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Bevacizumab regulates inflammatory cytokines and inhibits VEGFR2 signaling pathway in an ovalbumin-induced rat model of airway hypersensitivity. Inflammopharmacology 2021; 29:683-694. [PMID: 33742375 DOI: 10.1007/s10787-021-00798-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/06/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bevacizumab with anti-angiogenesis properties reduces the vascular endothelial growth factor (VEGF) level and has widely been used to treat various diseases such as lung diseases and chronic obstructive pulmonary disease (COPD). This study, therefore, aimed to consider the effects of bevacizumab on VEGF receptor 2 (VEGFR2) and lung inflammation of the ovalbumin-induced rat model of airway hypersensitivity. MATERIALS AND METHODS Twenty-one male Wistar rats were randomly divided into 3 groups (n = 7 in each group): (1) control, (2) ovalbumin (OVA)-sensitized, and (3) OVA-sensitized with bevacizumab (OVA + Bmab). Groups 2 and 3 were sensitized with ovalbumin (OVA) and aluminum hydroxide on days 1, 8 and challenged with OVA on day 15 by atomization for 10 days (inhalation). After OVA sensitization, the OVA + Bmab was treated with bevacizumab for 2 weeks. VEGFR2 was semiquantitatively analyzed in the lungs by immunohistochemistry. VEGF was measured in the lung tissue by ELISA method. The mRNA of IL-10 and IL-6 lung tissue were measured by real-time PCR. RESULTS Ovalbumin exposure promoted the expression of VEGF and resulted in inflammatory factors overexpression (p ≤ 0.05). However, rats in OVA + Bmab group showed significantly a decrease in VEGFR2 and IL-1β, IL-6, TNFα, and an increase in IL-10 (p ≤ 0.05). CONCLUSION The results show that bevacizumab efficiently diminishes bronchial inflammation via reducing the expression of VEGFR2, and IL-6 genes and enhancing the expression of IL-10 gene. Hence, bevacizumab could be considered as a potential candidate drug to control pathological conditions relevant to airway hypersensitivity.
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Drug-Related Pneumonitis in Cancer Treatment during the COVID-19 Era. Cancers (Basel) 2021; 13:cancers13051052. [PMID: 33801385 PMCID: PMC7958630 DOI: 10.3390/cancers13051052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/24/2021] [Indexed: 12/17/2022] Open
Abstract
Interstitial lung disease is recognized as a group of diseases with a different etiopathogenesis characterized by chronic lung inflammation with the accumulation of inflammatory cells, lymphocytes and macrophages, and the consequent release of proinflammatory cytokines. Various degrees of pulmonary fibrosis can be associated with this inflammatory condition. Interstitial lung disease related to oncological drugs is a relevant problem in clinical practice. The etiopathogenetic mechanisms underlying this adverse event are not completely known but can be partly explained by the mechanism of action of the drug involved. Therefore, knowledge of the relevance of this potentially fatal adverse event supported by the reported safety data of pivotal studies becomes fundamental in the management of patients. The prompt diagnosis of drug-related pneumonia and the consequent differential diagnosis with other forms of pneumonia allow a rapid suspension of treatment and the establishment of an immunosuppressive treatment if necessary. In the context of the health emergency related to SARS CoV2 infection and COVID-19-related interstitial lung disease, such knowledge holds decisive relevance in the conscious choice of cancer treatments. Our intent was to describe the oncological drugs most correlated with this adverse event by reporting, where possible, the percentages of insurgency in pivotal studies to provide an overview and therefore promote greater awareness of this important toxicity related to oncological treatment.
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Davidson KR, Ha DM, Schwarz MI, Chan ED. Bronchoalveolar lavage as a diagnostic procedure: a review of known cellular and molecular findings in various lung diseases. J Thorac Dis 2020; 12:4991-5019. [PMID: 33145073 PMCID: PMC7578496 DOI: 10.21037/jtd-20-651] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Bronchoalveolar lavage (BAL) is a commonly used procedure in the evaluation of lung disease as it allows for sampling of the lower respiratory tract. In many circumstances, BAL differential cell counts have been reported to be typical of specific lung disorders. In addition, more specific diagnostic tests including molecular assays such as polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay, special cytopathologic stains, or particular microscopic findings have been described as part of BAL fluid analysis. This review focuses on common cellular and molecular findings of BAL in a wide range of lung diseases. Since the performance of the first lung irrigation in 1927, BAL has become a common and important diagnostic tool. While some pulmonary disorders have a highly characteristic signature of BAL findings, BAL results alone often lack specificity and require interpretation along with other clinical and radiographic details. Development of new diagnostic assays is certain to reinforce the utility of BAL in the future. Our review of the BAL literature is intended to serve as a resource to assist clinicians in the care of patients with lung disorders.
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Affiliation(s)
- Kevin R Davidson
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Duc M Ha
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Marvin I Schwarz
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Edward D Chan
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,National Jewish Health, Denver, Colorado, USA
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Distefano G, Fanzone L, Palermo M, Tiralongo F, Cosentino S, Inì C, Galioto F, Vancheri A, Torrisi SE, Mauro LA, Foti PV, Vancheri C, Palmucci S, Basile A. HRCT Patterns of Drug-Induced Interstitial Lung Diseases: A Review. Diagnostics (Basel) 2020; 10:diagnostics10040244. [PMID: 32331402 PMCID: PMC7236658 DOI: 10.3390/diagnostics10040244] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022] Open
Abstract
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Through the PubMed database, an extensive search was performed in the fields of drug toxicity and interstitial lung disease. We have evaluated the different classes of drugs associated with pulmonary toxicity. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). Finally, from the electronic database of our Institute we have selected and commented on some cases of drug-induced lung diseases related to the administration of common drugs. As the imaging patterns are rarely specific, an accurate evaluation of the clinical history is required and a multidisciplinary approach—involving pneumologists, cardiologists, radiologists, pathologists, and rheumatologists—is recommended.
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Affiliation(s)
- Giulio Distefano
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
- Correspondence: ; Tel.: +39-338-5020-778
| | - Luigi Fanzone
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Monica Palermo
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Francesco Tiralongo
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Salvatore Cosentino
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Corrado Inì
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Federica Galioto
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Ada Vancheri
- Department of Clinical and Experimental Medicine, University of Catania, Regional Referral Centre for Rare Lung Disease, 95123 Catania, Italy; (A.V.); (S.E.T.)
| | - Sebastiano E. Torrisi
- Department of Clinical and Experimental Medicine, University of Catania, Regional Referral Centre for Rare Lung Disease, 95123 Catania, Italy; (A.V.); (S.E.T.)
| | - Letizia A. Mauro
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Pietro V. Foti
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Carlo Vancheri
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Stefano Palmucci
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
| | - Antonio Basile
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”-University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy; (L.F.); (M.P.); (F.T.); (S.C.); (C.I.); (F.G.); (L.A.M.); (P.V.F.); (C.V.); (S.P.); (A.B.)
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Koyama N, Katayanagi S, Kawachi S. Pre-existing interstitial lung disease as a risk factor for pneumonitis associated with ramucirumab and paclitaxel in patients with gastric cancer: The impact of usual interstitial pneumonia. PLoS One 2018; 13:e0198886. [PMID: 29879213 PMCID: PMC5991747 DOI: 10.1371/journal.pone.0198886] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 05/25/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Combination treatment with ramucirumab and paclitaxel shows significant efficacy in patients with advanced gastric cancer as a second-line standard therapy. However, limited information is available about the development of pneumonitis associated with this treatment in clinical practice. This study aimed to characterize this form of pneumonitis and identify the risk factors for its onset. METHODS We retrospectively analyzed the medical records of 44 patients with gastric cancer who received combination treatment with ramucirumab and paclitaxel from 2016 to 2017. Then, the clinicopathological characteristics of patients who developed treatment-related pneumonitis were evaluated and further compared with those of patients who did not. RESULTS Six patients (13.6%) developed pneumonitis within five treatment cycles, and in five cases, remission was observed after cessation of combination treatment alone. The onset of pneumonitis was independently associated with pre-existing interstitial lung disease (ILD) (p = 0.025; odds ratio = 206.4). Patients with pneumonitis showed reduced time to treatment failure (median 56 vs. 138 days; p = 0.008), as compared with those without pneumonitis. Most patients with pre-existing ILD with a usual interstitial pneumonia (UIP) pattern developed pneumonitis. CONCLUSIONS In clinical practice, pneumonitis associated with the combination treatment of ramucirumab and paclitaxel was generally mild, but common. Patients with gastric cancer with pre-existing ILD, particularly those presenting with a UIP pattern, undergoing this combination treatment, should be carefully monitored for the development of treatment-related pneumonitis.
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Affiliation(s)
- Nobuyuki Koyama
- Department of Clinical Oncology, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, Japan
| | - Sou Katayanagi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, Japan
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Xu P, Li H. [Application of Bevacizumab in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2017; 20:272-277. [PMID: 28442017 PMCID: PMC5999671 DOI: 10.3779/j.issn.1009-3419.2017.04.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
At present, non-small cell lung cancer is one of the highest incidence of cancers in the world, and its incidence increased year by year, this situation prompted people to continue to seek a variety of treatment in order to extend the survival of patients and improve the quality of life of patients. This review aims to discuss the progress of bevacizumab in the treatment of non-small cell lung cancer, through the clinical data so far to explore the clinical use of the drug, the choice of patients and the future direction of development.
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Affiliation(s)
- Ping Xu
- Department of Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Hongmei Li
- Department of Oncology, Affiliated Hospital of Qingdao University, Qingdao 266000, China
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Sekimoto Y, Kato M, Shukuya T, Koyama R, Nagaoka T, Takahashi K. Bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in non-small cell lung cancer. Respirol Case Rep 2016; 4:e00151. [PMID: 27081491 PMCID: PMC4818583 DOI: 10.1002/rcr2.151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/16/2016] [Accepted: 01/23/2016] [Indexed: 01/07/2023] Open
Abstract
Bevacizumab is a monoclonal antibody targeting the vascular endothelial growth factor receptor and a key drug for advanced non-small cell lung cancer. There are few reports describing bevacizumab-induced chronic interstitial pneumonia. A 62-year-old man with advanced non-small cell lung cancer was admitted to our hospital with dyspnea. He previously received four courses of carboplatin plus paclitaxel with bevacizumab combination therapy and thereafter received four courses of maintenance bevacizumab monotherapy. A chest-computed tomography scan on admission revealed diffuse ground glass opacity. He had not received any other drugs and did not have pneumonia. Thus, he was diagnosed with bevacizumab-induced chronic interstitial pneumonia and was treated with a high dose of corticosteroids. After steroid treatment, his dyspnea and radiological findings improved. This case report is the first description of bevacizumab-induced chronic interstitial pneumonia during maintenance therapy in a patient with non-small cell lung cancer.
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Affiliation(s)
- Yasuhito Sekimoto
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Motoyasu Kato
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Takehiko Shukuya
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Ryo Koyama
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Tetsutaro Nagaoka
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Kazuhisa Takahashi
- Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
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