Andrea Gramegna

University of Milan

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Co-Authors

Francesco Blasi

University of Milan

147

Stefano Aliberti

Humanitas University

111

Francesco Amati

Humanitas University

Martina Contarini

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Giovanni Sotgiu

University of Sassari

Leonardo Terranova

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Gianfranco Alicandro

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Martina Oriano

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Marco Mantero

University of Milan

Paola Marchisio

Pediatric Oncology Group

Cooperative Institutions

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

337

University of Milan

319

Istituti di Ricovero e Cura a Carattere Scientifico

242

Ospedale Maggiore

176

University Orthopedics Center

114

Institute for Transfusion Medicine

110

University of Milano-Bicocca

Luigi Sacco Hospital

Ninewells Hospital

University of Dundee

Author Statistics

Papers

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The impact of elexacaftor/tezacaftor/ivacaftor therapy on the pulmonary management of adults with cystic fibrosis: An expert-based Delphi consensus

Respiratory Medicine (2023)

Andrea Gramegna Stefano Aliberti Maria Adelaide Calderazzo Rosaria Casciaro Clara Ceruti

BackgroundThe advent of elexacaftor/tezacaftor/ivacaftor (ETI) resulted in unprecedented clinical benefits for eligible adults with CF. As a result, the question of whether chronic treatments can be safely stopped or adapted to this new situation has become a matter of great interest. Our objective was to derive a consensus among Italian experts on the impact of ETI on the current clinical management of CF lung disease.MethodsFrom December 2021 to April 2022 a panel of Italian experts endorsed by the national CF scientific society derived and graded a set of statements on the pulmonary management of adults with cystic fibrosis through a modified Delphi methodology.ResultsThe panel produced 13 statements exploring possible modifications in the fields of inhaled antibiotics and mucoactives; airway clearance and physical activity; chronic macrolides and bronchodilators; and lung transplant referral. The areas that the experts considered most urgent to explore were the impact of ETI on the role of inhaled antibiotics and lung transplant.ConclusionsThe list of priorities that emerged from this study could be useful to guide and inform clinical research on the most urgent area of impact of ETI on CF lung disease and its clinical management.

Ivacaftor

Delphi Method

Disease management

10.1016/j.rmed.2023.107455

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Citations (3)

A new call for influenza and pneumococcal vaccinations during COVID-19 pandemic in Italy: A SIP/IRS (Italian Respiratory Society) and SITA (Italian Society of Antiinfective therapy) statement

Respiratory Medicine (2021)

Francesco Blasi Marta Di Pasquale Andrea Gramegna Pierluigi Viale Carmelo Iacobello

Pandemic

Pneumococcal pneumonia

10.1016/j.rmed.2021.106674

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Citations (4)

WS06.04 Lung volumes as possible factors explaining the heterogeneity in the response to elexacaftor/tezacaftor/ivacaftor in patients with cystic fibrosis and advanced lung disease

Journal of Cystic Fibrosis (2023)

Chiara Premuda Andrea Gramegna Gianfranco Alicandro Francesca Lucca Mariangela Retucci

Ivacaftor

10.1016/s1569-1993(23)00220-5

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Citations (0)

What is the best technique to extract bacterial DNA from sputum?

Martina Oriano Leonardo Terranova Luca Ruggiero Camilla Tafuro Antonio Teri

Introduction: There is no consensus on which is the best method to extract bacterial DNA from sputum. We aimed at comparing 20 different DNA extraction techniques on both mock community and sputum samples. Methods: One mock was built and 5 sputa from cystic fibrosis and bronchiectasis patients were evaluated at the Policlinico Hospital in Milan, Italy. 20 techniques for sputum bacterial DNA extraction were compared, including two enzyme-based (Roche and Zymo) and two beads-based (Mobio and QIAGEN) techniques which were tested with/without Dithiothreitol (DTT) and with/without lysostaphin (0.18 and 0.36 mg/mL) steps. Extractions were performed in duplicate to evaluate the variability among samples. DNA was quantified and, then, tested using Real time PCR for 16S rDNA and S. aureus. Results: Although 16S rDNA was similarly detected across all the different techniques in 20 ng of extract (range 19-21 Ct), Roche kit gave the highest DNA yield in both mock and sputa (see figure). The mean standard deviation between replicates was lower in DTT-treated vs non-treated samples (0.17 vs 0.47 Ct, respectively). In both enzymatic-based techniques, the lowest Ct values for Real time PCR for S. aureus in both mock and sputa was identified when lysostaphin was added. Conclusion: An enzyme-based kit with the addition of both DTT treatment and lysostaphin steps seems to be the preferred technique for DNA bacterial extraction on sputum.

Lysostaphin

Dithiothreitol

10.1183/13993003.congress-2018.pa5307

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Citations (11)

Respiratory failure in COVID-19: a patient's perspective and clinical cases

COVID (2021)

Francesco Amati A. Vigni Sofia Misuraca Francesco Bindo Andrea Gramegna

2019-20 coronavirus outbreak

10.1183/2312508x.10025320

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Citations (0)

In vitro antimicrobial activity of ceftolozane/tazobactam against Pseudomonas aeruginosa and other non-fermenting Gram-negative bacteria in adults with cystic fibrosis

Journal of Global Antimicrobial Resistance (2018)

Andrea Gramegna B.C. Millar Francesco Blasi J.S. Elborn D.G. Downey

Stenotrophomonas maltophilia

Etest

Burkholderia cenocepacia

Tazobactam

Colistin

10.1016/j.jgar.2018.03.002

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Citations (16)

Alpha-1 antitrypsin deficiency as a common treatable mechanism in chronic respiratory disorders and for conditions different from pulmonary emphysema? A commentary on the new European Respiratory Society statement

Multidisciplinary Respiratory Medicine (2018)

Andrea Gramegna Stefano Aliberti Marco Confalonieri Angelo Guido Corsico Luca Richeldi

The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease. The clinical spectrum of AATD lung disease might include different manifestations and the traditional paradigm of a younger emphysematous patient has been revealing insufficient. Targeting with appropriate testing only COPD patients might be considered a limited approach leading to underestimation of the real prevalence of the disease. Several reports have suggested the association between AATD and other chronic respiratory conditions, as asthma and bronchiectasis. A deeper evaluation of clinical, radiological, microbiological and functional variables is, therefore, needed in order to investigate different phenotypes in AATD patients. In addition, a new line of translational research in AATD might focus on the development of personalized therapeutic regimens taking into account the patient clinical profile and needs. Over the past years, AATD has been interpreted as a common mechanism of inflammatory disequilibrium and tissue damage across different conditions. Future research is gradually pointing toward this new paradigm by expanding the evidence of the role of AAT as a potent immunomodulatory and anti-inflammatory drug in conditions different from pulmonary emphysema.

Alpha 1-antitrypsin deficiency

10.1186/s40248-018-0153-4

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Citations (16)

Standards of care for CFTR variant-specific therapy (including modulators) for people with cystic fibrosis

Journal of Cystic Fibrosis (2022)

Kevin W Southern Carlo Castellani Elise Lammertyn Alan R Smyth Donald R. VanDevanter

Cystic fibrosis (CF) has entered the era of variant-specific therapy, tailored to the genetic variants in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene. CFTR modulators, the first variant-specific therapy available, have transformed the management of CF. The latest standards of care from the European CF Society (2018) did not include guidance on variant-specific therapy, as CFTR modulators were becoming established as a novel therapy. We have produced interim standards to guide healthcare professionals in the provision of variant-specific therapy for people with CF. Here we provide evidence-based guidance covering the spectrum of care, established using evidence from systematic reviews and expert opinion. Statements were reviewed by key stakeholders using Delphi methodology, with agreement (≥80%) achieved for all statements after one round of consultation. Issues around accessibility are discussed and there is clear consensus that all eligible people with CF should have access to variant-specific therapy.

Ivacaftor

Interim

Expert opinion

Delphi Method

10.1016/j.jcf.2022.10.002

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Citations (47)

The role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia

European Journal of Internal Medicine (2012)

Angelika Reißig Andrea Gramegna Stefano Aliberti

Lung Ultrasound

10.1016/j.ejim.2012.01.003

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Citations (99)

Standards of care and educational gaps in adult cystic fibrosis units: a European Respiratory Society survey

ERJ Open Research (2024)

Almudena Felipe Montiel Antonio Álvarez Fernández Mario Culebras Amigo Francesco Blasi Andrea Gramegna

Significant progress in the field of cystic fibrosis (CF) has substantially extended the life expectancy of patients with CF (pwCF). Consequently, the population of adult pwCF has outnumbered paediatric patients in most developed countries. Ageing is a new factor that can contribute to disease complexity and can require adaptation of CF units. Therefore, the necessity for standardised, specialised and multidisciplinary care is imperative. Concerns arise regarding the adequacy of current healthcare, therapeutic and educational offerings.

10.1183/23120541.00065-2024

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Citations (1)