Nato a Caserta nel 1986. Diploma di Liceo Classico nel 2004 con 100/100.
Grande tifoso della JuveCaserta.
Appassionato di calcio. Profondo amante del vino (Diploma di Assaggiatore ONAV - I Livello; in corso Diploma Assaggiatore Esperto di II Livello)
Viaggiatore con intensa passione per il freddo e per il mare (Subacqueo con brevetto Open Water, ed in via di acquisizione certificato per Advanced Open Water Diver).
Cultore di Storia e di bonsai.
EDUCATION
Laurea Magistrale in Medicina e Chirurgia nel 2010 - Università Cattolica del Sacro Cuore - Roma
Diploma di Specializzazione in Medicina Interna nel 2017 - Università Cattolica del Sacro Cuore - Roma
Dottorato in Genetica Medica nel 2021 - Università Cattolica del Sacro Cuore - Roma
Expanding the Therapeutic Landscape of Pericarditis: A Systematic Review of the Use of Conventional Immunosuppressants Andrea Silvio Giordani, Caterina Menghi, Antonella Risoli, Anna Baritussio, Federico Scognamiglio, Matteo Castegnaro, Elena Pontara, Maria Grazia Cattini, Elisa Bison, Celeste Ambra Murace, Elena Verrecchia, Marco Giuseppe Del Buono, Francesco Landi, Ludovico Luca Sicignano, Alida Linda Patrizia Caforio Medicina Lithuania, 2026 Background and Objectives: While interleukin-1 inhibitors represent the standard of care for refractory idiopathic recurrent acute pericarditis, current guidelines also endorse conventional immunosuppressive (IS) agents as potential alternatives. The use of conventional IS agents is particularly relevant in specific clinical scenarios, such as systemic immune-mediated disease (SID)-associated pericarditis. However, existing evidence regarding their efficacy and safety for pericarditis treatment remains fragmented, deriving exclusively from case reports, case series, and small monocentric observational studies. Our aims are: To characterize the clinical and diagnostic profiles of patients with pericarditis treated with conventional IS agents and to evaluate the therapeutic efficacy and safety of such agents. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines. Major electronic databases were searched from January 1970 to March 2026 for case reports, case series, and observational studies detailing the use of conventional IS therapies for pericarditis. Clinical and therapeutic data, including specific IS indications and dosing regimens, were systematically extracted. Results: The final analysis included 39 reports comprising 75 patients (60% female; median age 36.0 years). The underlying pericarditis aetiology was predominantly SID-related (53%, n = 40) or idiopathic/presumed viral recurrent disease (40%, n = 30). The most frequently prescribed first-line IS agents were azathioprine (44%) and methotrexate (25%). Across published reports, IS therapy was described as achieving pericarditis clinical resolution in all cases and facilitated corticosteroid withdrawal in 72% of patients. Overall, pericarditis recurrence while on IS therapy occurred in only 10% of the cohort. Adverse events requiring IS withdrawal were rare (n = 2, 3%). Conclusions: Conventional IS agents appear effective and generally well tolerated in the published literature on SID-associated and isolated recurrent pericarditis. These findings reinforce the clinical utility of conventional IS therapies as a viable, steroid-sparing strategy when targeted biologic therapies lack sufficient investigation.
NLRP12 as a Regulator of Inflammation: Insights into the Correlation with Autoinflammatory Disorders Beatrice Rosa, Elisabetta Tabolacci, Roberta Pietrobono, Eugenio Sangiorgi, Fiorella Gurrieri, Pietro Chiurazzi, Ludovico Luca Sicignano, Elena Verrecchia, Maurizio Genuardi, Donato Rigante, Raffaele Manna Genes, 2026 Background: Dysregulation of the innate immune system is a key feature of autoinflammatory disorders, characterized by recurrent or chronic inflammation in the absence of high-titer autoantibodies and antigen-specific T cells. Among regulators of innate immunity, NLRP12 has emerged as an important modulator of inflammatory signaling pathways. As a member of the nucleotide-binding oligomerization domain-like receptor (NLR) family, NLRP12 negatively regulates nuclear factor (NF)-κB activity and contributes to immune homeostasis. However, the clinical significance of NLRP12 variants and their association with disease phenotypes remain incompletely understood. This study aims to summarize current knowledge on the molecular role of NLRP12 and its involvement in autoinflammatory manifestations. Methods: A narrative review of the literature on NLRP12’s molecular functions and role in autoinflammatory diseases was performed. In addition, a cohort of 20 patients with recurrent fevers carrying NLRP12 variants was analyzed from a clinical perspective, evaluating genetic findings and clinical features. Results: Available evidence indicates that NLRP12 regulates inflammatory signaling, particularly through modulation of NF-κB activity. Variants in the NLRP12 gene have been associated with a spectrum of autoinflammatory phenotypes, ranging from periodic fever syndromes to broader systemic inflammatory manifestations. Clinical evaluation of the cohort confirmed the heterogeneity of disease presentations among individuals carrying NLRP12 variants. Conclusions: NLRP12 plays an important role in the regulation of innate immune responses and may contribute to autoinflammatory phenotypes. Integrating molecular data with clinical observations may improve the understanding of NLRP12 variants and support more accurate diagnostic and therapeutic strategies.
Immune Biomarker Signature in the Diagnostic Workup of Fever Without Source: A Pilot Study Angela Maria Di Francesco, Giuliana Pasciuto, Laura Gerardino, Ludovico Luca Sicignano, Elena Verrecchia, Andrea Urbani, Donato Rigante, Raffaele Manna Mediterranean Journal of Hematology and Infectious Diseases, 2026 Fevers without an identified source (FWS) are frequent in all-aged patients, even in children, with subjects being often labeled as affected with ‘fever of unknown origin’ if fever lasts for more than one week.1 This definition was formally created by Petersdorf and Beeson in the early ‘60s through the evaluation of a case series of subjects displaying unexplained rise of temperature over 38.3°C on several occasions for more than 3 weeks.2 It is well-known that FWS might include infectious, non-infectious inflammatory, tumoral diseases, but also further complex types of disorders in which fever is a predominant feature.3 Furthermore, among undiagnosed cases of FWS, the mortality rate may be relevant, varying from 6.9 to 18.6% in some reported series.4 In particular, investigating children with FWS may be may be frustrating because of multiple protean causes of fever, and autoinflammatory disorders.5 Infectious diseases are still a substantial etiology of FWS, while non-infectious conditions may elude many common diagnostic approaches, requiring imaging studies and more specific immunological or genetic tests.6
Hydroxychloroquine for recurrent pericarditis: A multicentre observational study Lucia Trotta, Francesco Agozzino, Silvia Berra, Ruggiero Mascolo, Francesco Rubuano, Olga Blagova, George Lazaros, Elisa Ceriani, Massimo Pancrazi, Angela Mauro, Emilia Lazarou, Nicola Marotta, Francesca Casarin, Ludovico L. Sicignano, Massimo Imazio, Antonio Brucato European Journal of Internal Medicine, 2026 AIM: To assess the effect of hydroxychloroquine (HCQ) in recurrent pericarditis (RP). METHODS: International longitudinal observational study including 80 patients with idiopathic or post-cardiac injury RP, treated with HCQ for at least 6 months (April 2014-August 2025); 3 other patients stopped HCQ within 6 months for side-effects. Recurrences, hospitalizations, side effects and therapies were evaluated before and after HCQ. Patient and physician-reported effectiveness were recorded. RESULTS: Females were 57/80 (71 %); median age 51.5 years [IQR 43.8-62.8]. C-reactive protein (CRP) was >10mg/L in 52 (65 %) patients. The median follow-up after starting HCQ was 27.3 [11.7-47.8] months, and the daily dose was 400 mg in 52 patients (65 %) and 200 mg in 28 (35 %). Among the 62 patients treated with HCQ for at least 12 months, recurrences decreased in the 12 months following treatment (median 1 [0-2]) compared with the 12 months preceding it (median 2 [1-3])(p < 0.001), as well as hospitalizations (5 vs 32) (p < 0.001). HCQ was effective either in CRP positive or CRP negative subjects. Fifty-four patients (67.5 %) were on steroids when HCQ was started, but only 21 (26.3 %) continued them at the last follow-up (p < 0.001); the median daily dose of prednisone was reduced from 10.0 mg [7.5-17.5] to 5.0 [2.5-5.0] (p < 0.001). Regarding patients' opinions about HCQ effectiveness, 64 pts (80 %) judged it useful, 16 (20 %) neutral (8 stopped HCQ for lack of effectiveness); the physicians' opinions were similar (concordance rate 74 (93.7 %), k 0.777; p < 0.001). CONCLUSIONS: HCQ reduced recurrences, hospitalizations, and corticosteroid dose in RP, with no relevant side effects.
ST-segment elevation in acute pericarditis and myocardial involvement: electrocardiographic and clinical profiling Elisa Ceriani, Silvia Berra, Francesco Agozzino, Martina Ceriani, Lucia Ghisolfi, Francesco Moda, Francesco Rubuano, Ludovico Luca Sicignano, Laura Gerardino, Lucia Trotta, Massimo Pancrazi, Caterina Chiara De Carlini, Silvia Maestroni, Davide Cumetti, Luisa Carrozzo, Francesca Casarin, Valentino Collini, Massimo Imazio, Antonio Brucato Open Heart, 2026 Background Pericardium is considered electrically inert, but diffuse ST-elevation is an electrocardiographic marker of acute pericarditis. We hypothesised that ST-elevation in acute pericarditis may reflect underlying myocardial involvement. Accordingly, this study aimed to assess the association between ST-elevation and myocardial involvement in pericarditis patients and to further characterise the clinical features and long-term outcomes of myopericarditis compared with isolated pericarditis. Methods This longitudinal multicentre study included 351 pericarditis patients (328 recurrent; 180 females), 70/351 with myopericarditis, defined by troponin elevation and/or suggestive cardiac MRI. Results 121 patients had ST-elevation (34.5%); they were younger: 38 years (23–53) vs 47 (31–58) (median (IQR)) (p<0.001), more often male: 63.6% (77/121) vs 40.9% (94/230) (p<0.001) and had higher C reactive protein values: 92.0 (35–170) vs 58.4 mg/L (15.8–137.5) (median (IQR)) (p=0.002) and less frequent pericardial effusions: 71.1% (86/121) vs 83.5% (192/230) (p=0.004). Myocardial involvement was diagnosed in 70/351 (19.9%) patients, occurring more frequently among those with ST-elevation: 26.4% (32/121), compared with those without: 16.5% (38/230) (p=0.035). ST-elevation predicted myocardial involvement with an OR of 1.82 (95% CI 1.07 to 3.10). Compared with isolated pericarditis, patients with myopericarditis were more frequently male: 61.4% (43/70) vs 45.6% (128/281) (p=0.023) and had a higher prevalence of transient systolic dysfunction: 13.5% (7/52) vs 2.1% (3/141) (p=0.004). During follow-up, myopericarditis patients had a lower remission rate: 18.5% (12/65) vs 31.2% (82/263) (p=0.047) and a higher annual hospitalisation rate (median 0.5 vs 0.4/year, p=0.010), while recurrence rates and disease duration were similar. Treatment strategies, including use of corticosteroids and interleukin 1 blockers, were also comparable. Conclusions ST-segment elevation in acute pericarditis was associated with myocardial involvement, supporting the concept that the pericardium is electrically inert. Myopericarditis was associated with lower remission rates and slightly higher hospitalisation needs compared to isolated pericarditis, despite otherwise comparable recurrence rates and treatment strategies.
Anakinra in Fulminant Acute Myocarditis: A Case Report and Review of the Literature Sofia Morini, Simone Filomia, Gianluigi Saponara, Daniela Pedicino, Alessia d’Aiello, Gaetano Pinnacchio, Ludovico Luca Sicignano, Maria Lucia Narducci, Francesco Burzotta, Marco Giuseppe Del Buono, Tommaso Sanna Journal of Cardiovascular Pharmacology, 2025 Fulminant myocarditis (FM) is a critical condition with high mortality. Interleukin-1 (IL-1) is a key mediator of myocardial inflammation. We describe the case of a 19-year-old male with FM, hemodynamic deterioration refractory to standard treatment, and a marked systemic inflammatory response. The introduction of anakinra, an IL-1 receptor antagonist, led to rapid clinical, hemodynamic, and laboratory improvement. A literature review identifies other cases of severe/fulminant myocarditis with hyperinflammation that benefited from IL-1 blockade, despite heterogeneous etiologies. These data suggest that anakinra could be a valuable rescue therapeutic option in selected patients with FM and hyperinflammation. Randomized trials are needed to confirm the role of IL-1 blockade in this high-risk population, focusing on the pharmacology of the immune response.
Use of anakinra during pregnancy and breastfeeding in women with recurrent pericarditis: A case series Lucia Trotta, Ruggiero Mascolo, Vartan Mardygan, Andreja Cerne Cercek, Anne-Marie Claveau, Ludovico Luca Sicignano, Giuseppe Lopalco, Emanuele Bizzi, Massimo Pancrazi, Elisa Calabrò, Alida Caforio, Andrea Silvio Giordani, Serdal Ugurlu, Valentino Collini, Alessandro Andreis, Massimo Imazio, Antonio Brucato European Journal of Obstetrics and Gynecology and Reproductive Biology, 2025
The Role of Cutibacterium acnes in the Etiopathogenesis of Sarcoidosis: Current Insights and Future Study Directions Angela Maria Di Francesco, Giuliana Pasciuto, Elena Verrecchia, Ludovico Luca Sicignano, Laura Gerardino, Donato Rigante, Raffaele Manna International Journal of Molecular Sciences, 2025 Cutibacterium acnes (C. acnes) is a commensal bacterium of the skin microbiota that can transform itself into a pathogen depending on the peculiar susceptibility of the host: it is the sole microorganism so far to be found in the specific organ lesions of sarcoidosis, and C. acnes-induced activation of T-helper-type-1 cell responses is generally higher in patients with sarcoidosis than in healthy subjects. This bacterium acts as an opportunistic agent in several inflammatory conditions other than sarcoidosis, such as prostate cancer and prosthetic joint infections. Both innate and adaptive immunity systems are involved in the pathogenesis of C. acnes-mediated sarcoid lesions, and a seminal role is played by host toll-like receptor (TLR)-2, TLR-4, TLR-6, NOD-like receptors, and mononuclear cell cytoplasmic receptors. This review summarizes current knowledge on the potential cause–effect relationship existing between C. acnes and sarcoidosis, addressing issues of future research directions and novel therapeutic strategies in the management of a complex disease such as sarcoidosis.
Prevalence and Clinical Correlates of Cerebrovascular Alterations in Fabry Disease: A Cross-Sectional Study Daniele Di Natale, Salvatore Rossi, Gianmarco Dalla Zanna, Antonio Funcis, Tommaso Filippo Nicoletti, Ludovico Luca Sicignano, Elena Verrecchia, Angela Romano, Maria Gabriella Vita, Naike Caraglia, Francesca Graziani, Federica Re, Gisella Guerrera, Luca Battistini, Gabriella Silvestri Brain Sciences, 2025 Background/Objectives: Fabry disease (FD) is an inborn error of the glycosphingolipid metabolism with variable kidney, heart, and central nervous system (CNS) involvement. CNS-related FD manifestations include early ischemic stroke and white matter lesions (WMLs) related to cerebral small-vessel disease (CSVD), possibly resulting in cognitive impairment. We studied 40 adult FD patients (17 male) to assess: (i) prevalence of cerebrovascular and cognitive manifestations in FD and their correlation with heart and renal involvement; and (ii) the potential value of serum neurofilament light chain (NfL) levels as an indicator of WMLs in FD. Methods: Patients underwent detailed diagnostic assessment related to FD, also including Mainz Severity Score Index (MSSI), neuropsychological tests, brain MRI to assess WMLs by the modified Fazekas score (mFS), and NfL determination by single-molecule array (SiMoA) (n = 22 FD patients vs. 15 healthy controls). Results: Overall, 4 FD patients had a history of ischemic stroke and 13/32 patients (40.6%) had an mFS ≥ 1. Almost two-thirds of FD patients (27/39, 69.2%) showed impairment on at least one cognitive test. On univariate analysis, only a reduction in estimated glomerular filtration rate was associated with an increased likelihood of having WMLs on brain MRI. Serum NfL levels were higher in FD patients vs. controls, with a trend toward significance (p = 0.08). Conclusions: Mild-to-moderate CSVD is a characteristic brain “signature” in FD patients. Both cardiac and renal involvement correlate with WML load, but only renal involvement appears to be predictive of CNS damage. Brain microvascular damage is associated with mild cognitive impairment in FD, and serum NfL might represent a potential biomarker of CSVD in FD.
Duration of Disease and Long-Term Outcomes in Patients With Difficult-To-Treat Recurrent Pericarditis: A Chronic Condition Treated With Nonsteroidal Anti-Inflammatory Drugs, Colchicine, Corticosteroids, and Anti–Interleukin-1 Agents Elisa Ceriani, Francesco Agozzino, Silvia Berra, Antonio Gidaro, Paolo Bindi, Alberto Pavarani, Silvia Macchi, Letizia Vena, Francesco Moda, Ludovico Luca Sicignano, Celeste Ambra Murace, Laura Gerardino, Elena Verrecchia, Caterina Chiara De Carlini, Silvia Maestroni, Gabriella Marinaro, Emanuele Bizzi, Antonio Brucato, Massimo Imazio Acr Open Rheumatology, 2025 ObjectiveWe aimed to investigate the remission rate and disease duration in idiopathic or post–cardiac injury pericarditis and risk factors for disease duration and anti–interleukin‐1 (IL‐1) agent discontinuation.MethodsThis was a multicenter, longitudinal, observational study including 370 patients (51.4% female). The remission rate was the proportion of patients who stopped all pericarditis‐related therapies for at least 6 months without recurrences.ResultsThe median follow‐up was 4.9 (interquartile range [IQR] 2.8–8.4) years, and the median age at the end of follow‐up was 49 (IQR 37–60) years. A median of 1.1 (IQR 0.6–1.9) recurrences/year and 0.4 (IQR 0.1–0.9) hospitalizations/year were recorded. The remission rate at follow‐up was 34.0%, 7% per year. Disease duration was shorter for patients in remission (3.1 years, IQR 1.6–6.2 years) than for those still receiving treatment (4 years, IQR 2.2–7.8; P = 0.02). Use of “guidelines‐based therapy” (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.25–2.73; P = 0.02) and colchicine use at first attack (HR 1.51, 95% CI 1.02–2.23; P = 0.038) were protective factors, whereas steroid use was associated with longer disease duration (HR 0.53, 95% CI 0.35–0.81; P = 0.003). Corticosteroids were used in 77.3% of patients, with a median duration of therapy of 1.1 (IQR 0.4–2.6) years. Anakinra was used in 25.9% with a median duration of therapy of 2.4 (IQR 0.9–5.0) years; only 19.8% were able to stop anakinra at the end of observation period.ConclusionThis study reports the largest and longest follow‐up in patients with recurrent pericarditis. Guideline adherence from the first attack is associated with a shorter course. The disease was long and impacting in terms of recurrences and hospitalizations, often requiring a long‐term treatment, in particular with anti–IL‐1 agents.
Recurrent pericarditis in older adults: Clinical and laboratory features and outcome Emanuele Bizzi, Francesco Cavaleri, Ruggiero Mascolo, Edoardo Conte, Stefano Maggiolini, Caterina Chiara Decarlini, Silvia Maestroni, Valentino Collini, Ludovico Luca Sicignano, Elena Verrecchia, Raffaele Manna, Massimo Pancrazi, Lucia Trotta, Giuseppe Lopalco, Danilo Malandrino, Giada Pallini, Sara Catenazzi, Luisa Carrozzo, Giacomo Emmi, George Lazaros, Antonio Brucato, Massimo Imazio Journal of the American Geriatrics Society, 2024
Drug survival of anakinra and canakinumab in monogenic autoinflammatory diseases: Observational study from the International AIDA Registry Jurgen Sota, Donato Rigante, Rolando Cimaz, Marco Cattalini, Micol Frassi, Raffaele Manna, Ludovico Luca Sicignano, Elena Verrecchia, Emma Aragona, Maria Cristina Maggio, Giuseppe Lopalco, Giacomo Emmi, Paola Parronchi, Alberto Cauli, Ewa Wiesik-Szewczyk, José Hernández-Rodríguez, Carla Gaggiano, Maria Tarsia, Mariam Mourabi, Gaafar Ragab, Antonio Vitale, Claudia Fabiani, Bruno Frediani, Vittoria Lamacchia, Alessandra Renieri, Luca Cantarini Rheumatology United Kingdom, 2021
Right ventricular strain in Anderson-Fabry disease Rosa Lillo, Francesca Graziani, Elena Panaioli, Erica Mencarelli, Maurizio Pieroni, Antonia Camporeale, Raffaele Manna, Ludovico Luca Sicignano, Elena Verrecchia, Antonella Lombardo, Gaetano Antonio Lanza, Filippo Crea International Journal of Cardiology, 2021
Clinical Features at Onset and Genetic Characterization of Pediatric and Adult Patients with TNF- α Receptor - Associated Periodic Syndrome (TRAPS): A Series of 80 Cases from the AIDA Network Carla Gaggiano, Antonio Vitale, Laura Obici, Giampaolo Merlini, Alessandra Soriano, Ombretta Viapiana, Marco Cattalini, Maria Cristina Maggio, Giuseppe Lopalco, Davide Montin, Masen Abdel Jaber, Lorenzo Dagna, Raffaele Manna, Antonella Insalaco, Matteo Piga, Francesco La Torre, Virginia Berlengiero, Viviana Gelardi, Luisa Ciarcia, Giacomo Emmi, Piero Ruscitti, Francesco Caso, Rolando Cimaz, José Hernández-Rodríguez, Paola Parronchi, Ludovico Luca Sicignano, Elena Verrecchia, Florenzo Iannone, Jurgen Sota, Salvatore Grosso, Carlo Salvarani, Bruno Frediani, Roberto Giacomelli, Maria Antonietta Mencarelli, Alessandra Renieri, Donato Rigante, Luca Cantarini Mediators of Inflammation, 2020
Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide F. Scaldaferri, M. Pizzoferrato, L. R. Lopetuso, T. Musca, F. Ingravalle, L. L. Sicignano, M. Mentella, G. Miggiano, M. C. Mele, E. Gaetani, C. Graziani, V. Petito, G. Cammarota, E. Marzetti, A. Martone, F. Landi, A. Gasbarrini Gastroenterology Research and Practice, 2017
Epidemiology of FMF Worldwide Lucia Cerrito, Ludovico Luca Sicignano, Elena Verrecchia, Raffaele Manna Rare Diseases of the Immune System, 2015
[Pulmonary-renal syndromes]. Giornale Italiano Di Nefrologia Organo Ufficiale Della Societa Italiana Di Nefrologia, 2011
