L'outcome dei pazienti sottoposti a trapianto allogenico di cellule staminali emopoietiche è fortemente influenzato da graft versus leukemia (GvL) e graft versus host disease (GvHD) che sono mediate, almeno in parte, dagli antigeni minori di istocompatibilità (mHAgs). In letteratura sono stati identificati 26 mHAgs che sono stati correlati a GvHD/GvL con risultati incompleti e in alcuni casi contrastanti; inoltre manca una metodica che sia in grado di genotipizzare contemporaneamente un pannello così ampio. Il lavoro è stato finalizzato alla preparazione di un protocollo di laboratorio che permetta di studiare in modo efficace i 26 mHAgs identificati, per poi correlarli con GvHD/GvL all’interno di uno specifico gruppo di trapiantati. Utilizzando la metodica IPlex Gold Mass Array Sequenom e tecniche di biologia molecolare convenzionale sono stati genotipizzati 26 antigeni minori di istocompatibilità per 46 coppie full-matched. Tutti i pazienti inclusi nel progetto di studio erano stati sottoposti a trapianto allogenico di cellule staminali emopoietiche da donatore familiare o volontario full-compatibile per leucemia mieloide cronica (n=46) o leucemia acuta linfoblastica Philadelphia positiva (LAL-Ph+, n=24). Il progetto ha confermato l'efficienza (98.6%) e la fattibilità delle metodiche proposte. Dal lavoro è inoltre emerso che, le differenze tra donatore e ricevente a libello mHAgs ACC-1, ACC-4, ACC-5, LB-MTHFD1-1Q, UGT2B17, DPH1, LRH1 potrebbero essere fattori predittivi di GvHD (p<0.05). La seconda evidenza è legata a un trend secondo cui il mismatch per LB-ADIR1 protegge dalla recidiva di malattia, in particolare nei confronti della LAL-Ph+ che è scarsamente responsiva all'allo-immunoterapia. Questo lavoro pilota, la cui casistica deve quindi essere ampliata, ha dimostrato l’efficacia della genotipizzazione con IPlex Gold Sequenom e l’elevato potenziale degli mHAgs sia come fattori predittivi di GvHD che come driver di GvL. / The outcome of allogeneic stem cell transplantation (Allo-SCT) is closely related to graft versus host disease (GvHD) and graft versus leukemia (GvL) effects which, in part, are mediated by mHAgs. Twenty-six mHAgs have been identified and reported to be differently and variably correlated with GVHD or GVL, but a simultaneous method to genotype a so large panel of mHAgs has never been employed. The aim of this work has been to develop a feasible method to genotype all the 26 mHAgs described so far and to test them for their correlation with GVHD and GVL in a group of donor/recipient pairs submitted to allo-SCT. For a multi-genotyping of 23 mHAgs we used iPlex Gold Mass Array technology (3 multiplex). For the other three mHAgs we designed other three assays based on conventional molecular biology. By these methods, we tested the 26 mHAgs in 46 donor/recipient pairs full-matched that underwent allo-SCT (sibling or MUD) because of Philadelphia positive CML (n=46) or ALL-Ph+ (n=24). Maldi-Tof IPlex Gold technology proved a high degree of efficiency (98.6%). As expected, sibling pairs showed most identity of MUD pairs. Notably, donor/recipient mismatch on ACC-1, ACC-4, ACC-5, LB-MTHFD1-1Q, UGT2B17, DPH1, LRH1 can drive GvHD effect (p<0.01). Next we identified that LB-ADIR1 can enhance (p=ns, but there is a trend) GvL effect specially on ALL-Ph+ that is otherwise un-responsible to allo-immunotherapy. Our data generated by a multi-genotype technique confirm the role of mHAgs in addressing GvL (in some cases without GvHD) and suggest that a study of mHAgs could be perfomed before transplant in order to better investigate the role of the known and new mHAgs involved in GvHD and GvL effects.

Sulla base delle evidenze della letteratura (Fenaux, 2009; Lyons, JCO 2009), a partire da Settembre 2004 nel Nostro Istituto sono stati trattati 57 pazienti affetti da Sindrome Mielodisplastica (MDS) mediante terapia demetilante con 5-Azacitidina. Sono stati utilizzati differenti regimi terapeutici a seconda della classe di rischio IPSS: i pazienti a rischio basso/intermedio-1 hanno ricevuto Azacitidina 75 mg/mq/die sottocute per 5 giorni/mese (schema 5) per 8 cicli; i pazienti a rischio alto/intermedio-2 hanno ricevuto Azacitidina 50 mg/mq/die sottocute per 10 giorni/mese (schema 5+2+5) o Azacitidina 75 mg/mq/die per 7 giorni/mese (schema 7) fino a perdita della risposta. Su una casistica totale di 57 pazienti (15 a rischio basso/int-1; 41 rischio alto/int-2), l’87.7% (50 pazienti) sono risultati valutabili. Tra questi le risposte osservate sono state del 68% (34 pazienti), di cui il 14% (7 pazienti) ha ottenuto una Remissione Completa (CR) ed il 54% (27 pazienti) ha ottenuto un Hematologic Improvement (HI). La valutazione della risposta è stata eseguita secondo i criteri dell’International Working Group 2006 (IWG, Cheeson 2006). Le principali tossicità osservate sono state rappresentate da reazioni cutanee locali nel sito d’iniezione, tossicità gastrointestinale (stipsi e/o diarrea), mielotossicità, neutropenia febbrile, sepsi (3 pazienti). Tra i pazienti trattati abbiamo osservato la presenza di risposta ematologica prolungata (≥ 20 mesi) in 10 pazienti (20% dei pazienti valutabili). Inoltre, grazie alla collaborazione con il Dipartimento di Anatomia Umana dell’Università di Bologna (Prof. L. Cocco, Dott.ssa M.Y. Follo), tutti i pazienti trattati sono stati valutati per i livelli di espressione genica e metilazione del gene della fosfolipasi PI-PLC-beta1. I dati biologici così ottenuti sono stati correlati con quelli clinici, evidenziando la presenza di una correlazione tra i livelli di espressione genica e mutilazione della PI-PLC-beta1 e la risposta alla terapia demetilante con 5-Azacitidina. / Based on the evidence of literature (Fenaux 2009; Lyons 2009), from September 2004, in our Institute, 57 patients (pts) with Myelodysplastic Syndrome were treated (MDS) with demethylating therapy. We used 4 different regimens depending on the class of IPSS risk: patients at risk low/int-1 received Azacitidine 75 mg/sqm/day subcutaneously for 5 days/month (AZA 5) for 8 cycles, patients at risk high/int-2 received Azacitidine 50 mg/sqm/day subcutaneously for 10 days/month (AZA 5-2-5) or Azacitidine 75 mg/sqm/day for 7 days/month (AZA 7) until loss of response. On a series total of 57 pts (15 lower risk; 41 higher risk), 87 .7% (50 pts) were evaluable. Among these, responses observed were 68% (34 pts): 14% (7 pts) achieved complete remission (CR) and 54% (27 pts) had a Hematologic Improvement (HI). The assessment of response was performed according to the criteria of the International Working Group 2006 (Cheeson 2006). The main toxicities observed were represented by local skin reactions at the injection site, gastrointestinal toxicity (constipation and/or diarrhea), myelotoxicity, febrile neutropenia, sepsis (3 pts). Among the patients we observed the presence of prolonged hematologic response (≥ 20 months) in 10 pts (20% of evaluable patients). In addition, thanks to the collaboration with the Department of Human Anatomy, University of Bologna (Prof. L. Cocco, Dr. Follo MY), all patients were evaluated for levels of gene expression and gene methylation of phospholipase PI PLC- ß 1. The biological data obtained were correlated with clinical, highlighting the presence of a correlation between the levels of gene expression and mutilation of PI-PLC-ß1 and response to therapy with demethylating 5-Azacitidine.

Abnormal Hedgehog signaling is associated with human malignancies. Smo, a key player of that signaling, is the most suitable target to inhibit this pathway. To this aim several molecules, antagonists of Smo, have been synthesized, and some of them have started the phase I in clinical trials. Our hospital participated to one of these studies which investigated the oral administration of a new selective inhibitor of Smo (SMOi). To evaluate ex vivo SMOi efficacy and to identify new potential clinical biomarkers of responsiveness, we separated bone marrow CD34+ cells from 5 acute myeloid leukemia (AML), 1 myelofibrosis (MF), 2 blastic phases chronic myeloid leukemia (CML) patients treated with SMOi by immunomagnetic separation, and we analysed their gene expression profile using Affimetrix HG-U133 Plus 2.0 platform. This analysis, showed differential expression after 28 days start of therapy (p-value ≤ 0.05) of 1,197 genes in CML patients and 589 genes in AML patients. This differential expression is related to Hedgehog pathway with a p-value = 0.003 in CML patients and with a p-value = 0.0002 in AML patients, suggesting that SMOi targets specifically this pathway. Among the genes differentially expressed we observed strong up-regulation of Gas1 and Kif27 genes, which may work as biomarkers of responsiveness of SMOi treatment in CML CD34+ cells whereas Hedgehog target genes (such as Smo, Gli1, Gli2, Gli3), Bcl2 and Abca2 were down-regulated, in both AML and CML CD34+ cells. It has been reported that Bcl-2 expression could be correlated with cancer therapy resistance and that Hedgehog signaling modulate ATP-binding (ABC) cassette transporters, whose expression has been correlated with chemoresistance. Moreover we confirmed that in vitro SMOi treatment targets Hedgehog pathway, down-regulate ABC transporters, Abcg2 and Abcb1 genes, and in combination with tyrosine kinase inhibitors (TKIs) could revert the chemoresistance mechanism in K562 TKIs-resistant cell line.

L’applicazione della citogenetica convenzionale e molecolare può identificare: Ph-negatività, traslocazioni t(9;22) varianti e alterazioni citogenetiche addizionali (ACA) al cromsoma Ph in pazienti con LMC alla diagnosi. Prima dell’introduzione della terapia con Imatinib, esse mostravano un impatto prognostico negativo o non chiaro. Nel nostro studio, 6 casi di LMC Ph- erano trattati con Imatinib. La FISH identificava 4 casi con riarrangiamento BCR/ABL sul der(9q), 1 sul der(22q) e 1 su entrambi i derivativi. Quattro pazienti (66,7%) raggiungevano la RCgC, 2 fallivano il trattamento e 1 sottoposto a TMO. A causa dello scarso numero di casi, non era possibile nessuna correlazione con la prognosi. Nell’ambito di studi prospettici multicentrici del GIMEMA-WP, abbiamo valutato: traslocazioni varianti e ACA. Dei 559 pazienti arruolati, 30(5%) mostravano traslocazioni varianti, 24 valutabili in FISH: 18(75%) mostravano meccanismo 1-step, 4(16,7%) meccanismo 2-step e 2(8,3%) meccanismo complesso. Abbiamo confermato che le varianti non influenzano la risposta e la sopravvivenza dei pazienti trattati con Imatinib. Dei 378 pazienti valutabili alla diagnosi con citogenetica convenzionale, 21(5,6%) mostravano ACA: 9(43%) avevano la perdita del cromosoma Y, 3(14%) trisomia 8, 2(10%) trisomia 19, 6(28%) altre singole anomalie e 1 cariotipo complesso. La presenza di ACA influenzava la risposta: le RCgC e RMolM erano significativamente più basse rispetto al gruppo senza ACA e le curve di sopravvivenza EFS e FFS non erano significativamente diverse. Le curve di PFS e OS erano sovrapponibili nei due gruppi, per il basso numero di eventi avversi oppure perché alcuni raggiungevano la risposta con TKI di seconda generazione. Le anomalie “major route” mostravano decorso clinico peggiore, ma non è stato possibile determinare l’impatto prognostico in relazione al tipo di alterazione. Pertanto, le ACAs alla diagnosi rivestono un ruolo negativo nella prognosi dei pazienti trattati con Imatinib, che quindi rappresentano una categoria più a rischio per la risposta. / At diagnosis in chronic myeloid leukemia (CML) patients, conventional cytogenetics and FISH analysis can identify: Ph- CML cases, variant t(9;22) translocations and additional chromosomal abnormalities (ACAs) in Ph-positive clone. Before the introduction of the Imatinib therapy, these characteristics showed a negative or not clear prognostic role. We analysed 6 Ph- cases treated with Imatinib. FISH analysis showed 4 cases with BCR/ABL rearrangement on der(9q), 1 on der(22q) and 1 on both derivatives chromosomes. Four patients (66,7%) reached CCgR, 2 failed treatment and 1 died after stem cell transplantation. Beacause of small of number of cases, we cannot stated that Ph-masked cases have a worse prognosis. Within the clinical trial of GIMEMA WP, we have analysed variant t(9;22) translocations and ACAs. Five-hundred-fifty-nine patients were enrolled; 30(5%) had variant translocations of which 24 could be evaluated by FISH: 18(75%) showed 1-step mechanism, 4(16,7%) 2-step mechanism and 2(8,3%) complex mechanism. We observed that variant translocations didn’t influence the responses and the outcome in patients treated with Imatinib. At diagnosis, 378 patients were evaluable by cytogenetics. Twenty-one (5,6%) showed ACAs: 9 (43%) had loss of Y chromosome, 3(14%) trisomy 8, 2(10%) trisomy 19, 6(28%) other isolated abnormalities and 1(15%) complex karyotype. We reported that the presence of ACAs influenced the responses: the CCgR and MMolR were significantly lower compared with those of the group without ACAs, but EFS and FFS were not significantly different. PFS and OS curves were overlapped, because of the low number of negative events or because some patients reached response with second generation TKI treatment. Cases with “major route” abnormalities showed worse outcome, but we cannot established the impact related to the kind of abnormality. However, ACAs at diagnosis had a negative role on the response to the therapy in CML patients, which constitute a “warning” category for Imatinib treatment.

This research work is aimed at the valorization of two types of pomace deriving from the extra virgin olive oil mechanical extraction process, such as olive pomace and a new by-product named “paté”, in the livestock sector as important sources of antioxidants and unsaturated fatty acids. In the first research the suitability of dried stoned olive pomace as a dietary supplement for dairy buffaloes was evaluated. The effectiveness of this utilization in modifying fatty acid composition and improving the oxidative stability of buffalo milk and mozzarella cheese have been proven by means of the analysis of qualitative and quantitative parameters. In the second research the use of paté as a new by-product in dietary feed supplementation for dairy ewes, already fed with a source of unsaturated fatty acids such as extruded linseed, was studied in order to assess the effect of this combination on the dairy products obtained. The characterization of paté as a new by-product was also carried out, studying the optimal conditions of its stabilization and preservation at the same time. The main results, common to both researches, have been the detection and the characterization of hydrophilic phenols in the milk. The analytical detection of hydroxytyrosol and tyrosol in the ewes’ milk fed with the paté and hydroxytyrosol in buffalo fed with pomace showed for the first time the presence in the milk of hydroxytyrosol, which is one of the most important bioactive compounds of the oil industry products; the transfer of these antioxidants and the proven improvement of the quality of milk fat could positively interact in the prevention of some human cardiovascular diseases and some tumours, increasing in this manner the quality of dairy products, also improving their shelf-life. These results also provide important information on the bioavailability of these phenolic compounds.

Nowadays it is requested more investigations on alternative rearing systems that are able to improve poultry welfare and to warrant high-quality and safe meat products. This thesis work was focused on the evaluation of the oxidative stability of poultry meats, obtained with different rearing systems, diets (supplemented with bioactive compounds), and packaging conditions. The thesis work was divided into the following parts: - Evaluation of the effects of different rearing systems on the quality, fatty acid composition and oxidative stability of poultry thigh and breast meat belonging to different product categories (“rotisserie” and “cut-up” carcasses); - Evaluation of the effects of different rearing systems and packaging conditions on the shelf-life of poultry thigh meat stored at 4°C for 14 days, and the effects of feed supplementation with thymol (control diet and diet with 2 different concentration of thymol) and packaging conditions on lipid oxidation of poultry thigh meat shelf-life (stored at 4°C for 14 days). The oxidative stability of poultry meat was studied by means of the spectrophotometric determinations of peroxide value and thiobarbituric acid reactive substances. - Evaluation of anti-inflammatory effects of different flavonoids (thymol, luteolin, tangeretin, sulforaphane, polymethoxyflavones, curcumin derivates) to detect their biological activity in LPS-stimulated RAW 264.7 macrophage cells in vitro, in order to study more in depth their action mechanisms. It was evaluated the cell vitality (MTT assay), nitrite concentration and protein profile. The study was focused on the identification of potential dietary bioactive compounds in order to investigate their biological activity and possible synergic effects, and to develop new suitable strategies for long-term promotion of human health, in particular against cancer. / Oggigiorno sono sempre più richiesti i lavori di ricerca sullo studio di sistemi di allevamento alternativi in grado di migliorare il benessere degli animali e di migliorare la qualità e la sicurezza delle carni. Il presente elaborato di tesi si è basato sulla valutazione dello stato ossidativo di carni avicole, provenienti da animali allevati con sistemi alternativi ed alimentati con diete integrate con composti bioattivi, e conservate in diverse tipologie di packaging. L’organizzazione della ricerca si è sviluppata nei seguenti punti: - Valutazione dell’effetto di sistemi di allevamento alternativi del pollo da carne sulla qualità, composizione degli acidi grassi e stabilità ossidativa della frazione lipidica muscolare delle carni di petto e coscia ottenute da due categorie commerciali (“Rotisserie” e “Cut-up”); - Studio della stabilità ossidativa condotta mediante prove di shelf-life su carni di coscia ottenute da polli allevati con diversi sistemi di allevamento e alimentati con tre tipi di diete (dieta di controllo e diete arricchite di timolo a due diverse concentrazioni). Queste carni sono state confezionate con diverse modalità (atmosfera ordinaria e protettiva) e conservate in condizioni di refrigerazione (2-4°C) per 14 giorni. La stabilità ossidativa è stata valutata mediante le determinazioni spettrofotometriche del numero di perossidi e delle sostanze reattive all’acido tiobarbiturico; - Valutazione dell’attività anti-infiammatoria di diversi bioflavonoidi (timolo, luteolina, tangeretina, sulforafano, polimetossiflavoni, derivati della curcumina), facendo luce sui meccanismi d’azione di quest’ultimi, su linee cellulari macrofagiche (LPS-stimulated RAW 264.7 cells) in vitro. Sono stati valutati la vitalità cellulare (MTT assay), la determinazione indiretta dell’ossido nitrico e l’identificazione delle proteine. In particolare, il lavoro si è soffermato sull’identificazione di potenziali componenti nutraceutici, caratterizzati da una forte azione sinergica, con lo scopo di indagare sulla loro attività biologica ed i loro possibili effetti sinergici e quindi di sviluppare nuove strategie finalizzate alla prevenzione del cancro, a lungo termine.

Over the past 15 years the Italian brewing scene showed interesting changes, especially with regard to the creation of many breweries with an annual production of less than 10,000 hectoliters. The beers produced by microbreweries are very susceptible to attack by spoilage micro-organisms that cause the deterioration of beer quality characteristics. In addition, most of the microbreweries do not practice heat treatments of stabilization and do not carry out quality checks on the product. The high presence of beer spoilage bacteria is an economic problem for the brewing industry because it can damage the brand and it causes high costs of product retrieval. This thesis project was aimed to study the management of the production process in the Italian microbreweries within a production less than 10,000 hl. In particular, the annual production, type of plant, yeast management, process management, cleaning and sanitizing of a representative sample of microbreweries were investigated. Furthermore was made a collection of samples in order to identify, with simple methods, what are spoilage bacteria more present in the Italian craft beers. 21% of the beers analysed were positive at the presence of lactic acid bacteria. These analytical data show the importance of understanding what are the weak points of the production process that cause the development of spoilage bacteria. Finally, the thesis examined the actual production of two microbreweries in order to understand the process management that can promote the growth of spoilage bacteria in beer and production plant. The analysis of the data for the two case studies was helpful to understand what are the critical points where the microorganisms are most frequently in contact with the product. The hygiene practices are crucial to ensure the quality of the finished product, especially in the case of non-pasteurized beer.

La tesi intende offrire una riflessione in merito al potere degli organi giurisdizionali di disporre normativamente su determinati aspetti del processo che si svolge dinanzi ad essi, sostituendosi così al legislatore. Il piano di indagine della tesi si sviluppa prevalentemente nella descrizione della realtà europea davanti alle autorità giurisdizionali di Lussemburgo, attraverso continui riferimenti a pronunce giurisprudenziali. La candidata si sofferma, preliminarmente, definendo, in termini generali, l’origine e l’applicazione dei c.d. atti di soft law in ambito europeo e soffermandosi sul ruolo che ricopre la giurisprudenza nell’ordinamento europeo. Sempre nel capitolo di apertura, un accenno è dedicato al panorama italiano che, alla luce delle recenti e continue riforme processuali ed, in particolare, della lettura costituzionalmente orientata del processo civile in forza della sua ragionevole durata, sta conoscendo, sempre più largamente, il fenomeno dei c.d. protocolli. La tesi si sviluppa, poi, in altri tre capitoli, nei quali sono analizzati tre esempi di manifestazione del potere normativo degli organi giurisdizionali europei sul processo. La candidata passa, così, all’esame delle “Istruzioni pratiche alle parti”, sviscerando le disposizioni ivi contenute alla luce di casi giurisprudenziali, al fine di poter definire la reale efficacia di tali atti e la loro vincolatività nei confronti dei rappresentanti delle parti. A tale capitolo segue quello sull’applicazione del rinvio pregiudiziale tra soft law (c.d. Raccomandazioni) e giurisprudenza. Infine, la candidata svolge le ultime riflessioni sul potere “eccezionale” della Corte di giustizia di limitare nel tempo gli effetti delle proprie sentenze interpretative. Potere che, in questo caso, si manifesta non mediante l’emanazione di atti di soft law, ma attraverso le proprie pronunce giurisprudenziali. / The thesis aims to reflect on the power of the courts to provide normatively on some aspects of the proceedings that take place before them, thus replacing the legislator. The investigation plan of the thesis is developed considering the European situation before the courts of Luxembourg, through continuous references to cases law. The candidate focuses, firstly, defining, in general terms, origin and application of so-called soft law acts in Europe and focusing on the role of jurisprudence in the European system. In the first chapter, a hint is dedicated to the Italian overview, in the light of recent reforms of civil proceedings and with particular reference to the phenomenon of so-called “protocols”. The thesis is then developed in three other chapters, in which the candidate analyzes three examples of the manifestation of normative power of the European Courts on the proceedings. The candidate examines the "Practice Directions to parties": identifying the provisions contained in the light of cases law, in order to define the real effectiveness of these acts and their binding against parties’ representatives. The third chapter is about preliminary ruling procedure between soft law (so-called “Recommendation to national courts and tribunals in relation to the initiation of preliminary ruling proceedings) and jurisprudence. In the end, the candidate plays the latest reflections on "exceptional" power of the Court of Justice of the European Union to limit the temporal effects of its interpretative judgments. Power which, in this case, is manifested not through the enactment of soft law acts, but through its case law.

La tesi intende offrire una panoramica approfondita dello strumento sommario, ed in particolare di come il legislatore ne abbia fatto uso nel nostro ordinamento, soprattutto nelle recenti riforme del codice di procedura civile. La candidata si sofferma, dapprima, in un’analisi generale circa la definizione del concetto stesso di sommarizzazione, anche attraverso la disamina delle varie posizioni dottrinali e giurisprudenziali emerse, sul punto, negli ultimi anni. / This thesis wants to provide an examination of the instrumento of summarisation, and in particular how the legislature has used it in our system, especially in the recent reforms of the Code of Civil Procedure. The candidate focuses, at first, in a general analysis on the definition of the concept of summarization, also through the examination of the various positions of doctrine and jurisprudence, emerged on this point in recent years.

Fusarium head blight (FHB), caused mainly by Fusarium graminearum, is one of the most destructive global diseases of small cereal grains worldwide. The most devastating effect of this disease is the deposition of mycotoxins in the grain. Deoxynivalenol (DON) and its analogs 3-ADON, 15-ADON and NIV are the major mycotoxins produced by the fungus. The chemotype, 15-ADON is more prevalent in North America, but recently a chemotypic shift has been observed. The rapid emergence of the 3-ADON chemotype over the traditional 15-ADON chemotype is a major concern in North America. The studies in this thesis were focused on understanding the behaviour of the 3-ADON and 15-ADON chemotypes and the possible reasons for the rapid chemotypic shift.