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Antinori S, Bonazzetti C, Giacomelli A, Corbellino M, Galli M, Parravicini C, Ridolfo AL. Non-human primate and human malaria: past, present and future. J Travel Med 2021; 28:6162451. [PMID: 33693917 DOI: 10.1093/jtm/taab036] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Studies of the malaria parasites infecting various non-human primates (NHPs) have increased our understanding of the origin, biology and pathogenesis of human Plasmodium parasites.This review considers the major discoveries concerning NHP malaria parasites, highlights their relationships with human malaria and considers the impact that this may have on attempts to eradicate the disease. RESULTS The first description of NHP malaria parasites dates back to the early 20th century. Subsequently, experimental and fortuitous findings indicating that some NHP malaria parasites can be transmitted to humans have raised concerns about the possible impact of a zoonotic malaria reservoir on efforts to control human malaria.Advances in molecular techniques over the last 15 years have contributed greatly to our knowledge of the existence and geographical distribution of numerous Plasmodium species infecting NHPs, and extended our understanding of their close phylogenetic relationships with human malaria parasites. The clinical application of such techniques has also made it possible to document ongoing spillovers of NHP malaria parasites (Plasmodium knowlesi, P. cynomolgi, P. simium, P. brasilianum) in humans living in or near the forests of Asia and South America, thus confirming that zoonotic malaria can undermine efforts to eradicate human malaria. CONCLUSIONS Increasing molecular research supports the prophetic intuition of the pioneers of modern malariology who saw zoonotic malaria as a potential obstacle to the full success of malaria eradication programmes. It is, therefore, important to continue surveillance and research based on one-health approaches in order to improve our understanding of the complex interactions between NHPs, mosquito vectors and humans during a period of ongoing changes in the climate and the use of land, monitor the evolution of zoonotic malaria, identify the populations most at risk and implement appropriate preventive strategies.
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Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cecilia Bonazzetti
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Carlo Parravicini
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
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Antinori S, Giacomelli A, Corbellino M, Torre A, Schiuma M, Casalini G, Parravicini C, Milazzo L, Gervasoni C, Ridolfo AL. Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020. J Fungi (Basel) 2021; 7:jof7060481. [PMID: 34198597 PMCID: PMC8231918 DOI: 10.3390/jof7060481] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022] Open
Abstract
Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.
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Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milan, Italy; (A.G.); (M.S.); (G.C.)
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
- Correspondence: ; Tel.: +39-0250319765; Fax: +39-0250319758
| | - Andrea Giacomelli
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milan, Italy; (A.G.); (M.S.); (G.C.)
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Alessandro Torre
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Marco Schiuma
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milan, Italy; (A.G.); (M.S.); (G.C.)
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Giacomo Casalini
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, 20157 Milan, Italy; (A.G.); (M.S.); (G.C.)
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | | | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Cristina Gervasoni
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, 20157 Milan, Italy; (M.C.); (A.T.); (L.M.); (C.G.); (A.L.R.)
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Pezzani MD, Di Cristo V, Parravicini C, Sonzogni A, Tonello C, Franzetti M, Sollima S, Corbellino M, Galli M, Milazzo L, Antinori S. Gastrointestinal basidiobolomycosis: An emerging mycosis difficult to diagnose but curable. Case report and review of the literature. Travel Med Infect Dis 2019; 31:101378. [PMID: 30660554 DOI: 10.1016/j.tmaid.2019.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 06/21/2018] [Revised: 12/18/2018] [Accepted: 01/16/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Gastrointestinal basidiobolomycosis (GIB) is a rare mycosis affecting almost exclusively immunocompetent subjects. METHODS We describe a case of GIB caused by Basidiobolus ranarum in a 25-year-old Italian immunocompetent man resident in Ireland who presented a 2-month history of epigastric pain. Suspecting colon cancer he underwent a right hemicolectomy subsequently leading to a diagnosis of GIB by means of molecular biology. After surgery a 9-month therapy with itraconazole was employed with a good outcome. A review of medical literature regarding GIB cases published in the period 1964-2017 is presented. RESULTS One-hundred and two cases of GIB were included in this analysis. The disease was observed predominantly in male gender (74.5%) and children (41.2%). Abdominal pain was the single most common complaint (86.3%) followed by fever (40.2%) and evidence of an abdominal mass (30.4%). Peripheral blood eosinophilia was detected in 85.7% of cases. Most of the patients were diagnosed in Saudi Arabia (37.2%) followed by USA (21.6%) and Iran (20.6%). Surgery plus antifungal therapy was employed in the majority of patients (77.5%). An unfavourable outcome was documented globally in 18.6% of patients. CONCLUSIONS GIB seems to be an emerging intestinal mycosis among immunocompetent patients living in the Middle East and Arizona.
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Affiliation(s)
- Maria Diletta Pezzani
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Italy
| | - Valentina Di Cristo
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Italy
| | | | | | | | - Marco Franzetti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy
| | - Salvatore Sollima
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Ospedale L Sacco, Milano, Italy.
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Abstract
Purpose of review The expanding population of immunocompromised patients coupled with the recognition of a growing number of different species of fungi responsible for diseases in such hosts makes the diagnosis of invasive fungal infection (IFI) a challenging task. The recent advances and challenges in the diagnosis of IFI in the setting of immunocompromised hosts are reviewed. The advantages and limitations of histopathology and the role of culture-independent methods, such as those based on the use of nucleic acids applied to fresh and formalin-fixed, paraffin-embedded sections, besides culture- and non-culture-based diagnostic methods, to obtain a timely and correct diagnosis of IFI are highlighted. Recent findings The therapeutic implications of identifying the genus and species of the fungus present in the specimen with the molecular diagnostics applied to tissue specimens are reviewed. No method alone is efficient in correctly identifying fungi and it is essential to combine the traditional histochemical staining with molecular methods to achieve a rapid and genus-/species-specific diagnosis of IFI. Summary We review the recent findings and challenges in the hystopathologic diagnosis of IFI in the setting of immunocompromised hosts. Non method alone is efficient in correctly identify fungi and pathologists should combine classic staining with molecular methods to achieve a rapid and genus/species fungal diagnosis.
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Affiliation(s)
- Spinello Antinori
- 1Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milano, Via GB Grassi, 74, 20157 Milan, Italy.,2III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Mario Corbellino
- 2III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Carlo Parravicini
- 3Pathology Unit, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
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Antinori S, Tonello C, Edouard S, Parravicini C, Gastaldi D, Grande R, Milazzo L, Ricaboni D, Fenollar F, Raoult D, Corbellino M, Mediannikov O. Diagnosis of Louse-Borne Relapsing Fever despite Negative Microscopy in Two Asylum Seekers from Eastern Africa. Am J Trop Med Hyg 2017; 97:1669-1672. [PMID: 29016302 DOI: 10.4269/ajtmh.17-0320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We report two cases of louse-borne relapsing fever observed at our Institution in June 2016. Both patients were young asylum seekers from Africa who had recently arrived in Milan, Italy. Notably, direct microscopic examination of peripheral blood smears was repeatedly negative for the presence of spirochetes and the diagnosis, supported by clinical and epidemiologic evidence, required molecular confirmation by polymerase chain reaction amplification of DNA extracted from blood and sequencing of the amplified products.
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Affiliation(s)
- Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Cristina Tonello
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Sophie Edouard
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Carlo Parravicini
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Romualdo Grande
- Clinical Microbiology, Virology and Bioemergence Diagnostics, Ospedale L Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Davide Ricaboni
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Florence Fenollar
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Oleg Mediannikov
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
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Antinori S, Parravicini C, Galimberti L, Tosoni A, Giunta P, Galli M, Corbellino M, Ridolfo AL. Is imported onchocerciasis a truly rare entity? Case report and review of the literature. Travel Med Infect Dis 2017; 16:11-17. [PMID: 28232074 DOI: 10.1016/j.tmaid.2017.02.006] [Citation(s) in RCA: 9] [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] [Received: 10/05/2016] [Revised: 02/13/2017] [Accepted: 02/16/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Onchocerciasis is endemic in a number of tropical countries in Africa and South America, and it is occasionally diagnosed as an imported disease in non-endemic areas. METHODS We describe the case of an African migrant with long-lasting pruritus and a cutaneous nodule who was diagnosed with onchocerciasis after nodulectomy, and review the medical literature regarding imported cases of onchocerciasis in the period 1994-2014. RESULTS Twenty-nine cases of onchocerciasis diagnosed in migrants from endemic countries, and in expatriates and travellers from non-endemic areas were retrieved. They were predominantly males (73.3%), had a median age of 37 years (two were aged <15 years), and acquired the diseases in sub-Saharan Africa, most frequently in Cameroon (43.3%). Diagnosis of onchocercosis was proven in 73.3% of patients. The most frequent clinical manifestations in these and our own patient were pruritus (23/30, 76.7%), unilateral leg or forearm swelling (13/30, 43.3%) and rash (12/30, 40.0%), whereas only two (6.9%) complained of eye symptoms. Eosinophilia was observed in almost all of the patients (92.0%), with median counts of 2915/μL among migrants and 1960/μL among travellers/expatriates. Eighteen patients underwent a skin snip biopsy, which was positive in 10 cases (55.5%); in the other 13 patients the parasite was directly demonstrated by means of a skin or nodule biopsy (n = 5), nodulectomy (n = 5) or slit lamp examination (n = 3). Eighteen received ivermectin, alone, and seven ivermectin combined with diethylcarbamazine or doxycycline. Outcome details were available for only 14 patients, all of whom were asymptomatic after a median follow-up of 10 months (range 1-48). CONCLUSIONS Onchocerciasis is a neglected tropical disease whose subtle and non-specific features may lead to under-diagnosis or underreporting in non-endemic areas. Physicians should consider this tropical disease when caring for migrants and travellers/expatriates with pruritus, skin lesions and eosinophilia.
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Affiliation(s)
- Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milano, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy.
| | - Carlo Parravicini
- Pathology Unit, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
| | - Laura Galimberti
- III Division of Infectious Diseases, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
| | - Antonella Tosoni
- Pathology Unit, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
| | - Paolo Giunta
- Pathology Unit, Melegnano and Martesana ASST, Vizzolo Predabissi, Italy
| | - Massimo Galli
- Luigi Sacco Department of Biomedical and Clinical Sciences, University of Milano, Italy; III Division of Infectious Diseases, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
| | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, Luigi Sacco Hospital, Fatebenefratelli Sacco ASST, Milano, Italy
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Tabanelli V, Santiago-Pacheco V, Corbellino M, Calleri A, Agostinelli C, Parravicini C, Pileri SA. Cytotoxic Epstein-Barr virus-positive large B cell lymphoma: a regulatory B cell-derived neoplasia? Histopathology 2016; 70:650-656. [PMID: 27782313 DOI: 10.1111/his.13109] [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: 07/01/2016] [Accepted: 10/24/2016] [Indexed: 12/01/2022]
Abstract
AIMS A new subtype of granzyme B (GrB)-producing regulatory B cells (Bregs ) has been described recently; these peculiar cytotoxic B cells are increased significantly in interleukin (IL)-21-rich settings, and in particular during HIV and Epstein-Barr virus (EBV) infection. Our aim is to report a unique case of an EBV-positive diffuse large B cell lymphoma (DLBCL) with cytotoxic features arisen in an HIV+ patient, and to understand if this lesion may represent a proliferation of neoplastic cytotoxic Bregs . METHODS AND RESULTS We describe a 66-year-old male patient who presented with cervical lymph node enlargement and B symptoms; subsequently, HIV infection was diagnosed. Histopathological, immunohistochemical and molecular studies were performed, and revealed an EBV-positive DLBCL with cytotoxic features. Considering the immunological setting and unconventional phenotype observed, we tried to evaluate further the expression of GrB and IL-21 in another 150 aggressive B cell lymphomas (17 of 150 EBV+ , two of 150 EBV+ /HIV+ ). Minimal dot-like expression of GrB was found in seven lymphomas (in fewer than 1% of tumour cells), three of which were EBV-positive. CONCLUSIONS Breg origin has never been reported in B cell lymphomas. We describe an exceptional case of EBV-positive DLBCL with aberrant expression of cytotoxic markers in a patient with a previously unknown HIV infection. We propose cytotoxic Bregs as a possible normal counterpart for this unusual tumour.
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Affiliation(s)
| | | | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
| | - Angelica Calleri
- Unit of Haematopathology, European Institute of Oncology, Milan, Italy
| | - Claudio Agostinelli
- Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Carlo Parravicini
- Section of Infectious Diseases and Immunopathology, Luigi Sacco Hospital, Milan, Italy
| | - Stefano A Pileri
- Unit of Haematopathology, European Institute of Oncology, Milan, Italy.,Bologna University School of Medicine, Bologna, Italy
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Giaccone G, Carella F, Parravicini C, Longhi E, Chiapparini L, Savoiardo M, Montano N, Morbin M, Albanese A, Tagliavini F. A 52-Year-Old Man with Myoclonic Jerks. Brain Pathol 2016; 26:291-2. [PMID: 27000489 DOI: 10.1111/bpa.12359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Giorgio Giaccone
- IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | | | | | | | | | - Mario Savoiardo
- IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Nicola Montano
- Luigi Sacco Hospital, Milano, Italy.,Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy
| | - Michela Morbin
- IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Alberto Albanese
- IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
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Eberini I, Palazzolo L, Peijnenburg A, Guerrini U, Parravicini C, Moretto A, Bovee T. In silico prioritization for endocrine active substances (EAS) and their in vitro validation. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1486] [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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10
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Cagnoni G, Rimoldi SG, Pagani C, Savi C, Stefani F, Terzi R, Olivieri P, Tosi G, Parravicini C, Di Gregorio A, Antona C, Gismondo MR. Can Drainage Using a Negative-Pressure Wound Therapy Device Replace Traditional Sample Collection Methods? Surg Infect (Larchmt) 2016; 17:577-82. [PMID: 27348793 DOI: 10.1089/sur.2016.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In 2015 a new device for the collection of mediastinal fluid from patients with deep sternal wound infection (DSWI) in the presence of negative-pressure wound therapy (NPWT) became available. The present study was designed to evaluate whether changing sample collection devices increased micro-organism detection in patients undergoing NPWT. METHODS During 2013-2014, 207 samples were collected and cultured from NPWT patients (n = 23) to demonstrate the presence of DSWI using reticulated polyurethane sponge culture, a swab, and blood culture. In 2015, a new collection device was introduced for specimen collection. A total of 357 samples (n = 17) were collected using the ESwab(™) (Copan, Murrieta, CA) for deep and superficial wound sample collection. In addition, blood culture devices were used for collecting mediastinal fluid aspirated directly from the wound and biologic fluid obtained from the NPWT device. Fisher exact test was performed to test the rate of independence rate of micro-organism identification using the NPWT sponge device and taking blood culture results as a reference for micro-organism identification. RESULTS After the introduction of the new collection device in our hospital, an overall increase in the detection of micro-organisms (46.7%) was reported. During 2013-2014 our traditional microbiologic collection method did not detect a pathogen in 30.4% of patients. During 2015, the new sample collection approach, direct from the NPWT device, improved micro-organism detection by 10.4% and reduced DSWIs with undetected pathogens to 17.6% (p < 0.01). CONCLUSIONS As a result of proficiency gained in the last year, the most representative specimen in wound infection was represented by mediastinal fluid collected directly from the wound and the NPWT device. Given the correlation between the blood culture of micro-organisms detected using the ESwab device from the wound, mediastinal drainage, and drainage from the NPWT device, we can assume that the NPWT device may replace the other biologic sampling devices.
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Affiliation(s)
- Giovanni Cagnoni
- 1 Unità Operativa di Cardiochirurgia, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Sara Giordana Rimoldi
- 2 Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Cristina Pagani
- 2 Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Claudio Savi
- 3 Unità Operativa di Cardioanestesia, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | | | - Roberta Terzi
- 5 Divisione I di Malattie Infettive, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Pietro Olivieri
- 6 Direzione Medica di Presidio, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Giulia Tosi
- 7 Unità Operativa di Farmacia, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Carlo Parravicini
- 8 Divisione di Anatomia Patologica, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Annamaria Di Gregorio
- 2 Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Carlo Antona
- 1 Unità Operativa di Cardiochirurgia, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
| | - Maria Rita Gismondo
- 2 Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Ospedaliera-Polo Universitario Luigi Sacco , Milano, Italy
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Antinori S, Mediannikov O, Corbellino M, Grande R, Parravicini C, Bestetti G, Longhi E, Ricaboni D, Ehounoud CB, Fenollar F, Raoult D, Rimoldi SG. Louse-Borne Relapsing Fever (Borrelia recurrentis) in a Somali Refugee Arriving in Italy: A Re-emerging Infection in Europe? PLoS Negl Trop Dis 2016; 10:e0004522. [PMID: 27149282 PMCID: PMC4858251 DOI: 10.1371/journal.pntd.0004522] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Spinello Antinori
- Department of Clinical and Biomedical Sciences Luigi Sacco, University of Milano, Milano, Italy
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy
- * E-mail:
| | - Oleg Mediannikov
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Emergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitaire (IHU) Mediterranee-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Mario Corbellino
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy
| | - Romualdo Grande
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, Luigi Sacco Hospital, Milano, Italy
| | - Carlo Parravicini
- Department of Diagnostic Services Pathology Unit, Luigi Sacco Hospital, Milano, Italy
| | - Giovanna Bestetti
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy
| | - Erika Longhi
- Department of Diagnostic Services Pathology Unit, Luigi Sacco Hospital, Milano, Italy
| | - Davide Ricaboni
- III Division of Infectious Diseases, Luigi Sacco Hospital, Milano, Italy
| | - Cyrille Bilé Ehounoud
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Emergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitaire (IHU) Mediterranee-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Florence Fenollar
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Emergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitaire (IHU) Mediterranee-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Emergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitaire (IHU) Mediterranee-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Sara Giordana Rimoldi
- Department of Diagnostic Services, Clinical Microbiology, Virology and Bioemergence Diagnostics, Luigi Sacco Hospital, Milano, Italy
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Oksenhendler E, Boutboul D, Beldjord K, Meignin V, de Labarthe A, Fieschi C, Dossier A, Agbalika F, Parravicini C, Tosato G, Gérard L, Galicier L. Human herpesvirus 8+ polyclonal IgMλ B-cell lymphocytosis mimicking plasmablastic leukemia/lymphoma in HIV-infected patients. Eur J Haematol 2013; 91:497-503. [PMID: 23992152 DOI: 10.1111/ejh.12191] [Citation(s) in RCA: 14] [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] [Accepted: 08/15/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE Multicentric Castleman disease (MCD) is a distinct lymphoproliferative disorder characterized by inflammatory symptoms, lymphadenopathy, splenomegaly, and cytopenia. Kaposi's sarcoma-associated herpesvirus (KSHV), also called human herpesvirus-8 (HHV-8), is the cause of virtually all cases of MCD occurring in patients with HIV infection. MCD lesions characteristically contain HHV-8-infected polyclonal IgMλ plasmablasts. A high frequency of HHV-8-related non-Hodgkin lymphoma has been reported in these patients. PATIENTS AND METHODS We now report on three patients who presented with severe symptoms of MCD, extreme splenomegaly, and rapid expansion of B-cell lymphocytosis (44-81%) attributable to circulating HHV-8 positive plasmablasts. RESULTS The circulating plasmablastic cells shared the phenotype (IgMλ, CD19+, CD20- CD138-) of HHV-8-infected cells from MCD lesions, mimicking the leukemic phase of large B-cell lymphoma occurring in HHV-8-related MCD. These patients displayed a very high HHV-8 viral load in blood (>7 logs HHV-8 DNA copies/ml) and high levels of serum vIL-6, the viral homolog of human interleukin 6. Serum IL-6 and IL-10 were also abnormally elevated. HHV-8-infected cells were demonstrated by immunoglobulin gene rearrangement analysis, to be polyclonal and likely represent an expansion of HHV-8-infected cells similar to those found in MCD lesions. CONCLUSION Thus, the spectrum of HHV-8-related plasmablastic lymphoproliferative disorders in patients with HIV infection is expanded to include HHV-8+ polyclonal IgMλ B-cell lymphocytosis. At onset, this lymphoproliferative disorder may mimic plasmablastic leukemia/lymphoma. Recognizing this unusual complication may have important implications in treatment decision avoiding unnecessary toxicity to the patients.
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Affiliation(s)
- Eric Oksenhendler
- Department of Clinical Immunology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, Paris, France
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Argentieri MC, Pilla D, Vanzati A, Lonardi S, Facchetti F, Doglioni C, Parravicini C, Cattoretti G. Antibodies are forever: a study using 12-26-year-old expired antibodies. Histopathology 2013; 63:869-76. [DOI: 10.1111/his.12225] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 07/06/2013] [Indexed: 01/23/2023]
Affiliation(s)
| | - Daniela Pilla
- Department of Pathology; AO San Gerardo; Monza Italy
| | - Alice Vanzati
- Department of Pathology; AO San Gerardo; Monza Italy
- Department of Surgical Sciences; Universitá degli Studi di Milano Bicocca; Milan Italy
| | - Silvia Lonardi
- Department of Pathology; University of Brescia, Spedali Civili; Brescia Italy
| | - Fabio Facchetti
- Department of Pathology; University of Brescia, Spedali Civili; Brescia Italy
| | | | | | - Giorgio Cattoretti
- Department of Pathology; AO San Gerardo; Monza Italy
- Department of Surgical Sciences; Universitá degli Studi di Milano Bicocca; Milan Italy
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Chiaravalli AM, Longhi E, Vigetti D, De Stefano FI, Deleonibus S, Capella C, Solcia E, Parravicini C. Gastrointestinal cancers reactive for the PAb416 antibody against JCV/SV40 T-Ag lack JCV DNA sequences while showing a distinctive pathologic profile. J Clin Pathol 2012; 66:44-9. [PMID: 23012397 DOI: 10.1136/jclinpath-2012-200963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM Immunohistochemical and molecular studies have suggested an oncogenic role for JCV in gastrointestinal carcinomas, but at least in colorectal cancers, the data are far from being unambiguous. METHODS Two large series of formalin-fixed paraffin-embedded gastric and colorectal cancers were analysed for the expression of JCV large T Antigen (T-Ag) with a panel of five antibodies, and for the presence of T-Ag DNA sequences using two PCR systems. RESULTS Intense nuclear staining was observed in 54/116 (46%) colorectal, and in 92/234 (39%) gastric cancers, using the PAb416 monoclonal antibody against large T-Ag. In colorectal cancers, PAb416-positivity was directly related to the presence of chromosomal instability, lymph node metastases and a more advanced tumour stage, and inversely related to proximal tumour site and the presence of microsatellite instability (MSI). In gastric cancers, the glandular histotype, the presence of lymph node metastases, a low frequency of MSI and EBV infection, and a worse prognosis were significantly associated with PAb416 immunoreactivity. Moreover, at both these sites, PAb416 expression was significantly associated with p53 nuclear accumulation. No positivity was obtained with all the other four anti-T-Ag-antibodies, and molecular analysis failed to demonstrate the presence of JCV DNA sequences in tested cases. CONCLUSIONS Our immunohistochemical and molecular results do not support the idea that JCV T-Ag has a role in gastrointestinal carcinogenesis. It is possible that PAb416, besides binding the viral protein, may cross-react with a hitherto undefined protein whose expression is associated with a distinct pathological profile and, at least in gastric cancers, with worse prognosis.
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Milazzo L, Mazzali C, Bestetti G, Longhi E, Foschi A, Viola A, Vago T, Galli M, Parravicini C, Antinori S. Liver-related factors associated with low vitamin D levels in HIV and HIV/HCV coinfected patients and comparison to general population. Curr HIV Res 2011; 9:186-93. [PMID: 21585333 DOI: 10.2174/157016211795945269] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 05/04/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Low 25-Hydroxyvitamin D (25[OH]D) was associated with severe fibrosis and low sustained virological response (SVR) after interferon (IFN)-based therapy in chronic hepatitis C. Furthermore, hypovitaminosis D was reported in HIV-infected individuals, but its role in liver disease progression in HIV/HCV coinfection is unknown. METHODS 25(OH)D was retrospectively measured in 237 HIV-infected patients (93 with HCV coinfection) and 76 healthy controls. Multivariate analysis included season, immuno-virological data, combined antiretroviral therapy (cART) and, in a subgroup of 51 HIV/HCV-genotype 1 coinfected patients, factors influencing SVR to pegylated-IFN and ribavirin. In a group of 20 patients, liver expression of cytochrome (CY)-P27A1 and CYP2R1, 25-hydroxylating enzymes, was assessed by immunohistochemistry. RESULTS Median 25(OH)D levels were 23.4 (interquartile range 16.7-33.7) ng/mL in the HIV-infected population and 24 ng/mL (18.3-29.5) in healthy controls (p=0.9). At multiple regression analysis, only winter/spring measurements correlated with lower 25(OH)D levels. No correlation with HCV coinfection, nor with cART regimens was found. Low 25(OH)D was independently associated with advanced fibrosis in HIV/HCV coinfected patients (p=0.023), whereas no association emerged with SVR to IFN-based therapy. CYP27A1 and CYP2R1 expression was associated neither with 25(OH)D serum levels nor with HCV-infection, liver histology, or cART. CONCLUSIONS In our experience, despite the high prevalence of 25(OH)D insufficiency, HIV and HCV-infection did not seem to influence vitamin D status. The role of HIV, HCV and cART on hypovitaminosis D needs further validation in larger cohorts that account for the vitamin levels in general populations and for seasonal and regional variability.
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Affiliation(s)
- Laura Milazzo
- Section of Infectious Diseases and Immunopathology, Department of Clinical Sciences L. Sacco, Università degli Studi di Milano, L. Sacco Hospital, Milan, Italy.
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Antinori S, Nebuloni M, Magni C, Fasan M, Adorni F, Viola A, Corbellino M, Galli M, Vago G, Parravicini C, Ridolfo AL. Trends in the postmortem diagnosis of opportunistic invasive fungal infections in patients with AIDS: a retrospective study of 1,630 autopsies performed between 1984 and 2002. Am J Clin Pathol 2009; 132:221-7. [PMID: 19605816 DOI: 10.1309/ajcpraae8lz7dtne] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We retrospectively evaluated autopsy-proven invasive fungal infections (IFIs) in patients with AIDS who died between 1984 and 2002. IFIs were identified in 297 (18.2%) of 1,630 autopsies. Their prevalence significantly decreased over time (from 25.0% in 1984-1988 to 15% in 1998-2002; P = .004), mainly owing to a significant decrease in pneumocystosis (P = .017) and cryptococcosis (P = .003), whereas the prevalence of aspergillosis and histoplasmosis remained relatively stable and of candidiasis and zygomycosis tended to increase in the last years (P = .028 and P = .042, respectively). IFIs were suspected or confirmed during life in only 46.8% of the cases; this proportion did not vary significantly over time (P = .320). The infections contributed to the deaths of 103 patients (34.7%), and their global impact on mortality was 6.3%. Of fatal cases, 38 (36.9%) were characterized by missed antemortem diagnoses, 17 (45%) of which met Goldman criteria for class I errors. The epidemiology of IFIs in patients with AIDS is evolving and not completely mirrored by clinical diagnoses or current diagnostic methods. Our results confirm the valuable role of autopsy data, even with highly effective therapies and advanced technologies.
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Antinori S, Calattini S, Piolini R, Longhi E, Bestetti G, Cascio A, Parravicini C, Corbellino M. Is real-time polymerase chain reaction (PCR) more useful than a conventional PCR for the clinical management of leishmaniasis? Am J Trop Med Hyg 2009; 81:46-51. [PMID: 19556565] [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: 05/28/2023] Open
Abstract
It is currently unknown if the use of a real-time polymerase chain reaction (PCR) adds value to the diagnosis and follow-up prognosis of patients affected by leishmaniasis. We performed a study using a real-time PCR directed against the alpha-polymerase gene and a semiquantitative PCR that target the SSU ribosomal RNA (rRNA) gene as control for the diagnosis and quantification of parasites in patients with visceral (VL) and cutaneous (CL) leishmaniasis. Our single copy real-time PCR missed one diagnosis of VL compared with the conventional PCR, whereas both PCR methods were able to detect Leishmania parasites in CL. Under anti-leishmania treatment the kinetics of parasitemia were comparable with the two methods. The real-time PCR directed against alpha-polymerase of Leishmania despite being able to make a more accurate quantification of parasites does not add to the decision-making management compared with a semiquantitative PCR, and it is comparatively expensive.
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Affiliation(s)
- Spinello Antinori
- Department of Clinical Sciences L Sacco, section of Infectious Diseases and Immunopathology, University of Milan, Via GB Grassi 74, 20157 Milano, Italy.
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Antinori S, Corbellino M, Piolini R, Cascio A, Longhi E, Calattini S, Bestetti G, Parravicini C. Is Real-Time Polymerase Chain Reaction (PCR) More Useful Than a Conventional PCR for the Clinical Management of Leishmaniasis? Am J Trop Med Hyg 2009. [DOI: 10.4269/ajtmh.2009.81.46] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Antinori S, Ridolfo AL, Fasan M, Magni C, Galimberti L, Milazzo L, Sollima S, Adorni F, Giuliani G, Galli M, Corbellino M, Parravicini C. AIDS-associated cryptococcosis: a comparison of epidemiology, clinical features and outcome in the pre- and post-HAART eras. Experience of a single centre in Italy. HIV Med 2009; 10:6-11. [DOI: 10.1111/j.1468-1293.2008.00645.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Simmonds P, Douglas J, Bestetti G, Longhi E, Antinori S, Parravicini C, Corbellino M. A third genotype of the human parvovirus PARV4 in sub-Saharan Africa. J Gen Virol 2008; 89:2299-2302. [PMID: 18753240 DOI: 10.1099/vir.0.2008/001180-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PARV4 is a recently discovered human parvovirus widely distributed in injecting drug users in the USA and Europe, particularly in those co-infected with human immunodeficiency virus (HIV). Like parvovirus B19, PARV4 persists in previously exposed individuals. In bone marrow and lymphoid tissue, PARV4 sequences were detected in two sub-Saharan African study subjects with AIDS but without a reported history of parenteral exposure and who were uninfected with hepatitis C virus. PARV4 variants infecting these subjects were phylogenetically distinct from genotypes 1 and 2 (formerly PARV5) that were reported previously. Analysis of near-complete genome sequences demonstrated that they should be classified as a third (equidistant) PARV4 genotype. The availability of a further near-complete genome sequence of this novel genotype facilitated identification of conserved novel open reading frames embedded in the ORF2 coding sequence; one encoded a putative protein with identifiable homology to SAT proteins of members of the genus Parvovirus.
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Affiliation(s)
- Peter Simmonds
- Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK
| | - Jill Douglas
- Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK
| | - Giovanna Bestetti
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Erika Longhi
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Spinello Antinori
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Carlo Parravicini
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Mario Corbellino
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
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Abstract
Leishmaniasis is a rarely reported disease among transplant recipients; however, the number of published cases has quadrupled since the beginning of the 1990s. Most cases have been observed in patients living in countries of the Mediterranean basin. Leishmaniasis is most commonly associated with kidney transplantation (77%), and cases are also recorded among patients undergoing liver, heart, lung, pancreas, and bone marrow transplantation. Visceral leishmaniasis (VL) is the most frequently observed clinical presentation, followed by mucosal leishmaniasis and more rarely cutaneous leishmaniasis. Transplant recipients with VL develop the classic clinical form of the disease, which is a febrile hepatosplenic and pancytopenic syndrome. Immunodepression seems to predispose to development of mucosal leishmaniasis caused by viscerotropic strains. Early diagnosis of VL is crucial for patient therapy and outcome; however, this is frequently overlooked or delayed in transplant patients. Pentavalent antimonials are the most commom form of treatment for VL, but have a high incidence of toxicity (34%). Although used in fewer patients, liposomal amphotericin B seems to be better tolerated and should be considered as first-line therapy in transplant recipients.
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Affiliation(s)
- Spinello Antinori
- Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, University of Milan, Milan, Italy.
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Morelli P, Bestetti G, Longhi E, Parravicini C, Corbellino M, Meroni L. Persistent parvovirus B19-induced anemia in an HIV-infected patient under HAART. Case report and review of literature. Eur J Clin Microbiol Infect Dis 2007; 26:833-7. [PMID: 17674060 DOI: 10.1007/s10096-007-0360-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Recent reports document resolution of human parvovirus B19-related pure red blood cell aplasia (PB19-PRCA) in HIV-infected patients upon commencement of highly active antiretroviral therapy (HAART). This article describes a patient with PB19-PRCA who, despite fully suppressive HAART, required cyclic administration of intravenous human immunoglobulin over a period of 17 months before PB19 seroconversion and subsequent resolution of relapsing severe anemia. All reports in the English literature describing PB19-related hematologic abnormalities in the post-HAART era are also described herein.
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Affiliation(s)
- P Morelli
- Institute of Infectious Diseases and Tropical Medicine, Luigi Sacco Hospital, University of Milan, Via GB Grassi 74, 20157, Milan, Italy.
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Antinori S, Longhi E, Bestetti G, Piolini R, Acquaviva V, Foschi A, Trovati S, Parravicini C, Corbellino M, Meroni L. Post-kala-azar dermal leishmaniasis as an immune reconstitution inflammatory syndrome in a patient with acquired immune deficiency syndrome. Br J Dermatol 2007; 157:1032-6. [PMID: 17854365 DOI: 10.1111/j.1365-2133.2007.08157.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis (VL) observed mainly in Sudan and India where it follows treated VL in 50% and 10% of cases, respectively. We report a 46-year-old patient with acquired immune deficiency syndrome who, 7 months after diagnosis of VL, developed PKDL and uveal leishmaniasis following HAART-induced immune recovery. In southern Europe PKDL seems to be an emerging clinical presentation among human immunodeficiency virus (HIV)-infected patients experiencing HAART-induced immune recovery after a previous diagnosis of VL. The best treatment among HIV-infected patients remains to be determined.
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Affiliation(s)
- S Antinori
- Department of Clinical Sciences L Sacco, Infectious and Tropical Diseases Section, University of Milano, Via GB Grassi, 74, 20157 Milano, Italy.
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Milazzo L, Trovati S, Pedenovi S, De Angelis S, Parravicini C. Recurrent herpes simplex virus (HSV) eyelid infection in an HIV-1 infected patient. Infection 2007; 35:393-4. [PMID: 17882358 DOI: 10.1007/s15010-007-6336-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 02/26/2007] [Indexed: 11/26/2022]
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Longhi E, Bestetti G, Acquaviva V, Foschi A, Piolini R, Meroni L, Magni C, Antinori S, Parravicini C, Corbellino M. Human parvovirus 4 in the bone marrow of Italian patients with AIDS. AIDS 2007; 21:1481-3. [PMID: 17589196 DOI: 10.1097/qad.0b013e3281e38558] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human parvovirus 4 (PARV4) is a recently discovered member of the Parvoviridae. We investigated the presence of this virus in bone-marrow aspirates of 35 Italian patients with AIDS. Viral DNA was detected by polymerase chain reaction in over 40% of patients (16/35). The infection was most prevalent in injection drug users (IDU; 12/18; 66.7%) as opposed to non-IDU (4/17; 23.5%). PARV4 infection is widespread in Italian patients with AIDS.
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Affiliation(s)
- Erika Longhi
- Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
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Antinori S, Calattini S, Longhi E, Bestetti G, Piolini R, Magni C, Orlando G, Gramiccia M, Acquaviva V, Foschi A, Corvasce S, Colomba C, Titone L, Parravicini C, Cascio A, Corbellino M. Clinical use of polymerase chain reaction performed on peripheral blood and bone marrow samples for the diagnosis and monitoring of visceral leishmaniasis in HIV-infected and HIV-uninfected patients: a single-center, 8-year experience in Italy and review of the literature. Clin Infect Dis 2007; 44:1602-10. [PMID: 17516404 DOI: 10.1086/518167] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.0] [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: 11/21/2006] [Accepted: 03/06/2007] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND To overcome some of the limitations of conventional microbiologic techniques, polymerase chain reaction (PCR)-based assays are proposed as useful tools for the diagnosis of visceral leishmaniasis. PATIENTS AND METHODS A comparative study using conventional microbiologic techniques (i.e., serologic testing, microscopic examination, and culture) and a Leishmania species-specific PCR assay, using peripheral blood and bone marrow aspirate samples as templates, was conducted during an 8-year period. The study cohort consisted of 594 Italian immunocompetent (adult and pediatric) and immunocompromised (adult) patients experiencing febrile syndromes associated with hematologic alterations and/or hepatosplenomegaly. Identification of the infecting protozoa at the species level was directly obtained by PCR of peripheral blood samples, followed by restriction fragment-length polymorphism analysis of the amplified products, and the results were compared with those of isoenzyme typing of Leishmania species strains from patients, which were isolated in vitro. RESULTS Sixty-eight patients (11.4%) had a confirmed diagnosis of visceral leishmaniasis. Eleven cases were observed in human immunodeficiency virus (HIV)-uninfected adults, 20 cases were observed in HIV-infected adults, and the remaining 37 cases were diagnosed in HIV-uninfected children. In the diagnosis of primary visceral leishmaniasis, the sensitivities of the Leishmania species-specific PCR were 95.7% for bone marrow aspirate samples and 98.5% for peripheral blood samples versus sensitivities of 76.2%, 85.5%, and 90.2% for bone marrow aspirate isolation, serologic testing, and microscopic examination of bone marrow biopsy specimens, respectively. None of 229 healthy blood donors or 25 patients with imported malaria who were used as negative control subjects had PCR results positive for Leishmania species in peripheral blood samples (i.e., specificity of Leishmania species-specific PCR, 100%). PCR and restriction fragment-length polymorphism analysis for Leishmania species identification revealed 100% concordance with isoenzyme typing in the 19 patients for whom the latter data were available. CONCLUSIONS PCR assay is a highly sensitive and specific tool for the diagnosis of visceral leishmaniasis in both immunocompetent and immunocompromised patients and can be reliably used for rapid parasite identification at the species level.
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Affiliation(s)
- Spinello Antinori
- Dipartimento di Scienze Cliniche L. Sacco, Sezione di Malattie Infettive e Tropicali, Università di Milano, Milan, Italy.
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Longhi E, Foschi A, Bestetti G, Acquaviva V, Radice A, Parravicini C, Antinori S, Corbellino M. P1411 PCR with universal primers targeting the small ribosomal RNA (16S rRNA) gene of bacteria as a diagnostic tool in 15 hospitalised patients with infectious diseases. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71250-5] [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: 11/25/2022]
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Antinori S, Gianelli E, Bonaccorso C, Ridolfo AL, Croce F, Sollima S, Parravicini C. Disseminated Penicillium marneffei infection in an HIV-positive Italian patient and a review of cases reported outside endemic regions. J Travel Med 2006; 13:181-8. [PMID: 16706952 DOI: 10.1111/j.1708-8305.2006.00039.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We describe a case of disseminated Penicillium marneffei in a human immunodeficiency virus (HIV)-positive Italian man who stayed for 4 years in Chiang Ray province, northern Thailand. A review of the literature shows that penicilliosis, although unusual, may represent an emerging opportunistic infection among HIV-positive people traveling to endemic areas.
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Affiliation(s)
- Spinello Antinori
- Department of Clinical Sciences, Section of Infections and Tropical Diseases, Luigi Sacco Hospital, University of Milan, Milano, Italy.
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Antinori S, Magni C, Nebuloni M, Parravicini C, Corbellino M, Sollima S, Galimberti L, Ridolfo AL, Wheat LJ. Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature. Medicine (Baltimore) 2006; 85:22-36. [PMID: 16523050 DOI: 10.1097/01.md.0000199934.38120.d4] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We reviewed the clinical, microbiologic, and outcome characteristics of 72 patients with human immunodeficiency virus (HIV)-associated histoplasmosis (4 newly described) reported in Europe over 20 years (1984-2004). Seven cases (9.7%) were acquired in Europe (autochthonous), whereas the majority involved a history of travel or arrival from endemic areas. The diagnosis of progressive disseminated histoplasmosis (PDH) was made during life in 63 patients (87.5%) and was the acquired immunodeficiency syndrome (AIDS)-presenting illness in 44 (61.1%). Disease was widespread in 66 patients (91.7%) and localized in 6 (8.3%), with the skin being the most frequent site of localized infection. Overall skin involvement was reported in 47.2% of the patients regardless of whether histoplasmosis was acquired in Africa or South America. Reticulonodular or diffuse interstial infiltrates occurred in 52.8%. The diagnosis was made during life by histopathology plus culture in 44 patients (69.8%), histopathology alone in 18 (28.5%), and culture alone in 1 (1.5%). During the induction phase amphotericin B and itraconazole (74.6%) were the single most frequently used drugs. Both drugs were also used either in combination (10.2%) or in sequential therapy (11.8%). Cumulative mortality rate during the induction phase of treatment was 15.2%. Overall, 37 patients died (57.8%); death occurred early in the course in 18 (28.1%). Seven of 40 patients (17.5%) who responded to therapy subsequently relapsed. Autopsy data in 13 patients confirmed the widespread disseminated nature of histoplasmosis (85%) among AIDS patients with a median of 4.5 organs involved. The results of the present report highlight the need to consider the diagnosis of PDH among patients with AIDS in Europe presenting with a febrile illness who have traveled to or who originated from an endemic area.
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Affiliation(s)
- Spinello Antinori
- From Department of Clinical Sciences, Section of Infectious and Tropical Diseases (SA, MC, SS, LG, ALR), University of Milan, Milan; Institute of Pathology (MN, CP), and I Infectious Diseases Unit (CM), Luigi Sacco Hospital, Milan, Italy; and MiraVista Diagnostics (LJW), Indianapolis, Indiana, United States
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30
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Antinori S, Radice A, Galimberti L, Magni C, Fasan M, Parravicini C. The role of cryptococcal antigen assay in diagnosis and monitoring of cryptococcal meningitis. J Clin Microbiol 2005; 43:5828-9. [PMID: 16272534 PMCID: PMC1287839 DOI: 10.1128/jcm.43.11.5828-5829.2005] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Bestetti G, Stellari A, Lattuada A, Corbellino M, Parravicini C, Calzarossa C, Cenzuales S, Moroni M, Galli M, Rossi E. ADAMTS 13 genotype and vWF protease activity in an Italian family with TTP. Thromb Haemost 2004; 90:955-6. [PMID: 14597993 DOI: 10.1160/th03-03-0150] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Giovanna Bestetti
- Institute of Infectious Disease and Tropical Medicine, L. Sacco Hospital,Via G.B. Grassi, 74 - 20157 Milan, Italy.
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32
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Ridolfo AL, Corbellino M, Tosca N, Capelletti A, Scalamogna C, Galli M, Parravicini C. Is switching protease inhibitor-based effective antiretroviral therapy safe in patients with AIDS-associated Kaposi's sarcoma? AIDS 2004; 18:1224-6. [PMID: 15166546 DOI: 10.1097/00002030-200405210-00024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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33
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Parravicini C, Scalamogna C, Calattini S, Poli F, Scalamogna M, Galli M, Moroni M, Corbellino M. KSHV reactivation in post-transplant Kaposi sarcoma. Nat Med 2003; 9:986; author reply 986. [PMID: 12894151 DOI: 10.1038/nm0803-986a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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34
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Gervasoni C, Ridolfo AL, Vaccarezza M, Parravicini C, Vago L, Adorni F, Cappelletti A, d'Arminio Monforte A, Galli M. Thrombotic microangiopathy in patients with acquired immunodeficiency syndrome before and during the era of introduction of highly active antiretroviral therapy. Clin Infect Dis 2002; 35:1534-40. [PMID: 12471574 DOI: 10.1086/344778] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2002] [Accepted: 08/15/2002] [Indexed: 11/03/2022] Open
Abstract
The incidence of thrombotic microangiopathy (TMA) was retrospectively evaluated in a cohort of 1223 patients with acquired immunodeficiency syndrome (AIDS) who were observed from January 1985 through December 1996 (before the era of highly active antiretroviral therapy [HAART]), and the incidence was prospectively assessed for 347 patients with AIDS during the period of January 1997 through December 2000 (during the HAART era). Seventeen cases were reported in the former cohort (1.4%). The increased risk of developing TMA was statistically significant in patients with cryptosporidiosis or AIDS-related cancer but not in those with other diseases. In the 1997-2000 cohort, no cases were observed during follow-up. TMA is associated with conditions observed in the advanced phases of human immunodeficiency virus infection. The disappearance of TMA during the HAART era may be explained by the lower percentage of patients with long-lasting CD4+ T cell depletion, advanced AIDS, or cryptosporidiosis or who have undergone multiple courses of chemotherapy for treatment of cancer.
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Affiliation(s)
- Cristina Gervasoni
- Institute of Infectious Diseases and Tropical Medicine, L. Sacco Hospital, University of Milan, 20157 Milano, Italy
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Corbellino M, Bestetti G, Scalamogna C, Calattini S, Galazzi M, Meroni L, Manganaro D, Fasan M, Moroni M, Galli M, Parravicini C. Long-term remission of Kaposi sarcoma-associated herpesvirus-related multicentric Castleman disease with anti-CD20 monoclonal antibody therapy. Blood 2001; 98:3473-5. [PMID: 11719390 DOI: 10.1182/blood.v98.12.3473] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Kaposi sarcoma-associated herpesvirus (KSHV)-related multicentric Castleman disease (MCD) is potentially lethal. Growing evidence indicates that, as in Epstein-Barr virus-driven lymphoproliferative disorders after transplantation, KSHV DNA burden in peripheral blood mononuclear cells (PBMCs) may represent the most accurate marker of disease activity. This report describes a patient with human immunodeficiency virus who was followed up clinically and by quantitative polymerase chain reaction for KSHV DNA sequences in PBMCs for more than 3 years following the diagnosis of KSHV-related MCD. Therapy with the antiherpesvirus agent cidofovir, antihuman interleukin-6 antibody BE-8, antiblastic chemotherapy, and combination antiretroviral agents did not achieve durable clinical or virologic remission of the disease. By contrast, administration of the anti-CD20 monoclonal antibody rituximab was well tolerated and allowed a 14-month remission of clinical symptoms and KSHV viremia. Rituximab should be added to the therapeutic armamentarium for KSHV-related MCD.
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Affiliation(s)
- M Corbellino
- Institute of Infectious Diseases and Tropical Medicine, University of Milan, Italy.
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Boneschi V, Brambilla L, Berti E, Ferrucci S, Corbellino M, Parravicini C, Fossati S. Human herpesvirus 8 DNA in the skin and blood of patients with Mediterranean Kaposi's sarcoma: clinical correlations. Dermatology 2001; 203:19-23. [PMID: 11549794 DOI: 10.1159/000051697] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Kaposi's sarcoma is a multifocal lympho-angioproliferative disease that appears in elderly subjects of Mediterranean origin (classical form), young Africans and immunodepressed patients (as a result of organ transplantation or AIDS). In 1994, DNA sequences of a new human herpesvirus, called HHV-8, were detected in skin lesions and peripheral blood of patients with AIDS-related Kaposi's sarcoma by confirmational display analysis and polymerase chain reaction. OBJECTIVE As HHV-8 in peripheral blood mononuclear cells is detected in about 50% of Mediterranean Kaposi's sarcoma patients and its presence fluctuates in time in the same patient, maybe its detection correlates with the clinical behaviour of the disease. METHODS By using routine and nested polymerase chain reaction we evaluated the presence of HHV-8-specific DNA sequences in the skin lesions, perilesional healthy skin and peripheral blood mononuclear cells of a group of 40 HIV-negative patients with Mediterranean Kaposi's sarcoma. RESULTS HHV-8 DNA sequences have been found in 40/40 (100%) lesional skin of Mediterranean Kaposi's sarcoma, in 35/40 (85%) perilesional apparently normal skin and in 24/40 (60%) peripheral blood monuclear cell samples. The results of polymerase chain reaction on peripheral blood monuclear cells were positive in 41% of the patients with slowly evolving disease as opposed to 74% of those with rapidly evolving disease, and in 47.6% of the patients with stage I-II disease as opposed to 73.6% of those with stage III-IV. CONCLUSION The detection of HHV-8 in peripheral blood monuclear cells seems to correlate with the more aggressive stages and the rapid evolution behaviour of Mediterranean Kaposi's sarcoma.
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Affiliation(s)
- V Boneschi
- Institute of Dermatology, State University, IRCCS, Ospedale Maggiore, Milan, Italy.
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Haque M, Ueda K, Nakano K, Hirata Y, Parravicini C, Corbellino M, Yamanishi K. Major histocompatibility complex class I molecules are down-regulated at the cell surface by the K5 protein encoded by Kaposi's sarcoma-associated herpesvirus/human herpesvirus-8. J Gen Virol 2001; 82:1175-1180. [PMID: 11297692 DOI: 10.1099/0022-1317-82-5-1175] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The expression of major histocompatibility complex class I (MHC-I) molecules at the cell surface was down-regulated in BC-3 cells infected with Kaposi's sarcoma-associated herpesvirus (KSHV)/human herpesvirus-8 at early times after treatment with 12-O-tetradecanoylphorbol acetate (TPA), and in HeLa cells transfected with the K5 gene of KSHV. However, an immunoprecipitation study on these cells with anti-MHC-I monoclonal antibody revealed that there was no significant reduction in the synthesis of MHC-I molecules. A pulse-chase analysis followed by endoglycosidase H digestion also demonstrated the stability and transport of MHC-I molecules from the endoplasmic reticulum to at least the medial-GOLGI: K5 antigen was clearly detected by immunohistological examination of samples from Kaposi's sarcoma, primary effusion lymphoma and Castleman's disease. These results suggest that the down-regulation of MHC-I molecules by K5 gene expression during reactivation may be important for evading immunological surveillance in the host.
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MESH Headings
- Antigens, Viral/biosynthesis
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Castleman Disease/immunology
- Castleman Disease/metabolism
- Castleman Disease/pathology
- Castleman Disease/virology
- Cell Membrane
- Down-Regulation
- HeLa Cells
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/immunology
- Herpesvirus 8, Human/metabolism
- Histocompatibility Antigens Class I/immunology
- Humans
- Immediate-Early Proteins/biosynthesis
- Immediate-Early Proteins/genetics
- Immediate-Early Proteins/immunology
- Sarcoma, Kaposi/immunology
- Sarcoma, Kaposi/metabolism
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Viral Proteins/biosynthesis
- Viral Proteins/genetics
- Viral Proteins/immunology
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Affiliation(s)
- Muzammel Haque
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan1
| | - Keiji Ueda
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan1
| | - Kazushi Nakano
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan1
| | - Yuko Hirata
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan1
| | - Carlo Parravicini
- Department of Pathology2 and Institute of Infectious Diseases3, University of Milan, 'L. Sacco' Hospital, Milan, Italy
| | - Mario Corbellino
- Department of Pathology2 and Institute of Infectious Diseases3, University of Milan, 'L. Sacco' Hospital, Milan, Italy
| | - Koichi Yamanishi
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan1
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Chen J, Ueda K, Sakakibara S, Okuno T, Parravicini C, Corbellino M, Yamanishi K. Activation of latent Kaposi's sarcoma-associated herpesvirus by demethylation of the promoter of the lytic transactivator. Proc Natl Acad Sci U S A 2001; 98:4119-24. [PMID: 11274437 PMCID: PMC31189 DOI: 10.1073/pnas.051004198] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) is strongly linked to Kaposi's sarcoma, primary effusion lymphomas, and a subset of multicentric Castleman's disease. The mechanism by which this virus establishes latency and reactivation is unknown. KSHV Lyta (lytic transactivator, also named KSHV/Rta), mainly encoded by the ORF 50 gene, is a lytic switch gene for viral reactivation from latency, inasmuch as it is both essential and sufficient to drive the entire viral lytic cycle. Here we show that the Lyta promoter region was heavily methylated in latently infected cells. Treatment of primary effusion lymphoma-delivered cell lines with tetradecanoylphorbol acetate caused demethylation of the Lyta promoter and induced KSHV lytic phase in vitro. Methylation cassette assay shows demethylation of the Lyta promoter region was essential for the expression of Lyta. In vivo, biopsy samples obtained from patients with KSHV-related diseases show the most demethylation in the Lyta promoter region, whereas samples from a latently infected KSHV carrier remained in a methylated status. These results suggest a relationship among a demethylation status in the Lyta promoter, the reactivation of KSHV, and the development of KSHV-associated diseases.
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Affiliation(s)
- J Chen
- Department of Microbiology, Osaka University Medical School, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan
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Rivas C, Thlick AE, Parravicini C, Moore PS, Chang Y. Kaposi's sarcoma-associated herpesvirus LANA2 is a B-cell-specific latent viral protein that inhibits p53. J Virol 2001; 75:429-38. [PMID: 11119611 PMCID: PMC113935 DOI: 10.1128/jvi.75.1.429-438.2001] [Citation(s) in RCA: 234] [Impact Index Per Article: 10.2] [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] [Indexed: 11/20/2022] Open
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV), or human herpesvirus 8, is associated with three proliferative diseases ranging from viral cytokine-induced hyperplasia to monoclonal neoplasia: multicentric Castleman's disease (CD), Kaposi's sarcoma (KS), and primary effusion lymphoma (PEL). Here we report a new latency-associated 1,704-bp KSHV spliced gene belonging to a cluster of KSHV sequences having homology to the interferon regulatory factor (IRF) family of transcription factors. ORFK10.5 encodes a protein, latency-associated nuclear antigen 2 (LANA2), which is expressed in KSHV-infected hematopoietic tissues, including PEL and CD but not KS lesions. LANA2 is abundantly expressed in the nuclei of cultured KSHV-infected B cells. Transcription of K10.5 in PEL cell cultures is not inhibited by DNA polymerase inhibitors nor significantly induced by phorbol ester treatment. Unlike LANA1, LANA2 does not elicit a serologic response from patients with KS, PEL, or CD as measured by Western blot hybridization. Both KSHV vIRF1 (ORFK9) and LANA2 (ORFK10.5) appear to have arisen through gene duplication of a captured cellular IRF gene. LANA2 is a potent inhibitor of p53-induced transcription in reporter assays. LANA2 antagonizes apoptosis due to p53 overexpression in p53-null SAOS-2 cells and apoptosis due to doxorubicin treatment of wild-type p53 U2OS cells. While LANA2 specifically interacts with amino acids 290 to 393 of p53 in glutathione S-transferase pull-down assays, we were unable to demonstrate LANA2-p53 interaction in vivo by immunoprecipitation. These findings show that KSHV has tissue-specific latent gene expression programs and identify a new latent protein which may contribute to KSHV tumorigenesis in hematopoietic tissues via p53 inhibition.
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Affiliation(s)
- C Rivas
- Department of Pathology, College of Physicians & Surgeons, Columbia University, New York, New York 10032, USA
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Milazzo F, Piconi S, Trabattoni D, Magni C, Coen M, Capetti A, Fusi ML, Parravicini C, Clerici M. Intractable pruritus in HIV infection: immunologic characterization. Allergy 1999; 54:266-72. [PMID: 10321563 DOI: 10.1034/j.1398-9995.1999.00885.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Severe, intractable pruritus, often associated with erythematopapular skin lesions and hypereosinophilia, is a condition observed in some nonatopic, HIV-infected patients. We performed immunovirologic analyses of this condition. METHODS Immunologic (mitogen-stimulated production of cytokines, tumor necrosis factor-alpha [TNF-alpha], and soluble CD23; serum levels of soluble CD23, ICAM-1, TNF-alpha, IgG, IgE, and IgA) and virologic (HIV viral load) parameters were analyzed in six patients with therapy-resistant pruritus. Hypereosinophilia was present in all these patients. Results were compared to those of seven HIV-seropositive individuals similar to the first one in terms of CD4 counts and clinical staging, but without pruritus. RESULTS Hypereosinophilia; hyper-IgE and hyper-IgA; augmented interleukin (IL)-4, IL-5, and sCD23; and reduced interferon-gamma production by mitogen-stimulated peripheral blood mononuclear cells (PBMC) were detected when patients with pruritus were compared to HIV controls. HIV viral load was also augmented in patients in whom pruritus was present. CONCLUSIONS The results suggest that therapy-resistant, intractable pruritus accompanied by hypereosinophilia may be used to define a subset of HIV-seropositive individuals showing prototypic hyperactivation of humoral immunity, and in whom augmented HIV viral load is present.
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Affiliation(s)
- F Milazzo
- Divisione di Malattie Infettive, Ospedale L. Sacco, Milan, Italy
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41
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Corbellino M, Pizzuto M, Bestetti G, Corsico L, Piazza M, Pigozzi B, Galli M, Baldini L, Neri A, Parravicini C. Absence of Kaposi's sarcoma--associated herpesvirus DNA sequences in multiple myeloma. Blood 1999; 93:1110-1. [PMID: 10025982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Nocera A, Corbellino M, Valente U, Barocci S, Torre F, De Palma R, Sementa A, Traverso GB, Icardi A, Fontana I, Arcuri V, Poli F, Cagetti P, Moore P, Parravicini C. Posttransplant human herpes virus 8 infection and seroconversion in a Kaposi's sarcoma affected kidney recipient transplanted from a human herpes virus 8 positive living related donor. Transplant Proc 1998; 30:2095-6. [PMID: 9723403 DOI: 10.1016/s0041-1345(98)00550-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- A Nocera
- Department of Immunology, S. Martino Hospital, Genoa, Italy
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43
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Bestetti G, Renon G, Mauclére P, Ruffié A, Mbopi Kéou FX, Eme D, Parravicini C, Corbellino M, de Thé G, Gessain A. High seroprevalence of human herpesvirus-8 in pregnant women and prostitutes from Cameroon. AIDS 1998; 12:541-3. [PMID: 9543461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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44
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Golay J, Broccoli V, Lamorte G, Bifulco C, Parravicini C, Pizzey A, Thomas NSB, Delia D, Ferrauti P, Vitolo D, Introna M. The A-Myb Transcription Factor Is a Marker of Centroblasts In Vivo. The Journal of Immunology 1998. [DOI: 10.4049/jimmunol.160.6.2786] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
The A-Myb transcription factor is structurally related to the c-myb proto-oncogene and is involved in the control of proliferation and/or differentiation of mature B lymphocytes. We have shown previously by PCR analysis that A-myb is preferentially expressed in CD38+CD39−sIgM− mature B cells. We demonstrate here, using in situ hybridization, that A-mybexpression is restricted to the dark zone of human tonsils and lymph nodes. Furthermore, we show that A-Myb expression is cell cycle regulated both in tonsillar B cells and in Burkitt’s lymphoma cell lines, being detectable only in the S and G2/M phases of the cell cycle and not in G0/G1 phase. Strong proliferation of resting human B cells induced in vitro by a variety of physiologic signals, including anti-μ, CD40 ligand, IL-2, IL-4, IL-6, IL-13, IFN-γ, TNF-α, anti-CD19, and anti-CD20, failed to induce A-myb expression, suggesting that proliferation alone is not sufficient for A-myb expression in the absence of induction of a true centroblast phenotype. Finally, we show that differentiation of germinal center B cells in vitro toward either memory or plasma cells is accompanied by rapid down-regulation of A-myb expression. We conclude that A-myb is a marker of centroblasts generated in vivo.
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Affiliation(s)
- Josée Golay
- *Istituto Ricerche Farmacologiche “Mario Negri,”
| | | | - Giuseppe Lamorte
- †Fondazione Matarelli, Hospital Fatebenefratelli e Oftalmico, and
| | - Carlo Bifulco
- ‡Department of Pathological Anatomy, Hospital L. Sacco, Milan, Italy
| | - Carlo Parravicini
- ‡Department of Pathological Anatomy, Hospital L. Sacco, Milan, Italy
| | - Arnold Pizzey
- §Department of Hematology, University College London Medical School, London, United Kingdom; and
| | - N. Shaun B. Thomas
- §Department of Hematology, University College London Medical School, London, United Kingdom; and
| | - Domenico Delia
- ¶Department of Experimental Oncology A, Istituto Nazionale dei Tumori, Milan, and
| | - Paola Ferrauti
- ∥Department of Experimental Medicine and Pathology, Immunopathology Section, Università di Roma La Sapienza, Rome, Italy
| | - Domenico Vitolo
- ∥Department of Experimental Medicine and Pathology, Immunopathology Section, Università di Roma La Sapienza, Rome, Italy
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Golay J, Broccoli V, Lamorte G, Bifulco C, Parravicini C, Pizzey A, Thomas NS, Delia D, Ferrauti P, Vitolo D, Introna M. The A-Myb transcription factor is a marker of centroblasts in vivo. J Immunol 1998; 160:2786-93. [PMID: 9510180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The A-Myb transcription factor is structurally related to the c-myb proto-oncogene and is involved in the control of proliferation and/or differentiation of mature B lymphocytes. We have shown previously by PCR analysis that A-myb is preferentially expressed in CD38+ CD39- sIgM- mature B cells. We demonstrate here, using in situ hybridization, that A-myb expression is restricted to the dark zone of human tonsils and lymph nodes. Furthermore, we show that A-Myb expression is cell cycle regulated both in tonsillar B cells and in Burkitt's lymphoma cell lines, being detectable only in the S and G2/M phases of the cell cycle and not in G0/G1 phase. Strong proliferation of resting human B cells induced in vitro by a variety of physiologic signals, including anti-mu, CD40 ligand, IL-2, IL-4, IL-6, IL-13, IFN-gamma, TNF-alpha, anti-CD19, and anti-CD20, failed to induce A-myb expression, suggesting that proliferation alone is not sufficient for A-myb expression in the absence of induction of a true centroblast phenotype. Finally, we show that differentiation of germinal center B cells in vitro toward either memory or plasma cells is accompanied by rapid down-regulation of A-myb expression. We conclude that A-myb is a marker of centroblasts generated in vivo.
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Affiliation(s)
- J Golay
- Istituto Ricerche Farmacologiche Mario Negri, Milan, Italy
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Berti E, Boneschi V, Montagnino G, Tarantino A, Piccolo A, Corbellino M, Parravicini C. Antibodies to Kaposi's sarcoma-associated herpesvirus (KSHV) in patients waiting for renal engrafting and in renal allograft recipients. J Dermatol Sci 1998. [DOI: 10.1016/s0923-1811(98)84172-8] [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: 11/30/2022]
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47
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Parravicini C, Lauri E, Baldini L, Neri A, Poli F, Sirchia G, Moroni M, Galli M, Corbellino M. Kaposi's sarcoma-associated herpesvirus infection and multiple myeloma. Science 1997; 278:1969-70; author reply 1972-3. [PMID: 9417642 DOI: 10.1126/science.278.5345.1969] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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48
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Parravicini C, Corbellino M, Paulli M, Magrini U, Lazzarino M, Moore PS, Chang Y. Expression of a virus-derived cytokine, KSHV vIL-6, in HIV-seronegative Castleman's disease. Am J Pathol 1997; 151:1517-22. [PMID: 9403701 PMCID: PMC1858372] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Castleman's disease is a rare B cell lymphoproliferative disorder related to excess interleukin-6 (IL-6)-like activity. Kaposi's sarcoma-associated herpesvirus (KSHV or HHV8), which encodes a functional cytokine (vIL-6), has been found in some patients with Castleman's disease. Lymph nodes from 14 HIV-seronegative Castleman's disease patients were compared to hyperplastic lymph nodes from 25 HIV-seronegative patients as well as Kaposi's sarcoma lesions from 48 patients for KSHV infection and vIL-6, human IL-6, and Epstein-Barr virus EBER expression. While all Kaposi's sarcoma tissues examined were polymerase chain reaction-positive and all control lymph nodes were polymerase chain reaction-negative for KSHV, none had detectable vIL-6 expression. Six of 14 (43%) Castleman's tissues were positive for KSHV by polymerase chain reaction and all 6 had evidence of vIL-6 expression by immunohistochemistry. vIL-6-positive Castleman's disease patients generally had the multicentric plasma cell variant form of the disease and had a rapidly fatal clinical course frequently associated with autoimmune hemolytic anemia and gammopathy. In contrast, 7 (88%) of the 8 vIL-6-negative Castleman's disease patients had localized disease and have remained disease-free after therapy. KSHV vIL-6 expression appears to be limited to hematopoietic cells and is not present in Kaposi's sarcoma spindle cells. These data suggest that Castleman's disease is a syndrome of multiple etiologies involving aberrant IL-6 activity from either endogenous or viral sources.
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Affiliation(s)
- C Parravicini
- Department of Pathology, University of Milano, L. Sacco Hospital, Milan, Italy
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49
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Parravicini C, Olsen SJ, Capra M, Poli F, Sirchia G, Gao SJ, Berti E, Nocera A, Rossi E, Bestetti G, Pizzuto M, Galli M, Moroni M, Moore PS, Corbellino M. Risk of Kaposi's sarcoma-associated herpes virus transmission from donor allografts among Italian posttransplant Kaposi's sarcoma patients. Blood 1997; 90:2826-9. [PMID: 9326251] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Kaposi's sarcoma-associated herpesvirus (KSHV) is a newly discovered herpes virus found in all forms of Kaposi's sarcoma (KS) including KS among immunosuppressed transplant patients. It is unknown whether this virus is transmitted by organ transplantation or is reactivated during immunosuppression among those patients infected before transplantation. To investigate the risk of KSHV transmission during organ transplantation, we conducted a case-control study of transplant recipients with and without KS matched to their respective donors. Sera were collected at time of transplantation and tested in a randomized and blinded fashion using four KSHV serologic assays testing for antibodies to both latent and lytic phase antigens. Ten (91%) of 11 organ recipients who developed KS were seropositive prior to transplantation by one or more of the assays compared with two (12%) of 17 control organ recipients (OR = 75, 95% CI = 4.7, 3500). KS cases were more likely to have been born in southern Italy where KS is endemic than the recipient controls or either donor group. Only four (36%) of 11 donors to case patients and three (18%) of 17 donors to control patients were seropositive (P = .38, two-tailed Fisher's exact test). KSHV transmission could not be ruled out for the single KS patient seronegative at transplantation and clear evidence for organ-related transmission was found for another KS patient outside of the case-control study. Antibodies to KSHV are detectable in the sera from most transplant recipients before initiation of immunosuppressive treatment suggesting that KS among immunosuppressed transplant patients is primarily due to virus reactivation. KSHV transmission, however, from an infected allograft can occur, and our study reports the first documented case of person-to-person transmission of KSHV.
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Affiliation(s)
- C Parravicini
- Department of Pathology, Ospedale L. Sacco, Milano, Italy
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50
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Berti E, Marzano AV, Decleva I, Bestetti G, Pizzuto M, Poirel L, Capra M, Parravicini C, Corbellino M. Simultaneous onset of primary cutaneous B-cell lymphoma and human herpesvirus 8-associated Kaposi's sarcoma. Br J Dermatol 1997; 136:924-9. [PMID: 9217827] [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: 02/04/2023]
Abstract
We report the simultaneous occurrence of Kaposi's sarcoma (KS) and primary cutaneous B-cell lymphoma (CBCL) of the leg in a 79-year-old woman, seronegative for HIV-1, HTLV-1 and HTLV-2. The CBCL underwent complete clinical remission after local radiotherapy, whilst the KS became disseminated within a year following diagnosis. However, 2 years after the diagnosis of KS, the patient died with neurological symptoms. These were presumed to be due to involvement of the central nervous system by lymphoma, although in the absence of an autopsy, this could not be proven. Skin biopsies from the original KS and CBCL lesions, as well as short-term culture of spindle cells from the KS lesion and peripheral blood mononuclear cells (PBMC), were studied by semiquantitative polymerase chain reaction (PCR) using primers specific for DNA sequences of a novel gamma-herpesvirus-8 (HHV-8). PCR studies were strongly positive for the virus on KS cells and PBMC; conversely, a low viral load was found on CBCL cells. A high titre of serum IgG antibodies reacting with the nuclei of the HHV-8 positive cell line BCP-1 was found. These data suggest that reactivation of latent infection with HHV-8 had occurred in this patient, and that HHV-8 is directly involved in KS, but not in CBCL of the leg, an aggressive variant of CBCL.
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MESH Headings
- Aged
- Antibodies, Viral/blood
- DNA, Viral/analysis
- Female
- HIV Seronegativity
- HIV-1
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/immunology
- Human T-lymphotropic virus 1
- Human T-lymphotropic virus 2
- Humans
- Leg
- Leukocytes, Mononuclear/virology
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/virology
- Polymerase Chain Reaction
- Sarcoma, Kaposi/complications
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Skin/pathology
- Skin Neoplasms/complications
- Skin Neoplasms/pathology
- Skin Neoplasms/virology
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Affiliation(s)
- E Berti
- Institute of Dermatologic Sciences-IRCCS H Maggiore, Sacco, Italy
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