Nowadays, data concerning the risk of autoimmune disease after SARS-CoV-2 (COVID-19) vaccination is controversial. The aim of this single centre prospective follow-up study was to evaluate whether healthcare workers (HCWs) vaccinated with BNT162b2 mRNA and mRNA-1273 will show a development and/or a persistence of autoantibodies, focussing on the detection of antibodies against nuclear antigens (antinuclear antibodies, ANA). We enrolled 155 HCWs, however only 108 of them received the third dose and were considered for further analysis. Blood samples were collected before vaccine inoculation (T0), at 3 (T1) and 12 months (T2) after the first dose. All samples were analysed for the presence of a) ANA using indirect Immunofluorescence [IIF] (dilutions of 1:80, 1:160. 1:320 and 1:640), and anti-smooth muscle antibodies (ASMA); b) anti-myeloperoxidase (anti-MPO), anti-proteinase 3 (anti-PR3) and anti-citrullinated peptide antibodies (aCCP) [FEIA]; c) anti-phospholipid antibodies (anticardiolipin [aCL], anti-beta-2- glycoprotein I [anti-ß-2GPI] (Chemiluminescence). Line-blot technology was performed using the following kit: EUROLINE ANA profile 3 plus DFS70 (IgG). Our research suggests that mRNA based anti-SARSCoV-2 vaccines can induce the production of de novo ANA in 22/77(28,57%) of subjects and that the percentage of positivity seems to be directly correlated to the number of vaccine expositions: 6/77 (7,79%) after 2 doses; 16/77 (20,78%) after 3 doses. Since it is known that hyperstimulation of the immune system could lead to autoimmunity, these preliminary results seem to further sustain the idea that the hyperstimulation of the immune system might lead to an autoinflammatory mechanism and eventually to autoimmune disorders. However, the link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated.

Given the critical role of general practitioners (GPs) in the early diagnosis and management of asbestos-related diseases (ARDs), and the significant history of asbestos fibres pollution in Alessandria Local Health Authority (ASL AL), this project aimed to assess the knowledge and awareness of asbestos risks, as well as the experience in diagnosing ARDs among GPs working in Alessandria province, Northern Italy. A questionnaire was administered to 216 GPs from all ASL AL territorial districts during 26 Territorial Assistance Equipes (EATs) meetings, held from September 2022 to January 2023. It contained 29 questions covering three main areas: ‘knowledge and awareness’, ‘competence and experience’, ‘sociodemographic characteristics and workload’. Although GPs were aware of the health hazards of asbestos (94 %) and the increased risk of mesothelioma from asbestos exposure (92.6 %), significant disparities and heterogeneity of knowledge were observed among territorial districts and by comparing Casale Monferrato district with all the others, particularly regarding asbestos exposure routes, reporting of occupational diseases, and mesothelioma latency. This project provides a comprehensive overview of GPs' knowledge, awareness and experience in managing ARDs, providing indications of customised training requirements. This evaluation could be extended to all areas with a history of previous asbestos exposure and provide a useful tool for policy makers to define and plan strategic actions on asbestos. This work could also be adapted to different realities with a history of environmental pollutant exposure other than asbestos, which pose a risk for the development of several diseases.

The aim of this work was to inspect the presence of asbestos fibers in colon tissue from a patient, with history of indirect exposure to asbestos and affected by colon cancer, who underwent surgery. Variable pressure scanning electron microscopy, coupled with energy dispersive spectroscopy (VP-SEM/EDS), was used for identification of inorganic fibers and for their morphological—chemical characterization. Fresh tissue samples from both, healthy area close to the neoplasia and from the neoplastic regions, were separately digested to eliminate the biological matrix. The precipitate was analyzed by VP-SEM/EDS, identifying in samples from healthy tissue asbestos bodies and small asbestos fibers, and in samples from neoplastic tissue long fibers of asbestos, free from covering. A quantification of the asbestos bodies and the free fibers in the two type of specimens is proposed. Moreover, to locate the fibers in the biological medium, histological sections from the colon of the same patient were also examined. Free asbestos fibers appeared concentrated in the tissue bridge between the healthy and the neoplastic areas. Immuno-histochemical investigation performed on the neoplasia seems to exclude a role of microsatellite instability in the carcinogenesis process, suggesting an influence of the fibers.

A soluble mesothelin-related peptide (SMRP) is the only FDA-approved biomarker for diagnosis of pleural mesothelioma (PM) and the most used for monitoring treatment. Radiological assessment of PM, based on modified RECIST (mRECIST) criteria, is challenging. This pilot study was designed to evaluate whether SMRP levels correlated over time with mRECIST score. Serial serum samples from PM patients were collected and SMRP levels were measured and compared with the mRECIST score obtained through centralized CT scans by blinded review. The within-patient SMRP-mRECIST relationship over time was estimated through a normal random-effects regression approach applied to the log-transformed mRECIST score. Overall, 58 PM patients were included (46 males and 12 females) with a median age at diagnosis of 67 years (min–max = 48–79), 44 (76%) with epithelioid and 14 (24%) with non-epithelioid histology. The total number of SMRP measurements and CT scans considered for analysis was 183. There was a statistically significant correlation between SMRP and mRECIST score in the 2 cohorts considered both separately and jointly. These results, although exploratory, suggest that SMRP measurement might be considered as an adjunct to monitor PM patients in order to delay CT scans time interval, thus warranting further investigation.