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Byrne L, McCarthy C, Fabre A, Gupta N. Pulmonary Manifestations of Sjögren's Disease. Semin Respir Crit Care Med 2024. [PMID: 38621712 DOI: 10.1055/s-0044-1785675] [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: 04/17/2024]
Abstract
Sjögren's disease (SjD) is a chronic, progressive autoimmune condition of exocrine and extraglandular tissues. It can present with isolated disease characterized by lymphocytic infiltration of salivary or lacrimal glands, but in approximately one-third of the patients, lymphocytic infiltration extends beyond exocrine glands to involve extraglandular organs such as the lungs. Pulmonary complications have been reported to occur between 9 and 27% of patients with SjD across studies. Respiratory manifestations occur on a spectrum of severity and include airways disease, interstitial lung disease, cystic lung disease, and lymphoma. Lung involvement can greatly affect patients' quality of life, has a major impact on the overall prognosis, and frequently leads to alteration in the treatment plans, highlighting the importance of maintaining a high index of clinical suspicion and taking appropriate steps to facilitate early recognition and intervention.
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Affiliation(s)
- Louise Byrne
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Nishant Gupta
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio
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2
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O'Callaghan M, Le Roux C, Fabre A, McCarthy C. Weight loss with GLP-1 analogues in preparation for transplantation. BMJ Case Rep 2024; 17:e256099. [PMID: 38594196 PMCID: PMC11015230 DOI: 10.1136/bcr-2023-256099] [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] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
This case describes a woman in her 20s with a 6-month history of progressive exertional dyspnoea and cough. Examination revealed hypoxia on room air, sinus tachycardia, finger clubbing and bibasal inspiratory crackles. Inflammatory markers were mildly elevated and empirical antimicrobial therapy was commenced. A multidisciplinary discussion consensus diagnosis of acute interstitial pneumonitis was made based on the findings of high-resolution CT of the chest, macrophage predominant bronchoalveolar lavage cell differential and surgical lung biopsy. There was clinical and radiological deterioration despite glucocorticoids and antifibrotic therapy. A body mass index of 37.5 kg/m2 precluded her from lung transplant assessment and consideration. Following consultation with the weight management service, she was commenced on glucagon-like peptide 1 (GLP-1) analogue therapy. She had a remarkable response within 6 months, was listed for lung transplantation, and within 18 months of her initial presentation, a double lung transplantation was performed.
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Affiliation(s)
- Marissa O'Callaghan
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
- University College Dublin, Dublin, Ireland
| | | | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
- University College Dublin, Dublin, Ireland
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3
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O'Callaghan M, Duignan J, Tarling EJ, Waters DK, McStay M, O'Carroll O, Bridges JP, Redente EF, Franciosi AN, McGrath EE, Butler MW, Dodd JD, Fabre A, Murphy DJ, Keane MP, McCarthy C. Analysis of tissue lipidomics and computed tomography pulmonary fat attenuation volume (CT PFAV ) in idiopathic pulmonary fibrosis. Respirology 2023; 28:1043-1052. [PMID: 37642207 DOI: 10.1111/resp.14582] [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] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND AND OBJECTIVE There is increasing interest in the role of lipids in processes that modulate lung fibrosis with evidence of lipid deposition in idiopathic pulmonary fibrosis (IPF) histological specimens. The aim of this study was to identify measurable markers of pulmonary lipid that may have utility as IPF biomarkers. STUDY DESIGN AND METHODS IPF and control lung biopsy specimens were analysed using a unbiased lipidomic approach. Pulmonary fat attenuation volume (PFAV) was assessed on chest CT images (CTPFAV ) with 3D semi-automated lung density software. Aerated lung was semi-automatically segmented and CTPFAV calculated using a Hounsfield-unit (-40 to -200HU) threshold range expressed as a percentage of total lung volume. CTPFAV was compared to pulmonary function, serum lipids and qualitative CT fibrosis scores. RESULTS There was a significant increase in total lipid content on histological analysis of IPF lung tissue (23.16 nmol/mg) compared to controls (18.66 mol/mg, p = 0.0317). The median CTPFAV in IPF was higher than controls (1.34% vs. 0.72%, p < 0.001) and CTPFAV correlated significantly with DLCO% predicted (R2 = 0.356, p < 0.0001) and FVC% predicted (R2 = 0.407, p < 0.0001) in patients with IPF. CTPFAV correlated with CT features of fibrosis; higher CTPFAV was associated with >10% reticulation (1.6% vs. 0.94%, p = 0.0017) and >10% honeycombing (1.87% vs. 1.12%, p = 0.0003). CTPFAV showed no correlation with serum lipids. CONCLUSION CTPFAV is an easily quantifiable non-invasive measure of pulmonary lipids. In this pilot study, CTPFAV correlates with pulmonary function and radiological features of IPF and could function as a potential biomarker for IPF disease severity assessment.
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Affiliation(s)
- Marissa O'Callaghan
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - John Duignan
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Elizabeth J Tarling
- Division of Cardiology, University of California, Los Angeles, California, USA
| | - Darragh K Waters
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Megan McStay
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Orla O'Carroll
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - James P Bridges
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | | | - Alessandro N Franciosi
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Emmet E McGrath
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Marcus W Butler
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jonathan D Dodd
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - David J Murphy
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Michael P Keane
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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O'Dowd EL, Tietzova I, Bartlett E, Devaraj A, Biederer J, Brambilla M, Brunelli A, Chorostowska J, Decaluwe H, Deruysscher D, De Wever W, Donoghue M, Fabre A, Gaga M, van Geffen W, Hardavella G, Kauczor HU, Kerpel-Fronius A, van Meerbeeck J, Nagavci B, Nestle U, Novoa N, Prosch H, Prokop M, Putora PM, Rawlinson J, Revel MP, Snoeckx A, Veronesi G, Vliegenthart R, Weckbach S, Blum TG, Baldwin DR. ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer. Eur J Cardiothorac Surg 2023; 64:ezad302. [PMID: 37804174 PMCID: PMC10876118 DOI: 10.1093/ejcts/ezad302] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/06/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation. METHODS A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council. RESULTS Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements. CONCLUSIONS This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.
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Affiliation(s)
- Emma L O'Dowd
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- University of Nottingham, Faculty of Medicine and Health Sciences, Nottingham, UK
| | - Ilona Tietzova
- Charles University, First Faculty of Medicine, Department of Tuberculosis and Respiratory Diseases, Prague, Czech Republic
| | - Emily Bartlett
- Royal Brompton and Harefield NHS Foundation Trust, Radiology, London, UK
| | - Anand Devaraj
- Royal Brompton and Harefield NHS Foundation Trust, Radiology, London, UK
| | - Jürgen Biederer
- University of Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
- German Center for Lung Research DZL, Translational Lung Research Center TLRC, Heidelberg, Germany
- University of Latvia, Faculty of Medicine, Riga, Latvia
- Christian-Albrechts-Universität zu Kiel, Faculty of Medicine, Kiel, Germany
| | - Marco Brambilla
- Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | | | - Joanna Chorostowska
- Institute of Tuberculosis and Lung Diseases, Warsaw, Genetics and Clinical Immunology, Warsaw, Poland
| | | | - Dirk Deruysscher
- Maastricht University Medical Centre, Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Limburg, The Netherlands
| | - Walter De Wever
- Universitaire Ziekenhuizen Leuven, Radiology, Leuven, Belgium
| | | | - Aurelie Fabre
- University College Dublin School of Medicine, Histopathology, Dublin, Ireland
| | - Mina Gaga
- Sotiria General Hospital of Chest Diseases of Athens, 7th Respiratory Medicine Department, Athens, Greece
| | - Wouter van Geffen
- Medical Centre Leeuwarden, Department of Respiratory Medicine, Leeuwarden, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - Georgia Hardavella
- Sotiria General Hospital of Chest Diseases of Athens, Respiratory Medicine, Athens, Greece
| | - Hans-Ulrich Kauczor
- University of Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
- German Center for Lung Research DZL, Translational Lung Research Center TLRC, Heidelberg, Germany
| | - Anna Kerpel-Fronius
- National Koranyi Institute of Pulmonology, Department of Radiology, Budapest, Hungary
| | | | - Blin Nagavci
- Institute for Evidence in Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ursula Nestle
- Kliniken Maria Hilf GmbH Monchengladbach, Nordrhein-Westfalen, Germany
| | - Nuria Novoa
- University Hospital of Salamanca, Thoracic Surgery, Salamanca, Spain
| | - Helmut Prosch
- Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna, Austria
| | - Mathias Prokop
- Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen, The Netherlands
| | - Paul Martin Putora
- Kantonsspital Sankt Gallen, Radiation Oncology, Sankt Gallen, Switzerland
- Inselspital Universitatsspital Bern, Radiation Oncology, Bern, Switzerland
| | | | - Marie-Pierre Revel
- Cochin Hospital, APHP, Radiology Department, Paris, France
- Université de Paris, Paris, France
| | | | - Giulia Veronesi
- Humanitas Research Hospital, Division of Thoracic and General Surgery, Rozzano, Italy
| | | | - Sabine Weckbach
- UniversitatsKlinikum Heidelberg, Heidelberg, Germany
- Bayer AG, Research and Development, Pharmaceuticals, Radiology, Berlin, Germany
| | - Torsten G Blum
- HELIOS Klinikum Emil von Behring GmbH, Lungenklinik Heckeshorn, Berlin, Germany
| | - David R Baldwin
- University of Nottingham, Faculty of Medicine and Health Sciences, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Department of Respiratory Medicine, Nottingham, UK
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5
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [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] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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6
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O'Dowd EL, Tietzova I, Bartlett E, Devaraj A, Biederer J, Brambilla M, Brunelli A, Chorostowska-Wynimko J, Decaluwe H, Deruysscher D, De Wever W, Donoghue M, Fabre A, Gaga M, van Geffen W, Hardavella G, Kauczor HU, Kerpel-Fronius A, van Meerbeeck J, Nagavci B, Nestle U, Novoa N, Prosch H, Prokop M, Putora PM, Rawlinson J, Revel MP, Snoeckx A, Veronesi G, Vliegenthart R, Weckbach S, Blum TG, Baldwin DR. ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer. Eur Respir J 2023; 62:2300533. [PMID: 37802631 DOI: 10.1183/13993003.00533-2023] [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] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/06/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Screening for lung cancer with low radiation dose computed tomography has a strong evidence base, is being introduced in several European countries and is recommended as a new targeted cancer screening programme. The imperative now is to ensure that implementation follows an evidence-based process that will ensure clinical and cost effectiveness. This European Respiratory Society (ERS) task force was formed to provide an expert consensus for the management of incidental findings which can be adapted and followed during implementation. METHODS A multi-European society collaborative group was convened. 23 topics were identified, primarily from an ERS statement on lung cancer screening, and a systematic review of the literature was conducted according to ERS standards. Initial review of abstracts was completed and full text was provided to members of the group for each topic. Sections were edited and the final document approved by all members and the ERS Science Council. RESULTS Nine topics considered most important and frequent were reviewed as standalone topics (interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities). Other topics considered of lower importance or infrequent were grouped into generic categories, suitable for general statements. CONCLUSIONS This European collaborative group has produced an incidental findings statement that can be followed during lung cancer screening. It will ensure that an evidence-based approach is used for reporting and managing incidental findings, which will mean that harms are minimised and any programme is as cost-effective as possible.
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Affiliation(s)
- Emma L O'Dowd
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- University of Nottingham, Faculty of Medicine and Health Sciences, Nottingham, UK
| | - Ilona Tietzova
- Charles University, First Faculty of Medicine, Department of Tuberculosis and Respiratory Diseases, Prague, Czech Republic
| | - Emily Bartlett
- Royal Brompton and Harefield NHS Foundation Trust, Radiology, London, UK
| | - Anand Devaraj
- Royal Brompton and Harefield NHS Foundation Trust, Radiology, London, UK
| | - Jürgen Biederer
- University of Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
- German Center for Lung Research DZL, Translational Lung Research Center TLRC, Heidelberg, Germany
- University of Latvia, Faculty of Medicine, Riga, Latvia
- Christian-Albrechts-Universität zu Kiel, Faculty of Medicine, Kiel, Germany
| | - Marco Brambilla
- Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | | | | | | | - Dirk Deruysscher
- Maastricht University Medical Centre, Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Limburg, The Netherlands
| | - Walter De Wever
- Universitaire Ziekenhuizen Leuven, Radiology, Leuven, Belgium
| | | | - Aurelie Fabre
- University College Dublin School of Medicine, Histopathology, Dublin, Ireland
| | - Mina Gaga
- Sotiria General Hospital of Chest Diseases of Athens, 7th Respiratory Medicine Department, Athens, Greece
| | - Wouter van Geffen
- Medical Centre Leeuwarden, Department of Respiratory Medicine, Leeuwarden, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - Georgia Hardavella
- Sotiria General Hospital of Chest Diseases of Athens, Respiratory Medicine, Athens, Greece
| | - Hans-Ulrich Kauczor
- University of Heidelberg, Diagnostic and Interventional Radiology, Heidelberg, Germany
- German Center for Lung Research DZL, Translational Lung Research Center TLRC, Heidelberg, Germany
| | - Anna Kerpel-Fronius
- National Koranyi Institute of Pulmonology, Department of Radiology, Budapest, Hungary
| | | | - Blin Nagavci
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ursula Nestle
- Kliniken Maria Hilf GmbH Monchengladbach, Nordrhein-Westfalen, Germany
| | - Nuria Novoa
- University Hospital of Salamanca, Thoracic Surgery, Salamanca, Spain
| | - Helmut Prosch
- Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna, Austria
| | - Mathias Prokop
- Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen, The Netherlands
| | - Paul Martin Putora
- Kantonsspital Sankt Gallen, Radiation Oncology, Sankt Gallen, Switzerland
- Inselspital Universitatsspital Bern, Radiation Oncology, Bern, Switzerland
| | | | - Marie-Pierre Revel
- Cochin Hospital, APHP, Radiology Department, Paris, France
- Université de Paris, Paris, France
| | | | - Giulia Veronesi
- Humanitas Research Hospital, Division of Thoracic and General Surgery, Rozzano, Italy
| | | | - Sabine Weckbach
- UniversitatsKlinikum Heidelberg, Heidelberg, Germany
- Bayer AG, Research and Development, Pharmaceuticals, Radiology, Berlin, Germany
| | - Torsten G Blum
- HELIOS Klinikum Emil von Behring GmbH, Lungenklinik Heckeshorn, Berlin, Germany
| | - David R Baldwin
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- University of Nottingham, Faculty of Medicine and Health Sciences, Nottingham, UK
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7
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Moran B, Smith CM, Zaborowski A, Ryan M, Karman J, Dunstan RW, Smith KM, Hambly R, Musilova J, Petrasca A, Fabre A, O'Donnell M, Hokamp K, Mills KHG, Housley WJ, Winter DC, Kirby B, Fletcher JM. Targeting the NLRP3 inflammasome reduces inflammation in hidradenitis suppurativa skin. Br J Dermatol 2023; 189:447-458. [PMID: 37243544 DOI: 10.1093/bjd/ljad184] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Treatment for the debilitating disease hidradenitis suppurativa (HS) is inadequate in many patients. Despite an incidence of approximately 1%, HS is often under-recognized and underdiagnosed, and is associated with a high morbidity and poor quality of life. OBJECTIVES To gain a better understanding of the pathogenesis of HS, in order to design new therapeutic strategies. METHODS We employed single-cell RNA sequencing to analyse gene expression in immune cells isolated from involved HS skin vs. healthy skin. Flow cytometry was used to quantify the absolute numbers of the main immune populations. The secretion of inflammatory mediators from skin explant cultures was measured using multiplex and enzyme-linked immunosorbent assays. RESULTS Single-cell RNA sequencing analysis identified a significant enrichment in the frequency of plasma cells, T helper (Th) 17 cells and dendritic cell subsets in HS skin, and the immune transcriptome was distinct and more heterogeneous than healthy skin. Flow cytometry revealed significantly increased numbers of T cells, B cells, neutrophils, dermal macrophages and dendritic cells in HS skin. Genes and pathways associated with Th17 cells, interleukin (IL)-17, IL-1β and the NLRP3 inflammasome were enhanced in HS skin, particularly in samples with a high inflammatory load. Inflammasome constituent genes principally mapped to Langerhans cells and a subpopulation of dendritic cells. The secretome of HS skin explants contained significantly increased concentrations of inflammatory mediators, including IL-1β and IL-17A, and culture with an NLRP3 inflammasome inhibitor significantly reduced the secretion of these, as well as other, key mediators of inflammation. CONCLUSIONS These data provide a rationale for targeting the NLRP3 inflammasome in HS using small-molecule inhibitors that are currently being tested for other indications.
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Affiliation(s)
- Barry Moran
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Conor M Smith
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | - Mark Ryan
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Jozsef Karman
- AbbVie, Immunology Systems Computational Biology, Cambridge Research Center, Cambridge, MA, USA
| | - Robert W Dunstan
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Kathleen M Smith
- AbbVie, Immunology Systems Computational Biology, Cambridge Research Center, Cambridge, MA, USA
| | - Roisin Hambly
- Department of Dermatology, St. Vincent's University Hospital and Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Jana Musilova
- Education and Research Centre, University College Dublin, Dublin, Ireland
| | - Andreea Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital and School of Medicine, University College Dublin, Ireland
| | | | - Karsten Hokamp
- Department of Genetics, School of Genetics and Microbiology, Smurfit Institute of Genetics
| | - Kingston H G Mills
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - William J Housley
- AbbVie, Immunology Discovery Research, AbbVie Bioresearch Center, Worcester, MA, USA
| | - Desmond C Winter
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital and Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Jean M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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8
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Di Capua DM, Shanahan W, Bourke M, Ramlaul N, Appel J, Canney A, Docherty NG, McGrath E, Ring E, Jones F, Boyle M, McCormack J, Gallagher T, Hoti E, Nolan N, Ryan JD, Houlihan DD, Fabre A. Tumour stemness and poor clinical outcomes in haemochromatosis patients with hepatocellular carcinoma. J Clin Pathol 2023:jcp-2022-208679. [PMID: 37253536 DOI: 10.1136/jcp-2022-208679] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/14/2023] [Indexed: 06/01/2023]
Abstract
AIMS Patients with haemochromatosis (HFE) are known to have an increased risk of developing hepatocellular carcinoma (HCC). Available data are conflicting on whether such patients have poorer prognosis, and there is lack of data regarding the biology of HFE-HCC. We compared the course of HFE-HCC with a matched non-HFE-HCC control group and examined tumour characteristics using immunohistochemistry. METHODS In this tertiary care-based retrospective analysis, 12 patients with HFE and 34 patients with alcohol/non-alcoholic steatohepatitis who underwent initially successful curative HCC therapy with ablation or resection were identified from our registry. Time to tumour progression was compared. Resected liver tissue from a separate cohort of 11 matched patients with HFE-HCC and without HFE-HCC was assessed for the expression of progenitor and epithelial-mesenchymal transition markers using immunohistochemistry. RESULTS The median follow-up was 24.39 and 24.28 months for patients with HFE-HCC and those without HFE-HCC, respectively (p>0.05). The mean time to progression was shorter in the HFE group compared with the non-HFE group (12.87 months vs 17.78 months; HR 3.322, p<0.05). Patients with HFE-HCC also progressed to more advanced disease by the end of follow-up (p<0.05). Immunohistochemical analysis of matched HFE-HCC and non-HFE-HCC explants demonstrated increased expression of the cancer stem cell markers EpCAM (epithelial cell adhesion molecule) and EpCAM/SALL4 (spalt-like transcription factor 4) coexpression in HFE-HCC specimens (p<0.05). There was a high frequency of combined tumour subtypes within the HFE cohort. CONCLUSIONS This study demonstrates that the clinical course of patients with HFE-HCC is more aggressive and provides the first data indicating that their tumours have increased expression of progenitor markers. These findings suggest patients with HFE-HCC may need to be considered for transplant at an earlier stage.
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Affiliation(s)
| | | | - Michele Bourke
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Navneet Ramlaul
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Josh Appel
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Aoife Canney
- Histopathology, University Hospital Galway, Galway, Ireland
| | - Neil G Docherty
- University College Dublin School of Medicine, Dublin, Ireland
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Erinn McGrath
- HIstopathology, St Vincent's University Hospital, Dublin, Ireland
| | - Eabha Ring
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Fiona Jones
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Marie Boyle
- Liver Unit, St Vincent's University Hospital, Dublin, Ireland
| | - Janet McCormack
- Reseach Pathology Core, Conway Institute, University College Dublin, Dublin, Ireland
| | - Tom Gallagher
- University College Dublin School of Medicine, Dublin, Ireland
- Hepatobiliary and Transplant Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Emir Hoti
- University College Dublin School of Medicine, Dublin, Ireland
- Hepatobiliary and Transplant Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Niamh Nolan
- HIstopathology, St Vincent's University Hospital, Dublin, Ireland
| | - John D Ryan
- Hepatology Unit, Beaumont Hospital, Dublin, ireland
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Aurelie Fabre
- HIstopathology, St Vincent's University Hospital, Dublin, Ireland
- University College Dublin School of Medicine, Dublin, Ireland
- Reseach Pathology Core, Conway Institute, University College Dublin, Dublin, Ireland
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9
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Jouida A, McFadden P, Buckley G, Lynn E, Marissa O, Sekimoto Y, Fabre A, Keane MP, McCarthy C. Abstract 1230: The pre-metastatic niche establishment through the induction of the epithelial-to-mesenchymal transition by circulating exosomes in lymphangioleiomyomatosis (LAM): implication of the complement cascade. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1230] [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: 04/07/2023]
Abstract
Abstract
Exosomes are a class of extra cellular vesicles (EVs), with a multi vesicular endosomal origin, that are released by all cell types, with sizes ranging from 30-150nm and a lipid bilayer membrane. They have been shown to play key roles in disease progression and have diagnostic and disease monitoring potential. This study aims to characterize exosomes from the serum of patients with Lymphangioleiomyomatosis (LAM), a rare, low-grade, metastasizing neoplasm that occurs predominantly in females. Using Nanoparticle Tracking Analysis (NTA), serum from LAM patients (n=19) have significantly increased numbers of exosomes compared to serum samples from healthy controls (n=20) (8.9x109 vs 13.8x109 particles/ml; p=0.024). Furthermore, particles counts are significantly negatively correlated with the forced expiratory volume (FEV1) (r=-0.4667; p-value=0.0295) in LAM patients. Metalloproteinase activity in exosomes was measured by zymography. Interestingly, these LAM-derived exosomes had significantly higher activity of Pro-MMP-9 (3-fold increase; p-value=0.0278). We analyzed the effects of serum-derived exosomes on cells from an A549 cell line. Increased expression of vimentin, a major marker of EMT, was observed in cells treated with LAM-derived exosomes compared to healthy controls (1.4-fold increase; p=0.0217). Moreover, we showed by a modified Boyden chamber assay that exosomes derived from serum treatment increases the invasive capacity of A549 cells (fold change of 2.2; p-value=0.0004). We interrogated the LAM Single Cell Atlas and identified increased expression of TWIST1, a key transcription factor for EMT. TWIST1 was increased 8-fold in the lung and was uniquely expressed in 'LAM cells', which had metastasized. Furthermore, proteomic analysis revealed high expression of C3 and C5 in LAM-derived exosomes (respectively 1.4- and 2.1-fold change; p=0.0276 and p=0.0034) suggesting the potential regulatory role of the compliment system in the EMT mediated by exosomes These preliminary results highlight the urge to study the specific mechanistic interplay between MMPs and EMT, mediated by exosomes, and whether exosomes are involved in the metastatic spread of LAM cells to the lung and their role in influencing innate and adaptive immune cell response to this invasion.
Citation Format: Amina Jouida, Patrick McFadden, Grace Buckley, Evelyn Lynn, O'Callaghan Marissa, Yasuhito Sekimoto, Aurelie Fabre, Michael P. Keane, Cormac McCarthy. The pre-metastatic niche establishment through the induction of the epithelial-to-mesenchymal transition by circulating exosomes in lymphangioleiomyomatosis (LAM): implication of the complement cascade [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1230.
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Affiliation(s)
- Amina Jouida
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Patrick McFadden
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Grace Buckley
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Evelyn Lynn
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - O'Callaghan Marissa
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Yasuhito Sekimoto
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Aurelie Fabre
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Michael P. Keane
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
| | - Cormac McCarthy
- 1UCD Conway Institute of Biomolecular & Biomedical Research, Dublin, Ireland
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10
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Granahan A, Fabre A, Ryan A, Lally A. A rapidly enlarging nonpigmented nodule on the chest wall. Clin Exp Dermatol 2023; 48:426-428. [PMID: 36757909 DOI: 10.1093/ced/llac139] [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: 10/02/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/22/2023]
Abstract
We report a clinicopathological case of a patient with a rapidly enlarging nonpigmented nodule on the chest wall. There was no personal or family history of skin disease or cutaneous malignancy.
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Affiliation(s)
- Aoife Granahan
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- University College Dublin School of Medicine, Dublin, Ireland
| | - Aisling Ryan
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - Aoife Lally
- Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
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11
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Collins DM, McCormack J, Ivers LP, Pina JJB, Ballot J, Quinn C, Skrobo D, Eustace AJ, Walsh N, Fabre A, Crown J. Abstract P5-02-11: Immune cell profile of tumors from patients with metastatic (met) HER2+ breast cancer (BC) with < 30 months overall survival (OS). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-11] [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: The “Thousand Patient HER-2 database” project at Saint Vincent’s University Hospital (SVUH) Dublin has been used to identify HER2+ BC patients with durable complete response (never relapsed) to trastuzumab-based therapy. ~10% of met HER2+ BC patients achieve a durable complete response to trastuzumab, meaning the majority of patients progress on treatment. Higher stromal tumour immune infiltrate has been associated with longer OS in met HER2+ BC. There is limited tumor immune profile and PD-1 expression data available for patients with met HER2+ BC with short OS. Using the SVUH database, we have identified a preliminary cohort of 21 met HER2+ BC patients that received trastuzumab and had an OS < 30 months. This study examines the levels of pan T cell marker CD3, cytotoxic T cell marker CD8, Natural Killer (NK) cell marker CD56 and immune checkpoint PD-1 by immunohistochemistry (IHC) in this preliminary cohort. Methods: Formalin-fixed, paraffin-embedded (FFPE) biopsy specimens (n=21 primary, n=7 matched metastatic biopsies) and associated clinico-pathological data were curated. Tumor biopsies were processed for IHC staining of CD8 (Agilent IR62361-2), CD3 (Agilent IR50361-2), CD56 (Agilent IR62861-2) and PD-1 (Roche 07099029001). PD-1 staining was available for 20/21 samples. Staining was performed using the DAKO Link 48 Autostainer as per the manufacturer’s instructions using positive (tonsil tissue) and negative controls (isotype controls). Slides were processed using the Aperio AT2 Digital Slide Scanner (Leica Biosystems), reviewed using Aperio ImageScope 12.4 software (Leica Biosystems) and analyzed in QuPath (University of Edinburgh). Images were annotated to outline tumor areas and an algorithm was trained to identify cells and classify them as either tumor or stromal. Data was expressed as number of positively stained cells/mm2 breast tumor or stromal tissue. Survival studies utilized the Kaplan Meier method. The paired Student’s T test was utilized for primary vs metastatic site comparisons. Results: Designating samples with > 1 stained cell/mm2 breast tumor as positive (pos) and zero stained cells as negative (neg), 19/21 (90.5%) primary samples were pos for CD3, 15/21 (71.4%) for CD56, 14/21 (66.6%) for CD8, and 10/20 (50%) for PD-1. Within the stromal compartment, 20/21 (95.2%) primary samples were pos for CD8, 18/21 (85.7%) for CD56, 16/21 (76.2%) for CD3 and 8/20 (40%) for PD-1. PD-1 expression in the primary tumor (median OS PD-1pos 7.85 mo vs PD-1neg 5.39 mo, hazard ratio (HR) 0.642 (95% CI 0.256-1.613), p=0.346) or the stroma (median OS PD-1pos 8.84 mo vs PD-1neg 5.39 mo, HR 0.495 (95% CI 0.197-1.244), p=0.135) was not significantly associated with OS. When comparing matched primary and metastatic samples (n=7), increased stromal levels of CD3 (4/7), CD8 (4/7), CD56 (5/7) and PD-1 (4/7) were observed. Increased levels of CD3 and CD8 were observed for 2/7 samples, and increased levels of CD56 and PD-1 for 4/7 samples. With the exception of tumor CD8 levels which decreased, mean values for tumor and stromal CD3, CD56, PD-1 and stromal CD8 levels were higher in metastatic sites but all differences were not found to be significant (p>0.05). Conclusions: Our results suggest that met HER2+ BC patients with < 30 months OS have significant T cell and NK cell presence in the tumor and stromal compartments in both primary and metastatic sites. Further expansion of this limited dataset is planned to gain greater insight in to the immune cell profiles and PD-1 status of met HER2+ BC patients with short OS.
Citation Format: Denis M. Collins, Janet McCormack, Laura P. Ivers, Jose Javier Berenguer Pina, Jo Ballot, Cecily Quinn, Darko Skrobo, Alex J. Eustace, Naomi Walsh, Aurelie Fabre, John Crown. Immune cell profile of tumors from patients with metastatic (met) HER2+ breast cancer (BC) with < 30 months overall survival (OS). [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 P5-02-11.
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Affiliation(s)
- Denis M. Collins
- 1Cancer Biotherapeutics, National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland, Dublin, Dublin, Ireland
| | | | | | | | - Jo Ballot
- 5Department of Medical Oncology, St Vincent’s University Hospital, Dublin, Ireland
| | - Cecily Quinn
- 6St. Vincent’s University Hospital, Dublin, Ireland
| | | | | | - Naomi Walsh
- 9Dublin City University, Dublin 9, Dublin, Ireland
| | - Aurelie Fabre
- 10Saint Vincent’s University Hospital, Dublin, Ireland
| | - John Crown
- 11Department of Medical Oncology, Saint Vincent’s University Hospital, Dublin, Ireland, Ireland
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12
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O’Brien C, Duignan JA, Gleeson M, O’Carroll O, Franciosi AN, O’Toole D, Fabre A, Crowley RK, McCarthy C, Dodd JD, Murphy DJ. Quantitative Airway Assessment of Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) on CT as a Novel Biomarker. Diagnostics (Basel) 2022; 12:diagnostics12123096. [PMID: 36553103 PMCID: PMC9776594 DOI: 10.3390/diagnostics12123096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) occurs due to abnormal proliferation of pulmonary neuroendocrine cells. We hypothesized that performing a quantitative analysis of airway features on chest CT may reveal differences to matched controls, which could ultimately help provide an imaging biomarker. Methods: A retrospective quantitative analysis of chest CTs in patients with DIPNECH and age matched controls was carried out using semi-automated post-processing software. Paired segmental airway and artery diameters were measured for each bronchopulmonary segment, and the airway:artery (AA) ratio, airway wall thickness:artery ratio (AWTA ratio) and wall area percentage (WAP) calculated. Nodule number, size, shape and location was recorded. Correlation between CT measurements and pulmonary function testing was performed. Results: 16 DIPNECH and 16 control subjects were analysed (all female, mean age 61.7 +/− 11.8 years), a combined total of 425 bronchopulmonary segments. The mean AwtA ratio, AA ratio and WAP for the DIPNECH group was 0.57, 1.18 and 68.8%, respectively, compared with 0.38, 1.03 and 58.3% in controls (p < 0.001, <0.001, 0.03, respectively). DIPNECH patients had more nodules than controls (22.4 +/− 32.6 vs. 3.6 +/− 3.6, p = 0.03). AA ratio correlated with FVC (R2 = 0.47, p = 0.02). A multivariable model incorporating nodule number, AA ratio and AWTA-ratio demonstrated good performance for discriminating DIPNECH and controls (AUC 0.971; 95% CI: 0.925−1.0). Conclusions: Quantitative CT airway analysis in patients with DIPNECH demonstrates increased airway wall thickness and airway:artery ratio compared to controls. Advances in knowledge: Quantitative CT measurement of airway wall thickening offers a potential imaging biomarker for treatment response.
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Affiliation(s)
- Cormac O’Brien
- Department of Radiology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- National Centre for Neuroendocrine Tumours, ENETS NET Centre of Excellence, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - John A. Duignan
- Department of Radiology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Margaret Gleeson
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Orla O’Carroll
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Alessandro N. Franciosi
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Dermot O’Toole
- National Centre for Neuroendocrine Tumours, ENETS NET Centre of Excellence, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Aurelie Fabre
- National Centre for Neuroendocrine Tumours, ENETS NET Centre of Excellence, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- Department of Pathology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Rachel K. Crowley
- National Centre for Neuroendocrine Tumours, ENETS NET Centre of Excellence, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
- Department of Endocrinology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Jonathan D. Dodd
- Department of Radiology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - David J. Murphy
- Department of Radiology, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- National Centre for Neuroendocrine Tumours, ENETS NET Centre of Excellence, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
- Correspondence: ; Tel.: +353-1-221400
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O'Connor D, Fabre A, Gibbons D. Application of a Standardized Terminology and Nomenclature for Respiratory Cytology: Experience from a Large Tertiary Respiratory Cancer Centre. Acta Cytol 2022; 67:46-54. [PMID: 36446316 DOI: 10.1159/000527435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/26/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION In 2020, the World Health Organization-International Agency for Research on Cancer/International Academy of Cytology (WHO-IARC IAC) joint project was commenced to develop standardized nomenclature and diagnostic criteria in cytopathology internationally. Our institution has been coding all respiratory cytological specimens in a similar fashion for over 10 years. Our aim was to analyse the effectiveness of our respiratory cytology coding system by calculating the estimated risk of malignancy (ROM) and rates of each diagnostic category. METHODS Over a 2 year period, all endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), bronchial brushing, bronchial washing, bronchial lavage, and sputum specimens reported at our institution were analysed. For each specimen, the diagnostic code, the relevant indication for each diagnostic procedure, the diagnosis, and the presence or absence of a positive corresponding biopsy were recorded. RESULTS In total, 1,432 respiratory cytological specimens from 945 patients over a 2-year period were analysed. 467 specimens were confirmed to be associated with a malignant process. The overall ROM for respiratory cytology specimens was 37.7% for nondiagnostic, 18.1% for benign, 46.7% for atypical, 85.7% for suspicious for malignancy, and 91.9% for malignant. For each diagnostic procedure, the ROM increased from the benign to malignant categories. DISCUSSION/CONCLUSION Our ROM rates for overall respiratory cytology specimens and for EBUS-TBNA, bronchial brushing, and bronchial washing specimens separately are concordant with other major international studies. With the WHO-IARC IAC joint project in progress and an international respiratory cytology coding system being developed, our study has the potential to add value by providing indicative ROM rates, which can be used to inform the development of this new classification system. Our rates of diagnostic accuracy are in keeping with international standards, which support the accuracy of our data.
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Affiliation(s)
- Diarmuid O'Connor
- Histopathology Department, St. Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Histopathology Department, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - David Gibbons
- Histopathology Department, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
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Bosco P, O'kelly J, Briot K, Mehsen-Cetre N, Fabre A, Lassalle R, Abouelfath A. Efficacité en vie réelle des traitements de l'ostéoporose sur le risque de fracture: une étude de cohorte en population française. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.013] [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: 11/06/2022] Open
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15
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McNally E, Cronje L, Fabre A, Moloney E. Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma associated with coeliac disease. BMJ Case Rep 2022; 15:15/11/e250423. [DOI: 10.1136/bcr-2022-250423] [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: 11/19/2022] Open
Abstract
Pulmonary mucosa-associated lymphoid tissue (pMALT) lymphomas are rare, representing <1% of lung malignancies. An association between pMALT and autoimmune conditions has been described, but there is a paucity of documented cases linked to coeliac disease. We present the case of a patient with a history of coeliac disease who presented with weight loss but no respiratory symptoms. CT revealed diffuse endobronchial opacities with associated bronchial dilation and pulmonary nodules. Bronchoscopy confirmed widespread polypoid endobronchial lesions. Histology demonstrated diffuse lymphoid infiltrate which stained positive for CD20. Clonality studies confirmed low grade B cell MALT lymphoma. She was treated with anti CD20 monoclonal antibody, rituximab. Prognosis of pMALT is good with 5-year survival >80%. Thus, an index of suspicion and early detection are vital. This case highlights that pMALT should be considered in patients with non-specific symptoms and coeliac disease. Bronchoscopy is a valuable diagnostic tool to be used in these cases.
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de Leusse C, Roman C, Roquelaure B, Fabre A. Estimating the prevalence of congenital disaccharidase deficiencies using allele frequencies from gnomAD. Arch Pediatr 2022; 29:599-603. [PMID: 36167617 DOI: 10.1016/j.arcped.2022.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are currently three known congenital disaccharidase deficiencies: congenital lactase deficiency (CLD), congenital sucrase-isomaltase deficiency (CSD), and congenital trehalase deficiency (CTD). No congenital deficiency has been described for maltase-glucoamylase (MGAM). METHODS A literature search was performed in PubMed for the pathogenic variants CLD, CSD, and CTD and the articles retrieved were analyzed to estimate the prevalence of congenital disaccharidase deficiencies. RESULTS Based on reported variants, the estimated prevalence was 1.3 per 106 births (95% CI: 1.1-1.7) for CLD, and 31.4 per 106 births (95% CI: 28.3-34.8) for CSD. Using data on previously reported variants and variants predicted to be loss-of-function in gnomAD, the overall estimated prevalence was 2.3 per 106 births (95% CI: 1.9-2.9) for CLD, 57.6 per 106 births (95% CI:52.5-63.2) for CSD, and 9.2 per 106 births (95% CI: 2.5-3.7) for CTD. CONCLUSION The prevalence of CSD was found to be relatively high, while for other congenital disaccharidase deficiencies, the estimated prevalence was very low.
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Affiliation(s)
- C de Leusse
- AP-HM, Hôpital de la Timone Enfants, Service de pédiatrie multidisciplinaire, Marseille, France
| | - C Roman
- AP-HM, Hôpital de la Timone Enfants, Service de pédiatrie multidisciplinaire, Marseille, France
| | - B Roquelaure
- AP-HM, Hôpital de la Timone Enfants, Service de pédiatrie multidisciplinaire, Marseille, France
| | - A Fabre
- AP-HM, Hôpital de la Timone Enfants, Service de pédiatrie multidisciplinaire, Marseille, France; Aix Marseille Univ, INSERM, MMG, Marseille, France.
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17
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O’Callaghan M, Rooney L, Khan J, Flanagan S, Keane MP, Fabre A, O’Neill L, McCarthy C. A Man With Malaise, Myalgia, and Rapidly Progressive Interstitial Lung Disease. Chest 2022; 162:e111-e116. [PMID: 36088095 PMCID: PMC9449304 DOI: 10.1016/j.chest.2022.03.052] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 11/03/2022] Open
Abstract
A 45-year-old man sought treatment at the ED during the third wave of the COVID-19 pandemic with a month-long history of fatigue, cough, myalgia, and hand stiffness. He did not report dyspnea. He had no past medical history and previously was fit and active, working as a farmer. He was a lifelong nonsmoker and had no family history of lung disease.
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18
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Eyres M, Bell JA, Davies ER, Fabre A, Alzetani A, Jogai S, Marshall BG, Johnston DA, Xu Z, Fletcher SV, Wang Y, Marshall G, Davies DE, Offer E, Jones MG. Spatially resolved deconvolution of the fibrotic niche in lung fibrosis. Cell Rep 2022; 40:111230. [PMID: 35977489 PMCID: PMC10073410 DOI: 10.1016/j.celrep.2022.111230] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/07/2022] [Accepted: 07/26/2022] [Indexed: 11/03/2022] Open
Abstract
A defining pathological feature of human lung fibrosis is localized tissue heterogeneity, which challenges the interpretation of transcriptomic studies that typically lose spatial information. Here we investigate spatial gene expression in diagnostic tissue using digital profiling technology. We identify distinct, region-specific gene expression signatures as well as shared gene signatures. By integration with single-cell data, we spatially map the cellular composition within and distant from the fibrotic niche, demonstrating discrete changes in homeostatic and pathologic cell populations even in morphologically preserved lung, while through ligand-receptor analysis, we investigate cellular cross-talk within the fibrotic niche. We confirm findings through bioinformatic, tissue, and in vitro analyses, identifying that loss of NFKB inhibitor zeta in alveolar epithelial cells dysregulates the TGFβ/IL-6 signaling axis, which may impair homeostatic responses to environmental stress. Thus, spatially resolved deconvolution advances understanding of cell composition and microenvironment in human lung fibrogenesis.
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Affiliation(s)
- Michael Eyres
- Medicines Discovery Catapult, Alderley Park, Cheshire, UK
| | - Joseph A Bell
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Elizabeth R Davies
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital & UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Aiman Alzetani
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; University Hospital Southampton, Southampton, UK
| | - Sanjay Jogai
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; University Hospital Southampton, Southampton, UK
| | - Ben G Marshall
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; University Hospital Southampton, Southampton, UK
| | - David A Johnston
- Biomedical Imaging Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Zijian Xu
- Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Sophie V Fletcher
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; University Hospital Southampton, Southampton, UK
| | - Yihua Wang
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Gayle Marshall
- Medicines Discovery Catapult, Alderley Park, Cheshire, UK
| | - Donna E Davies
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Emily Offer
- Medicines Discovery Catapult, Alderley Park, Cheshire, UK
| | - Mark G Jones
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK.
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Jouida A, O’Callaghan M, Mc Carthy C, Fabre A, Nadarajan P, Keane MP. Exosomes from EGFR-Mutated Adenocarcinoma Induce a Hybrid EMT and MMP9-Dependant Tumor Invasion. Cancers (Basel) 2022; 14:cancers14153776. [PMID: 35954442 PMCID: PMC9367273 DOI: 10.3390/cancers14153776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023] Open
Abstract
Exosomes, a class of extra cellular nano-sized vesicles (EVs), and their contents have gained attention as potential sources of information on tumor detection and regulatory drivers of tumor progression and metastasis. The effect of exosomes isolated from patients with an Epidermal Growth Factor Receptor (EGFR)-mutated adenocarcinoma on the promotion of epithelial–mesenchymal transition (EMT) and invasion were examined. Exosomes derived from serum of patients with EGFR-mutated non-small cell lung cancer (NSCLC) mediate the activation of the Phosphoinositide 3-kinase (PI3K)/AKT/ mammalian target of rapamycin (mTOR) pathway and induce an invasion through the up-regulation of matrix metalloproteinase-9 (MMP-9) in A549 cells. We observed a significant increase in the expression of vimentin, a mesenchymal marker, while retaining the epithelial characteristics, as evidenced by the unaltered levels of E-cadherin and Epithelial cell adhesion molecule (EPCAM). We also observed an increase of nuclear factor erythroid 2-related factor 2 (NFR2) and P-cadherin expression, markers of hybrid EMT. Exosomes derived from EGFR-mutated adenocarcinoma serum could be a potential mediator of hybrid EMT and tumor invasion. Understanding how cancerous cells communicate and interact with their environment via exosomes will improve our understanding of lung cancer progression and metastasis formation.
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Affiliation(s)
- Amina Jouida
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
| | - Marissa O’Callaghan
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Cormac Mc Carthy
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Aurelie Fabre
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Parthiban Nadarajan
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Michael P. Keane
- School of Medicine, University College Dublin, D14 E099 Dublin, Ireland; (A.J.); (M.O.); (C.M.C.); (A.F.); (P.N.)
- Department of Respiratory Medicine, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
- Correspondence: ; Tel.: +353-1-221-4474; Fax: +353-1-221-3750
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20
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Jouida A, McCarhty C, Fabre A, Kelly A, Nadarajan P, Callaghan MO, Keane MP. Abstract 958: Exosomes from EGFR-mutated adenocarcinoma induce a hybrid EMT and MMP9-dependant tumour invasion. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-958] [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: 11/16/2022]
Abstract
Abstract
Exosomes are a class of extra cellular vesicles (EVs), with a multi vesicular endosomal origin, that are released by all cell types, with sizes ranging from 30-150nm and a lipid bilayer membrane. Recent studies document that tumour cells shed exosomes at considerably higher rates, and these exosomes play critical roles in several early and late events associated with tumour development and metastasis. Thus, circulating exosomes are emerging as a new paradigm of ‘liquid biopsy’ for non-invasive cancer diagnosis. They have been reported to influence epithelial mesenchymal transition (EMT) in pathological states such as metastatic lung cancer. We successfully isolated exosomes from an Epidermal Growth Factor Receptor (EGFR) mutated cell line (HCC827) and from serum of different lung cancer patients: EGFR-mutated adenocarcinoma (N=5), wild-type adenocarcinoma (N=5), squamous (N=3) and serum of patients with no cancer (N=5) and analysed their effects on cells from an A549 cell line. By zymography, we observed that exosomes derived from the EGFR-mutated adenocarcinoma patients contains significantly more MMP-9 and pro-MMP-9 than those derived from other patients. When incubated with A549 cells, all exosomes, derived from the EGFR mutated cell line and from patients (regardless of patient origin), induced an increase in MMP2 activity. However, the increase of MMP9 activity was seen only in A549 cells treated with exosomes derived from EGFR-mutated adenocarcinoma patients and from the EGFR mutated cell line. MMPs are one of the major attributes that epithelial cells acquire after undergoing EMT. Respectively by a modified Boyden chamber assay and by wound healing assay, we showed, that EGFR-mutated exosomes treatment increases the invasive capacity (fold change of 1.7; p-value=0.0008) and the migratory capacity [CM1] of A549 and HBE4 E6/E7 cells in an MMP-9 dependant pathway. By western blot and qPCR, we observed a significant increase of vimentin expression, a mesenchymal marker while retaining the epithelial characteristics as evidenced by the unaltered levels of E-cadherin and EPCAM. EMT is not a binary process but instead, cells often exhibit a spectrum of epithelial/mesenchymal phenotype(s). Such hybrid cells can move collectively as clusters which is thought to enhance their invasive properties. By qPCR, we observed an increase of NRF2, P-cadherin and cytokeratin 14, markers of hybrid-EMT and collective migration. Our results suggest that exosomes derived from EGFR-mutated adenocarcinoma serum could be a potential mediator of hybrid-EMT and tumour invasion and may provide insights into the mechanisms of lung cancer progression and metastasis. Further studies are required to precisely delineate these mechanisms and explore novel therapeutic avenues.
Citation Format: Amina Jouida, Cormac McCarhty, Aurelie Fabre, Allan Kelly, Parthiban Nadarajan, Marissa O Callaghan, Michael P. Keane. Exosomes from EGFR-mutated adenocarcinoma induce a hybrid EMT and MMP9-dependant tumour invasion [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 958.
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Terwiel M, Borie R, Crestani B, Galvin L, Bonella F, Fabre A, Froidure A, Griese M, Grutters JC, Johannson K, Kannengiesser C, Kawano-Dourado L, Molina-Molina M, Prasse A, Renzoni EA, van der Smagt J, Poletti V, Antoniou K, van Moorsel CHM. Genetic testing in interstitial lung disease: An international survey. Respirology 2022; 27:747-757. [PMID: 35652243 DOI: 10.1111/resp.14303] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/05/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Genetic analysis is emerging for interstitial lung diseases (ILDs); however, ILD practices are not yet standardized. We surveyed patients', relatives' and pulmonologists' experiences and needs on genetic testing in ILD to evaluate the current situation and identify future needs. METHODS A clinical epidemiologist (MT) together with members of the ERS taskforce and representatives of the European Idiopathic Pulmonary Fibrosis and related disorders Federation (EU-IPFF) patient organisation developed a survey for patients, relatives and pulmonologists. Online surveys consisted of questions on five main topics: awareness of hereditary ILD, the provision of information, genetic testing, screening of asymptomatic relatives and clinical impact of genetic analysis in ILD. RESULTS Survey respondents consisted of 458 patients with ILD, 181 patients' relatives and 352 pulmonologists. Most respondents think genetic testing can be useful, particularly for explaining the cause of disease, predicting its course, determining risk for developing disease and the need to test relatives. Informing patients and relatives on genetic analysis is primarily performed by the pulmonologist, but 88% (218) of pulmonologists identify a need for more information and 96% (240) ask for guidelines on genetic testing in ILD. A third of the pulmonologists who would offer genetic testing currently do not offer a genetic test, primarily because they have limited access to genetic tests. Following genetic testing, 72% (171) of pulmonologists may change the diagnostic work-up and 57% (137) may change the therapeutic approach. CONCLUSION This survey shows that there is wide support for implementation of genetic testing in ILD and a high need for information, guidelines and access to testing among patients, their relatives and pulmonologists.
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Affiliation(s)
- Michelle Terwiel
- ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Raphael Borie
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Bruno Crestani
- Service de Pneumologie A, Hôpital Bichat, APHP, Paris, France.,INSERM, Unité 1152, Université de Paris, Paris, France
| | - Liam Galvin
- European Idiopathic Pulmonary Fibrosis and Related Disorders Federation, Overijse, Belgium
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital & School of Medicine, University College Dublin, Dublin, Ireland
| | - Antoine Froidure
- Service de Pneumologie, Cliniques universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique, UC Louvain, Bruxelles, Belgium
| | - Matthias Griese
- Dr. von Hauner Children's Hospital, Ludwig-Maximilians University Munich, German Center for Lung Research (DZL), Munich, Germany
| | - Jan C Grutters
- ILD Center of Excellence, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Kerri Johannson
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Caroline Kannengiesser
- INSERM, Unité 1152, Université de Paris, Paris, France.,Laboratoire de Génétique, Hôpital Bichat, APHP, Paris, France
| | - Leticia Kawano-Dourado
- INSERM, Unité 1152, Université de Paris, Paris, France.,Pneumologie, Hôpital Bichat, APHP, Paris, France.,HCOR Research Institute, Hospital do Coracao, Sao Paulo, Brazil
| | - Maria Molina-Molina
- ILD Unit, Respiratory Department, Bellvitge University Hospital-IDIBELL, CIBERES, Barcelona, Spain
| | - Antje Prasse
- Pneumologie, Hannover Hochschule, Hannover, Germany
| | - Elisabetta A Renzoni
- Royal Brompton and Harefield Clinical Group, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Margaret Turner Warwick Centre for Fibrosing Lung Diseases, NHLI, Imperial College, London, UK
| | - Jasper van der Smagt
- Klinische Genetica, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Venerino Poletti
- Department of Diseases of the Thorax, University of Bologna/GB Morgagni Hospital, Forli, Italy
| | - Katerina Antoniou
- Department of Thoracic Medicine, University of Crete, Heraklion, Greece
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Casalou C, Moreiras H, Mayatra JM, Fabre A, Tobin DJ. Loss of 'Epidermal Melanin Unit' Integrity in Human Skin During Melanoma-Genesis. Front Oncol 2022; 12:878336. [PMID: 35574390 PMCID: PMC9097079 DOI: 10.3389/fonc.2022.878336] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 02/17/2022] [Accepted: 03/09/2022] [Indexed: 12/13/2022] Open
Abstract
Cutaneous melanoma can be a most challenging neoplasm of high lethality, in part due to its extreme heterogeneity and characteristic aggressive and invasive nature. Indeed, its moniker 'the great masquerader' reflects that not all melanomas are created equal in terms of their originating cellular contexts, but also that melanoma cells in the malignant tumor can adopt a wide range of different cell states and variable organotropism. In this review, we focus on the early phases of melanomagenesis by discussing how the originating pigment cell of the melanocyte lineage can be influenced to embark on a wide range of tumor fates with distinctive microanatomical pathways. In particular, we assess how cells of the melanocyte lineage can differ by maturation status (stem cell; melanoblast; transiently amplifying cell; differentiated; post-mitotic; terminally-differentiated) as well as by micro-environmental niche (in the stratum basale of the epidermis; within skin appendages like hair follicle, eccrine gland, etc). We discuss how the above variable contexts may influence the susceptibility of the epidermal-melanin unit (EMU) to become unstable, which may presage cutaneous melanoma development. We also assess how unique features of follicular-melanin unit(s) (FMUs) can, by contrast, protect melanocytes from melanomagenesis. Lastly, we postulate how variable melanocyte fates in vitiligo, albinism, psoriasis, and alopecia areata may provide new insights into immune-/non immune-mediated outcomes for melanocytes in cutaneous melanin units.
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Affiliation(s)
- Cristina Casalou
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Hugo Moreiras
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jay M Mayatra
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Dublin, Ireland.,The Conway Institute of Biomedical and Biomolecular Science, University College Dublin, Dublin, Ireland
| | - Desmond J Tobin
- The Charles Institute of Dermatology, School of Medicine, University College Dublin, Dublin, Ireland.,The Conway Institute of Biomedical and Biomolecular Science, University College Dublin, Dublin, Ireland
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23
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Alcántara I, Somma A, Chalar G, Fabre A, Segura A, Achkar M, Arocena R, Aubriot L, Baladán C, Barrios M, Bonilla S, Burwood M, Calliari DL, Calvo C, Capurro L, Carballo C, Céspedes-Payret C, Conde D, Corrales N, Cremella B, Crisci C, Cuevas J, De Giacomi S, De León L, Delbene L, Díaz I, Fleitas V, González-Bergonzoni I, González-Madina L, González-Piana M, Goyenola G, Gutiérrez O, Haakonsson S, Iglesias C, Kruk C, Lacerot G, Langone J, Lepillanca F, Lucas C, Martigani F, Martínez de la Escalera G, Meerhoff M, Nogueira L, Olano H, Pacheco JP, Panario D, Piccini C, Quintans F, Teixeira de Mello F, Terradas L, Tesitore G, Vidal L, García-Rodríguez F. A reply to "Relevant factors in the eutrophication of the Uruguay River and the Río Negro". Sci Total Environ 2022; 818:151854. [PMID: 34826482 DOI: 10.1016/j.scitotenv.2021.151854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/02/2021] [Accepted: 11/17/2021] [Indexed: 06/13/2023]
Abstract
A recent paper by Beretta-Blanco and Carrasco-Letelier (2021) claims that agricultural eutrophication is not one of the main causes for cyanobacterial blooms in rivers and artificial reservoirs. By combining rivers of markedly different hydrological characteristics e.g., presence/absence and number of dams, river discharge and geological setting, the study speculates about the role of nutrients for modulating phytoplankton chlorophyll-a. Here, we identified serious flaws, from erratic and inaccurate data manipulation. The study did not define how erroneous original dataset values were treated, how the variables below the detection/quantification limit were numerically introduced, lack of mandatory variables for river studies such as flow and rainfall, arbitrary removal of pH > 7.5 values (which were not outliers), and finally how extreme values of other environmental variables were included. In addition, we identified conceptual and procedural mistakes such as biased construction/evaluation of model prediction capability. The study trained the model using pooled data from a short restricted lotic section of the (large) Uruguay River and from both lotic and reservoir domains of the Negro River, but then tested predictability within the (small) Cuareim River. Besides these methodological considerations, the article shows misinterpretations of the statistical correlation of cause and effect neglecting basic limnological knowledge of the ecology of harmful algal blooms (HABs) and international research on land use effects on freshwater quality. The argument that pH is a predictor variable for HABs neglects overwhelming basic paradigms of carbon fluxes and change in pH because of primary productivity. As a result, the article introduces the notion that HABs formation are not related to agricultural land use and water residence time and generate a great risk for the management of surface waterbodies. This reply also emphasizes the need for good practices of open data management, especially for public databases in view of external reproducibility.
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Affiliation(s)
- I Alcántara
- Ud. Bioestadística, Departamento de Salud Pública, Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay
| | - A Somma
- Polo de Ecología Fluvial, CENUR Litoral Norte sede Paysandú, Universidad de la República, Paysandú, Uruguay; Unidad Usinas de Montevideo, Área Tratamiento - Obras Sanitarias del Estado, Aguas Corrientes, Canelones, Uruguay
| | - G Chalar
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - A Fabre
- ITR Suroeste, Universidad Tecnológica, La Paz, Colonia, Uruguay
| | - A Segura
- Modelización y Análisis de Recursos Naturales, Centro Universitario Regional del Este, Universidad de la República, Rocha, Uruguay
| | - M Achkar
- LDSGAT, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - R Arocena
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - L Aubriot
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - C Baladán
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - M Barrios
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - S Bonilla
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - M Burwood
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - D L Calliari
- Sección Oceanografía y Ecología Marina, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - C Calvo
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - L Capurro
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - C Carballo
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - C Céspedes-Payret
- UNCIEP, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - D Conde
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - N Corrales
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - B Cremella
- Laboratory of Environmental Analysis, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - C Crisci
- Modelización y Análisis de Recursos Naturales, Centro Universitario Regional del Este, Universidad de la República, Rocha, Uruguay
| | - J Cuevas
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - S De Giacomi
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - L De León
- Ministerio de Ambiente - Dirección Nacional de Calidad y Evaluación Ambiental, Uruguay
| | - L Delbene
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - I Díaz
- LDSGAT, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - V Fleitas
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - I González-Bergonzoni
- Polo de Ecología Fluvial, CENUR Litoral Norte sede Paysandú, Universidad de la República, Paysandú, Uruguay
| | - L González-Madina
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay; Unidad Usinas de Montevideo, Área Tratamiento - Obras Sanitarias del Estado, Aguas Corrientes, Canelones, Uruguay
| | - M González-Piana
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - G Goyenola
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - O Gutiérrez
- UNCIEP, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - S Haakonsson
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - C Iglesias
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - C Kruk
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay; Modelización y Análisis de Recursos Naturales, Centro Universitario Regional del Este, Universidad de la República, Rocha, Uruguay
| | - G Lacerot
- Ecología Funcional de Sistemas Acuáticos, Centro Universitario Regional del Este, Universidad de la República, Uruguay
| | - J Langone
- Unidad Usinas de Montevideo, Área Tratamiento - Obras Sanitarias del Estado, Aguas Corrientes, Canelones, Uruguay
| | - F Lepillanca
- Departamento de Microbiología, Instituto de Investigaciones Biológicas Clemente Estable, Ministerio de Educación y Cultura, Montevideo, Uruguay
| | - C Lucas
- Polo de Ecología Fluvial, CENUR Litoral Norte sede Paysandú, Universidad de la República, Paysandú, Uruguay
| | - F Martigani
- Área Hidrobiología, Gerencia de Gestión de Laboratorios, OSE, Montevideo, Uruguay
| | - G Martínez de la Escalera
- Departamento de Microbiología, Instituto de Investigaciones Biológicas Clemente Estable, Ministerio de Educación y Cultura, Montevideo, Uruguay
| | - M Meerhoff
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay; Department of Biosciences, Aarhus University, Silkeborg, Denmark
| | - L Nogueira
- Unidad Usinas de Montevideo, Área Tratamiento - Obras Sanitarias del Estado, Aguas Corrientes, Canelones, Uruguay
| | - H Olano
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - J P Pacheco
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - D Panario
- UNCIEP, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - C Piccini
- Departamento de Microbiología, Instituto de Investigaciones Biológicas Clemente Estable, Ministerio de Educación y Cultura, Montevideo, Uruguay
| | - F Quintans
- Sección Limnología, IECA, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - F Teixeira de Mello
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - L Terradas
- UNCIEP, IECA, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - G Tesitore
- Departamento de Ecología y Gestión Ambiental, Centro Universitario Regional del Este, Universidad de la República, Maldonado, Uruguay
| | - L Vidal
- Área Hidrobiología, Gerencia de Gestión de Laboratorios, OSE, Montevideo, Uruguay
| | - F García-Rodríguez
- Departamento de Geociencias, Centro Universitario Regional del Este, Universidad de la República, Rocha, Uruguay; Instituto de Oceanografia, Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil.
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24
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Starr N, Perez-Garcia C, Beirne E, Dempsey E, Baby T, Ging P, Chan G, Hannan M, Fabre A, Keogan M, O'Neill J, Joyce E. Challenges of Treating Late Onset Severe Antibody Mediated Rejection Post Orthotopic Heart Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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25
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JOUIDA A, Mccarthy C, Fabre A, Kelly A, Nadarajan P, O Calllaghan M, Keane MP. Exosomes from EGFR-mutated adenocarcinoma induce a partial/hybrid EMT. Lung Cancer 2022. [DOI: 10.1183/23120541.lsc-2022.29] [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: 11/05/2022]
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26
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Dyck L, Prendeville H, Raverdeau M, Wilk MM, Loftus RM, Douglas A, McCormack J, Moran B, Wilkinson M, Mills EL, Doughty M, Fabre A, Heneghan H, LeRoux C, Hogan A, Chouchani ET, O’Shea D, Brennan D, Lynch L. Suppressive effects of the obese tumor microenvironment on CD8 T cell infiltration and effector function. J Exp Med 2022; 219:e20210042. [PMID: 35103755 PMCID: PMC8932531 DOI: 10.1084/jem.20210042] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 10/06/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022] Open
Abstract
Obesity is one of the leading preventable causes of cancer; however, little is known about the effects of obesity on anti-tumor immunity. Here, we investigated the effects of obesity on CD8 T cells in mouse models and patients with endometrial cancer. Our findings revealed that CD8 T cell infiltration is suppressed in obesity, which was associated with a decrease in chemokine production. Tumor-resident CD8 T cells were also functionally suppressed in obese mice, which was associated with a suppression of amino acid metabolism. Similarly, we found that a high BMI negatively correlated with CD8 infiltration in human endometrial cancer and that weight loss was associated with a complete pathological response in six of nine patients. Moreover, immunotherapy using anti-PD-1 led to tumor rejection in lean and obese mice and partially restored CD8 metabolism and anti-tumor immunity. These findings highlight the suppressive effects of obesity on CD8 T cell anti-tumor immunity, which can partially be reversed by weight loss and/or immunotherapy.
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Affiliation(s)
- Lydia Dyck
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Hannah Prendeville
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Mathilde Raverdeau
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Mieszko M. Wilk
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Roisin M. Loftus
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Aaron Douglas
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Janet McCormack
- Research Pathology Core Facility, Conway Institute, University College Dublin, Dublin, Ireland
| | - Bruce Moran
- Department of Pathology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Michael Wilkinson
- University College Dublin Gynaecological Oncology Group, University College Dublin School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Evanna L. Mills
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA
- Department of Cell Biology, Harvard Medical School, Boston, MA
| | - Michael Doughty
- Department of Cellular Pathology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Pathology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Helen Heneghan
- School of Medicine, St. Vincent's University Hospital and University College Dublin, Dublin, Ireland
| | - Carel LeRoux
- School of Medicine, St. Vincent's University Hospital and University College Dublin, Dublin, Ireland
| | - Andrew Hogan
- Human Health Institute, Department of Biology, Maynooth University, Maynooth, Ireland
- National Children’s Research Centre, Dublin, Ireland
| | - Edward T. Chouchani
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA
- Department of Cell Biology, Harvard Medical School, Boston, MA
| | - Donal O’Shea
- School of Medicine, St. Vincent's University Hospital and University College Dublin, Dublin, Ireland
| | - Donal Brennan
- University College Dublin Gynaecological Oncology Group, University College Dublin School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- Systems Biology Ireland, School of Medicine, University College Dublin, Dublin, Ireland
| | - Lydia Lynch
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
- Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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27
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Dyck L, Prendeville H, Raverdeau M, Wilk MM, Loftus RM, Douglas A, McCormack J, Moran B, Wilkinson M, Mills EL, Doughty M, Fabre A, Heneghan H, LeRoux C, Hogan A, Chouchani ET, O'Shea D, Brennan D, Lynch L. Correction: Suppressive effects of the obese tumor microenvironment on CD8 T cell infiltration and effector function. J Exp Med 2022; 219:213040. [PMID: 35226044 PMCID: PMC8941668 DOI: 10.1084/jem.2021004202072022c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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28
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Brereton CJ, Yao L, Davies ER, Zhou Y, Vukmirovic M, Bell JA, Wang S, Ridley RA, Dean LSN, Andriotis OG, Conforti F, Brewitz L, Mohammed S, Wallis T, Tavassoli A, Ewing RM, Alzetani A, Marshall BG, Fletcher SV, Thurner PJ, Fabre A, Kaminski N, Richeldi L, Bhaskar A, Schofield CJ, Loxham M, Davies DE, Wang Y, Jones MG. Pseudohypoxic HIF pathway activation dysregulates collagen structure-function in human lung fibrosis. eLife 2022; 11:e69348. [PMID: 35188460 PMCID: PMC8860444 DOI: 10.7554/elife.69348] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/04/2022] [Indexed: 12/13/2022] Open
Abstract
Extracellular matrix (ECM) stiffening with downstream activation of mechanosensitive pathways is strongly implicated in fibrosis. We previously reported that altered collagen nanoarchitecture is a key determinant of pathogenetic ECM structure-function in human fibrosis (Jones et al., 2018). Here, through human tissue, bioinformatic and ex vivo studies we provide evidence that hypoxia-inducible factor (HIF) pathway activation is a critical pathway for this process regardless of the oxygen status (pseudohypoxia). Whilst TGFβ increased the rate of fibrillar collagen synthesis, HIF pathway activation was required to dysregulate post-translational modification of fibrillar collagen, promoting pyridinoline cross-linking, altering collagen nanostructure, and increasing tissue stiffness. In vitro, knockdown of Factor Inhibiting HIF (FIH), which modulates HIF activity, or oxidative stress caused pseudohypoxic HIF activation in the normal fibroblasts. By contrast, endogenous FIH activity was reduced in fibroblasts from patients with lung fibrosis in association with significantly increased normoxic HIF pathway activation. In human lung fibrosis tissue, HIF-mediated signalling was increased at sites of active fibrogenesis whilst subpopulations of human lung fibrosis mesenchymal cells had increases in both HIF and oxidative stress scores. Our data demonstrate that oxidative stress can drive pseudohypoxic HIF pathway activation which is a critical regulator of pathogenetic collagen structure-function in fibrosis.
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Affiliation(s)
- Christopher J Brereton
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Liudi Yao
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Elizabeth R Davies
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Yilu Zhou
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Milica Vukmirovic
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of MedicineNew HavenUnited States
- Leslie Dan Faculty of Pharmacy, University of TorontoTorontoCanada
| | - Joseph A Bell
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Siyuan Wang
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Robert A Ridley
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Lareb SN Dean
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Orestis G Andriotis
- Institute of Lightweight Design and Structural Biomechanics, TU WienViennaAustria
| | - Franco Conforti
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Lennart Brewitz
- Department of Chemistry and the Ineos Oxford Institute for Antimicrobial Research, Chemistry Research LaboratoryOxfordUnited Kingdom
| | - Soran Mohammed
- School of Chemistry, University of SouthamptonSouthamptonUnited Kingdom
| | - Timothy Wallis
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Ali Tavassoli
- School of Chemistry, University of SouthamptonSouthamptonUnited Kingdom
| | - Rob M Ewing
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Aiman Alzetani
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Benjamin G Marshall
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Sophie V Fletcher
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- University Hospital SouthamptonSouthamptonUnited Kingdom
| | - Philipp J Thurner
- Institute of Lightweight Design and Structural Biomechanics, TU WienViennaAustria
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital & UCD School of Medicine, University College DublinDublinIreland
| | - Naftali Kaminski
- Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of MedicineNew HavenUnited States
| | - Luca Richeldi
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Unità Operativa Complessa di Pneumologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli IRCCSRomeItaly
| | - Atul Bhaskar
- Faculty of Engineering and Physical Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Christopher J Schofield
- Department of Chemistry and the Ineos Oxford Institute for Antimicrobial Research, Chemistry Research LaboratoryOxfordUnited Kingdom
| | - Matthew Loxham
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Donna E Davies
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Yihua Wang
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Biological Sciences, Faculty of Environmental and Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
| | - Mark G Jones
- Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthamptonUnited Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital SouthamptonSouthamptonUnited Kingdom
- Institute for Life Sciences, University of SouthamptonSouthamptonUnited Kingdom
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29
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Saha R, Ryan DT, McVeigh N, Garvey JF, Ryan S, Murphy DJ, Fabre A, McCarthy C, Keane MP, Dodd JD. Unclassifiable interstitial lung disease on HRCT: aggressive progressive disease with macrocystic lung destruction. QJM 2022; 114:812-814. [PMID: 34002222 DOI: 10.1093/qjmed/hcab125] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Saha
- From the Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - D T Ryan
- From the Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - N McVeigh
- From the Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - J F Garvey
- Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - S Ryan
- Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Irelandand
| | - D J Murphy
- From the Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Irelandand
| | - A Fabre
- School of Medicine, University College Dublin, Dublin 4, Irelandand
- Department of Histopathology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - C McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Irelandand
| | - M P Keane
- Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Irelandand
| | - J D Dodd
- From the Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- School of Medicine, University College Dublin, Dublin 4, Irelandand
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MacCann R, O'Brien C, McCarthy C, Dodd JD, Fabre A, Feeney ER. Cavitary Pneumocystis jirovecii pneumonia. QJM 2021; 114:607-608. [PMID: 33950259 DOI: 10.1093/qjmed/hcab122] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R MacCann
- Department of Infectious Diseases, St Vincent's University Hospital, Dublin 4, Ireland
| | - C O'Brien
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland
| | - C McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin 4, Ireland and School of Medicine, University College Dublin, Dublin 4, Ireland
| | - J D Dodd
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland and School of Medicine, University College Dublin, Dublin 4, Ireland
| | - A Fabre
- School of Medicine, University College Dublin, Dublin 4, Ireland and Department of Histopathology, St Vincent's University Hospital, Dublin 4, Ireland
| | - E R Feeney
- Department of Infectious Diseases, St Vincent's University Hospital, Dublin 4, Ireland
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Roche L, Moriarty B, Fabre A, Crowne J, Lally A. Deceleration in the rate of keratinocyte cancers and pre-cancerous lesions during PD-1 inhibition for advanced melanoma, with recrudescence on discontinuation. Clin Exp Dermatol 2021; 47:582-584. [PMID: 34633688 DOI: 10.1111/ced.14974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 11/28/2022]
Abstract
Immune checkpoint inhibition has revolutionised the treatment of many cancer subtypes. PD-1 inhibition typically results in T-cell activation via immune activation rather than by directly targeting tumour cells1 . We present 3 patients treated with pembrolizumab for advanced melanoma, noted to have a significant deceleration in the rate of development of keratinocyte cancers, pre-cancerous lesions and improvement in field cancerisation during PD-1 inhibition; 1 patient demonstrated a significant recrudescence on discontinuation of therapy.
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Affiliation(s)
- L Roche
- Departments of Dermatology, St Vincent's Healthcare Group strategic skin cancer network, St Vincent's University Hospital, Dublin, Ireland
| | - B Moriarty
- Departments of Dermatology, St Vincent's Healthcare Group strategic skin cancer network, St Vincent's University Hospital, Dublin, Ireland
| | - A Fabre
- Histopathology, , St Vincent's Healthcare Group strategic skin cancer network, St Vincent's University Hospital, Dublin, Ireland
| | - J Crowne
- Medical Oncology, St Vincent's Healthcare Group strategic skin cancer network, St Vincent's University Hospital, Dublin, Ireland
| | - A Lally
- Departments of Dermatology, St Vincent's Healthcare Group strategic skin cancer network, St Vincent's University Hospital, Dublin, Ireland
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Ottewill C, Aamir S, Nash D, Dunne R, Redmond K, Fabre A, Durcan L, Keogan M, Hurley K. Isolated interstitial lung disease associated with anti-Ku autoantibodies: a case responding to a CD20 inhibitor. QJM 2021; 114:258-260. [PMID: 32697838 DOI: 10.1093/qjmed/hcaa227] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 06/24/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Ottewill
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
| | - S Aamir
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
| | - D Nash
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
| | - R Dunne
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Radiology Department, Beaumont Hospital, Dublin, Ireland-Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Redmond
- Thoracic Surgery Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
| | - L Durcan
- Department of Rheumatology, Beaumont Hospital, Dublin, Ireland
| | - M Keogan
- Immunology Department, Beaumont Hospital, Dublin, Ireland
| | - K Hurley
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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Hawkins P, Chawke L, Cormican L, Wikenheiser-Brokamp KA, Fabre A, Keane MP, McCarthy C. Autoimmune pulmonary alveolar proteinosis: a discrepancy between symptoms and CT findings. Lancet 2021; 398:e7. [PMID: 34274066 DOI: 10.1016/s0140-6736(21)01254-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/03/2021] [Accepted: 05/13/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Padraig Hawkins
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Liam Chawke
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland
| | - Liam Cormican
- Department of Respiratory Medicine, Connolly Hospital, Blanchardstown, Dublin, Ireland
| | - Kathryn A Wikenheiser-Brokamp
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Michael P Keane
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
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34
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Murphy L, McGuckin M, Giblin G, Keogh A, McGovern B, Fabre A, O'Neill J, Mahon N, Joyce E. The role of endomyocardial biopsy in suspected myocarditis in the contemporary era: a 10-year National Transplant Centre experience. Cardiovasc Pathol 2021; 54:107366. [PMID: 34224863 DOI: 10.1016/j.carpath.2021.107366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/27/2021] [Accepted: 06/27/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Diagnostic endomyocardial biopsy (EMB) in patients with suspected myocarditis helps to direct therapy and guide prognosis. This study aimed to investigate the correlation between the 2007 clinical guideline indications for EMB and the presence of a diagnostic biopsy result and associated outcomes in patients with suspected myocarditis in a national quaternary referral center in a contemporary cohort. METHODS All cases of suspected myocarditis referred to the National Cardiac Transplant Centre who underwent EMB between 2009 and 2019 were identified retrospectively through pathology records. Outcomes including subsequent need for inotrope and/or mechanical circulatory support (MCS), heart transplantation and in-hospital mortality were recorded. RESULTS In total, 25 (68% male, mean age of 45 ± 15 years) EMBs were performed for this indication across this time period, 64% (n = 16) of which demonstrated diagnostic results, the majority (75%, n = 12) identifying acute lymphocytic myocarditis, 13% (n = 2) giant cell, one patient (6.3%) eosinophilic and one (6.3%) an immune checkpoint inhibitor myocarditis. The majority of those with histologically confirmed myocarditis had a Class I or IIa guideline indication for EMB (n = 12, 75%). The remaining 4 patients (25%), either met Class IIb criteria (n = 2) or would not have been accounted for in this guideline. The majority of patients requiring inotropes and/or MCS (n = 9/11), and/or heart transplant (n = 3/4), or who later died (n = 4/5) were in the diagnostic biopsy group. CONCLUSIONS In this 10-year National referral sample, 75% of patients with histologically confirmed myocarditis had a Class I or IIa indication for EMB, reinforcing the usefulness of traditional guidelines in this contemporary era. However, 25% of patients with a subsequent confirmed histological diagnosis had either none or a less well-established indication for EMB, highlighting the need for clinical suspicion outside of accepted clinical scenarios.
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Affiliation(s)
- Laura Murphy
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland
| | - Molly McGuckin
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland
| | - Gerard Giblin
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland
| | - Anna Keogh
- Department of Pathology, Mater University Hospital, Dublin, Ireland
| | - Brianan McGovern
- Department of Pathology, Mater University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Pathology, Mater University Hospital, Dublin, Ireland; Department of Pathology, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - James O'Neill
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland
| | - Niall Mahon
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland
| | - Emer Joyce
- Department of Cardiovascular Medicine, Mater University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
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Hawkins P, Doyle A, Gavin L, Fabre A, Murphy DJ, Dunican E, McCarthy C. A 33-Year-Old Man With Dyspnea, Chest Pain, and a Massive Pleural Effusion. Chest 2021; 159:e39-e43. [PMID: 33422239 DOI: 10.1016/j.chest.2020.08.2102] [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: 07/09/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 10/22/2022] Open
Abstract
CASE PRESENTATION A 33-year-old white man presented to the ED with 1-month history of worsening dyspnea. He experienced gradual onset of right-sided scapular pain and shortness of breath on exertion that progressively worsened over the course of 1 month. He had a mild nonproductive cough and intermittent subjective fevers and reported weight loss of approximately 2 kg over 1 month. He had a history of two episodes of acute pancreatitis that was thought to be autoimmune in origin. He was a never smoker; he denied illicit drug use or recent alcohol consumption. He had no known TB exposure, but his mother had a history of sarcoidosis.
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Affiliation(s)
- Padraig Hawkins
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Aoife Doyle
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Leo Gavin
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - David J Murphy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Eleanor Dunican
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
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Linehan A, O’Reilly M, Lynch E, Keane F, Walshe J, Crown J, Fabre A, Cotter M, Finn S, Hanrahan E. Comparison of immunohistochemistry and polymerase chain reaction for single gene vs multigene panel with next generation sequencing for identifying targetable mutations in non-small cell lung cancer. Lung Cancer 2021. [DOI: 10.1016/s0169-5002(21)00302-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schiappa R, Uzbelger G, Thamphya B, Fabre A, Toledano S, Bailleux C, Barranger E, Chamorey E. RUBY – Développement d’algorithme d’intelligence artificielle pour la structuration automatique des comptes rendus médicaux de patientes atteintes d’un cancer du sein. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
Exosomes are major contributors in cell to cell communication due to their ability to transfer biological material such as protein, RNA, DNA, and miRNA. Additionally, they play a role in tumor initiation, promotion, and progression, and recently, they have emerged as a potential source of information on tumor detection and may be useful as diagnostic, prognostic, and predictive tools. This review focuses on exosomes from lung cancer with a focus on EGFR mutations. Here, we outline the role of exosomes and their functional effect in carcinogenesis, tumor progression, and metastasis. Finally, we discuss the possibility of exosomes as novel biomarkers in early detection, diagnosis, assessment of prognosis, and prediction of therapeutic response in EGFR-mutated lung cancer.
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Affiliation(s)
- Amina Jouida
- UCD School of Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- UCD School of Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital and School of Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- UCD School of Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
- St. Vincent's University Hospital and School of Medicine, University College Dublin, Dublin, Ireland
| | - Michael P Keane
- UCD School of Medicine, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
- St. Vincent's University Hospital and School of Medicine, University College Dublin, Dublin, Ireland.
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39
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O’Callaghan M, Ryan ME, Cotter M, Kelly A, O’Mahony A, Hanrahan E, Higgins M, Keane M, Fabre A. Plasma cell-free DNA EGFR mutation detection in patients with non-small cell lung carcinoma using two commercially available platforms the COBAS® and Idylla™. Lung Cancer 2021. [DOI: 10.1016/s0169-5002(21)00249-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Keane S, Fabre A, Keane D. Characterization of atrial histology in a patient with hypertrophic cardiomyopathy: Possible evidence of a primary atrial myopathy. HeartRhythm Case Rep 2021; 7:413-417. [PMID: 34194992 PMCID: PMC8226312 DOI: 10.1016/j.hrcr.2021.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Stephen Keane
- Department of Cardiology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Pathology, St. Vincent’s University Hospital, Dublin, Ireland
| | - David Keane
- Department of Cardiology, St. Vincent’s University Hospital, Dublin, Ireland
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41
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De Backer O, Hafiz H, Fabre A, Lertsapcharoen P, Srimahachota S, Foley D, Sondergaard L. State-of-the-art preclinical testing of the OMEGA TM left atrial appendage occluder. Catheter Cardiovasc Interv 2021; 97:E1011-E1018. [PMID: 33034944 DOI: 10.1002/ccd.29331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/14/2020] [Accepted: 10/02/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aimed to present a new approach of thorough preclinical testing of a novel left atrial appendage (LAA) occluder device. BACKGROUND The development of a safe and effective LAA occluder has been shown to be challenging. METHODS The novel OMEGATM LAA occluder (Eclipse Medical, Ireland) was tested in a porcine model and three-dimensional (3D) human LAA models - this as a prelude to its first-in-human use. RESULTS In a first series of in-vivo experiments, the OMEGATM LAA occluder was shown to have a satisfactory device biocompatibility in a porcine model. The design of the OMEGATM device was further refined and optimized following three more series of in-vivo experiments. The second generation OMEGATM device was designed with thinner wires, leading to a profile reduction. Based on in-vitro testing of different OMEGATM device sizes implanted at different depths in human three-dimensional (3D) LAA models, it could be determined that (1) the landing zone should be measured at a median depth of 12 mm from the LAA ostium; (2) the distal self-retaining inverted cup should have 10%-25% compression to minimize device embolization risk; and (3) the disc should be slightly inverted, i.e. pulled into the LAA, to promote complete LAA occlusion. The combined in-vivo and in-vitro testing resulted in an optimized pre-procedural planning of the first-in-human case treated with the OMEGATM device. CONCLUSIONS This series of carefully planned in-vivo and in-vitro experiments allowed demonstration of the safety and efficacy of the OMEGATM LAA occluder. This approach of thorough preclinical testing of medical devices may reduce the risk of complications in first-in-human cases and may become the standard approach for device development and preclinical testing in the future.
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Affiliation(s)
- Ole De Backer
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hussein Hafiz
- Department of Cardiology, Beaumont Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University College Hospital, Dublin, Ireland
| | | | | | - David Foley
- Department of Cardiology, Beaumont Hospital, Dublin, Ireland
| | - Lars Sondergaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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O'Brien LM, Thuillier R, Tolan M, Fabre A. Clear cell 'sugar' tumour of the lung. BMJ Case Rep 2021; 14:e241698. [PMID: 33637514 PMCID: PMC7919567 DOI: 10.1136/bcr-2021-241698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Luke Martin O'Brien
- Department of Cardiothoracic Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Rhona Thuillier
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
| | - Michael Tolan
- Department of Cardiothoracic Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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O'Callaghan M, Fabre A, McCann J, Healy G, McCarthy A, Keane MP, McDonnell TJ, McCarthy C. A 34-Year-Old Man With a Chylothorax and Bony Pain. Chest 2021; 157:e131-e136. [PMID: 32252938 DOI: 10.1016/j.chest.2019.10.033] [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] [Received: 07/29/2019] [Revised: 10/07/2019] [Accepted: 10/25/2019] [Indexed: 10/24/2022] Open
Abstract
CASE PRESENTATION A 34-year-old man presented to a community hospital with sudden-onset pleuritic chest pain on a background of a 12-month indolent history of progressive exertional dyspnea. He denied cough, fevers, night sweats, or weight loss. He reported some low back pain and ache. He had a history of gastroesophageal reflux and was a current smoker with a 20-pack year history. There were no known occupational or environmental exposures and there was no family history of any lung disease.
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Affiliation(s)
- Marissa O'Callaghan
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; Department of Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland; Department of Medicine, University College Dublin, Dublin, Ireland
| | - Jeff McCann
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Gerard Healy
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Aoife McCarthy
- Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Michael P Keane
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; Department of Medicine, University College Dublin, Dublin, Ireland
| | - Timothy J McDonnell
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; Department of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland; Department of Medicine, University College Dublin, Dublin, Ireland.
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44
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Murray K, Floudas A, Murray C, Fabre A, Crown J, Fearon U, Veale D. First use of tofacitinib to treat an immune checkpoint inhibitor-induced arthritis. BMJ Case Rep 2021; 14:14/2/e238851. [PMID: 33541985 PMCID: PMC7868229 DOI: 10.1136/bcr-2020-238851] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Immune checkpoint inhibitors have revolutionised cancer treatment; however, immune-related adverse events do occur, with up to 7% developing inflammatory arthritis. Common rheumatoid arthritis therapies such as methotrexate, prednisolone and biologics have been used to treat this arthritis in small, uncontrolled case series with varying success. In this case of personalised medicine, we report the first use of tofacitinib, a small molecular inhibitor of the Janus kinase-signal transducer and activator of transcription pathway, to treat checkpoint inhibitor-related inflammatory arthritis. This resulted in a rapid clinical response and complete, sustained remission of the arthritis with associated marked reduction in synovial molecular and cellular immune response.
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Affiliation(s)
- Kieran Murray
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland
| | - Achilleas Floudas
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Ciara Murray
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - John Crown
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - Ursula Fearon
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Douglas Veale
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
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Abstract
Lymphangioleiomyomatosis (LAM) is a diffuse cystic lung disease. There are two main types of LAM: sporadic, and LAM associated with the tuberous sclerosis complex (TSC), which is caused by mutations in the TSC1 and TSC2 genes. LAM is characterised by cystic lung disease resulting in progressive dyspnoea, renal angiomyolipomas and lymphatic complications. Pneumothorax occurs frequently (70%) and definitive management with pleurodesis is recommended as the risk of recurrence is high. Characteristic thin-walled cysts are seen on computed tomography and the presence of elevated serum levels of a vascular endothelial growth factor-D has good diagnostic specificity. Currently, no single clinical or serological factor has been shown to predict prognosis. However, over the past decade, significant advances in our understanding of the pathophysiology of LAM has led to improved recognition of this rare disease and identification of treatment options. Mechanistic target of rapamycin inhibitors slow the rate of lung function decline and can resolve chylous effusion and regress angiomyolipomas. Life expectancy in patients with LAM is favourable, with a mean transplant-free survival >20 years from the time of diagnosis. Continued advances in understanding the molecular basis of LAM will lead to improved therapeutic targets and the development of more robust prognostic indicators. Educational aims To illustrate the clinical features, common presentations and radiological features of LAMTo outline the diagnostic approach to LAM, including the role of VEGF-DTo review the current prognostic indicators in LAM, and outline the impact of lung function, hormonal status, VEGF-D and clinical presentation on outcomeTo inform clinicians on the management options for LAM both pharmacological and nonpharmacological.
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Affiliation(s)
- Anne M O'Mahony
- Dept of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland.,These authors contributed equally
| | - Evelyn Lynn
- Dept of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland.,These authors contributed equally
| | - David J Murphy
- Dept of Radiology, St Vincent's University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Dept of Histopathology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Cormac McCarthy
- Dept of Respiratory Medicine, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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Hofman P, Ilié M, Chamorey E, Brest P, Schiappa R, Nakache V, Antoine M, Barberis M, Begueret H, Bibeau F, Bonnetaud C, Boström P, Brousset P, Bubendorf L, Carvalho L, Cathomas G, Cazes A, Chalabreysse L, Chenard MP, Copin MC, Côté JF, Damotte D, de Leval L, Delongova P, Thomas de Montpreville V, de Muret A, Dema A, Dietmaier W, Evert M, Fabre A, Forest F, Foulet A, Garcia S, Garcia-Martos M, Gibault L, Gorkiewicz G, Jonigk D, Gosney J, Hofman A, Kern I, Kerr K, Kossai M, Kriegsmann M, Lassalle S, Long-Mira E, Lupo A, Mamilos A, Matěj R, Meilleroux J, Ortiz-Villalón C, Panico L, Panizo A, Papotti M, Pauwels P, Pelosi G, Penault-Llorca F, Pop O, Poté N, Cajal SRY, Sabourin JC, Salmon I, Sajin M, Savic-Prince S, Schildhaus HU, Schirmacher P, Serre I, Shaw E, Sizaret D, Stenzinger A, Stojsic J, Thunnissen E, Timens W, Troncone G, Werlein C, Wolff H, Berthet JP, Benzaquen J, Marquette CH, Hofman V, Calabrese F. Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future. ESMO Open 2020; 6:100024. [PMID: 33399086 PMCID: PMC7780004 DOI: 10.1016/j.esmoop.2020.100024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. Materials and methods A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. Results Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. Conclusions The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe. Biosafety measures used in the first wave of the COVID-19 crisis were heterogeneous in 53 European pathology laboratories. A dramatic decrease of the workload in pathology laboratories was noted. No case of healthcare workers contaminated with SARS-CoV-2 associated with samples handling was identified.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Chamorey
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - P Brest
- Team 4, IRCAN, INSERM, CNRS, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - R Schiappa
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - V Nakache
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - M Antoine
- Department of Pathology, Hôpital Tenon, AP-HP, Paris, France
| | - M Barberis
- Unit of Histopathology and Molecular Diagnostics, Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Begueret
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - F Bibeau
- Department of Pathology, CHU de Caen, Université de Caen Normandie, Caen, France
| | - C Bonnetaud
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - P Brousset
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - L Bubendorf
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - L Carvalho
- Institute of Anatomical and Molecular Pathology and University Hospital, University of Coimbra, Coimbra, Portugal
| | - G Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Cazes
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - M-P Chenard
- Department of Pathology, University Hospital of Strasbourg, Strasbourg, France
| | - M-C Copin
- Institut de Pathologie, CHU Lille, Université de Lille, Lille, France
| | - J-F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - D Damotte
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - P Delongova
- Institute of Pathology, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A de Muret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Dema
- Department of Pathology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - W Dietmaier
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - M Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - A Fabre
- Department of Histopathology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - A Foulet
- Department of Pathology, Centre Hospitalier, Le Mans, France
| | - S Garcia
- Department of Pathology, Hôpital Nord, AP-HM, Aix Marseille University, Marseille, France
| | - M Garcia-Martos
- Pulmonary Pathology Department, Gregorio Marañon University Hospital, Madrid, Spain
| | - L Gibault
- Department of Pathology, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, Paris, France
| | - G Gorkiewicz
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Jonigk
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - J Gosney
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, UK
| | - A Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - K Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - M Kossai
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - M Kriegsmann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - A Lupo
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - A Mamilos
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - R Matěj
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer Hospital and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - J Meilleroux
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - C Ortiz-Villalón
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - L Panico
- Unit of Pathology, Azienda Ospedaliera dei Colli, Monaldi-Cotugno-CTO, Naples, Italy
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Papotti
- Department of Oncology, University of Torino, Torino, Italy
| | - P Pauwels
- Centre for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, and IRCCS MultiMedica, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - O Pop
- Department of Pathology, University of Oradea, Oradea, Romania
| | - N Poté
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - S R Y Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J-C Sabourin
- Department of Pathology, Inserm 1245, Rouen University Hospital Normandy University, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - M Sajin
- Department of Pathology, Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - S Savic-Prince
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - H-U Schildhaus
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - P Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - I Serre
- Department of Biopathology, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - E Shaw
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Sizaret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - J Stojsic
- Department of Thoracic Pathology, Service of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - E Thunnissen
- Department of Pathology, Amsterdam University Medical Centres, Location VUmc, Amsterdam, The Netherlands
| | - W Timens
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G Troncone
- Department of Public Health, University of Naples Frederico II, Naples, Italy
| | - C Werlein
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - H Wolff
- Laboratory of Pathology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - J-P Berthet
- Department of Thoracic Surgery, FHU OnoAge, Louis Pasteur Hospital, University Côte d'Azur, Nice, France
| | - J Benzaquen
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - C-H Marquette
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Pathological Anatomy Section, University of Padova Medical School, Padova, Italy
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Fleming H, Clifford SM, Haughey A, MacDermott R, McVeigh N, Healy GM, Lavelle L, Abbara S, Murphy DJ, Fabre A, McKone E, McCarthy C, Butler M, Doran P, Lynch DA, Keane MP, Dodd JD. Differentiating combined pulmonary fibrosis and emphysema from pure emphysema: utility of late gadolinium-enhanced MRI. Eur Radiol Exp 2020; 4:61. [PMID: 33141269 PMCID: PMC7641295 DOI: 10.1186/s41747-020-00187-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022] Open
Abstract
Background Differentiating combined pulmonary fibrosis with emphysema (CPFE) from pure emphysema can be challenging on high-resolution computed tomography (HRCT). This has antifibrotic therapy implications. Methods Twenty patients with suspected CPFE underwent late gadolinium-enhanced (LGE) thoracic magnetic resonance imaging (LGE-MRI) and HRCT. Data from twelve healthy control subjects from a previous study who underwent thoracic LGE-MRI were included for comparison. Quantitative LGE signal intensity (SI) was retrospectively compared in regions of fibrosis and emphysema in CPFE patients to similar lung regions in controls. Qualitative comparisons for the presence/extent of reticulation, honeycombing, and traction bronchiectasis between LGE-MRI and HRCT were assessed by two readers in consensus. Results There were significant quantitative differences in fibrosis SI compared to emphysema SI in CPFE patients (25.8, IQR 18.4–31.0 versus 5.3, IQR 5.0–8.1, p < 0.001). Significant differences were found between LGE-MRI and HRCT in the extent of reticulation (12.5, IQR 5.0–20.0 versus 25.0, IQR 15.0–26.3, p = 0.038) and honeycombing (5.0, IQR 0.0–10.0 versus 20.0, IQR 10.6–20.0, p = 0.001) but not traction bronchiectasis (10.0, IQR 5–15 versus 15.0, IQR 5–15, p = 0.878). Receiver operator curve analysis of fibrosis SI compared to similarly located regions in control subjects showed an area under the curve of 0.82 (p = 0.002). A SI cutoff of 19 yielded a sensitivity of 75% and specificity of 86% in differentiating fibrosis from similarly located regions in control subjects. Conclusion LGE-MRI can differentiate CPFE from pure emphysema and may be a useful adjunct test to HRCT in patients with suspected CPFE.
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Affiliation(s)
- Hannah Fleming
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Simon M Clifford
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Aoife Haughey
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Roisin MacDermott
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Niall McVeigh
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Gerard M Healy
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Lisa Lavelle
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Suhny Abbara
- Department of Radiology, UT Southwestern Hospital, Dallas, TX, USA
| | - David J Murphy
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Aurelie Fabre
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Pathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Edward McKone
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Cormac McCarthy
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Marcus Butler
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Peter Doran
- UCD Clinical Research Center, University College Dublin, Dublin, Ireland
| | - David A Lynch
- Department of Radiology, National Jewish Medical and Research Center, Denver, CO, USA
| | - Michael P Keane
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - Jonathan D Dodd
- Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. .,School of Medicine, University College Dublin, Dublin, Ireland.
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McCarthy C, Keane MP, Fabre A. Lipid-Laden Macrophages Are Not Diagnostic of Pulmonary Alveolar Proteinosis Syndrome and Can Indicate Lung Injury. Am J Respir Crit Care Med 2020; 202:1197-1198. [PMID: 32673084 PMCID: PMC7560793 DOI: 10.1164/rccm.202005-1880le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Cormac McCarthy
- St. Vincent's University Hospital Dublin, Ireland and.,University College Dublin Dublin, Ireland
| | - Michael P Keane
- St. Vincent's University Hospital Dublin, Ireland and.,University College Dublin Dublin, Ireland
| | - Aurelie Fabre
- St. Vincent's University Hospital Dublin, Ireland and.,University College Dublin Dublin, Ireland
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Brunod I, Rességuier N, Fabre A. Medical thesis publication and academic productivity of pediatric residents at the Medical University of Marseille: Associated factors and evolution over 20 years. Arch Pediatr 2020; 27:408-415. [PMID: 33082032 DOI: 10.1016/j.arcped.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/03/2020] [Accepted: 09/19/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND In many countries, as in France, medical training is not complete until the defense of a thesis, based on a research project; however, the publication of research work is not mandatory. This study investigated the evolution of the publication pattern of pediatric residents and identified the possible factors associated with an increased productivity, by investigating both thesis and non-thesis-related publications. MATERIALS AND METHODS We conducted a retrospective cohort study of pediatric residents who graduated from the Medical University of Marseille in France over a 20-year period (1996-2015). Their theses were retrieved from the French database of university theses (SUDOC). Their publications were collated by scanning the PubMed and Google Scholar databases. Non-thesis-related publications were included up to 1 year after the medical thesis defense and medical thesis publications were included without date limits. For each thesis or publication, the resident's characteristics, the supervisor's characteristics, the thesis characteristics, and bibliometric features were retrieved. RESULTS Out of the 148 graduated residents, 110 (74%) published articles (thesis-related article with no publication deadline and non-thesis-related articles with a publication deadline of up to 1 year postgraduation): 76 residents (51%) published their medical thesis and 88 residents (60%) published at least one non-thesis-related article. In multivariate analysis, publishing the thesis was significantly associated with a shorter dissertation length (43 vs. 84 pages [median]; p=0.009**) and with a thesis supervisor more experienced in supervising theses (P=0.01**). The thesis publication rate increased significantly over the years (P=0.005**), with the number of theses published tripling. Dissertation length significantly decreased over the years (linear slope=-4.13 pages/year; P<0.0001***). In multivariate analysis, the number of publications per resident was significantly higher when the resident had also completed a scientific thesis (β=1.62; P=0.007**), when he or she had published more papers during the post-residency period (β=0.40; P<0.0001***) and when he or she graduated at an older age (β=0.24; P=0.04*). CONCLUSION The thesis publication rate of pediatric residents has improved significantly in 20 years; however, these results are from a single-center study. Publishing the thesis was significantly associated with shorter dissertation length and a more experienced thesis supervisor.
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Affiliation(s)
- I Brunod
- Aix-Marseille University, Faculty of Medicine, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - N Rességuier
- Department of Epidemiology and Health Economics, AP-HM/EA 3279 CEReSS (Centre d'Études et de Recherche sur les Services de Santé et la Qualité de vie), Aix-Marseille University, Faculty of Medicine, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - A Fabre
- Aix Marseille Université, inserm, MMG, 27, boulevard Jean-Moulin, 13005 Marseille, France; AP-HM, Hôpital de la Timone Enfant, Service de Pédiatrie Multidisciplinaire, 278, rue Saint-Pierre, 13005 Marseille, France.
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50
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Ralph J, Maguire M, Malone V, Fabre A, Foley CC. A generalized unexpected eruption. Clin Exp Dermatol 2020; 46:383-386. [PMID: 33080076 DOI: 10.1111/ced.14474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- J Ralph
- Departments of, Department of, Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - M Maguire
- Departments of, Department of, Dermatology, St Vincent's University Hospital, Dublin, Ireland
| | - V Malone
- Department of, Histopatology, St Vincent's University Hospital, Dublin, Ireland
| | - A Fabre
- Department of, Histopatology, St Vincent's University Hospital, Dublin, Ireland
| | - C C Foley
- Departments of, Department of, Dermatology, St Vincent's University Hospital, Dublin, Ireland
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