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To verify whether myo-inositol plus α-lactalbumin may reduce insulin resistance and excessive fetal growth in women with gestational diabetes mellitus. In a 12-month period, 120 women with a diagnosis of gestational diabetes mellitus were consecutively enrolled with an allocation of 1:1 in each group and randomly treated with myo-inositol plus α-lactalbumin plus folic acid (treated group) or folic acid (control group) for 2 months. Primary outcome was the variation of insulin resistance through the study evaluated by HOMA-IR. Secondary outcome was the evaluation, through the study, of fetal growth by ultrasound measurements of abdominal circumference centiles and estimated fat thickness. Some clinical outcomes were also considered. After 2 months, in the treated group, a significant reduction in insulin resistance (HOMA values 3.1 ± 1.4 vs 6.1 ± 3.4, p = 0.0002) and fetal growth was shown (Abdominal circumference centiles 54.9 ± 23.5 vs 67.5 ± 22.6, P = 0.006). Among clinical outcomes, a significant decrease in the rate of women who needed insulin (6.7% vs 20.3%, p = 0.03) and of pre-term birth (0 vs 15.2%, p = 0.007) was evidenced. A combination of myo-inositol and α-lactalbumin may reduce insulin resistance and excessive fetal growth. Clinical trial registration: ClinicalTrials.gov, http://www.clinicaltrials.gov, NCT 03763669, first posted date 04/12/2018; last posted date December 06/12/2018. [ABSTRACT FROM AUTHOR]

For a long period of time, the transcription factor CCAAT/ enhancer-binding protein homologous protein (CHOP) has been thought to inhibit transcriptional activity for its ability to interact with CCAAT enhancer-binding protein family factors, thus preventing their binding to DNA. We have previously shown that in human T lymphocytes the CHOP phosphorylation induced by prostaglandin E2 (PGE2)-increased interleukin- 8 (IL-8) gene expression. Given the CHOP positive role in the regulation of transcription, here we have investigated the molecular mechanism(s) by which CHOP increases IL-8 gene activity under PGE2 stimulus. Transfection experiments with mutants showed both that the CHOP transactivation domain is essential for IL-8 transcription and that the IL-8/activator protein 1 (AP-1) promoter mutated in NF-κB and NF-IL-6, but not in the AP-1 site, harbors essential CHOP-responsive elements. CHOP silencing confirmed its role in the IL-8 transcriptional regulation and protein production, whereas c-Jun small interfering RNA experiments showed that the PGE2- induced activation of IL-8 promoter is mainly c-Jun-independent. Moreover, PGE2 induced CHOP-DNA complexes only when the entire IL-8/AP-1 promoter or the wild type sequences encompassing the AP-1 upstream region were employed. Mutations introduced in these sequences prevented the DNA-CHOP complex formation. The IL-8/AP-1 mutant promoter lacking the sequence immediately upstream the AP-1 site is PGE2-unresponsive. Finally, chromatin immunoprecipitation data confirmed in vivo that PGE2 induces CHOP binding to the IL-8 promoter. Taken together, our results suggest that the increased expression of CHOP in response to PGE2 exerts a positive transcriptional regulation of the IL-8 promoter mediated by direct binding to a novel consensus site. [ABSTRACT FROM AUTHOR]

The effect of prostaglandin E2 (PGE2) in regulating the synthesis of the pro-inflammatory chemokine interleukin.8 (IL-8) in T lymphocytes is not yet defined, even though it may reduce or enhance IL-8 synthesis in other cell types. Here, we demonstrate that, in human T cells, PGE2 induced IL-8 mRNA transcription through prostaglandin E2 receptors 1- and 4- dependent signal transduction pathways leading to the activation of the transcription factor C/EBP homologous protein (CHOP), never before implicated in IL-8 transcription. Several kinases, including protein kinase C, Src family tyrosine kinases, phosphatidylinositol 3-kinase, and p38 MAPK, were involved in PGE2-induced CHOP activation and IL-8 production. The transactivation of the IL-8 promoter by CHOP was NF-κB-independent. Our data suggest that PGE2 acts as a potent pro-inflammatory mediator by inducing IL-8 gene transcription in activated T cells through different signal transduction pathways leading to CHOP activation. These findings show the complexity with which PGE2 regulates IL-8 synthesis by inhibiting or enhancing its production depending on the cell types and environmental conditions. [ABSTRACT FROM AUTHOR]

Local Allergic Rhinitis (LAR) is an emerging disease. However, its incidence in the pediatric popolution has not yet been studied. The gold standard for the diagnosis is the nasal provocation test that is not everywhere avalaible and difficult to apply in children. The aim of our study was to evaluate the nasal lavage fluid IgE as a biomarker of LAR in children. 54 pediatric patients [IQR 4.0-12.0 years] were divided into 3 groups: study group (26 children with rhinitis symptoms and without evidence of systemic atopy); allergic rhinitis (AR) group (15 children) and 13 healty controls (HC). Every child was subjected to nasal lavage using 2 ml/nostril of physiologic saline solution, that was therefore analyzed by ImmunoCAP to obtain the IgE concentration. Rhinofibroscopy and nasal cytology were performed. Our data showed the presence of higher value of nasal lavage fluid IgE (average of 6.005 UI/ml; range: 4.47-7.74 UI/ml) in 16 out of 26 patients of the study group who therefore may be classified as affected by LAR. We observed a statistically significant difference (P< 0.0001) between NAR/HC group and LAR group, identifying a cut-off of 3.85 UI/ml. Finally, we found a better response to previous AR therapy in the LAR group than in the NAR group. Our data showed the high incidence of LAR in pediatric patients previously classified as NAR. The measurment of IgE in nasal lavage fluid may be considered an easy and rapid method for the diagnosis of LAR in children. Besides, our data add confirmatory evidence about the good response of LAR children to the classic AR therapy., Competing Interests: The authors declared no conflict of interest.

Objectives: Circulating proangiogenic haematopoietic cells (PHCs), including CD34+ cells, play an important role in endothelial homeostasis. Among PHCs, CD34+ cells are the largest cell population, thus, much of the regenerative/reparative potential of PHCs may be attributed to CD34+ cells. Our aim was to determine the association between inflammation and CD34+ cell number, intracellular levels of reactive oxygen species (ROS) and expression of Toll-like receptor 3 (TLR3) and interleukin 1β (IL-1β), arterial stiffness (AS) indices, and carotid intima-media thickness (cIMT) in patients affected by rheumatoid arthritis (RA)., Methods: CD34+ cells were isolated from 24 RA patients and 26 matched controls. ROS levels, TLR3 and IL-1β expression were measured. C-reactive protein (CRP), fibrinogen, AS, and cIMT were also evaluated., Results: CD34+ count was lower in RA patients as compared to controls. In CD34+ cells from RA patients, ROS, TLR3 and IL-1β expressions were increased compared to controls. In RA patients, we found higher CRP and fibrinogen levels, and higher values of Pulse Wave Velocity (PWV) and Augmentation Index (AIx), both AS indices, and of cIMT. CD34+ cell numbers were inversely correlated with CRP, TLR3, IL-1β, ROS, and AS indices. TLR3 levels were related to CRP, IL-1β, fibrinogen and ROS. IL-1β levels were correlated with expression of CRP, ROS, and PWV., Conclusions: Inflammatory status in RA is associated with an increased expression of TLR3 and of IL-1β in CD34+ cells, which appear to affect cell number. These new findings suggest a perspective on accelerated atherosclerosis and vascular damage in RA.