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Introduction
Additional affiliations
December 2010 - March 2016
University of Milan Bicocca, Milan, Italy
Position
- Research Assistant
August 2011 - present
December 2010 - present
Publications
Publications (647)
Background: Nosocomial lower respiratory tract infections (nLRTIs) are associated with unfavorable clinical outcomes and significant healthcare costs. nLRTIs include hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and other ICU-acquired pneumonia phenotypes. While risk factors for mortality in these infections are critical...
Background
Dipeptidyl peptidase-1 (DPP1) activates neutrophil serine proteases (NSPs), which are implicated in chronic lung diseases. DPP1 inhibitors have shown positive results in bronchiectasis clinical trials, including one in Phase 3. We investigated the mechanism of action of a DPP1 inhibitor by exploring its impact on neutrophil proteins and...
Background
The rare monogenic syndrome Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) leads to multisystemic autoimmunity with possible lung involvement. Autoimmune pneumonitis is a rare manifestation, with bronchiectasis being the most frequent radiologic pattern, and may lead to fatal outcome. The Sardinian population in...
Introduction: Prior exacerbations are the main risk factor for exacerbations in bronchiectasis. Guidelines recommend macrolide only in frequent exacerbators. Other studies suggest that symptoms are related to increased exacerbation risk. We aimed to investigate if symptoms could independently predict future exacerbations and identify responders to...
Background: Serum anti-glycopeptidolipid (GPL) core immunoglobuin A (IgA) antibody test has been proposed as a diagnostic tool for Mycobacterium avium complex pulmonary diseases. Cross-reactivity with other non-tuberculous mycobacteria (NTM), including M. abscessus, indicates that it may have a role as a broader screening test for NTM pulmonary dis...
Predictors of outcomes are essential to identifying severe COVID-19 cases and optimizing treatment and care settings. The respiratory rate-oxygenation (ROX) index, originally introduced for predicting the failure of non-invasive support in acute hypoxemic respiratory failure (AHRF), has not been extensively studied over time during hospitalization....
A-kinase anchoring proteins (AKAPs) are key orchestrators of cAMP signaling that act by recruiting protein kinase A (PKA) in proximity of its substrates and regulators to specific subcellular compartments. Modulation of AKAPs function offers the opportunity to achieve compartment-restricted modulation of the cAMP/PKA axis, paving the way to new tar...
Introduction: Aspergillus sp. cause diverse clinical manifestations in bronchiectasis including Allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitization (AS) and raised IgG indicating exposure or infection with Aspergillus.
Research question: What is the prevalence and clinical significance of Aspergillus-associated conditions in...
Plain language summary
A review on the safety aspects of drugs currently being used in bronchiectasis
This review aims to detail the safety aspects of drugs that are currently prescribed to patients with bronchiectasis. These drugs are used in bronchiectasis without some of the high quality trials seen for other lung conditions. The drugs used have...
Non-tuberculous mycobacteria (NTM) account for high clinical burden, and treatment can be challenging. Moreover, accessibility of NTM medications varies across centers. These challenges may lead to unplanned therapeutic changes, discontinuations, potentially affecting patient outcomes. Aim of this survey was to evaluate the accessibility of NTM-tar...
Introduction: Bronchiectasis, characterized by airway dilation, mucus hypersecretion, and recurrent exacerbations, is increasingly recognized in children and adolescents. Recent guidelines from the European Respiratory Society (ERS) and Thoracic Society of Australia and New Zealand (TSANZ) emphasize early diagnosis and optimized management. This re...
Bronchiectasis presents a significant challenge due to its rising prevalence, associated economic burden and clinical heterogeneity. This review synthesises contemporary understanding and literature of bronchiectasis exacerbations, addressing the transition from stable state to exacerbations, underlining the importance of early and precise recognit...
Formerly regarded as a rare disease, bronchiectasis is increasingly recognised. A renewed interest in this disease has led to significant progress in bronchiectasis research. Randomised clinical trials have demonstrated the benefits of airway clearance techniques, inhaled antibiotics and long-term macrolide therapy in bronchiectasis patients. Howev...
Background
Immunodeficiencies (IDs) are conditions caused by immune system dysfunctions which predispose to chronic infections. Cystic fibrosis (CF) patients are characterized by the presence of bronchiectasis filled with hyper-viscous secretions that constitute the ideal environment for infections. Although CF and IDs might share similarities in t...
Rationale
The inflammasome is a key regulatory complex of the inflammatory response leading to IL-1β release and activation. IL-1β amplifies inflammatory responses and induces mucus secretion and hyperconcentration in other diseases. The role of IL-1β in bronchiectasis has not been investigated.
Objectives
To characterize the role of airway IL-1β...
Background
Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.
Methods
A survey-based study investigating Long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS)...
Different factors, not limited to the lung, influence the progression of ILDs. A “treatable trait” strategy was recently proposed for ILD patients as a precision model of care to improve outcomes. However, no data have been published so far on the prevalence of TTs in ILD. A prospective, observational, cohort study was conducted within the ILD Prog...
Rationale: Bronchiectasis is characterised by acute exacerbations but the biological mechanisms underlying these events is poorly characterised. Objectives To investigate the inflammatory and microbial characteristics of exacerbations of bronchiectasis. Methods: 120 patients with bronchiectasis were enrolled and presented with acute exacerbations w...
Background
Identifying patients at risk of nontuberculous mycobacterial pulmonary disease (NTM-PD) is challenging. Delays in NTM-PD identification and management are associated with declining lung function and increased morbidity and mortality.
Study design and methods
European NTM-PD experts (n=12) participated in a three-round modified Delphi pr...
Rationale: Chest computed tomography -scans (CTs) are essential to diagnose and monitor bronchiectasis (BE). To date, little quantitative data is available about the nature and extent of structural lung abnormalities (SLA) on CTs of BE patients.
Objectives: to investigate SLA on CTs of patients with bronchiectasis and the relationship of SLAs to c...
Background
International guidelines recommend airway clearance management as one of the important pillars of bronchiectasis treatment. However, the extent to which airway clearance is used for people with bronchiectasis in Europe is unclear. The aim of the study was to identify the use of airway clearance management in patients with bronchiectasis...
Introduction
A validated 4-point sputum colour chart can be used to objectively evaluate the levels of airway inflammation in bronchiectasis patients. In the EMBARC registry, we tested whether sputum colour would be associated with disease severity and clinical outcomes.
Methods
Prospective, observational registry of adults with bronchiectasis con...
Objectives
Vasoactive drugs have exhibited clinical efficacy in addressing pulmonary arterial hypertension, manifesting a significant reduction in morbidity and mortality. Pulmonary hypertension may complicate advanced interstitial lung disease (PH-ILD) and is associated with high rates of disability, hospitalisation due to cardiac and respiratory...
Recurrent respiratory papillomatosis (RRP) is a non-malignant disease, characterized by the production of wart-like growths in the respiratory tract, affecting both young people and adults (juvenile-onset recurrent respiratory papillomatosis, JORRP, and adult-onset recurrent respiratory papillomatosis, AORRP, respectively). Infection caused by huma...
Community-acquired pneumonia (CAP) is globally one of the major causes of hospitalization and mortality. Severe CAP (sCAP) presents great challenges and need a comprehensive understanding of its long-term outcomes. Cardiovascular events and neurological impairment, due to persistent inflammation and hypoxemia, contribute to long-term outcomes in CA...
Background: Asthma is commonly reported in patients with a diagnosis of bronchiectasis.
Objective: The aim of this study was to evaluate whether patients with bronchiectasis and asthma (BE+A) had a different clinical phenotype and different outcomes compared with patients with bronchiectasis without concomitant asthma.
Methods: A prospective obse...
Rationale and objective:
Bronchiectasis and COPD are associated conditions but misdiagnosis is believed to be common. A recently published international consensus definition of bronchiectasis (BE) and COPD association: The ROSE criteria (radiological bronchiectasis(R), obstruction: FEV1/FVC ratio<0.7 (O), symptoms (S) and exposure:≥10 pack year sm...
Introduction:
Application of whole-genome shotgun metagenomics to the airway microbiome in bronchiectasis highlights a diverse pool of antimicrobial resistance genes: the 'resistome', the clinical significance of which remains unclear.
Methods:
Individuals with bronchiectasis were prospectively recruited into cross-sectional and longitudinal coh...
Recurrent respiratory papillomatosis (RRP) is a non- malignant disease, characterized by the production of wart-like growths in respiratory tract, affecting both young and adults (Juvenile-Onset Recurrent Respiratory Papillomatosis, JORRP and Adult-Onset Recurrent Respiratory Papillomatosis, AORRP, respectively). Infection caused by Human Papilloma...
Extract
Over recent decades, the prevalence and incidence of nontuberculous mycobacterial pulmonary disease (NTM-PD) have increased worldwide, with Mycobacterium avium complex being the most common causative agents [1–5]. The 2020 American Thoracic Society/European Respiratory Society/European Society of Clinical Microbiology and Infectious Disease...
Background: Tracheal stenosis represents a fearsome complication that substantially impairs quality of life. The recent SARS-CoV-2 pandemic increased the number of patients requiring invasive ventilation through prolonged intubation or tracheostomy, increasing the risk of tracheal stenosis. Study design and methods: In this prospective, observation...
Introduction
Over the last ten years an increasing prevalence and incidence of non-tuberculous mycobacteria (NTM) has been reported among patients with cystic fibrosis (CF) Viviani (J Cyst Fibros, 15(5):619–623, 2016). NTM pulmonary disease has been associated with negative clinical outcomes and often requires pharmacological treatment. Although sp...
Rationale:
Although inflammation and infection are key disease drivers in bronchiectasis, few studies have integrated host inflammatory and microbiome data to guide precision medicine.
Objectives:
To identify clusters among bronchiectasis patients based on inflammatory markers and assess the association between inflammatory endotypes, microbiome...
Introduction
Eosinophilic bronchiectasis is a recently described clinical entity defined by eosinophilic inflammation in the absence of asthma and/or allergic bronchopulmonary aspergillosis. This study aimed to characterise eosinophilic bronchiectasis, using two bronchiectasis patient cohorts, to determine whether eosinophilia represents a treatabl...
Introduction
Aspergillus fumigatus causes airway disorders including Allergic bronchopulmonary aspergillosis (ABPA), Aspergillus sensitisation (AS) and Aspergillus bronchitis (AB). The clinical significance of Aspergillus lung diseases in bronchiectasis is not well understood, partially due to no universally-accepted diagnostic criteria for ABPA....
Introduction
The relationship between neutrophilic inflammation and microbiome dysbiosis, two central features of bronchiectasis pathophysiology, is not fully understood. We used novel full length 16s rRNA sequencing, which provides detailed characterisation of bacterial communities at species level, to investigate the relationship between microbio...
Background: Although cystic fibrosis (CF) standards of care have been produced and regularly updated, they are not specifically targeting at the adult population. The ECFS Standards of Care Project established an international task force of experts to identify quality standards for adults with CF and assess their adherence.
Methods: This study was...
Introduction: Inflammation is believed to be central to the pathophysiology of bronchiectasis. This study aimed to perform inflammatory endotyping in bronchiectasis and examine the validity of identified inflammatory clusters by comparing the microbiome profiles and exacerbation risk among endotypes of bronchiectasis. Methods: Patients with stable...