https://hdl.handle.net/10807/1 2026-06-21T15:41:15Z 2026-06-21T15:41:15Z https://hdl.handle.net/10807/339998 2026-06-21T15:40:45Z 2023-01-01T00:00:00Z

Titolo: COVID‐19 illness: Different comorbidities may require different immunological therapeutic targets Autori: Gremese, Elisa; Tolusso, Barbara; Bruno, Dario; Paglionico, Anna Maria; Perniola, Simone; Ferraccioli, Gianfranco; Alivernini, Stefano Abstract: Background: The SARS-CoV-2 pandemic has led to more than 6,870.000 deaths worldwide. Despite recent therapeutic advances, deaths in Intensive Care Units still range between 34 and 72%, comprising substantial unmet need as we move to an endemic phase. The general agreement is that in the first few days of infection, antiviral drugs and neutralizing monoclonal antibodies should be adopted. When the patient is hospitalized and develops severe pneumonia, progressing to a systemic disease, immune modifying therapy with corticosteroids is indicated. Such interventions, however, are less effective in the context of comorbidities (e.g., diabetes, hypertension, heart failure, atrial fibrillation, obesity and central nervous system-CNS diseases) which are by themselves associated with poor outcomes. Such comorbidities comprise common and some distinct underlying inflammatory pathobiology regulated by differential cytokine taxonomy. Methods: Searching in the PubMed database, literature pertaining to the biology underlying the different comorbidities, and the data from the studies related to various immunological treatments for the Covid-19 disease were carefully analyzed. Results: Several experimental and clinical data have demonstrated that hypertension and atrial fibrillation present an IL-6 dependent signature, whereas diabetes, obesity, heart failure and CNS diseases may exhibit an IL-1a/b predominant signature. Distinct selective cytokine targeting may offer advantage in treating severe COVID-19 illness based on single or multiple associated comorbidities. When the patient does not immediately respond, a broader target range through JAKs pathway inhibitors may be indicated. Conclusions: Herein, we discuss the biological background associated with distinct comorbidities which might impact the SARS-CoV-2 infection course and how these should to be addressed to improve the current therapeutic outcome.

2023-01-01T00:00:00Z https://hdl.handle.net/10807/339997 2026-06-21T15:30:43Z 2026-01-01T00:00:00Z

Titolo: "A quelli che sembrano cretini dargli la scuola a pieno termpo". Disuguaglianze di partenza e l'educazione liberatrice. Autori: D. Simeone Abstract: Il contributo propone una riflessione articolata sulla proposta contenuta in Lettera a una professoressa, dove don Lorenzo Milani e i ragazzi della Scuola di Barbiana non si limitano a denunciare i guasti della scuola italiana, ma formulano delle ipotesi per rendere la scuola migliore, più inclusiva ed equa. La riflessione qui si concentra sulla seconda di queste proposte “A quelli che sembrano cretini dargli la scuola a pieno tempo”. Dopo aver illustrato il significato profondo di tale proposta nella prospettiva del Priore di Barbiana, il contributo descrive le linee pedagogiche di una educazione liberatrice e il ruolo della scuola a tempo pieno per il contrasto all’abbandono scolastico e alle disuguaglianze sociali.

2026-01-01T00:00:00Z https://hdl.handle.net/10807/339996 2026-06-21T15:32:43Z 2023-01-01T00:00:00Z

Titolo: COVID-19 illness: Different comorbidities may require different immunological therapeutic targets Autori: Elisa Gremese; Barbara Tolusso; Dario Bruno; Anna Maria Paglionico; Simone Perniola; Gianfranco Ferraccioli; Stefano Alivernini Abstract: Background: The SARS-CoV-2 pandemic has led to more than 6,870.000 deaths worldwide. Despite recent therapeutic advances, deaths in Intensive Care Units still range between 34 and 72%, comprising substantial unmet need as we move to an endemic phase. The general agreement is that in the first few days of infection, antiviral drugs and neutralizing monoclonal antibodies should be adopted. When the patient is hospitalized and develops severe pneumonia, progressing to a systemic disease, immune modifying therapy with corticosteroids is indicated. Such interventions, however, are less effective in the context of comorbidities (e.g., diabetes, hypertension, heart failure, atrial fibrillation, obesity and central nervous system-CNS diseases) which are by themselves associated with poor outcomes. Such comorbidities comprise common and some distinct underlying inflammatory pathobiology regulated by differential cytokine taxonomy. Methods: Searching in the PubMed database, literature pertaining to the biology underlying the different comorbidities, and the data from the studies related to various immunological treatments for the Covid-19 disease were carefully analyzed. Results: Several experimental and clinical data have demonstrated that hypertension and atrial fibrillation present an IL-6 dependent signature, whereas diabetes, obesity, heart failure and CNS diseases may exhibit an IL-1a/b predominant signature. Distinct selective cytokine targeting may offer advantage in treating severe COVID-19 illness based on single or multiple associated comorbidities. When the patient does not immediately respond, a broader target range through JAKs pathway inhibitors may be indicated. Conclusions: Herein, we discuss the biological background associated with distinct comorbidities which might impact the SARS-CoV-2 infection course and how these should to be addressed to improve the current therapeutic outcome.

2023-01-01T00:00:00Z https://hdl.handle.net/10807/339986 2026-06-21T15:00:03Z 2026-01-01T00:00:00Z

Titolo: Clinical and serological features of triple autoantibody-negative patients with systemic sclerosis: insights from the multicentric SPRING registry of the Italian Society for Rheumatology Autori: Batani V.; Cavazzana I.; Orlandi M.; De Angelis R.; Campochiaro C.; De Lorenzis E.; Natalello G.; Verardi L.; Bajocchi G.; Bellando-Randone S.; Zanframundo G.; Foti R.; Cacciapaglia F.; Cuomo G.; Ariani A.; Rosato E.; Lepri G.; Girelli F.; Riccieri V.; Zanatta E.; Ingegnoli F.; De Santis M.; Murdaca G.; Abignano G.; Giorgio P.; Della Rossa A.; Caminiti M.; Iuliano A. M.; Beretta L.; Bagnato G.; Lubrano E.; De Andres I.; Idolazzi L.; Bruni C.; Fornaro M.; Saracco M.; Agnes C.; Cipolletta E.; Lumetti F.; Spinella A.; De Pinto M.; Magnani L.; Codullo V.; Visalli E.; Iandoli C.; Gigante A.; Pellegrino G.; Pigatto E.; Lazzaroni M. -G.; Franceschini F.; Motta F.; Tonutti A.; Mennillo G.; Di Battista M.; Mariano G. P.; Furini F.; Vultaggio L.; Parisi S.; Peroni C. L.; Bianchi G.; Fusaro E.; Sebastiani G. D.; Govoni M.; D'Angelo S.; Cozzi F.; Guiducci S.; Doria A.; Salvarani C.; Iannone F.; D'Agostino M. A.; Bosello S. L.; Dagna L.; Giuggioli D.; Ferri C.; Matucci Cerinic M.; De Luca G. Abstract: Background: Antitopoisomerase I (ATA), anticentromere (ACA) and anti-RNA polymerase III (RNAP3) antibodies are included in the 2013 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for systemic sclerosis (SSc). A subset of patients with SSc satisfy criteria but may lack these specific autoantibodies, being classified as ‘triple-negative’. Methods: We conducted a retrospective evaluation of triple-negative patients with SSc prevalence and clinical features among the multicentric Systemic sclerosis Progression INvestiGation registry. Results: Out of 1480 patients with SSc, 295 (19.9%) were triple-negative, while 1185 (81.1%) had SSc-specific antibodies: ACA (54.3%), ATA (43.6%) and RNAP3 (2.1%). The triple-negative group showed a higher prevalence of myopathy (16.7% vs 10.1%, p=0.003), suggested by higher creatine phosphokinase (CPK) levels (126.2 vs 92.5 U/mL, p=0.002), more frequent CPK increase over 2–3 times (2.4% vs 0.2%, p=0.028). Triple-negative patients also exhibited fewer vascular complications, including digital ulcers (17.3% vs 22.8%, p=0.04) and calcinosis (8.2% vs 12.8%, p=0.027), and a higher prevalence of interstitial lung disease (p<0.001). Consistently, lower diffusing capacity for carbon monoxide (66.4% vs 70.98%, p=0.004) and forced vital capacity (97.01% vs 102.92%, p<0.001) were found in the triple-negative group. Triple-negative patients more frequently received corticosteroids (79.3% vs 67.9%, p=0.003), cyclophosphamide (43.4% vs 26%, p<0.001) and azathioprine (38.5% vs 22.3%, p=0.002), while less frequently received prostanoids (71.6% vs 85.9%, p<0.001), calcium channel blockers (80.1% vs 87.7%, p=0.005) and phosphodiesterase-5 inhibitors (4% vs 20%, p<0.001). Conclusions: A higher prevalence of myopathy and interstitial lung disease and a reduced vascular burden were found in the triple-negative patients, suggesting that the non-specific and non-routinely tested autoantibodies may identify an SSc endotype resembling sclero-myositis.

2026-01-01T00:00:00Z