1
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Molina-Zayas M, Garrido-Navas C, García-Puche JL, Barwell J, Pedrinaci S, Atienza MM, García-Linares S, de Haro-Muñoz T, Lorente JA, Serrano MJ, Poyatos-Andújar A. Identification of hereditary breast and ovarian cancer germline variants in Granada (Spain): NGS perspective. Mol Genet Genomics 2022; 297:859-871. [PMID: 35451682 PMCID: PMC9130174 DOI: 10.1007/s00438-022-01891-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/23/2022] [Indexed: 12/09/2022]
Abstract
The aim of this study was to assess the prevalence of germline variants in cancer-predisposing genes by either targeted (BRCA1/2) or multigene NGS panel in a high-risk Hereditary Breast and Ovarian Cancer (HBOC) cohort. Samples from 824 Caucasian probands were retrospectively collected and the impact of genetic diagnosis and genetic variants epidemiology in this cohort was evaluated. Performance of risk-reducing prophylactic measures, such as prophylactic mastectomy and/or prophylactic oophorectomy, was assessed through clinical follow-up of patients with a positive genetic result. Pathogenic variants predisposing to HBOC were identified in 11.9% (98/824) individuals at BRCA2 (47/98), BRCA1 (24/98), PALB2 (8/51), ATM (7/51), CHEK2 (6/51) MSH6, (2/51), RAD51C (2/51) and TP53 (2/386). Of them, 11 novel pathogenic variants and 12 VUS were identified, characterized, and submitted to ClinVar. Regarding clinical impact, the risk of developing basal or Her2 breast cancer was increased 15.7 times or 37.5 times for BRCA1 and MSH6 pathogenic variants respectively. On the contrary, the risk of developing basal or luminal A breast cancer was reduced to 81% or 77% for BRCA2 and BRCA1 pathogenic variants, respectively. Finally, 53.2% of individuals testing positive for class IV/V variants underwent prophylactic surgery (mastectomy, oophorectomy or both) being significantly younger at the cancer diagnosis than those undertaking prophylactic measures (p = 0.008). Of them, 8 carried a pathogenic/likely pathogenic variant in other genes different from BRCA1 and BRCA2, and the remaining (46.7%) decided to continue with clinical follow-up. No differences in pathogenicity or risk of developing cancer were found for BRCA1/2 between targeted and multigene sequencing strategies; however, NGS was able to resolve a greater proportion of high-risk patients.
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Affiliation(s)
- María Molina-Zayas
- UGC de Laboratorios, Hospital Universitario Clínico San Cecilio, Avda de la Investigación s/n, 18016, Granada, Spain
| | - Carmen Garrido-Navas
- Genetics Department, Faculty of Sciences, Universidad de Granada, 18071, Granada, Spain. .,CONGEN, Genetic Counselling Services, C/Albahaca 4, 18006, Granada, Spain.
| | - Jose Luis García-Puche
- Oncology Department, Vithas Granada Hospital, Avda de Santa María de La Alhambra, Granada, Spain
| | - Julian Barwell
- Leicestershire Clinical Genetics Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Susana Pedrinaci
- UGC de Laboratorios, Hospital Universitario Virgen de Las Nieves, Avda de Las Fuerzas Armadas, 2, 18014, Granada, Spain
| | - Margarita Martínez Atienza
- UGC de Laboratorios, Hospital Universitario Virgen de Las Nieves, Avda de Las Fuerzas Armadas, 2, 18014, Granada, Spain
| | - Susana García-Linares
- UGC de Laboratorios, Hospital Universitario Clínico San Cecilio, Avda de la Investigación s/n, 18016, Granada, Spain
| | - Tomás de Haro-Muñoz
- UGC de Laboratorios, Hospital Universitario Clínico San Cecilio, Avda de la Investigación s/n, 18016, Granada, Spain
| | - Jose Antonio Lorente
- Legal Medicine Department, Medicine School, Universidad de Granada, 18016, Granada, Spain
| | - M Jose Serrano
- Department of Medical Oncology, Bio-Health Research Institute (Instituto de Investigación Biosanitaria Ibs GRANADA), Hospital Universitario Virgen de Las Nieves Granada, University of Granada, Granada, Spain.,Department of Pathological Anatomy, Faculty of Medicine, Campus de Ciencias de la Salud, University of Granada, Granada, Spain
| | - Antonio Poyatos-Andújar
- UGC de Laboratorios, Hospital Universitario Clínico San Cecilio, Avda de la Investigación s/n, 18016, Granada, Spain.
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Ruiz-Rodríguez AJ, Molina-Vallejo MP, Aznar-Peralta I, González Puga C, Cañas García I, González E, Lorente JA, Serrano MJ, Garrido-Navas MC. Deep Phenotypic Characterisation of CTCs by Combination of Microfluidic Isolation (IsoFlux) and Imaging Flow Cytometry (ImageStream). Cancers (Basel) 2021; 13:cancers13246386. [PMID: 34945008 PMCID: PMC8699219 DOI: 10.3390/cancers13246386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/19/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Cells that escape the primary tumour and have the potential ability to colonise distant organs through metastasis are called circulating tumour cells (CTCs). The study of CTCs in colorectal cancer (CRC) has demonstrated their prognostic utility, although current methodologies only allow the evaluation of CTC numbers and a maximum of two markers. Here, we developed a novel protocol for the isolation and characterisation of CTCs by combining two existing technologies. This new methodology allows the simultaneous evaluation of multiple markers and parameters. In particular, we evaluated the expression of a mutant protein (BRAFV600E) associated with poor response to therapies against EGFR and the expression of PD-L1, a marker for immunotherapy. Based on these markers, we evaluated the CTCs (positive for cytokeratin) of 16 early CRC patients and demonstrated the suitability of our protocol to classify patients into potential responders and non-responders. Abstract The isolation of circulating tumour cells (CTCs) in colorectal cancer (CRC) mostly relies on the expression of epithelial markers such as EpCAM, and phenotypic characterisation is usually performed under fluorescence microscopy with only one or two additional markers. This limits the ability to detect different CTC subpopulations based on multiple markers. The aim of this work was to develop a novel protocol combining two platforms (IsoFluxTM and ImageStream®X) to improve CTC evaluation. Cancer cell lines and peripheral blood from healthy donors were used to evaluate the efficiency of each platform independently and in combination. Peripheral blood was extracted from 16 early CRC patients (before loco-regional surgery) to demonstrate the suitability of the protocol for CTC assessment. Additionally, peripheral blood was extracted from nine patients one month after surgery to validate the utility of our protocol for identifying CTC subpopulation changes over time. Results: Our protocol had a mean recovery efficiency of 69.5% and a limit of detection of at least four cells per millilitre. We developed an analysis method to reduce noise from magnetic beads used for CTC isolation. CTCs were isolated from CRC patients with a median of 37 CTCs (IQ 13.0–85.5) at baseline. CTCs from CRC patients were significantly (p < 0.0001) larger than cytokeratin (CK)-negative cells, and patients were stratified into two groups based on BRAFV600E and PD-L1 expression on CK-positive cells. The changes observed over time included not only the number of CTCs but also their distribution into four different subpopulations defined according to BRAFV600E and PD-L1 positivity. We developed a novel protocol for semi-automatic CTC isolation and phenotypic characterisation by combining two platforms. Assessment of CTCs from early CRC patients using our protocol allowed the identification of two clusters of patients with changing phenotypes over time.
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Affiliation(s)
- Antonio J. Ruiz-Rodríguez
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, 18016 Granada, Spain;
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
| | - Maria P. Molina-Vallejo
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
| | - Inés Aznar-Peralta
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
- Legal Medicine Department, Medicine School, University of Granada, 18016 Granada, Spain
| | - Cristina González Puga
- Clinical Management Unit of Surgery, San Cecilio University Hospital, 18016 Granada, Spain; (C.G.P.); (I.C.G.)
| | - Inés Cañas García
- Clinical Management Unit of Surgery, San Cecilio University Hospital, 18016 Granada, Spain; (C.G.P.); (I.C.G.)
| | - Encarna González
- Clinical Management Unit of Oncology, University Hospital Virgen de las Nieves, 18014 Granada, Spain;
| | - Jose A. Lorente
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
- Legal Medicine Department, Medicine School, University of Granada, 18016 Granada, Spain
| | - M. Jose Serrano
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
- Medical Oncology Department, Bio-Health Research Institute (IBS, Granada), University Hospital Virgen de las Nieves, University of Granada, 18012 Granada, Spain
- Department of Pathological Anatomy, Faculty of Medicine, Campus de Ciencias de la Salud, University of Granada, 18016 Granada, Spain
- Correspondence: (M.J.S.); (M.C.G.-N.); Tel.: +34-958715500 (ext. 123) (M.J.S.); +34-958715500 (ext. 208) (M.C.G.-N.)
| | - M. Carmen Garrido-Navas
- GENYO Centre for Genomics and Oncological Research: Pfizer, University of Granada, Andalusian Regional Government, Liquid Biopsy and Cancer Interception Group, PTS Granada, 18016 Granada, Spain; (M.P.M.-V.); (I.A.-P.); (J.A.L.)
- Genetics Department, Faculty of Sciences, University of Granada, 18071 Granada, Spain
- Correspondence: (M.J.S.); (M.C.G.-N.); Tel.: +34-958715500 (ext. 123) (M.J.S.); +34-958715500 (ext. 208) (M.C.G.-N.)
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3
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Rolfo CD, de Miguel Perez D, Russo A, AK M, Gunasekaran M, Manca P, Peterson CB, Mamindla P, Er ME, Peddagangireddy V, Buemi F, Cooper B, Hester L, Hsia RC, Cardona AF, Arrieta O, Naing A, Kaushal S, Serrano MJ, Colen RR. Dynamic levels of extracellular vesicle PD-L1 and complementary radiomics for the prediction of the response to immune checkpoint inhibitors in lung cancer patients. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e21144] [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: 11/20/2022] Open
Abstract
e21144 Background: Immune-checkpoint inhibitors (ICIs) have revolutionized the therapeutic landscape of lung cancer patients. However, its low treatment efficacy is still an issue and the current standard of care tissue PD-L1 presents high variability. Liquid biopsy is a promising tool in the discovery of biomarkers in body fluids. In particular, extracellular vesicles (EVs) can present PD-L1 in their membranes, playing a role in the inhibition of the anti-tumor immune response. Likewise, TGF-β is crucial in the immune response found in the circulation and into EVs. On the other hand, radiomics analysis of conventional imaging provides information about tumor heterogeneity and immune response. Hence, we aimed to evaluate the predictive role of circulating biomarkers in lung cancer patients undergoing ICIs and the additional value of radiomics data. Methods: This is a retrospective analysis of 30 advanced/metastatic non-small lung cancer patients treated with ICIs. Plasma samples were collected at baseline and at 8 weeks during treatment, matching the first response evaluation. Patients with complete, partial response, or stable disease were classified as responders and those with progressive disease as non-responders following RECIST v1.1. EVs were isolated from plasma by ultracentrifugation and PD-L1 expression was revealed by immunoblot. Circulating and EV levels of TGF-β were analyzed by ELISA. Additionally, 400 radiomics features from target and non-target lesions were analyzed to evaluate response in 24 patients according to RECIST v1.1 and irRECIST. Robustness of predictive models was validated by ridge penalty and leave-one-out cross-validation. Results: The analysis of the dynamics of EV PD-L1 during treatment identified increased levels in non-responders in comparison to responders ( p= 0.012), while tissue PD-L1 levels were not associated to the response ( p= 0.585). The predictive model for EV PD-L1 reported a high accuracy with an area under the curve (AUC) = 77%, 91.7% sensitivity, and 61.1% specificity. The combination with radiomics, improved the accuracy and reported an AUC = 83%, 82% sensitivity, and 77% specificity. Additionally, the analysis of the association of the circulating biomarkers with the outcome revealed that increasing dynamics of EV PD-L1 and high baseline EV TGF-β were associated with shorter progression-free survival and overall survival, outperforming the circulating levels of TGF-β. Conclusions: This pilot study demonstrated that EV PD-L1 could serve as better predictive factor than tissue PD-L1 for the stratification of lung cancer patients undergoing ICIs and that it could be complemented with radiomics. Moreover, EV levels of PD-L1 and TGF-β have potential for the stratification and prognosis of patients treated with ICIs and their novel combinations with TGF-β blockade.
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Affiliation(s)
- Christian Diego Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | - Diego de Miguel Perez
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD
| | | | - Murat AK
- University of Pittsburgh, Pittsburgh, PA
| | | | - Paolo Manca
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | | | | | - Brandon Cooper
- University of Maryland School of Medicine, Baltimore, MD
| | - Lisa Hester
- University of Maryland School of Medicine, Baltimore, MD
| | - Ru-ching Hsia
- University of Maryland School of Medicine, Baltimore, MD
| | - Andrés Felipe Cardona
- Clinical and Translational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Oscar Arrieta
- Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Aung Naing
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sunjay Kaushal
- University of Maryland School of Medicine, Baltimore, MD
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4
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Garrido-Navas MC, García-Díaz A, Molina-Vallejo MP, González-Martínez C, Alcaide Lucena M, Cañas-García I, Bayarri C, Delgado JR, González E, Lorente JA, Serrano MJ. The Polemic Diagnostic Role of TP53 Mutations in Liquid Biopsies from Breast, Colon and Lung Cancers. Cancers (Basel) 2020; 12:E3343. [PMID: 33198130 PMCID: PMC7696715 DOI: 10.3390/cancers12113343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022] Open
Abstract
Being minimally invasive and thus allowing repeated measures over time, liquid biopsies are taking over traditional solid biopsies in certain circumstances such as those for unreachable tumors, very early stages or treatment monitoring. However, regarding TP53 mutation status analysis, liquid biopsies have not yet substituted tissue samples, mainly due to the lack of concordance between the two types of biopsies. This needs to be examined in a study-dependent manner, taking into account the particular type of liquid biopsy analyzed, that is, circulating tumor cells (CTCs) or cell-free DNA (cfDNA), its involvement in the tumor biology and evolution and, finally, the technology used to analyze each biopsy type. Here, we review the main studies analyzing TP53 mutations in either CTCs or cfDNA in the three more prevalent solid tumors: breast, colon and lung cancers. We evaluate the correlation for mutation status between liquid biopsies and tumor tissue, suggesting possible sources of discrepancies, as well as evaluating the clinical utility of using liquid biopsies for the analysis of TP53 mutation status and the future actions that need to be undertaken to make liquid biopsy analysis a reality for the evaluation of TP53 mutations.
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Affiliation(s)
- M. Carmen Garrido-Navas
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Universidad Internacional de la Rioja, Avenida de la Paz, 137, 26006 Logroño, Spain
| | - Abel García-Díaz
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Departamento de Medicina, Facultad de Medicina, Universidad de Granada, 18016 Granada, Spain
| | - Maria Pilar Molina-Vallejo
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
| | - Coral González-Martínez
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
| | - Miriam Alcaide Lucena
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico San Cecilio, 18016 Granada, Spain
| | - Inés Cañas-García
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico San Cecilio, 18016 Granada, Spain
| | - Clara Bayarri
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Department of Thoracic Surgery, Virgen de las Nieves University Hospital, Av. de las Fuerzas Armadas, 2, 18014 Granada, Spain
| | - Juan Ramón Delgado
- Bio-Health Research Institute (Instituto de Investigación Biosanitaria ibs. GRANADA), Complejo Hospitalario Universitario Granada (CHUG), University of Granada, 18012 Granada, Spain; (J.R.D.); (E.G.)
| | - Encarna González
- Bio-Health Research Institute (Instituto de Investigación Biosanitaria ibs. GRANADA), Complejo Hospitalario Universitario Granada (CHUG), University of Granada, 18012 Granada, Spain; (J.R.D.); (E.G.)
| | - Jose Antonio Lorente
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Laboratory of Genetic Identification, Department of Legal Medicine, University of Granada, Av. de la Investigación, 11, 18071 Granada, Spain
| | - M. Jose Serrano
- GENYO Centre for Genomics and Oncological Research, formed by Pfizer, the University of Granada and the Andalusian Regional Government, PTS Granada, Liquid Biopsy and Cancer Interception Group, Av. de la Ilustración, 114, 18016 Granada, Spain; (A.G.-D.); (M.P.M.-V.); (C.G.-M.); (M.A.L.); (I.C.-G.); (C.B.); (J.A.L.)
- Bio-Health Research Institute (Instituto de Investigación Biosanitaria ibs. GRANADA), Complejo Hospitalario Universitario Granada (CHUG), University of Granada, 18012 Granada, Spain; (J.R.D.); (E.G.)
- Department of Pathological Anatomy, Faculty of Medicine, Campus de Ciencias de la Salud, University of Granada, 18016 Granada, Spain
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Abstract
Previous studies demonstrated that chondroitin sulfate proteoglycans (CSPGs) on apical surfaces of palatal medial edge epithelial (MEE) cells were necessary for palatal adhesion. In this study, we identified 2 proteoglycans, biglycan and decorin, that were expressed in the palatal shelves prior to adhesion. In addition, we established that these proteoglycans were dependent on transforming growth factor β (TGFβ) signaling. Laser capture microdissection was used to collect selected palatal epithelial cells from embryonic mouse embryos at various palate development stages. The expression of specific messenger RNA (mRNA) for biglycan and decorin was determined with quantitative real-time polymerase chain reaction. The TGFβrI kinase inhibitor (SB431542) was used in palatal organ cultures to determine if blocking TFGβ signaling changed biglycan and decorin distribution. Immunohistochemistry of both biglycan and decorin revealed expression on the apical and lateral surfaces of MEE cells. Biglycan protein and mRNA levels peaked as the palatal shelves adhered. Decorin was less abundant on the apical epithelial surface and also had reduced mRNA levels compared to biglycan. Their proteins were not expressed on MEE cells of palates treated with SB431542, an inhibitor of TGFβ signaling. The temporal expression of biglycan and decorin on the apical surface of MEE, combined with the evidence that these proteins were regulated through the TGFβ pathway, indicated that they may be important for adhesion.
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Affiliation(s)
- I Ibrahim
- 1 Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - M J Serrano
- 1 Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - L B Ruest
- 1 Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - K K H Svoboda
- 1 Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
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6
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Alvarez Cubero MJ, Lorente JA, Robles-Fernandez I, Rodriguez-Martinez A, Puche JL, Serrano MJ. Circulating Tumor Cells: Markers and Methodologies for Enrichment and Detection. Methods Mol Biol 2017; 1634:283-303. [PMID: 28819860 DOI: 10.1007/978-1-4939-7144-2_24] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cancer is a leading cause of disease worldwide; however, nowadays many points of its initiation processes are unknown. In this chapter, we are focusing on the role of liquid biopsies in cancer detection and progression. CTCs are one of the main components of liquid biopsies, they represent a subset of tumor cells that have acquired the ability to disseminate from the primary tumor and intravasate to the circulatory system. The greatest challenge in the detection of CTCs is their rarity in the blood. Human blood consists of white blood cells (5-10 × 106/mL), red blood cells (5-9 × 109/mL), and platelets (2.5-4 × 108/mL); very few CTCs will be present even in patients with known metastatic disease, with often less than one CTC per mL of blood. CTCs are found in frequencies on the order of 1-10 CTCs per mL of whole blood in patients with metastatic disease, and it is reduced in half for non-metastatic stages. Therefore, accurate methodologies for their capture and analysis are really important. The main aim of the present chapter is to describe different methodologies for CTCs capturing and analysis.
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MESH Headings
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/metabolism
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Biomarkers, Tumor/metabolism
- Cell Count
- Cell Line, Tumor
- Cell Separation/instrumentation
- Cell Separation/methods
- Cell Survival
- Centrifugation, Density Gradient/methods
- Epithelial Cell Adhesion Molecule/genetics
- Epithelial Cell Adhesion Molecule/immunology
- Epithelial Cell Adhesion Molecule/metabolism
- Epithelial-Mesenchymal Transition/genetics
- Equipment Design
- ErbB Receptors/genetics
- ErbB Receptors/immunology
- ErbB Receptors/metabolism
- Ficoll/chemistry
- Fluorescent Dyes/chemistry
- Humans
- Immunoassay
- Keratins/genetics
- Keratins/immunology
- Keratins/metabolism
- Microfluidic Analytical Techniques/instrumentation
- Neoplasms/blood
- Neoplasms/diagnosis
- Neoplasms/immunology
- Neoplasms/pathology
- Neoplastic Cells, Circulating/immunology
- Neoplastic Cells, Circulating/metabolism
- Neoplastic Cells, Circulating/pathology
- Protein Binding
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Affiliation(s)
- M J Alvarez Cubero
- GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Av. de la Ilustración 114, 18016, Granada, Spain.
| | - J A Lorente
- GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Av. de la Ilustración 114, 18016, Granada, Spain
- Laboratory of Genetic Identification, University of Granada-Dept. of Legal Medicine - Faculty of Medicine, Granada, 18016, Spain
| | - I Robles-Fernandez
- GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Av. de la Ilustración 114, 18016, Granada, Spain
| | - A Rodriguez-Martinez
- GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Av. de la Ilustración 114, 18016, Granada, Spain
- Laboratory of Genetic Identification, University of Granada-Dept. of Legal Medicine - Faculty of Medicine, Granada, 18016, Spain
| | - J L Puche
- Integral Oncology Division, Clinical University Hospitals of Granada, Av. de las Fuerzas Armadas, 2, 18014, Granada, Spain
| | - M J Serrano
- GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Av. de la Ilustración 114, 18016, Granada, Spain
- Integral Oncology Division, Clinical University Hospitals of Granada, Av. de las Fuerzas Armadas, 2, 18014, Granada, Spain
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Ordonez JM, Serrano MJ, García-Puche JL, Ortega FG, Diaz-Monchon JJ, Lorente JA, Perez DDM. miRNA21 as a specific marker for the detection of circulating tumor cell. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22025] [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)
| | | | | | - Francisco Gabriel Ortega
- Genyo - Pfizer-Universidad De Granada-Junta De Andalucia Centre for Genomics and Oncological Research, Granada, Spain
| | - Juan José Diaz-Monchon
- Genyo - Pfizer-Universidad De Granada-Junta De Andalucia Centre for Genomics and Oncological Research, Granada, Spain
| | | | - Diego de Miguel Perez
- Genyo - Pfizer-Universidad De Granada-Junta De Andalucia Centre for Genomics and Oncological Research, Granada, Spain
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8
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Serrano MJ, Ortega FG, Lorente JA, Delgado M, Puche JL. Predictive value of circulating tumor cells positive for VEGFR expression in patients with advanced colorectal cancer undergoing treatment with FOLFOX plus bevacizumab. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e22026] [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)
| | | | | | - Mayte Delgado
- Medical Oncology, Hospital Universitario Clínico San Cecilio, Granada, Spain
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9
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Nadal R, Ortega FG, Salido M, Lorente JA, Rodríguez-Rivera M, Delgado-Rodríguez M, Macià M, Fernández A, Corominas JM, García-Puche JL, Sánchez-Rovira P, Solé F, Serrano MJ. CD133 expression in circulating tumor cells from breast cancer patients: Potential role in resistance to chemotherapy. Int J Cancer 2013; 133:2398-407. [DOI: 10.1002/ijc.28263] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/28/2013] [Accepted: 04/17/2013] [Indexed: 12/26/2022]
Affiliation(s)
| | - F. Gabriel. Ortega
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
| | - Marta Salido
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | | | - Maria Rodríguez-Rivera
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | | | - Marta Macià
- Division of Preventive Medicine and Public Health; CIBERESP, University of Jaén; Jaén; Spain
| | - Ana Fernández
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
| | - Josep M. Corominas
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | - J. Luis García-Puche
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
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10
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De la Haba- Rodriguez J, Salvador Bofill J, Codes M, Ciruelos EM, Jaen A, Galan A, Gil M, Serrano MJ, Baena JM, Villanueva Silva MJ, Gonzalez E, Murias A, Miguel A, Garcia H, Bayo JL, Sánchez-Rovira P. Study of the usefulness of angiotensin type 1 receptor (AGTR1) as a possible response predictor in patients with metastatic breast cancer (mBC) subjected to chemotherapy and treatment with bevacizumab (AVALUZ Study). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.10608] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10608 Background: Angiotensin type 1 receptor (AGTR1) is a membrane receptor implicated in the regulation of arterial pressure. It has also been related to carcinogenesis and tumor spread, and participates in neoangiogenesis. AGTR1 is expressed in a number of neoplasms as BC. In a previous neoadjuvant study, a significant relationship was observed between AGTR1 expression and CR to a regimen of chemo and bevacizumab (B). To study and confirm the relationship between tumor expression of AGTR1 and response to a regimen of chemo and B in pts with mBC. Methods: AGTR1 expression was subjected to immunofluorescence (monoclonal AGTR1 sc1173 antibody, Santa Cruz Biotechnology, CA, USA Dilution 1:50) in 50 samples of mBC pts from the AVALUZ study treated with first line bevacizumab 10 mg/kg, paclitaxel 150 mg/m2 and gemcitabine 2000 mg/m2 d 1 and 15 c/28 d until PD, unacceptable toxicity or medical decision. Immunoreactivity was reported as negative (0), low positive (1+) and high positive (2+). RNA was extracted from paraffin blocks, using the QIAamp DNA FFPE Tissue Kit and Deparaffinization Solution (QIAGEN) and expression of AGTR1 candidate gene was quantified using reverse transcription-PCR (RT-PCR). Results: 60% of the samples expressed AGTR1 (26% weak and 34% intense) – expression being more frequent in HR + tumors (65% vs 45%). Among the 50 samples analyzed, measurable disease was present in 39 pts. Treatment activity was significantly greater in the tumors AGTR1 expression 2+ (p=0.009) (Table). With a median follow-up of 19.30 months, the progression-free interval was longer in the tumors with intense AGTR1 expression (17.7 vs 10.8 months, p=0.132). More consolidated PFS and OS will be presented. Conclusions: AGTR1 expression may be useful as a predictor of response to chemo and bevacizumab. Prospective studies are needed to confirm these findings. [Table: see text]
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Affiliation(s)
| | | | | | | | | | | | - Miquel Gil
- Instituto Catalán de Oncología, Bellvitge, Spain
| | | | | | | | | | - Adolfo Murias
- Hospital Universitario Insular Gran Canaria, Gran Canaria, Spain
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11
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Serrano MJ, Nadal R, Lorente JA, Salido M, Rodríguez R, Rodríguez M, Macià M, Sánchez-Rovira P, Corominas JM, González L, Vera L, Albanell J, Solé F. Circulating cancer cells in division in an early breast cancer patient. Ann Oncol 2011; 22:2150-2151. [PMID: 21743104 DOI: 10.1093/annonc/mdr322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- M J Serrano
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada.
| | - R Nadal
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - J A Lorente
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada; Laboratory of Genetic Identification-UGR, Department of Legal Medicine, University of Granada, Granada
| | - M Salido
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - R Rodríguez
- Laboratory of Genetic Identification, Department of Legal Medicine, University of Granada, Granada
| | - M Rodríguez
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - M Macià
- Oncology Department, Hospital del Mar-IMAS, Barcelona
| | - P Sánchez-Rovira
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada; Medical Oncology Department, University Hospital, Jaén, Spain
| | - J M Corominas
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - L González
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada
| | - L Vera
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada
| | - J Albanell
- Oncology Department, Hospital del Mar-IMAS, Barcelona
| | - F Solé
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
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12
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Gaforio JJ, Serrano MJ, Algarra I, Ortega E, Alvarez de Cienfuegos G. Phagocytosis of apoptotic cells assessed by flow cytometry using 7-Aminoactinomycin D. Cytometry 2002; 49:8-11. [PMID: 12210605 DOI: 10.1002/cyto.10136] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Apoptotic cells are recognized specifically by macrophages and are cleared rapidly by phagocytosis. However, the recognition mechanisms involved in the clearance of apoptotic cells by macrophages are still not fully understood. Therefore, new methods must be designed to better our understanding of the mechanisms of interaction between macrophages and apoptotic cells. 7-Aminoactinomycin D (7-AAD) is a fluorescent DNA-binding stain usually used as a single agent to detect apoptotic cells by flow cytometry. We propose the use of 7-AAD-stained apoptotic cells as targets for a new flow cytometry phagocytosis assay. METHODS Murine T-cell lymphoma YAC-1 cells were treated with etoposide to induce apoptosis. Etoposide-treated YAC-1 target cells were stained subsequently with 7-AAD and then coincubated with resident peritoneal macrophages to allow phagocytosis. The samples were analyzed by flow cytometry. Macrophages that had phagocytosed 7-AAD-stained apoptotic cells were identified by their bright red fluorescence and the resulting values were expressed as the percentage of cells. RESULTS The phagocytic cells appeared as a distinct population characterized by bright fluorescence, which could not be detected in the negative controls. The effects of a phagocytic enhancer (interferon-gamma [IFN-gamma]) or inhibitor (incubation at 4 degrees C) were assessed accurately with this flow cytometric method. CONCLUSIONS We describe the use of 7-AAD in an assay that is easy and quick to perform. This flow cytometric-based assay allows the quantification of phagocytosis of apoptotic cells by macrophages.
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Affiliation(s)
- J J Gaforio
- Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain.
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13
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Algarra I, Ortega E, Serrano MJ, Alvarez de Cienfuegos G, Gaforio JJ. Suppression of splenic macrophage Candida albicans phagocytosis following in vivo depletion of natural killer cells in immunocompetent BALB/c mice and T-cell-deficient nude mice. FEMS Immunol Med Microbiol 2002; 33:159-63. [PMID: 12110477 DOI: 10.1111/j.1574-695x.2002.tb00586.x] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The resistance of mice to systemic infections caused by Candida albicans is associated with activated splenic macrophages. In addition, there is a correlation between natural killer (NK) cell activation and the resistance to systemic candidiasis. The present study was designed to clarify the role of NK cells in the control of splenic macrophage C. albicans phagocytosis by either depleting NK cells (anti-asialo GM(1) treatment) or maintaining them in an activated state (tilorone treatment) in both immunocompetent BALB/c mice and T-cell-deficient nude mice. The results of the in vitro phagocytosis assays were analyzed by flow cytometry and demonstrate the pivotal role of NK cells in controlling the capacity of splenic macrophages to phagocytose C. albicans. In summary, these data provide evidence that the NK cells are the main inducers of phagocytic activity of splenic macrophages and that they mediate the protection against C. albicans systemic infection.
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Affiliation(s)
- I Algarra
- Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071, Jaén, Spain
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14
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Gaforio JJ, Serrano MJ, Ortega E, Algarra I, Alvarez de Cienfuegos G. Use of SYTOX green dye in the flow cytometric analysis of bacterial phagocytosis. Cytometry 2002; 48:93-6. [PMID: 12116370 DOI: 10.1002/cyto.10107] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Fluorescein isothiocyanate (FITC) is used widely to label the targets used in flow cytometric phagocytosis assays. Unfortunately, the fluorescence intensity of phagocytosed FITC-labeled targets is influenced by changes in intracellular pH level, making quantitative measurements with this fluorophore problematic. We describe the use of SYTOX green nucleic acid stain to measure phagocytosis by flow cytometry. METHODS Suspensions of isopropyl alcohol-permeabilized Escherichia coli DH5alpha were stained with the SYTOX green dye and then incubated with resident peritoneal macrophages. The samples were analyzed by flow cytometry and phagocytosis was determined by gating the cells. RESULTS Results are expressed as percentage of phagocyte-associated green fluorescent cells. The validity of the method was shown by the effects of a phagocytosis inhibitor (incubation at 4 degrees C) or enhancer (gamma interferon [IFN- gamma] treatment) being accurately assessed with this assay. CONCLUSIONS The method described was reproducible and provides an advantageous alternative to the use of FITC to label bacteria for the flow cytometric measurement of target uptake by phagocytic cells.
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Affiliation(s)
- J J Gaforio
- Unit of Microbiology, Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain.
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15
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Ortega E, Algarra I, Serrano MJ, Alvarez de Cienfuegos G, Gaforio JJ. The use of 7-amino-actinomycin D in the analysis of Candida albicans phagocytosis and opsonization. J Immunol Methods 2001; 253:189-93. [PMID: 11384680 DOI: 10.1016/s0022-1759(01)00358-1] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We describe the use of 7-amino-actinomycin D (7AAD) to measure phagocytosis and the opsonizing capacity of serum. Heat-inactivated Candida albicans was previously stained with 7AAD and incubated with resident peritoneal macrophages. The samples were analyzed by flow cytometry and phagocytic cells were identified by their bright red fluorescence. This is a rapid, reproducible and reliable one-step procedure and provides a means of evaluating low levels of phagocytosis.
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Affiliation(s)
- E Ortega
- Microbiology Unit, Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071 Jaén, Spain
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16
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Ortega E, Algarra I, Serrano MJ, de Pablo MA, Alvarez de Cienfuegos G, Gaforio JJ. Enhanced resistance to experimental systemic candidiasis in tilorone-treated mice. FEMS Immunol Med Microbiol 2000; 28:283-9. [PMID: 10891651 DOI: 10.1111/j.1574-695x.2000.tb01488.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Candida albicans is an increasingly important opportunistic fungal pathogen in immunocompromised patients. Natural killer (NK) cells constitute an important immune effector mechanism and are involved in the response to different pathological disorders. We wished to determine if this immune mechanism is involved in the specific response to C. albicans. Tilorone hydrochloride and related compounds have been described to display antiviral and antitumoral activity, as well as to enhance NK cell activity. In this study, we show the antimicrobial activity of different tilorone analogues and the enhanced resistance of tilorone-treated mice in experimental systemic candidiasis. We also present data suggesting that there is a correlation between NK cell activation and the resistance to experimental systemic candidiasis. Thus, it seems that the immunosurveillance of metastatic spread and the infection by C. albicans share some immune effector mechanisms, in particular activation of NK cells.
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Affiliation(s)
- E Ortega
- Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Paraje Las Lagunillas S/N, Spain.
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17
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Algarra I, Perez M, Serrano MJ, Garrido F, Gaforio JJ. c-K-ras overexpression is characteristic for metastases derived from a methylcholanthrene-induced fibrosarcoma. Invasion Metastasis 2000; 18:261-70. [PMID: 10729771 DOI: 10.1159/000024519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We investigated the relationship between the activation of the c-myc and c-K-ras proto-oncogenes and the acquisition of metastatic potential in a methylcholanthrene-induced BALB/c fibrosarcoma. The murine fibrosarcoma GR9 was originally induced in BALB/c mice following exposure to the carcinogenic chemical 3-methylcholanthrene. To induce spontaneous metastasis, we used two tumor cell clones (B9 and G2) known to differ in their metastatic potential, local tumor growth, H-2 class I expression and sensitivity to natural killer (NK) cells. The metastatic nodes were obtained from the lung, liver and kidney. The results showed: (1) amplification of the c-myc proto-oncogene in original tumor clones as well as in all metastatic nodes; (2) mRNA overexpression without amplification of the K-ras proto-oncogene in the metastatic cells, regardless of their anatomical location; (3) no c-K-ras point mutations at codons 12 and 61, and (4) in general, a statistically significantly reduced in vitro sensitivity of metastatic tumor cells to NK cells as compared with the tumor clones used to induce them (p<0.05). These results therefore suggest that overexpressed c-K-ras mRNA is important during tumor progression, perhaps rendering metastatic tumor cells more resistant to lysis by NK cells.
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Affiliation(s)
- I Algarra
- University of Jaen, Department of Health Sciences, Microbiology Unit, Jaén, Spain
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18
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Soria C, Freire P, Serrano MJ, Guerrero A. [Skin manifestations of infection by Borrelia burgdorferi]. Enferm Infecc Microbiol Clin 1990; 8:36-42. [PMID: 2095903] [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: 12/30/2022]
Abstract
Interest in Lyme's disease is recent in Spain. We review the dermatological features of the disease caused by B. burgdorferi, its differential diagnosis and its therapy, with reference to three patients with Borrelia burgdorferi infection in whom the diagnosis was made on the basis of the dermatological picture. One patient had migratory erythema developing from the umbilical area, where he had been bitten by a tick. Another patient had arthritis of the knee and meningoradiculitis, together with multiple skin lesions. The last patient had atypical migratory erythema and concomitant arthritis.
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Affiliation(s)
- C Soria
- Servicio de Dermatología, Hospital Ramón y Cajal, Madrid
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19
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Guerrero A, Serrano MJ. [Incidence and clinical spectrum of Borrelia burgdorferi infection in Spain. Study group for Lyme disease in Spain]. Med Clin (Barc) 1989; 92:438-9. [PMID: 2786124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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20
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Guerrero A, Serrano MJ, García Moncó C. [Lyme borreliosis in Spain]. Med Clin (Barc) 1988; 90:434. [PMID: 3398618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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