Tetrahydrocannabinol/Cannabidiol Oromucosal Spray in Patients With Multiple Sclerosis: A Pilot Study on the Plasma Concentration-Effect Relationship.
Identifieur interne : 000320 ( Main/Exploration ); précédent : 000319; suivant : 000321Tetrahydrocannabinol/Cannabidiol Oromucosal Spray in Patients With Multiple Sclerosis: A Pilot Study on the Plasma Concentration-Effect Relationship.
Auteurs : Manuela Contin ; Luca Mancinelli ; Alessandro Perrone ; Loredana Sabattini ; Susan Mohamed ; Cinzia Scandellari ; Matteo Foschi [Italie] ; Veria Vacchiano [Italie] ; Alessandra Lugaresi ; Roberto RivaSource :
- Clinical neuropharmacology [ 1537-162X ]
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Association médicamenteuse (MeSH), Cannabidiol (administration et posologie), Cannabidiol (sang), Dronabinol (administration et posologie), Dronabinol (sang), Femelle (MeSH), Humains (MeSH), Mâle (MeSH), Projets pilotes (MeSH), Pulvérisations buccales (MeSH), Sclérose en plaques (physiopathologie), Sclérose en plaques (sang), Sclérose en plaques (traitement médicamenteux), Spasticité musculaire (sang), Spasticité musculaire (traitement médicamenteux), Spasticité musculaire (étiologie), Études prospectives (MeSH).
- MESH :
- administration et posologie : Cannabidiol, Dronabinol.
- physiopathologie : Sclérose en plaques.
- sang : Cannabidiol, Dronabinol, Sclérose en plaques, Spasticité musculaire.
- traitement médicamenteux : Sclérose en plaques, Spasticité musculaire.
- étiologie : Spasticité musculaire.
- Adulte, Adulte d'âge moyen, Association médicamenteuse, Femelle, Humains, Mâle, Projets pilotes, Pulvérisations buccales, Études prospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Cannabidiol (administration & dosage), Cannabidiol (blood), Dronabinol (administration & dosage), Dronabinol (blood), Drug Combinations (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Multiple Sclerosis (blood), Multiple Sclerosis (drug therapy), Multiple Sclerosis (physiopathology), Muscle Spasticity (blood), Muscle Spasticity (drug therapy), Muscle Spasticity (etiology), Oral Sprays (MeSH), Pilot Projects (MeSH), Prospective Studies (MeSH).
- MESH :
- chemical , administration & dosage : Cannabidiol, Dronabinol.
- chemical , blood : Cannabidiol, Dronabinol.
- blood : Multiple Sclerosis, Muscle Spasticity.
- drug therapy : Multiple Sclerosis, Muscle Spasticity.
- etiology : Muscle Spasticity.
- physiopathology : Multiple Sclerosis.
- Adult, Drug Combinations, Female, Humans, Male, Middle Aged, Oral Sprays, Pilot Projects, Prospective Studies.
Abstract
OBJECTIVES
We aimed to assess the potential relationship between intrasubject 9-tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray plasma profiles and clinical effects elicited by subacute dosing in chronically treated patients with multiple sclerosis (MS).
METHODS
The study design was pilot, single center, open, and prospective. The patients were challenged with a morning test dose of 2 THC/CBD sprays at a 15-minute interval. Venous blood samples were collected before the first spray administration and every 30 minutes after the second spray, until 240 minutes postdosing. Patients rated their spasticity by the Numerical Rating Scale (NRS) simultaneously with blood drawings. Postural and motor tests were performed before the first spray and 90 and 180 minutes thereafter.
RESULTS
Twelve patients were recruited. Peak plasma concentrations of THC/CBD largely varied among patients, from 0.60 to 13.29 ng/mL for THC and 0.55 to 11.93 ng/mL for CBD. Time to peak plasma concentrations ranged from 150 to 240 minutes for THC and 90 to 240 minutes for CBD. Patients' NRS serial scores decreased after dosing, from a median value of 6 to 3.5 (P < 0.001). A significant inverse correlation was observed between median intrasubject repeated NRS scores and corresponding median values of both THC (P < 0.01) and CBD (P < 0.002) plasma concentrations. No significant effect of cannabinoids dosing could be appreciated according to posturographic and motor tests.
CONCLUSIONS
Our kinetic dynamic findings from THC/CBD oromucosal spray are the first obtained in real MS patients. Although preliminary, they suggest that subacute dosing might elicit a subjective clinically significant effect on MS-related spasticity, paralleling cannabinoids measurable plasma concentrations.
DOI: 10.1097/WNF.0000000000000294
PubMed: 30024443
Affiliations:
Links toward previous steps (curation, corpus...)
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Relationship.</title><author><name sortKey="Contin, Manuela" sort="Contin, Manuela" uniqKey="Contin M" first="Manuela" last="Contin">Manuela Contin</name></author><author><name sortKey="Mancinelli, Luca" sort="Mancinelli, Luca" uniqKey="Mancinelli L" first="Luca" last="Mancinelli">Luca Mancinelli</name></author><author><name sortKey="Perrone, Alessandro" sort="Perrone, Alessandro" uniqKey="Perrone A" first="Alessandro" last="Perrone">Alessandro Perrone</name><affiliation><nlm:affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</nlm:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Sabattini, Loredana" sort="Sabattini, Loredana" uniqKey="Sabattini L" first="Loredana" last="Sabattini">Loredana Sabattini</name><affiliation><nlm:affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</nlm:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Mohamed, Susan" sort="Mohamed, Susan" uniqKey="Mohamed S" first="Susan" last="Mohamed">Susan Mohamed</name><affiliation><nlm:affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</nlm:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Scandellari, Cinzia" sort="Scandellari, Cinzia" uniqKey="Scandellari C" first="Cinzia" last="Scandellari">Cinzia Scandellari</name><affiliation><nlm:affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</nlm:affiliation><wicri:noCountry code="subField">and</wicri:noCountry></affiliation></author><author><name sortKey="Foschi, Matteo" sort="Foschi, Matteo" uniqKey="Foschi M" first="Matteo" last="Foschi">Matteo Foschi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna</wicri:regionArea><wicri:noRegion>University of Bologna Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Vacchiano, Veria" sort="Vacchiano, Veria" uniqKey="Vacchiano V" first="Veria" last="Vacchiano">Veria Vacchiano</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna</wicri:regionArea><wicri:noRegion>University of Bologna Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Lugaresi, Alessandra" sort="Lugaresi, Alessandra" uniqKey="Lugaresi A" first="Alessandra" last="Lugaresi">Alessandra Lugaresi</name></author><author><name sortKey="Riva, Roberto" sort="Riva, Roberto" uniqKey="Riva R" first="Roberto" last="Riva">Roberto Riva</name></author></analytic><series><title level="j">Clinical neuropharmacology</title><idno type="eISSN">1537-162X</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Cannabidiol (administration & dosage)</term><term>Cannabidiol (blood)</term><term>Dronabinol (administration & dosage)</term><term>Dronabinol (blood)</term><term>Drug Combinations (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Multiple Sclerosis (blood)</term><term>Multiple Sclerosis (drug therapy)</term><term>Multiple Sclerosis (physiopathology)</term><term>Muscle Spasticity (blood)</term><term>Muscle Spasticity (drug therapy)</term><term>Muscle Spasticity (etiology)</term><term>Oral Sprays (MeSH)</term><term>Pilot Projects (MeSH)</term><term>Prospective Studies (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Association médicamenteuse (MeSH)</term><term>Cannabidiol (administration et posologie)</term><term>Cannabidiol (sang)</term><term>Dronabinol (administration et posologie)</term><term>Dronabinol (sang)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Projets pilotes (MeSH)</term><term>Pulvérisations buccales (MeSH)</term><term>Sclérose en plaques (physiopathologie)</term><term>Sclérose en plaques (sang)</term><term>Sclérose en plaques (traitement médicamenteux)</term><term>Spasticité musculaire (sang)</term><term>Spasticité musculaire (traitement médicamenteux)</term><term>Spasticité musculaire (étiologie)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Cannabidiol</term><term>Dronabinol</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Cannabidiol</term><term>Dronabinol</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Cannabidiol</term><term>Dronabinol</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Multiple Sclerosis</term><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Multiple Sclerosis</term><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Muscle Spasticity</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Sclérose en plaques</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Multiple Sclerosis</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Cannabidiol</term><term>Dronabinol</term><term>Sclérose en plaques</term><term>Spasticité musculaire</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Sclérose en plaques</term><term>Spasticité musculaire</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Spasticité musculaire</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Drug Combinations</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Oral Sprays</term><term>Pilot Projects</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Association médicamenteuse</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Projets pilotes</term><term>Pulvérisations buccales</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>We aimed to assess the potential relationship between intrasubject 9-tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray plasma profiles and clinical effects elicited by subacute dosing in chronically treated patients with multiple sclerosis (MS).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>The study design was pilot, single center, open, and prospective. The patients were challenged with a morning test dose of 2 THC/CBD sprays at a 15-minute interval. Venous blood samples were collected before the first spray administration and every 30 minutes after the second spray, until 240 minutes postdosing. Patients rated their spasticity by the Numerical Rating Scale (NRS) simultaneously with blood drawings. Postural and motor tests were performed before the first spray and 90 and 180 minutes thereafter.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Twelve patients were recruited. Peak plasma concentrations of THC/CBD largely varied among patients, from 0.60 to 13.29 ng/mL for THC and 0.55 to 11.93 ng/mL for CBD. Time to peak plasma concentrations ranged from 150 to 240 minutes for THC and 90 to 240 minutes for CBD. Patients' NRS serial scores decreased after dosing, from a median value of 6 to 3.5 (P < 0.001). A significant inverse correlation was observed between median intrasubject repeated NRS scores and corresponding median values of both THC (P < 0.01) and CBD (P < 0.002) plasma concentrations. No significant effect of cannabinoids dosing could be appreciated according to posturographic and motor tests.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Our kinetic dynamic findings from THC/CBD oromucosal spray are the first obtained in real MS patients. Although preliminary, they suggest that subacute dosing might elicit a subjective clinically significant effect on MS-related spasticity, paralleling cannabinoids measurable plasma concentrations.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30024443</PMID><DateCompleted><Year>2018</Year><Month>12</Month><Day>11</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>11</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1537-162X</ISSN><JournalIssue CitedMedium="Internet"><Volume>41</Volume><Issue>5</Issue><PubDate><MedlineDate>2018 Sep/Oct</MedlineDate></PubDate></JournalIssue><Title>Clinical neuropharmacology</Title><ISOAbbreviation>Clin Neuropharmacol</ISOAbbreviation></Journal><ArticleTitle>Tetrahydrocannabinol/Cannabidiol Oromucosal Spray in Patients With Multiple Sclerosis: A Pilot Study on the Plasma Concentration-Effect Relationship.</ArticleTitle><Pagination><MedlinePgn>171-176</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/WNF.0000000000000294</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">We aimed to assess the potential relationship between intrasubject 9-tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray plasma profiles and clinical effects elicited by subacute dosing in chronically treated patients with multiple sclerosis (MS).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The study design was pilot, single center, open, and prospective. The patients were challenged with a morning test dose of 2 THC/CBD sprays at a 15-minute interval. Venous blood samples were collected before the first spray administration and every 30 minutes after the second spray, until 240 minutes postdosing. Patients rated their spasticity by the Numerical Rating Scale (NRS) simultaneously with blood drawings. Postural and motor tests were performed before the first spray and 90 and 180 minutes thereafter.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Twelve patients were recruited. Peak plasma concentrations of THC/CBD largely varied among patients, from 0.60 to 13.29 ng/mL for THC and 0.55 to 11.93 ng/mL for CBD. Time to peak plasma concentrations ranged from 150 to 240 minutes for THC and 90 to 240 minutes for CBD. Patients' NRS serial scores decreased after dosing, from a median value of 6 to 3.5 (P < 0.001). A significant inverse correlation was observed between median intrasubject repeated NRS scores and corresponding median values of both THC (P < 0.01) and CBD (P < 0.002) plasma concentrations. No significant effect of cannabinoids dosing could be appreciated according to posturographic and motor tests.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our kinetic dynamic findings from THC/CBD oromucosal spray are the first obtained in real MS patients. Although preliminary, they suggest that subacute dosing might elicit a subjective clinically significant effect on MS-related spasticity, paralleling cannabinoids measurable plasma concentrations.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Contin</LastName><ForeName>Manuela</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Mancinelli</LastName><ForeName>Luca</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Perrone</LastName><ForeName>Alessandro</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sabattini</LastName><ForeName>Loredana</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mohamed</LastName><ForeName>Susan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Scandellari</LastName><ForeName>Cinzia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>IRCCS, Institute of Neurological Sciences of Bologna, and.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Foschi</LastName><ForeName>Matteo</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vacchiano</LastName><ForeName>Veria</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lugaresi</LastName><ForeName>Alessandra</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Riva</LastName><ForeName>Roberto</ForeName><Initials>R</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Neuropharmacol</MedlineTA><NlmUniqueID>7607910</NlmUniqueID><ISSNLinking>0362-5664</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004338">Drug Combinations</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D058993">Oral Sprays</NameOfSubstance></Chemical><Chemical><RegistryNumber>19GBJ60SN5</RegistryNumber><NameOfSubstance UI="D002185">Cannabidiol</NameOfSubstance></Chemical><Chemical><RegistryNumber>7J8897W37S</RegistryNumber><NameOfSubstance UI="D013759">Dronabinol</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002185" MajorTopicYN="N">Cannabidiol</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013759" MajorTopicYN="N">Dronabinol</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004338" MajorTopicYN="N">Drug Combinations</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009103" MajorTopicYN="N">Multiple Sclerosis</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009128" MajorTopicYN="N">Muscle Spasticity</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058993" MajorTopicYN="N">Oral Sprays</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>7</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>12</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>7</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30024443</ArticleId><ArticleId IdType="doi">10.1097/WNF.0000000000000294</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country></list><tree><noCountry><name sortKey="Contin, Manuela" sort="Contin, Manuela" uniqKey="Contin M" first="Manuela" last="Contin">Manuela Contin</name><name sortKey="Lugaresi, Alessandra" sort="Lugaresi, Alessandra" uniqKey="Lugaresi A" first="Alessandra" last="Lugaresi">Alessandra Lugaresi</name><name sortKey="Mancinelli, Luca" sort="Mancinelli, Luca" uniqKey="Mancinelli L" first="Luca" last="Mancinelli">Luca Mancinelli</name><name sortKey="Mohamed, Susan" sort="Mohamed, Susan" uniqKey="Mohamed S" first="Susan" last="Mohamed">Susan Mohamed</name><name sortKey="Perrone, Alessandro" sort="Perrone, Alessandro" uniqKey="Perrone A" first="Alessandro" last="Perrone">Alessandro Perrone</name><name sortKey="Riva, Roberto" sort="Riva, Roberto" uniqKey="Riva R" first="Roberto" last="Riva">Roberto Riva</name><name sortKey="Sabattini, Loredana" sort="Sabattini, Loredana" uniqKey="Sabattini L" first="Loredana" last="Sabattini">Loredana Sabattini</name><name sortKey="Scandellari, Cinzia" sort="Scandellari, Cinzia" uniqKey="Scandellari C" first="Cinzia" last="Scandellari">Cinzia Scandellari</name></noCountry><country name="Italie"><noRegion><name sortKey="Foschi, Matteo" sort="Foschi, Matteo" uniqKey="Foschi M" first="Matteo" last="Foschi">Matteo Foschi</name></noRegion><name sortKey="Vacchiano, Veria" sort="Vacchiano, Veria" uniqKey="Vacchiano V" first="Veria" last="Vacchiano">Veria Vacchiano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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