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Mihalik N, Hidvégi B, Hársing J, Várkonyi J, Csomor J, Kovalszky I, Marschalkó M, Kárpáti S. Clinical observations in cutan mastocytosis. Orv Hetil 2013; 154:1469-75. [DOI: 10.1556/oh.2013.29702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Mastocytosis is a clonal mast cell proliferative disease, devided into cutaneous and systemic forms. The characteristic symptoms are caused by neoplastic mast cell infiltrations in different organs and/or the release of mediators. Aim: The aim of the authors was to summarize their clinical observations in patients with mastocytosis. Method: 22 adult patients diagnosed consecutively with mastocytosis were enrolled in the study. Skin and bone marrow biopsies were taken to establish the diagnosis and perform c-KIT mutation (D816V) analysis. Results: One of the 22 patients had teleangiectasia macularis eruptiva perstans, while 20/22 patients had urticaria pigmentosa. All patients had cutaneous lesions. In 12 patients iliac crest biopsy was performed and 9 of them had bone marrow involvement, classified as indolent systemic mastocytosis. The c-kit mutation D816V was found in one subject both in skin and bone marrow samples. The patients were treated with antihistamine, PUVA, interferon-α or imatinib. Conclusions: The authors draw attention to this rare disease in order to help recognition of relevant signs and symptoms and establish an early diagnosis. Orv. Hetil., 2013, 154, 1469–1475.
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Affiliation(s)
- Noémi Mihalik
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Bernadett Hidvégi
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Judit Hársing
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Judit Várkonyi
- Semmelweis Egyetem, Általános Orvostudományi Kar III. Belgyógyászati Klinika Budapest
| | - Judit Csomor
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Patológiai és Kísérleti Rákkutató Intézet Budapest
| | - Ilona Kovalszky
- Semmelweis Egyetem, Általános Orvostudományi Kar I. Patológiai és Kísérleti Rákkutató Intézet Budapest
| | - Márta Marschalkó
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
| | - Sarolta Kárpáti
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest Mária u. 41. 1085
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Furumoto Y, Charles N, Olivera A, Leung WH, Dillahunt S, Sargent JL, Tinsley K, Odom S, Scott E, Wilson TM, Ghoreschi K, Kneilling M, Chen M, Lee DM, Bolland S, Rivera J. PTEN deficiency in mast cells causes a mastocytosis-like proliferative disease that heightens allergic responses and vascular permeability. Blood 2011; 118:5466-75. [PMID: 21926349 DOI: 10.1182/blood-2010-09-309955] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Kit regulation of mast cell proliferation and differentiation has been intimately linked to the activation of phosphatidylinositol 3-OH kinase (PI3K). The activating D816V mutation of Kit, seen in the majority of mastocytosis patients, causes a robust activation of PI3K signals. However, whether increased PI3K signaling in mast cells is a key element for their in vivo hyperplasia remains unknown. Here we report that dysregulation of PI3K signaling in mice by deletion of the phosphatase and tensin homolog (Pten) gene (which regulates the levels of the PI3K product, phosphatidylinositol 3,4,5-trisphosphate) caused mast cell hyperplasia and increased numbers in various organs. Selective deletion of Pten in the mast cell compartment revealed that the hyperplasia was intrinsic to the mast cell. Enhanced STAT5 phosphorylation and increased expression of survival factors, such as Bcl-XL, were observed in PTEN-deficient mast cells, and these were further enhanced by stem cell factor stimulation. Mice carrying PTEN-deficient mast cells also showed increased hypersensitivity as well as increased vascular permeability. Thus, Pten deletion in the mast cell compartment results in a mast cell proliferative phenotype in mice, demonstrating that dysregulation of PI3K signals is vital to the observed mast cell hyperplasia.
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Lanternier F, Cohen-Akenine A, Palmerini F, Feger F, Yang Y, Zermati Y, Barète S, Sans B, Baude C, Ghez D, Suarez F, Delarue R, Casassus P, Bodemer C, Catteau A, Soppelsa F, Hanssens K, Arock M, Sobol H, Fraitag S, Canioni D, Moussy A, Launay JM, Dubreuil P, Hermine O, Lortholary O. Phenotypic and genotypic characteristics of mastocytosis according to the age of onset. PLoS One 2008; 3:e1906. [PMID: 18404201 PMCID: PMC2292130 DOI: 10.1371/journal.pone.0001906] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Accepted: 02/14/2008] [Indexed: 01/08/2023] Open
Abstract
Adult's mastocytosis is usually associated with persistent systemic involvement and c-kit 816 mutation, while pediatrics disease is mostly limited to the skin and often resolves spontaneously. We prospectively included 142 adult patients with histologically proven mastocytosis. We compared phenotypic and genotypic features of adults patients whose disease started during childhood (Group 1, n = 28) with those of patients whose disease started at adult's age (Group 2, n = 114). Genotypic analysis was performed on skin biopsy by sequencing of c-kit exons 17 and 8 to 13. According to WHO classification, the percentage of systemic disease was similar (75 vs. 73%) in 2 groups. C-kit 816 mutation was found in 42% and 77% of patients in groups 1 and 2, respectively (p<0.001). 816 c-kit mutation was associated with systemic mastocytosis in group 2 (87% of patients with systemic mastocytosis vs. 45% with cutaneous mastocytosis, p = 0.0001). Other c-kit activating mutations were found in 23% of patients with mastocytosis' onset before the age of 5, 0% between 6 and 15 years and 2% at adults' age (p<0.001). In conclusion, pathogenesis of mastocytosis significantly differs according to the age of disease's onset. Our data may have major therapeutic relevance when considering c-kit-targeted therapy.
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Affiliation(s)
- Fanny Lanternier
- Université Paris V, Service de maladies infectieuses et tropicales, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | | | - Fabienne Palmerini
- Inserm: Centre de Recherches en Cancérologie de Marseille, Hématopoïèse Moléculaire et Fonctionnelle, U599, Marseille, France
- Institut Paoli-Calmettes, Département de Biopathologie, Marseille, France
- Université Méditerranée, Marseille, France
| | - Frédéric Feger
- Laboratoire de Biotechnologies et de Pharmacologie génétique Appliquée CNRS UMR8113 Ecole Normale Supérieure de Cachan, Cachan, France
| | - Ying Yang
- Inserm: Centre de Recherches en Cancérologie de Marseille, Hématopoïèse Moléculaire et Fonctionnelle, U599, Marseille, France
- Institut Paoli-Calmettes, Département de Biopathologie, Marseille, France
- Université Méditerranée, Marseille, France
| | - Yael Zermati
- Service de Biochimie, Hôpital Lariboisière, Paris, France
| | - Stéphane Barète
- Service de dermatologie, centre de référence des mastocytoses, Hôpital Tenon, Paris, France
| | - Beatrix Sans
- Service de dermatologie, Hôpital Purpan, Toulouse, France
| | | | - David Ghez
- Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Université Paris V, IFR Necker, Paris, France
| | - Felipe Suarez
- Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Université Paris V, IFR Necker, Paris, France
| | - Richard Delarue
- Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Université Paris V, IFR Necker, Paris, France
| | | | - Christine Bodemer
- Service de dermatologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Université Paris V, IFR Necker, Paris, France
| | | | | | | | - Michel Arock
- Laboratoire de Biotechnologies et de Pharmacologie génétique Appliquée CNRS UMR8113 Ecole Normale Supérieure de Cachan, Cachan, France
| | - Hagay Sobol
- Institut Paoli-Calmettes, Département de Biopathologie, Marseille, France
| | - Sylvie Fraitag
- Service d'anatomopathologie, Hôpital Necker Enfants malades, Paris, France
| | - Danièle Canioni
- Service d'anatomopathologie, Hôpital Necker Enfants malades, Paris, France
| | | | | | - Patrice Dubreuil
- Inserm: Centre de Recherches en Cancérologie de Marseille, Hématopoïèse Moléculaire et Fonctionnelle, U599, Marseille, France
- Institut Paoli-Calmettes, Département de Biopathologie, Marseille, France
- Université Méditerranée, Marseille, France
| | - Olivier Hermine
- Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Université Paris V, IFR Necker, Paris, France
- CNRS UMR 8147, Paris, France
- * E-mail: (OH); (OL)
| | - Olivier Lortholary
- Université Paris V, Service de maladies infectieuses et tropicales, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Centre d'Infectiologie Necker-Pasteur, Paris, France
- * E-mail: (OH); (OL)
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Verzijl A, Heide R, Oranje AP, van Schaik RHN. C-kit Asp-816-Val mutation analysis in patients with mastocytosis. Dermatology 2007; 214:15-20. [PMID: 17191042 DOI: 10.1159/000096907] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 04/28/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mastocytosis is a heterogeneous group of disorders characterized by abnormal accumulation of mast cells. OBJECTIVE Skin biopsies from 24 patients (23 with proven mastocytosis) were screened for the presence of the c-kit Asp-816-Val mutation. METHODS In frozen biopsies, RNA was isolated, cDNA synthesis and PCR, the expected PCR product of 346 bp was obtained from 23 patients. RESULTS In patients with urticaria pigmentosa, the mutation was detected in 38% of the adults and 25% of the children. With regard to the clinical presentation of the disease, no difference was found between adult patients with and without the mutation, as detected with our assay. One out of the 2 children with the mutation had an atypical presentation of the disease. CONCLUSION the mutation could not be detected in all the patients, probably due to lack of sensitivity of the methods.
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Affiliation(s)
- A Verzijl
- Department of Dermato-Venereology, Erasmus MC, Rotterdam, The Netherlands
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Abstract
PURPOSE OF REVIEW Mast cell disease is markedly heterogeneous in its underlying molecular pathogenesis, clinical presentation, natural history, and specific treatment. Skin-only disease (cutaneous mastocytosis) is infrequent in adults and systemic mastocytosis may be broadly classified as an indolent or aggressive variant based on the absence or presence of impaired organ function. Urticaria pigmentosa and mast cell mediator release symptoms can occur in all categories of mast cell disease and may not be prognostically detrimental. The purpose of this review is to summarize current concepts and recent advances in the pathogenesis and treatment of adult mast cell disease. RECENT FINDINGS A series of laboratory investigations has revealed that mast cell disease is a clonal stem cell disorder, and at least two genes (c-kit and PDGFRA) with pathogenetically relevant mutations have been identified. FIP1L1-PDGFRA+ mast cell disease responds completely to imatinib mesylate. Both Asp816Val c-kit+ and molecularly undefined cases have been shown to respond to 2-chlorodeoxyadenosine therapy after failing treatment with interferon-alpha. SUMMARY A partial molecular classification of mast cell disease is now possible; Asp816Val c-kit+, FIP1L1-PDGFRA+, and molecularly undefined cases. Such molecular classification is therapeutically relevant.
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Affiliation(s)
- Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA.
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