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2022 - Dietary Patterns and Blood Biochemical and Metabolic Parameters in an Italian Population: A Cross-Sectional Study [Articolo su rivista]
Cecchini, Marta; Urbano, Teresa; Lasagni, Daniela; De Luca, Tiziana; Malavolti, Marcella; Baraldi, Claudia; Grioni, Sara; Agnoli, Claudia; Sieri, Sabina; Santachiara, Annalisa; Pertinhez, Thelma A.; Fustinoni, Silvia; Baricchi, Roberto; Vinceti, Marco; Filippini, Tommaso

Diet has long been identified as a major determinant of cardiovascular and other chronic diseases. In this study, we assess the relation between adherence to different dietary patterns and biochemical and metabolic parameters as well as the 10-year risk of major cardiovascular diseases (CVDs) in a community of blood donors in Northern Italy. We assess their adherence to four dietary patterns, namely, the Dietary Approach to Stop Hypertension (DASH) diet, the Mediterranean diet through the Greek and Italian Mediterranean Indices (GMI and IMI) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, using a validated semi-quantitative food frequency questionnaire (FFQ). We then assess their association with blood parameters and the 10-year risk of major CVD using a spline regression model. We found an inverse association between the DASH and MIND diets and total and LDL cholesterol, and triglyceride and HDL cholesterol values for the Mediterranean diets (IMI and GMI). Additionally, according to our sex-stratified analyses, men who have greater adherence to dietary patterns have a decreased risk of major CVD for all patterns. The results suggest that greater adherence to dietary patterns positively influences blood biochemical and metabolic parameters, thus reducing the risk of developing cardiovascular disease and delaying the use of drug treatments

2021 - Associations between urinary and dietary selenium and blood metabolic parameters in a healthy northern italy population [Articolo su rivista]
Urbano, T.; Filippini, T.; Lasagni, D.; De Luca, T.; Sucato, S.; Polledri, E.; Bruzziches, F.; Malavolti, M.; Baraldi, C.; Santachiara, A.; Pertinhez, T. A.; Baricchi, R.; Fustinoni, S.; Vinceti, M.

Selenium is both an essential nutrient and a highly toxic element, depending on its dose and chemical forms. We aimed to quantify urinary selenium excretion and dietary selenium intake in 137 healthy non-smoking blood donors living in the northern Italian province of Reggio Emilia. We assessed selenium status by determining urinary selenium levels (mean 26.77 µg/L), and by estimating dietary selenium intake (mean 84.09 µg/day) using a validated semi-quantitative food frequency questionnaire. Fasting blood levels of glucose, lipids and thyroid-stimulating hormone were measured using automatized laboratory procedures. Dietary and urinary selenium were correlated (beta coefficient (β) = 0.19). Despite this, the association of the two indicators with health endpoints tended to diverge. Using linear regression analysis adjusted for age, sex, body mass index, cotinine levels and alcohol intake, we observed a positive association between urinary selenium and blood triglyceride (β = 0.14), LDL-cholesterol (β = 0.07) and glucose levels (β = 0.08), and an inverse one with HDL-cholesterol (β = −0.12). Concerning dietary selenium, a slightly positive association could be found with glycemic levels only (β = 0.02), while a negative one emerged for other endpoints. The two selenium indicators showed conflicting and statistically highly imprecise associations with circulating TSH levels. Our findings suggest that higher selenium exposure is adversely associated with blood glucose levels and lipid profile. This is the case even at selenium exposures not exceeding tolerable upper intake levels according to current guidelines.

2020 - Comparison of Methodologies to Estimate Dietary Cadmium Intake in an Italian Population [Articolo su rivista]
Filippini, Tommaso; Upson, Kristen; Adani, Giorgia; Malagoli, Carlotta; Baraldi, Claudia; Michalke, Bernhard; Vinceti, Marco

Cadmium is a metal that is toxic to humans, and the major source of cadmium exposure in the non-smoking general population is diet. To identify major food sources and lower exposure from diet, an accurate estimate of dietary cadmium intake is needed. Hence, the objectives of this study are to develop a method to assess dietary cadmium intake using a biomarker measurement and to improve the estimation of dietary cadmium intake when using a food frequency questionnaire (FFQ). In a random sample of an Italian population, we collected dietary habits by FFQ and measured cadmium in foods and beverages. These data were used to compute the estimated weekly dietary intake (WDI) of cadmium (µg) by kilogram (kg) of body weight (bw) (WDIFFQ). We also measured fasting serum cadmium levels by inductively-coupled plasma mass spectrometry. We used these data to develop a model for the estimation of the biomarker-derived dietary cadmium intake (WDIbio). In the 51 subjects recruited, the median level of serum cadmium was 0.041 µg/L (interquartile range (IQR): 0.030-0.054). The median WDIFFQ and WDIbio were 1.34 µg/kg bw/week (IQR: 0.86-1.70) and 0.72 µg/kg bw/week (IQR: 0.55-1.11), respectively. The correlation between the two estimates was low-to-moderate (r = 0.291). In exploratory analyses, the correlation was slightly higher in women and participants ages <50 years, and markedly higher in participants with body mass index <25 kg/m2 and smokers. Our approach allows for the dietary contribution to be isolated from the overall cadmium exposure measured with a biomarker; the estimated dietary cadmium intake was roughly similar to that estimated using the FFQ, especially in select subgroups. Future refinements to the biomarker-derived dietary cadmium intake approach should take into consideration additional sources of cadmium exposure, as well as factors affecting its absorption and metabolism.

2018 - Correlation between dietary cadmium exposure with biochemical and metabolic parameters: A cross-sectional study in Northern Italy population [Abstract in Atti di Convegno]
Filippini, T; Lasagni, D; Bruzziches, F; Baraldi, C; Malagoli, C; Grioni, S; Sieri, S; Santachiara, A; De Luca, T; Pertinhez, T; Baricchi, R; Vinceti, M.

Background and aim: Cadmium is a heavy metal classified as carcinogen for humans. It accumulates in the organism, especially in kidney and liver. Recent findings suggested that cadmium could influence human metabolism acting as endocrine disruptor and high cadmium exposure has been associated with impairment of cardiovascular and endocrine systems. This study aims at assessing the dietary intake of cadmium in an Italian community of Northern Italy and to evaluate its correlation with endocrine and metabolic factors. Methods: In a sample adult population of ever smokers from Reggio Emilia Province we estimated dietary cadmium intake through a food frequency questionnaire, validated for the Northern Italy population. From each participant we collected a fasten blood sample for determination of biochemical parameters and hormones levels, including alanine transaminase, blood glucose, total cholesterol, high-density lipoproteins (HDL), and thyroid-stimulating hormone (TSH). All subjects who participated to this study signed a written informed consent. Results: We eventually recruited 104 participants (men/women: 46/58), with mean (standard deviation) dietary intake of cadmium of 16.0 (8.5) μg/day. Correlation between cadmium intake and biochemical factors demonstrated a positive association with total cholesterol levels, blood glucose and TSH. Adjustment for main confounders, including sex, age, and bass index did not substantially alter the results. No clear correlation emerged with other parameters under investigation. Discussion: The results show that in our sampled population, dietary intake of cadmium is similar with other Italian and European populations. They also suggest that cadmium intake could influence the levels of metabolic and other biochemical factor which are important risk factors for chronic cardiovascular and endocrine system diseases. Acknowledgements We acknowledge the collaboration of the personnel of Transfusion Medicine Unit of AUSL-IRCCS of Reggio Emilia, staff and volunteers of AVIS – Section of Reggio Emilia, and all blood donors who participated to this study.

2018 - Correlation between dietary selenium exposure with biochemical and metabolic parameters: a cross-sectional study in Northern Italy population. [Abstract in Atti di Convegno]
Vinceti, M; Lasagni, D; Bruzziches, F; Baraldi, C; Malagoli, C; Grioni, S; Sieri, S; Santachiara, A; De Luca, T; Pertinhez, T; Baricchi, R; Filippini, T.


2018 - Livelli di assunzione di selenio in un campione di popolazione italiana e correlazione con parametri metabolici ed ormonali: uno studio trasversale in Emilia Romagna. [Abstract in Atti di Convegno]
Vinceti, M; Lasagni, D; Bruzziches, F; Baraldi, C; Malagoli, C; Grioni, S; Sieri, S; Santachiara, Alessia; De Luca, T; Pertinez, T; Baricchi, R; Filippini, T.


2018 - Livelli di esposizione alimentare a cadmio e correlazione con parametri metabolici ed ormonali: uno studio cross-sectional in una popolazione emiliana. [Abstract in Atti di Convegno]
Filippini, T; Lasagni, D; Bruzziches, F; Baraldi, C; Malavolti, M; Grioni, S; Sieri, S; Santachiara, A; De Luca, T; Pertinez, T; Baricchi, R; Vinceti, M


2011 - Experimental study on Satureja montana as a treatment for premature ejaculation [Articolo su rivista]
Zavatti, Manuela; Zanoli, Paola; Benelli, Augusta; Rivasi, Marianna; Baraldi, Claudia; Baraldi, Mario

AbstractAim of the studySatureja montana (winter savory) is a medicinal plant traditionally used to treat different disorders including male sexual dysfunction. In this study we evaluated the effect of Satureja montana hydroalcoholic extract on copulatory behavior of sexually potent male rats.Materials and methodsThe extract was orally administered acutely or repetitively for 8 consecutive days at the doses of 25 and 50 mg/kg. The main parameters of sexual behavior, mount (ML), intromission (IL), ejaculation (EL) latencies and post-ejaculatory interval (PEI), were evaluated in animals submitted to mating test and multiple ejaculations test. Testosterone serum levels were measured in rats acutely treated with Satureja montana extract dosed at 50 mg/kg. In addition the open field test was conducted to evaluate the locomotor behavior.ResultsWhen acutely administered at both dosages, the extract was able to significantly increase EL and decrease intromission frequency (IF) in comparison with controls. The significant increase in EL was found also when the extract was subacutely administered, daily for 8 consecutive days, at the dose of 25 mg/kg. In the multiple ejaculations test, EL values of treated rats were significantly increased during the 1st and 2nd sequence in comparison with controls; in addition only rats treated with the extract were able to reach the 4th ejaculation within 30 min. Testosterone serum level measured in rats acutely treated with Satureja montana at the dose of 50 mg/kg was significantly increased in rats in comparison with controls. Finally, the locomotor activity recorded in the open field test was not affected by the acute administration of the plant extract.ConclusionsThese data suggest that Satureja montana could be considered as a natural remedy for the treatment of premature ejaculation delaying ejaculation latency without exerting any negative effect on the other parameters of sexual behavior and without exerting a sedative effect. In addition the increased serum level of testosterone confirms the positive influence of Satureja montana on male sexual function.

2009 - Natural endogenous ligands for benzodiazepine receptors in hepatic encephalopathy. [Articolo su rivista]
Baraldi, Mario; Avallone, Rossella; Corsi, Lorenzo; Venturini, I; Baraldi, Claudia; Zeneroli, Maria Luisa

Benzodiazepines of natural origin (NBZDs) have been found in human blood and brains as well as in medicinal plants and foods. In plasma and brain tissue there are i.e. diazepam and nordiazepam equal to commercial drugs but there are also other benzodiazepine-like compounds termed “endozepines”, which act as agonists at the benzodiazepine receptors of central type (CBR). A synthetic pathway for the production of NBZDs has not yet been found, but it has been suggested that micro-organisms may synthesize molecules with benzodiazepine-like structures. Hence NBZDs could be of both endogenous and exogenous source and be considered as natural anxyolitic and sedative. Interestingly there are also natural compounds, such as the polypeptide Diazepam Binding Inhibitor (DBI) acting as an “inversive agonist” implicated in fair and panic disorders. It has been suggested that NBZDs may play a role in the pathogenesis of hepatic encephalopathy (HE). Multidirectional studies evaluated NBZDs levels (1) in the blood of normal subjects, of cirrhotic with or without HE and in commercial benzodiazepine consumers; (2) in the blood of cirrhotic treated or not with a non-absorbable antibiotic; (3) in several constituents of our diet. In conclusion, NBZDs increase sometime in cirrhotics with or without HE but they reach concentrations not higher than those found in commercial benzodiazepines consumers. Hence NBZDs must be considered as occasional precipitating factor of HE and benzodiazepine antagonists only symptomatic drugs. The finding that NBZDs may be in part synthesized by intestinal bacterial flora and in part constituent of our diet underlines the importance to feed cirrhotic patients with selected food.

2008 - Improved sexual behavior in male rats treated with a Chinese herbal extract: hormonal and neuronal implications [Articolo su rivista]
Zanoli, Paola; Benelli, Augusta; Zavatti, Manuela; Rivasi, Marianna; Baraldi, Claudia; Baraldi, Mario

Aim: To investigate the influence of an extract obtained from five Chinese medicinal plants on sexual behavior ofadult male rats. Methods: The extract was administered at doses of 30, 60 and 120 mg/kg by oral gavage, acutely (onetime, 45 min before mating test) or subchronically (daily for 10 days) in sexually potent and sexually sluggish/impotentrats. Sexual behavior, serum levels of luteinizing hormone (LH) and testosterone (T) were evaluated in treatedrats and compared with controls receiving vehicle. The effect of the extract on central dopaminergic neurotransmissionwas assessed in the nucleus accumbens using a microdialysis technique. Results: In sexually potent rats, bothacute and subchronic treatment with the extract dosed at 30 and 60 mg/kg reduced mount latency and intromissionlatency. In sluggish/impotent rats, the acutely administered extract at the dose of 60 mg/kg shortened ejaculationlatency, whereas subchronically administered at the doses of 30 and 60 mg/kg, reduced mount, intromission andejaculation latencies, increasing also the percentage of mounting and ejaculating rats. The extract dosed at 60 mg/kgsignificantly increased LH and T following acute and subchronic administration and increased 3,4-dihydroxyphenylaceticacid levels in the nucleus accumbens, 30 min after the acute administration. Conclusion: The improvement in bothappetitive and consummatory components of sexual behavior observed in male rats treated with the extract could beascribed to increased serum T level in parallel with the activation of the central dopaminergic system.

2005 - Management of hepatic encephalopathy: Role of rifaximin [Articolo su rivista]
Zeneroli, Maria Luisa; Avallone, Rossella; Corsi, Lorenzo; I., Venturini; Baraldi, Claudia; Baraldi, Mario

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome, which develops in patients with acute or chronic liver failure. It is widely accepted to be due to impairment of hepatic clearance of toxic products from the gut such as ammonia. Accumulation of ammonia induces a glutamate neurotoxicity leading to an increased tone of the gamma-aminobutyric acid A (GABA-A) receptor system in the brain which results in HE. Factors either increasing the ammonia levels (protein load, constipation, sepsis, or gastrointestinal bleeding) or potentiating the functional activity of the GABAergic system [natural benzodiazepine-like compounds (NBZDs) or exogenous benzodiazepines] may act as precipitating factors of HE. NBZDs are present in trace amounts in the blood of normal subjects and have been found to be increased in the blood of patients with liver cirrhosis, with or without HE. These compounds may derive either from the diet since they have been found in plants, vegetables and animals or from gut bacteria. The observation that intestinal bacterial flora is involved in the production of both primary agent of HE (ammonia) and precipitating factors (NBZDs) suggests that the use of nonabsorbable antibiotics such as rifaximin may be useful in preventing episodes of HE in patients with liver cirrhosis. Copyright

2002 - Antiproliferative effects of Ceratonia siliqua L. on mouse hepatocellular carcinoma cell line [Articolo su rivista]
Corsi, Lorenzo; Avallone, Rossella; F., Cosenza; F., Farina; Baraldi, Claudia; Baraldi, Mario

Extracts from pods and leaves of carob (Ceratonia siliqua L.) were tested for their ability to inhibit cell proliferation of mouse hepatocellular carcinoma cell line (T1). The two extracts showed a marked alteration of T1 cell proliferation in a dose-related fashion reaching the maximal effect at 1 mg/ml. Moreover, we demonstrated that leaf and pod extracts were able to induce apoptosis in T1 cell lines after 24-h treatment mediating a direct activation of the caspase 3 pathway. HPLC analysis revealed the presence of gallic acid, epigallocatechin-3-gallate and (-) epi catechin - 3 -gallate in pod and leaf extracts, compounds well known to exert antiproliferative effects. Their concentration reached 6.28 mg/g in carob leaves and 1.36 mg/g in carob pods extract. The discovery that carob pod and leaf extracts contained antiproliferative agents could be of practical importance in the development of functional foods and/or chemopreventive drugs.

2002 - Extraction and purification from Ceratonia siliqua of compounds acting on central andperipheral benzodiazepine receptors [Articolo su rivista]
Avallone, Rossella; Cosenza, Francesca; Farina, Franco; Baraldi, Claudia; Baraldi, Mario

The presence of molecules with high affinity for central and peripheral benzodiazepine receptors was determined in the pod and leaves of Ceratonia siliqua carob. The amount of the substances able to selectively bind the central benzodiazepine receptor recovered fromcarob pods and leaves was respectively 12.17 and 18.7 ng diazepam equivalentg. The amount of compounds active on peripheral benzodiazepine receptor in both pods and leaves was higher in comparison with the central one, being 49.83 and 40.00 PK 11195 equivalentg, respectively. In particular the compounds acting on peripheral benzodiazepine receptors were found to be extremely concentrated in the young leaves Ž2572.57 ng PK 11195equivalentg. The presence of substances with central benzodiazepine activity in carob extracts seems of great importance in view of the possibility to use carob extract as potential natural products with anxiolytic-sedative effects. Moreover, the prevalence in leaves ofsubstances acting on peripheral benzodiazepine receptor suggests the possible utilisation of leave extracts as chemopreventive agents.

2000 - Caratterizzazione dell'attività farmacologica dell'iperforina in confronto all'estratto di Hypericum perforatum [Abstract in Atti di Convegno]
Muscatello, Cinzia; Baraldi, Claudia; Rivasi, Marianna; Avallone, Rossella; Zanoli, Paola

Allo scopo di chiarire il meccanismo con cui l'iperforina svolge la sua azione ansiolitica, sono stati eseguiti studi preliminari con antagonisti famcaologici che hanno suggerito un possibile coinvolgimento del sistema serotoninergico e una scarsa implicazione del sistema recettoriale benzodiazepinico.

2000 - Characterisation of pharmacoligical activity of hyperforin in comparison with Hypericum extract [Abstract in Atti di Convegno]
Zanoli, Paola; Muscatello, Cinzia; Baraldi, Claudia; Rivasi, Marianna; Avallone, Rossella

In our experiments we studied the influence of hyperforin on locomotor behavior of rats and evaluated its effect in two experimental models of anxiety in comparison with the administration of hypericum extract.

2000 - Definizione delle attività farmacologiche dell'iperforina e relativi meccanismi d'azione [Abstract in Atti di Convegno]
Zanoli, Paola; Muscatello, Cinzia; Baraldi, Claudia; Rivasi, Marianna; Avallone, Rossella

nel nostro studio abbiamo preso in considerazione l'effetto dell'iperforina sul comportamento motorio del ratto e la sua influenza in modelli sperimentali di ansia. In tali esprimenti abbiamo messo a confronto l'attività dell'iperforina acetato con quella di un estratto totale di iperico ottenuto con la tecnica della CO2 supercritica.

2000 - Le benzodiazepine dalla molecola alla pratica clinica [Monografia/Trattato scientifico]
Baraldi, Mario; Avallone, Rossella; Corsi, Lorenzo; Zanoli, Paola; Baraldi, Claudia; Zeneroli, Maria Luisa

La ricerca di molecola endogene ad attività benzodiazepino-simile ha portato alla scoperta di molecole sia negli alimenti che nell'uomo.

2000 - Le benzodiazepine naturali [Capitolo/Saggio]
Baraldi, Mario; Avallone, Rossella; Corsi, Lorenzo; Zanoli, Paola; Baraldi, Claudia; Ml, Zeneroli

Sull’origine delle benzodiazepine naturali trovate nei tessuti e nel sangue di mammiferi sono state formulate due ipotesi: a) origine esogena; b) origine endogena. Entrambe sono state prese in considerazione.Per quanto riguarda l’origine esogena, un nostro studio sistematico sul contenuto di sostanze benzodiazepino-simili negli alimenti (verdure, cereali, frutta, carne, latte, formaggio e condimenti) utilizzati nella dieta mediterranea, ha messo in evidenza una differenza significativa nel contenuto di tali composti fra le varietà dei vegetali diverse sia per genotipo sia per fenotipo [2]. La nozione che le benzodiazepine naturali sono presenti in molti alimenti ha suggerito la possibilità di interferire sullo stato di vigilanza dell’uomo, attraverso la somministrazione di diete particolari capaci di modificarne l’omeostasi nel sangue. E’ possibile pertanto mettere a punto diete a basso contenuto di tali sostanze nei pazienti a rischio di sviluppare disturbi neurologici come nel caso della cirrosi epatica o utilizzare diete ricche di benzodiazepine naturali quali il latte nei soggetti ansiosi o con disturbi del sonno.Per quanto riguarda l’origine endogena, pazienti affetti da cirrosi epatica di media gravità sono stati in primo luogo sottoposti ad una dieta in modo da controllare l’apporto benzodiazepinico alimentare [3]. Dopo 3 giorni di dieta essi sono stati trattati per via orale con rifaximina (800 mg/dì per os per 7 giorni), antibiotico non assorbibile capace di modificare la flora batterica intestinale. L’azione antibatterica della rifaximina ha prodotto in questo breve periodo di terapia una riduzione media del 40 % dei livelli di sostanze benzodiazepino-simili nel sangue. Questa osservazione sembra indicare che la flora batterica intestinale sia capace di influenzare i livelli di sostanze benzodiazepino-simili nel sangue e suggerisce la possibilità di utilizzare nella dieta probiotici e prebiotici e relative associazioni nel tentativo di aumentare la flora batterica intestinale utile alla produzione di benzodiazepine endogene capaci di prevenire eccessive lesioni psichiche e disturbi del sonno.

2000 - Prresenza di sostanze attive sia sul recettore centrale che periferico delle benzodiazepine in estratti di farina e foglie di carruba (Certonia siliqua) [Abstract in Atti di Convegno]
Baraldi, Claudia; Avallone, Rossella; Cosenza, Francesca; A., Trovato; Baraldi, Mario

Nell'ambito di numerose indagini dedicat alla determinazione di composti benzodiazepino-simili in diversi prodotti alimentari, parte delle ricerche hanno riguardato la presenza di tali composti nel bacello e nelle foglie di carruba (Ceratonia siliqua), pianta sempreverde ampiamentediffusa in tutta l'area mediterranea. Se i semi trovano una grande utilizzazione nell'indusria alimentare per l'alta concentrazione di gomme, l'utilizzo dell'intero bacello ha invece delle strette limitazioni per il prevalente carattere astringente dovuto alla presenza dei tannini.

1998 - Diazepam binding inhibitor and total cholesterol plasma levels in cirrhosis and hepatocellular carcinoma [Articolo su rivista]
Venturini, ; Zeneroli, Maria Luisa; Corsi, Lorenzo; Baraldi, Claudia; C., Ferrarese; N., Pecora; M., Frigo; H., Alho; Farina, Franco; Baraldi, Mario

Cholesterol is used by cells for biosynthetic processes and for steroid synthesis. Although the role of cholesterol in tumorigenesis is not clear it is known that steroids are important factors in human carcinogenesis. A polypeptide, diazepam binding inhibitor (DBI), which is an endogenous ligand for peripheral benzodiazepine receptors enhances steroidigenesis by promoting cholesterol delivery to the inner mitochondrial membrane which represents the rate-limiting step of steroid biosynthesis. We have assayed the total cholesterol (TC) and the DBI plasma concentrations in patients with liver cirrhosis complicated by hepatocellular carcinoma (HCC) in comparison with those of uncomplicated liver cirrhosis. TC and DBI levels have been studied in 73 cirrhotic patients and in 23 patients with HCC. Both TC and DBI levels were higher in HCC patients when compared with age, sex and Child–Pugh class matched cirrhotic controls. The values (mean±S.D.) in patients in Child–Pugh class B and C with and without HCC were respectively 128±30 mg/dl vs. 106±27 mg/dl (P<0.01) and 2.05±0.78 pmol/ml vs. 0.78±0.84 pmol/ml (P<0.0001). The data may be the result of the metabolic influence of tumors that enhances steroid biosynthesis during tumor proliferation.

1998 - Endogenous benzodiazepine-like compounds and diazepam binding inhibitor in serum of patients with liver cirrhosis with and without overt encephalopathy [Articolo su rivista]
Avallone, Rossella; Zeneroli, Maria Luisa; I., Venturini; Corsi, Lorenzo; P., Schreier; M., Kleinschnitz; C., Ferrarese; Farina, Franco; Baraldi, Claudia; N., Pecora; M., Frigo; Baraldi, Mario

Background/Aim—Despite some controversy, it has been suggested that endogenous benzodiazepine plays a role in the pathogenesis of hepatic encephalopathy. The aim of the present study was to evaluatethe concentrations of endogenous benzodiazepines and the peptide, diazepam binding inhibitor, in the blood of patients with liver cirrhosis with and without overt encephalopathy, and to compare theselevels with those of consumers of commercial benzodiazepines.Subjects—Normal subjects (90), benzodiazepine consumers (14), and cirrhotic patients (113) were studied. Methods—Endogenous benzodiazepines were measured by the radioligand bindingtechnique after high performance liquid chromatography (HPLC) purification. The presence of diazepam and N-desmethyldiazepam was assayed by HPLC-electrospray tandem mass spectrometry.Diazepam binding inhibitor was studied in serum by radioimmunoassay. Results—Endogenous benzodiazepineswere below the limit of detection in 7% of patients with encephalopathy. When detectable, their levels were at least comparable with those of benzodiazepine consumers and correlated with the liver dysfunction but not the stage of encephalopathy.Serum levels of diazepam binding inhibitor tended to decrease when endogenous benzodiazepines levels increased. Conclusions—Endogenous benzodiazepines may accumulate in patients withliver cirrhosis during the course of the disease, and the phenomenon appears to be independent of the presence or absence of encephalopathy.

1996 - Hepatic Encephalopathy in Liver Transplant Recipients Precipitated By Benzodiazepines Present in Transfused Blood [Articolo su rivista]
Zeneroli, Maria Luisa; I., Venturini; Avallone, Rossella; Farina, Franco; Corsi, Lorenzo; Baraldi, Claudia; G., Ardizzone; M., Centanaro; A., Arrigo; Baraldi, Mario

The observation that there are episodes of encephalopathy in liver cirrhosis patients after orthotopic liver transplantation, despite a well functioning graft and despite the lack of cerebral complications, prompted us to investigate the potential role of circulating benzodiazepine-like compounds in these episodes. The plasma levels of benzodiazepines were examined in 14 liver cirrhotic patients before and after transplantation. The benzodiazepines in the fluids infused during surgery and in individual bags of blood administered after surgery to 4 of these patients were also assayed. Herein we report that benzodiazepines accumulating in the blood of some transplanted patients appear to derive from blood transfusions utilized during surgery. The analysis of the types of benzodiazepines present in the blood utilized for transfusions suggests the use of commercial benzodiazepines by the donors. These compounds seem to be able to precipitate hepatic encephalopathy in patients with preexisting encephalopathy. Hence we suggest not using benzodiazepine consumers as blood donors, at least for patients with encephalopathy undergoing to liver transplantation.