Daniele Guasti

Acquired corneal subepithelial hypertrophy (ACSH) is a rare corneal condition whose ultrastructural features have not previously been characterized. We report the first detailed ultrastructural analysis of ACSH in a 57-year-old man with a history of penetrating keratoplasty for corneal trauma followed by Descemet stripping automated endothelial keratoplasty who presented with progressive visual decline due to a superficial corneal opacity. Clinical evaluation included slitlamp biomicroscopy, anterior segment optical coherence tomography, corneal topography, and pachymetry, which localized the lesion to the subepithelial compartment. The lesion was managed with selective surgical peeling, and the excised tissue was examined by light microscopy and transmission electron microscopy. Surgical removal led to restoration of best-corrected visual acuity with no recurrence at 1-year follow-up. Histopathological analysis demonstrated irregular epithelial thickening, complete absence of Bowman layer, and subepithelial fibrosis with myofibroblast proliferation, without evidence of inflammation or neovascularization. Ultrastructural examination revealed epithelial mitochondrial damage with mitophagy, disruption of intercellular junctions, and subepithelial myofibroblasts containing abundant rough endoplasmic reticulum, consistent with active fibrotic remodeling. These findings support ACSH as an acquired corneal fibrotic process driven by wound healing mechanisms, with clinical, epidemiological, and histopathological features distinct from other corneal degenerations and confirmed that surgical peeling of the thickened epithelial and subepithelial tissue can be curative.

Although photobiomodulation (PBM) therapy (i.e., the application of light with a 600–1100 nm wavelength using laser or light‐emitting diode devices, a power density of less than 100 mW/cm ² , and an energy density of less than 10 J/cm ² at the target) is emerging as a significant noninvasive strategy of promoting regeneration of damaged skeletal muscle tissue, its actual benefits remain debated. In particular, operating parameters exhibiting positive effects on regenerative muscle satellite stem cells need to be clearly identified. Hence, we investigated the effects of red PBM carried out by a laser diode (635 ± 10 nm; 0.4, 4, and 8 J/cm ² ; 4 mW/cm ² ; non‐contact mode; continuous wave; single exposure) on murine myoblasts undergoing differentiation and on mature myotubes by combining morphological, biochemical, and functional analyses. Red PBM, especially with a 4 J/cm ² energy density, did not alter cell viability but successfully promoted the expression of myogenic transcription factors as myoblast determination protein 1 (MyoD) and myogenin, as well as myotube formation, mitochondrial metabolism, and biogenesis. Consistently, electrophysiological analyses of cell membrane passive properties and inward ion currents indicated the acquisition of a more differentiated phenotype in PBM‐treated cells. Moreover, we found that PBM was able to enhance the release of extracellular vesicles (EVs) during cell differentiation according to a promyogenic phenotype. Red PBM treatment did not alter mature myotube viability and dimension while increasing their secretion of promyogenic EVs. Overall, this study provides experimental evidence supporting promyogenic effects of red PBM and the essential groundwork for further preclinical and clinical studies in the field of skeletal muscle regenerative medicine.

Organogenesis occurs in the uterus under low oxygen levels (4%). Preterm birth exposes immature newborns to a hyperoxic environment, which can induce a massive production of reactive oxygen species and potentially affect organ development, leading to diseases such as necrotizing enterocolitis. The β3-adrenoreceptor (β3-AR) has an oxygen-dependent regulatory mechanism, and its activation exerts an antioxidant effect. To test the hypothesis that β3-AR could protect postnatal ileal development from the negative impact of high oxygen levels, Sprague–Dawley rat pups were raised under normoxia (21%) or hyperoxia (85%) for the first 2 weeks after birth and treated or not with BRL37344, a selective β3-AR agonist, at 1, 3, or 6 mg/kg. Hyperoxia alters ileal mucosal morphology, leading to increased cell lipid oxidation byproducts, reduced presence of β3-AR-positive resident cells, decreased junctional protein expression, disrupted brush border, mucin over-production, and impaired vascularization. Treatment with 3 mg/kg of BRL37344 prevented these alterations, although not completely, while the lower 1 mg/kg dose was ineffective, and the higher 6 mg/kg dose was toxic. Our findings indicate the potential of β3-AR agonism as a new therapeutic approach to counteract the hyperoxia-induced ileal alterations and, more generally, the disorders of prematurity related to supra-physiologic oxygen exposure.

Hyponatremia is the prevalent electrolyte imbalance in cancer patients, and it is associated with a worse outcome. Notably, emerging clinical evidence suggests that hyponatremia adversely influences the response to anticancer treatments. Therefore, this study aims to investigate how reduced extracellular [Na⁺] affects the responsiveness of different cancer cell lines (from human colon adenocarcinoma, neuroblastoma, and small cell lung cancer) to cisplatin and the underlying potential mechanisms. Cisplatin dose–response curves revealed higher IC50 in low [Na⁺] than normal [Na⁺]. Accordingly, cisplatin treatment was less effective in counteracting the proliferation and migration of tumor cells when cultured in low [Na⁺], as demonstrated by colony formation and invasion assays. In addition, the expression analysis of proteins involved in autophagosome–lysosome formation and the visualization of lysosomal areas by electron microscopy revealed that one of the main mechanisms involved in chemoresistance to cisplatin is the promotion of autophagy. In conclusion, our data first demonstrate that the antitumoral effect of cisplatin is markedly reduced in low [Na⁺] and that autophagy is an important mechanism of drug escape. This study indicates the role of hyponatremia in cisplatin chemoresistance and reinforces the recommendation to correct this electrolyte alteration in cancer patients.

Adipokines are peptide hormones produced by the adipose tissue involved in several biological functions. Among adipokines, adiponectin (ADPN) has antidiabetic and anti-inflammatory properties. It can also modulate food intake at central and peripheral levels, acting on hypothalamus and facilitating gastric relaxation. ADPN exerts its action interacting with two distinct membrane receptors and triggering some well-defined signaling cascades. The ceramidase activity of ADPN receptor has been reported in many tissues: it converts ceramide into sphingosine. In turn, sphingosine kinase (SK) phosphorylates it into sphingosine-1 phosphate (S1P), a crucial mediator of many cellular processes including contractility. Using a multidisciplinary approach that combined biochemical, electrophysiological and morphological investigations, we explored for the first time the possible role of S1P metabolism in mediating ADPN effects on the murine gastric fundus muscle layer. By using a specific pharmacological inhibitor of SK2, we showed that ADPN affects smooth muscle cell membrane properties and contractile machinery via SK2 activation in gastric fundus, adding a piece of knowledge to the action mechanisms of this hormone. These findings help to identify ADPN and its receptors as new therapeutic targets or as possible prognostic markers for diseases with altered energy balance and for pathologies with fat mass content alterations.

Fibroblasts play a crucial role in wound healing and skin fibrosis. It is also probably the cell model used to study in vitro photobiomodulation. Our previous in vivo results evidenced a faster recovery in blue-light-treated wounds (410–430 nm). In vitro experiments demonstrated that the lower dose increases cell metabolism, while higher doses (30.9 and 41.2 J/cm²) reduce it. Furthermore, 20.6 J/cm² affects outward currents and Cytochrome C. Here, we described our preliminary results on the effects of blue LED light on mitochondria and reactive oxygen species production. Globally, our results demonstrated that short-wavelength blue LED light has PBM properties.

Adiponectin (ADPN), a hormone produced by adipose tissue, facilitates gastric relaxation and can be a satiety signal in the network connecting peripheral organs and the central nervous system for feeding behavior control. Here, we performed preclinical research by morpho-functional analyses on murine gastric fundus smooth muscle to add insights into the molecular mechanisms underpinning ADPN action. Moreover, we conducted a clinical study to evaluate the potential use of ADPN as a biomarker for eating disorders (ED) based on the demonstrated gastric alterations and hormone level fluctuations that are often associated with ED. The clinical study recruited patients with ED and healthy controls who underwent blood draws for ADPN dosage and psychopathology evaluation tests. The findings of this basic research support the ADPN relaxant action, as indicated by the smooth muscle cell membrane pro-relaxant effects, with mild modifications of contractile apparatus and slight inhibitory effects on gap junctions. All of these actions engaged the ADPN/nitric oxide/guanylate cyclase pathway. The clinical data failed to unravel a correlation between ADPN levels and the considered ED, thus negating the potential use of ADPN as a valid biomarker for ED management for the moment. Nevertheless, this adipokine can modulate physiological eating behavior, and its effects deserve further investigation.

The understanding of the molecular mechanisms leading to melanoma dissemination is urgently needed in view of the identification of new targets and the development of innovative strategies to improve patients’ outcomes. Within the complexity of tumor intercellular communications leading to metastatic dissemination, extracellular vesicles (EV) released by tumor cells are central players. Indeed, the ability to travel through the circulatory system conveying oncogenic bioactive molecules even at distant sites makes EV capable of modulating recipient cells to facilitate metastatic dissemination. The dynamic remodeling of the tumor microenvironment might influence, along with a number of other events, tumoral EV release. We observed that, in melanoma, extracellular acidosis increases the release of EV enriched in miR-214, an onco-miRNA involved in melanoma metastasis. Then, miR-214-enriched EV were found to induce a state of macrophage activation, leading to an overproduction of proinflammatory cytokines and nitric oxide. Such an inflammatory microenvironment was able to alter the endothelial cell permeability, thereby facilitating the trans-endothelial migration of melanoma cells, a crucial step in the metastatic cascade. The use of synthetic miR-214 inhibitors and miR-214 overexpression allowed us to demonstrate the key role of miR-214 in the EV-dependent induction of macrophage activation. Overall, our in vitro study reveals that the release of tumor miR-214-enriched EV, potentiated by adapting tumor cells to extracellular acidosis, drives a macrophage-dependent trans-endothelial migration of melanoma cells. This finding points to miR-214 as a potential new therapeutic target to prevent melanoma intravasation.

Considerable evidence accumulated over the past decade supports that telocytes (TCs)/CD34⁺ stromal cells represent an exclusive type of interstitial cells identifiable by transmission electron microscopy (TEM) or immunohistochemistry in various organs of the human body, including the skin. By means of their characteristic cellular extensions (telopodes), dermal TCs are arranged in networks intermingled with a multitude of neighboring cells and, hence, they are thought to contribute to skin homeostasis through both intercellular contacts and releasing extracellular vesicles. In this context, fibrotic skin lesions from patients with systemic sclerosis (SSc, scleroderma) appear to be characterized by a disruption of the dermal network of TCs, which has been ascribed to either cell degenerative processes or possible transformation into profibrotic myofibroblasts. In the present study, we utilized the well-established mouse model of bleomycin-induced scleroderma to gain further insights into the TC alterations found in cutaneous fibrosis. CD34 immunofluorescence revealed a severe impairment in the dermal network of TCs/CD34⁺ stromal cells in bleomycin-treated mice. CD31/CD34 double immunofluorescence confirmed that CD31⁻/CD34⁺ TC counts were greatly reduced in the skin of bleomycin-treated mice compared with control mice. Ultrastructural signs of TC injury were detected in the skin of bleomycin-treated mice by TEM. The analyses of skin samples from mice treated with bleomycin for different times by either TEM or double immunostaining and immunoblotting for the CD34/α-SMA antigens collectively suggested that, although a few TCs may transition to α-SMA⁺ myofibroblasts in the early disease stage, most of these cells rather undergo degeneration, and then are lost. Taken together, our data demonstrate that TC changes in the skin of bleomycin-treated mice mimic very closely those observed in human SSc skin, which makes this experimental model a suitable tool to (i) unravel the pathological mechanisms underlying TC damage and (ii) clarify the possible contribution of the TC loss to the development/progression of dermal fibrosis. In perspective, these findings may have important implications in the field of skin regenerative medicine.