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Prof. Dr. Loreto Gesualdo
The Nephrology, Dialysis and Transplantation Unit "Aldo Moro", University of Bari, Azienda Ospedaliero-Universitaria Consorziale "Policlinico", Piazza Giulio Cesare, 11-70124 Bari, Italy

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0 Dialysis
0 Kidney Disease
0 diabetic nephropathy
0 Kidney transplantation
0 Nephropathology

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Kidney Disease
Dialysis
Kidney transplantation
diabetic nephropathy
Renal pathology

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Journal article
Published: 18 August 2021 in International Journal of Molecular Sciences
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CD40 crosslinking plays an important role in regulating cell migration, adhesion and proliferation in renal cell carcinoma (RCC). CD40/CD40L interaction on RCC cells activates different intracellular pathways but the molecular mechanisms leading to cell scattering are not yet clearly defined. Aim of our study was to investigate the main intracellular pathways activated by CD40 ligation and their specific involvement in RCC cell migration. CD40 ligation increased the phosphorylation of extracellular signal-regulated kinase (ERK), c-Jun NH (2)-terminal kinase (JNK) and p38 MAPK. Furthermore, CD40 crosslinking activated different transcriptional factors on RCC cell lines: AP-1, NFkB and some members of the Nuclear Factor of Activated T cells (NFAT) family. Interestingly, the specific inhibition of NFAT factors by cyclosporine A, completely blocked RCC cell motility induced by CD40 ligation. In tumor tissue, we observed a higher expression of NFAT factors and in particular an increased activation and nuclear migration of NFATc4 on RCC tumor tissues belonging to patients that developed metastases when compared to those who did not. Moreover, CD40-CD40L interaction induced a cytoskeleton reorganization and increased the expression of integrin β1 on RCC cell lines, and this effect was reversed by cyclosporine A and NFAT inhibition. These data suggest that CD40 ligation induces the activation of different intracellular signaling pathways, in particular the NFATs factors, that could represent a potential therapeutic target in the setting of patients with metastatic RCC.

ACS Style

Paola Pontrelli; Margherita Gigante; Federica Spadaccino; Giuseppe Stefano Netti; Marilisa Saldarelli; Luigi Balducci; Maddalena Gigante; Michele Battaglia; Walter J. Storkus; Giuseppe Castellano; Giovanni Stallone; Loreto Gesualdo; Elena Ranieri. CD40 Cross-Linking Induces Migration of Renal Tumor Cell through Nuclear Factor of Activated T Cells (NFAT) Activation. International Journal of Molecular Sciences 2021, 22, 8871 .

AMA Style

Paola Pontrelli, Margherita Gigante, Federica Spadaccino, Giuseppe Stefano Netti, Marilisa Saldarelli, Luigi Balducci, Maddalena Gigante, Michele Battaglia, Walter J. Storkus, Giuseppe Castellano, Giovanni Stallone, Loreto Gesualdo, Elena Ranieri. CD40 Cross-Linking Induces Migration of Renal Tumor Cell through Nuclear Factor of Activated T Cells (NFAT) Activation. International Journal of Molecular Sciences. 2021; 22 (16):8871.

Chicago/Turabian Style

Paola Pontrelli; Margherita Gigante; Federica Spadaccino; Giuseppe Stefano Netti; Marilisa Saldarelli; Luigi Balducci; Maddalena Gigante; Michele Battaglia; Walter J. Storkus; Giuseppe Castellano; Giovanni Stallone; Loreto Gesualdo; Elena Ranieri. 2021. "CD40 Cross-Linking Induces Migration of Renal Tumor Cell through Nuclear Factor of Activated T Cells (NFAT) Activation." International Journal of Molecular Sciences 22, no. 16: 8871.

Journal article
Published: 21 July 2021 in Vaccines
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Background: Solid-organ transplant (SOT) recipients are at a high risk of severe COVID-19, and are priority for vaccination. Here, we describe three cases of severe COVID-19 caused by SARS-CoV-2 B.1.1.7 lineage in vaccinated SOT recipients. Methods: Three SOT patients were hospitalized in the Policlinico Hospital of Bari (southern Italy) and underwent nasopharyngeal swabs for molecular detection of SARS-CoV-2 genes and spike protein mutations by real-time PCR. One sample was subjected to whole-genome sequencing. Results: One patient was a heart transplant recipient and two were kidney transplant recipients. All were hospitalized with severe COVID-19 between March and May 2021. Two patients were fully vaccinated and one had received only one dose of the BNT162b2 mRNA vaccine. All the patients showed a high viral load at diagnosis, and molecular typing revealed the presence of B.1.1.7 lineage SARS-CoV-2. In all three cases, prolonged viral shedding was reported. Conclusions: The three cases pose concern about the role of the B.1.1.7 lineage in severe COVID-19 and about the efficacy of COVID-19 vaccination in immunocompromised patients. Protecting immunocompromised patients from COVID-19 is a challenge. SOT recipients show a suboptimal response to standard vaccination, and thus, an additive booster or a combined vaccination strategy with mRNA, protein/subunit, and vector-based vaccines may be necessary. This population should continue to practice strict COVID-19 precautions post-vaccination, until new strategies for protection are available.

ACS Style

Daniela Loconsole; Emma Stea; Anna Sallustio; Giulia Fontò; Virginia Pronzo; Simona Simone; Francesca Centrone; Marisa Accogli; Loreto Gesualdo; Maria Chironna. Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients. Vaccines 2021, 9, 806 .

AMA Style

Daniela Loconsole, Emma Stea, Anna Sallustio, Giulia Fontò, Virginia Pronzo, Simona Simone, Francesca Centrone, Marisa Accogli, Loreto Gesualdo, Maria Chironna. Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients. Vaccines. 2021; 9 (8):806.

Chicago/Turabian Style

Daniela Loconsole; Emma Stea; Anna Sallustio; Giulia Fontò; Virginia Pronzo; Simona Simone; Francesca Centrone; Marisa Accogli; Loreto Gesualdo; Maria Chironna. 2021. "Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients." Vaccines 9, no. 8: 806.

Review article
Published: 06 July 2021 in Frontiers in Immunology
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Donor organ shortage still remains a serious obstacle for the access of wait-list patients to kidney transplantation, the best treatment for End-Stage Kidney Disease (ESKD). To expand the number of transplants, the use of lower quality organs from older ECD or DCD donors has become an established routine but at the price of increased incidence of Primary Non-Function, Delay Graft Function and lower-long term graft survival. In the last years, several improvements have been made in the field of renal transplantation from surgical procedure to preservation strategies. To improve renal outcomes, research has focused on development of innovative and dynamic preservation techniques, in order to assess graft function and promote regeneration by pharmacological intervention before transplantation. This review provides an overview of the current knowledge of these new preservation strategies by machine perfusions and pharmacological interventions at different timing possibilities: in the organ donor, ex-vivo during perfusion machine reconditioning or after implementation in the recipient. We will report therapies as anti-oxidant and anti-inflammatory agents, senolytics agents, complement inhibitors, HDL, siRNA and H2S supplementation. Renal delivery of pharmacologic agents during preservation state provides a window of opportunity to treat the organ in an isolated manner and a crucial route of administration. Even if few studies have been reported of transplantation after ex-vivo drugs administration, targeting the biological pathway associated to kidney failure (i.e. oxidative stress, complement system, fibrosis) might be a promising therapeutic strategy to improve the quality of various donor organs and expand organ availability.

ACS Style

Rossana Franzin; Alessandra Stasi; Marco Fiorentino; Simona Simone; Rainer Oberbauer; Giuseppe Castellano; Loreto Gesualdo. Renal Delivery of Pharmacologic Agents During Machine Perfusion to Prevent Ischaemia-Reperfusion Injury: From Murine Model to Clinical Trials. Frontiers in Immunology 2021, 12, 1 .

AMA Style

Rossana Franzin, Alessandra Stasi, Marco Fiorentino, Simona Simone, Rainer Oberbauer, Giuseppe Castellano, Loreto Gesualdo. Renal Delivery of Pharmacologic Agents During Machine Perfusion to Prevent Ischaemia-Reperfusion Injury: From Murine Model to Clinical Trials. Frontiers in Immunology. 2021; 12 ():1.

Chicago/Turabian Style

Rossana Franzin; Alessandra Stasi; Marco Fiorentino; Simona Simone; Rainer Oberbauer; Giuseppe Castellano; Loreto Gesualdo. 2021. "Renal Delivery of Pharmacologic Agents During Machine Perfusion to Prevent Ischaemia-Reperfusion Injury: From Murine Model to Clinical Trials." Frontiers in Immunology 12, no. : 1.

Journal article
Published: 02 July 2021 in Cells
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Glomerulonephritis are renal inflammatory processes characterized by increased permeability of the Glomerular Filtration Barrier (GFB) with consequent hematuria and proteinuria. Glomerular endothelial cells (GEC) and podocytes are part of the GFB and contribute to the maintenance of its structural and functional integrity through the release of paracrine mediators. Activation of the complement cascade and pro-inflammatory cytokines (CK) such as Tumor Necrosis Factor α (TNF-α) and Interleukin-6 (IL-6) can alter GFB function, causing acute glomerular injury and progression toward chronic kidney disease. Endothelial Progenitor Cells (EPC) are bone-marrow-derived hematopoietic stem cells circulating in peripheral blood and able to induce angiogenesis and to repair injured endothelium by releasing paracrine mediators including Extracellular Vesicles (EVs), microparticles involved in intercellular communication by transferring proteins, lipids, and genetic material (mRNA, microRNA, lncRNA) to target cells. We have previously demonstrated that EPC-derived EVs activate an angiogenic program in quiescent endothelial cells and renoprotection in different experimental models. The aim of the present study was to evaluate in vitro the protective effect of EPC-derived EVs on GECs and podocytes cultured in detrimental conditions with CKs (TNF-α/IL-6) and the complement protein C5a. EVs were internalized in both GECs and podocytes mainly through a L-selectin-based mechanism. In GECs, EVs enhanced the formation of capillary-like structures and cell migration by modulating gene expression and inducing the release of growth factors such as VEGF-A and HGF. In the presence of CKs, and C5a, EPC-derived EVs protected GECs from apoptosis by decreasing oxidative stress and prevented leukocyte adhesion by inhibiting the expression of adhesion molecules (ICAM-1, VCAM-1, E-selectin). On podocytes, EVs inhibited apoptosis and prevented nephrin shedding induced by CKs and C5a. In a co-culture model of GECs/podocytes that mimicked GFB, EPC-derived EVs protected cell function and permeselectivity from inflammatory-mediated damage. Moreover, RNase pre-treatment of EVs abrogated their protective effects, suggesting the crucial role of RNA transfer from EVs to damaged glomerular cells. In conclusion, EPC-derived EVs preserved GFB integrity from complement- and cytokine-induced damage, suggesting their potential role as therapeutic agents for drug-resistant glomerulonephritis.

ACS Style

Davide Medica; Rossana Franzin; Alessandra Stasi; Giuseppe Castellano; Massimiliano Migliori; Vincenzo Panichi; Federico Figliolini; Loreto Gesualdo; Giovanni Camussi; Vincenzo Cantaluppi. Extracellular Vesicles Derived from Endothelial Progenitor Cells Protect Human Glomerular Endothelial Cells and Podocytes from Complement- and Cytokine-Mediated Injury. Cells 2021, 10, 1675 .

AMA Style

Davide Medica, Rossana Franzin, Alessandra Stasi, Giuseppe Castellano, Massimiliano Migliori, Vincenzo Panichi, Federico Figliolini, Loreto Gesualdo, Giovanni Camussi, Vincenzo Cantaluppi. Extracellular Vesicles Derived from Endothelial Progenitor Cells Protect Human Glomerular Endothelial Cells and Podocytes from Complement- and Cytokine-Mediated Injury. Cells. 2021; 10 (7):1675.

Chicago/Turabian Style

Davide Medica; Rossana Franzin; Alessandra Stasi; Giuseppe Castellano; Massimiliano Migliori; Vincenzo Panichi; Federico Figliolini; Loreto Gesualdo; Giovanni Camussi; Vincenzo Cantaluppi. 2021. "Extracellular Vesicles Derived from Endothelial Progenitor Cells Protect Human Glomerular Endothelial Cells and Podocytes from Complement- and Cytokine-Mediated Injury." Cells 10, no. 7: 1675.

Journal article
Published: 17 June 2021 in Microorganisms
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We aimed to develop an innovative synbiotic formulation for use in reducing dysbiosis, uremic toxins (e.g., p-cresol and indoxyl sulfate), and, consequently, the pathognomonic features of patients with chronic kidney disease (CKD). Twenty-five probiotic strains, belonging to lactobacilli and Bifidobacterium, were tested for their ability to grow in co-culture with different vegetable (pomegranate, tomato, and grapes) sources of antioxidants and prebiotics (inulin, fructo-oligosaccharides, and β-glucans). Probiotics were selected based on the acidification rates and viable cell counts. Inulin and fructo-oligosaccharides reported the best prebiotic activity, while a pomegranate seed extract was initially chosen as antioxidant source. The investigation was also conducted in fecal batches from healthy and CKD subjects, on which metabolomic analyses (profiling volatile organic compounds and total free amino acids) were conducted. Two out of twenty-five probiotics were finally selected. After the stability tests, the selective innovative synbiotic formulation (named NatuREN G) comprised Bifidobacterium animalis BLC1, Lacticaseibacillus casei LC4P1, fructo-oligosaccharides, inulin, quercetin, resveratrol, and proanthocyanidins. Finally, NatuREN G was evaluated on fecal batches collected from CKD in which modified the viable cell densities of some cultivable bacterial patterns, increased the concentration of acetic acid and decane, while reduced the concentration of nonanoic acid, dimethyl trisulfide, and indoxyl sulfate.

ACS Style

Mirco Vacca; Giuseppe Celano; Marcello Lenucci; Sergio Fontana; Flavia Forgia; Fabio Minervini; Aurelia Scarano; Angelo Santino; Giuseppe Dalfino; Loreto Gesualdo; Maria De Angelis. In Vitro Selection of Probiotics, Prebiotics, and Antioxidants to Develop an Innovative Synbiotic (NatuREN G) and Testing Its Effect in Reducing Uremic Toxins in Fecal Batches from CKD Patients. Microorganisms 2021, 9, 1316 .

AMA Style

Mirco Vacca, Giuseppe Celano, Marcello Lenucci, Sergio Fontana, Flavia Forgia, Fabio Minervini, Aurelia Scarano, Angelo Santino, Giuseppe Dalfino, Loreto Gesualdo, Maria De Angelis. In Vitro Selection of Probiotics, Prebiotics, and Antioxidants to Develop an Innovative Synbiotic (NatuREN G) and Testing Its Effect in Reducing Uremic Toxins in Fecal Batches from CKD Patients. Microorganisms. 2021; 9 (6):1316.

Chicago/Turabian Style

Mirco Vacca; Giuseppe Celano; Marcello Lenucci; Sergio Fontana; Flavia Forgia; Fabio Minervini; Aurelia Scarano; Angelo Santino; Giuseppe Dalfino; Loreto Gesualdo; Maria De Angelis. 2021. "In Vitro Selection of Probiotics, Prebiotics, and Antioxidants to Develop an Innovative Synbiotic (NatuREN G) and Testing Its Effect in Reducing Uremic Toxins in Fecal Batches from CKD Patients." Microorganisms 9, no. 6: 1316.

Journal article
Published: 03 June 2021 in Cancer Biology & Therapy
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Monoclonal gammopathy of undetermined significance (MGUS) represents the pre-clinical stage of Multiple Myeloma (MM) with the 5% of MGUS progresses to MM. Although the progression from MGUS to MM has not been completely characterized, it is possible to monitor the DNA modifications of patients diagnosed with MGUS to detect early specific genomic abnormalities, including copy number variations (CNV). The CNVs of chromosome 1q and chromosome 13q are associated with a worse prognosis in MM.In the present study, we showed that it is possible to monitor the 1q21 gain and 13q deletion frequencies in gDNA using digital PCR. The CNV analysis of three cell lines with a well-characterized cytogenetic profile were compared with measures performed by a real-time PCR approach and with a digital PCR approach. Then, we analyzed CNVs in CD138+ plasma cells isolated from bone marrow of MGUS and MM patients.Our results show that digital PCR and targeted DNA monitoring represent a specific and accurate technique for the early detection of specific genomic abnormalities both in MM and in MGUS patients.Our results could represent a remarkable advancement in MM and MGUS diagnosis and in CNV analysis for the evaluation of the risk of progression from MGUS to MM.

ACS Style

Fabio Sallustio; Claudia Curci; Antonio Giovanni Solimando; Patrizia Leone; Paola Pontrelli; Loreto Gesualdo; Angelo Vacca; Vito Racanelli; Anna Gallone. Identification and monitoring of Copy Number Variants (CNV) in monoclonal gammopathy. Cancer Biology & Therapy 2021, 22, 404 -412.

AMA Style

Fabio Sallustio, Claudia Curci, Antonio Giovanni Solimando, Patrizia Leone, Paola Pontrelli, Loreto Gesualdo, Angelo Vacca, Vito Racanelli, Anna Gallone. Identification and monitoring of Copy Number Variants (CNV) in monoclonal gammopathy. Cancer Biology & Therapy. 2021; 22 (5-6):404-412.

Chicago/Turabian Style

Fabio Sallustio; Claudia Curci; Antonio Giovanni Solimando; Patrizia Leone; Paola Pontrelli; Loreto Gesualdo; Angelo Vacca; Vito Racanelli; Anna Gallone. 2021. "Identification and monitoring of Copy Number Variants (CNV) in monoclonal gammopathy." Cancer Biology & Therapy 22, no. 5-6: 404-412.

Review
Published: 01 June 2021 in International Journal of Molecular Sciences
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High-density lipoproteins (HDLs) are a class of blood particles, principally involved in mediating reverse cholesterol transport from peripheral tissue to liver. Omics approaches have identified crucial mediators in the HDL proteomic and lipidomic profile, which are involved in distinct pleiotropic functions. Besides their role as cholesterol transporter, HDLs display anti-inflammatory, anti-apoptotic, anti-thrombotic, and anti-infection properties. Experimental and clinical studies have unveiled significant changes in both HDL serum amount and composition that lead to dysregulated host immune response and endothelial dysfunction in the course of sepsis. Most SARS-Coronavirus-2-infected patients admitted to the intensive care unit showed common features of sepsis disease, such as the overwhelmed systemic inflammatory response and the alterations in serum lipid profile. Despite relevant advances, episodes of mild to moderate acute kidney injury (AKI), occurring during systemic inflammatory diseases, are associated with long-term complications, and high risk of mortality. The multi-faceted relationship of kidney dysfunction with dyslipidemia and inflammation encourages to deepen the clarification of the mechanisms connecting these elements. This review analyzes the multifaced roles of HDL in inflammatory diseases, the renal involvement in lipid metabolism, and the novel potential HDL-based therapies.

ACS Style

Alessandra Stasi; Rossana Franzin; Marco Fiorentino; Enrico Squiccimarro; Giuseppe Castellano; Loreto Gesualdo. Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications. International Journal of Molecular Sciences 2021, 22, 5980 .

AMA Style

Alessandra Stasi, Rossana Franzin, Marco Fiorentino, Enrico Squiccimarro, Giuseppe Castellano, Loreto Gesualdo. Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications. International Journal of Molecular Sciences. 2021; 22 (11):5980.

Chicago/Turabian Style

Alessandra Stasi; Rossana Franzin; Marco Fiorentino; Enrico Squiccimarro; Giuseppe Castellano; Loreto Gesualdo. 2021. "Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications." International Journal of Molecular Sciences 22, no. 11: 5980.

Journal article
Published: 14 May 2021 in International Journal of Molecular Sciences
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Diabetic nephropathy (DN) is the most frequent cause of end-stage renal disease. Tubulointerstitial accumulation of lysine 63 (K63)-ubiquitinated (Ub) proteins is involved in the progression of DN fibrosis and correlates with urinary miR-27b-3p downregulation. We explored the renoprotective effect of an inhibitor of K63-Ub (NSC697923), alone or in combination with the ACE-inhibitor ramipril, in vitro and in vivo. Proximal tubular epithelial cells and diabetic DBA/2J mice were treated with NSC697923 and/or ramipril. K63-Ub protein accumulation along with α-SMA, collagen I and III, FSP-1, vimentin, p16INK4A expression, SA-α Gal staining, Sirius Red, and PAS staining were measured. Finally, we measured the urinary albumin to creatinine ratio (uACR), and urinary miR-27b-3p expression in mice. NSC697923, both alone and in association with ramipril, in vitro and in vivo inhibited hyperglycemia-induced epithelial to mesenchymal transition by significantly reducing K63-Ub proteins, α-SMA, collagen I, vimentin, FSP-1 expression, and collagen III along with tubulointerstitial and glomerular fibrosis. Treated mice also showed recovery of urinary miR-27b-3p and restored expression of p16INK4A. Moreover, NSC697923 in combination with ramipril demonstrated a trend in the reduction of uACR. In conclusion, we suggest that selective inhibition of K63-Ub, when combined with the conventional treatment with ACE inhibitors, might represent a novel treatment strategy to prevent the progression of fibrosis and proteinuria in diabetic nephropathy and we propose miR-27b-3p as a biomarker of treatment efficacy.

ACS Style

Paola Pontrelli; Francesca Conserva; Rossella Menghini; Michele Rossini; Alessandra Stasi; Chiara Divella; Viviana Casagrande; Claudia Cinefra; Mariagrazia Barozzino; Simona Simone; Francesco Pesce; Giuseppe Castellano; Giovanni Stallone; Anna Gallone; Francesco Giorgino; Massimo Federici; Loreto Gesualdo. Inhibition of Lysine 63 Ubiquitination Prevents the Progression of Renal Fibrosis in Diabetic DBA/2J Mice. International Journal of Molecular Sciences 2021, 22, 5194 .

AMA Style

Paola Pontrelli, Francesca Conserva, Rossella Menghini, Michele Rossini, Alessandra Stasi, Chiara Divella, Viviana Casagrande, Claudia Cinefra, Mariagrazia Barozzino, Simona Simone, Francesco Pesce, Giuseppe Castellano, Giovanni Stallone, Anna Gallone, Francesco Giorgino, Massimo Federici, Loreto Gesualdo. Inhibition of Lysine 63 Ubiquitination Prevents the Progression of Renal Fibrosis in Diabetic DBA/2J Mice. International Journal of Molecular Sciences. 2021; 22 (10):5194.

Chicago/Turabian Style

Paola Pontrelli; Francesca Conserva; Rossella Menghini; Michele Rossini; Alessandra Stasi; Chiara Divella; Viviana Casagrande; Claudia Cinefra; Mariagrazia Barozzino; Simona Simone; Francesco Pesce; Giuseppe Castellano; Giovanni Stallone; Anna Gallone; Francesco Giorgino; Massimo Federici; Loreto Gesualdo. 2021. "Inhibition of Lysine 63 Ubiquitination Prevents the Progression of Renal Fibrosis in Diabetic DBA/2J Mice." International Journal of Molecular Sciences 22, no. 10: 5194.

Journal article
Published: 05 May 2021 in Toxins
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Proteolytic dysbiosis of the gut microbiota has been recognized as both a typical feature of chronic kidney disease (CKD) and a risk factor for its progression. Blood accumulation of gut-derived uremic toxins (UTs) like indoxyl sulfate (IS) and p-cresyl sulfate (PCS), intestinal permeability and constipation are typical features accompanying CKD progression and triggering chronic inflammation. In order to verify the efficacy of the innovative synbiotic formulation NATUREN G® in modulating the levels of circulating UTs, intestinal permeability and gastrointestinal symptoms, we set up a randomized, single-blind, placebo-controlled, pilot trial in stage IIIb-IV CKD patients and in healthy controls. Two-month administration of the synbiotic resulted in a decrease of free IS, as compared with the placebo-treated arm, only in the CKD group. The other UTs did not significantly change, although different trends in time (increase in the placebo arm and decrease in the synbiotic arm) were observed. Moreover, after supplementation, reduction of small intestinal permeability and amelioration of abdominal pain and constipation syndromes were observed only in the CKD group. The obtained results suggest the specificity of action of NATUREN G® in CKD and justify further validation in a wider study population.

ACS Style

Carmela Cosola; Maria Rocchetti; Ighli di Bari; Paola Acquaviva; Valentina Maranzano; Simone Corciulo; Agostino Di Ciaula; Domenica Di Palo; Flavia La Forgia; Sergio Fontana; Maria De Angelis; Piero Portincasa; Loreto Gesualdo. An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients. Toxins 2021, 13, 334 .

AMA Style

Carmela Cosola, Maria Rocchetti, Ighli di Bari, Paola Acquaviva, Valentina Maranzano, Simone Corciulo, Agostino Di Ciaula, Domenica Di Palo, Flavia La Forgia, Sergio Fontana, Maria De Angelis, Piero Portincasa, Loreto Gesualdo. An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients. Toxins. 2021; 13 (5):334.

Chicago/Turabian Style

Carmela Cosola; Maria Rocchetti; Ighli di Bari; Paola Acquaviva; Valentina Maranzano; Simone Corciulo; Agostino Di Ciaula; Domenica Di Palo; Flavia La Forgia; Sergio Fontana; Maria De Angelis; Piero Portincasa; Loreto Gesualdo. 2021. "An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients." Toxins 13, no. 5: 334.

Journal article
Published: 16 April 2021 in Journal of Personalized Medicine
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IgA Nephropathy (IgAN) is the most common glomerulonephritis worldwide, characterized by the mesangial deposition of abnormally glycosylated IgA1 (Gd-IgA). The production of Gd-IgA occurs in mucose-associated lymphoid tissue (MALT). The microbiota plays a role in MALT modulation. Rifaximin (NORMIX®), a non-absorbable oral antibiotic, induces positive modulation of the gut microbiota, favoring the growth of bacteria beneficial to the host. Here, we evaluate the effect of rifaximin on a humanized mice model of IgAN (α1KI-CD89Tg). Methods: The α1KI-CD89Tg mice were treated by the vehicle (olive oil) or rifaximin (NORMIX®). Serum levels of hIgA, hIgA1–sCD89, and mIgG–hIgA1 immune complexes were determined. Glomerular hIgA1 deposit and CD11b+ cells recruitment were revealed using confocal microscopy. Furthermore, the mRNA of the B-Cell Activating Factor (BAFF), polymeric immunoglobulin receptor (pIgR), and Tumor Necrosing Factor-α (TNF-α) in gut samples were detected by qPCR. Results: Rifaximin treatment decreased the urinary protein-to-creatinine ratio, serum levels of hIgA1–sCD89 and mIgG–hIgA1 complexes, hIgA1 glomerular deposition, and CD11b+ cell infiltration. Moreover, rifaximin treatment decreased significantly BAFF, pIgR, and TNF-α mRNA expression. Conclusions: Rifaximin decreased the IgAN symptoms observed in α1KI-CD89Tg mice, suggesting a possible role for it in the treatment of the disease.

ACS Style

Vincenzo Di Leo; Patrick Gleeson; Fabio Sallustio; Carine Bounaix; Jennifer Da Silva; Gesualdo Loreto; Sanae Ben Mkaddem; Renato Monteiro. Rifaximin as a Potential Treatment for IgA Nephropathy in a Humanized Mice Model. Journal of Personalized Medicine 2021, 11, 309 .

AMA Style

Vincenzo Di Leo, Patrick Gleeson, Fabio Sallustio, Carine Bounaix, Jennifer Da Silva, Gesualdo Loreto, Sanae Ben Mkaddem, Renato Monteiro. Rifaximin as a Potential Treatment for IgA Nephropathy in a Humanized Mice Model. Journal of Personalized Medicine. 2021; 11 (4):309.

Chicago/Turabian Style

Vincenzo Di Leo; Patrick Gleeson; Fabio Sallustio; Carine Bounaix; Jennifer Da Silva; Gesualdo Loreto; Sanae Ben Mkaddem; Renato Monteiro. 2021. "Rifaximin as a Potential Treatment for IgA Nephropathy in a Humanized Mice Model." Journal of Personalized Medicine 11, no. 4: 309.

Review
Published: 02 April 2021 in Pharmaceuticals
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The analysis of microRNA (miRNAs), small, non-coding endogenous RNA, plays a crucial role in oncology. These short regulatory sequences, acting on thousands of messenger RNAs (mRNAs), modulate gene expression at the transcriptional and post-transcriptional level leading to translational repression or degradation of target molecules. Although their function is required for several physiological processes, such as proliferation, apoptosis and cell differentiation, miRNAs are also responsible for development and/or progression of several cancers, since they may interact with classical tumor pathways. In this review, we highlight recent advances in deregulated miRNAs in cancer focusing on renal cell carcinoma (RCC) and provide an overview of the potential use of miRNA in their clinical settings, such as diagnostic and prognostic markers.

ACS Style

Federica Spadaccino; Margherita Gigante; Giuseppe Netti; Maria Rocchetti; Rossana Franzin; Loreto Gesualdo; Giuseppe Castellano; Giovanni Stallone; Elena Ranieri. The Ambivalent Role of miRNAs in Carcinogenesis: Involvement in Renal Cell Carcinoma and Their Clinical Applications. Pharmaceuticals 2021, 14, 322 .

AMA Style

Federica Spadaccino, Margherita Gigante, Giuseppe Netti, Maria Rocchetti, Rossana Franzin, Loreto Gesualdo, Giuseppe Castellano, Giovanni Stallone, Elena Ranieri. The Ambivalent Role of miRNAs in Carcinogenesis: Involvement in Renal Cell Carcinoma and Their Clinical Applications. Pharmaceuticals. 2021; 14 (4):322.

Chicago/Turabian Style

Federica Spadaccino; Margherita Gigante; Giuseppe Netti; Maria Rocchetti; Rossana Franzin; Loreto Gesualdo; Giuseppe Castellano; Giovanni Stallone; Elena Ranieri. 2021. "The Ambivalent Role of miRNAs in Carcinogenesis: Involvement in Renal Cell Carcinoma and Their Clinical Applications." Pharmaceuticals 14, no. 4: 322.

Medicine
Published: 02 March 2021 in Frontiers in Medicine
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Acute kidney injury (AKI) is increasingly emerging as a global emergency. Sepsis, major surgery, and nephrotoxic drugs are the main causes of AKI in hospitalized patients. However, glomerulonephritis accounts for about 10% of AKI episodes in adults, mainly related to rapidly progressive glomerulonephritis resulting from granulomatous polyangiitis (GPA, Wegener granulomatosis), microscopic polyangiitis (MPA), and anti-glomerular basement membrane (GBM) disease. Also, diffuse proliferative lupus nephritis, immunoglobulin A nephropathy, post-streptococcal glomerulonephritis, mixed cryoglobulinemia, mesangiocapillary glomerulonephritis, membranous nephropathy, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and scleroderma can induce acute renal failure. Early diagnosis of AKI due to glomerulonephritis is crucial for prompt, effective management to improve short- and long-term outcomes. Kidney biopsy is the gold standard for the diagnosis of glomerular disease, but it is not frequently performed in critically ill patients because of their clinical conditions. In this setting, a growing number of diagnostic assays can support the working hypothesis, including antineutrophil cytoplasmic antibodies (ANCAs), anti-double-stranded DNA antibodies, anti-GBM antibodies, antistreptolysin O and anti-DNase B antibodies, cryoglobulins, antiphospholipid antibodies, and complement levels. Therapeutic strategies in AKI patients with glomerulonephritis include high-dose corticosteroids, cyclophosphamide, and plasma exchange. This article reviews the wide spectrum of glomerulopathies associated with AKI, describing the immunological mechanisms underlying glomerular diseases and presenting an overview of the therapeutic options.

ACS Style

Francesco Pesce; Emma D. Stea; Michele Rossini; Marco Fiorentino; Fausta Piancone; Barbara Infante; Giovanni Stallone; Giuseppe Castellano; Loreto Gesualdo. Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention. Frontiers in Medicine 2021, 7, 1 .

AMA Style

Francesco Pesce, Emma D. Stea, Michele Rossini, Marco Fiorentino, Fausta Piancone, Barbara Infante, Giovanni Stallone, Giuseppe Castellano, Loreto Gesualdo. Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention. Frontiers in Medicine. 2021; 7 ():1.

Chicago/Turabian Style

Francesco Pesce; Emma D. Stea; Michele Rossini; Marco Fiorentino; Fausta Piancone; Barbara Infante; Giovanni Stallone; Giuseppe Castellano; Loreto Gesualdo. 2021. "Glomerulonephritis in AKI: From Pathogenesis to Therapeutic Intervention." Frontiers in Medicine 7, no. : 1.

Journal article
Published: 18 February 2021 in Journal of Clinical Medicine
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Nutritional therapy (NT) is a therapeutic option in the conservative treatment of chronic kidney disease (CKD) patients to delay the start of dialysis. The aim of this study was to evaluate the specific effect of ketoanalogs (KA)-supplemented diets for gut microbiota modulation. In a previous study we observed that the Mediterranean diet (MD) and a KA-supplemented very-low-protein diet (VLPD) modulated beneficially gut microbiota, reducing indoxyl- and p-cresyl-sulfate (IS, PCS) serum levels, and ameliorating the intestinal permeability in CKD patients. In the current study, we added a third diet regimen consisting of KA-supplemented MD. Forty-three patients with CKD grades 3B–4 continuing the crossover clinical trial were assigned to six months of KA-supplemented MD (MD + KA). Compared to MD, KA-supplementation in MD + KA determined (i) a decrease of Clostridiaceae, Methanobacteriaceae, Prevotellaceae, and Lactobacillaceae while Bacteroidaceae and Lachnospiraceae increased; (ii) a reduction of total and free IS and PCS compared to a free diet (FD)—more than the MD, but not as effectively as the VLPD. These results further clarify the driving role of urea levels in regulating gut integrity status and demonstrating that the reduction of azotemia produced by KA-supplemented VLPD was more effective than KA-supplemented MD in gut microbiota modulation mainly due to the effect of the drastic reduction of protein intake rather than the effect of KA.

ACS Style

Maria Rocchetti; Biagio Di Iorio; Mirco Vacca; Carmela Cosola; Stefania Marzocco; Ighli di Bari; Francesco Calabrese; Roberto Ciarcia; Maria De Angelis; Loreto Gesualdo. Ketoanalogs’ Effects on Intestinal Microbiota Modulation and Uremic Toxins Serum Levels in Chronic Kidney Disease (Medika2 Study). Journal of Clinical Medicine 2021, 10, 840 .

AMA Style

Maria Rocchetti, Biagio Di Iorio, Mirco Vacca, Carmela Cosola, Stefania Marzocco, Ighli di Bari, Francesco Calabrese, Roberto Ciarcia, Maria De Angelis, Loreto Gesualdo. Ketoanalogs’ Effects on Intestinal Microbiota Modulation and Uremic Toxins Serum Levels in Chronic Kidney Disease (Medika2 Study). Journal of Clinical Medicine. 2021; 10 (4):840.

Chicago/Turabian Style

Maria Rocchetti; Biagio Di Iorio; Mirco Vacca; Carmela Cosola; Stefania Marzocco; Ighli di Bari; Francesco Calabrese; Roberto Ciarcia; Maria De Angelis; Loreto Gesualdo. 2021. "Ketoanalogs’ Effects on Intestinal Microbiota Modulation and Uremic Toxins Serum Levels in Chronic Kidney Disease (Medika2 Study)." Journal of Clinical Medicine 10, no. 4: 840.

Journal article
Published: 16 January 2021 in Pathogens
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The good installation, as well as commissioning plan, of a water network is a crucial step in reducing the risk of waterborne diseases. The aim of this study was to monitor the microbiological quality of water from a newly built pavilion before it commenced operation. Overall, 91 water samples were tested for coliforms, Escherichia coli, enterococci, Pseudomonas aeruginosa and Legionella at three different times: T0 (without any water treatment), T1 (after treatment with hydrogen peroxide and silver ions at initial concentration of 20 mg/L and after flushing of water for 20 min/day for seven successive days) and T2 (15 days later). Coliforms were detected in 47.3% of samples at T0, 36.3% at T1 and 4.4% at T2. E. coli was isolated in 4.4% of the samples only at T1, while enterococci appeared in 12.1% of the samples at T1 and in 2.2% at T2. P. aeruginosa was isolated in 50.5% of the samples at T0, 29.7% at T1 and 1.1% at T2. Legionella pneumophila serogroup 8 was isolated in 80.2% of the samples at T0, 36.3% at T1 and 2.2% at T2. Our results confirmed the need for a water safety plan in new hospital pavilions to prevent the risk of waterborne diseases.

ACS Style

Osvalda De Giglio; Giusy Diella; Marco Lopuzzo; Francesco Triggiano; Carla Calia; Chrysovalentinos Pousis; Fabrizio Fasano; Giuseppe Calabrese; Vincenza Rafaschieri; Lucia Carpagnano; Matilde Carlucci; Loreto Gesualdo; Maria Ricci; Maria Scaturro; Maria Rota; Lucia Bonadonna; Luca Lucentini; Maria Montagna. Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion. Pathogens 2021, 10, 75 .

AMA Style

Osvalda De Giglio, Giusy Diella, Marco Lopuzzo, Francesco Triggiano, Carla Calia, Chrysovalentinos Pousis, Fabrizio Fasano, Giuseppe Calabrese, Vincenza Rafaschieri, Lucia Carpagnano, Matilde Carlucci, Loreto Gesualdo, Maria Ricci, Maria Scaturro, Maria Rota, Lucia Bonadonna, Luca Lucentini, Maria Montagna. Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion. Pathogens. 2021; 10 (1):75.

Chicago/Turabian Style

Osvalda De Giglio; Giusy Diella; Marco Lopuzzo; Francesco Triggiano; Carla Calia; Chrysovalentinos Pousis; Fabrizio Fasano; Giuseppe Calabrese; Vincenza Rafaschieri; Lucia Carpagnano; Matilde Carlucci; Loreto Gesualdo; Maria Ricci; Maria Scaturro; Maria Rota; Lucia Bonadonna; Luca Lucentini; Maria Montagna. 2021. "Management of Microbiological Contamination of the Water Network of a Newly Built Hospital Pavilion." Pathogens 10, no. 1: 75.

Original research
Published: 01 January 2021 in Journal of Clinical Monitoring and Computing
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Mechanically ventilated patients with ARDS due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seem particularly susceptible to AKI. Our hypothesis was that the renal blood flow could be more compromised in SARS-CoV-2 patients than in patients with “classical” ARDS. We compared the renal resistivity index (RRI) and the renal venous flow (RVF) in ARDS patients with SARS-CoV-2 and in ARDS patients due to other etiologies. Prospective, observational pilot study performed on 30 mechanically ventilated patients (15 with SARS-COV-2 ARDS and 15 with ARDS). Mechanical ventilation settings included constant-flow controlled ventilation, a tidal volume of 6 ml/kg of ideal body weight and the PEEP level titrated to the lowest driving pressure. Ultrasound Doppler measurements of RRI and RVF pattern were performed in each patient. Patients with SARS-COV-2 ARDS had higher RRI than patients with ARDS (0.71[0.67–0.78] vs 0.64[0.60–0.74], p = 0.04). RVF was not-continuous in 9/15 patients (71%) in the SARS-COV-2 ARDS group and in and 5/15 (33%) in the ARDS group (p = 0.27). A linear correlation was found between PEEP and RRI in patients with SARS-COV-2 ARDS (r2 = 0.31; p = 0.03) but not in patients with ARDS. Occurrence of AKI was 53% in patients with SARS-COV-2 ARDS and 33% in patients with ARDS (p = 0.46). We found a more pronounced impairment in renal blood flow in mechanically ventilated patients with SARS-COV-2 ARDS, compared with patients with “classical” ARDS.

ACS Style

Alberto Fogagnolo; Salvatore Grasso; Martin Dres; Loreto Gesualdo; Francesco Murgolo; Elena Morelli; Irene Ottaviani; Elisabetta Marangoni; Carlo Alberto Volta; Savino Spadaro. Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study. Journal of Clinical Monitoring and Computing 2021, 1 -7.

AMA Style

Alberto Fogagnolo, Salvatore Grasso, Martin Dres, Loreto Gesualdo, Francesco Murgolo, Elena Morelli, Irene Ottaviani, Elisabetta Marangoni, Carlo Alberto Volta, Savino Spadaro. Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study. Journal of Clinical Monitoring and Computing. 2021; ():1-7.

Chicago/Turabian Style

Alberto Fogagnolo; Salvatore Grasso; Martin Dres; Loreto Gesualdo; Francesco Murgolo; Elena Morelli; Irene Ottaviani; Elisabetta Marangoni; Carlo Alberto Volta; Savino Spadaro. 2021. "Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study." Journal of Clinical Monitoring and Computing , no. : 1-7.

Journal article
Published: 29 December 2020 in International Journal of Molecular Sciences
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Adult Renal Stem/Progenitor Cells (ARPCs) have been recently identified in the human kidney and several studies show their active role in kidney repair processes during acute or chronic injury. However, little is known about their immunomodulatory properties and their capacity to regulate specific T cell subpopulations. We co-cultured ARPCs activated by triggering Toll-Like Receptor 2 (TLR2) with human peripheral blood mononuclear cells for 5 days and 15 days and studied their immunomodulatory capacity on T cell subpopulations. We found that activated-ARPCs were able to decrease T cell proliferation but did not affect CD8+ and CD4+ T cells. Instead, Tregs and CD3+ CD4- CD8- double-negative (DN) T cells decreased after 5 days and increased after 15 days of co-culture. In addition, we found that PAI1, MCP1, GM-CSF, and CXCL1 were significantly expressed by TLR2-activated ARPCs alone and were up-regulated in T cells co-cultured with activated ARPCs. The exogenous cocktail of cytokines was able to reproduce the immunomodulatory effects of the co-culture with activated ARPCs. These data showed that ARPCs can regulate immune response by inducing Tregs and DN T cells cell modulation, which are involved in the balance between immune tolerance and autoimmunity.

ACS Style

Claudia Curci; Angela Picerno; Nada Chaoul; Alessandra Stasi; Giuseppe De De Palma; Rossana Franzin; Paola Pontrelli; Giuseppe Castellano; Giovanni B. Pertosa; Luigi Macchia; Vito Francesco Di Lorenzo; Carlo Sabbà; Anna Gallone; Loreto Gesualdo; Fabio Sallustio. Adult Renal Stem/Progenitor Cells Can Modulate T Regulatory Cells and Double Negative T Cells. International Journal of Molecular Sciences 2020, 22, 274 .

AMA Style

Claudia Curci, Angela Picerno, Nada Chaoul, Alessandra Stasi, Giuseppe De De Palma, Rossana Franzin, Paola Pontrelli, Giuseppe Castellano, Giovanni B. Pertosa, Luigi Macchia, Vito Francesco Di Lorenzo, Carlo Sabbà, Anna Gallone, Loreto Gesualdo, Fabio Sallustio. Adult Renal Stem/Progenitor Cells Can Modulate T Regulatory Cells and Double Negative T Cells. International Journal of Molecular Sciences. 2020; 22 (1):274.

Chicago/Turabian Style

Claudia Curci; Angela Picerno; Nada Chaoul; Alessandra Stasi; Giuseppe De De Palma; Rossana Franzin; Paola Pontrelli; Giuseppe Castellano; Giovanni B. Pertosa; Luigi Macchia; Vito Francesco Di Lorenzo; Carlo Sabbà; Anna Gallone; Loreto Gesualdo; Fabio Sallustio. 2020. "Adult Renal Stem/Progenitor Cells Can Modulate T Regulatory Cells and Double Negative T Cells." International Journal of Molecular Sciences 22, no. 1: 274.

Review
Published: 15 December 2020 in Journal of Clinical Medicine
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of coronavirus disease 2019 (COVID-19), first emerged in Wuhan, China. The clinical manifestations of patients infected with COVID-19 include fever, cough, and dyspnea, up to acute respiratory distress syndrome (ARDS) and acute cardiac injury. Thus, a lot of severe patients had to be admitted to intensive care units (ICU). The pathogenic mechanisms of SARS-CoV-2 infection are mediated by the binding of SARS-CoV-2 spikes to the human angiotensin-converting enzyme 2 (ACE-2) receptor. The overexpression of human ACE-2 is associated with the disease severity in SARS-CoV-2 infection, demonstrating that viral entry into cells is a pivotal step. Although the lung is the organ that is most commonly affected by SARS-CoV-2 infection, acute kidney injury (AKI), heart dysfunction and abdominal pain are the most commonly reported co-morbidities of COVID-19. The occurrence of AKI in COVID-19 patients might be explained by several mechanisms that include viral cytopathic effects in renal cells and the host hyperinflammatory response. In addition, kidney dysfunction could exacerbate the inflammatory response started in the lungs and might cause further renal impairment and multi-organ failure. Mounting recent evidence supports the involvement of cardiovascular complications and endothelial dysfunction in COVID-19 syndrome, in addition to respiratory disease. To date, there is no vaccine, and no specific antiviral medicine has been shown to be effective in preventing or treating COVID-19. The removal of pro-inflammatory cytokines and the shutdown of the cytokine storm could ameliorate the clinical outcome in severe COVID-19 cases. Therefore, several interventions that inhibit viral replication and the systemic inflammatory response could modulate the severity of the renal dysfunction and increase the probability of a favorable outcome.

ACS Style

Alessandra Stasi; Giuseppe Castellano; Elena Ranieri; Barbara Infante; Giovanni Stallone; Loreto Gesualdo; Giuseppe Stefano Netti. SARS-CoV-2 and Viral Sepsis: Immune Dysfunction and Implications in Kidney Failure. Journal of Clinical Medicine 2020, 9, 4057 .

AMA Style

Alessandra Stasi, Giuseppe Castellano, Elena Ranieri, Barbara Infante, Giovanni Stallone, Loreto Gesualdo, Giuseppe Stefano Netti. SARS-CoV-2 and Viral Sepsis: Immune Dysfunction and Implications in Kidney Failure. Journal of Clinical Medicine. 2020; 9 (12):4057.

Chicago/Turabian Style

Alessandra Stasi; Giuseppe Castellano; Elena Ranieri; Barbara Infante; Giovanni Stallone; Loreto Gesualdo; Giuseppe Stefano Netti. 2020. "SARS-CoV-2 and Viral Sepsis: Immune Dysfunction and Implications in Kidney Failure." Journal of Clinical Medicine 9, no. 12: 4057.

Book chapter
Published: 04 November 2020 in Endocrinology
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Endocrine and renal pathophysiology are interwoven at a granular level, and physicians involved in both disciplines must work closely together to appreciate diagnostic subtleties that can make a substantial difference in the therapeutic approach. Diabetes is the leading cause of end-stage renal disease worldwide. Diabetic nephropathy (DN) affects one-third of patients with diabetes mellitus and is associated with considerable cardiovascular morbidity and mortality. However, at histological level, diabetic patients show a high prevalence of nondiabetic renal diseases or mixed forms; thus, the term diabetic nephropathy should be used only for biopsy-proven kidney disease caused by diabetes. As the treatment may diverge, and the risk profile is comparable to that of the general population, renal biopsy should be performed to allow a proper diagnosis and prognosis. Obesity, on the other hand, is becoming increasingly worrying, as indicated by the recent upward surge in incidence of obesity-related glomerulopathy. Such complex disorder affects the kidney leading to glomerular damage, chronic kidney disease, nephrolithiasis, and kidney cancers and demands population-wide interventions since preventive measures are definitely possible. Here, we also analyze the alterations of thyroid hormones, renin-angiotensin-aldosterone system, antidiuretic hormone, parathyroid, and sexual hormones in the setting of chronic kidney disease. The interplay between different endocrine axes is taken into account in light of the clinical changes driven by modifications in renal function.

ACS Style

Silvia Matino; Francesco Pesce; Michele Rossini; Giuseppina D’Ettorre; Alessandro Mascolo; Loreto Gesualdo. Impact of Endocrine Disorders on the Kidney. Endocrinology 2020, 123 -156.

AMA Style

Silvia Matino, Francesco Pesce, Michele Rossini, Giuseppina D’Ettorre, Alessandro Mascolo, Loreto Gesualdo. Impact of Endocrine Disorders on the Kidney. Endocrinology. 2020; ():123-156.

Chicago/Turabian Style

Silvia Matino; Francesco Pesce; Michele Rossini; Giuseppina D’Ettorre; Alessandro Mascolo; Loreto Gesualdo. 2020. "Impact of Endocrine Disorders on the Kidney." Endocrinology , no. : 123-156.

Journal article
Published: 25 October 2020 in Electronics
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The histological assessment of glomeruli is fundamental for determining if a kidney is suitable for transplantation. The Karpinski score is essential to evaluate the need for a single or dual kidney transplant and includes the ratio between the number of sclerotic glomeruli and the overall number of glomeruli in a kidney section. The manual evaluation of kidney biopsies performed by pathologists is time-consuming and error-prone, so an automatic framework to delineate all the glomeruli present in a kidney section can be very useful. Our experiments have been conducted on a dataset provided by the Department of Emergency and Organ Transplantations (DETO) of Bari University Hospital. This dataset is composed of 26 kidney biopsies coming from 19 donors. The rise of Convolutional Neural Networks (CNNs) has led to a realm of methods which are widely applied in Medical Imaging. Deep learning techniques are also very promising for the segmentation of glomeruli, with a variety of existing approaches. Many methods only focus on semantic segmentation—which consists in segmentation of individual pixels—or ignore the problem of discriminating between non-sclerotic and sclerotic glomeruli, so these approaches are not optimal or inadequate for transplantation assessment. In this work, we employed an end-to-end fully automatic approach based on Mask R-CNN for instance segmentation and classification of glomeruli. We also compared the results obtained with a baseline based on Faster R-CNN, which only allows detection at bounding boxes level. With respect to the existing literature, we improved the Mask R-CNN approach in sliding window contexts, by employing a variant of the Non-Maximum Suppression (NMS) algorithm, which we called Non-Maximum-Area Suppression (NMAS). The obtained results are very promising, leading to improvements over existing literature. The baseline Faster R-CNN-based approach obtained an F-Measure of 0.904 and 0.667 for non-sclerotic and sclerotic glomeruli, respectively. The Mask R-CNN approach has a significant improvement over the baseline, obtaining an F-Measure of 0.925 and 0.777 for non-sclerotic and sclerotic glomeruli, respectively. The proposed method is very promising for the instance segmentation and classification of glomeruli, and allows to make a robust evaluation of global glomerulosclerosis. We also compared Karpinski score obtained with our algorithm to that obtained with pathologists’ annotations to show the soundness of the proposed workflow from a clinical point of view.

ACS Style

Nicola Altini; Giacomo Donato Cascarano; Antonio Brunetti; Irio De De Feudis; Domenico Buongiorno; Michele Rossini; Francesco Pesce; Loreto Gesualdo; Vitoantonio Bevilacqua. A Deep Learning Instance Segmentation Approach for Global Glomerulosclerosis Assessment in Donor Kidney Biopsies. Electronics 2020, 9, 1768 .

AMA Style

Nicola Altini, Giacomo Donato Cascarano, Antonio Brunetti, Irio De De Feudis, Domenico Buongiorno, Michele Rossini, Francesco Pesce, Loreto Gesualdo, Vitoantonio Bevilacqua. A Deep Learning Instance Segmentation Approach for Global Glomerulosclerosis Assessment in Donor Kidney Biopsies. Electronics. 2020; 9 (11):1768.

Chicago/Turabian Style

Nicola Altini; Giacomo Donato Cascarano; Antonio Brunetti; Irio De De Feudis; Domenico Buongiorno; Michele Rossini; Francesco Pesce; Loreto Gesualdo; Vitoantonio Bevilacqua. 2020. "A Deep Learning Instance Segmentation Approach for Global Glomerulosclerosis Assessment in Donor Kidney Biopsies." Electronics 9, no. 11: 1768.

Journal article
Published: 23 September 2020 in Environmental Research
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The COVID-19 pandemic started in China in early December 2019, and quickly spread around the world. The epidemic gradually started in Italy at the end of February 2020, and by May 31, 2020, 232,664 cases and 33,340 deaths were confirmed. As a result of this pandemic, the Italian Ministerial Decree issued on March 11, 2020, enforced lockdown; therefore, many social, recreational, and cultural centers remained closed for months. In Apulia (southern Italy), all non-urgent hospital activities were suspended, and some wards were closed, with a consequent reduction in the use of the water network and the formation of stagnant water. This situation could enhance the risk of exposure of people to waterborne diseases, including legionellosis. The purpose of this study was to monitor the microbiological quality of the water network (coliforms, E. coli, Enterococci, P. aeruginosa, and Legionella) in three wards (A, B and C) of a large COVID-19 regional hospital, closed for three months due to the COVID-19 emergency. Our study revealed that all three wards' water network showed higher contamination by Legionella pneumophila sg 1 and sg 6 at T1 (after lockdown) compared to the period before the lockdown (T0). In particular, ward A at T1 showed a median value = 5600 CFU/L (range 0–91,000 CFU/L) vs T0, median value = 75 CFU/L (range 0–5000 CFU/L) (p-value = 0.014); ward B at T1 showed a median value = 200 CFU/L (range 0–4200 CFU/L) vs T0, median value = 0 CFU/L (range 0–300 CFU/L) (p-value = 0.016) and ward C at T1 showed a median value = 175 CFU/L (range 0–22,000 CFU/L) vs T0, median value = 0 CFU/L (range 0–340 CFU/L) (p-value < 0.001). In addition, a statistically significant difference was detected in ward B between the number of positive water samples at T0 vs T1 for L. pneumophila sg 1 and sg 6 (24% vs 80% p-value < 0.001) and for coliforms (0% vs 64% p-value < 0.001). Moreover, a median value of coliform load resulted 3 CFU/100 ml (range 0–14 CFU/100 ml) at T1, showing a statistically significant increase versus T0 (0 CFU/100 ml) (p-value < 0.001). Our results highlight the need to implement a water safety plan that includes staff training and a more rigorous environmental microbiological surveillance in all hospitals before occupying a closed ward for a longer than one week, according to national and international guidelines.

ACS Style

Osvalda De Giglio; Giusy Diella; Marco Lopuzzo; Francesco Triggiano; Carla Calia; Chrysovalentinos Pousis; Fabrizio Fasano; Giuseppina Caggiano; Giuseppe Calabrese; Vincenza Rafaschieri; Federica Carpagnano; Matilde Carlucci; Loreto Gesualdo; Maria Luisa Ricci; Maria Scaturro; Maria Cristina Rota; Lucia Bonadonna; Luca Lucentini; Maria Teresa Montagna. Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic. Environmental Research 2020, 191, 110231 -110231.

AMA Style

Osvalda De Giglio, Giusy Diella, Marco Lopuzzo, Francesco Triggiano, Carla Calia, Chrysovalentinos Pousis, Fabrizio Fasano, Giuseppina Caggiano, Giuseppe Calabrese, Vincenza Rafaschieri, Federica Carpagnano, Matilde Carlucci, Loreto Gesualdo, Maria Luisa Ricci, Maria Scaturro, Maria Cristina Rota, Lucia Bonadonna, Luca Lucentini, Maria Teresa Montagna. Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic. Environmental Research. 2020; 191 ():110231-110231.

Chicago/Turabian Style

Osvalda De Giglio; Giusy Diella; Marco Lopuzzo; Francesco Triggiano; Carla Calia; Chrysovalentinos Pousis; Fabrizio Fasano; Giuseppina Caggiano; Giuseppe Calabrese; Vincenza Rafaschieri; Federica Carpagnano; Matilde Carlucci; Loreto Gesualdo; Maria Luisa Ricci; Maria Scaturro; Maria Cristina Rota; Lucia Bonadonna; Luca Lucentini; Maria Teresa Montagna. 2020. "Impact of lockdown on the microbiological status of the hospital water network during COVID-19 pandemic." Environmental Research 191, no. : 110231-110231.