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Issue Title: Including PIH Articles on Epigenetic and metabolic regulation in hematopoiesis/leukemogenesis

Background and Aim. Although mercury is involved in several immunological diseases, nothing is known about its implication in celiac disease. Our aim was to evaluate blood and urinary levels of mercury in celiac patients. Methods. We prospectively enrolled 30 celiac patients (20 treated with normal duodenal mucosa and 10 untreated with duodenal atrophy) and 20 healthy controls from the same geographic area. Blood and urinary mercury concentrations were measured by means of flow injection inductively coupled plasma mass spectrometry. Enrolled patients underwent dental chart for amalgam fillings and completed a food-frequency questionnaire to evaluate diet and fish intake. Results. Mercury blood/urinary levels were 2.4±2.3/1.0±1.4, 10.2±6.7/2.2±3.0 and 3.7±2.7/1.3±1.2 in untreated CD, treated CD, and healthy controls, respectively. Resulting mercury levels were significantly higher in celiac patients following a gluten-free diet. No differences were found regarding fish intake and number of amalgam fillings. No demographic or clinical data were significantly associated with mercury levels in biologic samples. Conclusion. Data demonstrate a fourfold increase of mercury blood levels in celiac patients following a gluten-free diet. Further studies are needed to clarify its role in celiac mechanism.

Multiple chemical sensitivity (MCS) is a multisystem, recurrent, environmental disorder that flares in response to different exposures (i.e., pesticides, solvents, toxic metals and molds) under the threshold limit value (TLV) calculated for age and gender in the general population. MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological and neurological signs and symptoms. We performed a systematic review of the literature to summarize the current clinical and therapeutic evidence and then oriented an eDelphi consensus. Four main research domains were identified (diagnosis, treatment, hospitalization and emergency) and discussed by 10 experts and an MCS patient. Thus, the first Italian MCS consensus had the double aim: (a) to improve MCS knowledge among healthcare workers and patients by standardizing the clinical and therapeutic management to MCS patients; and (b) to improve and shed light on MCS misconceptions not supported by evidence-based medicine (EBM).

[1] {Table 1} Treatment with 1-deamino-8-d-arginine-vasopressin (DDAVP) which was administered intravenously at a dose of 0.3 μg/kg did not show a significant improvement in bleeding time (BT), plasma levels of factor VIII, and vWF. [...]he received intravenous infusions of factor VIII/vWF concentrates (Haemate-P; Centeon, Marburg, Germany) at a daily dose of 40 IU/kg until the third postoperative day for an average of five administrations, achieving a shortened BT (from more than 18 min to 8 min) as well as transient correction of factor VIII and vWF plasma levels. [2],[3] The unusual dyscrasia reported here highlights that some AvWS patients may be unresponsive to DDAVP. [...]the replacement therapy with factor VIII/VWF concentrates remains, the sole option of treatment in AvWS patients with IgM-MGUS, although this will produce transitory effects [4] as was the case in our patient.

Transplacental exposure to heavy metals may affect child growth and cause neurodevelopmental delays. [...]efforts should be made to measure and quantify maternal exposure to heavy metals in placenta to estimate environmental prenatal exposure.