Internal Medicine, Cell Biology, Immunology and Allergy, Rheumatology
71
Scopus Publications
Scopus Publications
Macrophage Extracellular Traps in the Oral Mucosa: Autoimmune Disease and Platelet-Derived Epithelial Modulation Stelvio Tonello, Nicole Vercellino, Davide D’Onghia, Marco Bagnati, Daniele Sola, et al. Life, 2026 Extracellular traps (ETs) are immune-derived chromatin networks initially described as antimicrobial barriers but increasingly recognized as modulators of tissue homeostasis and autoimmunity. The oral mucosa, constantly exposed to inflammatory stimuli, is particularly sensitive to ET-mediated remodeling (extracellular traps-mediated remodeling). In this study, we investigated how platelet-rich plasma (PRP), platelet-poor plasma (PPP), and washed platelets (WPT), widely used in regenerative medicine, influence ETosis in monocytes and macrophages, and how these ETs modulate the responses of primary buccal keratinocytes (pBMKs). ETs were induced in monocytes/macrophages using PRP, PPP, and WPT. pBMKs were exposed to ET-rich supernatants, and proliferation was monitored in real time through a live cell imaging system. ETs derived from PRP, PPP, and WPT did not induce either a statistically significant proliferation or morphological changes in buccal keratinocytes. These findings suggest that both platelet-derived products (PRP, PPP, WPT) and ETs play a crucial role in modulating epithelial biology, thus suggesting their possible role in chronic autoimmune diseases characterized by persistent inflammation and epithelial remodeling.
The Role of Obstructive Sleep Apnea and CPAP Therapy in the Functional Hypogonadism of Male Patients With Severe Obesity Alessandro Amodeo, Biagio Cangiano, Nicoletta Del Duca, Alessandro Chilà, Antonio Musolino, et al. Journal of Clinical Endocrinology and Metabolism, 2026 Context Only a few studies have reported a correlation between severe obstructive sleep apnea syndrome (OSAS) and hypogonadism in patients with obesity, regardless of body mass index (BMI). However, longitudinal studies exploring the role of continuous positive airway pressure (CPAP) on gonadal function are scanty. Objective This work aimed to investigate in men with severe/complicated obesity the role of OSAS in decreasing testosterone levels and evaluate the effects of CPAP on hormonal status. Methods This cross-sectional study consecutively enrolled 204 male inpatients with complicated severe obesity, without known hypogonadism. Polysomnography (or overnight oximetry during CPAP) and blood tests for inflammation and metabolic and hormonal profiles were performed. “Decompensated OSAS” was defined as an Apnea/Hypopnea Index (AHI) in newly diagnosed, or Oxygen Desaturation Index (ODI) in treated patients, above 30 events/hour. A multiple linear regression was implemented to identify the independent factors correlated with total testosterone (TT). Lastly, a longitudinal study of 14 newly diagnosed patients was performed to evaluate the effects of CPAP on TT after 3 months of treatment. Results A total of 127 of 204 patients showed low TT (≤10.4 nmol/L). BMI, type 2 diabetes, C-reactive protein, and decompensated OSAS were independently associated with TT (P = .039; P = .006, P = .003, and P = .014, respectively). After 3 months of CPAP therapy, TT was higher (P = .009) and ODI was associated with such improvement, independently of BMI (P = .04). Conclusion Decompensated OSAS was found to correlate with low testosterone in men with severe obesity. Moreover, CPAP therapy was shown to improve TT independently of BMI changes.
Hazard and determinants of dropout and rehospitalization in patients with obesity after residential rehabilitation Daniele Sola, Samuele Minari, Raffaella Sabatino, Davide Soranna, Elisa Prina, et al. Journal of Endocrinological Investigation, 2026 Purpose To identify clinical and sociodemographic factors that predict follow-up discontinuation and rehospitalisation after multidisciplinary residential rehabilitation for severe obesity, thereby defining high-risk patient profiles and guiding tailored retention strategies. Methods We retrospectively followed 1,851 adults with obesity discharged from a multidisciplinary residential programme between 2015 and 2018 (median BMI 42 kg m⁻²). Dropout, defined as more than twelve months without contact, was studied with discrete-time survival models; time to rehospitalisation was analysed with Cox regression. Results Within twelve months 1,513 patients (87%) discontinued follow-up. Each five-year increase in age lowered drop-out risk (HR 0.97, 95% CI 0.94–0.99, p = 0.004); diabetes had a similar protective effect (HR 0.89, 0.79–1.00, p = 0.0455). Rehospitalisation occurred in 591 patients (32%). Risk increased with age (5-years increment; HR = 1.05, 95% CI 1.01–1.09, p = 0.0191), baseline BMI (HR = 1.04, 95% CI 1.03–1.05, p < 0.0001), diabetes (HR = 1.22, 95% CI 1.02–1.30, p = 0.0306) and eating disorders (HR = 1.48, 95% CI 1.07–2.05, p = 0.0193). Discussion Maintaining the benefits of residential rehabilitation is important. In our cohort, 87% of patients dropped out of follow-up within one year and 32% were readmitted. Two distinct profiles emerged: younger and non-diabetic subjects were prone to dropout, while patients with higher BMI, diabetes, or eating disorders were at higher risk of rehospitalization. Early identification of these groups may suggest flexible, technology-assisted follow-up for working-age patients and integrated metabolic-psychiatric care for complex cases, safeguarding outcomes and optimizing resources.
Extracellular Traps in Inflammation: Pathways and Therapeutic Targets Stelvio Tonello, Nicole Vercellino, Davide D’Onghia, Alessia Fracchia, Giulia Caria, et al. Life, 2025 New roles for immune cells, overcoming the classical cytotoxic response, have been highlighted by growing evidence. The immune cells, such as neutrophils, monocytes/macrophages, and eosinophils, are versatile cells involved in the release of web-like DNA structures called extracellular traps (ETs) which represent a relevant mechanism by which these cells prevent microbes’ dissemination. In this process, many enzymes, such as elastase, myeloperoxidase (MPO), and microbicidal nuclear and granule proteins, which contribute to the clearance of entrapped microorganisms after DNA binding, are involved. However, an overproduction and release of ETs can cause unwanted and dangerous effects in the host, resulting in several pathological manifestations, among which are chronic inflammatory disorders, autoimmune diseases, cancer, and diabetes. In this review, we discuss the release mechanisms and the double-edged sword role of ETs both in physiological and in pathological contexts. In addition, we evaluated some possible strategies to target ETs aimed at either preventing their formation or degrading existing ones.
Use, misuse and abuse of diuretics Ettore Bartoli, Luca Rossi, Daniele Sola, Luigi Castello, Pier Paolo Sainaghi, et al. European Journal of Internal Medicine, 2016
