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Russo I, Marino D, Cozzolino C, Del Fiore P, Nerjaku F, Finotto S, Cattelan A, Calabrò ML, Belloni Fortina A, Russano F, Mazza M, Galuppo S, Bezzon E, Sbaraglia M, Krengli M, Brunello A, Mocellin S, Piaserico S, Alaibac M. Kaposi's Sarcoma: Evaluation of Clinical Features, Treatment Outcomes, and Prognosis in a Single-Center Retrospective Case Series. Cancers (Basel) 2024; 16:691. [PMID: 38398082 PMCID: PMC10887034 DOI: 10.3390/cancers16040691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Kaposi's sarcoma (KS) is a rare angioproliferative tumor classified in four different clinical-epidemiological forms. The diagnosis is based on histopathological and immunohistochemical analyses. The treatment is heterogeneous and includes several local and systemic therapeutic strategies. Methods: This is a retrospective cohort study including 86 KS patients treated between 1993 and 2022 at the University Hospital of Padua (AOPD) and at the Veneto Institute of Oncology (IOV). The data were extracted from an electronic database. Survival curves were generated using the Kaplan-Meier method, and Cox regression models were employed to explore associations with overall and disease-free survival. The male sex (89.53%), classical variant (43.02%), and cutaneous involvement (77.9%) were predominant. More than 61.6% of patients received a single treatment. Surgery, antiretroviral therapy, and chemotherapy were the mostly adopted approaches. A persistent response was observed in approximately 65% of patients, with a 22% relapse rate (at least 2 years). The overall survival ranges from 90 to 70% at 2 to 10 years after the diagnosis. Iatrogenic KS demonstrated a higher mortality (52.9%). This study reflects our experience in the management of KS. Comorbidities are very frequent, and treatments are heterogeneous. A multidisciplinary approach involving multiple referral specialists is essential for the appropriate management of this disease during diagnosis, treatment, and follow-up.
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Affiliation(s)
- Irene Russo
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
| | - Dario Marino
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy (S.F.)
| | - Claudia Cozzolino
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35128 Padova, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
| | - Fitnete Nerjaku
- Department of Medicine (DIMED), School of Medicine, University of Padova, 35128 Padova, Italy; (F.N.); (M.S.)
| | - Silvia Finotto
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy (S.F.)
| | - Annamaria Cattelan
- Infectious and Tropical Diseases Unit, Padova University Hospital, 35128 Padova, Italy;
| | - Maria Luisa Calabrò
- Immunology and Molecular Oncology, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy;
| | - Anna Belloni Fortina
- Dermatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (A.B.F.); (S.P.); (M.A.)
- Pediatric Dermatology Regional Center, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | - Francesco Russano
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
| | - Marcodomenico Mazza
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
| | - Sara Galuppo
- Radiotherapy Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (S.G.); (M.K.)
| | - Elisabetta Bezzon
- Radiology Unit, Veneto Institute of Oncology, IOV – IRCCS, 35128 Padova, Italy
| | - Marta Sbaraglia
- Department of Medicine (DIMED), School of Medicine, University of Padova, 35128 Padova, Italy; (F.N.); (M.S.)
- Department of Pathology, Azienda Ospedale—University of Padova, 35128 Padova, Italy
| | - Marco Krengli
- Radiotherapy Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (S.G.); (M.K.)
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy
| | - Antonella Brunello
- Oncology 1 Unit, Department of Oncology, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy (S.F.)
| | - Simone Mocellin
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, 35128 Padova, Italy; (I.R.); (C.C.); (F.R.); (M.M.); (S.M.)
- Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35128 Padova, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (A.B.F.); (S.P.); (M.A.)
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (A.B.F.); (S.P.); (M.A.)
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Brunello A, Galiano A, Schiavon S, Guglieri I, Nucci D, Pambuku A, Dal Col A, Bergamo F, Finotto S, Bolshinsky M, Stragliotto S, Rizzato M, Lonardi S, Zagonel V. 1273P Early integration between oncologic treatment and palliative care: Experience of the simultaneous care outpatient clinic at Veneto Institute of Oncology, ESMO Designated Center. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1406] [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: 11/01/2022] Open
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Brunello A, Galiano A, Schiavon S, Nardi M, Feltrin A, Pambuku A, De Toni C, Dal Col A, Lamberti E, Pittarello C, Bergamo F, Basso U, Maruzzo M, Finotto S, Bolshinsky M, Stragliotto S, Procaccio L, Rizzato MD, Formaglio F, Lombardi G, Lonardi S, Zagonel V. Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy. Cancers (Basel) 2022; 14:cancers14102568. [PMID: 35626172 PMCID: PMC9139444 DOI: 10.3390/cancers14102568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 12/12/2022] Open
Abstract
Benefits of early palliative care referral in oncology are well-validated. At the Veneto Institute of Oncology-IRCCS, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients with advanced cancer are evaluated by an oncologist together with a palliative care team. We prospectively assessed SCOC patients’ characteristics and SCOC outcomes through internal procedure indicators. Data were retrieved from the SCOC prospectively maintained database. There were 753 eligible patients. The median age was 68 years; primary tumor sites were gastrointestinal (75.2%), genitourinary (15.0%) and other sites (9.8%). Predominant symptoms were psychological issues (69.4%), appetite loss (67.5%) and pain (65.9%). Dyspnea was reported in 53 patients (7%) in the referral form, while it was detected in 226 patients (34.2%) during SCOC visits (p < 0.0001). Median survival of patients after the SCOC visit was 7.3 months. Survival estimates by the referring oncologist were significantly different from the actual survival. Psychological intervention was deemed necessary and undertaken in 34.6% of patients, and nutritional support was undertaken in 37.9% of patients. Activation of palliative care services was prompted for 77.7% of patients. Out of 357 patients whose place of death is known, 69.2% died at home, in hospice or residential care. With regard to indicators’ assessment, the threshold was reached for 9 out of 11 parameters (81.8%) requested by the procedure. This study confirmed the importance of close collaboration between oncologists and palliative care teams in responding properly to cancer patients’ needs. The introduction of a procedure with indicators allowed punctual assessment of a team’s performance.
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Affiliation(s)
- Antonella Brunello
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Antonella Galiano
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Stefania Schiavon
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Mariateresa Nardi
- Clinical Nutrition Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Alessandra Feltrin
- Hospital Psychology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy;
| | - Ardi Pambuku
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Chiara De Toni
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Alice Dal Col
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Evelina Lamberti
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Chiara Pittarello
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Francesca Bergamo
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Umberto Basso
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Marco Maruzzo
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Silvia Finotto
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Maital Bolshinsky
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Silvia Stragliotto
- Department of Oncology, Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, 31033 Castelfranco Veneto, Italy; (S.S.); (S.L.)
| | - Letizia Procaccio
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Mario Domenico Rizzato
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Fabio Formaglio
- Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (S.S.); (A.P.); (A.D.C.); (F.F.)
| | - Giuseppe Lombardi
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
| | - Sara Lonardi
- Department of Oncology, Medical Oncology 3, Veneto Institute of Oncology IOV-IRCCS, 31033 Castelfranco Veneto, Italy; (S.S.); (S.L.)
| | - Vittorina Zagonel
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy; (A.B.); (A.G.); (C.D.T.); (E.L.); (C.P.); (F.B.); (U.B.); (M.M.); (S.F.); (M.B.); (L.P.); (M.D.R.); (G.L.)
- Correspondence: ; Tel.: +39-049-8215953
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Marino D, Pizzi M, Kotova I, Schmidt R, Schröder C, Guzzardo V, Talli I, Peroni E, Finotto S, Scapinello G, Dei Tos AP, Piazza F, Trentin L, Zagonel V, Piovan E. High ETV6 Levels Support Aggressive B Lymphoma Cell Survival and Predict Poor Outcome in Diffuse Large B-Cell Lymphoma Patients. Cancers (Basel) 2022; 14:cancers14020338. [PMID: 35053500 PMCID: PMC8774128 DOI: 10.3390/cancers14020338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/29/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of prognostic factors for aggressive B-cell lymphomas still represents an unmet clinical need. We used forward phase protein arrays (FFPA) to identify proteins associated with overall survival (OS) from diagnostic formalin-fixed paraffin-embedded material of diffuse large B-cell lymphoma (DLBCL) patients (n = 47). Univariate Cox regression analysis identified numerous proteins, including immune check-point molecules (PDCD1, PDCD2 and PD1L2) and BCL2 to be significantly associated with OS. However, only ETV6 and PIM2 proteins persisted following multivariate Cox analysis. Independent validation studies by immunohistochemistry and analysis of public gene expression profiles of DLBCL confirmed a prognostic role for high ETV6 and ETV6/PIM2 ratios in DLBCL. ETV6 is a recurrently mutated/deleted gene in DLBCL for which its function in this disease entity is currently unknown. We find that ETV6 is upregulated during oncogenic transformation of germinal center B-cells and that it regulates DLBCL survival, as its acute loss results in marked apoptosis. Fluctuations in survivin (BIRC5) expression levels were associated with this phenomenon. Furthermore, an inverse correlation between ETV6 and BIRC5 expression levels was found and correlated with a response to the BIRC5 inhibitor, YM155. In conclusion, we present evidence for an oncogenic function of ETV6 in DLBCL.
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Affiliation(s)
- Dario Marino
- Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padova, Italy; (D.M.); (S.F.); (V.Z.)
| | - Marco Pizzi
- Surgical Pathology & Cytopathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (M.P.); (V.G.); (A.P.D.T.)
| | - Iuliia Kotova
- Sciomics GmbH, 69151 Neckargemünd, Germany; (I.K.); (R.S.); (C.S.)
| | - Ronny Schmidt
- Sciomics GmbH, 69151 Neckargemünd, Germany; (I.K.); (R.S.); (C.S.)
| | | | - Vincenza Guzzardo
- Surgical Pathology & Cytopathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (M.P.); (V.G.); (A.P.D.T.)
| | - Ilaria Talli
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy;
| | - Edoardo Peroni
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padova, Italy;
| | - Silvia Finotto
- Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padova, Italy; (D.M.); (S.F.); (V.Z.)
| | - Greta Scapinello
- Hematology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (G.S.); (F.P.); (L.T.)
| | - Angelo Paolo Dei Tos
- Surgical Pathology & Cytopathology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (M.P.); (V.G.); (A.P.D.T.)
| | - Francesco Piazza
- Hematology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (G.S.); (F.P.); (L.T.)
| | - Livio Trentin
- Hematology Unit, Department of Medicine—DIMED, University of Padova, 35128 Padova, Italy; (G.S.); (F.P.); (L.T.)
| | - Vittorina Zagonel
- Medical Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padova, Italy; (D.M.); (S.F.); (V.Z.)
| | - Erich Piovan
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35128 Padova, Italy;
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padova, Italy;
- Correspondence: ; Tel.: +39-(049)-8215895
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Pierantoni F, Maruzzo M, Bimbatti D, Finotto S, Marino D, Galiano A, Basso U, Zagonel V. High dose chemotherapy followed by autologous hematopoietic stem cell transplantation for advanced germ cell tumors: State of the art and a single-center experience. Crit Rev Oncol Hematol 2021; 169:103568. [PMID: 34890801 DOI: 10.1016/j.critrevonc.2021.103568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Evidence for the choice of second line, standard vs high dose chemotherapy, (SDCT, HDCT) for patients with relapsed germ cell tumors (GCTs) comes mainly from retrospective studies. MATERIAL AND METHODS relevant literature was reviewed, considering as endpoints both survival and long term quality of life (QoL). Patients with metastatic GCT progressing after first-line treatment at our Institution were retrospectively evaluated. RESULTS HDCT seems to achieve a higher rate of long-term remissions. QoL data for this group of patients are lacking. Our experience on 29 patients was in line with these results. Two-year OS for the 18 patients treated with one or two HDCT/PBSCT procedures was 47.5 %, while 2-year PFS was 44 %. For the 11 receiving SDCT 2-year OS was 36.4 %, and 2-year PFS was 32.7 %. CONCLUSIONS HDCT/PBSCT confirmed to be effective in treating patients with relapsed GCT, but prospective studies are needed.
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Affiliation(s)
| | - Marco Maruzzo
- Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Davide Bimbatti
- Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Silvia Finotto
- Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Dario Marino
- Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | | | - Umberto Basso
- Oncologia 1, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
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Bega G, Olivieri J, Riva M, Scapinello G, Paolini R, Finotto S, Sartori R, Lucchini E, Guandalini G, Facchinelli D, Tisi MC, Basso M, Ballotta L, Piazza F, Ferrarini I, Visco C. Rituximab and Bendamustine (BR) Compared with Rituximab, Bendamustine, and Cytarabine (R-BAC) in Previously Untreated Elderly Patients with Mantle Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13236089. [PMID: 34885198 PMCID: PMC8657015 DOI: 10.3390/cancers13236089] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Both BR, and R-BAC are suitable induction therapies in elderly patients with mantle cell lymphoma (MCL). However, the two regimens have not been compared before. We retrospectively analysed the outcome and the safety features of elderly patients with newly diagnosed MCL, treated with BR or R-BAC between 2008 and 2019 at eight institutions. We used propensity scores to reduce selection bias, thus analysing 156 patients (53 BR, 103 R-BAC). Patients treated with R-BAC achieved higher CR rate than BR (91% vs. 60%, p < 0.0001). The 2-year PFS was 87 ± 3% and 64 ± 7% for R-BAC and BR, respectively (p = 0.001). Median overall survival (OS) was 121 months for R-BAC and 78 months for BR (p = 0.08). R-BAC was associated with significantly more pronounced grade 3–4 thrombocytopenia than BR (50% vs. 17%). This study indicates that R-BAC is associated with significantly prolonged 2-year PFS than BR in elderly patients with MCL. Abstract Background: Rituximab plus bendamustine (BR), and rituximab, bendamustine, and cytarabine (R-BAC) are well-known induction therapies in elderly patients with mantle cell lymphoma (MCL), according to clinical guidelines. However, a direct comparison between the two regimens has never been performed. Methods: In this multicentre retrospective study, we compared the outcome of patients with newly diagnosed MCL, treated with BR or R-BAC. Primary endpoint was 2-year progression-free survival (PFS). Inclusion bias was assessed using a propensity score stratified by gender, age, MCL morphology, and MIPI score. Results: After adjusting by propensity score, we identified 156 patients (53 BR, 103 R-BAC) with median age of 72 (53–90). Median follow-up was 46 months (range 12–133). R-BAC was administered in a 2-day schedule or with attenuated dose in 51% of patients. Patients treated with R-BAC achieved CR in 91% of cases, as compared with 60% for BR (p < 0.0001). The 2-year PFS was 87 ± 3% and 64 ± 7% for R-BAC and BR, respectively (p = 0.001). In terms of toxicity, R-BAC was associated with significantly more pronounced grade 3–4 thrombocytopenia than BR (50% vs. 17%). Conclusions: This study indicates that R-BAC, even when administered with judiciously attenuated doses, is associated with significantly prolonged 2-year PFS than BR in elderly patients with previously untreated MCL.
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Affiliation(s)
- Giulia Bega
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Jacopo Olivieri
- Hematology and SCT Unit, Azienda Sanitaria Universitaria Integrata Santa Maria della Misericordia, 33100 Udine, Italy;
| | - Marcello Riva
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Greta Scapinello
- Department of Medicine, Section of Hematology, University of Padova, 35122 Padova, Italy; (G.S.); (F.P.)
| | - Rossella Paolini
- Oncohematology, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy;
| | - Silvia Finotto
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV-IRCSS, 35128 Padova, Italy;
| | - Roberto Sartori
- Onco Hematology Unit, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy; (R.S.); (M.B.)
| | - Elisa Lucchini
- Hematology Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, 34148 Trieste, Italy; (E.L.); (L.B.)
| | - Gianmarco Guandalini
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Davide Facchinelli
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Maria Chiara Tisi
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Marco Basso
- Onco Hematology Unit, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy; (R.S.); (M.B.)
| | - Laura Ballotta
- Hematology Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, 34148 Trieste, Italy; (E.L.); (L.B.)
| | - Francesco Piazza
- Department of Medicine, Section of Hematology, University of Padova, 35122 Padova, Italy; (G.S.); (F.P.)
| | - Isacco Ferrarini
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
- Correspondence: ; Tel.: +39-045-8124797; Fax: +39-045-8124660
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Bonometti A, Passoni E, Finotto S, Berti E. Nail involvement in Langerhans cell histiocytosis and its association with multisystem presentation and lung involvement. Indian J Dermatol Venereol Leprol 2021; 87:850-854. [PMID: 34491685 DOI: 10.25259/ijdvl_50_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 05/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Arturo Bonometti
- Department of Molecular Medicine, Unit of Anatomic Pathology, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Emanuela Passoni
- Department of Dermatology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Finotto
- Department of Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Emilio Berti
- Department of Dermatology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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8
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Milan E, Miceli P, Sernicola A, Finotto S, Marino D, Alaibac M. Complete remission of primary cutaneous anaplastic large cell lymphoma after a short course of brentuximab vedotin. Mol Clin Oncol 2021; 14:121. [PMID: 33936594 DOI: 10.3892/mco.2021.2283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 02/15/2021] [Indexed: 12/31/2022] Open
Abstract
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare CD30+ lymphoproliferative disorder characterized by the development of lesions ranging from papules to large tumors. Most cases present as localized disease, however multifocal and generalized involvement of the skin can occur. Several treatments have been proposed for PCALCL; however a highly effective standard approach to multifocal disease has not yet been elucidated. The disease expression of CD30 antigen in at least 75% of the tumor makes it an optimal target for immunotherapy. The current study presents a case of a 62-year-old male referred to the University of Padua Dermatology Clinic complaining about nodular and ulcerated lesions involving the frontal area and scalp that were 8 cm in diameter. Doses of 180 mg brentuximab vedotin (BV), which is an antibody drug conjugate binding CD30 antigen, were administered every 21 days. A 75% decrease in dimensions after the first infusion and a complete remission after the second was observed. Disease response appeared to be dose-related and adverse reactions, in particular peripheral neuropathy, may be an effect of cumulative toxicity, meaning that treatment cycle reduction should be considered. Based on the present results, A high dose, short course of BV is recommended as a cost-effective approach for PCALCL. However, further studies are required to assess the efficacy and other potential advantages of this therapeutic regimen.
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Affiliation(s)
- Elisa Milan
- Unit of Dermatology, University of Padua, Padova I-35128, Italy
| | - Paola Miceli
- Unit of Dermatology, University of Padua, Padova I-35128, Italy
| | | | - Silvia Finotto
- Unit of Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova I-35128, Italy
| | - Dario Marino
- Unit of Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova I-35128, Italy
| | - Mauro Alaibac
- Unit of Dermatology, University of Padua, Padova I-35128, Italy
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9
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Brunello A, Galiano A, Finotto S, Monfardini S, Colloca G, Balducci L, Zagonel V. Older cancer patients and COVID-19 outbreak: Practical considerations and recommendations. Cancer Med 2020; 9:9193-9204. [PMID: 33219746 PMCID: PMC7774711 DOI: 10.1002/cam4.3517] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 05/12/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Since the COVID-19 outbreak started, it has been affecting mainly older individuals. Among the most vulnerable older individuals are those with cancer. Many published guidelines and consensus papers deal with prioritizing cancer care. Given the lack of high-quality evidence for management of cancer in older patients also in normal times, it is even more stringent to provide some resources on how to avoid both undertreatment and overtreatment in this population, who as of now is twice challenged to death, due to both a greater risk of getting infected with COVID-19 as well as from cancer not adequately addressed and treated. We hereby discuss some general recommendations (implement triage procedures; perform geriatric assessment; carefully assess comorbidity; promote early integration of palliative care in oncology; acknowledge the role of caregivers; maintain active take in charge to avoid feeling of abandonment; mandate seasonal flu vaccination) and discuss practical suggestions for specific disease settings (early-stage and advanced-stage disease for solid tumors, and hematological malignancies). The manuscript provides resources on how to avoid both undertreatment and overtreatment in older patients with cancer, who as of now is twice challenged to death, due to both a greater risk of getting infected with COVID-19 as well as from cancer not adequately addressed and treated.
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Affiliation(s)
- Antonella Brunello
- Oncology 1 UnitDepartment of OncologyIstituto Oncologico Veneto IOV ‐ IRCCSPadovaItaly
| | - Antonella Galiano
- Oncology 1 UnitDepartment of OncologyIstituto Oncologico Veneto IOV ‐ IRCCSPadovaItaly
| | - Silvia Finotto
- Oncology 1 UnitDepartment of OncologyIstituto Oncologico Veneto IOV ‐ IRCCSPadovaItaly
| | | | - Giuseppe Colloca
- Dipartimento di Diagnostica per ImmaginiRadioterapia Oncologica ed EmatologiaIstituto di RadiologiaFondazione Policlinico A. Gemelli IRCCS ‐ Università Cattolica Sacro CuoreRomaItaly
| | - Lodovico Balducci
- Moffitt Cancer CenterUniversity of South Florida College of MedicineTampaFloridaUSA
| | - Vittorina Zagonel
- Oncology 1 UnitDepartment of OncologyIstituto Oncologico Veneto IOV ‐ IRCCSPadovaItaly
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10
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Merli M, Marino D, Cencini E, Rattotti S, Fraenza C, Grossi P, Bianchi B, Mora B, Sciarra R, Finotto S, Mecacci B, Passamonti F, Visco C, Arcaini L. Direct-acting antivirals in hepatitis C virus-positive mantle cell lymphomas. Hematol Oncol 2020; 39:263-266. [PMID: 33150988 DOI: 10.1002/hon.2825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Michele Merli
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Dario Marino
- Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Italy
| | - Emanuele Cencini
- Hematology, Azienda Ospedaliera Senese, University of Siena, Siena, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Costanza Fraenza
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Grossi
- Infectious and Tropical Diseases, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Benedetta Bianchi
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Barbara Mora
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Finotto
- Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Italy
| | - Bianca Mecacci
- Hematology, Azienda Ospedaliera Senese, University of Siena, Siena, Italy
| | - Francesco Passamonti
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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11
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Marino D, Finotto S, Basso U, Galiano A, Bolshinsky M, Amato O, Marson P, Tison T, Colpo A, Zagonel V. To Transplant or Not to Transplant During the SARS-CoV-2 Pandemic? That Is the Question. Oncologist 2020; 26:e336-e337. [PMID: 33044758 PMCID: PMC7675713 DOI: 10.1002/onco.13563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus disease 2019 has grown to be a global public health emergency. The rapid spread of the infection has raised many questions in the oncohematological scientific community regarding the appropriateness of high‐dose chemotherapy with autologous stem cell transplantation (ASCT). We here report two cases of patients who received ASCT at our Institute during the epidemic in Italy, affected with Hodgkin lymphoma and germ cell tumor, respectively. The two patients underwent a nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) on hospital admittance and during the period of bone marrow aplasia. They were attended to exclusively by dedicated health care staff who followed specifically implemented protocols for bedside nursing and care. They completed the procedure without unexpected side effect. Our experience demonstrates how ASCT can be performed safely if procedures are reorganized ad hoc to reduce the risk of SARS‐CoV‐2 infection. The COVID‐19 pandemic has raised many questions in the oncohematological scientific community about risks associated with transplant procedures. This article reports two patient cases, focusing on the risks of performing high‐dose chemotherapy with autologous peripheral blood stem cell transplantation during the COVID‐19 pandemic weighed against the expected clinical benefit.
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Affiliation(s)
- Dario Marino
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Silvia Finotto
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Umberto Basso
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Antonella Galiano
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Maital Bolshinsky
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Ottavia Amato
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
| | - Piero Marson
- Department of Transfusion Medicine, University Hospital of PaduaPaduaItaly
| | - Tiziana Tison
- Department of Transfusion Medicine, University Hospital of PaduaPaduaItaly
| | - Anna Colpo
- Department of Transfusion Medicine, University Hospital of PaduaPaduaItaly
| | - Vittorina Zagonel
- Department of Clinical and Experimental Oncology, Medical Oncology Unit 1, Veneto Institute of Oncology (IOV), Istituto Ricerca Cura Carattere ScientificoPaduaItaly
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Liu M, Andreev D, Kachler K, Koelle J, Rauber S, Ramming A, Finotto S, Schett G, Bozec A. OP0132 ALLERGIC ASTHMA INDUCES THE ACCUMULATION OF SYNOVIAL RESIDENT EOSINOPHILS, TRIGGERING THE RESOLUTION OF INFLAMMATORY ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory disorder, involving synovial joints, which affects approximately 1 percent of the world population[1]. Our former work demonstrated that the Th2-eosinophil pathway is a strong anti-inflammatory mediator of inflammatory arthritis[2]. Allergic asthma is an inflammatory disease of the airway, triggered by type 2 immune response. Hitherto, clinical observations on the impact of asthma on RA showed controversial results. Herein, we investigated the action of allergic asthma on inflammatory arthritis.Objectives:We aimed to delineate the molecular and cellular responses induced by allergic asthma on inflammatory arthritis, particularly depicting the role of eosinophil subsets in arthritic synovium.Methods:Allergic asthma was induced in wild type and genetically modified mice by ovalbumin (OVA) treatment. After the initiation of allergic asthma, K/BxN serum was transferred into the asthmatic mice or control mice to trigger serum induced arthritis (SIA). Then, arthritis severity, circulating cytokines and the cytology of lung and synovium were analyzed. Eosinophil subsets were studied by flow cytometry, single cell RNA sequencing analysis, and were isolated and transferred into the synovial cavity of eosinophil deficient arthritic mice. Clinical data of patients with both RA and asthma were collected and checked for the relapse of RA after asthma treatment with anti-interleukin (IL)-5 antibody.Results:Mice induced with allergic asthma exhibited a rapid resolution of SIA. The OVA-triggered resolution disappeared in eosinophil deficient mice (ΔdblGATA), and was partially blocked by IL-5 neutralization. We could detect that IL-5 was mainly produced by type 2 innate lymphoid cell (ILC2) in the lung. Allergic asthma exclusively induced the proliferation (Ki67+) and accumulation of synovial resident eosinophils (rEos, Siglec-Fint), which switched classical macrophages into alternatively activated macrophages. Synovial induced eosinophils (iEos, Siglec-Fhigh) appeared only in the acute phase of SIA. Single cell RNA sequencing analysis showed that rEos played an anti-inflammatory role, while iEos had pro-inflammatory properties in arthritis. The roles of rEos and iEos in arthritis were confirmed by transferring rEos/iEos into the synovial cavity of arthritic mice. Patiens with both RA and asthma showed a remission relapse of RA after using humanized monoclonal IL-5 antibody for treating sever eosinophilic asthma.Conclusion:Allergic asthma induced an IL-5 mediated proliferation and accumulation of synovial rEos. The latter triggered the resolution of inflammatory arthritis. In human, eosinophils induced by asthma were essential for the sustaining of RA remission.References:[1]Myasoedova, E., et al., Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum, 2010.62(6): p. 1576-82.[2]Chen, Z., et al., Th2 and eosinophil responses suppress inflammatory arthritis. Nat Commun, 2016.7: p. 11596.Acknowledgments:Mengdan Liu and Darja Andreev contributed equally to this studyDisclosure of Interests:Mengdan Liu: None declared, Darja Andreev: None declared, Katerina Kachler: None declared, Julia Koelle: None declared, Simon Rauber: None declared, Andreas Ramming Grant/research support from: Pfizer, Novartis, Consultant of: Boehringer Ingelheim, Novartis, Gilead, Pfizer, Speakers bureau: Boehringer Ingelheim, Roche, Janssen, Susetta Finotto: None declared, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Aline Bozec: None declared
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Rastrelli M, Ferrazzi B, Tropea S, Costa A, Finotto S, Marino D, Campana L, Del Fiore P, Rossi CR, Alaibac M. Aggressive Merkel Cell Carcinoma After Janus Kinase Inhibitor Ruxolitinib for Polycythemia Vera. In Vivo 2020; 33:1667-1669. [PMID: 31471421 DOI: 10.21873/invivo.11653] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022]
Abstract
Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma of the skin. It is highly aggressive and represents the second most common cause of skin cancer-related death. Ruxolitinib is an orally administered selective inhibitor of Janus associated kinases1 and 2, which is used in the management of patients with symptomatic myelofibrosis and polycythemia vera who are non-responders or intolerant to hydroxyurea. Herein, we report the case of a 47-year-old woman with a 14-year history of chronic myeloproliferative syndrome initially treated with hydroxyurea for 4 years. She was then enrolled in the Response trial and treated for 7 years with ruxolitinib subsequently developing an MCC. This report shows the possibility of development of MCC in patients treated with ruxolitinib. Periodic skin examination is indicated in patients who undergo ruxolitinib therapy, especially if they have a history of skin cancer; dermatologists and oncohematologists should be aware of this possibility in order to introduce appropriate preventive strategies.
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Affiliation(s)
- Marco Rastrelli
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Beatrice Ferrazzi
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Saveria Tropea
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Alessandra Costa
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Silvia Finotto
- Medical Oncology 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Dario Marino
- Medical Oncology 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Luca Campana
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Paolo Del Fiore
- Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Mauro Alaibac
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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14
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Olivieri J, Mosna F, Pelosini M, Fama A, Rattotti S, Giannoccaro M, Carli G, Tisi MC, Ferrero S, Sgherza N, Mazzone AM, Marino D, Calimeri T, Loseto G, Saraceni F, Tomei G, Sica S, Perali G, Codeluppi K, Billio A, Olivieri A, Orciuolo E, Matera R, Stefani PM, Borghero C, Ghione P, Cascavilla N, Lanza F, Chiusolo P, Finotto S, Federici I, Gherlinzoni F, Centurioni R, Fanin R, Zaja F. A Comparison of the Conditioning Regimens BEAM and FEAM for Autologous Hematopoietic Stem Cell Transplantation in Lymphoma: An Observational Study on 1038 Patients From Fondazione Italiana Linfomi. Biol Blood Marrow Transplant 2018; 24:1814-1822. [DOI: 10.1016/j.bbmt.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/14/2018] [Indexed: 01/17/2023]
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Haag P, Sharma H, Rauh M, Zimmermann T, Vuorinen T, Papadopoulos NG, Weiss ST, Finotto S. Soluble ST2 regulation by rhinovirus and 25(OH)-vitamin D3 in the blood of asthmatic children. Clin Exp Immunol 2018; 193:207-220. [PMID: 29645082 PMCID: PMC6046486 DOI: 10.1111/cei.13135] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 12/27/2022] Open
Abstract
Paediatric asthma exacerbations are often caused by rhinovirus (RV). Moreover, 25(OH)-vitamin D3 (VitD3) deficiency during infancy was found associated with asthma. Here, we investigated the innate immune responses to RV and their possible modulation by 25(OH)-VitD3 serum levels in a preschool cohort of children with and without asthma. The innate lymphoid cell type 2 (ILC2)-associated marker, ST2, was found up-regulated in the blood cells of asthmatic children with low serum levels of 25(OH)-VitD3 in the absence of RV in their airways. Furthermore, in blood cells from control and asthmatic children with RV in their airways, soluble (s) ST2 (sST2) protein was found reduced. Asthmatic children with low 25(OH)-VitD3 in serum and with RV in vivo in their airways at the time of the analysis had the lowest sST2 protein levels in the peripheral blood compared to control children without RV and high levels of 25(OH)-VitD3. Amphiregulin (AREG), another ILC2-associated marker, was found induced in the control children with RV in their airways and low serum levels of 25(OH)-VitD3. In conclusion, the anti-inflammatory soluble form of ST2, also known as sST2, in serum correlated directly with interleukin (IL)-33 in the airways of asthmatic children. Furthermore, RV colonization in the airways and low serum levels of 25(OH)-VitD3 were found to be associated with down-regulation of sST2 in serum in paediatric asthma. These data indicate a counter-regulatory role of 25(OH)-VitD3 on RV-induced down-regulation of serum sST2 in paediatric asthma, which is relevant for the therapy of this disease.
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Affiliation(s)
- P. Haag
- Department of Molecular PneumologyFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum ErlangenErlangenGermany
| | - H. Sharma
- Translational Genomics Core, Partners Biobank, Partners HealthCare, Personalized MedicineCambridgeMAUSA
| | - M. Rauh
- Department of Allergy and Pneumology, Children's HospitalFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum ErlangenErlangenGermany
| | - T. Zimmermann
- Department of Allergy and Pneumology, Children's HospitalFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum ErlangenErlangenGermany
| | - T. Vuorinen
- Department of VirologyUniversity of TurkuTurkuFinland
| | - N. G. Papadopoulos
- Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and KapodistriaUniversity of AthensAthensGreece
| | - S. T. Weiss
- Translational Genomics Core, Partners Biobank, Partners HealthCare, Personalized MedicineCambridgeMAUSA
| | - S. Finotto
- Department of Molecular PneumologyFriedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum ErlangenErlangenGermany
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Procaccio L, Schirripa M, Aliberti C, Bergamo F, Dadduzio V, Finotto S, Loupakis F, Menichetti A, Zagonel V. Partial splenic embolization in chemotherapy-induced thrombocytopenia: a retrospective analysis with long term follow up. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.043] [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: 11/14/2022] Open
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Procaccio L, Schirripa M, Bergamo F, Dadduzio V, Finotto S, Menichetti A, Ziampiri S, Carandina R, Loupakis F, Lonardi S, Zagonel V, Aliberti C. Partial splenic embolization in chemotherapy-induced thrombocytopenia: A retrospective analysis with long term follow-up. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21654] [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] [Indexed: 11/20/2022] Open
Abstract
e21654 Background: Chemotherapy-induced thrombocytopenia (CIT) may result in a chemotherapy (CT) dose delay or reduction, thus affecting dose density and intensity. Historically, partial splenic embolization (PSE) has been performed to improve hematologic parameters related to hypersplenism. In this study we reviewed our institutional experience with PSE for gastrointestinal cancer (GI) experiencing CIT. Methods: A retrospective analysis of GI cancer patients with splenomegaly undergoing PSE was performed. Mean PLT (platelet) count was collected at the following time points: before CT start; at nadir pre-PSE; 1 week before PSE (pre-PSE); 4 weeks after PSE (post-PSE); and at the nadir after CT reintroduction post PSE. Time to CT restart after PSE, time to recurrent CIT, periprocedural lab values and adverse events were recorded. Wilcoxon test was adopted to exploratively compare PLT count before and after PSE. Results: 11 patients underwent PSE, 5 with colorectal, 3 with pancreatic and 3 with biliary cancer, 73% had metastatic disease. Baseline PLT count before initiation of CT was 146 x109/L (range, 81-255 x 109/L). PLT count at nadir pre-PSE was 60 x109/L (range, 44-82 x 109/L), and pre-PSE PLT count was 78 x109/L (range, 62-99 x 109/L). Post-PSE PLT count improved significantly ( 132 x 109/L; range, 67-172 x109/L) compared with nadir pre-PSE (p = 0.003). The mean hospital stay was 1 day. Post-procedure abdominal pain occurred in 3 patients. All patients resumed CT and mean time to CT re-start after PSE was 43 days (range, 4-193 d). All patients exhibited recurrent thrombocytopenia. PLT count at nadir after PSE was 54 x 109/L (range, 28-78 x 109/L) and occurred at a mean of 169 days after PSE (range, 37-664 d) No differences were observed when comparing CIT at nadir pre and post PSE (p = 0.447). All patients experienced CT dose delay and 82% of them experienced dose reduction after PSE. Conclusions: Our findings underline that PSE is safe and effective to achieve short-term improvement of CIT and resumption of CT in GI patients. However, PSE does not sustain long-term adequate PLT count. Further studies may help guide patient selection by identifying characteristics that allow a sustained improvement in CIT.
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Affiliation(s)
- Letizia Procaccio
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Marta Schirripa
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Francesca Bergamo
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Vincenzo Dadduzio
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Silvia Finotto
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Alice Menichetti
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Stamatia Ziampiri
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Riccardo Carandina
- Interventional Radiology, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Fotios Loupakis
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Sara Lonardi
- Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Vittorina Zagonel
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Oncologic Institute of Veneto, IRCCS, Padua, Italy
| | - Camillo Aliberti
- Interventional Radiology, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
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Visco C, Chiappella A, Nassi L, Patti C, Ferrero S, Barbero D, Evangelista A, Spina M, Molinari A, Rigacci L, Tani M, Rocco AD, Pinotti G, Fabbri A, Zambello R, Finotto S, Gotti M, Carella AM, Salvi F, Pileri SA, Ladetto M, Ciccone G, Gaidano G, Ruggeri M, Martelli M, Vitolo U. Rituximab, bendamustine, and low-dose cytarabine as induction therapy in elderly patients with mantle cell lymphoma: a multicentre, phase 2 trial from Fondazione Italiana Linfomi. The Lancet Haematology 2017; 4:e15-e23. [DOI: 10.1016/s2352-3026(16)30185-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 01/11/2023]
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Koch S, Reppert S, Finotto S. NFATc1 deletion in T lymphocytes inhibits the allergic trait in a murine model of asthma. Clin Exp Allergy 2016; 45:1356-66. [PMID: 25640055 DOI: 10.1111/cea.12493] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/09/2014] [Accepted: 01/16/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND NFATc1 isoforms are highly regulated in peripheral T cells where they contribute to the effector function and cell homeostasis. OBJECTIVE Here, we investigated the role of NFATc1 in asthma and in T cells. METHODS In a murine model of allergic asthma, we analysed differences in T-cell development in this allergic disease model, between wild-type and NFATc1 conditional knockout mice. Thus, we performed quantitative real-time PCR to investigate the mRNA expression of Th2-associated genes as well as genes that are involved in IgE immunoglobulin class-switch. Additionally, we used ELISA, Western blot and flow cytometry (FACS) to analyse protein concentrations of Th1-, Th2- and Th17-specific transcription factors and cytokines and the Th2 chemokine, thymus and activation-regulated chemokine/chemokine ligand 17 (TARC/CCL17) by ELISA. RESULTS Mice lacking NFATc1 in CD4(+) T cells display a significant reduction in lung Th2 and Th17 as well as an increase of Th1 cells in an experimental asthma model. Additionally, Batf gene, a recently described transcription factor of the Th2 and Th17 cell differentiation as well as a key T and B transcription factor involved in the IgE immunoglobulin class-switch, was found decreased in the lungs of these mice. As a consequence, serum OVA-specific IgE and IgG1 levels were found significantly decreased after allergen exposure and in the absence of NFATc1 in T cells in experimental allergic asthma. CONCLUSIONS AND CLINICAL RELEVANCE Targeting NFATc1 in T lymphocytes ameliorated the allergic trait in the airways of NFATc1(fl/fl) xCD4Cre mice. NFATc1 emerges as a novel target for anti-allergy intervention.
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Affiliation(s)
- S Koch
- Division of Molecular Pneumology, Department of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany
| | - S Reppert
- Division of Molecular Pneumology, Department of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany
| | - S Finotto
- Division of Molecular Pneumology, Department of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany
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20
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Graser A, Ekici AB, Sopel N, Melichar VO, Zimmermann T, Papadopoulos NG, Taka S, Ferrazzi F, Vuorinen T, Finotto S. Rhinovirus inhibits IL-17A and the downstream immune responses in allergic asthma. Mucosal Immunol 2016; 9:1183-92. [PMID: 26732679 PMCID: PMC7099698 DOI: 10.1038/mi.2015.130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 09/25/2014] [Accepted: 11/09/2015] [Indexed: 02/04/2023]
Abstract
The proinflammatory cytokine interleukin-17A (IL-17A) is known to mediate antimicrobial activity, but its role during rhinovirus (RV) infections and in asthma needs further investigation. Therefore, we addressed the role of IL-17A during allergic asthma and antiviral immune response in human and murine immunocompetent cells. In this study we found that asthmatic children with a RV infection in their upper airways have upregulated mRNA levels of the antiviral cytokine interferon type I (IFN)-β and the transcription factor T-box 21 (TBX21) and reduced levels of IL-17A protein in their peripheral blood mononuclear cells (PBMCs). We also found that IL-17A inhibited RV1b replication in infected human lung epithelial cells A549. Furthermore, by using gene array analysis we discovered that targeted deletion of Il17a in murine lung CD4(+) T cells impaired Oas1g mRNA downstream of Ifnβ, independently from RV infection. Additionally, in PBMCs of children with a RV infection in their nasalpharyngeal fluid OAS1 gene expression was found downregulated. Finally RV1b inhibited IL-17A production in lung CD4(+) T cells in a setting of experimental asthma. These results indicate that the RV1b inhibits IL-17A in T helper type 17 cells and IL-17A clears RV1b infection in epithelial cells. In both cases IL-17A contributes to fend off RV1b infection by inducing genes downstream of interferon type I pathway.
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Affiliation(s)
- A Graser
- grid.411668.c0000 0000 9935 6525Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - A B Ekici
- grid.411668.c0000 0000 9935 6525Institute of Humangenetics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - N Sopel
- grid.411668.c0000 0000 9935 6525Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - V O Melichar
- grid.411668.c0000 0000 9935 6525Department of Paediatrics and Adolescent Medicine, Paediatric Pneumology-Allergology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - T Zimmermann
- grid.411668.c0000 0000 9935 6525Department of Paediatrics and Adolescent Medicine, Paediatric Pneumology-Allergology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - N G Papadopoulos
- grid.5216.00000 0001 2155 0800Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - S Taka
- grid.5216.00000 0001 2155 0800Allergy and Clinical Immunology Unit, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - F Ferrazzi
- grid.411668.c0000 0000 9935 6525Institute of Humangenetics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - T Vuorinen
- grid.1374.10000 0001 2097 1371Department of Virology, University of Turku, Turku, Finland
| | - S Finotto
- grid.411668.c0000 0000 9935 6525Department of Molecular Pneumology, Universitätsklinikum Erlangen, Erlangen, Germany
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Trufa D, Andreev K, Siegemund R, Rieker RJ, Hartmann A, Sirbu H, Finotto S. Erhöhter IL-35-Spiegel im Serum und erhöhte IL-35-Expression im Tumor von Patienten mit nicht-kleinzelligem Lungenkarzinom. Zentralbl Chir 2015. [DOI: 10.1055/s-0035-1559979] [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: 10/23/2022]
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Trufa DI, Engelhardt M, Andreev K, Reppert S, Schubert M, Mathews M, Sirbu H, Finotto S. Decreased transtyretin and increased IL-10 in postoperative serum of patients with lung adenocarcinoma. Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1389280] [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: 10/24/2022]
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Visco C, Finotto S. Hepatitis C virus and diffuse large B-cell lymphoma: Pathogenesis, behavior and treatment. World J Gastroenterol 2014; 20:11054-11061. [PMID: 25170194 PMCID: PMC4145748 DOI: 10.3748/wjg.v20.i32.11054] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 02/25/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
A significant association between hepatitis C virus (HCV) infection and B-cell lymphoma has been reported by epidemiological studies, most of them describing a strong relationship between indolent lymphomas and HCV. Furthermore, the curative potential of antiviral therapy on HCV related indolent lymphomas supports a specific role for the virus in lymphomagenesis. These observations are reinforced by numerous laboratory experiments that led to several hypothetical models of B-cell transformation by HCV. Diffuse large B-cell lymphoma (DLBCL), the most common lymphoma subtype in the western countries, has been associated to HCV infection despite its aggressive nature. This association seems particularly prominent in some geographical areas. Clinical presentation of HCV-associated DLBCL has consistently been reported to differ from the HCV-negative counterpart. Nevertheless, histopathology, tolerance to standard-of-care chemo-immunotherapy (R-CHOP or CHOP-like regimens) and final outcome of HCV-positive DLBCL patients is still matter of debate. Addition of rituximab has been described to enhance viral replication but the probability of severe hepatic complications remains low, with some exceptions (i.e., hepatitis B virus or immune immunodeficiency virus co-infected patients, presence of grade > 2 transaminases elevation, cirrhosis or hepatocarcinoma). HCV viral load in this setting is not necessarily directly associated with liver damage. Overall, treatment of HCV associated DLBCL should be performed in an interdisciplinary approach with hepatologists and hematologists with close monitoring of liver function. Available reports reveal that the final outcome of HCV-positive DLBCL that receive standard immunochemotherapy is not inferior to their HCV-negative counterpart. This review summarizes data on epidemiology, pathogenesis and therapeutic approach on HCV-associated DLBCL. Several issues that are matter of debate like clinical management of patients with transaminase elevation, criteria for discontinuing or starting immuno-chemotherapy, as well as the exact role of monoclonal antibodies will be analyzed.
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MESH Headings
- Animals
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiviral Agents/therapeutic use
- Cell Transformation, Viral
- Drug Resistance, Neoplasm
- Hepacivirus/drug effects
- Hepacivirus/pathogenicity
- Hepatitis C/diagnosis
- Hepatitis C/drug therapy
- Hepatitis C/epidemiology
- Hepatitis C/virology
- Humans
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/virology
- Treatment Outcome
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Perbellini O, Falisi E, Giaretta I, Boscaro E, Novella E, Facco M, Fortuna S, Finotto S, Amati E, Maniscalco F, Montaldi A, Alghisi A, Aprili F, Bonaldi L, Paolini R, Scupoli MT, Trentin L, Ambrosetti A, Semenzato G, Pizzolo G, Rodeghiero F, Visco C. Clinical significance of LAIR1 (CD305) as assessed by flow cytometry in a prospective series of patients with chronic lymphocytic leukemia. Haematologica 2014; 99:881-7. [PMID: 24415628 PMCID: PMC4008102 DOI: 10.3324/haematol.2013.096362] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [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: 10/11/2013] [Accepted: 01/08/2014] [Indexed: 01/30/2023] Open
Abstract
Most patients affected by chronic lymphocytic leukemia are diagnosed by flow cytometry. Several immunophenotypic markers have been identified as significant and independent prognostic variables, especially from retrospective cohorts. However, while attractive because their detection is inexpensive and feasible in most laboratories, only few have been validated by independent series. The expression of leukocyte-associated immunoglobulin-like receptor-1 (also known as LAIR1, LAIR-1 or CD305), an inhibitor of B-cell receptor-mediated signaling, has been reported to be lacking in high-risk chronic lymphocytic leukemia. However, its correlation with biological variables and its prognostic significance remain unknown. We investigated 311 consecutive patients, prospectively enrolled since 2007. Methods for studying patients were standardized and included clinical assessment, immunophenotype, fluorescence in situ hybridization, and status of immunoglobulin heavy chain variable region genes. Overall, 22.1% of patients had Binet stage B or C disease, 38.5% had unmutated immunoglobulin genes, 15.1% had high-risk cytogenetic abnormalities, 23.4% were CD38(+), 37.8% CD49d(+), and 59.8% LAIR1(+). Expression of LAIR1 was inversely related to that of CD38 (P=0.0005), but was not associated with CD49d expression (P=0.96). A significantly lower expression of LAIR1 was observed in patients with Binet stage B or C disease (P=0.023), and in the presence of high-risk cytogenetic abnormalities (P=0.048) or unmutated immunoglobulin heavy chain variable region genes (P<0.0001). At univariate analysis LAIR1(+) was significantly associated with longer time to first treatment (P=0.0002). This favorable effect of LAIR1(+) was confirmed by multivariate analysis (hazard ratio=2.1, P=0.03 for LAIR1). Our results indicate that LAIR1 expression is a reliable and inexpensive marker capable of independently predicting time to first treatment in newly diagnosed unselected patients with chronic lymphocytic leukemia.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Aberrations
- Disease Progression
- Female
- Flow Cytometry
- Follow-Up Studies
- Gene Expression
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Male
- Middle Aged
- Mutation
- Neoplasm Staging
- Patient Outcome Assessment
- Prognosis
- Prospective Studies
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
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Visco C, Cortelezzi A, Moretta F, Falisi E, Maura F, Finotto S, Barcellini W, Ambrosetti A, Neri A, Ruggeri M, Rodeghiero F. Autoimmune cytopenias in chronic lymphocytic leukemia at disease presentation in the modern treatment era: is stage C always stage C? Leuk Lymphoma 2013; 55:1261-5. [DOI: 10.3109/10428194.2013.834054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Falisi E, Novella E, Visco C, Guercini N, Maura F, Giaretta I, Pomponi F, Nichele I, Finotto S, Montaldi A, Neri A, Rodeghiero F. B-cell receptor configuration and mutational analysis of patients with chronic lymphocytic leukaemia and trisomy 12 reveal recurrent molecular abnormalities. Hematol Oncol 2013; 32:22-30. [PMID: 23861036 DOI: 10.1002/hon.2086] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 02/27/2013] [Revised: 05/15/2013] [Accepted: 06/04/2013] [Indexed: 01/02/2023]
Abstract
Trisomy 12 (+12) is the third most frequent cytogenetic aberration in chronic lymphocytic leukaemia (CLL) retrievable both as the sole chromosomal abnormality or in association with additional alterations. NOTCH1 mutations are known to be more prevalent among +12 patients, whereas mutations of FBXW7, a gene involved in NOTCH1 degradation, that lead to the constitutional activation of NOTCH1 have not been investigated in this setting. We analyzed a unicentric cohort of 44 +12 patients with CLL for mutations of TP53, NOTCH1 and FBXW7 genes, and we correlated them with B-cell receptor (BCR) configurations. FBXW7, TP53 and NOTCH1 mutations were identified in 4.5%, 6.8% and 18.2% of patients, respectively. FBXW7 and NOTCH1 mutations appeared in a mutually exclusive fashion, suggesting that both aberrations might affect the same biological pathway. We found that 44.1% of +12 CLL patients had stereotyped B-cell receptors, which is significantly higher than that observed in patients with CLL and no +12 (27%, p = 0.01). Subsets #1, #8, #10, #28 and #59 were the most represented stereotyped patterns, and IGHV4-39*01 was the gene configuration most commonly used. There was a significantly higher risk for Richter's syndrome (RS) transformation in patients with NOTCH1 or FBXW7 mutations, with four of the seven (57%) patients developing RS and characterized at least by one of the two abnormalities. These observations suggest that, similarly to the aberrations of NOTCH1, FBXW7 gene mutations may also result in cell proliferation and evasion from apoptosis in patients with +12 CLL. Together with the extremely high frequency of stereotyped BCRs and RS transformation, these abnormalities appear to cluster in these CLL patients with additional chromosome 12, suggesting a connection with the prognosis of the disease.
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Affiliation(s)
- Erika Falisi
- Department of Hematology and Cell Therapy, S. Bortolo Hospital, Vicenza, Italy
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Trufa DI, Andreev K, Reppert S, Siegemund R, Matjl A, Mathiew M, Sirbu H, Finotto S. P-237INCREASED FORKHEAD-BOX-P3 IN THE TUMOURAL REGION IN HUMAN NON-SMALL-CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Visco C, Finotto S, Zambello R, Paolini R, Menin A, Zanotti R, Zaja F, Semenzato G, Pizzolo G, D'Amore ES, Rodeghiero F. Combination of Rituximab, Bendamustine, and Cytarabine for Patients With Mantle-Cell Non-Hodgkin Lymphoma Ineligible for Intensive Regimens or Autologous Transplantation. J Clin Oncol 2013; 31:1442-9. [DOI: 10.1200/jco.2012.45.9842] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The combination of bendamustine (B) and rituximab (R) is efficacious, with favorable toxicity in mantle-cell lymphoma (MCL). In this phase II study, we combined cytarabine with R and B (R-BAC) in patients with MCL age ≥ 65 years who were previously untreated or relapsed or refractory (R/R) after one prior immunochemotherapy treatment. Patients and Methods In stage one, we established the maximum-tolerated dose (MTD) of cytarabine in R-BAC. In stage two, patients received R (375 mg/m2 intravenously [IV] on day 1), B (70 mg/m2 IV on days 2 and 3), and cytarabine (MTD IV on days 2 to 4) every 28 days for four to six cycles. The primary end point (overall response rate [ORR]) was evaluated by positron emission tomography. Secondary end points included safety, progression-free survival (PFS), response duration, and overall survival. Results Forty patients (median age, 70 years; 20 previously untreated patients) were enrolled; 93% had Ann Arbor stage III/IV disease; 49% had high Mantle Cell International Prognostic Index scores, with 15% blastoid histology. All R/R patients (35% refractory) had previously received R-containing regimens. The cytarabine MTD used in stage two was 800 mg/m2, and R-BAC was well tolerated, with an 85% treatment completion rate. The major toxicity was transient grades 3 to 4 thrombocytopenia (87% of patients); febrile neutropenia occurred in 12%. The ORR was 100% (95% complete response [CR]) for previously untreated and 80% (70% CR) for R/R patients. The 2-year PFS rate (± standard deviation) was 95% ± 5% for untreated and 70% ± 10% for R/R patients. Conclusion R-BAC is well tolerated and active against MCL.
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Affiliation(s)
- Carlo Visco
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Silvia Finotto
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Renato Zambello
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Rossella Paolini
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Andrea Menin
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Roberta Zanotti
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Francesco Zaja
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Gianpietro Semenzato
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Giovanni Pizzolo
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Emanuele S.G. D'Amore
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Francesco Rodeghiero
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
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Visco C, Moretta F, Falisi E, Facco M, Maura F, Novella E, Nichele I, Finotto S, Giaretta I, Ave E, Perbellini O, Guercini N, Scupoli MT, Trentin L, Trimarco V, Neri A, Semenzato G, Rodeghiero F, Pizzolo G, Ambrosetti A. Double productive immunoglobulin sequence rearrangements in patients with chronic lymphocytic leukemia. Am J Hematol 2013; 88:277-82. [PMID: 23450508 DOI: 10.1002/ajh.23396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 11/06/2022]
Abstract
The immunoglobulin heavy chain variable (IGHV) gene mutational status represents a major prognostic marker in chronic lymphocytic leukemia (CLL). Usually, the prognostic implications of IGHV gene analysis can be reliably ascertained but, occasionally, double productive rearrangements have been detected. Clinical presentation and biological features of such cases are unknown. Sixty patients with morphologically and phenotypically monoclonal CLL but double productive IGHV rearrangements were retrospectively identified by mRNA analysis from three Hematology Institutions. Clinical and biological features and survival of these 60 patients were compared with a control group of patients with CLL and single IGHV rearrangement. A prospective registry was used to assess the epidemiology of double productive IGHV among incidental patients with CLL. Using standard criteria to define IGHV-mutated (M) or unmutated (U) cases, 39 of the 60 patients (65%) with double productive IGHV rearrangement had concordant status (23 MM, 16 UU), while 21 (35%) had discordant IGHV status. As compared with M patients, the MM ones had lower CD38 expression, more favorable cytogenetics and more indolent clinical behavior. Cases with UU had similar characteristics of U patients. Discordant cases presented with adverse prognostic features and had an aggressive clinical behavior requiring early treatment, similar to U patients. The prevalence of double IGHV was 3.1%. Patients with CLL with double concordant mutational status (MM or UU) have a clinical course similar to that of the corresponding single IGHV status, while those exhibiting discordant status represent a high risk population. This may help correct stratification within clinical trials.
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Affiliation(s)
- Carlo Visco
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Francesca Moretta
- Hematology Section, Department of Medicine; University of Verona; Italy
| | - Erika Falisi
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Monica Facco
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Francesco Maura
- Department of Medical Sciences and Hematology-CTMO; University of Milano; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano Italy
| | | | - Ilaria Nichele
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | - Silvia Finotto
- Department of Hematology S. Bortolo Hospital; Vicenza Italy
| | | | - Elisa Ave
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Omar Perbellini
- Hematology Section, Department of Medicine; University of Verona; Italy
| | | | | | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Valentina Trimarco
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Antonino Neri
- Department of Medical Sciences and Hematology-CTMO; University of Milano; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano Italy
| | - Gianpietro Semenzato
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | | | - Giovanni Pizzolo
- Hematology Section, Department of Medicine; University of Verona; Italy
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Visco C, Finotto S, Pomponi F, Sartori R, Laveder F, Trentin L, Paolini R, Di Bona E, Ruggeri M, Rodeghiero F. The combination of rituximab, bendamustine, and cytarabine for heavily pretreated relapsed/refractory cytogenetically high-risk patients with chronic lymphocytic leukemia. Am J Hematol 2013; 88:289-93. [PMID: 23450436 DOI: 10.1002/ajh.23391] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 01/08/2013] [Indexed: 12/30/2022]
Abstract
Treatment of patients with B-cell chronic lymphocytic leukemia (CLL) relapsed/refractory (R/R) to conventional treatments is particularly challenging. The combination of bendamustine and cytarabine has demonstrated distinct and synergistic mechanisms of action in preclinical studies on cell lines and primary tumor cells of several B-cell lymphomas, including 17p deleted or TP53 mutated CLL. The efficacy of rituximab (375 mg/m(2) , Day 1), plus bendamustine (70 mg/m(2) , days 1-2), and cytarabine (800 mg/m(2) , Day 1-3; R-BAC), every 28 days for up to four courses, was evaluated in a pilot trial enrolling 13 patients with very selected high-risk R/R CLL. All patients (median age 60 years, range 53-74) had symptomatic Binet stage B or C active disease requiring treatment, were characterized by adverse cytogenetics (17p deletion, 11q deletion, or both), unmutated immunoglobulin heavy-chain variable region, and were heavily pretreated (1-5, median three previous lines). Overall, R-BAC was well tolerated with limited non-hematological toxicity. Major toxicities were transient Grade 3/4 neutropenia and thrombocytopenia in 84% and 85% of patients, respectively. Overall response rate (OR) was 84%, including complete and partial response in 38% and 46% of patients, respectively. Patients with 17p deletion had an OR of 78%. After a median follow-up of 17 months, median progression-free survival was 16 months while median overall survival (OS) was not reached (1-year OS: 75 ± 13%). R-BAC is an active regimen in R/R heavily pretreated high-risk patients with CLL, representing an option for the treatment of patients that are usually refractory to standard therapy.
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Affiliation(s)
- Carlo Visco
- Department of Cell Therapy and Hematology; San Bortolo Hospital; Vicenza Italy
| | - Silvia Finotto
- Department of Cell Therapy and Hematology; San Bortolo Hospital; Vicenza Italy
| | - Fabrizio Pomponi
- Department of Cell Therapy and Hematology; San Bortolo Hospital; Vicenza Italy
| | - Roberto Sartori
- Department of Immunohematology; San Giacomo Hospital; Castelfranco Veneto Italy
| | | | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch; Padua University School of Medicine; Padova Italy
| | - Rossella Paolini
- Department of Oncohaematology; S. Maria della Misericordia Hospital; Rovigo Italy
| | - Eros Di Bona
- Department of Cell Therapy and Hematology; San Bortolo Hospital; Vicenza Italy
| | - Marco Ruggeri
- Department of Cell Therapy and Hematology; San Bortolo Hospital; Vicenza Italy
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Reppert S, Boross I, Koslowski M, Türeci Ö, Koch S, Lehr HA, Finotto S. A role for T-bet-mediated tumour immune surveillance in anti-IL-17A treatment of lung cancer. Nat Commun 2011; 2:600. [PMID: 22186896 DOI: 10.1038/ncomms1609] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 11/23/2011] [Indexed: 12/29/2022] Open
Abstract
Lung cancer is the leading cause of cancer deaths worldwide. The cytokine interleukin-17A supports tumour vascularization and growth, however, its role in lung cancer is unknown. Here we show, in the lungs of patients with lung adenocarcinoma, an increase in interleukin-17A that is inversely correlated with the expression of T-bet and correlated with the T regulatory cell transcription factor Foxp3. Local targeting of interleukin-17A in experimental lung adenocarcinoma results in a reduction in tumour load, local expansion of interferon-γ-producing CD4(+) T cells and a reduction in lung CD4(+)CD25(+)Foxp3(+) regulatory T cells. T-bet((-/-)) mice have a significantly higher tumour load compared with wild-type mice. This is associated with the local upregulation of interleukin-23 and induction of interleukin-17A/interleukin-17R-expressing T cells infiltrating the tumour. Local anti-interleukin-17A antibody treatment partially improves the survival of T-bet((-/-)) mice. These results suggest that local anti-interleukin-17A antibody therapy could be considered for the treatment of lung tumours.
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Affiliation(s)
- S Reppert
- Department of Anesthesia, Laboratories of Cellular and Molecular Lung Immunology, Institute of Molecular Pneumology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Hartmannstraße 14, Erlangen 91052, Germany
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Albiero E, Ruggeri M, Fortuna S, Finotto S, Bernardi M, Madeo D, Rodeghiero F. Isolated erythrocytosis: study of 67 patients and identification of three novel germ-line mutations in the prolyl hydroxylase domain protein 2 (PHD2) gene. Haematologica 2011; 97:123-7. [PMID: 21828119 DOI: 10.3324/haematol.2010.039545] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The oxygen sensing pathway modulates erythropoietin expression. In normal cells, intracellular oxygen tensions are directly sensed by prolyl hydroxylase domain (PHD)-containing proteins. PHD2 isozyme has a key role in tagging hypoxia-inducible factor (HIF)-α subunits for polyubiquitination and proteasomal degradation. Erythrocytosis-associated PHD2 mutations reduce hydroxylation of HIF-α. The investigation of 67 patients with isolated erythrocytosis, either sporadic or familial, allowed the identification of three novel mutations in the catalytic domain of the PHD2 protein. All new mutations are germ-line, heterozygous and missense, and code for a predicted full length mutant PHD2 protein. Identification of the disease-causing genes will be of critical importance for a better classification of familial and acquired erythrocytosis, offering additional insight into the erythropoietin regulating oxygen sensing pathway.
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Affiliation(s)
- Elena Albiero
- Department of Cellular Therapies and Haematology, San Bortolo Hospital, Vicenza, Italy
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Albiero E, Ruggeri M, Fortuna S, Bernardi M, Finotto S, Madeo D, Rodeghiero F. Analysis of the oxygen sensing pathway genes in familial chronic myeloproliferative neoplasms and identification of a novel EGLN1 germ-line mutation. Br J Haematol 2011; 153:405-8. [PMID: 21275967 DOI: 10.1111/j.1365-2141.2010.08551.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ruggeri M, Finotto S, Fortuna S, Rodeghiero F. Treatment outcome in a cohort of young patients with polycythemia vera. Intern Emerg Med 2010; 5:411-3. [PMID: 20607450 DOI: 10.1007/s11739-010-0429-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 01/18/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
Abstract
The treatment of polycythemia vera in young adults is challenging, requiring one to run a balance between the increased risk of vascular complications, if left untreated, versus the potential of promoting secondary leukemia/myelodysplasia or cancer, if actively managed with chemotherapy. We report the results of a 20-year retrospective analysis in a cohort of 30 young adults with PV (median age 37 years, range 19-45) treated exclusively with phlebotomy, aspirin and hydroxyurea only in case of vascular complications occurring in the presence of thrombocytosis (platelet count > 600 × 10(9)/L). With this approach, vascular complications were no higher than in other published series, and secondary leukemia/myelodysplasia or cancer was not observed during a follow-up of 14 years.
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Affiliation(s)
- Marco Ruggeri
- Department of Cell Therapy and Hematology, San Bortolo Hospital, Viale Rodolfi 37, Vicenza, Italy
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Wiewrodt R, Burg J, Rapp G, Taube C, Buhl R, Kirkpatrik C, Finotto S. Gesteigerte Expression des Lymphozyten-Transkriptionsfaktor T-bet bei COPD. Pneumologie 2010. [DOI: 10.1055/s-0030-1251104] [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: 10/19/2022]
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Abstract
Effector and regulatory T cells (Tregs) play a fundamental role in the airways in allergic asthma. Here, the role of T cells in the immunopathogenesis of human asthma as well as in animal models of allergic airway inflammation is reviewed. Recent data have shown that Th2 and Th17 effector T cells augment experimental airway inflammation, while Tregs have an important anti-inflammatory function. The local induction of Th2 cells is critically dependent on the balance between the transcription factors T-bet and GATA-3, while Th17 and Tregs require the transcription factors ROR-gammat and Foxp3, respectively. Cytokine signaling controls the development and activation of all the above T-cell subsets. For instance, local blockade of the membrane-bound interleukin (IL)-6R results in induction of lung CD4+CD25+ Foxp3+Tregs producing TGF-Beta and IL-10. In humans, it has been suggested that asthmatic patients have increased Th2 but decreased Tregs, however the role of Th17 cells in allergic asthma remains to be elucidated. However, the currently available data suggest that allergic asthma is a multifaceted disease that is actively controlled by T lymphocytes. A better understanding of effector and Treg activation will most likely lead to novel treatment strategies in the near future.
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Affiliation(s)
- S Finotto
- Laboratory of Cellular and Molecular Lung Immunology, First Medical Clinic, Mainz, Germany
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Teich R, Blümer N, Patrascan C, Heine H, Holst O, Garn H, Renz H, Debarry J, Hanuszkiewicz A, Stein K, Mages J, Lang R, Sabri A, Braren I, Mempel M, Bredehorst R, Ollert M, Spillner E, Rasche C, Wolfram C, Zuberbier T, Worm M, Röschmann K, Ulmer A, Petersen A, Goldmann T, Schramm G, Mohrs K, Wodrich M, Doenhoff M, Pearce E, Haas H, Mohrs M, Darcan Y, Meinicke H, Fels G, Hegend O, Henke W, Hamelmann E, Blume C, Förster S, Gilles S, Becker W, Ring J, Behrendt H, Traidl-Hoffmann C, Edele F, Molenaar R, Reinhold C, Gütle D, Dudda J, Homey B, Mebius R, Hornef M, Martin S, Albrecht M, Suezer Y, Staib C, Sutter G, Vieths S, Reese G, Sudowe S, Zindler E, Gehrke N, Reuter S, Neufurth M, Finotto S, Taube C, Reske-Kunz A, Meyer HA, Krokowski M, Heidt C. Experimentelle Allergologie/Immunologie. Allergo J 2007. [DOI: 10.1007/bf03370607] [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: 10/21/2022]
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Kilic A, Sonar S, Hahn C, Schwinge D, Yildirim A, Achenbach S, Fehrenbach H, Renz H, Nockher W, Abram M, Fokuhl V, Luger E, Radbruch A, Wegmann M, Reuter S, Heinz A, Sieren M, Wiewrodt R, Stassen M, Buhl R, Taube C, Hausding M, Karwot R, Scholtes P, Lehr H, Blumberg R, Sternemann K, Finotto S, Maxeiner J, Caucig P, Dinges S, Teschner D, von Stebut E, Darcan Y, Haberland A, Hegend O, Spohn S, Krokowski M, Henke W, Hamelmann E, Dicke T, Sel S, Garn H, Gupta S, Fuchs B, Schulz-Maronde S, Heitland A, Escher S, Tillmann H, Braun A, Forssmann WF, Elsner J, Jaudszus A, Jahreis G, Möckel P. Atemwege. Allergo J 2007. [DOI: 10.1007/bf03370557] [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: 10/21/2022]
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Karwot R, Maxeiner JH, Schmitt S, Scholtes P, Sauer K, Hausding M, Doganci A, Lehr HA, Galle PR, Finotto S. Essential role of NFATc2 in CD8+ T cells in experimental model of asthma. Pneumologie 2007. [DOI: 10.1055/s-2007-967225] [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: 10/21/2022]
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Maxeiner JH, Karwot R, Sauer K, Scholtes P, Wiewrodt R, Galle PR, Lehr HA, Finotto S. Defective lung CD8+ T cells lacking NFATc2 induced lung metastasis in NFATc2 deficient mice in a bronchoalveolar adenocarcinoma murine model. Pneumologie 2007. [DOI: 10.1055/s-2007-967256] [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: 10/21/2022]
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Affiliation(s)
- M F Neurath
- Laboratory of Immunology, I. Medical Clinic, University of Mainz, 55131 Mainz, Germany
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Finotto S, Siebler J, Hausding M, Schipp M, Wirtz S, Klein S, Protschka M, Doganci A, Lehr HA, Trautwein C, Khosravi-Far R, Strand D, Lohse A, Galle PR, Blessing M, Neurath MF, Khosravi-Fahr R. Severe hepatic injury in interleukin 18 (IL-18) transgenic mice: a key role for IL-18 in regulating hepatocyte apoptosis in vivo. Gut 2004; 53:392-400. [PMID: 14960523 PMCID: PMC1773961 DOI: 10.1136/gut.2003.018572] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [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: 12/11/2022]
Abstract
BACKGROUND Interleukin 18 (IL-18) is a cytokine with pleiotropic activity that augments T helper 1 responses and cytotoxic activity of natural killer cells. METHODS To assess the function of IL-18 in vivo, we generated IL-18 transgenic (IL-18 Tg) mice under the control of a CD2 promoter/enhancer construct. RESULTS Macroscopically, IL-18 Tg mice showed reduced relative liver weight compared with wild-type littermates. TUNEL assays demonstrated increased hepatocyte apoptosis, and primary hepatocytes isolated from IL-18 Tg mice exhibited an increased spontaneous apoptosis rate. Furthermore, cross linking of Fas increased significantly the apoptosis rate in hepatocytes isolated from wild- type mice but to a much lesser extent in IL-18 Tg mice, suggesting spontaneous activation of the Fas pathway in the latter mice. In fact, in vivo blockade of Fas signal transduction by an adenovirus overexpressing the dominant negative form of the Fas associated death domain rescued hepatocytes from undergoing apoptosis. Finally, adoptive transfer of CD4(+) T cells from IL-18 Tg mice but not from wild-type littermates in SCID mice resulted in severe liver failure with massive periportal fibrosis due to hepatocyte apoptosis. CONCLUSION IL-18 plays a fundamental role in regulating hepatocyte apoptosis. Furthermore, our transgenic model provides a novel tool to study the mechanisms of IL-18 dependent liver injury in vivo.
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Affiliation(s)
- S Finotto
- Laboratory of Immunology, I Medical Clinic, University of Mainz, Germany.
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Saloga J, Knop J, Rihs HP, Dumont B, Rozynek P, Lundberg M, Cremer R, Brüning T, Raulf-Heimsoth M, Yeang HY, Sander I, Arif SAM, Fleischer C, Brüning T, Pöppelmann M, Grobe K, Becker WM, Petersen A, Wicklein D, Lindner B, Lepp U, Altmann F, Hipler UC, Frank U, Schliemann-Willers S, Kaatz M, Eisner P, Kasche A, Krämer U, Klaus S, Buters J, Traidl-Hoffmann C, Ring J, Behrendt H, Huss-Marp J, Brockow K, Darsow U, Risse U, Böttcher I, Sellinghausen I, Brand P, Klostermann B, Mariant V, Jakob T, Hochrein H, Müller MJ, Wagner H, Baron JM, Schiffer R, Bostonci Ö, Merk HF, Zwadlo-Klarwasser G, Schäkel K, Kannagi R, Kniep B, Goto Y, Mitsuoka C, Zwirner J, Soruri A, von Kietzell M, Rieber P, Lisewski M, Mommert S, Kapp A, Zwirner J, Werfet T, Gutzmer R, Langer K, Werfel T, Soewarto D, Köllisch G, Howaldt M, Sandholzer N, Kreramer E, Hrabé deAngelis M, Balling R, Ollert M, Pfeffer K, Wolf E, Flaswinkel H, Ngoumou G, Schäfer D, Mattes J, Moseler M, Kühr J, Kopp MV, Gutzmer R, Wittmann M, Janssen S, Köther B, Alter M, Stünkel T, Hausdirjg M, Ho TC, Buerke M, Lehr AH, Lux C, Schipp M, Galle RP, Finotto S, Bünder R, Mittermann I, Herz U, Valenta R, Renz H, Seidel-Guvenot W, Goez R, Maurer M, Metz M, Blessing M, Schramm C, Steinbrink K, Köllisch GV, Mempel M, Bauer S, Völcker V, Kasche A, Fesq H, Feussner I, Schober W, Buters J, Hueltner L, Lippert U, Artuc M, Babina M, Blaschke V, Zachmann K, Neumann C, Henz BM, Stassen M, Müller C, Richter C, Neudörfl C, Hüttner L, Bhakdi S, Walev I, Schmitt E, Mageri M, Maurer M, Hartmann K, Artuc M, Hermes B, Mekori YA, Henz BM, Breit S, Schöpf P, Dugas M, Schiffl H, Ruëff F, Przybilla B, Forssmann U, Härtung I, Bälder R, Escher SE, Spodsberg N, Dulkys Y, Walden M, Heitland A, Braun A, Forssmann WG, Elsner J, Raap U, Deneka N, Bruder M, Wedi B, Feser A, Plötz SG, Kreyling W, Schober W, Weichenmeier I, Papo D, Eberlein-König B, Berresheim HW, Grimm V, Winneke G, Kleine-Tebbe J, Breuer K, Vieths S, Worm M, Kunkel G, Wahn U, Lau S, Errlmann SM, Sauer I, Termeer C, Salman S, Averbeck M, Simon JC, Heine G, Frotscher B, Anton K, Mahnke K, Qian Y, Enk A, Enk AH, Beinghausen I, Darcan Y, Seitzer U, Ahmed J, Sudowe S, Ludwig-Portugall I, Ross R, Reske-Kunz AB, Maurer T, Lipford G, Wagner H, Rueff F, Bauer C, Gosepath J, Mewes T, Ziegler E, Ziegler EA, Flagge A, Hipler UC, Baumbach H, Zintl F, Eisner P, Mainz J, Huber S, Protschka M, Burg J, Galle PR, Lohse AW, Podlech J, Köhler H, Wegmann M, Heimann S, Fehrenbach A, Wagner U, Alfke H, Fehrenbach H, Beier J, Semmler D, Beeh KM, Kornmann O, Buhl R, Quarcoo D, Ahrens B, Meeuw A, Reese G, Vieths S, Hameimann E, Heratizadeh A, Wulf A, Constien A, Tetau D, Lingelbach A, Rakoski J, Fiedler EM, Zuberbier T, Weidermiller M, Winterkamp S, Schwab D, Nabe A, Nägel A, Maiss J, Mühldorfer SDN, Hahn EG, Raithel M, Weidenhiller M, Abel R, Baenkler HW, Mühldorfer S, Funkt G, Klinik I, Scheibenzuber M, Meyer-Pittroff R, Reese I, Oppel T, Hartmann K, Pfützner W, Biedermann T, Sing A, Dechene M, Staubach P, Hanau A, Magerl M, Eckhardt-Henn A, Onnen K, Kromminga A, Lüdtke R, Tschentscher I, Lange J, Berkenheide S, Kuehr J, Simon D, von Gunten S, Borelli S, Braathen LR, Simon HU, Fokken N, Wittmann M, Mrabet-Dahbi S, Klotz M, Heeg K, Soost S, Lee H, Klinger R, Becker D, Bruchhausen S, Jaeger C, Hartschuh W, Jappe U. 15. Mainzer Allergie-Workshop 2003. Allergo J 2003. [DOI: 10.1007/bf03361093] [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: 11/24/2022]
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Neurath MF, Weigmann B, Finotto S, Glickman J, Nieuwenhuis E, Iijima H, Mizoguchi A, Mizoguchi E, Mudter J, Galle PR, Bhan A, Autschbach F, Sullivan BM, Szabo SJ, Glimcher LH, Blumberg RS. The transcription factor T-bet regulates mucosal T cell activation in experimental colitis and Crohn's disease. J Exp Med 2002; 195:1129-43. [PMID: 11994418 PMCID: PMC2193714 DOI: 10.1084/jem.20011956] [Citation(s) in RCA: 477] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2001] [Revised: 03/08/2002] [Accepted: 03/19/2002] [Indexed: 12/13/2022] Open
Abstract
The balance between pro and antiinflammatory cytokines secreted by T cells regulates both the initiation and perpetuation of inflammatory bowel diseases (IBD). In particular, the balance between interferon (IFN)-gamma/interleukin (IL)-4 and transforming growth factor (TGF)-beta activity controls chronic intestinal inflammation. However, the molecular pathways that evoke these responses are not well understood. Here, we describe a critical role for the transcription factor T-bet in controlling the mucosal cytokine balance and clinical disease. We studied the expression and function of T-bet in patients with IBD and in mucosal T cells in various T helper (Th)1- and Th2-mediated animal models of chronic intestinal inflammation by taking advantage of mice that lack T-bet and retroviral transduction techniques, respectively. Whereas retroviral transduction of T-bet in CD62L(+) CD4(+) T cells exacerbated colitis in reconstituted SCID mice, T-bet-deficient T cells failed to induce colitis in adoptive transfer experiments suggesting that overexpression of T-bet is essential and sufficient to promote Th1-mediated colitis in vivo. Furthermore, T-bet-deficient CD62L(-) CD4(+) T cells showed enhanced protective functions in Th1-mediated colitis and exhibited increased TGF-beta signaling suggesting that a T-bet driven pathway of T cell activation controls the intestinal balance between IFN-gamma/IL-4 and TGF-beta responses and the development of chronic intestinal inflammation in T cell-mediated colitis. Furthermore, TGF-beta was found to suppress T-bet expression suggesting a reciprocal relationship between TGF-beta and T-bet in mucosal T cells. In summary, our data suggest a key regulatory role of T-bet in the pathogenesis of T cell-mediated colitis. Specific targeting of this pathway may be a promising novel approach for the treatment of patients with Crohn's disease and other autoimmune diseases mediated by Th1 T lymphocytes.
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Affiliation(s)
- M F Neurath
- Laboratory of Immunology, I. Medical Clinic, University of Mainz, 55131 Mainz, Germany.
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Finotto S, De Sanctis GT, Lehr HA, Herz U, Buerke M, Schipp M, Bartsch B, Atreya R, Schmitt E, Galle PR, Renz H, Neurath MF. Treatment of allergic airway inflammation and hyperresponsiveness by antisense-induced local blockade of GATA-3 expression. J Exp Med 2001; 193:1247-60. [PMID: 11390432 PMCID: PMC2193377 DOI: 10.1084/jem.193.11.1247] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.0] [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] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Recent studies in transgenic mice have revealed that expression of a dominant negative form of the transcription factor GATA-3 in T cells can prevent T helper cell type 2 (Th2)-mediated allergic airway inflammation in mice. However, it remains unclear whether GATA-3 plays a role in the effector phase of allergic airway inflammation and whether antagonizing the expression and/or function of GATA-3 can be used for the therapy of allergic airway inflammation and hyperresponsiveness. Here, we analyzed the effects of locally antagonizing GATA-3 function in a murine model of asthma. We could suppress GATA-3 expression in interleukin (IL)-4-producing T cells in vitro and in vivo by an antisense phosphorothioate oligonucleotide overlapping the translation start site of GATA-3, whereas nonsense control oligonucleotides were virtually inactive. In a murine model of asthma associated with allergic pulmonary inflammation and hyperresponsiveness in ovalbumin (OVA)-sensitized mice, local intranasal administration of fluorescein isothiocyanate-labeled GATA-3 antisense oligonucleotides led to DNA uptake in lung cells associated with a reduction of intracellular GATA-3 expression. Such intrapulmonary blockade of GATA-3 expression caused an abrogation of signs of lung inflammation including infiltration of eosinophils and Th2 cytokine production. Furthermore, treatment with antisense but not nonsense oligonucleotides induced a significant reduction of airway hyperresponsiveness in OVA-sensitized mice to levels comparable to saline-treated control mice, as assessed by both enhanced pause (PenH) responses and pulmonary resistance determined by body plethysmography. These data indicate a critical role for GATA-3 in the effector phase of a murine asthma model and suggest that local delivery of GATA-3 antisense oligonucleotides may be a novel approach for the treatment of airway hyperresponsiveness such as in asthma. This approach has the potential advantage of suppressing the expression of various proinflammatory Th2 cytokines simultaneously rather than suppressing the activity of a single cytokine.
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Affiliation(s)
- S Finotto
- Laboratory of Immunology, University of Mainz, 55099 Mainz, Germany.
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Finotto S, Buerke M, Lingnau K, Schmitt E, Galle PR, Neurath MF. Local administration of antisense phosphorothioate oligonucleotides to the c-kit ligand, stem cell factor, suppresses airway inflammation and IL-4 production in a murine model of asthma. J Allergy Clin Immunol 2001; 107:279-86. [PMID: 11174194 DOI: 10.1067/mai.2001.113049] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The c-kit ligand, stem cell factor (SCF), is an important activating and chemotactic factor for both mast cells and eosinophils. These cells are known to play a fundamental role in the pathogenesis of asthma. OBJECTIVE Our goal was to analyze the functional role of SCF in the pathogenesis of asthma. METHODS The expression of SCF was targeted in fibroblasts, epithelial cells, and locally in a murine model of asthma in mice induced by ovalbumin sensitization with an antisense DNA strategy. RESULTS We could suppress SCF expression in NIH 3T3 fibroblasts and SP1 epithelial cells by a specific antisense phosphorothioate oligonucleotide overlapping the translation start site of SCF, whereas control oligonucleotides were virtually inactive. We then focused on the role of SCF in a murine model of asthma associated with late-phase allergic inflammation in ovalbumin-sensitized mice: Local intranasal administration of FITC-labeled SCF antisense oligonucleotides led to strong DNA uptake in interstitial lung cells associated with a striking reduction of intracellular SCF expression. Such intrapulmonary blockade of SCF expression after repeated allergen challenges suppressed various signs of lung inflammation including IL-4 production and infiltration of eosinophils. SCF antisense DNA treatment was at least as effective as corticosteroid treatment. CONCLUSION These data indicate a critical role for SCF in a murine asthma model and suggest that local delivery of SCF antisense oligonucleotides may be a novel approach for the treatment of inflammatory lung disorders such as asthma.
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Affiliation(s)
- S Finotto
- Laboratory of Immunology, Medical Clinic I, Medical Clinic II, and the Institute of Immunology, University of Mainz, Germany
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Neurath MF, Finotto S, Fuss I, Boirivant M, Galle PR, Strober W. Regulation of T-cell apoptosis in inflammatory bowel disease: to die or not to die, that is the mucosal question. Trends Immunol 2001; 22:21-6. [PMID: 11286687 DOI: 10.1016/s1471-4906(00)01798-1] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
T-cell resistance against apoptosis contributes to inappropriate T-cell accumulation and the perpetuation of chronic mucosal inflammation in inflammatory bowel diseases (IBDs). Anti-interleukin-12 (IL-12) and anti-IL-6 receptor antibodies suppress colitis activity by the induction of T-cell apoptosis. These findings have important implications for the design of effective treatment regimens in IBD.
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Affiliation(s)
- M F Neurath
- Laboratory of Immunology, I. Medical Clinic, University of Mainz, 55131, Mainz, Germany.
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Abstract
Allergic asthma is a chronic pulmonary disease associated with bronchoconstriction and inflammation. Recent studies have shown that mediator substances and proinflammatory cytokines produced by mast cells, eosinophils and T-lymphocytes appear to be important for the pathogenesis of asthma. These substances contribute both to the initiation and perpetuation of the disease. In particular, it has been shown that allergic asthma is associated with increased TH2 (IL-4, IL-5, IL-13) cytokine production that causes activation of eosinophils and T-cells and production of chemokines (e.g. eotaxin) by pulmonary fibroblasts. Based on recent advances in our understanding of the immunopathogenesis of asthma in animal models several novel therapeutic approaches have been developed. Such approaches comprise treatment with recombinant anti-inflammatory cytokines, treatment with TH1-inducing cytokines such as IL-12, induction of oral tolerance and TGF-beta producing T-cells that can provide bystander suppression for TH2 cells, inhibitors of IgE, and antagonists of proinflammatory cytokines (e.g. IL-4 and IL-5) and their receptors. These novel treatment modalities will hopefully permit a more selective and effective suppression of pulmonary inflammation and bronchoconstriction in patients with allergic asthma compared to local treatment with corticosteroids. However, the clinical value of these novel therapeutic approaches remains to be determined. In particular, long term efficacy and safety of immunomodulatory therapy has to be studied more in detail.
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Affiliation(s)
- S Finotto
- Labor Immunologie I, I. Medizinische Klinik der Johannes Gutenberg Universität Mainz.
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Atreya R, Mudter J, Finotto S, Müllberg J, Jostock T, Wirtz S, Schütz M, Bartsch B, Holtmann M, Becker C, Strand D, Czaja J, Schlaak JF, Lehr HA, Autschbach F, Schürmann G, Nishimoto N, Yoshizaki K, Ito H, Kishimoto T, Galle PR, Rose-John S, Neurath MF. Blockade of interleukin 6 trans signaling suppresses T-cell resistance against apoptosis in chronic intestinal inflammation: evidence in crohn disease and experimental colitis in vivo. Nat Med 2000; 6:583-8. [PMID: 10802717 DOI: 10.1038/75068] [Citation(s) in RCA: 981] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The pro-inflammatory cytokine interleukin (IL)-6 (refs. 1-5) can bind to cells lacking the IL-6 receptor (IL-6R) when it forms a complex with the soluble IL-6R (sIL-6R) (trans signaling). Here, we have assessed the contribution of this system to the increased resistance of mucosal T cells against apoptosis in Crohn disease (CD), a chronic inflammatory disease of the gastrointestinal tract. A neutralizing antibody against IL-6R suppressed established experimental colitis in various animal models of CD mediated by type 1 T-helper cells, by inducing apoptosis of lamina propria T cells. Similarly, specific neutralization of sIL-6R in vivo by a newly designed gp130-Fc fusion protein caused suppression of colitis activity and induction of apoptosis, indicating that sIL-6R prevents mucosal T-cell apoptosis. In patients with CD, mucosal T cells showed strong evidence for IL-6 trans signaling, with activation of signal transducer and activator of transcription 3, bcl-2 and bcl-xl. Blockade of IL-6 trans signaling caused T-cell apoptosis, indicating that the IL-6-sIL-6R system mediates the resistance of T cells to apoptosis in CD. These data indicate that a pathway of T-cell activation driven by IL-6-sIL-6R contributes to the perpetuation of chronic intestinal inflammation. Specific targeting of this pathway may be a promising new approach for the treatment of CD.
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Affiliation(s)
- R Atreya
- Lab. of Immunology and Section Pathophysiology, I. Medical Clinic, University of Mainz, 55131 Mainz, Germany
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Hildner K, Finotto S, Becker C, Schlaak J, Schirmacher P, Galle PR, Märker-Hermann E, Neurath MF. Tumour necrosis factor (TNF) production by T cell receptor-primed T lymphocytes is a target for low dose methotrexate in rheumatoid arthritis. Clin Exp Immunol 1999; 118:137-46. [PMID: 10540171 PMCID: PMC1905404 DOI: 10.1046/j.1365-2249.1999.01022.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [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] [Accepted: 06/22/1999] [Indexed: 11/20/2022] Open
Abstract
Methotrexate (MTX) is an effective immunosuppressive agent in various chronic inflammatory diseases such as rheumatoid arthritis (RA). However, its mechanisms of action are only partially understood. In this study, we assessed the effects of MTX on the differentiation of peripheral blood (PB) CD4+CD45RA 'naive' and CD4+CD45RO 'memory' T cells from healthy controls and patients with RA. Accordingly, purified T cells were primed and restimulated in vitro via the T cell receptor (TCR) in the presence of IL-2 to generate effector T cells secreting large amounts of Th1 and Th2 cytokines. We observed that low doses of MTX strongly suppress TNF and to a lesser extent interferon-gamma (IFN-gamma) production by T cells from both healthy donors and RA patients when present during T cell priming via the TCR. Similar data were obtained for TCR-primed synovial fluid mononuclear cells in RA. In contrast, production of IL-4 by TCR-primed CD45RA T cells was significantly increased upon MTX treatment. Interestingly, MTX did not enhance IL-4 production when present during restimulation of effector CD45RO T cells, although it still suppressed TNF production. The results indicate that MTX effects depend on the stage of T cell activation and identify TNF production by TCR-primed T lymphocytes as a target for low-dose MTX treatment in RA. These findings could explain the delayed clinical effects of MTX and may contribute to its potent anti-inflammatory and immunoregulatory properties.
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Affiliation(s)
- K Hildner
- Laboratory of Immunology, I. Medical Clinic, University of Mainz, Mainz, Germany
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