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Grenier JM, Borst AJ, Sheppard SE, Snyder KM, Li D, Surrey LF, Al-Ibraheemi A, Weber DR, Treat JR, Smith CL, Laje P, Dori Y, Adams DM, Acord M, Srinivasan AS. Pathogenic variants in PIK3CA are associated with clinical phenotypes of kaposiform lymphangiomatosis, generalized lymphatic anomaly, and central conducting lymphatic anomaly. Pediatr Blood Cancer 2023:e30419. [PMID: 37194624 DOI: 10.1002/pbc.30419] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
Complex lymphatic anomalies are debilitating conditions characterized by aberrant development of the lymphatic vasculature (lymphangiogenesis). Diagnosis is typically made by history, examination, radiology, and histologic findings. However, there is significant overlap between conditions, making accurate diagnosis difficult. Recently, genetic analysis has been offered as an additional diagnostic modality. Here, we describe four cases of complex lymphatic anomalies, all with PIK3CA variants but with varying clinical phenotypes. Identification of PIK3CA resulted in transition to a targeted inhibitor, alpelisib. These cases highlight the genetic overlap between phenotypically diverse lymphatic anomalies.
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Affiliation(s)
- Jeremy M Grenier
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alexandra J Borst
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sarah E Sheppard
- Unit on Vascular Malformations, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Kristen M Snyder
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Dong Li
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lea F Surrey
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - David R Weber
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - James R Treat
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Christopher L Smith
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Pablo Laje
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Yoav Dori
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Denise M Adams
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Michael Acord
- Division of Interventional Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Abhay S Srinivasan
- Comprehensive Vascular Anomaly Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Division of Interventional Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Abstract
With the advent of checkpoint blockade therapies, immunotherapy is now a critical modality for the treatment of some cancers. While some patients respond well to checkpoint blockade, many do not, necessitating the need for other forms of therapy. Vaccination against malignancy has been a long sought goal of science. For cancers holding a microbial etiology, vaccination has been highly effective in reducing the incidence of disease. However, vaccination against established malignancy has been largely disappointing. In this review, we discuss efforts to develop diverse vaccine modalities in the treatment of cancer with a particular focus on melanoma. Recent work has suggested that vaccines targeting patient-specific tumor mutations may be more relevant than those targeting unmutated proteins. Nonetheless, tumor cells utilize many strategies to evade host immunity. It is likely that the full potential of cancer vaccination will only be realized when vaccines are combined with other therapies targeting tumor immunoevasive mechanisms. By modulating inhibitory molecules, regulatory immune cells, and the metabolic resources and demands of T cells, scientists and clinicians can ensure vaccine-stimulated T cells are fully functional within the immunosuppressive tumor microevironment.
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Affiliation(s)
- Jeremy M Grenier
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States
| | - Stephen T Yeung
- Department of Microbiology, New York University Langone School of Medicine, New York, NY, United States
| | - Kamal M Khanna
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States.,Department of Microbiology, New York University Langone School of Medicine, New York, NY, United States.,Perlmutter Cancer Center, New York University Langone Health, New York, NY, United States
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3
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Grenier JM, Yeung ST, Qiu Z, Jellison ER, Khanna KM. Combining Adoptive Cell Therapy with Cytomegalovirus-Based Vaccine Is Protective against Solid Skin Tumors. Front Immunol 2018; 8:1993. [PMID: 29387061 PMCID: PMC5775971 DOI: 10.3389/fimmu.2017.01993] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/22/2017] [Indexed: 12/16/2022] Open
Abstract
Despite many years of research, cancer vaccines have largely been ineffective in the treatment of established cancers. Many barriers to immune-mediated destruction of malignant cells exist, and these likely limit the efficacy of cancer vaccines. In this study, we sought to enhance the efficacy of a cytomegalovirus (CMV)-based vaccine targeting melanoma by combining vaccination with other forms of immunotherapy. Adoptive cell therapy in humans and in animal models has been shown to be effective for tumor regression. Thus, in this study, we assessed whether CMV-based vaccines in combination with adoptively transferred antitumor T cells could provide greater antitumor protection than either therapy alone. Our results show that adoptive cell therapy greatly enhanced the antitumor effects of CMV-based vaccines targeting the foreign model antigen, OVA, or the melanoma differentiation antigen, gp100. Combination adoptive cell therapy and vaccination induced the upregulation of the inhibitory ligands, PD-L1, and Qa-1b, on B16 tumor cells. This expression paralleled the infiltration of tumors by vaccine-stimulated T cells which also expressed high levels of the receptors PD-1 and NKG2A/C/E, suggesting a potential mechanism of tumor immune evasion. Surprisingly, therapeutic blockade of the PD-1/PD-L1 and NKG2A/Qa-1b axes did not delay tumor growth following vaccination, suggesting that the presence of inhibitory ligands within malignant tissue may not be an effective biomarker for successful combination therapy with CMV-based vaccines. Overall, our studies show that therapeutic CMV-based vaccines in combination with adoptive T cell transfer alone are effective for tumor rejection.
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Affiliation(s)
- Jeremy M Grenier
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States
| | - Stephen T Yeung
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States
| | - Zhijuan Qiu
- Department of Molecular Genetics and Microbiology, Center for Infectious Diseases, Stony Brook University, Stony Brook, New York, NY, United States
| | - Evan R Jellison
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States
| | - Kamal M Khanna
- Department of Immunology, University of Connecticut Health, Farmington, CT, United States
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Grenier JM, Qiu Z, Khanna KM. Adoptive cell transfer enhances antitumor response generated by Cytomegalovirus-based vaccine. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.143.20] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Methods for generating long-lived T cell responses to tumor antigen have been highly sought for potential therapy against many cancers. Our group has recently developed a novel vaccine against melanoma using recombinant Mouse Cytomegalovirus (MCMV) expressing a modified tumor antigen which generated life-long CD8+ T cell responses to the melanoma antigen, gp100. While this vaccine delays tumor growth in a mouse model of B16 metastatic melanoma, mice eventually succumb to the disease. Adoptive cell therapy has shown clinical efficacy in some patients with melanoma; however, it requires in vitro activation of large numbers of T cells to be effective. We hypothesized that combining these therapies would result in more effective tumor rejection by 1) increasing precursor frequency of tumor specific T cells, thus inducing a more robust T cell response following vaccination and 2) promoting life-long persistence of transferred cells following transfer. To test this, C57BL/6 mice received 105 CD8+ T cells expressing a transgenic T cell receptor recognizing gp100 (PMEL) followed by vaccination. Five days after transfer, PMEL cells constituted up to 20% of all CD8+ T cells in peripheral blood following MCMV vaccination in contrast to 7.5% following vaccination with another viral vaccine, Vesicular Stomatitis Virus. Our results also show that adoptive transfer and MCMV vaccination delays B16 tumor growth and improves survival in a solid tumor model. In summary, this study tests a novel method for stimulating adoptively transferred antitumor T cells, while avoiding the need for long-term in vitroculture of cells. Future work will also examine if immune checkpoint inhibitors or costimulatory agonists further improve this therapy.
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Ritzel RM, Crapser J, Patel AR, Verma R, Grenier JM, Chauhan A, Jellison ER, McCullough LD. Age-Associated Resident Memory CD8 T Cells in the Central Nervous System Are Primed To Potentiate Inflammation after Ischemic Brain Injury. J Immunol 2016; 196:3318-30. [PMID: 26962232 PMCID: PMC4868658 DOI: 10.4049/jimmunol.1502021] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/05/2016] [Indexed: 01/17/2023]
Abstract
Aging is associated with an increase in basal inflammation in the CNS and an overall decline in cognitive function and poorer recovery following injury. Growing evidence suggests that leukocyte recruitment to the CNS is also increased with normal aging, but, to date, no systematic evaluation of these age-associated leukocytes has been performed. In this work, the effect of aging on CNS leukocyte recruitment was examined. Aging was associated with more CD45(high) leukocytes, primarily composed of conventional CD8(+) T cells. These results were strain independent and seen in both sexes. Intravascular labeling and immunohistology revealed the presence of parenchymal CD8(+) T cells in several regions of the brain, including the choroid plexus and meninges. These cells had effector memory (CD44(+)CD62L(-)) and tissue-resident phenotypes and expressed markers associated with TCR activation. Analysis of TCRvβ repertoire usage suggested that entry into the CNS is most likely stochastic rather than Ag driven. Correlational analyses revealed a positive association between CD8 T cell numbers and decreased proinflammatory function of microglia. However, the effects of cerebral ischemia and ex vivo stimulation of these cells dramatically increased production of TNF, IFN-γ, and MCP-1/CCL2. Taken together, we identified a novel population of resident memory, immunosurveillant CD8 T cells that represent a hallmark of CNS aging and appear to modify microglia homeostasis under normal conditions, but are primed to potentiate inflammation and leukocyte recruitment following ischemic injury.
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Affiliation(s)
- Rodney M Ritzel
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030
| | - Joshua Crapser
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030
| | - Anita R Patel
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030
| | - Rajkumer Verma
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030
| | - Jeremy M Grenier
- Immunology Department, University of Connecticut Health Center, Farmington, CT 06030; and
| | - Anjali Chauhan
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030
| | - Evan R Jellison
- Immunology Department, University of Connecticut Health Center, Farmington, CT 06030; and
| | - Louise D McCullough
- Neuroscience Department, University of Connecticut Health Center, Farmington, CT 06030; Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston, TX 77370
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Qiu Z, Grenier JM, Khanna KM. Reviving virus based cancer vaccines by using cytomegalovirus vectors expressing modified tumor antigens. Oncoimmunology 2015; 5:e1056974. [PMID: 26942064 DOI: 10.1080/2162402x.2015.1056974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 05/20/2015] [Revised: 05/24/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022] Open
Abstract
Cancer vaccines that have utilized various immunization strategies to induce antitumor immunity have largely failed in clinical settings. We have recently developed a cancer vaccine using a cytomegalovirus (CMV) based vector that expressed a modified melanoma antigen that elicited a robust antitumor CD8+ T cell response and tumor rejection.
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Affiliation(s)
| | | | - Kamal M Khanna
- Department of Immunology; Department of Pediatrics; University of Connecticut Health Center; Farmington, CT USA
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Ritzel RM, Patel AR, Grenier JM, Crapser J, Verma R, Jellison ER, McCullough LD. Functional differences between microglia and monocytes after ischemic stroke. J Neuroinflammation 2015; 12:106. [PMID: 26022493 PMCID: PMC4465481 DOI: 10.1186/s12974-015-0329-1] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [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: 03/03/2015] [Accepted: 05/20/2015] [Indexed: 01/16/2023] Open
Abstract
Background The brain’s initial innate response to stroke is primarily mediated by microglia, the resident macrophage of the CNS. However, as early as 4 h after stroke, the blood–brain barrier is compromised and monocyte infiltration occurs. The lack of discriminating markers between these two myeloid populations has led many studies to generate conclusions based on the grouping of these two populations. A growing body of evidence now supports the distinct roles played by microglia and monocytes in many disease models. Methods Using a flow cytometry approach, combined with ex-vivo functional assays, we were able to distinguish microglia from monocytes using the relative expression of CD45 and assess the function of each cell type following stroke over the course of 7 days. Results We found that at 72 h after a 90-min middle cerebral artery occlusion (MCAO), microglia populations decrease whereas monocytes significantly increase in the stroke brain compared to sham. After stroke, BRDU incorporation into monocytes in the bone marrow increased. After recruitment to the ischemic brain, these monocytes accounted for nearly all BRDU-positive macrophages. Inflammatory activity peaked at 72 h. Microglia produced relatively higher reactive oxygen species and TNF, whereas monocytes were the predominant IL-1β producer. Although microglia showed enhanced phagocytic activity after stroke, monocytes had significantly higher phagocytic capacity at 72 h. Interestingly, we found a positive correlation between TNF expression levels and phagocytic activity of microglia after stroke. Conclusions In summary, the resident microglia population is vulnerable to the effects of severe ischemia, show compromised cell cycle progression, and adopt a largely pro-inflammatory phenotype after stroke. Infiltrating monocytes are primarily involved with early debris clearance of dying cells. These findings suggest that the early wave of infiltrating monocytes may be beneficial to stroke repair and future therapies aimed at mitigating microglia cell death may prove more effective than attempting to elicit targeted anti-inflammatory responses from damaged cells. Electronic supplementary material The online version of this article (doi:10.1186/s12974-015-0329-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rodney M Ritzel
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Anita R Patel
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Jeremy M Grenier
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Joshua Crapser
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Rajkumar Verma
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | - Evan R Jellison
- Department of Immunology, University of Connecticut Health Center, Farmington, CT, USA.
| | - Louise D McCullough
- Department of Neurology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA.
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8
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Qiu Z, Huang H, Grenier JM, Perez OA, Smilowitz HM, Adler B, Khanna KM. Cytomegalovirus-Based Vaccine Expressing a Modified Tumor Antigen Induces Potent Tumor-Specific CD8(+) T-cell Response and Protects Mice from Melanoma. Cancer Immunol Res 2015; 3:536-46. [PMID: 25633711 DOI: 10.1158/2326-6066.cir-14-0044] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 01/20/2015] [Indexed: 11/16/2022]
Abstract
The presence of tumor-infiltrating CD8(+) T cells is associated with tumor regression and better prognosis. Cytomegalovirus (CMV) infection elicits a robust and long-lasting CD8(+) T-cell response, which makes CMV a potentially promising vaccine vector against cancer. In the current study, we used recombinant murine CMV (MCMV) strains as prophylactic and therapeutic vaccines in an aggressive B16 lung metastatic melanoma model. Immunization with MCMV-expressing ovalbumin (OVA) induced a potent OVA-specific CD8(+) T-cell response and was effective in protecting mice from OVA-expressing B16 melanoma in an antigen-dependent manner. We engineered MCMV to express a modified B16 melanoma antigen gp100 (MCMV-gp100KGP). Immunization with MCMV-gp100KGP was highly effective in overcoming immune tolerance to self-antigen and induced a strong, long-lasting gp100-specific CD8(+) T-cell response even in the presence of preexisting anti-CMV immunity. Furthermore, both prophylactic and therapeutic vaccinations of mice with MCMV-gp100KGP effectively protected mice from highly aggressive lung B16-F10 melanoma, and the protection was mediated by gp100-specific CD8(+) T cells. We showed that MCMV is a superior vaccine vector compared with a commonly used vesicular stomatitis virus vector. Collectively, our studies demonstrate that CMV is a promising vaccine vector to prevent and treat tumors.
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Affiliation(s)
- Zhijuan Qiu
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut
| | - Huakang Huang
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut
| | - Jeremy M Grenier
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut
| | - Oriana A Perez
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut
| | - Henry M Smilowitz
- Department of Cell Biology, University of Connecticut Health Center, Farmington, Connecticut
| | - Barbara Adler
- Max von Pettenkofer-Institute for Virology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Kamal M Khanna
- Department of Immunology, University of Connecticut Health Center, Farmington, Connecticut.
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Chiang LW, Grenier JM, Ettwiller L, Jenkins LP, Ficenec D, Martin J, Jin F, DiStefano PS, Wood A. An orchestrated gene expression component of neuronal programmed cell death revealed by cDNA array analysis. Proc Natl Acad Sci U S A 2001; 98:2814-9. [PMID: 11226323 PMCID: PMC30222 DOI: 10.1073/pnas.051630598] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2000] [Accepted: 12/28/2000] [Indexed: 12/11/2022] Open
Abstract
Programmed cell death (PCD) during neuronal development and disease has been shown to require de novo RNA synthesis. However, the time course and regulation of target genes is poorly understood. By using a brain-biased array of over 7,500 cDNAs, we profiled this gene expression component of PCD in cerebellar granule neurons challenged separately by potassium withdrawal, combined potassium and serum withdrawal, and kainic acid administration. We found that hundreds of genes were significantly regulated in discreet waves including known genes whose protein products are involved in PCD. A restricted set of genes was regulated by all models, providing evidence that signals inducing PCD can regulate large assemblages of genes (of which a restricted subset may be shared in multiple pathways).
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Affiliation(s)
- L W Chiang
- Millennium Pharmaceuticals, 640 Memorial Drive, Cambridge, MA 02139, USA.
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Abstract
The authors report a case of malignant transformation (carcinoma cuniculatum) of a venous leg ulcer developed since 60 years. They draw the principal lessons from the review of literature.
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Affiliation(s)
- J M Grenier
- Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-Louis, Paris
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Duriot JF, Dutertre JP, Grenier JM, Autret A, Martin A. [Amineptin dependence and iatrogenic acne. Review of the literature apropos of a case]. Ann Med Psychol (Paris) 1991; 149:795-7. [PMID: 1839203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We relate the case of a drug addict of 31 years old whose dependence to the amineptine got complicated with severe acne-like lesions, as it sometimes happens. Compared, with teenage acne, severe acne can be distinguished by its late out break, its monstrous nature and its larger surface area. Amineptine has been found (or its metabolites) in the plasma, the urine. The treatment consists in the stopping of the drug addiction, combined with the prescription of isotretinoin.
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Affiliation(s)
- J F Duriot
- Centre Régional de Pharmacovigilence, Tours
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