; Martina Ferioli; Mariarosaria Sessa; Francesca Bonifazi; Lucia Zanoni; Elena Sabattini; Tiziana Lazzarotto. Successful management of EBV-PTLD in allogeneic bone marrow transplant recipient by virological–immunological monitoring of EBV infection, prompt diagnosis and early treatment. Transplant Immunology 2016, 34, 60 -64.
AMA StyleAngela Chiereghin, Clara Bertuzzi, Giulia Piccirilli, Liliana Gabrielli, Diego Squarzoni, Gabriele Turello, Martina Ferioli, Mariarosaria Sessa, Francesca Bonifazi, Lucia Zanoni, Elena Sabattini, Tiziana Lazzarotto. Successful management of EBV-PTLD in allogeneic bone marrow transplant recipient by virological–immunological monitoring of EBV infection, prompt diagnosis and early treatment. Transplant Immunology. 2016; 34 ():60-64.
Chicago/Turabian StyleAngela Chiereghin; Clara Bertuzzi; Giulia Piccirilli; Liliana Gabrielli; Diego Squarzoni; Gabriele Turello; Martina Ferioli; Mariarosaria Sessa; Francesca Bonifazi; Lucia Zanoni; Elena Sabattini; Tiziana Lazzarotto. 2016. "Successful management of EBV-PTLD in allogeneic bone marrow transplant recipient by virological–immunological monitoring of EBV infection, prompt diagnosis and early treatment." Transplant Immunology 34, no. : 60-64.