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Muller I, Maioli S, Armenti M, Porcaro L, Currò N, Iofrida E, Pignataro L, Manso J, Mian C, Geginat J, Salvi M. Alemtuzumab-induced thyroid eye disease successfully treated with a single low dose of rituximab. Eur Thyroid J 2024; 13:e230236. [PMID: 38471303 PMCID: PMC11046353 DOI: 10.1530/etj-23-0236] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/12/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Secondary thyroid autoimmunity, especially Graves' disease (GD), frequently develops in patients with multiple sclerosis (MS) following alemtuzumab treatment (ALTZ; anti-CD52). Thyroid eye disease (TED) can also develop, and rituximab (RTX; anti-CD20) is a suitable treatment. Case presentation A 37-year-old woman with MS developed steroid-resistant active moderate-to-severe TED 3 years after ALTZ, that successfully responded to a single 500 mg dose of i.v. RTX. Before RTX peripheral B-cells were low, and were totally depleted immediately after therapy. Follow-up analysis 4 years post ALTZ and 1 year post RTX showed persistent depletion of B cells, and reduction of T regulatory cells in both peripheral blood and thyroid tissue obtained at thyroidectomy. Conclusion RTX therapy successfully inactivated TED in a patient with low B-cell count derived from previous ALTZ treatment. B-cell depletion in both thyroid and peripheral blood was still present 1 year after RTX, indicating a likely cumulative effect of both treatments.
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Affiliation(s)
- Ilaria Muller
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Maioli
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Mirco Armenti
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Laura Porcaro
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Nicola Currò
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Ophthalmology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Iofrida
- Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- Department of Specialistic Surgical Sciences, Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Jens Geginat
- Department of Clinical Sciences and Community Health, University of Milan, Italy
- National Institute of Molecular Genetics (INGM) “Romeo and Enrica Invernizzi”, Milan, Italy
| | - Mario Salvi
- Endocrinology Unit, Graves’ Orbitopathy Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Censi S, Galuppini F, Clausi C, Battheu F, Manso J, Piva I, Corvaglia S, Pedron MC, Mondin A, Iacobone M, Torresan F, Merante Boschin I, Bertazza L, Barollo S, Pennelli G, Mian C. Tumor Grade and Molecular Characteristics Associated with Survival in Sporadic Medullary Thyroid Carcinoma. Thyroid 2024; 34:177-185. [PMID: 38047536 DOI: 10.1089/thy.2023.0482] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background: The International Medullary Thyroid Carcinoma Grading System (IMTCGS) divides medullary thyroid carcinoma (MTC) into two categories, high- and low-grade tumors, which has a profound impact on patient outcomes. The aim of this study was to explore the association between IMTCGS grading, clinical data, and molecular status in sporadic MTC. Methods: A retrospective cohort study was performed on consecutive sporadic MTCs from patients undergoing initial surgery between January 2000 and January 2022 at the Padua Endocrine Surgery Unit. Clinical, pathological, and follow-up data were collected, tumors were graded, and somatic mutations of RET and RAS genes were analyzed. Patient outcomes were based on Ct levels and MTC-related deaths. Survival analyses were carried out employing the Kaplan-Meier method and the log-rank test. A Cox proportional hazard regression model was employed for multivariable survival analysis with the following covariates: somatic RET mutation, MTC stage at diagnosis, sex, age at diagnosis, and IMTCGS grade. Results: We included 141 consecutive sporadic MTCs. The median follow-up was 80.0 months (interquartile ranges: 41.5-122.5 months). Seventeen patients (12.1%) died from disease-related causes. 107/141 (76.9%) were classified as low-grade tumors, 32/141 (23.1%) as high-grade. Patients carrying a RET mutation had more aggressive features and shorter disease-specific survival (DSS) (p = 0.001) and were more frequently classified high-grade than low-grade MTC (p < 0.001). At multivariable survival analysis, only IMTCGS grading was independently associated with DSS (hazard ratio 8.8 [confidence interval: 2.7-28.3], p = 0.005). RET mutations, in particular RET-M918T, were more frequent in high-grade than in low-grade MTC (68.8% vs. 29.4% mutated in RET, 46.9% vs. 12.7% mutated in RET-M918T; p < 0.001). None of the high-grade tumors was mutated in the RAS gene, but the mutation was present in 11.8% of low-grade tumors. Conclusions: IMTCGS grading was associated with DSS independently of other clinical, pathological, and molecular factors. Moreover, MTC grading was associated with RET and RAS patterns, which explains, at least in part, the molecular basis of the aggressive behavior of high-grade MTC.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Cristina Clausi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Fiammetta Battheu
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Sara Corvaglia
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maria Chiara Pedron
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Isabella Merante Boschin
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Censi S, Carducci S, Zoppini G, Toffalini A, Tonelli V, Manso J, Sabbadin C, Galuppini F, Pennelli G, Piva I, Barollo S, Bertazza L, Pilotto V, Basso D, Fabris B, Bernardi S, Farinati F, Scaroni C, Mian C. Calcitonin levels in autoimmune atrophic gastritis-related hypergastrinemia. J Endocrinol Invest 2024; 47:357-365. [PMID: 37460914 DOI: 10.1007/s40618-023-02152-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/02/2023] [Indexed: 02/13/2024]
Abstract
PURPOSE Calcitonin (Ct) is currently the most sensitive biochemical marker of C-cell disease (medullary thyroid cancer [MTC] and C-cell hyperplasia), but its specificity is relatively low. Our aim was to examine whether autoimmune atrophic gastritis (AAG) and chronic hypergastrinemia, with or without chronic autoimmune thyroiditis (AT), are conditions associated with increased Ct levels. METHODS Three groups of patients were consecutively enrolled in this multicentric study: group A consisted of patients with histologically-proven AAG (n = 13; 2 males, 11 females); group B fulfilled the criteria for group A but also had AT (n = 92; 15 males, 77 females); and group C included patients with AT and without AAG (n = 37; 6 males, 31 females). RESULTS Median Ct levels did not differ between the three groups. Ct levels were undetectable in: 8/13 cases (61.5%) in group A, 70/92 (76.1%) in group B, and 27/37 (73.0%) in group C. They were detectable but ≤ 10 ng/L in 4/13 (30.8%), 20/92 (21.7%) and 7/37 (18.9%) cases, respectively; and they were > 10 ng/L in 1/13 (7.7%), 2/92 (2.2%) and 3/37 (8.1%) cases, respectively (P = 0.5). Only three patients had high Ct levels (> 10 ng/L) and high gastrin levels and had an MTC. There was no correlation between Ct and gastrin levels (P = 0.353, r = 0.0785). CONCLUSIONS High gastrin levels in patients with AAG do not explain any hypercalcitoninemia, regardless of whether patients have AT or not. This makes it mandatory to complete the diagnostic process to rule out MTC in patients with high Ct levels and AAG.
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Affiliation(s)
- S Censi
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - S Carducci
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - G Zoppini
- Endocrinologia, Diabetologia E Malattie del Metabolismo, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - A Toffalini
- Endocrinologia, Diabetologia E Malattie del Metabolismo, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - V Tonelli
- Endocrinologia, Diabetologia E Malattie del Metabolismo, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - J Manso
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
- Department of Woman's and Child 's Health-Pediatric Endocrinology and Adolescence Unit, University Hospital of Padua, Padua, Italy
| | - C Sabbadin
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - F Galuppini
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - G Pennelli
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - I Piva
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - S Barollo
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - L Bertazza
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - V Pilotto
- Gastroenterology Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - D Basso
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - B Fabris
- Dipartimento Di Scienze Mediche, Chirurgiche E Della Salute, Università Degli Studi Di Trieste, Trieste, Italy
| | - S Bernardi
- Dipartimento Di Scienze Mediche, Chirurgiche E Della Salute, Università Degli Studi Di Trieste, Trieste, Italy
| | - F Farinati
- Gastroenterology Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - C Scaroni
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - C Mian
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy.
- Department of Medical and Surgical Sciences, Endocrinology Unit, Via Ospedale N.105, 35128, Padua, Italy.
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Manso J, Pedron MC, Mondin A, Censi S, Pennelli G, Galuppini F, Barollo S, Bertazza L, Radu CM, Ghini F, Simioni P, Sabbadin C, Ceccato F, Armanini D, Mian C. First Evidence of Mineralocorticoid Receptor Gene and Protein Expression in Rat and Human Thyroid Tissues and Cell Cultures. Int J Mol Sci 2024; 25:754. [PMID: 38255827 PMCID: PMC10815259 DOI: 10.3390/ijms25020754] [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: 11/29/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Aldosterone (Aldo) exerts its action through binding with the mineralocorticoid receptor (MR). Clinically, a link between primary aldosteronism (PA) and thyroid diseases has been hypothesised. However, the presence and activity of MR on the thyroid have not yet been demonstrated. We investigated the gene/protein expression and activation of MR in primary thyroid cell cultures (normal rat thyroid [FRTL-5] and human papillary thyroid cancer [PTC] cell lines, BCPAP and K1) through qRT-PCR analysis, immunofluorescence, and confocal microscopy. We also studied the effects of Aldo on thyroid-specific and inflammation genes in vitro. Paired human normal and neoplastic thyroid tissues were also studied. We demonstrated both gene and protein expression and activation of MR in normal rat thyroid and human PTC lines. Incubation with Aldo induced an acute increase in IL-6 expression in both the FRTL-5 and BCPAP lines, which was antagonised by spironolactone, and an acute and late upregulation of thyroid-specific genes in FRTL-5. MR was also expressed at both gene and protein levels in normal human thyroid tissues and in PTC, with a progressive decline during neoplastic tumourigenesis, particularly in more aggressive histotypes. We present the first evidence of MR gene and protein expression in both normal and pathological thyroid cells and tissues. We have shown that MR is present and functionally activated in thyroid tissue. Binding of Aldo to MR induces the expression of inflammatory and thyroid-specific genes, and the thyroid may thus be considered a novel mineralocorticoid target tissue.
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Affiliation(s)
- Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Maria Chiara Pedron
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Gianmaria Pennelli
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Claudia Maria Radu
- General Internal Medicine and Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
| | - Francesca Ghini
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Paolo Simioni
- General Internal Medicine and Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy
| | - Chiara Sabbadin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Filippo Ceccato
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Decio Armanini
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35128 Padua, Italy; (J.M.)
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Armanini D, Sabbadin C, Manso J, Boscaro M. Consideration in the evaluation of follow-up of resistant hypertension. J Hypertens 2024; 42:56-57. [PMID: 38033254 DOI: 10.1097/hjh.0000000000003603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Decio Armanini
- Department of Medicine - Endocrinology Unit, Hospital-University of Padua, Padua, Italy
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Piva I, Censi S, Manso J, Barollo S, Bertazza L, Scaroni C, Mian C, Barbot M. A Novel TSH Receptor Gene Variant Associated with Non-Autoimmune Hyperthyrotropinemia: A Case Report. Endocr Metab Immune Disord Drug Targets 2024; 24:273-276. [PMID: 37622708 DOI: 10.2174/1871530323666230824153915] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Resistance to TSH is defined as reduced sensitivity to normal, biologicallyactive TSH, and abnormally high levels of TSH are needed to achieve normal levels of thyroid hormones. CASE PRESENTATION A 15-year-old female patient, having been treated since childhood with levothyroxine for hyperthyrotropinemia was referred to our institution complaining of tachycardia after the levothyroxine therapy had been increased. Thyroid ultrasound features were normal, and thyroid antibodies were negative. The therapy was gradually tapered in light of the symptoms, although subclinical hypothyroidism was evident at thyroid function tests. First-degree relatives were tested for thyroid function, and the father was also found to have a previously-unknown subclinical hypothyroidism. The patient underwent genetic testing for TSH receptor (TSHR) gene mutations, which revealed a gene variant hitherto not described: p.C598R (c.1792T>C). The father was also tested and was found to carry the same mutation, while other first-degree relatives were wild-type for the TSHR gene. An in-silico analysis was performed, which revealed a loss-of-function phenotype corresponding to the described variant, suggesting a novel loss-of-function TSH receptor gene mutation. CONCLUSION In this case report, we present a novel loss-of-function gene mutation in the TSH receptor gene associated with a TSH resistance phenotype.
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Affiliation(s)
- Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Department of Woman's and Child 's Health, Pediatric Endocrinology and Adolescence Unit, University Hospital of Padova, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Carla Scaroni
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mattia Barbot
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Censi S, Salmaso L, Ceccato F, Manso J, Fedeli U, Saia M, Mian C. Hyperthyroidism incidence in a large population-based study in northeastern Italy. Endocr Connect 2023; 12:e230292. [PMID: 37855396 PMCID: PMC10692690 DOI: 10.1530/ec-23-0292] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/18/2023] [Indexed: 10/20/2023]
Abstract
Objective An improvement in iodine status in Veneto Region has been documented in the last decade. We aimed at estimating the incidence of hyperthyroidism in the Veneto Region (Italy) over the period 2013-2022. Methods Retrospective population-based study conducted in Veneto (4.9 million people) using the population registry, an administrative health database. Between 2012 and 2022, hyperthyroidism incidence was defined thank to a health-care co-payment exemption for hyperthyroidism or any hospital diagnosis of hyperthyroidism. Incident hyperthyroidism was defined from 2013 to 2022 to exclude prevalent cases. Standardized incidence rates (IRs) were reported by age, sex, and etiology of thyroid hyperfunction too. Results We identified 26,602 incident cases (IR of 54.38 per 100,000 person-years, 2.47-fold higher in females than in males). IR decreased from 69.87 (95% CI: 67.49, 72.25) in 2013 to 42.83 (95% CI: 40.99, 44.66) in 2022. In 2020, an out-of-trend decrease in hyperthyroidism incidence was documented, corresponding to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, with a realignment to the trend in the subsequent years. The annual percentage change according to the cause of hyperthyroidism was as follows: -6.62% (95% CI: 8.47, 4.73) (P < 0.0001) in toxic multinodular goiter, -7.56% in toxic uninodular goiter (95% CI: 10.54, 4.48) (P < 0.001) and -4.70% (95% CI: 6.33, 3.04) in toxic diffuse goiter (Graves' disease) (P < 0.001). Conclusions We documented a decline in the incidence of hyperthyroidism in Veneto Region, paralleling the improvement of the iodine status, thanks to a long and sustained iodine prophylaxis campaign. SARS-CoV-2 pandemic and vaccination campaign did not change the declining trend of hyperthyroidism incidence in our study region. Significance statement An improvement in iodine status in the population residing in the Veneto region has been documented in the last decade, thanks to a nationwide voluntary iodine prophylaxis program running since 2005, but its impact on the epidemiology of thyroid disease has never been documented. This is the largest study on the incidence rates of hyperthyroidism carried out in Italy and covers the longest observation period among all regionwide population-based studies of hyperthyroidism in our country. We documented a reduction in the incidence of hyperthyroidism, which was more pronounced in nodular goiter diagnosis but involved also toxic diffuse goiter. The decline in the incidence of hyperthyroidism in Veneto Region shows the efficacy and safety of the iodine prophylaxis campaign.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Laura Salmaso
- Clinical Governance Unit, Azienda Zero, Veneto Region, Italy
| | - Filippo Ceccato
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Padua University Hospital, Padova, Italy
| | - Ugo Fedeli
- Clinical Governance Unit, Azienda Zero, Veneto Region, Italy
| | - Mario Saia
- Clinical Governance Unit, Azienda Zero, Veneto Region, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Manso J, Censi S, Clausi C, Piva I, Zhu YH, Mondin A, Pedron MC, Barollo S, Bertazza L, Midena G, Parrozzani R, Mian C. Circulating miR-146a predicts glucocorticoid response in thyroid eye disease. Eur Thyroid J 2023; 12:e230083. [PMID: 37606076 PMCID: PMC10563606 DOI: 10.1530/etj-23-0083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/21/2023] [Indexed: 08/23/2023] Open
Abstract
Objective Thyroid eye disease (TED) is an immune-mediated disorder of the eye. Intravenous glucocorticoid (GC) is the first-line treatment for patients with active moderate-to-severe TED. However, the response rate is between 50% and 80%. There are still no simple and reliable markers of responsiveness to GC therapy. We aimed to explore the possible role of miR-146a and miR-21 as predictors of responsiveness to GC treatment in TED. Methods We carried out a prospective longitudinal study on 30 consecutive adult patients with active moderate-to-severe TED and eligible for GC therapy. All patients received the standard GC treatment with methylprednisolone i.v. In cases of progressive worsening of Gorman Score for diplopia or with duction restriction <30° in at least two consecutive controls, patients also underwent orbital radiotherapy. Response to GC treatment was defined as a decrease of two or more points in the clinical activity score (CAS) or CAS <4/10 at 24 weeks. Circulating miRNAs were extracted from patients' serum and quantified by real-time PCR. Results Twenty-three (77%) patients responded to GC. Thyroid surgery, higher CAS, greater proptosis and higher pre-treatment circulating levels of miR-146a emerged as predictive factors of responsiveness to GC. A ROC analysis revealed that miR-146a could predict responsiveness to GC with a positive predictive value of 100%. Conclusion This is the first study investigating the role of pre-treatment circulating miR-21 and miR-146a to predict responsiveness to GC in TED. miR-146a emerged as a simple, objective, new marker of GC sensitivity that could be used to avoid ineffective administration of GC therapy to TED patients.
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Affiliation(s)
- Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
- Department of Women’s and Children’s Health, Pediatric Endocrinology Unit, Padua University Hospital, Padua, Italy
| | - Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Cristina Clausi
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Ilaria Piva
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Yi Hang Zhu
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Alberto Mondin
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Maria Chiara Pedron
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Giulia Midena
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | | | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
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Mondin A, Bertazza L, Barollo S, Pedron MC, Manso J, Piva I, Basso D, Merante Boschin I, Iacobone M, Pezzani R, Mian C, Censi S. Validation of miRNAs as diagnostic and prognostic biomarkers, and possible therapeutic targets in medullary thyroid cancers. Front Endocrinol (Lausanne) 2023; 14:1151583. [PMID: 37361540 PMCID: PMC10285659 DOI: 10.3389/fendo.2023.1151583] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Medullary thyroid cancer (MTC) is a rare type of neuroendocrine tumor that produces a hormone called calcitonin (CT). Thyroidectomy is the preferred treatment for MTC, as chemotherapy has been shown to have limited effectiveness. Targeted therapy approaches are currently being used for patients with advanced, metastatic MTC. Several studies have identified microRNAs, including miR-21, as playing a role in the development of MTC. Programmed cell death 4 (PDCD4) is a tumor suppressor gene that is an important target of miR-21. Our previous research has shown that high levels of miR-21 are associated with low PDCD4 nuclear scores and high CT levels. The aim of this study was to investigate the potential of this pathway as a novel therapeutic target for MTC. Methods We used a specific process to silence miR-21 in two human MTC cell lines. We studied the effect of this anti-miRNA process alone and in combination with cabozantinib and vandetanib, two drugs used in targeted therapy for MTC. We analyzed the effect of miR-21 silencing on cell viability, PDCD4 and CT expression, phosphorylation pathways, cell migration, cell cycle, and apoptosis. Results Silencing miR-21 alone resulted in a reduction of cell viability and an increase in PDCD4 levels at both mRNA and protein levels. It also led to a reduction in CT expression at both mRNA and secretion levels. When combined with cabozantinib and vandetanib, miR-21 silencing did not affect cell cycle or migration but was able to enhance apoptosis. Conclusion Silencing miR-21, although not showing synergistic activity with TKIs (tyrosine kinase inhibitors), represents a potential alternative worth exploring as a therapeutic target for MTC.
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Affiliation(s)
- Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maria Chiara Pedron
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Daniela Basso
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Isabella Merante Boschin
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Manso J, Piva I, Censi S, Clausi C, Bardi M, Schiavon B, Merante Boschin I, Tona F, Mian C. Safety and efficacy of prophylactic treatment for hyperthyroidism induced by iodinated contrast media in a high-risk population. Front Endocrinol (Lausanne) 2023; 14:1154251. [PMID: 37255974 PMCID: PMC10225693 DOI: 10.3389/fendo.2023.1154251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction The use of iodinated contrast media (ICM) can lead to thyrotoxicosis, especially in patients with risk factors, such as Graves' disease, multinodular goiter, older age, and iodine deficiency. Although hyperthyroidism may have clinically relevant effects, whether high-risk patients should receive prophylactic treatment before they are administered ICM is still debated. Aim of the study We aimed to demonstrate the safety and efficacy of prophylactic treatment with sodium perchlorate and/or methimazole to prevent ICM-induced hyperthyroidism (ICMIH) in a population of high-risk cardiac patients. We ran a cost analysis to ascertain the most cost-effective prophylactic treatment protocol. We also aimed to identify possible risk factors for the onset of ICMIH. Materials and methods We performed a longitudinal retrospective study on 61 patients admitted to a tertiary-level cardiology unit for diagnostic and/or therapeutic ICM-procedures. We included patients with available records of thyroid function tests performed before and after ICM were administered, who were at high risk of developing ICMIH. Patients were given one of two different prophylactic treatments (methimazole alone or both methimazole and sodium perchlorate) or no prophylactic treatment. The difference between their thyroid function at the baseline and 11-30 days after the ICM-related procedure was considered the principal endpoint. Results Twenty-three (38%) of the 61 patients were given a prophylactic treatment. Thyroid function deteriorated after the administration of ICM in 9/61 patients (15%). These cases were associated with higher plasma creatinine levels at admission, higher baseline TSH levels, lower baseline FT4 levels, and no use of prophylactic treatment. The type of prophylaxis provided did not influence any onset of ICMIH. A cost-benefit analysis showed that prophylactic treatment with methimazole alone was less costly per person than the combination protocol. On multivariate analysis, only the use of a prophylactic treatment was independently associated with a reduction in the risk of ICMIH. Patients not given any prophylactic treatment had a nearly five-fold higher relative risk of developing ICMIH. Conclusion Prophylactic treatment can prevent the onset of ICMIH in high-risk populations administered ICM. Prophylaxis is safe and effective in this setting, especially in cardiopathic patients. Prophylaxis with methimazole alone seems to be the most cost-effective option.
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Affiliation(s)
- Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Pediatric Endocrinology Unit, Department of Women’s and Children’s Health, Padua University Hospital, Padova, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Cristina Clausi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maria Bardi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Benedetta Schiavon
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Isabella Merante Boschin
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Francesco Tona
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Censi S, Manso J, Benvenuti T, Piva I, Iacobone M, Mondin A, Torresan F, Basso D, Crivellari G, Zovato S, Mian C. The role of procalcitonin in the follow-up of medullary thyroid cancer. Eur Thyroid J 2023; 12:e220161. [PMID: 36476491 PMCID: PMC9874959 DOI: 10.1530/etj-22-0161] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Calcitonin (Ct) represents the most important biochemical marker of medullary thyroid cancer (MTC), but has certain limits. We analyzed the performance of procalcitonin (ProCt) in follow-up MTC patients. Methods In this monocentric and retrospective study, we consecutively obtained ProCt and Ct values from all MTC patients that we visited during the period from April 2021 to May 2022. Patients were defined as having structural evidence of disease (29/90, 32.2%) irrespective of Ct values or, in its absence, as not evident disease (NED) if Ct was ≤10 ng/L (47/90, 52.2%), or minimal residual disease if Ct was >10 ng/L (14/90, 15.6%). Results Ct and ProCt values were highly correlated (r = 0.883, P < 0.01). Median ProCt values differed between NED, minimal residual disease, and structural disease, being 0.04 ng/mL, 0.26 ng/mL, and 1.98 ng/mL, respectively (P < 0.01). ProCt was undetectable (<0.04 ng/mL) in 40/47 (85.1%) of NED patients, in 3/14 (21.4%) patients with minimal residual disease and in none of the patients with a structural disease (P < 0.01). Among the 11 patients with detectable but ≤10 ng/L Ct and undetectable ProCt values, none had a structural disease. The most accurate cut-off of ProCt to distinguish between the presence or absence of a structural disease was >0.12 ng/mL (P < 0.01, area under the curve: 0.963), with the following sensitivity, specificity, positive predictive value, and negative predictive value (NPV): 100%, 83.61%, 74.4%, and 100.0%. Conclusions ProCt and Ct have a high correlation in MTC follow-up. ProCt may be useful as an adjunct to Ct, especially for its NPV concerning the structural disease.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Teresa Benvenuti
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Daniela Basso
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gino Crivellari
- Hereditary Tumor Unit, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy
| | - Stefania Zovato
- Hereditary Tumor Unit, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Abstract
BACKGROUND Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor originating from parafollicular C-cells. It represents 2% of all thyroid malignancies and 0.4-1.4% of all thyroid nodules. MTC has a variable clinical course, with complete remission often difficult to achieve. An early diagnosis is still crucial in MTC management, enabling a radical surgical treatment, the only chance for curing the patient. Calcitonin (Ct) is a very sensitive MTC tumor marker in patients with thyroid nodules, although Ct-negative MTCs have been described, but not all clinical guidelines recommend the Ct routine measurement in thyroid nodules because of the absolute low prevalence of MTC in the general population and the consequent scarce positive predictive value of Ct. Moreover, the specificity of moderately high Ct levels is not high. Thus, the scientific community has been investigating the possible role of other tumor markers for MTC diagnosis and prognosis. AIM OF THE REVIEW The present review is an attempt to summarize the knowledge available today on the role of other serum markers for MTC alternative to Ct. CONCLUSIONS At present, literature data does not seem solid enough yet to establish effective flowcharts in evaluating a thyroid nodule for MTC, involving alternative serum markers, particularly in cases of moderately high CT levels. MTC is a rare diagnosis in thyroid nodules, and this makes the evaluation of any tumor serum marker accuracy problematic. More extensive and prospective studies are needed to shed more light on this intriguing challenge.
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Affiliation(s)
- Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy
| | - Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy
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Armanini D, Bordin L, Manso J, Boscaro M, Sabbadin C. Pitfalls in website information on dietary sodium restriction. J Clin Hypertens (Greenwich) 2022; 24:1293-1295. [PMID: 36210543 PMCID: PMC9581088 DOI: 10.1111/jch.14587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Decio Armanini
- Department of Medicine–EndocrinologyUniversity of PadovaPadovaItaly
| | - Luciana Bordin
- Department of Molecular Medicine‐Biological ChemistryUniversity of PadovaPadovaItaly
| | - Jacopo Manso
- Department of Medicine–EndocrinologyUniversity of PadovaPadovaItaly
| | - Marco Boscaro
- Department of Medicine–EndocrinologyUniversity of PadovaPadovaItaly
| | - Chiara Sabbadin
- Department of Medicine–EndocrinologyUniversity of PadovaPadovaItaly
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Manso J, Zhu YH, Margoni M, Rinaldi F, Censi S, Carducci S, Cosma C, Plebani M, Gallo P, Mian C. Alemtuzumab-induced autoimmune thyroid events in patients with relapsing-remitting multiple sclerosis: A real-life and monocentric experience at a tertiary-level centre. Clin Endocrinol (Oxf) 2022; 97:331-338. [PMID: 34724236 DOI: 10.1111/cen.14616] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/01/2021] [Accepted: 10/01/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Alemtuzumab-induced autoimmune thyroid events (AIATEs) are the most common adverse effects observed in relapsing-remitting multiple sclerosis (RRMS) patients. This study aims to explore the clinical and biochemical characteristics of such AIATEs, and to examine the risk factors for their occurrence, particularly for the worst clinical phenotype of fluctuating Graves' disease (GD). DESIGN, PATIENTS, MEASUREMENTS We retrospectively analysed a real-life single-centre consecutive series of 57 RRMS patients treated with alemtuzumab whose clinical and biochemical parameters were collected before starting the treatment and then monthly during their follow-up. RESULTS AIATEs developed in 39% of patients a mean 17 months ± 11 after the first cycle of alemtuzumab. The most common AIATEs were GD (64%), followed by Hashimoto's thyroiditis with hypothyroidism (23%), TSH-receptor-antibody (TRAb)-positive hypothyroidism (9%), and silent thyroiditis (4%). GD showed a fluctuating course in 57% of cases. Baseline positivity for anti-thyroperoxidase antibodies, and higher absolute titers of anti-thyroglobulin and anti-thyroperoxidase antibodies correlated significantly with the risk of developing AIATEs, but TRAb positivity did not. Higher TRAb titers at the time of GD being diagnosed correlated strongly with a greater risk of the fluctuating GD phenotype. On ROC curve analysis, we found that a cut-off of 7.3 IU/L could be used to predict the risk of developing a fluctuating GD, with a positive predictive value of 100%. CONCLUSIONS TRAb levels measured with commercial automatic methods at the time of a patient being diagnosed with alemtuzumab-induced GD emerged as a novel biomarker for predicting a fluctuating disease phenotype, with an influence on subsequent therapeutic decisions and patients' follow-up.
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Affiliation(s)
- Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Yi Hang Zhu
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Monica Margoni
- Veneto Regional Multiple Sclerosis Center (CeSMuV), Padua University Hospital, Padua, Italy
| | - Francesca Rinaldi
- Veneto Regional Multiple Sclerosis Center (CeSMuV), Padua University Hospital, Padua, Italy
| | - Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Sofia Carducci
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Chiara Cosma
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Paolo Gallo
- Veneto Regional Multiple Sclerosis Center (CeSMuV), Padua University Hospital, Padua, Italy
- Department of Neurosciences, Padua University, Padua, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
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15
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Censi S, De Rosa A, Galuppini F, Manso J, Bertazza L, Merante-Boschin I, Plebani M, Faggian D, Pennelli G, Barollo S, Vianello F, Iacobone M, Mian C. Can ultrasensitive thyroglobulin immunoassays avoid the need for ultrasound in thyroid cancer follow-up? Endocrine 2022; 75:837-845. [PMID: 34800265 DOI: 10.1007/s12020-021-02936-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Differentiated thyroid cancer (DTC) is the most common endocrine neoplasm, with a rising incidence and a long life expectancy. It has recently been suggested that patients with low- and intermediate-risk DTC with a good response to treatment at one year could be followed up using only highly sensitive immunoassays for thyroglobulin (Tg). The aim of this study was to examine the serum Tg levels in a series of DTC patients with histologically proven persistent or recurrent diseases. METHODS The study involved 50 consecutive patients being routinely followed up at our center, whose clinical, histological, and biochemical data were retrospectively collected. RESULTS The false-negative rate of ultrasensitive serum Tg assay was 14.3% (5/35) overall, and limited to anti-thyroglobulin autoantibodies (TgAb)-negative patients. Among them, only one patient had an excellent response to treatment at one-year follow-up and was diagnosed with a 4 mm recurrence, after more than seven years of periodic ultrasounds. The size of the neck lesion documented in the histological report was slightly larger in patients with detectable as opposed to negative Tg values (P < 0.05). CONCLUSIONS Serum highly sensitive Tg is undetectable in a proportion of patients with a proven persistent or recurrent DTC. The reasons behind this phenomenon are still unknown. However, in low/intermediate-risk patients cured at one-year follow-up, highly sensitive Tg without neck US seems an appropriate strategy for patients' management.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Antonio De Rosa
- Department of Oncology, Veneto Institute of Oncology IOV IRCCS, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Isabella Merante-Boschin
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Diego Faggian
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Federica Vianello
- Department of Radiotherapy, Veneto Institute of Oncology IOV IRCCS, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
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Suarez C, Hernández-Pinto P, Manso J, Maestre JM. Use of clinical simulation to support a pediatric face mask procurement process. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:491-492. [PMID: 34531158 DOI: 10.1016/j.redare.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 06/13/2023]
Affiliation(s)
- C Suarez
- Servicio de Anestesiología y Reanimación, Hospital Marqués de Valdecilla y Hospital virtual Valdecilla, Santander, Cantabria, Spain
| | - P Hernández-Pinto
- Servicio de Anestesiología y Reanimación, Hospital Marqués de Valdecilla y Hospital virtual Valdecilla, Santander, Cantabria, Spain
| | - J Manso
- Servicio de Anestesiología y Reanimación, Hospital Marqués de Valdecilla y Hospital virtual Valdecilla, Santander, Cantabria, Spain
| | - J M Maestre
- Servicio de Anestesiología y Reanimación, Hospital Marqués de Valdecilla y Hospital virtual Valdecilla, Santander, Cantabria, Spain.
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Vianello F, Censi S, Watutantrige-Fernando S, Barollo S, Zhu YH, Albiger N, Bertazza L, Manso J, Carducci S, Benna C, Iacobone M, Galuppini F, Pennelli G, Mian C. The role of the size in thyroid cancer risk stratification. Sci Rep 2021; 11:7303. [PMID: 33790328 PMCID: PMC8012699 DOI: 10.1038/s41598-021-86611-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
Only a minority of cases of differentiated thyroid carcinoma (DTC) have a poor clinical outcome. Clinical outcomes and molecular aspects were assessed in: 144 DTC ≤ 40 mm without distant metastases (group 1); 50 DTC > 40 mm without distant metastases (group 2); and 46 DTC with distant metastases (group 3). Group 3 had a worse outcome than the other two groups: during the follow-up, patients more frequently had persistent disease, died, or underwent further treatment. The outcomes did not differ between groups 1 and 2. Group 3 had a higher prevalence of TERT promoter mutations than group 2 (32.6% vs 14%). Group 1 had a higher frequency of BRAF mutations than groups 2 or 3 (61.1% vs 16.0% and 26.1%, respectively), while RAS mutations were more common in group 2 than in groups 1 and 3 (16.0% vs 2.1% and 6.5%, respectively). Groups 1 and 2 shared the same outcome, but were genetically distinct. Only lymph node involvement, distant metastases, older age and (among the molecular markers) TERT promoter mutations were independent predictors of a worse outcome. Metastatic DTC had the worst outcome, while the outcome was identical for large and small non-metastatic DTC, although they showed different molecular patterns. TERT promoter mutations emerged as an independent factor pointing to a poor prognosis.
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Affiliation(s)
- Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Yi Hang Zhu
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Nora Albiger
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Sofia Carducci
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Clara Benna
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
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Manso J, Sharifi-Rad J, Zam W, Tsouh Fokou PV, Martorell M, Pezzani R. Plant Natural Compounds in the Treatment of Adrenocortical Tumors. Int J Endocrinol 2021; 2021:5516285. [PMID: 34567112 PMCID: PMC8463247 DOI: 10.1155/2021/5516285] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/14/2021] [Accepted: 08/31/2021] [Indexed: 01/08/2023] Open
Abstract
Plant natural products are a plethora of diverse and complex molecules produced by the plant secondary metabolism. Among these, many can reserve beneficial or curative properties when employed to treat human diseases. Even in cancer, they can be successfully used and indeed numerous phytochemicals exert antineoplastic activity. The most common molecules derived from plants and used in the fight against cancer are polyphenols, i.e., quercetin, genistein, resveratrol, curcumin, etc. Despite valuable data especially in preclinical models on such compounds, few of them are currently used in the medical practice. Also, in adrenocortical tumors (ACT), phytochemicals are scarcely or not at all used. This work summarizes the available research on phytochemicals used against ACT and adrenocortical cancer, a very rare disease with poor prognosis and high metastatic potential, and wants to contribute to stimulate preclinical and clinical research to find new therapeutic strategies among the overabundance of biomolecules produced by the plant kingdom.
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Affiliation(s)
- Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | - Wissam Zam
- Analytical and Food Chemistry Department, Faculty of Pharmacy, Tartous University, Tartous, Syria
| | | | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, Centre for Healthy Living, University of Concepción, Concepción 4070386, Chile
- Universidad de Concepción, Unidad de Desarrollo Tecnológico, UDT, Concepción 4070386, Chile
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
- Phytotherapy Lab, Endocrinology Unit, Department of Medicine (DIMED), University of Padova, via Ospedale 105, 35128 Padova, Italy
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Abstract
PURPOSE OF REVIEW MicroRNAs emerged as pivotal regulators of cell differentiation, growth, and cell death, suggesting their implication in tumorigenesis and prognosis of cancer. In the last decades, knowledge about the alterations of microRNAs in medullary thyroid cancer (MTC) is increasing. In this review, we try to summarize the most relevant findings regarding microRNA dysregulation in MTC. RECENT FINDINGS A literature analysis was performed in MEDLINE for studies published up to August 2020. Comprehensively, at least 27 different microRNAs have been investigated in MTC showing evidence for overexpression or underexpression in comparison with normal thyroid tissue samples, healthy blood controls, or primary tumor site or hereditary form of MTC. We highlight the evidence in favor of a possible use of microRNAs for diagnosis, prognosis and treatment in MTC and their role in MTC pathogenesis. SUMMARY This review reveals the emerging complexity of the molecular genetic and epigenetic panorama in MTC. Further studies are needed to confirm and refine the findings on microRNA expression pattern in MTC. Thus, in the future, microRNA analysis could enter in clinical practice and may pave the way to new risk-stratification tools and novel therapeutic approaches for MTC.
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Affiliation(s)
- Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
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Censi S, Di Stefano M, Repaci A, Benvenuti T, Manso J, Pagotto U, Iacobone M, Barollo S, Bertazza L, Galuppini F, Benna C, Pennelli G, Plebani M, Faggian D, Colombo C, Fugazzola L, Mian C. Basal and Calcium-Stimulated Procalcitonin for the Diagnosis of Medullary Thyroid Cancers: Lights and Shadows. Front Endocrinol (Lausanne) 2021; 12:754565. [PMID: 34721303 PMCID: PMC8548712 DOI: 10.3389/fendo.2021.754565] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Procalcitonin (proCt) was recently proposed as an alternative or in addition to calcitonin (Ct) in medullary thyroid cancer (MTC) diagnostics. METHODS Serum basal Ct (bCt) and proCt (bproCt) levels were measured before surgery from a consecutive series of patients with (n=43) and without (n=75) MTC, retrospectively collected in Padua. Serum bproCt, bCt and stimulated proCt and Ct (sproCt and sCt) were measured in another consecutive series of 33 patients seen at three tertiary-level institutions undergoing a calcium stimulation test prior to surgery, 20 of them with a final diagnosis of MTC, and 13 with non-MTC nodular disease. RESULTS Median bproCt levels were higher in MTC than in non-MTC. A positive correlation was found for bproCt with bCt (P<0.01, R2 = 0.75), and with tumor size (P<0.01, R2 = 0.39). The cut-off for bproCt differentiating between MTC and non-MTC patients was >0.07 ng/ml (sensitivity: 85.7%, specificity: 98.9%, positive predictive value [PPV]: 98.2%, negative predictive value [NPV]: 90.6%, P<0.01). While bproCt was >0.07 ng/ml in 38/39 (97.4%) patients with MTC >10 mm, it was above said cut-off only in 15/23 (65.2%) patients with tumors ≤10 mm. A sproCt >0.19 ng/ml was able to identify MTC [sensitivity: 90.0%, specificity:100.0%, PPV: 100.0%, NPV: 86.7% (P<0.01)]. CONCLUSIONS Our data suggest that bproCt can be a good adjunct to Ct for MTC diagnostic purposes. In consideration of its high specificity, it can be used in combination with Ct in MTC diagnostics, particularly in the case of mildly elevated basal Ct levels.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Marta Di Stefano
- Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Repaci
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Teresa Benvenuti
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Uberto Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Clara Benna
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Diego Faggian
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Carla Colombo
- Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Laura Fugazzola
- Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- *Correspondence: Caterina Mian,
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Censi S, Bertazza L, Piva I, Manso J, Benna C, Iacobone M, Mondin A, Plebani M, Faggian D, Galuppini F, Pennelli G, Barollo S, Mian C. Serum miR-375 for Diagnostic and Prognostic Purposes in Medullary Thyroid Carcinoma. Front Endocrinol (Lausanne) 2021; 12:647369. [PMID: 33854485 PMCID: PMC8039521 DOI: 10.3389/fendo.2021.647369] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Having previously demonstrated that tissue miR-375 expression in medullary thyroid carcinoma (MTC) tissues is linked to prognosis, the aim of this study was to assess the diagnostic and prognostic value of circulating miR-375 levels in MTC patients. METHODS A series of 68 patients with MTC was retrospectively retrieved and assessed in terms of their clinicopathological characteristics. MiR-375 levels were measured in all patients' presurgical blood samples. Both serum and tissue levels were tested prior to surgery in a subgroup of 57 patients. Serum miR-375 levels were also measured in serum from 49 patients with non-C-cell thyroid nodular diseases (non-CTN), 14 patients with pheochromocytoma, and 19 healthy controls. RESULTS Circulating miR-375 levels were 101 times higher in the serum of patients with MTC than in all other patients and controls, with no overlap (P < 0.01). No correlation emerged between serum and tissue miR-375 levels. Serum miR-375 levels were higher in MTC patients with N0 than in those with N1 disease (P = 0.01), and also in patients who were biochemically cured than in those who were not (P = 0.02). In the whole series of patients and controls, calcitonin (CT) and serum miR-375 levels were correlated at diagnosis (R2 = 0.40, P < 0.01), but in a U-shaped manner: a positive correlation was found with low CT levels, then the correlation turns negative as CT rises (in MTC patients). A negative correlation was indeed found in MTC patients between serum miR-375 and CT (R2 = -0.10, P = 0.01). On ROC curve analysis, a cut-off of 2.1 for serum miR-375 proved capable of distinguishing between MTC patients and the other patients and controls with a 92.6% sensitivity and a 97.6% specificity (AUC: 0.978, P < 0.01). CONCLUSIONS Serum miR-375 levels can serve as a marker in the diagnosis of MTC, with a remarkable specificity. Serum miR-375 also proved a novel marker of prognosis in this disease. Further in vitro experiments to corroborate our results are currently underway.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Clara Benna
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Alberto Mondin
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Diego Faggian
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- *Correspondence: Caterina Mian,
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Manso J, Censi S, Iacobone M, Galuppini F, Pennelli G, Betterle C, Mian C. First proof of association between autoimmune polyglandular syndrome and multiple endocrine neoplasia in humans. Endocr J 2020; 67:929-934. [PMID: 32475862 DOI: 10.1507/endocrj.ej20-0099] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Autoimmune Addison's disease (AAD) is a rare condition occurring either in isolation or associated with other autoimmune diseases as part of an autoimmune polyglandular syndrome (APS) type 1, 2 or 4. Multiple endocrine neoplasia (MEN) type 1, 2 or 4 is a hereditary autosomal dominant cancer syndrome. Medullary thyroid carcinoma and pheochromocytoma are neoplasms common to MEN-2a and MEN-2b. We describe a unique, complex case of a man resulted affected by both APS-2 and MEN-2a. The patient developed Hashimoto's thyroiditis, diabetes mellitus type 1 and AAD, despite testing negative for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OHAb). Moreover, he had also a family history for MEN-2a and he first developed medullay thyroid cancer, then bilateral pheochromocytoma on the adrenal substrate of an AAD. On adrenal histology we found complete bilateral cortical atrophy in the presence of a lymphocytic infiltration and fibrosis, confirming an ACA and 21-OHAb-negative AAD. This datum is the first documented in a living individual and confirms that the absence of autoantibodies is not incompatible with an autoimmune disease and confirms that AAD is a cell-mediated autoimmune disease limited to the adrenal cortex and sparing medullary. In the light of a literature review concerning the association between APS and MEN, this is the first proven case to be reported in humans. Finally, our findings suggest that adrenal medullary tumor can develop even on an adrenal gland with cortical atrophy due to autoimmune adrenalitis.
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Affiliation(s)
- Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Maurizio Iacobone
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Endocrine Surgery Unit, Padua University Hospital, Padua, Italy
| | - Francesca Galuppini
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Padua University, Padua, Italy
| | - Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Padua University, Padua, Italy
| | - Corrado Betterle
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
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Manso J, Censi S, Roberti A, Iacobone M, Barollo S, Bertazza L, Galuppini F, Vianello F, Albinger N, Scaroni C, Pennelli G, Mian C. Prognostic significance of the sum of the diameters of single foci in multifocal papillary thyroid cancer: the concept of new-old tumor burden. Ther Adv Endocrinol Metab 2020; 11:2042018820964326. [PMID: 33110488 PMCID: PMC7557686 DOI: 10.1177/2042018820964326] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/11/2020] [Indexed: 11/16/2022] Open
Abstract
AIM The prognostic value of multifocality (Mu) in papillary thyroid cancer (PTC) remains controversial. The present study aimed to investigate this issue and test the possible prognostic significance of the sum of the diameters of single foci (SDSF), the total number of foci (TNF), and primary tumor size (PTS) in multifocal PTC. METHODS We retrospectively analyzed a single-center consecutive series of 370 PTCs. For multifocal cases we analyzed bilaterality occurrence, SDSF, TNF, and PTS. RESULTS Mu was observed in 41.1% PTCs, and bilaterality in 30%. Mu was associated with an advanced T-category. In bilateral multifocal PTC, the PTS was larger, and microPTC was less frequent, while T-categories were higher. Mu and bilaterality per se had no impact on prognosis. At univariate analysis, PTS, SDSF, vascular invasion, lymph node metastases, distant metastases, T-categories, Initial Risk Stratification System score, second treatment and TERT promoter mutation correlated with persistence/recurrence or death in the multifocal PTC group. On multivariate Cox proportional hazards regression analyses, SDSF again independently predicted persistence/recurrence or death in multifocal PTCs. We found that a cut-off for SDSF less than 40 mm was able to identify multifocal PTC patients with a very low risk of persistence/recurrence (negative predictive value 96.9%). Disease-free survival was significantly shorter in patients with multifocal PTCs and SDSF ⩾40 mm. CONCLUSIONS Mu and bilaterality per se were not prognostically significant. SDSF emerged as a new independent prognostic factor for persistence/recurrence of multifocal PTC. SDSF might better represent the tumor burden in multifocal PTC, with SDSF < 40 mm identifying multifocal PTC patients with a good prognosis.
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Affiliation(s)
| | - Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Amir Roberti
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Maurizio Iacobone
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Endocrine Surgery Unit, Padua University Hospital, Padua, Italy
- Department of Cardiac, Thoracic and Vascular Sciences (DCTV), Biostatistics Epidemiology and Public Health Unit, Padua University Hospital, Padua, Italy
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Francesca Galuppini
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Padua University, Padua, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico del Veneto, IOV-IRCCS, Padova, Italy
| | - Nora Albinger
- Department of Radiotherapy, Istituto Oncologico del Veneto, IOV-IRCCS, Padova, Italy
| | - Carla Scaroni
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
| | - Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Padua University, Padua, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, Padua University, Padua, Italy
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Censi S, Iacobone M, Simmini S, Manso J, Franceschet G, Plebani M, Frigo AC, Zaninotto M, Torresan F, De Silvestro G, Scaroni C, Mian C, Camozzi V. PTH: Redefining Reference Ranges in a Healthy Population-The Role of Interfering Factors and the Type of Laboratory Assay. Int J Endocrinol 2020; 2020:1053719. [PMID: 32148482 PMCID: PMC7054804 DOI: 10.1155/2020/1053719] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/23/2020] [Indexed: 01/22/2023] Open
Abstract
UNLABELLED Introduction. Parathyroid hormone (PTH) is a linear peptide constituted by 84 amino acids and active in its 1-84 form, but a wide range of PTH forms produced by its post-transcriptional modifications are present in blood. Many assays with different specificities are commercially available. The aim of our study was to compare a 2nd and 3rd generation in healthy population in order to better define the reference range in the healthy population residing in our region. Materials and Methods. 108 subjects (53 females and 55 males) referring to the transfusion donor were enrolled in the study centre in April 2016 and underwent PTH levels measurements with a 3rd generation kit (chemiluminescent immunoassay DiaSorin Liaison) and with a 2nd generation kit (immunoradiometric assay Total Intact PTH Assay (Coated Tube), Scantibodies). Also calcium, phosphate, creatinine, and 25OHD3 were measured. A questionnaire on lifestyle and dietary habits was obtained. RESULTS The median PTH values obtained with the 2nd generation assay and the whole 3rd generation assay were 20.26 pg/ml and 23.11 pg/ml, respectively. Bland-Altman method showed substantial concordance between the two PTH assays, although with an overestimation of the 3rd generation method over the 2nd generation method. There was no correlation between 3rd generation PTH and 25OHD3 and creatinine. Calcium was negatively correlated with PTH only when measured with 3rd generation kit. CONCLUSIONS On the basis of our data, obtained from healthy subjects, we can conclude that the reference range used by our laboratory was too narrow and was necessary to reestablish normal ranges according to our population. This is useful to avoid hyperparathyroidism misdiagnosis.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy
| | - Stefano Simmini
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Giulio Franceschet
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Anna Chiara Frigo
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padua, Padua, Italy
| | - Martina Zaninotto
- Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy
| | | | - Carla Scaroni
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Valentina Camozzi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Cavedon E, Manso J, Negro I, Censi S, Serra R, Busetto L, Vettor R, Plebani M, Pezzani R, Nacamulli D, Mian C. Selenium Supplementation, Body Mass Composition, and Leptin Levels in Patients with Obesity on a Balanced Mildly Hypocaloric Diet: A Pilot Study. Int J Endocrinol 2020; 2020:4802739. [PMID: 32565792 PMCID: PMC7275228 DOI: 10.1155/2020/4802739] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/05/2020] [Accepted: 03/18/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Adequate levels of selenium (Se) have protective effects against several chronic diseases, such as obesity. The aim of this study was to assess the effect of Se supplementation in a selected group of patients with obesity. METHODS This randomized prospective study included 37 overweight/obese individuals aged 18-65 years, who adopted a slightly hypocaloric diet for 3 months. An intervention group received 240 μg/day of L-selenomethionine for 3 months; a control group received a placebo. Clinical and biochemical parameters, body composition measurements, and the Psychological General Well-Being Index (PGWBI) questionnaire were tested at the beginning and end of the treatment. RESULTS A comparison of the two groups showed a significant change in body composition, involving a decrease in body fat mass, between the baseline and the end of the follow-up, in the intervention group. Unlike the placebo group, the group given Se had a significant increase in lean body and muscle mass and a significant decrease in leptin levels after 3 months on diet. At the end of the follow-up, the group given Se scored higher on the PGWBI than those who did not. CONCLUSION Se could reinforce the effects of diet for overweight and obesity. This work was registered in the ISRCTN registry with study ID ISRCTN6106073.
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Affiliation(s)
- Elisabetta Cavedon
- Familial Cancer Clinic and Oncoendocrinology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Isabella Negro
- Internal Medicine, Alto Vicentino Hospital, Santorso (VI), Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Roberto Serra
- Internal Medicine 3, Department of Medicine, University of Padua, Padua, Italy
| | - Luca Busetto
- Internal Medicine 3, Department of Medicine, University of Padua, Padua, Italy
| | - Roberto Vettor
- Internal Medicine 3, Department of Medicine, University of Padua, Padua, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University of Padua, Padua, Italy
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
- AIROB, Associazione Italiana per La Ricerca Oncologica di Base, Padua, Italy
| | - Davide Nacamulli
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
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Censi S, Watutantrige-Fernando S, Groccia G, Manso J, Plebani M, Faggian D, Mion MM, Venturini R, Andrisani A, Casaro A, Vita P, Avogadro A, Camilot M, Scaroni C, Bertazza L, Barollo S, Mian C. The Effects of Iodine Supplementation in Pregnancy on Iodine Status, Thyroglobulin Levels and Thyroid Function Parameters: Results from a Randomized Controlled Clinical Trial in a Mild-to-Moderate Iodine Deficiency Area. Nutrients 2019; 11:nu11112639. [PMID: 31689890 PMCID: PMC6893432 DOI: 10.3390/nu11112639] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 08/24/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Iodine supplementation during pregnancy in areas with mild-to-moderate iodine deficiency is still debated. METHODS A single-center, randomized, single-blind and placebo-controlled (3:2) trial was conducted. We enrolled 90 women before 12 weeks of gestation. From enrollment up until 8 weeks after delivery, 52 women were given an iodine supplement (225 ug/day, potassium iodide tablets) and 38 were given placebo. At recruitment (T0), in the second (T1) and third trimesters (T2), and 8 weeks after delivery (T3), we measured participants' urinary iodine-to-creatinine ratio (UI/Creat), thyroid function parameters (thyroglobulin (Tg), TSH, FT3, and FT4), and thyroid volume (TV). The newborns' urinary iodine concentrations were evaluated in 16 cases. RESULTS Median UI/Creat at recruitment was 53.3 ug/g. UI/Creat was significantly higher in supplemented women at T1 and T2. Tg levels were lower at T1 and T2 in women with UI/Creat ≥ 150 ug/g, and in the Iodine group at T2 (p = 0.02). There was a negative correlation between Tg and UI/Creat throughout the study (p = 0.03, r = -0.1268). A lower TSH level was found in the Iodine group at T3 (p = 0.001). TV increased by +Δ7.43% in the Iodine group, and by +Δ11.17% in the Placebo group. No differences were found between the newborns' TSH levels on screening the two groups. CONCLUSION Tg proved a good parameter for measuring iodine intake in our placebo-controlled series. Iodine supplementation did not prove harmful to pregnancy in areas of mild-to-moderate iodine deficiency, with no appreciable harmful effect on thyroid function.
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Affiliation(s)
- Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | | | - Giulia Groccia
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Mario Plebani
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Diego Faggian
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Monica Maria Mion
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Roberta Venturini
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Alessandra Andrisani
- Department of Women's and Children's Health, University of Padua, Salus Pueri, 35128 Padua, Italy.
| | - Anna Casaro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Pietro Vita
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Alessandra Avogadro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Marta Camilot
- Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.
| | - Carla Scaroni
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
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Censi S, Manso J, Pandolfo G, Franceschet G, Cavedon E, Zhu YH, Carducci S, Gomiero W, Plebani M, Zaninotto M, Watutantrige-Fernando S, Mian C, Camozzi V. Bone turnover markers, BMD and TBS after short-term, high-dose glucocorticoid therapy in patients with Graves' orbitopathy: a small prospective pilot study. J Endocrinol Invest 2019; 42:859-865. [PMID: 30519958 DOI: 10.1007/s40618-018-0992-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/27/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Chronic GC administration has numerous side effects, but little is known about the side effects of their short-term use (< 3 months)-particularly, when high doses are involved, as in the treatment of Graves' orbitopathy (GO). We investigated the effects of short-term, high-dose GC on bone turnover markers, bone mineral density (BMD), and trabecular bone scores (TBS). METHODS Eleven patients (10 females and 1 male; median age 56 years) with active GO who were candidates for treatment with intravenous (iv) methylprednisone were consecutively enrolled. All patients were pretreated with a loading dose of 300,000 units of cholecalciferol, then given a median cumulative dose of 4.5 g (range 1.5-5.25 g) iv methylprednisone. Biochemical parameters of bone metabolism (25OHD3, PTH, P1NP, CTX and bALP) were measured at the baseline, and then 1 week and 1, 3, 6 and 12 months. BMD and TBS were obtained by X-ray absorptiometry (DXA) at the baseline and at 6 and 12 months. On DXA image, morphometric vertebral fracture assessment (VFA) was done. RESULTS There were no significant changes in PTH, bALP or P1NP. A significant drop in CTX was seen at 1 month (down Δ49.31% from the baseline, p = 0.02), with a return to the baseline at the 3-month measurement. There was a moderate (not significant), but persistent reduction in P1NP. No changes in BMD or TBS came to light. No vertebral fractures were documented. CONCLUSIONS Short-term, high-dose GC treatment caused a rapid, transient suppression of bone resorption, with no effects on BMD or bone micro-architecture (TBS).
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Affiliation(s)
- S Censi
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - J Manso
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - G Pandolfo
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - G Franceschet
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - E Cavedon
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - Y H Zhu
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - S Carducci
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - W Gomiero
- Sport and Exercise Medicine Division, Department of Medicine (DIMED), Università di Padova, Padua, Italy
| | - M Plebani
- Laboratory Medicine, Department of Medicine (DIMED), Università di Padova, Padua, Italy
| | - M Zaninotto
- Laboratory Medicine, Department of Medicine (DIMED), Università di Padova, Padua, Italy
| | - S Watutantrige-Fernando
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - C Mian
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy
| | - V Camozzi
- Endocrinology Unit, Department of Medicine (DIMED), Università di Padova, Via Ospedale n. 105, 35128, Padua, Italy.
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Censi S, Barollo S, Grespan E, Watutantrige-Fernando S, Manso J, Iacobone M, Casal Ide E, Galuppini F, Fassina A, Bertazza L, Vianello F, Pennelli G, Mian C. Prognostic significance of TERT promoter and BRAF mutations in TIR-4 and TIR-5 thyroid cytology. Eur J Endocrinol 2019; 181:1-11. [PMID: 31042674 DOI: 10.1530/eje-19-0073] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/29/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Follicular-derived thyroid cancers generally have a good prognosis, but in a minority of cases, they have an aggressive behavior and develop distant metastases, with an increase in the associated mortality. None of the prognostic markers currently available prior to surgery can identify such cases. METHODS TERT promoter and BRAF gene mutations were examined in a series of 436 consecutive TIR-4 and TIR-5 nodes referred for surgery. Follow-up (median: 59 months, range: 7-293 months) was available for 384/423 patients with malignant nodes. RESULTS TERT promoter and BRAF mutations were detected in 20/436 (4.6%) and 257/434 thyroid nodules (59.2%), respectively. At the end of the follow-up, 318/384 patients (82.8%) had an excellent outcome, 48/384 (12.5%) had indeterminate response or biochemical persistence, 18/384 (4.7%) had a structural persistence or died from thyroid cancer. TERT promoter mutations correlated with older age (P < 0.0001), larger tumor size (P = 0.0002), oxyntic and aggressive PTC variants (P = 0.01), higher tumor stages (P < 0.0001), distant metastases (<0.0001) and disease outcome (P < 0.0001). At multivariate analysis, TERT promoter mutation was not an independent predictor of disease outcome. TERT promoter mutation- (OR: 40.58; 95% CI: 3.06-539.04), and N1b lymph node metastases (OR: 40.16, 95% CI: 3.48-463.04) were independent predictors of distant metastases. BRAF mutation did not predict the outcome, and it correlated with a lower incidence of distant metastases (P = 0.0201). CONCLUSIONS TERT promoter mutation proved an independent predictor of distant metastases, giving clinicians the chance to identify many of the patients who warranted more aggressive initial treatment and closer follow-up.
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Affiliation(s)
- Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Elisabetta Grespan
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | | | - Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Endocrine Surgery Unit, University of Padua, Padua, Italy
| | - Eric Casal Ide
- Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Endocrine Surgery Unit, University of Padua, Padua, Italy
| | - Francesca Galuppini
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Pathology Unit, University of Padua, Padua, Italy
| | - Ambrogio Fassina
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Pathology Unit, University of Padua, Padua, Italy
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy
| | - Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Pathology Unit, University of Padua, Padua, Italy
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit, University of Padua, Padua, Italy
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Manso J, Pezzani R, Scarpa R, Gallo N, Betterle C. The natural history of autoimmune Addison's disease with a non-classical presentation: a case report and review of literature. Clin Chem Lab Med 2019; 56:896-900. [PMID: 29478039 DOI: 10.1515/cclm-2017-1108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/27/2017] [Accepted: 01/24/2018] [Indexed: 11/15/2022]
Abstract
Autoimmune Addison's disease (AAD) is the most frequent cause of adrenocortical insufficiency. The natural history of AAD usually comprises five consecutive stages with the first stage characterized by the increase of plasma renin consistent with the impairment of pars glomerulosa, which is usually the first affected layer of the adrenal cortex. We describe a 19-year-old female with Hashimoto's thyroiditis (HT) who underwent an autoantibody screening due to having the personal and family history of other autoimmune diseases in the absence of relevant clinical manifestations. She was positive for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OH Ab) at high titers. She had increased basal levels of ACTH with normal basal cortisol not responding to ACTH stimulation, reduced levels of dehydroepiandrosterone-sulfate but normal levels of orthostatic renin and aldosterone. This scenario was consistent with a subclinical AAD presenting with first impairments in pars fasciculata and reticularis and conserved pars glomerulosa function. Only subsequently, progressive deficiency in pars glomerulosa function has become evident. Review of the literature showed that there was only one case, reported to date, with a similar atypical natural history of AAD. The strategies for screening for ACA/21-OH Ab in patients with HT are discussed.
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Affiliation(s)
- Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Riccardo Scarpa
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Nicoletta Gallo
- Laboratory Medicine, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Corrado Betterle
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
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Censi S, Cavedon E, Watutantrige-Fernando S, Barollo S, Bertazza L, Manso J, Iacobone M, Nacamulli D, Galuppini F, Pennelli G, Mian C. Unique Case of a Large Indolent Medullary Thyroid Carcinoma: Time to Reconsider the Medullary Thyroid Adenoma Entity? Eur Thyroid J 2019; 8:108-112. [PMID: 31192151 PMCID: PMC6514480 DOI: 10.1159/000494675] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/03/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Medullary thyroid carcinoma (MTC) is a rare neuroendocrine cancer originating from parafollicular, calcitonin (Ctn)-producing C-cells. Prognosis correlates with primary tumor stage and Ctn levels. PATIENT We describe a case of MTC involving a mass 7 cm in its largest dimension, associated with high Ctn concentrations (> 5,000 pg/mL), but normal carcinoembryonic antigen levels, and with no lymph nodes or distant metastases, in complete remission after thyroid surgery. The MTC had very peculiar histological features, with an expansive, noninfiltrating growth around the thyroid follicles, and no signs of invasion. These histopathological characteristics are reminiscent of the C-cell adenoma described in animals. The tumor also revealed an ossifying extracellular matrix unlike the classical amyloid. Despite the size of the tumor and the patient's high Ctn levels at diagnosis, the case described here reached complete remission after surgery. CONCLUSIONS Further studies are needed to clarify the characteristics of MTC and better predict its behavior at diagnosis.
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Affiliation(s)
- Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Elisabetta Cavedon
- Familial Tumor Unit, Veneto Institute of Oncology, (IOV)-IRCCS, Padua, Italy
| | | | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maurizio Iacobone
- Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy
| | - Davide Nacamulli
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Galuppini
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- *Prof. Caterina Mian, Endocrinology Unit, Department of Medicine-DIMED, Via Ospedale n. 105, IT–35128 Padua(Italy), E-Mail
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Censi S, Barollo S, Watutantrige-Fernando S, Manso J, Ferrara AM, Mian C. A Novel Thyroid Hormone Receptor Beta Mutation (G357R) in a Family with Resistance to Thyroid Hormone Beta: Extending the Borders of the "Hot" Region in the THRB Gene. Thyroid 2019; 29:449-451. [PMID: 30458118 DOI: 10.1089/thy.2018.0201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Resistance to thyroid hormone beta (RTHβ) is a syndrome characterized by high serum levels of thyroid hormone and unsuppressed serum thyrotropin concentrations. RTHβ is caused by mutations in the thyroid hormone receptor beta (THRB) gene, which are mostly clustered in three "hot" regions along the gene. Here, a report is given on a family with RTHβ caused by a novel mutation in the THRB gene (c.1069 G>C, p.G357R) occurring outside the historically known "hot" regions.
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Affiliation(s)
- Simona Censi
- 1 Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Susi Barollo
- 1 Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Jacopo Manso
- 1 Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Caterina Mian
- 1 Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Naletto L, Frigo AC, Ceccato F, Sabbadin C, Scarpa R, Presotto F, Dalla Costa M, Faggian D, Plebani M, Censi S, Manso J, Furmaniak J, Chen S, Rees Smith B, Masiero S, Pigliaru F, Boscaro M, Scaroni C, Betterle C. The natural history of autoimmune Addison's disease from the detection of autoantibodies to development of the disease: a long-term follow-up study on 143 patients. Eur J Endocrinol 2019; 180:223-234. [PMID: 30608902 DOI: 10.1530/eje-18-0313] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Received: 04/13/2018] [Accepted: 01/02/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adrenal cortex autoantibodies (ACAs) and/or 21-hydroxylase (21OHAb) are markers of autoimmune Addison's disease (AAD) and progression to overt AAD. The reported cumulative risk of developing AAD varies from 0 to 90% in different studies. AIM To assess the predictive value of different parameters in the progression toward AAD in patients with ACA and/or 21OHAb-positive patients with autoimmune polyendocrine syndromes (APS). MATERIALS AND METHODS Twenty-nine patients with APS-1 and 114 patients with APS-2 or APS-4 were followed up for a median of 10 years (range 6 months to 33 years) and were assessed using ACTH test. The risk of AAD was estimated according to age, gender, stage of adrenal dysfunction, associated diseases and antibody titer. Univariate and multivariate Cox proportional hazard models were used for statistical analysis. RESULTS The cumulative risk (CR) of developing AAD was higher in APS-1 patients (94.2%) than in patients with APS-2/APS-4 (38.7%). The CR was high in both male and female APS-1 patients, while in patients with APS-2/APS-4 it was high only in males. Stage 1 (increased plasma renin) for patients with APS-1 and Stage 2 (no response of cortisol to ACTH test) for patients with APS-2/APS-4 were established as the points of no return in the progression to AAD. Adjusted hazard ratio analyses by multivariate Cox model for AAD showed that gender, diseases and adrenal function were independent risk factors for developing clinical AAD. The risk of developing clinical AAD appears to subside after 19 years of follow-up. CONCLUSIONS A model for estimating the probability to survive free of AAD has been developed and should be a useful tool in designing appropriate follow-up intervals and future therapeutic strategies.
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Affiliation(s)
| | - Anna Chiara Frigo
- Unit of Biostatistic, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | | | | | - Fabio Presotto
- Unit of Internal Medicine, Ospedale dell'Angelo, Mestre-Venezia, Italy
| | | | - Diego Faggian
- Unit of Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Mario Plebani
- Unit of Laboratory Medicine, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | | | | | - Shu Chen
- FIRS Laboratories, RSR Ltd, Parc Ty Glas, Llanishen, Cardiff, UK
| | | | | | - Francesca Pigliaru
- Endocrine Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
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Pezzani R, Bertazza L, Cavedon E, Censi S, Manso J, Watutantrige-Fernando S, Pennelli G, Galuppini F, Barollo S, Mian C. Novel Prognostic Factors Associated with Cell Cycle Control in Sporadic Medullary Thyroid Cancer Patients. Int J Endocrinol 2019; 2019:9421079. [PMID: 30911297 PMCID: PMC6398011 DOI: 10.1155/2019/9421079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/10/2018] [Accepted: 01/17/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Medullary thyroid cancer (MTC) is a rare neuroendocrine-derived malignancy. It is represented by sporadic and familiar forms, and both can have RET oncogene mutations. Numerous markers can be used to define MTC; however, none is generally approved for predicting the outcome of sporadic MTC. AIM The aim of this work was to analyze PTTG1/securin and Aurora kinase A expressions in MTC patients, both at the gene and protein levels, and to define their prognostic role in MTC assessing their association with lab and clinical parameters. PATIENTS AND METHODS Seventy-one sporadic MTC human samples were analyzed for RET mutations and by qPCR for PTTG1 and AURKA (Aurora kinase A) expression. Ki-67 levels and western blot reactivity for PTTG1 and Aurora kinase A were also determined in a selected cohort of patients. RESULTS RET somatic mutations were found in 48% of the patients (34/71). PTTG1 expression was statistically different among the groups with or without regional lymph node metastasis (p < 0.0001) and advanced stage disease (p < 0.01). PTTG1 and AURKA expressions were statistically higher than those of controls (p = 0.01 and p < 0.002, respectively). PTTG1 expression and Ki-67 levels were statistically different among the groups with remitted or persistent disease (p < 0.05 and p < 0.01, respectively). We found a significant correlation between the expressions of AURKA and PTTG1 (p < 0.0002, r = 0.5298) and between the expressions of PTTG1 and Ki-67 (p = 0.01). Ki-67 levels were statistically different among the groups with or without metastatic lymph nodes (p = 0.01) or distant metastases (p = 0.003). CONCLUSION The presence of an altered expression of PTTG1 and AURKA is a negative prognostic factor associated with a more aggressive course of disease, such as an advanced stage or disease persistence. It emerges as a cell cycle process mediated by the 2 factors, in addition to the RET pathway, which can be altered in MTC patients.
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Affiliation(s)
- Raffaele Pezzani
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
- Associazione Italiana per la Ricerca Oncologica di Base (AIROB), Padova, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Elisabetta Cavedon
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Sara Watutantrige-Fernando
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Gianmaria Pennelli
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padova, Via Gabelli 61, 35121 Padova, Italy
| | - Francesca Galuppini
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padova, Via Gabelli 61, 35121 Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padova, Via Ospedale 105, Padova 35128, Italy
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Sabbadin C, Bordin L, Donà G, Manso J, Avruscio G, Armanini D. Licorice: From Pseudohyperaldosteronism to Therapeutic Uses. Front Endocrinol (Lausanne) 2019; 10:484. [PMID: 31379750 PMCID: PMC6657287 DOI: 10.3389/fendo.2019.00484] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/03/2019] [Indexed: 01/06/2023] Open
Abstract
Licorice has been used as a medicinal plant from 2.500 years. It shows a wide range of biological and pharmacological activities, including anti-inflammatory and immune regulatory actions. One of its most known effects is the induction of hypertension, and it can induce what appears to be pseudohyperaldosteronism, due to glycyrrhetinic acid, the main active component of the root. Glycyrrhetinic acid and metabolites block the 11 beta-hydroxysteroid dehydrogenase type 2 and also bind mineralocorticoid receptors directly, acting as agonists. However, other interesting therapeutic uses of licorice are linked to its anti-androgen and estrogen-like activity, especially in the treatment of polycystic ovary syndrome (PCOS) in conjunction with spironolactone therapy. In this brief review, we report the main features and possible therapeutic uses of this ancient plant.
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Affiliation(s)
- Chiara Sabbadin
- Endocrinology Unit, Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Luciana Bordin
- Department of Molecular Medicine—Biological Chemistry, University of Padua, Padua, Italy
| | - Gabriella Donà
- Department of Molecular Medicine—Biological Chemistry, University of Padua, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Giampiero Avruscio
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Padua, Italy
| | - Decio Armanini
- Endocrinology Unit, Department of Medicine, University Hospital of Padua, Padua, Italy
- *Correspondence: Decio Armanini
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Galuppini F, Vianello F, Censi S, Barollo S, Bertazza L, Carducci S, Colato C, Manso J, Rugge M, Iacobone M, Watutantrige Fernando S, Pennelli G, Mian C. Differentiated Thyroid Carcinoma in Pediatric Age: Genetic and Clinical Scenario. Front Endocrinol (Lausanne) 2019; 10:552. [PMID: 31456750 PMCID: PMC6698790 DOI: 10.3389/fendo.2019.00552] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/25/2019] [Indexed: 12/04/2022] Open
Abstract
Introduction: Follicular-derived differentiated thyroid carcinoma (DTC) is the most common endocrine and epithelial malignancy in children. The differences in the clinical and pathological features of pediatric vs. adult DTC could relate to a different genetic profile. Few studies are currently available in this issue, however, and most of them involved a limited number of patients and focused mainly on radiation-exposed populations. Materials and Methods: We considered 59 pediatric patients who underwent surgery for DTC between 2000 and 2017. RET/PTC rearrangement was investigated with fluorescent in situ hybridization and real-time polymerase chain reaction. Sequencing was used to analyze mutations in the BRAF, NRAS, PTEN, PIK3CA genes, and the TERT promoter. The pediatric patients' clinical and molecular features were compared with those of 178 adult patients. Results: In our pediatric sample, male gender and age <15 years coincided with more extensive disease and more frequent lymph node and distant metastases. Compared with adults, the pediatric patients were more likely to have lymph node and distant metastasis, and to need second treatments (p < 0.01). In all, 44% of the pediatric patients were found to carry molecular alterations. RET/PTC rearrangement was confirmed as the most frequent genetic alteration in childhood DTC (24.6%) and correlated with aggressive features. BRAFV600E was only identified in 16% of the pediatric DTCs, while NRASQ61R, NRASQ61K, and TERTC250T mutations were very rare. Conclusions: Pediatric DTC is more aggressive at diagnosis and more likely to recur than its adult counterpart. Unlike the adult disease, point mutations have no key genetic role.
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Affiliation(s)
- Francesca Galuppini
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
- Department of Women's and Children's Health, Padova University Hospital, Padova, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico del Veneto, IOV-IRCCS, Padova, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Sofia Carducci
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Chiara Colato
- Pathology Section, Department of Pathology and Diagnostics, University of Verona, Verona, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Massimo Rugge
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Maurizio Iacobone
- Endocrine Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), Padova University Hospital, Padova, Italy
| | | | - Gianmaria Pennelli
- Pathology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
- *Correspondence: Caterina Mian
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Sabbadin C, Andrisani A, Ambrosini G, Bordin L, Donà G, Manso J, Ceccato F, Scaroni C, Armanini D. Aldosterone in Gynecology and Its Involvement on the Risk of Hypertension in Pregnancy. Front Endocrinol (Lausanne) 2019; 10:575. [PMID: 31507531 PMCID: PMC6716345 DOI: 10.3389/fendo.2019.00575] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022] Open
Abstract
Aldosterone is the main mineralocorticoid hormone, responsible of the regulation of fluid and electrolyte balance and blood pressure. It acts also as a pro-inflammatory factor responsible of an increased cardiovascular risk, independent from blood pressure values. After the discovery of mineralocorticoid receptor (MR) in mononuclear leukocytes, further studies supported its role in inflammatory and even autoimmune mechanisms underlying several diseases. In particular, recent studies reported a possible involvement of aldosterone in some gynecological conditions and diseases, characterized by inflammation, hypertension and increased cardio-metabolic risk, such as use of hormonal contraceptives, preeclampsia, polycystic ovary syndrome, uterine fibroids, and endometriosis. The aim of this mini-review is to report the possible involvement of aldosterone in all these gynecological conditions, suggesting different pathogenetic mechanisms and new target treatments of MR blockers for these diseases.
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Affiliation(s)
- Chiara Sabbadin
- Department of Medicine–Endocrinology, University of Padova, Padua, Italy
| | | | - Guido Ambrosini
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Luciana Bordin
- Department of Molecular Medicine-Biological Chemistry, University of Padova, Padua, Italy
| | - Gabriella Donà
- Department of Molecular Medicine-Biological Chemistry, University of Padova, Padua, Italy
| | - Jacopo Manso
- Department of Medicine–Endocrinology, University of Padova, Padua, Italy
| | - Filippo Ceccato
- Department of Medicine–Endocrinology, University of Padova, Padua, Italy
| | - Carla Scaroni
- Department of Medicine–Endocrinology, University of Padova, Padua, Italy
| | - Decio Armanini
- Department of Medicine–Endocrinology, University of Padova, Padua, Italy
- *Correspondence: Decio Armanini
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Bertazza L, Sensi F, Cavedon E, Watutantrige-Fernando S, Censi S, Manso J, Vianello F, Casal Ide E, Iacobone M, Pezzani R, Mian C, Barollo S. EF24 (a Curcumin Analog) and ZSTK474 Emphasize the Effect of Cabozantinib in Medullary Thyroid Cancer. Endocrinology 2018; 159:2348-2360. [PMID: 29688429 DOI: 10.1210/en.2018-00124] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/18/2018] [Indexed: 12/11/2022]
Abstract
XL184 is a small-molecule kinase inhibitor recently included in first-line systemic therapy for patients with advanced, progressive medullary thyroid cancer (MTC). EF24 is a curcumin analog with a high bioavailability, and ZSTK474 is an inhibitor of the phosphatidylinositol 3-kinase signaling pathway. We investigated the effect of these compounds, alone and in combination, in two rearranged during transfection (RET)-mutated TT and MZ-CRC-1 MTC cell lines and in six mostly RET wild-type human MTC primary cultures. Low IC50 values demonstrated the efficacy of the drugs, whereas the combination index revealed an important synergistic effect of combinations of XL184 + ZSTK474 and XL184 + EF24. Cell-cycle changes and the induction of apoptosis or necrosis were modulated by single compounds or combinations thereof. Both XL184 and EF24, alone or combined, were effective in reducing calcitonin secretion. Western blot and in-cell Western analysis showed that the compounds prompted a decrease in general reactivity to phosphorylated antibodies. Our data confirm XL184 alone as the reference drug for RET-mutated MTC, but we also demonstrated that EF24 alone is effective in inhibiting MTC cell viability. We tested the combinations XL184 + ZSTK474 and XL184 + EF24 too, finding that they act synergistically, irrespective of RET mutation status.
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Affiliation(s)
- Loris Bertazza
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Francesca Sensi
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Elisabetta Cavedon
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Sara Watutantrige-Fernando
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Federica Vianello
- Department of Radiotherapy, Istituto Oncologico Veneto-Istituto Di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - Eric Casal Ide
- Surgical Pathology Unit, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padova, Italy
| | - Maurizio Iacobone
- Surgical Pathology Unit, Department of Surgical, Oncological and Gastroenterological Sciences, Padua University Hospital, Padova, Italy
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine, Padua University Hospital, Padova, Italy
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Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. It has undergone in-depth clinical and laboratory investigations, with the help of the most important research groups all over the world. Nonetheless the cure for this kind of neoplasia is not right around the corner, given its complexity and multi-faceted feature, that lead researchers to think at "one person one ACC." Currently total resection is the most concrete option for ACC patients, whenever possible. Mitotane remains the main drug for primary or adjuvant therapy, but gives partial and unsatisfactory therapeutic results, especially in metastatic ACC. This prompted the researchers to find other ways to fight against this malignancy: targeted therapy seems the most promising answer, as it is based on biomolecular and genetic cancer signature. Numerous specific targets were explored for the treatment of ACC, such as those involving angiogenesis, steroidogenesis, Wnt/β-catenin pathway and many others key factors. Even if large efforts have been made, no effective target therapy entered in the clinical use. This data should not be considered only as detrimental, rather it should propel scientific research to invest more resources into the therapeutic exploration of ACC and in particular on the most promising strategy, the targeted therapy.
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Affiliation(s)
- Jacopo Manso
- Unit of Endocrinology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Raffaele Pezzani
- Unit of Endocrinology, Department of Medicine (DIMED), University of Padua, Padua, Italy - .,Associazione Italiana per la Ricerca Oncologica di Base (AIROB), Padua, Italy
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Watutantrige-Fernando S, Barollo S, Bertazza L, Cavedon E, Censi S, Manso J, Vianello F, Mian C. Efficacy of educational intervention to improve awareness of the importance of iodine, use of iodized salt, and dietary iodine intake in northeastern Italian schoolchildren. Nutrition 2018; 53:134-139. [PMID: 29778950 DOI: 10.1016/j.nut.2018.02.010] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/05/2018] [Accepted: 02/08/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE An educational program was conducted among school-aged children to improve their knowledge about iodine prophylaxis, their iodine status, and their dietary habits. METHODS At the baseline (T0) and after 6 mo (T1), participants (970 at T0 and 949 at T1) answered questionnaires testing their knowledge about iodine prophylaxis and their eating habits. Urine samples were collected from a randomly selected subgroup of participants (313 at T0 and 312 at T1). RESULTS From T0 to T1 there was a significant improvement in respondents' knowledge about iodine prophylaxis (from 44% to 70%), iodized salt consumption (from 78% to 84%), and median urine iodine concentrations (from 70 µg/L to 91 µg/L). Milk and iodized salt intakes were associated with a better iodine status per se, and more so when used simultaneously. Girls drank milk less often than boys did (daily in 52% and 59% of cases, respectively). Children of foreign origin ate sodium-rich food more often than Italians did. CONCLUSION Educational intervention improved the children's knowledge about iodine prophylaxis and use of iodized salt. Consuming salt in addition to milk improves iodine status. Children of foreign origin have different eating habits.
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Affiliation(s)
- Sara Watutantrige-Fernando
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Elisabetta Cavedon
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Jacopo Manso
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy
| | - Federica Vianello
- Radiotherapy Unit, Veneto Institute of Oncology IOV-IRCCS, via Giustiniani 2, 35128 Padua, Italy
| | | | - Caterina Mian
- Endocrinology Unit, Department of Medicine, University of Padua, via Ospedale Civile 105, 35128, Padua, Italy.
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Rubin B, Manso J, Monticelli H, Bertazza L, Redaelli M, Sensi F, Zorzan M, Scaroni C, Mian C, Iacobone M, Armanini D, Bertolini C, Barollo S, Boscaro M, Pezzani R. Crude extract of Origanum vulgare L. induced cell death and suppressed MAPK and PI3/Akt signaling pathways in SW13 and H295R cell lines. Nat Prod Res 2018; 33:1646-1649. [PMID: 29334260 DOI: 10.1080/14786419.2018.1425846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 12/18/2022]
Abstract
Oregano (Origanum vulgare L.) is a common aromatic plant used in Mediterranean and Asian Regions for treating respiratory diseases, painful menstruation, rheumatoid arthritis, etc. Recently its role as an anticancer plant has been suggested, although oregano has been never evaluated into adrenocortical tumour cell models. This study analysed for the first time the anticancer effects of a crude extract of wild mountain oregano (Origanum vulgare L.) in SW13 and H295R cell lines. The crude extract was characterised by GC/MS and the toxic effects of oregano were first analysed by brine shrimp lethality assay. Our findings demonstrated that oregano decreased cell viability, survival, modified cell cycle and induced cell death (through necrotic process) and that the effects can be attributed to a blockade of MAPK and PI3 K/Akt pathways. These results suggest that oregano extract exerts anticancer activities in adrenocortical tumour cell lines, providing evidence for further research in higher models.
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Affiliation(s)
- Beatrice Rubin
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Jacopo Manso
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Halenya Monticelli
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Loris Bertazza
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Marco Redaelli
- b AIROB, Associazione Italiana per la Ricerca Oncologica di Base , Padova , Italy.,c Venetian Institute for Molecular Science and Experimental Technologies, VIMSET , Liettoli di Campolongo Maggiore, Italy
| | - Francesca Sensi
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Maira Zorzan
- d Department of Molecular Medicine (DMM) , University of Padova , Padova , Italy
| | - Carla Scaroni
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Caterina Mian
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Maurizio Iacobone
- e Minimally Invasive Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology (DISCOG) , University of Padova , Padova , Italy
| | - Decio Armanini
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Cristina Bertolini
- b AIROB, Associazione Italiana per la Ricerca Oncologica di Base , Padova , Italy
| | - Susi Barollo
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Marco Boscaro
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy
| | - Raffaele Pezzani
- a Department of Medicine (DIMED) , O.U. Endocrinology, University of Padova , Padova , Italy.,b AIROB, Associazione Italiana per la Ricerca Oncologica di Base , Padova , Italy
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González AM, Manso J, de la Rubia L, Canga AM. Laryngeal stridor secondary to a giant cervical haemangioma. Rev Esp Anestesiol Reanim 2016; 63:610-611. [PMID: 27424875 DOI: 10.1016/j.redar.2016.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 06/06/2023]
Affiliation(s)
- A M González
- Servicio de Anestesiología y Reanimación, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
| | - J Manso
- Servicio de Anestesiología y Reanimación, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - L de la Rubia
- Servicio de Pediatría, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - A M Canga
- Servicio de Radiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
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Galuppini F, Pennelli G, Vianello F, Censi S, Zambonin L, Watutantrige-Fernando S, Manso J, Nacamulli D, Lora O, Pelizzo MR, Rugge M, Barollo S, Mian C. BRAF analysis before surgery for papillary thyroid carcinoma: correlation with clinicopathological features and prognosis in a single-institution prospective experience. ACTA ACUST UNITED AC 2016; 54:1531-9. [DOI: 10.1515/cclm-2015-0218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 12/27/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Risk stratification in patients with papillary thyroid carcinoma (PTC) currently relies on postoperative parameters. Testing forBRAFmutations preoperatively may serve as a novel tool for identifying PTC patients at risk of persistence/recurrence after surgery.Methods:The study involved 185 consecutive patients with a histological diagnosis of PTC andBRAFanalysis performed on thyroid fine-needle aspiration biopsy (FNAB). We assessedBRAFstatus in FNAB specimens obtained before thyroidectomy for PTC, and examined its association with the clinicopathological characteristics identified postoperatively, and with outcome after a mean 55±15 months of follow-up.Results:One hundred and fifteen of 185 (62%) PTCs carried aBRAFmutation. Univariate analysis showed thatBRAFstatus correlated with the histological variant of PTC, cancer size, and stage at diagnosis, but not with gender, age, multifocality, or lymph node involvement.BRAF-mutated cases had a higher prevalence of persistent/recurrent disease by the end of the follow-up (11% vs. 8%), but this difference was not statistically significant. The Kaplan-Meier curve shows that among the patients with persistent/recurrent disease,BRAF-mutated patients needed a second treatment earlier than patients withBRAFwild-type, although the difference did not completely reach the statistical significance.Conclusions:Our study confirmed that preoperatively-identifiedBRAFmutation are associated with certain pathological features of PTC that correlate with prognosis. We speculate that it has a role in identifying PTCs that would generally be considered low-risk but that may reveal an aggressive behavior during their follow-up.
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Manso J, García-Barrera T, Gómez-Ariza JL, González AG. A multiple hollow fibre liquid-phase microextraction method for the determination of halogenated solvent residues in olive oil. Anal Bioanal Chem 2013; 406:1567-71. [DOI: 10.1007/s00216-013-7552-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/18/2013] [Accepted: 12/03/2013] [Indexed: 10/25/2022]
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Gamella M, Campuzano S, Manso J, González de Rivera G, López-Colino F, Reviejo AJ, Pingarrón JM. A novel non-invasive electrochemical biosensing device for in situ determination of the alcohol content in blood by monitoring ethanol in sweat. Anal Chim Acta 2013; 806:1-7. [PMID: 24331037 DOI: 10.1016/j.aca.2013.09.020] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 09/06/2013] [Accepted: 09/07/2013] [Indexed: 01/31/2023]
Abstract
A non-invasive, passive and simple to use skin surface based sensing device for determining the blood's ethanol content (BAC) by monitoring transdermal alcohol concentration (TAC) is designed and developed. The proposed prototype is based on bienzyme amperometric composite biosensors that are sensitive to the variation of ethanol concentration. The prototype correlates, through previous calibration set-up, the amperometric signal generated from ethanol in sweat with its content in blood in a short period of time. The characteristics of this sensor device permit determination of the ethanol concentration in isolated and in continuous form, giving information of the BAC of a subject either in a given moment or its evolution during long periods of time (8h). Moreover, as the measurements are performed in a biological fluid, the evaluated individual is not able to alter the result of the analysis. The maximum limit of ethanol in blood allowed by legislation is included within the linear range of the device (0.0005-0.6 g L(-1)). Moreover, the device shows higher sensitivity than the breathalyzers marketed at the moment, allowing the monitoring of the ethanol content in blood to be obtained just 5 min after ingestion of the alcoholic drink. The comparison of the obtained results using the proposed device in the analysis of 40 volunteers with those provided by the gas chromatographic reference method for determination of BAC pointed out that there were no significant differences between both methods.
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Affiliation(s)
- M Gamella
- Dpto. Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
| | - S Campuzano
- Dpto. Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
| | - J Manso
- Dpto. Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
| | - G González de Rivera
- Escuela Politécnica Superior, Universidad Autónoma de Madrid, E-28049 Madrid, Spain.
| | - F López-Colino
- Escuela Politécnica Superior, Universidad Autónoma de Madrid, E-28049 Madrid, Spain.
| | - A J Reviejo
- Dpto. Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
| | - J M Pingarrón
- Dpto. Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
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Manso J, García-Barrera T, Gómez-Ariza J. New home-made assembly for hollow-fibre membrane extraction of persistent organic pollutants from real world samples. J Chromatogr A 2011; 1218:7923-35. [DOI: 10.1016/j.chroma.2011.09.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 09/06/2011] [Accepted: 09/08/2011] [Indexed: 11/25/2022]
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Manso J, Agüí L, Yáñez‐Sedeño P, Pingarrón JM. Development and Characterization of Colloidal Gold‐Cysteamine‐Carbon Paste Electrodes. ANAL LETT 2007. [DOI: 10.1081/al-120030285] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Blanco JR, Ferrero FJ, Campo J, Anton J, Pingarron JM, Reviejo AJ, Manso J. Design of a Low-Cost Portable Potentiostat for Amperometric Biosensors. ACTA ACUST UNITED AC 2006. [DOI: 10.1109/imtc.2006.328670] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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