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Biomedical subjects

G Ferraccioli

Publications and source records attributed to G Ferraccioli.

At least 37 records · Page 2Linked to original sources

The polymerase chain reaction detects B cell clonalities in patients with Sjögren's syndrome and suspected malignant lymphoma.

OBJECTIVE: To investigate the usefulness of the polymerase chain reaction (PCR) to detect B cell clonal expansions in tissues where lymphoproliferative disease was suspected in the course of Sjögren's syndrome (SS). METHODS: Tissue samples from 7 patients with definite (5 cases) or probable (2 cases) SS were subjected to routine histopathologic studies, immunophenotyping, and genotypic analysis, including Southern blotting and PCR amplification of immunoglobulin heavy chain (IgH) variable-diversity-joining (VDJ) region gene rearrangements. RESULTS: Malignant lymphoma was detected in 3 cases, and myoepithelial sialadenitis in the remaining 4. B cell clonal expansion was detected in 7/7 cases by PCR, 5/7 by Southern blotting, and in no case of myoepithelial sialadenitis by kappa/lambda light chain immunophenotyping. CONCLUSION: PCR may represent a quick and powerful tool to detect B cell clonalities in SS. Such information may provide new insights into the pathogenesis of the disease and may improve the clinical approach to the patients.

Adult↗

Peripheral neuropathy in essential mixed cryoglobulinaemia.

The prevalence of various forms of peripheral neuropathy has not been previously assessed in large series of patients with essential mixed cryoglobulinaemia (EMC). Clinical and electrophysiological signs of peripheral neuropathy were observed in 21 of 37 EMC patients, consisting of polyneuropathy in 19, mononeuropathy or multiple mononeuropathy in eight, and both in six. The various forms of peripheral neuropathy occurred differently in the subgroups of EMC. Isolated polyneuropathy was more common with type II (eight of 10) than type III EMC (two of eight). Multifocal neuropathy, in association with polyneuropathy, was the most common form in type III EMC (five of eight). Patients with peripheral neuropathy and type II EMC were significantly older than type II EMC patients without neuropathy, regarding present age and age of onset of EMC. Patients with peripheral neuropathy and type III EMC tended to have higher values of ESR and IgM than type III EMC patients without neuropathy. Electrophysiological findings and sural nerve biopsy specimens (nine cases) showed prominent axonal changes. Vascular changes included vasculitis and alterations of the endoneurial microvessels in type II and type III EMC. Our findings suggest that distinct pathogenic factors are implicated in the subgroups of cryoglobulinaemic neuropathy, possibly inducing different types of vascular changes underlying polyneuropathy or, respectively, mononeuropathy and multiple mononeuropathy.

Adult↗

[Polymyalgia rheumatica and malignant neoplasms. A report of 3 cases].

Polymyalgia rheumatica (PMR) is an inflammatory disease which mainly affects elderly patients and is highly responsive to steroid therapy. PMR can be associated with giant cell arteritis and, less frequently, with malignancy. The authors describe three cases of paraneoplastic PMR. In one patient PMR has been the initial manifestation of a B-cell non-Hodgkin lymphoma, in two of a malignant neoplasm of the gastrointestinal system. In two patients the response to steroid therapy was documented. A careful clinical evaluation and a long term follow-up is needed before considering PMR an idiopathic disease.

Adenocarcinoma↗

Analysis of disability in knee osteoarthritis. Relationship with age and psychological variables but not with radiographic score.

Sixty-one women with symptomatic knee osteoarthritis were given the Italian version of Arthritis Impact Measurement Scale which showed a good construct through the factorial analysis. The disability index was then related to the body mass index, the anatomical/radiographic damage, to the severity of pain assessed either through the McGill Pain Questionnaire or a visual analog scale, and finally to the degree of anxiety and depression as obtained from the Zung depression and anxiety inventory scores. A statistically significant relationship was found between radiographic damage and body weight, while disability correlated with the degree of psychological involvement and with the age of the patients. Through the stepwise multiple regression analysis we demonstrated that the pain experience and disability scores are strongly influenced by psychological impact. Our data may have important therapeutic implications.

Aged↗

[Peripheral neuropathy with mixed cryoglobulinemia].

Among 54 patients with mixed cryoglobulinemia a peripheral neuropathy was demonstrated in 23 patients (42.6%). Five patients had a secondary form while the majority (18) had essential cryoglobulinemia. The immunoglobulin components were polyclonal in 5 cases, only present in trace amounts in 5 and of type II in 13 patients. Fifteen patients had symptoms of polyneuropathy, but in 18 cases the symptomatology had symmetrical features and in two cases asymmetrical characteristics. In 8 patients a mono-polyneuropathy was observed. The most significant electrophysiological finding was the decreased amplitude of the sensory action potential of the sural nerve, which we observed in 95% of the instances, whereas a decreased sensory conduction velocity was seen in 8/23 cases only. A biopsy of the sural nerve, performed in eleven cases, always showed abnormal epi- and endoneurial vessels. Epineurial vessel vasculitis was found in 4 cases and fibrous thickening of the vessel wall in two cases. Endothelial swelling of the endoneurial vessels was observed in 7 patients and luminal obliteration in 3 samples. Axonal degeneration demonstrated in 7 of the 11 processed sample tissues was the main pathological finding. Signs of de/remyelination were associated in 3 cases, and were the dominant lesions in a single specimen. The simultaneous biopsy of the peroneus brevis muscle showed signs of denervation in all samples, vasculitis in 7 cases and deposits of filaments plus annular bodies of the vessel wall in 2 samples. All these data support the hypothesis that ischaemic damage may be the final common pathway of the majority of peripheral neuropathies in mixed cryoglobulinemia patients.

Adult↗

Association between DR antigens, rheumatoid arthritis with and without extraarticular features and systemic lupus erythematosus in northern Italy.

Seventy-two patients with rheumatoid arthritis (RA) and 18 with systemic lupus erythematosus (SLE) were typed for HLA class I and II antigens. No association was found with any of the antigens tested. However, B8 and DR3 were increased in patients with extraarticular features (EAF), while DR1 was increased in those with RA without EAF. In SLE a trend towards an increased frequency of DR7 was observed. DR5 was the negative marker in both diseases. Our results confirm the peculiar genetic characteristics in our population.

Adolescent↗

EMG-biofeedback training in fibromyalgia syndrome.

Fifteen patients with fibromyalgia syndrome were given EMG-BFB (biofeedback) training sessions because of persistent aches after one year of monthly courses of NSAID. A long-lasting clinical benefit was observed in 56%. The improvement was found in those without overt psychopathological disturbances. In fact, a subgroup of clinically depressed patients responded poorly. Our findings were confirmed in a controlled study. Six patients were allocated into "true EMG-BFB" and 6 into "false EMG-BFB" treatment in a blinded fashion. The rheumatological assessment revealed a significant improvement in most of the variables only in the "true EMG-BFB" group.

Adult↗

Toxicity due to remission inducing drugs in rheumatoid arthritis. Association with HLA-B35 and Cw4 antigens.

Twenty-five patients with rheumatoid arthritis (RA) who developed toxicity while taking remission inducing drugs and 30 without toxicity were studied for possible associations with class I and II HLA antigens. A strong association has been found between nephritis and dermatitis due to Tiopronin (a D-Penicillamine like compound) and class I antigens B35-Cw4, and between dermatitis due to gold thiosulphate and B35. Compared to healthy controls a lower DR5 frequency was observed in patients with RA except for the Tiopronin related nephritis group.

Adult↗

Indomethacin-related serum sickness-like illness with IgM lambda cryoparaprotein?

A unique association of a transient IgM lambda monoclonal gammopathy and a serum sickness-like illness, appearing after a short course of indomethacin, is described. The IgM lambda monoclone did cryoprecipitate along with fibronectin in hypotonic medium and disappeared with the resolution of the clinical picture. Emphasis is given to the role of some foreign antigens in the induction of benign monoclones.

Clone Cells↗

Interaction between fibronectin, rheumatoid factor and aggregated gamma globulins.

Fibronectin (Fn) was detected in 12/14 2.5% polyethylene glycol precipitates of rheumatoid serum positive for rheumatoid factor (RF). This association led to an investigation of the capacity of Fn to interact with IgM RF and heat aggregated human IgG. Our data suggest that Fn can interact directly with both of these substances at a site in the Fc fragment of the immunoglobulin molecule. The exact cite of the interaction is still to be defined but evidence indicates that it is probably distinct from sites binding staphylococcal protein A and complement.

Arthritis, Rheumatoid↗

Hypouricemic action of diflunisal in gouty patients: in vitro and in vivo studies.

Sixteen hyperuricemic gouty patients were treated with diflunisal, a novel salicylate, 500 mg BID. Serum and urine uric acid along with uric acid clearances were studied before and after a 7-day treatment. A clear hypouricemic action was observed, but 2 different mechanisms of action were seen when overexcretor patients and normoexcretor patients were analyzed separately. In overexcretors an allopurinol-like action was evident, whereas in normoexcretors a uricosuric action occurred. In vitro experiments showed a competitive inhibition of xanthine-oxidase exerted by diflunisal at low concentrations.

Adult↗

Immunochemical analyses of components of immune complexes in the sera of patients with autoimmune diseases.

Immune complexes were precipitated with polyethylene glycol (PEG) from sera of patients with rheumatoid arthritis (RA), psoriatic arthritis and systemic lupus erythematosus. Precipitates were tested for their capacity to consume complement and for the presence of fibronectin (Fn) and specific autoantibodies rheumatoid factor (RF, anti-DNA). The results showed enrichment of autoantibody activity in the precipitates. In RA, RF was especially enriched in 2.5% PEG precipitates, while IgM anti-DNA activity was more evident in 3.5% precipitates. IgG anti-DNA antibody was detected only in 3.5% precipitates from lupus sera. Complement consumption activity of precipitates was mainly related to IgM autoantibodies. There was a strong correlation between the presence of RF activity and Fn in the PEG precipitates. Nephelometric studies revealed direct interaction between the Fn and IgM RF or heat aggregated gammaglobulin. It may be possible to monitor the serum levels of immune complex material using PEG precipitation.

Antibodies↗

Controlled multicenter trial of tiopronin and d-penicillamine for rheumatoid arthritis.

Fifty-seven patients took part in a controlled double-blind trial between tiopronin and D-penicillamine as basic treatment for rheumatoid arthritis. Thirty-nine (19 receiving tiopronin, 20 receiving D-penicillamine) completed the trial after 1 year. Both drugs resulted in a decrease of the erythrocyte sedimentation rate, Ritchie index, and Lee index and in a sparing effect on symptomatic antiinflammatory therapy. Improvement in these variables was statistically highly significant at any interval with tiopronin, but was sometimes less or not at all significant with D-penicillamine. Nevertheless, the difference in effects between the 2 drugs never reached statistical significance. Six patients receiving tiopronin and 6 receiving D-penicillamine were taken out of the experiment because of side effects.

Aged↗

Cryoprecipitation. In vitro studies on fibronectin as an independent cryoprecipitagogue.

Fifteen patients affected by essential mixed cryoglobulinemia or secondary cryoglobulins were studied. Fibronectin was detected in the majority of essential mixed cryoglobulinemias, but in a minority of secondary cryoglobulins. In vitro studies gave strong evidence of an interaction between fibronectin and heat-aggregated gammaglobulins. The effects of fibronectin on cryoprecipitation of heat-aggregated gammaglobulins seem to support the independent role of the glycoprotein in the cryoformation mechanism, although its presence does not appear essential for cryoglobulin appearance.

Chemical Precipitation↗