alessandra colantoni

@ausl.bologna.it

emergency department ospedale maggiore bologna
ausl bologna emergency department

Her training in Hepatology included mentorship under esteemed physicians Giovanni Gasbarrini, MD, and Mauro Bernardi, MD, in Bologna and later under David H. Van Thiel, MD, in the United States. During her time in the U.S. (1993-2002), she enhanced her clinical training with extensive basic science research, collaborating with renowned scientists such as Elizabeth Kovacs, PhD; Robert Floyd, PhD; Judith Gavaler, PhD; Pamela Witte, PhD; MaryAnn Emanuele, MD; and Richard Gamelli, MD, in the fields of aging, free radical biology, cytokine biology, and alcohol research.
She practiced as an Emergency Room physician at Policlinico of Modena Hospital. Since 2017, she is a senior physician in the Emergency Department of Maggiore Hospital, AUSL of Bologna,

EDUCATION

Alessandra Colantoni, born in Bologna, Italy, in November 1966, attended the University of Bologna School of Medicine. She obtained her MD degree cum laude in 1992. She is a specialist in Geriatrics with a Master’s degree in Hepatology and Transplant Medicine.

RESEARCH, TEACHING, or OTHER INTERESTS

Geriatrics and Gerontology, Emergency Medicine, Hepatology

FUTURE PROJECTS

GERIATRIC EMERGENCY MEDICINE

DISSEMINATION OF GERIATRIC CULTURE IN THE EMERGENCY DEPARTMENT. MULTIDISCIPLINARY APPROACH


Applications Invited
78

Scopus Publications

Scopus Publications

  • The early acute phase response after burn injury in mice
    Timothy P. Plackett, Alessandra Colantoni, Scott A. Heinrich, Kelly A. N. Messingham, Richard L. Gamelli, and Elizabeth J. Kovacs

    Oxford University Press (OUP)
    In the hours immediately after burn injury, the body enters into an acute phase reaction characterized, in part, by the augmentation of cytokine and acute phase protein production. This reaction has been poorly characterized in the 24 hours immediately after injury. To better understand the early acute phase response, 8- to 10-week-old BALB/C female mice were subjected to a 15% total body surface area (TBSA). Hepatic levels of tumor necrosis factor-α, interleukin-1β, and interleukin-6 were monitored. In addition, the circulating level of serum amyloid A, an acute phase protein, also was measured at the same time points. Tumor necrosis factor-α levels peaked 2 hours after burn injury, whereas interleukin-1β had a biphasic response, increasing 2 hours after injury and again at 12 hours. Interleukin-6 and serum amyloid A were not increased until 12 hours after injury and began to decline at 24 hours. These results demonstrate that within the liver, the acute phase response after burn injury initially involves tumor necrosis factor-α and interleukin-1β, whereas interleukin-6 is not involved until later and that systemic serum amyloid A levels are not increased until interleukin-6 is also increased.

  • Lymphoproliferative disorders in chronic hepatitis C
    R. Idilman, A. Colantoni, N. De Maria, S. Alkan, S. Nand, and D. H. Van Thiel

    Wiley
    Summary.  Chronic hepatitis C virus (HCV) infection is associated with the development of lymphoproliferative disorders (LPDs). The aim of this investigation was to determine the prevalence and characterization of monoclonal gammopathy and benign and malignant LPDs in individuals with chronic hepatitis C. A total of 233 subjects diagnosed with chronic hepatitis C (male/female ratio: 131/102, median age; 49 years) were studied. Serum and urine were examined for the presence of a monoclonal gammopathy. A bone marrow aspirate and biopsy was obtained in individuals with a monoclonal gammopathy. Thirty‐two patients (13.7%, 32 of 233) had a monoclonal gammopathy; 75% of them were benign and were not associated with malignant disorders (24 of 32) while 25% were associated with malignant LPDs or a plasma cell disorder (eight of 32). Two additional subjects without monoclonal gammopathy were diagnosed as having a malignant LPDs. The prevalence of malignant LPDs/plasma cell disorder in individuals with HCV‐induced chronic liver disease was 4.3%. No difference was found in terms of disease duration, HCV genotype, viral load, alanine aminotransferase level or histopathologic score between the subjects with or without a monoclonal gammopathy. The presence of mixed cryoglobulinaemia was strongly associated with the presence of an underlying malignant disorder. Hence a monoclonal gammopathy is found in 14% of patients with chronic hepatitis C and is associated with malignant B‐cell LPD in more than a quarter of such patients. The prevalence of LPDs in individuals with HCV‐induced chronic liver disease is greater than that of the normal healthy population.

  • Hepatic apoptosis and proliferation in male and female rats fed alcohol: Role of cytokines
    Alessandra Colantoni, Ramazan Idilman, Nicola De Maria, Nancy La Paglia, Joseph Belmonte, Frederick Wezeman, Nicholas Emanuele, David H. Van Thiel, Elizabeth J. Kovacs, and Mary Ann Emanuele

    Wiley
    Background: The female liver is more sensitive to the toxic effect of chronic alcohol intake than the male liver. The aim of the study was to compare the influence of gender and sex hormonal status on apoptosis and cell proliferation following chronic ethanol intake.Methods: Male and female rats were pair fed for 8 weeks a liquid diet containing 36% of their total daily calories as ethanol (ETOH group) or sucrose (control group). Liver samples were analyzed for apoptosis and hepatocyte proliferation by immunohistochemistry. The hepatic production of factors able to influence cell death and proliferation, such as tumor necrosis factor alpha (TNFα) and interleukin 6 (IL‐6) were determined.Results: In both male and female rats, ethanol intake promoted apoptosis in the liver. This effect of ethanol was more evident in female than male rat livers. Hepatic TNFα levels, which promote apoptosis, are significantly more elevated in female than in male livers. Hepatic IL‐6 production, which promotes hepatocyte proliferation, was induced by ethanol only in males, but not female animals.Conclusion: This observed difference in cytokine responses may contribute to the enhanced sensitivity of female liver to EtOH‐induced injury.

  • Elevated monocyte chemoattractant protein-1 levels following thermal injury precede monocyte recruitment to the wound site and are controlled, in part, by tumor necrosis factor-α
    Scott A. Heinrich, Kelly A. N. Messingham, Meredith S. Gregory, Alessandra Colantoni, Ahalia M. Ferreira, Luisa A. Dipietro, and Elizabeth J. Kovacs

    Wiley
    In previous studies, mice given a full‐thickness scald injury had an influx of neutrophils into the skin that followed a local increase in a neutrophil chemoattractant. Because macrophages are known to infiltrate the wound area after neutrophils and are essential for normal wound repair, studies were designed to characterize the time course of macrophage accumulation in the wound and to identify the factor(s) responsible for this influx. A macrophage infiltrate into the wound was observed at 4 days post‐injury and persisted through at least 10 days. This influx was preceded by an initial fourfold increase in dermal monocyte chemoattractant protein‐1 levels at 24 hours post‐injury (p < 0.05). This elevation in monocyte chemoattractant protein‐1 was enhanced at 4 and 10 days postburn resulting in a sixfold increase over baseline (p < 0.01). Levels of tumor necrosis factor‐α, a proinflammatory cytokine known to induce chemokine production, were elevated at 90 minutes after injury in burn‐ versus sham‐injured groups (p < 0.05). Furthermore, administration of tumor necrosis factor‐α neutralizing antibody in vivo reduced the dermal levels of monocyte chemoattractant protein‐1 seen at 10 days postburn by 57% (p < 0.01); however, macrophage accumulation was not altered. Thus, elevated systemic TNF‐α levels may influence the local chemokine milieu following burn injury. (WOUND REP REG 2003;11:110–119)

  • Estrogen receptor classification for hepatocellular carcinoma: Comparison with clinical staging systems
    Erica Villa, Alessandra Colantoni, Calogero Cammà, Antonella Grottola, Paola Buttafoco, Roberta Gelmini, Ilva Ferretti, and Federico Manenti

    American Society of Clinical Oncology (ASCO)
    Purpose: Several scoring systems to evaluate patients with hepatocellular carcinoma (HCC) exist. A good scoring system should provide information on prognosis and guide therapeutic decisions. The presence of variant liver estrogen receptor (ER) transcripts in the tumor has been shown to be the strongest negative predictor of survival in HCC. The aim of this study was to compare the predictive value of the commonly applied clinical scoring systems for survival of patients with HCC with that of the evaluation of ER in patients with HCC (molecular scoring system). Materials and Methods: HCC was staged according to the Okuda classification, Barcelona Clinic Liver Cancer classification, Italian classification system (CLIP), French classification, and ER status in 96 patients. Analysis of survival was performed according to the Kaplan-Maier test and was made for each classification system and ER. A comparison between classifications was made by univariate and multivariate analysis. Results: Among the clinical classification systems, only the CLIP was able to identify patient populations with good, intermediate, and poor prognosis. On multivariate analysis, ER classification was shown to be the best predictive classification for survival of patients with HCC (P <.0001). This difference was the result of a better allocation of patients with ominous prognosis (variant ER) having nevertheless good clinical score. Conclusion: The evaluation of the presence of wild-type or variant ER transcripts in the tumor is the best predictor of survival in patients with HCC. Its accuracy in discriminating patients with good or unfavorable prognosis is significantly greater than that of the commonly used scoring systems for the staging of HCC.

  • Impaired response to 5mU/day interferon treatment in African-Americans with chronic hepatitis C
    Alessandra Colantoni, Nicola De Maria, and David H. Van Thiel

    Elsevier

  • Impaired antibody response rates after high dose short interval hepatitis B virus vaccination of immunosuppressed individuals


  • ALEX® (artificial liver for extracorporeal xenoassistance): A new bioreactor containing a porcine autologous biomatrix as hepatocyte support. Preliminary results in an ex vivo experimental model
    G. Ambrosino, S. Varotto, S. Basso, D. Galavotti, A. Cecchetto, P. Carraro, A. Naso, G. De Silvestro, M. Plebani, G. Giron,et al.

    SAGE Publications
    Long-term maintenance of viability and expression of differentiated hepatocyte function is crucial for bioartificial liver support. We developed a new bioreactor design (ALEX®), associated with a new extracellular autologous hepatocyte biomatrix (Porcine Autologous Biomatrix - PBM) support. To test this new bioreactor, we compared it to a standard BAL (Bio-Artificial Liver) cartridge in a ex vivo model using human plasma added to bilirubin, ammonium and lidocaine. A pathology study was performed on both bioreactors. The results suggest that ALEX® allows a maximal contact between the perfusing plasma and the liver cells and a proper hepatocyte support by a cell-to-matrix attachment. ALEX® is a suitable cell support bioreactor, guaranteeing long-term maintenance of the metabolic activity of hepatocytes when compared to a standard BAL cartridge.

  • Variant estrogen receptors and their role in liver disease
    Erica Villa, Alessandra Colantoni, Antonella Grottola, Ilva Ferretti, Paola Buttafoco, Helga Bertani, Nicola De Maria, and Federico Manenti

    Elsevier BV

  • Estrogens receptors and oxidative damage in the liver
    Fabio Farinati, R Cardin, M Bortolami, A Grottola, M Manno, A Colantoni, and E Villa

    Elsevier BV

  • Hepatic estrogen receptors and alcohol intake
    Alessandra Colantoni, Mary Ann Emanuele, Elizabeth J Kovacs, Erica Villa, and David H Van Thiel

    Elsevier BV

  • Bronchoalveolar lavage fluid analysis in individuals with chronic hepatitis C
    Ramazan Idilman, Hülya Çetinkaya, İsmail Savaş, Nuray Aslan, Serpil Dizbay Sak, Mehmet Baştemir, Mustafa Sarioğlu, İrfan Soykan, Mithat Bozdayı, Alessandra Colantoni,et al.

    Wiley
    AbstractA number of disorders for which an association with hepatitis C virus infection exist. These disorders include essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and idiopathic pulmonary fibrosis. This study was initiated to investigate the cellular content and lymphocyte subpopulations of bronchoalveolar lavage fluid obtained from individuals with chronic hepatitis C and to compare the results to those of controls. Eighteen patients with chronic hepatitis C (male/female, 6/12) and 14 healthy volunteers (male/female, 6/8), were studied. Bronchoalveolar lavage fluid was obtained from each; and the lymphocyte subtypes and the presence of HCV‐RNA in the bronchoalveolar lavage fluid were determined. All anti‐HCV positive subjects were HCV‐RNA positive in serum. One (5.6%) had a HCV‐RNA positive bronchoalveolar lavage. The total cell and neutrophil counts of the bronchoalveolar lavage fluid were significantly greater in patients with chronic hepatitis C as compared to controls (5,799.6 ± 957.4 × 103/ml vs. 1,835.7 ± 447.8 × 103/ml, P = 0.001; 1,175.8 ± 634.7 × 103/ml vs. 53.1 ± 28.1 × 103/ml, P = 0.029). In contrast, the lymphocyte, macrophage and eosinophil counts did not differ. No difference in the percentage, median or range of individual T cell subsets or B cell numbers in the bronchoalveolar lavage fluid existed between the groups. It is concluded that hepatitis C virus infection may be associated with an occult pulmonary inflammatory reaction manifested by an increased number of polymorphonuclear neutrophils in bronchoalveolar lavage fluid. This finding may contribute to the process that leads to idiopathic pulmonary fibrosis seen in a minority of cases of chronic hepatitis C. J. Med. Virol. 66:34–39, 2002. © 2002 Wiley‐Liss, Inc.

  • Development of a new bioartificial liver using a porcine autologous biomatrix as hepatocyte support
    Giovanni Ambrosino, Sergio Varotto, M. M. Stefano Basso, Daniele Galavotti, Attilio Cecchetto, Paolo Carraro, Agostino Naso, Giustina De Silvestro, Mario Plebani, Gianpiero Giron,et al.

    Ovid Technologies (Wolters Kluwer Health)
    Long-term maintenance of hepatocyte viability and differentiated function expression is crucial for bioartificial liver support. The maintenance of hepatocyte function in a bioreactor is still a problem. A major advance was the recognition that hepatocytes in attachment cultures can maintain their differentiation longer. To restore hepatocyte polarity and prolong their function, we developed a new bioreactor with a cross-flow geometry configuration and an original hepatocyte extracellular autologous biomatrix (Porcine Bio-Matrix) support. To test this new bioreactor, we compared it with a standard bioartificial liver cartridge in a suitable surgical model of acute liver failure in pigs. In our model, we performed a total hepatectomy, followed by partial liver transplantation after an 18 hour anhepatic phase. The results showed that the bioreactor containing the biomatrix was able to bridge the animal to transplantation and to sustain the transplanted liver until all function recovered (80% of animals survived, p = 0.0027). No animal survived more than 24 hours after liver transplantation in the group treated with the traditional bioartificial liver, whereas hepatocyte viability on the Porcine Bio-Matrix was 65% after 12 hours of treatment. The results suggest that our biomatrix is a suitable cell support and guarantees long-term maintenance of metabolic activity of hepatocytes. Further studies are needed, but the results obtained with this new three-dimensional bioreactor are promising, and its potential is attractive.

  • Liver transplantation for fulminant hepatic failure
    David H. Van Thiel, John Brems, Abdul Nadir, Ramazan Idilman, Alessandra Colantoni, David Holt, and Steven Edelstein

    Springer Science and Business Media LLC

  • Hepatocellular carcinoma: Role of estrogen receptors in the liver
    ERICA VILLA, ANTONELLA GROTTOLA, ALESSANDRA COLANTONI, NICOLA DE MARIA, PAOLA BUTTAFOCO, ILVA FERRETTI, and FEDERICO MANENTI

    Wiley
    Abstract: Experimental and clinical evidence indicates that estrogens have a relevant role in the pathogenesis of cancer of hormone‐sensitive organs. Estrogen receptors (ERs) are present in liver cells. Normal liver expresses almost exclusively wild‐type ERs derived from the full‐length transcript of the gene. During progression of liver disease to hepatocellular carcinoma, variant forms of ERs have been demonstrated that greatly influence the course of the disease and the possibility of palliative treatment. Peritumoral cirrhotic tissue of patients with hepatocellular carcinoma, especially males, expresses a variant form of ER (vER) with an exon 5 deletion. In hepatocellular carcinoma, vER largely predominates and sometimes becomes the only form expressed. That the occurrence of vER alone is limited almost exclusively to males suggests that it could be one of the molecular events that eventually lead to the preferential development of hepatocellular carcinoma in males. In addition, the presence of vER appears most frequently in patients infected with the hepatitis B virus. The growth rate of hepatocellular carcinoma in patients with vER is also significantly higher than that in patients with tumors expressing wtER.


  • Pretransplantation pre-S2 and S protein heterogeneity predisposes to hepatitis B virus recurrence after liver transplantation
    A Grottola

    Ovid Technologies (Wolters Kluwer Health)
    Liver transplantation (LT) in patients with hepatitis B virus (HBV) infection often is complicated by recurrence of infection despite immunoglobulin treatment. To evaluate whether variability in HBV genomic sequences and the target of antibody to hepatitis B surface antigen action in pre‐LT samples may be associated with a high recurrence rate, HBV pre‐S/S regions of 14 HBV‐positive candidates for LT (in 9 of these patients, HBV infection subsequently recurred) were amplified and sequenced. Two hundred ninety‐one mutations in 1,167 sequenced nucleotides (24.9%) were found. Of these, 120 mutations (10.2%) led to an amino‐acid change. The only significant difference between patients with and without recurrent disease was in the number of mutations in the pre‐S2 region (total mutations, P = .042; missense mutations, P = .012) of pre‐LT HBV DNA. In addition, a difference in amino‐acid level was present in the pre‐S2 region (P = .030). The delay in HBV infection recurrence was proportional to the number of pre‐LT HBV mutations in the pre‐S2 and S genes: the higher the number, the longer the interval between LT and recurrence of infection (pre‐S2, P = .0124; S, P = .0060; total number of mutations in S protein, P = .0421). In conclusion, pre‐LT determination of pre‐S/S gene sequence variability showed that heterogeneity of the pre‐S2 and, to a lesser extent, S genes was associated with a greater chance for HBV recurrence. Modification of B‐cell epitopes of S, but especially of pre‐S2, protein leading to conformational changes and alterations in the viral encapsidation and secretion process may facilitate HBV recurrence and contribute to the failure of immune globulin therapy.

  • Impaired response to high-dose interferon treatment in African-Americans with chronic hepatitis C


  • Reply to: A cut-off serum creatinine value of 1.5mg/dl for AKI To be or not to be
    Claudia Fagundes, Rogelio Barreto, Ezequiel Rodríguez, Isabel Graupera, Esteban Poch, Elsa Solà, Javier Fernández, and Pere Ginès

    Elsevier BV

  • Reply
    E Villa, N De Maria, A Colantoni, M Manno, and H Bertani

    Springer Science and Business Media LLC


  • Liver transplantation for fulminant hepatic failure
    David H. Van Thiel, John Brems, Abdul Nadir, Ramazan Idilman, Alessandra Colantoni, David Holt, and Steven Edelstein

    Springer Science and Business Media LLC

  • Increased effective immunogenicity to high-dose and short-interval hepatitis B virus vaccination in individuals with chronic hepatitis without cirrhosis
    N. De Maria, R. Idilman, A. Colantoni, and D. H. Van Thiel

    Wiley
    Hepatitis B virus (HBV) vaccination is recommended for individuals with chronic liver disease. However, the response to standard doses of hepatitis B vaccines in such individuals has been poor. The aim of the present study was to assess the response to high‐dose short‐interval HBV vaccination in individuals with chronic liver disease of different aetiologies. A total two hundred and 24 subjects with chronic liver disease (138 chronic active hepatitis and 86 cirrhosis) and 26 healthy controls were vaccinated using a high‐dose (40 μg) short‐interval (monthly for 3 consecutive months) HBV vaccination schedule.One hundred and thirty‐eight of the 224 subjects with chronic liver disease (62%) seroconverted to anti‐HBs antibody positivity (>10 mIU/mL) after the third dose of vaccine as compared with 24 of the 26 controls (92%) (P < 0.01). The response rate was reduced in individuals with cirrhosis (36/86, 42%), particularly in alcohol‐induced cirrhosis (2/17, 12%), as compared with individuals with chronic hepatitis (102/138, 74%) (P < 0.001). No significant HBV vaccination‐related adverse effects were seen in individuals with or without cirrhosis as well as in the controls.High‐dose short‐interval HBV vaccination is safe and efficacious in individuals with chronic liver disease. The response to HBV vaccination is reduced in cirrhotics, particularly those with alcoholic cirrhosis. These data suggest that HBV vaccination should be accomplished early in an individual cause of chronic liver disease prior to the development of cirrhosis.

  • Effect of human immunodeficiency virus on the outcome of hepatitis C virus infection
    Ramazan Idilman, Alessandra Colantoni, Nicola De Maria, James M. Harig, and David H. van Thiel

    Informa UK Limited

  • Peripubertal paternal EtOH exposure: Testicular oxidative injury, fecundity, and offspring
    Nicholas V Emanuele, Nancy LaPaglia, Jennifer Steiner, Allessandra Colantoni, David H Van Thiel, and Mary Ann Emanuele

    Springer Science and Business Media LLC