Nicoletta Del Papa

MD, Director Scleroderma Clinic U.O.C.
Day Hospital Reumatologia ASST G. Pini-CTO. Milan, Italy
Nicoletta Del Papa
Degree in Medicine and Surgery obtained from the University of Milan with a final grade of 110/100 with honors, after presenting an experimental research thesis on "Anti-endothelial cell antibodies in vasculitides".
Degree as Specialist in Allergy and Clinical Immunology obtained from the University of Milano (final grade 70/70 with honors) after presenting a thesis on "Characterization of antigen recognized by anti-endothelial cell antibodies".
Degree as Specialist in Internal medicine obtained from the University of Milano (final grade 70/70 with honors) after presenting a thesis on "Role of Beta2-glycoprotein I in the anti-phospholipid syndrome".
Lecturer for the Post-graduate School in Rheumatology from 1999 to the present.
An experienced rheumatologst specialized in the diagnosis and treatment of rheumatic diseases, including systemic lupus erythematosis, systemic sclerosis, Sjogren' syndrome and rheumatoid arthritis. Extensive knowledge relative to the laboratory assays used for the diagnosis of autoimmune diseases. In addition, she has considerable expertise in the managing of immunosuppressive therapies, including biological agents. Responsible for the "Systemic Sclerosis Clinic" and the project of stem cell transplantation in the autoimmune diseases (in collaboration with the Bone Marrow Transplantation Unit, University of Milan).

She is a published author, and has written extensively on the subject of endothelial involvement in the rheumatic disease. Studies focusing on the involvement of endothelial cells and anti-endothelial cell antibodies in connective tissue diseases. Particularly, involved in the characterization of anti-endothelial cell antibodies. In the last years conducting research on the role of bone-marrow derived stem cells in vasculogenesis and angiogenesis in systemic sclerosis. Described and defined for the first time the presence of circulating endothelial cells in the course of systemic sclerosis.
SSc Screening and Patient Selection
for Autologous Hematopoietic Stem Cell
Sharing the Experience at International Conference in Moscow, Russia, November 2019
Systemic Sclerosis (SSc) is a complex autoimmune disease, characterized by high mortality and morbidity. Although there has been significant progress over the years in identifying the early phases of the disease, and recognizing different clinical phenotypes with variable course, really effective therapy remains an unsolved issue and, to date, no disease-modifying agents are available. In this scenario, it is not surprising that SSc was one of the first autoimmune diseases challenged with high-dose immunosuppressive treatment followed by autologous hematopoietic stem cell transplantation (AHSCT). In the last decades, AHSCT has emerged as a treatment option for refractory SSc through a reduction of the aberrant immune cells, followed byre-constitution of anew, self-tolerant immune system. After several case series and pilot studies, more recently three randomized controlled trials have shown a benefit in skin involvement, organ functions and quality of life measures in AHSCT compared to monthly cyclophosphamide. In addition, although AHSCT presents a certain risk of mortality, it has been shown that the overall survival is better, compared to the cyclophosphamide group. Current evidence suggests that SSc patients who are most likely to benefit from AHSCT are early, with a high level of disease activity, with rapidly progressing diffuse skin disease, and mild involvement of internal organs. Although this procedure maintains a certain risk of mortality, as the studies have progressed, it has become evident the need for a more rigorous patient selection, the optimization of transplant and post-transplant procedures, and the intervention of multidisciplinary teams of specialists to increase the safety and efficacy of AHSCT in SSc.
Nicoletta Del Papa
Scleroderma Clinic U.O.C. Day Hospital Reumatologia ASST G. Pini-CTO, Milan, Italy