Search

The Endo-Bronchial UltraSound-guided TransBronchialNeedle Aspiration (EBUS-TBNA) is appropriated for diagnosis, staging and molecular typing of primary pulmonary or metastatic cancer, and for cystic, infective or granulomatous disease of the mediastinum. The EBUS-TBNA enables, usually, the determination of oncological markers when necessary. The procedure is done in local anesthesia and in moderate sedation with the monitoring of life parameters. We analyzed retrospectively 246 patients, subjected to EBUS-TBNA between October 2014 and December 2017, in our structure. The scope of our study is to evaluate the adequacy and diagnostic yield of the method, both in its entirety and as a function of indication and of the biopsied nodale station. The reliability of negative results has been evaluated with at least 6 months of clinical-radiological follow-up. Sedation, safety and learning curve have also been evaluated. The sample turned out adequate in 91% of cases and it was diagnostic in 59% overall. In 6 negative cases EBUSTBNA has been repeated and it has resulted positive for neoplasia. Two cases were false negative at follow-up. At last 26 negative cases resulted un-note at the end of the 6 months. Totally 318 target sites were biopsied: 92% lymph nodes and 8% mediastinum-pulmonary lesion. The EBUS-TBNA was diagnostic in 59% of the patients with suspected neoplasia. It allowed a reliable staging, controlled by follow-up in 83% of the cases with this indication, and it confirmed the diagnosis of sarcoidosis in 94% of the cases with this indication. The adequacy was not significantly associated with the lymph node's stations or with the method of sedation, besides, in our study, there was not a learning curve. The limits of our study was the retrospective nature, the monocentricity, and the loss of patients during follow-up. [ABSTRACT FROM AUTHOR]

Reactive oxygen species (ROS) are suggested to play a role in the pathogenesis of contagious bovine pleuropneumonia, a severe respiratory disorder caused by Mycoplasma mycoides subsp. mycoides ( Mmm ). The present study investigated the generation of ROS by different strains of Mmm , as well as their effect on the oxidative response of bovine neutrophils. The production of ROS was indirectly measured using a luminol-based chemiluminescence assay. Our results confirm that Mmm can produce ROS via the metabolism of glycerol, significant differences existing between African and European strains. Mmm was capable of adhering to the external surface of neutrophils. Interestingly, Mmm enhanced the respiratory burst of bovine neutrophils. This activity was particularly pronounced with the African field strain and in presence of glycerol. Taken together, our data argue in favour of a major role for neutrophils as the main source of ROS in contagious bovine pleuropneumonia. [ABSTRACT FROM AUTHOR]

Post-weaning multisystemic wasting syndrome (PMWS) is a relevant, worldwide disease caused by porcine circovirus type 2 (PCV2). Microscopically, PMWS is mainly characterized by lymphocytic depletion, macrophage infiltration and syncytia in lymphoid tissues. Some data suggest that follicular dendritic cells (FDCs) could be infected by PCV2, thus likely playing a role in the pathogenesis of PMWS. The present paper aims at assessing, qualitatively and quantitatively, the FDCs' network in the soft palate tonsils of clinically healthy and PMWS-affected pigs. Consecutive tissue sections were tested by immunohistochemistry to detect PCV2, FDCs and macrophages. FDCs and PCV2 antigens were quantitatively assessed by means of the Image J software and results submitted to statistical analysis. Our data demonstrated that FDCs are significantly reduced in PMWS-affected pigs compared with healthy pigs and that FDCs' depletion should be considered among microscopic features of PMWS. It is reasonable to hypothesize that depletion of FDCs further compromises the immune response and enhances the occurrence and the severity of secondary infections, which are relevant for the clinical manifestation of PMWS. [ABSTRACT FROM AUTHOR]

Abstract: Enzootic pneumonia by Mycoplasma hyopneumoniae and pleuropneumonia by Actinobacillus pleuropneumoniae are among the most common and economically relevant pulmonary diseases in swine herds. We herein investigated the activity and expression of 5-lipoxygenase (5-LOX) and cyclooxygenase-2 (COX-2) in healthy and diseased porcine lungs, by means of immunohistochemical, immunochemical and biochemical assays. Diseased lungs showed a significantly higher activity and expression of 5-LOX and COX-2 in a wide range of cell types, thus suggesting the likely involvement of both enzymes in the pathogenesis of bacterial porcine pneumonia. Consistently, increased enzyme activities were paralleled by increased leukotriene B4 (LTB4), a 5-LOX product and prostaglandin E2 (PGE2), a COX-2 product, content in diseased versus healthy lungs. [Copyright &y& Elsevier]

Abstract: Follicular dendritic cells (FDCs) residing within ileal Peyer’s patches (PPs) are of crucial relevance for sheep scrapie early pathogenesis and subsequent scrapie prion neuroinvasion. In this study, ileal PP follicles were significantly more numerous in lambs than in adult Sarda breed sheep, with significant differences being also found in lymphoid follicle area, perimeter and FDC density. Furthermore, PrPd deposition within ileal PPs and host’s PrP genotype did not significantly influence these parameters. We conclude that age significantly affects FDC density in ileal PPs from Sarda breed ovines, independently from host’s scrapie status and PrP genotype. [Copyright &y& Elsevier]

andida albicans is among the major agents of mucous membrane mycosis in humans and animals, with systemic and deep infections observed in immunocompromised hosts. We describe a case of fatal granulomatous myocarditis caused by C albicans in a 20-day-old canary (Serinus canaria). The etiologic diagnosis was confirmed by identifying characteristic morphologic features of the organism, combined with histochemical staining, and followed by the use of ad hoc biomolecular analysis. [ABSTRACT FROM AUTHOR]

Ileal Peyer’s patches (PPs) are involved early during sheep scrapie infection. This study qualitatively and semi-quantitatively evaluated ileal tract and PP innervation in 29 Sarda ovines of different age, PrP genotype and scrapie status. A prominent network of fibres was detected within PPs, mainly located in interfollicular lymphoid and stromal components. Intrafollicular fibres were rarely observed, with no apparent differences between scrapie-free and scrapie-affected animals, or among ovines carrying different PrP genotypes. In adult sheep, independent of their scrapie status, nerve fibres could be detected infrequently, close to the follicle-associated epithelium. Fibres were also detected within newly formed follicles and intrafollicular microgranulomas. [ABSTRACT FROM AUTHOR]

Innate and adaptive immunity plays a critical role in the defence of the lung and other mucosal surfaces exposed to micro-organisms. Anti-microbial peptides and proteins, cytokines and chemokines are important immune weapons as they build up the protective front for the respiratory tract. The notion that susceptibility to infectious diseases may be inherited is widely accepted and, as it is the failure to activate adaptive immunity that may allow infection to become established and progress toward invasion and dissemination, the recognition of specific gene defects affecting the ability of the immune system to overcome invading pathogens may shed light upon those mechanisms of immune regulation that are playing the most critical roles. The aim of the present review is to discuss some of the advances in infection immunogenetics that may lead to identify new strategies in the development of new anti-infectious and anti-inflammatory drugs. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Since 1987, at least eight morbillivirus infection (MI) epidemics have caused mass mortality of several free-living pinniped and cetacean populations around the world. The responsible agents, all belonging to the genus Morbillivirus (family Paramyxoviridae), have been characterized as either‘canine distemper virus’ strains, infecting pinnipeds, or as three new morbilliviruses, namely‘phocid (phocine) distemper virus’ ,‘porpoise morbillivirus’ and‘dolphin morbillivirus’ . The last two agents are currently gathered under the common denomination of‘cetacean morbillivirus’. At post-mortem examination, a commonly occurring macroscopic lesion is represented by more or less severe bilateral pneumonia, with consolidation, congestion and oedema of both lungs, which fail to collapse. Histologically, a non-suppurative broncho-interstitial pneumonia, characterized by type II pneumocyte hyperplasia and by formation of endobronchial, endobronchiolar and endoalveolar‘Warthin–Finkeldey type’ syncytia, as well as a multifocal, non-suppurative encephalitis, associated with a severe and generalized lymphoid tissue depletion, are common pathological findings. Furthermore, eosinophilic viral inclusions are often detected, at both the intracytoplasmic and intranuclear level, within bronchial and bronchiolar epithelial, pulmonary syncytial, neuronal and other cell types. These inclusions, along with lymphoid and other cellular elements, are often found to be immunohistochemically positive for morbillivirus antigen. Among the still debated, or even controversial issues regarding MI in sea mammals, the one related to the origin of their causative agents is of particular concern. Another intriguing issue regards the synergistic effects, if any, associated with chronic exposure to a number of environmental pollutants, such as organochlorines and heavy metals. In fact, it is also unknown whether and how these chemicals contribute towards modulating the pathogenic and pathogenetic activity primarily displayed by sea mammal morbilliviruses. [ABSTRACT FROM AUTHOR]

Background and Objective: Sarcoidosis can manifest with atypical findings on chest computed tomography (CT). Cysts are a rare manifestation of lung sarcoidosis. The aim of the study was to describe a series of patients with cystic sarcoidosis and their clinical‐radiological characteristics and progression. Methods: In this retrospective, bicentric study we recruited all patients affected by sarcoidosis with lung cystic lesions at chest CT. We collected clinical characteristics, pulmonary tests and tracked number, distribution and size of the cysts at diagnosis and at the last evaluation. Results: Twelve patients (6 males, median age 53 years) were identified (prevalence: 1.9%; 95% Confidence Interval: 0.8%–2.9%). All patients presented multiple cystic lesions (median number: 14 [range: 2–216]) with a bilateral distribution in 10/12, micronodules and nodules in 11/12 and fibrotic lesions in 4/12. Seven patients had normal lung function test, three had an obstructive syndrome, one had a restrictive syndrome and one had coexistence of both. During follow‐up (median: 10 years [range 1–16 years]), an increase of the number of cysts was observed in four patients. At last evaluation, 3/12 patients experienced a decline of forced vital capacity >10% and 3/12 patients a decline of diffusing capacity for carbon monoxide (DLCO) >10%. A lower DLCO at diagnosis, and the presence of nodules or fibrotic lesions on CT were associated with an increase in the number of cysts. Conclusion: Cystic lung lesions are rare in patients with sarcoidosis and do not influence long term prognosis. Cystic lung lesions are rare in sarcoidosis (estimated prevalence: 1.9%; 95%CI: 0.8%–2.9%) and do not influence long term prognosis. [ABSTRACT FROM AUTHOR]

Smooth muscle cells are major components of bronchiolar wall. Bronchiolar smooth muscle is reported to increase in some veterinary pulmonary disorders, but such assumption is not supported by detailed morphometric analyses. The present investigation aimed at quantitatively evaluating bronchiolar smooth muscle in healthy and diseased pig lungs. Our results suggest that bronchiolar smooth muscle cells significantly modify in size and number under different disease conditions, namely parasitic bronchopneumonia and Mycoplasma hyopneumoniae-induced enzootic pneumonia. Further studies are needed in order to understand the pathogenesis and the functional impact of such changes. [ABSTRACT FROM AUTHOR]

Abstract: Porcine circovirus type 2 (PCV2) infection is distributed worldwide and PCV2-associated disease (PCVAD) is considered among the most economically relevant ones to the global swine industry. PCV2 is known to play a causal role in the porcine respiratory disease complex, usually in close association with a large plethora of other biologic agents. We describe herein a case of fatal parasitic bronchopneumonia by Metastrongylus elongatus in a PCV2-infected pig. Metastrongylosis may still represent a major concern for outdoor herds. Our recent experience suggests that a concurrent PCVAD condition may trigger metastrongylosis, which may subsequently result, at its turn, in severe, sometimes fatal, pulmonary disease. [Copyright &y& Elsevier]

Background: Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections. Case Presentation: We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled. Conclusions: The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established. [ABSTRACT FROM AUTHOR]

Pulse-wave Doppler (PWD) ultrasonography of the testicular artery was recently used to compare parameters in fertile and infertile males, or males with normal and abnormal semen quality, while no studies verified the concomitant histological feature of the testis. The experimental hypothesis of the present study was that the blood flow parameters measured by PWD at different levels of the testicular artery reflect sperm attributes evaluated on spermatozoa collected from the tail of the epididymis and testicular histological characteristics. Pulse-wave Doppler parameters were recorded on both testes from 16 dogs of unknown fertility. After routine castration, epididymal spermatozoa were collected and evaluated for sperm total and progressive motility, membrane integrity, and sperm morphology. Testes were submitted to histological and immunohistochemical evaluations to quantify microscopic attributes and connective tissue and vascular area extent, respectively. The findings showed that the increased PWD indexes were suggestive of testicular histological alteration since negative correlations were found between pulsatility index and resistive index, measured in the marginal testicular artery, and histological attributes such as the seminiferous epithelial thickness (R = −0.528, P = 0.016 and R = −0.554, P = 0.005, respectively) and the tubular area/total area ratio (R = −0.494, P = 0.024 and R = −0.563, P = 0.004, respectively). Some histological characteristics, such as tubular diameter, seminiferous epithelium thickness, and the tubular area/total area ratio of the testis are correlated with the percentage of primary abnormalities (R = −0.874, P = 0.001, and R = −0.847, P = 0.001, and R = - 0.865, P = 0.001, respectively). In testes with increased sperm primary abnormalities, higher pulsatility index was found compared with testes with normal spermatogenesis in supratesticular artery (1.07 ± 0.06 vs 0.82 ± 0.23, P < 0.05), marginal artery (0.73 ± 0.04 vs 0.61 ± 0.07, P < 0.05), and intratesticular artery (0.67 ± 0.03 vs 0.43 ± 0.1, P < 0.05). Similarly, the resistive index was found significantly higher in the same vessel tracts in testes with abnormal and normal spermatogenesis (0.62 ± 0.02, 0.53 ± 0.02, and 0.46 ± 0.02 vs 0.51 ± 0.06, 0.44 ± 0.04, and 0.32 ± 0.06, respectively; P < 0.05). Our data demonstrated for the first time the relationship between PWD indexes and the contextual testicular architecture, suggesting that the pulsatility and resistive indexes could be an effective tool in andrology. In light of different histological alterations in the testis, caution is warranted in the definition of thresholds for normal and abnormal testicular blood flow indexes. • The ultrasound blood flow parameters could be useful tools in andrology. • Relationships between PWD, epididymal sperm, and testicular histology were investigated. • Correlations between PI and RI and histological parameters were found. • PI and RI were higher in testis with abnormal spermatogenesis. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "A 49-year-old man with concurrent diagnosis of lung cancer, sarcoidosis, and multiple regions of adenopathy on positron emission tomography" by M. McNeill, T. B. Zanders and M. J. Morris in the February 2009 issue.

Ultrasound elastography was proposed for the evaluation of testicular focal lesions, but no studies verified the agreement between the whole histological architecture of the testis and the stiffness measured by elastography. The present study explored the use of strain elastography in the evaluation of testis with normal or abnormal spermatogenesis, classified based on epididymal sperm attributes, and the consistency between elastographic parameters and the testicular histological feature. Strain elastography was performed during the routine andrological examination in 22 dogs presented for elective orchiectomy. Epididymal sperm attributes and testicular histology were analyzed after orchiectomy. Based on the epididymal sperm characteristics, testes were classified according to normal or abnormal spermatogenesis, and strain elastographic attributes were compared between groups. Possible correlations between strain elastography and histological features were also explored. Consistent with the literature in humans, testes with abnormal spermatogenesis were stiffer (mean strain elastographic index 3.6 ± 0.6) compared with normal testes (mean strain elastographic index 1.9 ± 0.2; P < 0.01). The strain elastographic index was negatively correlated with the area occupied by seminiferous tubules (Pearson's rho = −0.716; P = 0.0003), the mean diameter (Pearson's rho = -0.742; P = 0.0002), and thickness of the seminiferous tubule (Pearson's rho = −0.728; P = 0.0002). Surprisingly, no correlations were found between the area occupied by connective tissue in histological sections and elastographic attributes, suggesting that the increased stiffness was not related to the increased amount of connective tissue. This study demonstrated that strain elastography could be used to support the andrological examination, but measurements should be acquired in specific regions to be reliable. • Strain elastography estimates tissue stiffness semi-quantitatively. • Abnormal testes were stiffer when compared with normal testis. • Strain elastography index was negatively correlated with seminiferous tubule area, diameter, and thickness. • No correlations were found between stiffness and the amount of connective tissue. • Strain elastography index was correlated with sperm primary abnormalities. [ABSTRACT FROM AUTHOR]

A 7-year-old Dachshund was clinically examined because of a 10-day history of lameness in the left hind limb. On the basis of radiological and cytological findings, an osteosarcoma of the left acetabular region was suspected. The dog underwent a hemipelvectomy and osteosarcoma was diagnosed by subsequent histopathological examination. An immovable subcutaneous mass was noted on the left chest wall during the physical examination and non-septic neutrophilic inflammation was diagnosed by cytology. Forty days later, the dog showed signs of respiratory distress with an in-diameter increase of the subcutaneous mass up to 4 cm. Thoracic radiography and ultrasonography revealed pleural effusion and a lytic process in the fourth left rib. Furthermore, ultrasound examination revealed a mixed echogenic mobile structure with a diameter of around 2 cm floating within the pleural fluid of the left hemithorax close to the pericardium. The dog underwent surgery for an en bloc resection of the subcutaneous mass together with the fourth rib and the parietal pleura. Moreover, the left altered lung lobe, corresponding to the mobile structure detected by ultrasound, was removed. Based on cytological, histopathological, and immunohistochemical examinations, an invasive epithelioid pleural malignant mesothelioma was diagnosed. [ABSTRACT FROM AUTHOR]

During the past decades, a growing interest has been raised in evaluating nontuberculous mycobacteria (NTM) in patients with noncystic fibrosis bronchiectasis (NCFBE). This paper reviews several aspects of the correlations between NTM and NCFBE, including pathogenesis, radiological features, diagnosis, and management. Bronchiectasis and NTM lung disease are connected, but which one comes first is still an unresolved question. The rate of NTM lung disease in NCFBE varies through the studies, from 5% to 30%. The most frequent species isolated is MAC. NCFBE patients affected by NTM infection frequently present coinfections, including both other different NTM species and microorganisms, such as P. aeruginosa. Once a diagnosis of NTM disease has been reached, the initiation of therapy is not always mandatory. NTM species isolated, patients’ conditions, and disease severity and its evolution should be considered. Risk factors for disease progression in NCFBE patients with NTM are low body mass index, cavitary disease, consolidations, and macrolide resistance at presentation. [ABSTRACT FROM AUTHOR]

Nocardiosis is a rare and potentially life-threatening infection caused by several species of the Nocardia genus. Most cases occur in immunocompromised patients, and a delay in establishing the diagnosis is common due to the non-specific clinical presentations and the difficulty in cultivating Nocardia. Although the majority of pulmonary nocardiosis cases are caused by Nocardia asteroides, cases of human infection due to N. farcinica are increasingly diagnosed due to recent developments in taxonomy and diagnostic methods. N. farcinica is a separate species from N. asteroides and appears to be more virulent and resistant to antibiotics. Herein, we describe the case of a 65-year-old HIV-negative immunocompromised patient with a fulminant bilateral pulmonary nocardiosis while on empirical treatment with trimethoprim/sulfamethoxazole and imipenem. Post-mortem diagnosis of N. farcinica infection was performed by means of DNA amplification and sequencing of the 65-kDa bacterial heat shock protein. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Despite advances in diagnosis and treatment, Mycobacterium tuberculosis causes active disease in about 8 million people worldwide annually. The study of the interplay between the host and the pathogen at the site of infection in human TB may contribute to elucidate the pathogenesis of the disease. In this work, using macroarray technology and real-time PCR, we analyzed the modulation of 847 genes encoding immune-inflammatory mediators in BALF samples of patients affected by active pulmonary TB (PTB) and control patients affected by non-TB diseases. The data show that the PTB milieu contains a complex network of gene activation. Different genes with adhesive properties and involved in tissue repair and fibrosis were modulated. In TB patients, we observed the up-regulation of cytokines, including IFN-γ and IFN-γ pathway genes, of several apoptotic genes, and of potent transcriptional activators. These findings can contribute to elucidate the mechanisms of MTB pathogenicity in humans. [Copyright &y& Elsevier]

Heat shock proteins (HSPs) are strongly implicated in the control of cell growth, differentiation and biological behaviour of many human cutaneous neoplasms. To our knowledge, no data have been published in the veterinary literature concerning either normal or neoplastic skin. In this study, the immunohistochemical expression of Hsp27, Hsp72 and Hsp73 was evaluated in normal canine skin, 14 intracutaneous cornifying epitheliomas (ICE), 10 well-differentiated and 5 moderately differentiated squamous cell carcinomas (SCC). Expression was correlated with the histological degree of keratinocyte differentiation and proliferation, and investigated as to its usefulness in the differential diagnosis of these canine tumours. In normal epidermis, Hsp27 exhibited cytoplasmic labelling in the spinous and granular layers, whereas in neoplastic tissues it was detected particularly in those areas showing squamous differentiation. Hsp72 immunoreactivity was more intense in ICE and well-differentiated SCC than in normal skin; however, reduced immunolabelling was observed in moderately differentiated SCC. Unlike Hsp72, Hsp73 showed less intense labelling in ICE and well-differentiated SCC than in normal epithelium and an increased positivity in moderately differentiated SCC. These results indicate that HSP immunoreactivity differs between normal and neoplastic canine skin. Hsp27 expression seems to correlate directly with cellular differentiation; by contrast, the involvement of Hsp72/73 in proliferation and differentiation of tumour cells remains controversial. The pattern and intensity of immunolabelling of each investigated HSP did not show, however, significant differences between ICE and SCC; therefore, they do not seem to be useful in the differential diagnosis of these two canine tumours. [ABSTRACT FROM AUTHOR]

Simple Summary: The assessment of a normal postpartum course is pivotal to maximize the likelihood to achieve a new pregnancy, especially in equids. However, postpartum (PP) uterine involution was studied in the horse but, to date, very little is known about the donkey, and many aspects of this fine-tuning reproductive phase remain to be clarified. The present study aimed to investigate the PP uterine involution in normal foaling Martina Franca jennies by ultrasonography, histology, and cytology. The results showed that ultrasonographic differences between the post-pregnant and non-post-pregnant uterine horn disappeared by PP Day 7. Endometrial glands area and perimeter showed a significant constant trend of decrease from PP Day 1 to PP Day 28. Epithelial thickness significantly increased from PP Days 1–3 to PP Day 7, and again, concurrently with the foal heat, to PP Day 14. Endometrial cytology showed a marked neutrophil reduction at PP Day 7, and an eosinophil increase from the first 3 days after parturition to the PP Days 7–14. Based on the combined ultrasonographic, histological, and cytological findings, the results of the present study suggest that, in Martina Franca jennies with normal foaling, the PP uterine involution can be considered complete at PP Day 14. This study investigated the postpartum (PP) uterine involution in nine multiparous Martina Franca jennies with at term, normal, and singleton foaling. Transrectal ultrasonography performed at Days 1, 3, 7, 14, 21, and 28 showed that the uterine tip diameters did not differ between the post-pregnant (PPH) and non-post-pregnant uterine horns (NPPH), whereas the diameter of the middle PPH was larger than the NPPH until Day 7 (p < 0.05). The diameter of the corpora-cornual junction resulted larger in the PPH than NPPH at Day 7 (p < 0.05). At Day 3, the microcaruncolae were not detected. Endometrial glands (GL) number increased, with the highest value on Day 28. Endometrial GL area and perimeter decreased (p < 0.001) from Day 1 to Day 28. Epithelial thickness increased from Days 1–3 to Day 7 (p < 0.001), and concurrently with the foal heat to Day 14 (p < 0.001), with a decrease at Days 21–28. A marked neutrophils reduction on Day 7 and eosinophil increase from the first three days to Days 7–14 was observed. The results suggest that, in Martina Franca jennies with normal foaling, the PP uterine involution can be considered complete on Day 14. [ABSTRACT FROM AUTHOR]

A 3-week-old suckling piglet spontaneously died after septicemic colibacillosis. At postmortem examination, bulging and ulcerated lesions were seen, affecting the oral mucosa on the inner surface of the lower lip. After histopathological investigation, the diagnosis of congenital oral squamous cell carcinoma was made. To the best of our knowledge, this is the first case of congenital oral squamous cell carcinoma ever described. A relationship has been shown or suggested between papillomavirus infection and oral squamous cell carcinoma in humans and animals. However, next-generation sequencing study did not demonstrate any papillomavirus sequences in the case reported herein. [ABSTRACT FROM AUTHOR]

Porcine circovirus 2 (PCV-2) is the causative agent of porcine circovirus diseases (PCVD). A study was undertaken to determine whether PCV-2 was present in samples collected from commercial pigs (n = 46) and warthogs (n = 42) in Namibia between 2019 and 2020. Twenty-three of the collected samples were positive by PCR (13 from pigs and 10 from warthogs), and a phylogenetic analysis of ORF2 identified three genotypes (PCV-2b and PCV-2d in pigs and PCV-2c in warthogs). This is the first time that PCV-2 has been identified in warthogs and in Namibia. It is also the first report of PCV-2c in Africa. [ABSTRACT FROM AUTHOR]

Background and Aim: Pseudomonas aeruginosa is a relevant opportunistic and difficult to treat pathogen due to its widespread environmental diffusion, intrinsic resistance to many classes of antimicrobials, high ability to acquire additional resistance mechanisms, and wide range of pathogenic factors. The present study aimed to investigate the prevalence of P. aeruginosa in canine clinical samples, the antimicrobial susceptibility against antipseudomonal antibiotics, and the presence of extracellular pathogenic factors of the isolates, as well as their ability to produce biofilm. Materials and Methods: Overall, 300 clinical specimens from dogs with pyoderma or abscesses (n=58), otitis (n=59), and suspected bladder infection (n=183) were analyzed by standard bacteriological methods. P. aeruginosa isolates were tested for their antimicrobial susceptibility by disk and gradient diffusion methods to determine the minimum inhibitory concentrations. The ability of the isolates to produce biofilm was investigated by a microtiter plate assay, while virulence genes coding for elastase (lasB), exotoxin A (toxA), alkaline protease (aprA), hemolytic phospholipase C (plcH), and exoenzyme S (ExoS) were detected by polymerase chain reaction method. Results: A total of 24 isolates of P. aeruginosa were found in clinical specimens (urine n=3, skin/soft tissue n=6, and ear canal n=15). No resistance was found to ceftazidime, gentamicin, aztreonam, and imipenem (IMI), while low levels of resistance were found to enrofloxacin (ENR) (4.2%) and piperacillin-tazobactam (8.3%). However, 41.7% and 29.2% of the isolates showed intermediate susceptibility to ENR and IMI, respectively. Disk and gradient diffusion methods showed high concordance. The majority of the isolates revealed a weak (33.3%) or intermediate (45.8%) ability to form biofilm, while the strong biofilm producers (20.8%) derived exclusively from the ear canal samples. All isolates (100%) were positive for lasB, aprA, and plcH genes, while exoS and toxA were amplified in 21 (87.5%) and 22 (91.7%) isolates, respectively. Conclusion: In the present study, P. aeruginosa isolates from canine clinical samples were characterized by low levels of antimicrobial resistance against antipseudomonal drugs. However, the high presence of isolates with intermediate susceptibility for some categories of antibiotics, including carbapenems which are not authorized for veterinary use, could represent an early warning signal. Moreover, the presence of isolates with strong ability to produce biofilm represents a challenge for the interpretation of the antimicrobial susceptibility profile. In addition, the high prevalence of the extracellular pathogenic factors was indicative of the potential virulence of the isolates. [ABSTRACT FROM AUTHOR]

Background and Aim: Neutrophils represent between 20% and 75% of white blood cells in animals and play a key role in an effective immune response. The generation of reactive oxygen species (ROS) is commonly referred to as an oxidative burst and is crucial under healthy and disease conditions. Interestingly, ROS are emerging as regulators of several neutrophil functions, including their oxidative burst. The present study aimed to investigate the effect of hydrogen peroxide on the oxidative burst of neutrophils, collected from domestic animal species (namely, pig, cattle, and sheep), and exposed to different stimuli. Materials and Methods: A total of 65 slaughtered animals were included in the present study: Twenty-two pigs, 21 cattle, and 22 sheep. Blood samples were collected at bleeding and neutrophils were then purified using ad hoc developed and species-specific protocols. Neutrophils were treated with hydrogen peroxide at micromolar-to-millimolar concentrations, alone, or combined with other stimuli (i.e., opsonized yeasts, and phorbol 12-myristate 13-acetate). The generation of ROS was evaluated using a luminol-derived chemiluminescence (CL) assay. For each animal species, data were aggregated and reported as mean area under curve±standard deviation. Finally, data were statistically analyzed by one-way ANOVA, followed by Tukey's post hoc test. Results: Exposure of bovine and ovine neutrophils to hydrogen peroxide alone resulted in a dose-dependent enhancement of the CL response, which was significantly stronger at its highest concentration and proved particularly prominent in sheep. Opsonized yeasts and phorbol 12-myristate 13-acetate both proved capable of stimulating the generation of ROS in all animal species under study. Hydrogen peroxide negatively modulated the oxidative burst of neutrophils after exposure to those stimuli, observed response patterns varying between pigs and ruminants. Porcine neutrophils, pre-exposed to micromolar concentrations of hydrogen peroxide, showed a decreased CL response only to opsonized yeasts. Conversely, pre-exposure to hydrogen peroxide reduced the CL response of ruminant neutrophils both to yeasts and phorbol 12-myristate 13-acetate, the effect being most prominent at 1 mM concentration. Conclusion: These results indicate that hydrogen peroxide is capable of modulating the oxidative bursts of neutrophils in a species-specific and dose-dependent manner, substantial differences existing between pigs and ruminants. Further investigation is required to fully comprehend such modulation, which is crucial for the proper management of the generation of ROS under healthy and disease conditions. [ABSTRACT FROM AUTHOR]

Introduction. The respiratory activity in the Lombardy Region is very rich and varied in terms of appropriate network capacity. Many respiratory DRGs are also produced by division of Internal Medicine, Geriatrics and Rehabilitation. Purpose. AIPO Lombardy together with Lombardy Region proposed the compilation of a "real life" questionnaire that investigated the volumes of activities dedicated to respiratory DRGs. Methods. Hospital and outpatient units both as simple and complex activities in Lombardy received a questionnaire inviting them to detect the activity carried out over a period of 2 different weeks. The survey included 45 topics/arguments with the following: general data; number of staff on duty; case studies; number of diagnoses; procedures performed; number of physio pathological and interventional procedures. Results. 56 of the 71 respondents (79%) responded including Respiratory Units (RU), Respiratory Rehabilitation, outpatient respiratory services and Internal Unit (IU) with simple respiratory facilities. Among the most significant data we report: 35% of RU and 9% of Rehabilitation have a RICU (Respiratory Intensive Care Unit); 26% of RU has an active guard H24; beds saturation of RU is 112%; RICU production is 6% of the total; respiratory failure is present in 50% of admissions in RU and Respiratory Rehabilitation while only 14% in IU. The most frequent DRGs were: 1) in RU pneumonia/Respiratory Failure (RF), Chronic Obstructive Pulmonary Disease (COPD)/RF and pneumonia 2) in Rehabilitation COPD/RF, COPD, Obstructive Sleep Apnea (OSA)/RF 3) in IU pneumonia, COPD/RF and COPD; tracheostomized patients and patients in VAM and tracheostomy (extimated about 200/year) are hospitalized only in RU and respiratory rehabilitation. Patients in NIMV are about 8% and are also present in IU although numerically inferior. 40% of patients use O2 therapy; 37% are enticed/forced into armchairs; 14% of patients have swallowing problems and finally, 35% of patients are at risk of falling. About 14 spirometry/day are performed, mostly global; 3 consultations and 14 outpatient visits are carried out every day; simple interventional procedures are about 4 per day, while complex interventional maneuvers are done in only 56% of RU. Conclusions. Lombardy pneumological world is able to respond to the challenges of multidisciplinary and multi-professionality according to the best scientific evidence, with fairness of access to care and continuity of care. The regional reality is ready for the implementation of a system of care based on a pathology network. [ABSTRACT FROM AUTHOR]

Mycoplasma infections are commonly associated with respiratory diseases in farm animals. However, few data are currently available about the presence and the etiology of mycoplasma pneumonia in small ruminants in central Italy, a region particularly devoted to pastoralism. The present study aims to investigate retrospectively the causative agents of pneumonia in sheep and goats, a special emphasis being placed upon mycoplasmas. In total, respiratory pathogens were identified in 129 of 380 carcasses (32.36%). Mycoplasmas were detected in a high percentage of cases, alone (59 animals) or in combination with other pathogens (26 animals), Mycoplasma arginini being the most frequent species. No evidence of mycoplasma infection was demonstrated in 44 carcasses; in such animals, Mannheimia haemolytica and Pasteurella multocida were most commonly isolated. Overall, our results suggest that mycoplasma infections can contribute to a relevant portion of respiratory diseases in small ruminants and support the role of Mycoplasma arginini as a frequent cause of pneumonia in sheep. We consider that such data are of value to efficiently manage the health status of animal populations. [ABSTRACT FROM AUTHOR]

Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a "tree-in-bud" pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research. [ABSTRACT FROM AUTHOR]

Arboviruses cause acute diseases that increasingly affect global health. We used bluetongue virus (BTV) and its natural sheep host to reveal a previously uncharacterized mechanism used by an arbovirus to manipulate host immunity. Our study shows that BTV, similarly to other antigens delivered through the skin, is transported rapidly via the lymph to the peripheral lymph nodes. Here, BTV infects and disrupts follicular dendritic cells, hindering B-cell division in germinal centers, which results in a delayed production of high affinity and virus neutralizing antibodies. Moreover, the humoral immune response to a second antigen is also hampered in BTV-infected animals. Thus, an arbovirus can evade the host antiviral response by inducing an acute immunosuppression. Although transient, this immunosuppression occurs at the critical early stages of infection when a delayed host humoral immune response likely affects virus systemic dissemination and the clinical outcome of disease. [ABSTRACT FROM AUTHOR]

Hepatitis E virus (HEV) was detected in stools collected from wild boars in Italy, with an overall prevalence of 1.5 % (3/196). The sequence of a ~3.0-kb portion at the 3′ end of the genome of one such strain, HEV/WB/P6-15/ITA, was determined. In the full-length ORF2, which encodes the capsid protein, the virus was genetically closest to wild boar and human HEV strains currently classified as genotype 3 subtype c. Interestingly, the 3' end of ORF2 of the WB/P6-15/ITA matched the 340-nucleotide (nt) sequence (94.0 % nt identity) of the human strain PeGe, identified in 2015 from a patient with acute hepatitis E in Genoa, Italy, suggesting that similar HEV strains are circulating in the same geographical setting in humans and animals. [ABSTRACT FROM AUTHOR]

Aelurostrongylus abstrusus is a metastrongyloid nematode infesting the respiratory system of domestic cats worldwide. Troglostrongylus brevior and Troglostrongylus subcrenatus, two lungworms thought to infest wild felids, have been found recently in domestic cats from Spain and Italy. These unexpected findings have raised doubts about the assumed past and present occurrence of Troglostrongylus spp., especially T. brevior, in domestic hosts and suggest that there may have been missed detection or misdiagnosis. The present retrospective study evaluated the presence of lungworms in cats from Italy with a diagnosis of respiratory parasitism or with compatible lung lesions from 2002 to 2013. Sixty-eight samples of DNA and larvae from cats with a diagnosis of aelurostrongylosis, and 53 formalin-fixed paraffin-embedded lung samples from cats confirmed as lungworm infested or with compatible lesions, were investigated using two DNA-based assays specific for A. abstrusus or T. brevior. All DNA and larval samples were positive for A. abstrusus and one was additionally positive for T. brevior. Most paraffin-embedded lung tissues were positive only for A. abstrusus, but two samples tested positive for both lungworms and one for T. brevior only. This study supports the major role of A. abstrusus in causing feline respiratory parasitism in endemic areas of Italy. [ABSTRACT FROM AUTHOR]

Atypical and classical scrapie-infected sheep brain tissue was monolaterally injected into the tonsils of lambs to investigate their role as a prion entry point. We first detected classical PrPSc within the inoculated tonsil and in the ipsilateral retropharyngeal lymph node at 3 months postinoculation (p.i.). At 7 months p.i., PrPSc colonized other lymphoid tissues bilaterally, including ileal Peyer's patches. The earliest PrPSc deposition within the brain was ipsilaterally observed at 9 months p.i. in the substantia reticularis of the medulla oblongata. At 12 months p.i., PrPSc deposition was present bilaterally in the nucleus parasympathicus nervi vagi, as well as in the intermediolateral cell column of the thoracolumbar spinal cord. No PrPSc was detected in the lambs inoculated with atypical scrapie. These findings suggest that neuroinvasion may naturally occur from the tonsil after a widespread prion replication within the lymphoid tissues during classical scrapie only, thus mimicking the pathogenesis after oral ingestion. [ABSTRACT FROM AUTHOR]

Canine distemper virus (CDV) infection is a primary threat affecting a wide number of carnivore species, including wild animals. In January 2013, two carcasses of Apennine wolves (Canis lupus) were collected in Ortona dei Marsi (L'Aquila province, Italy) by the local Veterinary Services. CDV was immediately identified either by RT-PCR or immunohistochemistry in lung and central nervous tissue samples. At the same time, severe clinical signs consistent with CDV infection were identified and taped (Videos S1–S3) from three wolves rescued in the areas surrounding the National Parks of the Abruzzi region by the Veterinary Services. The samples collected from these symptomatic animals also turned out CDV positive by RT-PCR. So far, 30 carcasses of wolves were screened and CDV was detected in 20 of them. The sequencing of the haemagglutinin gene and subsequent phylogenetic analysis demonstrated that the identified virus belonged to the CDV Arctic lineage. Strains belonging to this lineage are known to circulate in Italy and in Eastern Europe amongst domestic dogs. To the best of our knowledge this is the first report of CDV Arctic lineage epidemics in the wild population in Europe. [ABSTRACT FROM AUTHOR]

Background: Evidence has been provided that a cell-based therapy combined with the use of bioactive materials may significantly improve bone regeneration prior to dental implant, although the identification of an ideal source of progenitor/stem cells remains to be determined. Aim: In the present research, the bone regenerative property of an emerging source of progenitor cells, the amniotic epithelial cells (AEC), loaded on a calcium-phosphate synthetic bone substitute, made by direct rapid prototyping (rPT) technique, was evaluated in an animal study. Material And Methods: Two blocks of synthetic bone substitute (∼0.14 cm3), alone or engineered with 1×106 ovine AEC (oAEC), were grafted bilaterally into maxillary sinuses of six adult sheep, an animal model chosen for its high translational value in dentistry. The sheep were then randomly divided into two groups and sacrificed at 45 and 90 days post implantation (p.i.). Tissue regeneration was evaluated in the sinus explants by micro-computer tomography (micro-CT), morphological, morphometric and biochemical analyses. Results And Conclusions: The obtained data suggest that scaffold integration and bone deposition are positively influenced by allotransplantated oAEC. Sinus explants derived from sheep grafted with oAEC engineered scaffolds displayed a reduced fibrotic reaction, a limited inflammatory response and an accelerated process of angiogenesis. In addition, the presence of oAEC significantly stimulated osteogenesis either by enhancing bone deposition or making more extent the foci of bone nucleation. Besides the modulatory role played by oAEC in the crucial events successfully guiding tissue regeneration (angiogenesis, vascular endothelial growth factor expression and inflammation), data provided herein show that oAEC were also able to directly participate in the process of bone deposition, as suggested by the presence of oAEC entrapped within the newly deposited osteoid matrix and by their ability to switch-on the expression of a specific bone-related protein (osteocalcin, OCN) when transplanted into host tissues. [ABSTRACT FROM AUTHOR]

In sheep scrapie, pathological prion protein (PrPSc) deposition occurs in the lymphoreticular and central nervous systems. We investigated PrPSc distribution in scrapie-affected sheep showing simultaneous evidence of chronic lymphofollicular, lymphoproliferative/non-lymphofollicular, and/or granulomatous inflammations in their mammary gland, lung, and ileum. To do this, PrPSc detection was carried out via immunohistochemistry and Western Blotting techniques, as well as through inflammatory cell immunophenotyping. Expression studies of gene coding for biological factors modulating the host’s inflammatory response were also carried out. We demonstrated that ectopic PrPSc deposition occurs exclusively in the context of lymphofollicular inflammatory sites, inside newly formed and well-organized lymphoid follicles harboring follicular dendritic cells. On the contrary, no PrPSc deposition was detected in granulomas, even when they were closely located to newly formed lymphoid follicles. A significantly more consistent expression of lymphotoxin α and β mRNA was detected in lymphofollicular inflammation compared to the other two types, with lymphotoxin α and β signaling new lymphoid follicles’ formation and, likely, the occurrence of ectopic PrPSc deposition inside them. Our findings suggest that, in sheep co-affected by scrapie and chronic inflammatory conditions, only newly formed lymphoid follicles provide a suitable micro-environment that supports the scrapie agent’s replication in inflammatory sites, with an increased risk of prion shedding through body secretions/excretions. [ABSTRACT FROM AUTHOR]

We have examined the innervation of the gut-associated lymphoid system of the sheep ileum, with a view to identifying potential sites for neuroinvasion by pathogens, such as prions (PrPSc). Special attention has been paid to the follicles of Peyer’s patches (PPs), which are major sites of PrPSc accumulation during infection. Evidence exists that the enteric nervous system, together with the parasympathetic and sympathetic pathways projecting to the intestine, are important for PrPSc entry into the central nervous system. Thus, PrPSc might move from PPs to the neurons and nerve fibres that innervate them. We investigated, by immunohistochemistry and retrograde tracing (DiI) from the follicles, the distribution and phenotype of enteric neurons innervating the follicles. Antibodies against protein gene product 9.5, tyrosine hydroxylase, dopamine β hydroxylase, choline acetyltransferase, calbindin (CALB), calcitonin gene-related peptide (CGRP), and nitric oxide synthase were used to characterise the neurons. Immunoreactivity for each of these was observed in fibres around and inside PP follicles. CGRP-immunoreactive fibres were mainly seen at the follicular dome. Retrograde tracing revealed submucosal neurons that contributed to the innervation of PPs, including Dogiel type II neurons and neurons immunoreactive for CALB and CGRP. The major source of the adrenergic fibres are the sympathetic ganglia. Our results thus suggest that enteric and sympathetic neurons are involved during the first stage of neuroinvasion, with neurons connecting to them acting as potential carriers of PrPSc to the central nervous system. [ABSTRACT FROM AUTHOR]

Background: Eosinophils and T lymphocytes represent constant features in the airways of subjects with exacerbated chronic bronchitis. Eotaxin is the most potent and selective eosinophil chemoattractant which can also attracts lymphocytes. The aim of the study was to evaluate the expression of eotaxin and its receptor, CCR3, in bronchial airways during exacerbation of chronic bronchitis. Methods: By immunohistochemistry we studied eotaxin and CCR3 expression in the lamina propria of 14 subjects with acute exacerbation of chronic bronchitis, 20 asthmatics, and 8 healthy subjects. We determined the cell types expressing the CCR3 receptor by colocalization experiments. We finally studied the relationship between eotaxin and CCR3 and eosinophils and T lymphocytes. Results: The number of eotaxin+ and CCR3+ cells was significantly higher in exacerbated chronic bronchitis (P < 0.003 and P < 0.002) and asthma (P < 0.002 and P < 0.0001) when compared to healthy subjects. CCR3 was mainly expressed by eosinophils and to a lesser extent by CD4+ and CD8+ lymphocytes. In exacerbated chronic bronchitis the number of CCR3+ cells was strongly correlated to the number of eosinophils (P < 0.0002, r = 0.85) and to the number of CD4+ lymphocytes (P < 0.05, r = 0.57). Conclusion: Our study suggests that eotaxin and CCR3 are up-regulated and could be involved in the eosinophil and CD4+ lymphocyte recruitment into the airways which occur during acute exacerbations of chronic bronchitis. [ABSTRACT FROM AUTHOR]

Simple Summary: Scoring lesions in slaughtered pigs can provide useful feedback to the swine industry, although the systematic recording of lesions is very challenging and time consuming. Artificial intelligence offers interesting opportunities to solve highly repetitive tasks, such as those performed by veterinarians at postmortem inspection in high-throughput slaughterhouses and to consistently analyze large amounts of data. The present investigation indicates that enzootic pneumonia-like lesions can be effectively detected and quantified through artificial intelligence methods under routine slaughter conditions. The slaughterhouse can act as a valid checkpoint to estimate the prevalence and the economic impact of diseases in farm animals. At present, scoring lesions is a challenging and time-consuming activity, which is carried out by veterinarians serving the slaughter chain. Over recent years, artificial intelligence(AI) has gained traction in many fields of research, including livestock production. In particular, AI-based methods appear able to solve highly repetitive tasks and to consistently analyze large amounts of data, such as those collected by veterinarians during postmortem inspection in high-throughput slaughterhouses. The present study aims to develop an AI-based method capable of recognizing and quantifying enzootic pneumonia-like lesions on digital images captured from slaughtered pigs under routine abattoir conditions. Overall, the data indicate that the AI-based method proposed herein could properly identify and score enzootic pneumonia-like lesions without interfering with the slaughter chain routine. According to European legislation, the application of such a method avoids the handling of carcasses and organs, decreasing the risk of microbial contamination, and could provide further alternatives in the field of food hygiene. [ABSTRACT FROM AUTHOR]

A 14-month-old half-breed horse showed a severe lameness due to a lesion of the right forefoot which appeared completely and asymmetrically cleaved, from the solar margin to the coronary band. The horse was presented to an abattoir for slaughter and both forelimbs were collected for diagnostic investigations. The hoof lesion described herein does not fulfil the diagnostic criteria of equine polydactyly since post mortem imaging and pathological investigations ruled out the presence of supernumerary digits. Based on the clinical signs, diagnostic imaging (computed tomography) and gross examination, a diagnosis of pseudo-polydactyly was proposed. To the best of our knowledge, the features of the present case report are unique, thus widening the range of lesions observed at the level of the hoof, which is crucial for horse health and activity. [ABSTRACT FROM AUTHOR]

Idiopathic pulmonary fibrosis (IPF), the most lethal form of interstitial pneumonia of unknown cause, is associated with a specific radiological and histopathological pattern (the so-called "usual interstitial pneumonia" pattern) and has a median survival estimated to be between 3 and 5 years after diagnosis. However, evidence shows that IPF has different clinical phenotypes, which are characterized by a variable disease course over time. At present, the natural history of IPF is unpredictable for individual patients, although some genetic factors and circulating biomarkers have been associated with different prognoses. Since in its early stages, IPF may be asymptomatic, leading to a delayed diagnosis. Two drugs, pirfenidone and nintedanib, have been shown to modify the disease course by slowing down the decline in lung function. It is also known that 5–10% of the IPF patients may be affected by episodes of acute and often fatal decline. The acute worsening of disease is sometimes attributed to identifiable conditions, such as pneumonia or heart failure; but many of these events occur without an identifiable cause. These idiopathic acute worsenings are termed acute exacerbations of IPF. To date, clinical biomarkers, diagnostic, prognostic, and theranostic, are not well characterized. However, they could become useful tools helping facilitate diagnoses, monitoring disease progression and treatment efficacy. The aim of this review is to cover molecular mechanisms underlying IPF and research into new clinical biomarkers, to be utilized in diagnosis and prognosis, even in patients treated with antifibrotic drugs. [ABSTRACT FROM AUTHOR]

B METHODS: b We performed a retrospective study on patients hospitalized at the San Gerardo Hospital, Monza, Italy from January, 1st 2013 to December, 31st 2017 with a diagnosis of ARF in known chronic, unknow or de novo ILDs, who underwent a bronchoscopic evaluation during hospitalization. B RESULTS: b Out of 54 patients included (69% males, median age 67 yrs), 51 patients underwent BAL microbiological and cytological analysis, 2 patients underwent only microbiological analysis, 1 patient underwent transbronchial biopsy only. In 4 out of 5 cases lymphocytosis was found in unknown chronic or de novo ILD, and in 3 cases this finding helped defining ILD diagnosis (drug-induced ILD, chronic hypersensitivity pneumonitis and organizing pneumonia). [Extracted from the article]