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McRonald FE, Pethick J, Santaniello F, Shand B, Tyson A, Tulloch O, Goel S, Lüchtenborg M, Borthwick GM, Turnbull C, Shaw AC, Monahan KJ, Frayling IM, Hardy S, Burn J. Identification of people with Lynch syndrome from those presenting with colorectal cancer in England: baseline analysis of the diagnostic pathway. Eur J Hum Genet 2024; 32:529-538. [PMID: 38355963 PMCID: PMC11061113 DOI: 10.1038/s41431-024-01550-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
It is believed that >95% of people with Lynch syndrome (LS) remain undiagnosed. Within the National Health Service (NHS) in England, formal guidelines issued in 2017 state that all colorectal cancers (CRC) should be tested for DNA Mismatch Repair deficiency (dMMR). We used a comprehensive population-level national dataset to analyse implementation of the agreed diagnostic pathway at a baseline point 2 years post-publication of official guidelines. Using real-world data collected and curated by the National Cancer Registration and Analysis Service (NCRAS), we retrospectively followed up all people diagnosed with CRC in England in 2019. Nationwide laboratory diagnostic data incorporated somatic (tumour) testing for dMMR (via immunohistochemistry or microsatellite instability), somatic testing for MLH1 promoter methylation and BRAF status, and constitutional (germline) testing of MMR genes. Only 44% of CRCs were screened for dMMR; these figures varied over four-fold with respect to geography. Of those CRCs identified as dMMR, only 51% underwent subsequent diagnostic testing. Overall, only 1.3% of patients with colorectal cancer had a germline MMR genetic test performed; up to 37% of these tests occurred outside of NICE guidelines. The low rates of molecular diagnostic testing in CRC support the premise that Lynch syndrome is underdiagnosed, with significant attrition at all stages of the testing pathway. Applying our methodology to subsequent years' data will allow ongoing monitoring and analysis of the impact of recent investment. If the diagnostic guidelines were fully implemented, we estimate that up to 700 additional people with LS could be identified each year.
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Affiliation(s)
| | - Joanna Pethick
- National Disease Registration Service, NHS England, London, UK
| | - Francesco Santaniello
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Brian Shand
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Adele Tyson
- National Disease Registration Service, NHS England, London, UK
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Oliver Tulloch
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Shilpi Goel
- National Disease Registration Service, NHS England, London, UK
- Health Data Insight, Cambridge, UK
| | - Margreet Lüchtenborg
- National Disease Registration Service, NHS England, London, UK
- Cancer Epidemiology and Cancer Services Research, King's College London, London, UK
| | - Gillian M Borthwick
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Adam C Shaw
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Kevin J Monahan
- St Mark's Hospital Centre for Familial Intestinal Cancer, Imperial College, London, UK
| | - Ian M Frayling
- St Mark's Hospital Centre for Familial Intestinal Cancer, Imperial College, London, UK
- St Vincent's University Hospital, Dublin, Ireland
| | - Steven Hardy
- National Disease Registration Service, NHS England, London, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
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Cook S, Pethick J, Kibbi N, Hollestein L, Lavelle K, de Vere Hunt I, Turnbull C, Rous B, Husain A, Burn J, Lüchtenborg M, Santaniello F, McRonald F, Hardy S, Linos E, Venables Z, Rajan N. Sebaceous carcinoma epidemiology, associated malignancies and Lynch/Muir-Torre syndrome screening in England from 2008 to 2018. J Am Acad Dermatol 2023; 89:1129-1135. [PMID: 37031776 DOI: 10.1016/j.jaad.2023.03.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/24/2022] [Revised: 02/02/2023] [Accepted: 03/19/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Sebaceous carcinomas (SC) may be associated with the cancer predisposition syndrome Muir-Torre/Lynch syndrome (MTS/LS), identifiable by SC mismatch repair (MMR) screening; however, there is limited data on MMR status of SC. OBJECTIVE To describe the epidemiology of SC, copresentation of other cancers, and population level frequency of MMR screening in SC. METHODS A population-based retrospective cohort study of SC patients in the National Cancer Registration and Analysis Service in England. RESULTS This study included 1077 SC cases (739 extraocular, 338 periocular). Age-standardized incidence rates (ASIR) were higher in men compared with women, 2.74 (95% CI, 2.52-9.69) per 1,000,000 person-years for men versus 1.47 person-years (95% CI, 1.4-1.62) for women. Of the patients, 19% (210/1077) developed at least one MTS/LS-associated malignancy. MMR immunohistochemical screening was performed in only 20% (220/1077) of SC tumors; of these, 32% (70/219) of tumors were MMR deficient. LIMITATIONS Retrospective design. CONCLUSIONS Incorporation of MMR screening into clinical practice guidelines for the management of SC will increase the opportunity for MTS/LS diagnoses, with implications for cancer surveillance, chemoprevention with aspirin, and immunotherapy treatment targeted to MTS/LS cancers.
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Affiliation(s)
- Sam Cook
- Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Joanna Pethick
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Loes Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands; Department of Research, Netherlands Comprehensive Cancer Center (IKNL), Utrecht, The Netherlands
| | - Katrina Lavelle
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Isabella de Vere Hunt
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Clare Turnbull
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Brian Rous
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Akhtar Husain
- Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Margreet Lüchtenborg
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, London, United Kingdom
| | - Francesco Santaniello
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Health Data Insight, Cambridge, United Kingdom
| | - Fiona McRonald
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Steven Hardy
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom
| | - Eleni Linos
- Department of Dermatology, Stanford University School of Medicine, Stanford, California
| | - Zoe Venables
- National Disease Registration Service (NDRS), NHS Digital, London, United Kingdom; Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
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3
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Loong L, Huntley C, McRonald F, Santaniello F, Pethick J, Torr B, Allen S, Tulloch O, Goel S, Shand B, Rahman T, Luchtenborg M, Garrett A, Barber R, Bedenham T, Bourn D, Bradshaw K, Brooks C, Bruty J, Burghel GJ, Butler S, Buxton C, Callaway A, Callaway J, Drummond J, Durkie M, Field J, Jenkins L, McVeigh TP, Mountford R, Nyanhete R, Petrides E, Robinson R, Scott T, Stinton V, Tellez J, Wallace AJ, Yarram-Smith L, Sahan K, Hallowell N, Eccles DM, Pharoah P, Tischkowitz M, Antoniou AC, Evans DG, Lalloo F, Norbury G, Morris E, Burn J, Hardy S, Turnbull C. Germline mismatch repair (MMR) gene analyses from English NHS regional molecular genomics laboratories 1996-2020: development of a national resource of patient-level genomics laboratory records. J Med Genet 2023; 60:669-678. [PMID: 36572524 PMCID: PMC10359571 DOI: 10.1136/jmg-2022-108800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/18/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To describe national patterns of National Health Service (NHS) analysis of mismatch repair (MMR) genes in England using individual-level data submitted to the National Disease Registration Service (NDRS) by the NHS regional molecular genetics laboratories. DESIGN Laboratories submitted individual-level patient data to NDRS against a prescribed data model, including (1) patient identifiers, (2) test episode data, (3) per-gene results and (4) detected sequence variants. Individualised per-laboratory algorithms were designed and applied in NDRS to extract and map the data to the common data model. Laboratory-level MMR activity audit data from the Clinical Molecular Genetics Society/Association of Clinical Genomic Science were used to assess early years' missing data. RESULTS Individual-level data from patients undergoing NHS MMR germline genetic testing were submitted from all 13 English laboratories performing MMR analyses, comprising in total 16 722 patients (9649 full-gene, 7073 targeted), with the earliest submission from 2000. The NDRS dataset is estimated to comprise >60% of NHS MMR analyses performed since inception of NHS MMR analysis, with complete national data for full-gene analyses for 2016 onwards. Out of 9649 full-gene tests, 2724 had an abnormal result, approximately 70% of which were (likely) pathogenic. Data linkage to the National Cancer Registry demonstrated colorectal cancer was the most frequent cancer type in which full-gene analysis was performed. CONCLUSION The NDRS MMR dataset is a unique national pan-laboratory amalgamation of individual-level clinical and genomic patient data with pseudonymised identifiers enabling linkage to other national datasets. This growing resource will enable longitudinal research and can form the basis of a live national genomic disease registry.
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Affiliation(s)
- Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Catherine Huntley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Fiona McRonald
- NHS Digital, National Disease Registration Service, London, UK
| | - Francesco Santaniello
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Joanna Pethick
- NHS Digital, National Disease Registration Service, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Sophie Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Oliver Tulloch
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Shilpi Goel
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Brian Shand
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Tameera Rahman
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Margreet Luchtenborg
- NHS Digital, National Disease Registration Service, London, UK
- Centre for Cancer, Society & Public Health, King's College London, London, UK
| | - Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Richard Barber
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Tina Bedenham
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Bourn
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Kirsty Bradshaw
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Brooks
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jonathan Bruty
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Chris Buxton
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - Jonathan Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Joanne Field
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lucy Jenkins
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Terri P McVeigh
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Roger Mountford
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - Rodney Nyanhete
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Evgenia Petrides
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rachel Robinson
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Tracy Scott
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Victoria Stinton
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - James Tellez
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Kate Sahan
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Nina Hallowell
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Diana M Eccles
- Cancer Sciences, University of Southampton Faculty of Medicine, Southampton, UK
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Pharoah
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Antonis C Antoniou
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Evolution & Genomic Sciences, The University of Manchester, Manchester, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gail Norbury
- South East Genomic Laboratory Hub, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Eva Morris
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Steven Hardy
- NHS Digital, National Disease Registration Service, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
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Palmigiano A, Santaniello F, Cerutti A, Penkov D, Purushothaman D, Makhija E, Luzi L, di Fagagna FD, Pelicci PG, Shivashankar V, Dellino GI, Blasi F. PREP1 tumor suppressor protects the late-replicating DNA by controlling its replication timing and symmetry. Sci Rep 2018; 8:3198. [PMID: 29453404 PMCID: PMC5816642 DOI: 10.1038/s41598-018-21363-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/01/2018] [Indexed: 12/15/2022] Open
Abstract
The synthesis of middle-to-late-replicating DNA can be affected independently of the rest of the genome by down-regulating the tumor suppressor PREP1 (PKNOX1). Indeed, DNA combing shows that PREP1 down-regulation affects DNA replication rate, increases the number of simultaneously firing origins and the asymmetry of DNA replication, leading to DNA damage. Genome-wide analysis of replication timing by Repli-seq shows that, upon PREP1 down-regulation, 25% of the genome is replicated earlier in the S-phase. The targeted DNA sequences correspond to Lamin-Associated Domains (LADs), and include late-replicating (LRRs) and temporal transition regions (TTRs). Notably, the distribution of PREP1 DNA binding sites and of its target genes indicates that DNA replication defects are independent of the overall PREP1 transcriptional activity. Finally, PREP1 down-regulation causes a substantial decrease in Lamin B1 levels. This suggests that DNA is released from the nuclear lamina earlier than in the control cells and is available for replication, thus explaining timing defects and DNA damage.This is the first evidence that the replication timing of a specific fraction of the human genome is affected by PREP1 tumor suppressor. This previously unknown function might significantly contribute to the genomic instability observed in human tumors.
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Affiliation(s)
- Angela Palmigiano
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
- Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, via Olgettina 60, Milan, 20138, Italy
| | - Francesco Santaniello
- Department of Experimental Oncology, European Institute of Oncology, via Adamello 16, 20139, Milan, Italy
| | - Aurora Cerutti
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
- Oncogenomics Department, Netherland Cancer Institute (NKI), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Dmitry Penkov
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
- Lomonosov Moscow State University, Leninskiye Gori 1, 119991, Moscow, Russia
| | - Divya Purushothaman
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
| | - Ekta Makhija
- Mechano-Biology Institute, National University of Singapore, Singapore, Singapore
| | - Lucilla Luzi
- Department of Experimental Oncology, European Institute of Oncology, via Adamello 16, 20139, Milan, Italy
| | - Fabrizio d'Adda di Fagagna
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
- Istituto di Genetica Molecolare, Consiglio Nazionale delle Ricerche (IGM-CNR), Via Abbiategrasso 207, 27100, Pavia, Italy
| | - Pier Giuseppe Pelicci
- Department of Experimental Oncology, European Institute of Oncology, via Adamello 16, 20139, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Santa Sofia 9, 20142, Milan, Italy
| | - Viveswara Shivashankar
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy
- Mechano-Biology Institute, National University of Singapore, Singapore, Singapore
| | - Gaetano Ivan Dellino
- Department of Experimental Oncology, European Institute of Oncology, via Adamello 16, 20139, Milan, Italy.
- Department of Oncology and Hemato-Oncology, University of Milan, Via Santa Sofia 9, 20142, Milan, Italy.
| | - Francesco Blasi
- IFOM (Foundation FIRC Institute of Molecular Oncology), via Adamello 16, 20139, Milan, Italy.
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Miraglia del Giudice M, Matera MG, Capristo C, Conte M, Santaniello F, Chinellato I, Leonardi S, Miraglia del Giudice MC, Perrone L. LABAs in asthmatic children: highlights and new inside. Pulm Pharmacol Ther 2013; 26:540-3. [PMID: 23583567 DOI: 10.1016/j.pupt.2013.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 03/29/2013] [Accepted: 04/02/2013] [Indexed: 11/30/2022]
Abstract
International asthma guidelines recommend increasing the dose of ICS or adding leukotriene modifiers or the use of long-acting inhaled beta2-agonists (LABAs) in combination with inhaled corticosteroids (ICS) when uncontrolled asthma occurs in adult and children in treatment with low-dose inhaled corticosteroids. However, in children, the effects of this last treatment option are unclear because there are few studies on the efficacy and safety of these drugs in pediatric age. Furthermore, salmeterol is licensed for use in children over 4 years and formoterol in children of more than 6 years. Finally, recent data provides evidence that repeated bronchoconstriction induces epithelial cell stress that may lead to remodeling and these findings may have potential implications for asthma management, particularly for LABAs treatment in the future.
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Pedullà M, Miraglia Del Giudice M, Fierro V, Arrigo T, Gitto E, Salpietro A, Lionetti E, Salpietro V, Leonardi S, Santaniello F, Perrone L. Atopy as a risk factor for thyroid autoimmunity in children. J BIOL REG HOMEOS AG 2012; 26:S9-S14. [PMID: 22691261] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recently, there has been considerable interest in the relationship between allergic and autoimmune diseases. We evaluated the prevalence of thyroid autoimmunity in 566 children affected by atopic dermatitis (AD), urticaria, rhinitis, chronic cough, and asthma. Our results suggest that allergy and autoimmunity can be two potential outcomes of dysregulated immunity. It is tempting to speculate that NK Th2 cells can favour asthma onset and at the same time improve thyroid autoimmunity.
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Affiliation(s)
- M Pedullà
- Department of Pediatrics, Second University of Naples, Italy
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Giannantoni A, Mearini E, Del Zingaro M, Santaniello F, Porena M. Botulinum A toxin in the treatment of neurogenic detrusor overactivity: a consolidated field of application. BJU Int 2008; 102 Suppl 1:2-6. [DOI: 10.1111/j.1464-410x.2008.07820.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Giannantoni A, Serva M, Proietti S, Santaniello F, Costantini E, Mearini E, Porena M. SIX-YEAR FOLLOW-UP OF INTRADETRUSORIAL INJECTIONS OF BOTULINUM TOXIN TYPE A IN PATIENTS WITH REFRACTORY NEUROGENIC DETRUSOR OVERACTIVITY: CLINICAL AND URODYNAMIC RESULTS. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60563-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Santaniello F, Giannantoni A, Cochetti G, Zucchi A, Costantini E. Body mass index and lower urinary tract symptoms in women. Arch Ital Urol Androl 2007; 79:17-9. [PMID: 17484398] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION The prevalence of obesity has been rising sharply in industrialised countries over the past decade. As the Body Mass Index (BMI) is recognized as an accurate and objective measurement of individual body mass, this study investigated whether BMI is associated with lower urinary tract symptoms in women. MATERIALS AND METHODS This retrospective study analysed a database of 750 female patients who were referred to the Uro-Gynaecology Unit from 2002 to 2004 because of urinary and sexual disturbances. Patients were divided into four classes (I, II, III, IV). Each class was analysed as a function of the following variables: type and grade of urinary incontinence, number of daily pads, irritative symptoms, sexual activity, micturitional urgency or detrusor hyperactivity, urine leakage during urodynamics testing while coughing or performing Valsava's manoeuvre, dysuria, abdominal straining, stop-go micturition, feeling of incomplete bladder emptying, feeling of perineal heaviness, hypovalid stream, constipation, grade and type of urogenital prolapse. RESULTS In BMI class I did not complain of urinary incontinence. 155 70.8% referred urinary leakage while coughing or under physical effort. In Class II BMI 78.9% referred urinary incontinence. The incidence rose as the BMI increased. In BMI class III, 95.1% referred urinary incontinence and all 16 patients in BMI class IV were incontinent. CONCLUSIONS Obese women are more prone to urinary incontinence which has a negative impact on the patient's quality of life and depression status. Mental status as well as anatomic deficits may explain the relationship between obesity and incontinence.
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Giannantoni A, Mearini E, Costantini E, Zucchi A, Tascini MC, Santaniello F, Porena M. 1267: Bladder and Urethral Sphincter Function after Radical Prostatectomy: 3 Years Follow Up. J Urol 2006. [DOI: 10.1016/s0022-5347(18)33480-3] [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: 10/17/2022]
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Magner WJ, Kazim AL, Stewart C, Romano MA, Catalano G, Grande C, Keiser N, Santaniello F, Tomasi TB. Activation of MHC class I, II, and CD40 gene expression by histone deacetylase inhibitors. J Immunol 2000; 165:7017-24. [PMID: 11120829 DOI: 10.4049/jimmunol.165.12.7017] [Citation(s) in RCA: 227] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epigenetic mechanisms are involved in regulating chromatin structure and gene expression through repression. In this study, we show that histone deacetylase inhibitors (DAIs) that alter the acetylation of histones in chromatin enhance the expression of several genes on tumor cells including: MHC class I, II, and the costimulatory molecule CD40. Enhanced transcription results in a significant increase in protein expression on the tumor cell surface, and expression can be elicited on some tumors that are unresponsive to IFN-gamma. The magnitude of induction of these genes cannot be explained by the effect of DAIs on the cell cycle or enhanced apoptosis. Induction of class II genes by DAIs was accompanied by activation of a repressed class II transactivator gene in a plasma cell tumor but, in several other tumor cell lines, class II was induced in the apparent absence of class II transactivator transcripts. These findings also suggest that the abnormalities observed in some tumors in the expression of genes critical to tumor immunity may result from epigenetic alterations in chromatin and gene regulation in addition to well-established mutational mechanisms.
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Affiliation(s)
- W J Magner
- Departments of. Immunology, Biophysics, and Pathology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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