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Wu H, Ding M, Zhu J, Mao S, Tang X, Fang S, Liu L, Pan Q, Yue C. Causal Relationship between Sex Hormone-Binding Globulin and Risk of Neuroblastoma: A Bidirectional Two-Sample Mendelian Randomization Study. Cancer Epidemiol Biomarkers Prev 2024; 33:846-853. [PMID: 38530247 DOI: 10.1158/1055-9965.epi-23-1480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The causal relationship between sex hormone-binding globulin (SHBG) and neuroblastoma remains unknown. This study aimed to explore the causality between SHBG and the risk of neuroblastoma using bidirectional two-sample Mendelian randomization (MR) study. METHODS Instrumental variables associated with SHBG were obtained from the genome-wide association study (GWAS) of European containing 214,989 females and 185,221 males from the UK Biobank. Summary-level data for neuroblastoma were derived from the IEU OpenGWAS project with 1,627 patients and 3,254 controls. The inverse-variance weighted (IVW) method served as the primary analytic tool. RESULTS The IVW method revealed a significant positive causal relationship between male SHBG and the risk of neuroblastoma [OR, 2.169; 95% confidence interval (CI), 1.207-3.897; P = 0.010]. Conversely, female SHBG showed no significant causal link with neuroblastoma (IVW OR, 1.004; 95% CI, 0.542-1.860; P = 0.990). No significant reverse causality was detected. Sensitivity analyses validated these findings. CONCLUSIONS Elevated SHBG levels in males, but not in females, can causally increase the risk of neuroblastoma. This gender-specific effect indicates a potential differential role of SHBG in the etiology of neuroblastoma. Further research is needed to elucidate the underlying mechanisms of this gender disparity. Monitoring SHBG levels, especially in males, could be pivotal in neuroblastoma risk assessment and management. IMPACT This study highlights a novel gender-specific aspect in the risk of neuroblastoma, emphasizing the potential role of male SHBG levels in neuroblastoma incidence, and sets the stage for targeted preventative strategies and further investigation into gender-based biological mechanisms.
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Affiliation(s)
- Han Wu
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Miao Ding
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiabei Zhu
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Siwei Mao
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaochen Tang
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sijia Fang
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Liu
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiuhui Pan
- Clinical Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Faculty of Medical Laboratory Science, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Clinical Molecular Diagnostics for Pediatrics, Shanghai, China
- Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya, Hainan, China
| | - Chaoyan Yue
- Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Zhang Z, Li D, Xie F, Zhang H. The causal relationship between gut microbiota and neuroblastoma: a bidirectional Mendelian randomization analysis and meta-analysis. Microbiol Spectr 2024; 12:e0365623. [PMID: 38411074 PMCID: PMC10986465 DOI: 10.1128/spectrum.03656-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024] Open
Abstract
Neuroblastoma (NB) is a type of neuroectodermal tumor that originates from primitive sympathetic ganglion cells. Although many risk factors contributing to the occurrence of NB have been reported in recent years, the role of the gut microbiota in its development remains unclear. A bidirectional Mendelian randomization (MR) analysis was conducted to elucidate the causal relationship between the gut microbiota and NB. In the MR analysis, we employed the inverse-variance weighted (IVW) method as the primary criterion for assessing causality, while also utilizing three additional approaches, including MR-Egger, weighted median model, and weighted mode, for comprehensive evaluation. For gut microbiota that were causally associated with NB, a reverse MR was also used to assess the stability of this causal relationship. Finally, we also used external cohorts for validation and performed a meta-analysis of the results. The IVW results indicated a causal relationship between six gut microbiota and NB. Among the six gut microbiota, genus Lachnospiraceae [IVW odds ratio (OR): 2.66, 95% confidence interval (CI): 1.09-6.51, P value: 0.03] exhibited a detrimental effect against NB. On the other hand, the class Actinobacteria (IVW OR: 0.24, 95% CI: 0.07-0.77, P value: 0.02), the family Bifidobacteriaceae (IVW OR: 0.40, 95% CI: 0.17-0.96, P value: 0.04), the genus Desulfovibrio (IVW OR: 0.50, 95% CI: 0.25-0.97, P value: 0.04), the genus Bifidobacterium (IVW OR: 0.39, 95% CI: 0.16-0.92, P value: 0.03), and the genus Howardella (IVW OR: 0.55, 95% CI: 0.31-0.97, P value: 0.04) displayed a protective effect on NB. A reverse MR analysis did not reveal a causality between NB and the six gut microbiota. Meta-analysis showed that genus Bifidobacterium (meta OR: 0.41, 95% CI: 0.22-0.75, P < 0.01) and genus Lachnospiraceae (meta OR: 2.20, 95% CI: 1.01-4.79, P < 0.05) were still significant. IMPORTANCE Bidirectional Mendelian randomization was used to explore the causality between gut microbiota and neuroblastoma (NB). The results showed that there is a causal relationship between the six gut microbiota and NB, of which two gut microbiota were further confirmed in the meta-analysis. This may provide a new perspective on the prevention and treatment of NB.
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Affiliation(s)
- Zexin Zhang
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongting Li
- The Affiliated Guangzhou Hospital of TCM of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fengxi Xie
- Maoming Hospital of Guangzhou University of Chinese Medicine, Maoming, China
| | - Haibo Zhang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Key Laboratory of Clinical Research of Chinese Medicine, Guangzhou, China
- Guangdong Joint Laboratory of Guangdong, Hong Kong and Macao Chinese Medicine and Immune Diseases, Guangzhou, China
- State Key Laboratory of Wet Certificate of Chinese Medicine Jointly Built by the Province and the Ministry, Guangzhou, China
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Tambasco D, Franklin M, Harris SA, Tibout P, Doria AS. A geospatial assessment of industrial releases and pediatric neuroblastic tumours at diagnosis: A retrospective case series. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2024; 78:455-470. [PMID: 38190263 DOI: 10.1080/19338244.2023.2291734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/01/2023] [Indexed: 01/10/2024]
Abstract
Environmental risk factors associated with malignancy of pediatric neuroblastic tumours are not well-known and few studies have examined the relationship between industrial emissions and neuroblastic tumour diagnosis. A retrospective case series of 310 patients was evaluated at a tertiary hospital in Toronto, Canada between January 2008, and December 2018. Data from the National Pollutant Release Inventory (NPRI) were used to estimate exposure for a dozen chemicals with known or suspected carcinogenicity or embryotoxicity. Comparative analysis and predictive logistic regression models for malignant versus benign neuroblastic tumours included variables for residential proximity, number, and type of industries, mean total emissions within 2 km, and inverse distance weighted (IDW) quantity of chemical-specific industrial emissions estimated within 10 and 50 km of cases. No significant difference was seen between malignant and benign cases with respect to the mean nearest residential distance to industry, the number or type of industry, or the mean total quantity of industrial emissions within a 2 km radius of residential location of cases. However, there were statistically significant differences in the interpolated IDW emissions of dioxins and furans released between 1993 and 2019 within 10 km. Concentrations were significantly higher in malignant neuroblastic tumours at 1.65 grams (g) toxic equivalent (TEQ) (SD 2.01 g TEQ) compared to benign neuroblastic tumours at 1.13 g TEQ (SD 0.84 g TEQ) (p = 0.05). Within 50 km 3 years prior to diagnosis, malignant cases were exposed to higher levels of aluminum, benzene, and nitrogen dioxide (p = 0.02, p = 0.04, and p = 0.02 respectively). Regression analysis of the IDW emissions within a 50 km radius revealed higher odds of exposure to benzene for malignant neuroblastic tumours (OR = 1.03, CI: 1.01-1.05, p = 0.01). These preliminary findings suggest a potential role of industrial emissions in the development of malignant pediatric neuroblastic tumours and underscore the need for further research to investigate these associations.
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Affiliation(s)
- Domenica Tambasco
- Department of Family and Community Medicine, Women's College Hospital, Environmental Health Clinic and University of Toronto, Toronto, Ontario, Canada
| | - Meredith Franklin
- Department of Statistical Sciences and School of the Environment, University of Toronto, Toronto, Ontario, Canada
| | - Shelley A Harris
- Divisions of Epidemiology & Occupational and Environmental Health, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Pauline Tibout
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Askins L, Orimoloye HT, Deng C, Hansen J, Olsen J, Ritz B, Janzen C, Heck JE. Preeclampsia, antihypertensive medication use in pregnancy and risk of childhood cancer in offspring. Cancer Causes Control 2024; 35:43-53. [PMID: 37535154 PMCID: PMC10764520 DOI: 10.1007/s10552-023-01745-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/26/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE Preeclampsia is a serious pregnancy complication that presents a significant risk to both the mother and the fetus. Preeclampsia and medications associated with its treatment are potentially linked to increased childhood cancer risk. Therefore, we examined the association between preeclampsia, antihypertensive medications, and childhood cancer in offspring. METHODS Cases (n = 6,420) and controls (n = 160,484) were obtained from Danish national registries. We performed conditional logistic regression analyses to estimate the association between preeclampsia and childhood cancer risk, and examined the effects of antihypertensive medication use in pregnancy in relation to childhood cancer risk in the offspring with adjustment for relevant covariates. RESULTS We observed an increased risk of acute lymphoblastic leukemia (ALL) among those whose mothers had preeclampsia (OR = 1.36, 95% CI 1.03, 1.79), especially for severe preeclampsia (OR = 2.36, 95% CI 1.37, 4.08). We also estimated an increased cancer risk in children born to mothers who were prescribed diuretics during pregnancy [OR = 2.09, 95% confidence interval (CI) 1.39, 3.14]. Intake of other antihypertensive medications was not associated with childhood cancer (OR = 0.78, 95% CI 0.50, 1.23). Among women who did not take diuretics in pregnancy, preeclampsia was associated with neuroblastoma (OR = 2.22, 95% CI 1.08, 4.55). CONCLUSION Our findings suggested an increased risk for certain types of cancer in the offspring of mothers with preeclampsia and an increased risk of cancer with diuretic intake during pregnancy.
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Affiliation(s)
- Lexie Askins
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Helen T Orimoloye
- College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA
| | - Chuanjie Deng
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Carla Janzen
- Department of Obstetrics and Gynecology, University of California, Box 951740, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California (UCLA), Box 951772, Los Angeles, CA, 90095-1772, USA.
- College of Health and Public Service, University of North Texas, 1155 Union Circle #311340, Denton, TX, 76203-5017, USA.
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Zhang Y, Zhang WL, Huang DS, Wang YZ, Hu HM, Zhi T, Mei YY. Prognostic factors for intermediate- or high-risk neuroblastomas in children in China. BMC Pediatr 2023; 23:617. [PMID: 38053080 PMCID: PMC10699076 DOI: 10.1186/s12887-023-04258-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/21/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Evidence regarding the characteristics and prognosis of neuroblastoma (NBL) in China is limited. We aimed to investigate the characteristics and prognosis of intermediate- or high-risk NBL in children in China. METHODS We included 147 patients with intermediate- or high-risk NBL evaluated from January 2006 to March 2015. The patients were aged 1 month to 15.5 years, 66% of them were boys, and 117 (79.6%) were diagnosed with high-risk NBL. RESULTS After a median follow-up of 32.5 months, 80 (45.6%) patients survived, with a median survival time of 48 months (95% confidence interval [CI]: 36.41-59.59). High-risk patients (hazard ratio [HR]: 12.467; 95% CI: 11.029-12.951), partial response (PR) (HR: 1.200; 95% CI: 1.475-2.509) or progression disease (PD) (HR: 1.924; 95% CI: 1.623-3.012) after induction chemotherapy, and intracranial metastasis (HR: 3.057; 95% CI: 0.941-4.892) were independent risk factors for survival (p < 0.05) and postrelapse survival (p < 0.05). NBL relapse, male sex, and PR or PD after induction chemotherapy were risk factors for event-free survival (p < 0.05). CONCLUSIONS In addition to previously established independent risk factors, such as age, risk group, and relapse, efficacy of induction chemotherapy and intracranial metastasis play significant roles in the prognosis of NBL.
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Affiliation(s)
- Yi Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
| | - Wei-Ling Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
| | - Dong-Sheng Huang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China.
| | - Yi-Zhuo Wang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
| | - Hui-Min Hu
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
| | - Tian Zhi
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
| | - Yan-Yan Mei
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No 2, Xihuan South Road, Daxing Zone, Beijing, China
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Orimoloye HT, Deng C, Hansen J, Olsen J, Saechao C, Ritz B, Heck JE. Hyperemesis gravidarum and the risk of childhood cancer - A case-control study in Denmark. Cancer Epidemiol 2023; 87:102472. [PMID: 37879293 PMCID: PMC10754053 DOI: 10.1016/j.canep.2023.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Only a few studies have reported on the association between hyperemesis gravidarum and the risk of childhood cancer. We examined possible associations in this population-based study in Denmark. METHODS Pediatric cancer cases (n = 6420) were ascertained from the Denmark Cancer Registry among children born between 1977 and 2013. Twenty-five controls were matched to each case by sex and birth date from the Central Person Registry (n = 160500). Mothers with hyperemesis gravidarum were ascertained from the National Patient Register. The risk of childhood cancer was estimated using conditional logistic regression. In a separate analysis, we examined pregnancy prescription of antinauseant medications, ascertained from the National Pharmaceutical Register, to determine associations with childhood cancers. RESULTS In Denmark, hyperemesis gravidarum was associated with an increased risk of childhood cancer [all types combined; Odds Ratio (OR) = 1.43, 95% confidence interval (CI) 1.12, 1.81; n = 73 exposed cases). Hyperemesis gravidarum was also associated with an increased risk of neuroblastoma (OR = 2.52, 95% CI 1.00, 6.36; n = 5 exposed cases), acute lymphoblastic leukemia (OR = 1.63, 95% CI 0.98, 2.72; n = 16 exposed cases), and non-Hodgkin's lymphoma (OR = 2.41, 95% CI 0.95, 6.08; n = 5 exposed cases). We observed no childhood cancer risk increase from antinauseant prescriptions (OR = 1.05, 95% CI 0.84, 1.30; n = 91 exposed cases). CONCLUSION Our results are suggestive of an association between hyperemesis gravidarum and the overall cancer risk in offspring, particularly for neuroblastoma. Mothers with hyperemesis gravidarum should be closely monitored and receive appropriate treatment during pregnancy.
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Affiliation(s)
- Helen T Orimoloye
- College of Health and Public Service, University of North Texas, 1155 Union Circle # 311340, Denton, TX 76203-5017, USA
| | - Chuanjie Deng
- Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Chai Saechao
- UCLA Health, University of California, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA
| | - Julia E Heck
- College of Health and Public Service, University of North Texas, 1155 Union Circle # 311340, Denton, TX 76203-5017, USA; Department of Epidemiology, Fielding School of Public Health, Box 951772, University of California, Los Angeles, Los Angeles, CA, 900951772 USA.
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Carraro C, Rabusin M, Murru FM, Ammar L, Barbi E, Amaddeo A, Cozzi G. Neck stiffness and bone osteolytic lesion in a 3-years old child: a case report. Ital J Pediatr 2023; 49:132. [PMID: 37775763 PMCID: PMC10543269 DOI: 10.1186/s13052-023-01534-4] [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: 08/06/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Neuroblastoma is the most frequent extracranial solid tumor occurring in childhood, representing approximately 28% of all cancers diagnosed in infants. Signs and symptoms of neuroblastoma vary with the site of development of the tumor and can mimic other diseases due to its extreme clinical variability. However, torticollis is not reported in the medical literature as a leading symptom of neuroblastoma. CASE PRESENTATION Here we report the case of a 3 years-old girl with fever and neck stiffness. Blood tests revealed a mild anemia and a rise in inflammatory markers. CT-scan showed a solid, heterogeneous, predominantly hypodense surrenal mass with eccentric calcification and extensive inhomogeneity of the vertebral metamers. Blood tests revealed raised serum levels of Neuron-Specific Enolase. At the 24-hours urine collection urinary catecholamines were greatly increased. A course of chemotherapy for neuroblastoma was promptly started with immediate clinical improvement. CONCLUSIONS This case shows that the presence of torticollis could be a chief complaint of neuroblastoma. To our knowledge, neuroblastoma is not mentioned among life-threatening underlying conditions of torticollis in most recent literature reviews.
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Affiliation(s)
- Carolina Carraro
- University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy.
| | - Marco Rabusin
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Flora Maria Murru
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Lydie Ammar
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giorgio Cozzi
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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Broso F, Gatto P, Sidarovich V, Ambrosini C, De Sanctis V, Bertorelli R, Zaccheroni E, Ricci B, Destefanis E, Longhi S, Sebastiani E, Tebaldi T, Adami V, Quattrone A. Alpha-1 Adrenergic Antagonists Sensitize Neuroblastoma to Therapeutic Differentiation. Cancer Res 2023; 83:2733-2749. [PMID: 37289021 DOI: 10.1158/0008-5472.can-22-1913] [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: 06/10/2022] [Revised: 03/28/2023] [Accepted: 06/02/2023] [Indexed: 06/09/2023]
Abstract
Neuroblastoma (NB) is an aggressive childhood tumor, with high-risk cases having a 5-year overall survival probability of approximately 50%. The multimodal therapeutic approach for NB includes treatment with the retinoid isotretinoin (13-cis retinoic acid; 13cRA), which is used in the post-consolidation phase as an antiproliferation and prodifferentiation agent to minimize residual disease and prevent relapse. Through small-molecule screening, we identified isorhamnetin (ISR) as a synergistic compound with 13cRA in inhibiting up to 80% of NB cell viability. The synergistic effect was accompanied by a marked increase in the expression of the adrenergic receptor α1B (ADRA1B) gene. Genetic knockout of ADRA1B or its specific blockade using α1/α1B adrenergic antagonists led to selective sensitization of MYCN-amplified NB cells to cell viability reduction and neural differentiation induced by 13cRA, thus mimicking ISR activity. Administration of doxazosin, a safe α1-antagonist used in pediatric patients, in combination with 13cRA in NB xenografted mice exerted marked control of tumor growth, whereas each drug alone was ineffective. Overall, this study identified the α1B adrenergic receptor as a pharmacologic target in NB, supporting the evaluation of adding α1-antagonists to the post-consolidation therapy of NB to more efficiently control residual disease. SIGNIFICANCE Targeting α-adrenergic receptors synergizes with isotretinoin to suppress growth and to promote differentiation of neuroblastoma, revealing a combinatorial approach for more effective management of the disease and prevention of relapse.
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Affiliation(s)
- Francesca Broso
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Pamela Gatto
- High-Throughput Screening (HTS) and Validation Core Facility, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Viktoryia Sidarovich
- High-Throughput Screening (HTS) and Validation Core Facility, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Chiara Ambrosini
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Veronica De Sanctis
- Next Generation Sequencing (NGS) Core Facility LaBSSAH, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Roberto Bertorelli
- Next Generation Sequencing (NGS) Core Facility LaBSSAH, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Elena Zaccheroni
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Benedetta Ricci
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Eliana Destefanis
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Sara Longhi
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Enrico Sebastiani
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Toma Tebaldi
- Laboratory of RNA and Disease Data Science, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
- Section of Hematology, Yale Cancer Center and Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Valentina Adami
- High-Throughput Screening (HTS) and Validation Core Facility, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Alessandro Quattrone
- Laboratory of Translational Genomics, Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
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Lan MS, Chen C. Small Molecules Targeting INSM1 for the Treatment of High-Risk Neuroblastoma. BIOLOGY 2023; 12:1134. [PMID: 37627018 PMCID: PMC10452524 DOI: 10.3390/biology12081134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023]
Abstract
Human neuroblastoma (NB) is the most common childhood extracranial tumor arising from the sympathetic nervous system. It is also a clinically heterogeneous disease that ranges from spontaneous regression to high-risk stage 4 disease. The cause of this disease remains elusive. However, the amplification of NMYC oncogene occurred in roughly 30% of NB patients, which strongly correlated with the advanced stage of disease subtype and the worse prognosis status. We discovered that N-Myc oncoprotein binds and activates INSM1, a zinc-finger transcription factor of neuroendocrine tumors. We also found that INSM1 modulates N-Myc stability mediated through PI3K/AKT/GSK3β signaling pathway. Therefore, INSM1 emerges as a critical co-player with N-Myc in facilitating NB tumor cell growth and sustaining the advanced stage of malignancy. Using an INSM1-promoter driven luciferase screening-platform, we have recently identified fifteen small molecules that negatively regulate INSM1 expression. Interestingly, the identified small molecules can be divided into four large groups of compounds such as cell signaling inhibitor, DNA/RNA inhibitor, HDAC inhibitor, and cardiac glycoside. These findings support the presence of a unique mechanism associated with INSM1 and N-Myc interplay, which is critical in regulating NB tumor cell growth. We discuss the feasibility of identifying novel or repurposing small molecules targeting INSM1 as a potential treatment option for high-risk NB.
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Affiliation(s)
- Michael S. Lan
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
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Maternal anemia and childhood cancer: a population-based case-control study in Denmark. Cancer Epidemiol 2023; 82:102308. [PMID: 36434977 PMCID: PMC9904448 DOI: 10.1016/j.canep.2022.102308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/29/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Childhood cancer risk is associated with maternal health during pregnancy. Anemia in pregnancy is a common condition, especially in low-income countries, but a possible association between maternal anemia and childhood cancer has not been widely studied. METHODS We examined the relation in a population-based study in Denmark (N = 6420 cancer cases, 160,485 controls). Cases were taken from the Danish Cancer Registry, and controls were selected from national records. We obtained maternal anemia diagnoses from the National Patient and Medical Births registries. In a separate analysis within the years available (births 1995-2014), we examined cancer risks among mothers taking prescribed vitamin supplements, using data from the National Prescription Register. We estimated the risks of childhood cancer using conditional logistic regression. RESULTS The risks of neuroblastoma [odds ratio (OR= 1.83, 95% confidence interval (CI): 1.04, 3.22] and acute lymphoblastic leukemia (OR= 1.46, 95% CI 1.09, 1.97) were increased in children born to mothers with anemia in pregnancy. There was a two-fold increased risk for bone tumors (OR= 2.59, 95% CI: 1.42, 4.72), particularly osteosarcoma (OR= 3.54, 95% CI 1.60, 7.82). With regards to prescribed supplement use, mothers prescribed supplements for B12 and folate deficiency anemia (OR= 4.03, 95% CI 1.91, 8.50) had an increased risk for cancer in offspring. CONCLUSION Our results suggest that screening for anemia in pregnancy and vitamin supplementation may be an actionable strategy to prevent some cases of childhood cancer.
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Zhou Y, Gao J. A Novel Online Nomogram Established with Five Features before Surgical Resection for Predicating Prognosis of Neuroblastoma Children: A Population-Based Study. Technol Cancer Res Treat 2023; 22:15330338221145141. [PMID: 36604997 PMCID: PMC9829992 DOI: 10.1177/15330338221145141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Neuroblastoma (NB) is the most common childhood cancer, but doctors are unable to predict its overall survival (OS) rate before surgery. We aimed to predict the OS of NB children with some clinical features obtained from biopsy before surgery. Methods: Clinical features of NB children were retrospectively collected from the Therapeutically Applicable Research to Generate Effective Treatments database. The C-index, area under the receiver operating characteristic curve (AUC), calibration curves, and decision curves analysis were used to estimate nomogram models. Results: A total of 488 NB children were evaluated, and the Boruta algorithm was used to detect risk factors. The results showed that artificial neural networks with selected features were able to predict more than 90% of NB children. Five risk factors were used in the construction of the nomogram, including age at diagnosis, MYCN status, ploidy value, histology, and mitosis-karyorrhexis index (MKI). The C-index of the nomogram in training cohort and validation cohort was 0.716 and 0.731. AUC values for 1-, 3-, and 5-years OS predictions were 0.706, 0.755, and 0.762, respectively, and showed good calibrations. Decision curve analysis indicated a better predictability with the nomogram model based on Cox regression compared with one that included all variables and histology only. Also, the Kaplan-Meier curves showed a significantly higher survival probability in the low-risk group (total score <118.34) versus the high-risk group (total score ≥ 118.34) (p < 0.05) using the nomogram model. Conclusions: A web application based on the nomogram model in the present study can be accessed at https://mdzhou.shinyapps.io/DynNomapp/, which could help doctors make accurate clinical decisions about NB children.
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Affiliation(s)
- Yu Zhou
- Department of Child Rehabilitation Division, Huai’an Maternal and
Child Health Care Center, Huai’an, China,Affiliated Hospital of Yang Zhou University Medical College Huai’an
Maternal and Child Health Care Center, Huai’an, China
| | - Jing Gao
- Department of Child Rehabilitation Division, Huai’an Maternal and
Child Health Care Center, Huai’an, China,Affiliated Hospital of Yang Zhou University Medical College Huai’an
Maternal and Child Health Care Center, Huai’an, China,Jing Gao, Department of Child
Rehabilitation Division, Huai’an Maternal and Child Health Care Center, Huai’an
223002, China.
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12
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Nutraceutical Preventative and Therapeutic Potential in Neuroblastoma: From Pregnancy to Early Childhood. Life (Basel) 2022; 12:life12111762. [DOI: 10.3390/life12111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Neuroblastoma (NB) is a highly malignant embryonic extracranial solid tumor that arises from sympathoadrenal neuroblasts of neural crest origin. In addition to genetic factors, NB has been linked to maternal exposure to a variety of substances during pregnancy. Recent interest in the potential of nutrients to prevent cancer and reduce malignancy has resulted in the identification of several nutraceuticals including resveratrol, curcumin, and molecular components of garlic, which together with certain vitamins may help to prevent NB development. As NBs arise during fetal development and progress during early childhood, specific NB inhibiting nutraceuticals and vitamins could enhance the preventative influence of maternal nutrition and breast feeding on the development and early progression of NB. In this article, we review NB inhibitory nutraceuticals and vitamins, their mechanisms of action and expound their potential as maternal nutritional supplements to reduce NB development and progression during fetal growth and early childhood, whilst at the same time enhancing maternal, fetal, and infant health.
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Li M, Wang J, Guo P, Jin L, Tan X, Zhang Z, Zhanghuang C, Mi T, Liu J, Wang Z, Wu X, Wei G, He D. Exosome mimetics derived from bone marrow mesenchymal stem cells ablate neuroblastoma tumor in vitro and in vivo. BIOMATERIALS ADVANCES 2022; 142:213161. [PMID: 36308859 DOI: 10.1016/j.bioadv.2022.213161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE To develop exosome-mimetics derived from bone marrow mesenchymal stem cells (EM) as a novel nanoscale drug delivery system(nanoDDS) with improved tumor targeting activity, therapeutic effect, and biosafety, and to evaluate the therapeutic effect of doxorubicin loaded EM (EM-Dox) on neuroblastoma (NB) in vitro and in vivo. METHODS EM was prepared by serial extrusion of bone marrow mesenchymal stem cells (BMSCs), ammonium sulfate gradient method was used to promote the active loading of doxorubicin, and EM-Dox was obtained after removal of free doxorubicin by dialysis. The obtained EM and EM-Dox were characterized by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), Western Blot assay(WB), and the yield of exosomes and EM was further compared. Confocal fluorescent microscopy was used to verify the uptake of EM-Dox and free doxorubicin (Free-Dox) by NB cells. CCK-8 assay, cell cycle assay, and cell apoptosis assay were used to evaluate the antitumor effect of EM-Dox on NB cells in vitro. In addition, the targeted therapeutic effect and biosafety of EM-Dox against NB were evaluated in tumor-bearing nude mice. RESULTS TEM, NTA, and WB verified that both EM and EM-Dox feature highly similar morphology, size and marker protein expression in comparison with naturally occurred exosomes, but the particle size of EM-Dox increased slightly after loading doxorubicin. The protein yield and particle yield of EM-Dox were 16.8 and 26.3-folds higher than those of exosomes, respectively. Confocal fluorescent microscopy showed that EM and doxorubicin had a definite co-localization. EM-Dox was readily internalized in two well-established human NB cell lines. The intracellular content of doxorubicin in cells treated with EM-Dox was significantly higher than that treated with Free-Dox. CCK-8 assay and flow cytometry confirmed that EM-Dox could inhibit NB cell proliferation, induce G2/M phase cell cycle arrest, and promote NB cell apoptosis in vitro. In vivo bioluminescence imaging results demonstrated that EM-Dox effectively targets NB tumors in vivo. Compared with Free-Dox, EM-Dox had a significantly increased inhibitory effect against NB tumor proliferation and progression in vivo, without inducing any myocardial injury. CONCLUSIONS EM-Dox showed significantly increased anti-tumor activity in comparison with free doxorubicin in vitro and in vivo, and scalable EMs may represent a new class of NanoDDS that can potentially replace naturally occurred exosomes in preclinical or clinical translations.
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Affiliation(s)
- Mujie Li
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jinkui Wang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Peng Guo
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, PR China
| | - Liming Jin
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Xiaojun Tan
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhaoxia Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Chenghao Zhanghuang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Tao Mi
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jiayan Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhang Wang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Xin Wu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Dawei He
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, PR China; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China.
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Schraw JM, Rodriguez KB, Scheurer ME, Foster JH, Lupo PJ. Associations of demographic and perinatal factors with childhood neuroblastoma in Texas, 1995–2011. Cancer Epidemiol 2022; 78:102165. [DOI: 10.1016/j.canep.2022.102165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/25/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
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15
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Caputo L, Capozzolo F, Amato G, De Feo V, Fratianni F, Vivenzio G, Nazzaro F. Chemical composition, antibiofilm, cytotoxic, and anti-acetylcholinesterase activities of Myrtus communis L. leaves essential oil. BMC Complement Med Ther 2022; 22:142. [PMID: 35596201 PMCID: PMC9123742 DOI: 10.1186/s12906-022-03583-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 04/04/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The potential of essential oils (EOs) and of their principal constituents for eradication of biofilm and at the same time the research of new potential acetylcholinesterase inhibitors is gaining increasing interest in last years. The aims of this study were to determine the chemical composition and to evaluate the antibacterial, cytotoxic, and anti-acetylcholinesterase properties of Myrtus communis leaves essential oil and its main constituents. METHODS Essential oil was obtained by hydrodistillation of M. communis L. leaves and was analyzed by GC and GC-MS. The antimicrobial activity was carried out against both gram-negative and gram-positive bacteria. The microdilution method was used to estimate the minimum inhibitory concentrations (MICs). Then, the capacity of essential oil and its main constituent to inhibit biofilm growth, with the method of O'Toole and Kolterand, and the metabolic activity of biofilm cells through the MTT colorimetric method were evaluated at different times. Moreover, was studied the potential cytotoxic activity against SH-SY5Y cell line with MTT assay and the anti-acetylcholinesterase activity using Ellman's assay. RESULTS Myrtenyl-acetate, 1,8 cineole, α-pinene, and linalool were the main components in the EO. The myrtle EO, at the minimum tested dose (0.4 mg/ml), inhibited S. aureus biofilm by 42.1% and was capable of inhibiting the biofilm cell metabolism in all tested strains, except Staphylococcus aureus. Moreover, the EO showed good cytotoxic and anti-acetylcholinesterase activities IC50 of 209.1 and 32.8 μg/ml, respectively. CONCLUSIONS The results suggest that myrtle EO and its main constituents could be used as possible products that could act against the resistant pathogenic species E. coli, P. aeruginosa, L. monocytogenes and S. aureus, on the other hand, as possible coadjutants in the treatment of neurological diseases.
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Affiliation(s)
- Lucia Caputo
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, Salerno, Italy
| | - Francesca Capozzolo
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, Salerno, Italy
| | - Giuseppe Amato
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, Salerno, Italy
| | - Vincenzo De Feo
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, Salerno, Italy. .,Institute of Food Science, CNR-ISA, via Roma 64, 83100, Avellino, Italy.
| | | | - Giovanni Vivenzio
- Department of Pharmacy, University of Salerno, via Giovanni Paolo II, 132, 84084, Fisciano, Salerno, Italy
| | - Filomena Nazzaro
- Institute of Food Science, CNR-ISA, via Roma 64, 83100, Avellino, Italy
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16
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Granja C, Mota L. Paediatric neuroblastoma presenting as an asymptomatic abdominal mass: a report on the importance of a complete clinical examination with a view to a timely diagnosis and therapeutic guidance in paediatric oncology. BMJ Case Rep 2022; 15:e247907. [PMID: 35589269 PMCID: PMC9121434 DOI: 10.1136/bcr-2021-247907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/04/2022] Open
Abstract
Neuroblastoma (NB) is the most common extracranial solid tumour in children after lymphoblastic leukaemias, brain tumours and lymphomas.We report a case of an NB in a previously healthy toddler. Though she had no abdominal complaints, on physical examination, she had a palpable mass identified over the right upper portion of the abdomen. Imaging studies demonstrated a heterogeneous tumour with an irregular capsule and visible calcifications.After initial diagnosis, the patient underwent chemotherapy and was subjected to a radical resection of the tumour 4 months later. One-year follow-up of the patient showed no recurrence.In children, oncological diseases are often asymptomatic or have non-specific symptoms, and in remote locations where specialised/paediatric services may not be available, the importance of medical training in paediatrics is highlighted, with emphasis on performing a complete clinical examination, namely abdominal palpation. The role of timely referral will be evident in such a situation.
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Affiliation(s)
- Cátia Granja
- Paediatric, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
- Paediatric, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
| | - Lourdes Mota
- Paediatric, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
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17
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DERVİŞOĞLU G, ÇOBANOĞLU DN, YELKOVAN S, KARAHAN D, ÇAKIR Y, KOÇYİĞİT S. Comprehensive Study on BeeBread: Palynological Analysis, Chemical Composition, Antioxidant and Cytotoxic Activities. INTERNATIONAL JOURNAL OF SECONDARY METABOLITE 2022. [DOI: 10.21448/ijsm.1066884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Neuroblastoma: Essential genetic pathways and current therapeutic options. Eur J Pharmacol 2022; 926:175030. [DOI: 10.1016/j.ejphar.2022.175030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 12/29/2022]
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Chen Y, Miao L, Lin H, Zhuo Z, He J. The role of m6A modification in pediatric cancer. Biochim Biophys Acta Rev Cancer 2022; 1877:188691. [PMID: 35122883 DOI: 10.1016/j.bbcan.2022.188691] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 02/07/2023]
Abstract
With the development of RNA modification research, the importance of N6-methyladenosine (m6A) in tumors cannot be ignored. m6A promotes the self-renewal of tumor stem cells and the proliferation of tumor cells. It affects post-transcriptional gene expression through epigenetic mechanisms, combining various factors to determine proteins' fate and altering the biological function. This modification process runs through the entire tumors, and genes affected by m6A modification may be the critical targets for cancers breakthroughs. Though generally less dangerous than adult cancer, pediatric cancer accounts for a significant proportion of child deaths. What is more alarming is that the occurrences of adult tumors are highly associated with the poor prognoses of pediatric tumors. Therefore, it is necessary to pay attention to the importance of pediatric cancer and discover new therapeutic targets, which will help improve the therapeutic effect and prognoses of the diseases. We collected and investigated m6A modification in pediatric cancers based on mRNA and non-coding RNA, finding that m6A factors were involved in glioma, hepatoblastoma, nephroblastoma, neuroblastoma, osteosarcoma, medulloblastoma, retinoblastoma, and acute lymphoblastic leukemia. Consequently, we summarized the relationships between the m6A factors and these pediatric cancers.
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Affiliation(s)
- Yongping Chen
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Lei Miao
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Huiran Lin
- Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
| | - Zhenjian Zhuo
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China; Laboratory Animal Center, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen 518055, China.
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China.
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Wang J, Xiao D, Wang J. A 16-miRNA Prognostic Model to Predict Overall Survival in Neuroblastoma. Front Genet 2022; 13:827842. [PMID: 35846139 PMCID: PMC9278893 DOI: 10.3389/fgene.2022.827842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/17/2022] [Indexed: 02/05/2023] Open
Abstract
Neuroblastoma is the most malignant childhood tumor. The outcome of neuroblastoma is hard to predict due to the limitation of prognostic markers. In our study, we constructed a 16-miRNA prognostic model to predict the overall survival of neuroblastoma patients for early diagnosis. A total of 205 DE miRNAs were screened using RNA sequencing data from GSE121513. Lasso Cox regression analysis generated a 16-miRNA signature consisting of hsa-let-7c, hsa-miR-135a, hsa-miR-137, hsa-miR-146a, hsa-miR-149, hsa-miR-15a, hsa-miR-195, hsa-miR-197, hsa-miR-200c, hsa-miR-204, hsa-miR-302a, hsa-miR-331, hsa-miR-345, hsa-miR-383, hsa-miR-93, and hsa-miR-9star. The concordance index of multivariate Cox regression analysis was 0.9, and the area under the curve (AUC) values of 3-year and 5-year survival were 0.92 and 0.943, respectively. The mechanism was further investigated using the TCGA and GSE90689 datasets. Two miRNA-gene interaction networks were constructed among DEGs from two datasets. Functional analysis revealed that immune-related processes were involved in the initiation and metastasis of neuroblastoma. CIBERSORT and survival analysis suggested that lower CD8 T-cell proportion and higher SPTA1 expressions were related to a better prognosis. Our study demonstrated that the miRNA signature may be useful in prognosis prediction and management improvement.
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Affiliation(s)
- Jiepin Wang
- Shenzhen Children’s Hospital, Shenzhen, China
- Shantou University Medical College, Shantou, China
| | - Dong Xiao
- Shenzhen Children’s Hospital, Shenzhen, China
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21
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Defining Pathological Activities of ALK in Neuroblastoma, a Neural Crest-Derived Cancer. Int J Mol Sci 2021; 22:ijms222111718. [PMID: 34769149 PMCID: PMC8584162 DOI: 10.3390/ijms222111718] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 12/13/2022] Open
Abstract
Neuroblastoma is a common extracranial solid tumour of childhood, responsible for 15% of cancer-related deaths in children. Prognoses vary from spontaneous remission to aggressive disease with extensive metastases, where treatment is challenging. Tumours are thought to arise from sympathoadrenal progenitor cells, which derive from an embryonic cell population called neural crest cells that give rise to diverse cell types, such as facial bone and cartilage, pigmented cells, and neurons. Tumours are found associated with mature derivatives of neural crest, such as the adrenal medulla or paraspinal ganglia. Sympathoadrenal progenitor cells express anaplastic lymphoma kinase (ALK), which encodes a tyrosine kinase receptor that is the most frequently mutated gene in neuroblastoma. Activating mutations in the kinase domain are common in both sporadic and familial cases. The oncogenic role of ALK has been extensively studied, but little is known about its physiological role. Recent studies have implicated ALK in neural crest migration and sympathetic neurogenesis. However, very few downstream targets of ALK have been identified. Here, we describe pathological activation of ALK in the neural crest, which promotes proliferation and migration, while preventing differentiation, thus inducing the onset of neuroblastoma. Understanding the effects of ALK activity on neural crest cells will help find new targets for neuroblastoma treatment.
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Does the Incremental Value of 123I-Metaiodobenzylguanidine SPECT/CT over Planar Imaging Justify the Increase in Radiation Exposure? Nucl Med Mol Imaging 2021; 55:173-180. [PMID: 34422127 DOI: 10.1007/s13139-021-00707-5] [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: 02/18/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022] Open
Abstract
Purpose Planar scintigraphy with 123I-radiolabeled metaiodobenzylguanidine (123I-mIBG) is an important imaging modality to evaluate neuroblastoma. In recent years, Single Photon Emission Computed Tomography combined with Computed Tomography (SPECT/CT) has revolutionized nuclear medicine. Nevertheless, the addition of the CT has increased the patients' irradiation. We aimed to evaluate the incremental benefits of 123I-mIBG SPECT/CT over conventional planar imaging and to estimate the relative increase of radiation dose. Methods We retrospectively evaluated the added value of 56 SPECT/CT performed in 40 children in terms of better characterization of the lesion and its locoregional extension, better lymph node staging, detection of new lesions, and elimination of false positives by a paired comparison between the planar images and the SPECT/CT ones. Then, we calculated the percentage contribution of the additional radiation of the CT in this hybrid imagery. Results In 88% (49 out of 56) of the examinations, SPECT/CT provided additional information, which was crucial in 20% of the cases. It allowed a better characterization of the lesion and its locoregional extension in 44 cases, a better lymph node staging in 28 cases, the detection of 33 new lesions, and the elimination of 9 false positives. The CT effective dose was significantly lower than the SPECT one. The average additional radiation exposure due to CT was 12% (4-23%). Conclusion 123I-mIBG SPECT/CT has an undeniable added value that improves planar imaging interpretation and impacts patient management. These potential benefits would justify the low additional radiation induced by the CT.
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El-Soussi S, Hanna R, Semaan H, Khater AR, Abdallah J, Abou-Kheir W, Abou-Antoun T. A Novel Therapeutic Mechanism of Imipridones ONC201/ONC206 in MYCN-Amplified Neuroblastoma Cells via Differential Expression of Tumorigenic Proteins. Front Pediatr 2021; 9:693145. [PMID: 34422720 PMCID: PMC8373200 DOI: 10.3389/fped.2021.693145] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/22/2021] [Indexed: 01/07/2023] Open
Abstract
Neuroblastoma is the most common extracranial nervous system tumor in children. It presents with a spectrum of clinical prognostic measures ranging from benign growths that regress spontaneously to highly malignant, treatment evasive tumors affiliated with increased mortality rates. MYCN amplification is commonly seen in high-risk neuroblastoma, rendering it highly malignant and recurrence prone. In our current study, we investigated the therapeutic potential of small molecule inducers of TRAIL, ONC201, and ONC206 in MYCN-amplified IMR-32 and non-MYCN-amplified SK-N-SH human neuroblastoma cell lines. Our results exhibit potent antitumor activity of ONC201 and ONC206 via a novel inhibition of EGF-induced L1CAM and PDGFRβ phosphorylation in both cell lines. Drug treatment significantly reduced cellular proliferation, viability, migration, invasion, tumorsphere formation potential, and increased apoptosis in both cell lines. The protein expression of tumorigenic NMYC, Sox-2, Oct-4, FABP5, and HMGA1 significantly decreased 48 h post-drug treatment, whereas cleaved PARP1/caspase-3 and γH2AX increased 72 h post-drug treatment, compared with vehicle-treated cells in the MYCN-amplified IMR-32 cell line. We are the first to report this novel differential protein expression after ONC201 or ONC206 treatment in human neuroblastoma cells, demonstrating an important multitarget effect which may yield added therapeutic benefits in treating this devastating childhood cancer.
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Affiliation(s)
- Sarra El-Soussi
- Shool of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Reine Hanna
- Shool of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Hanna Semaan
- Shool of Pharmacy, Lebanese American University, Byblos, Lebanon
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | | | - Jad Abdallah
- Shool of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Wassim Abou-Kheir
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Koga Y, Sanefuji M, Toya S, Oba U, Nakashima K, Ono H, Yamamoto S, Suzuki M, Sonoda Y, Ogawa M, Yamamoto H, Kusuhara K, Ohga S. Infantile neuroblastoma and maternal occupational exposure to medical agents. Pediatr Res 2021:10.1038/s41390-021-01634-z. [PMID: 34244617 DOI: 10.1038/s41390-021-01634-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/07/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Healthcare workers are often exposed to hazardous agents and are at risk for adverse health consequences that affect not only themselves but also their infants. This study aimed to examine whether such occupational exposure increased the risk of childhood cancer in offspring. METHODS We used the dataset of the Japan Environment and Children's Study, a nationwide birth cohort involving over 100,000 mother-child pairs. Information was obtained via successive questionnaires that were completed until the child turned 1 year of age. The parents were asked whether they occupationally handled medical agents during pregnancy. RESULTS A total of 26 infants developed neoplasms: neuroblastoma, leukemia, and brain tumor. The incidence of neuroblastoma was significantly higher in infants whose mothers were exposed to radiation (3/2142: 140.1 per 100,000 population) than in those who were not (12/90,384: 13.3 per 100,000 population). Multivariable regression analyses revealed a close association between maternal irradiation and the development of neuroblastoma (adjusted incident rate ratio: 10.68 [95% confidence interval: 2.98‒38.27]). CONCLUSIONS The present study demonstrated, for the first time, a potential association between maternal occupational exposure and the occurrence of neuroblastoma in offspring. Further studies involving the large pediatric cancer registries are needed to confirm these preliminary results. IMPACT Healthcare workers are often exposed to hazardous agents and are at risk for adverse health consequences that affect not only themselves but also their infants. This study examined the association between such occupational exposure and offspring's cancers that developed until the age of 1 year. Maternal exposure to ionizing radiation was associated with infantile neuroblastoma in offspring. Further studies involving the large pediatric cancer registries are needed to confirm these preliminary results.
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Affiliation(s)
- Yuhki Koga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masafumi Sanefuji
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Syunichiro Toya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Utako Oba
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Nakashima
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Ono
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Yamamoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maya Suzuki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuri Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanobu Ogawa
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Yamamoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
- Regional Center for Japan Environment and Children's Study, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Research Center for Environment and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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van Heerden J, Kruger M, Esterhuizen TM, Pinxten W. Neuroblastoma: The basis for cure in limited-resource settings. Pediatr Blood Cancer 2021; 68:e28923. [PMID: 33533177 DOI: 10.1002/pbc.28923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/22/2020] [Accepted: 01/08/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Neuroblastoma (NB) contributes the most to the mortality of childhood malignancies worldwide. The disease spectrum is heterogenous and the management complex and costly, especially in advanced disease or disease with adverse biology. In low- and middle-income countries (LMICs) the majority of NB presents in advanced stages. Therefore, with limited resources and poor prognosis the treatment of NB is often not a priority. The aim of the study was to evaluate the research activities and perceptions of the management of NB that determine the research and treatment approaches in LMICs. METHODS Data were sourced from https://www.clinicaltrials.gov/ identifying NB trials open to LMIC. Abstracts on NB research presented at the International Society for Paediatric Oncology (SIOP) Congresses between 2014 and 2020 were evaluated according to income status. An online survey evaluating medical views on NB in LMICs and the effect on the management was conducted. Descriptive analysis was done. Where appropriate categorical association between covariates was assessed using the Pearson chi-square (χ2 ) test or Fishers exact test. RESULTS There were 15/562 (2.7%) trials open to LMIC. Only six of 138 (4.3%) LMIC participated in NB trials. Of the 688 abstracts presented between 2014 and 2020 at the SIOP International Congress on NB as primary subject, 297 (42.7%) were from LMICs. Only two were from low-income countries (LICs). Sixty-one countries responded to the NB survey. Positive views towards NB management were present when treatment was based on a national protocol, the availability of trimodal or advanced treatment options were present, and when a balance of metastatic or local disease were treated. CONCLUSION Management of NB in LMICs should include increased advocacy and research as well as implementation of national management strategies.
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Affiliation(s)
- Jaques van Heerden
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Mariana Kruger
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Tonya Marianne Esterhuizen
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Wim Pinxten
- Department of Healthcare and Ethics, Hasselt University, Hasselt, Belgium
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26
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Moreno MM, Barrell WB, Godwin A, Guille M, Liu KJ. Anaplastic lymphoma kinase (alk), a neuroblastoma associated gene, is expressed in neural crest domains during embryonic development of Xenopus. Gene Expr Patterns 2021; 40:119183. [PMID: 34020009 DOI: 10.1016/j.gep.2021.119183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/11/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
Neuroblastoma is a neural crest-derived paediatric cancer that is the most common and deadly solid extracranial tumour of childhood. It arises when neural crest cells fail to follow their differentiation program to give rise to cells of the sympathoadrenal lineage. These undifferentiated cells can proliferate and migrate, forming tumours mostly found associated with the adrenal glands. Activating mutations in the kinase domain of anaplastic lymphoma kinase (ALK) are linked to high-risk cases, where extensive therapy is ineffective. However, the role of ALK in embryonic development, downstream signal transduction and in metastatic transformation of the neural crest is poorly understood. Here, we demonstrate high conservation of the ALK protein sequences among vertebrates. We then examine alk mRNA expression in the frog models Xenopus laevis and Xenopus tropicalis. Using in situ hybridisation of Xenopus embryos, we show that alk is expressed in neural crest domains throughout development, suggesting a possible role in neuroblastoma initiation. Lastly, RT-qPCR analyses show high levels of alk expression at tadpole stages. Collectively, these data may begin to elucidate how alk functions in neural crest cells and how its deregulation can result in tumorigenesis.
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Affiliation(s)
- Marcela M Moreno
- Centre for Craniofacial and Regenerative Biology, King's College London, London, SE1 9RT, UK
| | - William B Barrell
- Centre for Craniofacial and Regenerative Biology, King's College London, London, SE1 9RT, UK
| | - Annie Godwin
- European Xenopus Resource Centre, School of Biological Sciences, University of Portsmouth, Portsmouth, PO1 2DY, UK
| | - Matthew Guille
- European Xenopus Resource Centre, School of Biological Sciences, University of Portsmouth, Portsmouth, PO1 2DY, UK
| | - Karen J Liu
- Centre for Craniofacial and Regenerative Biology, King's College London, London, SE1 9RT, UK.
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27
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Qiu ZL, Saito S, Kayano D, Wakabayashi H, Kinuya S. Comparison of the detecting capability between 123I-mIBG and post-therapeutic 131I-mIBG scintigraphy for curie scoring in patients with neuroblastoma after chemotherapy. Ann Nucl Med 2021; 35:649-661. [PMID: 33866530 DOI: 10.1007/s12149-020-01569-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the detecting capability between planar imaging (PI) and PI combined with single-photon emission computed tomography/computed tomography (PICWS), including 123I- and 131I-labeled metaiodobenzylguanidine (mIBG) and to compare the detecting capability between 123I-mIBG and post-therapeutic 131I-mIBG scintigraphy including PI and PICWS for Curie scoring in patients with neuroblastoma. METHODS Sixty-two patients with 66 pairs of complete images with neuroblastoma were enrolled in this retrospective study. RESULTS Comparing the Curie scoring between 123I-mIBG PI and PICWS and between post-therapeutic 131I-mIBG PI and PICWS, findings were concordantly negative in 28.79% and 18.18% of studies, concordantly positive in 66.67% and 74.24% of studies, and discordant in 4.54% and 7.58% of studies, respectively. PICWS was superior to PI including 123I- and 131I-mIBG in the evaluation of Curie scoring for neuroblastoma patients (both P < 0.001). Comparing the Curie scores between 123I- and post-therapeutic 131I-mIBG PI and between 123I- and post-therapeutic 131I-mIBG PICWS, concordantly negative imaging was visualized in 22.73% and 19.70% of studies, concordantly positive imaging in 66.67% and 69.70% of studies, and discordant imaging in 10.60% and 10.60% of studies, respectively. Post-therapeutic 131I-mIBG was significantly better than that of 123I-mIBG scintigraphy including PI and PICWS in detecting the Curie scoring for neuroblastoma patients (both P < 0.001). CONCLUSION The present study demonstrates that 131I- or 123I-mIBG PICWS are more helpful in the evaluation of Curie scores than that of conventional PI and that post-therapeutic 131I-mIBG is superior to 123I-mIBG scintigraphy for the detecting capability of Curie scoring in patients with neuroblastoma.
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Affiliation(s)
- Zhong-Ling Qiu
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Shintaro Saito
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Daiki Kayano
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Hiroshi Wakabayashi
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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28
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Rezaei O, Honarmand Tamizkar K, Hajiesmaeili M, Taheri M, Ghafouri-Fard S. Non-Coding RNAs Participate in the Pathogenesis of Neuroblastoma. Front Oncol 2021; 11:617362. [PMID: 33718173 PMCID: PMC7945591 DOI: 10.3389/fonc.2021.617362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
Neuroblastoma is one of the utmost frequent neoplasms during the first year of life. This pediatric cancer is believed to be originated during the embryonic life from the neural crest cells. Previous studies have detected several types of chromosomal aberrations in this tumor. More recent studies have emphasized on expression profiling of neuroblastoma samples to identify the dysregulated genes in this type of cancer. Non-coding RNAs are among the mostly dysregulated genes in this type of cancer. Such dysregulation has been associated with a number of chromosomal aberrations that are frequently detected in neuroblastoma. In this study, we explain the role of non-coding transcripts in the malignant transformation in neuroblastoma and their role as biomarkers for this pediatric cancer.
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Affiliation(s)
- Omidvar Rezaei
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammadreza Hajiesmaeili
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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29
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Kildisiute G, Kholosy WM, Young MD, Roberts K, Elmentaite R, van Hooff SR, Pacyna CN, Khabirova E, Piapi A, Thevanesan C, Bugallo-Blanco E, Burke C, Mamanova L, Keller KM, Langenberg-Ververgaert KPS, Lijnzaad P, Margaritis T, Holstege FCP, Tas ML, Wijnen MHWA, van Noesel MM, Del Valle I, Barone G, van der Linden R, Duncan C, Anderson J, Achermann JC, Haniffa M, Teichmann SA, Rampling D, Sebire NJ, He X, de Krijger RR, Barker RA, Meyer KB, Bayraktar O, Straathof K, Molenaar JJ, Behjati S. Tumor to normal single-cell mRNA comparisons reveal a pan-neuroblastoma cancer cell. SCIENCE ADVANCES 2021; 7:eabd3311. [PMID: 33547074 PMCID: PMC7864567 DOI: 10.1126/sciadv.abd3311] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/18/2020] [Indexed: 05/22/2023]
Abstract
Neuroblastoma is a childhood cancer that resembles developmental stages of the neural crest. It is not established what developmental processes neuroblastoma cancer cells represent. Here, we sought to reveal the phenotype of neuroblastoma cancer cells by comparing cancer (n = 19,723) with normal fetal adrenal single-cell transcriptomes (n = 57,972). Our principal finding was that the neuroblastoma cancer cell resembled fetal sympathoblasts, but no other fetal adrenal cell type. The sympathoblastic state was a universal feature of neuroblastoma cells, transcending cell cluster diversity, individual patients, and clinical phenotypes. We substantiated our findings in 650 neuroblastoma bulk transcriptomes and by integrating canonical features of the neuroblastoma genome with transcriptional signals. Overall, our observations indicate that a pan-neuroblastoma cancer cell state exists, which may be attractive for novel immunotherapeutic and targeted avenues.
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Affiliation(s)
| | - Waleed M Kholosy
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | | | | | | | - Sander R van Hooff
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | | | | | - Alice Piapi
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK
| | | | | | - Christina Burke
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK
| | | | - Kaylee M Keller
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | | | - Philip Lijnzaad
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Thanasis Margaritis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Frank C P Holstege
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Michelle L Tas
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Marc H W A Wijnen
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Max M van Noesel
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
| | - Ignacio Del Valle
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK
| | - Giuseppe Barone
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | | | - Catriona Duncan
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | - John Anderson
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | - John C Achermann
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK
| | - Muzlifah Haniffa
- Wellcome Sanger Institute, CB10 1SA Hinxton, UK
- Institute of Cellular Medicine, Newcastle University, NE2 4HH Newcastle upon Tyne, UK
- Department of Dermatology and NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals, NHS Foundation Trust, NE2 4LP Newcastle upon Tyne, UK
| | | | - Dyanne Rampling
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | - Neil J Sebire
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | - Xiaoling He
- MRC-WT Cambridge Stem Cell Institute, University of Cambridge, CB2 0QQ Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, CB2 0QQ Cambridge, UK
| | - Ronald R de Krijger
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - Roger A Barker
- MRC-WT Cambridge Stem Cell Institute, University of Cambridge, CB2 0QQ Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, CB2 0QQ Cambridge, UK
| | | | | | - Karin Straathof
- UCL Great Ormond Street Institute of Child Health, WC1N 1EH London, UK.
- Great Ormond Street Hospital for Children (GOSH), NHS Foundation Trust, NIHR Great Ormond Street Hospital Biomedical Research Centre, WC1N 3JH London, UK
| | - Jan J Molenaar
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, Netherlands.
| | - Sam Behjati
- Wellcome Sanger Institute, CB10 1SA Hinxton, UK.
- Cambridge University Hospitals NHS Foundation Trust, CB2 0QQ Cambridge, UK
- Department of Paediatrics, University of Cambridge, CB2 0QQ Cambridge, UK
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30
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Association of Genetic Polymorphisms and Serum Levels of IL-6 and IL-8 with the Prognosis in Children with Neuroblastoma. Cancers (Basel) 2021; 13:cancers13030529. [PMID: 33573284 PMCID: PMC7866803 DOI: 10.3390/cancers13030529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/21/2023] Open
Abstract
Simple Summary Neuroblastoma (NB) presents diverse biological and clinical characteristics, from spontaneous regression to highly malignant and aggressive unfavorable tumors that condition the therapeutic failure of conventional treatments. The tumorigenesis of NB can be the result of different genetic variants, which can influence the clinical outcome, and the survival of patients who have metastatic tumors is low. The role of cytokines such as interleukin (IL)-6 has been described in the NB microenvironment promoting tumor progression and metastasis. Single nucleotide polymorphism (SNP)-174 G > C in IL-6 and -251 T > A and +781 C > T in IL-8 regulate the expression of these cytokines, and could be associated with the clinical outcome in patients with NB. Our objective was to evaluate the association of the genetic polymorphisms of IL-6 and IL-8, as well as the serum levels of these cytokines in patients with NB, as this will allow the genetic bases of NB to be characterized and understood, in order to predict the outcome of the disease and develop new therapeutic strategies. Abstract There is evidence that high circulating levels of IL-6 and IL-8 are markers of a poor prognosis in various types of cancer, including NB. The participation of these cytokines in the tumor microenvironment has been described to promote progression and metastasis. Our objective was to evaluate the prognostic role of genetic polymorphisms and serum levels of IL-6 and IL-8 in a cohort of Mexican pediatric patients with NB. The detection of the SNPs rs1800795 IL-6 and rs4073 and rs2227306 IL-8 was carried out by PCR-RFLP and the levels of cytokines were determined by the ELISA method. We found elevated circulating levels of IL-8 and IL-6 in NB patients compared to the control group. The genotype frequencies of the rs1800795 IL-6 and rs4073 IL-8 variants were different between the patients with NB and the control group. Likewise, the survival analysis showed that the GG genotypes of rs1800795 IL-6 (p = 0.014) and AA genotypes of rs4073 IL-8 (p = 0.002), as well as high levels of IL-6 (p = 0.009) and IL-8 (p = 0.046), were associated with lower overall survival. We confirmed the impact on an adverse prognosis in a multivariate model. This study suggests that the SNPs rs1800795 IL-6 and rs4073 IL-8 and their serum levels could be promising biomarkers of a poor prognosis, associated with overall survival, metastasis, and a high risk in Mexican children with NB.
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Liu J, Zhang M, Kan Y, Wang W, Liu J, Gong J, Yang J. Nuclear Factor-κB Activating Protein Plays an Oncogenic Role in Neuroblastoma Tumorigenesis and Recurrence Through the Phosphatidylinositol 3-Kinase/Protein Kinase B Signaling Pathway. Front Cell Dev Biol 2021; 8:622793. [PMID: 33553160 PMCID: PMC7859273 DOI: 10.3389/fcell.2020.622793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Abstract
Nuclear factor-κB activating protein (NKAP) is a conserved nuclear protein that acts as an oncogene in various cancers and is associated with a poor prognosis. This study aimed to investigate the role of NKAP in neuroblastoma (NB) progression and recurrence. We compared NKAP gene expression between 89 recurrence and 134 non-recurrence patients with NB by utilizing the ArrayExpress database. The relationship between NKAP expression and clinicopathological features was evaluated by correlation analysis. We knocked down NKAP expression in NB1 and SK-N-SH cells by small interfering RNA transfection to verify its role in tumor proliferation, apoptosis, and the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway. NKAP gene expression in NB tissues was significantly overexpressed in the recurrence group compared with the non-recurrence group, and NKAP was enriched in the PI3K/AKT pathway. Correlation analysis revealed NKAP expression was correlated with chromosome 11q deletion in patients with NB. Knockdown of NKAP expression significantly inhibited the proliferation and promoted the apoptosis of NB1 and SK-N-SH cells. Moreover, we found that small interfering NKAP significantly reduced p-PI3K and p-AKT expression. NKAP knockdown played an oncogenic role in NB by inhibiting PI3K/AKT signaling pathway activations both in vitro and in vivo. Our research revealed that NKAP mediates NB cells by inhibited proliferation and promoted apoptosis through activating the PI3K/AKT signaling pathways, and the expression of NKAP may act as a novel biomarker for predicting recurrence and chromosome 11q deletion in patients with NB.
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Affiliation(s)
- Jun Liu
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Mingyu Zhang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Ying Kan
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Jie Liu
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
| | - Jianhua Gong
- Oncology Department, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jigang Yang
- Department of Nuclear Medicine, Beijing Friendship Hospital, Affiliated to Capital Medical University, Beijing, China
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van Heerden J, Kruger M. Management of neuroblastoma in limited-resource settings. World J Clin Oncol 2020; 11:629-643. [PMID: 32879849 PMCID: PMC7443833 DOI: 10.5306/wjco.v11.i8.629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/23/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neuroblastoma (NB) is a heterogeneous disease with variable outcomes among countries. Little is known about NB in low- and middle-income countries (LMICs).
AIM The aim of this review was to evaluate regional management protocols and challenges in treating NB in paediatric oncology units in LMICs compared to high-income countries (HICs).
METHODS PubMed, Global Health, Embase, SciELO, African Index Medicus and Google Scholar were searched for publications with keywords pertaining to NB, LMICs and outcomes. Only English language manuscripts and abstracts were included. A descriptive review was done, and tables illustrating the findings were constructed.
RESULTS Limited information beyond single-institution experiences regarding NB outcomes in LMICs was available. The disease characteristics varied among countries for the following variables: sex, age at presentation, MYCN amplification, stage and outcome. LMICs were found to be burdened with a higher percentage of stage 4 and high-risk NB compared to HICs. Implementation of evidence-based treatment protocols was still a barrier to care. Many socioeconomic variables also influenced the diagnosis, management and follow-up of patients with NB.
CONCLUSION Patients presented at a later age with more advanced disease in LMICs. Management was limited by the lack of resources and genetic studies for improved NB classification. Further research is needed to develop modified diagnostic and treatment protocols for LMICs in the face of limited resources.
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Affiliation(s)
- Jaques van Heerden
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
- Department of Paediatric Haematology and Oncology, Antwerp University Hospital, Edegem 2650, Belgium
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa
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Parhar D, Joharifard S, Lo AC, Schlosser MP, Daodu OO. How well do image-defined risk factors (IDRFs) predict surgical outcomes and survival in patients with neuroblastoma? A systematic review and meta-analysis. Pediatr Surg Int 2020; 36:897-907. [PMID: 32533235 DOI: 10.1007/s00383-020-04696-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Since their introduction to the International Neuroblastoma Risk Group (INRG) staging system in 2009, the role of Image-Defined Risk Factors (IDRFs) in predicting outcomes has been studied in heterogeneous populations with varying results. We conducted a systematic review and meta-analysis in order to determine quantitative measures of precisely how well pre-treatment IDRFs predict surgical outcomes and survival. METHODS A systematic review was performed for studies between January 1990 and July 2019 that compared surgical outcomes and/or survival in pediatric neuroblastoma patients with one or more IDRFs to patients without IDRFs. Summary risk ratios (RR) and hazard ratios (HR) were calculated using a random-effects model. RESULTS 19 retrospective cohort studies were included, representing data from 1132 patients. The risk ratio (RR) of incomplete surgical resection in IDRF-positive patients compared to IDRF-negative patients was 2.45 (95% CI 1.51-3.97). The RR of surgical complications was 2.30 (95% CI 1.46-3.61). The hazard ratio (HR) for 5-year EFS was 2.08 (95% CI 2.93-4.13) while the 5-year HR for OS was 2.44 (95% CI 1.46-4.08). CONCLUSION IDRF-positive neuroblastoma patients have a higher risk of incomplete surgical resection, surgical complications, and 5-year mortality and/or relapse. Our results affirm that IDRFs remain a useful prognostic tool for neuroblastoma patients both for short and long-term outcomes. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Dennis Parhar
- Department of Radiology, University of British Columbia, Gordon & Leslie Diamond Health Centre, 11th Floor, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
| | - Shahrzad Joharifard
- Departément de Chirurgie, Division de Chirurgie Pédiatrique, Université de Montréal, Montréal, QC, Canada
| | - Andrea C Lo
- Department of Radiation Oncology, BC Cancer, Vancouver, BC, Canada
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Mary-Pat Schlosser
- Department of Pediatric Medicine, Division of Immunology, Hematology/Oncology, Palliative Care and Environmental Medicine, University of Alberta, Edmonton, AB, Canada
| | - Oluwatomilayo O Daodu
- Department of Surgery, Division of Pediatric Surgery, University of Calgary, Calgary, AB, Canada
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34
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Duvalyan A, Cha A, Goodarzian F, Arkader A, Villablanca JG, Marachelian A. Premature epiphyseal growth plate arrest after isotretinoin therapy for high-risk neuroblastoma: A case series and review of the literature. Pediatr Blood Cancer 2020; 67:e28236. [PMID: 32386124 DOI: 10.1002/pbc.28236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/15/2020] [Accepted: 02/04/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Vitamin A-derived retinoids have been reported to cause skeletal abnormalities ranging from hypercalcemia to premature epiphyseal closure. Isotretinoin is a retinoid used as standard therapy for high-risk neuroblastoma and has been reported to cause premature epiphyseal growth plate arrest. PROCEDURE We identified patients from the Children's Hospital Los Angeles (CHLA) database with high-risk neuroblastoma diagnosed from 1991 to 2018 who experienced premature epiphyseal growth plate arrest and compared their characteristics to other patients with high-risk neuroblastoma. We then performed a literature review of this complication. Data collection included diagnosis age of neuroblastoma, presentation age, agent of exposure, dose, exposure range, and skeletal deformity. RESULTS Among 216 patients, high-risk neuroblastoma was diagnosed before age of five years (n = 165), between ages of 5 and 10 years (n = 41), and after 10 years of age (n = 13). Three out of 216 patients developed premature epiphyseal growth arrest after isotretinoin exposure (overall incidence = 1.38%). The incidence of bony abnormalities was significantly higher in patients diagnosed in 5- to 10-year age group than in other two groups (P = 0.014). Literature review identified eight additional patients with neuroblastoma who presented with retinoid associated skeletal abnormalities. The median range of isotretinoin exposure for these 11 patients was between 6.5 and 7.625 years (range, 2-14) with no cases of isotretinoin therapy completion before age 5 years. CONCLUSION Bone toxicity associated with isotretinoin exposure is a concern. Growth plate arrest is a serious adverse effect that is attributable to isotretinoin therapy. Our findings suggest the prepubescent growth plate may be most at risk, and we recommend special attention to this population.
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Affiliation(s)
| | - Angela Cha
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Fariba Goodarzian
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | | | - Judith G Villablanca
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Araz Marachelian
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
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35
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Serra-Roma A, Shakhova O. Identification of Novel Small-Molecule Kinase Modulators for the Treatment of Neuroblastoma. Oncol Ther 2020; 8:133-145. [PMID: 32700077 PMCID: PMC7359976 DOI: 10.1007/s40487-020-00113-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Indexed: 11/02/2022] Open
Abstract
Neuroblastoma represents 8-10% of all childhood cancer cases and is responsible for 15% of all cancer-related deaths in infants. Even though patients with low- and intermediate-risk disease have a good prognosis, the 5-year survival rate of the vast majority of patients with high-risk neuroblastoma is 50%. Despite extensive research efforts to find a cure for neuroblastoma, current treatment options are still limited. The aim of our study was to identify novel therapeutic compounds using high-throughput drug screening of a small molecule kinase inhibitor library containing 960 compounds. This screening resulted in the identification of two compounds, ST013381 and ST022328, that showed pronounced cytotoxic effects in six human neuroblastoma cell lines in vitro while having reduced effects in the BJ-5ta control cell line. These effects were observed in both MYCN-amplified and -non-amplified cells, indicating that these compounds can affect a wide range of neuroblastomas. Our experiments also revealed that several signaling pathways underlie the selective elimination of neuroblastoma cells by the ST013381 and ST022328 compounds. In summary, we have identified two novel compounds with a strong cytotoxic effect in vitro as promising agents for the treatment of neuroblastoma.
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Affiliation(s)
- André Serra-Roma
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Olga Shakhova
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.
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36
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Youlden DR, Jones BC, Cundy TP, Karpelowsky J, Aitken JF, McBride CA. Incidence and outcomes of neuroblastoma in Australian children: A population-based study (1983-2015). J Paediatr Child Health 2020; 56:1046-1052. [PMID: 32068329 DOI: 10.1111/jpc.14810] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/12/2019] [Accepted: 01/23/2020] [Indexed: 12/16/2022]
Abstract
AIM Neuroblastoma predominantly affects younger children and exhibits heterogeneous behaviour. This study describes incidence and outcomes for neuroblastoma using national population-based data from the Australian Childhood Cancer Registry. METHODS Deidentified data for all children (0-14 years) diagnosed with neuroblastoma and ganglioneuroblastoma from 1983 to 2015 were extracted. Cause-specific (CSS) and event-free survival were estimated using the cohort method. Adjusted hazard ratios were calculated using a multivariable flexible parametric survival model. Other outcomes investigated included recurrence and second primary malignancies (SPMs). RESULTS The study cohort comprised 1269 patients. Age-standardised incidence rates remained steady across the study period at approximately 9.5 per million children per year. The proportion of patients with metastatic disease at diagnosis decreased from 63% in 1983-1995 to 42% by 2006-2015 (P < 0.001). CSS and event-free survival both improved significantly over time and reached 75% (95% confidence interval (CI) = 71-79%) and 71% (95% CI = 66-75%) at 5 years post-diagnosis, respectively, for children diagnosed between 2004 and 2013. Of patients achieving full remission, 28% relapsed with subsequent 5-year CSS of only 20%. Although SPMs were rare, neuroblastoma survivors carried a fivefold increased risk compared to cancer rates in the general population (standardised incidence ratio = 5.18, 95% CI = 3.01-8.91), with 7 of the 13 patients (54%) who were diagnosed with an SPM dying within 5 years. CONCLUSIONS CSS for childhood neuroblastoma has improved substantially over time in Australia, but still remains lower than for most other types of childhood cancer. SPMs are uncommon and carry a better prognosis than relapse of the primary tumour.
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Affiliation(s)
- Danny R Youlden
- Australian Childhood Cancer Registry, Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Brendan C Jones
- Department of Paediatric Surgery, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
| | - Thomas P Cundy
- Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Karpelowsky
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Division of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Children's Cancer Research Unit, Kids Research Institute, Sydney, New South Wales, Australia
| | - Joanne F Aitken
- Australian Childhood Cancer Registry, Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Queensland, Australia
| | - Craig A McBride
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Department of Paediatric Surgery, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.,Discipline of Paediatrics and Child Health, University of Queensland, Brisbane, Queensland, Australia
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37
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Pediatric applications of Dotatate: early diagnostic and therapeutic experience. Pediatr Radiol 2020; 50:882-897. [PMID: 32495176 DOI: 10.1007/s00247-020-04688-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/17/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
In recent years, new somatostatin receptor agents (SSTRs) have become available for diagnostic imaging and therapy in neuroendocrine tumors. The novel SSTR ligand DOTA-DPhel-Tyr3-octreotate (Dotatate) in particular can be linked with 68Gallium for diagnostic imaging purposes, and with the β-emitter 177Lutetium for radiotherapy in the setting of neuroendocrine tumors. Dotatate imaging offers distinct advantages in the evaluation of neuroendocrine tumors compared to standard techniques, including greater target-to-background ratio and lesion conspicuity, high sensitivity/specificity, improved spatial resolution with positron emission tomography (PET)/CT or PET/MR, and decreased radiation exposure. Although currently off-label in pediatrics, Dotatate theranostics in children are being explored, most notably in the setting of neuroblastoma and hereditary neuroendocrine syndromes. This article provides a multicenter case series of Dotatate imaging and therapy in pediatric patients in order to highlight the spectrum of potential clinical applications.
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38
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Zhao Q, Liu Y, Zhang Y, Meng L, Wei J, Wang B, Wang H, Xin Y, Dong L, Jiang X. Role and toxicity of radiation therapy in neuroblastoma patients: A literature review. Crit Rev Oncol Hematol 2020; 149:102924. [PMID: 32172225 DOI: 10.1016/j.critrevonc.2020.102924] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/13/2020] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
Abstract
Neuroblastoma is the most common extracranial solid tumor, arising from primitive sympathetic ganglion cells, in pediatric patients. The unique features of neuroblastoma include variable clinical behaviors, such as rapid progression to death and maturation to benign ganglioneuroma, followed by regression. Radiation therapy (RT) is usually administered to both the primary tumor bed and persistent metastatic sites after induction chemotherapy for high-risk neuroblastoma. RT to the tumor bed after surgical resection contributes significantly to local disease control and prevention of local relapse, confirming the role of RT. Palliative radiotherapy for metastatic neuroblastoma is also effective and safe and mainly provides symptomatic relief. The late side effects of RT in neuroblastoma patients include growth and developmental failure, hypothyroidism, gastrointestinal dysfunction, neurocognitive defects, pulmonary and cardiac abnormalities, infertility, and secondary cancers. In this article, we reviewed the role and toxicity of RT in neuroblastoma patients.
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Affiliation(s)
- Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Yang Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Yuyu Zhang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Lingbin Meng
- Department of Internal Medicine, Florida Hospital, Orlando, FL, 32803, USA.
| | - Jinlong Wei
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Bin Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Huanhuan Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, 130021, China.
| | - Lihua Dong
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, 130021, China.
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Heck JE, Lee PC, Wu CK, Tsai HY, Ritz B, Arah OA, Li CY. Gestational risk factors and childhood cancers: A cohort study in Taiwan. Int J Cancer 2020; 147:1343-1353. [PMID: 32020595 DOI: 10.1002/ijc.32905] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022]
Abstract
Gestational risk factors such as birth weight, gestational age and parity have been repeatedly found to be related to pediatric cancers, but few reports have emerged from Asian countries. Here we report on demographic and gestational factors in a Taiwanese cohort. Our study included all children born in Taiwan 2004-2014 for whom there was a birth record (n = 2,079,037), of which 1900 children had been diagnosed with cancer prior to age 12. We conducted multivariable hazard regression to examine associations between demographic and gestational factors with cancer. Greater parity (family with 2+ older children) was related to acute myeloid leukemia [Hazard ratio (HR) = 2.15, 95% confidence interval (CI): 1.31, 3.55), central nervous system tumors (HR = 1.67, CI: 1.13, 2.48) and neuroblastoma (HR = 1.67, CI: 1.07, 2.63). Hepatoblastoma cases had a higher risk of low birth weight (<2,500 g; HR = 3.01, CI: 1.85, 4.91), very preterm birth (<33 weeks gestation; HR = 13.71, CI: 7.45, 25.23), plural pregnancies (HR = 2.37, CI: 1.10, 5.14) and both small (HR = 2.13, CI: 1.23, 3.67) and large (HR = 1.83, CI: 1.01, 3.32) for gestational age. Germ cell tumors were more common among children born in rural areas (HR = 1.63, CI: 1.02, 2.60). Despite that Taiwan has lower rates of both high and low birthweight compared to other developed nations, we observed several similar associations to those reported in Western Countries. Further research should examine unique exposures in Taiwan that may be contributing to higher incidence of certain cancer types.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsin-Yun Tsai
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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40
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Zhou JG, Liang B, Jin SH, Liao HL, Du GB, Cheng L, Ma H, Gaipl US. Development and Validation of an RNA-Seq-Based Prognostic Signature in Neuroblastoma. Front Oncol 2019; 9:1361. [PMID: 31867276 PMCID: PMC6904333 DOI: 10.3389/fonc.2019.01361] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022] Open
Abstract
Objective: The stratification of neuroblastoma (NBL) prognosis remains difficult. RNA-based signatures might be able to predict prognosis, but independent cross-platform validation is still rare. Methods: RNA-Seq-based profiles from NBL patients were acquired and then analyzed. The RNA-Seq prognostic index (RPI) and the clinically adjusted RPI (RCPI) were successively established in the training cohort (TARGET-NBL) and then verified in the validation cohort (GSE62564). Survival prediction was assessed using a time-dependent receiver operating characteristic (ROC) curve and area under the ROC curve (AUC). Functional enrichment analysis of the genes was conducted using bioinformatics methods. Results: In the training cohort, 10 gene pairs were eventually integrated into the RPI. In both cohorts, the high-risk group had poor overall survival (OS) (P < 0.001 and P < 0.001, respectively) and favorable event-free survival (EFS) (P = 0.00032 and P = 0.06, respectively). ROC curve analysis also showed that the RPI predicted OS (60 month AUC values of 0.718 and 0.593, respectively) and EFS (60 month AUC values of 0.627 and 0.852, respectively) well in both the training and validation cohorts. Clinicopathological indicators associated with prognosis in the univariate and multivariate regression analyses were identified and added to the RPI to form the RCPI. The RCPI was also used to divide populations into different risk groups, and the high-risk group had poor OS (P < 0.001 and P < 0.001, respectively) and EFS (P < 0.05 and P < 0.05, respectively). Finally, the RCPI had higher accuracy than the RPI for the prediction of OS (60 month AUC values of 0.730 and 0.852, respectively) and EFS (60 month AUC values of 0.663 and 0.763, respectively) in both the training and validation cohorts. Moreover, these differentially expressed genes may be involved in certain NBL-related events. Conclusions: The RCPI could reliably categorize NBL patients based on different risks of death.
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Affiliation(s)
- Jian-Guo Zhou
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bo Liang
- Affiliated Nanjing Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Su-Han Jin
- Department of Orthodontics, Affiliated Stemmatological Hospital of Zunyi Medical University, Zunyi, China
| | - Hui-Ling Liao
- College of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou, China
| | - Guo-Bo Du
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Long Cheng
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hu Ma
- Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
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Moringin from Moringa Oleifera Seeds Inhibits Growth, Arrests Cell-Cycle, and Induces Apoptosis of SH-SY5Y Human Neuroblastoma Cells through the Modulation of NF-κB and Apoptotic Related Factors. Int J Mol Sci 2019; 20:ijms20081930. [PMID: 31010127 PMCID: PMC6515259 DOI: 10.3390/ijms20081930] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/16/2019] [Indexed: 01/01/2023] Open
Abstract
In the last decades, glucosinolates (GLs), precursors of isothiocyanates (ITCs), have been studied mostly for their chemopreventive and chemotherapeutic properties. The aim of our research was to study the antiproliferative effect of 4-(α-L-rhamnopyranosyloxy) benzyl glucosinolate (glucomoringin; GMG) bioactivated by myrosinase enzyme to form the corresponding isothiocyanate 4-(α-L-rhamnopyranosyloxy) benzyl C (moringin) in SH-SY5Y human neuroblastoma cells. We found that moringin significantly reduced SH-SY5Y cell growth in a time and concentration-dependent (p < 0.05, 0.01, and 0.001 vs. ctrl, after treatment with 16.4 µM moringin for 24, 48, and 72 h, respectively) manner through a mechanism involving the activation of apoptotic machinery. In addition, it altered the normal progression of cells through the cell cycle, increasing the cell population in both G2 and S phases, as well as decreasing that in the G1 phase. Studying the drug mechanism of action, we found that moringin was able to increase the expression of p53, p21, and Bax at both the protein and transcriptional level. Moreover, exposure of SH-SY5Y cells to moringin significantly increased the gene expression of both caspase 3 and 9 and enhanced their cleavage, thereby initiating an intrinsic apoptotic cascade. Finally, moringin inhibited nuclear translocation of NF-κB. Our study demonstrates the ability of moringin to reduce the growth of SH-SY5Y cells and reveals its mechanism of action, suggesting its promising role as an anticancer drug.
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42
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Cariati F, Borrillo F, Shankar V, Nunziato M, D'Argenio V, Tomaiuolo R. Dissecting Intra-Tumor Heterogeneity by the Analysis of Copy Number Variations in Single Cells: The Neuroblastoma Case Study. Int J Mol Sci 2019; 20:ijms20040893. [PMID: 30791380 PMCID: PMC6412524 DOI: 10.3390/ijms20040893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 02/07/2023] Open
Abstract
Tumors often show intra-tumor heterogeneity because of genotypic differences between all the cells that compose it and that derive from it. Recent studies have shown significant aspects of neuroblastoma heterogeneity that may affect the diagnostic-therapeutic strategy. Therefore, we developed a laboratory protocol, based on the combination of the advanced dielectrophoresis-based array technology and next-generation sequencing to identify and sort single cells individually and carry out their copy number variants analysis. The aim was to evaluate the cellular heterogeneity, avoiding overestimation or underestimation errors, due to a bulk analysis of the sample. We tested the above-mentioned protocol on two neuroblastoma cell lines, SK-N-BE(2)-C and IMR-32. The presence of several gain or loss chromosomal regions, in both cell lines, shows a high heterogeneity of the copy number variants status of the single tumor cells, even if they belong to an immortalized cell line. This finding confirms that each cell can potentially accumulate different alterations that can modulate its behavior. The laboratory protocol proposed herein provides a tool able to identify prevalent behaviors, and at the same time highlights the presence of particular clusters that deviate from them. Finally, it could be applicable to many other types of cancer.
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Affiliation(s)
- Federica Cariati
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy.
- KronosDNA srl, Spin-Off of Università di Napoli Federico II, Via Loggia dei Piasani 25, 80133 Naples, Italy.
| | - Francesca Borrillo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy.
| | - Varun Shankar
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- KronosDNA srl, Spin-Off of Università di Napoli Federico II, Via Loggia dei Piasani 25, 80133 Naples, Italy.
| | - Marcella Nunziato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy.
| | - Valeria D'Argenio
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy.
- KronosDNA srl, Spin-Off of Università di Napoli Federico II, Via Loggia dei Piasani 25, 80133 Naples, Italy.
| | - Rossella Tomaiuolo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy.
- KronosDNA srl, Spin-Off of Università di Napoli Federico II, Via Loggia dei Piasani 25, 80133 Naples, Italy.
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Kaufmann MR, Camilon PR, Janz TA, Levi JR. Factors Associated With the Improved Survival of Head and Neck Neuroblastomas Compared to Other Body Sites. Ann Otol Rhinol Laryngol 2018; 128:241-248. [PMID: 30565471 DOI: 10.1177/0003489418818586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To examine pediatric neuroblastoma survival and management in the head and neck compared to other body sites. STUDY DESIGN Retrospective analysis of a large population database. METHODS Patients in the Surveillance, Epidemiology, and End Results (SEER) database with neuroblastoma, NOS; ganglioneuroblastoma; or olfactory neuroblastoma diagnosed from birth to 18 years between 1973 and 2014 were included. These patients were classified into 1 of 3 categories based on primary tumor site: head and neck, adrenal, and "other." RESULTS Four thousand five hundred neuroblastoma cases were identified. One hundred seventy-five (3.9%) occurred in the head and neck, 1,934 (43.0%) occurred in the adrenal gland, and 2,391 (53.1%) occurred in "other" sites. The mean age at diagnosis was 4.21 years in the head and neck, 2.23 years in the adrenal gland, and 2.47 years in the "other" cohorts (P < .001). Two- and 5-year disease-specific survival rates were 89% and 84% in the head and neck versus 77% and 65% in the adrenal and 84% and 77% in the "other" cohorts (P < .001). The risk of disease-specific death (DSD) was higher in the adrenal cohort (adjusted hazard ratio [aHR] = 2.85; 95% CI, 1.54-5.27) compared to the head and neck cohort. Patients treated with surgery only had the lowest risk of DSD (aHR = 0.22; 95% CI, 0.13-0.35) compared to all other studied treatments. CONCLUSION Our results demonstrate that primary neuroblastoma of the head and neck has a better prognosis than primary neuroblastoma of the adrenal gland.
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Affiliation(s)
| | | | - Tyler A Janz
- University of Central Florida College of Medicine, Orlando, FL, USA
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Theerakulpisut D, Raruenrom Y, Wongsurawat N, Somboonporn C. Value of SPECT/CT in Diagnostic I-131 MIBG Scintigraphy in Patients with Neuroblastoma. Nucl Med Mol Imaging 2018; 52:350-358. [PMID: 30344783 DOI: 10.1007/s13139-018-0532-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/12/2018] [Accepted: 06/28/2018] [Indexed: 12/27/2022] Open
Abstract
Purpose Diagnostic I-131 MIBG scintigraphy is an important imaging modality for evaluation of patients with neuroblastoma (NB) especially in centers where I-123 MIBG is not available. Single photon emission computed tomography/computed tomography (SPECT/CT) could potentially improve lesion detection over planar scintigraphy, but studies regarding its usefulness as an add-on to diagnostic I-131 MIBG scintigraphy are limited. This study aimed to determine the usefulness and factors related to usefulness of SPECT/CT in diagnostic I-131 MIBG scintigraphy in NB patients. Methods Usefulness of SPECT/CT for lesion detection, lesion localization, resolving suspicious findings, and clarifying the nature of lesions on anatomical imaging were retrospectively reviewed in 86 diagnostic planar I-131 MIBG scintigrams with add-on SPECT/CT. Results SPECT/CT detected additional lesions in 23.2%(20/86), helped localize lesions in 21.1%(8/38), resolved suspicious findings in 85.7%(6/7), determined functional status of lesions on anatomical imaging in 94.4%(17/18), and changed diagnosis from a negative to a positive study in 19.5%(8/41). Independent predictors of SPECT/CT being useful included presence of suspicious findings on planar imaging (OR 99.08; 95% C.I. 6.99-1404.41; p = 0.001), positive findings on planar imaging (OR 4.61; 95% C.I. 1.05, 20.28; p < 0.001), and presence of structural lesions on anatomical imaging (OR 32.54; 95% C.I. 5.37-196.96; p < 0.001). Conclusion SPECT/CT is a useful add-on to diagnostic planar I-131 MIBG scintigraphy. Predictors of usefulness of SPECT/CT include suspicious or positive findings on planar scintigraphy and the presence of structural lesions on anatomical imaging.
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Affiliation(s)
- Daris Theerakulpisut
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp highway, Muang, Khon Kaen, 40002 Thailand
| | - Yutapong Raruenrom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp highway, Muang, Khon Kaen, 40002 Thailand
| | - Nantaporn Wongsurawat
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp highway, Muang, Khon Kaen, 40002 Thailand
| | - Charoonsak Somboonporn
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, 123 Mittraparp highway, Muang, Khon Kaen, 40002 Thailand
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45
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Zhou K, Li XL, Pan J, Xu JZ, Wang J. Analysis of the risk factor for the poor prognosis of localized neuroblastoma after the surgical. Medicine (Baltimore) 2018; 97:e12718. [PMID: 30290678 PMCID: PMC6200457 DOI: 10.1097/md.0000000000012718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Neuroblastoma is a unique malignancy in infants often presenting with either localized or metastatic disease. The study was carried out to explore the risk stratification of the poor prognosis for patients underwent surgical treatment.60 patients diagnosed with neuroblastoma were primarily enrolled in the study from April 2008 to April 2016. All the patients underwent surgical treatment and received 5-year follow-up. Clinical variables, including age, International Neuroblastoma Staging System (INSS) stage, tumor size and site, histology, and MYCN status were retrospectively analyzed, and EFS was chosen as the endpoint.The median age of patients was 8.2 months and average follow-up period was 40.2 ± 8.6 months. Among 60 patients, complete remission was achieved in 35 patients and partial remission in 14 subjects. Poor prognosis including patient death and tumor progression were overserved in 11 patients. Cox multifactor regression analysis revealed that age, histology and MYCN status had significant prognostic effect on event-free survival (EFS) rate for neuroblastoma patients underwent surgical treatment.In our study, we identified a series of prognostic factors including age, histology, and MYCN status predicting the prognosis of neuroblastoma patients after surgical treatment.
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Affiliation(s)
- Kai Zhou
- Department of General Surgery, Children's Hospital of Soochow University, Suzhou
- Department of Pediatric Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiao-lu Li
- Department of General Surgery, Children's Hospital of Soochow University, Suzhou
| | - Jian Pan
- Department of General Surgery, Children's Hospital of Soochow University, Suzhou
| | - Jian-zhong Xu
- Department of Pediatric Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jian Wang
- Department of General Surgery, Children's Hospital of Soochow University, Suzhou
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46
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Müller-Schulte E, Kurlemann G, Harder A. Tobacco, alcohol and illicit drugs during pregnancy and risk of neuroblastoma: systematic review. Arch Dis Child Fetal Neonatal Ed 2018; 103:F467-F473. [PMID: 29162685 DOI: 10.1136/archdischild-2017-313615] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/03/2017] [Accepted: 09/24/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine whether prenatal and perinatal maternal consumption of alcohol, tobacco and/or illicit drugs is associated with risk of neuroblastoma. DATA SOURCES Medline and Embase (both from inception to February 2017), and reference lists of included studies. STUDY SELECTION To be eligible, a study had to be an original report including data on intake of alcohol, tobacco smoking and/or consumption of illicit drugs during pregnancy and risk of neuroblastoma in the child. DATA EXTRACTION From eligible studies, data study characteristics as well as effect measures and confounders were extracted. We assessed unadjusted and confounder-adjusted estimates, performed risk of bias analysis, constructed random-effects models and assessed heterogeneity. RESULTS We identified 14 case-control studies (1987-2016) involving a total of 3114 children with neuroblastoma. Meta-analysis of unadjusted estimates showed an association between alcohol (OR 1.26; 95% CI 1.07 to 1.49), tobacco (OR 1.22; 95% CI 1.04 to 1.44) and illicit drug consumption during pregnancy and risk of neuroblastoma during childhood, with illicit drug consumption showing the strongest association (OR 3.26; 95% CI 1.36 to 7.86). However, adjusted estimates were highly heterogeneous. LIMITATIONS All studies were at high risk of bias. CONCLUSIONS Smoking, alcohol or illicit drugs during pregnancy might play a role in the development of neuroblastoma. However, well-designed studies are needed to assess whether these exposures are causal and whether time period during pregnancy, dose or co-consumption of substances is critical. TRIAL REGISTRATION NUMBER Registration number CRD42016036165.
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Affiliation(s)
- Eloise Müller-Schulte
- Institute of Medical Microbiology, Saarland University Medical Center, Homburg, Germany
| | - Gerhard Kurlemann
- Department of Pediatric Neurology, Children's University Hospital, Münster, Germany
| | - Anja Harder
- Institute of Pathology, Brandenburg Medical School, Brandenburg, Germany.,Institute of Neuropathology, University Hospital, Münster, Germany
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47
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Lucena JN, Alves MTS, Abib SCV, Souza GOD, Neves RPDC, Caran EMM. CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OUTCOMES OF CHILDREN WITH NEUROBLASTOMA: 21 YEARS OF EXPERIENCE AT THE INSTITUTO DE ONCOLOGIA PEDIÁTRICA, IN SÃO PAULO, BRAZIL. ACTA ACUST UNITED AC 2018; 36:254-260. [PMID: 29995142 PMCID: PMC6202906 DOI: 10.1590/1984-0462/;2018;36;3;00007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/15/2017] [Indexed: 02/06/2023]
Abstract
Objective: To describe the clinical and epidemiological characteristics and survival
outcomes of children with neuroblastoma (NB) treated at a pediatric oncology
center from 1991 to 2012. Methods: A retrospective study with clinical and epidemiological data from 258
patients with neuroblastoma treated at a pediatric oncology center from 1991
to 2012, using medical records. Results: The average age of the children at diagnosis was 40.5±46.4 months with a
median age of 28.9 months (interquartile range 42.2). The male:female ratio
was 1.3:1, and 1% of the patients were asymptomatic. The most frequent
manifestations were: fever (25%), abdominal pain (22%), abdominal mass
(19%), and bone pain (19%). The mean time from symptom onset to diagnosis
was 3.0±4.8 months. The most common location of the tumor was the abdomen
(63%). Metastases occurred in the bone marrow (37%) and in the bone (33%).
Overall survival (OS) and event-free survival (EFS) in five years were 62
and 52%, respectively. The main cause of death was the progression of the
disease (72%). Conclusions: The clinical features of children with neuroblastoma are variable and mostly
nonspecific, which makes clinical recognition difficult and, in general, too
late. In children less than 5 years old, with an abdominal mass and/or bone
pain, irritability, and a fever from an unknown cause, neuroblastoma should
be considered as a possible diagnosis.
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48
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Gholizadeh S, Dolman EM, Wieriks R, Sparidans RW, Hennink WE, Kok RJ. Anti-GD2 Immunoliposomes for Targeted Delivery of the Survivin Inhibitor Sepantronium Bromide (YM155) to Neuroblastoma Tumor Cells. Pharm Res 2018. [PMID: 29516187 PMCID: PMC5842274 DOI: 10.1007/s11095-018-2373-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Purpose Sepantronium bromide (YM155) is a hydrophilic quaternary compound that cannot be administered orally due to its low oral bioavailability; it is furthermore rapidly eliminated via the kidneys. The current study aims at improving the pharmacokinetic profile of YM155 by its formulation in immunoliposomes that can achieve its enhanced delivery into tumor tissue and facilitate uptake in neuroblastoma cancer cells. Methods PEGylated YM155 loaded liposomes composed of DPPC, cholesterol and DSPE-PEG2000 were prepared via passive film-hydration and extrusion method. Targeted (i.e. immuno-)liposomes were prepared by surface functionalization with SATA modified monoclonal anti-disialoganglioside (GD2) antibodies. Liposomes were characterized based on their size, charge, antibody coupling and YM155 encapsulation efficiency, and stability. Flow cytometry analysis and confocal microscopy were performed on IMR32 and KCNR neuroblastoma cell lines. The efficacy of developed formulations were assessed by in-vitro toxicity assays. A pilot pharmacokinetic analysis was performed to assess plasma circulation and tumor accumulation profiles of the developed liposomal formulations. Results YM155 loaded immunoliposomes had a size of 170 nm and zeta potential of −10 mV, with an antibody coupling efficiency of 60% andYM155 encapsulation efficiency of14%. Targeted and control liposomal formulations were found to have similar YM155 release rates in a release medium containing 50% serum. An in-vitro toxicity study on KCNR cells showed less toxicity for immunoliposomes as compared to free YM155. In-vivo pharmacokinetic evaluation of YM155 liposomes showed prolonged blood circulation and significantly increased half-lives of liposomal YM155 in tumor tissue, as compared to a bolus injection of free YM155. Conclusions YM155 loaded immunoliposomes were successfully formulated and characterized, and initial in-vivo results show their potential for improving the circulation time and tumor accumulation of YM155. Electronic supplementary material The online version of this article (10.1007/s11095-018-2373-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shima Gholizadeh
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Emmy M Dolman
- Department of Oncogenomics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Rebecca Wieriks
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Rolf W Sparidans
- Department of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wim E Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Robbert J Kok
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands.
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49
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Costa RA, Seuánez HN. Investigation of major genetic alterations in neuroblastoma. Mol Biol Rep 2018; 45:287-295. [PMID: 29455316 DOI: 10.1007/s11033-018-4161-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/08/2018] [Indexed: 12/11/2022]
Abstract
Neuroblastoma (NB) is the most common extracranial solid tumor in childhood. This malignancy shows a wide spectrum of clinical outcome and its prognosis is conditioned by manifold biological and genetic factors. We investigated the tumor genetic profile and clinical data of 29 patients with NB by multiplex ligation-dependent probe amplification (MLPA) to assess therapeutic risk. In 18 of these tumors, MYCN status was assessed by fluorescence in situ hybridization (FISH). Copy number variation was also determined for confirming MLPA findings in two 6p loci. We found 2p, 7q and 17q gains, and 1p and 11q losses as the most frequent chromosome alterations in this cohort. FISH confirmed all cases of MYCN amplification detected by MLPA. In view of unexpected 6p imbalance, copy number variation of two 6p loci was assessed for validating MLPA findings. Based on clinical data and genetic profiles, patients were stratified in pretreatment risk groups according to international consensus. MLPA proved to be effective for detecting multiple genetic alterations in all chromosome regions as requested by the International Neuroblastoma Risk Group (INRG) for therapeutic stratification. Moreover, this technique proved to be cost effective, reliable, only requiring standard PCR equipment, and attractive for routine analysis. However, the observed 6p imbalances made PKHD1 and DCDC2 inadequate for control loci. This must be considered when designing commercial MLPA kits for NB. Finally, four patients showed a normal MLPA profile, suggesting that NB might have a more complex genetic pattern than the one assessed by presently available MLPA kits.
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Affiliation(s)
- Régis Afonso Costa
- Genetics Program, Instituto Nacional de Câncer, Rua André Cavalcanti 37, Rio de Janeiro, RJ, 20231-050, Brazil.,Department of Genetics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Héctor N Seuánez
- Genetics Program, Instituto Nacional de Câncer, Rua André Cavalcanti 37, Rio de Janeiro, RJ, 20231-050, Brazil. .,Department of Genetics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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50
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Georgakis MK, Dessypris N, Baka M, Moschovi M, Papadakis V, Polychronopoulou S, Kourti M, Hatzipantelis E, Stiakaki E, Dana H, Bouka E, Antunes L, Bastos J, Coza D, Demetriou A, Agius D, Eser S, Gheorghiu R, Sekerija M, Trojanowski M, Zagar T, Zborovskaya A, Ryzhov A, Tragiannidis A, Panagopoulou P, Steliarova-Foucher E, Petridou ET. Neuroblastoma among children in Southern and Eastern European cancer registries: Variations in incidence and temporal trends compared to US. Int J Cancer 2017; 142:1977-1985. [PMID: 29250786 DOI: 10.1002/ijc.31222] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/29/2017] [Accepted: 11/03/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Marios K. Georgakis
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
| | - Margarita Baka
- Department of Pediatric Hematology-Oncology; “Pan. & Agl. Kyriakou” Children's Hospital; Athens Greece
| | - Maria Moschovi
- Pediatric Hematology/Oncology Unit, First Department of Pediatrics; University of Athens, “Agia Sofia” Children's Hospital; Athens Greece
| | - Vassilios Papadakis
- Department of Pediatric Hematology-Oncology; “Agia Sofia” Children's Hospital; Athens Greece
| | - Sophia Polychronopoulou
- Department of Pediatric Hematology-Oncology; “Agia Sofia” Children's Hospital; Athens Greece
| | - Maria Kourti
- Department of Pediatric Hematology and Oncology; Hippokration Hospital; Thessaloniki Greece
| | - Emmanuel Hatzipantelis
- 2nd Hematology Oncology Unit, 2nd Pediatric Department; Aristotle University of Thessaloniki, AHEPA Hospital; Thessaloniki Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology; University of Crete; Heraklion Greece
| | - Helen Dana
- Department of Pediatric Hematology-Oncology; “Mitera” Children's Hospital; Athens Greece
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
| | - Luis Antunes
- North Region Cancer Registry of Portugal (RORENO), Portuguese Institute of Oncology; Porto Portugal
| | - Joana Bastos
- Registo Oncológico Regional do Centro (ROR-Centro), Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E.; Coimbra Portugal
| | - Daniela Coza
- The Oncology Institute “Prof. Dr. Ion Chiricuţă”; Cluj-Napoca Romania
| | - Anna Demetriou
- Health Monitoring Unit, Ministry of Health; Nicosia Cyprus
| | - Domenic Agius
- Department for Policy in Health - Health Information and Research; Malta National Cancer Registry; Pieta Malta
| | - Sultan Eser
- Izmir Cancer Registry, Izmir Hub, Izmir and Hacettepe; University Institute of Public Health; Ankara Turkey
| | - Raluca Gheorghiu
- Regional Cancer Registry, National Institute of Public Health; Iasi Romania
| | - Mario Sekerija
- Croatian Institute of Public Health, Croatian National Cancer Registry; Zagreb Croatia
- Andrija Štampar School of Public Health, School of Medicine; University of Zagreb; Zagreb Croatia
| | - Maciej Trojanowski
- Wielkopolskie Centrum Onkologii, Poznan University of Medical Sciences; Poznan Poland
| | - Tina Zagar
- Cancer Registry of Slovenia, Institute of Oncology Ljubljana; Ljubljana Slovenia
| | - Anna Zborovskaya
- Belarusian Research Center for Paediatric Oncology, Haematology and Immunology; Childhood Cancer Subregistry of Belarus; Minsk Belarus
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer; Kiev Ukraine
| | - Athanassios Tragiannidis
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
- 2nd Hematology Oncology Unit, 2nd Pediatric Department; Aristotle University of Thessaloniki, AHEPA Hospital; Thessaloniki Greece
| | - Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
- Fourth Department of Pediatrics; Medical School, General Hospital “Papageorgiou”, Aristotle University of Thessaloniki; Thessaloniki Greece
| | | | - Eleni Th. Petridou
- Department of Hygiene, Epidemiology and Medical Statistics Medical School; National and Kapodistrian University of Athens; Athens, Greece
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