1
|
Zucco J, Baldan F, Allegri L, Bregant E, Passon N, Franzoni A, D'Elia AV, Faletra F, Damante G, Mio C. A bird's eye view on the use of whole exome sequencing in rare congenital ophthalmic diseases. J Hum Genet 2024:10.1038/s10038-024-01237-6. [PMID: 38459225 DOI: 10.1038/s10038-024-01237-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 03/10/2024]
Abstract
Phenotypic and genotypic heterogeneity in congenital ocular diseases, especially in anterior segment dysgenesis (ASD), have created challenges for proper diagnosis and classification of diseases. Over the last decade, genomic research has indeed boosted our understanding in the molecular basis of ASD and genes associated with both autosomal dominant and recessive patterns of inheritance have been described with a wide range of expressivity. Here we describe the molecular characterization of a cohort of 162 patients displaying isolated or syndromic congenital ocular dysgenesis. Samples were analyzed with diverse techniques, such as direct sequencing, multiplex ligation-dependent probe amplification, and whole exome sequencing (WES), over 20 years. Our data reiterate the notion that PAX6 alterations are primarily associated with ASD, mostly aniridia, since the majority of the cohort (66.7%) has a pathogenic or likely pathogenic variant in the PAX6 locus. Unexpectedly, a high fraction of positive samples (20.3%) displayed deletions involving the 11p13 locus, either partially/totally involving PAX6 coding region or abolishing its critical regulatory region, underlying its significance. Most importantly, the use of WES has allowed us to both assess variants in known ASD genes (i.e., CYP1B1, ITPR1, MAB21L1, PXDN, and PITX2) and to identify rarer phenotypes (i.e., MIDAS, oculogastrointestinal-neurodevelopmental syndrome and Jacobsen syndrome). Our data clearly suggest that WES allows expanding the analytical portfolio of ocular dysgenesis, both isolated and syndromic, and that is pivotal for the differential diagnosis of those conditions in which there may be phenotypic overlaps and in general in ASD.
Collapse
Affiliation(s)
- Jessica Zucco
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Federica Baldan
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Lorenzo Allegri
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Elisa Bregant
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Nadia Passon
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandra Franzoni
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Angela Valentina D'Elia
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Flavio Faletra
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
| | - Giuseppe Damante
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Catia Mio
- Department of Medicine (DMED), University of Udine, Udine, Italy
| |
Collapse
|
2
|
Galli J, Loi E, Franzoni A, Accorsi P, Micheletti S, Pansera L, Fazzi E. Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero. Neuropediatrics 2023; 54:412-416. [PMID: 37579766 DOI: 10.1055/s-0043-1771388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years. We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile. This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.
Collapse
Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Erika Loi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandra Franzoni
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Patrizia Accorsi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Laura Pansera
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| |
Collapse
|
3
|
Tosoni L, Fabbro D, Pizzano U, Mullai R, Morelli G, Franzoni A, Damante G, Toffoletti E, Damiani D, Fanin R, Tiribelli M. JAK2 V617F-mutated polycythemia vera developing in a patient with a 20-year-long chronic myeloid leukemia at the time of first molecular response. Ann Hematol 2023; 102:1279-1280. [PMID: 36947213 DOI: 10.1007/s00277-023-05187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/18/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Luca Tosoni
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
| | - Dora Fabbro
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Umberto Pizzano
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
| | - Rikard Mullai
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
| | - Gianluca Morelli
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
| | - Alessandra Franzoni
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giuseppe Damante
- Institute of Medical Genetics, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
| | - Eleonora Toffoletti
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
| | - Daniela Damiani
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
| | - Renato Fanin
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy
- Department of Medicine, University of Udine, Udine, Italy
| | - Mario Tiribelli
- Division of Hematology and Bone Marrow Transplantation, Azienda Sanitaria Universitaria Friuli Centrale, P.Le S. M. Misericordia 15, 33100, Udine, Italy.
- Department of Medicine, University of Udine, Udine, Italy.
| |
Collapse
|
4
|
Gerratana L, Roncato R, Sturlese M, Davis AA, Velimirovic M, REDUZZI C, Clifton KK, Hensing WL, Shah AN, Dai CS, D’Amico P, Medford AJ, Franzoni A, Cucciniello L, Wehbe F, Wander SA, Belletti B, Gradishar W, Behdad A, Damante G, Ma C, Puglisi F, Bardia A, Cristofanilli M. Abstract PD10-01: PD10-01 Impact of ESR1 mutations on Selective Estrogen Receptor Degraders and Modulators: an integrated liquid-biopsy and pharmacodynamics approach. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd10-01] [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: 03/06/2023]
Abstract
Abstract
Background: ESR1 hotspot mutations (HS) (i.e. 380, 536, 537, and 538) are important drivers of resistance to aromatase inhibitors, but the differential impact of genomic variants (HS vs non-HS) on response to endocrine therapies (ET) under clinical development, such as novel oral Selective Estrogen Receptor Degraders and Modulators (SERDs and SERMs), is not known. The aim of the study was to evaluate the impact of non-HS ESR1 mutations on the pharmacodynamics of SERDs and SERMs as an additional ET resistance mechanism. Materials and Methods: The study analyzed a multi-institutional cohort of 1008 patients with hormone receptor positive metastatic breast cancer characterized by circulating tumor DNA (ctDNA). Pathway classification was defined based on previous work (i.e. RTK, RAS, RAF, MEK, NRF2, ER, WNT, MYC, p53, Cell Cycle, Notch, PI3K). Single nucleotide variations (SNVs) were annotated through OncoKB; co-occurrence was tested by Fisher’s exact test. A structure-based computational strategy was used to create 3D-models of ESR1 mutants and predict changes in binding affinity (dAff) across approved and experimental drugs. A positive dAff reflects a lower affinity of the drug for mutant ESR1 compared with wild type and thus a potential for a reduced response. Results: Among the total 680 detected ESR1 mutations, 633 were missense, and 631 were gain-of-function. The most frequent mutations were in codon 537 (N=305), followed by 538 (N=224). No significant MAF differences were observed across ESR1 variants (P=0.0829). The L391F mutation resulted in an increased binding affinity for Lasofoxifene (LAS) (dAff -0.34), Giredestrant (GIR) (dAff -0.18), Elacestrant (ELA) (dAff -0.08) and Amcenestrant (AMC) (dAff -0.41), while a decreased binding affinity was observed for 4OH-Tamoxifen (TAM) (dAff 0.01), Imlunestrant (IML) (dAff 0.15), Fulvestrant (FUL) (dAff 0.43), and Camizestrant (CAM) (dAff 0.02). V392F decreased binding affinity for TAM (dAff 0.05), LAS (dAff 0.13), IML (dAff 0.11), GIR (dAff 0.11), FUL (dAff 0.04), CAM (dAff 0.05), AMC (dAff 0.06) but not for ELA (dAff -0.01). F404L decreased binding affinity for FUL (dAff 0.07), ELA (dAff 0.73), and CAM (dAff 0.26), while it increased binding affinity for TAM (dAff -0.27), LAS (dAff -0.02), IML (dAff -0.05), GIR (dAff -0.69), and AMC (dAff -2.01). G415E increased binding affinity for LAS, (dAff -0.15) GIR (dAff -0.02) and ELA (dAff -0.08), while it decreased binding affinity for TAM (dAff 0.11), IML (dAff 0.09), FUL (dAff 0.29), CAM (dAff 0.19) and AMC (dAff 0.10). Mutations in codon 537 did not affect dAff for TAM, GIR, and ELA; a significant decrease in binding affinity was observed for FUL and AMC, whereas it was increased for LAS. Mutational co-occurrence was tested between ESR1 mutations in FUL docking sites and oncogenic pathways. Significant associations were observed for cell cycle SNVs (P=0.047), Notch SNVs (P=0.020), and ER SNVs (P< 0.001). Within these pathways, significant single-gene associations were observed for FBXW7 SNVs (P=0.020), ESR1 SNVs (P< 0.001), and GATA3 SNVs (P= 0.016). Given the highly significant co-occurrence of non-HS with other ESR1 mutations, combined models were examined. The Y537/F404 combination resulted in decreased binding affinity for FUL and increased binding affinity for LAS, while L536/F404 decreased binding affinity for TAM and increased binding affinity for IML, ELA, and AMC. Notably, L540/F404 restored the FUL-ESR1 interaction resulting in an increased binding affinity (dAff -2.1). Conclusions: The study suggests that genomic variability in drug targets detectable through ctDNA may modulate therapeutic response. Preclinical models are under development to investigate the combined endocrine resistance mechanism suggested by the significant co-occurrence between ESR1 mutations in SERDs/SERMs docking sites and ESR1 hotspot mutations and provide valuable additional insights for drug development and future treatment algorithms.
Citation Format: Lorenzo Gerratana, Rossana Roncato, Mattia Sturlese, Andrew A. Davis, Marko Velimirovic, Carolina REDUZZI, Katherine K. Clifton, Whitney L. Hensing, Ami N. Shah, Charles S. Dai, Paolo D’Amico, Arielle J. Medford, Alessandra Franzoni, Linda Cucciniello, Firas Wehbe, Seth A. Wander, Barbara Belletti, William Gradishar, Amir Behdad, Giuseppe Damante, Cynthia Ma, Fabio Puglisi, Aditya Bardia, Massimo Cristofanilli. PD10-01 Impact of ESR1 mutations on Selective Estrogen Receptor Degraders and Modulators: an integrated liquid-biopsy and pharmacodynamics approach. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD10-01.
Collapse
Affiliation(s)
- Lorenzo Gerratana
- 1Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano
| | | | | | | | | | | | | | | | | | | | | | - Arielle J. Medford
- 12Massachusetts General Hospital Cancer Center/Dana Farber Cancer Institute
| | | | - Linda Cucciniello
- 14Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano
| | | | - Seth A. Wander
- 16Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Barbara Belletti
- 17Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano
| | - William Gradishar
- 18Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
| | | | | | - Cynthia Ma
- 21Washington University in St. Louis, St. Louis, MO
| | - Fabio Puglisi
- 22Department of Medicine (DAME), University of Udine, Udine, Italy and Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy, Friuli-Venezia Giulia, Italy
| | - Aditya Bardia
- 23Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | | |
Collapse
|
5
|
Galli J, Valente EM, Dewulf J, Franzoni A, Marie S, Plumari M, Zanetti F, Fazzi E. Expanding the spectrum of clinical severity of AICA-ribosiduria: Report of two siblings with mild phenotype caused by a novel pathogenic variant in ATIC gene. Am J Med Genet A 2023; 191:575-581. [PMID: 36367252 DOI: 10.1002/ajmg.a.63036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 09/07/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 11/13/2022]
Abstract
5-Amino-4-imidazolecarboxamide-ribosiduria (AICA-ribosiduria) is an extremely rare inborn error of purine biosynthesis metabolism caused by pathogenic variants in ATIC gene that encodes a protein catalyzing the last steps of the de novo purine biosynthesis. To date, only six cases have been reported presenting a severe phenotype characterized by coarse facies and variable dysmorphic features, intrauterine and postnatal growth retardation, severe and early neurodevelopment delay, profound congenital visual deficit, scoliosis and, less frequently, epilepsy, aortic coarctation, chronic hepatic cytolysis, nephrocalcinosis and mild genitalia malformation. In this article, we report two new cases of AICA-ribosiduria carrying new pathogenic variants in ATIC (c.421C>T;p.Arg141Ter and c.1753A>G p.Thr585Ala) associated to a milder phenotype compared to previously reported patients. Particularly, the children showed few dysmorphic features (bulging forehead, depressed nasal bridge, and flat nasal tip), postnatal growth impairment, psychomotor delay since the second year of life, reduction of visual acuity (from mild impairment to low vision from the age of 5 years and to partial blindness from the age of 7 years) and mild hepatic dysfunctions. Scoliosis as well as epilepsy, renal involvement, or genitalia malformation were not detected. According to literature data, we found an abnormal accumulation of intermediates of de novo purine biosynthesis in the urine of both siblings. This report expands the spectrum of phenotypic severity associated to ATIC biallelic pathogenic variants and prompts the need to investigate ultra-rare causes of metabolic disorders such as AICA-ribosiduria in subjects with early neurological and sensory involvement of uncertain etiology.
Collapse
Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia and Neurogenetics Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Joseph Dewulf
- Laboratoire des Maladies Métaboliques Héréditaires/Biochimie Génétique et Centre de Dépistage Néonatal, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Alessandra Franzoni
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Sandrine Marie
- Laboratoire des Maladies Métaboliques Héréditaires/Biochimie Génétique et Centre de Dépistage Néonatal, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Massimo Plumari
- Neurogenetics Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Zanetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| |
Collapse
|
6
|
Franzoni A, Baldan F, Passon N, Mio C, Driul D, Cogo P, Fogolari F, D'Aurizio F, Damante G. Novel IGFALS mutations with predicted pathogenetic effects by the analysis of AlphaFold structure. Endocrine 2023; 79:292-295. [PMID: 36348166 DOI: 10.1007/s12020-022-03244-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE According to the American College of Medical Genetics (ACMG) classification, variants of uncertain significance (VUS) are gene variations whose impact on the disease risk is not yet known. VUS, therefore, represent an unmet need for genetic counselling. Aim of the study is the use the AlphaFold artificial intelligence algorithm to predict the impact of novel mutations of the IGFALS gene, detected in a subject with short stature and initially classified as VUS according to the ACMG classification. METHODS A short-stature girl and her parents have been investigated. IGFALS mutations have been detected through clinical exome and confirmed by Sanger sequencing. The potential presence of co-occurring gene alterations was investigated in the proband by whole exome and CGH array. Structure of the ALS protein (encoded by the IGFALS gene) was evaluated through the AlphaFold artificial intelligence algorithm. RESULTS Two IGFALS variants were found in the proband: c.1349T > C (p.Leu450Pro) and c.1363_1365delCTC (p.Leu455del), both classified as VUS, according to ACMG. Parents' analysis highlighted the in trans position of the two variants. AlphaFold showed that the mutated positions were found the concave side a horseshoe structure of the ALS protein, likely interfering with protein-protein interactions. According to a loss of function (LoF) effect of the two variants, reduced levels of the IGF1 and IGFBP-3 proteins, as well as a growth hormone (GH) excess were detected in the proband's serum. CONCLUSIONS By using the AlphaFold structure we were able to predict two IGFALS gene mutations initially classified as VUS, as potentially pathogenetic. Our proof-of-concept showed a potential application of AlphaFold as tool to a better inform VUS interpretation of genetic tests.
Collapse
Affiliation(s)
- Alessandra Franzoni
- SOC Istituto di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale Udine, Udine, Italy
| | - Federica Baldan
- SOC Istituto di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale Udine, Udine, Italy
| | - Nadia Passon
- SOC Istituto di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale Udine, Udine, Italy
| | - Catia Mio
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
| | - Daniela Driul
- SOC Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Udine, Italy
| | - Paola Cogo
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
- SOC Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Udine, Italy
| | - Federico Fogolari
- Dipartimento di Scienze matematiche, Informatiche e Fisiche, Università di Udine, Udine, Italy
| | - Federica D'Aurizio
- SOC Istituto di Patologia Clinica Azienda Sanitaria Universitaria Friuli Centrale Udine, Udine, Italy
| | - Giuseppe Damante
- SOC Istituto di Genetica Medica, Azienda Sanitaria Universitaria Friuli Centrale Udine, Udine, Italy.
- Dipartimento di Area Medica, Università di Udine, Udine, Italy.
| |
Collapse
|
7
|
Bortot L, Basile D, Palmero L, Dri A, Cucciniello L, Buriolla S, Pastò B, Mazzeo R, Bonotto M, Bolzonello S, Franzoni A, Allegri L, Belletti B, Damante G, Gerratana L, Minisini A, Puglisi F. 261P Liquid biopsy–based biomarkers for the characterization of hormone receptor-positive (HR+) HER2-Low metastatic breast cancer (mBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.300] [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
|
8
|
Galli J, Loi E, Molinaro A, Calza S, Franzoni A, Micheletti S, Rossi A, Semeraro F, Fazzi E. Age-Related Effects on the Spectrum of Cerebral Visual Impairment in Children With Cerebral Palsy. Front Hum Neurosci 2022; 16:750464. [PMID: 35308614 PMCID: PMC8924515 DOI: 10.3389/fnhum.2022.750464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Cerebral Visual Impairment (CVI) is a very common finding in children affected by Cerebral Palsy (CP). In this paper we studied the characteristics of CVI of a large group of children with CP and CVI, describing their neurovisual profiles according to three different age subgroups (subgroup 1: infants 6 months–2 years; subgroup 2: pre-school age 3–5 years; subgroup 3: school age ≥ 6 years). Methods We enrolled 180 subjects (104 males, mean age 66 ± 42.6 months; range 6–192 months) with CP and CVI for the study. We carried out a demographic and clinical data collection, neurological examination, developmental or cognitive assessment, and a video-recorded visual function assessment including an evaluation of ophthalmological characteristics, oculomotor functions, and basic visual functions. In school-aged children, we also performed an evaluation of their cognitive-visual profiles. Results There were signs of CVI in all the three subgroups. Subgroup 1 (62 children) and subgroup 2 (50 children) were different for fixation (p = 0.02), visual acuity (p = 0.03) and contrast sensitivity (p < 0.01), being more frequently impaired in younger children. Comparing subgroup 2 with subgroup 3 (68 children), the older children presented more frequently myopia (p = 0.02) while the younger ones esotropia (p = 0.02) and alteration in smooth pursuit (p = 0.03) and saccades (p < 0.01). Furthermore, fixation, smooth pursuit, visual acuity, contrast sensitivity and visual filed (p < 0.01) were more frequently impaired in younger children (subgroup 1) compared to the older ones. Multiple correspondence analysis (MCA) confirmed the different neurovisual profiles according to age: younger children with CP showed more signs of CVI compared to the older ones. 34 out of 68 children belonging to subgroup 3 underwent the cognitive visual evaluation; an impairment of cognitive visual skills was detected in 21 subjects. Conclusion Younger children with CP showed more signs of CVI compared to the older ones, likely for the physiological maturation of visual system and mechanisms of neuroplasticity. In this direction, we suggest an early neurovisual evaluation to detect any weak visual functions.
Collapse
Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- *Correspondence: Jessica Galli,
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Anna Molinaro
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Stefano Calza
- BDbiomed, BODaI Lab, University of Brescia, Brescia, Italy
| | - Alessandra Franzoni
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
- Eye Clinic, University of Brescia, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | | |
Collapse
|
9
|
Gerratana L, Davis AA, Zhang Q, Basile D, Rossi G, Strickland K, Franzoni A, Allegri L, Mu Z, Zhang Y, Flaum LE, Damante G, Gradishar WJ, Platanias LC, Behdad A, Yang H, Puglisi F, Cristofanilli M. Longitudinal Dynamics of Circulating Tumor Cells and Circulating Tumor DNA for Treatment Monitoring in Metastatic Breast Cancer. JCO Precis Oncol 2021; 5:943-952. [PMID: 34136741 PMCID: PMC8202557 DOI: 10.1200/po.20.00345] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/10/2021] [Accepted: 04/21/2021] [Indexed: 12/13/2022] Open
Abstract
Liquid biopsy-based biomarkers, including circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), are increasingly important for the characterization of metastatic breast cancer (MBC). The aim of the study was to explore CTCs and ctDNA dynamics to better understand their potentially complementary role in describing MBC. METHODS The study retrospectively analyzed 107 patients with MBC characterized with paired CTCs and ctDNA assessments and a second prospective cohort, which enrolled 48 patients with MBC. CTCs were immunomagnetically isolated and ctDNA was quantified and then characterized through next-generation sequencing in the retrospective cohort and droplet digital polymerase chain reaction in the prospective cohort. Matched pairs variations at baseline, at evaluation one (EV1), and at progression were tested through the Wilcoxon test. The prognostic role of ctDNA parameters was also investigated. RESULTS Mutant allele frequency (MAF) had a significant decrease between baseline and EV1 and a significant increase between EV1 and progression. Number of detected alterations steadily increased across timepoints, CTCs enumeration (nCTCs) significantly increased only between EV1 and progression. MAF dynamics across the main altered genes was then investigated. Plasma DNA yield did not vary across timepoints both in the retrospective cohort and in the prospective cohort, while the short fragments fraction showed a potential role as a prognostic biomarker. CONCLUSION nCTCs and ctDNA provide complementary information about prognosis and treatment benefit. Although nCTCs appeared to assess tumor biology rather than tumor burden, MAF may be a promising biomarker for the dynamic assessment of treatment response and resistance.
Collapse
Affiliation(s)
- Lorenzo Gerratana
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL.,Department of Medicine, University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Andrew A Davis
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL.,Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Qiang Zhang
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Debora Basile
- Department of Medicine, University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Giovanna Rossi
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA.,Breast International Group (BIG), Brussels, Belgium
| | - Kimberly Strickland
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA.,Novant Health Cancer Institute, Charlotte, NC
| | | | | | - Zhaomei Mu
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Youbin Zhang
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Lisa E Flaum
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Giuseppe Damante
- Department of Medicine, University of Udine, Udine, Italy.,Institute of Human Genetics, ASUFC University Hospital, Udine, Italy
| | - William John Gradishar
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Leonidas C Platanias
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Amir Behdad
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Department of Pathology, Northwestern University, Chicago, IL
| | - Hushan Yang
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Fabio Puglisi
- Department of Medicine, University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Massimo Cristofanilli
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| |
Collapse
|
10
|
Palmero L, Mazzeo R, Buriolla S, Allegri L, Bortot L, Franzoni A, Michelotti A, Stefani EC, Turra G, Zilli M, Di Nardo P, Roncato R, Bonotto M, Cecchin E, Belletti B, Toffoli G, Gerratana L, Baldassarre G, Damante G, Puglisi F. Refining neutropenia risk assessment in patients treated with first-line endocrine therapy (ET) and cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) for metastatic breast cancer (MBC) through a cell-free DNA workflow (cfDNA). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1027 Background: The combination of ET and CDK4/6i is the current standard of care for hormone receptor (HR)-positive/HER2-negative MBC (luminal MBC), with neutropenia being the main dose limiting toxicity. We previously observed the potential association between leucocyte count (WBC) and different fractions of cell free circulating DNA (cfDNA) (Bortot et al 2020). The present study aimed to evaluate the feasibility of a cfDNA-based workflow as a new tool to assess the risk of treatment induced neutropenia. Methods: The study analyzed a prospective cohort 83 luminal MBC patients (pts) treated with first line ET and CDK4/6i in the CRO-2018-56 multicenter study from 2018 to 2021. cfDNA was characterized through droplet digital PCR (ddPCR) based on different ACTB DNA fragments lengths: short (s), medium (m) and long (l). Blood samples were collected before treatment start (BL) and at the first clinical evaluation after 3 months (E1). Associations between clinical characteristics, neutropenia and cfDNA were explored through Kruskal Wallis, time to G3 neutropenia (NG3) (TTN) was analyzed through log-rank and Cox regression. Results: Neutropenia was G3 in 44 out of 83 pts (53%) and G4 in 2 pts (2%). Median TTN was 1.8 months, 60% of NG3 occurred within 3.7 months. Overall, 74 pts (89%) resolved toxicity within 7 days, 10 pts (12%) reduced CDK4/6i dose after NG3. BL neutrophils count (Neu) and WBC were significantly lower in pts that developed NG3 (P = 0.0013 and P = 0.0020 respectively). De novo metastatic pts had numerically higher Neu (median 4825 vs 3895), but only a numerically lower risk of NG3 was observed (HR 0.53 P = 0.064). Although bone involvement was not associated with risk of developing NG3, the total number of metastatic lesions was associated with higher NG3 (P = 0.0016). In particular, > 5 metastatic lesions were associated with higher NG3 risk (p = 0.013). E1 ACTB_m was significantly lower with respect to BL in pts that experienced NG3 (median 100% vs 16%, P = 0.0136 in NG3 no vs yes) with a consistent impact on the risk of NG3 (HR: 2.81, P = 0.025). No associations were observed for the other ACTB fragment length fractions. BL Neu and ACTB_m dichotomized at the median were then combined to describe 4 distinct TTN risk groups (P = 0.0006). Interestingly, pts with low BL Neu and low E1 ACTB_m had a median TTN of 0.9 months, while pts with high BL Neu and high E1 ACTB_m have not experienced NG3 after a median follow-up of 16.1 months. Conclusions: The present study proofed the concept of using cfDNA to provide clinically meaningful data not only about tumor biology, but also for a comprehensive patient assessment. Based on these results, a prospective study focused on a multiparametric neutropenia risk assessment will be started.
Collapse
Affiliation(s)
- Lorenza Palmero
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Roberta Mazzeo
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Silvia Buriolla
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Lorenzo Allegri
- Department of Medicine (DAME) - University of Udine, Udine, Italy
| | - Lucia Bortot
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Alessandra Franzoni
- Institute of Human Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Anna Michelotti
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | | | - Giulia Turra
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Miriam Zilli
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Paola Di Nardo
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Rossana Roncato
- Clinical and Experimental Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Marta Bonotto
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | | | - Barbara Belletti
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology, National Cancer Institute, Aviano, Italy
| | - Lorenzo Gerratana
- Department of Medicine-Hematology and Oncology, Feinberg School of Medicine, Northwestern University; Department of Medicine (DAME), University of Udine, Chicago, IL
| | - Gustavo Baldassarre
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy
| | - Giuseppe Damante
- Università di Udine, Institute of Human Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Udine, Udine, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| |
Collapse
|
11
|
Gerratana L, Davis AA, Velimirovic M, D'Amico P, Shah AN, Clifton K, Zhang Q, Dai CS, Reduzzi C, Hensing WL, Bonotto M, Mazzeo R, Wehbe FH, Franzoni A, Belletti B, Behdad A, Ma CX, Puglisi F, Bardia A, Cristofanilli M. Uncovering the differential impact of ESR1 and PIK3CA codon variants on the clinical phenotype of metastatic breast cancer (MBC) through circulating tumor DNA (ctDNA) next-generation sequencing (NGS). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1033 Background: The exposure to endocrine therapy (ET) can induce the onset of ESR1 gene alterations that have an impact on not only treatment resistance but also clinical phenotype. We previously demonstrated the potential of liquid biopsy in describing the metastatic behavior of MBC. The aim of this study was to explore the different clinical phenotype across the main ESR1 and PIK3CA codon variants. Methods: The study retrospectively analyzed a cohort of 501 MBC patients (pts) characterized for ctDNA through NGS before treatment start at Northwestern University (Chicago, IL), Massachusetts General Hospital (Boston, MA), CRO National Cancer Institute (Aviano, IT) and ASUFC Hospital (Udine, IT) between 2014 and 2020. Associations between clinical characteristics and ESR1 and PIK3CA codon variants were explored through logistic regression corrected for sites and ESR1/ PIK3CA status. Survival was tested through Cox regression both for progression-free survival (PFS) and overall survival (OS). Results: Of the total 501 pts, 289 (58%) were diagnosed with hormone-receptor positive (HRpos) MBC, 114 (23%) with HER2-positive MBC, and 93 (19%) with triple-negative MBC. ESR1 mutations were detected in 71 pts (14%) and PIK3CA in 154 pts (31%). The most represented ESR1 gene mutations were found in codons 380 (9%), 536 (23%), 537 (34%), and 538 (34%), while alterations in codons 542 (19%), 545 (21%), and 1047 (60%) were the most common for PIK3CA. As expected, ESR1 mutations were found only in HRpos pts previously exposed to ET (P < 0.001). No significant differences were observed for PIK3CA. After multivariable analysis, ESR1mutations were confirmed as highly associated with liver and bone metastases (OR 3.31, P < 0.001 and OR 5.09, P < 0.001). Moreover, an association with lung (OR 2.07, P = 0.010) was observed in this cohort. After multivariable analysis, codon 537 mutations were associated with bone involvement (OR 12.97, P = 0.014), codon 538 with liver (OR 4.73, P = 0.010), and codon 536 with soft tissue (OR 5.84, P = 0.006) and liver (OR 4.06, P = 0.048). PIK3CA mutations were associated with bone (OR 2.61, P < 0.001) and lung metastases (OR 1.62, P = 0.044). Specifically, codon 1047 mutations were the primary driver (OR 3.14, P = 0.001 and OR 1.97, P = 0.019). In HRpos MBC, baseline mutations in ESR1 codon 537 and 538 had a negative impact on OS (HR 3.73, P < 0.010 and HR 2.99, P < 0.021), while 380 and 536 had a negative impact on PFS (HR 18.98, P < 0.001 and HR 2.60, P = 0.015). No impact was observed across PIK3CA gene variants. Conclusions: This study showed the different tumor biology across ESR1 and PIK3CA gene variants. As novel selective estrogen receptor degraders (SERDS) and PIK3CA inhibitors are gaining momentum as new ET options in MBC, these results highlight the future pivotal role of ctDNA NGS in refining tumor biology characterization.
Collapse
Affiliation(s)
- Lorenzo Gerratana
- Department of Medicine-Hematology and Oncology, Feinberg School of Medicine, Northwestern University; Department of Medicine (DAME), University of Udine, Chicago, IL
| | - Andrew A. Davis
- Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Paolo D'Amico
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | | | - Qiang Zhang
- Northwestern University, Department of Medicine, Division of Hematology/Oncology, Lurie Cancer Center, Chicago, IL
| | | | - Carolina Reduzzi
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | - Marta Bonotto
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - Roberta Mazzeo
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | | | - Alessandra Franzoni
- Institute of Human Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Barbara Belletti
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Amir Behdad
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Cynthia X. Ma
- Washington University School of Medicine, St. Louis, MO
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - Aditya Bardia
- Massachusetts General Hospital, Harvard Medical, Boston, MA
| | - Massimo Cristofanilli
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
12
|
Mazzeo R, Bortot L, Michelotti A, Buriolla S, Palmero L, Franzoni A, Bertoli E, Targato G, Allegri L, Da Ros L, Alberti M, Di Nardo P, Bonotto M, Sodde S, Belletti B, Spazzapan S, Baldassarre G, Damante G, Gerratana L, Puglisi F. Liquid biopsy for baseline evaluation of tumor burden in patients with hormone receptor-positive, HER2-negative metastatic breast cancer: A proof of principle study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e13008] [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
e13008 Background: Liquid biopsy-based biomarkers, including circulating tumor DNA (ctDNA), are increasingly important for the characterization of metastatic breast cancer (MBC). Currently, CA15.3 is the most commonly used serum marker for monitoring disease burden. To date, no liquid biopsy-based biomarkers have been proposed for this scope in clinical practice. Methods: The CRO-2018-56 multicenter study prospectively enrolled 83 patients (pts) with luminal-like MBC treated with first line endocrine therapy (ET) and CDK4/6 inhibitors. All pts were characterized for ctDNA through droplet digital PCR (ddPCR) in from 2018 to 2021. Clinicopathological and laboratory characteristics at baseline were tested for associations with tumor markers, ACTB fragments lengths, methylation status of ESR1 main promoters (expressed as promA and promB ratio, i.e., met_ratio) and ESR1/PIK3CA mutational status through Kruskal-Wallis test and Chi-square test. Prognosis was tested in terms of Progression Free Survival (PFS) and Overall Survival (OS) through log-rank test. Results: At baseline, in 26 (31%) pts disease was diagnosed as de novo metastatic, 66 (80%) pts had < 3 of metastatic sites, and 41 (49%) pts had < 5 of metastatic lesions. Bone metastases were detected in 53 (64%) pts, liver metastases in 21 (25%) pts, and lung lesions in 30 (36%) pts. A ctDNA-detected ESR1 mutation and a PIK3CA mutation were found in 15% of pts and in 34% pts, respectively. Met_ratio was > 1.5 in 35 (42%) of pts. Median CA15.3 was 48.2 U/mL and median CEA was 3.8 U/mL. Number of liver metastases and number of metastatic sites were significantly higher in pts with ESR1 mutation (respectively, P = 0.0055 and P = 0.0208). CA15.3 and ctDNA yield were significantly higher in pts with number of metastatic sites ≥ 3, (respectively, P = 0.0164, and P = 0.0239), while number of metastatic sites ≥ 3 and number of metastatic lesions ≥ 5 were significantly associated with CEA > 3.8 U/mL (respectively, P = 0.039, and P = 0.029). Presence of bone metastases was significantly associated with PIK3CA mutation (P = 0.040), while number of metastatic sites ≥ 3 was significantly associated with ESR1 mutation (P = 0.022). No association with tumor burden was observed for different ACTB DNA fragments lengths. Met_ratio > 1.5 was significantly associated with lower number of metastatic lesions (P = 0.031). Number of metastatic sites ≥ 3, high ctDNA yield and CEA were associated with worse OS (respectively P = 0.0465, P = 0.0250 and P = 0.0474), while only CEA impacted on PFS (P = 0.0097). Conclusions: In pts with luminal-like MBC, some liquid biopsy-based biomarkers (i.e., ctDNA-detected ESR1 and PIK3CA mutations, ctDNA yield) were significantly associated with the burden of disease. The potential clinical validity and utility of these results deserve to be tested in an expansion cohort.
Collapse
Affiliation(s)
- Roberta Mazzeo
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Lucia Bortot
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Anna Michelotti
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Silvia Buriolla
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| | - lorenza Palmero
- Department of Medical Area, University of Udine; Department of Medical Oncology, IRCCS, CRO of Aviano, Udine, Italy
| | - Alessandra Franzoni
- Institute of Human Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Elisa Bertoli
- Department of Medicine (DAME) - University of Udine, Udine, Italy
| | - Giada Targato
- Department of Oncology, ASUFC Santa Maria della Misericordia University Hospital; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Lorenzo Allegri
- Department of Medicine (DAME) - University of Udine, Udine, Italy
| | - Lucia Da Ros
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Martina Alberti
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Paola Di Nardo
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Marta Bonotto
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - Sara Sodde
- Clinical Trial Office, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Barbara Belletti
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Simon Spazzapan
- Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Gustavo Baldassarre
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Giuseppe Damante
- Università di Udine, Institute of Human Genetics, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Udine, Udine, Italy
| | - Lorenzo Gerratana
- Department of Medicine-Hematology and Oncology, Feinberg School of Medicine, Northwestern University; Department of Medicine (DAME), University of Udine, Chicago, IL
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine; Dipartimento di Oncologia Medica, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Udine, Italy
| |
Collapse
|
13
|
Gerratana L, Basile D, Franzoni A, Allegri L, Viotto D, Corvaja C, Bortot L, Bertoli E, Buriolla S, Targato G, Da Ros L, Russo S, Bonotto M, Belletti B, Baldassarre G, Damante G, Puglisi F. Plasma-Based Longitudinal Evaluation of ESR1 Epigenetic Status in Hormone Receptor-Positive HER2-Negative Metastatic Breast Cancer. Front Oncol 2020; 10:550185. [PMID: 33072577 PMCID: PMC7531252 DOI: 10.3389/fonc.2020.550185] [Citation(s) in RCA: 12] [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: 04/08/2020] [Accepted: 08/20/2020] [Indexed: 12/30/2022] Open
Abstract
Background Endocrine therapy (ET) is the mainstay of treatment for hormone receptor-positive human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer; however, adaptive mechanisms emerge in about 25–30% of cases through alterations in the estrogen receptor ligand-binding domain, with a consequent ligand-independent estrogen receptor activity. Epigenetic-mediated events are less known and potentially involved in alternative mechanisms of resistance. The aim of this study was to test the feasibility of estrogen receptor 1 (ESR1) epigenetic characterization through liquid biopsy and to show its potential longitudinal application for an early ET sensitivity assessment. Methods A cohort of 49 women with hormone receptor-positive HER2-negative MBC was prospectively enrolled and characterized through circulating tumor DNA using methylation-specific droplet digital PCR (MS-ddPCR) before treatment start (BL) and after 3 months concomitantly with computed tomography (CT) scan restaging (EV1). ESR1 epigenetic status was defined by assessing the methylation of its main promoters (promA and promB). The most established cell-free tumor DNA (ctDNA) factors associated with ET resistance [ESR1 and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutations] were assessed through next-generation sequencing. Associations were tested through Mann–Whitney U test, matched pairs variations through Wilcoxon signed rank test, and survival was analyzed by log-rank test. Results The ET backbone was mainly based on aromatase inhibitors (AIs) (70.83%) in association with CDK4/6 inhibitors (93.75%). Significantly lower promA levels at baseline were observed in patients with liver metastases (P = 0.0212) and in patients with ESR1 mutations (P = 0.0091). No significant impact on PFS was observed for promA (P = 0.3777) and promB (P = 0.7455) dichotomized at the median while a ≥2-fold increase in promB or in either promA or promB at EV1 resulted in a significantly worse prognosis (respectively P = 0.0189, P = 0.0294). A significant increase at EV1 was observed for promB among patients with PIK3CA mutation (P = 0.0173). A trend was observed for promB in ESR1 wild-type patients and for promA in the ESR1 mutant subgroup. Conclusion The study proofed the concept of an epigenetic characterization strategy based on ctDNA and is capable of being integrated in the current clinical workflow to give useful insights on treatment sensitivity.
Collapse
Affiliation(s)
- Lorenzo Gerratana
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Debora Basile
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Lorenzo Allegri
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Davide Viotto
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Carla Corvaja
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Lucia Bortot
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Elisa Bertoli
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - Silvia Buriolla
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Giada Targato
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - Lucia Da Ros
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Stefania Russo
- Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - Marta Bonotto
- Department of Oncology, ASUFC University Hospital, Udine, Italy
| | - Barbara Belletti
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Gustavo Baldassarre
- Unit of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Giuseppe Damante
- Institute of Human Genetics, ASUFC University Hospital, Udine, Italy
| | - Fabio Puglisi
- Department of Medicine (DAME), University of Udine, Udine, Italy.,Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| |
Collapse
|
14
|
Gerratana L, Zhang Q, Shah AN, Franzoni A, Yu J, Jia S, Davis AA, Zhang Y, Wehbe F, Behdad A, Platanias LC, Gradishar WJ, Cristofanilli M. Abstract P5-01-10: Next generation sequencing-based gene variant-oriented characterization in metastatic breast cancer: An innovative analysis using ctDNA. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-01-10] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Novel high throughput genomic technologies are enhancing the ability to dynamically characterize cancer on a granular level. Although Next Generation Sequencing (NGS) is becoming part of the common practice, little is known on the role of a characterization on a gene variant level. Large heterochromatic regions or blocks are a characteristic feature in the autosomes 1, 9, 16 and the blocks contain about 10% of the human genome. The heterochromatic regions consist of highly repetitive DNA of the classes Sat I to IV. Thus, these specific regions are preferential positions for genome instability. The aim of this study was to explore the feasibility of a gene variant-oriented characterization for variants interplay discovery and to explore the role of chromosome stability in gene variants incidence. Methods: This study analyzed a pilot cohort of 35 metastatic breast cancer (MBC) patients (pts) treated and characterized for CTCs and circulating tumor DNA (ctDNA) at Northwestern University (Chicago, IL). ctDNA was analyzed using the PredicinePLUS™ NGS 180-gene panel (Predicine Inc, CA). Associations between gene variants and clinico-molecular characteristics were tested through Fisher’s exact test. Chromosomes 1, 9, 16 where defined as instable (instable_chr) based on the presence of highly repeated sequences. Results: An overall set of 35 samples was analyzed, and the main variants were detected in the ARID1A (40%), ATM (20%), DNMT3A (37%), ESR1 (20%), PIK3CA (26%), and TP53 (49%) genes. A total of 448 gene variants were detected through the NGS panel and across them, ARID1A accounted for 5.13%, ATM 2.23%, DNMT3A 4.91%, ESR1 4.02%, PIK3CA 2.23%, and TP53 for 6.03%. Among the genes mutated, the DNMT3A:c.2644C>T, DNMT3A:c.2645G>A, ESR1:c.1138G>C,ESR1:c.1609T>A, ESR1:c.1610A>C, ESR1:c.1613A>G, PIK3CA:c.1624G>A were the most detected. Thirty-eight copy number variations (CNV) and 3 splicing variants were observed. Notably, 55.6% of detected variants were found in instable_chr. No significant differences were observed between instable_chr variants and MBC subtype. Interestingly, ARID1Aaberrations were significantly linked to ATM, ESR1 (P=0.006) and PIK3CA with ESR1 (P= 0.019). Consistently with literature, ATM and TP53 variants were mutually exclusive (P<0.0001). Intriguingly, both ATM and TP53 were associated with a higher incidence of variants affecting genes in instable_chr. Conclusions: MBC is often described as a non-gene-addicted disease, rendering the onset of gene variants a multi-factor phenomenon. The present results suggest a role for both chromosomal intrinsic instability and DNA repair impairment in this process, with a potential down-stream selection mediated by treatment resistance. Future studies are warranted to further validate this proof of concept approach.
Citation Format: Lorenzo Gerratana, Qiang Zhang, Ami N Shah, Alessandra Franzoni, Jianjun Yu, Shidong Jia, Andrew A Davis, Youbin Zhang, Firas Wehbe, Amir Behdad, Leonidas C Platanias, William J Gradishar, Massimo Cristofanilli. Next generation sequencing-based gene variant-oriented characterization in metastatic breast cancer: An innovative analysis using ctDNA [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-01-10.
Collapse
|
15
|
Lovrecic L, Gnan C, Baldan F, Franzoni A, Bertok S, Damante G, Isidor B, Peterlin B. Microduplication in the 2p16.1p15 chromosomal region linked to developmental delay and intellectual disability. Mol Cytogenet 2018; 11:39. [PMID: 29951117 PMCID: PMC6011332 DOI: 10.1186/s13039-018-0388-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/12/2018] [Accepted: 06/06/2018] [Indexed: 11/25/2022] Open
Abstract
Background Several patients with the 2p16.1p15 microdeletion syndrome have been reported. However, microduplication in the 2p16.1p15 chromosomal region has only been reported in one case, and milder clinical features were present compared to those attributed to 2p16.1p15 microdeletion syndrome. Some additional cases were deposited in DECIPHER database. Case presentation In this report we describe four further cases of 2p16.1p15 microduplication in four unrelated probands. They presented with mild gross motor delay, delayed speech and language development, and mild dysmorphic features. In addition, two probands have macrocephaly and one a congenital heart anomaly. Newly described cases share several phenotype characteristics with those detailed in one previously reported microduplication case. Conclusion The common features among patients are developmental delay, speech delay, mild to moderate intellectual disability and unspecific dysmorphic features. Two patients have bilateral clinodactyly of the 5th finger and two have bilateral 2nd-3rd toes syndactyly. Interestingly, as opposed to the deletion phenotype with some cases of microcephaly, 2 patients are reported with macrocephaly. The reported cases suggest that microduplication in 2p16.1p15 chromosomal region might be causally linked to developmental delay, speech delay, and mild intellectual disability.
Collapse
Affiliation(s)
- Luca Lovrecic
- 1Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Chiara Gnan
- 2Istituto di Genetica Medica, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Federica Baldan
- Dipartimento di Medicina Interna e Specialità Mediche dell'Università Sapienza di Roma, Udine, Italy
| | - Alessandra Franzoni
- 2Istituto di Genetica Medica, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Sara Bertok
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Bertrand Isidor
- 6Service de génétique médicale, CHU de Nantes, Nantes, France
| | - Borut Peterlin
- 1Clinical Institute of Medical Genetics, University Medical Center Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
16
|
Baldan F, Gnan C, Franzoni A, Ferino L, Allegri L, Passon N, Damante G. Genomic Deletion Involving the IMMP2L Gene in Two Cases of Autism Spectrum Disorder. Cytogenet Genome Res 2018; 154:196-200. [PMID: 29788020 DOI: 10.1159/000489001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 11/19/2022] Open
Abstract
Mutations/deletions of the IMMP2L gene have been associated with different cognitive/behavioral disturbances, including autism spectrum disorders (ASD). The penetrance of these defects is not complete since they often are inherited from a healthy parent. Using array-CGH in a cohort of 37 ASD patients, we found 2 subjects harboring a deletion inside the IMMP2L gene. In both cases, the IMMP2L gene deletion was inherited: from a healthy mother in one case and from a dyslectic father in the other. In the latter family, the IMMP2L deletion was also detected in the patient's brother, who showed delayed language development. In a cohort of 100 normal controls, no deletions including the IMMP2L gene were observed. However, a recent meta-analysis found no association between IMMP2L deletions and ASD. Our data would indicate that deletions involving the IMMP2L gene may contribute to the development of a subgroup of cognitive/behavioral disorders.
Collapse
|
17
|
Iodice A, Galli J, Molinaro A, Franzoni A, Micheli R, Pinelli L, Plebani A, Soresina A, Fazzi E. Neurovisual Assessment in Children with Ataxia Telangiectasia. Neuropediatrics 2018; 49:26-34. [PMID: 28992644 DOI: 10.1055/s-0037-1607216] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM Visual impairment is present in almost all patients with ataxia telangiectasia (AT) and, due to their early onset, constitute an important disabling aspect of the syndrome: the quality of vision is limited by dyspraxia and oculomotor abnormal movements. The purpose of this observational study was to describe visual disorders, notably oculomotor impairment, in a sample of children with AT. METHODS Fifteen AT patients (mean age 12 years and 4 months) underwent a neurovisual evaluation, particularly focused on oculomotor functions (fixation, smooth pursuit, saccades, and abnormal ocular movements). We compared the visual profile obtained with that described using the International Cooperative Ataxia Rating Scale (ICARS) subscale of oculomotor dysfunction. RESULTS Refractive errors were seen in eight patients and strabismus in three. Major oculomotor findings were fixation abnormalities (6/15), saccadic impairment (15/15), and abnormal smooth pursuit (14/15). Abnormal ocular movements were seen in 13/15 (saccadic intrusion in 8 and nystagmus in 5). Using ICARS scale, 13/15 children presented gaze-evoked nystagmus, 4/15 a clearly saccadic pursuit, and 11/15 dysmetria of saccades. DISCUSSION We propose a clinical neurovisual evaluation, which could be integrated with ICARS scores in the study of oculomotor involvement in AT pediatric patients. We strongly recommend the empowerment of visual functions to slow down progressive global disability of these patients.
Collapse
Affiliation(s)
- Alessandro Iodice
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy
| | - Jessica Galli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy.,Unit of Child Neurology and Psychiatry, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Anna Molinaro
- Unit of Child Neurology and Psychiatry, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | - Alessandra Franzoni
- Eye Clinic Department of Neurological Science and Vision, ASST Spedali Civili, Brescia, Italy
| | - Roberto Micheli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy
| | - Lorenzo Pinelli
- Unit of Neuroradiology, Pediatric Neuroradiology Section, Spedali Civili, Brescia, Italy
| | - Alessandro Plebani
- Department of Clinical and Experimental Sciences, Pediatrics Clinic, ASST Spedali Civili and University of Brescia, Brescia, Italy
| | | | - Elisa Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili, Brescia, Italy.,Unit of Child Neurology and Psychiatry, Department of Clinical and Experimental Sciences, ASST Spedali Civili and University of Brescia, Brescia, Italy
| |
Collapse
|
18
|
Franzoni A, Markova-Car E, Dević-Pavlić S, Jurišić D, Puppin C, Mio C, De Luca M, Petruz G, Damante G, Pavelić SK. A polymorphic GGC repeat in the NPAS2 gene and its association with melanoma. Exp Biol Med (Maywood) 2017; 242:1553-1558. [PMID: 28799406 DOI: 10.1177/1535370217724093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Circadian clock regulation in mammals is controlled by feedback loops of a set of circadian genes. One of these circadian genes, NPAS2, encodes for a member of the bHLH-PAS class of transcription factors and is expressed in the forebrain and in some peripheral organs such as liver and skin. Other biological processes are also regulated by circadian genes. For example, NPAS2 is involved in cell proliferation, DNA damage repair and malignant transformation. Aberrant expression of clock genes has been previously observed in melanoma which led to our effort to sequence the NPAS2 promoter region in this cancer type. The NPAS2 putative promoter and 5' untranslated region of ninety-three melanoma patients and ninety-six control subjects were sequenced and several variants were identified. Among these is a novel microsatellite comprising a GGC repeat with different alleles ranging from 7 to 13 repeats located in the 5' untranslated exon. Homozygosity of an allele with nine repeats (9/9) was more prevalent in melanoma than in control subjects (22.6% and 13.5%, respectively, P: 0.0206) suggesting that some NPAS2 variants might contribute to melanoma susceptibility. Impact statement This report describes a variable microsatellite repeat sequence located in the 5' untranslated exon of NSPAS2, a gene encoding a clock transcription factor. Significantly, this study is the first to show that a variant copy number GGC repeat sequence in the NPAS2 clock gene associates with melanoma risk and which may be useful in the assessment of melanoma predisposition.
Collapse
Affiliation(s)
- Alessandra Franzoni
- 1 Medical Genetics Institute, Azienda Ospedaliero-Universitaria di Udine, Udine 33017, Italy
| | - Elitza Markova-Car
- 2 Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka 51000, Croatia
| | - Sanja Dević-Pavlić
- 2 Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka 51000, Croatia
| | - Davor Jurišić
- 3 Department for Plastic and Reconstructive Surgery, Clinic for Surgery, University Hospital Centre Rijeka, Rijeka 51000, Croatia
| | - Cinzia Puppin
- 4 Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy
| | - Catia Mio
- 4 Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy
| | - Marila De Luca
- 4 Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy
| | - Giulia Petruz
- 4 Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy
| | - Giuseppe Damante
- 1 Medical Genetics Institute, Azienda Ospedaliero-Universitaria di Udine, Udine 33017, Italy.,4 Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy
| | - Sandra Kraljević Pavelić
- 2 Department of Biotechnology, Centre for High-Throughput Technologies, University of Rijeka, Rijeka 51000, Croatia
| |
Collapse
|
19
|
Gnan C, Franzoni A, Baldan F, Passon N, Damante G, Dello Russo P. Familial 5q12.3 Microdeletion: Evidence for a Locus Associated with Epilepsy. Mol Syndromol 2017; 8:98-102. [PMID: 28611550 DOI: 10.1159/000454725] [Citation(s) in RCA: 2] [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] [Accepted: 11/16/2016] [Indexed: 01/13/2023] Open
Abstract
The clinical use of array comparative genomic hybridization (array CGH) has allowed the identification of very rare deletion and duplication disorders, such as 5q12 deletion syndrome (OMIM 615668) described as a contiguous gene deletion syndrome of chromosome 5q12. Chromosome microdeletions including band 5q12 have rarely been reported and have been associated with different phenotypes showing postnatal growth restriction, intellectual disability, epileptic seizures, hyperactivity, and ocular abnormalities. In this study, we describe a family in which array-CGH analysis revealed the presence of an interstitial microdeletion spanning approximately 2.9 Mb in the 5q12 region. The microdeletion is associated with epilepsy in the father and 2 siblings (a boy and a girl). So far, this is the first report in which a familial microdeletion 5q12 manifests in epilepsy. We suggest that this familial microdeletion could delineate a locus for susceptibility to epilepsy.
Collapse
Affiliation(s)
- Chiara Gnan
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Alessandra Franzoni
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Federica Baldan
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Nadia Passon
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Giuseppe Damante
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.,Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Udine, Italy
| | - Patrizia Dello Russo
- Istituto di Genetica Medica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| |
Collapse
|
20
|
Franzoni A, Russo PD, Baldan F, D'Elia AV, Puppin C, Penco S, Damante G. A CGH array procedure to detect PAX6 gene structural defects. Mol Cell Probes 2016; 32:65-68. [PMID: 27919838 DOI: 10.1016/j.mcp.2016.12.001] [Citation(s) in RCA: 2] [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: 10/07/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
Abstract
Aniridia is a rare congenital disease characterized by eye development defects, in which the more evident clinical manifestation is iris absence or malformation. In most of the patients, aniridia is associated to PAX6 gene point mutations or deletions. When these deletions are large and involve other genes, a more complex disease, named WAGR syndrome, arises. In order to develop a new tool to analyze aniridia and WAGR subjects, a CGH array (CGHa) of the PAX6 genomic region was set up. We generated a custom microarray kit using an oligonucleotide-based platform that allows high resolution molecular profiling of genomic aberrations in 20 Mb of the 11p13 chromosomal region, centered on the PAX6 gene. The average probe spacing was 100 bp. Thirty-five subjects have been analyzed. The major advantage of CGHa compared to MLPA was the knowledge of the deletions borders. Our approach identifies patients harboring deletions including the WT1 gene and, therefore, at risk for kidney tumors. The CGHa assay confirmed that several aniridia patients show a deletion at the level of ELP4 gene, without involvement of the PAX6 exonic regions. In all these patients, deletions include the PAX6 transcriptional enhancer SIMO. This finding further highlights the role of mutation/deletion of long-range enhancers in monogenic human pathology.
Collapse
Affiliation(s)
- Alessandra Franzoni
- Istituto di Genetica Medica, Azienda Ospedaliero-Universitaria di Udine, Italy
| | | | - Federica Baldan
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Italy
| | | | - Cinzia Puppin
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Italy
| | - Silvana Penco
- Genetica Medica, Dipartimento di Medicina di Laboratorio, Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Giuseppe Damante
- Istituto di Genetica Medica, Azienda Ospedaliero-Universitaria di Udine, Italy; Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Italy.
| |
Collapse
|
21
|
Primignani P, Allegrini D, Manfredini E, Romitti L, Mauri L, Patrosso MC, Veniani E, Franzoni A, Del Longo A, Gesu GP, Piozzi E, Damante G, Penco S. Screening of PAX6 gene in Italian congenital aniridia patients revealed four novel mutations. Ophthalmic Genet 2016; 37:307-13. [PMID: 26849621 DOI: 10.3109/13816810.2015.1059459] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To uncover underlying mutations in a cohort of Italian patients with aniridia, a rare congenital panocular condition with an incidence ranging from 1:64,000 to 1:100,000. The disease may be found isolated or in association with other syndromes characterized by partial or complete absence of the iris and iris hypoplasia. METHODS We analyzed the PAX6 gene in 11 patients with aniridia fulfilling the following inclusion criteria: partial or complete absence of the iris and age < 18 years at the time of diagnosis. DNA sequence analysis was integrated with Multiple Ligation Probe Assay (MLPA) analysis. RESULTS We identified seven PAX6 mutations, including four novel ones. The majority of mutations lie in the DNA-binding domain and all produce a truncated protein. All tested patients did not have WT1 gene deletions thus excluding the WAGR syndrome. We present the clinical findings in the four cases harboring novel mutations. We were unable to identify mutations in four cases with complete aniridia thus indicating that other gene/s could be involved in the disease. CONCLUSIONS It is important to establish the molecular diagnosis early to avoid repeated and long-term screening for Wilms tumor. Our work further emphasizes that a wide range of ocular phenotypes are associated with loss of function PAX6 mutations. In addition to the possibility of stochastic variations, other genetic variations could play a role as modifier genes, thus giving rise to the observed different ocular phenotypes.
Collapse
Affiliation(s)
- Paola Primignani
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Davide Allegrini
- b Pediatric Ophthalmology, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Emanuela Manfredini
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Lorenza Romitti
- c Department of Laboratory Medicine , Pathology and Cytogenetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Lucia Mauri
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Maria Cristina Patrosso
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Emanuela Veniani
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Alessandra Franzoni
- d Institute of Genetics, Azienda Ospedaliero-Universitaria Udine , Udine , Italy
| | | | - Giovanni Pietro Gesu
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Elena Piozzi
- b Pediatric Ophthalmology, Niguarda Ca' Granda Hospital , Milan , Italy
| | - Giuseppe Damante
- d Institute of Genetics, Azienda Ospedaliero-Universitaria Udine , Udine , Italy
| | - Silvana Penco
- a Department of Laboratory Medicine , Medical Genetics, Niguarda Ca' Granda Hospital , Milan , Italy
| |
Collapse
|
22
|
Dello Russo P, Franzoni A, Baldan F, Puppin C, De Maglio G, Pittini C, Cattarossi L, Pizzolitto S, Damante G. A 16q deletion involving FOXF1 enhancer is associated to pulmonary capillary hemangiomatosis. BMC Med Genet 2015; 16:94. [PMID: 26462560 PMCID: PMC4605103 DOI: 10.1186/s12881-015-0241-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 10/04/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Pulmonary capillary hemangiomatosis (PCH) is an uncommon pulmonary disorder, with variable clinical features depending on which lung structure is affected, and it is usually linked to pulmonary arterial hypertension. Congenital PCH has been very rarely described and, so far, the only causative gene identified is EIF2AK4, which encodes for a translation initiation factor. However, not all PCH cases might carry a mutation in this gene. CASE PRESENTATION We report the clinical and cytogenetic characterization of a patient (male, newborn, first child of healthy non-consanguineous parents) died after three days of life with severe neonatal pulmonary hypertension, due to diffuse capillary hemangiomatosis diagnosed post mortem. Conventional karyotyping, Microarray-Based Comparative Genomic Hydridization (CGHa) and quantitative PCR were performed. CGHa revealed a heterozygous chromosome 16q23.3q24.1 interstitial deletion, spanning about 2.6 Mb and involving a FOXF1 gene enhancer. Quantitative PCR showed that the proband's deletion was de novo. Microsatellite analysis demonstrate that the deletion occurred in the maternal chromosome 16. CONCLUSION FOXF1 loss of function mutation have been so far identified in alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV), a lung disease different from PCH. Our data suggest the hypothesis that disruption of the FOXF1 gene enhancer could be a genetic determinant of PCH. Moreover, our findings support the idea that FOXF1 is a paternally imprinted gene.
Collapse
Affiliation(s)
- Patrizia Dello Russo
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Alessandra Franzoni
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Federica Baldan
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Piazzale Kolbe 4, 33100, Udine, Italy.
| | - Cinzia Puppin
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Piazzale Kolbe 4, 33100, Udine, Italy.
| | - Giovanna De Maglio
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Carla Pittini
- Dipartimento Materno-infantile, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Luigi Cattarossi
- Dipartimento Materno-infantile, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Stefano Pizzolitto
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy.
| | - Giuseppe Damante
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy. .,Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Piazzale Kolbe 4, 33100, Udine, Italy.
| |
Collapse
|
23
|
Mauri L, Franzoni A, Scarcello M, Sala S, Garavelli L, Modugno A, Grammatico P, Patrosso MC, Piozzi E, Del Longo A, Gesu GP, Manfredini E, Primignani P, Damante G, Penco S. SOX2, OTX2 and PAX6 analysis in subjects with anophthalmia and microphthalmia. Eur J Med Genet 2014; 58:66-70. [PMID: 25542770 DOI: 10.1016/j.ejmg.2014.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 05/14/2014] [Accepted: 12/04/2014] [Indexed: 01/31/2023]
Abstract
Anophthalmia (A) and microphthalmia (M) are rare developmental anomalies that have significant effects on visual activity. In fraction of A/M subjects, single genetic defects have been identified as causative. In this study we analysed 65 Italian A/M patients, 21 of whom are syndromic, for mutations in SOX2, OTX2 and PAX6 genes. In syndromic patients the presence of genome imbalances through array CGH was also investigated. No mutations were found for OTX2 and PAX6 genes. Three causative SOX2 mutations were found in subjects with syndromic A. In a subject with syndromic signs and monolateral M, two de novo 6.26 Mb and 1.37 Mb deletions in 4q13.2q13.3 have been identified. A SOX2 missense (p.Ala161Ser) mutation was found in 1 out of 39 a subject with non-syndromic monolateral M. Alanine at position 161 is conserved along phylogeny and the p.Ala161Ser mutation is estimated pathogenic by in silico analysis. However, this mutation was also present in the unaffected patient's daughter.
Collapse
Affiliation(s)
- Lucia Mauri
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Alessandra Franzoni
- Institute of Genetics, Azienda Ospedaliero-Universitaria Udine, Udine, Italy
| | - Manuela Scarcello
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Stefano Sala
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Livia Garavelli
- Clinical Genetics Unit, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | | | - Paola Grammatico
- Department of Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - Maria Cristina Patrosso
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Elena Piozzi
- Pediatric Ophthalmology, Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - Giovanni P Gesu
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Emanuela Manfredini
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Paola Primignani
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Giuseppe Damante
- Institute of Genetics, Azienda Ospedaliero-Universitaria Udine, Udine, Italy; Department of Medical and Biological Sciences, Udine University, Udine, Italy.
| | - Silvana Penco
- Department of Laboratory Medicine, Medical Genetics, Niguarda Ca' Granda Hospital, Milan, Italy.
| |
Collapse
|
24
|
Sulis G, Urbinati L, Franzoni A, Gargiulo F, Carvalho ACC, Matteelli A. Chlamydia trachomatis conjunctivitis in a male teenager: a case report. Infez Med 2014; 22:140-143. [PMID: 24955802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
An 18 year old man was seen at a Sexually Transmitted Infections (STIs) clinic for counselling and treatment of Chlamydia trachomatis genital infection which had been diagnosed during a screening survey of high school students. For two months he had reported conjunctival hyperaemia, increased tearing, itching, and mucopurulent secretions, predominantly on the left eye. His ophthalmologist had made a diagnosis of follicular conjunctivitis and lower superficial punctate keratitis (left eye more than right eye), irresponsive to topical treatment. Chlamydial conjunctivitis was suspected and confirmed by a positive nucleic acid amplification test (NAAT) performed on conjunctival scraping. The patient was treated with azithromycin 1 g single dose orally and tetracycline/betamethasone eye ointment for one month. A complete resolution of symptoms was observed three months after aetiological treatment. This case highlights the need to include C. trachomatis infection in the differential diagnosis of acute or chronic follicular conjunctivitis among sexually active young individuals.
Collapse
Affiliation(s)
- Giorgia Sulis
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Lucia Urbinati
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Alessandra Franzoni
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Franco Gargiulo
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Anna Cristina C Carvalho
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Alberto Matteelli
- University Division of Infectious and Tropical Diseases; Eye Clinic, Department of Neurological Sciences and Vision, University of Brescia; Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy; Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| |
Collapse
|
25
|
Damiani D, Tiribelli M, Franzoni A, Michelutti A, Fabbro D, Cavallin M, Toffoletti E, Simeone E, Fanin R, Damante G. BAALC overexpression retains its negative prognostic role across all cytogenetic risk groups in acute myeloid leukemia patients. Am J Hematol 2013; 88:848-52. [PMID: 23760853 DOI: 10.1002/ajh.23516] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/31/2013] [Accepted: 06/04/2013] [Indexed: 11/07/2022]
Abstract
Overexpression of brain and acute leukemia cytoplasmic (BAALC) gene confers poor prognosis in cytogenetically normal acute myeloid leukemia (AML) patients, while less defined is its role in AML with abnormal karyotype. We evaluated the effect of BAALC overexpression on outcome of 175 adult AML patients with different cytogenetic risks. Karyotype was favorable in 13, intermediate in 117 and unfavorable in 45 patients, respectively. Quantitative BAALC expression was determined by real-time PCR, with cut off value set at 50th percentile. BAALC was overexpressed in 87/175 (50%) patients, without association with cytogenetic status. High BAALC was associated with unmutated NPM (P = 0.006) and CD34 positivity (P < 0.0001). Complete remission (CR) was attained in 111 patients (63%), and was maintained at 5 years in 52 ± 7%. BAALC overexpression had a negative impact on CR achievement (P = 0.04), while did not influence relapse probability. Median survival was 22 months with a 5-years overall survival (OS) of 35%. Factors with a negative impact on OS were older age (P = 0.0001), unfavorable cytogenetic (P = 0.005), ABCG2 overexpression (P = 0.03) and high BAALC levels (P = 0.01). We observed a worse outcome in patients with high BAALC expression through all cytogenetic risk categories: 5-years OS was 100% vs. 71% in patients with favorable cytogenetics (P = 0.05), 55% vs. 40% in cases with intermediate karyotype (P = 0.04) and 34% vs. 23% in unfavorable cytogenetic subgroup (P = 0.02). BAALC overexpression identified AML patients with poor prognosis in all cytogenetic groups. Though relatively rare, BAALC positivity in patients with favorable or unfavorable karyotype significantly worsened survival.
Collapse
Affiliation(s)
- Daniela Damiani
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Mario Tiribelli
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | | | - Angela Michelutti
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Dora Fabbro
- Institute of Genetics; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Margherita Cavallin
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Eleonora Toffoletti
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Erica Simeone
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Renato Fanin
- Division of Hematology and Bone Marrow Transplantation; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| | - Giuseppe Damante
- Institute of Genetics; Azienda Ospedaliero-Universitaria Udine; Udine Italy
| |
Collapse
|
26
|
D'Elia AV, Grimaldi F, Pizzolitto S, De Maglio G, Bregant E, Passon N, Franzoni A, Verrienti A, Tamburrano G, Durante C, Filetti S, Fogolari F, Russo D, Damante G. A new germline VHL gene mutation in three patients with apparently sporadic pheochromocytoma. Clin Endocrinol (Oxf) 2013; 78:391-7. [PMID: 22946750 DOI: 10.1111/cen.12032] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 02/26/2012] [Accepted: 08/30/2012] [Indexed: 11/29/2022]
Abstract
CONTEXT Germline mutations in four genes (RET, VHL, SDHB and SDHD) are detected in about 17% of patients with apparently sporadic pheochromocytoma. Thus, genetic screening of all patients with this disease is suggested for a rational diagnostic approach and management. OBJECTIVE To report the clinical, biochemical and genetic analysis of three unrelated patients affected by pheochromocytoma. DESIGN AND PATIENTS All the coding regions and exon-intron boundaries of RET, VHL, SDHB and SDHD genes were sequenced in three unrelated patients with intra-adrenal pheochromocytoma: a 17-year-old girl, a 15-year-old boy and a 73-year-old man. The family history of all three cases was negative for von Hippel-Lindau lesions or other types of endocrine tumours. Structural modelling of the VHL protein was then performed. RESULTS We identified a novel germline VHL gene point mutation, a G to A nucleotide substitution in exon 3, leading to an aspartate to asparagine amino acid change in codon 197 (D197N). No mutations were found in RET, SDHB and SDHD genes. Structural modelling of the VHL protein suggests that the D197N mutation could have a functional role. CONCLUSIONS Our study expands the number of VHL gene known mutations and indicates the usefulness of performing the genetic analysis in all patients with apparently sporadic pheochromocytoma.
Collapse
Affiliation(s)
- Angela V D'Elia
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliero-Universitaria, Udine, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Tiribelli M, Fabbro D, Franzoni A, Fanin R, Damante G, Damiani D. Q141K polymorphism of ABCG2 protein is associated with poor prognosis in adult acute myeloid leukemia treated with idarubicin-based chemotherapy. Haematologica 2012; 98:e28-9. [PMID: 23065526 DOI: 10.3324/haematol.2012.075895] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
MESH Headings
- ATP Binding Cassette Transporter, Subfamily G, Member 2
- ATP-Binding Cassette Transporters/genetics
- Adult
- Aged
- Aged, 80 and over
- Amino Acid Substitution
- Antibiotics, Antineoplastic/therapeutic use
- Humans
- Idarubicin/therapeutic use
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Middle Aged
- Neoplasm Proteins/genetics
- Polymorphism, Single Nucleotide
- Prognosis
- Young Adult
Collapse
|
28
|
Passon N, Puppin C, Lavarone E, Bregant E, Franzoni A, Hershman JM, Fenton MS, D'Agostino M, Durante C, Russo D, Filetti S, Damante G. Cyclic AMP-response element modulator inhibits the promoter activity of the sodium iodide symporter gene in thyroid cancer cells. Thyroid 2012; 22:487-93. [PMID: 22510021 DOI: 10.1089/thy.2011.0360] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Indexed: 11/13/2022]
Abstract
BACKGROUND Comprehension of the regulatory mechanism involved in the sodium iodide symporter (NIS) expression is of great relevance for thyroid cancer. In fact, restoration of NIS expression would be a strategy to treat undifferentiated thyroid cancer. Previous in vitro findings suggest that the cyclic AMP-response element (CRE) modulator (CREM) is involved in control of NIS expression. In this work, we examined the expression of CREM in a series of thyroid cancer tissues and its action on NIS promoter in human thyroid cancer cells. METHODS Expression of mRNA levels for CREM, PAX8 and NIS was measured by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) in 6 normal thyroid tissues, 22 papillary, 12 follicular and 4 anaplastic thyroid cancers. The effect of CREM on transcriptional activity of the NIS promoter was investigated by transient transfection of human thyroid cell lines. RESULTS Compared to normal tissues, NIS and PAX8 mRNA levels were significantly reduced in all types of thyroid cancer. As expected, the maximal decrease was detected in anaplastic thyroid cancer. Conversely, CREM mRNA levels were increased in all types of thyroid cancer, reaching statistical significance for follicular and anaplastic thyroid carcinoma (p=0.0157 and 0.0045, respectively). Transfection experiments showed an inhibitory effect of CREM on NIS promoter activity in various thyroid cancer cell lines. CONCLUSIONS These data demonstrate that CREM expression is increased in thyroid cancer tissue and may play a role in the downregulation of NIS expression in thyroid cancer acting at the transcriptional level.
Collapse
Affiliation(s)
- Nadia Passon
- Department of Medical and Biological Science, University of Udine, Udine, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Franzoni A, Passon N, Fabbro D, Tiribelli M, Damiani D, Damante G. Histone post-translational modifications associated to BAALC expression in leukemic cells. Biochem Biophys Res Commun 2011; 417:721-5. [PMID: 22197554 DOI: 10.1016/j.bbrc.2011.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 12/05/2011] [Indexed: 01/14/2023]
Abstract
BAALC expression is an indicator of aggressiveness in acute myelogenous leukemia (AML). Overexpression of this gene is associated to poor of clinical outcome. It is known that post-translational histone modifications control gene transcription. Thus, here we have investigated BAALC expression and post-translational histone modifications in leukemia cell lines. We show that Kasumi-6 and Kyo cells have high and low BAALC mRNA levels, respectively. Moreover, we demonstrate that these cell lines present distinct profiles in terms of histone post-translational modifications (H3K9K14 acetylation, H3K4 trimethylation and H3K23 trimethylation) at the level of BAALC promoter. These findings, in light of recent data on how histone post-translational modifications control gene expression, indicate that BAALC gene is "paused" and that in leukemia cells its transcription can be activated or repressed by mechanisms acting on epigenetic marks.
Collapse
Affiliation(s)
- Alessandra Franzoni
- Istituto di Genetica Medica, Azienda Ospedaliero-Universitaria S. Maria della Misericordia Udine, Italy.
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
Nucleophosmin (NPM) is a multifunctional nucleolar protein that, depending on the context, can act as oncogene or tumour suppressor. Mutations of the NPM1 gene induce delocalization of NPM in acute myeloid leukaemia. Differently, in solid tumours, only NPM overexpression, but not delocalization, has been so far reported. Here, NPM localization in thyroid tumours was investigated. By using immunohistochemistry, we show increase of NPM cytoplasmic localization in follicular adenomas and papillary carcinomas compared to normal thyroid tissue (p = 0.0125 and <0.0001, respectively). NPM1 mutations commonly found in human leukaemia are not present in thyroid tumours. Immunofluorescence in cultured cell lines was utilized to discriminate between nucleolar and nuclear localization. We show that in thyroid cancer cell lines NPM localizes both in the nucleolus and in nucleus, while in non-tumorigenic thyroid cell lines localizes only in nucleolus. Either presence of the histone deacetylase inhibitor trichostatin A or absence of thyroid-stimulating hormone induces NPM nuclear localization in non-tumorigenic thyroid cell lines.
Collapse
Affiliation(s)
- Annalisa Pianta
- Dipartimento di Scienze e Tecnologie Biomediche, Università di Udine, Piazzale Kolbe 1, 33100 Udine, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Puppin C, Passon N, Franzoni A, Russo D, Damante G. Histone deacetylase inhibitors control the transcription and alternative splicing of prohibitin in thyroid tumor cells. Oncol Rep 2010; 25:393-7. [PMID: 21152868 DOI: 10.3892/or.2010.1075] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 09/23/2010] [Indexed: 11/05/2022] Open
Abstract
Prohibitin (PHB) is a ubiquitous protein with a number of different molecular functions. PHB is involved in tumorigenesis by exerting either a permissive or blocking action on tumor growth, depending on the cell context. In the present study, we investigated the effects of the histone deacetylase inhibitors (HDACis), trichostatin A (TSA) and sodium butyrate (NaB), on PHB expression in the thyroid tumor cell lines, TPC-1 and FRO. Both TSA and NaB increased PHB mRNA levels. Transfection experiments showed that the overexpression of HDAC1 or 2, but not 3, inhibited PHB promoter activity. The effects of TSA and NaB on the two major PHB mRNA splicing isoforms, were also investigated. Both TSA and NaB decreased the mRNA levels of the shorter isoform, but increased those of the longer isoform. Only the latter isoform contains a 3'UTR, which has been reported to exert a growth suppressive action. Thus, our data demonstrate that HDACis control both PHB transcription and alternative splicing. The effect of HDACis on PHB alternative splicing was not due to the modification of the expression of the ASF/SF2 splicing factor.
Collapse
Affiliation(s)
- Cinzia Puppin
- Dipartimento di Scienze e Tecnologie Biomediche, Università di Udine, and Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
| | | | | | | | | |
Collapse
|
32
|
Pianta A, Fabbro D, Damiani D, Tiribelli M, Fanin R, Franzoni A, Romanello M, Tell G, Di Loreto C, Damante G. Two novel NPM1 mutations in a therapy-responder AML patient. Hematol Oncol 2010; 28:151-5. [PMID: 19593743 DOI: 10.1002/hon.906] [Citation(s) in RCA: 2] [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: 11/07/2022]
Abstract
Nucleophosmin 1 (NPM1) is an abundant phosphoprotein mainly located in the nucleolus but also shuttling between the nucleus and cytoplasm. NPM1 has been proposed to be involved in synthesis and processing of ribosomal RNA, regulation of chromatin structure and transport of rRNA and ribosomal proteins. NPM1 gene is considered to be implicated in human cancer as it is a frequent target of genetic alterations, primarily in haematopoietic neoplasms. We describe a case of a therapy-responder acute myeloid leukaemia (AML) patient bearing two novel NPM1 mutations. Cells' transfection studies indicate that the presence of one of these mutations is associated to an abnormal nucleolar structure, suggesting that NPM1 may contribute to the control of nucleolar integrity.
Collapse
Affiliation(s)
- Annalisa Pianta
- Dipartimento di Scienze e Tecnologie Biomediche, Facoltà di Medicina, Università di Udine, Udine, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Pianta A, Puppin C, Franzoni A, Fabbro D, Di Loreto C, Bulotta S, Deganuto M, Paron I, Tell G, Puxeddu E, Filetti S, Russo D, Damante G. Nucleophosmin is overexpressed in thyroid tumors. Biochem Biophys Res Commun 2010; 397:499-504. [PMID: 20515654 DOI: 10.1016/j.bbrc.2010.05.142] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 05/27/2010] [Indexed: 11/27/2022]
Abstract
Nucleophosmin (NPM) is a protein that contributes to several cell functions. Depending on the context, it can act as an oncogene or tumor suppressor. No data are available on NPM expression in thyroid cells. In this work, we analyzed both NPM mRNA and protein levels in a series of human thyroid tumor tissues and cell lines. By using immunohistochemistry, NPM overexpression was detected in papillary, follicular, undifferentiated thyroid cancer, and also in follicular benign adenomas, indicating it as an early event during thyroid tumorigenesis. In contrast, various levels of NPM mRNA levels as detected by quantitative RT-PCR were observed in tumor tissues, suggesting a dissociation between protein and transcript expression. The same behavior was observed in the normal thyroid FRTL5 cell lines. In these cells, a positive correlation between NPM protein levels, but not mRNA, and proliferation state was detected. By using thyroid tumor cell lines, we demonstrated that such a post-mRNA regulation may depend on NPM binding to p-Akt, whose levels were found to be increased in the tumor cells, in parallel with reduction of PTEN. In conclusion, our present data demonstrate for the first time that nucleophosmin is overexpressed in thyroid tumors, as an early event of thyroid tumorigenesis. It seems as a result of a dysregulation occurring at protein and not transcriptional level related to an increase of p-Akt levels of transformed thyrocytes.
Collapse
Affiliation(s)
- Annalisa Pianta
- Dipartimento di Scienze e Tecnologie Biomediche, Università di Udine, Udine, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Pianta A, Fabbro D, Damiani D, Tiribelli M, Fanin R, Franzoni A, Romanello M, Tell G, Damante G. Unexpected phenotype of a typical NPM1 mutant. Br J Haematol 2009; 147:760-3. [PMID: 19737150 DOI: 10.1111/j.1365-2141.2009.07877.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Franzoni A, Dima M, D'Agostino M, Puppin C, Fabbro D, Loreto CD, Pandolfi M, Puxeddu E, Moretti S, Celano M, Bruno R, Filetti S, Russo D, Damante G. Prohibitin is overexpressed in papillary thyroid carcinomas bearing the BRAF(V600E) mutation. Thyroid 2009; 19:247-55. [PMID: 19207009 DOI: 10.1089/thy.2008.0235] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [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] [Indexed: 01/08/2023]
Abstract
BACKGROUND Prohibitin (PHB) is a multifunctional protein that is localized in different intracellular sites. PHB may exert different roles in tumorigenesis, having either a permissive action on tumor growth or an oncosuppressor role, depending on the cellular context. The objective of this study was to evaluate PHB expression in normal thyroid tissues, thyroid follicular adenomas (FAs), and papillary thyroid carcinomas (PTCs). METHODS PHB expression was analyzed by immunohistochemistry, Western blot, and quantitative reverse transcription polymerase chain reaction (RT-PCR). Transfections in the BCPAP and TPC-1 thyroid cancer cell lines were used to evaluate the PHB promoter activity. RESULTS In terms of protein and mRNA levels, normal tissues from patients with serum thyrotropin (TSH) values >0.8mU/L had PHB levels that were significantly reduced compared to specimens from patients with serum TSH values <0.5mU/L, suggesting that TSH exerts an inhibitory effect on PHB expression. Consistent with this was the finding that the presence of TSH was associated with low PHB levels in normal FRTL5 thyroid cells. Immunohistochemical analysis showed relatively low and high PHB expression in FAs and PTCs, respectively. PHB mRNA and protein overexpression, as assessed by quantitative RT-PCR and Western blot, was noted only in PTCs bearing the BRAF(V600E) mutation. Notably, cell transfection experiments suggested that presence of the BRAF(V600E) mutation may be associated to increase of the PHB promoter activity. CONCLUSIONS PHB is overexpressed in PTCs bearing the BRAF(V600E) mutation. We postulate that the presence of the BRAF(V600E) mutation increases PHB promoter activity and therefore potentially mediates effects of this mutation on the behavior of BRAF(V600E) positive PTCs.
Collapse
Affiliation(s)
- Alessandra Franzoni
- Dipartimento di Scienze e Tecnologie Biomediche, Università di Udine, Udine, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Cutaia L, Aviles M, Feresin F, Franzoni A, Peres L, Pincinato D, Bo GA. 12 THE EFFECT OF PROGESTERONE CONTENT IN A VAGINAL INSERT ON PREGNANCY RATES IN BEEF AND DAIRY CATTLE INSEMINATED AT FIXED TIME. Reprod Fertil Dev 2006. [DOI: 10.1071/rdv18n2ab12] [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: 11/23/2022] Open
Abstract
Three experiments were conducted to compare pregnancy rates in cows and heifers treated with intravaginal progesterone (P4)-releasing devices impregnated with either 0.5 or 1.0 g of P4 and inseminated at a fixed time (FTAI). In Experiment 1, 102 postpartum beef cows (Hereford and Angus crossbred with Tuli, 60 to 90 d postpartum) with a body condition score (BCS) of 2.5 to 3.0 (1 to 5 scale) were used. On Day 0, all cows received 2 mg of estradiol benzoate (EB; Syntex, Argentina) i.m. and were randomly assigned to receive an intravaginal progesterone-releasing device with 0.5 g of P4 (DIB 0.5 g; Syntex) or 1.0 g of P4 (DIB 1.0 g; Syntex). On Day 7, DIB devices were removed and all cows received 150 µg D(+)cloprostenol (Ciclase; Syntex) i.m. On Day 8, all cows received 1 mg EB and were FTAI 52 to 56 h after DIB removal. In Experiment 2, 93 Holstein cows that were 90 to 110 days in milk (DIM), producing on average 5000 kg of milk per lactation and with a BCS of 2.5 to 3.0 received the same treatments as those in Experiment 1. In Experiment 3, 100 Holstein heifers, 20 to 22 months old, with a BCS of 2.5 to 3.0, also received the same treatments as those in Experiment 1. Pregnancy rates in all experiments were determined by ultrasonography 35 days after FTAI and compared by chi-square test. No differences in pregnancy rates were detected between lactating beef cows, dairy cows, or dairy heifers treated with DIB devices impregnated with 0.5 or 1.0 g of P4 (Table 1). It was concluded that vaginal P4 releasing devices impregnated with 0.5 g or 1.0 g of P4 results in comparable pregnancy rates in FTAI protocols in beef and dairy cattle.
Table 1.
Pregnancy rates in postpartum beef cows, Holstein cows, and Holstein heifers treated with DIB devices impregnated with 0.5 or 1.0 g of P4 and subjected to FTAI
Collapse
|
37
|
Sbarbaro V, Zardini GB, Almici GM, Franzoni A. [Taurine in the treatment of epilepsy (Results in patients under 15 years of age treated with taurine)]. Riv Neurobiol 1980; 26:219-27. [PMID: 6792692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
38
|
Ghidini O, Del Campo A, Tomasi A, Franzoni A. [Complement activity in chronic liver diseases]. G Clin Med 1970; 51:568-579. [PMID: 5527274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
39
|
Pasoli CA, Mignosa G, Franzoni A. [On a case of perforation of the myocardium with a permanent intracardiac electrode catheter]. Fracastoro 1970; 63:33-9. [PMID: 5477737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
40
|
Del Campo A, Franzoni A, Pasqualicchio A, Tomasi A. [Experimental study of the problems of the immunizability of the aged. II. Active anti-diphtheria immunization experiments]. Ann Sanita Pubblica 1970; 31:37-50. [PMID: 5517763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
41
|
Del Campo A, Franzoni A, Pasqualicchio A, Tomasi A. [Experimental study of the problem of the immunizability of the aged. I. Active anti-tetanus immunization experiments]. Ann Sanita Pubblica 1970; 31:23-36. [PMID: 4103067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
42
|
Pasqualicchio A, Pasoli CA, Franzoni A, Ancona G, Bruschi E, Gianfranceschi G. [Hemodynamic study of the arteriovenous shunt for hemodialysis. (Findings with the polygraphic method)]. Fracastoro 1969; 62:26-8. [PMID: 5402908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
43
|
Pasqualicchio A, Pasoli CA, Franzoni A, Ancona G, Bruschi E, Gianfranceschi G. [Polygraphic studies before and after strophanthin therapy in subjects undergoing periodic dialytic treatment]. Fracastoro 1969; 62:21-5. [PMID: 5402907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
44
|
Franzoni A, Pasoli CA, Mansoldo G. [Contribution of the Pescador III P lead to the diagnosis of coronary insufficiency in the aged]. Fracastoro 1968; 61:872-9. [PMID: 4243201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
45
|
Galanti G, Pasqualicchio A, Gianfranceschi G, Pasoli C, Bruschi E, Franzoni A. [Hemodynamic changes in the reinfusion phase at the end of dialysis. Evaluation of some parameters]. Minerva Nefrol 1967; 14:195-7. [PMID: 5607562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
46
|
Del Campo A, Castellani G, Franzoni A. [The natural factors of immunological resistance in the senile age]. G Gerontol 1966; 14:1123-33. [PMID: 5992332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
47
|
Franzoni A. Sopra un caso di tubercolosi con pluridecennale ininterrotto decorso febbrile. Respiration 1955. [DOI: 10.1159/000191664] [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: 11/19/2022] Open
|