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Dr. Flaminia Bardanzellu
University of Cagliari (Italy)

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0 Metabolomics
0 Pediatrics
0 microbiomics
0 Neonatal nutrition and growth
0 Neonatology.

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Metabolomics
Neonatal nutrition and growth
microbiomics
Neonatology.

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Review
Published: 30 August 2021 in Children
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Susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD) are unclear and epidemiological data on the topic are still limited. There is some concern that patients with immuno-mediated diseases such as IBD, which are frequently treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 infection with its related serious adverse outcomes, including intensive care unit (ICU) admission and death. Corticosteroids, immunomodulators, and biologic drugs, which are commonly prescribed to these patients, have been associated with higher rates of severe viral and bacterial infections including influenza and pneumonia. It is not known whether these drugs can be so harmful as to justify their interruption during COVID-19 infection or if, on the contrary, patients with IBD can benefit from them. As shown by recent reports, it cannot be excluded that drugs that suppress the immune system can block the characteristic cytokine storm of severe forms of COVID-19 and consequently reduce mortality. Another cause for concern is the up-regulation of angiotensin converting enzyme-2 (ACE2) receptors that has been noticed in these patients, which could facilitate the entry and replication of SARS-CoV-2. The aim of this narrative review is to clarify the susceptibility of SARS-CoV-2 infection in patients with IBD, the clinical characteristics of patients who contract the infection, and the relationship between the severity of COVID-19 and immunosuppressive treatment.

ACS Style

Angelica Corrias; Gian Mario Cortes; Flaminia Bardanzellu; Alice Melis; Vassilios Fanos; Maria Antonietta Marcialis. Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases. Children 2021, 8, 753 .

AMA Style

Angelica Corrias, Gian Mario Cortes, Flaminia Bardanzellu, Alice Melis, Vassilios Fanos, Maria Antonietta Marcialis. Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases. Children. 2021; 8 (9):753.

Chicago/Turabian Style

Angelica Corrias; Gian Mario Cortes; Flaminia Bardanzellu; Alice Melis; Vassilios Fanos; Maria Antonietta Marcialis. 2021. "Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases." Children 8, no. 9: 753.

Review
Published: 18 August 2021 in Expert Review of Proteomics
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Pre-pregnancy overweight and obesity, depending on maternal nutrition and metabolic state, can influence fetal, neonatal and long-term offspring health, regarding cardio-metabolic, respiratory, immunological and cognitive outcomes. Thus, maternal weight can act, through mechanisms that are not full understood, on the physiology and metabolism of some fetal organs and tissues, to adapt themselves to the intrauterine environment and nutritional reserves. These effects could occur by modulating gene expression, neonatal microbiome, and through breastfeeding. In this paper, we investigated the potential effects of metabolites found altered in breast milk (BM) of overweight/obese mothers, through an extensive review of metabolomics studies, and the potential short- and long-term clinical effects in the offspring, especially regarding overweight, glucose homeostasis, insulin resistance, oxidative stress, infections, immune processes, and neurodevelopment. Metabolomics seems the ideal tool to investigate BM variation depending on maternal or fetal/neonatal factors. In particular, BM metabolome alterations according to maternal conditions were recently pointed out in cases of gestational diabetes, preeclampsia, intrauterine growth restriction and maternal overweight/obesity. In our opinion, even if BM is the food of choice in neonatal nutrition, the deepest comprehension of its composition in overweight/obese mothers could allow targeted supplementation, to improve offspring health and metabolic homeostasis.

ACS Style

Flaminia Bardanzellu; Melania Puddu; Diego Giampietro Peroni; Vassilios Fanos. The clinical impact of maternal weight on offspring health: lights and shadows in breast milk metabolome. Expert Review of Proteomics 2021, 1 -36.

AMA Style

Flaminia Bardanzellu, Melania Puddu, Diego Giampietro Peroni, Vassilios Fanos. The clinical impact of maternal weight on offspring health: lights and shadows in breast milk metabolome. Expert Review of Proteomics. 2021; ():1-36.

Chicago/Turabian Style

Flaminia Bardanzellu; Melania Puddu; Diego Giampietro Peroni; Vassilios Fanos. 2021. "The clinical impact of maternal weight on offspring health: lights and shadows in breast milk metabolome." Expert Review of Proteomics , no. : 1-36.

Review
Published: 01 June 2021 in Pediatric Reports
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The COVID-19 pandemic has led to an unprecedented closure of schools in terms of duration. The option of school closure, SARS-CoV-2 initially being poorly known, was influenced by the epidemiological aspects of the influenza virus. However, school closure is still under debate and seems unsupported by sure evidence of efficacy in the COVID-19 era. The aim of our narrative review is to discuss the available literature on SARS-CoV-2 spread among children and adolescents, in the school setting, trying to explain why children appear less susceptible to severe disease and less involved in viral spreading. We also tried to define the efficacy of school closure, through an overview of the effects of the choices made by the various countries, trying to identify which preventive measures could be effective for a safe reopening. Finally, we focused on the psychological aspects of such a prolonged closure for children and adolescents. SARS-CoV-2, children, COVID-19, influenza, and school were used as key words in our literature research, updated to 29 March 2021. To our knowledge, this is the first review summarizing the whole current knowledge on SARS-CoV-2 spreading among children and adolescents in the school setting, providing a worldwide overview in such a pandemic context.

ACS Style

Francesco Busa; Flaminia Bardanzellu; Maria Pintus; Vassilios Fanos; Maria Marcialis. COVID-19 and School: To Open or Not to Open, That Is the Question. The First Review on Current Knowledge. Pediatric Reports 2021, 13, 257 -278.

AMA Style

Francesco Busa, Flaminia Bardanzellu, Maria Pintus, Vassilios Fanos, Maria Marcialis. COVID-19 and School: To Open or Not to Open, That Is the Question. The First Review on Current Knowledge. Pediatric Reports. 2021; 13 (2):257-278.

Chicago/Turabian Style

Francesco Busa; Flaminia Bardanzellu; Maria Pintus; Vassilios Fanos; Maria Marcialis. 2021. "COVID-19 and School: To Open or Not to Open, That Is the Question. The First Review on Current Knowledge." Pediatric Reports 13, no. 2: 257-278.

Review
Published: 25 May 2021 in International Journal of Environmental Research and Public Health
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In this context of COVID-19 pandemic, great interest has been aroused by the potential maternal transmission of SARS-CoV-2 by transplacental route, during delivery, and, subsequently, through breastfeeding. Some open questions still remain, especially regarding the possibility of finding viable SARS-CoV-2 in breast milk (BM), although this is not considered a worrying route of transmission. However, in BM, it was pointed out the presence of antibodies against SARS-CoV-2 and other bioactive components that could protect the infant from infection. The aim of our narrative review is to report and discuss the available literature on the detection of anti-SARS-CoV-2 antibodies in BM of COVID-19 positive mothers, and we discussed the unique existing study investigating BM of SARS-CoV-2 positive mothers through metabolomics, and the evidence regarding microbiomics BM variation in COVID-19. Moreover, we tried to correlate metabolomics and microbiomics findings in BM of positive mothers with potential effects on breastfed infants metabolism and health. To our knowledge, this is the first review summarizing the current knowledge on SARS-CoV-2 effects on BM, resuming both “conventional data” (antibodies) and “omics technologies” (metabolomics and microbiomics).

ACS Style

Flaminia Bardanzellu; Melania Puddu; Vassilios Fanos. Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers. International Journal of Environmental Research and Public Health 2021, 18, 5668 .

AMA Style

Flaminia Bardanzellu, Melania Puddu, Vassilios Fanos. Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers. International Journal of Environmental Research and Public Health. 2021; 18 (11):5668.

Chicago/Turabian Style

Flaminia Bardanzellu; Melania Puddu; Vassilios Fanos. 2021. "Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers." International Journal of Environmental Research and Public Health 18, no. 11: 5668.

Review
Published: 16 February 2021 in Life
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In recent years, the role of human microbiota as a short- and long-term health promoter and modulator has been affirmed and progressively strengthened. In the course of one’s life, each subject is colonized by a great number of bacteria, which constitute its specific and individual microbiota. Human bacterial colonization starts during fetal life, in opposition to the previous paradigm of the “sterile womb”. Placenta, amniotic fluid, cord blood and fetal tissues each have their own specific microbiota, influenced by maternal health and habits and having a decisive influence on pregnancy outcome and offspring outcome. The maternal microbiota, especially that colonizing the genital system, starts to influence the outcome of pregnancy already before conception, modulating fertility and the success rate of fertilization, even in the case of assisted reproduction techniques. During the perinatal period, neonatal microbiota seems influenced by delivery mode, drug administration and many other conditions. Special attention must be reserved for early neonatal nutrition, because breastfeeding allows the transmission of a specific and unique lactobiome able to modulate and positively affect the neonatal gut microbiota. Our narrative review aims to investigate the currently identified pre- and peri-natal factors influencing neonatal microbiota, before conception, during pregnancy, pre- and post-delivery, since the early microbiota influences the whole life of each subject.

ACS Style

Alessandra Coscia; Flaminia Bardanzellu; Elisa Caboni; Vassilios Fanos; Diego Peroni. When a Neonate Is Born, So Is a Microbiota. Life 2021, 11, 148 .

AMA Style

Alessandra Coscia, Flaminia Bardanzellu, Elisa Caboni, Vassilios Fanos, Diego Peroni. When a Neonate Is Born, So Is a Microbiota. Life. 2021; 11 (2):148.

Chicago/Turabian Style

Alessandra Coscia; Flaminia Bardanzellu; Elisa Caboni; Vassilios Fanos; Diego Peroni. 2021. "When a Neonate Is Born, So Is a Microbiota." Life 11, no. 2: 148.

Journal article
Published: 21 January 2021 in Current Pediatric Reviews
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Introduction: Breast Milk (BM), containing nutrients and bioactive components, represents the best source for neonatal nutrition and determines short- and long- term benefits. Human milk oligosaccharides (HMOs) play an active role in these pathophysiological mechanisms. In fact, they influence the shaping of breastfed infant’s gut microbiota, promote intestinal development, confer protection against intestinal or systemic infections modulating immune system; moreover, HMOs determine extra-intestinal effects on several target organs, i.e reducing necrotizing enterocolitis rate or improving brain development. Aims: In this review, we analyze the great inter- and intra-individual variability of BM HMOs, investigating maternal, genetic and environmental factors modulating their composition. Moreover, we provide an update regarding HMOs’ unique properties, underlining their complex interaction with intestinal microbiota and host-derived metabolites. The possible HMOs’ influence on extraintestinal bacterial communities, potentially influencing newborns’ and even lactating mothers’ health, have been hypothesized. Finally, recognized HMOs’ crucial role, we underline the promising opportunities showed by their addition in formula milk, to make it more similar to maternal milk itself.

ACS Style

Flaminia Bardanzellu; Alessandra Reali; Maria A. Marcialis; Vassilios Fanos. Across the “Sweetest” Properties of Human Breast Milk: Focus on Oligosaccharides. Current Pediatric Reviews 2021, 16, 255 -264.

AMA Style

Flaminia Bardanzellu, Alessandra Reali, Maria A. Marcialis, Vassilios Fanos. Across the “Sweetest” Properties of Human Breast Milk: Focus on Oligosaccharides. Current Pediatric Reviews. 2021; 16 (4):255-264.

Chicago/Turabian Style

Flaminia Bardanzellu; Alessandra Reali; Maria A. Marcialis; Vassilios Fanos. 2021. "Across the “Sweetest” Properties of Human Breast Milk: Focus on Oligosaccharides." Current Pediatric Reviews 16, no. 4: 255-264.

Comment and response
Published: 11 January 2021 in JAMA Pediatrics
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ACS Style

Vassilios Fanos; Flaminia Bardanzellu; Maria Antonietta Marcialis. Why Is Antibiotic Treatment Rarely Performed in COVID-19–Positive Children Admitted in Pediatric Intensive Care Units? JAMA Pediatrics 2021, 1 .

AMA Style

Vassilios Fanos, Flaminia Bardanzellu, Maria Antonietta Marcialis. Why Is Antibiotic Treatment Rarely Performed in COVID-19–Positive Children Admitted in Pediatric Intensive Care Units? JAMA Pediatrics. 2021; ():1.

Chicago/Turabian Style

Vassilios Fanos; Flaminia Bardanzellu; Maria Antonietta Marcialis. 2021. "Why Is Antibiotic Treatment Rarely Performed in COVID-19–Positive Children Admitted in Pediatric Intensive Care Units?" JAMA Pediatrics , no. : 1.

Original research article
Published: 21 December 2020 in Frontiers in Pediatrics
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Introduction: In premature neonates, the persistence of hemodynamically significant ductus arteriosus (hsPDA) can be associated with short- and long-term consequences, impairing their outcome. The correct strategy of management for such condition is under debate, especially regarding contraindications and/or side effects. In recent years, metabolomics was applied to several perinatal, pediatric, and adult conditions to investigate potential biomarkers of disease, which have become useful for early diagnosis and/or therapeutic management.Aim of the Study: The main purpose of our exploratory study was to asses, through 1H-NMR metabolomics analysis of urinary samples at birth, possible metabolic pathways differentiating, with a significant predictive power, those preterm neonates who will subsequently develop hsPDA and neonates of comparable gestational age (GA) who will undergo spontaneous ductal closure or the persistence of an irrelevant PDA (no-hsPDA). Moreover, we investigated potential prenatal or perinatal clinical factors potentially influencing the development of hsPDA.Materials and Methods: We enrolled n = 35 preterm neonates with GA between 24 and 32 weeks; urinary samples were collected within the first 12 h of life. Patients were closely monitored regarding intensive care, respiratory support, fluid balance and administered drugs; an echocardiogram was performed at 48–72 h.Results: Our results reported a significant correlation between lower GA at birth and the development of hsPDA. Moreover, neonates with GA ≤ 30w developing hsPDA were characterized by lower Apgar scores at 1′ and 5′, higher rates of perinatal asphyxia, higher need of delivery room resuscitation and subsequent surfactant administration. Interestingly, metabolomics analysis at birth detected a clear separation between the 1H-NMR urinary spectra of subjects GA ≤ 30w not developing hsPDA (n = 19) and those of subjects born at GA ≤ 30w in which hsPDA was confirmed at 48–72 h of life (n = 5).Conclusions: This is the first study applying metabolomics to investigate the PDA condition. Although preliminary and conducted on a limited sample, our results reveal that metabolomics could be a promising tool in the early identification of hsPDA, potentially superior to the clinical or laboratory predictive tools explored to date and even to the clinical observations and correlations in our sample, through the detection of specific urinary metabolites.

ACS Style

Flaminia Bardanzellu; Cristina Piras; Alessandra Atzei; Paola Neroni; Vassilios Fanos. Early Urinary Metabolomics in Patent Ductus Arteriosus Anticipates the Fate: Preliminary Data. Frontiers in Pediatrics 2020, 8, 1 .

AMA Style

Flaminia Bardanzellu, Cristina Piras, Alessandra Atzei, Paola Neroni, Vassilios Fanos. Early Urinary Metabolomics in Patent Ductus Arteriosus Anticipates the Fate: Preliminary Data. Frontiers in Pediatrics. 2020; 8 ():1.

Chicago/Turabian Style

Flaminia Bardanzellu; Cristina Piras; Alessandra Atzei; Paola Neroni; Vassilios Fanos. 2020. "Early Urinary Metabolomics in Patent Ductus Arteriosus Anticipates the Fate: Preliminary Data." Frontiers in Pediatrics 8, no. : 1.

Other
Published: 01 September 2020 in The Journal of Maternal-Fetal & Neonatal Medicine
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ACS Style

Maria Antonietta Marcialis; Flaminia Bardanzellu; Vassilios Fanos. The dispelled hope, but not all is lost: the magic of human breast milk. The Journal of Maternal-Fetal & Neonatal Medicine 2020, 1 -2.

AMA Style

Maria Antonietta Marcialis, Flaminia Bardanzellu, Vassilios Fanos. The dispelled hope, but not all is lost: the magic of human breast milk. The Journal of Maternal-Fetal & Neonatal Medicine. 2020; ():1-2.

Chicago/Turabian Style

Maria Antonietta Marcialis; Flaminia Bardanzellu; Vassilios Fanos. 2020. "The dispelled hope, but not all is lost: the magic of human breast milk." The Journal of Maternal-Fetal & Neonatal Medicine , no. : 1-2.

Original article
Published: 05 August 2020 in The Journal of Maternal-Fetal & Neonatal Medicine
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Diabetes mellitus (DM) is a chronic disease widespread in the world. Sardinia represents, together with Finland, the region with the highest incidence of type 1 DM (DM1), as well as a high prevalence of gestational DM (GDM). Despite the improvement in obstetric surveillance, perinatal and long-term adverse outcomes are still frequent in the offspring of diabetic mothers. During gestations complicated by DM, fetal heart is one of the most affected organ potentially undergoing structural heart defects or several degrees of fetal myocardium hypertrophy and impaired cardiac function. The aim of our study was to evaluate, through echocardiographic examination, cardiac features and performance in a South Sardinian population of newborns of diabetic mothers comparing them to a group of control subjects. In our sample, the E/A ratio resulted a significant marker of early diastolic dysfunction in asymptomatic neonates born by diabetic mothers, even if such result should be confirmed on larger samples.

ACS Style

Stella Giulia Falqui; Flaminia Bardanzellu; Federico Mecarini; Vassilios Fanos; Paola Neroni. Could the E/A ratio be included in the cardiological evaluation of the offspring of diabetic mothers? A case-control study in South Sardinia. The Journal of Maternal-Fetal & Neonatal Medicine 2020, 1 -10.

AMA Style

Stella Giulia Falqui, Flaminia Bardanzellu, Federico Mecarini, Vassilios Fanos, Paola Neroni. Could the E/A ratio be included in the cardiological evaluation of the offspring of diabetic mothers? A case-control study in South Sardinia. The Journal of Maternal-Fetal & Neonatal Medicine. 2020; ():1-10.

Chicago/Turabian Style

Stella Giulia Falqui; Flaminia Bardanzellu; Federico Mecarini; Vassilios Fanos; Paola Neroni. 2020. "Could the E/A ratio be included in the cardiological evaluation of the offspring of diabetic mothers? A case-control study in South Sardinia." The Journal of Maternal-Fetal & Neonatal Medicine , no. : 1-10.

Accepted manuscript
Published: 10 July 2020 in Clinical Infectious Diseases
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ACS Style

Maria Antonietta Marcialis; Flaminia Bardanzellu; Vassilios Fanos. Microbiota and Coronavirus Disease 2019. Which Came First, the Chicken or the Egg? Clinical Infectious Diseases 2020, 72, 2245 -2246.

AMA Style

Maria Antonietta Marcialis, Flaminia Bardanzellu, Vassilios Fanos. Microbiota and Coronavirus Disease 2019. Which Came First, the Chicken or the Egg? Clinical Infectious Diseases. 2020; 72 (12):2245-2246.

Chicago/Turabian Style

Maria Antonietta Marcialis; Flaminia Bardanzellu; Vassilios Fanos. 2020. "Microbiota and Coronavirus Disease 2019. Which Came First, the Chicken or the Egg?" Clinical Infectious Diseases 72, no. 12: 2245-2246.

Journal article
Published: 01 June 2020 in The Journal of Pediatrics
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ACS Style

Flaminia Bardanzellu; Melania Puddu; Vassilios Fanos. The Human Breast Milk Metabolome in Preeclampsia, Gestational Diabetes, and Intrauterine Growth Restriction: Implications for Child Growth and Development. The Journal of Pediatrics 2020, 221, S20 -S28.

AMA Style

Flaminia Bardanzellu, Melania Puddu, Vassilios Fanos. The Human Breast Milk Metabolome in Preeclampsia, Gestational Diabetes, and Intrauterine Growth Restriction: Implications for Child Growth and Development. The Journal of Pediatrics. 2020; 221 ():S20-S28.

Chicago/Turabian Style

Flaminia Bardanzellu; Melania Puddu; Vassilios Fanos. 2020. "The Human Breast Milk Metabolome in Preeclampsia, Gestational Diabetes, and Intrauterine Growth Restriction: Implications for Child Growth and Development." The Journal of Pediatrics 221, no. : S20-S28.

Letter to the editor
Published: 28 May 2020 in Pediatrics International
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ACS Style

Marcialis Maria Antonietta; Flaminia Bardanzellu; Paola Neroni; Vassilios Fanos; Maria Antonietta Marcialis. “Points of view on periviable infants”. Pediatrics International 2020, 62, 656 -657.

AMA Style

Marcialis Maria Antonietta, Flaminia Bardanzellu, Paola Neroni, Vassilios Fanos, Maria Antonietta Marcialis. “Points of view on periviable infants”. Pediatrics International. 2020; 62 (5):656-657.

Chicago/Turabian Style

Marcialis Maria Antonietta; Flaminia Bardanzellu; Paola Neroni; Vassilios Fanos; Maria Antonietta Marcialis. 2020. "“Points of view on periviable infants”." Pediatrics International 62, no. 5: 656-657.

Review
Published: 27 March 2020 in Italian Journal of Pediatrics
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In the last years, ‘omics’ technologies, and especially metabolomics, emerged as expanding scientific disciplines and promising technologies in the characterization of several pathophysiological processes. In detail, metabolomics, able to detect in a dynamic way the whole set of molecules of low molecular weight in cells, tissues, organs, and biological fluids, can provide a detailed phenotypic portray, representing a metabolic “snapshot.” Thanks to its numerous strength points, metabolomics could become a fundamental tool in human health, allowing the exact evaluation of individual metabolic responses to pathophysiological stimuli including drugs, environmental changes, lifestyle, a great number of diseases and other epigenetics factors. Moreover, if current metabolomics data will be confirmed on larger samples, such technology could become useful in the early diagnosis of diseases, maybe even before the clinical onset, allowing a clinical monitoring of disease progression and helping in performing the best therapeutic approach, potentially predicting the therapy response and avoiding overtreatments. Moreover, the application of metabolomics in nutrition could provide significant information on the best nutrition regimen, optimal infantile growth and even in the characterization and improvement of commercial products’ composition. These are only some of the fields in which metabolomics was applied, in the perspective of a precision-based, personalized care of human health. In this review, we discuss the available literature on such topic and provide some evidence regarding clinical application of metabolomics in heart diseases, auditory disturbance, nephrouropathies, adult and pediatric cancer, obstetrics, perinatal conditions like asphyxia, neonatal nutrition, neonatal sepsis and even some neuropsychiatric disorders, including autism. Our research group has been interested in metabolomics since several years, performing a wide spectrum of experimental and clinical studies, including the first metabolomics analysis of human breast milk. In the future, it is reasonable to predict that the current knowledge could be applied in daily clinical practice, and that sensible metabolomics biomarkers could be easily detected through cheap and accurate sticks, evaluating biofluids at the patient’s bed, improving diagnosis, management and prognosis of sick patients and allowing a personalized medicine. A dream? May be I am a dreamer, but I am not the only one.

ACS Style

Flaminia Bardanzellu; Vassilios Fanos. How could metabolomics change pediatric health? Italian Journal of Pediatrics 2020, 46, 1 -13.

AMA Style

Flaminia Bardanzellu, Vassilios Fanos. How could metabolomics change pediatric health? Italian Journal of Pediatrics. 2020; 46 (1):1-13.

Chicago/Turabian Style

Flaminia Bardanzellu; Vassilios Fanos. 2020. "How could metabolomics change pediatric health?" Italian Journal of Pediatrics 46, no. 1: 1-13.

Hot topic
Published: 11 January 2020 in Current Nutrition Reports
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Breast milk (BM) is a peculiar fluid owing unique properties and resulting the ideal food during early neonatal period. As widely known, it can improve the outcome of both neonate and lactating mother, influencing their whole life. BM is characterized by several beneficial components; among these, a great role is played by BM own and specific microbiome, deeply investigated in many studies. Moreover, the use of metabolomics in BM analysis allowed a better characterization of its metabolic pathways that vary according to lactation stage and neonatal gestational age. The aim of this review is to describe growth factors, cytokines, immunity mediators, and stem cells (SCs) contained in BM and investigate their functions and effects on neonatal outcome, especially focusing on immuno- and neurodevelopment. We evaluated recent and updated literature on this field. The article that we analyzed to write this review have been found in MEDLINE using breast milk-derived stem cells, biofactors, growth factors, breastfeeding-related outcomes, neurodevelopment, and neonatal immunological system as keywords. Discovering and characterizing BM components could result very useful to clarify the pathophysiology of their influence on neonatal growth and even to improve artificial formulations’ composition. Moreover, since SCs abilities and their involvement in the development of several diseases, they could help to discover specific targets for new therapies. It could be useful to characterize BM-derived SC markers, properties, and variations during lactation stages, to understand their potential role in therapeutic applications, since they could be noninvasively isolated from BM. More studies will help to describe more in detail the characteristics of mother-to-child communication through breastfeeding and its potential role in the next future.

ACS Style

Flaminia Bardanzellu; Diego Giampietro Peroni; Vassilios Fanos. Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes. Current Nutrition Reports 2020, 9, 1 -13.

AMA Style

Flaminia Bardanzellu, Diego Giampietro Peroni, Vassilios Fanos. Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes. Current Nutrition Reports. 2020; 9 (1):1-13.

Chicago/Turabian Style

Flaminia Bardanzellu; Diego Giampietro Peroni; Vassilios Fanos. 2020. "Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes." Current Nutrition Reports 9, no. 1: 1-13.

Review
Published: 02 December 2019 in Expert Review of Proteomics
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Introduction: Among the OMICS technologies, that have emerged in recent years, metabolomics has allowed relevant step forwards in clinical research. Several improvements in disease diagnosis and clinical management have been permitted, even in neonatology. Among potentially evaluable biofluids, breast milk (BM) results are highly interesting, representing a fluid of conjunction between mothers newborns, describing their interaction. Areas covered: in this review, updating a previous review article, we discuss research article and reviews on BM metabolomics and found in MEDLINE using metabolomics, breast milk, neonatal nutrition, breastfeeding, human milk composition and preterm neonates as keywords. Expert opinion: Our research group has a profound interest in metabolomics research. In 2012, we published the first metabolomic analysis on BM samples, reporting interesting data on its composition and relevant differences with formula milk (FM), useful to improve FM composition. As confirmed by successive studies, such technology can detect the specific BM composition and its dependence on several variables, including lactation stage, gestational age, maternal or environmental conditions. Moreover, since BM contaminants or drug levels can be detected, metabolomics also results useful to determine BM safety. These are only few practical applications of BM analysis, which will be reviewed in this paper.

ACS Style

Flaminia Bardanzellu; Chiara Peila; Vassilios Fanos; Alessandra Coscia. Clinical insights gained through metabolomic analysis of human breast milk. Expert Review of Proteomics 2019, 16, 909 -932.

AMA Style

Flaminia Bardanzellu, Chiara Peila, Vassilios Fanos, Alessandra Coscia. Clinical insights gained through metabolomic analysis of human breast milk. Expert Review of Proteomics. 2019; 16 (11-12):909-932.

Chicago/Turabian Style

Flaminia Bardanzellu; Chiara Peila; Vassilios Fanos; Alessandra Coscia. 2019. "Clinical insights gained through metabolomic analysis of human breast milk." Expert Review of Proteomics 16, no. 11-12: 909-932.

Journal article
Published: 24 July 2019 in Twin Research and Human Genetics
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Exclusive breastfeeding is currently recommended until at least 6 months of postnatal age, due to maternal breast milk (BM) unique composition and beneficial properties. In fact, BM modifies itself according to gestational age (GA) at birth, adapting its composition to neonatal requests during lactation. Multiple births represent about 3% of the whole pregnancies; such neonates result more vulnerable than full-term newborns, due to lower GA and birth weight (BW) and the higher incidence of perinatal complications. Although an adequate nutrition is fundamental for twins and other multiples, studies on this topic are lacking. We collected and analyzed BM from mothers of 19 twins and 5 triplets showing GA < 33 weeks and BW < 1500 g, comparing it to a control group of 28 preterm singletons. As a result, at GA ≤ 28 weeks, we observed that protein content is higher in BM for multiples (1.53 vs. 1.29 g per 100 ml), lactose concentration is greater in BM for singletons (6.72 vs. 6.34 g per 100 ml) and GA results the most relevant factor influencing BM protein composition. BM for multiples results higher in proteins and lower in lactose, if compared with singleton's samples; this could promote and sustain growth and organ development in this vulnerable category. BM from multiples shows a trophic and immunologic role, since these neonates often show lower GA and BW instead of singletons. These findings could help in optimizing nutritional strategies and improving BM individualized fortification.

ACS Style

Marco Congiu; Alessandra Reali; Federica Deidda; Angelica Dessì; Flaminia Bardanzellu; Vassilios Fanos. Breast Milk for Preterm Multiples: More Proteins, Less Lactose. Twin Research and Human Genetics 2019, 22, 265 -271.

AMA Style

Marco Congiu, Alessandra Reali, Federica Deidda, Angelica Dessì, Flaminia Bardanzellu, Vassilios Fanos. Breast Milk for Preterm Multiples: More Proteins, Less Lactose. Twin Research and Human Genetics. 2019; 22 (4):265-271.

Chicago/Turabian Style

Marco Congiu; Alessandra Reali; Federica Deidda; Angelica Dessì; Flaminia Bardanzellu; Vassilios Fanos. 2019. "Breast Milk for Preterm Multiples: More Proteins, Less Lactose." Twin Research and Human Genetics 22, no. 4: 265-271.

Review
Published: 13 January 2019 in Expert Review of Proteomics
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Introduction: In recent years, several studies have highlighted the promising role of metabolomics in the analysis of amniotic fluid (AF), to describe and characterize the interactions occurring between the mother and the fetus during prenatal development. Among the available biological fluids, AF represents an ideal substrate to provide dynamic information regarding fetal organogenesis and metabolism through pregnancy, since it originates from both maternal and fetal tissues and contains substances derived from placenta, fetal skin, lungs, gastric fluid, and fetal urine. Areas covered: In this paper, we provide an update reporting the most recent results on AF metabolomics in the assessment of feto-maternal health, regarding physiological pregnancies but even fields such as prematurity, bronchopulmonary dysplasia, fetal malformations, chromosomopathies, maternal diseases, placental inflammation or infections, maternal diet or exposure to exogenous substances, according to the literature found on MEDLINE since 2015. Expert opinion: Metabolomics shows a promising role in describing both physiology and disease; the goal would be the identification of biomarkers able to precociously and efficaciously detect pathological conditions, allowing the identification of complicated pregnancy and improving their management. However, this field is under development and its reliability still needs to be clarified, especially through more numerous and accurate studies.

ACS Style

Flaminia Bardanzellu; Vassilios Fanos. The choice of amniotic fluid in metabolomics for the monitoring of fetus health - update. Expert Review of Proteomics 2019, 16, 487 -499.

AMA Style

Flaminia Bardanzellu, Vassilios Fanos. The choice of amniotic fluid in metabolomics for the monitoring of fetus health - update. Expert Review of Proteomics. 2019; 16 (6):487-499.

Chicago/Turabian Style

Flaminia Bardanzellu; Vassilios Fanos. 2019. "The choice of amniotic fluid in metabolomics for the monitoring of fetus health - update." Expert Review of Proteomics 16, no. 6: 487-499.

Journal article
Published: 21 August 2018 in Current Regenerative Medicine
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Flaminia Bardanzellu; Gavino Faa; Daniela Fanni; Vassilios Fanos; Maria Antonietta Marcialis. Regenerating the Womb: The Good, Bad and Ugly Potential of the Endometrial Stem Cells. Current Regenerative Medicine 2018, 7, 33 -45.

AMA Style

Flaminia Bardanzellu, Gavino Faa, Daniela Fanni, Vassilios Fanos, Maria Antonietta Marcialis. Regenerating the Womb: The Good, Bad and Ugly Potential of the Endometrial Stem Cells. Current Regenerative Medicine. 2018; 7 (1):33-45.

Chicago/Turabian Style

Flaminia Bardanzellu; Gavino Faa; Daniela Fanni; Vassilios Fanos; Maria Antonietta Marcialis. 2018. "Regenerating the Womb: The Good, Bad and Ugly Potential of the Endometrial Stem Cells." Current Regenerative Medicine 7, no. 1: 33-45.

Mini review article
Published: 07 August 2018 in Frontiers in Pediatrics
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Maternal breast milk (BM) is a complex and unique fluid that evolution adapted to satisfy neonatal needs; in addition to classical nutrients, it contains several bioactive components. BM characteristically shows inter-individual variability, modifying its composition during different phases of lactation. BM composition, determining important consequences on neonatal gut colonization, influences both short and long-term development. Maternal milk can also shape neonatal microbiota, through its glycobiome rich in Lactobacilli spp. and Bifidobacteria spp. Therefore, neonatal nourishment during the first months of life seems the most important determinant of individual's outcomes. Our manuscript aims to provide new evidence in the characterization of BM metabolome and microbiome, and its comparison to formula milk, allowing the evaluation of each nutrient's influence on neonatal metabolism. This result very interesting since potentially offers an innovative approach to investigate the complex relationship between BM components and infant's health, also providing the chance to intervene in a sartorial way on diet composition, according to the nutritional requests. Future research, integrating metabolomics, microbiomics and stem cells knowledge, could make significant steps forward in understanding BM extraordinary properties and functions.

ACS Style

Flaminia Bardanzellu; Vassilios Fanos; Francesca A. L. Strigini; Paolo G. Artini; Diego G. Peroni. Human Breast Milk: Exploring the Linking Ring Among Emerging Components. Frontiers in Pediatrics 2018, 6, 215 .

AMA Style

Flaminia Bardanzellu, Vassilios Fanos, Francesca A. L. Strigini, Paolo G. Artini, Diego G. Peroni. Human Breast Milk: Exploring the Linking Ring Among Emerging Components. Frontiers in Pediatrics. 2018; 6 ():215.

Chicago/Turabian Style

Flaminia Bardanzellu; Vassilios Fanos; Francesca A. L. Strigini; Paolo G. Artini; Diego G. Peroni. 2018. "Human Breast Milk: Exploring the Linking Ring Among Emerging Components." Frontiers in Pediatrics 6, no. : 215.