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Hathaway F, Martins R, Sorscher S, Bzura A, Dudbridge F, Fennell DA. Family Matters: Germline Testing in Thoracic Cancers. Am Soc Clin Oncol Educ Book 2023; 43:e389956. [PMID: 37167572 DOI: 10.1200/edbk_389956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Most thoracic cancers arise via a series of stepwise somatic alterations driven by a well-defined carcinogen (ie, tobacco or asbestos for lung cancer and mesothelioma, respectively). A small proportion can emerge on a background of pathogenic germline variants (PGVs), which have the property of heritability. In general, PGVs may be initially suspected on the basis of the presence of specific clinical features. Such gene × environment interactions significantly increase the risk of developing lung cancer (1.5- to 3.2-fold). PGVs have been discovered involving the actionable driver oncogene, epidermal growth factor receptor (EGFR), with an EGFR T790M PGV rate of 0.3%-0.9% in the nonsquamous non-small-cell lung cancer subtype. Its appearance during routine somatic DNA sequencing in those patients who have not had a previous tyrosine kinase inhibitor should raise suspicion. In patients with sporadic mesothelioma, BAP1 is the most frequently mutated tumor driver, with a PGV rate between 2.8% and 8%, associated with a favorable prognosis. BAP1 PGVs accelerate mesothelioma tumorigenesis after asbestos exposure in preclinical models and may be partly predicted by clinical criteria. At present, routine germline genetic testing for thoracic cancers is not a standard practice. Expert genetic counseling is, therefore, required for patients who carry a PGV. Ongoing studies aim to better understand the natural history of patients harboring PGVs to underpin future cancer prevention, precise counseling, and cancer management with the goal of improving the quality and length of life.
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Affiliation(s)
- Feighanne Hathaway
- Department of Medicine, Section of Hematology/Oncology, The University of Chicago Comprehensive Cancer Center, Chicago, IL
| | - Renato Martins
- Department of Hematology, Oncology, Palliative Care, Virginia Commonwealth University, Richmond, VA
| | | | | | | | - Dean A Fennell
- The University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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2
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Melaiu O, Gemignani F, Landi S. The genetic susceptibility in the development of malignant pleural mesothelioma. J Thorac Dis 2018; 10:S246-S252. [PMID: 29507792 DOI: 10.21037/jtd.2017.10.41] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Malignant pleural mesothelioma (MPM) is a cancer of the pleural cavity whose main risk factor is exposure to asbestos. However, it has been shown that only a minority of exposed people develops MPM. In fact, the incidence among professionally exposed workers was shown to vary between 0.5% and 18.0%. Various hints suggested that other important cofactors could play a role, in particular the genetic susceptibility. Impressive is the case of Cappadocians families exposed to erionite and affected by an "epidemic" of MPM with about half of the inhabitants dying for the disease. However, no results for a "Cappadocia" gene of susceptibility to MPM have been obtained yet and more studies are needed. Among asbestos-exposed workers, several studies reported familial cases of MPM, suggesting that heredity could be important in the tumor development. However, large studies on familial clusters showed only weak increased risks that could be attributable also to indirect exposures in a contaminated household. Moreover, the risk of developing MPM is increased of a limited extent among people exposed to asbestos with a positive history of familial cancers. A particular is represented by carriers of germline mutations within BAP1 gene. In families and in animal models, mutations within BAP1 are strongly predisposing to develop MPM. However, also other types of cancer (such as uveal melanoma) are present, thus BAP1 mutations are considered as responsible for a hereditary form of a multi-cancer syndrome. In any case, among sporadic MPM, the prevalence of germline BAP1 mutations is negligible. Finally, genetic studies highlighted the presence of low-risk susceptibility alleles, such as those within XRCC3, NAT2 or GSTM1. Two different genome-wide association studies could not find positive associations reaching the genome-wide statistical significance threshold, however, both were concordant in showing a weak signal within the SDK1 gene region. Overall, it could be concluded that, as for other types of sporadic cancers, the susceptibility to develop MPM following asbestos exposure is modulated moderately by the individual genetic background. Further studies on larger series could help in a better characterization of more genes predisposing to MPM, being this tumor a rare disease.
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Affiliation(s)
| | | | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
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Cheung M, Kadariya Y, Pei J, Talarchek J, Facciolo F, Visca P, Righi L, Cozzi I, Testa JR, Ascoli V. An asbestos-exposed family with multiple cases of pleural malignant mesothelioma without inheritance of a predisposing BAP1 mutation. Cancer Genet 2015; 208:502-7. [PMID: 26364129 DOI: 10.1016/j.cancergen.2015.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 07/17/2015] [Accepted: 07/24/2015] [Indexed: 11/15/2022]
Abstract
We report a family with domestic exposure to asbestos and diagnosis of multiple cancers, including eight pleural malignant mesotheliomas and several other lung or pleural tumors. DNA sequence analysis revealed no evidence for an inherited mutation of BAP1. Sequence analysis of other potentially relevant genes, including TP53, CDKN2A, and BARD1, also revealed no mutation. DNA microarray analysis of tissue from two mesotheliomas revealed multiple genomic imbalances, including consistent losses of overlapping segments in 2q, 6q, 9p, 14q, 15q, and 22q, but no losses of chromosome 3 harboring the BAP1 locus. However, the results of immunohistochemical analysis demonstrated loss of nuclear BAP1 staining in three of six mesotheliomas tested, suggesting that somatic alterations of BAP1 occurred in a subset of tumors from this family. Since mesothelioma could be confirmed in only a single generation, domestic exposure to asbestos may be the predominant cause of mesothelioma in this family. Given the existence of unspecified malignant pleural tumors and lung cancers in a prior generation, we discuss the possibility that some other tumor susceptibility or modifier gene(s) may contribute to the high incidence of mesothelioma in this family. Because the incidence of mesothelioma in this family is higher than that expected even in workers heavily exposed to asbestos, we conclude that both asbestos exposure and genetic factors have played a role in the high rate of mesothelioma and potentially other pleural or lung cancers seen in this family.
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Affiliation(s)
- Mitchell Cheung
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Yuwaraj Kadariya
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jianming Pei
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Francesco Facciolo
- Department of Oncologic Thoracic Surgery, Regina Elena Cancer Institute, Rome, Italy
| | - Paolo Visca
- Department of Pathology, Regina Elena Cancer Institute, Rome, Italy
| | - Luisella Righi
- Department of Oncology, San Luigi Hospital, University of Turin, Italy
| | - Ilaria Cozzi
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy
| | - Joseph R Testa
- Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Valeria Ascoli
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Italy.
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4
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Ascoli V, Romeo E, Carnovale Scalzo C, Cozzi I, Ancona L, Cavariani F, Balestri A, Gasperini L, Forastiere F. Familial malignant mesothelioma: a population-based study in central Italy (1980-2012). Cancer Epidemiol 2014; 38:273-8. [PMID: 24684899 DOI: 10.1016/j.canep.2014.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 02/24/2014] [Accepted: 02/28/2014] [Indexed: 12/23/2022]
Abstract
Malignant mesothelioma is a sporadic cancer linked to asbestos exposure. Its occurrence among blood relatives (familial mesothelioma) may point to genetic susceptibility or shared exposures. The burden of the familial disease is unknown. The aims of the study were to assess at population level the proportion of familial mesotheliomas among all mesotheliomas and to investigate the family history of cancer among relatives of mesothelioma cases. We actively searched familial clusters based on a mesothelioma registry from central Italy (5.5 million people, 10% of the Italian population) of the National Mesothelioma Register network (ReNaM) as well as a pathology-based archive. Among 997 incident mesotheliomas recorded in a 32-year-period (1980-2012), we detected 13 clusters and 34 familial cases, accounting for 3.4% of all mesotheliomas. The most common clusters where those with affected siblings and unaffected parents. Asbestos exposure was occupational (n=7 clusters), household (n=2), environmental (n=1), or not attributable for insufficient information (n=3). There were 25 additional cancers in nine families. Some were cancer sites for which there is sufficient evidence (lung and larynx) or limited evidence (stomach and colon) of causal association with asbestos. The results suggest potential genetic recessive effects in mesothelioma that interact with asbestos exposure, but it is not possible to estimate the specific proportion attributable to each of these components.
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Affiliation(s)
- Valeria Ascoli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Viale Regina Elena, 324, 00161 Rome, Italy.
| | - Elisa Romeo
- Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy
| | - Caterina Carnovale Scalzo
- Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy
| | - Ilaria Cozzi
- Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy
| | - Laura Ancona
- Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy
| | - Fulvio Cavariani
- Laboratory of Industrial Hygiene-Asbestos Regional Center, Local Health Unit, Via Nepesina, 1/a, 01033 Civita Castellana, Viterbo, Italy
| | - Anna Balestri
- Laboratory of Industrial Hygiene-Asbestos Regional Center, Local Health Unit, Via Nepesina, 1/a, 01033 Civita Castellana, Viterbo, Italy
| | - Letizia Gasperini
- Laboratory of Industrial Hygiene-Asbestos Regional Center, Local Health Unit, Via Nepesina, 1/a, 01033 Civita Castellana, Viterbo, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, 53, 00198 Rome, Italy
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Carbone M, Ly BH, Dodson RF, Pagano I, Morris PT, Dogan UA, Gazdar AF, Pass HI, Yang H. Malignant mesothelioma: facts, myths, and hypotheses. J Cell Physiol 2012; 227:44-58. [PMID: 21412769 PMCID: PMC3143206 DOI: 10.1002/jcp.22724] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Malignant mesothelioma (MM) is a neoplasm arising from mesothelial cells lining the pleural, peritoneal, and pericardial cavities. Over 20 million people in the US are at risk of developing MM due to asbestos exposure. MM mortality rates are estimated to increase by 5-10% per year in most industrialized countries until about 2020. The incidence of MM in men has continued to rise during the past 50 years, while the incidence in women appears largely unchanged. It is estimated that about 50-80% of pleural MM in men and 20-30% in women developed in individuals whose history indicates asbestos exposure(s) above that expected from most background settings. While rare for women, about 30% of peritoneal mesothelioma in men has been associated with exposure to asbestos. Erionite is a potent carcinogenic mineral fiber capable of causing both pleural and peritoneal MM. Since erionite is considerably less widespread than asbestos, the number of MM cases associated with erionite exposure is smaller. Asbestos induces DNA alterations mostly by inducing mesothelial cells and reactive macrophages to secrete mutagenic oxygen and nitrogen species. In addition, asbestos carcinogenesis is linked to the chronic inflammatory process caused by the deposition of a sufficient number of asbestos fibers and the consequent release of pro-inflammatory molecules, especially HMGB-1, the master switch that starts the inflammatory process, and TNF-alpha by macrophages and mesothelial cells. Genetic predisposition, radiation exposure and viral infection are co-factors that can alone or together with asbestos and erionite cause MM. J. Cell. Physiol. 227: 44-58, 2012. © 2011 Wiley Periodicals, Inc.
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Affiliation(s)
- Michele Carbone
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii 96813, USA.
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Betti M, Ferrante D, Padoan M, Guarrera S, Giordano M, Aspesi A, Mirabelli D, Casadio C, Ardissone F, Ruffini E, Betta PG, Libener R, Guaschino R, Matullo G, Piccolini E, Magnani C, Dianzani I. XRCC1 and ERCC1 variants modify malignant mesothelioma risk: a case-control study. Mutat Res 2011; 708:11-20. [PMID: 21277872 DOI: 10.1016/j.mrfmmm.2011.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 12/10/2010] [Accepted: 01/14/2011] [Indexed: 05/20/2023]
Abstract
Malignant pleural mesothelioma (MPM) is a rare aggressive tumor associated with asbestos exposure. The possible role of genetic factors has also been suggested and MPM has been associated with single nucleotide polymorphisms (SNPs) of xenobiotic and oxidative metabolism enzymes. We have identified an association of the DNA repair gene XRCC1 with MPM in the population of Casale Monferrato, a town exposed to high asbestos pollution. To extend this observation we examined 35 SNPs in 15 genes that could be involved in MPM carcinogenicity in 220 MPM patients and 296 controls from two case-control studies conducted in Casale (151 patients, 252 controls) and Turin (69 patients, 44 controls), respectively. Unconditional multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Two DNA repair genes were associated with MPM, i.e. XRCC1 and ERCC1. Considering asbestos-exposed only, the risk increased with the increasing number of XRCC1-399Q alleles (Casale: OR=1.44, 95%CI 1.02-2.03; Casale+Turin: OR=1.34, 95%CI 0.98-1.84) or XRCC1 -77T alleles (Casale+Turin: OR=1.33, 95%CI 0.97-1.81). The XRCC1-TGGGGGAACAGA haplotype was significantly associated with MPM (Casale: OR=1.76, 95%CI 1.04-2.96). Patients heterozygotes for ERCC1 N118N showed an increased OR in all subjects (OR=1.66, 95%CI 1.06-2.60) and in asbestos-exposed only (OR=1.59, 95%CI 1.01-2.50). When the dominant model was considered (i.e. ERCC1 heterozygotes CT plus homozygotes CC versus homozygotes TT) the risk was statistically significant both in all subjects (OR=1.61, 95%CI 1.06-2.47) and in asbestos-exposed only (OR=1.56, 95%CI 1.02-2.40). The combination of ERCC1 N118N and XRCC1 R399Q was statistically significant (Casale: OR=2.02, 95%CI 1.01-4.05; Casale+Turin: OR=2.39, 95%CI 1.29-4.43). The association of MPM with DNA repair genes support the hypothesis that an increased susceptibility to DNA damage may favour asbestos carcinogenicity.
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Affiliation(s)
- M Betti
- Laboratory of Genetic Pathology, Department of Medical Sciences, University of Piemonte Orientale, Novara, Italy
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Below JE, Cox NJ, Fukagawa NK, Hirvonen A, Testa JR. Factors that impact susceptibility to fiber-induced health effects. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2011; 14:246-66. [PMID: 21534090 PMCID: PMC3118508 DOI: 10.1080/10937404.2011.556052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Asbestos and related fibers are associated with a number of adverse health effects, including malignant mesothelioma (MM), an aggressive cancer that generally develops in the surface serosal cells of the pleural, pericardial, and peritoneal cavities. Although approximately 80% of individuals with MM are exposed to asbestos, fewer than 5% of asbestos workers develop MM. In addition to asbestos, other mineralogical, environmental, genetic, and possibly viral factors might contribute to MM susceptibility. Given this complex etiology of MM, understanding susceptibility to MM needs to be a priority for investigators in order to reduce exposure of those most at risk to known environmental carcinogens. In this review, the current body of literature related to fiber-associated disease susceptibility including age, sex, nutrition, genetics, asbestos, and other mineral exposure is addressed with a focus on MM, and critical areas for further study are recommended.
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Affiliation(s)
- Jennifer E Below
- Department of Medicine, Section of Genetic Medicine, University of Chicago, Chicago, Illinois 60637, USA.
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Betti M, Neri M, Ferrante D, Landi S, Biava A, Gemignani F, Bertolotti M, Mirabelli D, Padoan M, Ugolini D, Botta M, Bonassi S, Magnani C, Dianzani I. Pooled analysis of NAT2 genotypes as risk factors for asbestos-related malignant mesothelioma. Int J Hyg Environ Health 2009; 212:322-9. [DOI: 10.1016/j.ijheh.2008.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 07/31/2008] [Accepted: 08/04/2008] [Indexed: 10/21/2022]
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Christensen BC, Godleski JJ, Roelofs CR, Longacker JL, Bueno R, Sugarbaker DJ, Marsit CJ, Nelson HH, Kelsey KT. Asbestos burden predicts survival in pleural mesothelioma. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:723-726. [PMID: 18560526 PMCID: PMC2430226 DOI: 10.1289/ehp.11151] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Accepted: 02/11/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rapidly fatal asbestos-associated malignancy with a median survival time of <1 year following diagnosis. Treatment strategy is determined in part using known prognostic factors. OBJECTIVE The aim of this study was to examine the relationship between asbestos exposure and survival outcome in MPM in an effort to advance the understanding of the contribution of asbestos exposure to MPM prognosis. METHODS We studied incident cases of MPM patients enrolled through the International Mesothelioma Program at Brigham and Women's Hospital in Boston, Massachusetts, using survival follow-up, self-reported asbestos exposure (n=128), and a subset of cases (n=80) with quantitative asbestos fiber burden measures. RESULTS Consistent with the established literature, we found independent, significant associations between male sex and reduced survival (p<0.04), as well as between nonepithelioid tumor histology and reduced survival (p<0.02). Although self-reported exposure to asbestos was not predictive of survival among our cases, stratifying quantitative asbestos fiber burden [number of asbestos bodies per gram of lung (wet weight)] into groups of low (0-99 asbestos bodies), moderate (100-1,099), and high fiber burden (>1,099), suggested a survival duration association among these groups (p=0.06). After adjusting for covariates in a Cox model, we found that patients with a low asbestos burden had a 3-fold elevated risk of death compared to patients with a moderate fiber burden [95% confidence interval (CI), 0.95-9.5; p=0.06], and patients with a high asbestos burden had a 4.8-fold elevated risk of death (95% CI, 1.5-15.0; p<0.01) versus those with moderate exposure. CONCLUSION Our data suggest that patient survival is associated with asbestos fiber burden in MPM and is perhaps modified by susceptibility.
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Affiliation(s)
- Brock C. Christensen
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Pathology and Laboratory Medicine, Center for Environmental Health and Technology, Brown University, Providence, Rhode Island, USA
| | - John J. Godleski
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Cora R. Roelofs
- Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jennifer L. Longacker
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David J. Sugarbaker
- Division of Thoracic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Carmen J. Marsit
- Department of Pathology and Laboratory Medicine, Center for Environmental Health and Technology, Brown University, Providence, Rhode Island, USA
| | - Heather H. Nelson
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota, USA
| | - Karl T. Kelsey
- Department of Pathology and Laboratory Medicine, Center for Environmental Health and Technology, Brown University, Providence, Rhode Island, USA
- Department of Community Health, Center for Environmental Health and Technology, Brown University, Providence, Rhode Island, USA
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Lindholm P, Salmenkivi K, Vauhkonen H, Nicholson A, Anttila S, Kinnula V, Knuutila S. Gene copy number analysis in malignant pleural mesothelioma using oligonucleotide array CGH. Cytogenet Genome Res 2007; 119:46-52. [DOI: 10.1159/000109618] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 06/06/2007] [Indexed: 11/19/2022] Open
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Ugolini D, Neri M, Ceppi M, Cesario A, Dianzani I, Filiberti R, Gemignani F, Landi S, Magnani C, Mutti L, Puntoni R, Bonassi S. Genetic susceptibility to malignant mesothelioma and exposure to asbestos: the influence of the familial factor. Mutat Res 2007; 658:162-71. [PMID: 17904414 DOI: 10.1016/j.mrrev.2007.08.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 08/03/2007] [Accepted: 08/03/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND Asbestos is the principal etiological factor of malignant mesothelioma (MM), accounting for more than 80% of all tumor cases. However, other co-factors, including genetic susceptibility may play a role in the etiology of this disease, possibly modulating the effects of exposure to asbestos and other carcinogenic mineral fibers. The frequent report of familial clustering was the first indication supporting the involvement of genetic factors. Therefore, we performed an extensive literature search to evaluate existing studies reporting familial cases of MM. METHODS Published reports addressing the issue of familial susceptibility to MM have been searched through PubMed using keywords and free text tools. Eighty-two citations were retrieved and 20 of them actually reported a familial cluster of MM. Three more articles were identified through the references. The probability that the observed familial clusters of mesothelioma could have randomly occurred in exposed families was evaluated with the Family History Score Zi (FHSi). RESULTS The result of this analysis suggested that clustering of MM cases in families exposed to asbestos may be explained with the additional contribution of other familial factors. The FHSi allowed to reject the hypothesis of random occurrence of these clusters with a probability of a first type error ranging between 1 per cent and 1 per billion. CONCLUSIONS The evaluation of the published materials supports the hypothesis that - although familial clustering of MM is largely attributable to shared asbestos exposure - the additional contribution of factors dealing with genetic susceptibility may play a role in the etiology of MM.
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Affiliation(s)
- Donatella Ugolini
- Dipartimento di Oncologia, Biologia e Genetica, University of Genoa, Genoa, Italy
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12
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Ascoli V, Cavone D, Merler E, Barbieri PG, Romeo L, Nardi F, Musti M. Mesothelioma in blood related subjects: report of 11 clusters among 1954 Italy cases and review of the literature. Am J Ind Med 2007; 50:357-69. [PMID: 17407142 DOI: 10.1002/ajim.20451] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Malignant mesothelioma is a sporadic tumor related to asbestos. Its occurrence in blood relatives raises the question of potential contribution of predisposing factors. METHODS The study analyses the features of mesothelioma in blood relatives that might explain the disease clustering. Data sources of familial clusters were three population-based Mesothelioma Registries in Italy (Veneto and Apulia Regions, Brescia province; 1978-2005) and Medline, Toxline, and Oshline/Hseline databases for a review of the literature (1968-2006). RESULTS Eleven clusters (22 cases) were identified among 1954 Italy mesothelioma cases, and 51 clusters (120 cases) were extracted from 33 studies. The proportion of Italy familial cases was 1.4 per 100 mesothelioma cases; the ratio between the number of familial clusters and the number of non-familial mesothelioma cases was 1:148. The mesothelioma profile in consanguineous is the same as in non-consanguineous subjects (male prevalence; pleural site; age at diagnosis >50 years; asbestos exposure). Most clusters occurred in asbestos workers (shipyard, asbestos-cement production/processing, and insulation) and household-exposed blood relatives. Others were related to asbestos-cement factory pollution, asbestos-in-place, and handling asbestos-contaminated textiles. Two clusters were without any known exposure. Cancer family history revealed lung cancer cases in eight clusters. CONCLUSIONS Available data support asbestos exposure as the main risk factor in mesothelioma cases among blood relatives. Our finding of a low proportion of familial cases would not suggest the influence of a large genetic component for mesothelioma in blood relatives.
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Affiliation(s)
- Valeria Ascoli
- Department of Experimental Medicine, University La Sapienza, Rome, Italy.
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13
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Wilkins A, Popat S, Hughes S, O'Brien M. Malignant pleural mesothelioma: two cases in first degree relatives. Lung Cancer 2007; 57:407-9. [PMID: 17400330 DOI: 10.1016/j.lungcan.2007.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 02/01/2007] [Accepted: 02/08/2007] [Indexed: 10/23/2022]
Abstract
We report two cases of malignant pleural mesothelioma in first degree relatives arising within weeks of each other. The patients had a shared exposure to asbestos and age difference of over 20 years at time of presentation. In both cases, the anatomical pattern was similar and unusual for mesothelioma and initial histology was reported for both as non-small cell lung cancer. Both patients were treated with platinum-based combination chemotherapy.
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Affiliation(s)
- Anna Wilkins
- Department of Medical Oncology, Royal Marsden Hospital, Sutton, SURREY SM2 5PT, United Kingdom
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14
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Musti M, Kettunen E, Dragonieri S, Lindholm P, Cavone D, Serio G, Knuutila S. Cytogenetic and molecular genetic changes in malignant mesothelioma. ACTA ACUST UNITED AC 2006; 170:9-15. [PMID: 16965949 DOI: 10.1016/j.cancergencyto.2006.04.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 03/28/2006] [Accepted: 04/04/2006] [Indexed: 11/29/2022]
Abstract
Malignant mesothelioma (MM) results from the accumulation of a number of acquired genetic events, especially deletions, which lead to the inactivation of multiple onco-suppressor genes in a multistep cascade mechanism. Past asbestos exposure represents the major risk factor for MM, and the link between asbestos fibers and MM has been largely proved by several epidemiologic and experimental studies. Asbestos fibers induce DNA and chromosomal damage. Most MM cases have shown multiple chromosomal abnormalities. Chromosomal losses are more common than gains. The most common cytogenetic abnormality in MM is a deletion in 9p21, the locus of CDKN2A, a tumor suppressor gene (TSG). The deletion of CDKN2A is a negative prognostic factor in MM. Loss of TSG CDKN2A/p14(ARF) is also common in MM and mutations in NF2 occur in approximately half of the cases. Despite the ban on asbestos use in Western countries, the incidence of MM is increasing, and asbestos is still used in developing countries. This epidemiologic situation calls for further research. Ongoing studies are already applying high-throughput genomic profiling methods in MM. Genetic alterations observed in MM may be useful in differential diagnosis between lung cancer and MM, as diagnostic markers or therapeutic targets, and as indicators of premalignancy for primary prevention and health surveillance.
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Affiliation(s)
- Marina Musti
- Preventive Medicine of Workers and Psychotechnology, Department of Internal Medicine and Public Medicine, Section of Occupational Medicine, University of Bari, and National Register of Mesothelioma, Regional Operative Centre Apulia, Bari, Italy
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Pairon J, Jaurand M, Laurent F, Salmi R, Astoul P, Galateau-Sallé F, Brochard P. 1. Comment évaluer une exposition à l’amiante et identifier une population à risque? Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71781-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Marchevsky AM, Harber P, Crawford L, Wick MR. Mesothelioma in patients with nonoccupational asbestos exposure. Ann Diagn Pathol 2006; 10:241-50. [PMID: 16844568 DOI: 10.1016/j.anndiagpath.2006.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The specific parameters of nonoccupational asbestos exposures (NOAE) that can distinguish an idiopathic from an asbestos-caused malignant mesothelioma (MM) are controversial. A systematic literature review yielded 1028 cases with this putative association. Only 287 of those reports had a defined single exposure to a household, building occupant, or neighborhood/community asbestos source. The available "evidence" was used to develop semiarbitrary evidence-based causation guideline rules for the assessment of putative associations between MM and NOAE. The rules are classified into class A (tissue burden analysis shows asbestos body counts or fiber counts in lung tissues comparable to MM caused by occupational exposure to asbestos) and classes B to D based on whether certain combinations of NOAE features and MM (evidence) have been described in over 15% (class B), 5% to 15% (class C), and less than 5% (class D) of the patients reviewed. The proposed 4 classes of evidence-based causation guidelines provide a semiarbitrary framework to evaluate the causation of individual MM patients by NOAE based on decreasing levels of currently available evidence. The neoplasms in classes A to C patients are probably caused by NOAE, with decreasing weight of evidence in the 3 groups. There is minimal evidence to support the causation of MM by NOAE in class D patients. There is no evidence or only anecdotal evidence to support a causal association between MM and NOAE in individuals who cannot be classified into any of the 4 classes. Future studies are needed to provide more comprehensive data regarding the association between MM and NOAE.
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Affiliation(s)
- Alberto M Marchevsky
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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17
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Dianzani I, Gibello L, Biava A, Giordano M, Bertolotti M, Betti M, Ferrante D, Guarrera S, Betta GP, Mirabelli D, Matullo G, Magnani C. Polymorphisms in DNA repair genes as risk factors for asbestos-related malignant mesothelioma in a general population study. Mutat Res 2006; 599:124-34. [PMID: 16564556 DOI: 10.1016/j.mrfmmm.2006.02.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2005] [Revised: 01/23/2006] [Accepted: 02/15/2006] [Indexed: 10/24/2022]
Abstract
Differences in response to carcinogenic agents are due to the allelic variants of the genes that control it. Key genes are those involved in the repair of the DNA damage caused by such agents. This paper describes the results of a case-control epidemiological study designed to determine the genotypes of four of these genes in persons exposed to a single genotoxic factor, i.e. asbestos, who had or had not developed malignant mesothelioma (MM). Our working hypothesis was that an imperfect DNA repair, as revealed by subtle polymorphic variants, could reduce protection against the chronic DNA insult provoked by asbestos and eventually result in mutagenesis and cancer. Seven variants (i.e. XRCC1-R399Q-NCBI SNP, XRCC1-R194W, XRCC3-T241M, XRCC3-IVS6-14, XPD-K751Q, XPD-D312N, OGG1-S326C) were investigated in 81 patients and 110 age and sex-matched controls, all residents at Casale Monferrato, a Piedmontese town highly exposed to asbestos pollution. Unconditional multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). When considered as a categorical variable, XRCC1-399Q showed an increased OR both in heterozygotes (OR=2.08; 95% CI=1.00-4.33) and homozygotes (2.38; 95% CI=0.82-6.94), although individual ORs were not significant. When it was considered as a continuous variable OR was significant (OR=1.68; 95% CI: 1.02-2.75). When genotypes were divided into "non-risk" and "risk" genotypes, i.e. those thought to be associated with increased risk in the light of the functional significance of the variants, XRCC1-399Q (Q homozygotes+Q/R heterozygotes versus R homozygotes) had an OR=2.147 (95% CI: 1.08-4.28), whereas that of XRCC3-241T (T homozygotes+M/T heterozygotes versus M homozygotes) was 4.09 (95% CI: 1.26-13.21) and that of OGG1-326C was increased, though not significantly. None of the haplotypes showed a significantly different frequency between patients and controls. This is the first report of an association between polymorphisms in DNA repair genes and asbestos-associated MM. Our data indicate that genetic factors are involved in MM development.
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Affiliation(s)
- I Dianzani
- Laboratorio di Patologia Genetica, Dipartimento di Scienze Mediche, Università del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy.
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18
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Henderson DW, Rödelsperger K, Woitowitz HJ, Leigh J. After Helsinki: a multidisciplinary review of the relationship between asbestos exposure and lung cancer, with emphasis on studies published during 1997-2004. Pathology 2005; 36:517-50. [PMID: 15841689 DOI: 10.1080/00313020400010955] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite an extensive literature, the relationship between asbestos exposure and lung cancer remains the subject of controversy, related to the fact that most asbestos-associated lung cancers occur in those who are also cigarette smokers: because smoking represents the strongest identifiable lung cancer risk factor among many others, and lung cancer is not uncommon across industrialised societies, analysis of the combined (synergistic) effects of smoking and asbestos on lung cancer risk is a more complex exercise than the relationship between asbestos inhalation and mesothelioma. As a follow-on from previous reviews of prevailing evidence, this review critically evaluates more recent studies on this relationship--concentrating on those published between 1997 and 2004--including lung cancer to mesothelioma ratios, the interactive effects of cigarette smoke and asbestos in combination, and the cumulative exposure model for lung cancer induction as set forth in The Helsinki Criteria and The AWARD Criteria (as opposed to the asbestosis-->cancer model), together with discussion of differential genetic susceptibility/resistance factors for lung carcinogenesis by both cigarette smoke and asbestos. The authors conclude that: (i) the prevailing evidence strongly supports the cumulative exposure model; (ii) the criteria for probabilistic attribution of lung cancer to mixed asbestos exposures as a consequence of the production and end-use of asbestos-containing products such as insulation and asbestos-cement building materials--as embodied in The Helsinki and AWARD Criteria--conform to, and are further consolidated by, the new evidence discussed in this review; (iii) different attribution criteria (e.g., greater cumulative exposures) are appropriate for chrysotile mining/milling and perhaps for other chrysotile-only exposures, such as friction products manufacture, than for amphibole-only exposures or mixed asbestos exposures; and (iv) emerging evidence on genetic susceptibility/resistance factors for lung cancer risk as a consequence of cigarette smoking, and potentially also asbestos exposure, suggests that genotypic variation may represent an additional confounding factor potentially affecting the strength of association and hence the probability of causal contribution in the individual subject, but at present there is insufficient evidence to draw any meaningful conclusions concerning variation in asbestos-mediated lung cancer risk relative to such resistance/susceptibility factors.
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Affiliation(s)
- Douglas W Henderson
- Department of Anatomical Pathology, Flinders University and Flinders Medical Centre, Bedford Park, Adelaide, South Australia.
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Miller A. Mesothelioma in household members of asbestos-exposed workers: 32 United States cases since 1990. Am J Ind Med 2005; 47:458-62. [PMID: 15828068 DOI: 10.1002/ajim.20167] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mesothelioma is significant as an indicator of asbestos exposure, as a continuing major cause of death in those exposed, and as a risk following lesser exposures. One such exposure is living in the household of an asbestos worker, and coming into contact with fibers brought home on his/her body, clothing, etc. METHODS Law firms throughout the US known for their pursuit of asbestos claims were polled for mesothelioma claims brought on behalf of family members of identifiable asbestos-exposed workers. Cases with any occupational, environmental, or other possible exposure were not included. RESULTS This study reports 32 household-exposure mesothelioma cases, diagnosed since 1990. Relationships were wife (15), daughter (11), son (3), sister-in law (1), niece (1), and boarder (1). Occupations of the workers included shipyard (13), insulator (7), and other (12). Of the 27 pleural cases, 13 were epithelial, 5 fibrous, 3 biphasic, and 6 not specified; of the 5 peritoneal cases, 4 were epithelial and 1 fibrous. Latency was greater than 40 years in 27 cases; 6 cases were 40-49 years of age and 17 were 60 or older. CONCLUSIONS Records from law firms were a useful source of information. Mesothelioma resulting from household exposure is a continuing problem. It is more likely to present in the elderly, after latencies of >40 years.
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Abstract
About 80% of malignant mesotheliomas (MM) in the Western World develop in individuals with higher than background exposure to asbestos. Only a fraction of those exposed to asbestos develop mesothelioma, indicating that additional factors play a role. Simian virus 40 (SV40), a DNA tumor virus that preferentially causes mesothelioma in hamsters, has been detected in several human mesotheliomas. The expression of the SV40 large tumor antigen in mesothelioma cells, and not in nearby stromal cells, and the capacity of antisense T-antigen treatment to arrest mesothelioma cell growth in vitro suggest that SV40 contributes to tumor development. The capacity of T-antigen to bind and inhibit cellular p53 and retinoblastoma (Rb)-family proteins in mesothelioma, together with the very high susceptibility of human mesothelial cells to SV40-mediated transformation in vitro, supports a causative role of SV40 in the pathogenesis of mesothelioma. Asbestos appears to increase SV40-mediated transformation of human mesothelial cells in vitro, suggesting that asbestos and SV40 may be cocarcinogens. p53 mutations are rarely found in mesothelioma; p16, p14ARF, and NF2 mutations/losses are frequent. Recent studies revealed the existence of a genetic factor that predisposes affected individuals to mesothelioma in the villages of Karain and Tuzkoy, in Anatolia, Turkey. Erionite, a type of zeolite, may be a cofactor in these same villages, where 50% of deaths are caused by mesothelioma. Mesothelioma appears to have a complex etiology in which environmental carcinogens (asbestos and erionite), ionizing radiation, viruses, and genetic factors act alone or in concert to cause malignancy.
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Affiliation(s)
- Michele Carbone
- Cancer Immunology Program, Cardinal Bernardin Cancer Center, Department of Pathology, Loyola University Chicago, USA
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Ascoli V, Calisti R, Carnovale-Scalzo C, Nardi F. Malignant pleural mesothelioma in bakers and pastry cooks. Am J Ind Med 2001; 40:371-3. [PMID: 11598986 DOI: 10.1002/ajim.1111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The occurrence of malignant pleural mesothelioma (MPM) among bakers and pastry cooks has never been documented. CASE REPORTS We detected eight cases of MPM in bakers, pastry cooks, and biscuit cooks engaged in making, baking/cooking, and selling pastry/bread in two hospital-based series (Rome and Orbassano/Turin, Italy; period 1990-1997; 222 cases). Field-investigations revealed asbestos-containing material (ACM) in ovens for baking bread, that were manufactured prior to the 1980s. CONCLUSIONS It is suggested that there is a possible new association of the risk of having worked as a baker or pastry cook and MPM. Presumptive source of exposure to asbestos was the use of asbestos-insulated ovens.
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Affiliation(s)
- V Ascoli
- Department of Experimental Medicine and Pathology, La Sapienza University, Viale Regina Elena 324, 00161-Rome, Italy.
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Ascoli V, Aalto Y, Carnovale-Scalzo C, Nardi F, Falzetti D, Mecucci C, Knuutila S. DNA copy number changes in familial malignant mesothelioma. CANCER GENETICS AND CYTOGENETICS 2001; 127:80-2. [PMID: 11408072 DOI: 10.1016/s0165-4608(00)00420-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Malignant mesothelioma (MM) is predominantly a sporadic malignancy linked to exposure to asbestos. Clustering of MM in families suggests genetic susceptibility as a contributing factor. We performed comparative genomic hybridization (CGH) analysis on tumor samples from members of a family with MM of the pleura and a history of parental cancer. Our specific aim was to find a recurrent copy number loss indicating the chromosomal area to which a gene underlying the development of MM could be assigned according to the Knudson two-hit hypothesis. We found losses at 1p, 6q, 9p, 13q, and 14q. The copy number changes were very similar to those reported in sporadic cases. Our findings and results from sporadic cases highlight the importance of cloning the genes in the loss sites at 1p, 6q, 14q, and 22q.
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Affiliation(s)
- V Ascoli
- Department of Experimental Medicine and Pathology, La Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy.
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