Sara Caldrer

IntroductionCancer patients are at risk for serious complications in case of SARS-CoV-2 infection. In these patients SARS-CoV-2 vaccination is strongly recommended, with the preferential use of mRNA vaccines. The antibody response in cancer patients is variable, depending on the type of cancer and antitumoral treatment. In solid tumor patients an antibody response similar to healthy subjects has been confirmed after the second dose. Only few studies explored the duration of immunization after the two doses and the effect of the third dose.MethodsIn our study we explored a cohort of 273 solid tumor patients at different stages and treated with different anticancer therapies.Results and DiscussionOur analysis demonstrated that the persistence of the neutralizing antibody and the humoral response after the booster dose of vaccine was not dependent on either the tumor type, the stage or type of anticancer treatment.

Chimeric antigen receptor (CAR)-expressing T cells are a promising therapeutic option for patients with cancer. We developed a new CAR directed against the disialoganglioside GD2, a surface molecule expressed in neuroblastoma and in other neuroectoderm-derived neoplasms. The anti-GD2 single-chain variable fragment (scFv) derived from a murine antibody of IgM class was linked, via a human CD8α hinge-transmembrane domain, to the signaling domains of the costimulatory molecules 4-1BB (CD137) and CD3-ζ. The receptor was expressed in T lymphocytes by retroviral transduction and anti-tumor activities were assessed by targeting GD2-positive neuroblastoma cells using in vitro cytotoxicity assays and a xenograft model. Transduced T cells expressed high levels of anti-GD2 CAR and exerted a robust and specific anti-tumor activity in 4- and 48-hour cultures with neuroblastoma cells. Cytotoxicity was associated with the release of pro-apoptotic molecules such as TRAIL and IFN-γ. These results we...

The dataset refers to a study the objective of which was to retrospectively investigate the immune dysregulation associated with COVID-19 severity and clinical course in hospitalised patients. Immunophenotyipc analyses were performed by multi-colour flow cytometry on whole blood samples, the systemic concentration of selected cytokines was determined in serum samples. The dataset contains de-identified demographic and clinical information, as well as experimental raw data.

BackgroundThe host immune response has a prominent role in the progression and outcome of SARS-CoV-2 infection. Lymphopenia has been described as an important feature of SARS-CoV-2 infection and has been associated with severe disease manifestation. Lymphocyte dysregulation and hyper-inflammation have been shown to be associated with a more severe clinical course; however, a T cell subpopulation whose dysfunction correlate with disease progression has yet to be identify.MethodsWe performed an immuno-phenotypic analysis of T cell sub-populations in peripheral blood from patients affected by different severity of COVID-19 (n=60) and undergoing a different clinical evolution. Clinical severity was established based on a modified WHO score considering both ventilation support and respiratory capacity (PaO2/FiO2 ratio). The ability of circulating cells at baseline to predict the probability of clinical aggravation was explored through multivariate regression analyses.ResultsThe immuno-ph...

ABSTRACT Introduction: Molecular technology has played an important role in arboviruses diagnostics. PCR-based methods stand out in terms of sensitivity, specificity, cost, robustness, and accessibility, and especially the isothermal amplification (IA) method is ideal for field-adaptable diagnostics in resource-limited settings (RLS). Areas covered: In this review, we provide an overview of the various molecular methods for West Nile, Zika, Dengue and Chikungunya. We summarize literature works reporting the assessment and use of in house and commercial assays. We describe limitations and challenges in the usage of methods and opportunities for novel approaches such as NNext-GenerationSequencing (NGS). Expert opinion: The rapidity and accuracy of differential diagnosis is essential for a successful clinical management, particularly in co-circulation area of arboviruses. Several commercial diagnostic molecular assays are available, but many are not affordable by RLS and not usable as Point-of-care/Point-of-need (POC/PON) such as RReal-TimeRT-PCR, Array-based methods and NGS. In contrast, the IA-based system fits better for POC/PON but it is still not ideal for the multiplexing detection system. Improvement in the characterization and validation of current molecular assays is needed to optimize their translation to the point of care.

We assessed the performance of the Panbio rapid antigen detection (RAD) test for the detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and we compared it with the routine reverse transcriptase‐polymerase chain reaction (RT‐PCR)‐based molecular test in a population of 4167 unselected patients admitted to IRCCS Sacro Cuore Don Calabria Hospital. Analysis stratified by cycling threshold (Ct) value of SARS‐CoV‐2 gene targets indicated that antigen (Ag)‐positive Ct values were significantly lower compared to Ag‐negative values (p < 0.0001). Overall, we found discordance in 140, tested negative by RAD and positive by RT‐PCR, and in 4 resulted positive by RAD and negative by RT‐PCR. RAD test achieved a sensitivity and specificity of 66.82% and 99.89%, respectively. The positive predictive value was shown to be 97.87% while the negative predictive value was shown to be 97.62%. In our context, the RAD test showed a reliable diagnostic response in subjects that displayed high Ct values, corresponding to high viral load, while low ability was displayed to identify positive cases with medium‐low Ct values, thus presenting low viral load and where confirmatory RT‐PCR was needed. Our finding supports the use of the RAD test in real‐life settings where a high volume of swabs is being processed but with caution when interpreting a positive test result in a low prevalence setting.

Although antibody levels progressively decrease following SARS-CoV-2 infection, the immune memory persists for months. Thus, individuals who naturally contracted SARS-CoV-2 are expected to develop a more rapid and sustained response to COVID-19 vaccines than naïve individuals. In this study, we analyzed the dynamics of the antibody response to the BNT162b2 mRNA COVID-19 vaccine in six healthcare workers who contracted SARS-CoV-2 in March 2020, in comparison to nine control subjects without a previous infection. The vaccine was well tolerated by both groups, with no significant difference in the frequency of vaccine-associated side effects, with the exception of local pain, which was more common in previously infected subjects. Overall, the titers of neutralizing antibodies were markedly higher in response to the vaccine than after natural infection. In all subjects with pre-existing immunity, a rapid increase in anti-spike receptor-binding domain (RBD) IgG antibodies and neutralizin...

Anaemia is an important cause of morbidity and mortality globally. Among infectious agents responsible for anaemia, helminthic infections are often neglected, particularly in non-endemic countries. However, they should not be neglected in this setting, as international travel and migration are on the rise. In this narrative review, we aimed to describe soil-transmitted helminths as a cause of or contributing factor to anaemia, focusing on hookworms (Necator americanus and Ancylostoma duodenale), the whipworm (Trichuris trichiura), the roundworm (Ascaris lumbricoides), and the threadworm (Strongyloides stercoralis). A general review on the epidemiology, lifecycle, and clinical spectrum of anaemia is proposed, with a special focus on helminthic infections’ association with anaemia as well as the diagnostic approach, which are both particularly important in non-endemic settings.

Introduction: In vivo and ex vivo measurements of CFTR function in human cells and tissues can be used for screening and monitoring new ther- apies and phenotyping of controversial CFTR genotypes. Among the tools currently available, a technique enabling intestinal stem cells to expand into closed organoids containing crypt-like structures and an internal lumen lined by differentiated cells, recapitulating the in vivo tissue architecture (Sato T, et al. Gastroenterology. 2011;141:1762-72) was set up in our lab and used for measuring CFTR function by a simple and quantitative assay. Material and Methods: We developed intestinal organoids from 14 non-CF and 13 CF subjects and measured forskolin-induced swelling (FIS) (Dekkers JF, et al. Nat Med 2013;19:939-45). Results: In non-CF organoids swelling was completely blocked by the CFTR (inh)-172 and significantly enhanced following treatment with the potentiator ivacaftor (VX-770). Swelling rates in CF organoids were variable, dependent on the CFTR mutation. Remarkably, in organ- oids from a CF patient carrying the W1282X/R117H CFTR genotype we observed swelling following 24h exposure to the premature termination corrector ataluren (PTC124), but not in its absence. We also performed the membrane depolarization assay in monocytes (Sorio C, et al. PLoS One. 2011;6:e22212) carrying different CFTR mutations and detected resto- ration of CFTR function following 24h exposure to the corrector VRT-325 or the combination of lumacaftor (VX-809)+VX-770 (F508del mutation) and to PTC124 (nonsense mutations). Nasal potential difference (NPD) was abnormal but intestinal current measurement (ICM) was normal in the patient with the W1282X/R117H CFTR mutations and in a CF patient with F508del/T5TG13 CFTR genotype while sweat Cl - was 70 and 79mEq/L, respectively. ICM was abnormal in all other CF patients tested. Conclusions: This study explored and compared several robust assays for individualized medicine approaches aiming at supporting diagnosis, CFTR functional studies and new drug development and monitoring. We have been able to grow intestinal organoids from CF and non-CF subjects and to evaluate CFTR function by FIS assays showing partial restoration of CFTR activity in response to a CFTR potentiator, a CFTR corrector and a premature termination corrector. We can use a combination of CFTR func- tional tests covering multiple tissues and cell types including leukocytes (membrane potential), native intestinal epithelium (ICM), intestinal organ- oids (FIS), nasal epithelium (NPD), sweat gland duct (Gibson-Cooke sweat test) and sweat gland coil (ratiometric sweat rate measurements: Wine JJ, et al. PLoS One. 2013;8:e77114) for individualized approaches for CF diag- nosis, drug development and monitoring of new therapies targeting the basic defect

Cystic fibrosis is caused by mutations of CFTR gene, a protein kinase A-activated anion channel, and is associated to a persistent and excessive chronic lung inflammation, suggesting functional alterations of immune cells. Leukocytes express detectable levels of CFTR but the molecule has not been fully characterized in these cells. Freshly isolated monocytes from healthy individuals and CF patients were assessed by protein expression, single cell electrophysiological and membrane depolarization assays. We recorded chloride currents by patch clamp in healthy monocytes, after the administration of a CFTR stimulus. Currents were sensitive to a specific blocker of the CFTR channel, CFTRinh-172 and were absent in CF monocytes. Next, we evaluated the effects of ex vivo exposure of monocytes from cystic fibrosis patients carrying the F508del mutation to a chemical corrector, Vertex-325. We found an increase in CFTR expression by confocal microscopy and a recovery of CFTR function by both p...

Cyclic adenosine 3',5'-monophosphate (cAMP)-elevating agents, such as β2-adrenergic receptor (β2-AR) agonists and phosphodiesterase (PDE) inhibitors, remain a mainstay in the treatment of obstructive respiratory diseases, conditions characterized by airway constriction, inflammation, and mucus hypersecretion. However, their clinical use is limited by unwanted side effects because of unrestricted cAMP elevation in the airways and in distant organs. Here, we identified the A-kinase anchoring protein phosphoinositide 3-kinase γ (PI3Kγ) as a critical regulator of a discrete cAMP signaling microdomain activated by β2-ARs in airway structural and inflammatory cells. Displacement of the PI3Kγ-anchored pool of protein kinase A (PKA) by an inhaled, cell-permeable, PI3Kγ mimetic peptide (PI3Kγ MP) inhibited a pool of subcortical PDE4B and PDE4D and safely increased cAMP in the lungs, leading to airway smooth muscle relaxation and reduced neutrophil infiltration in a murine model of asthma. In human bronchial epithelial cells, PI3Kγ MP induced unexpected cAMP and PKA elevations restricted to the vicinity of the cystic fibrosis transmembrane conductance regulator (CFTR), the ion channel controlling mucus hydration that is mutated in cystic fibrosis (CF). PI3Kγ MP promoted the phosphorylation of wild-type CFTR on serine-737, triggering channel gating, and rescued the function of F508del-CFTR, the most prevalent CF mutant, by enhancing the effects of existing CFTR modulators. These results unveil PI3Kγ as the regulator of a β2-AR/cAMP microdomain central to smooth muscle contraction, immune cell activation, and epithelial fluid secretion in the airways, suggesting the use of a PI3Kγ MP for compartment-restricted, therapeutic cAMP elevation in chronic obstructive respiratory diseases.

Although dose intensification of chemotherapy has increased initial response rates in neuroblastoma (NB), this effect has not translated into durable remissions in patients with disseminated disease. Immunotherapy may be an alternative approach following cytoreductive chemotherapy providing a long-term disease control (I). We have engineered human cytotoxic T lymphocytes (CTL) to express a chimeric receptor (CR) for the specific recognition of GD2 that is expressed in NB (II). Chimeric lymphocytes (CL) have been previously introduced towards several tumors (III). Thus, we have generated a novel CR consisting of a single-chain variable domain of an anti-GD2 antibody in conjunction with a signal domain of 4-1BB molecule (CD137). Retroviral particles encoding for the flag gene only (GFP), for the whole CR and for a truncated receptor were generated. Peripheral blood cells from buffy-coat were specifically stimulated and transuced obtaining a cytotoxic population of T cells having high ...