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Pagliaro L, Cerretani E, Vento F, Montanaro A, Moron Dalla Tor L, Simoncini E, Giaimo M, Gherli A, Zamponi R, Tartaglione I, Lorusso B, Scita M, Russo F, Sammarelli G, Todaro G, Silini EM, Rigolin GM, Quaini F, Cuneo A, Roti G. CAD204520 Targets NOTCH1 PEST Domain Mutations in Lymphoproliferative Disorders. Int J Mol Sci 2024; 25:766. [PMID: 38255842 PMCID: PMC10815907 DOI: 10.3390/ijms25020766] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/01/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
NOTCH1 PEST domain mutations are often seen in hematopoietic malignancies, including T-cell acute lymphoblastic leukemia (T-ALL), chronic lymphocytic leukemia (CLL), splenic marginal zone lymphoma (SMZL), mantle cell lymphoma (MCL), and diffuse large B-cell lymphoma (DLBCL). These mutations play a key role in the development and progression of lymphoproliferative tumors by increasing the Notch signaling and, consequently, promoting cell proliferation, survival, migration, and suppressing apoptosis. There is currently no specific treatment available for cancers caused by NOTCH1 PEST domain mutations. However, several NOTCH1 inhibitors are in development. Among these, inhibition of the Sarco-endoplasmic Ca2+-ATPase (SERCA) showed a greater effect in NOTCH1-mutated tumors compared to the wild-type ones. One example is CAD204520, a benzimidazole derivative active in T-ALL cells harboring NOTCH1 mutations. In this study, we preclinically assessed the effect of CAD204520 in CLL and MCL models and showed that NOTCH1 PEST domain mutations sensitize cells to the anti-leukemic activity mediated by CAD204520. Additionally, we tested the potential of CAD204520 in combination with the current first-line treatment of CLL, venetoclax, and ibrutinib. CAD204520 enhanced the synergistic effect of this treatment regimen only in samples harboring the NOTCH1 PEST domain mutations, thus supporting a role for Notch inhibition in these tumors. In summary, our work provides strong support for the development of CAD204520 as a novel therapeutic approach also in chronic lymphoproliferative disorders carrying NOTCH1 PEST domain mutations, emerging as a promising molecule for combination treatment in this aggressive subset of patients.
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Affiliation(s)
- Luca Pagliaro
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Elisa Cerretani
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy; (M.S.); (G.M.R.); (A.C.)
| | - Federica Vento
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy; (M.S.); (G.M.R.); (A.C.)
| | - Anna Montanaro
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
| | - Lucas Moron Dalla Tor
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
| | - Elisa Simoncini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
| | - Mariateresa Giaimo
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Andrea Gherli
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Raffaella Zamponi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Isotta Tartaglione
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
| | - Bruno Lorusso
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
| | - Matteo Scita
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy; (M.S.); (G.M.R.); (A.C.)
| | - Filomena Russo
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Gabriella Sammarelli
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Giannalisa Todaro
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
| | - Enrico Maria Silini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
| | - Gian Matteo Rigolin
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy; (M.S.); (G.M.R.); (A.C.)
- Hematology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
| | - Antonio Cuneo
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy; (M.S.); (G.M.R.); (A.C.)
- Hematology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy
| | - Giovanni Roti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (L.P.); (A.M.); (L.M.D.T.); (E.S.); (M.G.); (A.G.); (R.Z.); (B.L.); (E.M.S.); (F.Q.)
- Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy; (E.C.); (F.V.); (I.T.)
- Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy; (F.R.); (G.S.); (G.T.)
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Mazzaschi G, Bocchialini G, Lorusso B, Pluchino M, Trentini F, Di Rienzo G, Cattadori S, Tor LMD, Verzè M, Minari R, Bordi P, Leonetti A, D’Agnelli S, Milanese G, Leo L, Gnetti L, Roti G, Ampollini L, Quaini F, Sverzellati N, Tiseo M. 189P The parallel interrogation of tissue and peripheral blood immune features unveils a bidirectional crosstalk with clinical impact on resected NSCLC. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00442-2] [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: 04/03/2023]
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Mazzaschi G, Tamarozzi P, Lorusso B, Verzè M, Pluchino M, Trentini F, Dalla Valle B, Minari R, Perrone F, Bordi P, Leonetti A, Moron Dalla Tor L, Leo L, Milanese G, Balbi M, Buti S, Roti G, Quaini F, Sverzellati N, Tiseo M. 238P Exploring blood immune cell dynamics to unravel the immunomodulatory effect of radiotherapy in NSCLC patients undergoing immune checkpoint inhibitors. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lorusso B, Cerasoli G, Falco A, Frati C, Graiani G, Madeddu D, Nogara A, Corradini E, Roti G, Cerretani E, Gherli A, Caputi M, Gnetti L, Pilato FP, Quaini F, Lagrasta C. Β-blockers activate autophagy on infantile hemangioma-derived endothelial cells in vitro. Vascul Pharmacol 2022; 146:107110. [PMID: 36103993 DOI: 10.1016/j.vph.2022.107110] [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] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 01/18/2023]
Abstract
The mechanisms underlying the success of propranolol in the treatment of infantile hemangioma (IH) remain elusive and do not fully explain the rapid regression of hemangiomatous lesions following drug administration. As autophagy is critically implicated in vascular homeostasis, we determined whether β-blockers trigger the autophagic flux on infantile hemangioma-derived endothelial cells (Hem-ECs) in vitro. MATERIAL AND METHODS Fresh tissue specimens, surgically removed for therapeutic purpose to seven children affected by proliferative IH, were subjected to enzymatic digestion. Cells were sorted with anti-human CD31 immunolabeled magnetic microbeads. Following phenotypic characterization, expanded Hem-ECs, at P2 to P6, were exposed to different concentrations (50 μM to 150 μM) of propranolol, atenolol or metoprolol alone and in combination with the autophagy inhibitor Bafilomycin A1. Rapamycin, a potent inducer of autophagy, was also used as control. Autophagy was assessed by Lysotracker Red staining, western blot analysis of LC3BII/LC3BI and p62, and morphologically by transmission electron microscopy. RESULTS Hem-ECs treated with either propranolol, atenolol or metoprolol displayed positive LysoTracker Red staining. Increased LC3BII/LC3BI ratio, as well as p62 modulation, were documented in β-blockers treated Hem-ECs. Abundant autophagic vacuoles and multilamellar bodies characterized the cytoplasmic ultrastructural features of autophagy in cultured Hem-ECs exposed in vitro to β-blocking agents. Importantly, similar biochemical and morphologic evidence of autophagy were observed following rapamycin while Bafilomycin A1 significantly prevented the autophagic flux promoted by β-blockers in Hem-ECs. CONCLUSION Our data suggest that autophagy may be ascribed among the mechanisms of action of β-blockers suggesting new mechanistic insights on the potential therapeutic application of this class of drugs in pathologic conditions involving uncontrolled angiogenesis.
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Affiliation(s)
- Bruno Lorusso
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Cerasoli
- Pediatric Surgery, Ospedale dei Bambini of Parma, University Hospital of Parma, Parma, Italy
| | - Angela Falco
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Caterina Frati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gallia Graiani
- Dental School, University of Parma Medical School, Parma, Italy
| | - Denise Madeddu
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonella Nogara
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Emilia Corradini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanni Roti
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elisa Cerretani
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Andrea Gherli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Letizia Gnetti
- Pathology Section, University Hospital of Parma, Parma, Italy
| | | | - Federico Quaini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Costanza Lagrasta
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
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Mazzaschi G, Moron Dalla Tor L, Balbi M, Milanese G, Tognazzi D, Lorusso B, Trentini F, Di Rienzo G, Verzè M, Pluchino M, Minari R, Leo L, Gnetti L, Bordi P, Leonetti A, Ampollini L, Roti G, Quaini F, Sverzellati N, Tiseo M. 1061P Static and dynamic tracking of radiomic and immunophenotypic features predicts the benefit of immune checkpoint inhibitors in advanced NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Mazzaschi G, Moron Dalla Tor L, Milanese G, Balbi M, Tognazzi D, Lorusso B, Verzè M, Pluchino M, Minari R, Leo L, Ledda R, Bordi P, Leonetti A, Buti S, Roti G, Quaini F, Sverzellati N, Tiseo M. P1.15-04 Dynamic Profiling of Blood Immunophenotypes and Radiomic Features to Predict Immunotherapy Response in Advanced Non-small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.200] [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: 10/14/2022]
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Montanaro A, Kitara S, Cerretani E, Marchesini M, Rompietti C, Pagliaro L, Gherli A, Su A, Minchillo ML, Caputi M, Fioretzaki R, Lorusso B, Ross L, Alexe G, Masselli E, Marozzi M, Rizzi FMA, La Starza R, Mecucci C, Xiong Y, Jin J, Falco A, Knoechel B, Aversa F, Candini O, Quaini F, Sportoletti P, Stegmaier K, Roti G. Identification of an Epi-metabolic dependency on EHMT2/G9a in T-cell acute lymphoblastic leukemia. Cell Death Dis 2022; 13:551. [PMID: 35710782 PMCID: PMC9203761 DOI: 10.1038/s41419-022-05002-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/27/2022] [Accepted: 06/07/2022] [Indexed: 01/21/2023]
Abstract
Genomic studies have identified recurrent somatic alterations in genes involved in DNA methylation and post-translational histone modifications in acute lymphoblastic leukemia (ALL), suggesting new opportunities for therapeutic interventions. In this study, we identified G9a/EHMT2 as a potential target in T-ALL through the intersection of epigenome-centered shRNA and chemical screens. We subsequently validated G9a with low-throughput CRISPR-Cas9-based studies targeting the catalytic G9a SET-domain and the testing of G9a chemical inhibitors in vitro, 3D, and in vivo T-ALL models. Mechanistically we determined that G9a repression promotes lysosomal biogenesis and autophagic degradation associated with the suppression of sestrin2 (SESN2) and inhibition of glycogen synthase kinase-3 (GSK-3), suggesting that in T-ALL glycolytic dependent pathways are at least in part under epigenetic control. Thus, targeting G9a represents a strategy to exhaust the metabolic requirement of T-ALL cells.
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Affiliation(s)
- Anna Montanaro
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Samuel Kitara
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA
| | - Elisa Cerretani
- grid.8484.00000 0004 1757 2064Department of Medical Science, University of Ferrara, Ferrara, 44121 Italy
| | - Matteo Marchesini
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy ,IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” IRST (S.r.l.), Meldola, 47014 Italy
| | - Chiara Rompietti
- grid.9027.c0000 0004 1757 3630Department of Medicine, Hematology and Clinical Immunology, University of Perugia, Perugia, 06123 Italy
| | - Luca Pagliaro
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Andrea Gherli
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Angela Su
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA
| | - Maria Laura Minchillo
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Mariafrancesca Caputi
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Rodanthi Fioretzaki
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Bruno Lorusso
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Linda Ross
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA
| | - Gabriela Alexe
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA
| | - Elena Masselli
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy ,grid.411482.aAzienda-Ospedaliera di Parma, Hematology and BMT Unit, Parma, 43126 Italy
| | - Marina Marozzi
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Federica Maria Angela Rizzi
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy ,grid.419691.20000 0004 1758 3396National Institute for Biostructures and Biosystems (I.N.B.B.), Rome, Italy
| | - Roberta La Starza
- grid.9027.c0000 0004 1757 3630Department of Medicine, Hematology and Clinical Immunology, University of Perugia, Perugia, 06123 Italy
| | - Cristina Mecucci
- grid.9027.c0000 0004 1757 3630Department of Medicine, Hematology and Clinical Immunology, University of Perugia, Perugia, 06123 Italy
| | - Yan Xiong
- grid.59734.3c0000 0001 0670 2351Mount Sinai Center for Therapeutics Discovery, Departments of Pharmacological Sciences and Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Jian Jin
- grid.59734.3c0000 0001 0670 2351Mount Sinai Center for Therapeutics Discovery, Departments of Pharmacological Sciences and Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Angela Falco
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Birgit Knoechel
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA ,grid.2515.30000 0004 0378 8438Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA 02215 USA
| | - Franco Aversa
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | | | - Federico Quaini
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy
| | - Paolo Sportoletti
- grid.9027.c0000 0004 1757 3630Department of Medicine, Hematology and Clinical Immunology, University of Perugia, Perugia, 06123 Italy
| | - Kimberly Stegmaier
- grid.38142.3c000000041936754XDepartment of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215 USA ,grid.2515.30000 0004 0378 8438Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA 02215 USA ,grid.66859.340000 0004 0546 1623The Broad Institute, Cambridge, MA 02142 USA
| | - Giovanni Roti
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, 43126 Italy ,grid.411482.aAzienda-Ospedaliera di Parma, Hematology and BMT Unit, Parma, 43126 Italy
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Gandini M, Farina E, Demaria M, Lorusso B, Crosetto L, Rowinski M, Ivaldi C, Cadum E, Bena A. Short-term effects on emergency room access or hospital admissions for cardio-respiratory diseases: methodology and results after three years of functioning of a waste-to-energy incinerator in Turin (Italy). Int J Environ Health Res 2022; 32:1164-1174. [PMID: 33249915 DOI: 10.1080/09603123.2020.1849579] [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] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/07/2020] [Indexed: 06/12/2023]
Abstract
This study is part of the health surveillance system set up with the construction of a waste-to-energy (WTE) plant in Turin (Italy). Circulatory and respiratory diseases in emergency room (ER) accesses and first hospital admissions were considered. Main concerns of population living in the area near WTE were to know whether single and repeated peaks in emissions would correspond to adverse health effects. We tackle this issue using spatio-temporal analyses, comparing an exposed group (EXP) living near the WTE with a reference group (NOEXP). Age-standardized rates of ER accesses between EXP and NOEXP were temporally compared, testing whether there have been significantly different changes over time. We also examined the relationship between emission peaks and ER accesses in the following days. Finally, with time-series analysis, we investigated variations in ER accesses and pollutants before and after WTE start-up. No significant relationship has been found for the outcome considered.
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Affiliation(s)
- M Gandini
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - E Farina
- Regional Epidemiology Unit, Asl TO3, Grugliasco, Italy
| | - M Demaria
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - B Lorusso
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - L Crosetto
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - M Rowinski
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - C Ivaldi
- Environmental Epidemiological Unit, Regional Environmental Protection Agency, Turin, Italy
| | - E Cadum
- Department of Hygiene and Health Prevention, Pavia, Italy
| | - A Bena
- Regional Epidemiology Unit, Asl TO3, Grugliasco, Italy
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Mazzaschi G, Verzè M, Tognazzi D, Lorusso B, Minari R, Pluchino M, Trentini F, Manini M, Bordi P, Leonetti A, Perrone F, Corianò M, Casali M, Toscani I, Cosenza A, Ferri L, Buti S, Sverzellati N, Quaini F, Tiseo M. 165P Dynamic evolution of blood immune-inflammatory descriptors in advanced non-small cell lung cancer undergoing first-line immunotherapy-based regimens. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Trentini F, Mazzaschi G, Milanese G, Pavone C, Madeddu D, Gnetti L, Frati C, Lorusso B, Lagrasta CAM, Minari R, Ampollini L, Ledda RE, Silva M, Sverzellati N, Quaini F, Roti G, Tiseo M. Validation of a radiomic approach to decipher NSCLC immune microenvironment in surgically resected patients. Tumori 2021; 108:86-92. [PMID: 33730957 DOI: 10.1177/03008916211000808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Radiomics has emerged as a noninvasive tool endowed with the potential to intercept tumor characteristics thereby predicting clinical outcome. In a recent study on resected non-small cell lung cancer (NSCLC), we identified highly prognostic computed tomography (CT)-derived radiomic features (RFs), which in turn were able to discriminate hot from cold tumor immune microenvironment (TIME). We aimed at validating a radiomic model capable of dissecting specific TIME profiles bearing prognostic power in resected NSCLC. METHODS The validation cohort included 31 radically resected NSCLCs clinicopathologically matched with the training set (n = 69). TIME was classified in hot and cold according to a multiparametric immunohistochemical analysis involving PD-L1 score and incidence of immune effector phenotypes among tumor infiltrating lymphocytes (TILs). High-throughput radiomic features (n = 841) extracted from CT images were correlated to TIME parameters to ultimately define prognostic classes. RESULTS We confirmed PD-1 to CD8 ratio as best predictor of clinical outcome among TIME characteristics. Significantly prolonged overall survival (OS) was observed in patients carrying hot (median OS not reached) vs cold (median OS 22 months; hazard ratio 0.28, 95% confidence interval 0.09-0.82; p = 0.015) immune background, thus validating the prognostic impact of these two TIME categories in resected NSCLC. Importantly, in the validation setting, three out of eight previously identified RFs sharply distinguishing hot from cold TIME were endorsed. Among signature-related RFs, Wavelet-HHH_gldm_HighGrayLevelEmphasis highly performed as descriptor of hot immune contexture (area under the receiver operating characteristic curve 0.94, 95% confidence interval 0.81-1.00; p = 0.01). CONCLUSION Radiomics may decipher specific TIME profiles providing a noninvasive prognostic approach in resected NSCLC and an exploitable predictive strategy in advanced cases.
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Affiliation(s)
- Francesca Trentini
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Giulia Mazzaschi
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Parma, Italy
| | - Claudio Pavone
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Parma, Italy
| | - Denise Madeddu
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Letizia Gnetti
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Caterina Frati
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Bruno Lorusso
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Costanza Anna Maria Lagrasta
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Parma, Italy
| | - Roberta Minari
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Department of Medicine and Surgery, University of Parma, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Roberta Eufrasia Ledda
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Parma, Italy
| | - Mario Silva
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Parma, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Parma, Italy
| | - Giovanni Roti
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Parma, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
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Mazzaschi G, Milanese G, Pagano P, Madeddu D, Gnetti L, Trentini F, Falco A, Frati C, Lorusso B, Lagrasta C, Minari R, Ampollini L, Silva M, Sverzellati N, Quaini F, Roti G, Tiseo M. Dataset on the identification of a prognostic radio-immune signature in surgically resected Non Small Cell Lung Cancer. Data Brief 2020; 31:105781. [PMID: 32548224 PMCID: PMC7286984 DOI: 10.1016/j.dib.2020.105781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/05/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/01/2022] Open
Abstract
The immune regulation of cancer growth and regression has been underscored by the recent success of immunotherapy. The possibility that immune microenvironmental factors may impact on clinical outcome and treatment response still requires intense investigations. Hereby, supporting data of the research article “Integrated CT Imaging and Tissue Immune Features Disclose a Radio-Immune Signature with High Prognostic Impact on Surgically Resected NSCLC” [1], are presented. With the ultimate aim to provide non-invasive prognostic scores, we report on our approach to correlate different Tumor Immune Microenvironment (TIME) profiles with CT imaging-derived qualitative (semantic, CT-SFs) and quantitative (radiomic, CT-RFs) features in a cohort of 60 surgically resected NSCLC. The renowned characterization of TIME, essentially based on the score evaluation of Programme Death Ligand-1 (PD-L1) and Tumor Infiltrating Lymphocytes (TILs), was implemented here by the assessment of effector and suppressor phenotypes including the analysis of Programme Death receptor 1 (PD-1). Thus, we defined two main TIME categories: hot inflamed (PD-L1high, CD8/CD3high and PD-1/CD8low) as opposed to cold inactive (PD-L1low, CD8/CD3lowand PD-1/CD8high). Importantly, as reported in the extended publication [1], these distinctive immune contextures identified different prognostic classes and were decoded by radiomics. To corroborate our radiomic approach, a comparative estimation of CT-RFs extracted from 60 NSCLC and 13 non neoplastic tissues was undertaken, documenting high discrimination ability. Moreover, we tested the potential association of qualitative radiologic features with clinico-pathological and TIME parameters. Taken together, our findings suggest that CT-SFs and CT-RFs may underlay specific patterns of lung cancer.
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Affiliation(s)
- Giulia Mazzaschi
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Paolo Pagano
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Denise Madeddu
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Letizia Gnetti
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Francesca Trentini
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Angela Falco
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Caterina Frati
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Bruno Lorusso
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Costanza Lagrasta
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Roberta Minari
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Luca Ampollini
- Department of Medicine and Surgery, University of Parma, Thoracic Surgery, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Mario Silva
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Giovanni Roti
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
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Mazzaschi G, Milanese G, Pagano P, Madeddu D, Gnetti L, Trentini F, Falco A, Frati C, Lorusso B, Lagrasta C, Minari R, Ampollini L, Silva M, Sverzellati N, Quaini F, Roti G, Tiseo M. Integrated CT imaging and tissue immune features disclose a radio-immune signature with high prognostic impact on surgically resected NSCLC. Lung Cancer 2020; 144:30-39. [PMID: 32361033 DOI: 10.1016/j.lungcan.2020.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/26/2019] [Revised: 03/06/2020] [Accepted: 04/07/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Qualitative and quantitative CT imaging features might intercept the multifaceted tumor immune microenvironment (TIME), providing a non-invasive approach to design new prognostic models in NSCLC patients. MATERIALS AND METHODS Our study population consisted of 100 surgically resected NSCLC patients among which 31 served as a validation cohort for quantitative image analysis. TIME was classified according to PD-L1 expression and the magnitude of Tumor Infiltrating Lymphocytes (TILs) and further defined as hot or cold by the tissue analysis of effector (CD8-to-CD3high/PD-1-to-CD8low) or inert (CD8-to-CD3low/PD-1-to-CD8high) phenotypes. CT datasets acted as source for qualitative (semantic, CT-SFs) and quantitative (radiomic, CT-RFs) features which were correlated with clinico-pathological and TIME profiles to determine their impact on survival outcome. RESULTS Specific CT-SFs (texture [TXT], effect [EFC] and margins [MRG]) strongly correlated to PD-L1 and TILs status and showed significant impact on survival outcome (TXT, HR:3.39, 95 % CI 1.12-10-27, P < 0.05; EFC, HR:0.41, 95 % CI 0.18-0.93, P < 0.05; MRG, HR:1.93, 95 % CI 0.88-4.25, P = 0.09). Seven CT derived radiomic features were able to sharply discriminate cases with hot (inflamed) vs cold (desert) TIME, which also exhibited opposite OS (long vs short, HR:0.09, 95 % CI 0.04-0.23, P < 0.001) and DFS (long vs short, HR:0.31, 95 % CI 0.16-0.58, P < 0.001). Moreover, we identified 6 prognostic radiomic features among which ClusterProminence displayed the highest statistical significance (HR:0.13, 95 % CI 0.06-0.31, P < 0.001). These findings were independently validated in an additional cohort of NSCLC (HR:0.11, 95 % CI 0.03-0.40, P = 0.001). Finally, in our training cohort we developed a multiparametric prognostic model, interlacing TIME and clinico-pathological characteristics with CT-SFs (ROC curve AUC:0.83, 95 % CI 0.71-0.92, P < 0.001) or CT-RFs (AUC: 0.91, 95 % CI 0.83-0.99, P < 0.001), which appeared to outperform pTNM staging (AUC: 0.66, 95 % CI 0.51-0.80, P < 0.05) in the risk assessment of NSCLC. CONCLUSION Higher order CT extracted features associated with specific TIME profiles may reveal a radio-immune signature with prognostic impact on resected NSCLC.
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Affiliation(s)
- Giulia Mazzaschi
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Gianluca Milanese
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Paolo Pagano
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Denise Madeddu
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Letizia Gnetti
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Francesca Trentini
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Angela Falco
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Caterina Frati
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Bruno Lorusso
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Costanza Lagrasta
- Department of Medicine and Surgery, University of Parma, Pathology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Roberta Minari
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Luca Ampollini
- Department of Medicine and Surgery, University of Parma, Thoracic Surgery, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Mario Silva
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Nicola Sverzellati
- Department of Medicine and Surgery, University of Parma, Institute of Radiologic Science, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Federico Quaini
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Giovanni Roti
- Department of Medicine and Surgery, Hematology and Bone Marrow Transplantation, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
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Armani G, Madeddu D, Mazzaschi G, Bocchialini G, Sogni F, Frati C, Lorusso B, Falco A, Lagrasta CA, Cavalli S, Mangiaracina C, Vilella R, Becchi G, Gnetti L, Corradini E, Quaini E, Urbanek K, Goldoni M, Carbognani P, Ampollini L, Quaini F. Blood and lymphatic vessels contribute to the impact of the immune microenvironment on clinical outcome in non-small-cell lung cancer. Eur J Cardiothorac Surg 2019; 53:1205-1213. [PMID: 29346540 DOI: 10.1093/ejcts/ezx492] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/02/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Lymphangiogenesis plays a critical role in the immune response, tumour progression and therapy effectiveness. The aim of this study was to determine whether the interplay between the lymphatic and the blood microvasculature, tumour-infiltrating lymphocytes and the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint constitutes an immune microenvironment affecting the clinical outcome of patients with non-small-cell lung cancer. METHODS Samples from 50 squamous cell carcinomas and 42 adenocarcinomas were subjected to immunofluorescence to detect blood and lymphatic vessels. CD3pos, CD8pos and PD-1pos tumour-infiltrating lymphocytes and tumour PD-L1 expression were assessed by immunohistochemical analysis. RESULTS Quantification of vascular structures documented a peak of lymphatics at the invasive margin together with a decreasing gradient of blood and lymphatic vessels from the peritumour area throughout the neoplastic core. Nodal involvement and pathological stage were strongly associated with vascularization, and an increased density of vessels was detected in samples with a higher incidence of tumour-infiltrating lymphocytes and a lower expression of PD-L1. Patients with a high PD-L1 to PD-1 ratio and vascular rarefaction had a gain of 10 months in overall survival compared to those with a low ratio and prominent vascularity. CONCLUSIONS Microvessels are an essential component of the cancer immune microenvironment. The clinical impact of the PD-1/PD-L1-based immune contexture may be implemented by the assessment of microvascular density to potentially identify patients with non-small-cell lung cancer who could benefit from immunotherapy and antiangiogenic treatment.
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Affiliation(s)
- Giovanna Armani
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Denise Madeddu
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Giulia Mazzaschi
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | | | - Francesco Sogni
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Caterina Frati
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Bruno Lorusso
- Department of Pathology, University Hospital of Parma, Parma, Italy
| | - Angela Falco
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | | | - Stefano Cavalli
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Chiara Mangiaracina
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Rocchina Vilella
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Gabriella Becchi
- Department of Pathology, University Hospital of Parma, Parma, Italy
| | - Letizia Gnetti
- Department of Pathology, University Hospital of Parma, Parma, Italy
| | - Emilia Corradini
- Department of Pathology, University Hospital of Parma, Parma, Italy
| | - Eugenio Quaini
- Clinical Institute Sant'Ambrogio, Department of Cardiac Surgery, Hospital Group San Donato, Milan, Italy
| | - Konrad Urbanek
- Section of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Matteo Goldoni
- Medical Statistics, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Paolo Carbognani
- Department of Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Department of Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Federico Quaini
- Hematology and Bone Marrow Transplantation Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
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Mazzaschi G, Pagano P, Milanese G, Madeddu D, Falco A, Armani G, Bocchialini G, Marturano D, Ampollini L, Lorusso B, Lagrasta C, Sverzellati N, Silva M, Tiseo M, Quaini F, Roti G. Advanced CT imaging features reflect distinct tissue immune profiles and exhibit high prognostic impact on NSCLC. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy493] [Citation(s) in RCA: 2] [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: 11/15/2022] Open
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Lorusso B, Vilella R, Cretella D, Falco A, Frati C, Madeddu D, Graiani G, Mangiaracina C, Zecca A, Armani G, Fioretzaki R, Lagrasta C, Frusca T, Quaini F. In vitro effects of caffeine on human umbilical artery and vein endothelial cells. Vascul Pharmacol 2018. [DOI: 10.1016/j.vph.2017.12.036] [Citation(s) in RCA: 2] [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: 11/27/2022]
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Mazzaschi G, Madeddu D, Veneziani M, Sogni F, Armani G, Frati C, Lagrasta C, Falco A, Lorusso B, Vilella R, Mangiaracina C, Bocchialini G, Silini E, Facchinetti F, Ardizzoni A, Missale G, Tiseo M, Quaini F. Divergent PD-1 expression in tissue and circulating CD8 lymphocytes defines an immune profile predictive of the response to nivolumab in advanced NSCLC. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.011] [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: 11/14/2022] Open
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Mazzaschi G, Madeddu D, Falco A, Bocchialini G, Goldoni M, Sogni F, Armani G, Lagrasta CA, Lorusso B, Mangiaracina C, Vilella R, Frati C, Alfieri R, Ampollini L, Veneziani M, Silini EM, Ardizzoni A, Urbanek K, Aversa F, Quaini F, Tiseo M. Low PD-1 Expression in Cytotoxic CD8+ Tumor-Infiltrating Lymphocytes Confers an Immune-Privileged Tissue Microenvironment in NSCLC with a Prognostic and Predictive Value. Clin Cancer Res 2017; 24:407-419. [DOI: 10.1158/1078-0432.ccr-17-2156] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/13/2017] [Accepted: 10/23/2017] [Indexed: 11/16/2022]
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Quaini F, Armani G, Madeddu D, Mazzaschi G, Bocchialini G, Sogni F, Frati C, Urbanek K, Lorusso B, Falco A, Lagrasta CA, Quaini E, Carbognani P, Ampollini L. F-066BLOOD AND LYMPHATIC VESSELS CONSTITUTE AN ESSENTIAL COMPONENT OF THE IMMUNE MICROENVIRONMENT AND ITS IMPACT ON NON-SMALL CELL LUNG CANCER CLINICAL OUTCOME. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.078] [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: 11/12/2022] Open
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Quaini F, Lorusso B, Falco A, Madeddu D, Lagrasta C, Bocchialini G, Mazzaschi G, Gervasi A, Cavalli S. P3.01-050 Isolation and Characterization of Lymphatic Endothelial Cells from Neoplastic and Normal Human Lung. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1616] [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: 10/20/2022]
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Urbanek K, Frati C, Graiani G, Madeddu D, Falco A, Cavalli S, Lorusso B, Gervasi A, Prezioso L, Savi M, Ferraro F, Galaverna F, Rossetti P, Lagrasta CA, Re F, Quaini E, Rossi F, Angelis AD, Quaini F. Cardioprotection by Targeting the Pool of Resident and Extracardiac Progenitors. Curr Drug Targets 2016; 16:884-94. [PMID: 25619752 DOI: 10.2174/1389450116666150126105002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/19/2014] [Accepted: 01/07/2015] [Indexed: 11/22/2022]
Abstract
The adult heart has the capacity to generate new myocytes that are markedly enhanced in acute and chronic heart failure of ischemic and non-ischemic origin. In addition, a pool of blood trafficking progenitor cells able to sense myocardial damage may home to the sites of injury participating to cardiac repair. This new view of myocardial biology leads to an expanding long-term research and therapeutic goals for cardioprotection. A fundamental concept to be analyzed is whether cardiac diseases are influenced by changes in the properties of tissue specific and circulating progenitors. Loss of self-renewal capacity, impaired growth or increased susceptibility to death may lead to a reduction of progenitors and leave myocardial damage unrepaired. Cardiac progenitors generate all myocardial cell lineages, thus impairment in their growth is expected to be critically involved in the structural and functional modifications of the heart. The fact that, in addition to well known effects of anthracyclines, also new drugs that target molecular pathways implicated in cell death and growth can be cardiotoxic further supports our hypothesis. Understanding the role of resident and extracardiac progenitors in the pathogenesis of cardiomyopathies of different etiology will provide not only a better comprehension of cardiac homeostasis but will also open new avenues for therapeutic interventions. The progress toward effective myocardial regeneration based on exploiting the self-renewal potential of the myocardium and the systemic pool of cardiogenic cells should advance the likelihood of efficient cardioprotection and restoration of cardiac function.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Federico Quaini
- Department of Clinical and Experimental Medicine, University-Hospital of Parma, Via Gramsci, 14, 43126 Parma, Italy.
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Madeddu D, Falco A, Frati C, Graiani G, Gervasi A, Lorusso B, Rosellini E, Rai R, Boccaccini A, Lagrasta C, Quaini F. Assessment of cardiac patches suitability for tissue engineering. Vascul Pharmacol 2015. [DOI: 10.1016/j.vph.2015.11.046] [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: 10/22/2022]
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Dang Z, Maselli D, Spinetti G, Sangalli E, Carnelli F, Rosa F, Seganfreddo E, Canal F, Furlan A, Paccagnella A, Paiola E, Lorusso B, Specchia C, Albiero M, Cappellari R, Avogaro A, Falco A, Quaini F, Ou K, Rodriguez-Arabaolaza I, Emanueli C, Sambataro M, Fadini GP, Madeddu P. Sensory neuropathy hampers nociception-mediated bone marrow stem cell release in mice and patients with diabetes. Diabetologia 2015; 58:2653-62. [PMID: 26358583 PMCID: PMC4589553 DOI: 10.1007/s00125-015-3735-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/30/2015] [Indexed: 11/29/2022]
Abstract
AIMS/HYPOTHESIS Upon tissue injury, peripheral sensory neurons release nociceptive factors (e.g. substance P [SP]), which exert local and systemic actions including the recruitment of bone marrow (BM)-derived haematopoietic stem and progenitor cells (HSPCs) endowed with paracrine pro-angiogenic properties. We herein explore whether diabetic neuropathy interferes with these phenomena. METHODS We first investigated the presence of sensory neuropathy in the BM of patients with type 2 diabetes by immunohistochemistry and morphometry analyses of nerve size and density and assessment of SP release by ELISA. We next analysed the association of sensory neuropathy with altered HSPC release under ischaemia or following direct stimulation with granulocyte colony-stimulating factor (G-CSF). BM and circulating HSPCs expressing the neurokinin 1 receptor (NK1R), which is the main SP receptor, were measured by flow cytometry. We finally assessed whether an altered modulation of SP secretion interferes with the mobilisation and homing of NK1R-HSPCs in a mouse model of type 2 diabetes after limb ischaemia (LI). RESULTS Nociceptive fibres were reduced in the BM of patients and mice with type 2 diabetes. Patients with neuropathy showed a remarkable reduction in NK1R-HSPC mobilisation under ischaemia or upon G-CSF stimulation. Following LI, diabetic mice manifested an altered SP gradient between BM, peripheral blood and limb muscles, accompanied by a depressed recruitment of NK1R-HSPCs to the ischaemic site. CONCLUSIONS/INTERPRETATION Sensory neuropathy translates into defective liberation and homing of reparative HSPCs. Nociceptors may represent a new target for treatment of diabetic complications.
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Affiliation(s)
- Zexu Dang
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Davide Maselli
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Gaia Spinetti
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Elena Sangalli
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Franco Carnelli
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Francesco Rosa
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Elena Seganfreddo
- Department of Pathology, Santa Maria of Ca' Foncello Hospital, Treviso, Italy
| | - Fabio Canal
- Department of Pathology, Santa Maria of Ca' Foncello Hospital, Treviso, Italy
| | - Anna Furlan
- Department of Specialized Medicines, Hematology Unit, Santa Maria of Ca' Foncello Hospital, Treviso, Italy
| | - Agostino Paccagnella
- Department of Specialized Medicines, Endocrine, Metabolic and Nutrition Diseases Unit, Santa Maria of Ca' Foncello Hospital, 1 Piazza Ospedale, 31100, Treviso, Italy
| | - Emanuela Paiola
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
| | - Bruno Lorusso
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Claudia Specchia
- I.R.C.C.S. (Scientific Institute of Medical Research) MultiMedica, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Mattia Albiero
- Department of Medicine, University of Padova, Padova, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padova, Padova, Italy
| | - Angela Falco
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Federico Quaini
- Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Kepeng Ou
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Iker Rodriguez-Arabaolaza
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Costanza Emanueli
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK
| | - Maria Sambataro
- Department of Specialized Medicines, Endocrine, Metabolic and Nutrition Diseases Unit, Santa Maria of Ca' Foncello Hospital, 1 Piazza Ospedale, 31100, Treviso, Italy.
| | | | - Paolo Madeddu
- Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8HW, UK.
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Ampollini L, Madeddu D, Falco A, Frati C, Lorusso B, Graiani G, Saccani F, Gervasi A, Rossetti P, Bonomini S, Gnetti L, Lagrasta CA, Silini EM, Quaini E, Petronini P, Alfieri R, Rusca M, Carbognani P, Quaini F. Lung mesenchymal cells function as an inductive microenvironment for human lung cancer propagating cells†. Eur J Cardiothorac Surg 2014; 46:e103-12. [PMID: 25312525 DOI: 10.1093/ejcts/ezu359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The aim of the present study was to characterize the biological properties and in vivo tumourigenic potential of mesenchymal cells (MCs) obtained from non-small-cell lung cancer (NSCLC) samples. METHODS NSCLC samples (53 adenocarcinomas and 24 squamous-cell carcinomas) surgically removed from 46 males and 31 females were processed to identify mesenchymal cells from human lung cancer (hLc-MCs). hLc-MCs were separated from neoplastic epithelial cells, expanded and extensively characterized in vitro. Subsequently, female BALB/c nude mice were subcutaneously injected with either 10(6) or 2.5 × 10(6) Calu-3 (human adenocarcinoma cell line able to reproducibly induce xenografted tumours) alone or in combination with equal doses of hLc-MCs. Control animals were injected with the two doses of hLc-MCs only. RESULTS Primary cultures of hLc-MCs were obtained from >80% of NSCLC specimens. The typical MCs immunophenotype was documented by the expression of CD90, CD105, CD73, CD13 and CD44 at fluorescence-activated cell sorting analysis. CD45, CD14, CD34 and epithelial antigens were negative while CD117 (c-kit) and CD133 (prominin) were partially expressed. Interestingly, nuclear transcription factors octamer-binding transcription factor 3/4 and sex determining region Y-box 2 involved in stemness, thyroid transcription factor 1 in bronchoalveolar commitment, and ETS1 in carcinogenesis, were expressed in hLc-MCs isolated from NSCLC. Specific conditioned media and cocultures confirmed the supportive role of hLc-MCs for cancer cells. In vivo experiments showed that at both doses Calu-3 xenografts doubled in size when hLc-MCs were coinjected. Cell tracking in xenografted tumours, by immunofluorescence combined with fluorescence in situ hybridization analysis, documented hX-chromosome-labelled, Calu-3-derived cytokeratin-positive adenocarcinoma structures surrounded by hLc-MCs. CONCLUSIONS Tumour-propagating cells require the inductive interaction of resident mesenchymal cells to foster lung cancer development.
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Affiliation(s)
- Luca Ampollini
- Thoracic Surgery, Department of Surgical Science, University Hospital of Parma, Parma, Italy
| | - Denise Madeddu
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Angela Falco
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Caterina Frati
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Bruno Lorusso
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Gallia Graiani
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Francesca Saccani
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Andrea Gervasi
- Department of Biomedical, Biotechnological and Translational Sciences, University Hospital of Parma, Parma, Italy
| | - Pietro Rossetti
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Sabrina Bonomini
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Letizia Gnetti
- Department of Biomedical, Biotechnological and Translational Sciences, University Hospital of Parma, Parma, Italy
| | | | - Enrico Maria Silini
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Eugenio Quaini
- Cardiothoracic Department, Humanitas Institute, Milan, Italy
| | | | - Roberta Alfieri
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Michele Rusca
- Thoracic Surgery, Department of Surgical Science, University Hospital of Parma, Parma, Italy
| | - Paolo Carbognani
- Thoracic Surgery, Department of Surgical Science, University Hospital of Parma, Parma, Italy
| | - Federico Quaini
- Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
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Ampollini L, Graiani G, Frati C, Madeddu D, Lorusso B, Falco A, Saccani F, Quaini E, Carbognani P, Quaini F. F-038 * LUNG MESENCHYMAL STEM CELLS FUNCTION AS THE INDUCTIVE MICROENVIRONMENT FOR HUMAN LUNG CANCER PROPAGATING CELLS. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.38] [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: 11/13/2022] Open
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Sindona G, Caruso A, Cozza A, Fiorentini S, Lorusso B, Marini E, Nardi M, Procopio A, Zicari S. Anti-Inflammatory Effect of 3,4-DHPEA-EDA [2-(3,4 -Hydroxyphenyl) ethyl (3S, 4E)- 4-Formyl-3-(2-Oxoethyl)Hex-4-Enoate] on Primary Human Vascular Endothelial Cells. Curr Med Chem 2012; 19:4006-13. [DOI: 10.2174/092986712802002536] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/28/2012] [Accepted: 04/02/2012] [Indexed: 11/22/2022]
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Fiorentini S, Luganini A, Dell'Oste V, Lorusso B, Cervi E, Caccuri F, Bonardelli S, Landolfo S, Caruso A, Gribaudo G. Human cytomegalovirus productively infects lymphatic endothelial cells and induces a secretome that promotes angiogenesis and lymphangiogenesis through interleukin-6 and granulocyte-macrophage colony-stimulating factor. J Gen Virol 2010; 92:650-60. [PMID: 21123547 DOI: 10.1099/vir.0.025395-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Endothelial cells (ECs) are a site of human cytomegalovirus (HCMV) productive replication, haematogenous dissemination and persistence, and are assumed to play a critical role in the development of HCMV-associated vascular diseases. Although early reports have shown the presence of HCMV antigens and DNA in lymphoid tissues, the ability of HCMV to infect lymphatic ECs (LECs) has remained unaddressed due to the lack of a suitable in vitro system. This study provided evidence that a clinical isolate of HCMV (retaining its natural endotheliotropism) was able to productively infect purified lymph node-derived LECs and that it dysregulated the expression of several LEC genes involved in the inflammatory response to viral infection. Qualitative and quantitative analysis of virus-free supernatants from HCMV-infected LEC cultures revealed virus-induced secretion of several cytokines, chemokines and growth factors, many of which are involved in the regulation of EC physiological properties. Indeed, functional assays demonstrated that the secretome produced by HCMV-infected LECs stimulated angiogenesis in both LECs and blood ECs, and that neutralization of either interleukin (IL)-6 or granulocyte-macrophage colony-stimulating factor (GM-CSF) in the secretome caused the loss of its angiogenic properties. The involvement of IL-6 and GM-CSF in the HCMV-mediated angiogenesis was further supported by the finding that the recombinant cytokines reproduced the angiogenic effects of the HCMV secretome. These findings suggest that HCMV induces haemangiogenesis and lymphangiogenesis through an indirect mechanism that relies on the stimulation of IL-6 and GM-CSF secretion from infected cells.
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Affiliation(s)
- Simona Fiorentini
- Department of Experimental and Applied Medicine, Section of Microbiology, University of Brescia, Brescia, Italy
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Garrafa E, Trainini L, Benetti A, Saba E, Fezzardi L, Lorusso B, Borghetti P, Bottio T, Ceri E, Portolani N, Bonardlli S, Giulini SM, Annibale G, Corradi A, Imberti L, Caruso A. Isolation, purification, and heterogeneity of human lymphatic endothelial cells from different tissues. Lymphology 2005; 38:159-66. [PMID: 16515224] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Relatively few attempts have been made in the past to isolate and expand lymphatic endothelial cells (LECs). Recently this task has become feasible thanks to the identification of new lymphatic markers such as Podoplanin, Lyve-1, Prox-1 and D2-40. Using a two-step purification method based on the sorting of endothelial cells with Ulex Europaeus Agglutinin 1-coated beads followed by purification with monoclonal antibody D2-40, we were able to purify and in vitro expand human derived LECs from tissues such as lymph node, spleen, thymus, palatine tonsil and iliac lymphatic vessels. The isolated LECs were expanded on collagen type 1 and fibronectin coated flasks for up to 8-10 passages and then analyzed for phenotypic and functional properties. LECs were able to form a capillary like network, when seeded on Cultrex BME, indicating their capability to form lymphatic vessels in vitro. Comparative studies were performed, and we found that specific lymphatic and vascular markers were differentially expressed by LECs prepared from different sources, clearly demonstrating the phenotypic heterogeneity of LECs from different organs and different segments of the lymphatic vasculature. We here propose a new technique to make available ready sources of abundant well-characterized human LECs to examine normal profiles and behavior to compare with abnormal conditions.
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Affiliation(s)
- E Garrafa
- Department of Microbiology, University of Brescia, Italy.
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Prato GP, Cortellini P, Lorusso B, Saletta D. Periodontal Diseases. Oral Dis 1999. [DOI: 10.1007/978-3-642-59821-0_15] [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: 10/17/2022]
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Lorusso B, Cortellini P, Parrini S. Oral Disease Prevention. Oral Dis 1999. [DOI: 10.1007/978-3-642-59821-0_23] [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: 11/29/2022]
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