1
|
Wang Y, Sen-Majumdar A, Li JM, Sarkar S, Passang T, Li Y, Cohen J, Chen Z, Chaudagar K, Das PK, Wang S, Bruk N, Papadantonakis N, Giver CR, Waller EK. Identification and characterization of vasoactive intestinal peptide receptor antagonists with high-affinity and potent anti-leukemia activity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.11.08.622716. [PMID: 39605448 PMCID: PMC11601233 DOI: 10.1101/2024.11.08.622716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
Vasoactive intestinal peptide (VIP) is a neuropeptide involved in tumor growth and immune modulating functions. Previous research indicated that a VIP antagonist (VIPhyb) enhances T-cell activation and induces T-cell-dependent anti-leukemic activity in mice. We created a combinatorial library of VIPhyb C-terminal sequence variations to develop a more potent VIP-receptor (VIP-R) antagonist, hypothesizing that specific amino acid substitutions would improve receptor binding and plasma stability. In silico screening analyses identified sequences with improved docking scores predicting increased binding affinity to human VIP receptors VPAC1 and VPAC2. Fifteen peptides were synthesized and tested for their ability to potentiate activation of purified mouse and human T cells and enhance T cell-dependent anti-leukemia responses in murine models of acute myeloid leukemia. Treating C57Bl/6 mice engrafted with a C1498 myeloid leukemia cell line with daily subcutaneous injections of VIP-R antagonist peptides induced T cell activation resulting in specific anti-leukemia responses. Strikingly, the predicted binding affinity of the VIP-R antagonists to VIP receptors correlated positively with their ability to augment mouse T-cell proliferation and anti-leukemia activity. ANT308 and ANT195 emerged as top candidates due to their high predicted VIP-R binding, low EC 50 for in vitro T cell activation, and potent anti-leukemia activities. ANT308 decreased CREB phosphorylation, a downstream signaling pathway of the VIP receptor, and stimulated granzyme B and perforin expression in CD8+ T cells from AML patients. Combining in silico modeling, in vitro T cell activation properties, and in vivo anti-leukemia activity has identified promising VIP-R antagonist candidates for further development as novel immunotherapies for AML, especially for patients with relapsed disease.
Collapse
|
2
|
Karele EN. All you need to know about VIPoma: Review on the latest studies. Presse Med 2024; 53:104222. [PMID: 38109967 DOI: 10.1016/j.lpm.2023.104222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/15/2023] [Accepted: 08/02/2023] [Indexed: 12/20/2023] Open
Abstract
Vasoactive intestinal peptide secreting tumor (VIPoma) is a rare mostly malignant neuroendocrine tumor that is characterized by watery diarrhea, hypokalemia and achlorhydria due to the nonregulated increased secretion of VIP. VIPomas ar diagnosed by the presence of the most common symptoms, laboratory analysis of blood and stool, radiological imaging and immunohistochemical findings. Primary treatment includes fluid replacement, electrolyte balance correction, pharmacological treatment with somatostatin analogs, surgical resection and chemotherapy. This review aims to provide an insight into the latest research on VIPoma epidemiology, pathophysiology, diagnostics and treatment.
Collapse
Affiliation(s)
- Emija Nikola Karele
- Faculty of Medicine, Riga Stradins University, 16 Dzirciema Street, Riga LV-1007, Latvia.
| |
Collapse
|
3
|
Chevalier B, Bonnet D, Lepage C, Perrier M, Borson-Chazot F, Abeillon J, Delobel JB, Jannin A, Hadoux J, Haissaguere M, Lombard-Bohas C, Walter T, Chardon L. Interference With VIP to Distinguish Between Real and False VIPoma: National Study From the French Endocrine Tumors Group. J Endocr Soc 2024; 8:bvae102. [PMID: 38854908 PMCID: PMC11156571 DOI: 10.1210/jendso/bvae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Indexed: 06/11/2024] Open
Abstract
Background Vasoactive intestinal peptide (VIP)-secreting tumors (VIPomas) are digestive neuroendocrine tumors in which the hormonal secretion is life-threatening. Biological confirmation is obtained by demonstrating an elevation in plasma VIP, usually using radioimmunoassay (RIA). In some cases, analytical interference is suspected. We developed 3 different techniques to detect interference in VIP RIA. Methods Three techniques were used: RIA after Sephadex column chromatography separation, RIA after polyethylene glycol precipitation, and 125I-labeled VIP binding test. We included patients with suspicion of false positive VIP (FPV) elevation. We then compared results with those of a group of "real," proven VIPoma (RV). Results A total of 15 patients with FPV elevation and 9 RV patients were included. Interference was detected in all FPV patients vs none in RV. Clinical and biochemical parameters did not differ between FPV and RV patients, but VIP concentration in RIA was significantly higher in FPV patients than in RV patients (228 pmol/L vs 66 pmol/L, P = .038). Using a 125I-labeled VIP binding test, median proportion of radioactivity in the pellet was significantly higher in FPV than in RV patients (53% vs 13%, P < .0001). A 20.5% threshold presented excellent performances (sensitivity 100% [79.6-100], specificity 100% [70.1-100]). Conclusion We developed 3 different laboratory techniques to reveal interference in RIA VIP assays. The diagnostic performance of all 3 was excellent. These techniques must be employed in cases of discordance between VIP elevation and clinical presentation.
Collapse
Affiliation(s)
- Benjamin Chevalier
- Department of Nuclear Medicine, Lille University Hospital, Lille 59000, France
- School of Medicine, University of Lille, Lille 59000, France
| | - Delphine Bonnet
- Department of Internal Medicine and Digestive Diseases, CHU Toulouse, Toulouse 31059, France
| | - Come Lepage
- Gastroenterology and Digestive Oncology, Hôpital Universitaire Le Bocage, Dijon 21079, France
| | - Marine Perrier
- Université Reims Champagne-Ardenne, Department of Gastroenterology and Digestive Oncology, Reims University Hospital, 51092 Reims, France
| | - Françoise Borson-Chazot
- Hospices Civils de Lyon, Hôpital Louis Pradel, Fédération d’Endocrinologie, Lyon 69500, France
| | - Juliette Abeillon
- Hospices Civils de Lyon, Hôpital Louis Pradel, Fédération d’Endocrinologie, Lyon 69500, France
| | | | - Arnaud Jannin
- School of Medicine, University of Lille, Lille 59000, France
- Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille 59000, France
- CANTHER—Cancer—Heterogeneity Plasticity and Resistance to Therapies, University of Lille, UMR9020-U1277—CNRS, INSERM, CHU Lille, Lille 59000, France
| | - Julien Hadoux
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Center, Villejuif 94800, France
| | - Magalie Haissaguere
- Endocrinology and Endocrine Oncology Department, Haut Leveque Hospital, University Hospital of Bordeaux, Bordeaux 33600, France
| | | | - Thomas Walter
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d’Oncologie, Lyon 69003, France
| | - Laurence Chardon
- Service de Biochimie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron 69500, France
| |
Collapse
|
4
|
Belei O, Basaca DG, Heredea ER, Iacob ER, Olariu L, Folescu R, Motoc AGM, Nanu AM, Mărginean O. Chronic Diarrhea Caused by Vasoactive Intestinal Peptide-Secreting Tumor. Life (Basel) 2023; 13:1974. [PMID: 37895355 PMCID: PMC10608053 DOI: 10.3390/life13101974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
VIPomas are a type of neuroendocrine tumor that independently produces vasoactive intestinal peptide (VIP). VIPomas causing watery diarrhea, hypokalemia, and achlorhydria (WDHA) syndrome are not frequently observed in adult patients without pancreatic ailments. However, in children, the occurrence of a VIPoma originating in the pancreas is exceedingly uncommon. Instead, WDHA syndrome is more commonly associated with neurogenic tumors that secrete VIP, often located in the retroperitoneum or mediastinum. Among infants, chronic diarrhea is a prevalent issue that often necessitates the attention of pediatric gastroenterologists. The underlying causes are diverse, and delays in arriving at a definitive diagnosis can give rise to complications affecting the overall well-being of the child. The authors present the case of an infant with chronic watery diarrhea, subocclusion manifestations, mild hypokalemia, and metabolic hyperchloremic acidosis secondary to a VIPoma in the retroperitoneum that was diagnosed via abdominal ultrasound and tomography. The laboratory results revealed lowered potassium levels and an excessive secretion of VIP. Following the surgical removal of the tumor, the diarrhea resolved, and both electrolyte levels and the imbalanced hormone levels returned to normal. Immunohistochemical examination confirmed the diagnosis of ganglioneuroblastoma, with N-MYC negative on molecular biology tests. We present the clinical and histo-genetic aspects of this rare clinical entity, with a literature review.
Collapse
Affiliation(s)
- Oana Belei
- First Pediatric Clinic, Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (O.B.); (O.M.)
- Third Pediatric Clinic, “Louis Țurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania; (L.O.); (A.-M.N.)
| | - Diana-Georgiana Basaca
- First Pediatric Clinic, Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (O.B.); (O.M.)
- Third Pediatric Clinic, “Louis Țurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania; (L.O.); (A.-M.N.)
| | - Elena Rodica Heredea
- Department of Pathology, “Louis Ţurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania;
- Department of Clinical Practical Skills, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Laura Olariu
- Third Pediatric Clinic, “Louis Țurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania; (L.O.); (A.-M.N.)
- First Pediatric Clinic, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Roxana Folescu
- Department of Balneology, Medical Recovery, and Rheumatology, Family Medicine Discipline, Center for Preventive Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Andrei Gheorghe Marius Motoc
- Department of Anatomy and Embryology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Anda-Maria Nanu
- Third Pediatric Clinic, “Louis Țurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania; (L.O.); (A.-M.N.)
| | - Otilia Mărginean
- First Pediatric Clinic, Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (O.B.); (O.M.)
- Third Pediatric Clinic, “Louis Țurcanu” Emergency Hospital for Children, 300011 Timișoara, Romania; (L.O.); (A.-M.N.)
| |
Collapse
|
5
|
Hofland J, de Herder WW. Effective strategies for adequate control of hormonal secretion in functioning neuroendocrine neoplasms. Best Pract Res Clin Endocrinol Metab 2023; 37:101787. [PMID: 37311669 DOI: 10.1016/j.beem.2023.101787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neuroendocrine neoplasms are a unique form of malignancies as they can be accompanied by specific functioning hormonal syndromes that can impair survival and quality of life in patients. Functioning syndromes are defined by the combination of specific clinical signs and symptoms in combination with inappropriately elevated circulating levels of hormones. Clinicians should remain vigilant for the presence of functioning syndromes in neuroendocrine neoplasm patients at presentation as well as during follow-up. The correct diagnostic work-up should be initiated in cases of clinical suspicion of a neuroendocrine neoplasm-associated functioning syndrome. Management of a functional syndrome includes options from supportive, surgical, hormonal and antiproliferative treatment modalities. Here, we review the patient and tumour characteristics for each functioning syndrome that should be taken into account when deciding the optimum treatment strategy in neuroendocrine neoplasm patients.
Collapse
Affiliation(s)
- Johannes Hofland
- Department of Internal Medicine, Section of Endocrinology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
| | - Wouter W de Herder
- Department of Internal Medicine, Section of Endocrinology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| |
Collapse
|
6
|
Sultana Q, Kar J, Verma A, Sanghvi S, Kaka N, Patel N, Sethi Y, Chopra H, Kamal MA, Greig NH. A Comprehensive Review on Neuroendocrine Neoplasms: Presentation, Pathophysiology and Management. J Clin Med 2023; 12:5138. [PMID: 37568540 PMCID: PMC10420169 DOI: 10.3390/jcm12155138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Neuroendocrine neoplasms (NENs) are a group of heterogeneous tumors with neuroendocrine differentiation that can arise from any organ. They account for 2% of all malignancies in the United States. A significant proportion of NEN patients experience endocrine imbalances consequent to increased amine or peptide hormone secretion, impacting their quality of life and prognosis. Over the last decade, pathologic categorization, diagnostic techniques and therapeutic choices for NENs-both well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs)-have appreciably evolved. Diagnosis of NEN mostly follows a suspicion from clinical features or incidental imaging findings. Hormonal or non-hormonal biomarkers (like serum serotonin, urine 5-HIAA, gastrin and VIP) and histology of a suspected NEN is, therefore, critical for both confirmation of the diagnosis and classification as an NET or NEC. Therapy for NENs has progressed recently based on a better molecular understanding, including the involvement of mTOR, VEGF and peptide receptor radionuclide therapy (PRRT), which add to the growing evidence supporting the possibility of treatment beyond complete resection. As the incidence of NENs is on the rise in the United States and several other countries, physicians are more likely to see these cases, and their better understanding may support earlier diagnosis and tailoring treatment to the patient. We have compiled clinically significant evidence for NENs, including relevant changes to clinical practice that have greatly updated our diagnostic and therapeutic approach for NEN patients.
Collapse
Affiliation(s)
- Qamar Sultana
- Department of Medicine, Deccan College of Medical Sciences, Hyderabad 500058, India;
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
| | - Jill Kar
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Department of Medicine, Lady Hardinge Medical College, New Delhi 110001, India
| | - Amogh Verma
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Rama Medical College Hospital and Research Centre, Hapur 245304, India
| | - Shreya Sanghvi
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai 400022, India
| | - Nirja Kaka
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Department of Medicine, GMERS Medical College, Himmatnagar 390021, India
| | - Neil Patel
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Department of Medicine, GMERS Medical College, Himmatnagar 390021, India
| | - Yashendra Sethi
- PearResearch, Dehradun 248001, India; (J.K.); (A.V.); (S.S.); (N.K.); (N.P.)
- Government Doon Medical College, HNB Uttarakhand Medical Education University, Dehradun 248001, India
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India;
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610017, China;
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1216, Bangladesh
- Enzymoics, Hebersham, NSW 2770, Australia
- Novel Global Community Educational Foundation, Hebersham, NSW 2770, Australia
| | - Nigel H. Greig
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| |
Collapse
|
7
|
Magi L, Marasco M, Rinzivillo M, Faggiano A, Panzuto F. Management of Functional Pancreatic Neuroendocrine Neoplasms. Curr Treat Options Oncol 2023; 24:725-741. [PMID: 37103745 PMCID: PMC10272249 DOI: 10.1007/s11864-023-01085-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/28/2023]
Abstract
OPINION STATEMENT Functional pancreatic neuroendocrine neoplasms (pNENs) are rare and heterogeneous diseases in terms of both clinical and pathological aspects. These tumors secrete hormones or peptides, which may cause a wide variety of symptoms related to a clinical syndrome. The management of functional pNENs is still challenging for clinicians due to the need to control both tumor growth and specific symptoms. Surgery remains the cornerstone in the management of local disease because it can definitively cure the patient. However, when the disease is not resectable, a broad spectrum of therapeutic options, including locoregional therapy, somatostatin analogs (SSAs), targeted therapies, peptide-receptor radionuclide therapy (PRRT), and chemotherapy, are available. The present review summarizes the main key issues regarding the clinical management of these tumors, providing a specific highlight on their therapeutic approach.
Collapse
Affiliation(s)
- Ludovica Magi
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Via di Grottarossa 1035, 00189, Rome, Italy
| | - Matteo Marasco
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Via di Grottarossa 1035, 00189, Rome, Italy
| | - Maria Rinzivillo
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Via di Grottarossa 1035, 00189, Rome, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via Di Grottarrossa 1035, 00189, Rome, Italy
| | - Francesco Panzuto
- Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Via di Grottarossa 1035, 00189, Rome, Italy.
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy.
| |
Collapse
|
8
|
Privalov E, Zenkel M, Schloetzer-Schrehardt U, Kuerten S, Bergua A, Hohberger B. Pressure-Dependent Elevation of Vasoactive Intestinal Peptide Level in Chicken Choroid. BIOLOGY 2023; 12:biology12040495. [PMID: 37106696 PMCID: PMC10136289 DOI: 10.3390/biology12040495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/13/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE Autonomic control is important in maintaining ocular integrity. As recent data suggested that intrinsic choroidal neurons (ICN), an intrinsic choroidal autonomic control, may regulate choroidal thickening via release of the vasodilative vasoactive intestinal peptide (VIP), it was the aim of the study to investigate the level of choroidal VIP (VIPchor) in the presence of an increased atmospheric pressure in a chicken model. METHODS Chicken choroidal whole mounts were exposed to ambient pressure (n = 20) and 40 mm Hg (n = 20) in a PC-controlled, open chamber system for 24 and 72 h, respectively. The VIP concentration was analyzed by ELISA, and the total protein concentration was measured by the BCA assay. Statistical analysis was done using an unpaired two-tailed t-test. RESULTS The pressurization systems enabled choroidal whole mount pressurization (40 mm Hg) with humidifying, pressure, temperature, and gas exchange. Overall, the VIPchor level concentration was significantly increased at 40 mmHg compared to the ambient pressure (30.09 ± 7.18 pg vs. 20.69 ± 3.24 pg; p < 0.0001). Subgroup analysis yielded a significantly increased VIPchor level at 40 mmHg compared to the ambient pressure after 24 h (28.42 ± 6.03 pg vs. 20.76 ± 4.06 pg; p = 0.005) and 72 h (31.77 ± 7.82 pg vs. 20.61 ± 2.12 pg; p = 0.002), respectively. The VIPchor elevation at 40 mm Hg ranged between 1.37- (24 h) and 1.54-fold (72 h) compared to the ambient pressure. No difference was observed between the VIPchor level at 24 h and 72 h (p > 0.05). CONCLUSIONS The increase of the total choroidal VIP level, representing the intracellular VIP content, in the presence of an increased ambient pressure argues for a retention of VIP within the neurons, decreasing both vasodilatation and, consequently, choroid thickness. This finding might be a passive or even active function of ICN in the regulation of choroidal thickness, ocular integrity and IOP.
Collapse
Affiliation(s)
- Evgeny Privalov
- Department of Ophthalmology, Universität of Erlangen-Nürnberg, Friedrich-Alexander-University-Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias Zenkel
- Department of Ophthalmology, Universität of Erlangen-Nürnberg, Friedrich-Alexander-University-Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Ursula Schloetzer-Schrehardt
- Department of Ophthalmology, Universität of Erlangen-Nürnberg, Friedrich-Alexander-University-Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Stefanie Kuerten
- Institute of Neuroanatomy, Medical Faculty, University of Bonn, 53115 Bonn, Germany
| | - Antonio Bergua
- Department of Ophthalmology, Universität of Erlangen-Nürnberg, Friedrich-Alexander-University-Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Bettina Hohberger
- Department of Ophthalmology, Universität of Erlangen-Nürnberg, Friedrich-Alexander-University-Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| |
Collapse
|
9
|
Murakami M, Fujimori N, Matsumoto K, Ohno A, Teramatsu K, Takamatsu Y, Takeno A, Ueda K, Oono T, Ito T, Ogawa Y. A clinical analysis on functioning pancreatic neuroendocrine tumors (focusing on VIPomas): a single-center experience. Endocr J 2022; 69:1201-1209. [PMID: 35644576 DOI: 10.1507/endocrj.ej22-0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
VIPomas are generally rare functioning pancreatic neuroendocrine tumors (PanNETs) that cause watery diarrhea, hypokalemia, and achlorhydria. Due to their extreme rarity, the clinicopathological features and outcomes of VIPomas have not been well reported. This study aimed to determine the diagnostic and therapeutic characteristics and prognosis of VIPomas and to compare them with other PanNETs at a Japanese reference hospital. Medical records of 293 patients with PanNETs were collected. Patient and tumor characteristics and outcomes were retrospectively reviewed. This cohort had only 1.4% (four patients) of patients with VIPomas, and three of these patients changed from non-functioning (NF-) PanNETs during their disease course. Recurrences of hormonal symptoms were observed in all patients despite the initial controls, and all of them died from their disease, more specifically mainly from hormonal symptoms. Compared to the other PanNETs, VIPomas were all located at the pancreatic tail, were larger, and had a higher Ki-67 index and more metastasis. The median survival time was significantly shorter for patients with VIPoma than for those with NF-PanNET (5.9 vs. 26.7 years, p < 0.0001), insulinoma (21.8 years, p < 0.0001), and gastrinoma (12.3 years, p = 0.0325). This study presents the possibility of shifting from non-symptomatic to symptomatic VIPomas as they grow or of transforming from NF-PanNETs to VIPomas. VIPomas should be considered in patients with relatively large NF-PanNETs, especially those located in the pancreatic tail, when diarrhea is continuously observed. As hormonal symptoms are an important cause of death in VIPomas, long-term symptomatic control, which is relatively difficult, is of great significance.
Collapse
Affiliation(s)
- Masatoshi Murakami
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Nao Fujimori
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Kazuhide Matsumoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Akihisa Ohno
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Katsuhito Teramatsu
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yu Takamatsu
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Ayumu Takeno
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Keijiro Ueda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
- Neuroendocrine Tumor Centre, Fukuoka Sanno Hospital, Fukuoka 814-0001, Japan
| | - Takamasa Oono
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Tetsuhide Ito
- Neuroendocrine Tumor Centre, Fukuoka Sanno Hospital, Fukuoka 814-0001, Japan
- Department of Gastroenterology, Graduate School of Medical Sciences, International University of Health and Welfare, Fukuoka 814-0001, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| |
Collapse
|
10
|
Shin JE, Youn SY, Kim Y, Lee M, Park SJ. Case 2: A 66-Year-Old Man With Chronic Watery Diarrhea. J Korean Med Sci 2022; 37:e221. [PMID: 35916044 PMCID: PMC9344035 DOI: 10.3346/jkms.2022.37.e221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ji Eun Shin
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital Catholic University of Korea, Suwon, Korea
| | - Seo Yeon Youn
- Department of Radiology, Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Korea
| | - Younghoon Kim
- Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - MyungAh Lee
- Division of Medical Oncology, Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Se Jun Park
- Division of Medical Oncology, Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
| |
Collapse
|
11
|
Han F, Chen Y, Li S, Yang Y, Bai Z. Advances in the Study of Inhaled Formulations for the Treatment of Pulmonary Arterial Hypertension. Appl Bionics Biomech 2022; 2022:6495645. [PMID: 35694279 PMCID: PMC9184198 DOI: 10.1155/2022/6495645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a serious disease with reduced systemic circulation and low bioavailability associated with conventional and dosed therapy, which inhaled drugs can avoid. A mean pulmonary artery pressure (mPAP) of ≥25 mmHg (1 mmHg = 0.133 kPa) at rest or ≥30 mmHg during exercise and a pulmonary capillary pressure or left atrial pressure (PLA) of ≤15 mmHg can be diagnosed with PAH. Pulmonary hypertension is classified into primary PAH and secondary PAH according to the presence or absence of principles or risk factors. The main symptoms of pulmonary hypertension include dyspnoea, syncope, weakness, chest pain, and the presence of varying degrees of peripheral oedema. It is a highly pathogenic and life-threatening disease and can lead to delays in treatment if not diagnosed in time. In the past few years, the studies related to this progressed slowly, which brought great harm to patients with PAH. Reports showed that patients diagnosed with PAH should receive routine preventative care, such as pneumococcal and influenza vaccinations. Inhalation therapy is mainly used for the treatment of respiratory diseases and is of great interest due to the concentration of the drug in the airways and lung tissues. Therefore, the present situation of pulmonary hypertension and the characteristics of inhalation preparation were reviewed in this paper to provide some related cue for the treatment of pulmonary hypertension. In the future, it is necessary to develop more treatment methods for pulmonary hypertension.
Collapse
Affiliation(s)
- Fei Han
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Cereal Fermentation and Food Biomanufacturing, Jiangnan University, Wuxi 214122, China
- Jiangsu Provincial Engineering Research Center for Bioactive Product Processing, Jiangnan University, Wuxi 214122, China
| | - Yongqi Chen
- Zhuhai Resproly Pharmaceutical Technology Co., Ltd., Zhuhai 519000, Guangzhou, China
| | - Shijie Li
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Cereal Fermentation and Food Biomanufacturing, Jiangnan University, Wuxi 214122, China
- Jiangsu Provincial Engineering Research Center for Bioactive Product Processing, Jiangnan University, Wuxi 214122, China
| | - Yankun Yang
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Cereal Fermentation and Food Biomanufacturing, Jiangnan University, Wuxi 214122, China
- Jiangsu Provincial Engineering Research Center for Bioactive Product Processing, Jiangnan University, Wuxi 214122, China
| | - Zhonghu Bai
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Wuxi 214122, China
- National Engineering Research Center for Cereal Fermentation and Food Biomanufacturing, Jiangnan University, Wuxi 214122, China
- Jiangsu Provincial Engineering Research Center for Bioactive Product Processing, Jiangnan University, Wuxi 214122, China
| |
Collapse
|
12
|
Li M, Cao W, Huang B, Zhu Z, Chen Y, Zhang J, Cao G, Chen B. Establishment and Analysis of an Individualized Immune-Related Gene Signature for the Prognosis of Gastric Cancer. Front Surg 2022; 9:829237. [PMID: 35174205 PMCID: PMC8841693 DOI: 10.3389/fsurg.2022.829237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/05/2022] [Indexed: 12/20/2022] Open
Abstract
A growing number of studies have shown that immunity plays an important clinical role in the process of gastric cancer (GC). The purpose of this study was to explore the function of differentially expressed immune-related genes (DEIRGs) of GC, and construct a gene signature to predict the overall survival (OS) of patients. Gene expression profiles and clinical data of GC patients were downloaded from TCGA and GEO databases. Combined with immune-related genes (IRGs) downloaded from the ImmPort database, 357 DEIRGs in GC tissues and adjacent tissues were identified. Based on the analysis of Lasso and Cox in the training set, a prognostic risk scoring model consisting of 9 (RBP7, DES, CCR1, PNOC, SPP1, VIP, TNFRSF12A, TUBB3, PRKCG) DEIRGs was obtained. Functional analysis revealed that model genes may participate in the formation and development of tumor cells by affecting the function of cell gap junction intercellular communication (GJJC). According to the model score, the samples were divided into high-risk and low-risk groups. In multivariate Cox regression analysis, the risk score was an independent prognostic factor (HR = 1.674, 95% CI = 1.470–1.907, P < 0.001). Survival analysis showed that the OS of high-risk GC patients was significantly lower than that of low-risk GC patients (P < 0.001). The area under the receiver operating characteristic curve (ROC) of the model was greater than other clinical indicators when verified in various data sets, confirming that the prediction model has a reliable accuracy. In conclusion, this study has explored the biological functions of DEIRGs in GC and discovered novel gene targets for the treatment of GC. The constructed prognostic gene signature is helpful for clinicians to determine the prognosis of GC patients and formulate personalized treatment plans.
Collapse
Affiliation(s)
- Mengying Li
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Wei Cao
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Bingqian Huang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Zhipeng Zhu
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Yaxin Chen
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Jiawei Zhang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Jiawei Zhang
| | - Guodong Cao
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Guodong Cao
| | - Bo Chen
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
- Bo Chen
| |
Collapse
|
13
|
Brugel M, Walter T, Goichot B, Smith D, Lepage C, Do Cao C, Hautefeuille V, Rebours V, Cadiot G, de Mestier L. Efficacy of treatments for VIPoma: A GTE multicentric series. Pancreatology 2021; 21:1531-1539. [PMID: 34404601 DOI: 10.1016/j.pan.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/28/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vasoactive intestinal peptide-secreting tumor (VIPoma) is a very rare, life-threatening, functioning pancreatic neuroendocrine tumor (pNET). The efficacy of antitumor therapies against functioning symptoms and tumor burden have been poorly described in VIPoma. OBJECTIVE Describe the impact of treatments on the secretory syndrome, tumor burden and survival in patients with VIPoma. METHODS We retrospectively reviewed the records of patients with VIPoma treated in seven French expert centers between 1990 and 2016. Diagnostic of VIPoma was reassessed using strict criteria. We evaluated the antisecretory efficacy (>50 % decrease of daily bowel movements), and antitumor efficacy (RECIST 1.1) of all treatments received. RESULTS Twenty-two patients were included. pNETs were mostly metastatic (77 %) and classified as grade 2 (83 %). Median follow-up was 78.2 months. Surgical excision of nonmetastatic VIPoma effectively controlled the secretory syndrome. Although 4/5 patients had metastatic recurrences, all patients were alive after median post-operative follow-up of 171 months. Among the 87 treatments received for metastatic VIPoma, curative-intent surgery (n = 14), somatostatin analogs alone (n = 11), chemotherapy (n = 23), transarterial liver embolization (TALE) (n = 14), everolimus (n = 10) and sunitinib (n = 7) achieved, respectively, 100 %, 67 %, 83 %, 50 %, 20 % and 100 % antisecretory efficacy. The 5-year OS rate was 63.6 %, with pejorative impact of higher Ki-67 index (P = 0.045) and higher plasma VIP concentration (P = 0.025). CONCLUSIONS Surgical resection of localized VIPoma is effective but rarely curative. For metastatic VIPoma, curative-intent surgery, chemotherapy and sunitinib are the therapeutic options that best combined antitumor and antisecretory efficacies.
Collapse
Affiliation(s)
- Mathias Brugel
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France.
| | - Thomas Walter
- Department of Digestive Oncology, ENETS Centre of Excellence, Hospices Civils de Lyon, Lyon, France
| | - Bernard Goichot
- Department of Internal Medicine, Endocrinology & Nutrition, Hôpital Hautepierre, Strasbourg University Hospital, France
| | - Denis Smith
- Department of Hepato-Gastroenterology and Digestive Oncology, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Côme Lepage
- Department of Hepato-Gastroenterology and Digestive Oncology, Dijon University Hospital, Dijon, France
| | - Christine Do Cao
- Department of Endocrinology, Hôpital Claude-Huriez, Lille University Hospital, Lille, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, Amiens University Hospital, Amiens, France
| | - Vinciane Rebours
- Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon and Université de Paris Nord, Clichy, France
| | - Guillaume Cadiot
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France
| | - Louis de Mestier
- Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon and Université de Paris Nord, Clichy, France
| | | |
Collapse
|
14
|
Yeh PJ, Chen SH, Lai JY, Lai MW, Chiu CH, Chao HC, Chen SH, Wu RC, Wang CJ, Chen CC. Rare Cases of Pediatric Vasoactive Intestinal Peptide Secreting Tumor With Literature Review: A Challenging Etiology of Chronic Diarrhea. Front Pediatr 2020; 8:430. [PMID: 32850544 PMCID: PMC7419468 DOI: 10.3389/fped.2020.00430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/22/2020] [Indexed: 12/25/2022] Open
Abstract
Vasoactive intestinal peptide (VIP) secreting tumor (VIPoma) is a rare disease, presenting with profuse diarrhea, electrolyte imbalance, and possibly fatal outcome. The diagnosis and treatment are challenging, and no consensus guideline of management is available. The pediatric incidence remains unclear. This study comprises two pediatric case reports from a tertiary center and a literature-based case series investigating the characteristics among children. The two reported cases both presented with severe diarrhea and laboratory abnormalities, including electrolyte imbalance and elevated plasma VIP level. Case 1 received several imaging investigations, partial pancreatectomy, octreotide, and everolimus, reflecting her complicated and refractory course. Case 2 underwent total excision of suprarenal ganglioneuroblastoma, and the clinical response was significant. In both cases, varied degrees of symptomatic control, reduced plasma VIP level, and correction of electrolyte imbalance were achieved. A literature review-based case series analyzed 45 pediatric cases retrieved from the PubMed database until December 31, 2019. Demographics, clinical features, diagnostic modalities, treatments, and outcomes were presented.
Collapse
Affiliation(s)
- Pai-Jui Yeh
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Shih-Hsiang Chen
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Jin-Yao Lai
- Department of Pediatric Surgery, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Ming-Wei Lai
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Cheng-Hsun Chiu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Hsun-Chin Chao
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Shih-Hsin Chen
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Ren-Chin Wu
- Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Chao-Jan Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Chien-Chang Chen
- Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| |
Collapse
|