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Article ; Online: Difficult-to-Treat Psoriatic Arthritis: A Conceptual Approach.

Fagni, Filippo / Motta, Francesca / Schett, Georg / Selmi, Carlo

Arthritis & rheumatology (Hoboken, N.J.)

2024 Volume 76, Issue 5, Page(s) 670–674

MeSH term(s)	Humans ; Arthritis, Psoriatic/drug therapy ; Antirheumatic Agents/therapeutic use
Chemical Substances	Antirheumatic Agents
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.42780
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Article ; Online: Inflammaging and Osteoarthritis.

Motta, Francesca / Barone, Elisa / Sica, Antonio / Selmi, Carlo

Clinical reviews in allergy & immunology

2022 Volume 64, Issue 2, Page(s) 222–238

Abstract: Osteoarthritis is a highly prevalent disease particularly in subjects over 65 years of age worldwide. While in the past it was considered a mere consequence of cartilage degradation leading to anatomical and functional joint impairment, in recent decades, ...

Abstract	Osteoarthritis is a highly prevalent disease particularly in subjects over 65 years of age worldwide. While in the past it was considered a mere consequence of cartilage degradation leading to anatomical and functional joint impairment, in recent decades, there has been a more dynamic view with the synovium, the cartilage, and the subchondral bone producing inflammatory mediators which ultimately lead to cartilage damage. Inflammaging is defined as a chronic, sterile, low-grade inflammation state driven by endogenous signals in the absence of infections, occurring with aging. This chronic status is linked to the production of reactive oxygen species and molecules involved in the development of age-related disease such as cancer, diabetes, and cardiovascular and neurodegenerative diseases. Inflammaging contributes to osteoarthritis development where both the innate and the adaptive immune response are involved. Elevated systemic and local inflammatory cytokines and senescent molecules promote cartilage degradation, and antigens derived from damaged joints further trigger inflammation through inflammasome activation. B and T lymphocyte populations also change with inflammaging and OA, with reduced regulatory functions, thus implicating self-reactivity as an additional mechanism of joint damage. The discovery of the underlying pathogenic pathways may help to identify potential therapeutic targets for the management or the prevention of osteoarthritis. We will provide a comprehensive evaluation of the current literature on the role of inflammaging in osteoarthritis and discuss the emerging therapeutic strategies.
MeSH term(s)	Humans ; Osteoarthritis/pathology ; Osteoarthritis/therapy ; Inflammation ; Inflammasomes/metabolism ; Cytokines ; Inflammation Mediators/metabolism
Chemical Substances	Inflammasomes ; Cytokines ; Inflammation Mediators
Language	English
Publishing date	2022-06-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1239045-8
ISSN	1559-0267 ; 1080-0549
ISSN (online)	1559-0267
ISSN	1080-0549
DOI	10.1007/s12016-022-08941-1
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Article ; Online: Steroid-induced osteonecrosis.

Motta, Francesca / Timilsina, Suraj / Gershwin, M Eric / Selmi, Carlo

Journal of translational autoimmunity

2022 Volume 5, Page(s) 100168

Abstract: Osteonecrosis associated with the use of glucocorticoids is a severe, potentially debilitating complication. In broader terms, it commonly involves the femoral head with secondary hip osteoarthritis. Osteonecrosis can also be caused by trauma and other ... ...

Abstract	Osteonecrosis associated with the use of glucocorticoids is a severe, potentially debilitating complication. In broader terms, it commonly involves the femoral head with secondary hip osteoarthritis. Osteonecrosis can also be caused by trauma and other non-traumatic factors besides steroid treatment. Nonetheless, glucocorticoid use is frequently observed in clinical settings in which this represents a common therapeutic option, including general practice, rheumatology and clinical immunology, among others. The pathogenesis involves genetic components, vascular impairment, adipocyte hypertrophy, and increased intraosseous pressure, ultimately leading to marrow and bone ischemia and necrosis and the process rapidly becomes irreversible. Osteonecrosis manifests with pain and impaired motility while the diagnosis is usually made with magnetic resonance imaging allowing early detection and potentially (dependent on the patient's needs for steroids and stage) timely management with conservative options, followed by joint replacement at late stages. In this review we discuss the pathogenesis, risk factors, diagnosis, staging, and management of this complication associated with glucocorticoid treatment.
Language	English
Publishing date	2022-09-30
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2589-9090
ISSN (online)	2589-9090
DOI	10.1016/j.jtauto.2022.100168
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Article ; Online: 5 reasons to encourage anti-SARS-CoV-2 vaccination in patients with rheumatic diseases.

Motta, Francesca / Selmi, Carlo / De Santis, Maria

Expert review of clinical immunology

2021 Volume 17, Issue 12, Page(s) 1241–1244

MeSH term(s)	COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; Health Promotion ; Humans ; Rheumatic Diseases ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2021-09-23
Publishing country	England
Document type	Editorial
ZDB-ID	2274260-8
ISSN	1744-8409 ; 1744-666X
ISSN (online)	1744-8409
ISSN	1744-666X
DOI	10.1080/1744666X.2021.1978289
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Article ; Online: Assessment of the psychometric properties of the italian version of the midwifery student evaluation of practice (MIDSTEP-IT): A validity and reliability study.

Nespoli, Antonella / Sacco, Gaia Giulia Angela / Bouhachem, Fatima Zahra / Motta, Francesca / Paredi, Simona / Antolini, Laura / Panzeri, Maria / Pellegrini, Edda / Fumagalli, Simona

Midwifery

2024 Volume 133, Page(s) 103991

Abstract: Background: Clinical learning is a crucial component of the midwifery education program, necessary to support the acquisition of professional abilities through the integration of theoretical and practical learning experiences. Evaluating Bachelor of ... ...

Abstract	Background: Clinical learning is a crucial component of the midwifery education program, necessary to support the acquisition of professional abilities through the integration of theoretical and practical learning experiences. Evaluating Bachelor of Midwifery students' perception of their clinical learning experiences is important to improve midwifery educational programs. Aim: the objective of this study was the translation, cultural adaptation, and validation of the Midwifery Student Evaluation of Practice (MidSTEP) in a group of Italian midwives' students. Methods: "Translation and Cultural Adaptation of Patient Reported Outcomes Measures - Principles of Good Practice" guidelines were adopted to achieve the MidSTEP Italian version. Exploratory Factor Analysis was performed. Internal consistency for reliability was assessed using Cronbach's alpha reliability coefficient (α) and Omega coefficient (ω), while Intraclass Correlation Coefficients (ICC) were used to determine if the tool was stable over time. Findings: The Italian version of MidSTEP (MidSTEP-IT) has good internal consistency: considering the Clinical Learning Environment Scale, Cronbach's α was 0.839 (for the "Skill Development" subscale α was equal to 0.739 and for the "Philosophy of Midwifery Practice" subscale α was equal to 0.825) while considering the Midwifery Preceptor Scale, Cronbach's α was 0.920. Factor analysis does not fully reflect the factorial analysis of the original version. Conclusion: The MidSTEP-IT had been proven to be a valid and reliable tool, easy and fast to administer, that could be effectively helpful for investigating and measuring the Italian midwifery students' perception of their clinical learning experiences, according to the setting and impact of mentors on their professional growth. It is an innovative tool, valuable in both clinical practice and research to highlight the importance of encouraging a supportive clinical learning environment and an efficient preceptorship.
Language	English
Publishing date	2024-04-05
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1036567-9
ISSN	1532-3099 ; 0266-6138
ISSN (online)	1532-3099
ISSN	0266-6138
DOI	10.1016/j.midw.2024.103991
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Zs.A 2662: Show issues

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Article ; Online: Serum autoantibodies and the risk of cancer in systemic sclerosis over time.

De Santis, Maria / Tonutti, Antonio / Motta, Francesca / Rodolfi, Stefano / Isailovic, Natasa / Selmi, Carlo

Arthritis & rheumatology (Hoboken, N.J.)

2023 Volume 76, Issue 2, Page(s) 314–315

MeSH term(s)	Humans ; Scleroderma, Systemic ; Autoantibodies ; Neoplasms/epidemiology
Chemical Substances	Autoantibodies
Language	English
Publishing date	2023-10-15
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.42701
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Article ; Online: Mushrooms and immunity.

Motta, Francesca / Gershwin, M Eric / Selmi, Carlo

Journal of autoimmunity

2020 Volume 117, Page(s) 102576

Abstract: In the wide field of nutraceuticals, the effects of mushrooms on immunity, cancer and including autoimmunity have been proposed for centuries but in recent years a growing interest has led scientists to elucidate which specific compounds have bioactive ... ...

Abstract	In the wide field of nutraceuticals, the effects of mushrooms on immunity, cancer and including autoimmunity have been proposed for centuries but in recent years a growing interest has led scientists to elucidate which specific compounds have bioactive properties and through which mechanisms. Glucans and specific proteins are responsible for most of the biological effects of mushrooms, particularly in terms of immunomodulatory and anti-tumor results. Proteins with bioactive effects include lectins, fungal immunomodulatory proteins (FIPs), ribosome inactivating proteins (RIPs), ribonucleases, laccases, among others. At the present status of knowledge, numerous studies have been performed on cell lines and murine models while only a few clinical trials have been conducted. As in most cases of dietary components, the multitude of variables implicated in the final effect and an inadequate standardization are expected to affect the observed differences, thus making the available evidence insufficient to justify the treatment of human diseases with mushrooms extracts. We will herein provide a comprehensive review and critically discussion the biochemical changes induced by different mushroom compounds as observed in in vitro studies, particularly on macrophages, dendritic cells, T cells, and NK cells, compared to in vivo and human studies. Additional effects are represented by lipids which constitute a minor part of mushrooms but may have a role in reducing serum cholesterol levels or phenols acting as antioxidant and reducing agents. Human studies provide a minority of available data, as well illustrated by a placebo-controlled study of athletes treated with β-glucan from Pleurotus ostreatus. Variables influencing study outcomes include different mushrooms strains, growing conditions, developmental stage, part of mushroom used, extraction method, and storage conditions. We foresee that future rigorous research will be needed to determine the potential of mushroom compounds for human health to reproduce the effects of some compounds such as lentinan which a metaanalysis demonstrated to increase the efficacy of chemotherapy in the treatment of lung cancer and in the improvement of the patients quality of life.
MeSH term(s)	Agaricales/chemistry ; Agaricales/classification ; Agaricales/metabolism ; Animals ; Antineoplastic Agents/chemistry ; Antineoplastic Agents/pharmacology ; Autoimmunity/drug effects ; Biological Products/chemistry ; Biological Products/pharmacology ; Dietary Proteins/metabolism ; Dietary Supplements ; Health Impact Assessment ; Humans ; Immunity/drug effects ; Immunity, Innate/drug effects ; Immunomodulation ; Leukocytes/drug effects ; Leukocytes/immunology ; Leukocytes/metabolism ; Lymphocyte Activation/drug effects ; Lymphocyte Activation/immunology ; beta-Glucans/metabolism
Chemical Substances	Antineoplastic Agents ; Biological Products ; Dietary Proteins ; beta-Glucans
Language	English
Publishing date	2020-12-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	639452-8
ISSN	1095-9157 ; 0896-8411
ISSN (online)	1095-9157
ISSN	0896-8411
DOI	10.1016/j.jaut.2020.102576
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Article ; Online: Frailty in Rheumatic Diseases.

Motta, Francesca / Sica, Antonio / Selmi, Carlo

Frontiers in immunology

2020 Volume 11, Page(s) 576134

Abstract: Frailty is a syndrome characterized by the decline in the physiologic reserve and function of several systems, leading to increased vulnerability and adverse health outcomes. While common in the elderly, recent studies have underlined the higher ... ...

Abstract	Frailty is a syndrome characterized by the decline in the physiologic reserve and function of several systems, leading to increased vulnerability and adverse health outcomes. While common in the elderly, recent studies have underlined the higher prevalence of frailty in chronic diseases, independent of age. The pathophysiological mechanisms that contribute to frailty have not been completely understood, although significant progresses have recently been made. In this context, chronic inflammation is likely to play a pivotal role, both directly and indirectly through other systems, such as the musculoskeletal, endocrine, and neurological systems. Rheumatic diseases are characterized by chronic inflammation and accumulation of deficits during time. Therefore, studies have recently started to explore the link between frailty and rheumatic diseases, and in this review, we report what has been described so far. Frailty is dynamic and potentially reversible with 8.3%-17.9% of older adults spontaneously improving their frailty status over time. Muscle strength is likely the most significant influencing factor which could be improved with training thus pointing at the need to maintain physical activity. Not surprisingly, frailty is more prevalent in patients affected by rheumatic diseases than in healthy controls, regardless of age and is associated with high disease activity to affect the clinical outcomes, largely due to chronic inflammation. More importantly, the treatment of the underlying condition may prevent frailty. Scales to assess frailty in patients affected by rheumatic diseases have been proposed, but larger casuistries are needed to validate disease-specific indexes, which could allow more accurate prognostic estimates than demographic and disease-related variables alone. Frail patients can be more vulnerable and more difficult to treat, due to the risk of side effects, therefore frailty should be taken into account in clinical decisions. Clinical trials addressing frailty could identify patients who are less likely to tolerate potentially toxic medications and might benefit from more conservative regimens. In conclusion, the implementation of the concept of frailty in rheumatology will allow a better understanding of the patient global health, a finest risk stratification and a more individualized management strategy.
MeSH term(s)	Age Factors ; Aged ; Body Composition ; Comorbidity ; Female ; Frail Elderly ; Frailty/diagnosis ; Frailty/epidemiology ; Frailty/physiopathology ; Frailty/therapy ; Functional Status ; Geriatric Assessment ; Humans ; Male ; Middle Aged ; Muscle Strength ; Nutrition Assessment ; Nutritional Status ; Predictive Value of Tests ; Prognosis ; Rheumatic Diseases/diagnosis ; Rheumatic Diseases/epidemiology ; Rheumatic Diseases/physiopathology ; Rheumatic Diseases/therapy ; Risk Assessment ; Risk Factors
Language	English
Publishing date	2020-10-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2020.576134
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Article ; Online: Anti-MDA5 Antibody Linking COVID-19, Type I Interferon, and Autoimmunity: A Case Report and Systematic Literature Review.

Tonutti, Antonio / Motta, Francesca / Ceribelli, Angela / Isailovic, Natasa / Selmi, Carlo / De Santis, Maria

Frontiers in immunology

2022 Volume 13, Page(s) 937667

Abstract: Introduction: The SARS-CoV-2 infection has been advocated as an environmental trigger for autoimmune diseases, and a paradigmatic example comes from similarities between COVID-19 and the myositis-spectrum disease associated with antibodies against the ... ...

Abstract	Introduction: The SARS-CoV-2 infection has been advocated as an environmental trigger for autoimmune diseases, and a paradigmatic example comes from similarities between COVID-19 and the myositis-spectrum disease associated with antibodies against the melanoma differentiation antigen 5 (MDA5) in terms of clinical features, lung involvement, and immune mechanisms, particularly type I interferons (IFN). Case report: We report a case of anti-MDA5 syndrome with skin manifestations, constitutional symptoms, and cardiomyopathy following a proven SARS-CoV-2 infection. Systematic literature review: We systematically searched for publications on inflammatory myositis associated with COVID-19. We describe the main clinical, immunological, and demographic features, focusing our attention on the anti-MDA5 syndrome. Discussion: MDA5 is a pattern recognition receptor essential in the immune response against viruses and this may contribute to explain the production of anti-MDA5 antibodies in some SARS-CoV-2 infected patients. The activation of MDA5 induces the synthesis of type I IFN with an antiviral role, inversely correlated with COVID-19 severity. Conversely, elevated type I IFN levels correlate with disease activity in anti-MDA5 syndrome. While recognizing this ia broad area of uncertainty, we speculate that the strong type I IFN response observed in patients with anti-MDA5 syndrome, might harbor protective effects against viral infections, including COVID-19.
MeSH term(s)	Antigens, Differentiation ; Autoimmune Diseases ; Autoimmunity ; Biomarkers ; COVID-19 ; Humans ; Interferon Type I ; Interferon-Induced Helicase, IFIH1 ; Melanoma ; Myositis ; SARS-CoV-2
Chemical Substances	Antigens, Differentiation ; Biomarkers ; Interferon Type I ; Interferon-Induced Helicase, IFIH1 (EC 3.6.4.13)
Language	English
Publishing date	2022-06-27
Publishing country	Switzerland
Document type	Case Reports ; Journal Article ; Systematic Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.937667
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Article ; Online: Immunosenescence, Inflammaging, and Frailty: Role of Myeloid Cells in Age-Related Diseases.

Bleve, Augusto / Motta, Francesca / Durante, Barbara / Pandolfo, Chiara / Selmi, Carlo / Sica, Antonio

Clinical reviews in allergy & immunology

2022 Volume 64, Issue 2, Page(s) 123–144

Abstract: The immune system is the central regulator of tissue homeostasis, ensuring tissue regeneration and protection against both pathogens and the neoformation of cancer cells. Its proper functioning requires homeostatic properties, which are maintained by an ... ...

Abstract	The immune system is the central regulator of tissue homeostasis, ensuring tissue regeneration and protection against both pathogens and the neoformation of cancer cells. Its proper functioning requires homeostatic properties, which are maintained by an adequate balance of myeloid and lymphoid responses. Aging progressively undermines this ability and compromises the correct activation of immune responses, as well as the resolution of the inflammatory response. A subclinical syndrome of "homeostatic frailty" appears as a distinctive trait of the elderly, which predisposes to immune debilitation and chronic low-grade inflammation (inflammaging), causing the uncontrolled development of chronic and degenerative diseases. The innate immune compartment, in particular, undergoes to a sequela of age-dependent functional alterations, encompassing steps of myeloid progenitor differentiation and altered responses to endogenous and exogenous threats. Here, we will review the age-dependent evolution of myeloid populations, as well as their impact on frailty and diseases of the elderly.
MeSH term(s)	Humans ; Aged ; Immunosenescence/physiology ; Frailty ; Aging/physiology ; Inflammation ; Myeloid Cells
Language	English
Publishing date	2022-01-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1239045-8
ISSN	1559-0267 ; 1080-0549
ISSN (online)	1559-0267
ISSN	1080-0549
DOI	10.1007/s12016-021-08909-7
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