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Pinkerton JW, Preite S, Piras A, Zervas D, Markou T, Freeman MS, Hofving T, Ivarsson E, Bonvini SJ, Brailsford W, Yrlid L, Belvisi MG, Birrell MA. PI3Kγδ inhibition suppresses key disease features in a rat model of asthma. Respir Res 2024; 25:175. [PMID: 38654248 PMCID: PMC11040934 DOI: 10.1186/s12931-024-02814-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Two isoforms of Phosphoinositide 3-kinase (PI3K), p110γ and p110δ, are predominantly expressed in leukocytes and represent attractive therapeutic targets for the treatment of allergic asthma. The study aim was to assess the impact of administration of an inhaled PI3Kγδ inhibitor (AZD8154) in a rat model of asthma. METHODS Firstly, we checked that the tool compound, AZD8154, inhibited rat PI3K γ & δ kinases using rat cell-based assays. Subsequently, a time-course study was conducted in a rat model of asthma to assess PI3K activity in the lung and how it is temporally associated with other key transcription pathways and asthma like features of the model. Finally, the impact on lung dosed AZD8154 on target engagement, pathway specificity, airway inflammation and lung function changes was assessed. RESULTS Data showed that AZD8154 could inhibit rat PI3K γ & δ isoforms and, in a rat model of allergic asthma the PI3K pathway was activated in the lung. Intratracheal administration of AZD8154 caused a dose related suppression PI3K pathway activation (reduction in pAkt) and unlike after budesonide treatment, STAT and NF-κB pathways were not affected by AZD8154. The suppression of the PI3K pathway led to a marked inhibition of airway inflammation and reduction in changes in lung function. CONCLUSION These data show that a dual PI3Kγδ inhibitor suppress key features of disease in a rat model of asthma to a similar degree as budesonide and indicate that dual PI3Kγδ inhibition may be an effective treatment for people suffering from allergic asthma.
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Affiliation(s)
- James W Pinkerton
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Silvia Preite
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Antonio Piras
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Dimitrios Zervas
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Thomais Markou
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Mark S Freeman
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Tobias Hofving
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Emil Ivarsson
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Sara J Bonvini
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Wayne Brailsford
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Linda Yrlid
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
| | - Maria G Belvisi
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK
| | - Mark A Birrell
- Early Respiratory & Immunology, Biopharmaceuticals R&D AstraZeneca, Gothenburg, Sweden.
- Respiratory Pharmacology group, Airway Disease section, NHLI, Imperial College, London, UK.
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Spanos F, Gerenu G, Goikolea J, Latorre-Leal M, Balleza-Tapia H, Gomez K, Álvarez-Jiménez L, Piras A, Gómez-Galán M, Fisahn A, Cedazo-Minguez A, Maioli S, Loera-Valencia R. Impaired astrocytic synaptic function by peripheral cholesterol metabolite 27-hydroxycholesterol. Front Cell Neurosci 2024; 18:1347535. [PMID: 38650656 PMCID: PMC11034371 DOI: 10.3389/fncel.2024.1347535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/19/2024] [Indexed: 04/25/2024] Open
Abstract
Astrocytes represent the most abundant cell type in the brain, where they play critical roles in synaptic transmission, cognition, and behavior. Recent discoveries show astrocytes are involved in synaptic dysfunction during Alzheimer's disease (AD). AD patients have imbalanced cholesterol metabolism, demonstrated by high levels of side-chain oxidized cholesterol known as 27-hydroxycholesterol (27-OH). Evidence from our laboratory has shown that elevated 27-OH can abolish synaptic connectivity during neuromaturation, but its effect on astrocyte function is currently unclear. Our results suggest that elevated 27-OH decreases the astrocyte function in vivo in Cyp27Tg, a mouse model of brain oxysterol imbalance. Here, we report a downregulation of glutamate transporters in the hippocampus of CYP27Tg mice together with increased GFAP. GLT-1 downregulation was also observed when WT mice were fed with high-cholesterol diets. To study the relationship between astrocytes and neurons, we have developed a 3D co-culture system that allows all the cell types from mice embryos to differentiate in vitro. We report that our 3D co-cultures reproduce the effects of 27-OH observed in 2D neurons and in vivo. Moreover, we found novel degenerative effects in astrocytes that do not appear in 2D cultures, together with the downregulation of glutamate transporters GLT-1 and GLAST. We propose that this transporter dysregulation leads to neuronal hyperexcitability and synaptic dysfunction based on the effects of 27-OH on astrocytes. Taken together, these results report a new mechanism linking oxysterol imbalance in the brain and synaptic dysfunction through effects on astrocyte function.
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Affiliation(s)
- Fokion Spanos
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Gorka Gerenu
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
- Department of Physiology, Biogipuzkoa Health Research Institute - Ikerbasque Basque foundation for Science and University of Basque Country, San Sebastian, Spain
- CIBERNED (Ministry of Economy and Competitiveness, Institute Carlos III), Madrid, Spain
| | - Julen Goikolea
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - María Latorre-Leal
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Hugo Balleza-Tapia
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Karen Gomez
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Laura Álvarez-Jiménez
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Antonio Piras
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Marta Gómez-Galán
- Anestesiologi Laboratory, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - André Fisahn
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Angel Cedazo-Minguez
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Silvia Maioli
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Raúl Loera-Valencia
- Department of Neurobiology Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
- School of Medicine and Health Sciences, Tecnologico de Monterrey, Chihuahua, Mexico
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Boldrini L, Chiloiro G, Cusumano D, Yadav P, Yu G, Romano A, Piras A, Votta C, Placidi L, Broggi S, Catucci F, Lenkowicz J, Indovina L, Bassetti MF, Yang Y, Fiorino C, Valentini V, Gambacorta MA. Radiomics-enhanced early regression index for predicting treatment response in rectal cancer: a multi-institutional 0.35 T MRI-guided radiotherapy study. Radiol Med 2024; 129:615-622. [PMID: 38512616 DOI: 10.1007/s11547-024-01761-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/03/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE The accurate prediction of treatment response in locally advanced rectal cancer (LARC) patients undergoing MRI-guided radiotherapy (MRIgRT) is essential for optimising treatment strategies. This multi-institutional study aimed to investigate the potential of radiomics in enhancing the predictive power of a known radiobiological parameter (Early Regression Index, ERITCP) to evaluate treatment response in LARC patients treated with MRIgRT. METHODS Patients from three international sites were included and divided into training and validation sets. 0.35 T T2*/T1-weighted MR images were acquired during simulation and at each treatment fraction. The biologically effective dose (BED) conversion was used to account for different radiotherapy schemes: gross tumour volume was delineated on the MR images corresponding to specific BED levels and radiomic features were then extracted. Multiple logistic regression models were calculated, combining ERITCP with other radiomic features. The predictive performance of the different models was evaluated on both training and validation sets by calculating the receiver operating characteristic (ROC) curves. RESULTS A total of 91 patients was enrolled: 58 were used as training, 33 as validation. Overall, pCR was observed in 25 cases. The model showing the highest performance was obtained combining ERITCP at BED = 26 Gy with a radiomic feature (10th percentile of grey level histogram, 10GLH) calculated at BED = 40 Gy. The area under ROC curve (AUC) of this combined model was 0.98 for training set and 0.92 for validation set, significantly higher (p = 0.04) than the AUC value obtained using ERITCP alone (0.94 in training and 0.89 in validation set). CONCLUSION The integration of the radiomic analysis with ERITCP improves the pCR prediction in LARC patients, offering more precise predictive models to further personalise 0.35 T MRIgRT treatments of LARC patients.
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Affiliation(s)
- Luca Boldrini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Giuditta Chiloiro
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | | | - Poonam Yadav
- Northwestern Memorial Hospital, Northwestern University Feinberg, Chicago, IL, USA
| | - Gao Yu
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Angela Romano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Claudio Votta
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Lorenzo Placidi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Sara Broggi
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | | | - Jacopo Lenkowicz
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Luca Indovina
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Michael F Bassetti
- Department of Human Oncology, School of Medicine and Public Heath, University of Wisconsin - Madison, Madison, USA
| | - Yingli Yang
- Department of Radiological Sciences, University of California, Los Angeles, CA, USA
| | - Claudio Fiorino
- Medical Physics, San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy
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Santo B, Bertini N, Cattaneo CG, De Matteis S, De Franco P, Grassi R, Iorio GC, Longo S, Boldrini L, Piras A, Desideri I, De Felice F, Salvestrini V. Nutritional counselling for head and neck cancer patients treated with (chemo)radiation therapy: why, how, when, and what? Front Oncol 2024; 13:1240913. [PMID: 38264757 PMCID: PMC10803628 DOI: 10.3389/fonc.2023.1240913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/14/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Bianca Santo
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Niccolò Bertini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Carlo Guglielmo Cattaneo
- Department of Radiotherapy, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Sara De Matteis
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Paola De Franco
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | | | - Silvia Longo
- Unità Operativa Complessa (UOC) Radioterapia Oncologica, Fondazione Policlinico Universitario Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “A. Gemelli”, Roma, Italy
| | - Luca Boldrini
- Unità Operativa Complessa (UOC) Radioterapia Oncologica, Fondazione Policlinico Universitario Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “A. Gemelli”, Roma, Italy
| | - Antonio Piras
- Unità Operativa (UO) Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
- Department of Biomedical Image Processing and Analysis, Ri.Med Foundation, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Molecular and Clinical Medicine, University of Palermo, Palermo, Italy
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Viola Salvestrini
- Radiation Oncology Unit, Centro Cyberknife, Istituto Fiorentino di Cura e Assistenza, Florence, Italy
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Boldrini L, D'Aviero A, De Felice F, Desideri I, Grassi R, Greco C, Iorio GC, Nardone V, Piras A, Salvestrini V. Artificial intelligence applied to image-guided radiation therapy (IGRT): a systematic review by the Young Group of the Italian Association of Radiotherapy and Clinical Oncology (yAIRO). Radiol Med 2024; 129:133-151. [PMID: 37740838 DOI: 10.1007/s11547-023-01708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/16/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION The advent of image-guided radiation therapy (IGRT) has recently changed the workflow of radiation treatments by ensuring highly collimated treatments. Artificial intelligence (AI) and radiomics are tools that have shown promising results for diagnosis, treatment optimization and outcome prediction. This review aims to assess the impact of AI and radiomics on modern IGRT modalities in RT. METHODS A PubMed/MEDLINE and Embase systematic review was conducted to investigate the impact of radiomics and AI to modern IGRT modalities. The search strategy was "Radiomics" AND "Cone Beam Computed Tomography"; "Radiomics" AND "Magnetic Resonance guided Radiotherapy"; "Radiomics" AND "on board Magnetic Resonance Radiotherapy"; "Artificial Intelligence" AND "Cone Beam Computed Tomography"; "Artificial Intelligence" AND "Magnetic Resonance guided Radiotherapy"; "Artificial Intelligence" AND "on board Magnetic Resonance Radiotherapy" and only original articles up to 01.11.2022 were considered. RESULTS A total of 402 studies were obtained using the previously mentioned search strategy on PubMed and Embase. The analysis was performed on a total of 84 papers obtained following the complete selection process. Radiomics application to IGRT was analyzed in 23 papers, while a total 61 papers were focused on the impact of AI on IGRT techniques. DISCUSSION AI and radiomics seem to significantly impact IGRT in all the phases of RT workflow, even if the evidence in the literature is based on retrospective data. Further studies are needed to confirm these tools' potential and provide a stronger correlation with clinical outcomes and gold-standard treatment strategies.
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Affiliation(s)
- Luca Boldrini
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario IRCCS "A. Gemelli", Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea D'Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari, Italy
| | - Francesca De Felice
- Radiation Oncology, Department of Radiological, Policlinico Umberto I, Rome, Italy
- Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carlo Greco
- Department of Radiation Oncology, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Valerio Nardone
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy.
| | - Viola Salvestrini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Cyberknife Center, Istituto Fiorentino di Cura e Assistenza (IFCA), 50139, Florence, Italy
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Burkart SS, Schweinoch D, Frankish J, Sparn C, Wüst S, Urban C, Merlo M, Magalhães VG, Piras A, Pichlmair A, Willemsen J, Kaderali L, Binder M. High-resolution kinetic characterization of the RIG-I-signaling pathway and the antiviral response. Life Sci Alliance 2023; 6:e202302059. [PMID: 37558422 PMCID: PMC10412806 DOI: 10.26508/lsa.202302059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
RIG-I recognizes viral dsRNA and activates a cell-autonomous antiviral response. Upon stimulation, it triggers a signaling cascade leading to the production of type I and III IFNs. IFNs are secreted and signal to elicit the expression of IFN-stimulated genes, establishing an antiviral state of the cell. The topology of this pathway has been studied intensively, however, its exact dynamics are less understood. Here, we employed electroporation to synchronously activate RIG-I, enabling us to characterize cell-intrinsic innate immune signaling at a high temporal resolution. Employing IFNAR1/IFNLR-deficient cells, we could differentiate primary RIG-I signaling from secondary signaling downstream of the IFN receptors. Based on these data, we developed a comprehensive mathematical model capable of simulating signaling downstream of dsRNA recognition by RIG-I and the feedback and signal amplification by IFN. We further investigated the impact of viral antagonists on signaling dynamics. Our work provides a comprehensive insight into the signaling events that occur early upon virus infection and opens new avenues to study and disentangle the complexity of the host-virus interface.
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Affiliation(s)
- Sandy S Burkart
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Darius Schweinoch
- Institute of Bioinformatics & Center for Functional Genomics of Microbes, University Medicine Greifswald, Greifswald, Germany
| | - Jamie Frankish
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Carola Sparn
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Sandra Wüst
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
| | - Christian Urban
- Technical University of Munich, School of Medicine, Institute of Virology, Munich, Germany
| | - Marta Merlo
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Vladimir G Magalhães
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
| | - Antonio Piras
- Technical University of Munich, School of Medicine, Institute of Virology, Munich, Germany
| | - Andreas Pichlmair
- Technical University of Munich, School of Medicine, Institute of Virology, Munich, Germany
- German Center for Infection Research (DZIF), Munich Partner Site, Munich, Germany
| | - Joschka Willemsen
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
| | - Lars Kaderali
- Institute of Bioinformatics & Center for Functional Genomics of Microbes, University Medicine Greifswald, Greifswald, Germany
| | - Marco Binder
- Research Group "Dynamics of Early Viral Infection and the Innate Antiviral Response", Division Virus-Associated Carcinogenesis (F170), German Cancer Research Center, Heidelberg, Germany
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Cuccia F, Tamburo M, Piras A, Mortellaro G, Iudica A, Daidone A, Federico M, Zagardo V, Ferini G, Marletta F, Spatola C, Fazio I, Filosto S, Pergolizzi S, Ferrera G. Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience. Medicina (Kaunas) 2023; 59:1442. [PMID: 37629732 PMCID: PMC10456704 DOI: 10.3390/medicina59081442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/25/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
Background: The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retrospective multicenter study evaluates the outcomes of a cohort of patients treated with stereotactic body radiotherapy for lymph-nodal oligometastases. Methods: Inclusion criteria were up to five lymph-nodal oligometastases detected either with Choline-PET or PSMA-PET in patients naïve for ADT or already ongoing with systemic therapy and at least 6 Gy per fraction for SBRT. Only patients with exclusive lymph-nodal disease were included. The primary endpoint of the study was LC; a toxicity assessment was retrospectively performed following CTCAE v4.0. Results: A total of 100 lymph-nodal oligometastases in 69 patients have been treated with SBRT between April 2015 and November 2022. The median age was 73 years (range, 60-85). Oligometastatic disease was mainly detected with Choline-PET in 47 cases, while the remaining were diagnosed using PSMA-PET, with most of the patients treated to a single lymph-nodal metastasis (48/69 cases), two in 14 cases, and three in the remaining cases. The median PSA prior to SBRT was 1.35 ng/mL (range, 0.3-23.7 ng/mL). Patients received SBRT with a median total dose of 35 Gy (range, 30-40 Gy) in a median number of 5 (range, 3-6) fractions. With a median follow-up of 16 months (range, 7-59 months), our LC rates were 95.8% and 86.3% at 1 and 2 years. DPFS rates were 90.4% and 53.4%, respectively, at 1 and 2 years, with nine patients developing a sequential oligometastatic disease treated with a second course of SBRT. Polymetastatic disease-free survival (PMFS) at 1 and 2 years was 98% and 96%. Six patients needed ADT after SBRT for a median time of ADT-free survival of 15 months (range, 6-22 months). The median OS was 16 months (range, 7-59) with 1- and 2-year rates of both 98%. In multivariate analysis, higher LC rates and the use of PSMA-PET were related to improved DPFS rates, and OS was significantly related to a lower incidence of distant progression. No G3 or higher adverse events were reported. Conclusions: In our experience, lymph-nodal SBRT for oligometastatic prostate cancer is a safe and effective option for ADT delay with no severe toxicity.
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Affiliation(s)
- Francesco Cuccia
- Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy; (G.M.)
| | - Maria Tamburo
- Radiotherapy Unit, Cannizzaro Hospital, 95100 Catania, Italy; (M.T.)
| | - Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, Italy; (A.P.); (A.D.)
- RI.MED Foundation, 90100 Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Molecular and Clinical Medicine, University of Palermo, 90100 Palermo, Italy
| | | | - Arianna Iudica
- Radiotherapy Unit, AOU Policlinico-VE, 95100 Catania, Italy; (A.I.); (C.S.)
| | - Antonino Daidone
- Radioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, Italy; (A.P.); (A.D.)
| | - Manuela Federico
- Radiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, Italy; (M.F.); (I.F.)
| | - Valentina Zagardo
- Radiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, Italy
| | - Gianluca Ferini
- Radiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, Italy
| | | | - Corrado Spatola
- Radiotherapy Unit, AOU Policlinico-VE, 95100 Catania, Italy; (A.I.); (C.S.)
| | - Ivan Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, Italy; (M.F.); (I.F.)
| | - Sergio Filosto
- Radiation Oncology Unit, La Maddalena Dipartimento Oncologico di III Livello, 90100 Palermo, Italy;
| | - Stefano Pergolizzi
- Department of Radiological Science, University of Messina, 98121 Messina, Italy
| | - Giuseppe Ferrera
- Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy; (G.M.)
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Piras A, Sanfratello A, Boldrini L, D'Aviero A, Pernice G, Sortino G, Valerio MR, Gennari R, D'Angelo I, Marazzi F, Angileri T, Daidone A. Stereotactic Radiotherapy in Early-Stage Breast Cancer in Neoadjuvant and Exclusive Settings: A Systematic Review. Oncol Res Treat 2023; 46:116-123. [PMID: 36509043 DOI: 10.1159/000528640] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Breast cancer (BC) is one of the most common tumors; better screening policies and multidisciplinary approach allow personalized treatment. Radiotherapy (RT) plays a central role in the multimodal approach in BC, and recent evidence has shown the non-inferiority of hypofractionated treatments. The aim of this study was to describe the feasibility and validity of stereotactic RT (SBRT) in BC in a neoadjuvant and exclusive setting. METHODS A PubMed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in BC. The search strategy was "breast [All Fields] AND "stereotactic" [All Fields] AND "radiotherapy" [All Fields]" and only original articles referred to BC in humans in the English language were considered. RESULTS A total of 2,149 studies were obtained using the mentioned search strategy on PubMed and Embase. After the complete selection process, a total of 12 papers were considered eligible for the analysis of the results. SBRT in BC was described in 8 studies regarding neoadjuvant approach and 4 papers regarding exclusive approach. CONCLUSIONS Relative low toxicity rates, the reduced treatment volumes in the neoadjuvant setting, and the possibility to replace surgery when not feasible in exclusive setting resulted to be main advantages for SBRT in BC. Current evidence shows that both the neoadjuvant and the definitive settings seem to be promising clinical scenarios for SBRT, especially for EBC.
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Affiliation(s)
- Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | | | - Luca Boldrini
- UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | | | | | | | - Maria Rosaria Valerio
- Università degli Studi di Palermo, Palermo, Italy.,UOC Oncologia Medica, AOUP "P. Giaccone", Palermo, Italy
| | - Roberto Gennari
- Division of Breast Surgery, Department of Surgical Oncology, HSR G. Giglio Foundation, Cefalù, Italy
| | | | - Fabio Marazzi
- UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy
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9
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Piras A, Boldrini L, Rinaldi C, Sanfratello A, D'Aviero A, Toscano A, Angileri T, Spada M, Daidone A. Heel Spur and Radiotherapy: Case Report and Systematic Literature Review. J Am Podiatr Med Assoc 2022; 112:21-090. [PMID: 35994409 DOI: 10.7547/21-090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Heel spur is a chronic inflammatory condition causing pain and other typical symptoms. Therapeutic recommendations include the use of several drug or orthotic/physical therapies, performed alone or in combination. Surgery is usually reserved for refractory conditions. Radiotherapy has been shown to ensure good clinical outcomes in this clinical setting. A systematic review was performed to describe the feasibility and effectiveness of radiotherapy in the treatment of heel spur, evaluating its role in alleviating pain and consequently ensuring a better quality of life. A case report of 45-year-old patient treated for refractary right hindfoot pain was reported. A single fraction of 6 Gy RT was delivered with symptomatic complete response at 2 months observed. A systematic database search was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The systematic review included studies describing heel spur treatment and providing complete information about radiotherapy. Fifteen articles published between 1996 and 2020 were reviewed. Study characteristic analysis resulted in seven prospective randomized studies and eight retrospective studies. Radiotherapy of painful heel spur seems to be safe and effective, with high response rates even at low doses and with an overall favorable toxicity profile. Predictive parameters and modern tailored treatment should be investigated with further studies.
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Affiliation(s)
- Antonio Piras
- *Unità Operativa Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Luca Boldrini
- †Unità Operativa Complessa Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.,‡Università Cattolica del Sacro Cuore, Rome, Italy
| | - Calogero Rinaldi
- §Unità Operativa Fisica Sanitaria, Villa Santa Teresa, Bagheria, Palermo, Italy
| | | | - Andrea D'Aviero
- †Unità Operativa Complessa Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Angelo Toscano
- ¶General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
| | - Tommaso Angileri
- #Unità Operativa Radiologia, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Massimiliano Spada
- **Unità Operativa Oncologia, Fondazione Istituto G. Giglio, Cefalù, Palermo, Italy
| | - Antonino Daidone
- *Unità Operativa Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
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10
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Radwanska A, Cottage CT, Piras A, Overed-Sayer C, Sihlbom C, Budida R, Wrench C, Connor J, Monkley S, Hazon P, Schluter H, Thomas MJ, Hogaboam CM, Murray LA. Increased expression and accumulation of GDF15 in IPF extracellular matrix contribute to fibrosis. JCI Insight 2022; 7:153058. [PMID: 35993367 PMCID: PMC9462497 DOI: 10.1172/jci.insight.153058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic disease of unmet medical need. It is characterized by formation of scar tissue leading to a progressive and irreversible decline in lung function. IPF is associated with repeated injury, which may alter the composition of the extracellular matrix (ECM). Here, we demonstrate that IPF patient–derived pulmonary ECM drives profibrotic response in normal human lung fibroblasts (NHLF) in a 3D spheroid assay. Next, we reveal distinct alterations in composition of the diseased ECM, identifying potentially novel associations with IPF. Growth differentiation factor 15 (GDF15) was identified among the most significantly upregulated proteins in the IPF lung–derived ECM. In vivo, GDF15 neutralization in a bleomycin-induced lung fibrosis model led to significantly less fibrosis. In vitro, recombinant GDF15 (rGDF15) stimulated α smooth muscle actin (αSMA) expression in NHLF, and this was mediated by the activin receptor-like kinase 5 (ALK5) receptor. Furthermore, in the presence of rGDF15, the migration of NHLF in collagen gel was reduced. In addition, we observed a cell type–dependent effect of GDF15 on the expression of cell senescence markers. Our data suggest that GDF15 mediates lung fibrosis through fibroblast activation and differentiation, implicating a potential direct role of this matrix-associated cytokine in promoting aberrant cell responses in disease.
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Affiliation(s)
- Agata Radwanska
- Bioscience COPD/IPF, Research and Early Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Christopher Travis Cottage
- Bioscience COPD/IPF, Research and Early Development, R&I, Biopharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Antonio Piras
- Bioscience In Vivo, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Catherine Overed-Sayer
- Bioscience COPD/IPF, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Carina Sihlbom
- Proteomics Core Facility of Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ramachandramouli Budida
- Translational Science and Experimental Medicine, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Catherine Wrench
- Bioscience COPD/IPF, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Jane Connor
- Bioscience COPD/IPF, Research and Early Development, R&I, Biopharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Susan Monkley
- Translational Science and Experimental Medicine, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Petra Hazon
- Bioscience COPD/IPF, Research and Early Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Holger Schluter
- Bioscience COPD/IPF, Research and Early Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Matthew J. Thomas
- Bioscience COPD/IPF, Research and Early Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Lynne A. Murray
- Bioscience COPD/IPF, Research and Early Development, R&I, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
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11
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Nilsson M, Rhedin M, Hendrickx R, Berglund S, Piras A, Blomgran P, Cavallin A, Collins M, Dahl G, Dekkak B, Ericsson T, Hagberg N, Holmberg AA, Leffler A, Lundqvist AJ, Markou T, Pinkerton J, Rönnblom L, Siu S, Taylor V, Wennberg T, Zervas D, Laurence ADJ, Mitra S, Belvisi MG, Birrell M, Borde A. Characterization of Selective and Potent JAK1 Inhibitors Intended for the Inhaled Treatment of Asthma. Drug Des Devel Ther 2022; 16:2901-2917. [PMID: 36068788 PMCID: PMC9441147 DOI: 10.2147/dddt.s354291] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Janus kinase 1 (JAK1) is implicated in multiple inflammatory pathways that are critical for the pathogenesis of asthma, including the interleukin (IL)-4, IL-5, IL-13, and thymic stromal lymphopoietin cytokine signaling pathways, which have previously been targeted to treat allergic asthma. Here, we describe the development of AZD0449 and AZD4604, two novel and highly selective JAK1 inhibitors with promising properties for inhalation. Methods The effects of AZD0449 and AZD4604 in JAK1 signaling pathways were assessed by measuring phosphorylation of signal transducer and activator of transcription (STAT) proteins and chemokine release using immunoassays of whole blood from healthy human volunteers and rats. Pharmacokinetic studies performed on rats evaluated AZD0449 at a lung deposited dose of 52 μg/kg and AZD4604 at 30 µg/kg. The efficacy of AZD0449 and AZD4604 was assessed by evaluating lung inflammation (cell count and cytokine levels) and the late asthmatic response (average enhanced pause [Penh]). Results Both compounds inhibited JAK1-dependent cytokine signaling pathways in a dose-dependent manner in human and rat leukocytes. After intratracheal administration in rats, both compounds exhibited low systemic exposures and medium-to-long terminal lung half-lives (AZD0449, 34 hours; AZD4604, 5 hours). Both compounds inhibited STAT3 and STAT5 phosphorylation in lung tissue from ovalbumin (OVA)-challenged rats. AZD0449 and AZD4604 also inhibited eosinophilia in the lung and reduced the late asthmatic response, measured as Penh in the OVA rat model. Conclusion AZD0449 and AZD4604 show potential as inhibitors of signaling pathways involved in asthmatic immune responses, with target engagement demonstrated locally in the lung. These findings support the clinical development of AZD0449 and AZD4604 for the treatment of patients with asthma.
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Affiliation(s)
- Magnus Nilsson
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
- Correspondence: Magnus Nilsson, Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, SE-431 83, Sweden, Tel +46722237222, Email
| | - Magdalena Rhedin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Ramon Hendrickx
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Susanne Berglund
- Medicinal Chemistry, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Antonio Piras
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Parmis Blomgran
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anders Cavallin
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Mia Collins
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Göran Dahl
- Discovery Science, R&D, AstraZeneca, Gothenburg, Sweden
| | - Bilel Dekkak
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Therese Ericsson
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Niklas Hagberg
- Rheumatology and Science for Life Laboratories, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ann Aurell Holmberg
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Agnes Leffler
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anders J Lundqvist
- DMPK, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Thomais Markou
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - James Pinkerton
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Lars Rönnblom
- Rheumatology and Science for Life Laboratories, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Stacey Siu
- Rigel Pharmaceuticals, South San Francisco, CA, USA
| | | | - Tiiu Wennberg
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Dimitrios Zervas
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Arian D J Laurence
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Suman Mitra
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Maria G Belvisi
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Mark Birrell
- Respiratory Pharmacology Group, Division of Airway Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Annika Borde
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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12
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D’Aviero A, Re A, Catucci F, Piccari D, Votta C, Piro D, Piras A, Di Dio C, Iezzi M, Preziosi F, Menna S, Quaranta F, Boschetti A, Marras M, Miccichè F, Gallus R, Indovina L, Bussu F, Valentini V, Cusumano D, Mattiucci GC. Clinical Validation of a Deep-Learning Segmentation Software in Head and Neck: An Early Analysis in a Developing Radiation Oncology Center. Int J Environ Res Public Health 2022; 19:ijerph19159057. [PMID: 35897425 PMCID: PMC9329735 DOI: 10.3390/ijerph19159057] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
Background: Organs at risk (OARs) delineation is a crucial step of radiotherapy (RT) treatment planning workflow. Time-consuming and inter-observer variability are main issues in manual OAR delineation, mainly in the head and neck (H & N) district. Deep-learning based auto-segmentation is a promising strategy to improve OARs contouring in radiotherapy departments. A comparison of deep-learning-generated auto-contours (AC) with manual contours (MC) was performed by three expert radiation oncologists from a single center. Methods: Planning computed tomography (CT) scans of patients undergoing RT treatments for H&N cancers were considered. CT scans were processed by Limbus Contour auto-segmentation software, a commercial deep-learning auto-segmentation based software to generate AC. H&N protocol was used to perform AC, with the structure set consisting of bilateral brachial plexus, brain, brainstem, bilateral cochlea, pharyngeal constrictors, eye globes, bilateral lens, mandible, optic chiasm, bilateral optic nerves, oral cavity, bilateral parotids, spinal cord, bilateral submandibular glands, lips and thyroid. Manual revision of OARs was performed according to international consensus guidelines. The AC and MC were compared using the Dice similarity coefficient (DSC) and 95% Hausdorff distance transform (DT). Results: A total of 274 contours obtained by processing CT scans were included in the analysis. The highest values of DSC were obtained for the brain (DSC 1.00), left and right eye globes and the mandible (DSC 0.98). The structures with greater MC editing were optic chiasm, optic nerves and cochleae. Conclusions: In this preliminary analysis, deep-learning auto-segmentation seems to provide acceptable H&N OAR delineations. For less accurate organs, AC could be considered a starting point for review and manual adjustment. Our results suggest that AC could become a useful time-saving tool to optimize workload and resources in RT departments.
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Affiliation(s)
- Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Alessia Re
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Francesco Catucci
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Danila Piccari
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
- Correspondence:
| | - Claudio Votta
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
| | - Domenico Piro
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
| | - Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, 90011 Bagheria, Italy;
| | - Carmela Di Dio
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Martina Iezzi
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Francesco Preziosi
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Sebastiano Menna
- Medical Physics, Mater Olbia Hospital, 07026 Sassari, Italy; (S.M.); (F.Q.); (D.C.)
| | | | - Althea Boschetti
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Marco Marras
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
| | - Francesco Miccichè
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
| | - Roberto Gallus
- Otolaryngology, Mater Olbia Hospital, 07026 Sassari, Italy;
| | - Luca Indovina
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
| | - Francesco Bussu
- Otolaryngology, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy;
- Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Università di Sassari, 07100 Sassari, Italy
| | - Vincenzo Valentini
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy; (F.M.); (L.I.); (V.V.)
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Davide Cusumano
- Medical Physics, Mater Olbia Hospital, 07026 Sassari, Italy; (S.M.); (F.Q.); (D.C.)
| | - Gian Carlo Mattiucci
- Radiation Oncology, Mater Olbia Hospital, 07026 Olbia, Italy; (A.D.); (A.R.); (F.C.); (C.V.); (D.P.); (C.D.D.); (M.I.); (F.P.); (A.B.); (M.M.); (G.C.M.)
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
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13
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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14
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Bergant V, Yamada S, Grass V, Tsukamoto Y, Lavacca T, Krey K, Mühlhofer MT, Wittmann S, Ensser A, Herrmann A, Vom Hemdt A, Tomita Y, Matsuyama S, Hirokawa T, Huang Y, Piras A, Jakwerth CA, Oelsner M, Thieme S, Graf A, Krebs S, Blum H, Kümmerer BM, Stukalov A, Schmidt-Weber CB, Igarashi M, Gramberg T, Pichlmair A, Kato H. Attenuation of SARS-CoV-2 replication and associated inflammation by concomitant targeting of viral and host cap 2'-O-ribose methyltransferases. EMBO J 2022; 41:e111608. [PMID: 35833542 PMCID: PMC9350232 DOI: 10.15252/embj.2022111608] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 12/12/2022] Open
Abstract
The SARS‐CoV‐2 infection cycle is a multistage process that relies on functional interactions between the host and the pathogen. Here, we repurposed antiviral drugs against both viral and host enzymes to pharmaceutically block methylation of the viral RNA 2'‐O‐ribose cap needed for viral immune escape. We find that the host cap 2'‐O‐ribose methyltransferase MTr1 can compensate for loss of viral NSP16 methyltransferase in facilitating virus replication. Concomitant inhibition of MTr1 and NSP16 efficiently suppresses SARS‐CoV‐2 replication. Using in silico target‐based drug screening, we identify a bispecific MTr1/NSP16 inhibitor with anti‐SARS‐CoV‐2 activity in vitro and in vivo but with unfavorable side effects. We further show antiviral activity of inhibitors that target independent stages of the host SAM cycle providing the methyltransferase co‐substrate. In particular, the adenosylhomocysteinase (AHCY) inhibitor DZNep is antiviral in in vitro, in ex vivo, and in a mouse infection model and synergizes with existing COVID‐19 treatments. Moreover, DZNep exhibits a strong immunomodulatory effect curbing infection‐induced hyperinflammation and reduces lung fibrosis markers ex vivo. Thus, multispecific and metabolic MTase inhibitors constitute yet unexplored treatment options against COVID‐19.
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Affiliation(s)
- Valter Bergant
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Shintaro Yamada
- Institute of Cardiovascular Immunology, University Hospital Bonn (UKB), Bonn, Germany
| | - Vincent Grass
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Yuta Tsukamoto
- Institute of Cardiovascular Immunology, University Hospital Bonn (UKB), Bonn, Germany
| | - Teresa Lavacca
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Karsten Krey
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Maria-Teresa Mühlhofer
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Sabine Wittmann
- Institute of Clinical and Molecular Virology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Armin Ensser
- Institute of Clinical and Molecular Virology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Alexandra Herrmann
- Institute of Clinical and Molecular Virology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Anja Vom Hemdt
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Yuriko Tomita
- Department of Virology III, National Institute of Infectious Diseases (NIID), Tokyo, Japan
| | - Shutoku Matsuyama
- Department of Virology III, National Institute of Infectious Diseases (NIID), Tokyo, Japan
| | - Takatsugu Hirokawa
- Transborder Medical Research Center, University of Tsukuba, Tsukuba, Japan.,Division of Biomedical Science, University of Tsukuba, Tsukuba, Japan.,Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Yiqi Huang
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Antonio Piras
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Constanze A Jakwerth
- Center for Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Madlen Oelsner
- Center for Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Susanne Thieme
- Laboratory for functional genome analysis (LAFUGA), Gene Centre, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Alexander Graf
- Laboratory for functional genome analysis (LAFUGA), Gene Centre, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Stefan Krebs
- Laboratory for functional genome analysis (LAFUGA), Gene Centre, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Helmut Blum
- Laboratory for functional genome analysis (LAFUGA), Gene Centre, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Beate M Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany.,German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Alexey Stukalov
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Carsten B Schmidt-Weber
- Center for Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Manabu Igarashi
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan.,Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Thomas Gramberg
- Institute of Clinical and Molecular Virology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Pichlmair
- Institute of Virology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.,German Center for Infection Research (DZIF), Munich partner site, Germany
| | - Hiroki Kato
- Institute of Cardiovascular Immunology, University Hospital Bonn (UKB), Bonn, Germany
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15
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Sanfratello A, Cusumano D, Piras A, Boldrini L, D'Aviero A, Fricano P, Messina M, Vaglica M, Galanti D, Spada M, Martorana G, Arena G, Angileri T, Daidone A. New dosimetric parameters to predict ano-rectal toxicity during radiotherapy treatment. Phys Med 2022; 99:55-60. [DOI: 10.1016/j.ejmp.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/05/2022] [Accepted: 05/15/2022] [Indexed: 12/09/2022] Open
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16
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Serrero MC, Girault V, Weigang S, Greco TM, Ramos-Nascimento A, Anderson F, Piras A, Hickford Martinez A, Hertzog J, Binz A, Pohlmann A, Prank U, Rehwinkel J, Bauerfeind R, Cristea IM, Pichlmair A, Kochs G, Sodeik B. The interferon-inducible GTPase MxB promotes capsid disassembly and genome release of herpesviruses. eLife 2022; 11:e76804. [PMID: 35475759 PMCID: PMC9150894 DOI: 10.7554/elife.76804] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Abstract
Host proteins sense viral products and induce defence mechanisms, particularly in immune cells. Using cell-free assays and quantitative mass spectrometry, we determined the interactome of capsid-host protein complexes of herpes simplex virus and identified the large dynamin-like GTPase myxovirus resistance protein B (MxB) as an interferon-inducible protein interacting with capsids. Electron microscopy analyses showed that cytosols containing MxB had the remarkable capability to disassemble the icosahedral capsids of herpes simplex viruses and varicella zoster virus into flat sheets of connected triangular faces. In contrast, capsids remained intact in cytosols with MxB mutants unable to hydrolyse GTP or to dimerize. Our data suggest that MxB senses herpesviral capsids, mediates their disassembly, and thereby restricts the efficiency of nuclear targeting of incoming capsids and/or the assembly of progeny capsids. The resulting premature release of viral genomes from capsids may enhance the activation of DNA sensors, and thereby amplify the innate immune responses.
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Affiliation(s)
- Manutea C Serrero
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
| | | | - Sebastian Weigang
- Institute of Virology, Freiburg University Medical Center, University of FreiburgFreiburgGermany
| | - Todd M Greco
- Department of Molecular Biology, Princeton UniversityPrincetonUnited States
| | | | - Fenja Anderson
- Institute of Virology, Hannover Medical SchoolHannoverGermany
| | - Antonio Piras
- Institute of Virology, Technical University MunichMunichGermany
| | | | - Jonny Hertzog
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Anne Binz
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
| | - Anja Pohlmann
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
| | - Ute Prank
- Institute of Virology, Hannover Medical SchoolHannoverGermany
| | - Jan Rehwinkel
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Rudolf Bauerfeind
- Research Core Unit Laser Microscopy, Hannover Medical SchoolHannoverGermany
| | - Ileana M Cristea
- Department of Molecular Biology, Princeton UniversityPrincetonUnited States
| | - Andreas Pichlmair
- Institute of Virology, Technical University MunichMunichGermany
- German Center for Infection Research (DZIF), Munich Partner siteMunichGermany
| | - Georg Kochs
- Institute of Virology, Freiburg University Medical Center, University of FreiburgFreiburgGermany
| | - Beate Sodeik
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
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17
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Piras A, Boldrini L, Menna S, Sanfratello A, D'Aviero A, Cusumano D, Di Cristina L, Messina M, Spada M, Angileri T, Daidone A. Five-Fraction Stereotactic Radiotherapy for Brain Metastases: A Single-Institution Experience on Different Dose Schedules. Oncol Res Treat 2022; 45:408-414. [PMID: 35172322 DOI: 10.1159/000522645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022]
Abstract
Introduction The most common intracranial neoplasm diagnosed in adults are brain metastases (BrM). The benefit in terms of clinical control and toxicity for stereotactic radiotherapy (SRT)has been investigated for patients with low load of brain metastases. Aim of this single-institution experience was to investigate the best dose schedule for five-fraction stereotactic radiotherapy (FFSRT). Methods A retrospective analysis of patients treated for BrM with different dose schedules of FFSRT was performed. Local Control and clinical outcomes were evaluated with Magnetic resonance imaging (MRI) at 3, 6 and 9 months. Toxicity data were also collected. Results A total of 41 patients treated from November 2016 to September 2020 were enrolled in the analysis. Non Small Cell Lung cancer (51,2%) and breast cancer (24,3%) represented the most frequent primitive tumors. Treatment was performed on 5 consecutive days with prescribed dose ranging from 30 to 40 Gy, prescribed to the 95% isodose line that covered at least 98% of the GTV. Statistically significant differences (p=0.025) with higher LC control rates for dose schedules > 6Gy for fractions. Toxicity rates were not found to be higher than G1. Conclusion The results of this retrospective analysis suggest that FFSRT for BrM seems to be safe and feasible. Our results also underline that a total dose lower than 30 Gy in 5 fractions should not be used due to the expected minor LC.
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Affiliation(s)
- Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Luca Boldrini
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Roma, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sebastiano Menna
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Roma, Italy
| | | | - Andrea D'Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari, Italy
| | - Davide Cusumano
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Roma, Italy
| | | | - Marco Messina
- UOC Oncologia Medica, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy
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18
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Piras A, Fionda B, Sanfratello A, D'Aviero A, Sortino G, Pernice G, Boldrini L, Angileri T, Daidone A. Bullous pemphigoid and radiotherapy: case report and literature review update. Dermatol Reports 2022; 14:9170. [PMID: 35795838 PMCID: PMC9251523 DOI: 10.4081/dr.2022.9170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
Bullous pemphigoid (BP) is a common autoimmune bullous disease generally occurring in elderly patients. Itchy and tense blisters on normal skin or erythematous and edematous lesions on the trunk and extremities usually characterize BP. Trigger factors are still unclear while several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence. A review was performed to provide an update of literature. A case report of a patient affected by BP undergoing two radiotherapy courses for a primary breast cancer was also reported. A comprehensive review of the published literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review included studies describing BP and its relationships with RT treatments. A total of 13 articles were reviewed. Studies characteristics analysis resulted in eleven case reports, one case series and one large-scale case– control study. Literature update confirms the existence of a reasonable connection between RT and BP. Case report showed that a multidisciplinary management seems to assure the feasibility of RT in patients affected by BP, not depriving them of standard therapeutic opportunities.
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19
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Casà C, Piras A, D’Aviero A, Preziosi F, Mariani S, Cusumano D, Romano A, Boskoski I, Lenkowicz J, Dinapoli N, Cellini F, Gambacorta MA, Valentini V, Mattiucci GC, Boldrini L. The impact of radiomics in diagnosis and staging of pancreatic cancer. Ther Adv Gastrointest Endosc 2022; 15:26317745221081596. [PMID: 35342883 PMCID: PMC8943316 DOI: 10.1177/26317745221081596] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 02/02/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Pancreatic cancer (PC) is one of the most aggressive tumours, and better risk stratification among patients is required to provide tailored treatment. The meaning of radiomics and texture analysis as predictive techniques are not already systematically assessed. The aim of this study is to assess the role of radiomics in PC. METHODS A PubMed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in PC. The search strategy was 'radiomics [All Fields] AND ("pancreas" [MeSH Terms] OR "pancreas" [All Fields] OR "pancreatic" [All Fields])' and only original articles referred to PC in humans in the English language were considered. RESULTS A total of 123 studies and 183 studies were obtained using the mentioned search strategy on PubMed and Embase, respectively. After the complete selection process, a total of 56 papers were considered eligible for the analysis of the results. Radiomics methods were applied in PC for assessment technical feasibility and reproducibility aspects analysis, risk stratification, biologic or genomic status prediction and treatment response prediction. DISCUSSION Radiomics seems to be a promising approach to evaluate PC from diagnosis to treatment response prediction. Further and larger studies are required to confirm the role and allowed to include radiomics parameter in a comprehensive decision support system.
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Affiliation(s)
- Calogero Casà
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | | | - Francesco Preziosi
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Mariani
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Cusumano
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angela Romano
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Ivo Boskoski
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - Jacopo Lenkowicz
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Nicola Dinapoli
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Cellini
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Carlo Mattiucci
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Boldrini
- UOC Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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Piras A, Fionda B, Sanfratello A, D'Aviero A, Sortino G, Pernice G, Boldrini L, Angileri T, Daidone A. Bullous pemphigoid and radiotherapy: case report and literature review update. Dermatol Reports 2021. [DOI: 10.4081/dr.2021.9170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTROUDCTION Bullous pemphigoid (BP) is a common autoimmune bullous disease generally occurring in elderly patients. Itchy and tense blisters on normal skin or erythematous and edematous lesions on the trunk and extremities usually characterize BP. Trigger factors are still unclear while several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence. A review was performed in order to provide an update of literature. A case report of a patient affected by BP undergoing two radiotherapy courses for a primary breast cancer was also reported. MATERIALS AND METHODS A comprehensive review of the published literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The review included studies describing BP and its relationships with RT treatments. RESULTS A total of 13 articles were reviewed. Studies characteristics analysis resulted in eleven case reports, one case series and one large-scale case–control study. CONCLUSIONS Literature update confirms the existence of a reasonable connection between RT and BP. Case report showed that a multidisciplinary management seems to assure the feasibility of RT in patients affected by BP, not depriving them of standard therapeutic opportunities.
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21
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Piras A, Boldrini L, Menna S, Sanfratello A, D'Aviero A, Guarini A, Toscano A, Gebbia V, Angileri T, Daidone A. Radiofrequency Thermoablation and Hypofractionated Radiotherapy Combined Treatment for Bone Metastases: A Retrospective Study. Oncol Res Treat 2021; 45:88-93. [PMID: 34879380 DOI: 10.1159/000520503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Bone metastases (BMs) are the common cause of cancer-related pain, as approximately 45% of cancer patients suffer from bone pain (BP). Radiotherapy (RT) is well established as BP treatment strategy; also, other approaches have been shown to be effective in this setting. Radiofrequency thermoablation (RFA) in a combined strategy with RT appears to be feasible and effective in the treatment of metastatic BP ensuring a better quality of life. Aim of this retrospective study was to describe a case series of patients with painful osteolytic lesions at risk of fracture treated with the RFA-RT combined approach, analyzing local control and pain control as outcomes. METHODS Data of all patients with BM treated with combined approach in our center from April 2016 to June 2020 were retrospectively analyzed. Patients underwent RFA followed by cementoplasty on the same day and RT in a second phase. RT dose ranged between 30 and 37.5 Gy in 5/10 fractions. BP was evaluated according to the numeric rating scale (NRS), at the beginning of treatment and at 1, 2, 3, 6, 9, and 12 months from the end of combined treatment. RESULTS A total of 27 patients were treated from April 2016 to June 2020 with RFA-RT combined approach. The large majority of patients underwent stereotactic body radiotherapy (SBRT) (23/27). All patients experienced an NRS value decrease >2 at 1 month and between the first and second months. NRS mean value reached 0 at 3, 6, 9, and 12 months' evaluations. DISCUSSION/CONCLUSION The results of this retrospective analysis of patients treated with RFA-RT combined approach for BP support its safety and efficacy in terms of pain reduction. SBRT role in this combined approach has to be investigated in randomized trials.
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Affiliation(s)
- Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Luca Boldrini
- UOC Radioterapia Oncologica-Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sebastiano Menna
- UOC Radioterapia Oncologica-Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | | | - Andrea D'Aviero
- UOC Radioterapia Oncologica, Mater Olbia Hospital, Olbia, Sassari, Italy
| | - Aurelia Guarini
- UO Oncologia, Fondazione Istituto G. Giglio, Cefalù, Palermo, Italy
| | - Angelo Toscano
- Ortopedia Generale, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Vittorio Gebbia
- Medical Oncology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, La Maddalena Clinic for Cancer, University of Palermo, Palermo, Italy.,GSTU Foundation, Palermo, Italy
| | | | - Antonino Daidone
- UO Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
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22
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Piras A, Boldrini L, Menna S, Venuti V, Pernice G, Franzese C, Angileri T, Daidone A. Hypofractionated Radiotherapy in Head and Neck Cancer Elderly Patients: A Feasibility and Safety Systematic Review for the Clinician. Front Oncol 2021; 11:761393. [PMID: 34868976 PMCID: PMC8633531 DOI: 10.3389/fonc.2021.761393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Radiotherapy (RT) in the head and neck (H&N) site are undoubtedly the most challenging treatments for patients. Older and frail patients are not always able to tolerate it, and there are still no clear guidelines on the type of treatments to be preferred for them. The recommendations for Risk-Adapted H&N Cancer Radiation Therapy during the coronavirus disease 2019 (COVID-19) pandemic provided by the ASTRO-ESTRO consensus statement achieved a strong agreement about hypofractionated RT (HFRT). A systematic literature review was conducted in order to evaluate the feasibility and safety of HFRT for older patients affected by H&N malignancies. Materials and Methods A systematic database search was performed on PubMed and Embase according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Original studies, case series, and case reports describing the use of HFRT (with at least 2.2 Gy fractions) in patients with mean age ≥65 years were included. The analysis was based on the type of study, number of patients, mean age, tumor site, histology, performance status (PS), RT details, concomitant chemotherapy (CT), and described clinical outcomes. All the reported doses have been calculated in equivalent dose in 2 Gy fractions (EQD2) and biologically effective dose (BED) using α/β = 10 Gy or α/β = 12 Gy. Results We selected 17 papers that met the inclusion criteria and divided them in 4 categories: 6 articles analyze HFRT performed twice daily in repeated cycles, 3 once a day in repeated cycles, 4 in alternative days, and the last 4 in consecutive days. Conclusion HFRT seems to be a good treatment with an acceptable prolonged disease control. In older patients fit for radical treatments, a 55 Gy in 20 fractions regimen can be proposed as a valid alternative to the standard fractionated RT, but there are a multitude of hypofractionated regimens, ranging from single fraction, quad shot, and 1-, 2-, 3-, 4-, and 5-week schedules that all may be appropriate. The correct regimen for a patient depends on many factors, and it represents the result of a more specific and complex decision.
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Affiliation(s)
- Antonio Piras
- UO Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Luca Boldrini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica-Fondazione Policlinico Universitario Agostino Gemelli (IRCCS), Rome, Italy
| | - Sebastiano Menna
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica-Fondazione Policlinico Universitario Agostino Gemelli (IRCCS), Rome, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | | | - Ciro Franzese
- Radiotherapy Department, Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Biomedical Science Department, Humanitas University, Milan, Italy
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Bussu F, Rizzo D, Saderi L, Piras A, De Luca LM, De Riu G, Vaira LA, Serra A, Altrudo P, Delogu D, Dettori I, Riu FG, Angioj F, Firino L, Govoni R, Ibba G, Lai V, Mura E, Paglietti B, Piu C, Puggioni A, Rimini E, Rocca G, Serra C, Uzzau S, Rubino S, Sotgiu G. "Swab Team" in the SARS-CoV-2 outbreak containment among healthcare workers. J Infect Dev Ctries 2021; 15:1640-1645. [PMID: 34898491 DOI: 10.3855/jidc.15067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/14/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION To analyze the virus spread among Sassari Hospital staff in the first Covid-19 wave and the impact of the Swab Team, a multidisciplinary task force entitled of nasopharyngeal swab collection and testing. METHODOLOGY Nasopharyngeal swabs from HCWs between March 6 and May 28 2020 are evaluated. RESULTS 4919 SARS-CoV-2 tests were performed on 3521 operators. Nurses and doctors are the categories at highest risk. After the Swab Team institution, the average number of swabs raised from 47/day to 86/day (p = 0.007). Positive samples decreased from 18.6% to 1.7% (p < 0.0001). CONCLUSIONS The Swab Team is effective in increasing the cases tested and in reducing the reporting time. Procedure standardization reduces the risk for all the subjects involved (no transmission among swab team members, nor during the sample collection).
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Affiliation(s)
- Francesco Bussu
- Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy
| | - Antonio Piras
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy.
| | | | - Giacomo De Riu
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Unit, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Antonello Serra
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Paola Altrudo
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Domenico Delogu
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Ignazio Dettori
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | | | - Laura Firino
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | | | - Vincenzo Lai
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Erica Mura
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | - Claudia Piu
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | | | - Elena Rimini
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Giulia Rocca
- Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Caterina Serra
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Sergio Uzzau
- Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Salvatore Rubino
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy, Swab Team, Azienda Ospedaliera Universitaria, Sassari, Italy, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy
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Piras A, Menna S, D'Aviero A, Marazzi F, Mazzini A, Cusumano D, Massaccesi M, Mattiucci GC, Daidone A, Valentini V, Boldrini L. New fractionations in breast cancer: a dosimetric study of 3D-CRT versus VMAT. J Med Radiat Sci 2021; 69:227-235. [PMID: 34551211 PMCID: PMC9163458 DOI: 10.1002/jmrs.530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/06/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Adjuvant radiation therapy (RT) following primary surgery in women affected by early breast cancer (EBC) plays a central role in reducing local recurrences and overall mortality. The FAST-FORWARD trial recently demonstrated that 1-week hypofractionated adjuvant RT is not inferior to the standard schedule in terms of local relapse, cosmetic outcomes and toxicity. The aim of this in silico study was to evaluate the dosimetric aspects of a 1-week RT course, administered through volumetric modulated arc therapy (VMAT), compared with traditional three-dimensional conformal radiation therapy (3D-CRT) with tangential fields. METHODS Patients affected by left-side EBC undergoing adjuvant RT were selected. ESTRO guidelines for the clinical target volume (CTV) delineation and FAST-FORWARD protocol for CTV to planning target volume (PTV) margin definition were followed. Total prescribed dose was 26 Gy in five fractions. The homogeneity index (HI) and the global conformity index (GCI) were taken into account for planning and dose distribution optimisation purposes. Both 3D-CRT tangential fields and VMAT plans were generated for each patient. RESULTS The analysis included 21 patients. PTV coverage comparison between 3D-CRT and VMAT plans showed significant increases for GCI (P < 0.05) in VMAT technique; no statistically significant differences were observed regarding HI. For organs at risks (OAR), statistically significant increases were observed in terms of skin V103% (P < 0.002) and ipsilateral lung V30% (P < 0.05) with 3D-CRT and of heart V5% (P < 0.05) with VMAT technique. CONCLUSIONS This in silico study showed that both 3D-CRT and VMAT are dosimetrically feasible techniques in the framework of 1-week hypofractionated treatments for left EBC.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Sebastiano Menna
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | | | - Fabio Marazzi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | | | - Davide Cusumano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Mariangela Massaccesi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Gian Carlo Mattiucci
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Antonino Daidone
- Radioterapia Oncologica, Villa Santa Teresa, Bagheria, Palermo, Italy
| | - Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Boldrini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.,Università Cattolica del Sacro Cuore, Roma, Italy
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Fionda B, Piras A, D'Aviero A, Venuti V, Casà C, Preziosi F, Catucci F, Boldrini L, Daidone A, Tagliaferri L, Gambacorta MA, Valentini V. The "PC-WIRED" study: Patient Centred Evolution of Websites of Italian Radiotherapy Departments. Patient Educ Couns 2021; 104:2152-2153. [PMID: 33608213 DOI: 10.1016/j.pec.2021.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/23/2020] [Accepted: 02/05/2021] [Indexed: 02/07/2023]
Affiliation(s)
- B Fionda
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - A Piras
- Villa Santa Teresa, Radioterapia Oncologica, Palermo, Italy
| | - A D'Aviero
- Università Cattolica del Sacro Cuore, Rome, Italy.
| | - V Venuti
- Università degli Studi di Palermo, Radioterapia Oncologica, Palermo, Italy
| | - C Casà
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Preziosi
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - F Catucci
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - L Boldrini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Daidone
- Villa Santa Teresa, Radioterapia Oncologica, Palermo, Italy
| | - L Tagliaferri
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - M A Gambacorta
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Valentini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
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Bussu F, Tagliaferri L, Piras A, Rizzo D, Tsatsaris N, De Corso E, Parrilla C, Paludetti G. Multidisciplinary approach to nose vestibule malignancies: setting new standards. ACTA ACUST UNITED AC 2021; 41:S158-S165. [PMID: 34060531 PMCID: PMC8172111 DOI: 10.14639/0392-100x-suppl.1-41-2021-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/15/2021] [Indexed: 11/23/2022]
Abstract
Nose vestibule malignancies, mainly SCCs, are considered rare neoplasms. In the present paper, we review the current state of the art concerning classification and treatment, and describe current evidence supporting a paradigm shift. In the current AJCC classification nose vestibule is considered part of nasal cavity/ethmoid. In daily clinical practice, nose vestibule lesions are often misclassified as skin primaries. This leads to an underestimation of the real incidence and to a mis-management. When nose vestibule primaries are correctly classified as nose primaries, the current AJCC TNM appears inadequate for prognostic stratification and an old staging system described 4 decades ago by Wang has been demonstrated to be more reliable in the literature and is preferred in centers with the largest volume of cases treated. The principles of Wang classification should be applied and nose vestibule acknowledged as a new distinct subsite of nose and paranasal sinuses by the AJCC/UICC. Surgery, External Beam RadioTherapy (EBRT) and Interventional RadioTherapy (IRT, BrachyTherapy BT) are the current therapeutic options for nose vestibule (NV) SCC. Increasing evidence demonstrates that IRT, with a proper multidisciplinary approach, is at least equivalent to surgery and EBRT for treatment of the primary lesions in terms of oncological outcomes, but markedly superior in terms of cosmetic and functional results, supporting HDR (high dose rate) IRT as the new standard for the treatment of the primary lesion in these malignancies. To optimize the advantages of IRT as primary therapeutic modality we set up a new approach to the implantation phase of IRT exploiting the anatomic planes of esthetic and functional nose surgery and the potential of intensity modulated and image guided brachytherapy to avoid septal and alar perforation (anatomic implantation).
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Affiliation(s)
- Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy.,UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Antonio Piras
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Davide Rizzo
- Otolaryngology, Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Università di Sassari, Italy
| | - Nicola Tsatsaris
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Eugenio De Corso
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Claudio Parrilla
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Gaetano Paludetti
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa Collo, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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sanfratello A, Piras A, Boldrini L, La Vecchia M, Venuti V, Torchia M, Lotà C, Rinaldi C, Amari M, Orlando M, Zichichi L, Angileri T, Daidone A. PO-1406 Paget’s disease of scrotum and penis: Case Report of a re-irradiation and Review of the Literature. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07857-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Piras A, Rizzo D, Gallus R, Artuso A, Bussu F. Submandibular gland degloving: A minimally invasive function-preserving surgical approach for benign diseases. Head Neck 2021; 43:2560-2563. [PMID: 33942927 DOI: 10.1002/hed.26728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/09/2021] [Indexed: 11/05/2022] Open
Abstract
In the Video S1, a modified technique for submandibular gland resection in benign disease is shown. The main plane of dissection is below the fascia and immediately superficial to the fibrous capsule of the gland. The video shows the surgical steps and the structures that become evident along the procedure and illustrates some tips and tricks. Facial vessels are dissected, easily spared, and not ligated as it occurs in the classical technique. This technical variant is minimally invasive, respectful of anatomy, and through preservation of the fascial layer investing the gland aims at reducing the risk of injury to the marginalis mandibulae branch of the facial nerve, which lies within the fascia itself.
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Affiliation(s)
- Antonio Piras
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Roberto Gallus
- Otolaryngology Division, Mater Olbia Hospital, Olbia, Italy
| | - Alberto Artuso
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy.,Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Italy
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Gallus R, Melis A, Rizzo D, Piras A, De Luca LM, Tramaloni P, Serra A, Longoni E, Soro GM, Bussu F. Audiovestibular symptoms and sequelae in COVID-19 patients. J Vestib Res 2021; 31:381-387. [PMID: 33579886 DOI: 10.3233/ves-201505] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND since the beginning of COVID-19 outbreak a growing number of symptoms and deficits associated with the new pathology have emerged, among them cochlear damage in otherwise asymptomatic COVID-19 patients has been described. OBJECTIVE to investigate general and audiovestibular symptoms and sequelae in healed patients, and to seek for any sign of residual or permanent hearing or vestibular loss. METHODS we reviewed the data coming from 48 Covid-19 patients whose nasopharyngeal swabs have turned negative, all employed at our facility, that opted in for a free screening of audiovestibular symptoms offered by our hospital after the aforementioned report was published. The screening included a tonal pure tone audiometry, a vHIT and SHIMP test, as well as a survey including known symptoms and audiovestibular symptoms. RESULTS general symptoms as reported by our patients largely reflect what reported by others in the literature. 4 (8.3%) patients reported hearing loss, 2 (4.2%) tinnitus, 4 dizziness (8.3%), 1 spinning vertigo (2%), 1 dynamic imbalance (2%), 3 static imbalance (6.3%). Most audiovestibular symptoms have regressed. Thresholds at pure tone audiometry and vHIT gain were within normality range in all post-Covid-19 patients. CONCLUSIONS even if some patients suffer from audiovestibular symptoms, these are mostly transitory and there is no clear evidence of clinically relevant persistent cochlear or vestibular damage after recovery.
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Affiliation(s)
| | - Andrea Melis
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | - Antonio Piras
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
| | | | | | - Antonello Serra
- Surveillance and Prevention Department, University Hospital of Sassari, Sassari, Italy
| | - Eleonora Longoni
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero - Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | | | - Francesco Bussu
- Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Italy
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Giua C, Minerba L, Piras A, Floris N, Romano F, Sifac G. The effect of sucralfate-containing ointment on quality of life in people with symptoms associated with haemorrhoidal disease and its complications: the results of the EMOCARE survey. Acta Biomed 2021; 92:e2021029. [PMID: 33683221 PMCID: PMC7975930 DOI: 10.23750/abm.v92i1.11309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 11/26/2022]
Abstract
Background and aim: A rectal ointment containing 3% of sucralfate and herbal extracts (calendula, witch hazel leaf (hamamelis), chamomile), became available in Italy in 2019 for the treatment of symptoms associated with haemorrhoidal disease. This survey evaluated the effect of the mentioned sucralfate ointment, on quality of life (QoL) and symptom frequency in participants seeking treatment for haemorrhoidal disease from community pharmacies in Italy. Methods: EMOCARE was a multicentre prospective survey conducted at community pharmacies in Italy. Eligible participants (≥18 years) were those with haemorrhoidal symptoms in the last 7 days and were willing to initiate a treatment with the sucralfate ointment and herbal extracts (calendula, witch hazel leaf (hamamelis), chamomile). A survey was administered by the investigating pharmacists at the beginning and end (~14 days) of treatment. The primary endpoint was the change in HEMO-FISS-QoL scores. Results: Of the 290 (mean age 53.1 years old; 58.3% female) enrolled, 287 attended the follow-up visit. After a mean duration of 13 days, the sucralfate ointment significantly improved total HEMO-FISS-QoL scores (mean change from baseline: –10.41; 95%CI –11.95, –8.86; P<0.001) and mean scores for all domains of the HEMO-FISS-QoL scale (–11.13 [95%CI –12.95, –9.30] for physical disorders, –6.14 [95%CI –7.42, –4.85] for psychology, –18.79 [95% CI –21.67, –15.90] for defaecation, and –6.46 [95%CI –8.40, –4.51] for sexuality; all P<0.001 versus baseline). At the end of treatment, 39.4% of participants reported that they no longer had haemorrhoidal symptoms and the frequency of all assessed symptoms were reduced significantly from baseline (all P<0.05). Conclusions: After a mean 13 days of treatment the sucralfate ointment with herbal extracts improved HEMO-FISS-QoL scores and reduced symptoms in people with haemorrhoidal disease. (www.actabiomedica.it)
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Affiliation(s)
- Corrado Giua
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.
| | - Luigi Minerba
- Department of Medical Science and Public Health - University of Cagliari, Cagliari, Italy.
| | | | | | - Flora Romano
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.
| | - Group Sifac
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy.
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Petrone G, Rossi ED, Gallus R, Petrelli L, Marrone S, Rizzo D, Piras A, Garofalo G, Rindi G, Galli J, Paludetti G, Bussu F. Utility of ultrasound-guided fine needle aspiration cytology in assessing malignancy in head and neck pathology. Cytopathology 2021; 32:407-415. [PMID: 33501764 DOI: 10.1111/cyt.12955] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/28/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Fine needle aspiration cytology (FNAC) is a well-established diagnostic procedure for head and neck masses not clearly originating from mucosal or cutaneous surfaces. We analysed head and neck masses evaluated over a 2-year period, to assess the reliability of FNAC for the evaluation of malignancy. METHODS We enrolled all patients undergoing FNAC, from April 2013 to July 2015, in a single service of a large Italian university hospital. Relevant clinical data and ultrasonographic parameters of the lesions were recorded. We performed both conventional and thin-prep smears. Clinical presentation, ultrasonographic features and final cytology diagnoses were analysed and correlated with histology. RESULTS The series included 301 lesions in 285 patients, with a single (94.4%) or two (5.6%) lesions. Only eight samples were considered non-diagnostic/inadequate (2.6%). Among the cases, 139 FNAC (46.1%) underwent surgery. Cytological-histological correspondence was found in 89% of the cases. Concerning malignancy, we documented less than 4% false positives and less than 2.5% false negatives, with 92.7% sensitivity and 94.6% specificity. CONCLUSION FNAC diagnosis can be highly specific. Most importantly, it is highly reliable in assessing malignancy, thus defining the priority and guiding the management procedures.
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Affiliation(s)
- Gianluigi Petrone
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - Esther Diana Rossi
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | | | - Livia Petrelli
- Otolaryngology Division, Ospedale San Filippo Neri, Rome, Italy
| | - Sabino Marrone
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Antonio Piras
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Gabriella Garofalo
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy
| | - Guido Rindi
- Pathology, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Jacopo Galli
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia.,ENT Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Gaetano Paludetti
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italia.,ENT Division, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliera Universitaria, Sassari, Italy.,Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Università di Sassari, Sassari, Italy
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Cusumano D, Boldrini L, Yadav P, Casà C, Lee SL, Romano A, Piras A, Chiloiro G, Placidi L, Catucci F, Votta C, Mattiucci GC, Indovina L, Gambacorta MA, Bassetti M, Valentini V. Delta Radiomics Analysis for Local Control Prediction in Pancreatic Cancer Patients Treated Using Magnetic Resonance Guided Radiotherapy. Diagnostics (Basel) 2021; 11:diagnostics11010072. [PMID: 33466307 PMCID: PMC7824764 DOI: 10.3390/diagnostics11010072] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of this study is to investigate the role of Delta Radiomics analysis in the prediction of one-year local control (1yLC) in patients affected by locally advanced pancreatic cancer (LAPC) and treated using Magnetic Resonance guided Radiotherapy (MRgRT). A total of 35 patients from two institutions were enrolled: A 0.35 Tesla T2*/T1 MR image was acquired for each case during simulation and on each treatment fraction. Physical dose was converted in biologically effective dose (BED) to compensate for different radiotherapy schemes. Delta Radiomics analysis was performed considering the gross tumour volume (GTV) delineated on MR images acquired at BED of 20, 40, and 60 Gy. The performance of the delta features in predicting 1yLC was investigated in terms of Wilcoxon Mann-Whitney test and area under receiver operating characteristic (ROC) curve (AUC). The most significant feature in predicting 1yLC was the variation of cluster shade calculated at BED = 40 Gy, with a p-value of 0.005 and an AUC of 0.78 (0.61-0.94). Delta Radiomics analysis on low-field MR images might play a promising role in 1yLC prediction for LAPC patients: further studies including an external validation dataset and a larger cohort of patients are recommended to confirm the validity of this preliminary experience.
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Affiliation(s)
- Davide Cusumano
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Luca Boldrini
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Poonam Yadav
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA; (P.Y.); (M.B.)
| | - Calogero Casà
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
- Correspondence: ; Tel.: +39-06-3015-5226
| | - Sangjune Laurence Lee
- Department of Oncology, University of Calgary, 1331 29 Street NW, Calgary, AB T2N 1N4, Canada;
| | - Angela Romano
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Antonio Piras
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Giuditta Chiloiro
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Lorenzo Placidi
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Francesco Catucci
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Claudio Votta
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Gian Carlo Mattiucci
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Luca Indovina
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Maria Antonietta Gambacorta
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
| | - Michael Bassetti
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA; (P.Y.); (M.B.)
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (D.C.); (L.B.); (A.R.); (A.P.); (G.C.); (L.P.); (F.C.); (C.V.); (G.C.M.); (L.I.); (M.A.G.); (V.V.)
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Melis A, Rizzo D, Gallus R, Leo ME, Turra N, Masnaghetti D, De Luca LM, Piras A, Bussu F. Relationship between calcium metabolism and benign paroxysmal positional vertigo in north Sardinia population. J Vestib Res 2020; 30:375-382. [PMID: 33285658 DOI: 10.3233/ves-200025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) has a reported recurrence ranging from 26.8 to 50%. Osteoporosis and Vitamin D deficiency seems to have an impact on recurrence of BPPV. OBJECTIVE to evaluate the impact of osteoporosis and Vitamin D deficiency on recurrence of BPPV. METHODS 73 consecutive patients were divided in two groups according to the presence (group 1) or absence (group 0) of a recurrent episode. BMD, femoral and lumbar T-scores and Vitamin D levels were recorded. Statistical analysis was performed to investigate correlations. RESULTS patients in group 1 had statistically significant lower values of both femoral (-1,62±1,06 vs. -0,53±1,51; p = 0,001), lumbar T-score (-2,10±1,19 vs -0, 53±1.51, p = 0.001) and Vitamin D (19.53±15.33). The values of femoral T-score and Vitamin D could be combined in a model able to properly classify 65.8% of the cases (p = 0.002) as isolated or recurrent BPPV, with high accuracy (AUC 0.710 [0.590 -0.830]). CONCLUSION present data show a probable correlation between osteoporosis and Vitamin D with recurrent BPPV.
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Affiliation(s)
- Andrea Melis
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | - Davide Rizzo
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | | | - Maria Eleonora Leo
- Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
| | - Nicola Turra
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | | | | | - Antonio Piras
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy
| | - Francesco Bussu
- Azienda Ospedaliero Universitaria, Otolaryngology Division, Sassari, Italy.,Division of Otolaryngology, Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
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Leal NS, Dentoni G, Schreiner B, Naia L, Piras A, Graff C, Cattaneo A, Meli G, Hamasaki M, Nilsson P, Ankarcrona M. Amyloid Β-Peptide Increases Mitochondria-Endoplasmic Reticulum Contact Altering Mitochondrial Function and Autophagosome Formation in Alzheimer's Disease-Related Models. Cells 2020; 9:cells9122552. [PMID: 33260715 PMCID: PMC7760163 DOI: 10.3390/cells9122552] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/19/2020] [Accepted: 11/25/2020] [Indexed: 01/24/2023] Open
Abstract
Recent findings have shown that the connectivity and crosstalk between mitochondria and the endoplasmic reticulum (ER) at mitochondria-ER contact sites (MERCS) are altered in Alzheimer's disease (AD) and in AD-related models. MERCS have been related to the initial steps of autophagosome formation as well as regulation of mitochondrial function. Here, the interplay between MERCS, mitochondria ultrastructure and function and autophagy were evaluated in different AD animal models with increased levels of Aβ as well as in primary neurons derived from these animals. We start by showing that the levels of Mitofusin 1, Mitofusin 2 and mitochondrial import receptor subunit TOM70 are decreased in post-mortem brain tissue derived from familial AD. We also show that Aβ increases the juxtaposition between ER and mitochondria both in adult brain of different AD mouse models as well as in primary cultures derived from these animals. In addition, the connectivity between ER and mitochondria are also increased in wild-type neurons exposed to Aβ. This alteration in MERCS affects autophagosome formation, mitochondrial function and ATP formation during starvation. Interestingly, the increment in ER-mitochondria connectivity occurs simultaneously with an increase in mitochondrial activity and is followed by upregulation of autophagosome formation in a clear chronological sequence of events. In summary, we report that Aβ can affect cell homeostasis by modulating MERCS and, consequently, altering mitochondrial activity and autophagosome formation. Our data suggests that MERCS is a potential target for drug discovery in AD.
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Affiliation(s)
- Nuno Santos Leal
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
- Correspondence: (N.S.L.); (M.A.); Tel.: +44-122-333-4390 (N.S.L.); +46-852-483-577 (M.A.)
| | - Giacomo Dentoni
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Bernadette Schreiner
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Luana Naia
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Antonio Piras
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Caroline Graff
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Antonio Cattaneo
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Roma, Italy; (A.C.); (G.M.)
| | - Giovanni Meli
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Roma, Italy; (A.C.); (G.M.)
| | - Maho Hamasaki
- Department of Genetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan;
| | - Per Nilsson
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
| | - Maria Ankarcrona
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, BioClinicum J9:20, Visionsgatan 4, 171 64 Solna, Sweden; (G.D.); (B.S.); (L.N.); (A.P.); (C.G.); (P.N.)
- Correspondence: (N.S.L.); (M.A.); Tel.: +44-122-333-4390 (N.S.L.); +46-852-483-577 (M.A.)
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Cusumano D, Boldrini L, Yadav P, Gao Y, Chiloiro G, Piras A, Broggi S, Lenkowicz J, Placidi L, Musunuru H, Dinapoli N, Barbaro B, Azario L, Gambacorta M, De Spirito M, Basetti M, Yang Y, Fiorino C, Valentini V. PH-0715: External validation of ERITCP as response predictor in rectal cancer using MR-guided Radiotherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00737-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zontone P, Affanni A, Bernardini R, Brisinda D, Del Linz L, Formaggia F, Minen D, Minen M, Savorgnan C, Piras A, Rinaldo R, Fenici R. Comparative assessment of drivers' stress induced by autonomous and manual driving with heart rate variability parameters and machine learning analysis of electrodermal activity. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Nowadays research on Autonomous Driving Systems (ADS) and attention towards novel technology allowing real-time assessment of car drivers' psycho-physiological status is growing, to quantify driver's stress during semi-autonomous or autonomous driving assistance and to investigate human reaction to different types of ADS. We present a system for automatic stress detection with combined machine learning analysis of Skin Potential Response (SPR) and electrocardiographic (ECG) recordings to compare the driver's stress reaction during both manual and autonomous driving sessions carried out in a dynamic professional drive simulator (PDS).
Methods
All data were acquired after informed consent from 14 healthy volunteers (HVs) in the Vi-grade (Udine) PDS. Two SPR signals (one from each hand) and three chest ECG leads were recorded. A Motion Artifact (MA) removal algorithm was used to remove motion artifacts from SPR signals. A cleaned, single SPR signal, obtained as the RMS value by combining the two original signals, was then sent together with the time-variation of heart rate (HR) to a Machine Learning (ML) classification algorithm, i.e., a Support Vector Machine (SVM), based on some specific features of this signal. The output of the SVM provides a series of labels, that indicate the presence or lack of stress episodes during the driving experiment. Stress occurrence was also independently quantified with heart rate variability (HRV) analysis in the time (TD) and frequency (FD) domains and with non-linear (NL) methods.
Results
All participants completed the driving protocol consisting of two subsequent sessions, one with conventional manual (MD) and the other with autonomous (AD) driving settings, along a highway where some unexpected events occurred, inducing different level stress response.
Figure 1 shows an example of time variant changes of the RMS SPR signal and of the HR of one tested individual during both experimental settings. A simultaneous increase of both SPR and HR signal is apparent during the stress episodes correctly identified by the SVM (gray shadows). Discriminant analysis of FD (VLF, LF and HF) and NL (SD1, SD2, Entropy and Recurrence Plot) HRV parameters, independently assessed by two researchers blind to SVM results, differentiated between stress induced by MD and AD (accuracy: 88,4% cross-correlated) in good agreement with automatic SVM assessment. In general stress level was lower during the AD, being all HRV parameters not significantly modified from baseline rest. SPR amplitude eventually increased also during AD, but SVM efficiently differentiated between AD and MD stress anyhow.
Conclusions
The proposed method for automatic assessment of stress reactions of car drivers with SVM of SPR and HR signals is reliable, in both MD and AD scenarios. The results seem to evidence that MD is in general more demanding than AD inducing higher activation of sympathetic nervous system, especially in critical situations.
Figure 1. Time variance of SPR and HR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Zontone
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | - A Affanni
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | - R Bernardini
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | - D Brisinda
- Catholic University of Sacred Heart - Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - L Del Linz
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | | | - D Minen
- Vi-grade s.r.l., Udine, Italy
| | - M Minen
- Vi-grade s.r.l., Udine, Italy
| | | | - A Piras
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | - R Rinaldo
- University of Udine, Dipartimento Politecnico di Ingegneria e Architettura, Udine, Italy
| | - R Fenici
- Biomagnetism and Clinical Physiology International Center (BSSS), Rome, Italy
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Piras A, Rizzo D, Longoni E, Turra N, Urru S, Saba PP, Musumano L, Bussu F. Nasopharyngeal swab collection in the suspicion of Covid-19. Am J Otolaryngol 2020; 41:102551. [PMID: 32487335 PMCID: PMC7255165 DOI: 10.1016/j.amjoto.2020.102551] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/24/2020] [Indexed: 11/24/2022]
Abstract
RT-PCR detection of SARS-CoV-2 mRNA on nasopharyngeal swab is the standard for diagnosing active Covid-19 disease in asymptomatic subjects and in symptomatic patients without the typical radiological findings. Nasopharyngeal swabbing appears a trivial procedure, still an inappropriate nasopharyngeal sampling, performed by untrained operators, can be a relevant cause of false negative findings with a clear negative impact on the effort to control the epidemic and, when PPE is not properly used, this can expose healthcare workers and patients to risks of contagion.
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Piras A, Porcedda S, Falconieri D, Fais A, Era B, Carta G, Rosa A. Supercritical extraction of volatile and fixed oils from Petroselinum crispum L. seeds: chemical composition and biological activity. Nat Prod Res 2020; 36:1883-1888. [PMID: 32820642 DOI: 10.1080/14786419.2020.1810031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The supercritical fluid extraction (SFE) of volatile and fixed oil from milled parsley (Petroselinum crispum L.) seeds, using CO2 as solvent, is presented in this study. Extraction experiments were carried out in two steps: at pressures of (90 or 300) bar and temperature of 40 °C. The first extraction step, performed at 90 bar, produced a volatile fraction mainly formed by apiole (82.1%) and myristicin (11.4%). The volatile oil yield was 2.6% by weight of the charge. The second extraction step, carried out at 300 bar produced a fixed oil at a yield of 0.4% by weight. The most represented fatty acids in P. crispum fixed oil were 18:1 n-12 (49.9%), 18:2 n-6 (18.2%), 18:1 n-9 (11.8%), and 16:0 (7.4%). In particular, the unsaturated fatty acids 18:1 n-12 and 18:1 n-9 averaged 182.2 mg/g and 92.1 mg/g of oil extract, respectively. The quality of the oils extracted by SFE, in terms of its chemical composition, was compared to the oils obtained by hydrodistillation (HD) in a Clevenger apparatus and by solvent extraction (SE) using n-hexane in a Soxhlet apparatus. The antioxidant properties were determined by means of the ABTS assay. The results indicated that the fixed oil possessed low antioxidant activity (EC50 = 0.4 mg/mL) and the volatile oil had no antioxidant activity. The total phenolic content, expressed as concentration of gallic acid (gallic acid equivalent, GAE), of the fixed oil was 1.5 mg/g. The fixed oil found to have inhibitory effects against α-glucosidase, the volatile oil is active on acetylcholinesterase (AChE), tyrosinase, and α-glucosidase. Both samples have weak inhibitory activity on α-amylase and no activity on butyrylcholinesterase (BChE).
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Affiliation(s)
- A Piras
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - S Porcedda
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - D Falconieri
- State Institute of Higher Education "Michele Giua", Cagliari, Italy
| | - A Fais
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - B Era
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - G Carta
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
| | - A Rosa
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Italy
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Cusumano D, Boldrini L, Yadav P, Yu G, Musurunu B, Chiloiro G, Piras A, Lenkowicz J, Placidi L, Broggi S, Romano A, Mori M, Barbaro B, Azario L, Gambacorta MA, De Spirito M, Bassetti MF, Yang Y, Fiorino C, Valentini V. External Validation of Early Regression Index (ERI TCP) as Predictor of Pathologic Complete Response in Rectal Cancer Using Magnetic Resonance-Guided Radiation Therapy. Int J Radiat Oncol Biol Phys 2020; 108:1347-1356. [PMID: 32758641 DOI: 10.1016/j.ijrobp.2020.07.2323] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/08/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Tumor control probability (TCP)-based early regression index (ERITCP) is a radiobiological parameter that showed promising results in predicting pathologic complete response (pCR) on T2-weighted 1.5 T magnetic resonance (MR) images of patients with locally advanced rectal cancer. This study aims to validate the ERITCP in the context of low-tesla MR-guided radiation therapy, using images acquired with different magnetic field strength (0.35 T) and image contrast (T2/T1). Furthermore, the optimal timing for pCR prediction was estimated, calculating the ERI index at different biologically effective dose (BED) levels. METHODS AND MATERIALS Fifty-two patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation therapy were enrolled in this multi-institutional retrospective study. For each patient, a 0.35 T T2/T1-weighted MR image was acquired during simulation and on each treatment day. Gross tumor volume was contoured according to International Commission on Radiation Units Report 83 guidelines. According to the original definition, ERITCP was calculated considering the residual tumor volume at BED = 25 Gy. ERI was also calculated in correspondence with several BED levels: 13, 21, 32, 40, 46, 54, 59, and 67. The predictive performance of the different ERI indices were evaluated in terms of receiver operating characteristic curve. The robustness of ERITCP with respect to the interobserver variability was also evaluated considering 2 operators and calculating the intraclass correlation index. RESULTS Fourteen patients showed pCR. ERITCP correctly 47 of 52 cases (accuracy = 90%), showing good results in terms of sensitivity (86%), specificity (92%), negative predictive value (95%), and positive predictive value (80%). The analysis at different BED levels shows that the best predictive performance is obtained when this parameter is calculated at BED = 25 Gy (area under the curve = 0.93). ERITCP results are robust with respect to interobserver variability (intraclass correlation index = 0.99). CONCLUSIONS This study confirmed the validity and the robustness of ERITCP as a pCR predictor in the context of low-tesla MR-guided radiation therapy and indicate 25 Gy as the best BED level to perform predictions.
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Affiliation(s)
- Davide Cusumano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Luca Boldrini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Poonam Yadav
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Gao Yu
- Department of Radiological Sciences, University of California, Los Angeles, California
| | - Bindu Musurunu
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Giuditta Chiloiro
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Antonio Piras
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Jacopo Lenkowicz
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Lorenzo Placidi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Sara Broggi
- Medical Physics, San Raffaele Scientific Institute, Milano, Italy
| | - Angela Romano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Martina Mori
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Brunella Barbaro
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Luigi Azario
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | | | - Marco De Spirito
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Michael F Bassetti
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Yingli Yang
- Department of Radiological Sciences, University of California, Los Angeles, California
| | - Claudio Fiorino
- Medical Physics, San Raffaele Scientific Institute, Milano, Italy
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Piras A, Sanfratello A, Boldrini L, La Vecchia M, Venuti V, Amari ML, Orlando M, Zichichi L, Angileri T, Daidone A. Paget's disease of scrotum and penis case report of a re-irradiation and review of the literature. Dermatol Ther 2020; 33:e13890. [PMID: 32584449 DOI: 10.1111/dth.13890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/21/2020] [Indexed: 12/19/2022]
Abstract
Extramammary Paget's disease (EMPD) is a rare cutaneous adenocarcinoma generally arising in the anogenital region. Surgery is still considered the treatment of choice for patients with EMPD, while Radiotherapy is a common alternative for inoperable cases and it's necessary in case of lack of surgical radicality. In this article, we described our experience and a review of the literature, with a particular focus on radiation-induced toxicity and on the feasibility of re-irradiation. A 70-year-old patient with EPMD underwent adjuvant radiotherapy in 2015. After 28 months for recurrence another radiant treatment was performed. No G3 (CTCAE v4) toxicity were recorded. In the last follow-up visit at 18 months, no signs of relapse were reported. A search strategy of the bibliographic database PubMed was performed. The inclusion criteria for the articles were case report, clinical prospective, or retrospective studies with histological confirmation of EMPD of scrotum and penis; studies with patients undergoing RT; studies in the past 30 years. In most of the 14 reported studies, RT was overall well tolerated. The major observed toxicity was G3 skin toxicity in one study. To our knowledge, there are no other cases of EPMD re-irradiation in literature. Our patient showed an excellent response and tolerated very well the high doses of both the radiation treatments. This suggests that the tolerance of skin to re-irradiation following a long period between the two treatments may be comparable to the normal constraints.
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Affiliation(s)
- Antonio Piras
- Villa Santa Teresa, Radioterapia Oncologica, Palermo, Italy
| | | | - Luca Boldrini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Roma, Italy
| | - Maria La Vecchia
- Radioterapia Oncologica, Università degli Studi di, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di, Palermo, Italy
| | | | - Marzia Orlando
- Villa Santa Teresa, Radioterapia Oncologica, Palermo, Italy
| | - Leonardo Zichichi
- U.O.C. Dermatologia e Venerologia, Ospedale San Antonio Abate, Trapani, Italy
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Pasero D, Rizzo D, Piras A, Floris L, Parrilla C, Riu F, Terragni P, Bussu F. Tracheotomy in COVID-19 patients: preliminary experience and technical refinements. Br J Surg 2020; 107:e304. [PMID: 32542655 PMCID: PMC7323130 DOI: 10.1002/bjs.11757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 12/23/2022]
Affiliation(s)
- D Pasero
- Intensive Care Unit, Rome, Italy.,Department of Medical, Surgical and Experimental Sciences, Università di Sassari, Rome, Italy
| | - D Rizzo
- Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Rome, Italy
| | - A Piras
- Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Rome, Italy
| | - L Floris
- Intensive Care Unit, Rome, Italy
| | - C Parrilla
- Otolaryngology Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - F Riu
- Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Rome, Italy
| | - P Terragni
- Intensive Care Unit, Rome, Italy.,Department of Medical, Surgical and Experimental Sciences, Università di Sassari, Rome, Italy
| | - F Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria Sassari, Rome, Italy.,Department of Medical, Surgical and Experimental Sciences, Università di Sassari, Rome, Italy
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Melis A, Riu F, Kihlgren C, Piras A, Rizzo D, Sotgiu A, Donadu M, Usai D, Zanetti S, Bussu F. Medical-surgical management and clinical outcome in cervical abscesses. J Infect Dev Ctries 2020; 14:527-531. [PMID: 32525840 DOI: 10.3855/jidc.12191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 04/23/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients presenting with cervicofacial abscesses. METHODOLOGY A total of 394 patients diagnosed with abscess at the University of Sassari Otorhinolaryngology Division between 2009 and 2017 were included; among these, eleven patients were diagnosed with necrotizing fasciitis. Personal and clinical parameters including the LRINEC score and the medical and/or surgical treatment used were analyzed for each patient. The most frequently affected site was the peritonsillar space (76.9%), followed by the parapharyngeal space. RESULTS Mean age was 41(±17) years, the male population was slightly overrepresented (68%). An average of 6 (±7) days of hospitalization duration was recorded. The mortality rate was confirmed to be relatively low (1/349 patients) and was reported only in one patient diagnosed with necrotizing fasciitis (1/11). CONCLUSION Diagnosis, correct clinical definition and early medical-surgical treatment of neck abscesses were crucial to reduce complications; LRNEC score, C-reactive protein, glycemia and creatininemia proved to be reliable prognostic indicators of difficult patient management and risk of complications.
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Affiliation(s)
- Andrea Melis
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Francesco Riu
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Caterina Kihlgren
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Antonio Piras
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Davide Rizzo
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Alessandro Sotgiu
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
| | - Matthew Donadu
- Section of Experimental and Clinical Microbiology, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Donatella Usai
- Section of Experimental and Clinical Microbiology, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Stefania Zanetti
- Section of Experimental and Clinical Microbiology, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Francesco Bussu
- Otolaryngology Division, Department of Medical, Surgical and Experimental sciences, University of Sassari, Sassari, Italy.
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Piras A, Rizzo D, Uzzau S, De Riu G, Rubino S, Bussu F. Inappropriate Nasopharyngeal Sampling for SARS-CoV-2 Detection Is a Relevant Cause of False-Negative Reports. Otolaryngol Head Neck Surg 2020; 163:459-461. [PMID: 32450754 DOI: 10.1177/0194599820931793] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Reverse transcriptase polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 mRNA on nasopharyngeal swab is the standard for diagnosing active COVID-19 disease in asymptomatic cases and in symptomatic patients without the typical radiologic findings. For the present COVID-19 outbreak in Italy, we describe 4 symptomatic patients with negative RT-PCR results at the first nasopharyngeal swab, which became positive when collected a few hours later by an otolaryngologist. All the patients showed nasal obstruction. The present report suggests that inadequate nasopharyngeal sampling performed by untrained operators in the presence of nasal obstruction can be a relevant case of false-negative findings at RT-PCR, with a clear negative impact on the efforts to contain the current outbreak.
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Affiliation(s)
- Antonio Piras
- Otolaryngology Division, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | - Davide Rizzo
- Otolaryngology Division, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
| | | | | | | | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy.,Otolaryngology, Dipartimento delle Scienze Mediche, Chirurgiche e Sperimentali, Sassari, Italy
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Alitto AR, Tagliaferri L, Lancellotta V, D'Aviero A, Piras A, Frascino V, Catucci F, Fionda B, Staackmann C, Saldi S, Valentini V, Kovacs G, Aristei C, Mantini G. BIT-ART: Multicentric Comparison of HDR-brachytherapy, Intensity-modulated Radiotherapy and Tomotherapy for Advanced Radiotherapy in Prostate Cancer. In Vivo 2020; 34:1297-1305. [PMID: 32354922 PMCID: PMC7279807 DOI: 10.21873/invivo.11905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIM The aim of the study was to evaluate acute and late genitourinary (GU) and gastrointestinal (GI) toxicity in patients with high- or intermediate-risk prostate cancer. PATIENTS AND METHODS We evaluated data of patients from three Radiation Oncology Departments (Rome, Lübeck and Perugia). Patients treated in Rome underwent exclusive intensity-modulated-radiotherapy (IMRT) or IMRT plus high-dose-rate interventional radiotherapy (HDR-IRT). IMRT plus two fractions HDR-IRT was performed in Lübeck, while in Perugia Helical Tomotherapy was performed. The Common Toxicity Criteria for Adverse Event (Version 4.03) scale was used to describe acute and late toxicity. RESULTS At a median follow-up of 28 months, all 51 patients were alive and disease-free. Patients treated by HDR-IRT plus VMAT showed only G1-2 genitourinary- gastrointestinal (GU-GI) acute and late toxicity. Univariate analysis showed a lower risk of acute GU toxicity (p=0.048) in IMRT+HDR-IRT. CONCLUSION Low grade and less acute GU toxicity was observed in patients undergoing HDR-IRT boost.
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Affiliation(s)
- Anna Rita Alitto
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | | | | | - Vincenzo Frascino
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Francesco Catucci
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Bruno Fionda
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Christian Staackmann
- Interdisciplinary Brachytherapy Unit, University of Lübeck - University Hospital S-H, Campus Lübeck, Lübeck, Germany
| | - Simonetta Saldi
- Radiation Oncology Section, Department of Surgery and Biomedical Science, University of Perugia, Perugia, Italy
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gyorgy Kovacs
- Interdisciplinary Brachytherapy Unit, University of Lübeck - University Hospital S-H, Campus Lübeck, Lübeck, Germany
- Università Cattolica del Sacro Cuore, Educational Program Director Gemelli-INTERACTS, Rome, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, Department of Surgery and Biomedical Science, University of Perugia, Perugia, Italy
| | - Giovanna Mantini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Massaccesi M, Boldrini L, Piras A, Stimato G, Quaranta F, Azario L, Mattiucci GC, Valentini V. Spatially fractionated radiotherapy (SFRT) targeting the hypoxic tumor segment for the intentional induction of non-targeted effects: An in silico study to exploit a new treatment paradigm. Tech Innov Patient Support Radiat Oncol 2020; 14:11-14. [PMID: 32154394 PMCID: PMC7052565 DOI: 10.1016/j.tipsro.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction The possibility of intentionally triggering non targeted effects (NTEs) using spatially fractionated radiotherapy (SFRT) alone or combined with immunotherapy is an intriguing and fascinating area of research. Among different techniques for SFRT, stereotactic body radiotherapy targeting exclusively the central hypoxic segment of bulky tumors, (SBRT-PATHY) might trigger immunogenic cell death more efficiently. This in silico study aims to identify the best possible dosimetric trade-off for prescribing SFRT with volumetric modulated arc (VMAT) based stereotactic radiotherapy (SRT). Material and methods Eight spherical volumes defined "Gross Tumor Volumes" (GTVs) were generated with diameters of 3-10 cm (with incremental steps of 1 cm), simulating tumor lesions. The inner third part of each GTV (GTVcentral) was selected to simulate the central hypoxic area and a ring structure was derived around it to simulate the tumor periphery (GTVperipheral). Volumetric modulated arc radiation treatment (VMAT) plans were calculated to deliver a single fraction of 10 Gy to each GTVcentral with different dose prescription methods: target mean and isodose driven (40, 50, 60, 70, 80 and 90%).The volume of GTVperipheral receiving less than 2 Gy was recorded as dosimetric performance indicator. Results 56 possible dosimetric scenarios were analyzed. The largest percentage of GTVperipheral spared from the dose of 2 Gy was achieved with dose prescription methods to the 70% isodose line for lesions smaller than 6 cm (range 42.9-48.4%) and to the target mean for larger ones (range 52.9-64.5%). Conclusions Optimizing the dose prescription method may reduce the dose to tumor periphery in VMAT-based SFRT, thus potentially sparing tumor infiltrating immune cells. The optimal method may vary according to the size of the lesion. This should be taken into account when designing prospective trials using SFRT.
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Affiliation(s)
- M Massaccesi
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy
| | - L Boldrini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy
| | - A Piras
- Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy
| | - G Stimato
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Fisica Sanitaria, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy
| | - F Quaranta
- Università Cattolica del Sacro Cuore, Istituto di Fisica, Roma, Italy
| | - L Azario
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Fisica Sanitaria, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy.,Università Cattolica del Sacro Cuore, Istituto di Fisica, Roma, Italy
| | - G C Mattiucci
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy.,Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy
| | - V Valentini
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Roma, Italy.,Università Cattolica del Sacro Cuore, Istituto di Radiologia, Roma, Italy
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Boldrini L, Piras A, Chiloiro G, Autorino R, Cellini F, Cusumano D, Fionda B, D'Aviero A, Campitelli M, Marazzi F, Balducci M, Valentini V, Gambacorta MA. Low Tesla magnetic resonance guided radiotherapy for locally advanced cervical cancer: first clinical experience. Tumori 2020; 106:497-505. [PMID: 32066345 DOI: 10.1177/0300891620901752] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Magnetic resonance-guided radiotherapy (MRgRT) represents an innovative approach for personalized radiotherapy treatments and its applications are being explored in various anatomical sites to fully understand its potential advantages. This study describes the first clinical experience of MRgRT application in patients with locally advanced cervical cancer (LACC) undergoing neoadjuvant chemoradiotherapy. The feasibility of the technique is evaluated and its toxicity profile and clinical outcomes are reported. METHODS Patients with LACC (International Federation of Gynecology and Obstetrics stage IIA-IVA) undergoing neoadjuvant chemoradiotherapy (CRT) on a 0.35T Tri-60-Co hybrid unit (ViewRay) were retrospectively compared with randomly selected patients treated with a standard linear accelerator. Total prescribed dose was 50.6 Gy (2.3 Gy/fraction) to planning target volume 1 (PTV1) and 39.6 Gy (1.8 Gy/fraction) to PTV2, delivered using a simultaneous integrated boost. Surgery was performed 8 weeks after the end of CRT. The effect of magnetic resonance guidance on replanning approaches, treatment-related toxicities, and pathologic response were assessed for each patient. Patient outcomes were noted and dosimetric comparisons performed between the 2 arms. RESULTS Nine patients with LACC treated from May 2018 to November 2018 were retrospectively enrolled and their records compared with the records of an equivalent cohort of randomly selected patients. Five replanning cases were performed in the MRgRT group and 0 in the linear accelerator group. Acute G1-G2 gastrointestinal toxicities were observed in 33.3% of MRgRT patients and in 55.5% of linear accelerator patients; acute G1-G2 genitourinary toxicities in 22.2% and 33.3%, respectively. No G3 toxicity was found except for neutropenia in 2 patients. No differences were observed in pathologic response between the 2 groups. CONCLUSIONS Despite the retrospective nature of the observations and the low number of enrolled patients, the application of MRgRT in LACC appears to be safe and feasible with a favorable toxicity profile and response rates comparable to gold standard, supporting the setup of larger prospective studies to investigate the potentialities of this new technology.
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Affiliation(s)
- Luca Boldrini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Antonio Piras
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuditta Chiloiro
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Rosa Autorino
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Francesco Cellini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Davide Cusumano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Fisica Sanitaria, Rome, Italy
| | - Bruno Fionda
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Andrea D'Aviero
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maura Campitelli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Fabio Marazzi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy
| | - Mario Balducci
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta Gambacorta
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Guerriero S, Ajossa S, Pascual MA, Rodriguez I, Piras A, Perniciano M, Saba L, Paoletti AM, Mais V, Alcazar JL. Ultrasonographic soft markers for detection of rectosigmoid deep endometriosis. Ultrasound Obstet Gynecol 2020; 55:269-273. [PMID: 30977185 DOI: 10.1002/uog.20289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/26/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the use of ultrasound (US) soft markers as a first-line imaging tool to raise suspicion of rectosigmoid (RS) involvement in women suspected of having deep endometriosis. METHODS We included in this prospective observational study all patients with clinical suspicion of deep endometriosis who underwent diagnostic transvaginal US evaluation at our unit from January 2016 to February 2017. Several US soft markers were evaluated for prediction of RS involvement (presence of US signs of uterine adenomyosis, presence of an endometrioma, adhesion of the ovary to the uterus (reduced ovarian mobility), presence of 'kissing ovaries' (KO) and absence of the 'sliding sign'), using as the gold standard expert US examination for the presence of RS endometriosis. RESULTS Included were 333 patients with clinical suspicion of deep endometriosis. Of these, 106 had an US diagnosis of RS endometriosis by an expert. The only significant variables found in the prediction model were absence of the sliding sign (odds ratio (OR), 13.95; 95% CI, 7.7-25.3), presence of KO (OR, 22.5; 95% CI, 4.1-124.0) and the interaction between these two variables (OR, 0.03; 95% CI, 0.004-0.28). Regarding their interaction, RS endometriosis was present when KO was absent and the sliding sign was present in 10% (19/190) of cases, when both KO and the sliding sign were present in 71.4% (5/7) of cases, when both KO and the sliding sign were absent in 60.8% (76/125) of cases and when KO was present and the sliding sign was absent in 54.5% (6/11) of cases. Thus, when the sliding sign was absent and/or KO was present, transvaginal US showed a specificity of 75% (95% CI, 69-80%) and a sensitivity of 82% (95% CI, 73-88%). CONCLUSIONS US findings of absence of the sliding sign and/or presence of KO in patients with clinical suspicion of endometriosis should raise suspicion of RS involvement and indicate referral for expert US examination, with a low rate of false-negative diagnosis. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- S Guerriero
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
- Department of Obstetrics and Gynecology, Azienda Ospedaliero Universitaria, Policlinico Universitario Duilio Casula, Monserrato, Italy
| | - S Ajossa
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - M A Pascual
- Department of Obstetrics, Gynecology and Reproduction, Hospital Universitari Dexeus, Barcelona, Spain
| | - I Rodriguez
- Unidad Epidemiología y Estadística, Departamento de Obstetricia, Ginecología y Reproducción, Hospital Universitario Dexeus, Barcelona, Spain
| | - A Piras
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - M Perniciano
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - L Saba
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Monserrato, Italy
| | - A M Paoletti
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - V Mais
- Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
| | - J L Alcazar
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
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Piras A, Ariu F, Martino N, Maltana A, Menéndez-Blanco I, Paramio M, Dell'Aquila M, Bogliolo L. 186 Protective effect of resveratrol on invitro fertilization of ovine oocytes matured under cadmium exposure. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cadmium (Cd) is one of the most toxic environmental and industrial heavy metals, with adverse effect on female reproduction. Earlier invitro studies have demonstrated that exposure to Cd during IVM impairs oocyte fertilization through the induction of oxidative stress (Martino et al. 2017 Reprod. Toxicol. 69, 132-145). The aim of this study was to evaluate the effect of supplementing IVM medium with resveratrol (Res), a phytoalexin with antioxidant activity, on IVF of ovine oocytes matured under Cd exposure and to evaluate whether this effect could be mediated by alterations of cortical granules (CGs) distribution and/or intracellular levels of reactive oxygen species (ROS). Cumulus-oocyte complexes collected from slaughterhouse-derived ovaries of prepubertal ewes were invitro matured with 0μM CdCl2 (control), 2μM CdCl2 (Cd group), or 2μM CdCl2 + 1μM Res (Cd-Res). Groups of MII oocytes were invitro fertilized with ram semen (Bogliolo et al. 2011 Reprod. Fertil. Dev. 23, 809-817). After 16h, oocytes were fixed with absolute ethanol, stained with Hoechst 33342, and classified as follows: normally fertilized (two pronuclei), polyspermic (more than two pronuclei), and abnormally fertilized (asynchronous pronucleus formation). Levels of ROS and distribution of CG in MII oocytes (n=25 each group) were evaluated by confocal laser scanning microscopy after staining with 2’,7’dichlorodihydrofluorescein diacetate and Alexa Fluor 488-conjugated lectin peanut agglutinin, respectively (Jiao et al. 2013 PLoS One 8, 58018). Data of fertilization and CGs distribution were analysed by Chi-squared test and ROS levels (mean±standard error) by Kruskal-Wallis test with STATA\IC 11.0 (Stata Corp.). Oocytes matured in presence of Res had higher normal fertilization and lower polyspermy rates than those matured without Res (Table 1). Levels of ROS in oocytes were lower in the Cd-Res group than in the Cd group (74.4±1.3 vs. 122.4±1.5 pixel/oocyte; P<0.05), and similar to those of the control (71.1±2.3 pixel/oocyte). The ratio of oocytes of Cd-Res group with CGs normally distributed in the peripheral region was higher than that of Cd group (91.3% vs. 65.2%; P<0.05) and comparable to that of control oocytes (95.8%). Collectively, our results showed that resveratrol protects oocytes from Cd-induced alteration of normal fertilization by preventing oxidative stress and improving the major mechanism responsible for blockage of polyspermic fertilization.
Table 1.Effect of resveratrol on IVF rate of oocytes matured under cadmium exposure
Group
No. of total oocytes
No. of MII oocytes
No. of fertilized oocytes (%)
Normal
Polyspermy
Abnormal
Control
136
105 (77.2)
59 (56.2)a
23 (21.9)a
6 (5.7)
Cd
146
106 (72.6)
39 (36.8)b
38 (35.8)b
7 (6.6)
Cd-Res
114
88 (77.2)
47 (53.4)a
16 (18.2)a
7 (7.9)
a,bValues in the same column with different superscripts differ significantly (P<0.05).
This project was supported by FDS 2016 (CUP J86C18000780005).
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Ariu F, Sanna Passino E, Piras A, Melosu V, Maioli M, Castagna A, Fontani V, Rinaldi S, Bogliolo L. 78 Radio electric asymmetric conveyer treatment during prolonged cold storage of ovaries enhances developmental competence of oocytes in the domestic cat model. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hypothermic storage (4°C) of ovaries for long-distance transport holds great potential to expand access to fertility preservation in animals and humans (Duncan et al. 2016 Reproduction 152, 201-210). However, storage for prolonged periods (over 24h) leads to structural/functional changes in the ovarian tissue with a critical reduction of follicular viability and oocyte quality (Piras et al. 2018 Reprod. Biol. Endocrinol. 10, 16-76; Isachenko et al. 2009 Fertil. Steril. 91, 1556-1559). The radio electric asymmetric conveyer (REAC) is a novel technology platform for neuro and bio-modulation that optimize the ion fluxes and the mechanisms driving cellular asymmetry and polarization in biological structures (Maioli et al. 2016 Sci. Rep. 6, 28682). The REAC has already proved to be effective in promoting cell differentiation and reprogramming and to counteract the biological mechanisms linked to aging and the degenerative process (Berlinguer et al. 2017 Reprod. Biol. Endocrinol. 15, 11; Maioli et al. 2014 Age 36, 9-20). In the present study, the domestic cat was used as an experimental model to evaluate the effect of REAC treatment during ovary storage at 4°C for 48h on invitro developmental ability of oocytes retrieved from antral follicles. Ovaries harvested from healthy domestic queens during ovariectomy were randomly assigned to the REAC-treated (R: n=13) and untreated (C: n=13) groups. In detail, ovaries were maintained in 4mL of phosphate-buffered saline at 4°C for 48h. The REAC device was set at 2.4 GHz, and its conveyer electrodes were immersed into the phosphate-buffered saline. After 48h, ovaries were sliced to release cumulus-oocyte complexes, which were selected according to their morphological characteristics (Johnston et al. 1991 Biol. Reprod. 45, 898-906) for IVM (R: n=130; C: n=133). Matured oocytes were fertilised (IVF) with frozen-thawed epididymal spermatozoa and presumptive zygote were invitro cultured (IVC) for 7 days. On Day 2 and Day 7 of IVC, respectively, the number of embryos cleaved and developing to the blastocyst stage was determined. The IVM, IVF, and IVC were performed according to the procedure of Piras et al. (2018 Reprod. Biol. End. 16, 76). Data were analysed by chi-square test with STATA\IC 11.0. Maturation rate of oocytes did not differ between groups (R: n=59/130, 45.4%; C: n=66/133, 49.6%). Cleavage rate was higher (P<0.05) in the R group (n=34/59, 57.6%) compared with the C group (n=25/66, 37.9%). The percentages of blastocyst formation relative to the number of cleaved embryos (R: n=12/34, 35.3%; C: n=3/25 12.0%) and to the total number of MII oocytes (R: n=12/59, 20.4%; C: n=3/66, 4.5%) increased (P<0.05) after REAC treatment compared with the untreated counterpart. In conclusion, REAC treatment during cold storage of cat ovaries for 48h positively affected the quality of oocytes as assessed by invitro embryo production outcome. The REAC technology could provide a useful approach for the optimization of ovarian tissue transport conditions for fertility preservation especially for endangered species and patients with fertility-threatening conditions.
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Menéndez-Blanco I, Ariu F, Piras A, Nieddu S, Paramio M, Arav A, Ledda S, Bogliolo L. 111 Fertilizing ability of frozen and freeze-dried semen following intracytoplasmic sperm injection of invitro-matured sheep oocytes. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Freeze-drying is a novel technique that permits the storage of semen at room temperature for long time periods, retaining their fertilizing capacity. The main objective of this work was to compare the fertilization ability of frozen-thawed (FT) and freeze-dried (FD) ram semen following intracytoplasmic sperm injection (ICSI) of invitro-matured (IVM) sheep oocytes. Oocytes were recovered by slicing the ovaries of slaughtered sheep. Selected cumulus-oocyte complexes (COCs) were IVM for 24h in tissue culture medium 199 (TCM-199) supplemented with 10% heat-treated oestrous sheep serum (ESS), 0.36mM pyruvate, FSH (1IUmL−1), and luteinising hormone (LH; 1IUmL−1) under mineral oil in a humidified atmosphere of 5% CO2, at 38.5°C. Semen was collected from fertile adult rams using an artificial vagina and processed for (1) freezing and thawing (Khalifa and Lymberopoulos, 2013 Cell Tissue Bank 14, 687-698; https://doi.org/10.1007/s10561-012-9357-6) or (2) freeze-drying and rehydration according to Arav et al. (2018 J. Assist. Reprod. Genet. 35, 1149-115; https://doi.org/10.1007/s10815-018-1145-1) protocols. For FD protocol, sperm samples were diluted in a sugar solution of trehalose and sorbitol (LyoB) and dehydrated for 24h. Later, the samples were rehydrated in a warming solution and diluted in TCM-199 before ICSI. After maturation, metaphase II (MII) oocytes with a polar body were injected with FT or FD sperm. Briefly, oocytes were transferred into groups of six in an ICSI dish containing 6-µL drops of holding medium (TCM-199 + 5% fetal bovine serum) and 3-µL drops of PVP for the sperm samples. Injection was carried out with an inverted microscope (Olympus IX73) connected to a micromanipulation system (Narishige) using ICSI pipettes with 7-µm internal diameter. Within 1h, ICSI oocytes were activated with 5 µM ionomycin for 4min and invitro cultured in modified synthetic oviductal fluid medium (Bogliolo et al. 2011 Reprod. Fertil. Dev. 23, 809-817; https://doi.org/10.1071/RD11023). After 17-21h, injected oocytes were fixed and stained in a solution of ethanol Hoechst 33342 and classified as FPN (one female pronucleus and one condensed sperm head), MPN (one male pronucleus and one MII), 2PN (two pronuclei, male and female), 3PN (three or more pronuclei), and NPN (no pronuclei). Data were analysed using analysis of variance (two-way ANOVA) followed by Tukey post hoc test with SAS software, version 9.4. The ICSI-FD group had a higher number of NPN and a lower number of 2PN than did the ICSI-FT group (P<0.05). We think that more technical advances in the FD process as well as the rehydration procedure are necessary to improve the application of FD ovine semen for invitro fertilization by ICSI in sheep, but in any case these results have showed that FD could be a useful tool for the future of invitro embryo production.
Table 1.Pronuclear formation at 17-21h post-injection1
Treatment
n
FPN
MPN
2PN
3PN
NPN
FT
71
9.66±4.12
4.26±1.48
48.13±2.79a
5.97±4.16
31.98±6.75a
FD
65
6.16±2.26
1.39±1.39
20.15±4.14b
10.57±6.59
61.73±6.89b
a,bValues in the same column with different superscript letters differ significantly (P<0.05).
1Data are presented as mean±s.e.m. FPN=female pronucleus, MPN=one male pronucleus and one metaphase II oocyte, 2PN=two pronuclei, male and female, 3PN=three or more pronuclei, NPN=no pronuclei.
Funding was provided by Spanish MINECO Grant AGL2017-85837-R, Spanish MECD pre-doctoral grant FPU15/00773, and Spanish MECD mobility grant EST18/00472 to Irene Menéndez Blanco.
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