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Jantuan E, Chiu B, Chiu B, Shen F, Oudit GY, Sergi C. The tumor microenvironment may trigger lymphoproliferation in cardiac myxoma. Transl Oncol 2020; 14:100911. [PMID: 33129111 PMCID: PMC7586245 DOI: 10.1016/j.tranon.2020.100911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Lymphoproliferative disorders (LPD) in cardiac myxomas (CM) has been occasionally reported, and chronic inflammation in response to viral infection may be the key. CM can upregulate autophagy, creating a favorable environment for Epstein Barr Virus (EBV)-driven oncogenesis. P62 accumulates when autophagy is inhibited, and aberrant excessive p62 may result from autophagy defect, causing oxidative stress and tumorigenesis. NanoString technology is a relatively new method for capturing tumor-immune signaling in tissues exploring how the signaling axis is associated with inflammation.
Cardiac myxomas (CM) and primary cardiac lymphoproliferative disorders (LPD) are rare primary cardiac neoplasms. The composite occurrence of LPD in CM has been occasionally reported, and chronic inflammation in response to viral infection has been suggested to be at the basis of oncogenesis. Cancers can upregulate autophagy to endure microenvironmental stress and to increase local growth and aggressiveness. CM exhibit a dichotomous separation in low and high inflammatory grades (LIG vs. HIG). We studied 23 CMs using autophagy-related proteins and NanoString technology for gene expression. Autophagy-related proteins (Beclin-1, LAMP-1, LC3, and p62) were demonstrated in both tumor and stromal cells. ATG genes showed a progression of involvement in CM using an 8-gene signature. They were associated with Epstein-Barr virus (EBV) encoded latent membrane protein 1 (EBV LMP1) activation. We suggest that CM can upregulate autophagy, creating a favorable environment for EBV-driven oncogenesis. To the best of our knowledge, the present study is the first to report on the TME using the expression of autophagy-related genes and proteins in CM. The microenvironment of CM is dynamic, with a variety of cell types and different molecular pathways at play, and this study may clearly warrant further investigation.
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Affiliation(s)
- Eugeniu Jantuan
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Brian Chiu
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Bonnie Chiu
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Fan Shen
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada
| | - Gavin Y Oudit
- Department of Medicine, Division of Cardiology, Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Consolato Sergi
- Department of Laboratory Medicine and Pathology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; National "111″ Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering, Hubei University of Technology, Wuhan, Hubei, China; Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, China.
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Heart myxoma develops oncogenic and metastatic phenotype. J Cancer Res Clin Oncol 2019; 145:1283-1295. [PMID: 30900156 DOI: 10.1007/s00432-019-02897-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Heart myxomas have been frequently considered as benign lesions associated with Carney's complex. However, after surgical removal, myxomas re-emerge causing dysfunctional heart. METHODS To identify whether cardiac myxomas may develop a metastatic phenotype as occurs in malignant cancers, a profile of several proteins involved in malignancy such as oncogenes (c-MYC, K-RAS and H-RAS), cancer-associated metabolic transcriptional factors (HIF-1α, p53 and PPAR-γ) and epithelial-mesenchymal transition proteins (fibronectin, vimentin, β-catenin, SNAIL and MMP-9) were evaluated in seven samples from a cohort of patients with atrial and ventricular myxomas. The analysis was also performed in: (1) cardiac tissue surrounding the area where myxoma was removed; (2) non-cancer heart tissue (NCHT); and (3) malignant triple negative breast cancer biopsies for comparative purposes. RESULTS Statistical analysis applying univariate (Kruskal-Wallis and Dunn's tests) and multivariate analyses (PCA, principal component analysis) revealed that heart myxomas (7-15 times) and myxoma surrounding tissue (22-99 times) vs. NCHT showed high content of c-MYC, p53, vimentin, and HIF-1α, indicating that both myxoma and its surrounding area express oncogenes and malignancy-related proteins as occurs in triple negative breast cancer. CONCLUSIONS Based on ROC (receiver operating characteristics) statistical analysis, c-MYC, HIF-1α, p53, and vimentin may be considered potential biomarkers for malignancy detection in myxoma.
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Anvari MS, Sabagh M, Goodarzynejad H, Ziaei S, Boroumand MA, Pourgholi L, Jenab Y, Abbasi K. Association between herpes simplex virus Types 1 and 2 with cardiac myxoma. Cardiovasc Pathol 2017; 27:31-34. [PMID: 28081512 DOI: 10.1016/j.carpath.2016.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/23/2016] [Accepted: 12/29/2016] [Indexed: 11/15/2022] Open
Abstract
Most cases of atrial myxoma are sporadic, and the exact etiology is unknown. We examined if herpes simplex virus (HSV)-1 and HSV-2 antigens and/or DNA could be detected in a cohort of Iranian patients with cardiac myxomas. From July 2004 to June 2014, among a total of 36,703 patients undergoing open heart surgeries, consecutive patients with cardiac myxoma who were treated by surgical excision at our center included in this study. Of 73 patients studied, 56% were female with a mean age of 54 years (ranging from 23 to 77 years). Seventy-four myxomas were surgically removed from 73 patients, since one patient had two myxomas which were located on both the right atrium and right ventricle. The materials for this analysis were retrospectively gathered from extracted tumors that stored in a pathology bank of tissue paraffin blocks. The formalin fixed paraffin embedded tissue samples were investigated for HSV genomic DNA by both immunohistochemistry (IHC) and polymerase chain reaction (PCR) analysis. In all 74 cases there was no presence of HSV 1 and HSV 2 infection. This suggests that HSV may not play a role in sporadic cardiac myxomas; however, evidence for such association is currently lacking, and further studies are required to determine such a role.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran..
| | - Moud Sabagh
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Goodarzynejad
- Department of Clinical and Experimental Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Ziaei
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Boroumand
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leyla Pourgholi
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kyomars Abbasi
- Department of cardiac surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Di Vito A, Mignogna C, Donato G. The mysterious pathways of cardiac myxomas: a review of histogenesis, pathogenesis and pathology. Histopathology 2014; 66:321-32. [DOI: 10.1111/his.12531] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Anna Di Vito
- Department of Clinical and Experimental Medicine; University of Catanzaro ‘Magna Graecia Medical School; Catanzaro Italy
| | - Chiara Mignogna
- Department of Health Science, Pathology Unit; University of Catanzaro ‘Magna Graecia Medical School; Catanzaro Italy
| | - Giuseppe Donato
- Department of Health Science, Pathology Unit; University of Catanzaro ‘Magna Graecia Medical School; Catanzaro Italy
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Hardt AL, Schildgen V, Tillmann RL, Brockmann M, Schildgen O. Utility of the QIAGEN/ artus PCR assays and Meningofinder™ for the detection of human herpes virus genomes in formalin-fixed paraffin-embedded clinical samples. Future Virol 2014. [DOI: 10.2217/fvl.14.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT: Aim: The aim of the study was to analyze whether human herpes viruses can be detected from formalin-fixed paraffin-embedded (FFPE) tissues with two commercial methods. Materials & methods: In total, 91 clinical FFPE samples were analyzed with QIAGEN/artus (Hilden, Germany) qPCRs and the Meningofinder™ assay from PathoFinder (Maastricht, The Netherlands). Results: A total of 27 out of 91 samples were tested for HSV-1 and HSV-2. Three of these 27 samples (11.1%) were positive for HSV-1 and one sample was positive for HSV-2. Out of 91 samples, 50 were tested for CMV, of which six samples were positive (12%). In total, 12 out of 91 samples were tested for the presence of Varizella zoster virus DNA, revealing one as positive (8%). Finally, two samples were tested negative for EBV. Conclusion: Minor differences were identified between both assays, making them a reliable tool for detection of herpes viruses from FFPE material, although this is an off-label use for both assays.
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Affiliation(s)
- Anna-Lena Hardt
- Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, D-51109 Cologne, Germany
| | - Verena Schildgen
- Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, D-51109 Cologne, Germany
| | - Ramona-Liza Tillmann
- Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, D-51109 Cologne, Germany
| | - Michael Brockmann
- Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, D-51109 Cologne, Germany
| | - Oliver Schildgen
- Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Institut für Pathologie, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, D-51109 Cologne, Germany
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Duarte MD, Barros SC, Henriques AM, Fagulha MT, Ramos F, Luís T, Fevereiro M. Development and validation of a real time PCR for the detection of myxoma virus based on the diploid gene M000.5L/R. J Virol Methods 2013; 196:219-24. [PMID: 24300832 DOI: 10.1016/j.jviromet.2013.11.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/18/2013] [Accepted: 11/22/2013] [Indexed: 11/30/2022]
Abstract
The myxoma virus (MYXV) causes severe infections in European rabbits that may reach mortality rates up to 100% depending on the viral strain. The typical symptoms and lesions induced by the virus are usually enough to permit the correct clinical diagnosis. However, in peracute forms the infection may be accompanied by unspecific symptoms. Sudden death may also occur without evident clinical signs of myxomatosis. Likewise, a clinical diagnosis of atypical forms of myxomatosis (amyxomatous) is often complicated and delayed due to the scarceness of skin lesions. As the disease control often depends on an early and unequivocal diagnosis of MYXV, laboratorial methods play a relevant role in the confirmation of MYXV infection. This study describes the development and validation of a novel, high accurate real time polymerase chain reaction assay (rtPCR) for the detection of MYXV. Primers were designed to amplify a 125-bp within the gene M000.5L/R, which is duplicated in the termini of the genome and is unique among Leporipoxvirus. The assay was negative for SFV and other poxviruses and was able to detect 2.6 copies of MYXV DNA proving the effectiveness, specificity and sensitivity of this diagnosis tool. The rtPCR has been applied successfully in INIAV laboratory for routine diagnosis of myxomatosis since 2005.
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Affiliation(s)
- Margarida Dias Duarte
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Sílvia Carla Barros
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Ana Margarida Henriques
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Maria Teresa Fagulha
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Fernanda Ramos
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Tiago Luís
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
| | - Miguel Fevereiro
- Instituto Nacional de Investigação Agrária e Veterinária, Laboratory of Virology, Rua General Morais Sarmento, 1459-011 Lisboa, Portugal.
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Marina K, Vasiliki KE, George S, Vasiliki V, Androniki T, Abraham G, Loukas K, Andreas K, Alkiviadis M. Recurrent cardiac myxoma in a 25 year old male: a DNA study. World J Surg Oncol 2013; 11:95. [PMID: 23618320 PMCID: PMC3654903 DOI: 10.1186/1477-7819-11-95] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 03/25/2013] [Indexed: 11/10/2022] Open
Abstract
We present a 25 year old Caucasian male patient with multiple recurrences of cardiac myxomas after surgical removal of the original tumor. His mother was operated on for right ventricular myxoma. The genetic analyses disclosed an aneuploid DNA content by flow cytometry analysis. The familial form of the cardiac myxomas must be distinguished from Carney complex syndrome. A long- term echocardiographic follow up is recommended to patients and their first degree relatives with cardiac myxomas.
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Affiliation(s)
- Kontogiorgi Marina
- Critical Care Department, Onasis Cardiac Surgery Center Hospital, Athens, Greece.
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