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Gambini D, Ferrero S, Bulfamante G, Pisani L, Corbo M, Kuhn E. Cerebellar phenotypes in germline PTEN mutation carriers. Neuropathol Appl Neurobiol 2024; 50:e12970. [PMID: 38504418 DOI: 10.1111/nan.12970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
PTEN hamartoma tumour syndrome (PHTS) comprises different hereditary conditions caused by germline PTEN mutations, predisposing to the development of multiple hamartomas in many body tissues and also increasing the risk of some types of cancer. Cerebellar involvement in PHTS patients has been long known due to the development of a pathognomonic cerebellar hamartoma (known as dysplastic gangliocytoma of the cerebellum or Lhermitte-Duclos disease). Recently, a crucial role of the cerebellum has been highlighted in the pathogenesis of autism spectrum disorders, now recognised as a phenotype expressed in a variable percentage of PHTS children. In addition, rare PTEN variants are indeed identified in medulloblastoma as well, even if they are less frequent than other germline gene mutations. The importance of PTEN and its downstream signalling enzymatic pathways, PI3K/AKT/mTOR, has been studied at different levels in both human clinical settings and animal models, not only leading to a better understanding of the pathogenesis of different disorders but, most importantly, to identify potential targets for specific therapies. In particular, PTEN integrity makes an important contribution to the normal development of tissue architecture in the nervous system, including the cerebellum. Thus, in patients with PTEN germline mutations, the cerebellum is an affected organ that is increasingly recognised in different disorders, whereas, in animal models, cerebellar Pten loss causes a variety of functional and histological alterations. In this review, we summarise the range of cerebellar involvement observed in PHTS and its relationships with germline PTEN mutations, along with the phenotypes expressed by murine models with PTEN deficiency in cerebellar tissue.
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Affiliation(s)
- Donatella Gambini
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Stefano Ferrero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Pathology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaetano Bulfamante
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Human Pathology and Molecular Pathology Unit, TOMA Advanced Biomedical Assays, Busto Arsizio, Italy
| | - Luigi Pisani
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy
| | - Elisabetta Kuhn
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Pathology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Kuhn E, Natacci F, Corbo M, Pisani L, Ferrero S, Bulfamante G, Gambini D. The Contribution of Oxidative Stress to NF1-Altered Tumors. Antioxidants (Basel) 2023; 12:1557. [PMID: 37627552 PMCID: PMC10451967 DOI: 10.3390/antiox12081557] [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: 07/19/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
The neurofibromatosis-1 gene (NF1) was initially characterized because its germline mutation is responsible for an inherited syndromic disease predisposing tumor development, in particular neurofibromas but also various malignancies. Recently, large-scale tumor sequencing efforts have demonstrated NF1 as one of the most frequently mutated genes in human cancer, being mutated in approximately 5-10% of all tumors, especially in malignant peripheral nerve sheath tumors and different skin tumors. NF1 acts as a tumor suppressor gene that encodes neurofibromin, a large protein that controls neoplastic transformation through several molecular mechanisms. On the other hand, neurofibromin loss due to NF1 biallelic inactivation induces tumorigenic hyperactivation of Ras and mTOR signaling pathways. Moreover, neurofibromin controls actin cytoskeleton structure and the metaphase-anaphase transition. Consequently, neurofibromin deficiency favors cell mobility and proliferation as well as chromosomal instability and aneuploidy, respectively. Growing evidence supports the role of oxidative stress in NF1-related tumorigenesis. Neurofibromin loss induces oxidative stress both directly and through Ras and mTOR signaling activation. Notably, innovative therapeutic approaches explore drug combinations that further increase reactive oxygen species to boost the oxidative unbalance of NF1-altered cancer cells. In our paper, we review NF1-related tumors and their pathogenesis, highlighting the twofold contribution of oxidative stress, both tumorigenic and therapeutic.
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Affiliation(s)
- Elisabetta Kuhn
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (S.F.); (G.B.)
- Pathology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Natacci
- Medical Genetics Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy; (M.C.); (L.P.); (D.G.)
| | - Luigi Pisani
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy; (M.C.); (L.P.); (D.G.)
| | - Stefano Ferrero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (S.F.); (G.B.)
- Pathology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gaetano Bulfamante
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (S.F.); (G.B.)
- Human Pathology and Molecular Pathology, TOMA Advanced Biomedical Assays S.p.A., 21052 Busto Arsizio, Italy
| | - Donatella Gambini
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milan, Italy; (M.C.); (L.P.); (D.G.)
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Moscardelli S, Rusconi D, Santangelo G, Bursi F, Micaglio E, Bulfamante G, Saponaro M, Centola M, Guazzi M. 903 NOVEL MALIGNANT MUTATION IN HYPERTROPHIC CARDIOMYOPATHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a common inherited disease almost invariably caused by mutations in sarcomeric genes. The HCM phenotype is clinically heterogeneous with myocyte hypertrophy, disarray, and myocardial fibrosis as histological hallmarks. This condition is recognized as an important cause of sudden cardiac death (SCD) in the youth and of heart failure (HF) in the elderly. Current guidelines mandate genetic analysis as a class I indication in HCM. Indeed, the advent of the next generation sequencing in the medical practice has led to decipher the molecular etiology of HCM and to assess the disease risk in family members with relevant insights into the clinical course.
Clinical case
A 62-year-old man followed-up at another Hospital with a non-obstructive HCM diagnosis, was referred to our Hospital for therapy optimization and clinical follow-up. Past medical history included third degree atrioventricular block at age 40 treated with dual chamber pacemaker (PM) and, at age of 60, atrial flutter with high ventricular response complicated with cardiogenic shock and stroke. Due to worsening systolic function and ventricular sustained tachycardia he was upgraded to implantable cardioverter defibrillator which delivered appropriate shocks. Echocardiography performed during current hospitalization showed a moderate concentric hypertrophy (intraventricular septum 17 mm, cardiac mass index 258 g/m2), dilated ventricle with reduced ejection fraction (33%) and akinesis of the mid inferior and infero-septal walls of the left ventricle and of the apex, with a stratified thrombotic apposition. Magnetic resonance was contraindicated because of non-compatible PM. Due to alteration in serum proteins and free light chain, to rule out systemic disease, extensive imaging diagnosis was performed including bone scintigraphy and abdominal ultrasonography which resulted negative. While waiting for bone marrow aspiration and biopsy the patient rapidly deteriorated with worsening renal failure, ensuing proteinuria until exitus. After an appropriate pre-test counseling the family consented to genetic test in the proband. Clinical exome sequencing revealed the presence of a missense mutation in MYH7 gene. This new mutation is characterized by the substitution of cysteine residue by a serine in 905 codon of MYH7 gene. Cys905Ser results in a semi-conservative amino acid substitution which may impact disulfide bond formation in the MYH7 protein. To date no study has described this mutation as a cause of HCM. A mutation affecting this same codon, Cys905Phe was reported in only one patient with HCM. From a biological point of view, this variant lies in the head region of the protein where the majority of the missense variants are grouped and statistically associated to HCM phenotype. Several studies reported that the occurrence of atrial fibrillation (AF) tends to be more prevalent in patients carrying the MYH7 mutation. Furthermore, AF is associated with substantial risk for HF-related mortality, stroke, and severe functional disability.
Awareness regarding the spectrum of MYH7 mutations probably related to SCD or HF combined with a thorough patient characterization for molecular and clinical features, may help to improve the genotype and phenotype correlation. This important challenge could elucidate better the mechanism of HCM enabling cardiologists to a better clinical decision-making and patients’ care.
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Affiliation(s)
- Silvia Moscardelli
- Divisione Di Cardiologia, Dipartimento Cardio-Respiratorio , Asst-Santi Paolo Carlo, Milano
| | - Daniela Rusconi
- UOC Anatomia Patologica , Citogenetica, Patologia Molecolare, Asst-Santi Paolo Carlo, Milano
| | - Gloria Santangelo
- Divisione Di Cardiologia, Dipartimento Cardio-Respiratorio , Asst-Santi Paolo Carlo, Milano
| | - Francesca Bursi
- Divisione Di Cardiologia, Dipartimento Cardio-Respiratorio , Asst-Santi Paolo Carlo, Milano
| | - Emanuele Micaglio
- Unità Operativa Di Aritmologia Ed Elettrofisiologia, IRCCS Policlinico San Donato , Milano
| | - Gaetano Bulfamante
- Dipartimento Di Scienza Della Salute, Università Degli Studi Di Milano , Milano
| | - Maria Saponaro
- UOC Anatomia Patologica , Citogenetica, Patologia Molecolare, Asst-Santi Paolo Carlo, Milano
| | - Marco Centola
- Dipartimento Di Cardiologia , Asst Brianza, Ospedale Di Desio
| | - Marco Guazzi
- Divisione Di Cardiologia, Dipartimento Cardio-Respiratorio , Asst-Santi Paolo Carlo, Milano
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Raimondi S, Massa V, Ravaldi C, Vannacci A, Bulfamante G, Marconi AM, Avagliano L. Maternal Risk Factors Associated with Antepartum Stillbirth. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4912276] [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: 12/23/2022]
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Avagliano L, Martini E, Antuono M, Bulfamante G. Fetal Autopsy: Improving Clinicians’ Knowledge to Increase Parents’ Acceptance. A Prospective Questionnaire-Based Study. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4911245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Colombo C, Pogliaghi G, Tosi D, Muzza M, Bulfamante G, Persani L, Fugazzola L, Cirello V. Thyroid cancer harboring PTEN and TP53 mutations: A peculiar molecular and clinical case report. Front Oncol 2022; 12:949098. [PMID: 36119511 PMCID: PMC9478947 DOI: 10.3389/fonc.2022.949098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
To date, the molecular mechanisms that underline aggressiveness and resistance to tyrosine kinase inhibitors in some thyroid carcinomas (TCs) are not known yet. We report the case of a young patient with a metastatic poorly differentiated (PDTC) and follicular thyroid carcinoma (FTC) refractory to conventional therapies and to Sorafenib. The patient, despite an initial partial response, died of progressive disease 21 months after diagnosis. The genetic analysis performed on the primary tumor and on lymph nodes and distant metastases allowed to identify a frameshift mutation (p.P248Tfs*5) in the PTEN gene, never described in TC. This mutation was present in the primary tumor and, with a lower allelic frequency, in metastases diagnosed after treatment with Sorafenib. Mutations in TP53 (p.C135Y and c.920-2A>G previously detected in anaplastic carcinomas and p.M133R never found in TC) were also detected in the primary tissue together with a mono-allelic expression of the p.C135Y mutant at RNA level. At metastatic sites level, we found only the TP53 splicing mutation c.920-2A>G. The presence of defects in mismatch repair (MMR) proteins and genomic instability was also evaluated. The primary tumor showed a partial expression of MMR proteins together with a strong genomic instability. In conclusion, we demonstrated that the rare combination of somatic PTEN and TP53 mutations in a patient with a metastatic FTC, together with the presence of tumor heterogeneity and genomic instability, might be associated with a high tumor aggressiveness and resistance to treatments.
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Affiliation(s)
- Carla Colombo
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gabriele Pogliaghi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Delfina Tosi
- Unit of Human Pathology, Department of Health Sciences Santi Paolo e Carlo Medical School, University of Milan, Milan, Italy
| | - Marina Muzza
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gaetano Bulfamante
- Unit of Human Pathology, Department of Health Sciences Santi Paolo e Carlo Medical School, University of Milan, Milan, Italy
| | - Luca Persani
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Laura Fugazzola
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Cirello
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
- *Correspondence: Valentina Cirello,
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Amodeo S, Cavoretto PI, Seidenari A, Paci G, Germano C, Monari F, Donno V, Giambanco L, Avagliano L, Di Martino D, Fusé F, Masturzo B, Chiantera V, Facchinetti F, Ferrazzi E, Candiani M, Bulfamante G, Farina A. Second trimester uterine arteries pulsatility index is a function of placental pathology and provides insights on stillbirth aetiology: A multicenter matched case-control study. Placenta 2022; 121:7-13. [DOI: 10.1016/j.placenta.2022.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/21/2022] [Accepted: 02/24/2022] [Indexed: 12/21/2022]
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Belotti A, Carpenito L, Bulfamante AM, Maccari A, Bulfamante G. Sinonasal teratocarcinosarcoma treated with surgery and proton beam therapy: clinical, histological aspects and differential diagnosis of a new case. Pathologica 2022; 113:469-474. [PMID: 34974554 PMCID: PMC8720401 DOI: 10.32074/1591-951x-215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/06/2021] [Indexed: 12/03/2022] Open
Abstract
Sinonasal teratocarcinosarcoma is a rare aggressive malignant tumor with a primary setting involving the nasal cavity followed by the ethmoid sinus and maxillary sinus. It accounts for approximately 3% of all head and neck cancers and less than 1% of all tumors. Nasal obstruction, recurrent epistaxis and headache represent the typical clinical presentation. Imaging shows the presence of a mass in the nasal cavity. The treatment usually consists of surgery and adjuvant intensity modulated radiotherapy. The rarity and the variability of the histological features make its diagnosis particularly difficult. In this paper, we report a case of sinonasal teratocarcinosarcoma in a 62-year-old male treated with a multidisciplinary approach. As an alternative to intensity modulated radiotherapy, we proposed proton beam therapy for the first time. The patient benefited from the new and personalized protocol that provided excellent results and few adverse effects. At 45 months follow-up there is no evidence of relapse and the patient is in good health.
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Affiliation(s)
- Alessia Belotti
- Human Pathology and Medical Genetic Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Laura Carpenito
- Human Pathology and Medical Genetic Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Antonio Mario Bulfamante
- Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Alberto Maccari
- Otolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Human Pathology and Medical Genetic Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
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Avagliano L, Massa V, Bulfamante G. Meconium-stained amniotic fluid and histologic signs of fetal distress in stillbirths. Eur J Obstet Gynecol Reprod Biol 2021; 266:55-62. [PMID: 34592650 DOI: 10.1016/j.ejogrb.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/31/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Stillbirth is one of the most devastating adverse pregnancy outcome, but it is often associated with a missing post-mortem histological examination. We aimed at evaluating whether the staining of amniotic fluid reflects the fetal conditions surrounding the death and if it correlates with any histologic sign of fetal distress. STUDY DESIGN Terminal gasping (represented by the massive presence of intra-alveolar squamous cells), thymic and adrenal cortex modifications were evaluated as histologic signs of fetal distress in stillbirths, and stratified according to the degree of staining of the amniotic fluid. RESULTS The presence of meconium-stained amniotic fluid did not correlate with the presence of gasping and/or thymic and/or adrenal cortex changes. Clear amniotic fluid was not associated with the absence of histologic signs of distress. CONCLUSIONS The evaluation of the staining of the amniotic fluid fails to identify distressed fetuses. A histologic evaluation of fetal organs provides detailed information, irrespective of the presence/absence of meconium-stained amniotic fluid.
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Affiliation(s)
- Laura Avagliano
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, 20142 Milano, Italy.
| | - Valentina Massa
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, 20142 Milano, Italy.
| | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, 20142 Milano, Italy; Complex Unit for Pathological Anatomy, San Paolo Hospital, 20142 Milano, Italy.
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Bocci T, Bulfamante G, Campiglio L, Coppola S, Falleni M, Chiumello D, Priori A. Brainstem involvement in COVID-19: A neuropathological and neurophysiological study. J Neurol Sci 2021. [PMCID: PMC8498374 DOI: 10.1016/j.jns.2021.117805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Avagliano L, Monari F, Salerno C, Menichini D, Facchinetti F, Bulfamante G. Chronic deciduitis in stillbirths: are there any specific clinical associations? J Matern Fetal Neonatal Med 2021; 35:8233-8236. [PMID: 34470133 DOI: 10.1080/14767058.2021.1967317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Placental chronic deciduitis is a lesion consistent with the presence of plasma cells within the placental basal plate. It could be associated with adverse pregnancy outcomes, including stillbirth. METHODS We retrospectively evaluated a cohort of 180 antepartum stillborn cases from singleton pregnancies, with the aim of investigating the clinical-histopathological relationship. Placental slides were reviewed following the standard protocol proposed by the "Amsterdam consensus statement". RESULTS We observed an association between chronic deciduitis and lesions consistent with maternal vascular malperfusion, delayed villous maturation, villitis of unknown etiology and maternal autoimmunity. CONCLUSIONS The observed clinical-histopathological associations suggest that an extensive maternal investigation could improve the comprehension of factors interfering with the placental development and the increasing risk of adverse pregnancy outcomes. HighlightsChronic deciduitis is associated with lesions consistent with maternal vascular malperfusionChronic deciduitis is associated with delayed villous maturationChronic deciduitis is associated with villitis of unknown etiologyChronic deciduitis is associated with maternal autoimmunity.
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Affiliation(s)
- Laura Avagliano
- Department of Health Sciences, San Paolo Hospital Medical School, University of Milan, Milano, Italy
| | - Francesca Monari
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Salerno
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniela Menichini
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School, University of Milan, Milano, Italy
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Toto V, Tosi D, De Vitis LA, Marconi AM, Bulfamante G. Finding of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Within Placental Tissue 11 Weeks After Maternal Infection. Arch Pathol Lab Med 2021; 145:920-921. [PMID: 33861299 DOI: 10.5858/arpa.2021-0076-le] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Valentina Toto
- Struttura Complessa di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, Milan, Italy
| | - Delfina Tosi
- Struttura Complessa di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, Milan, Italy.,Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | | | - Anna Maria Marconi
- Struttura Complessa di Ginecologia e Ostetricia, ASST Santi Paolo e Carlo, Milan, Italy.,Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Gaetano Bulfamante
- Struttura Complessa di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, Milan, Italy.,Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
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13
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Schwartz DA, Baldewijns M, Benachi A, Bugatti M, Bulfamante G, Cheng K, Collins RRJ, Debelenko L, De Luca D, Facchetti F, Fitzgerald B, Levitan D, Linn RL, Marcelis L, Morotti D, Morotti R, Patanè L, Prevot S, Pulinx B, Saad AG, Schoenmakers S, Strybol D, Thomas K, Tosi D, Toto V, van der Meeren LE, Verdijk RM, Vivanti AJ, Zaigham M. Hofbauer cells and coronavirus disease 2019 (COVID-19) in pregnancy: Molecular pathology analysis of villous macrophages, endothelial cells, and placental findings from 22 placentas infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without fetal transmission. Arch Pathol Lab Med 2021; 145:1328-1340. [PMID: 34297794 DOI: 10.5858/arpa.2021-0296-sa] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can undergo maternal-fetal transmission, heightening interest in the placental pathology findings from this infection. Transplacental SARS-CoV-2 transmission is typically accompanied by chronic histiocytic intervillositis together with necrosis and positivity of syncytiotrophoblast for SARSCoV-2. Hofbauer cells are placental macrophages that have been involved in viral diseases including HIV and Zika virus, but their involvement in SARS-CoV-2 in unknown. OBJECTIVE - To determine whether SARS-CoV-2 can extend beyond the syncytiotrophoblast to enter Hofbauer cells, endothelium and other villous stromal cells in infected placentas of liveborn and stillborn infants. DESIGN - Case-based retrospective analysis by 29 perinatal and molecular pathology specialists of placental findings from a preselected cohort of 22 SARS-CoV-2-infected placentas delivered to pregnant women testing positive for SARS-CoV-2 from 7 countries. Molecular pathology methods were used to investigate viral involvement of Hofbauer cells, villous capillary endothelium, syncytiotrophoblast and other fetal-derived cells. RESULTS - Chronic histiocytic intervillositis and trophoblast necrosis was present in all 22 placentas (100%). SARS-CoV-2 was identified in Hofbauer cells from 4/22 placentas (18%). Villous capillary endothelial staining was positive in 2/22 cases (9%), both of which also had viral positivity in Hofbauer cells. Syncytiotrophoblast staining occurred in 21/22 placentas (95%). Hofbauer cell hyperplasia was present in 3/22 placentas (14%). In the 7 cases having documented transplacental infection of the fetus, 2 occurred in placentas with Hofbauer cell staining positive for SARS-CoV-2. CONCLUSIONS - SARS-CoV-2 can extend beyond the trophoblast into the villous stroma, involving Hofbauer cells and capillary endothelial cells, in a small number of infected placentas. Most cases of SARS-CoV-2 transplacental fetal infection occur without Hofbauer cell involvement.
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Affiliation(s)
- David A Schwartz
- Department of Pathology, Medical College of Georgia, Augusta, GA
| | | | - Alexandra Benachi
- Division of Obstetrics and Gynecology, Antoine Béclère Hospital, Paris Saclay University Hospitals, Clamart, France
| | - Mattia Bugatti
- Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Gaetano Bulfamante
- Hospital Complex for Pathological Anatomy and Medical Genetics, ASST Santi Paolo e Carlo, Milan, Italy Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Rebecca R J Collins
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Larisa Debelenko
- Department of Pediatric and Perinatal Pathology, Columbia University Medical Center, New York, NY
| | - Danièle De Luca
- Neonatology Division of Pediatrics, Transportation and Neonatal Critical Care APHP, Paris Saclay University Hospitals, Medical Center "A.Béclère" & Physiopathology and Therapeutic Innovation Unit, Paris-Saclay University, Paris, France
| | - Fabio Facchetti
- Pathology Unit, Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Brendan Fitzgerald
- Department of Pathology, Cork University Hospital, Wilton, Cork, Ireland
| | - Daniel Levitan
- Department of Pathology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Rebecca L Linn
- Department of Pathology & Lab Medicine, Perelman School of Medicine at the University of Pennsylvania & Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Denise Morotti
- Pathology Unit and Medical Genetics Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Raffaella Morotti
- Department of Pathology and Pediatrics, Autopsy Service, Yale University School of Medicine, New Haven, CT
| | - Luisa Patanè
- Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sophie Prevot
- Division of Pathology, Bicêtre Hospital, Paris Saclay University Hospitals, APHP, Le Kremlin-Bicêtre, France
| | - Bianca Pulinx
- Department of Clinical Biology, Sint-Trudo Hospital, Sint-Truiden, Belgium
| | - Ali G Saad
- Department of Pathology, University of Miami Miller School of Medicine/Jackson Health System/Holtz Children's Hospital, Miami, FL
| | - Sam Schoenmakers
- Department of Obstetrics and Gynaecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - David Strybol
- Department of Pathology, Sint-Trudo Hospital, Sint-Truiden, Belgium
| | - Kristen Thomas
- Department of Pathology, NYU Langone Health, Main Campus & Bellevue Hospital Center, New York University School of Medicine, New York, NY
| | - Delfina Tosi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Valentina Toto
- Hospital Complex for Pathological Anatomy and Medical Genetics, ASST Santi Paolo e Carlo, Milan, Italy
| | - Lotte E van der Meeren
- Department of Pathology, Leiden University Medical Center, and Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert M Verdijk
- Department of Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alexandre J Vivanti
- Department of Obstetrics and Gynecology, Antoine Beclere Hospital, APHP, Université Paris Saclay, Clamart, France
| | - Mehreen Zaigham
- Obstetrics & Gynecology, Skåne University Hospital, Malmö, Sweden and Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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14
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Izzo G, Toto V, Doneda C, Parazzini C, Lanna M, Bulfamante G, Righini A. Fetal thick corpus callosum: new insights from neuroimaging and neuropathology in two cases and literature review. Neuroradiology 2021; 63:2139-2148. [PMID: 34021362 DOI: 10.1007/s00234-021-02699-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the correlation between fetal imaging (in vivo and ex vivo) and neuropathology in two fetuses at early gestational age (GA) with isolated thick corpus callosum (CC), a rare finding whose pathological significance and neuropathology data are scarce. METHODS Two fetuses at 21-week GA underwent fetal MRI (fMRI) for suspected callosal anomalies at ultrasound (US). After fMRI results, termination of pregnancy (TOP) was carried out and post-mortem MRI (pmMRI) was performed. Neuropathology correlation consisted in macro and microscopic evaluation with sections prepared for hematoxylin-eosin and immunohistochemistry staining. RESULTS Fetal imaging confirmed in both cases the presence of a shorter and thicker CC with respect to the reference standard at the same GA, without a clear distinction between its different parts. Moreover, on pmMRI, an abnormal slightly T2-weighted hyperintense layer along the superior and inferior surface of CC was noted in both cases. At histopathology, these findings corresponded to an increased amount of white matter tracts but also to an abnormal representation of embryological structures that contribute to CC development, naming induseum griseum (IG) and the glioepithelial layer (GL) of the "callosal sling." After reviewing the literature data, we confirmed the recent embryological theory regarding the CC development and provide new insights into the pathophysiology of the abnormal cases. CONCLUSIONS An abnormally thick CC at the early fetal period could be associated to an abnormal representation of the midline glia structures, so to result in potential disturbance of the axon guidance mechanism of callosal formation and eventually in CC dysgenesis.
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Affiliation(s)
- Giana Izzo
- Department of Radiology and Neuroradiology, Children's Hospital V. Buzzi , Via Castelvetro, 32 20154, Milan, Italy.
| | - Valentina Toto
- Department of Health Sciences, Pathology Division, San Paolo Hospital, University of Milan, Milan, Italy
| | - Chiara Doneda
- Department of Radiology and Neuroradiology, Children's Hospital V. Buzzi , Via Castelvetro, 32 20154, Milan, Italy
| | - Cecilia Parazzini
- Department of Radiology and Neuroradiology, Children's Hospital V. Buzzi , Via Castelvetro, 32 20154, Milan, Italy
| | - Mariano Lanna
- Obstetrics and Gynecology Department, Children's Hospital V. Buzzi - ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, Pathology Division, San Paolo Hospital, University of Milan, Milan, Italy
| | - Andrea Righini
- Department of Radiology and Neuroradiology, Children's Hospital V. Buzzi , Via Castelvetro, 32 20154, Milan, Italy
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15
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Bulfamante G, Bocci T, Falleni M, Campiglio L, Coppola S, Tosi D, Chiumello D, Priori A. Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung. J Neurol 2021; 268:4486-4491. [PMID: 34003372 PMCID: PMC8129960 DOI: 10.1007/s00415-021-10604-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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: 03/10/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
Introduction SARS-CoV-2 might spread through the nervous system, reaching respiratory centers in the brainstem. Because we recently reported neurophysiological brainstem reflex abnormalities in COVID-19 patients, we here neuropathologically assessed structural brainstem damage in two COVID-19 patients. Materials and methods We assessed neuropathological features in two patients who died of COVID-19 and in two COVID-19 negative patients as controls. Neuronal damage and corpora amylacea (CA) numbers /mm2 were histopathologically assessed. Other features studied were the immunohistochemical expression of the SARS-CoV-2 nucleoprotein (NP) and the Iba-1 antigen for glial activation. Results Autopsies showed normal gross brainstem anatomy. Histopathological examination demonstrated increased neuronal and CA damage in Covid-19 patients’ medulla oblongata. Immunohistochemistry disclosed SARS-CoV-2 NP in brainstem neurons and glial cells, and in cranial nerves. Glial elements also exhibited a widespread increase in Iba-1 expression. Sars-Co-V2 was immunohistochemically detected in the vagus nerve fibers. Discussion Neuropathologic evidence showing SARS-CoV-2 in the brainstem and medullary damage in the area of respiratory centers strongly suggests that the pathophysiology of COVID-19-related respiratory failure includes a neurogenic component. Sars-Co-V2 detection in the vagus nerve, argues for viral trafficking between brainstem and lung. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10604-8.
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Affiliation(s)
- Gaetano Bulfamante
- Pathology and Medical Genetics Unit, University of Milan, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Tommaso Bocci
- Neurology Unit I, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy.,``Aldo Ravelli'' Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Monica Falleni
- Pathology and Medical Genetics Unit, University of Milan, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Laura Campiglio
- Neurology Unit I, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy.,``Aldo Ravelli'' Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Silvia Coppola
- Intensive Care, Anesthesia and Resuscitation Unit, University of Milan, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Delfina Tosi
- Pathology and Medical Genetics Unit, University of Milan, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Davide Chiumello
- Intensive Care, Anesthesia and Resuscitation Unit, University of Milan, Milan, Italy.,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Alberto Priori
- Neurology Unit I, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, Italy. .,ASST Santi Paolo & Carlo and Department of Health Sciences, University of Milan, Milan, Italy. .,``Aldo Ravelli'' Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.
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16
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Falleni M, Tosi D, Savi F, Chiumello D, Bulfamante G. Endothelial-Mesenchymal Transition in COVID-19 lung lesions. Pathol Res Pract 2021; 221:153419. [PMID: 33857718 PMCID: PMC7997691 DOI: 10.1016/j.prp.2021.153419] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 01/13/2023]
Abstract
Sars-Cov-2 infection is still a healthcare emergency and acute respiratory distress failure with Diffuse Alveolar Damage (DAD) features is the main causes of patients’ death. Pathogenic mechanisms of the disease are not clear yet, but new insights are necessary to improve therapeutic management, to prevent fatal irreversible multi-organ damage and to adequately follow up those patients who survive. Here we investigated, by histochemistry and immunohistochemistry, a wide number of mapped lung specimens taken from whole body autopsies of 7 patients dead of COVID-19 disease. Our data confirm morphological data of other authors, and enlarge recent reports of the literature suggesting that Endothelial–Mesenchymal Transition might be central to COVID-19 lung fibrosing lesions. Furthermore, based upon recent acquisition of new roles in immunity and vascular pathology of the CD31 molecule, we hypothesize that this molecule might be important in the development and treatment of COVID-19 pulmonary lesions. These preliminary findings need further investigations to shed light on the complexity of Sars-Cov-2 disease.
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Affiliation(s)
- Monica Falleni
- Unità di Anatomia Patologica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142, Milan, Italy; Struttura Complessa Dipartimentale di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, 20142, Milan, Italy.
| | - Delfina Tosi
- Unità di Anatomia Patologica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142, Milan, Italy
| | - Federica Savi
- Struttura Complessa Dipartimentale di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, 20142, Milan, Italy
| | - Davide Chiumello
- Anestesia e Rianimazione, Ospedale, Centro ricerca coordinata di insufficienza respiratoria, Dipartimento di Scienze della Salute, Università degli Studi di Milano ASST Santi Paolo e Carlo, 20142, Milan, Italy
| | - Gaetano Bulfamante
- Unità di Anatomia Patologica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142, Milan, Italy; Struttura Complessa Dipartimentale di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, 20142, Milan, Italy
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17
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Bocci T, Bulfamante G, Campiglio L, Coppola S, Falleni M, Chiumello D, Priori A. Brainstem clinical and neurophysiological involvement in COVID-19. J Neurol 2021; 268:3598-3600. [PMID: 33735401 PMCID: PMC7969346 DOI: 10.1007/s00415-021-10474-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 12/17/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/23/2022]
Affiliation(s)
- Tommaso Bocci
- Clinical Neurology Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Pathology and Medical Genetics Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Laura Campiglio
- Clinical Neurology Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Silvia Coppola
- Intensive Care, Anesthesia and Resuscitation Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Monica Falleni
- Pathology and Medical Genetics Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Davide Chiumello
- Intensive Care, Anesthesia and Resuscitation Unit, University of Milan, Milan, Italy
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy
| | - Alberto Priori
- Clinical Neurology Unit, University of Milan, Milan, Italy.
- ASST Santi Paolo and Carlo and Department of Health Sciences, University of Milan, Milan, Italy.
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.
- Divisione di Neurologia I, Ospedale Universitario San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy.
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18
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Foglio B, Rossini L, Garbelli R, Regondi MC, Mercurio S, Bertacchi M, Avagliano L, Bulfamante G, Coras R, Maiorana A, Nicolis S, Studer M, Frassoni C. Dynamic expression of NR2F1 and SOX2 in developing and adult human cortex: comparison with cortical malformations. Brain Struct Funct 2021; 226:1303-1322. [PMID: 33661352 DOI: 10.1007/s00429-021-02242-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/03/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023]
Abstract
The neocortex, the most recently evolved brain region in mammals, is characterized by its unique areal and laminar organization. Distinct cortical layers and areas can be identified by the presence of graded expression of transcription factors and molecular determinants defining neuronal identity. However, little is known about the expression of key master genes orchestrating human cortical development. In this study, we explored the expression dynamics of NR2F1 and SOX2, key cortical genes whose mutations in human patients cause severe neurodevelopmental syndromes. We focused on physiological conditions, spanning from mid-late gestational ages to adulthood in unaffected specimens, but also investigated gene expression in a pathological context, a developmental cortical malformation termed focal cortical dysplasia (FCD). We found that NR2F1 follows an antero-dorsallow to postero-ventralhigh gradient as in the murine cortex, suggesting high evolutionary conservation. While SOX2 is mainly expressed in neural progenitors next to the ventricular surface, NR2F1 is found in both mitotic progenitors and post-mitotic neurons at GW18. Interestingly, both proteins are highly co-expressed in basal radial glia progenitors of the outer sub-ventricular zone (OSVZ), a proliferative region known to contribute to cortical expansion and complexity in humans. Later on, SOX2 becomes largely restricted to astrocytes and oligodendrocytes although it is also detected in scattered mature interneurons. Differently, NR2F1 maintains its distinct neuronal expression during the whole process of cortical development. Notably, we report here high levels of NR2F1 in dysmorphic neurons and NR2F1 and SOX2 in balloon cells of surgical samples from patients with FCD, suggesting their potential use in the histopathological characterization of this dysplasia.
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Affiliation(s)
- Benedetta Foglio
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy
| | - Laura Rossini
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy
| | - Rita Garbelli
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy
| | - Maria Cristina Regondi
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy
| | - Sara Mercurio
- Department of Biotechnology and Bioscience, University of Milan-Bicocca, Milan, Italy
| | - Michele Bertacchi
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy.,Université Côte d'Azur, CNRS, Inserm, iBV, Nice, France
| | - Laura Avagliano
- Departement of Health Sciences, San Paolo Hospital Medical School University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Departement of Health Sciences, San Paolo Hospital Medical School University of Milan, Milan, Italy
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Antonino Maiorana
- Department of Medical and Surgical Sciences, Institute of Pathology, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Nicolis
- Department of Biotechnology and Bioscience, University of Milan-Bicocca, Milan, Italy
| | | | - Carolina Frassoni
- Clinical and Experimental Epileptology Unit, C/O AmadeoLab, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Amadeo 42, 20133, Milan, Italy.
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19
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Maggioni L, Maderna E, Gorio MC, Cappella A, Andreola S, Bulfamante G, Cattaneo C. The frequently dismissed importance of properly sampling skin bruises. Leg Med (Tokyo) 2021; 50:101867. [PMID: 33639541 DOI: 10.1016/j.legalmed.2021.101867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/15/2020] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
The correct interpretation of skin lesions is a crucial issue in forensic medicine. Many macroscopic and microscopic vital reaction markers and molecules have been studied in the past years in order to estimate the timing of injuries. However, literature lacks information regarding how to perform sampling to obtain a more reliable and accurate response. The present study investigates 25 bruises and analyses the different histological asset in different areas (central or marginal) and the different layers (epidermis, dermis, hypodermis and muscle) of the wound. All wounds were sampled in several areas and analysed under a 200× magnification optical microscope, simply counting the degree of haemorrhaging (i.e hematic infiltration) visible in each optical field (0 = 0%-5%; 1 = 6%-25%; 2 = 26%-50%; 3 = 51%-75%; 4 = 76%-100%). All the injuries presented some kind of infiltration in at least one area, nonetheless only 56% of the wounds were infiltrated in the entirety of the areas. Finally, in 28% the dermal layer did not show any trace of infiltration. Therefore, considering such results it seems that depth or area of sampling of a bruise may largely influence the evaluation of vitality and hence of age of a wound. Though this may seem intuitive, no studies have examined this issue in depth.
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Affiliation(s)
- Lidia Maggioni
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy.
| | - Emanuela Maderna
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy
| | - Maria Carlotta Gorio
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy
| | - Annalisa Cappella
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy; Sezione di Anatomia Umana, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 31, 20133 Milan, Italy
| | - Salvatore Andreola
- Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy
| | - Gaetano Bulfamante
- Sezione di Citogenetica e Patologia Molecolare, Dipartimento di patologia umana, ASST Santi Paolo e Carlo, Milan, Italy
| | - Cristina Cattaneo
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, via Luigi Mangiagalli 37, 20133 Milan, Italy
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20
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Priori A, Baisi A, Banderali G, Biglioli F, Bulfamante G, Canevini MP, Cariati M, Carugo S, Cattaneo M, Cerri A, Chiumello D, Colosio C, Cozzolino M, D'Arminio Monforte A, Felisati G, Ferrari D, Gambini O, Gardinali M, Marconi AM, Olivari I, Orfeo NV, Opocher E, Pietrogrande L, Previtera A, Rossetti L, Vegni E, Toschi V, Zuin M, Centanni S. The Many Faces of Covid-19 at a Glance: A University Hospital Multidisciplinary Account From Milan, Italy. Front Public Health 2021; 8:575029. [PMID: 33490013 PMCID: PMC7820812 DOI: 10.3389/fpubh.2020.575029] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/19/2020] [Indexed: 01/08/2023] Open
Abstract
In March 2020, northern Italy became the second country worldwide most affected by Covid-19 and the death toll overtook that in China. Hospital staff soon realized that Covid-19 was far more severe than expected from the few data available at that time. The Covid-19 pandemic forced hospitals to adjust to rapidly changing circumstances. We report our experience in a general teaching hospital in Milan, the capital of Lombardy, the most affected area in Italy. First, we briefly describe Lombardy's regional Covid-19-related health organizational changes as well as general hospital reorganization. We also provide a multidisciplinary report of the main clinical, radiological and pathological Covid-19 findings we observed in our patients.
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Affiliation(s)
- Alberto Priori
- Neurology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Alessandro Baisi
- Thoracic Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Giuseppe Banderali
- Pediatrics, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Federico Biglioli
- Maxillofacial Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Gaetano Bulfamante
- Pathology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Maria Paola Canevini
- Pediatric Neuropsychiatry, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Maurizio Cariati
- Radiology Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Stefano Carugo
- From the Units of Cardiology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Marco Cattaneo
- Internal Medicine, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Amilcare Cerri
- Dermatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Davide Chiumello
- Intensive Care, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Claudio Colosio
- Workers' Health, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Mario Cozzolino
- Nephrology & Dialysis, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Antonella D'Arminio Monforte
- Infectious Disease, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Giovanni Felisati
- Otorhinolaryngology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Daris Ferrari
- Oncology Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Orsola Gambini
- Psychiatry, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Marco Gardinali
- Emergency Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Anna Maria Marconi
- Obstetrics & Gynecology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Isotta Olivari
- Neurology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Nicola Vincenzo Orfeo
- Strategic Hospital Management, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Enrico Opocher
- Surgery, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Luca Pietrogrande
- Orthopedy & Traumatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Antonino Previtera
- Rehabilitation, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Luca Rossetti
- Surgical Ophthalmology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Elena Vegni
- Clinical Psychology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Vincenzo Toschi
- Transfusion Unit, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Massimo Zuin
- Gastroenterology & Hepatology, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
| | - Stefano Centanni
- Respiratory Medicine, Department of Health Sciences, San Paolo University Hospital, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Milan Medical School, Milan, Italy
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21
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Colombo C, Minna E, Gargiuli C, Muzza M, Dugo M, De Cecco L, Pogliaghi G, Tosi D, Bulfamante G, Greco A, Fugazzola L, Borrello MG. The molecular and gene/miRNA expression profiles of radioiodine resistant papillary thyroid cancer. J Exp Clin Cancer Res 2020; 39:245. [PMID: 33198784 PMCID: PMC7667839 DOI: 10.1186/s13046-020-01757-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022]
Abstract
Background Papillary thyroid cancer (PTC) is the most frequent endocrine tumor. Radioiodine (RAI) treatment is highly effective in these tumors, but up to 60% of metastatic cases become RAI-refractory. Scanty data are available on either the molecular pattern of radioiodine refractory papillary thyroid cancers (PTC) or the mechanisms responsible for RAI resistance. Methods We analyzed the molecular profile and gene/miRNA expression in primary PTCs, synchronous and RAI-refractory lymph node metastases (LNMs) in correlation to RAI avidity or refractoriness. We classified patients as RAI+/D+ (RAI uptake/disease persistence), RAI−/D+ (absent RAI uptake/disease persistence), and RAI+/D- (RAI uptake/disease remission), and analyzed the molecular and gene/miRNA profiles, and the expression of thyroid differentiation (TD) related genes. Results A different molecular profile according to the RAI class was observed: BRAFV600E cases were more frequent in RAI−/D+ (P = 0.032), and fusion genes in RAI+/D+ cases. RAI+/D- patients were less frequently pTERT mutations positive, and more frequently wild type for the tested mutations/fusions. Expression profiles clearly distinguished PTC from normal thyroid. On the other hand, in refractory cases (RAI+/D+ and RAI−/D+) no distinctive PTC expression patterns were associated with either tissue type, or RAI uptake, but with the driving lesion and BRAF−/RAS-like subtype. Primary tumors and RAI-refractory LNMs with BRAFV600E mutation display transcriptome similarity suggesting that RAI minimally affects the expression profiles of RAI-refractory metastases. Molecular profiles associated with the expression of TPO, SLC26A4 and TD genes, that were found more downregulated in BRAFV600E than in gene fusions tumors. Conclusions The present data indicate a different molecular profile in RAI-avid and RAI-refractory metastatic PTCs. Moreover, BRAFV600E tumors displayed reduced differentiation and intrinsic RAI refractoriness, while PTCs with fusion oncogenes are RAI-avid but persistent, suggesting different oncogene-driven mechanisms leading to RAI refractoriness. Supplementary Information The online version contains supplementary material available at 10.1186/s13046-020-01757-x.
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Affiliation(s)
- Carla Colombo
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Emanuela Minna
- Department of Research, Molecular Mechanisms Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Gargiuli
- Department of Applied Research and Technology Development, Platform of Integrated Biology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina Muzza
- Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Matteo Dugo
- Department of Applied Research and Technology Development, Platform of Integrated Biology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Loris De Cecco
- Department of Applied Research and Technology Development, Platform of Integrated Biology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Gabriele Pogliaghi
- Laboratory of Endocrine and Metabolic Research, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Delfina Tosi
- Department of Health Sciences, Division of Human Pathology, Università degli Studi di Milano, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, Division of Human Pathology, Università degli Studi di Milano, Milan, Italy
| | - Angela Greco
- Department of Research, Molecular Mechanisms Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Fugazzola
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. .,Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Maria Grazia Borrello
- Department of Research, Molecular Mechanisms Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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22
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Peron A, La Briola F, Bruschi F, Terraneo S, Vannicola C, Previtali R, Perazzoli S, Morenghi E, Bulfamante G, Vignoli A, Canevini MP. Tuberous sclerosis complex (TSC), lymphangioleiomyomatosis, and COVID-19: The experience of a TSC clinic in Italy. Am J Med Genet A 2020; 182:2479-2485. [PMID: 32804431 PMCID: PMC7461282 DOI: 10.1002/ajmg.a.61810] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/06/2020] [Accepted: 07/18/2020] [Indexed: 11/11/2022]
Abstract
Individuals with comorbidities are at higher risk of coronavirus disease 2019 (COVID-19) and worse outcome, but little information has been available about patients with genetic diseases and COVID-19. This study aims at evaluating the presence and outcome of COVID-19 in a cohort of Italian patients with tuberous sclerosis complex (TSC) and/or lymphangioleiomyomatosis (LAM), and at reviewing the possible effects of mTOR inhibitors on SARS-CoV-2 infection. We included 102 unselected individuals with a diagnosis of TSC and/or LAM assessed between January 1, 2020 and April 24, 2020 (29% children, 71% adults). Twenty-six patients were on mTOR inhibitors. Demographic data, TSC manifestations, presence, and outcomes in individuals with confirmed or suspected SARS-CoV-2 infection were evaluated. Health status and outcomes of all patients on mTOR inhibitors were assessed. One patient with severe TSC had polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection, was admitted to ICU, and died. Nine additional patients either met the definition of suspect case or presented with at least two of the most common symptoms of SARS-CoV-2 infection. All recovered fully. None of the patients treated with mTOR inhibitors for their underlying comorbidities was diagnosed with COVID-19, and those who showed suspicious respiratory symptoms recovered fully. This cohort study provides preliminary information on COVID-19 in people with TSC in Italy and suggests feasibility to systematically evaluate the role of mTOR inhibitors in SARS-CoV-2 infection.
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Affiliation(s)
- Angela Peron
- Human Pathology and Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Francesca La Briola
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Fabio Bruschi
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia Terraneo
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Chiara Vannicola
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Roberto Previtali
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Sabrina Perazzoli
- DAMA (Disabled Advanced Medical Assistance), Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Gaetano Bulfamante
- Human Pathology and Medical Genetics, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Aglaia Vignoli
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Maria Paola Canevini
- Child Neuropsychiatry Unit - Epilepsy Center, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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23
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Barabino M, Piccolo G, Tosi D, Masserano R, Santambrogio R, Piozzi G, Cigala C, Luigiano C, Codecà C, Ferrari D, Ierardi AM, Bulfamante G, Carrafiello G, Opocher E. Correction to: Immunohistochemical evaluation of microsatellite instability in resected colorectal liver metastases: a preliminary experience. Med Oncol 2020; 37:71. [PMID: 32715358 DOI: 10.1007/s12032-020-01399-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The original version of this article unfortunately contained a mistake. All the authors first name and second name has been inadvertently interchanged. Now the authors name are corrected.
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Affiliation(s)
- Matteo Barabino
- Hepatobiliary Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
| | - Gaetano Piccolo
- Hepatobiliary Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Delfina Tosi
- Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Riccardo Masserano
- Hepatobiliary Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | | | - Guglielmo Piozzi
- Hepatobiliary Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Claudia Cigala
- Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Carmelo Luigiano
- Digestive Endoscopy Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Carla Codecà
- Division of Oncology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Daris Ferrari
- Division of Oncology, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Anna Maria Ierardi
- Radiology Unit, IRCCS Ca' Granda Foundation, Policlinico Hospital, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Gianpaolo Carrafiello
- Radiology Unit, IRCCS Ca' Granda Foundation, Policlinico Hospital, University of Milan, Milan, Italy
| | - Enrico Opocher
- Hepatobiliary Surgery Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
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24
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Carpenito L, D'Ercole M, Porta F, Di Blasi E, Doi P, Fagara GR, Rey R, Bulfamante G. The autopsy at the time of SARS-CoV-2: Protocol and lessons. Ann Diagn Pathol 2020; 48:151562. [PMID: 32653819 PMCID: PMC7334655 DOI: 10.1016/j.anndiagpath.2020.151562] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 01/09/2023]
Abstract
A new viral disease named COVID-19 has recently turned into a pandemic. Compared to a common viral pneumonia it may evolve in an atypical way, causing the rapid death of the patient. For over two centuries, autopsy has been recognized as a fundamental diagnostic technique, particularly for new or little-known diseases. To date, it is often considered obsolete giving the inadequacy to provide samples of a quality appropriate to the sophisticated diagnostic techniques available today. This is probably one of the reasons why during this pandemic autopsies were often requested only in few cases, late and discouraged, if not prohibited, by more than one nation. This is in contrast with our firm conviction: to understand the unknown we must look at it directly and with our own eyes. This has led us to implement an autopsy procedure that allows the beginning of the autopsy shortly after death (within 1–2 h) and its rapid execution, also including sampling for ultrastructural and molecular investigations. In our experience, the tissue sample collected for diagnosis and research were of quality similar to biopsy or surgical resections. This procedure was performed ensuring staff and environmental safety. We want to propose our experience, our main qualitative results and a few general considerations, hoping that they can be an incentive to use autopsy with a new procedure adjusted to match the diagnostic challenges of the third millennium. Early performed autopsy (within 1-2 hour from death) provides tissue samples for diagnosis and research of quality similar to biopsy or surgical resections. Early samples collection reduces post-mortem artifacts, thus preventing the wrong interpretation of the morphological pictures observed. Precise autopsy planning prevents risks for the staff.
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Affiliation(s)
- L Carpenito
- School of Pathology, University of Milan, Milan, Italy.
| | - M D'Ercole
- School of Pathology, University of Milan, Milan, Italy
| | - F Porta
- School of Pathology, University of Milan, Milan, Italy
| | - E Di Blasi
- School of Pathology, University of Milan, Milan, Italy
| | - P Doi
- Complex Unit of Pathological Anatomy and Medical Genetics, San Paolo Hospital, University of Milan, Milan, Italy
| | - G Redolfi Fagara
- Complex Unit of Pathological Anatomy and Medical Genetics, San Paolo Hospital, University of Milan, Milan, Italy
| | - R Rey
- Complex Unit of Pathological Anatomy and Medical Genetics, San Paolo Hospital, University of Milan, Milan, Italy
| | - G Bulfamante
- Complex Unit of Pathological Anatomy and Medical Genetics, San Paolo Hospital, University of Milan, Milan, Italy
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25
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Bulfamante G, Chiumello D, Canevini MP, Priori A, Mazzanti M, Centanni S, Felisati G. First ultrastructural autoptic findings of SARS -Cov-2 in olfactory pathways and brainstem. Minerva Anestesiol 2020; 86:678-679. [DOI: 10.23736/s0375-9393.20.14772-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Massa V, Avagliano L, Grazioli P, De Castro SCP, Parodi C, Savery D, Vergani P, Cuttin S, Doi P, Bulfamante G, Copp AJ, Greene NDE. Dynamic acetylation profile during mammalian neurulation. Birth Defects Res 2019; 112:205-211. [PMID: 31758757 PMCID: PMC7004172 DOI: 10.1002/bdr2.1618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/16/2019] [Revised: 10/25/2019] [Accepted: 11/03/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Neural tube defects (NTDs) result from failure of neural tube closure during embryogenesis. These severe birth defects of the central nervous system include anencephaly and spina bifida, and affect 0.5-2 per 1,000 pregnancies worldwide in humans. It has been demonstrated that acetylation plays a pivotal role during neural tube closure, as animal models for defective histone acetyltransferase proteins display NTDs. Acetylation represents an important component of the complex network of posttranslational regulatory interactions, suggesting a possible fundamental role during primary neurulation events. This study aimed to assess protein acetylation contribution to early patterning of the central nervous system both in human and murine specimens. METHODS We used both human and mouse (Cited2 -/- ) samples to analyze the dynamic acetylation of proteins during embryo development through immunohistochemistry, western blot analysis and quantitative polymerase chain reaction. RESULTS We report the dynamic profile of histone and protein acetylation status during neural tube closure. We also report a rescue effect in an animal model by chemical p53 inhibition. CONCLUSIONS Our data suggest that the p53-acetylation equilibrium may play a role in primary neurulation in mammals.
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Affiliation(s)
- Valentina Massa
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Laura Avagliano
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Paolo Grazioli
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Sandra C P De Castro
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Chiara Parodi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Dawn Savery
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Patrizia Vergani
- Department of Obstetrics and Gynaecology, Foundation MBBM, University of Milano-Bicocca, Monza, Italy
| | - Serena Cuttin
- Department of Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Patrizia Doi
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Andrew J Copp
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Nicholas D E Greene
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Beltrami B, Prada E, Tolva G, Scuvera G, Silipigni R, Graziani D, Bulfamante G, Gervasini C, Marchisio P, Milani D. Unexpected phenotype in a frameshift mutation of PTCH1. Mol Genet Genomic Med 2019; 8:e987. [PMID: 31578813 PMCID: PMC6978275 DOI: 10.1002/mgg3.987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/17/2019] [Revised: 07/11/2019] [Accepted: 09/03/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Gorlin syndrome, also known as basal cell nevus syndrome (BCNS), is a rare autosomal dominant genetic condition, characterized by the presence of multiple basal cell carcinomas at a young age, odontogenic keratocysts, skeletal anomalies, macrocephaly, and dysmorphisms. BCNS is mainly caused by mutations in PTCH1, an onco-suppressor gene that maps at 9q22.3 region. A disease related to BCNS is the 9q22.3 microdeletion syndrome. This condition has an overlapping clinical phenotype with the BCNS, but it can present in addition: metopic craniosynostosis, overgrowth, obstructive hydrocephalus, developmental delay, intellectual disability, and seizures. This syndrome is caused by the deletion of a genomic region containing the PTCH1 and the FANCC. METHODS AND RESULTS We report the case of an 11-year-old girl that came to our attention for overgrowth, dysmorphic features of the face, and craniosynostosis, but with a normal intellectual and motor development. At first we performed an array-comparative genomic hybridization (aCGH) analysis. The analysis showed no copy number changes. Then, we performed the analysis of the PTCH1 by next-generation sequencing. This analysis showed a heterozygous frameshift mutation. CONCLUSION This is the first case with a PTCH1 point mutation with a 9q22.3 microdeletion syndrome phenotype. This finding may strengthen the importance of the role of the PTCH1, especially regarding the metopic craniosynostosis.
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Affiliation(s)
- Benedetta Beltrami
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Elisabetta Prada
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Gianluca Tolva
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giulietta Scuvera
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Rosamaria Silipigni
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Daniela Graziani
- Department of Human Pathology, Cytogenetic and Molecular Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gaetano Bulfamante
- Department of Human Pathology, Cytogenetic and Molecular Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Cristina Gervasini
- Department of Health Sciences, Medical Genetics, Università degli Studi di Milano, Milano, Italy
| | - Paola Marchisio
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Donatella Milani
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Cirello V, Colombo C, Pogliaghi G, Proverbio MC, Rossi S, Mussani E, Tosi D, Bulfamante G, Bonoldi E, Gherardi G, Persani L, Fugazzola L. Genetic variants of PARP4 gene and PARP4P2 pseudogene in patients with multiple primary tumors including thyroid cancer. Mutat Res 2019; 816-818:111672. [PMID: 31203137 DOI: 10.1016/j.mrfmmm.2019.111672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/11/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
Recently, the PARP4 gene has been identified as a possible susceptibility gene of primary thyroid and breast cancers. We analyzed PARP4 in 53 patients with multiple primary cancers including a thyroid cancer (TC), in 74 patients with TC alone, and in 88 healthy donors. Two PARP4 intronic variants within the IVS29 (c.3543 + 44T > C) and the IVS22 (c.2758 + 9G > A) were found only in the two patient groups. Moreover, we found a rare variant (r.522C > A) within a PARP4 pseudogene (PARP4P2) in one patient with four primary tumors, and with a familial cancer history. PARP4 mRNA was absent in all primary tumors and matched normal tissues, whereas the pseudogene variant transcript was always expressed. Consistently, immunostaining for PARP4 protein was negative at nuclear level in all tissues, thus suggesting that PARP4P2 pseudogene variant could alter its regulatory role on PARP4, inducing the down-regulation of PARP4 expression at both tumor and normal tissues level. In conclusion, germline intronic PARP4 variants could be a risk factor for the development of TC, and PARP4P2 pseudogene variations associated with PARP4 down-regulation may confer susceptibility to develop multiple metachronous cancers.
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Affiliation(s)
- Valentina Cirello
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy
| | - Carla Colombo
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy
| | - Gabriele Pogliaghi
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy
| | - Maria Carla Proverbio
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefania Rossi
- ASST Fatebenefratelli Sacco, UOC Anatomia Patologica Fatenefratelli, Milan, Italy
| | - Elena Mussani
- ASST Fatebenefratelli Sacco, UOC Anatomia Patologica Fatenefratelli, Milan, Italy
| | - Delfina Tosi
- Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Mila, Italy
| | - Gaetano Bulfamante
- Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Mila, Italy
| | | | - Giorgio Gherardi
- ASST Fatebenefratelli Sacco, UOC Anatomia Patologica Fatenefratelli, Milan, Italy
| | - Luca Persani
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Laura Fugazzola
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
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Ciceri P, Falleni M, Tosi D, Martinelli C, Bulfamante G, Messa P, Cozzolino M. FP445Iron citrate reduces high-phosphate induced vascular calcification by inhibiting osteo-chondrogenic shift of extracellular matrix in VSMCs. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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De Cillà S, Vezzola D, Farruggio S, Vujosevic S, Clemente N, Raina G, Mary D, Casini G, Rossetti L, Avagliano L, Martinelli C, Bulfamante G, Grossini E. The subthreshold micropulse laser treatment of the retina restores the oxidant/antioxidant balance and counteracts programmed forms of cell death in the mice eyes. Acta Ophthalmol 2019; 97:e559-e567. [PMID: 30585429 DOI: 10.1111/aos.13995] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/16/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE Subthreshold micropulse laser (SMPL) has been increasingly used for the treatment of different retinal and choroidal macular disorders. However, the exact mechanisms of action have not yet been clearly defined. Therefore, we aimed to examine the role of SMPL treatment in the modulation of oxidant/antioxidant systems, apoptosis and autophagy in the mice eyes. METHODS A specific laser contact lens for retina was positioned on the cornea of 40 mice (20 young and 20 old) in order to focus the laser on the eye fundus for SMPL treatment. Within 6 months, 20 animals received one treatment only, whereas the others were treated three times. Eye specimens underwent histological analysis and were used for thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) quantification, as well as for the superoxide dismutase 1 (SOD1) and the selenoprotein thioredoxin reductase 1 (TrxR1) expression evaluation. Western blot was performed for nitric oxide synthase (NOS) subtypes detection and to examine changes in apoptotic/autophagy proteins expression. RESULTS SMPL treatment reduced TBARS and increased GSH and SOD1 in the mice eyes. It also reduced cytochrome c, caspase 3 expression and activity and cleaved caspase 9, and increased Beclin 1, p62 and LC3β. The effects were more relevant in the elderly animals. CONCLUSION Our results showed that SMPL therapy restored the oxidant/antioxidant balance within retinal layers and modulated programmed forms of cell death. Further studies may confirm these data and could evaluate their relevance in clinical practice.
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Affiliation(s)
- Stefano De Cillà
- Ophthalmology Unit Department of Health Sciences Azienda Ospedaliera Universitaria Maggiore della Carità University of East Piedmont Novara Italy
| | - Diego Vezzola
- Lab. Physiology/Experimental Surgery Department of Translational Medicine University of East Piedmont Novara Italy
| | - Serena Farruggio
- Lab. Physiology/Experimental Surgery Department of Translational Medicine University of East Piedmont Novara Italy
- AGING Project Department of Translational Medicine University of Eastern Piedmont Novara Italy
| | - Stela Vujosevic
- Ophthalmology Unit Department of Health Sciences Azienda Ospedaliera Universitaria Maggiore della Carità University of East Piedmont Novara Italy
| | - Nausicaa Clemente
- Lab. Immunology IRCAD Department of Health Sciences University East Piedmont Novara Italy
| | - Giulia Raina
- Lab. Physiology/Experimental Surgery Department of Translational Medicine University of East Piedmont Novara Italy
- AGING Project Department of Translational Medicine University of Eastern Piedmont Novara Italy
| | - David Mary
- Lab. Physiology/Experimental Surgery Department of Translational Medicine University of East Piedmont Novara Italy
- AGING Project Department of Translational Medicine University of Eastern Piedmont Novara Italy
| | - Giamberto Casini
- Department of Surgical Medical, Molecular and Critical Area Pathology University of Pisa Pisa Italy
| | - Luca Rossetti
- Eye Clinic San Paolo Hospital University of Milan Milan Italy
| | - Laura Avagliano
- Pathological Anatomy Department of Health Sciences San Paolo Hospital University of Milan Milan Italy
| | - Carla Martinelli
- Pathological Anatomy Department of Health Sciences San Paolo Hospital University of Milan Milan Italy
| | - Gaetano Bulfamante
- Pathological Anatomy Department of Health Sciences San Paolo Hospital University of Milan Milan Italy
| | - Elena Grossini
- Lab. Physiology/Experimental Surgery Department of Translational Medicine University of East Piedmont Novara Italy
- AGING Project Department of Translational Medicine University of Eastern Piedmont Novara Italy
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Colombo C, Muzza M, Proverbio MC, Tosi D, Soranna D, Pesenti C, Rossi S, Cirello V, De Leo S, Fusco N, Miozzo M, Bulfamante G, Vicentini L, Ferrero S, Zambon A, Tabano S, Fugazzola L. Impact of Mutation Density and Heterogeneity on Papillary Thyroid Cancer Clinical Features and Remission Probability. Thyroid 2019; 29:237-251. [PMID: 30501571 DOI: 10.1089/thy.2018.0339] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The need to integrate the classification of cancer with information on the genetic pattern has emerged in recent years for several tumors. METHODS The genomic background of a large series of 208 papillary thyroid cancers (PTC) followed at a single center was analyzed by a custom MassARRAY genotyping platform, which allows the simultaneous detection of 19 common genetic alterations, including point mutations and fusions. RESULTS Of the PTCs investigated, 71% were found to have pathognomonic genetic findings, with BRAFV600E and TERT promoter mutations being the most frequent monoallelic alterations (42% and 23.5%, respectively), followed by RET/PTC fusions. In 19.2% of cases, two or more point mutations were found, and the co-occurrence of a fusion with one or more point mutation(s) was also observed. Coexisting BRAFV600E and TERT promoter mutations were detected in a subgroup of aggressive PTCs (12%). A correlation between several aggressive features and mutation density was found, regardless of the type of association (i.e., only point mutations, or point mutations and fusions). Importantly, Kaplan-Meier curves demonstrated that mutation density significantly correlated with a higher risk of persistent disease. In most cases, the evaluation of the allelic frequencies normalized for the cancer cell content indicated the presence of the monoallelic mutation in virtually all tumor cells. A minority of cases was found to harbor low allelic frequencies, consistent with the presence of the mutations in a small subset of cancer cells, thus indicating tumor heterogeneity. Consistently, the presence of coexisting genetic alterations with different allelic frequencies in some tumors suggests that PTC can be formed by clones/subclones with different mutational profiles. CONCLUSIONS A large mono-institutional series of PTCs was fully genotyped by means of a cost- and time-effective customized panel, revealing a strong impact of mutation density and genetic heterogeneity on the clinical features and on disease outcomes, indicating that an accurate risk stratification of thyroid cancer cannot rely on the analysis of a single genetic event. Finally, the heterogeneity found in some tumors warrants attention, since the occurrence of this phenomenon is likely to affect response to targeted therapies.
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Affiliation(s)
- Carla Colombo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marina Muzza
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 3 Endocrine Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Carla Proverbio
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Delfina Tosi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Chiara Pesenti
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Rossi
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valentina Cirello
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Simone De Leo
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicola Fusco
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Monica Miozzo
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaetano Bulfamante
- 4 Unit of Pathology, ASST Santi Paolo e Carlo, Milan, Italy
- 5 Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Leonardo Vicentini
- 10 Endocrine Surgery Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Stefano Ferrero
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- 9 Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Antonella Zambon
- 7 Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Silvia Tabano
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- 8 Division of Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Fugazzola
- 1 Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Higgins PB, Folli F, Andrade MCR, Foster J, Mattern V, Paroni R, Schlabritz-Loutsevitch N, Voruganti VS, Kumar S, Guardado-Mendoza R, Bulfamante G, Fiorina P, Pontiroli AE, Hubbard GB, Owston M, Dick EJ, Comuzzie AG. Duodenal adipose tissue is associated with obesity in baboons (Papio sp): a novel site of ectopic fat deposition in non-human primates. Acta Diabetol 2019; 56:227-236. [PMID: 30673859 PMCID: PMC6691506 DOI: 10.1007/s00592-019-01286-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/02/2019] [Indexed: 12/13/2022]
Abstract
AIMS Ectopic fat is a recognized contributor to insulin resistance and metabolic dysfunction, while the role of fat deposition inside intestinal wall tissue remains understudied. We undertook this study to directly quantify and localize intramural fat deposition in duodenal tissue and determine its association with adiposity. METHODS Duodenal tissues were collected from aged (21.2 ± 1.3 years, 19.5 ± 3.1 kg, n = 39) female baboons (Papio sp.). Fasted blood was collected for metabolic profiling and abdominal circumference (AC) measurements were taken. Primary tissue samples were collected at the major duodenal papilla at necropsy: one full cross section was processed for hematoxylin and eosin staining and evaluated; a second full cross section was processed for direct chemical lipid analysis on which percentage duodenal fat content was calculated. RESULTS Duodenal fat content obtained by direct tissue quantification showed considerable variability (11.95 ± 6.93%) and was correlated with AC (r = 0.60, p < 0.001), weight (r = 0.38, p = 0.02), leptin (r = 0.63, p < 0.001), adiponectin (r = - 0.32, p < 0.05), and triglyceride (r = 0.41, p = 0.01). The relationship between duodenal fat content and leptin remained after adjusting for body weight and abdominal circumference. Intramural adipocytes were found in duodenal sections from all animals and were localized to the submucosa. Consistent with the variation in tissue fat content, the submucosal adipocytes were non-uniformly distributed in clusters of varying size. Duodenal adipocytes were larger in obese vs. lean animals (106.9 vs. 66.7 µm2, p = 0.02). CONCLUSIONS Fat accumulation inside the duodenal wall is strongly associated with adiposity and adiposity related circulating biomarkers in baboons. Duodenal tissue fat represents a novel and potentially metabolically active site of ectopic fat deposition.
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Affiliation(s)
- Paul B Higgins
- Department of Genetics, Texas Biomedical Research Institute, PO Box 760549, San Antonio, TX, 78245-0549, USA.
| | - Franco Folli
- Endocrinology and Metabolism, Department of Health Science, University of Milan, Via A. di Rudini, 8, 20142, Milan, Italy.
- UOSD of Diabetes and Metabolic Disorders, ASST Santi Paolo e Carlo, Milan, Italy.
| | - Marcia C R Andrade
- Center for Laboratory Animal Breeding, Oswaldo Cruz Foundation, Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Jaydee Foster
- Department of Genetics, Texas Biomedical Research Institute, PO Box 760549, San Antonio, TX, 78245-0549, USA
| | - Vicki Mattern
- Department of Genetics, Texas Biomedical Research Institute, PO Box 760549, San Antonio, TX, 78245-0549, USA
| | - Rita Paroni
- Laboratory of Clinical Biochemistry and Mass Spectrometry, Department of Health Science, University of Milan, Milan, Italy
| | - Natalia Schlabritz-Loutsevitch
- Department of Obstetrics and Gynecology, School of Medicine, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - V Saroja Voruganti
- Nutrition Research Institute, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Shyamesh Kumar
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | | | - Gaetano Bulfamante
- Pathological Anatomy, Department of Health Science, University of Milano, Via A. di Rudini' 8, 20142, Milan, Italy
- ASST Santi Paolo e Carlo, Milan, Italy
| | - Paolo Fiorina
- Department of Biomedical and Clinical Sciences, "L. Sacco", University of Milan, Milan, Italy
| | | | - Gene B Hubbard
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Michael Owston
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
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Sciarra A, Schmidt S, Pellegrinelli A, Maggioni M, Dondossola D, Pasquier J, Cigala C, Tosi D, Halkic N, Bulfamante G, Viale G, Bosari S, Balabaud C, Bioulac-Sage P, Sempoux C. OATPB1/B3 and MRP3 expression in hepatocellular adenoma predicts Gd-EOB-DTPA uptake and correlates with risk of malignancy. Liver Int 2019; 39:158-167. [PMID: 30218633 DOI: 10.1111/liv.13964] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 06/14/2018] [Revised: 08/22/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Hepatobiliary phase (HBP) Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) has increased the accuracy in differentiating focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA). However, the ability of this technique to distinguish HCA subtypes remains controversial. The aim of this study was to investigate the expression of hepatocyte transporters (OATPB1/B3, MRP2, MRP3) in HCA subtypes, hence to understand their MRI signal intensity on HBP Gd-EOB-DTPA-enhanced MRI. METHODS By means of immunohistochemistry (IHC), we scored the expression of OATPB1/B3, MRP2 and MRP3, in resected specimens of FNH (n = 40), subtyped HCA (n = 58) and HCA with focal malignant transformation (HCA-HCC, n = 4). Results were validated on a supplementary set of FNH (n = 6), subtyped HCA (n = 17) and HCA-HCC (n = 1) with Gd-EOB-DTPA MR images. RESULTS All FNH showed a preserved expression of hepatocytes transporters. Beta-catenin-activated HCA (at highest risk of malignant transformation) and HCA-HCC were characterized by preserved/increased OATPB1/B3 expression (predictor of hyperintensity on HBP), as opposed to other HCA subtypes (P < 0.01) that mostly showed OATPB1/B3 absence (predictor of hypointensity on HBP). HCA-HCC showed an additional MRP3 overexpressed profile (P < 0.01). On HBP Gd-EOB-DTPA-enhanced MRI, FNH and HCA signal intensity reflected the profile predicted by their specific OATPB1/B3 tissue expression. The hyperintense vs hypointense HBP signal criterion was able to distinguish all higher risk HCA and HCA-HCC (100% accuracy). CONCLUSIONS OATPB1/B3 and MRP3 IHC and signal intensity on HBP Gd-EOB-DTPA-enhanced MRI can help to stratify HCA according to their risk of malignant transformation.
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Affiliation(s)
- Amedeo Sciarra
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland.,Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Sabine Schmidt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Marco Maggioni
- Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Daniele Dondossola
- Liver Transplant and General Surgery Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Jerome Pasquier
- Institute for Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Claudia Cigala
- Unit of Pathology, San Paolo Hospital Medical School, Department of Health Sciences, University of Milan, Milan, Italy
| | - Delfina Tosi
- Unit of Pathology, San Paolo Hospital Medical School, Department of Health Sciences, University of Milan, Milan, Italy
| | - Nermin Halkic
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Gaetano Bulfamante
- Unit of Pathology, San Paolo Hospital Medical School, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giuseppe Viale
- European Institute of Oncology, University of Milan, Milan, Italy
| | - Silvano Bosari
- Pathology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Charles Balabaud
- Pathology Department, Inserm, UMR-1053, CHU de Bordeaux, Pellegrin Hospital, Bordeaux, France
| | - Paulette Bioulac-Sage
- Pathology Department, Inserm, UMR-1053, CHU de Bordeaux, Pellegrin Hospital, Bordeaux, France
| | - Christine Sempoux
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
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Perrucci GL, Barbagallo VA, Corlianò M, Tosi D, Santoro R, Nigro P, Poggio P, Bulfamante G, Lombardi F, Pompilio G. Integrin ανβ5 in vitro inhibition limits pro-fibrotic response in cardiac fibroblasts of spontaneously hypertensive rats. J Transl Med 2018; 16:352. [PMID: 30541573 PMCID: PMC6292173 DOI: 10.1186/s12967-018-1730-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/06/2018] [Indexed: 12/22/2022] Open
Abstract
Background To date the TGF-β1 activation mediated by integrin ανβ5 during fibrosis is well-known. This process has been shown also in the heart, where cardiac fibroblasts (CF) differentiate into α-smooth muscle actin (α-SMA)-positive myofibroblasts (MyoFB). Here, we studied the effects on CF, isolated by spontaneously hypertensive rats (SHR), of integrin ανβ5 inhibition in MyoFB differentiation. Methods Staining and immunohistochemistry were performed on rat cardiac tissue. CF were isolated by enzymatic digestion from SHR (SHR-CF) and normotensive WKY (WKY-CF) rat hearts and then treated for in vitro evaluation. Results SHR heart tissues revealed a higher TGF-β1 expression vs. WKY samples. SHR-CF showed an enhanced SMAD2/3 activation and an up-regulated expression of α-SMA, a typical MyoFB marker, especially after TGF-β1 treatment. Immunostaining on cardiac tissues revealed a higher expression of integrin ανβ5 in SHR vs. WKY rat hearts. In vitro results confirmed the up-regulation of integrin ανβ5 expression in SHR-CF at basal condition and after TGF-β1 treatment, in comparison with WKY-CF. Inhibition of integrin ανβ5 by cilengitide treatment led a decreased expression of ανβ5, collagen I, and α-SMA in SHR-CF vs. WKY-CF, resulting in a diminished differentiation of CF into MyoFB. Taking together, results suggested that SHR-CF are more susceptible to TGF-β1, showing an up-regulated activation of SMAD2/3 signaling, and an increased ανβ5, α-SMA, and collagen I expression. Hypertension stimulus promoted an up-regulation of integrin ανβ5 on SHR cardiac tissue and its in vitro inhibition reverted pro-fibrotic events of SHR-CF. Conclusion Inhibition of integrin ανβ5 exerted by cilengitide strongly diminished SHR-CF differentiation into detrimental MyoFB. So, integrin ανβ5 might be considered a novel therapeutic target and cilengitide an effective pharmacological tool to limit the progression of hypertension-induced cardiac fibrosis. Electronic supplementary material The online version of this article (10.1186/s12967-018-1730-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gianluca Lorenzo Perrucci
- Unità di Biologia Vascolare e Medicina Rigenerativa, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy. .,Unità di Biologia Vascolare e Medicina Rigenerativa, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy.
| | | | - Maria Corlianò
- Unità di Biologia Vascolare e Medicina Rigenerativa, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy
| | - Delfina Tosi
- Unità di Patologia, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Ospedale San Paolo, via Antonio di Rudinì 8, Milan, Italy
| | - Rosaria Santoro
- Unità di Biologia Vascolare e Medicina Rigenerativa, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy
| | - Patrizia Nigro
- Unità di Biologia Vascolare e Medicina Rigenerativa, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy
| | - Paolo Poggio
- Unità per lo Studio di Patologie Aortiche, Valvolari e Coronariche, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy
| | - Gaetano Bulfamante
- Unità di Patologia, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Ospedale San Paolo, via Antonio di Rudinì 8, Milan, Italy
| | - Federico Lombardi
- Unità di Biologia Vascolare e Medicina Rigenerativa, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy.,Unità di Cardiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Giulio Pompilio
- Unità di Biologia Vascolare e Medicina Rigenerativa, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy.,Unità di Biologia Vascolare e Medicina Rigenerativa, Centro Cardiologico Monzino IRCCS, via Carlo Parea 4, Milan, Italy
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Cassani B, Soldano G, Finocchiaro D, Conti S, Bulfamante A, Lemorini G, Bulfamante G. Detection and genotyping of HPV-DNA through different types of diagnostic platforms in liquid-based cervical-cytology samples. Pathologica 2018; 110:294-301. [PMID: 30799441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND At present cervical cancer represents the second most common cancer in women worldwide and it reaches a global mortality rate of 52%. Only the early detection and the adequate treatment of pre-neoplastic lesions and early-stage cervical cancer decrease the mortality rate for this type of cancer. Cervical carcinoma screening, as a method of second prevention, is currently feasible through molecular research of high-risk HPV genotypes and in lots of organized screening programs the Pap-test is performed only in women with positive HPV-test. Currently, there are various diagnostic platforms detecting and molecular genotyping HPV, which are based on different procedures, determining uneven viral genotypes panels and using diverse type of vials to collect and store the samples. Previous studies have pointed out that DNA-HPV test can be negative in pre-neoplastic lesions, even of high grade, or in presence of cervical cancer. Therefore, it's important to assess the risk of false negative diagnoses using DNA-HPV molecular test, because in this circumstance women do not undergo immediately Pap-test, but they are submitted to second round screening with DNA-HPV test after 5 years: this protocol could increase the incidence of "interval cancers". The present study aims at comparing the results of HPV detection and genotyping on liquid based cervical cytology, using some of the most relevant diagnostic platforms in commerce. METHODS The study is based on a group of patients which went to their private gynecologist in a contest of opportunistic screening. The vial used in the examined population has been EASYPREP® preservative solution (YD Diagnostics CORP-Republic of Korea); liquid-based cervical cytology sampling has been done using a single device (plastic brush), allowing to collect simultaneously cytological material from exocervix and endocervix (Rovers® Cervex-Brush®). The diagnostic platforms employed have been the following: A) Digene HC2 HPV DNA Test, on RCS System (QIAGEN); B) BD Onclarity™ HPV test, on automate platform BD Viper™ LT (Becton Dickinson); C) Xpert® HPV, on GeneXpert® Infinity Systems platform (Cepheid). Every platform researched high-risk HPV genotypes panels (hr-HPV). Part of the clinical records has also been analyzed through PCR and genes L1 and E6/E7 complete sequencing, in order to further typing the viral population. RESULTS We have examined 1284 samples of women aged 16 to 73 years: 1125 have been tested using HC2 procedure, 272 samples with Onclarity method, 159 with Xpert® method and 55 samples have been analyzed using PCR and sequencing of gene L1 and gene E6/E7. HPV-DNA was detected with Onclarity method in 15,07%, with Xpert® method in 13,83% and using HC2 procedure in 12,27% of samples. The comparison between the three molecular methods revealed diagnostic discrepancies in 3,14% of our records between Onclarity test and Xpert® method and in 2,20% (6/272) between HC2 test and Onclarity test. Globally, in 431 tests, compared using different diagnostic platforms, discrepant diagnoses, referring to hr-HPV presence or to detected genotype, have been observed 11 times (2,55%). Genotype 16 appeared the most expressed in the positive samples (20,99%), whereas genotype 18 resulted the less expressed in the examined population (4,94%). DISCUSSION The present study highlights the following: 1) Positive results' percentage for high-risk HPV-DNA genotypes, deriving from the three diagnostic platforms used and with the same vial to collect and store samples, does not significantly vary on the basis of the type of equipment and it is congruent with the Italian percentage already detected during organized screening programs. 2) Even the molecular diagnostic approach could give false negative results, preventing the detection in the screened population of cervical HPV-related lesions and theoretically endangering women to develop "interval cancer". 3) In the population examined, genotype 16 has been the most expressed, whereas genotype 18 was among the less frequently detected. Other genotypes often noticed have been: 56-59-66 (Onclarity P3 group), 31, 51 and 35-39-68 (Onclarity P2 group). This remark emphasizes the importance of HPV infection and genotypes distribution's continuous monitoring, considering that HPV-vaccines planned in Italy in the "National vaccination prevention program 2017-2019" are not specific for the majority of these genotypes. 4) The necessity to improve the screening program to identify cervical carcinomas and pre-neoplastic cervical lesions is remarked by the detection during HPV-test of possible coinfection (present at least in 8,76% of our records). In fact, the risk of development of cervical cancer might be associated with type-specific interactions between genotypes in multiple infections and, in addition, other genotypes, not targeted by quadrivalent HPV-vaccine, can increase the risk of cervical carcinoma. 5) As there's a different combination of HPV-genotypes in diagnostic categories used by the HPV screening platforms, it's important that anyone who is in charge of this diagnostic analysis promotes among clinicians the adequate rendition of the laboratory's data in the patient records, reporting both the diagnostic result and the method through which it has been obtained.
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Affiliation(s)
- B Cassani
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - G Soldano
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - D Finocchiaro
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - S Conti
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - A Bulfamante
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - G Lemorini
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
| | - G Bulfamante
- U.O.C. di Anatomia Patologica, Citogenetica e Patologia Molecolare, P.O. San Paolo, ASST dei Santi Paolo e Carlo, Milano, Italia; Dipartimento di Scienze della Salute, Università degli Studi di Milano, Italia; Servizio di medicina di laboratorio per il programma di screening lombardo del tumore della cervice uterina (D.D.G. n. 12386 del 28 novembre 2016)
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Nydegger C, Martinelli C, Di Marco F, Bulfamante G, von Segesser L, Tozzi P, Samaja M, Milano G. Phosphodiesterase-5 Inhibition Alleviates Pulmonary Hypertension and Basal Lamina Thickening in Rats Challenged by Chronic Hypoxia. Front Physiol 2018; 9:289. [PMID: 29636700 PMCID: PMC5880920 DOI: 10.3389/fphys.2018.00289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Hypoxia represents both an outcome of cardiopulmonary diseases and a trigger for severe pulmonary complications as pulmonary hypertension. Because nitric oxide (NO) is a critical mediator in the development of pulmonary hypertension, the modulators of its downstream function may become target of pharmacological interventions aimed at alleviating the impact of this condition. Here, we investigate the effects of an early administration of phosphodiesterase-5 inhibitor in rats where pulmonary artery hypertension was induced by chronic exposure to hypoxia. Methods: Rats were divided into three groups: normoxic control, hypoxic with no treatments (2 weeks breathing an atmosphere containing 10% oxygen), and hypoxic treated with sildenafil (1.4 mg/Kg per day in 0.3 mL i.p.). After sacrifice, hearts and lungs were removed and harvested for analyses. Results: Sildenafil reduced hypoxia-induced right ventricle hypertrophy without effects in lung hypertrophy, and blunted the increase in right ventricle pressure without effects on left ventricle pressure. Furthermore, the NO-producing systems (i.e., the phosphorylation of the endothelial isoforms of NO synthase that was measured in both myocardial and lung tissues), and the blood NO stores (i.e., the plasma level of nitrates and nitrites) were up-regulated by sildenafil. We did not find significant effects of sildenafil on weight and hemoglobin concentration. Morphological analysis in lung biopsies revealed that 2-week hypoxia increased the frequency of small pulmonary vessels leaving large vessels unaffected. Finally, ultrastructural analysis showed that sildenafil down-regulated the hypoxia-induced increase in the thickness of the pulmonary basal lamina. Conclusions: In this model of pulmonary hypertension, sildenafil contrasts the negative effects of hypoxia on pulmonary vascular and right ventricle remodeling. This action does not only encompass the canonical vasomodulatory effect, but involves several biochemical pathways. Although the human pathological model is certainly more complex than that described here (for example, the inflammatory issue), the potential role of phosphodiesterase-5 for long-term treatment, and perhaps prevention, of pulmonary hypertension is worthy of investigation.
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Affiliation(s)
- Coline Nydegger
- Laboratory of Cardiovascular Research, Department of Surgery and Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Fabiano Di Marco
- Department of Health Science, University of Milan, Milan, Italy.,ASST Santi Paolo e Carlo, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Science, University of Milan, Milan, Italy.,ASST Santi Paolo e Carlo, Milan, Italy
| | - Ludwig von Segesser
- Laboratory of Cardiovascular Research, Department of Surgery and Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Laboratory of Cardiovascular Research, Department of Surgery and Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Michele Samaja
- Department of Health Science, University of Milan, Milan, Italy
| | - Giuseppina Milano
- Laboratory of Cardiovascular Research, Department of Surgery and Anesthesiology, University Hospital of Lausanne, Lausanne, Switzerland
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Peron A, Vignoli A, Briola FL, Morenghi E, Tansini L, Alfano RM, Bulfamante G, Terraneo S, Ghelma F, Banderali G, Viskochil DH, Carey JC, Canevini MP. Deep phenotyping of patients with Tuberous Sclerosis Complex and no mutation identified in TSC1 and TSC2. Eur J Med Genet 2018; 61:403-410. [PMID: 29432982 DOI: 10.1016/j.ejmg.2018.02.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/14/2017] [Revised: 01/12/2018] [Accepted: 02/08/2018] [Indexed: 01/08/2023]
Abstract
Tuberous Sclerosis Complex (TSC) is a multisystemic condition caused by mutations in TSC1 or TSC2, but a pathogenic variant is not identified in up to 10% of the patients. The aim of this study was to delineate the phenotype of pediatric and adult patients with a definite clinical diagnosis of TSC and no mutation identified in TSC1 or TSC2. We collected molecular and clinical data of 240 patients with TSC, assessing over 50 variables. We compared the phenotype of the homogeneous group of individuals with No Mutation Identified (NMI) with that of TSC patients with a TSC1 and TSC2 pathogenic variant. 9.17% of individuals were classified as NMI. They were diagnosed at an older age (p = 0.001), had more frequent normal cognition (p < 0.001) and less frequent epilepsy (p = 0.010), subependymal nodules (p = 0.022) and giant cell astrocytomas (p = 0.008) than patients with TSC2 pathogenic variants. NMI individuals showed more frequent bilateral and larger renal angiomyolipomas (p = 0.001; p = 0.003) and pulmonary involvement (trend) than patients with TSC1 pathogenic variants. Only one NMI individual had intellectual disability. None presented with a subependymal giant cell astrocytoma. Other medical problems not typical of TSC were found in 42.86%, without a recurrent pattern of abnormalities. Other TSC-associated neuropsychiatric disorders and drug-resistance in epilepsy were equally frequent in the three groups. This study provides a systematic clinical characterization of patients with TSC and facilitates the delineation of a distinctive phenotype indicative of NMI patients, with important implications for surveillance.
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Affiliation(s)
- Angela Peron
- Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Department of Pediatrics, Division of Medical Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Aglaia Vignoli
- Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Francesca La Briola
- Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, Milan, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, Humanitas Clinical and Research Center, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Lucia Tansini
- Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, Milan, Italy
| | - Rosa Maria Alfano
- Human Pathology and Molecular Pathology Unit, San Paolo Hospital, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Human Pathology and Molecular Pathology Unit, San Paolo Hospital, Milan, Italy
| | - Silvia Terraneo
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Respiratory Unit, San Paolo Hospital, Milan, Italy
| | - Filippo Ghelma
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; DAMA (Disabled Advanced Medical Assistance), San Paolo Hospital, Milan, Italy
| | - Giuseppe Banderali
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Pediatrics Unit, San Paolo Hospital, Milan, Italy
| | - David H Viskochil
- Department of Pediatrics, Division of Medical Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - John C Carey
- Department of Pediatrics, Division of Medical Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Maria Paola Canevini
- Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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Santambrogio R, Cigala C, Barabino M, Maggioni M, Scifo G, Bruno S, Bertolini E, Opocher E, Bulfamante G. Intraoperative ultrasound for prediction of hepatocellular carcinoma biological behaviour: Prospective comparison with pathology. Liver Int 2018; 38:312-320. [PMID: 28732141 DOI: 10.1111/liv.13524] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/13/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Preoperative prediction of both microinvasive hepatocellular carcinoma and histological grade of hepatocellular carcinoma is pivotal to treatment planning and prognostication. The aim of this study was to evaluate whether some intraoperative ultrasound features correlate with both the presence of same histological patterns and differentiation grade of hepatocellular carcinoma on the histological features of the primary resected tumour. METHODS All patients with single, small hepatocellular carcinoma that underwent hepatic resection were included in this prospective double-blind study: the intraoperative ultrasound patterns of nodule were registered and compared with similar histological features. RESULTS A total of 179 patients were enclosed in this study: 97 (54%) patients (34% in HCC ≤2 cm) had a microinvasive hepatocellular carcinoma at ultrasound examination, while 82 (46%) patients (41% in HCC ≤2 cm) at histological evaluation. Statistical analysis showed that diameters ≤2 cm, presence of satellites and microinvasive hepatocellular carcinoma at ultrasound examination were the variables with the strongest association with the histological findings. In the multivariate analysis, the vascular microinfiltration and infiltrative hepatocellular carcinoma aspect were independent predictors for grading. CONCLUSIONS In patients with cirrhosis and hepatocellular carcinoma, the prevalence of microinvasive hepatocellular carcinoma is high, even in cases of HCC ≤2 cm. Intraoperative ultrasound findings strongly correlated with histopathological criteria in detecting microinvasive patterns and are useful to predict neoplastic differentiation. The knowledge of these features prior to treatment are highly desired (this can be obtained by an intraoperative ultrasound examination), as they could help in providing optimal management of patients with hepatocellular carcinoma.
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Affiliation(s)
- Roberto Santambrogio
- UOC di Chirurgia Epato-bilio-pancreatica e Digestiva, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
| | - Claudia Cigala
- U.O.C. Anatomia Patologica, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
| | - Matteo Barabino
- UOC di Chirurgia Epato-bilio-pancreatica e Digestiva, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
| | - Marco Maggioni
- U.O.C. Anatomia Patologica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università di Milano, Milano, Italy
| | - Giovanna Scifo
- UOC di Chirurgia Epato-bilio-pancreatica e Digestiva, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
| | - Savino Bruno
- Humanitas University Medicine and Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Emanuela Bertolini
- Cattedra di Medicina Interna, Azienda Ospedaliera San Paolo - Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Milano, Milan, Italy
| | - Enrico Opocher
- UOC di Chirurgia Epato-bilio-pancreatica e Digestiva, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
| | - Gaetano Bulfamante
- U.O.C. Anatomia Patologica, ASST Santi Paolo e Carlo, Università di Milano, Milano, Italy
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Albano D, Martinelli N, Bianchi A, Romeo G, Bulfamante G, Galia M, Sconfienza LM. Posterior tibial tendon dysfunction: Clinical and magnetic resonance imaging findings having histology as reference standard. Eur J Radiol 2017; 99:55-61. [PMID: 29362151 DOI: 10.1016/j.ejrad.2017.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 10/24/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the correlation between MRI, clinical tests, histopathologic features of posterior tibial tendon (PTT) dysfunction in patients with acquired adult flatfoot deformity surgically treated with medializing calcaneal osteotomy and flexor digitorum longus tendon transposition. MATERIALS AND METHODS Nineteen patients (11 females; age: 46 ± 15 year, range 18-75) were pre-operatively evaluated using the single heel rise (HR) and the first metatarsal rise (FMR) sign tests. Two reviewers graded the PTT tears on a I-III scale and measured the hindfoot valgus angle on the pre-operative MRI of the ankle. The specimens of the removed portion of PTT were histologically analysed by two pathologists using the Bonar and Movin score. Linear regression, Spearman's rank-order, and intraclass correlation coefficient (ICC) statistics were used. RESULTS ICC for MRI was excellent (0.952). Correlation between FMR and HR tests was at limit of significance (r = 0.454; P = 0.051). The HR and FMR tests were significantly correlated to the Movin score (r = 0.581; P = 0.009 and r = 0.538; P = 0.018, respectively) and were not significantly correlated to the Bonar score (both with a r = 0.424; P = 0.070). PTT tendinopathy grading at MRI was significantly correlated to the FMR test (p = 0.041) but not to the hindfoot valgus angle (p = 0.496), the HR test (p = 0.943), the Bonar score (p = 0.937), and the Movin score (p = 0.436). The hindfoot angle was not correlated to any of the other variables (p > 0.264). CONCLUSION For PTT dysfunction, there is high correlation between HR and FMR test and histology evaluated using the Movin score, while no correlation was seen for the Bonar score. Semiquantitative grading of PTT dysfunction at MRI only correlates to the FMR and not to histology. The hindfoot valgus angle is not correlated to any of the considered variables.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Nicolò Martinelli
- Foot and Ankle Surgery Unit, Istituto Clinico Città Studi, Milano, Italy
| | - Alberto Bianchi
- Foot and Ankle Surgery Unit, Istituto Clinico Città Studi, Milano, Italy
| | - Giovanni Romeo
- Foot and Ankle Surgery Unit, Istituto Clinico Città Studi, Milano, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School University of Milan, Via di Rudinì 8, 20142, Milan, Italy
| | - Massimo Galia
- Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy
| | - Luca Maria Sconfienza
- Department of Biomedical Sciences for Health, University of Milano, Via Pascal 36, 20135, Milano, Italy; Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20166, Milano, Italy.
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40
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Biglioli F, Kutanovaite O, Autelitano L, Lozza A, Moneghini L, Bulfamante G, Allevi F. Surgical treatment of painful inferior alveolar nerve injuries following endodontic treatment: a consecutive case series of seven patients. Oral Maxillofac Surg 2017; 21:461-466. [PMID: 28932988 DOI: 10.1007/s10006-017-0656-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/14/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Injuries of the inferior alveolar nerve (IAN) related to endodontic treatment are being increasingly reported. However, consensus on the preferred intervention and the timing of and indications for surgical treatment is lacking. Here, we describe our experience with painful IAN injuries arising from endodontic treatment and requiring prompt microsurgical treatment. METHODS Seven consecutive patients with painful IAN injuries were referred to the Maxillofacial Surgery Unit of San Paolo Hospital in Milan. All patients had undergone root canals endodontic treatment in the mandibular molar or premolar between 2007 and 2014. The time elapsed between injury and referral for surgical treatment ranged from 10 days to 20 months. Each patient was treated by one of several different microsurgical procedures, described herein. RESULTS Overall, neurosensory status and IAN-related pain improved in all seven patients. The best results were obtained by IAN replacement with a sural nerve graft. However, complete sensory recovery was not achieved in any of the patients. CONCLUSIONS Although our sample includes only seven patients, early surgical treatment with an interpositional sural nerve graft seems to allow neurosensory recovery. Less satisfactory results are achieved in patients with IAN injuries of > 12 months duration.
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Affiliation(s)
- Federico Biglioli
- Maxillofacial Surgical Unit, San Paolo Hospital, Department of Health Sciences, University of Milan, Via di Rudini' 8, 20142, Milan, Italy
| | - Otilija Kutanovaite
- Maxillofacial Surgery Department, Vilnius University Hospital Zalgiris Clinics, Vilnius, Lithuania
| | - Luca Autelitano
- Maxillofacial Surgical Unit, San Paolo Hospital, Department of Health Sciences, University of Milan, Via di Rudini' 8, 20142, Milan, Italy
| | - Alessandro Lozza
- Neurophysiopathology Service, C. Mondino National Neurological Institute, Pavia, Italy
| | - Laura Moneghini
- Unit of Pathology, Department of Health Sciences, San Paolo Hospital, Scienze della Salute Department, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Unit of Pathology, Department of Health Sciences, San Paolo Hospital, Scienze della Salute Department, University of Milan, Milan, Italy
| | - Fabiana Allevi
- Maxillofacial Surgical Unit, San Paolo Hospital, Department of Health Sciences, University of Milan, Via di Rudini' 8, 20142, Milan, Italy.
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Gianelli U, Fiori S, Cattaneo D, Bossi A, Cortinovis I, Bonometti A, Ercoli G, Bucelli C, Orofino N, Bulfamante G, Iurlo A. Prognostic significance of a comprehensive histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis in primary myelofibrosis patients. Histopathology 2017; 71:897-908. [PMID: 28710830 DOI: 10.1111/his.13309] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 04/13/2017] [Accepted: 07/12/2017] [Indexed: 01/25/2023]
Abstract
AIMS To evaluate whether a comprehensive histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis in bone marrow trephine biopsies (BMBs) of primary myelofibrosis (PMF) patients may have prognostic implications. METHODS AND RESULTS Reticulin fibrosis, collagen deposition and osteosclerosis were graded from 0 to 3 in a series of 122 baseline BMBs. Then, we assigned to each case a comprehensive score [reticulin, collagen, osteosclerosis (RCO) score, ranging from 0 to 9] that allowed us to distinguish two groups of patients, with low-grade (RCO score 0-4) and high-grade (RCO score 5-9) stromal changes. Of 122 patients, 88 displayed a low-grade and 34 a high-grade RCO score. The latter was associated more frequently with anaemia, thrombocytopenia, peripheral blood blasts and increased lactate dehydrogenase levels. The RCO score was correlated strictly with overall mortality (P = 0.013) and International Prognostic Scoring System (IPSS) risk categories, and was able to discriminate the overall survival of both low- and high-grade patients (log-rank test: P < 0.001). Moreover, it proved to be more accurate than the European Consensus on Grading of Bone Marrow Fibrosis (ECGMF grade) in identifying high-risk patients with poor prognosis. Finally, a combined analysis of RCO scores and IPSS risk categories in an integrated clinical-pathological evaluation was able to increase the positive predictive value (PPV) for mortality in high-risk patients. CONCLUSION The comprehensive RCO score, obtained by histological evaluation of reticulin fibrosis, collagen deposition and osteosclerosis was prognostically significant and more accurate than ECGMF grade in identifying high-risk patients and improved PPV when applied in addition to IPSS.
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Affiliation(s)
- Umberto Gianelli
- Division of Pathology, Department of Pathophysiology and Transplantation, University of Milan and IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Stefano Fiori
- Division of Pathology, Department of Pathophysiology and Transplantation, University of Milan and IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Daniele Cattaneo
- Hematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Anna Bossi
- Laboratory GA Maccacaro, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ivan Cortinovis
- Laboratory GA Maccacaro, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Arturo Bonometti
- Division of Pathology, Department of Pathophysiology and Transplantation, University of Milan and IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Giulia Ercoli
- Division of Pathology, Department of Pathophysiology and Transplantation, University of Milan and IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Cristina Bucelli
- Hematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Nicola Orofino
- Hematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Division of Pathology, Department of Health Sciences, University of Milan and San Paolo Hospital, Milan, Italy
| | - Alessandra Iurlo
- Hematology Division, IRCCS Ca' Granda, Maggiore Policlinico Hospital Foundation, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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Zirpoli S, Munari AM, Rustico M, Bulfamante G, Lista G, Spaccini L, Cesaretti C. Fetal-MRI prenatal diagnosis of severe bilateral lung hypoplasia: alveolar capillary dysplasia case report. J Prenat Med 2017; 10:15-19. [PMID: 28725341 DOI: 10.11138/jpm/2016.10.3.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare and lethal developmental disorder of the lung that affect both acinar structure and the intrinsic pulmonary vasculature. We report prenatal and postnatal imaging with histopathological findings of this rare condition. We, first, describe MR imaging features and discuss its role in prenatal imaging.
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Affiliation(s)
- Salvatore Zirpoli
- Pediatric Radiology and Neuroradiology, Children's Hospital V. Buzzi, Milan, Italy
| | | | - Mariangela Rustico
- Unit of Prenatal Diagnosis and Fetal Surgery, Children's Hospital V. Buzzi, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
| | - Gianluca Lista
- Division of Neonatology, Children's Hospital V. Buzzi, Milan, Italy
| | - Luigina Spaccini
- Clinical Genetics Service, Children's Hospital V. Buzzi, Milan, Italy
| | - Claudia Cesaretti
- Medical Genetics Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Ciceri P, Elli F, Falleni M, Tosi D, Bulfamante G, Cozzolino M. SP362EFFECT OF IRON CITRATE ON MATRIX AND SIMIL-OSTEOBLASTIC DIFFERENTIATION IN HIGH PHOSPHATE TREATED VASCULAR SMOOTH MUSCLE CELLS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx147.sp362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ferrari D, Codecà C, Viale G, Bocci B, Broggio F, Crepaldi F, Violati M, Luciani A, Bauer D, Moneghini L, Bulfamante G, Foa P. An unusual case of tracheo-pleural fistula and cardiac metastases in oropharyngeal carcinoma: a case report and review of the literature. Cancers Head Neck 2016; 1:16. [PMID: 31093345 PMCID: PMC6460740 DOI: 10.1186/s41199-016-0018-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
Background Oropharyngeal cancer is frequently associated with human papilloma virus, that also represents a strong prognostic factor. Local relaps and treatment-related complications are frequent, whereas distant metastases occur in about 25% of patients. Case presentation A 49 years-old male presented with a loco-regionally advanced oropharyngeal squamous cell carcinoma and was treated with concomitant chemoradiation. A complete clinical and pathological response was achieved, but the occurrence of necrotising tracheo-esophagitis, with tracheo-mediastino-pleural fistula formation, further complicated the subsequent clinical course. The patient died suddenly. Autopsy revealed multiple myocardial and epicardial metastases from oropharyngeal squamous cell carcinoma. Conclusions Even in case of a transient complete local response, the potential occurrence of severe complications and distant metastases, although infrequent, should be considered. Cardiac metastases are frequently underestimated, as they are often asymptomatic, but may lead to sudden death. Further efforts are needed to improve diagnosis and therapy in this setting.
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Affiliation(s)
- Daris Ferrari
- 1Medical Oncology, San Paolo Hospital, Milan, Italy.,5San Paolo Hospital, via Di Rudinì 8, 20142 Milan, Italy
| | - Carla Codecà
- 1Medical Oncology, San Paolo Hospital, Milan, Italy
| | - Giulia Viale
- 1Medical Oncology, San Paolo Hospital, Milan, Italy
| | | | | | | | | | | | - Dario Bauer
- 2Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy
| | - Laura Moneghini
- 2Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy
| | - Gaetano Bulfamante
- 3Department of Medicine, Surgery and Dentistry, Division of Pathology, San Paolo Hospital, University of Milan Medical School, Milan, Italy
| | - Paolo Foa
- 4Department of Oncology, Medical Oncology, San Paolo Hospital, University of Milan Medical School, Milan, Italy
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45
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Mecacci F, Serena C, Avagliano L, Cozzolino M, Baroni E, Rambaldi MP, Simeone S, Castiglione F, Taddei GL, Bulfamante G. Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology. PLoS One 2016; 11:e0166514. [PMID: 27936018 PMCID: PMC5147826 DOI: 10.1371/journal.pone.0166514] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 10/31/2016] [Indexed: 02/07/2023] Open
Abstract
Objective To investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births. Methods A retrospective case-control study of 150 singleton term stillbirths. The livebirth control groups included 586 cases of low-risk pregnancies and 153 late fetal growth restriction fetuses. Stillbirths and livebirths from low-risk pregnancies were classified using customized standards for fetal weight at birth, as adequate for gestational age (AGA; 10-90th percentile), small (SGA; <10th percentile) or large for gestational age (LGA; >90th percentile). Placental characteristics in stillbirth were compared with those from livebirths using four categories: inflammation, disruptive, obstructive and adaptive lesions. Results There was a higher rate of SGA (26% vs 6%, p<0.001) and LGA fetuses (10.6% vs 5.6%, p<0.05) in the stillbirth group. Among stillbirth fetuses, almost half of the SGA were very low birthweight (≤3°percentile) (12% vs 0.3%, p<0.001). The disruptive (7.3% vs 0.17%;p<0.001), obstructive (54.6% vs 7.5%;p<0.001) and adaptive (46.6% vs 35.8%;p<0.001) findings were significantly more common in than in livebirth-low risk. Placental characteristics of AGA and SGA stillbirth were compared with those of AGA and FGR livebirth. In stillbirths-SGA we found a higher number of disruptive (12.8% vs 0%; p<0.001), obstructive (58.9% vs 23.5%;p<0.001) and adaptive lesions (56.4% vs 49%; p 0.47) than in livebirth-FGR. Conclusion The assessment of fetal weight with customized curves can identify fetuses which have not reached their genetically determined growth potential and are therefore at risk for adverse outcomes. Placental evaluation in stillbirths can reveal chronic histological signs that might be useful to clinical assessment, especially in underweight fetuses.
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Affiliation(s)
- Federico Mecacci
- Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy
| | - Caterina Serena
- Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy
- * E-mail:
| | - Laura Avagliano
- Department of Health Sciences, San Paolo Hospital Medical School University of Milan, Milan, Italy
| | - Mauro Cozzolino
- Department of Biomedical, Experimental and Clinical Sciences-Division of Obstetrics and Gynaecology, University of Florence, Florence, Italy
| | - Eleonora Baroni
- Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy
| | - Marianna Pina Rambaldi
- Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy
| | - Serena Simeone
- Department of Sciences for the Health of Women and Children, Careggi Hospital, Florence, Italy
| | | | | | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School University of Milan, Milan, Italy
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46
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Ciceri P, Elli F, Cappelletti L, Tosi D, Savi F, Bulfamante G, Cozzolino M. Osteonectin (SPARC) Expression in Vascular Calcification: In Vitro and Ex Vivo Studies. Calcif Tissue Int 2016; 99:472-480. [PMID: 27339669 DOI: 10.1007/s00223-016-0167-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/16/2016] [Indexed: 01/27/2023]
Abstract
Osteonectin, also termed SPARC, is a noncollagenous protein of bone matrix. Since there are controversial results regarding its role during the process of vascular calcification, we investigated osteonectin expression in our in vitro calcification model. Rat vascular smooth muscle cells (VSMCs) were challenged with high phosphate (5 mmol/L Pi) and analyzed quantifying calcium levels, through immunohistochemical studies, and studying gene expression. We detected a peak of osteonectin expression at day 7 in cell treated with high phosphate. The time course of calcium deposition, reflected the expression of osteonectin, resulting extensively present at day 7. On the contrary, the expression of the mitotic marker Ki-67 had a peak at day 4, showing no correlation between osteonectin and cell proliferation. Moreover, 7 days was the time point in which Cbfα1/RUNX-2 had its maximal expression. Furthermore, ascorbic acid increased osteonectin expression, supporting a procalcifying role for this protein. Next we decided to study osteonectin expression ex vivo in fetal, adult not calcified, and adult calcific vessels. Immunohistochemical studies demonstrated a spread and strong reactivity in VSMCs of a 20-week fetus, confirming that osteonectin may have a potential role in regulation of mitosis and in cell differentiation. In adult not calcified arteries, osteonectin was constitutively expressed and its levels increased in atherosclerotic and in calcified plaques, where it could have a regulatory role in the calcification process. Our in vitro and ex vivo data show osteonectin expression during the calcification process and suggest its potential role as procalcifying factor.
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Affiliation(s)
- Paola Ciceri
- Laboratory of Experimental Nephrology, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì,8, 20142, Milan, Italy
| | - Francesca Elli
- Laboratory of Experimental Nephrology, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì,8, 20142, Milan, Italy
| | - Laura Cappelletti
- Laboratory of Experimental Nephrology, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì,8, 20142, Milan, Italy
| | - Delfina Tosi
- Unit of Human Pathology, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Savi
- Unit of Human Pathology, Department of Health Sciences, University of Milan, Milan, Italy
| | - Gaetano Bulfamante
- Unit of Human Pathology, Department of Health Sciences, University of Milan, Milan, Italy
| | - Mario Cozzolino
- Laboratory of Experimental Nephrology, Department of Health Sciences, San Paolo Hospital, University of Milan, Via A. di Rudinì,8, 20142, Milan, Italy.
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47
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Mameli C, Selvaggio G, Cerini C, Bulfamante G, Madia C, Riccipetitoni G, Zuccotti GV. Atypical Leydig Cell Tumor in Children: Report of 2 Cases. Pediatrics 2016; 138:peds.2016-0151. [PMID: 27940757 DOI: 10.1542/peds.2016-0151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 11/24/2022] Open
Abstract
Leydig cell tumors (LCTs) are rare cord-stromal tumors that may occur in testis or ovaries and may produce androgens or estrogens. The majority has been found in men between the ages of 20 and 60 years. Adults with androgen-secreting LCTs are usually asymptomatic; feminizing syndromes may result from the production of estradiol or the peripheral aromatization of testosterone. In children, LCTs usually present between 5 and 10 years of age with isosexual precocious pseudopuberty or gynecomastia. We report 2 cases of LCT in prepubertal boys presenting with advanced unilateral pubarche and testicular volume asymmetry. Both subjects had normal penis size for age; no axillary hair or other signs of puberty were present. Height velocity was normal, and bone age was coincident with chronological age. Androgen levels were normal, as well as estrogen, corticotropin, and cortisol concentration. Testicular ultrasound demonstrated a testicular mass. Histology examination revealed a well-differentiated LCT. This is the first report of 2 pediatric patients with LCT presenting with advanced pubarche in absence of systemic hyperandrogenism. We hypothesize that the neoplastic cells may locally produce high levels of androgens or androgen-like bioactivity molecules that are responsible for the clinical manifestation. We suggest that a testicular ultrasound should be obtained in all children presenting with unilateral pubarche, with or without hyperandrogenism.
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Affiliation(s)
| | - Giorgio Selvaggio
- Pediatric Surgery, Children's Hospital "V. Buzzi," University of Milan, Milan, Italy
| | - Chiara Cerini
- Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, California; and
| | - Gaetano Bulfamante
- Human Pathology Unit, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy
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48
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Perrucci GL, Corlian!ò M, Tosi D, Nigro P, Bulfamante G, Pompilio G, Lombardi F. Abstract P107: Hypertension Enhances the Differentiation of Cardiac Fibroblasts Into Myofibroblasts After TGF-beta1 Treatment. Hypertension 2016. [DOI: 10.1161/hyp.68.suppl_1.p107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives:
In cardiac fibrosis associated with hypertension, TGF-beta1 plays a key role by acting on differentiation of cardiac fibroblasts (CF) into alpha-smooth muscle actin (alpha-SMA)-positive myofibroblasts. In this study, we tested the effect of TGF-beta1 during the myofibroblast differentiation process of CF from normotensive and hypertensive rats.
Methods:
CF were obtained by enzymatic digestion of hearts isolated from Spontaneously Hypertensive (hCF) and normotensive Wistar Kyoto (nCF) rats (n=5 rat/group). Gene and protein expression in CF was evaluated by Western blot and qRT-PCR analyses, respectively. Immunohistochemistry analysis for integrin alpha-v beta-5 was performed on rat cardiac tissue (n=5 rat/group).
Results:
Cultured hCF showed an enhanced SMAD2/3 activation and alpha-SMA protein expression after treatment with TGF-beta1 (5 ng/ml) in comparison with nCF. Alpha-SMA up-regulation was further confirmed by qRT-PCR analysis that showed a significant increase in alpha-SMA gene expression in hCF after TGF-beta1 treatment (2.78±0.25 vs 2.01±0.21 fold increase,
p
<0.05). Moreover, immunostaining on cardiac tissues revealed a higher expression of integrin alpha-v beta-5 in hypertensive
vs
normotensive rat hearts (345.3±170.0 vs 48.2±22.3 mm
2
of integrin-positive area,
p
<0.05). This result was also confirmed
in vitro
; indeed, integrin alpha-v beta-5 gene expression in hCF increased 2.8-fold in basal condition and 5.12-fold after TGF-beta1 treatment when compared to untreated nCF.
Conclusions:
Taken together, these results suggest that hCF are more prone to upregulate integrin alpha-v beta-5 and consequently differentiate into myofibroblasts
in vitro
under TGF-beta1 treatment. Thus, targeting alpha-v beta-5 might open a novel prospective for the treatment of fibrosis in hypertensive hearts likely reducing integrin-mediated TGF-beta1 activation.
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49
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Frassoni C, Avagliano L, Inverardi F, Spaccini L, Parazzini C, Rustico MA, Bulfamante G, Righini A. Familial Precocious Fetal Abnormal Cortical Sulcation. Neuropediatrics 2016; 47:253-8. [PMID: 27177044 DOI: 10.1055/s-0036-1583185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The development of the human cerebral cortex is a complex and precisely programmed process by which alterations may lead to morphological and functional neurological abnormalities. We report familial cases of prenatally diagnosed abnormal brain, characterized by aberrant symmetrical mesial oversulcation of the parietooccipital lobes, in fetuses affected by abnormal skeletal features. Fetal brain anomalies were characterized by prenatal magnetic resonance imaging at 21 weeks of gestation and histologically evaluated at 22 weeks. Histological examination added relevant information showing some focal cortical areas of micropoligyria and heterotopic extension of the cortical plate into the marginal zone beneath the cortical surface. Genetic analysis of the fetuses excluded FGFR3 mutations known to be related to skeletal dysplasia and aberrant symmetrical oversulcation in other brain areas (temporal lobes). Hence, the present report suggests the existence of a class of rare syndromes of skeleton and brain development abnormality unrelated to FGFR3 mutations or related to other not described FGFR3 gene defects. Using magnetic resonance imaging, histopathology and molecular characterization we provide an example of a translational study of a rare and unreported brain congenital malformation.
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Affiliation(s)
- Carolina Frassoni
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS, Istituto Neurologico "C. Besta," Milano, Italy
| | - Laura Avagliano
- Department of Health Sciences, San Paolo Hospital Medical School, University of Milan, Milano, Italy
| | - Francesca Inverardi
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS, Istituto Neurologico "C. Besta," Milano, Italy
| | - Luigina Spaccini
- Department of Obstetrics and Gynecology, Children's Hospital V. Buzzi, Milan, Italy
| | - Cecilia Parazzini
- Department of Pediatric Radiology and Neuroradiology, Children's Hospital V. Buzzi, Milan, Italy
| | - Maria Angela Rustico
- Department of Obstetrics and Gynecology, Children's Hospital V. Buzzi, Milan, Italy
| | - Gaetano Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School, University of Milan, Milano, Italy
| | - Andrea Righini
- Department of Pediatric Radiology and Neuroradiology, Children's Hospital V. Buzzi, Milan, Italy
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50
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Peron A, Vignoli A, La Briola F, Volpi A, Montanari E, Morenghi E, Ghelma F, Bulfamante G, Cefalo G, Canevini MP. Do patients with tuberous sclerosis complex have an increased risk for malignancies? Am J Med Genet A 2016; 170:1538-44. [PMID: 27061015 DOI: 10.1002/ajmg.a.37644] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/20/2016] [Indexed: 02/01/2023]
Abstract
Tuberous Sclerosis Complex (TSC) is generally characterized by the presence of benign tumors, but some patients with malignancies have been reported in the literature. We examined a large Italian TSC population (240 individuals followed from 2001 to 2015, aged 3 months-74 years), assessing the frequency of malignancies to determine whether there is an increased risk for cancer in this disorder, and looking for possible features associated with the development of neoplasia. Fifteen patients had malignancies (6.25%); median age at diagnosis was 37.5 years (range of 1.6-58). Five of seven renal tumors were renal cell carcinomas. Eight patients had a non-renal malignancy (3.3%), but we did not find a more prevalent type of cancer. No patient developed more than one malignancy. The prevalence of all malignant tumors was compatible with the prevalence in the general population (5.6%, 95%CI 2.99-9.31%, vs. 4.4% in Italy). Median age at cancer diagnosis was lower (37.5 years, 95%CI 28.6-44.7, vs. 66.0 years). Two patients (13.3%) died of their cancer, while outcome was favorable in the remaining individuals. Malignant tumors were more frequently diagnosed in patients with mutations in TSC1 when compared to TSC2 and patients with no mutation identified (P = 0.032). Our study demonstrated that TSC patients do not seem to have an increased risk for malignancies besides renal cell carcinoma. However, when cancer develops, age at diagnosis is lower than in the general population, and malignant tumors are more frequently diagnosed in patients with mutations in TSC1. Further studies are needed to confirm these data. ©2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Angela Peron
- Child Neurology Unit-Epilepsy Center, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Aglaia Vignoli
- Child Neurology Unit-Epilepsy Center, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Francesca La Briola
- Child Neurology Unit-Epilepsy Center, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Angela Volpi
- Nephrology Unit, San Paolo Hospital, Milan, Italy
| | - Emanuele Montanari
- Urology Unit, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Morenghi
- Biostatististics Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - Filippo Ghelma
- DAMA Unit (Disabled Advanced Medical Assistance), San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gaetano Bulfamante
- Human Pathology Unit, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Graziella Cefalo
- Pediatrics Department, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Maria Paola Canevini
- Child Neurology Unit-Epilepsy Center, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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