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Terziroli Beretta-Piccoli B, Buescher G, Dalekos G, Zachou K, Geerts A, Semmo N, Kolev M, De Martin E, Janik MK, Madaleno J, Lalosevic Stojkovic M, Dumortier J, Vanwolleghem T, Schregel I, Steinmann S, Lacaille F, Sebode M. Hepatic safety and efficacy of immunomodulatory drugs used in patients with autoimmune hepatitis. J Autoimmun 2023; 140:103113. [PMID: 37716078 DOI: 10.1016/j.jaut.2023.103113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/28/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND AND AIMS There is little data on the hepatic efficacy and safety of immunomodulatory drugs used in patients with autoimmune hepatitis (AIH), despite their established use in dermatology, rheumatology and inflammatory bowel diseases (IBD). Our aim was to collect real-life data on the experience of expert centres in treating AIH patients with these drugs, considered unconventional for AIH management. METHODS Online survey among hepatology centres being part of the European Reference Network on Hepatological Diseases (ERN RARE-LIVER). RESULTS 25 AIH patients have been reported. Ten were female, median age at diagnosis was 28 years; median follow-up was 17 months. All had initially received AIH-standard treatment. AIH-unconventional treatment was initiated for concomitant autoimmune diseases in 15 cases: nine for IBD (five vedolizumab and four ustekinumab), and one each for following diseases: autoinflammatory syndrome (tocilizumab), chronic urticaria (omalizumab), rheumatoid arthritis (abatacept), psoriasis (guselkumab), psoriatric arthritis (secukinumab, followed by ustekinumab) and alopecia (ruxolitinib). Three patients were treated with immunomodulatory drugs for side effects of previous treatments, including two patients with IBD treated with vedolizumab and ustekinumab, respectively, and one treated with belimumab. At the end of follow-up, 13 patients were in complete biochemical response, the patient on omalizumab had a relapse, and four patients with concomitant IBD had insufficient response. Seven patients were treated for lack of biochemical remission, of whom six with belimumab, all initially reaching complete biochemical response, but five relapsing during follow-up; and one with secukinumab, having concomitant rheumatoid arthritis and ankylosing spondylitis, reaching complete biochemical response. Only the patient on abatacept received unconventional treatment as monotherapy. Side effects were reported in two patients on belimumab: one recurrent soft tissue infections, one fatigue and arthralgia. CONCLUSION Among 25 AIH patients who were treated with immunomodulatory drugs for different reasons, the majority had a fovorable course, relapse was frequent in difficult-to-treat patients who received belimumab, and four with concomitant IBD had insufficient response.
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Affiliation(s)
- Benedetta Terziroli Beretta-Piccoli
- Epatocentro Ticino, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; MowatLabs, Faculty of Life Sciences & Medicine, King's College London, King's College Hospital, London, UK.
| | - Gustav Buescher
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - George Dalekos
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Centre in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Kalliopi Zachou
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Centre in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Anja Geerts
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Department of Gastroenterology and Hepatology, University Hospital of Ghent, Belgium
| | - Nasser Semmo
- Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Mirjam Kolev
- Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Eleonora De Martin
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Hépatologie et Transplantation Hépatique, Hôpital Paul Brousse, Villejuif, France
| | - Maciej K Janik
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; . Department of Hepatology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - João Madaleno
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Liver Disease Unit, Internal Medicine Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Milica Lalosevic Stojkovic
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; University Clinical Center of Serbia, Belgrade, Serbia
| | - Jérôme Dumortier
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Hôpital Edouard Herriot, Hospices Civils de Lyon and Université Claude Bernard Lyon 1, Lyon, France
| | - Thomas Vanwolleghem
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Department of Gastroenterology and Hepatology Antwerp University Hospital, Antwerp, Belgium; Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Antwerp, Belgium
| | - Ida Schregel
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Silja Steinmann
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Florence Lacaille
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; Hôpital Necker-Enfants Malades, Paris, France
| | - Marcial Sebode
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany; I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Kolev M, Sarbu AC, Möller B, Maurer B, Kollert F, Semmo N. Belimumab treatment in autoimmune hepatitis and primary biliary cholangitis - a case series. J Transl Autoimmun 2023; 6:100189. [PMID: 36718275 PMCID: PMC9883290 DOI: 10.1016/j.jtauto.2023.100189] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Background The majority of patients with autoimmune hepatitis (AIH) achieve complete remission with established treatment regiments. In patients with intolerance or insufficient response to these drugs, the remaining options are limited and novel treatment approaches necessary. In primary biliary cholangitis (PBC), ursodeoxycholic acid (UDCA) and fibrates have improved prognosis dramatically, but there remains a proportion of patients with refractory disease.In patients with refractory AIH and/or PBC, we used a novel treatment strategy with the anti-B cell activating factor, belimumab. The first three patients had concomitant Sjögren's disease. The connecting element between all three diseases is B cell activation, including elevated levels of the B cell activating factor (BAFF). Furthermore, belimumab has been shown to be beneficial in Sjögren's disease. Aims and methods To retrospectively investigate treatment response in six patients with AIH or PBC with or without concomitant Sjögren's disease treated with the anti-BAFF therapy belimumab at the University Hospital in Bern, Switzerland. Results In all three patients with AIH, belimumab improved disease control and helped by-pass or reduce problematic side effects from corticosteroids and calcineurin inhibitors. In PBC patients (n = 3), there was no clear improvement of liver function tests, despite reduction or normalization of IgM. All patients with concomitant Sjögren's disease (n = 3) had an improvement of sicca symptoms and two out of three patients experienced an initially marked reduction in fatigue, which lessened over time. Conclusions Belimumab may be a promising treatment option for patients with AIH and further investigations are needed. In PBC however, response was not convincing. The effects on sicca symptoms and fatigue were encouraging.
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Key Words
- AIH, autoimmune hepatitis
- ALT, alanine aminotransferase
- AMA, anti-mitochondrial antibodies
- ANA, anti-nuclear antibodies
- AP, alkaline phosphatase
- APS, anti-phospholipid-antibody syndrome
- AZA, azathioprine
- Autoimmune hepatitis
- Autoimmune liver disease
- BDN, budesonide
- Belimumab
- CI, calcineurin inhibitor
- CyA, cyclosporine A
- INR, international normalized ratio
- IgG, immunoglobulin G
- IgM, immunoglobulin M
- LC 1, liver cytosol 1 antibodies
- LKM-1, liver-kidney-microsomal antibodies
- MMF, mycophenolate mofetil
- MRCP, magnetic resonance cholangiopancreatography
- NA, not applicable
- NRH, nodular regenerative hyperplasia
- PBC, primary biliary cholangitis
- PDN, prednisolone
- PLA2R, anti-phospholipase 2 receptor antibody
- PSC, primary sclerosing cholangitis
- Primary biliary cholangitis
- RF, rheumatoid factor
- SLA, soluble liver antigen antibodies
- SLE, systemic lupus erythematosus
- SMA, smooth-muscle cell antibodies
- SS-A, SS-A (Ro) antibodies
- SS-B, SS-B (La) antibodies
- Sjögren's disease
- TNFi, tumor necrosis factor inhibitor
- UDCA, ursodeoxycholic acid
- ULN, upper limit of normal
- disease-modifying anti-rheumatic drugs, DMARDs
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Affiliation(s)
- Mirjam Kolev
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland,Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Adela-Cristina Sarbu
- Department of Rheumatology and Immunology, Bern University Hospital, University of Bern, Switzerland
| | - Burkhard Möller
- Department of Rheumatology and Immunology, Bern University Hospital, University of Bern, Switzerland
| | - Britta Maurer
- Department of Rheumatology and Immunology, Bern University Hospital, University of Bern, Switzerland
| | - Florian Kollert
- Department of Rheumatology and Immunology, Bern University Hospital, University of Bern, Switzerland
| | - Nasser Semmo
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland,Corresponding author. University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Murtenstrasse 35, 3010, Bern, Switzerland.
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Codoni G, Kirchner T, Engel B, Villamil AM, Efe C, Stättermayer AF, Weltzsch JP, Sebode M, Bernsmeier C, Lleo A, Gevers TJG, Kupčinskas L, Castiella A, Pinazo J, De Martin E, Bobis I, Sandahl TD, Pedica F, Invernizzi F, Del Poggio P, Bruns T, Kolev M, Semmo N, Bessone F, Giguet B, Poggi G, Ueno M, Jang H, Elpek GÖ, Soylu NK, Cerny A, Wedemeyer H, Vergani D, Mieli-Vergani G, Lucena MI, Andrade RJ, Zen Y, Taubert R, Beretta-Piccoli BT. Histological and serological features of acute liver injury after SARS-CoV-2 vaccination. JHEP Rep 2022; 5:100605. [DOI: 10.1016/j.jhepr.2022.100605] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
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Kolev M. Prise en compte des points de vue des patients pour développer l’hémodialyse à domicile dans une logique d’auto-soins. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kolev M, Horn MP, Semmo N, Nagler M. Rational development and application of biomarkers in the field of autoimmunity: A conceptual framework guiding clinicians and researchers. J Transl Autoimmun 2022; 5:100151. [PMID: 35309737 PMCID: PMC8927991 DOI: 10.1016/j.jtauto.2022.100151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022] Open
Abstract
Clear guidance is needed in the development and implementation of laboratory biomarkers in medicine. So far, no standardized phased approach is established that would pilot researchers and clinicians in this process. This leads to often incompletely validated biomarkers, which can bear the consequence of wrong applications, misinterpretation and inadequate management in the clinical context. In this conceptual article, we describe a stepwise approach to develop and comprehensively validate laboratory biomarkers. We will delineate basic steps including technical performance, pre-analytical issues, and biological variation, as well as advanced aspects of biomarker utility comprising interpretability, diagnostic and prognostic accuracy, and health-care outcomes. These aspects will be illustrated by using well-known examples from the field of immunology. The application of this conceptual framework will guide researchers in conducting meaningful projects to develop and evaluate biomarkers for the use in clinical practice. Furthermore, clinicians will be able to adequately interpret pre-clinical and clinical diagnostic literature and rationally apply biomarkers in clinical practice. Improvement in the implementation and application of biomarkers might relevantly change the management and outcomes of our patients for the better.
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Moullet B, Kolev M, Ebner L, Langer R, Gräni C, Obmann V, Maurer M, Semmo N, Christe A, Huber AT. Adult form of Langerhans cell histiocytosis with pulmonary and hepatic involvement mimicking malignancy in a patient with chronic hepatitis C infection. Radiol Case Rep 2020; 16:327-333. [PMID: 33318775 PMCID: PMC7724096 DOI: 10.1016/j.radcr.2020.11.022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) is a myeloid neoplasm with inflammatory properties. There are few published reports of adult LCH with liver involvement, which is still poorly understood, but shows high morbidity and mortality. We report a case of a 37-year-old woman suffering from hepatitis C showing a LCH affecting the lung as well as the liver. Consistent with histology, we found an early stage of a proliferative/granulomatous phase of hepatobiliary LCH, whereas pulmonary findings showed a nodular stage of adult pulmonary LCH. Although hepatocellular carcinoma is a common malignancy in patients suffering from hepatitis C, it is crucial to keep in mind differential diagnosis for newly appearing liver lesions.
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Affiliation(s)
- Barbara Moullet
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Mirjam Kolev
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Rupert Langer
- Department of Pathology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Verena Obmann
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Martin Maurer
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Nasser Semmo
- Hepatology, Department of Visceral Surgery and Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
| | - Adrian Thomas Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital University Hospital, University of Bern, Freiburgstrasse 10, Inselspital, 3010, Bern, Switzerland
- Corresponding author.
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Liszewski M, Kolev M, Le Friec G, Leung M, Bertram P, Pickering M, Drouet C, Meri S, Arstila T, Pekkarinen P, Reinheckel T, Cordoba SRD, Afzali B, Atkinson J, Kemper C. Evidence for intracellular complement activation vital to Th1 immunity. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bükki J, Stanga Z, Tellez FB, Duclos K, Kolev M, Krähenmann P, Pabst T, Iff S, Jüni P. Omega-3 Poly-Unsaturated Fatty Acids for the Prevention of Severe Neutropenic Enterocolitis in Patients with Acute Myeloid Leukemia. Nutr Cancer 2013; 65:834-42. [DOI: 10.1080/01635581.2013.801998] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Johannes Bükki
- a Department of Internal Medicine , Bern University Hospital , Switzerland
- e Department of Palliative Medicine , Munich University Hospital , Germany
| | - Zeno Stanga
- a Department of Internal Medicine , Bern University Hospital , Switzerland
- b Division of Endocrinology, Diabetes and Clinical Nutrition , Bern University Hospital , Switzerland
| | | | - Kathleen Duclos
- c Institute of Social and Preventive Medicine , University of Bern , Bern , Switzerland
| | - Mirjam Kolev
- a Department of Internal Medicine , Bern University Hospital , Switzerland
| | - Peter Krähenmann
- a Department of Internal Medicine , Bern University Hospital , Switzerland
| | - Thomas Pabst
- d Department of Medical Oncology , Bern University Hospital , Bern , Switzerland
| | - Samuel Iff
- c Institute of Social and Preventive Medicine , University of Bern , Bern , Switzerland
- f Clinical Trials Unit, Bern , Bern University Hospital , Bern , Switzerland
| | - Peter Jüni
- c Institute of Social and Preventive Medicine , University of Bern , Bern , Switzerland
- f Clinical Trials Unit, Bern , Bern University Hospital , Bern , Switzerland
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Kolev M, Oppliger S, Jung S, Steiner S. [There is something amiss]. Praxis (Bern 1994) 2013; 102:111-113. [PMID: 23384955 DOI: 10.1024/1661-8157/a001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report the case of a 54-year old man with slowly progressive symmetrical weakness of the proximal legs and atactic gait. The diagnostic work-up is reviewed. It revealed the diagnosis of a Lambert-Eaton myasthenic syndrome(LEMS) and SIADH caused by a small cell lung cancer (SCLC).
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Affiliation(s)
- Mirjam Kolev
- Universitätsklinik für Allgemeine Innere Medizin, Inselspital, Bern
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Adler S, Kolev M, Varisco PA, Tham M, von Gunten M, Tappeiner C, Villiger PM. Induction of severe systemic lupus erythematosus by TNF blockade and response to anti-IL-6 strategy. J Allergy Clin Immunol 2012; 131:1235-7, 1237.e1. [PMID: 23154083 DOI: 10.1016/j.jaci.2012.09.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 09/06/2012] [Accepted: 09/12/2012] [Indexed: 11/24/2022]
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Jackiewicz Z, Jorcyk CL, Kolev M, Zubik-Kowal B. Correlation between Animal and Mathematical Models for Prostate Cancer Progression. Computational and Mathematical Methods in Medicine 2009. [DOI: 10.1080/17486700802517518] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This work demonstrates that prostate tumour progressionin vivocan be analysed by using solutions of a mathematical model supplemented by initial conditions chosen according to growth rates of cell linesin vitro. The mathematical model is investigated and solved numerically. Its numerical solutions are compared with experimental data from animal models. The numerical results confirm the experimental results with the growth ratesin vivo.
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Affiliation(s)
- Z. Jackiewicz
- Department of Mathematics and Statistics, Arizona State University, Tempe, AZ, USA
| | - C. L. Jorcyk
- Department of Biology, Boise State University, Boise, ID, USA
| | - M. Kolev
- Department of Mathematics and Computer Science, University of Warmia and Mazury, Olsztyn, Poland
| | - B. Zubik-Kowal
- Department of Mathematics, Boise State University, Boise, ID, USA
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Semela D, Piguet AC, Kolev M, Schmitter K, Hlushchuk R, Djonov V, Stoupis C, Dufour JF. Vascular remodeling and antitumoral effects of mTOR inhibition in a rat model of hepatocellular carcinoma. J Hepatol 2007; 46:840-8. [PMID: 17321636 DOI: 10.1016/j.jhep.2006.11.021] [Citation(s) in RCA: 167] [Impact Index Per Article: 9.8] [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: 06/27/2006] [Revised: 09/26/2006] [Accepted: 11/02/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Hepatocellular carcinoma (HCC) is amenable to only few treatments. Inhibitors of the kinase mTOR are a new class of immunosuppressors already in use after liver transplantation. Their antiproliferative and antiangiogenic properties suggest that these drugs could be considered to treat HCC. We investigated the antitumoral effects of mTOR inhibition in a HCC model. METHODS Hepatoma cells were implanted into livers of syngeneic rats. Animals were treated with the mTOR inhibitor sirolimus for 4 weeks. Tumor growth was monitored by MR imaging. Antiangiogenic effects were assessed in vivo by microvessel density and corrosion casts and in vitro by cell proliferation, tube formation and aortic ring assays. RESULTS Treated rats had significantly longer survival and developed smaller tumors, fewer extrahepatic metastases and less ascites than controls. Sirolimus decreased intratumoral microvessel density resulting in extensive necrosis. Endothelial cell proliferation was inhibited at lower drug concentrations than hepatoma cells. Tube formation and vascular sprouting of aortic rings were significantly impaired by mTOR inhibition. Casts revealed that in tumors treated with sirolimus vascular sprouting was absent, whereas intussusception was observed. CONCLUSIONS mTOR inhibition significantly reduces HCC growth and improves survival primarily via antiangiogenic effects. Inhibitors of mTOR may have a role in HCC treatment.
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MESH Headings
- Angiogenesis Inhibitors/pharmacology
- Animals
- Antibiotics, Antineoplastic/pharmacology
- Capillaries/drug effects
- Carcinoma, Hepatocellular/blood supply
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/enzymology
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Enzyme Inhibitors/pharmacology
- Liver Neoplasms, Experimental/blood supply
- Liver Neoplasms, Experimental/drug therapy
- Liver Neoplasms, Experimental/enzymology
- Neoplasm Transplantation
- Neovascularization, Pathologic/drug therapy
- Neovascularization, Pathologic/enzymology
- Phosphorylation/drug effects
- Protein Kinases/drug effects
- Protein Kinases/metabolism
- Rats
- Regional Blood Flow/drug effects
- Sirolimus/pharmacology
- TOR Serine-Threonine Kinases
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Affiliation(s)
- David Semela
- Institute of Clinical Pharmacology, University of Berne, Murtenstrasse 35, CH-3010 Berne, Switzerland
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Pavlow P, Dumanov Y, Denev Y, Kolev M, Stoyanova R, Loseva T, Djankov I. A study of parasite-host immunological interrelations. IV. Investigation of the protein profiles in lambs, cats and birds in experimental spirochetosis and leptospirosis. Zentralbl Veterinarmed B 1973; 20:230-40. [PMID: 4734054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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