1
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Castresana-Aguirre M, Guala D, Sonnhammer ELL. Benefits and Challenges of Pre-clustered Network-Based Pathway Analysis. Front Genet 2022; 13:855766. [PMID: 35620466 PMCID: PMC9127507 DOI: 10.3389/fgene.2022.855766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/25/2022] [Indexed: 12/13/2022] Open
Abstract
Functional analysis of gene sets derived from experiments is typically done by pathway annotation. Although many algorithms exist for analyzing the association between a gene set and a pathway, an issue which is generally ignored is that gene sets often represent multiple pathways. In such cases an association to a pathway is weakened by the presence of genes associated with other pathways. A way to counteract this is to cluster the gene set into more homogenous parts before performing pathway analysis on each module. We explored whether network-based pre-clustering of a query gene set can improve pathway analysis. The methods MCL, Infomap, and MGclus were used to cluster the gene set projected onto the FunCoup network. We characterized how well these methods are able to detect individual pathways in multi-pathway gene sets, and applied each of the clustering methods in combination with four pathway analysis methods: Gene Enrichment Analysis, BinoX, NEAT, and ANUBIX. Using benchmarks constructed from the KEGG pathway database we found that clustering can be beneficial by increasing the sensitivity of pathway analysis methods and by providing deeper insights of biological mechanisms related to the phenotype under study. However, keeping a high specificity is a challenge. For ANUBIX, clustering caused a minor loss of specificity, while for BinoX and NEAT it caused an unacceptable loss of specificity. GEA had very low sensitivity both before and after clustering. The choice of clustering method only had a minor effect on the results. We show examples of this approach and conclude that clustering can improve overall pathway annotation performance, but should only be used if the used enrichment method has a low false positive rate.
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Affiliation(s)
| | | | - Erik L. L. Sonnhammer
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
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2
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Human T-Lymphotropic virus type 1 infection in absence of tax gene: A challenge for molecular diagnosis. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 90:104765. [PMID: 33578000 DOI: 10.1016/j.meegid.2021.104765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 01/02/2021] [Accepted: 02/06/2021] [Indexed: 01/01/2023]
Abstract
This is the first report of HTLV-1 infection without detectable tax gene. Even though the tax gene of HTLV-1 presents high genetic stability, in the case presented here no sequence of tax was detected by three different and widely used molecular assays targeting several sequences of the gene. Nevertheless, HTLV-1 pol and env genes and LTR region were properly detectable. Several PCRs targeting tax sequences have been developed and largely used for molecular diagnosis of HTLV infection since the tax gene of HTLV-1 is known to be well preserved and intolerant to changes or mutations. In the case reported here, molecular detection of the virus was challenging. HTLV prevalence is complex and in many regions remains unknown. The identification of HTLV-infected individuals is important to determine its actual prevalence and design strategies to reduce viral spread. The finding and communication of HTLV-1 defective-provirus strains is important and necessary to guide the selection of representative target sequences on HTLV genome to design molecular assays, highlighting that different sequences should be combined to ensure adequate diagnosis. The latter is especially relevant in cases when discordant results between serological and molecular assays. This report contributes to the knowledge of the overall molecular epidemiology of HTLV-1 and encourages the need of surveillance of HTLV-1 "missed tax gene profiles" and the evaluation of the impact of these defective viral variants on molecular diagnosis and human health.
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3
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Single-Cell Heterogeneity of Cutaneous T-Cell Lymphomas Revealed Using RNA-Seq Technologies. Cancers (Basel) 2020; 12:cancers12082129. [PMID: 32751918 PMCID: PMC7464763 DOI: 10.3390/cancers12082129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 01/04/2023] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) represent a large, heterogeneous group of non-Hodgkin lymphomas that primarily affect the skin. Among multiple CTCL variants, the most prevalent types are mycosis fungoides (MF) and Sézary syndrome (SS). In the past decade, the molecular genetics of CTCL have been the target of intense study, increasing the knowledge of CTCL genomic alterations, discovering novel biomarkers, and potential targets for patient-specific therapy. However, the detailed pathogenesis of CTCL development still needs to be discovered. This review aims to summarize the novel insights into molecular heterogeneity of malignant cells using high-throughput technologies, such as RNA sequencing and single-cell RNA sequencing, which might be useful to identify tumour-specific molecular signatures and, therefore, offer guidance for therapy, diagnosis, and prognosis of CTCL.
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4
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Dotimas J, Das M, Martin D. Cutaneous T-cell lymphoma in the setting of anti-tumor necrosis factor and immunomodulator therapy: A case report and literature review. SAGE Open Med Case Rep 2020; 8:2050313X20937223. [PMID: 32655868 PMCID: PMC7328350 DOI: 10.1177/2050313x20937223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/31/2020] [Indexed: 01/23/2023] Open
Abstract
Immunosuppressive therapy is well recognized as increasing the risk of lymphoma. Mycosis fungoides is a rare cutaneous form of T-cell lymphoma with a largely unknown etiology and not typically associated with immunosuppression. In this article, we describe our encounter with a 24-year-old male with Crohn’s disease in remission on immunotherapy, specifically dual therapy with azathioprine and infliximab, presenting with a facial rash found to be consistent with mycosis fungoides on biopsy. The patient’s rash resolved with treatment of topical steroids. In addition, the decision was made to discontinue his azathioprine to minimize his risks of developing future malignancies.
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Affiliation(s)
- James Dotimas
- The University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Manjusha Das
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Daniel Martin
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The University of Illinois College of Medicine at Peoria, Peoria, IL, USA
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5
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Gallego S, Frutos MC, Blanco S, Castro G, Balangero M, Elías Panigo D, Mangeaud A, Remondegui C, Santos Rocha A, Melo Franco G, Lobato Martins M, Barbosa-Stancioli EF, Nates S. First Description of Seronegative HTLV-1 Carriers in Argentina. Am J Trop Med Hyg 2020; 102:889-895. [PMID: 32043459 DOI: 10.4269/ajtmh.19-0647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In some areas of Argentina endemic for human T-lymphotropic virus type 1 (HTLV-1), tropical spastic paraparesis is frequent in subjects who lack antibodies against the virus; however, the relevance of this seronegative status in the country has not been investigated. In neighboring countries, HTLV-1 seronegative status has been described in patients with different diseases; however, data regarding features of seronegative HTLV-1 carriers are scarce. We investigated the seronegative status in 124 relatives of 28 HTLV-1 infected subjects from an endemic area in Northwest Argentina. Blood samples and clinical/epidemiological data were collected. Human T-lymphotropic virus type 1 infection was diagnosed by serology and long terminal repeat (LTR) sequence, env and tax gene detection. IgG anti-Tax HTLV-1 antibody, tax gene sequence, and DNA proviral load were also evaluated. Seventy-five percent of the 124 relatives were negative for HTLV-1/2 antibodies; 35.5% were also negative by molecular assays and 64.5% were negative for HTLV-1 LTR and env sequences, but positive for two sequences of HTLV-1 tax gene. Also, 35.7% of these subjects had IgG anti-Tax antibodies. The seronegative HTLV-1 status was significantly associated with male gender, youth, and sensory symptoms/autonomic nervous system dysfunction. High rates of seronegative symptomatic and asymptomatic HTLV-1 carriers in Argentina are described. The evidence highlights that HTLV-1 prevalence may be underestimated worldwide. Larger cohort studies are required to assess disease outcome in these seronegative subjects. Also, the findings emphasize the limitations of ongoing screening assays for diagnosis and blood safety. Therefore, algorithms for HTLV-1 diagnosis should include not only serological but also molecular assays.
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Affiliation(s)
- Sandra Gallego
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María C Frutos
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Sebastián Blanco
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Gonzalo Castro
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Marcos Balangero
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - David Elías Panigo
- Departamento de Matemática, Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Arnaldo Mangeaud
- Departamento de Matemática, Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carlos Remondegui
- Servicio de Infectología y Enfermedades Tropicales, Hospital San Roque, San Salvador de Jujuy, Argentina
| | - Anderson Santos Rocha
- Interdisciplinary HTLV Research Group, Belo Horizonte, Brasil.,Laboratorio de Virología Básica e Aplicada, Departamento de Microbiología, Instituto de Ciencias Biológicas, Universidad Federal de Minas Gerais-UFMG, Belo Horizonte, Brasil
| | - Gabriela Melo Franco
- Interdisciplinary HTLV Research Group, Belo Horizonte, Brasil.,Laboratorio de Virología Básica e Aplicada, Departamento de Microbiología, Instituto de Ciencias Biológicas, Universidad Federal de Minas Gerais-UFMG, Belo Horizonte, Brasil
| | | | - Edel Figueiredo Barbosa-Stancioli
- Interdisciplinary HTLV Research Group, Belo Horizonte, Brasil.,Laboratorio de Virología Básica e Aplicada, Departamento de Microbiología, Instituto de Ciencias Biológicas, Universidad Federal de Minas Gerais-UFMG, Belo Horizonte, Brasil
| | - Silvia Nates
- Instituto de Virología "Dr. J. M. Vanella," Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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6
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Pallazola VA, Deib G, Abha S, Geha RM, Kobayashi K. An Elusive Case of Mycosis Fungoides: Case Report and Review of the Literature. J Gen Intern Med 2019; 34:2669-2674. [PMID: 31388911 PMCID: PMC6848709 DOI: 10.1007/s11606-019-05231-z] [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: 10/19/2018] [Revised: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 11/26/2022]
Abstract
Erythroderma refers to a spectrum of skin diseases resulting in diffuse erythema and scaling encompassing ≥ 90% of the body surface area. The differential diagnosis ranges from primary dermatologic diseases such as atopic dermatitis and psoriasis to potentially deadly causes such as staphylococcal toxic shock syndrome, toxic epidermal necrolysis, and malignancy. Cutaneous T cell lymphoma (CTCL) is an uncommon but highly morbid cause of erythroderma. This non-Hodgkin lymphoma remains a diagnostic challenge due to its variable clinical presentation and varied histologic features. Mycosis fungoides (MF) is the most common form of CTCL. Making a timely diagnosis is challenging as it may mimic inflammatory diseases of the skin including eczema, psoriasis, lichen planus, and cutaneous lupus. We present a case of a 58-year-old man who presented with 5 years of cutaneous symptoms and several months of fevers and night sweats, ultimately diagnosed as MF. Owing to diffuse CD30 positivity, he was a candidate for brentuximab vedotin, an antibody-drug conjugate medication that selectively targets the CD30 antigen. This resulted in an excellent therapeutic response.
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Affiliation(s)
- Vincent A Pallazola
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
| | - Gerard Deib
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Soni Abha
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rabih M Geha
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Medical Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Kimiyoshi Kobayashi
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
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7
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Martinez XU, Di Raimondo C, Abdulla FR, Zain J, Rosen ST, Querfeld C. Leukaemic variants of cutaneous T-cell lymphoma: Erythrodermic mycosis fungoides and Sézary syndrome. Best Pract Res Clin Haematol 2019; 32:239-252. [PMID: 31585624 PMCID: PMC9056079 DOI: 10.1016/j.beha.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 01/22/2023]
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common types of cutaneous lymphoma, accounting for approximately 60% of cutaneous T-cell lymphomas. Diagnosis requires correlation of clinical, histologic, and molecular features. A multitude of factors have been linked to the aetiopathogenesis, however, none have been definitively proven. Erythrodermic MF (E-MF) and SS share overlapping clinical features, such as erythroderma, but are differentiated on the degree of malignant blood involvement. While related, they are considered to be two distinct entities originating from different memory T cell subsets. Differential expression of PD-1 and KIR3DL2 may represent a tool for distinguishing MF and SS, as well as a means of monitoring treatment response. Treatment of E-MF/SS is guided by disease burden, patients' ages and comorbidities, and effect on quality of life. Current treatment options include biologic, targeted, immunologic, and investigational therapies that can provide long term response with minimal side effects. Currently, allogeneic stem cell transplantation is the only potential curative treatment.
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Affiliation(s)
| | - Cosimo Di Raimondo
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - Farah R Abdulla
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
| | - Jasmine Zain
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
| | - Steven T Rosen
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, United States.
| | - Christiane Querfeld
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, United States.
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8
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Ghazawi FM, Alghazawi N, Le M, Netchiporouk E, Glassman SJ, Sasseville D, Litvinov IV. Environmental and Other Extrinsic Risk Factors Contributing to the Pathogenesis of Cutaneous T Cell Lymphoma (CTCL). Front Oncol 2019; 9:300. [PMID: 31106143 PMCID: PMC6499168 DOI: 10.3389/fonc.2019.00300] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/01/2019] [Indexed: 01/17/2023] Open
Abstract
The applications of disease cluster investigations in medicine have developed rather rapidly in recent decades. Analyzing the epidemiology of non-random aggregation of patients with a particular disease fostered identification of environmental and external exposures as disease triggers and promoters. Observation of patient clusters and their association with nearby exposures, such as Dr. John Snow's astute mapping analysis in the mid-1800's, which revealed proximity of cholera patients in London to a contaminated water pump infected with Vibrio cholerae, have paved the way for the field of epidemiology. This approach enabled the identification of triggers for many human diseases including infections and cancers. Cutaneous T-cell lymphomas (CTCL) represent a group of non-Hodgkin lymphomas that primarily affect the skin. The detailed pathogenesis by which CTCL develops remains largely unknown. Notably, non-random clustering of CTCL patients was reported in several areas worldwide and this rare malignancy was also described to affect multiple members of the same family. These observations indicate that external factors are possibly implicated in promoting CTCL lymphomagenesis. Here, we review the epidemiology of CTCL worldwide and the clinical characteristics of CTCL patients, as revealed by global epidemiological data. Further, we review the known risk factors including sex, age, race as well as environmental, infectious, iatrogenic and other exposures, that are implicated in CTCL lymphomagenesis and discuss conceivable mechanisms by which these factors may trigger this malignancy.
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Affiliation(s)
- Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | - Nebras Alghazawi
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Michelle Le
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | | | | | - Denis Sasseville
- Division of Dermatology, McGill University, Montréal, QC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University, Montréal, QC, Canada
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9
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Querfeld C, Zain J, Rosen ST. Primary Cutaneous T-Cell Lymphomas: Mycosis Fungoides and Sezary Syndrome. Cancer Treat Res 2019; 176:225-248. [PMID: 30596221 DOI: 10.1007/978-3-319-99716-2_11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mycosis fungoides and Sézary syndrome are the most common subtypes of all primary cutaneous lymphomas and represent complex diseases that require a multidisciplinary assessment by dermatologists, oncologists, and pathologists. Staging and work-up are critical to guarantee an optimal treatment plan that includes skin-directed and/or systemic regimens depending on the clinical stage, tumor burden, drug-related side effect profile, and patient comorbidities. However, there is no cure and patients frequently relapse, requiring repeated treatment courses for disease control. The study of the tumor microenvironment and molecular mechanisms of these rare neoplasms may assist in the development of new immune therapies providing promising treatment approaches tailored for patients with relapse/refractory disease.
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Affiliation(s)
- Christiane Querfeld
- Division of Dermatology, City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
- Department of Hematology/Hematopoietic Cell Transplantation, Duarte, USA.
- Department of Pathology, Duarte, USA.
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA.
| | - Jasmine Zain
- Department of Hematology/Hematopoietic Cell Transplantation, Duarte, USA
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Steven T Rosen
- Department of Hematology/Hematopoietic Cell Transplantation, Duarte, USA
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA
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10
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Abstract
T-cell lymphoma, a collection of subtypes of Non-Hodgkin lymphoma, is a rare malignancy. The low prevalence of this disease has made it challenging to identify subtype-specific risk factors. Potential risk factors could enable us to identify high-risk patients and predict patient outcomes. Here, we report on the current epidemiologic and prognostic factors data associated with the individual subtypes both of peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) found in large cohort and case studies. Additionally, with recent findings, as well as updates in the new World Health Organization (WHO) classification of lymphoid neoplasms, we consider what this could do to change our approach to this group of diseases.
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11
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Keehn CA, Belongie IP, Shistik G, Fenske NA, Glass LF. The Diagnosis, Staging, and Treatment Options for Mycosis Fungoides. Cancer Control 2017; 14:102-11. [PMID: 17387295 DOI: 10.1177/107327480701400203] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Cutaneous T-cell lymphoma (CTCL) represents a spectrum of diseases composed of malignant T lymphocytes. The most common type is mycosis fungoides (MF). An accurate diagnosis of early MF may be difficult because of the varied clinical and histologic expressions of the disease. Methods The authors review the epidemiology, possible risk factors, clinical manifestations, diagnostic techniques, staging, prognosis, and treatment options for MF. Results The varied and often nonspecific clinical and bistologic presentations of MF may delay diagnosis and staging, thus necessitating further studies such as immunophenotyping and T-cell receptor gene rearrangement analysis. Conclusions A multidisciplinary approach to the diagnosis, staging, and treatment of MF assists in optimizing outcomes from management of patients with this disease.
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Affiliation(s)
- Connie A Keehn
- Cutaneous Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
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12
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Fava P, Bergallo M, Astrua C, Brizio M, Galliano I, Montanari P, Tovo PA, Novelli M, Savoia P, Quaglino P, Fierro MT. Human Endogenous Retrovirus Expression in Primary Cutaneous T-Cell Lymphomas. Dermatology 2015; 232:38-43. [DOI: 10.1159/000438669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/12/2015] [Indexed: 11/19/2022] Open
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13
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Dulmage BO, Feng H, Mirvish E, Geskin L. Black cat in a dark room: the absence of a directly oncogenic virus does not eliminate the role of an infectious agent in cutaneous T-cell lymphoma pathogenesis. Br J Dermatol 2015; 172:1449-51. [PMID: 25385510 DOI: 10.1111/bjd.13519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- B O Dulmage
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, U.S.A
| | - H Feng
- Cancer Virology Program, University of Pittsburgh Cancer Institute, Pittsburgh, PA, U.S.A
| | - E Mirvish
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, U.S.A
| | - L Geskin
- Department of Dermatology, Columbia University, 161 Fort Washington Avenue, 12th Floor, New York, NY, 10032, U.S.A
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14
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Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome). J Am Acad Dermatol 2014; 70:205.e1-16; quiz 221-2. [DOI: 10.1016/j.jaad.2013.07.049] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 06/25/2013] [Accepted: 07/01/2013] [Indexed: 02/08/2023]
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15
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Abstract
The etiology of cutaneous T-cell lymphoma (CTCL) remains unknown, with potential infectious causes having been explored. This contribution evaluates the evidence suggesting an infectious etiology and pathogenesis of the disease, characterizes the relationships between various specific pathogens and CTCL, and discusses some of the difficulties in establishing a causal link between infectious agents and CTCL carcinogenesis. Researchers have evaluated CTCL specimens for evidence of infection with a variety of agents, including human T-lymphotropic virus, Epstein-Barr virus, human herpesvirus-8, and Staphylococcus aureus, although other pathogens also have been detected in CTCL. Although there is significant evidence implicating one or more infectious agents in CTCL, studies to date have not linked definitively any pathogen to disease development, and various studies have yielded conflicting results.
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16
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Malignant diseases and mortality in blood donors infected with human T-lymphotropic virus type 1 in Israel. Int J Infect Dis 2013; 17:e1022-4. [DOI: 10.1016/j.ijid.2013.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 03/04/2013] [Accepted: 03/10/2013] [Indexed: 11/17/2022] Open
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17
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Maliniemi P, Vincendeau M, Mayer J, Frank O, Hahtola S, Karenko L, Carlsson E, Mallet F, Seifarth W, Leib-Mösch C, Ranki A. Expression of human endogenous retrovirus-w including syncytin-1 in cutaneous T-cell lymphoma. PLoS One 2013; 8:e76281. [PMID: 24098463 PMCID: PMC3788054 DOI: 10.1371/journal.pone.0076281] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 08/22/2013] [Indexed: 12/03/2022] Open
Abstract
The pathomechanism of mycosis fungoides (MF), the most common type of primary cutaneous T-cell lymphomas (CTCLs) and a malignancy of non-recirculating, skin-resident T-cells, is unknown albeit underlying viral infections have been sought for. Human endogenous retroviruses (HERVs) are ancient retroviral sequences in the human genome and their transcription is often deregulated in cancers. We explored the transcriptional activity of HERV sequences in a total of 34 samples comprising MF and psoriasis skin lesions, as well as corresponding non-malignant skin using a retrovirus-specific microarray and quantitative RT-PCR. To identify active HERV-W loci, we cloned the HERV-W specific RT-PCR products, sequenced the cDNA clones and assigned the sequences to HERV-W loci. Finally, we used immunohistochemistry on MF patient and non-malignant inflammatory skin samples to confirm specific HERV-encoded protein expression. Firstly, a distinct, skin-specific transcription profile consisting of five constitutively active HERV groups was established. Although individual variability was common, HERV-W showed significantly increased transcription in MF lesions compared to clinically intact skin from the same patient. Predominantly transcribed HERV-W loci were found to be located in chromosomes 6q21 and 7q21.2, chromosomal regions typically altered in CTCL. Surprisingly, we also found the expression of 7q21.2/ERVWE1-encoded Syncytin-1 (Env) protein in MF biopsies and expression of Syncytin-1 was seen in malignant lymphocytes, especially in the epidermotropic ones, in 15 of 30 cases studied. Most importantly, no Syncytin-1 expression was detected in inflammatory dermatosis (Lichen ruber planus) with skin-homing, non-malignant T lymphocytes. The expression of ERVWE1 mRNA was further confirmed in 3/7 MF lesions analyzed. Our observations strengthen the association between activated HERVs and cancer. The study offers a new perspective into the pathogenesis of CTCL since we demonstrate that differences in HERV-W transcription levels between lesional MF and non-malignant skin are significant, and that ERVWE1-encoded Syncytin-1 is expressed in MF lymphoma cells.
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Affiliation(s)
- Pilvi Maliniemi
- Department of Dermatology and Allergology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Michelle Vincendeau
- Institute of Virology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Research Unit Cellular Signal Integration, Institute of Molecular Toxicology and Pharmacology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Jens Mayer
- Department of Human Genetics, Center of Human and Molecular Biology, Medical Faculty, University of Saarland, Homburg, Germany
| | - Oliver Frank
- Department of Hematology and Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, Germany
| | - Sonja Hahtola
- Department of Dermatology and Allergology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Leena Karenko
- Department of Dermatology and Allergology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Emilia Carlsson
- Department of Dermatology and Allergology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Francois Mallet
- Joint Unit Hospices Civils de Lyon-bioMérieux, Cancer Biomarkers Research Group, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Wolfgang Seifarth
- Department of Hematology and Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, Germany
| | - Christine Leib-Mösch
- Institute of Virology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Department of Hematology and Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, Germany
| | - Annamari Ranki
- Department of Dermatology and Allergology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
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Glowacka I, Korn K, Potthoff SA, Lehmann U, Kreipe HH, Ivens K, Barg-Hock H, Schulz TF, Heim A. Delayed Seroconversion and Rapid Onset of Lymphoproliferative Disease After Transmission of Human T-Cell Lymphotropic Virus Type 1 From a Multiorgan Donor. Clin Infect Dis 2013; 57:1417-24. [DOI: 10.1093/cid/cit545] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Willerslev-Olsen A, Krejsgaard T, Lindahl LM, Bonefeld CM, A. Wasik M, B. Koralov S, Geisler C, Kilian M, Iversen L, Woetmann A, Odum N. Bacterial toxins fuel disease progression in cutaneous T-cell lymphoma. Toxins (Basel) 2013; 5:1402-21. [PMID: 23949004 PMCID: PMC3760043 DOI: 10.3390/toxins5081402] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 08/02/2013] [Accepted: 08/06/2013] [Indexed: 01/02/2023] Open
Abstract
In patients with cutaneous T-cell lymphoma (CTCL) bacterial infections constitute a major clinical problem caused by compromised skin barrier and a progressive immunodeficiency. Indeed, the majority of patients with advanced disease die from infections with bacteria, e.g., Staphylococcus aureus. Bacterial toxins such as staphylococcal enterotoxins (SE) have long been suspected to be involved in the pathogenesis in CTCL. Here, we review links between bacterial infections and CTCL with focus on earlier studies addressing a direct role of SE on malignant T cells and recent data indicating novel indirect mechanisms involving SE- and cytokine-driven cross-talk between malignant- and non-malignant T cells.
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Affiliation(s)
- Andreas Willerslev-Olsen
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
| | - Thorbjørn Krejsgaard
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
| | - Lise M. Lindahl
- Department of Dermatology, Aarhus University Hospital, Aarhus 8000, Denmark; E-Mails: (L.M.L.); (L.I.)
| | - Charlotte Menne Bonefeld
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
| | - Mariusz A. Wasik
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; E-Mail:
| | - Sergei B. Koralov
- Department of Pathology, NYU Langone Medical Center, New York, NY 10016, USA; E-Mail:
| | - Carsten Geisler
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
| | - Mogens Kilian
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark; E-Mail:
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus 8000, Denmark; E-Mails: (L.M.L.); (L.I.)
| | - Anders Woetmann
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
| | - Niels Odum
- Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen 2200, Denmark; E-Mails: (A.W.-O.); (T.K.); (C.M.B.); (C.G.); (A.W.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +45-3532-7879
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20
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Coelho-dos-Reis JGA, Passos L, Duarte MC, Araújo MG, Campi-Azevedo AC, Teixeira-Carvalho A, Peruhype-Magalhães V, Trindade BC, dos Santos Dias R, Martins ML, Carneiro-Proietti ABDF, Guedes AC, Gonçalves DU, Martins-Filho OA. Immunological profile of HTLV-1-infected patients associated with infectious or autoimmune dermatological disorders. PLoS Negl Trop Dis 2013; 7:e2328. [PMID: 23936564 PMCID: PMC3723575 DOI: 10.1371/journal.pntd.0002328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 06/14/2013] [Indexed: 11/19/2022] Open
Abstract
In the present study, the frequency, the activation and the cytokine and chemokine profile of HTLV-1 carriers with or without dermatological lesions were thoroughly described and compared. The results indicated that HTLV-1-infected patients with dermatological lesions have distinct frequency and activation status when compared to asymptomatic carriers. Alterations in the CD4(+)HLA-DR(+), CD8(+) T cell, macrophage-like and NKT subsets as well as in the serum chemokines CCL5, CXCL8, CXCL9 and CXCL10 were observed in the HTLV-1-infected group with skin lesions. Additionally, HTLV-1 carriers with dermatological skin lesions showed more frequently high proviral load as compared to asymptomatic carriers. The elevated proviral load in HTLV-1 patients with infectious skin lesions correlated significantly with TNF-α/IL-10 ratio, while the same significant correlation was found for the IL-12/IL-10 ratio and the high proviral load in HTLV-1-infected patients with autoimmune skin lesions. All in all, these results suggest a distinct and unique immunological profile in the peripheral blood of HTLV-1-infected patients with skin disorders, and the different nature of skin lesion observed in these patients may be an outcome of a distinct unbalance of the systemic inflammatory response upon HTLV-1 infection.
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Affiliation(s)
- Jordana Grazziela Alves Coelho-dos-Reis
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Aaron Diamond AIDS Research Center, Rockefeller University, New York, New York, United States of America
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | - Livia Passos
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Costa Duarte
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Grossi Araújo
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Campi-Azevedo
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa Peruhype-Magalhães
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Caetano Trindade
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel dos Santos Dias
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Lobato Martins
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | | | - Antônio Carlos Guedes
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Utsch Gonçalves
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Olindo Assis Martins-Filho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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21
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No evidence for viral sequences in mycosis fungoides and Sézary syndrome skin lesions: a high-throughput sequencing approach. J Invest Dermatol 2012; 133:853-855. [PMID: 23096719 DOI: 10.1038/jid.2012.371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Fontaine J, Heimann M, Day MJ. Cutaneous epitheliotropic T-cell lymphoma in the cat: a review of the literature and five new cases. Vet Dermatol 2011; 22:454-61. [DOI: 10.1111/j.1365-3164.2011.00972.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Abstract
Mycosis fungoides is the most common type of primary cutaneous lymphomas. The phenotype of the tumor cell corresponds to an effector/memory-type of helper T cell which, given its repertoire of homing receptors, is specialized for recirculation through the skin. In recent years genetic analyses have uncovered various chromosomal aberrations in the tumour cells of mycosis fungoides. Their relevance to the pathogenesis and clinical appearance are discussed in the following.
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Affiliation(s)
- Marc Beyer
- Department of Dermatology, Venereology and Allergology, Charité- Universitätsmedizin Berlin, Germany.
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24
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Bonin S, Tothova SM, Barbazza R, Brunetti D, Stanta G, Trevisan G. Evidence of multiple infectious agents in mycosis fungoides lesions. Exp Mol Pathol 2010; 89:46-50. [PMID: 20470773 DOI: 10.1016/j.yexmp.2010.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 05/05/2010] [Accepted: 05/05/2010] [Indexed: 11/16/2022]
Abstract
The etiology of mycosis fungoides (MF) remains to be determined. Several studies have proposed a viral etiology with controversial results. In this case-control study we investigated the presence of Epstein-Barr virus (EBV) and the debated presence of Human T-cell lymphotrophic virus I (HTLV-I) sequences, by polymerase chain reaction on nucleic acid extracts from formalin-fixed paraffin-embedded skin biopsies. Moreover, by a multivariate approach we analyzed in the same case-control study also the contribution of two previously examined pathogens: Hepatitis C virus (HCV) and Borrelia burgdorferi (Bb). Significant differences in the frequency of infectious agents in cases and controls were detected for Bb, HTLV-I and EBV. In MF patients we found the concurrent presence of two or three of these pathogen sequences in 21 out of 83 cases, but only in 1 out of 83 healthy controls. Our results suggest that the persistence of multiple infectious agents may cause a long-term antigenic stimulation contributing to the malignant transformation of T lymphocytes, especially when associated with HTLV-I like sequences. However, these infectious agents do not seem to have effects on disease progression.
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Affiliation(s)
- Serena Bonin
- ACADEM Department, Unit of Dermatology, University of Trieste, Trieste, Italy
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25
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D'Acunto C, Gurioli C, Neri I. Plaque stage mycosis fungoides treated with bexarotene at low dosage and UVB-NB. J DERMATOL TREAT 2010; 21:45-8. [DOI: 10.3109/09546630903103980] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Courgnaud V, Duthanh A, Guillot B, Sitbon M, Dereure O. Absence of HTLV-Related Sequences in Skin Lesions and Peripheral Blood of Cutaneous T-Cell Lymphomas. J Invest Dermatol 2009; 129:2520-2. [DOI: 10.1038/jid.2009.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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27
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Fontaine J, Bovens C, Bettenay S, Mueller RS. Canine cutaneous epitheliotropic T-cell lymphoma: a review. Vet Comp Oncol 2009; 7:1-14. [DOI: 10.1111/j.1476-5829.2008.00176.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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28
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Epstein-Barr virus in cutaneous T-cell lymphomas: evaluation of the viral presence and significance in skin and peripheral blood. J Invest Dermatol 2009; 129:1556-61. [PMID: 19131945 DOI: 10.1038/jid.2008.396] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The importance of viral agents in the development of cutaneous T-cell lymphomas (CTCL) is still debated. For this purpose, we retrospectively evaluated the Epstein-Barr virus (EBV) presence in Sézary syndrome (SS), mycosis fungoides (MF), inflammatory dermatoses (ID), and healthy donors (HD) using different approaches: EBV-DNA was quantified in skin biopsies and peripheral blood using real-time PCR, EBV-encoded small RNA (EBER) transcripts were detected by in situ hybridization (ISH), and latent membrane protein1-2 antigens were detected by immunohistochemistry. Skin biopsies were EBV-DNA-positive in 8/30 (27%) SS, 7/71 (10%) MF, and 2/18 (11%) ID patients and in none of the 25 normal skin samples. Positive mRNA (EBER) signals, always confined to cerebriform T lymphocytes, were found in 5/30 SS patients (17%), whereas signals in all MF and ID patients were negative. The presence of EBV-DNA in skin and blood samples was associated with a significantly lower survival in MF/SS patients. In evaluating EBV serological status, most (>70%) SS, MF, and ID patients showed a serological reactivation demonstrated by the presence of anti-EA IgG. In conclusion, although the finding of EBV-DNA in CTCL does not prove its etiopathogenetic role and may be related instead to immunosuppression, our study demonstrates that it has prognostic relevance.
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29
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Rodríguez-Gil Y, Palencia SI, López-Ríos F, Ortiz PL, Rodríguez-Peralto JL. Mycosis Fungoides After Solid-Organ Transplantation: Report of 2 New Cases. Am J Dermatopathol 2008; 30:150-5. [DOI: 10.1097/dad.0b013e318164cf6e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Adult T-cell lymphoma with HTLV-I and HTLV-II infection. South Med J 2007; 100:1178-9. [PMID: 17984755 DOI: 10.1097/smj.0b013e318157efef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Tothova SM, Bonin S, Trevisan G, Stanta G. Mycosis fungoides: is it a Borrelia burgdorferi-associated disease? Br J Cancer 2006; 94:879-83. [PMID: 16495924 PMCID: PMC2361364 DOI: 10.1038/sj.bjc.6602997] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Mycosis fungoides (MF) is the most frequently found cutaneous T-cell lymphoma with an unknown aetiology. Several aetiopathogenetic mechanisms have been postulated, including persistent viral or bacterial infections. We looked for evidence of Borrelia burgdorferi (Bb), the aetiologic agent of Lyme disease (LD), in a case study of MF patients from Northeastern Italy, an area with endemic LD. Polymerase chain reaction for the flagellin gene of Bb was used to study formalin-fixed paraffin-embedded lesional skin biopsies from 83 patients with MF and 83 sex- and age-matched healthy controls with homolocalised cutaneous nevi. Borrelia burgdorferi-specific sequence was detected in 15 out of 83 skin samples of patients with MF (18.1%), but in none out of 83 matched healthy controls (P<0.0001). The Bb positivity rates detected in this study support a possible role for Bb in the aetiopathogenesis of MF in a population endemic for LD.
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Affiliation(s)
- S Miertusova Tothova
- ICGEB – International Centre for Genetic Engineering and Biotechnology, 99 Padriciano, Trieste 34012, Italy
| | - S Bonin
- ICGEB – International Centre for Genetic Engineering and Biotechnology, 99 Padriciano, Trieste 34012, Italy
- Department of Clinical, Morphological and Technological Sciences, University of Trieste, 1-Dermatology Unit, 2-Pathology Unit, Cattinara Hospital, 447 Strada di Fiume, Trieste 34149, Italy
| | - G Trevisan
- Department of Clinical, Morphological and Technological Sciences, University of Trieste, 1-Dermatology Unit, 2-Pathology Unit, Cattinara Hospital, 447 Strada di Fiume, Trieste 34149, Italy
| | - G Stanta
- ICGEB – International Centre for Genetic Engineering and Biotechnology, 99 Padriciano, Trieste 34012, Italy
- Department of Clinical, Morphological and Technological Sciences, University of Trieste, 1-Dermatology Unit, 2-Pathology Unit, Cattinara Hospital, 447 Strada di Fiume, Trieste 34149, Italy
- ICGEB – International Centre for Genetic Engineering and Biotechnology, 99 Padriciano, Trieste 34012, Italy. E-mail:
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Awasthi S, Sharma A, Wong K, Zhang J, Matlock EF, Rogers L, Motloch P, Takemoto S, Taguchi H, Cole MD, Lüscher B, Dittrich O, Tagami H, Nakatani Y, McGee M, Girard AM, Gaughan L, Robson CN, Monnat RJ, Harrod R. A human T-cell lymphotropic virus type 1 enhancer of Myc transforming potential stabilizes Myc-TIP60 transcriptional interactions. Mol Cell Biol 2005; 25:6178-98. [PMID: 15988028 PMCID: PMC1168837 DOI: 10.1128/mcb.25.14.6178-6198.2005] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The human T-cell lymphotropic virus type 1 (HTLV-1) infects and transforms CD4+ lymphocytes and causes adult T-cell leukemia/lymphoma (ATLL), an aggressive lymphoproliferative disease that is often fatal. Here, we demonstrate that the HTLV-1 pX splice-variant p30II markedly enhances the transforming potential of Myc and transcriptionally activates the human cyclin D2 promoter, dependent upon its conserved Myc-responsive E-box enhancer elements, which are associated with increased S-phase entry and multinucleation. Enhancement of c-Myc transforming activity by HTLV-1 p30II is dependent upon the transcriptional coactivators, transforming transcriptional activator protein/p434 and TIP60, and it requires TIP60 histone acetyltransferase (HAT) activity and correlates with the stabilization of HTLV-1 p30II/Myc-TIP60 chromatin-remodeling complexes. The p30II oncoprotein colocalizes and coimmunoprecipitates with Myc-TIP60 complexes in cultured HTLV-1-infected ATLL patient lymphocytes. Amino acid residues 99 to 154 within HTLV-1 p30II interact with the TIP60 HAT, and p30II transcriptionally activates numerous cellular genes in a TIP60-dependent or TIP60-independent manner, as determined by microarray gene expression analyses. Importantly, these results suggest that p30II functions as a novel retroviral modulator of Myc-TIP60-transforming interactions that may contribute to adult T-cell leukemogenesis.
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Affiliation(s)
- Soumya Awasthi
- Laboratory of Molecular Virology, Department of Biological Sciences, Southern Methodist University, 334-DLS, 6501 Airline Drive, Dallas, TX 75275-0376.
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Morozov VA, Syrtsev AV, Ellerbrok H, Nikolaeva EV, Bavykin AS, Pauli G. Mycosis fungoides in European Russia: No Antibodies to Human T Cell Leukemia Virus Type I Structural Proteins, but Virus-Like Sequences in Blood and Saliva. Intervirology 2005; 48:362-71. [PMID: 16024940 DOI: 10.1159/000086063] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Accepted: 12/07/2004] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Mycosis fungoides (MF) is the most frequent form of cutaneous T cell lymphoma (CTCL). Human T cell leukemia virus type 1 (HTLV-1) involvement in MF progression is a matter of debate. The goal of the investigation was to search for HTLV-1 markers in a group of MF patients from a nonendemic area to HTLV-1. MATERIALS AND METHODS Fifty MF patients and 60 healthy donors from Moscow and the Moscow region were examined for HTLV-1 markers by Western blot, PCR, nested PCR, PCR/Southern hybridization, TaqMan real-time PCR and sequencing. RESULTS Plasma samples from MF patients were repeatedly negative for antibodies to HTLV-1 structural proteins. HTLV-1 tax-related sequences (corresponding to the second exon) were found in blood from 20 of 50 MF patients and in 3 of 5 saliva specimens. Three of 8 sequenced tax-like amplimers were identical and 5 of 8 contained 1-2 substitutions. tax transcripts and antibodies to p40(tax) were detected in some 'PCR-tax'-positive MF patients. Defective HTLV-1 genomes were demonstrated in 2 of 50 MF patients. Phylogenetic analysis of the defective genome 5'-LTR sequence revealed a relationship with HTLV-1a sequences from the transcontinental subgroup of HTLV-1. CONCLUSIONS HTLV-1 tax-like sequences were revealed in blood and for the first time in saliva from MF patients living in an HTLV-1 nonendemic region. Expression of tax-like sequences was confirmed by both reverse transcription PCR and Western blot.
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Vonderheid EC, Boselli CM, Conroy M, Casaus L, Espinoza LC, Venkataramani P, Bigler RD, Hou JS. Evidence for Restricted Vβ Usage in the Leukemic Phase of Cutaneous T Cell Lymphoma. J Invest Dermatol 2005; 124:651-61. [PMID: 15737208 DOI: 10.1111/j.0022-202x.2004.23586.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Antibodies directed against the beta chain of the T cell receptor (anti-Vbeta antibodies) are useful to identify the Vbeta repertoire of T cells in various diseases and to quantify numbers of Vbeta-bearing T cells. The goals of this study were to identify Vbeta+ cases of leukemic phase cutaneous T cell lymphoma (CTCL) and to compare the percentage of positive calls with other measures of blood tumor burden, i.e., lymphocyte subsets with a CD4+CD7- and CD4+CD26- phenotype and Sezary cell counts. Thirty-three of 49 (67%) cases of leukemic CTCL reacted with an anti-Vbeta antibody. When combined with reports from the literature, the frequency of Vbeta5 (probably Vbeta5.1) usage was relatively high when compared with Vbeta2 that is also frequently expressed by normal CD4+ T cells. The percentage of Vbeta+ cells correlated to the percentage of CD4+CD7- and CD4+CD26- cells for cases in which the neoplastic cells were deficient in expression of CD7 and CD26, respectively, but not the Sezary cell count. We hypothesize that the increased Vbeta5.1 usage in CTCL may be the result of depletion of Vbeta2 and other Vbeta-bearing T cells by staphylococcal superantigens prior to neoplastic transformation, resulting in a relative increase in the frequency of Vbeta5.1 usage in CTCL.
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Affiliation(s)
- Eric C Vonderheid
- Department of Dermatology, Johns Hopkins Medical Institutes, Baltimore, Maryland 21205, USA.
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35
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Abstract
Epidemiological studies have demonstrated that the relative percentage of malignant lymphoid proliferations varies widely according to geographical location and ethnic populations. HTLV-I is the etiological agent of adult T-cell leukemia/lymphoma (ATLL) and is also associated with cutaneous T-cell lymphoma (CTCL). However, a definite role of HTLV-I in mycosis fungoides (MF) and/or Sezary syndrome (SS) remains controversial. While most HTLV-I-infected individuals remain asymptomatic carriers, 1-5% will develop ATLL, an invariably fatal expansion of virus-infected CD4+ T cells. This low incidence and the long latency period preceding occurrence of the disease suggest that additional factors are involved in development of ATLL. In this review, diagnosis, clinical features, and molecular pathogenesis of HTLV-I are discussed.
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Affiliation(s)
- Christophe Nicot
- Department of Microbiology, Immunology and Molecular Genetics, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
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36
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Nobre V, Guedes ACM, Proietti FA, Stanciolli E, Martins ML, Serufo JC, Antunes CM, Grossi MA, Lambertucci JR. [Dermatologic lesions in patients infected with the human T-cell lymphotropic virus type 1 (HTLV-1)]. Rev Soc Bras Med Trop 2005; 38:43-52. [PMID: 15717094 DOI: 10.1590/s0037-86822005000100009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Human T-cell Lymphotropic virus type I (HTLV-1) was the first human retrovirus described. Some time after its discovery a group of diseases were related to this virus, such as, adult T-cell leukemia lymphoma (ATLL), HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and HTLV-1 associated uveitis (HAU). In the nineties, HTLV-1 was associated to a severe eczema of children, called infective dermatitis (ID). Since then, several other skin manifestations have been observed in HTLV-1-infected individuals, particularly in patients with ATLL or HAM/TSP. However, according to some reports, dermatologic lesions are also common in asymptomatic HTLV-1 carriers. Besides ID, all other skin lesions reported are nonspecific. The aim of this review is to outline the dermatologic manifestations reported in HTLV-1 infected patients, emphasizing the clinical and epidemiological value of these findings.
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Affiliation(s)
- Vandack Nobre
- Serviço de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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37
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Sokol L, Agrawal D, Loughran TP. Characterization of HTLV envelope seroreactivity in large granular lymphocyte leukemia. Leuk Res 2004; 29:381-7. [PMID: 15725471 DOI: 10.1016/j.leukres.2004.08.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Accepted: 08/30/2004] [Indexed: 11/21/2022]
Abstract
T-cell large granular lymphocyte (T-LGL) leukemia is a rare chronic lymphoproliferative disorder of unknown etiology. We have previously reported that patients with T-LGL leukemia were seroreactive against BA21, a 34 amino acid peptide derived from HTLV-I envelope protein p21. We tested sera from 70 patients with T-LGL leukemia and found that 21/70 (30%) of them were seroreactive against fusion peptide GST-BA21. In control group of healthy blood donors 3/30 (10%) were seroreactive. We synthesized a set of overlapping peptides derived from BA21 and tested them against sera from patients. Only a single peptide (p21 env 417-430) showed reactivity. We then generated multiple fusion peptides consisting of 5-14 amino acid residues derived from this peptide and tested them against patient and control sera. Shortest peptide giving positive seroreactivity was octapeptide P8 (p21 env 418-425). Competitive Western blot assay with use of fusion peptides revealed that the minimal HTLV-I epitope responsible for seroreactivity found in patients with T-LGL leukemia is a decapeptide PP10 (p21 env 417-426). Protein Bank (NCBI) search did not reveal any significant homology between PP10 epitope and known human proteins. These results further define the epitope responsible for HTLV env seroreactivity observed in LGL leukemia.
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Affiliation(s)
- Lubomir Sokol
- Department of Interdisciplinary Oncology, University of South Florida and H Lee, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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38
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Singh F, Lebwohl MG. Cutaneous T-cell lymphoma treatment using bexarotene and PUVA: A case series. J Am Acad Dermatol 2004; 51:570-3. [PMID: 15389192 DOI: 10.1016/j.jaad.2003.05.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mycosis fungoides, the most common form of cutaneous T-cell lymphoma, often presents as chronic eczematous or psoriasiform patches and plaques that can be resistant to a variety of single-agent treatment modalities, necessitating combination therapy. OBJECTIVE To evaluate the efficacy of combination therapy with bexarotene and psoralen plus ultraviolet A (PUVA) in treating patients with cutaneous T-cell lymphoma (CTCL) that recurred following monotherapy with multiple agents, including electron-beam irradiation, interferon, PUVA, and topical steroids. This was done by retrospective chart review. METHODS Retrospective chart review analysis of eight patients with CTCL ranging from stage Ia to IIb who failed multiple single-agent treatment regimens treated with low-dose oral bexarotene and PUVA combination therapy. RESULTS We noted an initial response in all eight patients and complete remission in five of the patients treated, with pruritus being the most common adverse event. CONCLUSION In view of its good safety profile, combination therapy with bexarotene and PUVA may be considered for patients with treatment resistant CTCL refractory to monotherapy.
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Affiliation(s)
- Fiza Singh
- Department of Dermatology, Mount Sinai School of Medicine, New York, New York 10029, USA
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39
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Yawalkar N, Ferenczi K, Jones DA, Yamanaka K, Suh KY, Sadat S, Kupper TS. Profound loss of T-cell receptor repertoire complexity in cutaneous T-cell lymphoma. Blood 2003; 102:4059-66. [PMID: 12829591 DOI: 10.1182/blood-2003-04-1044] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a malignancy of skin-homing T cells. A major feature of CTCL is profound immunosuppression, such that patients with advanced mycosis fungoides or Sézary syndrome have been compared with patients with advanced HIV disease and are susceptible to opportunistic infection. The etiology of this immunosuppression is unclear. We analyzed peripheral blood T cells of patients with CTCL with stage I to IV disease, using a sensitive beta-variable complementarity-determining region 3 spectratyping approach. Our data revealed a profound disruption of the complexity of the T-cell repertoire, which was universally observed in patients with advanced disease (stages III and IV), and present in up to 50% of patients with early-stage disease (stages I and II). In most patients, multiple monoclonal and oligoclonal complementarity-determining region 3 (CDR3) spectratype patterns in many different beta-variable families were seen. Equally striking was a reduction of normal T cells (as judged by absolute CD4 counts) across multiple beta-variable families. In general, CTCL spectratypes were reminiscent of advanced HIV spectratypes published elsewhere. Taken together, these data are most consistent with a global assault on the T-cell repertoire in patients with CTCL, a process that can be observed even in early-stage disease.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- CD4 Lymphocyte Count
- Case-Control Studies
- Clone Cells
- Complementarity Determining Regions/genetics
- Female
- Genes, T-Cell Receptor beta
- HIV Infections/immunology
- Humans
- Immunologic Deficiency Syndromes
- Lymphoma, T-Cell, Cutaneous/etiology
- Lymphoma, T-Cell, Cutaneous/immunology
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- RNA/analysis
- Receptors, Antigen, T-Cell/immunology
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Affiliation(s)
- Nikhil Yawalkar
- Harvard Skin Disease Research Center, Harvard Institutes of Medicine, 77 Avenue Louis Pasteur, Boston, MA 02115, USA
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40
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Dezzutti CS, Guenthner PC, Daniel S, Utz U, Cabrera T, Marshall JH, Bianco C, Lal RB, Cowan EP. Detection of human T-lymphotropic virus (HTLV) tax sequences in New York City blood donors seronegative for HTLV types 1 and 2. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2003; 10:715-7. [PMID: 12853410 PMCID: PMC164244 DOI: 10.1128/cdli.10.4.715-717.2003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A potential public health concern is the reported detection of the human T-lymphotropic virus (HTLV) tax gene in the lymphocytes of up to 11% of a low-risk group of New York City blood donors (NYBD). This study aimed to independently confirm the prevalence of HTLV tax sequences in 293 NYBD. All NYBD tested negative for antibodies to HTLV types 1 and 2 and HTLV Tax. HTLV tax sequences were not detected in the NYBD lymphocytes. These data demonstrate the lack of HTLV-1 tax in this group of NYBD at low risk for HTLV infection.
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Affiliation(s)
- Charlene S Dezzutti
- Division of AIDS, STD, and TB Laboratory Research, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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41
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Zucker-Franklin D, Pancake BA, Najfeld V. Localization of HTLV-I tax proviral DNA in mononuclear cells. Blood Cells Mol Dis 2003; 31:1-6. [PMID: 12850476 DOI: 10.1016/s1079-9796(03)00124-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The tax sequence of HTLV-I is demonstrable in the skin and blood mononuclear cells of patients with mycosis fungoides, as well as in the mononuclear leukocytes of some healthy blood donors, but was not demonstrable when PCR/Southern analyses were carried out on preparations of high-molecular-weight genomic DNA. Therefore, it was postulated that tax DNA may not be integrated. To investigate this possibility fluorescence in situ hybridization was carried out on cells arrested in metaphase, using a probe containing the HTLV-I tax proviral DNA full-length open reading frame coding sequence. While metaphases prepared from C91PL cells, a cell line infected with HTLV-I, showed an abundance of chromosome-associated as well as extra-chromosomal signals, metaphases prepared with blood mononuclear cells from healthy tax sequence positive donors did not reveal any tax DNA associated with chromosomes. Such signals were readily detected extra-chromosomally. Although it has been demonstrated that transactivation of genes by gene products encoded by extra-chromosomal DNA may have nosocomial implications, whether transactivation by p40 tax generated from extra-chromosomal tax sequences is responsible for the development of neoplasia remains to be investigated.
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42
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Miyoshi I, Takemoto S, Taguchi H, Taguchi F, Sawada T. Adult T-cell leukemia with cyclic neutropenia in a seronegative patient carrying only the tax gene of HTLV-I. Am J Hematol 2002; 71:137-8. [PMID: 12353317 DOI: 10.1002/ajh.10163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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43
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Dereure O, Levi E, Vonderheid EC, Kadin ME. Infrequent Fas mutations but no Bax or p53 mutations in early mycosis fungoides: a possible mechanism for the accumulation of malignant T lymphocytes in the skin. J Invest Dermatol 2002; 118:949-56. [PMID: 12060388 DOI: 10.1046/j.1523-1747.2002.01794.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mycosis fungoides (MF) is the most frequent manifestation of cutaneous T cell lymphoma but its cause and pathophysiology remain unclear. Because progression of lesions is characteristically slow, we hypothesized that mycosis fungoides originates from an accumulation of lymphocytes due to defective apoptosis of skin homing T lymphocytes. In this study, we investigate possible alterations of three molecules regulating apoptosis, i.e., Fas antigen, Bax, and p53, at the genomic level in skin lesions from 44 patients with MF, as Fas mediates one of two major pathways for apoptosis of activated T cells. Fas mutations were found in six patients using a polymerase chain reaction and single-strand conformational polymorphism method followed by cloning and sequencing of abnormal polymerase chain reaction products. The mutations predict for defective transmission of the death signal in three cases. Immunohistochemistry demonstrated the lack of Fas protein expression on dermal lymphocytes in one case with Fas gene mutation predicting for a truncated death domain, whereas Fas protein was expressed by dermal lymphocytes in the other investigated cases. By contrast, no mutations of Bax or p53 were found, whereas immunohistochemistry demonstrated increased p53 expression in the nucleus of basal keratinocytes above the neoplastic infiltrate in some MF cases. These results support the hypothesis that Fas defects may play a role in the pathogenesis of MF.
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Affiliation(s)
- Olivier Dereure
- Department of Pathology, Beth Israel Deaconess Medical Center-Harvard Medical School, Boston, Massachusetts 02215, USA
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44
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Zucker-Franklin D. The role of interleukin-7 and interleukin-15 in cutaneous T-cell lymphoma. Blood 2002; 99:3488; author reply 3488-9. [PMID: 12001911 DOI: 10.1182/blood-2002-02-0432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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45
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Zhao TM, Bryant MA, Kindt TJ, Simpson RM. Monoclonally integrated HTLV type 1 in epithelial cancers from rabbits infected with an HTLV type 1 molecular clone. AIDS Res Hum Retroviruses 2002; 18:253-8. [PMID: 11860672 DOI: 10.1089/088922202753472829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In addition to T cell leukemias and lymphomas, human T cell leukemia virus type 1 (HTLV-1) infection has been associated with nonhematologic malignancies and described as the cause of one case of small-cell lung carcinoma. Infected primary epithelial cells have been isolated from sweat gland and oral mucosae of HTLV-1-infected human patients. In the present study, epithelial neoplasms developed in two rabbits experimentally infected with a molecular clone of HTLV-1 (strain K30p). Serologic detection of anti-HTLV-1 and isolation of virus from blood lymphocytes at multiple time points postinjection established a course of chronic asymptomatic infection in both. One rabbit, infected for 5.5 years after intramuscular injection of HTLV-1 DNA, developed a thymoma having features of medullary differentiation. HTLV-1 provirus was detected in both thymocytes and neoplastic epithelium isolated discretely from the thymoma by laser capture microdissection. These findings provide the first experimental evidence of HTLV-1 disease after infection by HTLV-1 DNA injection. Endometrial adenocarcinoma occurred in a second rabbit 2.5 years after its inoculation with cell-associated virus. In this second case, an epithelial cell line derived ex vivo from a metastatic lesion produced virus in culture. In tumors from each of the two rabbits, the neoplastic epithelium was infected and harbored monoclonally integrated HTLV-1 provirus. Although monoclonal provirus integration alone does not establish retroviral cause of carcinogenesis unequivocally, these and other accumulating data indicate that there may be a role for HTLV-1 in diseases associated with infection of epithelia, including some epithelial cancers.
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Affiliation(s)
- Tong Mao Zhao
- Molecular and Cellular Immunogenetics Research Section, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA
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46
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Hodak E, Lapidoth M, Kohn K, David D, Brautbar B, Kfir K, Narinski N, Safirman S, Maron M, Klein K. Mycosis fungoides: HLA class II associations among Ashkenazi and non-Ashkenazi Jewish patients. Br J Dermatol 2001; 145:974-80. [PMID: 11899152 DOI: 10.1046/j.1365-2133.2001.04496.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND An immunogenetic mechanism has been suggested to play a role in the pathogenesis of mycosis fungoides (MF). While results of studies on HLA class I associations haveproved inconsistent, two previous studies showed that certain HLA class II alleles were significantly increased among North American caucasian patients with MF: HLA-DRB1*11 and DQB1*03. OBJECTIVES To investigate the possible HLA class I and class II associations with MF among Jewish patients. METHODS The patient group comprised 68 Jewish patients with MF: 38 Ashkenazi and 30 non-Ashkenazi. The control group comprised 252 healthy Jewish volunteers: 132 Ashkenazi and 120 non-Ashkenazi. Tissue typing for HLA class I (A and B) was performed using the National Institutes of Health microlymphocytotoxicity technique. DNA-based low-medium resolution analysis for DRB1* and DQB1* alleles was performed using polymerase chain reaction (PCR) amplification with sequence-specific primers. For those alleles found to have significantly increased frequency, high-resolution analysis was done by means of PCR sequence-specific oligotyping. RESULTS The allele frequency of HLA-DRB1*11 was found to be significantly increased but only among Ashkenazi patients with MF (30% vs. 19% in the controls; P = 0.034). High-resolution analysis for DRB1*11, not previously performed, suggested that its greater frequency is due to the increased number of Ashkenazi MF patients with the DRB1*1104 allele (P corrected = 0.036). Analysed together, DQB1*03 alleles (DQB1*0301-0304) had a significantly greater frequency in MF as a group as compared with controls (47% vs. 33%, P = 0.003). DQB1*0301 was demonstrated to be the specific allele associated with MF in Jewish patients (allele frequency of 36% vs. 23% in controls; P corrected = 0.0068), which was not the case for North American caucasian patients with MF. No greater frequencies of any of the HLA class I A or B antigens were found. CONCLUSIONS Our findings further demonstrate the 'universality' of MF HLA class II susceptibility alleles, i.e. HLA-DRB1*11 and HLA-DQB1*03, suggesting that HLA polymorphism is likely to be important in the pathogenesis of MF in Jewish patients, as it is in North American caucasian patients. Not previously reported is our finding that HLA-DRB1*1104 is the specific allele more prevalent among patients with MF. Our study also underscores some differences in HLA profiles between non-Jewish and Jewish patients with MF and between Ashkenazi and non-Ashkenazi Jewish patients, indicating the possibility of diverse HLA disease associations in populations with different genetic backgrounds. Our study provides further evidence for the lack of association between HLA class I and MF.
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Affiliation(s)
- E Hodak
- Department of Dermatology, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel.
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47
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Sander CA, Flaig MJ, Jaffe ES. Cutaneous manifestations of lymphoma: a clinical guide based on the WHO classification. World Health Organization. CLINICAL LYMPHOMA 2001; 2:86-100; discussion 101-2. [PMID: 11707848 DOI: 10.3816/clm.2001.n.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cutaneous lymphomas are a heterogeneous group of lymphomas that show variations in histology, immunophenotype, and prognosis. At the time of presentation, cutaneous lymphomas may be primary or may involve the skin as a secondary site of involvement. Primary cutaneous lymphomas, in many instances, are distinct from morphologically similar lymphomas arising in lymph nodes. Their natural history is often more indolent than nodal lymphomas, and for that reason, they often require different therapeutic approaches. A classification scheme should recognize those lymphomas that are unique to the skin, as well as those arising in other sites. The mode of presentation of a lymphoma is often an indication of underlying biological distinctions. However, organ-specific classification systems undermine communication among medical specialists. The World Health Organization classification of hematopoietic and lymphoid malignancies offers a comprehensive approach and proposes that lymphomas should be viewed as a list of individual diseases and that each disease can be defined by a constellation of morphological, biological, and clinical features. The current review will focus on the spectrum of primary and secondary cutaneous lymphomas, emphasizing those features of importance to the clinical oncologist.
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Affiliation(s)
- C A Sander
- Department of Dermatology, Ludwig-Maximilians-Universitaet, Munich, Germany
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48
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Zucker-Franklin D. The role of human T cell lymphotropic virus type I tax in the development of cutaneous T cell lymphoma. Ann N Y Acad Sci 2001; 941:86-96. [PMID: 11594585 DOI: 10.1111/j.1749-6632.2001.tb03713.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although it has been well established that the human T cell lymphotropic virus type I (HTLV-I) causes adult T cell leukemia/lymphoma (ATLL) in regions of the world where this virus is endemic, its role in the pathogenesis of cutaneous T cell lymphoma (CTCL) in the Western world has been less well established. Most patients with CTCL are negative for antibodies to the structural proteins of HTLV-I, and thus a causative role for this virus is usually dismissed. However, the Tax sequence of HTLV-I has been found in the peripheral blood mononuclear cells of practically all patients with CTCL. Such patients express Tax mRNA and have antibodies to p40Tax, the protein encoded by this sequence. Sequence analysis of a 159-bp region of Tax extracted from CTCL cells proved to be homologous with the same region prepared from a cell line infected with prototypic HTLV-I. By in situ PCR, Tax has been demonstrated in the lymphocytes infiltrating the skin as well as in the keratinocytes of such patients. Apart from the pathophysiologic and clinical interest of these studies, these observations may have therapeutic implications. In vitro, the proliferation of HTLV-I-transformed cells can be inhibited by antisense to HTLV-I Tax. Since Tax has not been identified in the normal human genome, antisense to Tax deserves serious consideration as a treatment modality for patients whose cells have been demonstrated to harborTax.
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MESH Headings
- Cell Division
- Cell Line
- DNA, Viral/analysis
- Gene Products, tax/genetics
- Gene Products, tax/physiology
- HTLV-I Infections/pathology
- Human T-lymphotropic virus 1/genetics
- Human T-lymphotropic virus 1/isolation & purification
- Humans
- In Situ Hybridization
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Leukocytes, Mononuclear/virology
- Lymphoma, T-Cell, Cutaneous/ultrastructure
- Lymphoma, T-Cell, Cutaneous/virology
- Mycosis Fungoides/virology
- Oligonucleotides, Antisense/pharmacology
- RNA, Viral/analysis
- Skin/virology
- Skin Neoplasms/ultrastructure
- Skin Neoplasms/virology
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Affiliation(s)
- D Zucker-Franklin
- Department of Medicine, New York University School of Medicine, New York 10016, USA.
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49
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Leroy S, Dubois S, Tenaud I, Chebassier N, Godard A, Jacques Y, Dréno B. Interleukin-15 expression in cutaneous T-cell lymphoma (mycosis fungoides and Sezary syndrome). Br J Dermatol 2001; 144:1016-23. [PMID: 11359391 DOI: 10.1046/j.1365-2133.2001.04192.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cytokines are of potential importance in the pathogenesis of cutaneous T-cell mediated disorders, including cutaneous T-cell lymphoma (CTCL). OBJECTIVES To compare interleukin (IL)-15 expression in certain inflammatory cutaneous diseases, with that in CTCL (mycosis fungoides and Sézary syndrome). METHODS IL-15 mRNA and protein expression were examined by in situ hybridization and immunohistochemistry, respectively, on formalin-fixed, paraffin-embedded biopsies of normal human skin, atopic dermatitis, psoriasis, parapsoriasis and CTCL. RESULTS Despite similar expression of IL-15 mRNA, we found differences in IL-15 protein expression between normal human skin, atopic dermatitis and psoriasis on the one hand, and parapsoriasis and CTCL on the other. IL-15 protein expression was not detected in normal human skin, atopic dermatitis or psoriasis, but was detected, mainly at low levels but in a few patients at higher levels, in epidermal keratinocytes in parapsoriasis, mycosis fungoides and Sézary syndrome. CONCLUSIONS Induction of keratinocyte IL-15 expression appears to be a feature of CTCL. The factors stimulating such an expression remain unknown.
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50
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Mahana W, Samaan A, Zhao TM, Kindt TJ, Simpson RM. Evidence for humoral and cellular reactivity against keratin and thyroglobulin in HTLV-I infected rabbits. Autoimmunity 2001; 32:57-65. [PMID: 10958176 DOI: 10.3109/08916930008995988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Human T cell leukemia virus type I (HTLV-I) infection was initially associated with T cell leukemia and a progressive neurologic disease but has since been linked to an increasing number of autoimmune disorders, including Sjogren's syndrome, uveitis, and polyarthritis. A survey of serum samples from a rabbit model of HTLV-I infection revealed that all had antibodies against keratin and thyroglobulin. Sera from several infected rabbits also reacted with collagen, while antibody reactions with other autoantigens tested, including DNA, were rare and sporadic. In addition to antibodies, cellular reactivity to keratin, but not thyroglobulin, was demonstrated by cellular proliferation in presence of IL-2 and keratin. Expanded cell cultures were positive for T cell activation markers and CD8. Association of the auto-reactivity with HTLV-I infection rather than random anti-cellular responses was supported by the fact that no antikeratin or antithyroglobulin was seen in uninfected controls, including that inoculated with uninfected lymphocytes. Finding autoantibodies in rabbits infected using naked HTLV-I DNA clones provided further assurance that infection induced the autoimmune reactions detected.
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Affiliation(s)
- W Mahana
- Loboratory, of Immunogenetics, National Institute of Allergy and Infectious Diseases, NIH--Twinbrook Facility, Rockville, MD 20852, USA
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