Diabetes is known to be a major contributor to blindness in industrialized countries but few data are available on the situation in Italy. As an introductory step to the implementation of permanent ...screening for diabetic retinopathy, a search was carried out on the causes of visual loss in the provincial territory surrounding Turin, the main city of North-West Italy. The case notes of all 4549 residents in the province who were certified blind between 1967 and 1991 were examined with regard to cause, age at onset, and year of onset of visual acuity < or = 1/20. Diabetic retinopathy was the second commonest cause of bilateral blindness (13.1% of cases), preceded by cataract (26.7%) and followed by myopia (11.1%), optic atrophy (8.9%), glaucoma (8.9%), retinitis pigmentosa (7.2%), and senile macular degeneration (4.1%). Diabetic retinopathy was the commonest eye disease among those who became blind between the ages of 50 and 70 and remained the leading cause of visual loss when the age groups 20 to 70 were pooled together. The incidence of diabetic retinopathy-related blindness did not show any trend to decrease over the 25 years investigated. It is concluded that, in spite of widespread availability of facilities for its assessment and treatment, diabetic retinopathy remains a leading cause of blindness in North-West Italy. This fully justifies the implementation of screening programmes and efficient referral chains for the early detection and prompt treatment of this complication of diabetes.
La peau est un organe très exposé à l’environnement et fournit la première ligne de défense contre de nombreux pathogènes. Cette fonction est remplie dans l’épiderme murin par les cellules de ...Langerhans (LCs) et les cellules T dendritiques de l’épiderme (DETCs). Alors que le développement de ces cellules a bien été étudié, peu d’expériences ont été effectuées sur leur renouvellement en condition homéostatique chez des animaux adultes sans manipulations. Nous avons alors développé un système de traçage cellulaire par fluorescence multicolore pour étudier l’homéostasie des LCs et des DETCs. Cette approche de «fate mapping» m’a permis de mettre en évidence un modèle dans lequel le réseau adulte des LCs est formé d’unités prolifératives adjacentes composées de LCs en division et leurs cellules filles. Nous avons identifié que les cellules en division étaient majoritairement représentées par la fraction la plus immature des LCs, suggérant que ces LCs peuvent régénérer leur réseau grâce à une capacité de prolifération limitée. Lors d’une inflammation importante, les LCs sont renouvelées par des progéniteurs issus de la moelle osseuse et s’organisent également en unités de prolifération. Je me suis ensuite intéressé à l’homéostasie des DETCs. Ce réseau est formé de la même manière par des unités prolifératives de DETCs. Un modèle de greffe de peau nous a permis de montrer que les DETCs semblent renouveler les cellules disparues dans une zone restreinte. En conclusion, mes travaux de thèse ont permis de révéler les dynamiques cellulaires qui régissent l’homéostasie des cellules immunitaires de l’épiderme.
The skin is an organ very much exposed to the environment and supplies the primary line of defence against several pathogens. In the mouse model epidermis, this function is fulfilled by Langerhans’ cells (LCs) and dendritic T cells (DETCs). While LCs and DETCs development have thoroughly been studied, few experiences have been carried out concerning the renewal of these cells through homeostatic conditions in adult “nonmanipulated” animals. Then we have designed a new system of fate mapping, by way of multi-coloured fluorescence to study the LCs and DETCs homeostasis. This method of fate mapping allowed me to highlight a model in which the adult network of LCs is made up of adjacent proliferating units, made of dividing LCs and of their daughter cells. We have identified that the dividing cells were mainly represented by the most immature fraction of LCs, suggesting that these LCs can renew their network thanks to a limited ability to proliferate. During significant inflammation, LCs are renewed by progenitors coming from the bone marrow and organize themselves in proliferation units as well. I also took an interest in the homeostasis of DETCs. In the same way as for the LCs, this network seems to be made up of DETCs proliferating units. A model of skin graft led us to show that the DETCs seem to renew the missing cells in a restricted area. As a conclusion, my research work allowed me to reveal the cellular dynamism which governs the homeostasis of the epidermis’ immune cells.
Hexarelin, an analogue of GHRP-6, in which D-Tryptophan has been
replaced by its 2-methyl derivative, is known to release growth hormone
(GH) in vivo and in vitro by direct action on
receptors ...present in anterior pituitary cells. Measurement of second
messengers (c-AMP, Ca++, IP3) upon somatotrophs
stimulation, suggests the existence of more than one GHRP receptor
subtype. In order to document such an hypothesis, we have used a new
photoactivatable derivative of Hexarelin, Tyr-Bpa-Ala-Hexarelin. This
derivative was shown to be fully active in the release of GH in
vivo with neonate rats. Using this photoactivatable ligand, we
have specifically labeled a protein with an apparent Mr of
57 000 in human, bovine and porcine anterior pituitary membranes.
Hexarelin and the spiroindoline sulfonamide MK-0677 displaced the
Mr −57 000 photolabeled band with an apparent
ED50 of 6×10−7 M and 2×10−5 M
respectively. Taking into account the high efficiency (>60%) of
covalent incorporation of the Bpa residue, this photoactivatable
Hexarelin derivative has allowed the identification of a pituitary GHRP
receptor subtype, which is apparently distinct from the recently cloned
GH secretagogue receptor.
The mechanism by which asbestos fibers are fibrogenic and tumorigenic is still matter of debate. The higher pathogenicity of longer fibers has been traditionally associated with their slower ...clearance in respiratory airways. However, short amosite fibers, obtained by grinding longer ones, exhibited a lower potential to damage nude DNA and a lower in vitro cytotoxicity. We have thus revisited the two sets of long and short fibers in order to compare their surface properties to their activity in cell systems. In this study we report that, in human lung epithelial cells A549, long amosite fibers, more effectively than the short ones, initiate free radical reactions, inhibit the glucose 6-phosphate dehydrogenase activity and the pentose phosphate pathway, decrease the intracellular level of reduced glutathione, and increase the generation of thiobarbituric acid reactive substances and the leakage of lactate dehydrogenase in the extracellular medium. These results suggest that the shortening of fibers by prolonged milling affects not only their biopersistence, but also their surface properties, hence their interaction with cellular metabolism. Our data provide also a mechanism by which asbestos fibers inhibit the pentose phosphate pathway, i.e., via the oxidative inhibition of glucose 6-phosphate dehydrogenase, which is prevented by reduced glutathione.
acromegalic therapeutic goals are directed at removing the tumor, preventing tumor re-growth and reducing long-term morbidity and mortality. In this scenario, the acromegalic patient needs a variety ...of health resources (diagnostic tests, surgery, radiotherapy, specialist visits and drugs) for his/her cure, in order to decrease/stop the progression of the disease and to cure the co-morbid diseases. Lack of epidemiological data has suggested performing an Italian retrospective study aiming to assess the health resource consumption that is caused by acromegalic cure and the relative co-morbidities, in order to estimate the amount of the direct costs of acromegalic patients.
a retrospective study was performed on a total of 134 patients (142 patients selected, 76 in Genoa and 66 in Turin) for a period of about 7 yr preceding the enrolment date. Only direct costs were evaluated by performing an analysis on the perspective of Italian Healthcare Service (SSN).
the mean total direct costs for acromegaly cure ranged from 7,968.41 to 12,533.02 Euros/yr (p < 0.01; Mann Whitney Test), respectively, for Responders and Non-Responders. The cost driver was drug (SS analogs) for acromegalic cure. The co-morbidity conditions associated to acromegalic Non-Responder patients are clearly higher than those with well-controlled disease.
the study supports the hypothesis that controlled patients drove a saving for SSN in comparison to poor control patients that use more health resources.
The increasing prevalence of obesity has triggered intense research on its pharmacotherapy. Besides central neuroendocrine pathways, many peripheral endocrino-metabolic signals have been ...investigated, but only few are probably of some utility in weight loss. This review reports about ghrelin and other gastrointestinal peptides involved in hunger and satiety.
Summary
Background Impaired GH secretion is a common finding in patients with primary hyperparathyroidism (PHP). Ghrelin displays strong GH‐releasing action, mainly at the hypothalamic level.
...Objective To evaluate secretory response of GH to ghrelin in PHP patients.
Patients Fifteen patients 11 women/4 men, mean age 54 years, range 32–70 years, body mass index (BMI) 25·0 ± 0·7 kg/m2 affected with PHP due to single parathyroid adenoma and 35 normal age‐matched subjects (23 women/12 men, mean age 58 years, range 35–68 years, BMI 24·1 ± 1·1 kg/m2).
Methods A measure of 1 µg/kg body weight i.v. acylated ghrelin or 1 µg/kg body weight i.v. GH releasing hormone (GHRH) followed by 0·5 g/kg body weight i.v. arginine (ARG) hydrochloride were administered to all subjects on alternate days in order to evaluate GH response.
Results Mean serum GH peak after GHRH + ARG was 32·6 ± 7·8 and 17·4 ± 4·0 µg/l, in controls and PHP patients, respectively (P < 0·05). Mean serum GH peak after ghrelin was 70·4 ± 31·5 and 16·8 ± 1·9 µg/l, in controls and PHP patients, respectively, (P < 0·001). Using ROC curves, a serum GH peak > 22 µg/l after ghrelin stimulation might be considered as a cut‐off value for identifying normal subjects. Ten (67%) PHP patients have impaired GH response to GHRH + ARG and 13 (87%) to ghrelin. Serum GH peak after ghrelin or GHRH + ARG was unrelated to serum IGF‐1, PTH or ionized calcium concentrations.
Conclusions The present data confirm that GH secretion is impaired in PHP patients using the potent GH secretagogue ghrelin and suggest that impaired GH secretion is likely due to a deleterious effect of hypercalcaemia at the hypothalamic level in PHP patients.
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