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BC: Articoli scritti da U. Basile

Efficacia e utilità del monitoraggio terapeutico di autoanticorpi e farmaci inibitori del Tumor Necrosis Factor alpha in pazienti in trattamento per patologie autoimmuni
Therapeutic monitoring of autoantibodies Tumor Necrosis Factor α inhibitor drugs: efficacy and benefit for patients with autoimmune diseases
<p>Therapeutic monitoring of autoantibodies Tumor Necrosis Factor &alpha; inhibitor drugs: efficacy and benefit for patients with autoimmune diseases. Tumor necrosis factor alpha (TNF&alpha;) is a proinflammatory cytokine involved in the pathogenesis of chronic inflammatory disease, such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Chron&rsquo;s disease and ulcerative colitis. TNF&alpha; inhibitors (anti-TNF&alpha;) are monoclonal antibodies drugs directed against TNF&alpha; (i.e. adalimumab, infliximab, etarnecept, golimumab and certolizumab). Their effect consists in reducing the inflammatory response of autoimmune diseases. Several randomized controlled trials and observational studies evaluated the therapeutic efficacy of these drugs and reported a clear benefit for patients affected by chronic inflammatory disease treated with anti-TNF&alpha;, but also a high risk of reactions and infections in the injection site. These drugs are immunogenic, and consequent anti-drug antibodies (ADA) formation may decrease the functional drug concentration resulting in a loss of response. Therefore, we evaluated the impact of ADA on therapeutic response through meta-analyses, showing that detectable ADA significantly reduced TNF&alpha; inhibitors response. ADA could interfere with drugs and compromise their effects, so the determination of serum ADA levels could improve the patient&rsquo;s management. Even if the decrease of therapeutic response, due to ADA production, is well documented, the clinical benefit of serum ADA determination remains unclear. At the moment, there are many indications about the use of immunogenicity test to guide the therapy, but more information should be acquired before implementing this test in clinical practice.</p>
Biochimica Clinica ; 42(3) 266-273
Documenti SIBioC - SIBioC Documents
 
Il contributo della diagnostica proteica nella gestione delle gammopatie monoclonali
Protein diagnostics in the management of monoclonal gammopathies
<p>This document examines laboratory tests&nbsp;to be used for the management of monoclonal gammopathies in different clinical scenarios, from screening to&nbsp;monitoring and assessment of the response to therapy. The content is based on international recommendations and&nbsp;guidelines currently available. It includes sections on the analytical aspects of different tests&nbsp;(serum&nbsp;protein&nbsp;electrophoresis, typing and quantification of monoclonal components, Bence Jones protein determination and free&nbsp;light chain measurement) and on their clinical significance as well. Different clinical settings are examined: screening,&nbsp;diagnosis, risk stratification, monitoring and response assessment. For each of those, laboratory tests to be used are&nbsp;indicated. Aim of the document is to help clinical laboratories avoiding unnecessary tests, ensuring in the meantime&nbsp;that all the investigations required for a optimal patient management are carried out.</p>
Biochimica Clinica ; 38(1) 47-53
Documenti SIBioC - SIBioC Documents
 
Rispondono gli Autori dell’articolo in questione
In reply
Biochimica Clinica ; 38(1) 74
Lettere all'Editore - Letters to the Editor
 
Razionale e prospettive della determinazione delle catene leggere libere del siero nelle patologie infiammatorie croniche
Rationale and prospects of serum immunoglobulin free light chain (FLC) determination in chronic inflammatory disease
U. Basile  |  M. Mussap  | 
<p>The development of serum assays for free FLC <span style="font-family:symbol">k</span> and<span style="font-family:symbol"> l</span> has opened the door to new&nbsp;applications increasing their clinical importance beyond monoclonal gammopathies and plasma cell dyscrasias. In&nbsp;particular, the availability of these tests may open new prospects for diagnosing and managing various diseases&nbsp;characterized by chronic inflammation, namely autoimmune disease, allergic disease, viral infections, inflammatory&nbsp;disorders of the central nervous system and others. For most of these diseases, serum polyclonal FLC concentrations&nbsp;correlate with disease activity, being a potential useful index for adjusting therapeutic regimens. The aim of this review&nbsp;is to summarize current available data from the literature and to analyze the possible role of FLC in improving the&nbsp;clinical management of patients with chronic inflammatory disorders.</p>
Biochimica Clinica ; 37(5) 357-364
Rassegne - Reviews
 
Una gammopatia monoclonale di difficile tipizzazione
A monoclonal gammopathy of difficult characterization
F. Gulli  |  U. Basile  |  S. Borrello  |  C. Zuppi  | 
<p>IgD monoclonal gammopathy is a rare event, but its recognition and management are quite important because the condition is potentially life-threatening. This paper reports a peculiar case of IgD monoclonal gammopathy. The monoclonal protein was rapidly degraded by proteolysis and the usual laboratory tests showed different immunochemical patterns. The study of the proteolitic dynamic of the monoclonal immunoglobulin allowed us to obtain the complete characterization of the monoclonal component.</p>
Biochimica Clinica ; 37(1) 64-67
Casi Clinici - Case Report
 
Determinazione del CD138 solubile nel siero di pazienti affetti da mieloma multiplo IgD
Soluble CD138 concentrations in serum of patients with IgD myeloma
U. Basile  |  F. Gulli  |  G. Cigliana  |  S. Storti  | 
Biochimica Clinica ; 35(1) 56
CASI CLINICI - CASI CLINICI