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Zirmire RK, Saha D, Dey R, Tanimu H, Zaarour R, Bird D, Cherian P, Rana I, Roy N, Sanyal A, Misra N, Jamora C. Bacopa monnieri phytochemicals regulate fibroblast cell migration via modulation of focal adhesions. iScience 2024; 27:109489. [PMID: 38558933 PMCID: PMC10981128 DOI: 10.1016/j.isci.2024.109489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/03/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
The Bacopa monnieri plant contains phytochemicals that have been used extensively in traditional medicine to treat various diseases. More recently it has been shown to accelerate wound healing, though its mechanism of action is largely unknown. Here we investigated the cellular pathways activated by a methanol extract of Bacopa monnieri in human dermal fibroblasts, which play many critical roles in the wound healing program. Gene expression analysis revealed that the Bacopa monnieri extract can modulate multiple processes involved in the wound healing program such as migration, proliferation, and angiogenesis. We discovered that the extract can increase migration of fibroblasts via modulating the size and number of focal adhesions. Bacopa monnieri-mediated changes in focal adhesions are dependent on α5β1 integrin activation and subsequent phosphorylation of focal adhesion kinase (FAK). Altogether our results suggest that Bacopa monnieri extract could enhance the wound healing rate via modulating fibroblast migration into the wound bed.
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Affiliation(s)
- Ravindra K. Zirmire
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
- Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur, Tamil Nadu 613401, India
| | - Dyuti Saha
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
- Department of Biology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rakesh Dey
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
| | - Habibu Tanimu
- JAIN (Deemed-to-be University), #44/4, District Fund Road, Jayanagar 9th Block, Bangalore, Karnataka 560069, India
| | - Rania Zaarour
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, UAE
| | - Deborah Bird
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
| | - Prakash Cherian
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
| | - Isha Rana
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
- Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur, Tamil Nadu 613401, India
| | - Nita Roy
- L'Oréal, Research & Innovation, Bengaluru, India
| | | | - Namita Misra
- L’Oréal, Research and Innovation, Aulnay, France
| | - Colin Jamora
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka 560065, India
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Rossi M, Terreri S, Battafarano G, Rana I, Buonuomo PS, Di Giuseppe L, D'Agostini M, Porzio O, Di Gregorio J, Cipriani C, Jenkner A, Gonfiantini MV, Bartuli A, Del Fattore A. Analysis of circulating osteoclast and osteogenic precursors in patients with Gorham-Stout disease. J Endocrinol Invest 2024:10.1007/s40618-024-02365-8. [PMID: 38556572 DOI: 10.1007/s40618-024-02365-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Gorham-Stout disease is a very rare disorder characterized by progressive bone erosion and angiomatous proliferation; its etiopathogenesis is still unknown, and diagnosis is still performed by exclusion criteria. The alteration of bone remodeling activity has been reported in patients; in this study, we characterized circulating osteoclast and osteogenic precursors that could be important to better understand the osteolysis observed in patients. METHODS Flow cytometry analysis of PBMC (Peripheral Blood Mononuclear Cells) was performed to characterize circulating osteoclast and osteogenic precursors in GSD patients (n = 9) compared to healthy donors (n = 55). Moreover, ELISA assays were assessed to evaluate serum levels of bone markers including RANK-L (Receptor activator of NF-κB ligand), OPG (Osteoprotegerin), BALP (Bone Alkaline Phosphatase) and OCN (Osteocalcin). RESULTS We found an increase of CD16-/CD14+CD11b+ and CD115+/CD14+CD11b+ osteoclast precursors in GSD patients, with high levels of serum RANK-L that could reflect the increase of bone resorption activity observed in patients. Moreover, no significant alterations were found regarding osteogenic precursors and serum levels of BALP and OCN. CONCLUSION The analysis of circulating bone cell precursors, as well as of RANK-L, could be relevant as an additional diagnostic tool for these patients and could be exploited for therapeutic purposes.
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Affiliation(s)
- M Rossi
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - S Terreri
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - G Battafarano
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy
| | - I Rana
- Rare Diseases and Medical Genetic Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P S Buonuomo
- Rare Diseases and Medical Genetic Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Di Giuseppe
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - M D'Agostini
- Clinical Laboratory, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - O Porzio
- Clinical Laboratory, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - J Di Gregorio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Cristiana Cipriani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - A Jenkner
- Pediatric Palliative Care Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M V Gonfiantini
- Rare Diseases and Medical Genetic Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Bartuli
- Rare Diseases and Medical Genetic Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Del Fattore
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children's Hospital, IRCCS, Viale San Paolo 15, 00146, Rome, Italy.
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Cartwright E, Slater S, Saffery C, Tran A, Turkes F, Smith G, Aresu M, Kohoutova D, Terlizzo M, Zhitkov O, Rana I, Johnston EW, Sanna I, Smyth E, Mansoor W, Fribbens C, Rao S, Chau I, Starling N, Cunningham D. Phase II trial of domatinostat (4SC-202) in combination with avelumab in patients with previously treated advanced mismatch repair proficient oesophagogastric and colorectal adenocarcinoma: EMERGE. ESMO Open 2024; 9:102971. [PMID: 38518549 DOI: 10.1016/j.esmoop.2024.102971] [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: 12/20/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Most oesophagogastric adenocarcinomas (OGAs) and colorectal cancers (CRCs) are mismatch repair proficient (MMRp), responding poorly to immune checkpoint inhibition. We evaluated the safety and efficacy of domatinostat (histone deacetylase inhibitor) plus avelumab (anti-PD-L1 antibody) in patients with previously treated inoperable, advanced/metastatic MMRp OGA and CRC. PATIENTS AND METHODS Eligible patients were evaluated in a multicentre, open-label dose escalation/dose expansion phase II trial. In the escalation phase, patients received escalating doses of domatinostat [100 mg once daily (OD), 200 mg OD, 200 mg twice daily (BD)] orally for 14 days followed by continuous dosing plus avelumab 10 mg/kg administered intravenously 2-weekly (2qw) to determine the recommended phase II dose (RP2D). The trial expansion phase evaluated the best objective response rate (ORR) during 6 months by RECIST version 1.1 using a Simon two-stage optimal design with 2/9 and 1/10 responses required to proceed to stage 2 in the OGA and CRC cohorts, respectively. RESULTS Patients (n = 40) were registered between February 2019 and October 2021. Patients in the dose escalation phase (n = 12) were evaluated to confirm the RP2D of domatinostat 200 mg BD plus avelumab 10 mg/kg. No dose-limiting toxicities were observed. Twenty-one patients were treated at the RP2D, 19 (9 OGA and 10 CRC) were assessable for the best ORR; 2 patients with CRC did not receive combination treatment and were not assessable for the primary endpoint analysis. Six patients were evaluated in the dose escalation and expansion phases. In the OGA cohort, the best ORR was 22.2% (95% one-sided confidence interval lower bound 4.1) and the median duration of disease control was 11.3 months (range 9.9-12.7 months). No responses were observed in the CRC cohort. No treatment-related grade 3-4 adverse events were reported at the RP2D. CONCLUSIONS Responses in the OGA cohort met the criteria to expand to stage 2 of recruitment with an acceptable safety profile. There was insufficient signal in the CRC cohort to progress to stage 2. TRIAL REGISTRATION NCT03812796 (registered 23rd January 2019).
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Affiliation(s)
- E Cartwright
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - S Slater
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - C Saffery
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - A Tran
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - F Turkes
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - G Smith
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - M Aresu
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - D Kohoutova
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - M Terlizzo
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - O Zhitkov
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Rana
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - E W Johnston
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Sanna
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - E Smyth
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - W Mansoor
- Oesophago-Gastric Cancer Services, The Christie NHS Foundation Trust, Manchester, UK
| | - C Fribbens
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - S Rao
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - I Chau
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - N Starling
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London
| | - D Cunningham
- Gastrointestinal and Lymphoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London.
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Wei W, Felippi R, Abbasi G, Pinn T, Rose KS, Rana I. The Impact of Electronic Health Record Interventions on Patient Access to Post-Hospital Discharge Prescriptions. Hosp Pharm 2023; 58:212-218. [PMID: 36890959 PMCID: PMC9986571 DOI: 10.1177/00185787221130689] [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] [Indexed: 03/05/2023]
Abstract
Purpose: Assess the impact of electronic health record interventions on patient access to post-hospital discharge prescriptions. Methods: Five interventions were implemented in the electronic health record to improve patient access to prescriptions after discharge from hospital: electronic prior authorization, alternative medication suggestions, order sets, mail order pharmacy alerts, and medication interchange instructions. This was a retrospective cohort study of patient responses from discharges during 6 months before the first intervention implementation and 6 months after the last intervention implementation documented in the electronic health record and a transition-in-care platform. Primary endpoint was the proportion of discharges with patient-reported issues that would have been prevented by the studied interventions out of number of discharges with at least one prescription, analyzed using Chi-squared test (level of significance .05). Results: Discharges with patient-reported issues that would have been prevented by the studied interventions decreased from 1.68 to 1.07 out of 1000 discharges with prescriptions (P < .001). Conclusion: Interventions in the electronic health record reduced barriers faced by patients to picking up prescriptions post-discharge from hospital, potentially leading to improved patient satisfaction and improved health outcomes. Important factors to consider for electronic health record intervention implementation are workflow development and intrusiveness of clinical decision support. Multiple targeted electronic health record interventions can improve patients' access to prescriptions after discharge from hospital.
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Affiliation(s)
- Wenfei Wei
- Department of Pharmacy, Houston
Methodist, Houston, TX, USA
| | - Rafael Felippi
- Physicians’ Alliance for Quality
Department, Houston Methodist, Houston, TX, USA
| | - Ghalib Abbasi
- Department of Pharmacy, Houston
Methodist, Houston, TX, USA
| | - Theresa Pinn
- Physicians’ Alliance for Quality
Department, Houston Methodist, Houston, TX, USA
| | - Kelly St. Rose
- Department of Pharmacy, Houston
Methodist, Houston, TX, USA
| | - Isha Rana
- Department of Pharmacy, Mount Sinai
Health System, New York, NY, USA
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Rana I, Kataria S, Tan TL, Hajam EY, Kashyap DK, Saha D, Ajnabi J, Paul S, Jayappa S, Ananthan ASHP, Kumar P, Zaarour RF, Haarshaadri J, Kansagara G, Rizvi A, Zirmire RK, Badarinath K, Khedkar SU, Chandra Y, Samuel R, George R, Danda D, Jacob PM, Dey R, Dhandapany PS, He YW, Varga J, Varghese S, Jamora C. Mindin (SPON2) Is Essential for Cutaneous Fibrogenesis in a Mouse Model of Systemic Sclerosis. J Invest Dermatol 2022; 143:699-710.e10. [PMID: 36528128 DOI: 10.1016/j.jid.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 12/16/2022]
Abstract
Systemic sclerosis is a fibrotic disease that initiates in the skin and progresses to internal organs, leading to a poor prognosis. Unraveling the etiology of a chronic, multifactorial disease such as systemic sclerosis has been aided by various animal models that recapitulate certain aspects of the human pathology. We found that the transcription factor SNAI1 is overexpressed in the epidermis of patients with systemic sclerosis, and a transgenic mouse recapitulating this expression pattern is sufficient to induce many clinical features of the human disease. Using this mouse model as a discovery platform, we have uncovered a critical role for the matricellular protein Mindin (SPON2) in fibrogenesis. Mindin is produced by SNAI1 transgenic skin keratinocytes and aids fibrogenesis by inducing early inflammatory cytokine production and collagen secretion in resident dermal fibroblasts. Given the dispensability of Mindin in normal tissue physiology, targeting this protein holds promise as an effective therapy for fibrosis.
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Affiliation(s)
- Isha Rana
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; School of Chemical and Biotechnology, Shanmugha Arts, Science, Technology and Research Academy (SASTRA) Deemed University, Thanjavur, India
| | - Sunny Kataria
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; National Centre for Biological Sciences, Bangalore, India
| | - Tuan Lin Tan
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, San Diego, California, USA; School of Chemical & Life Sciences, Singapore Polytechnic, Singapore, Singapore
| | - Edries Yousaf Hajam
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; School of Chemical and Biotechnology, Shanmugha Arts, Science, Technology and Research Academy (SASTRA) Deemed University, Thanjavur, India
| | - Deepak Kumar Kashyap
- Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India; Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Dyuti Saha
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Johan Ajnabi
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Sayan Paul
- Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Shashank Jayappa
- Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Akhil S H P Ananthan
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Pankaj Kumar
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Rania F Zaarour
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; Thumbay Research Institute for Precision Medicine (TRIPM), Gulf Medical University, Ajman, United Arab Emirates
| | - J Haarshaadri
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Gaurav Kansagara
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; Animal Care and Resource Centre (ACRC), Bangalore Life Science Cluster, Bangalore, India
| | - Abrar Rizvi
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Ravindra K Zirmire
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; School of Chemical and Biotechnology, Shanmugha Arts, Science, Technology and Research Academy (SASTRA) Deemed University, Thanjavur, India
| | - Krithika Badarinath
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India; National Centre for Biological Sciences, Bangalore, India
| | - Sneha Uday Khedkar
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | - Yogesh Chandra
- Animal Care and Resource Centre (ACRC), Bangalore Life Science Cluster, Bangalore, India
| | - Rekha Samuel
- Centre for Stem Cell Research (CSCR), Christian Medical College Vellore, Vellore, India; Department of Pathology, Manipal - Tata Medical College Jamshedpur, Jamshedpur, India
| | - Renu George
- Department of Dermatology, Venereology and Leprosy, Christian Medical College Vellore, Vellore, India
| | - Debashish Danda
- Department of Clinical Immunology & Rheumatology, Christian Medical College Vellore, Vellore, India
| | | | - Rakesh Dey
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India
| | | | - You-Wen He
- Department of Immunology, Duke University School of Medicine, Durham, North Carolina, USA
| | - John Varga
- Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Shyni Varghese
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, San Diego, California, USA; Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA; Department of Mechanical Engineering & Materials Science, Duke University, Durham, North Carolina, USA; Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Colin Jamora
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science & Regenerative Medicine, Bangalore, India.
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Turkes F, Crux R, Tran A, Cartwright E, Rana I, Johnston E, Dunlop A, Thomas J, Smith A, Smyth E, Fribbens C, Rao S, Watkins D, Chau I, Starling N, Cunningham D. 1253P Safety and efficacy of Wnt inhibition with a DKK1 inhibitor, DKN-01, in combination with atezolizumab in patients with advanced oesophagogastric adenocarcinoma: Phase IIa results of the WAKING trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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7
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Buonuomo P, El Hachem M, Mastrogiorgio G, Pisaneschi E, Diociaiuti A, Rana I, Macchiaiolo M, Capolino R, Gonfiantini M, Vecchio D, Novelli A, Bartuli A. A PEDIATRIC CASE OF TEK-RELATED MALFORMATIONS AND MARFANOID HABITUS: AN INCIDENTAL FINDING OR A FEATURE? Lymphology 2022. [DOI: 10.2458/lymph.5145] [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: 11/05/2022]
Abstract
Vascular malformations encompass a wide range of complex vascular lesions. Due to the extreme variability of clinical presentation, classification and their related syndromes presents a challenge. Here we describe a case of a boy presenting with Marfanoid habitus, cutaneous vascular malformations, and severe acute anemia due to ileal venous malformations. Although a panel of genetic markers for the Marfan phenotype was negative, we identified a de novo mutation in the TEK gene in the patient. This case supports expansion of the phenotypic spectrum of TEK-related vascular malformations.
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Affiliation(s)
| | | | | | | | | | - I. Rana
- Bambino Gesù Children's Hospital
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8
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Slater S, Cartwright E, Saffery C, Tran A, Smith G, Bacason M, Zhitkov O, Rana I, Johnston E, Sanna I, Aresu M, Kohoutova D, Terlizzo M, Turkes F, Smyth E, Mansoor W, Fribbens C, Rao S, Watkins D, Starling N, Chau I, Cunningham D. PD-2 EMERGE: A multi-centre, non-randomised, single-arm phase II study investigating domatinostat plus avelumab in patients with previously treated advanced mismatch repair-proficient oesophagogastric and colorectal adenocarcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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9
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Zaarour RF, Saha D, Dey R, Dutta A, Kumar P, Rana I, Pulianmackal A, Rizvi A, Misra N, Breton L, Jamora C. The neuropeptide Substance P facilitates the transition from an inflammatory to proliferation phase associated responses in dermal fibroblasts. Exp Dermatol 2022; 31:1188-1201. [PMID: 35353932 DOI: 10.1111/exd.14573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/14/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
The wound healing process is a product of three successive and overlapping phases of inflammation, proliferation and remodeling. Considerable efforts have been invested in deconstructing the intercellular crosstalk that orchestrates tissue repair and we investigated the role of neuropeptides released from peripheral neurons upon injury in mediating these interactions. Amongst the most abundant of these neuropeptides secreted by nerves in the skin, is Substance P (SP). Given the role of dermal fibroblasts in coordinating multiple processes in the wound healing program, the effect of SP on human dermal fibroblasts of different ages was evaluated. The use of a substrate that recapitulates the mechanical properties of the in vivo tissue revealed novel effects of SP on dermal fibroblasts, including a block in inflammatory cytokine expression. Moreover, SP can promote expression of some extracellular matrix components and generates signals that regulate angiogenesis. Interestingly, the response of fibroblasts to SP was reduced concomitant with donor age. Altogether, SP acts to inhibit the inflammatory responses and promote proliferation associated responses in an age-dependent manner in dermal fibroblasts, suggesting a role as a molecular switch between the inflammatory and proliferative phases of the wound healing response.
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Affiliation(s)
- Rania F Zaarour
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India.,Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, UAE
| | - Dyuti Saha
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India.,Department of Biology, Manipal Academy of Higher Education, Manipal, India
| | - Rakesh Dey
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Anupam Dutta
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Pankaj Kumar
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Isha Rana
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India.,Shanmugha Arts, Science, Technology and Research Academy, SASTRA) University, Thanjavur, India
| | - Ajai Pulianmackal
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Abrar Rizvi
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
| | - Namita Misra
- L'Oréal, Research and Innovation, Aulnay, France
| | | | - Colin Jamora
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine, Bangalore, India
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10
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Rana I, Buonuomo P, Mastrogiorgio G, Del Fattore A, Jenkner A, Barbuti D, De Vito R, Pizzoferro M, Callea M, Crostelli M, Mazza O, Rotunno R, Bartuli A. EXPANDING THE SPECTRUM OF GORHAM STOUT DISEASE EXPLORING A SINGLE CENTER PEDIATRIC CASE SERIES. Lymphology 2022. [DOI: 10.2458/lymph.4839] [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: 11/05/2022]
Abstract
Gorham-Stout Disease (GSD), also named vanishing bone disease, is an ultrarare condition characterized by progressive osteolysis with intraosseous lymphatic vessel proliferation and bone cortical loss. So far, about 300 cases have been reported. It may occur at any age but more commonly affects children and young adults. The aim of this study is to retrospectively review our internal patient series and to hypothesize a diagnostic-therapeutic protocol for earlier diagnosis and treatment. Clinical datasets from our center were examined to identify all GSD patients for collection and analysis. We identified 9 pediatric cases and performed a retrospective case-series review to examine and document both diagnosis and treatment. We found that delay in diagnosis after first symptoms played a critical role in determining morbidity and that multidisciplinary care is key for proper diagnosis and treatment. Our study provides additional insight to improve the critical challenge of early diagnosis and highlights a multidisciplinary treatment approach for the most appropriate management of patients with rare GSD disease. Although GSD is an ultrarare disease, physicians should keep in mind the main clinical features since neglected cases may result in potentially fatal complications.
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Affiliation(s)
- I. Rana
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | | | | | - A. Jenkner
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - D. Barbuti
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - R. De Vito
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | - M. Callea
- Bambino Gesù Children's Hospital IRCCS, Rome
| | | | - O. Mazza
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - R. Rotunno
- Bambino Gesù Children's Hospital IRCCS, Rome
| | - A. Bartuli
- Bambino Gesù Children's Hospital IRCCS, Rome
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11
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Buonuomo PS, El Hachem M, Mastrogiorgio G, Pisaneschi E, Diociaiuti A, Rana I, Macchiaiolo M, Capolino R, Gonfiantini MV, Vecchio D, Novelli A, Bartuli A. A pediatric case of TEK-Related malformations and marfanoid habitus: an incidental finding or a feature? Lymphology 2022; 55:36-39. [PMID: 35896114] [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: 06/15/2023]
Abstract
Vascular malformations encompass a wide range of complex vascular lesions. Due to the extreme variability of clinical presentation, classification and their related syndromes presents a challenge. Here we describe a case of a boy presenting with Marfanoid habitus, cutaneous vascular malformations, and severe acute anemia due to ileal venous malformations. Although a panel of genetic markers for the Marfan phenotype was negative, we identified a de novo mutation in the TEK gene in the patient. This case supports expansion of the phenotypic spectrum of TEK-related vascular malformations.
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Affiliation(s)
- P S Buonuomo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M El Hachem
- Pediatric Dermatology, Bambino Gesù Children's Hospital Rome, Italy
| | - G Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - E Pisaneschi
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Diociaiuti
- Pediatric Dermatology, Bambino Gesù Children's Hospital Rome, Italy
| | - I Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M Macchiaiolo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - R Capolino
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - M V Gonfiantini
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - D Vecchio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Novelli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
| | - A Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital Rome, Italy
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12
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Rana I, Badarinath K, Zirmire RK, Jamora C. Isolation and Quantification of Mouse γδT-cells in vitro and in vivo. Bio Protoc 2021; 11:e4148. [PMID: 34604453 DOI: 10.21769/bioprotoc.4148] [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: 02/22/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 11/02/2022] Open
Abstract
The skin plays an important role in protecting the body from pathogens and chemicals in the external environment. Upon injury, a healing program is rapidly initiated and involves extensive intercellular communication to restore tissue homeostasis. The deregulation of this crosstalk can lead to abnormal healing processes and is the foundation of many skin diseases. A relatively overlooked cell type that nevertheless plays critical roles in skin homeostasis, wound repair, and disease is the dendritic epidermal T cells (DETCs), which are also called γδT-cells. Given their varied roles in both physiological and pathological scenarios, interest in the regulation and function of DETCs has substantially increased. Moreover, their ability to regulate other immune cells has garnered substantial attention for their potential role as immunomodulators and in immunotherapies. In this article, we describe a protocol to isolate and culture DETCs and analyse them in vivo within the skin. These approaches will facilitate the investigation of their crosstalk with other cutaneous cells and the mechanisms by which they influence the status of the skin. Graphic abstract: Overall workflow to analyse DETCs in vitro and in vivo.
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Affiliation(s)
- Isha Rana
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka, India.,Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur, Tamil Nadu, India
| | - Krithika Badarinath
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka, India.,National Centre for Biological Sciences (NCBS), Bangalore, Karnataka, India
| | - Ravindra K Zirmire
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka, India.,Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur, Tamil Nadu, India
| | - Colin Jamora
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Science and Regenerative Medicine (inStem), Bangalore, Karnataka, India
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13
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Rana I, von Oehsen W, Nabulsi NA, Sharp LK, Donnelly AJ, Shah SD, Stubbings J, Durley SF. A comparison of medication access services at 340B and non-340B hospitals. Res Social Adm Pharm 2021; 17:1887-1892. [PMID: 33846100 DOI: 10.1016/j.sapharm.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND For patients that face barriers to filling their prescriptions, the availability of medication access services at their site of care can mean the difference between receiving prescribed drug therapy, and undue interruptions in care. Hospitals often provide medication access services that are not reimbursed by payers; however, they can be challenging to sustain. The 340B Drug Pricing Program allows covered entities to generate savings through discounted pricing for certain outpatient medications, which can then be used to provide more comprehensive services, including medication access services. OBJECTIVE To characterize medication access services provided at hospitals that participate in the 340B Drug Pricing Program compared to hospitals that do not participate in the 340B Program. METHODS Primary questionnaire response data was collected from a national sample of Directors of Pharmacy at non-federal acute care hospitals from March 2019 to May 2019. American Hospital Association Data Viewer was used to collect demographic information on 1,531 hospitals. Hospitals were excluded if they had 199 beds or fewer, did not have a unique Medicare provider ID, were federally owned, were located outside the continental U.S., or were non-acute care hospitals that served niche patient populations. This study utilized a proportional stratified sampling strategy to administer an electronic questionnaire to 340B and non-340B hospitals to assess the number and type of medication access service offerings. A final randomized sample of 500 hospitals were administered the questionnaire, and data was collected through recorded responses in Qualtrics software. RESULTS 340B hospitals provided a significantly higher average number of medication access services compared to non-340B hospitals (6.20 vs. 3.91, p = 0.0001), adjusted for differences in hospital size and ownership type. For all nine medication access services that were assessed, a higher percentage of 340B hospitals reported providing the service compared to non-340B hospitals. This difference was statistically significant for six out of nine programs assessed. CONCLUSIONS 340B hospitals provided more medication access services, on average, than comparably sized non-340B hospitals, suggesting that hospitals participating in the 340B Drug Pricing Program may be better positioned to create and administer programs that support medication access services.
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Affiliation(s)
- Isha Rana
- Department of Pharmacy, Houston Methodist, 7550 Greenbriar Dr., Houston, TX, 77030, USA.
| | - William von Oehsen
- Powers Pyles Sutter & Verville PC, 1501 M Street NW, Seventh Floor, Washington, D.C, 20005, USA.
| | - Nadia A Nabulsi
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA.
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA.
| | - Andrew J Donnelly
- Department of Pharmacy Practice, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA; Department of Pharmacy, UI Health, 1740 W. Taylor St., Chicago IL, 60612, USA.
| | - Sima Dinesh Shah
- Howard Brown Health, 1025 W. Sunnyside Ave., Chicago, IL, 66040, USA.
| | - JoAnn Stubbings
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA; Department of Pharmacy Practice, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA.
| | - Sandra F Durley
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA; Department of Pharmacy Practice, University of Illinois Chicago, College of Pharmacy, 833 S. Wood St., Chicago, IL, 60612, USA; Department of Pharmacy, UI Health, 1740 W. Taylor St., Chicago IL, 60612, USA.
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14
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Rana I, Buonuomo PS, Mastrogiorgio G, Del Fattore A, Jenkner A, Barbuti D, De Vito R, Pizzoferro M, Callea M, Crostelli M, Mazza O, Rotunno R, Bartuli A. Expanding the spectrum of Gorham Stout disease exploring a single center pediatric case series. Lymphology 2021; 54:182-194. [PMID: 35073622] [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: 06/14/2023]
Abstract
Gorham-Stout Disease (GSD), also named vanishing bone disease, is an ultrarare condition characterized by progressive osteolysis with intraosseous lymphatic vessel proliferation and bone cortical loss. So far, about 300 cases have been reported. It may occur at any age but more commonly affects children and young adults. The aim of this study is to retrospectively review our internal patient series and to hypothesize a diagnostic-therapeutic protocol for earlier diagnosis and treatment. Clinical datasets from our center were examined to identify all GSD patients for collection and analysis. We identified 9 pediatric cases and performed a retrospective case-series review to examine and document both diagnosis and treatment. We found that delay in diagnosis after first symptoms played a critical role in determining morbidity and that multidisciplinary care is key for proper diagnosis and treatment. Our study provides additional insight to improve the critical challenge of early diagnosis and highlights a multidisciplinary treatment approach for the most appropriate management of patients with rare GSD disease. Although GSD is an ultrarare disease, physicians should keep in mind the main clinical features since neglected cases may result in potentially fatal complications.
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Affiliation(s)
- I Rana
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P S Buonuomo
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Mastrogiorgio
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Del Fattore
- Bone Physiopathology Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Jenkner
- Division of Immunology and Infectious Diseases, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Barbuti
- Pediatric Radiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R De Vito
- Laboratory of Histopatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Pizzoferro
- Nuclear Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Callea
- Unit of Dentistry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Crostelli
- Vertebral Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - O Mazza
- Pediatric Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - R Rotunno
- Pediatric Dermatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Bartuli
- Rare Diseases and Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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15
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Khakoo S, Carter P, Valeri N, Shaikh R, Jones T, Begum R, Rana I, Picchia S, Bali M, Brown G, Wotherspoon A, Terlizzo M, von Loga K, Ahmed I, Watkins D, Chau I, Starling N, Tait D, Hubank M, Cunningham D. Circulating tumour DNA (ctDNA) as a tool to assess response and guide therapy adaptation in rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Gund R, Lee P, Dutta A, Pincha N, Rana I, Ghosh S, Witherden D, Kandyba E, MacLeod A, Kobielak K, Havran W, Jamora C. 1349 Stimulation of hair follicle stem cell proliferation through an IL-1α dependent activation of γδT-cells. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Lee P, Gund R, Dutta A, Pincha N, Rana I, Ghosh S, Witherden D, Kandyba E, MacLeod A, Kobielak K, Havran WL, Jamora C. Stimulation of hair follicle stem cell proliferation through an IL-1 dependent activation of γδT-cells. eLife 2017; 6. [PMID: 29199946 PMCID: PMC5714500 DOI: 10.7554/elife.28875] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 05/22/2017] [Accepted: 11/09/2017] [Indexed: 02/01/2023] Open
Abstract
The cutaneous wound-healing program is a product of a complex interplay among diverse cell types within the skin. One fundamental process that is mediated by these reciprocal interactions is the mobilization of local stem cell pools to promote tissue regeneration and repair. Using the ablation of epidermal caspase-8 as a model of wound healing in Mus musculus, we analyzed the signaling components responsible for epithelial stem cell proliferation. We found that IL-1α and IL-7 secreted from keratinocytes work in tandem to expand the activated population of resident epidermal γδT-cells. A downstream effect of activated γδT-cells is the preferential proliferation of hair follicle stem cells. By contrast, IL-1α-dependent stimulation of dermal fibroblasts optimally stimulates epidermal stem cell proliferation. These findings provide new mechanistic insights into the regulation and function of epidermal cell–immune cell interactions and into how components that are classically associated with inflammation can differentially influence distinct stem cell niches within a tissue. The skin is a physical barrier that protects the body from the outside world. If the skin is injured, the body mounts a “wound healing” response to rapidly mend and restore this protective barrier. Wound healing is a complex process and relies on the different types of cells in the skin communicating with each other. Stem cells provide tissues, like the skin, with new cells. Normally, stem cells are in a resting or inactive state. Yet, during wound healing, stem cells near the injured area are awakened and start producing more cells to repair the wound. Understanding how stem cells become activated in a wound has proved challenging because only a small number of cells near a damaged site will respond, and it is difficult to distinguish their response from that of other cells slightly further away. Now, Lee et al. overcome this hurdle by analyzing a genetically engineered mouse in which the entire skin displays a wound healing response, even without any injury or trauma. In these mice, most of the stem cells in the skin are awakened from their normal resting state and behave as if there is a wound to heal. It turns out that a protein called interleukin-1, which is released from damaged skin cells known as keratinocytes, can activate two different groups of stem cells in the skin to help repair the injured tissue. One group lives in the hair follicle and is normally responsible for replacing the hair that falls from the body. Lee et al. found that when the skin is wounded interleukin-1 activates certain immune cells (called γδT-cells). These immune cells then awaken the resting stem cells in the hair follicle to multiply and travel to the wound site to repair the injury. The other group of stem cells resides in the outermost layer of the skin. Interleukin-1 can also activate so-called fibroblast cells, which then stimulate this second group of stem cells to divide and cover the open wound. Quickly healing wounds has many health benefits such as preventing infection and shortening the time to recover from an injury. These new findings may help to repair injured skin in diseases such as diabetes, where wounds can take months to heal and often leads to permanent tissue damage. The next challenge is to identify the cues that instruct the stem cells to travel to the wound site and turn into the specific cells that are required to replace the damaged cells.
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Affiliation(s)
- Pedro Lee
- Section of Cell and Developmental Biology, University of California, San Diego, La Jolla, United States
| | - Rupali Gund
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India
| | - Abhik Dutta
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India
| | - Neha Pincha
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India.,Graduate Studies, Manipal University, Manipal, India
| | - Isha Rana
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India.,Shanmugha Arts, Science, Technology and Research Academy (SASTRA) University, Thanjavur, India
| | - Subhasri Ghosh
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India
| | - Deborah Witherden
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, United States
| | - Eve Kandyba
- Eli and Edythe Broad Center for Regenerative Medicine & Stem Cell Research, Department of Pathology, University of Southern California, Los Angeles, United States
| | - Amanda MacLeod
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, United States
| | - Krzysztof Kobielak
- Eli and Edythe Broad Center for Regenerative Medicine & Stem Cell Research, Department of Pathology, University of Southern California, Los Angeles, United States
| | - Wendy L Havran
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, United States
| | - Colin Jamora
- IFOM-inStem Joint Research Laboratory, Centre for Inflammation and Tissue Homeostasis, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore, India
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18
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Davidson M, Bryant H, Aronson L, Howard-Reeves J, Cunningham D, Starling N, Watkins D, Rao S, Cutts R, Llorca-Cardenosa M, Begum R, Rana I, Wotherspoon A, Swansbury J, Chau I, Chong I. Clonal diversity of MYC amplification evaluated by FISH and digital droplet polymerase chain reaction (ddPCR) in oesophagogastric (OG) cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Rana I, Lukram A. Seminoma of solitary testis: A case report. Indian J Cancer 2017; 53:376. [PMID: 28244462 DOI: 10.4103/0019-509x.200667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- I Rana
- Shija Hospitals and Research Institute, Imphal, Manipur, India
| | - A Lukram
- Shija Hospitals and Research Institute, Imphal, Manipur, India
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20
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Abstract
Maintaining potassium balance in the body is essential for cellular function. Even a slight increase in normal serum potassium levels (3.5-5.0 mEq/L) can interfere with metabolism, electrical action potentials, and cellular processes. Hyperkalemia is commonly seen in patients with chronic kidney disease (CKD) and in patients on renin-angiotensin-aldosterone system (RAAS) inhibitors. Sodium polystyrene sulfonate (SPS), diuretics, and hemodialysis are currently available methods for removing potassium from the body; however, these options have their limitations. Patiromer (Veltassa) and sodium zirconium cyclosilicate are 2 new therapeutic options that can potentially lead a new frontier in the management of hyperkalemia. This article will review these novel treatments.
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Affiliation(s)
- Antony Q Pham
- 1 Arnold and Marie Schwartz College of Pharmacy and Health Sciences, LIU Pharmacy, Brooklyn, NY, USA.,2 Department of Veterans Affairs-Manhattan Campus, New York Harbor Healthcare System, New York, NY, USA
| | - Jessica Sexton
- 1 Arnold and Marie Schwartz College of Pharmacy and Health Sciences, LIU Pharmacy, Brooklyn, NY, USA
| | - Dexter Wimer
- 1 Arnold and Marie Schwartz College of Pharmacy and Health Sciences, LIU Pharmacy, Brooklyn, NY, USA
| | - Isha Rana
- 1 Arnold and Marie Schwartz College of Pharmacy and Health Sciences, LIU Pharmacy, Brooklyn, NY, USA
| | - Timothy Nguyen
- 1 Arnold and Marie Schwartz College of Pharmacy and Health Sciences, LIU Pharmacy, Brooklyn, NY, USA
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21
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Lee DJ, Du F, Chen SW, Nakasaki M, Rana I, Shih VFS, Hoffmann A, Jamora C. Regulation and Function of the Caspase-1 in an Inflammatory Microenvironment. J Invest Dermatol 2015; 135:2012-2020. [PMID: 25815426 PMCID: PMC4504759 DOI: 10.1038/jid.2015.119] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 03/06/2014] [Revised: 03/14/2015] [Accepted: 03/18/2015] [Indexed: 01/18/2023]
Abstract
The inflammasome is a complex of proteins that has a critical role in mounting an inflammatory response in reply to a harmful stimulus that compromises the homeostatic state of the tissue. The NLRP3 inflammasome, which is found in a wound-like environment, is comprised of three components: the NLRP3, the adaptor protein ASC and caspase-1. Interestingly, although ASC levels do not fluctuate, caspase-1 levels are elevated in both physiological and pathological conditions. Despite the observation that merely raising caspase-1 levels is sufficient to induce inflammation, the crucial question regarding the mechanism governing its expression is unexplored. We found that, in an inflammatory microenvironment, caspase-1 is regulated by NF-κB. Consistent with this association, the inhibition of caspase-1 activity parallels the effects on wound healing caused by the abrogation of NF-κB activation. Surprisingly, not only does inhibition of the NF-κB/caspase-1 axis disrupt the inflammatory phase of the wound-healing program, but it also impairs the stimulation of cutaneous epithelial stem cells of the proliferative phase. These data provide a mechanistic basis for the complex interplay between different phases of the wound-healing response in which the downstream signaling activity of immune cells can kindle the amplification of local stem cells to advance tissue repair.
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Affiliation(s)
- Dai-Jen Lee
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California, USA
| | - Fei Du
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California, USA
| | - Shih-Wei Chen
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California, USA
| | - Manando Nakasaki
- IFOM-inSTEM Joint Research Laboratory, Institute for Stem Cell Biology and Regenerative Medicine, Centre for Inflammation and Tissue Homeostasis, Bangalore, India
| | - Isha Rana
- IFOM-inSTEM Joint Research Laboratory, Institute for Stem Cell Biology and Regenerative Medicine, Centre for Inflammation and Tissue Homeostasis, Bangalore, India
| | - Vincent F S Shih
- Department of Chemistry and Biochemistry, Signaling Systems Laboratory, University of California, San Diego, La Jolla, California, USA
| | - Alexander Hoffmann
- Department of Chemistry and Biochemistry, Signaling Systems Laboratory, University of California, San Diego, La Jolla, California, USA
| | - Colin Jamora
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California, USA; IFOM-inSTEM Joint Research Laboratory, Institute for Stem Cell Biology and Regenerative Medicine, Centre for Inflammation and Tissue Homeostasis, Bangalore, India; Department of Bioengineering, Jacobs School of Engineering, University of California, San Diego, La Jolla, California, USA.
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22
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Rana I, Badoer E, Alahmadi E, Leo CH, Woodman OL, Stebbing MJ. Microglia are selectively activated in endocrine and cardiovascular control centres in streptozotocin-induced diabetic rats. J Neuroendocrinol 2014; 26:413-25. [PMID: 24762326 DOI: 10.1111/jne.12161] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 12/06/2013] [Revised: 03/20/2014] [Accepted: 04/16/2014] [Indexed: 12/30/2022]
Abstract
Type 1 and 2 diabetes are associated with dysfunction in multiple hormone systems, as well as increased sympathetic nerve activity, which may contribute to the development of diabetic complications. In other pathologies, such as myocardial infarction, increased sympathetic drive is associated with neuroinflammation and microglial activation in the hypothalamic paraventricular nucleus (PVN), a brain region that regulates sympathetic drive and multiple endocrine responses. In the present study, we used immunohistochemistry to study microglial and neuronal activation in the PVN and related brain regions in streptozotocin (STZ)-induced diabetic rats. As expected, STZ treatment was associated with elevated blood glucose within 1 week. STZ injections also caused neuronal activation in the PVN and superoptic nucleus (SON) but not in the nucleus tractus solitarius (NTS), which was evident by 6 weeks. STZ-treated rats showed increased plasma osmolarity, which would be expected to activate PVN and SON neurones. There was no apparent increase in histochemical markers of microglial activation, including phospho-p38, phospho-extracellular signal regulated kinase, P2X4 receptor or interleukin 1-β even at 10 weeks after STZ-treatment. However, we did see a significant increase in the percentage of microglia with an activated morphology in the PVN, SON and NTS, although not in surrounding hypothalamic, brainstem or cortical regions. These morphological changes included a significant reduction in microglial process length and were evident by 8 weeks but not 6 weeks. The delayed onset of microglial changes compared to neuronal activation in the PVN and SON suggests the over-excitation of neurones as a mechanism of microglial activation. This delayed microglial activation may, in turn, contribute to the endocrine dysregulation and the elevated sympathetic nerve activity reported in STZ-treated rats.
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Affiliation(s)
- I Rana
- School of Medical Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Australia
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Zinno F, Landi F, Aureli V, Cometa AM, Scerpa MC, Caniglia M, Pinto RM, Rana I, Balduino G, Miele MJ, Isacchi G. Immunomagnetic selection of CD34+ cells carried out in cryopreserved cell concentrates from a paediatric patient affected with non-Hodgkin lymphoma. Transfus Med 2010; 20:283-6. [DOI: 10.1111/j.1365-3148.2010.00991.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Finocchi A, Palma P, Di Matteo G, Chiriaco M, Lancella L, Simonetti A, Rana I, Livadiotti S, Rossi P. Visceral Leishmaniasis Revealing Chronic Granulomatous Disease in a Child. Int J Immunopathol Pharmacol 2008; 21:739-43. [DOI: 10.1177/039463200802100330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report the first description of visceral leishmaniasis (VL) infection as a harbinger of chronic granulomatous disease (CGD) in a 3-year old child. Although VL is not frequently suspected in CGD patients, our case emphasises the importance of a complete evaluation of the immune system in children presenting with VL in order to exclude underlying immunodeficiency states. As the prognosis of CGD is poor, with high morbidity and mortality, establishing an early diagnosis has important practical implications in the successful treatment of these patients. Following the diagnosis, the patient received Human Leukocyte Antigen (HLA) identical sibling bone marrow transplantation (BMT). The child is now 2 years post-transplant and is in good general conditions with normal blood counts, and evidence of full-donor chimerism in repeated fluorescence in situ hybridization (FISH) studies.
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Affiliation(s)
- A. Finocchi
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
| | - P. Palma
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
| | - G. Di Matteo
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
| | - M. Chiriaco
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
| | - L. Lancella
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
| | - A. Simonetti
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
| | - I. Rana
- Division of Haematology Children's Hospital Bambino Gesù, Rome, Italy
| | - S. Livadiotti
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
| | - P. Rossi
- Division of Paediatrics, Dept. of Public Health, University of Tor Vergata, Rome
- Division of Immunology and Infectious Diseases Children's Hospital Bambino Gesù, Rome
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Nuara M, Vigano E, Longoni D, Rovelli A, Rana I, Uderzo C. Possible role of high-dose busulfan in second reciprocal transplant between brother and sister for resistant acute leukemia. Bone Marrow Transplant 2005; 35:731-2. [PMID: 15723082 DOI: 10.1038/sj.bmt.1704875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Yudd M, Kasimis B, Chang V, Srinivas S, Hwang S, Sodagum L, Rana I, Anani A, Boholli I, Miller M. Renal effects of high-dose celecoxib (CX) and docetaxel (D) During a phase II trial for hormone resistant prostate cancer (HRPC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4752] [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: 11/20/2022] Open
Affiliation(s)
- M. Yudd
- VA NJ Health Care System, East Orange, NJ
| | - B. Kasimis
- VA NJ Health Care System, East Orange, NJ
| | - V. Chang
- VA NJ Health Care System, East Orange, NJ
| | | | - S. Hwang
- VA NJ Health Care System, East Orange, NJ
| | - L. Sodagum
- VA NJ Health Care System, East Orange, NJ
| | - I. Rana
- VA NJ Health Care System, East Orange, NJ
| | - A. Anani
- VA NJ Health Care System, East Orange, NJ
| | - I. Boholli
- VA NJ Health Care System, East Orange, NJ
| | - M. Miller
- VA NJ Health Care System, East Orange, NJ
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Abstract
The aspiration of a foreign body in an airway is usually associated with respiratory distress, wheeze and persistent cough. The highest incidence of foreign body inhalation occurs between the age of 1 and 3 years [Ann. Otol. Rhinol. Laryngol. 89 (1980) 434: Med. J. Aust. 2 (1983) 322]. Asymptomatic and long standing foreign bodies may lead to complications such as recurrent pneumonia, bronchiectasis, atelectasis and even death. We present here a case of a metallic bronchial foreign body, which was discovered only as an accidental radiological finding on a chest X-ray, which was done for a mild lower respiratory tract infection, presumably 4 months after such an aspiration.
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Affiliation(s)
- J K Sahni
- Department of ENT, Lady Hardinge Medical College, 110 001, New Delhi, India
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Abstract
A child with AML underwent allogeneic BMT from an HLA-identical sister donor. Prompt and stable triline-age engraftment occurred and after few months he returned to a normal life. Eight years later a primary NHL of bone developed in his sister. A partial remission was obtained by means of standard NHL treatment, but 3 months later rapid disease progression occurred with complete bone marrow invasion (ALL-L3). She was treated with a leukemia relapse protocol, obtaining a second partial remission. Unpurged bone marrow harvested from the brother, transplanted for AML 8 years earlier, was infused after conditioning with TBI and thiothepa. No GVHD prophylaxis was given. Neutrophil engraftment occurred by 14 days and platelet engraftment by 20 days after BMT. No acute GVHD was observed, but unexpectedly she developed skin and liver GVHD-like symptoms 80 days after BMT. Since the liver biopsy was suggestive of liver GVHD and in the absence of any other evidence as a possible cause of the hepatic damage, the patient started mycophenolate. Two months later serum hepatitis B markers were detectable.
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Affiliation(s)
- I Rana
- Division of Haematology, Bambino Gesù Paediatric Hospital, Rome, Italy
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Mengarelli A, Zarcone D, Caruso R, Tenca C, Rana I, Pinto RM, Grossi CE, De Rossi G. Adhesion molecule expression, clinical features and therapy outcome in childhood acute lymphoblastic leukemia. Leuk Lymphoma 2001; 40:625-30. [PMID: 11426534 DOI: 10.3109/10428190109097660] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In view of the relevance of adhesion molecule expression for the mechanisms of homing, trafficking and spreading of malignant cells, we have investigated the expression of surface adhesion molecules in lymphoblasts from 57 acute lymphoblastic leukemia (ALL) cases and tried to correlate the adhesive phenotype with immunological typing, prognostic factors at diagnosis and clinical follow-up. Blasts from all cases expressed adhesion molecules at high rates. Beta1 integrin chain (CD18) was consistently found on blasts from most ALL cases: among integrins of the beta2 family. LFA-1 was detected in 58% of cases, in the virtual absence of other alpha chains. CD54 and CD58 were expressed in variable proportions by ALL blasts and CD44 was detected in the majority of the malignant cells, whereas the CD62L selectin was only present in 24% of cases. B-lineage ALL's displayed similar adhesion molecule phenotypes irrespective of maturational stages of the leukemic cells. We found a significantly reduced expression of beta2 alphaL integrins in the hybrid ALL cases (CD13 and/or CD33 positive). However, these cases did not show differences in clinical presentation and behaviour in comparison with patients of other groups. We did not find a significant correlation between adhesion molecule expression and well established risk factors (age, white blood cell count, central nervous system involvement, chromosomal abnormalities), with the exception of splenomegaly, that was significantly associated with CD18 expression. In the follow-up, no evidence of significant correlation between adhesive phenotype and adverse events such as leukemic relapse and death was found. In conclusion, although expression of adhesion molecules on lymphoblasts confirms the phenotypic heterogeneity of ALL, it appears that this is not relevant for the clinical aspects of the disease and for prognosis.
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Affiliation(s)
- A Mengarelli
- Divisione di Ematologia, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovera e Cura a Carattere Scientifico, Città del Vaticano, Italy
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Baronci C, Petrone A, Miano C, Lombardi A, Caniglia M, Russo LA, Luciani M, Pinto RM, Rana I, Caruso R, De Rossi G. Treatment of acute idiopathic thrombocytopenic purpura in children. A retrospective evaluation of 120 cases. Ann Ist Super Sanita 1999; 34:457-61. [PMID: 10234876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Acute idiopathic thrombocytopenic purpura (AITP) in children is generally a benign disease with a high frequency of spontaneous remission. Nevertheless the debate over treating or not is still open, because of the high risk of hemorrhage as long as the platelet count remains below 20 x 10(9)/l. We have retrospectively evaluated 120 pediatric cases from our center, receiving different treatments at diagnosis: no treatment (76); IVIG: 400 mg/kg/d for 5 days (28); continuous oral PDN: 1-1.5 mg/kg/d for at least two weeks (16). No patients had been previously treated for AITP. Follow-up is up to fifty months. We found no significant differences as to the percentage of responses among the three groups. We conclude that waiting without treatment is safe and appropriate in most cases; whether the hemorrhagic risk suggests treatment, standard dose continuous oral PDN and IVIG may be equally effective, but IVIG may achieve a significantly faster rise in the platelet count. The timing of treatment and the cost/benefit ratio are discussed.
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Affiliation(s)
- C Baronci
- Divisione di Ematologia, Ospedale Pediatrico Bambino Gesà, Rome, Italy
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Bonamico M, Ballati G, Mariani P, Latini M, Triglione P, Rana I, Porro E, Mesturino MA, Criscione S. Screening for coeliac disease: the meaning of low titers of anti-gliadin antibodies (AGA) in non-coeliac children. Eur J Epidemiol 1997; 13:55-9. [PMID: 9062780 DOI: 10.1023/a:1007301424656] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Coeliac disease is diagnosed by means of jejunal biopsy, an invasive procedure. Anti-gliadin antibodies (AGA) have therefore been used in the first screening of the disease. On the other hand, low titers of AGA are widely detected also in normal subjects. In order to investigate if low levels of AGA could be correlated with laboratory and clinical data, we performed a study on 167 subjects with various illnesses, such as recurrent abdominal pain, failure to thrive, short stature, diarrhoea or constipation, cow-milk protein intolerance and/or food allergy, recurrent vomiting or previous gastroenteritis, all non coeliac conditions which have been associated with AGA presence. Seventy coeliac children, all biopsied, were selected as a control group. Among the 167 cases we found 60 subjects positive for AGA (35.9%), a high proportion as compared with the general population. Only 33/167 patients, all IgG and IgA AGA positive, fulfil our laboratory and clinical criteria to perform a 'confirming' biopsy. For the 134 residual cases (14 IgA, 13 only IgG AGA positive, 107 AGA negative) a diagnosis of coeliac disease has been excluded by clinical criteria (scoring). As a whole, the patients with coeliac disease had significantly higher levels of AGA of both IgG and IgA classes (p < 0.01). On the other hand, no significant difference emerged for all the anamnestic and laboratory parameters considered between AGA+ and AGA- non-coeliac subjects. However, laboratory parameters of IgG-AGA and/or IgA-AGA positive patients were similar to those of coeliac children for ion, Xylose, total IgA count. As no biopsied case showed mucosal atrophy, it is suggested that the presence of even low AGA levels in non-coeliac children may represent a highly sensitive index of intestinal alteration causing an increased permeability to macromolecules, but it is very unlikely that one could detect coeliac children by means of Ig-AGA among such illnesses and normal subjects. Strong clinical diagnosis and laboratory parameters are required to justify intestinal biopsies. In fact, the production of AGA seems to be a merely immunological phenomenon linked to an increased and probably transient permeability to macromolecules of the intestinal mucosa.
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Affiliation(s)
- M Bonamico
- First Pediatric Clinic, University La Sapienza, Rome, Italy
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Porro E, Calamita P, Nardelli M, Rana I, Montini L, Criscione S. [Epidemiologic correlation between microhematuria in children and hypertension in their parents]. Pediatr Med Chir 1993; 15:33-6. [PMID: 8488123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The significance of asymptomatic microhematuria in children is unknown. In 1976 Dodge et al. found a "surprising" high prevalence of proteinuria and haematuria in 12,000 healthy schoolchildren and, in the absence of knowledge of the natural history, this finding prompted them to postpone urinary mass screening. Nonetheless, the progressive course of most chronic renal disease in adulthood argues for investigation of microhematuria in children to uncover any sub-groups "at risk" of kidney diseases. The sensitivity of screening for microhematuria could be increased by a questionnaire on family medical history? We have investigated 1554 boys and 1484 girls aged 3-12 years, from the school population of a rural district near Rome. A self-administered questionnaire on renal disease and related symptoms in families was distributed to the parents. Urinalyses were done on all the children except for those with diseases or symptoms related to the urinary apparatus and girls who were menstruating. Haematuria was tested for by dipstick ("Combur 7"; Boehringer), children with microhematuria were retested 10 day and 1 year later. On the initial 3038 dipstick tests 175 (5.76%) were positive, and 52 children (1.71%) had haematuria in all three specimens. The questionnaires were used only if they had been filled in properly (1821/3038). Of the 1821 valid questionnaires 121 (6.64%) revealed a family history of hypertension, but the frequency of such a family history was significantly higher for the 128 children with haematuria (14.8%, p < 0.005) and the 52 with persistent haematuria (23.0%; p < 0.001).
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Affiliation(s)
- E Porro
- Dipartimento di Pediatria, Università dell'Aquila, Roma, Italia
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Porro E, Calamita P, Rana I, Montini L, Criscione S. Atopy and environmental factors in upper respiratory infections: an epidemiological survey on 2304 school children. Int J Pediatr Otorhinolaryngol 1992; 24:111-20. [PMID: 1428590 DOI: 10.1016/0165-5876(92)90137-e] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Upper respiratory infections (URI) during the first years of life are mostly viral in origin. However, a number of observations suggest the influence of both predisposing and triggering factors. Atopy in particular seems to play an important role as do environmental factors. Many children with early symptoms such as blocked or runny nose are likely to become skin-positive later in life to antigens such as, e.g., D. pteronissinus. A standardized questionnaire was administered to 2304 schoolchildren in order to ascertain the URI frequency and to correlate it with family and environmental factors and with results of prick tests for main allergens in our climate (D. pteronissinus and Grasses). Results showed a wide overlapping of URI and lower respiratory illnesses (in particular, asthma), which are widely distributed in the families of patients. Passive smoking and the quality of housing are the main triggering environmental factors. In our sample, skin positivity for D. pteronissinus and Grasses largely exceeds the symptomatic portion of the whole population. It is therefore suggested that many asymptomatic children are "at risk" for allergic respiratory illness. The highest incidence of winter rhinitis in skin-negative subjects (71.7%) and the skin positivity for D. pteronissinus in patients with perennial symptoms, suggest the importance of both atopy and viral infections in the occurrence of URI. Nasal troubles are most frequent in asthmatic subjects and may be considered the actual additional symptom in asthma.
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Affiliation(s)
- E Porro
- Department of Experimental Medicine, University of L'Aquila, Collemaggio, Italy
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