1
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Mata DA, Lee JK, Shanmugam V, Marcus CB, Schrock AB, Williams EA, Ritterhouse LL, Hickman RA, Janovitz T, Patel NR, Kroger BR, Ross JS, Mirza KM, Oxnard GR, Vergilio JA, Elvin JA, Benhamida JK, Decker B, Xu ML. Liquid biopsy-based circulating tumour (ct)DNA analysis of a spectrum of myeloid and lymphoid malignancies yields clinically actionable results. Histopathology 2024; 84:1224-1237. [PMID: 38422618 DOI: 10.1111/his.15168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
AIMS Liquid biopsy (LBx)-based next-generation sequencing (NGS) of circulating tumour DNA (ctDNA) can facilitate molecular profiling of haematopoietic neoplasms (HNs), particularly when tissue-based NGS is infeasible. METHODS AND RESULTS We studied HN LBx samples tested with FoundationOne Liquid CDx, FoundationOne Liquid, or FoundationACT between July 2016 and March 2022. We identified 271 samples: 89 non-Hodgkin lymphoma (NHL), 43 plasma-cell neoplasm (PCN), 41 histiocytoses, 27 myelodysplastic syndrome (MDS), 25 diffuse large B-cell lymphoma (DLBCL), 22 myeloproliferative neoplasm (MPN), 14 Hodgkin lymphoma (HL), and 10 acute myeloid leukaemia (AML). Among 73.4% with detectable pathogenic alterations, median maximum somatic allele frequency (MSAF) was 16.6%, with AML (36.2%), MDS (19.7%), and MPN (44.5%) having higher MSAFs than DLBCL (3.9%), NHL (8.4%), HL (1.5%), PCN (2.8%), and histiocytoses (1.8%) (P = 0.001). LBx detected characteristic alterations across HNs, including in TP53, KRAS, MYD88, and BTK in NHLs; TP53, KRAS, NRAS, and BRAF in PCNs; IGH in DLBCL; TP53, ATM, and PDCD1LG2 in HL; BRAF and MAP2K1 in histiocytoses; TP53, SF3B1, DNMT3A, TET2, and ASXL1 in MDS; JAK2 in MPNs; and FLT3, IDH2, and NPM1 in AML. Among 24 samples, the positive percent agreement by LBx was 75.7% for variants present in paired buffy coat, marrow, or tissues. Also, 75.0% of pairs exhibited alterations only present on LBx. These were predominantly subclonal (clonal fraction of 3.8%), reflecting the analytical sensitivity of LBx. CONCLUSION These data demonstrate that LBx can detect relevant genomic alterations across HNs, including at low clonal fractions, suggesting a potential clinical utility for identifying residual or emerging therapy-resistant clones that may be undetectable in site-specific tissue biopsies.
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Affiliation(s)
| | | | - Vignesh Shanmugam
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | | | - Erik A Williams
- Foundation Medicine, Inc., Cambridge, MA, USA
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | | | | | - Benjamin R Kroger
- Division of Hematology/Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, MA, USA
- Departments of Pathology, Urology, and Medicine (Oncology), State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Kamran M Mirza
- Department of Pathology, Michigan Medicine, Ann Arbor, MI, USA
| | | | | | | | - Jamal K Benhamida
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mina L Xu
- Department of Pathology, Yale New-Haven Hospital, Yale School of Medicine, New Haven, CT, USA
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2
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Bihn JR, Cioffi G, Waite KA, Kruchko C, Neff C, Price M, Ostrom QT, Swinnerton KN, Elbers DC, Mooney MA, Rachlin J, Stein TD, Brophy MT, Do NV, Ferguson RE, Priemer DS, Perl DP, Hickman RA, Nabors B, Rusiecki J, Barnholtz-Sloan JS, Fillmore NR. Brain tumors in United States military veterans. Neuro Oncol 2024; 26:387-396. [PMID: 37738677 PMCID: PMC10836768 DOI: 10.1093/neuonc/noad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Comprehensive analysis of brain tumor incidence and survival in the Veteran population has been lacking. METHODS Veteran data were obtained from the Veterans Health Administration (VHA) Medical Centers via VHA Corporate Data Warehouse. Brain tumor statistics on the overall US population were generated from the Central Brain Tumor Registry of the US data. Cases were individuals (≥18 years) with a primary brain tumor, diagnosed between 2004 and 2018. The average annual age-adjusted incidence rates (AAIR) and 95% confidence intervals were estimated per 100 000 population and Kaplan-Meier survival curves evaluated overall survival outcomes among Veterans. RESULTS The Veteran population was primarily white (78%), male (93%), and between 60 and 64 years old (18%). Individuals with a primary brain tumor in the general US population were mainly female (59%) and between 18 and 49 years old (28%). The overall AAIR of primary brain tumors from 2004 to 2018 within the Veterans Affairs cancer registry was 11.6. Nonmalignant tumors were more common than malignant tumors (AAIR:7.19 vs 4.42). The most diagnosed tumors in Veterans were nonmalignant pituitary tumors (AAIR:2.96), nonmalignant meningioma (AAIR:2.62), and glioblastoma (AAIR:1.96). In the Veteran population, survival outcomes became worse with age and were lowest among individuals diagnosed with glioblastoma. CONCLUSIONS Differences between Veteran and US populations can be broadly attributed to demographic composition differences of these groups. Prior to this, there have been no reports on national-level incidence rates and survival outcomes for Veterans. These data provide vital information that can drive efforts to understand disease burden and improve outcomes for individuals with primary brain tumors.
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Affiliation(s)
- John R Bihn
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Corey Neff
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mackenzie Price
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Quinn T Ostrom
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
- The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, North Carolina, USA
| | | | - Danne C Elbers
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Michael A Mooney
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jacob Rachlin
- VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Thor D Stein
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Mary T Brophy
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Nhan V Do
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ryan E Ferguson
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Boston University, Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - David S Priemer
- Department of Pathology, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Daniel P Perl
- Department of Pathology, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
| | - Richard A Hickman
- Henry M. Jackson Foundation for The Advancement of Military Medicine, Bethesda, Maryland, USA
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, New York, USA
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Burt Nabors
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University School of Medicine, Bethesda, Maryland, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Bethesda, Maryland, USA
| | - Nathanael R Fillmore
- VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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3
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Hickman RA, Gedvilaite E, Ptashkin R, Reiner AS, Cimera R, Nandakumar S, Price A, Vanderbilt C, Fahy T, Young RJ, Miller AM, Mellinghoff IK, Rosenblum MK, Ladanyi M, Arcila ME, Zhang Y, Brannon AR, Bale TA. CDKN2A/B mutations and allele-specific alterations stratify survival outcomes in IDH-mutant astrocytomas. Acta Neuropathol 2023; 146:845-847. [PMID: 37831210 PMCID: PMC10628020 DOI: 10.1007/s00401-023-02639-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Affiliation(s)
- Richard A Hickman
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
- Murtha Cancer Center Research Program, Uniformed Services of the Health Sciences, Bethesda, MD, 20817, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, 20817, USA
| | - Erika Gedvilaite
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ryan Ptashkin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Robert Cimera
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Subhiksha Nandakumar
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA
| | - Adam Price
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA
| | - Chad Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Tara Fahy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Robert J Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Alexandra M Miller
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Ingo K Mellinghoff
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marc K Rosenblum
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Marc Ladanyi
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Maria E Arcila
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Yanming Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - A Rose Brannon
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Tejus A Bale
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
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4
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Agin-Liebes J, Hickman RA, Vonsattel JP, Faust PL, Flowers X, Sosunova IU, Ntiri J, Mayeux R, Surface M, Marder K, Fahn S, Przedborski S, Alcalay RN. Patterns of TDP-43 Deposition in Brains with LRRK2 G2019S Mutations. Mov Disord 2023; 38:1541-1545. [PMID: 37218402 PMCID: PMC10524857 DOI: 10.1002/mds.29449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 03/09/2023] [Accepted: 05/01/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE To assess for TDP-43 deposits in brains with and without a LRRK2 G2019S mutation. BACKGROUND LRRK2 G2019S mutations have been associated with parkinsonism and a wide range of pathological findings. There are no systematic studies examining the frequency and extent of TDP-43 deposits in neuropathological samples from LRRK2 G2019S carriers. METHODS Twelve brains with LRRK2 G2019S mutations were available for study from the New York Brain Bank at Columbia University; 11 of them had samples available for TDP-43 immunostaining. Clinical, demographic, and pathological data are reported for 11 brains with a LRRK2 G2019S mutation and compared to 11 brains without GBA1 or LRRK2 G2019S mutations with a pathologic diagnosis of Parkinson's disease (PD) or diffuse Lewy body disease. They were frequency matched by age, gender, parkinsonism age of onset, and disease duration. RESULTS TDP-43 aggregates were present in 73% (n = 8) of brains with a LRRK2 mutation and 18% (n = 2) of brains without a LRRK2 mutation (P = 0.03). In one brain with a LRRK2 mutation, TDP-43 proteinopathy was the primary neuropathological change. CONCLUSIONS Extranuclear TDP-43 aggregates are observed with greater frequency in LRRK2 G2019S autopsies compared to PD cases without a LRRK2 G2019S mutation. The association between LRRK2 and TDP-43 should be further explored. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Julian Agin-Liebes
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Richard A. Hickman
- Department of Defense/Uniformed Services University Brain Tissue Repository, Uniformed Services University, Bethesda, MD, 20817, USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Jean Paul Vonsattel
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA
| | - Phyllis L. Faust
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA
| | - Xena Flowers
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA
| | | | - Joel Ntiri
- Columbia College, 1130 Amsterdam Ave, New York, NY 10027, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Matthew Surface
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
- The Michael J. Fox Foundation for Parkinson’s Research, New York, New York, USA
| | - Karen Marder
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Stanley Fahn
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Serge Przedborski
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA
- Department of Neuroscience Columbia University, 630 W 168th Street, New York, NY, 10032, USA
| | - Roy N. Alcalay
- Department of Neurology, Columbia University Irving Medical Center, New York, USA
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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5
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Hickman RA, Scholz SW. Precision diagnosis and staging of TDP-43 proteinopathies: harnessing the power of artificial intelligence. Brain 2023; 146:2666-2668. [PMID: 37224516 PMCID: PMC10316762 DOI: 10.1093/brain/awad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 05/26/2023] Open
Abstract
This scientific commentary refers to ‘Data-driven neuropathological staging and subtyping of TDP-43 proteinopathies’ by Young et al. (https://doi.org/10.1093/brain/awad145).
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Affiliation(s)
- Richard A Hickman
- Department of Defense/Uniformed Services University Brain Tissue Repository, Uniformed Services University, Bethesda, MD 20817, USA
- Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD 20817, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY 10065, USA
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD 21287, USA
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6
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Hickman RA, Miller AM, Arcila ME. Cerebrospinal fluid: A unique source of circulating tumor DNA with broad clinical applications. Transl Oncol 2023; 33:101688. [PMID: 37196447 DOI: 10.1016/j.tranon.2023.101688] [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: 10/03/2022] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023] Open
Abstract
Malignancies involving the central nervous system present unique challenges for diagnosis and monitoring due to the difficulties and risks of direct biopsies and the low specificity and/or sensitivity of other techniques for assessment. In recent years, liquid biopsy of the cerebrospinal fluid (CSF) has emerged as a convenient alternative that combines minimal invasiveness with the ability to detect disease-defining or therapeutically actionable genetic alterations from circulating tumor DNA (ctDNA). Since CSF can be obtained by lumbar puncture, or an established ventricular access device at multiple time points, ctDNA analysis enables initial molecular characterization and longitudinal monitoring throughout a patient's disease course, promoting optimization of treatment regimens. This review outlines some of the key aspects of ctDNA from CSF as a highly suitable approach for clinical assessment, the benefits and drawbacks, testing methods, as well as potential future advancements in this field. We anticipate wider adoption of this practice as technologies and pipelines improve and envisage significant improvements for cancer care.
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Affiliation(s)
- Richard A Hickman
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, United States; Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Alexandra M Miller
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, NY, United States; Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Maria E Arcila
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
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7
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Hickman RA, Traynor BJ, Marder KS, Vonsattel JP. Reply: More than a co-incidence? Exploring the increased frequency of amyotrophic lateral sclerosis in Huntington disease. Acta Neuropathol 2023; 145:259-261. [PMID: 36542109 PMCID: PMC10132522 DOI: 10.1007/s00401-022-02532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Richard A Hickman
- Department of Defense/Uniformed Services University Brain Tissue Repository, Uniformed Services University, Bethesda, MD, 20817, USA.
- Human Oncogenesis and Pathogenesis Program, Sloan Kettering Institute, New York, NY, 10065, USA.
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, 20892, USA
| | - Karen S Marder
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Jean-Paul Vonsattel
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
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8
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Lim RG, Al-Dalahmah O, Wu J, Gold MP, Reidling JC, Tang G, Adam M, Dansu DK, Park HJ, Casaccia P, Miramontes R, Reyes-Ortiz AM, Lau A, Hickman RA, Khan F, Paryani F, Tang A, Ofori K, Miyoshi E, Michael N, McClure N, Flowers XE, Vonsattel JP, Davidson S, Menon V, Swarup V, Fraenkel E, Goldman JE, Thompson LM. Huntington disease oligodendrocyte maturation deficits revealed by single-nucleus RNAseq are rescued by thiamine-biotin supplementation. Nat Commun 2022; 13:7791. [PMID: 36543778 PMCID: PMC9772349 DOI: 10.1038/s41467-022-35388-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
The complexity of affected brain regions and cell types is a challenge for Huntington's disease (HD) treatment. Here we use single nucleus RNA sequencing to investigate molecular pathology in the cortex and striatum from R6/2 mice and human HD post-mortem tissue. We identify cell type-specific and -agnostic signatures suggesting oligodendrocytes (OLs) and oligodendrocyte precursors (OPCs) are arrested in intermediate maturation states. OL-lineage regulators OLIG1 and OLIG2 are negatively correlated with CAG length in human OPCs, and ATACseq analysis of HD mouse NeuN-negative cells shows decreased accessibility regulated by OL maturation genes. The data implicates glucose and lipid metabolism in abnormal cell maturation and identify PRKCE and Thiamine Pyrophosphokinase 1 (TPK1) as central genes. Thiamine/biotin treatment of R6/1 HD mice to compensate for TPK1 dysregulation restores OL maturation and rescues neuronal pathology. Our insights into HD OL pathology spans multiple brain regions and link OL maturation deficits to abnormal thiamine metabolism.
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Affiliation(s)
- Ryan G Lim
- UCI MIND, University of California Irvine, Irvine, CA, USA
| | - Osama Al-Dalahmah
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Jie Wu
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, USA
| | - Maxwell P Gold
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Guomei Tang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Miriam Adam
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - David K Dansu
- Advanced Science Research Center at the City University of New York, New York, NY, USA
| | - Hye-Jin Park
- Advanced Science Research Center at the City University of New York, New York, NY, USA
| | - Patrizia Casaccia
- Advanced Science Research Center at the City University of New York, New York, NY, USA
| | | | - Andrea M Reyes-Ortiz
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, USA
| | - Alice Lau
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Fatima Khan
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Fahad Paryani
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Alice Tang
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Kenneth Ofori
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Emily Miyoshi
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Neethu Michael
- Department of Pathology, University of California Irvine, Irvine, CA, USA
| | - Nicolette McClure
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Xena E Flowers
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York City, New York, NY, USA
| | - Jean Paul Vonsattel
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York City, New York, NY, USA
| | - Shawn Davidson
- Lewis-Sigler Institute for Integrative Genomics, Princeton, NJ, USA
| | - Vilas Menon
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - Vivek Swarup
- UCI MIND, University of California Irvine, Irvine, CA, USA
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Ernest Fraenkel
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - James E Goldman
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York City, New York, NY, USA.
| | - Leslie M Thompson
- UCI MIND, University of California Irvine, Irvine, CA, USA.
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, USA.
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA.
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA.
- Sue and Bill Gross Stem Cell Center University of California Irvine, Irvine, CA, USA.
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Pitt D, Lo CH, Gauthier SA, Hickman RA, Longbrake E, Airas LM, Mao-Draayer Y, Riley C, De Jager PL, Wesley S, Boster A, Topalli I, Bagnato F, Mansoor M, Stuve O, Kister I, Pelletier D, Stathopoulos P, Dutta R, Lincoln MR. Toward Precision Phenotyping of Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/6/e200025. [PMID: 36041861 PMCID: PMC9427000 DOI: 10.1212/nxi.0000000000200025] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 02/07/2022] [Indexed: 11/15/2022]
Abstract
The classification of multiple sclerosis (MS) has been established by Lublin in 1996 and revised in 2013. The revision includes clinically isolated syndrome, relapsing-remitting, primary progressive and secondary progressive MS, and has added activity (i.e., formation of white matter lesions or clinical relapses) as a qualifier. This allows for the distinction between active and nonactive progression, which has been shown to be of clinical importance. We propose that a logical extension of this classification is the incorporation of additional key pathological processes, such as chronic perilesional inflammation, neuroaxonal degeneration, and remyelination. This will distinguish MS phenotypes that may present as clinically identical but are driven by different combinations of pathological processes. A more precise description of MS phenotypes will improve prognostication and personalized care as well as clinical trial design. Thus, our proposal provides an expanded framework for conceptualizing MS and for guiding development of biomarkers for monitoring activity along the main pathological axes in MS.
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Affiliation(s)
- David Pitt
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada.
| | - Chih Hung Lo
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Susan A Gauthier
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Richard A Hickman
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Erin Longbrake
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Laura M Airas
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Yang Mao-Draayer
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Claire Riley
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Philip Lawrence De Jager
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Sarah Wesley
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Aaron Boster
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Ilir Topalli
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Francesca Bagnato
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Mohammad Mansoor
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Olaf Stuve
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Ilya Kister
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Daniel Pelletier
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Panos Stathopoulos
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Ranjan Dutta
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
| | - Matthew R Lincoln
- From the Yale University (David Pitt, C.H.L., E.L., M.M., M.R.L.), New Haven; Nanyang Technological University (C.H.L.), Singapore; Weill Cornell Medicine (S.A.G.), New York; Memorial Sloan Kettering Cancer Center (R.A.H.), New York; University of Turku (L.M.A.), Finland; University of Michigan Medical School (Y.M.-D.), Ann Arbor; Columbia University Medical Center (C.R., P.L.D.J., S.W.), New York; The Boster Center for Multiple Sclerosis (A.B.), Columbus, OH; Cerneris Inc (I.T.), Wilmington, DE; Vanderbilt University Medical Center (F.B.), Nashville, TN; University of Texas Southwestern Medical Center (O.S.), Dallas; NYU Langone Medical Center (I.K.), New York; University of Southern California (Daniel Pelletier), Los Angeles; National and Kapodistrian University of Athens Medical School (P.S.), Greece; Cleveland Clinic Lerner College of Medicine (R.D.), Case Western Reserve University, OH; and University of Toronto and St. Michael's Hospital (M.L.), ON, Canada
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Hickman RA, Faust PL, Marder K, Yamamoto A, Vonsattel JP. The distribution and density of Huntingtin inclusions across the Huntington disease neocortex: regional correlations with Huntingtin repeat expansion independent of pathologic grade. Acta Neuropathol Commun 2022; 10:55. [PMID: 35440014 PMCID: PMC9020040 DOI: 10.1186/s40478-022-01364-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/08/2022] [Indexed: 12/12/2022] Open
Abstract
Huntington disease is characterized by progressive neurodegeneration, especially of the striatum, and the presence of polyglutamine huntingtin (HTT) inclusions. Although HTT inclusions are most abundant in the neocortex, their neocortical distribution and density in relation to the extent of CAG repeat expansion in the HTT gene and striatal pathologic grade have yet to be formally established. We immunohistochemically studied 65 brains with a pathologic diagnosis of Huntington disease to investigate the cortical distributions and densities of HTT inclusions within the calcarine (BA17), precuneus (BA7), motor (BA4) and prefrontal (BA9) cortices; in 39 of these brains, a p62 immunostain was used for comparison. HTT inclusions predominate in the infragranular cortical layers (layers V-VI) and layer III, however, the densities of HTT inclusions across the human cerebral cortex are not uniform but are instead regionally contingent. The density of HTT and p62 inclusions (intranuclear and extranuclear) in layers V-VI increases caudally to rostrally (BA17 < BA7 < BA4 < BA9) with the median burden of HTT inclusions being 38-fold greater in the prefrontal cortex (BA9) than in the calcarine cortex (BA17). Conversely, intranuclear HTT inclusions prevail in the calcarine cortex irrespective of HTT CAG length. Neocortical HTT inclusion density correlates with CAG repeat expansion, but not with the neuropathologic grade of striatal degeneration (Vonsattel grade) or with the duration of clinical disease since motor onset. Extrapolation of these findings suggest that HTT inclusions are at a regionally-contingent, CAG-dependent, density during the advanced stages of HD. The distribution and density of HTT inclusions in HD therefore does not provide a measure of pathologic disease stage but rather infers the degree of pathogenic HTT expansion.
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Affiliation(s)
- Richard A. Hickman
- grid.51462.340000 0001 2171 9952Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| | - Phyllis L. Faust
- grid.413734.60000 0000 8499 1112Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032 USA
| | - Karen Marder
- grid.21729.3f0000000419368729Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Ai Yamamoto
- grid.413734.60000 0000 8499 1112Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032 USA ,grid.21729.3f0000000419368729Department of Neurology, Columbia University Irving Medical Center, New York, USA
| | - Jean-Paul Vonsattel
- grid.413734.60000 0000 8499 1112Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032 USA ,grid.239585.00000 0001 2285 2675Taub Institute for Research On Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY 10032 USA
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11
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Troy C, Gill BJA, Miller ML, Hickman RA, Canoll P, Zacharoulis S, Feldstein NA, Bruce JN. Adenocarcinoma Arising in a Yolk Sac Tumor of the Pineal Gland. J Neuropathol Exp Neurol 2022; 81:291-295. [PMID: 35172008 DOI: 10.1093/jnen/nlac002] [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: 11/14/2022] Open
Affiliation(s)
- Christopher Troy
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Brian J A Gill
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael L Miller
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Peter Canoll
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Stergios Zacharoulis
- Department of Hematology-Oncology, Columbia University Irving Medical Center, New York, New York, USA
| | - Neil A Feldstein
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA
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Hickman RA, Gionco JT, Faust PL, Miller ML, Bruce J, Page-Wilson G, Rosenblum MK, Asa SL. Pituitary corticotroph tumour with adrenocortical cells: A distinct clinicopathologic entity with unique morphology and methylation profile. Neuropathol Appl Neurobiol 2022; 48:e12754. [PMID: 34296770 PMCID: PMC9344380 DOI: 10.1111/nan.12754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/27/2022]
Abstract
We describe a rare TPIT-positive corticotroph PitNET that is admixed with SF1-positive adrenocortical cells. This dimorphous population of cells showed no colocalisation between TPIT and SF1 by immunofluorescence, and an adrenocortical choristoma was favoured. Methylation array analysis revealed a novel methylation profile in relation to other pituitary neoplasms.
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Affiliation(s)
- Richard A. Hickman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - John T. Gionco
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Phyllis L. Faust
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Michael L. Miller
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Jeffrey Bruce
- Department of Neurological Surgery, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Gabrielle Page-Wilson
- Department of Medicine, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Marc K. Rosenblum
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sylvia L. Asa
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, USA
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13
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Hickman RA, Dewan R, Cortes E, Traynor BJ, Marder K, Vonsattel JP. Amyotrophic lateral sclerosis is over-represented in two Huntington's disease brain bank cohorts: further evidence to support genetic pleiotropy of pathogenic HTT gene expansion. Acta Neuropathol 2022; 143:105-108. [PMID: 34800149 PMCID: PMC8918027 DOI: 10.1007/s00401-021-02385-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Richard A Hickman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA.
| | - Ramita Dewan
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, 20892, USA
| | - Etty Cortes
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, 20892, USA
| | - Karen Marder
- Department of Neurology and Psychiatry, Columbia University Irving Medical Center, New York, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Jean-Paul Vonsattel
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, 630 W 168th Street, New York, NY, 10032, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
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14
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Thakur KT, Miller EH, Glendinning MD, Al-Dalahmah O, Banu MA, Boehme AK, Boubour AL, Bruce SS, Chong AM, Claassen J, Faust PL, Hargus G, Hickman RA, Jambawalikar S, Khandji AG, Kim CY, Klein RS, Lignelli-Dipple A, Lin CC, Liu Y, Miller ML, Moonis G, Nordvig AS, Overdevest JB, Prust ML, Przedborski S, Roth WH, Soung A, Tanji K, Teich AF, Agalliu D, Uhlemann AC, Goldman JE, Canoll P. COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital. Brain 2021; 144:2696-2708. [PMID: 33856027 PMCID: PMC8083258 DOI: 10.1093/brain/awab148] [Citation(s) in RCA: 222] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 11/14/2022] Open
Abstract
Many patients with SARS-CoV-2 infection develop neurological signs and symptoms; although, to date, little evidence exists that primary infection of the brain is a significant contributing factor. We present the clinical, neuropathological and molecular findings of 41 consecutive patients with SARS-CoV-2 infections who died and underwent autopsy in our medical centre. The mean age was 74 years (38-97 years), 27 patients (66%) were male and 34 (83%) were of Hispanic/Latinx ethnicity. Twenty-four patients (59%) were admitted to the intensive care unit. Hospital-associated complications were common, including eight patients (20%) with deep vein thrombosis/pulmonary embolism, seven (17%) with acute kidney injury requiring dialysis and 10 (24%) with positive blood cultures during admission. Eight (20%) patients died within 24 h of hospital admission, while 11 (27%) died more than 4 weeks after hospital admission. Neuropathological examination of 20-30 areas from each brain revealed hypoxic/ischaemic changes in all brains, both global and focal; large and small infarcts, many of which appeared haemorrhagic; and microglial activation with microglial nodules accompanied by neuronophagia, most prominently in the brainstem. We observed sparse T lymphocyte accumulation in either perivascular regions or in the brain parenchyma. Many brains contained atherosclerosis of large arteries and arteriolosclerosis, although none showed evidence of vasculitis. Eighteen patients (44%) exhibited pathologies of neurodegenerative diseases, which was not unexpected given the age range of our patients. We examined multiple fresh frozen and fixed tissues from 28 brains for the presence of viral RNA and protein, using quantitative reverse-transcriptase PCR, RNAscope® and immunocytochemistry with primers, probes and antibodies directed against the spike and nucleocapsid regions. The PCR analysis revealed low to very low, but detectable, viral RNA levels in the majority of brains, although they were far lower than those in the nasal epithelia. RNAscope® and immunocytochemistry failed to detect viral RNA or protein in brains. Our findings indicate that the levels of detectable virus in coronavirus disease 2019 brains are very low and do not correlate with the histopathological alterations. These findings suggest that microglial activation, microglial nodules and neuronophagia, observed in the majority of brains, do not result from direct viral infection of brain parenchyma, but more likely from systemic inflammation, perhaps with synergistic contribution from hypoxia/ischaemia. Further studies are needed to define whether these pathologies, if present in patients who survive coronavirus disease 2019, might contribute to chronic neurological problems.
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Affiliation(s)
- Kiran T Thakur
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Emily Happy Miller
- Department of Medicine, Division of Infectious Diseases, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the NewYork Presbyterian Hospital, New York, NY 10032, USA
| | - Michael D Glendinning
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Osama Al-Dalahmah
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Matei A Banu
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Amelia K Boehme
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Alexandra L Boubour
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Samuel S Bruce
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Alexander M Chong
- Department of Medicine, Division of Infectious Diseases, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the NewYork Presbyterian Hospital, New York, NY 10032, USA
| | - Jan Claassen
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Phyllis L Faust
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Gunnar Hargus
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Sachin Jambawalikar
- Department of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Alexander G Khandji
- Department of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Carla Y Kim
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Robyn S Klein
- Departments of Medicine, Pathology and Immunology, Neurosciences, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Angela Lignelli-Dipple
- Department of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Chun-Chieh Lin
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
| | - Yang Liu
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Michael L Miller
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Gul Moonis
- Department of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Anna S Nordvig
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Jonathan B Overdevest
- Department of Otolaryngology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, The New York Presbyterian Hospital, New York, NY 10032, USA
| | - Morgan L Prust
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Serge Przedborski
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
- Department of Neuroscience, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - William H Roth
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Allison Soung
- Departments of Medicine, Pathology and Immunology, Neurosciences, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Kurenai Tanji
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Andrew F Teich
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Dritan Agalliu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Anne-Catrin Uhlemann
- Department of Medicine, Division of Infectious Diseases, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the NewYork Presbyterian Hospital, New York, NY 10032, USA
| | - James E Goldman
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
| | - Peter Canoll
- Department of Pathology and Cell Biology, Division of Neuropathology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, and the New York Presbyterian Hospital, New York, NY 10032, USA
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15
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Fan Y, Nirujogi RS, Garrido A, Ruiz-Martínez J, Bergareche-Yarza A, Mondragón-Rezola E, Vinagre-Aragón A, Croitoru I, Gorostidi Pagola A, Paternain Markinez L, Alcalay R, Hickman RA, Düring J, Gomes S, Pratuseviciute N, Padmanabhan S, Valldeoriola F, Pérez Sisqués L, Malagelada C, Ximelis T, Molina Porcel L, Martí MJ, Tolosa E, Alessi DR, Sammler EM. R1441G but not G2019S mutation enhances LRRK2 mediated Rab10 phosphorylation in human peripheral blood neutrophils. Acta Neuropathol 2021; 142:475-494. [PMID: 34125248 PMCID: PMC8357670 DOI: 10.1007/s00401-021-02325-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/30/2022]
Abstract
Heterozygous gain-of-kinase function variants in LRRK2 (leucine-rich repeat kinase 2) cause 1-2% of all cases of Parkinson's disease (PD) albeit with incomplete and age-dependent penetrance. All pathogenic LRRK2 mutations reside within the two catalytic domains of LRRK2-either in its kinase domain (e.g. G2019S) with modest effect or its ROC-COR GTPase domain (e.g. R1441G/H) with large effect on LRRK2 kinase activity. We have previously reported assays to interrogate LRRK2 kinase pathway activity in human bio-samples measuring phosphorylation of its endogenous substrate Rab10, that mirrors LRRK2 kinase activation status. Here, we isolated neutrophils from fresh peripheral blood from 101 participants including 42 LRRK2 mutation carriers (21 with the G2019S and 21 with the R1441G mutations), 27 patients with idiopathic PD, and 32 controls. Using a dual approach, LRRK2 dependent Rab10 phosphorylation at Threonine 73 (pRab10Thr73) was measured by quantitative multiplexed immunoblotting for pRab10Thr73/total Rab10 as well as targeted mass-spectrometry for absolute pRab10Thr73 occupancy. We found a significant over fourfold increase in pRab10Thr73 phosphorylation in carriers of the LRRK2 R1441G mutation irrespective of clinical disease status. The effect of the LRRK2 G2019S mutation did not reach statistical significance. Furthermore, we show that LRRK2 phosphorylation at Serine 935 is not a marker for LRRK2 kinase activity in human neutrophils. When analysing pRab10Thr73 phosphorylation in post-mortem brain samples, we observed overall high variability irrespective of clinical and LRRK2 mutation status and attributed this mainly to the adverse effect of the peri- and post-mortem period on the stability of posttranslational modifications such as protein phosphorylation. Overall, in vivo LRRK2 dependent pRab10Thr73 phosphorylation in human peripheral blood neutrophils is a specific, robust and promising biomarker for significant LRRK2 kinase hyperactivation, as with the LRRK2 R1441G mutation. Additional readouts and/or assays may be needed to increase sensitivity to detect modest LRRK2 kinase activation, as with the LRRK2 G2019S mutation. Our assays could be useful for patient stratification and target engagement studies for LRRK2 kinase inhibitors.
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Affiliation(s)
- Ying Fan
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | - Raja S Nirujogi
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | - Alicia Garrido
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Javier Ruiz-Martínez
- Group of Neurodegenerative Diseases, Biodonostia Research Institute, San Sebastian, Spain
| | | | | | - Ana Vinagre-Aragón
- Group of Neurodegenerative Diseases, Biodonostia Research Institute, San Sebastian, Spain
| | - Ioana Croitoru
- Group of Neurodegenerative Diseases, Biodonostia Research Institute, San Sebastian, Spain
| | - Ana Gorostidi Pagola
- Group of Neurodegenerative Diseases, Biodonostia Research Institute, San Sebastian, Spain
| | | | - Roy Alcalay
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Jonas Düring
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | - Sara Gomes
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | - Neringa Pratuseviciute
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | | | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Leticia Pérez Sisqués
- Departament de Biomedicina, Facultat de Medicina I Ciències de La Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Cristina Malagelada
- Departament de Biomedicina, Facultat de Medicina I Ciències de La Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Teresa Ximelis
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Molina Porcel
- Neurological Tissue Bank of the Biobanc-Hospital Clinic-Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut D'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria José Martí
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Eduardo Tolosa
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Dario R Alessi
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK
| | - Esther M Sammler
- Medical Research Council Protein Phosphorylation and Ubiquitylation Unit, University of Dundee, Dundee, DD1 5EH, UK.
- Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK.
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16
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O'Shea SA, Hickman RA, Cortes E, Vonsattel JP, Fahn S, Okur V, Alcalay RN, Chung WK. Neuropathological Findings in a Case of Parkinsonism and Developmental Delay Associated with a Monoallelic Variant in PLXNA1. Mov Disord 2021; 36:2681-2687. [PMID: 34415653 DOI: 10.1002/mds.28756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/02/2021] [Accepted: 07/19/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND PLXNA1 encodes for Plexin-A, a transmembrane protein expressed in the developing nervous system. Mutations in this gene have been associated with developmental delay but have not been previously associated with the development of parkinsonism. OBJECTIVES To describe the case of a 38-year-old patient with developmental delay who developed parkinsonism later in life. METHODS Post-mortem exome sequencing was performed with confirmation by Sanger sequencing. Brain autopsy was also performed. RESULTS Post-mortem exome sequencing on the proband identified a heterozygous predicted nonsense PLXNA1 variant (c.G3361T:p.Glu1121Ter). Pathology demonstrated arhinencephaly with brainstem heterotopia, diffuse Lewy body disease, and frontotemporal lobar dementia-tau. CONCLUSIONS This case of a patient with developmental delay and parkinsonism with PLXNA1 mutation highlights a need for assessing long-term outcomes of individuals with neurodevelopmental disorders, as well as the need for genetic testing in adults. It also suggests that the link between PLXNA1 and α-synuclein should be explored in the future. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sarah A O'Shea
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Richard A Hickman
- Department of Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Etty Cortes
- Department of Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.,Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jean Paul Vonsattel
- Department of Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Stanley Fahn
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Volkan Okur
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
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17
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Hickman RA, Faust PL, Rosenblum MK, Marder K, Mehler MF, Vonsattel JP. Developmental malformations in Huntington disease: neuropathologic evidence of focal neuronal migration defects in a subset of adult brains. Acta Neuropathol 2021; 141:399-413. [PMID: 33517535 PMCID: PMC7882590 DOI: 10.1007/s00401-021-02269-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/27/2020] [Accepted: 01/19/2021] [Indexed: 12/14/2022]
Abstract
Neuropathologic hallmarks of Huntington Disease (HD) include the progressive neurodegeneration of the striatum and the presence of Huntingtin (HTT) aggregates that result from abnormal polyQ expansion of the HTT gene. Whether the pathogenic trinucleotide repeat expansion of the HTT gene causes neurodevelopmental abnormalities has garnered attention in both murine and human studies; however, documentation of discrete malformations in autopsy brains of HD individuals has yet to be described. We retrospectively searched the New York Brain Bank (discovery cohort) and an independent cohort (validation cohort) to determine whether developmental malformations are more frequently detected in HD versus non-HD brains and to document their neuropathologic features. One-hundred and thirty HD and 1600 non-HD whole brains were included in the discovery cohort and 720 HD and 1989 non-HD half brains were assessed in the validation cohort. Cases with developmental malformations were found at 6.4–8.2 times greater frequency in HD than in non-HD brains (discovery cohort: OR 8.68, 95% CI 3.48–21.63, P=4.8 × 10-5; validation cohort: OR 6.50, 95% CI 1.83–23.17, P=0.0050). Periventricular nodular heterotopias (PNH) were the most frequent malformations and contained HTT and p62 aggregates analogous to the cortex, whereas cortical malformations with immature neuronal populations did not harbor such inclusions. HD individuals with malformations had heterozygous HTT CAG expansions between 40 and 52 repeats, were more frequently women, and all were asymmetric and focal, aside from one midline hypothalamic hamartoma. Using two independent brain bank cohorts, this large neuropathologic series demonstrates an increased occurrence of developmental malformations in HD brains. Since pathogenic HTT gene expansion is associated with genomic instability, one possible explanation is that neuronal precursors are more susceptible to somatic mutation of genes involved in cortical migration. Our findings further support emerging evidence that pathogenic trinucleotide repeat expansions of the HTT gene may impact neurodevelopment.
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Affiliation(s)
- R A Hickman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, USA.
| | - P L Faust
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, USA
| | - M K Rosenblum
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - K Marder
- Department of Neurology and Psychiatry, Columbia University Irving Medical Center, New York, USA
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - M F Mehler
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, New York, USA
- Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, USA
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, USA
| | - J P Vonsattel
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, USA
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
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18
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Dewan R, Chia R, Ding J, Hickman RA, Stein TD, Abramzon Y, Ahmed S, Sabir MS, Portley MK, Tucci A, Ibáñez K, Shankaracharya FNU, Keagle P, Rossi G, Caroppo P, Tagliavini F, Waldo ML, Johansson PM, Nilsson CF, Rowe JB, Benussi L, Binetti G, Ghidoni R, Jabbari E, Viollet C, Glass JD, Singleton AB, Silani V, Ross OA, Ryten M, Torkamani A, Tanaka T, Ferrucci L, Resnick SM, Pickering-Brown S, Brady CB, Kowal N, Hardy JA, Van Deerlin V, Vonsattel JP, Harms MB, Morris HR, Ferrari R, Landers JE, Chiò A, Gibbs JR, Dalgard CL, Scholz SW, Traynor BJ. Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis. Neuron 2021; 109:448-460.e4. [PMID: 33242422 PMCID: PMC7864894 DOI: 10.1016/j.neuron.2020.11.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/02/2020] [Accepted: 11/04/2020] [Indexed: 02/01/2023]
Abstract
We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40-64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered.
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Affiliation(s)
- Ramita Dewan
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Ruth Chia
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Jinhui Ding
- Computational Biology Group, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Thor D Stein
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA; Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA 02118, USA; Research and Development Service, Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA; Department of Veterans Affairs Medical Center, Bedford, MA 01730, USA
| | - Yevgeniya Abramzon
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA; Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, University College London, London WC1N 1PJ, UK
| | - Sarah Ahmed
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
| | - Marya S Sabir
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
| | - Makayla K Portley
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
| | - Arianna Tucci
- Clinical Pharmacology, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - Kristina Ibáñez
- Clinical Pharmacology, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
| | - F N U Shankaracharya
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Pamela Keagle
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Giacomina Rossi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan 20133, Italy
| | - Paola Caroppo
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan 20133, Italy
| | - Fabrizio Tagliavini
- Scientific Directorate, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan 20133, Italy
| | - Maria L Waldo
- Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Lund 221 84, Sweden
| | - Per M Johansson
- Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Lund 221 84, Sweden; Department of Internal Medicine, Sahlgrenska Academy, University of Gottenburg, Gottenburg 413 45, Sweden
| | - Christer F Nilsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, 205 02 Malmö, Sweden
| | - James B Rowe
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, Cambridge Biomedical Campus, Cambridge CB2 02Z, UK
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy
| | - Giuliano Binetti
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy; MAC Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia 25125, Italy
| | - Edwin Jabbari
- Department of Neurology, Royal Free Hospital, London NW3 2PF, UK; Department of Clinical and Movement Neuroscience, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Coralie Viollet
- Department of Anatomy, Physiology and Genetics, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Jonathan D Glass
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Andrew B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Vincenzo Silani
- Department of Neurology - Stroke Unit and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy; Department of Pathophysiology and Transplantation, Dino Ferrari Center, Università degli Studi di Milano, Milan 20122, Italy
| | - Owen A Ross
- Department of Neuroscience & Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Mina Ryten
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, University College London, London WC1N 1PJ, UK; Genetics and Genomic Medicine, Great Ormond Street Institute of Child Health, University College London, London WC1E 6BT, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London WC1N 3JH, UK
| | - Ali Torkamani
- The Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Toshiko Tanaka
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD 21224, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD 21224, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD 21224, USA
| | - Stuart Pickering-Brown
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK
| | - Christopher B Brady
- Department of Neurology & Program in Behavioral Neuroscience, Boston University School of Medicine, Boston, MA 02118, USA; Research and Development Service, Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA
| | - Neil Kowal
- Department of Neurology, Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA; Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - John A Hardy
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, University College London, London WC1N 1PJ, UK; Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK; UK Dementia Research Institute at UCL and Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK; NINR University College London Hospitals Biomedical Research Centre, University College London, London W1T 7DN, UK; Institute for Advanced Study, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Vivianna Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jean Paul Vonsattel
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Matthew B Harms
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Huw R Morris
- Department of Neurology, Royal Free Hospital, London NW3 2PF, UK; Department of Clinical and Movement Neuroscience, Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Raffaele Ferrari
- Department of Neurology, Royal Free Hospital, London NW3 2PF, UK
| | - John E Landers
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Adriano Chiò
- Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin 10126, Italy; Institute of Cognitive Sciences and Technologies, C.N.R., Rome 00185, Italy; Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Turin 10126, Italy
| | - J Raphael Gibbs
- Computational Biology Group, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Clifton L Dalgard
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA; Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD 21287, USA
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA; Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, University College London, London WC1N 1PJ, UK; Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD 21287, USA.
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Hickman RA, Bruce JN, Otten M, Khandji AG, Flowers XE, Siegelin M, Lopes B, Faust PL, Freda PU. Gonadotroph tumours with a low SF-1 labelling index are more likely to recur and are associated with enrichment of the PI3K-AKT pathway. Neuropathol Appl Neurobiol 2020; 47:415-427. [PMID: 33128255 DOI: 10.1111/nan.12675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/09/2020] [Revised: 10/19/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022]
Abstract
AIMS The gonadotroph tumour (GT) is the most frequently resected pituitary neuroendocrine tumour. Although many symptomatic GT are successfully resected, some recur. We sought to identify histological biomarkers that may predict recurrence and explore biological mechanisms that explain this difference in behaviour. METHODS SF-1 immunohistochemistry of 51 GT, a subset belonging to a longitudinal prospective cohort study (n = 25), was reviewed. Four groups were defined: Group 1-recently diagnosed GT (n = 20), Group 2-non-recurrent GT with long-term follow up (n = 11), Group 3-initial resections of GT that recur (n = 7) and Group 4-recurrent GT (n = 13). The percentage of SF-1 immunolabelling in the lowest staining fields (SF-1 labelling index (SLI)) was assessed and RNA sequencing was performed on 5 GT with SLI <80% and 5 GT with SLI >80%. RESULTS Diffuse, strong SF-1 immunolabelling was the most frequent pattern in Groups 1/2, whereas patchy SF-1 staining predominated in Groups 3/4. There was a lower median SLI in Groups 3/4 than 1/2. Overall, GT with SLI <80% recurred earlier than GT with SLI >80%. Differential expression analysis identified 89 statistically significant differentially expressed genes (FDR <0.05) including over-expression of pituitary stem cell genes (SOX2, GFRA3) and various oncogenes (e.g. BCL2, ERRB4) in patchy SF-1 GT. Gene set enrichment analysis identified significant enrichment of genes involved in the PI3K-AKT pathway. CONCLUSIONS We speculate that patchy SF-1 labelling in GT reflects intratumoural heterogeneity and are less differentiated tumours than diffusely staining GT. SF-1 immunolabelling patterns may have prognostic significance in GT, but confirmatory studies are needed for further validation.
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Affiliation(s)
- Richard A Hickman
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Jeffrey N Bruce
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - Marc Otten
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - Alexander G Khandji
- Department of Radiology, Columbia University Medical Center, New York, NY, USA
| | - Xena E Flowers
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Markus Siegelin
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Beatriz Lopes
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Phyllis L Faust
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Pamela U Freda
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
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Hickman RA, Vonsattel JP, Agin-Liebes J, Marder K, Alcalay RN. Authors' replies to the comments of Koga et al. on "Movement disorders rounds: A case of missing pathology in a patient with LRRK2 Parkinson's disease". Parkinsonism Relat Disord 2020; 79:131-132. [PMID: 32928644 DOI: 10.1016/j.parkreldis.2020.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/28/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Richard A Hickman
- Department of Pathology and Cell Biology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 W. 168th St, New York, NY, 10032, USA
| | - Jean-Paul Vonsattel
- Department of Pathology and Cell Biology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 W. 168th St, New York, NY, 10032, USA
| | - Julian Agin-Liebes
- Department of Neurology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Karen Marder
- Department of Neurology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA.
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21
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Al-Dalahmah O, Thakur KT, Nordvig AS, Prust ML, Roth W, Lignelli A, Uhlemann AC, Miller EH, Kunnath-Velayudhan S, Del Portillo A, Liu Y, Hargus G, Teich AF, Hickman RA, Tanji K, Goldman JE, Faust PL, Canoll P. Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage. Acta Neuropathol Commun 2020; 8:147. [PMID: 32847628 PMCID: PMC7447601 DOI: 10.1186/s40478-020-01024-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/15/2020] [Indexed: 02/07/2023] Open
Abstract
We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection.
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22
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Hickman RA, Flowers XE, Wisniewski T. Primary Age-Related Tauopathy (PART): Addressing the Spectrum of Neuronal Tauopathic Changes in the Aging Brain. Curr Neurol Neurosci Rep 2020; 20:39. [PMID: 32666342 DOI: 10.1007/s11910-020-01063-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Primary age-related tauopathy (PART) was recently proposed as a pathologic diagnosis for brains that harbor neurofibrillary tangles (Braak stage ≤ 4) with little, if any, amyloid burden. We sought to review the clinicopathologic findings related to PART. RECENT FINDINGS Most adult human brains show at least focal tauopathic changes, and the majority of individuals with PART do not progress to dementia. Older age and cognitive impairment correlate with increased Braak stage, and multivariate analyses suggest that the rate of cognitive decline is less than matched patients with Alzheimer disease (AD). It remains unclear whether PART is a distinct tauopathic entity separate from AD or rather represents an earlier histologic stage of AD. Cognitive decline in PART is usually milder than AD and correlates with tauopathic burden. Biomarker and ligand-based radiologic studies will be important to define PART antemortem and prospectively follow its natural history.
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Affiliation(s)
- Richard A Hickman
- Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 630 West 168th Street, PH 15-124, New York, NY, 10032, USA.
| | - Xena E Flowers
- Department of Pathology and Cell Biology and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, 630 West 168th Street, PH 15-124, New York, NY, 10032, USA
| | - Thomas Wisniewski
- Departments of Neurology, Pathology and Psychiatry, Center for Cognitive Neurology, NYU School of Medicine, Science Building, Rm 1017, 435 East 30th Street, New York, NY, 10016, USA
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Asa SL, Asioli S, Bozkurt S, Casar-Borota O, Chinezu L, Comunoglu N, Cossu G, Cusimano M, Delgrange E, Earls P, Ezzat S, Gazioglu N, Grossman A, Guaraldi F, Hickman RA, Ikeda H, Jaffrain-Rea ML, Karavitaki N, Kraljević I, La Rosa S, Manojlović-Gačić E, Maartens N, McCutcheon IE, Messerer M, Mete O, Nishioka H, Oz B, Pakbaz S, Pekmezci M, Perry A, Reiniger L, Roncaroli F, Saeger W, Söylemezoğlu F, Tachibana O, Trouillas J, Turchini J, Uccella S, Villa C, Yamada S, Yarman S. Pituitary neuroendocrine tumors (PitNETs): nomenclature evolution, not clinical revolution. Pituitary 2020; 23:322-325. [PMID: 31834538 DOI: 10.1007/s11102-019-01015-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sylvia L Asa
- Case Western Reserve University, Cleveland, USA.
| | - Sofia Asioli
- Universita degli Studi di Bologna Scuola di Medicina e Chirurgia, Bologna, Italy
| | | | | | - Laura Chinezu
- University of Medicine and Pharmacy of Târgu-Mureş, Mures, Romania
| | | | | | | | | | - Peter Earls
- Saint Vincents Hospital, University of Sydney, Darlinghurst, Australia
| | | | | | | | - Federica Guaraldi
- Universita degli Studi di Bologna Scuola di Medicina e Chirurgia, Bologna, Italy
| | | | | | | | | | | | | | | | - Niki Maartens
- Alfred Hospital, University of Melbourne, Parkville, Australia
| | | | | | | | | | - Buge Oz
- Cerrahpasa University, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | | | | - Silvia Uccella
- Università degli studi dell'Insubria Varese, Varèse, Italy
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Leskinen S, Flowers X, Thoene K, Uhlemann AC, Goldman JE, Hickman RA. Meningomyeloencephalitis secondary to Mycobacterium haemophilum infection in AIDS. Acta Neuropathol Commun 2020; 8:73. [PMID: 32430060 PMCID: PMC7236527 DOI: 10.1186/s40478-020-00937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022] Open
Abstract
Infections by opportunistic non-tuberculous mycobacteria (NTM) are rising in global incidence. One emerging, slowly growing NTM is Mycobacterium haemophilum, which can cause skin, lung, bone, and soft tissue infections in immunocompromised patients as well as lymphadenitis in immunocompetent individuals. Detection of this microorganism is difficult using conventional culture-based methods and few reports have documented involvement of this pathogen within the central nervous system (CNS). We describe the neuropathologic autopsy findings of a 39-year-old man with AIDS who died secondary to M. haemophilum CNS infection. He initially presented with repeated bouts of pyrexia, nausea and vomiting, and altered mental status that required numerous hospitalizations. CSF infectious workups were consistently negative. His most recent admission identified hyperintensities within the brainstem by MRI and despite antibiotic therapies for suspected CNS infection, he died. Autopsy revealed a swollen brain with marked widening of the brainstem. Microscopic examination of the brain and spinal cord showed focal lymphohistiocytic infiltrates, gliosis and neuronal loss that were associated with acid-fast bacilli (AFB). The brainstem was the most severely damaged and AFB were found to congregate along arterial territories lending support to the notion of hematogenous spread as a mechanism for the organisms’ dissemination. 16S rRNA sequencing on formalin-fixed paraffin-embedded tissue enabled post-mortem identification of M. haemophilum. This sequencing methodology may permit diagnosis on CSF intra-vitam.
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Abstract
Rasmussen encephalitis (RE) is a rare, devastating, progressive pediatric epilepsy. First described 60 years ago, RE continues to present challenges in diagnosis and management. RE causes a unilateral focal epilepsy in children that typically becomes medically refractory, results in significant hemiparesis, and causes progressive cognitive decline. The etiology is a cell-mediated immune attack on one cerebral hemisphere, though the inciting antigen remains unknown. While the underlying histopathology is unilateral and RE is described as "unihemispheric," studies have demonstrated (1) atrophy of the unaffected hemisphere, (2) electroencephalographic abnormalities (slowing and spikes) in the unaffected hemisphere, and (3) cognitive decline referable to the unaffected hemisphere. These secondary contralateral effects likely reflect the impact of uncontrolled epileptic activity (i.e., epileptic encephalopathy). Hemispheric disconnection (HD) renders 70 to 80% of patients seizure free. While it has the potential to limit the influence of seizures and abnormal electrical activity emanating from the pathological hemisphere, HD entails hemiparesis and hemianopia, as well as aphasia for patients with dominant HD. With the recent expansion of available immunomodulatory therapies, there has been interest in identifying an alternative to HD, though evidence for disease modification is limited to date. We review what is known and what remains unknown about RE.
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Affiliation(s)
- Karla C Cay-Martinez
- Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Richard A Hickman
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
| | - Guy M McKhann Ii
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York
| | - Frank A Provenzano
- Department of Neurology, Columbia University Irving Medical Center, New York, New York.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York
| | - Tristan T Sands
- Department of Neurology, Columbia University Irving Medical Center, New York, New York.,Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, New York
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Freda PU, Bruce JN, Khandji AG, Jin Z, Hickman RA, Frey E, Reyes-Vidal C, Otten M, Wardlaw SL, Post KD. Presenting Features in 269 Patients With Clinically Nonfunctioning Pituitary Adenomas Enrolled in a Prospective Study. J Endocr Soc 2020; 4:bvaa021. [PMID: 32258955 PMCID: PMC7101088 DOI: 10.1210/jendso/bvaa021] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/14/2020] [Indexed: 11/19/2022] Open
Abstract
Context Clinically nonfunctioning pituitary adenomas (CNFPAs) typically remain undetected until mass effect symptoms develop. However, currently, head imaging is performed commonly for many other indications, which may increase incidental discovery of CNFPAs. Since current presentation and outcome data are based on older, retrospective series, a prospective characterization of a contemporary CNFPA cohort was needed. Objective To determine the prevalence of incidental presentation and hypopituitarism and its predictors in a CNFPA cohort that spanned 6 to 9 mm micro- to macroadenoma included observational and surgical therapy. Methods At enrollment in a prospective, observational study, 269 patients with CNFPAs were studied by history, examination, blood sampling, and pituitary imaging analysis and categorized into incidental or symptoms presentation groups that were compared. Results Presentation was incidental in 48.7% of patients and due to tumor symptoms in 51.3%. In the symptoms and incidental groups, 58.7% and 27.4% of patients had hypopituitarism, respectively, and 25% of patients with microadenomas had hypopituitarism. Many had unappreciated signs and symptoms of pituitary disease. Most tumors were macroadenomas (87%) and were larger in the symptoms than incidental and hypopituitary groups than in the eupituitary groups. The patients in the incidental group were older, and males were older and had larger tumors in both the incidental and symptoms groups. Conclusions Patients with CNFPAs commonly present incidentally and with previously unrecognized hypopituitarism and symptoms that could have prompted earlier diagnosis. Our data support screening all large micro and macro-CNFPAs for hypopituitarism. Most patients with CNFPAs still have mass effect signs at presentation, suggesting the need for more awareness of pituitary disease. Our ongoing, prospective observation of this cohort will assess outcomes of these CNFPA groups.
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Affiliation(s)
- Pamela U Freda
- Departments of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Jeffrey N Bruce
- Departments of Neurosurgery, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Alexander G Khandji
- Departments of Radiology, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Zhezhen Jin
- Departments of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Richard A Hickman
- Departments of Pathology and Cell Biology, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Emily Frey
- Departments of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Carlos Reyes-Vidal
- Departments of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Marc Otten
- Departments of Neurosurgery, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Sharon L Wardlaw
- Departments of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
| | - Kalmon D Post
- Departments of Neurosurgery, Mount Sinai School of Medicine, New York, New York
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Hickman RA, Yang L, Pei Z. "Nature versus Nurture" and the indigenous microbiome. J Public Health Emerg 2017; 1:30. [PMID: 30246171 PMCID: PMC6145807 DOI: 10.21037/jphe.2017.03.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Liying Yang
- New York University School of Medicine, New York, NY,
USA
| | - Zhiheng Pei
- New York University School of Medicine, New York, NY,
USA
- Department of Veterans Affairs New York Harbor Healthcare
System, New York, NY, USA
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Hickman RA, Bradshaw AD, Cassai N, Neto AG, Zhou D, Fu T, Lee P, Pei Z, Wieczorek R. A rare case of anal carcinosarcoma with human papilloma virus infection in both biphasic tumor elements: An immunohistochemical, molecular and ultrastructural study. Papillomavirus Res 2016; 2:164-166. [PMID: 28616595 PMCID: PMC5467539 DOI: 10.1016/j.pvr.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Carcinosarcoma of the anus is rare and has yet to be reportedly associated with the keratinocyte-specific Human Papilloma Virus (HPV). We describe a case of anal carcinosarcoma with HPV infection in both the epithelial and mesenchymal components of the tumor by immunohistochemistry, chromogenic in-situ hybridization (CISH) and further supported by electron microscopy (EM). Microscopic examination of the tumor showed nests of poorly-differentiated invasive squamous cell carcinoma with basaloid features intermixed with a hypercellular, atypical spindle cell proliferation. Immunohistochemistry demonstrated that the epithelial component was positive for AE1/AE3, p63, CK5/6 and p16, whilst the mesenchymal component was positive for smooth muscle actin, vimentin, and focally positive for desmin and p16, consistent with carcinosarcoma. The tumor was negative for GATA-3, CK7 and CK20. CISH demonstrated that the tumor was positive for high risk HPV (subtype 16/18) in both tumor components. EM further supported the presence of intracellular virus particles (~50 nm) that is compatible with HPV infection. Infection of both epithelial and mesenchymal tumor components by HPV has not been previously observed in the gastrointestinal tract. This finding may represent initial epithelial HPV infection with subsequent divergent tumoral differentiation and suggests the presence of viral replication in both biphasic tumor components.
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Affiliation(s)
- Richard A Hickman
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Azore-Dee Bradshaw
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Nicholas Cassai
- Department of Veterans Affairs New York Harbor Healthcare System, New York, NY 10010, USA
| | - Antonio Galvao Neto
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - David Zhou
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Tinghao Fu
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Peng Lee
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.,Department of Veterans Affairs New York Harbor Healthcare System, New York, NY 10010, USA
| | - Zhiheng Pei
- Department of Pathology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.,Department of Veterans Affairs New York Harbor Healthcare System, New York, NY 10010, USA
| | - Rosemary Wieczorek
- Department of Veterans Affairs New York Harbor Healthcare System, New York, NY 10010, USA
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Kaarme J, Hickman RA, Nevéus T, Blomberg J, Öhrmalm C. Reassuringly low carriage of enteropathogens among healthy Swedish children in day care centres. Public Health 2016; 140:221-227. [PMID: 27527845 DOI: 10.1016/j.puhe.2016.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/15/2016] [Accepted: 05/16/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Infectious gastroenteritis is one of the most common diseases among children and has a considerable impact on health and socio-economy. Day care centres are high-risk environments for infections. The aim of this study was to investigate if asymptomatic preschool children constitute a reservoir for potential enteropathogens. STUDY DESIGN In total, 438 individual diapers were collected from day care centres in Uppsala, Sweden, during spring and autumn, and molecular techniques were used to estimate the prevalence of asymptomatic carriage of multiple enteropathogens. METHODS Faecal samples were analysed with multiplex polymerase chain reaction (PCR) (xTAG® Gastrointestinal Pathogen Panel; Luminex Corporation, Toronto, Canada) targeting 21 different pathogens. Samples with a median fluorescence intensity above threshold were re-analysed with a second PCR assay. RESULTS Sixteen of the 438 samples were positive for enteropathogens, 1.6% for enteric adenovirus, 0.7% for Campylobacter spp., and 0.7% for norovirus. CONCLUSIONS Preschool children in Uppsala constitute a limited reservoir for potential enteropathogens.
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Affiliation(s)
- J Kaarme
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - R A Hickman
- Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Uppsala University, Uppsala, Sweden
| | - T Nevéus
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - J Blomberg
- Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Uppsala University, Uppsala, Sweden
| | - C Öhrmalm
- Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Uppsala University, Uppsala, Sweden.
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Hickman RA, Alexander M, Provet J, Melamed J, Deng FM. Inflammatory myofibroblastic tumour of the testis with confirmed anaplastic lymphoma kinase gene rearrangement. Histopathology 2015; 68:1109-11. [PMID: 26444540 DOI: 10.1111/his.12888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Richard A Hickman
- Department of Pathology, NYU School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - Melissa Alexander
- Department of Pathology, NYU School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - John Provet
- Department of Urology, NYU School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - Jonathan Melamed
- Department of Pathology, NYU School of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - Fang-Ming Deng
- Department of Pathology, NYU School of Medicine, NYU Langone Medical Center, New York, NY, USA
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Hickman RA, Hira-Kazal R, Yee CS, Toescu V, Gordon C. The efficacy and safety of rituximab in a chart review study of 15 patients with systemic lupus erythematosus. Clin Rheumatol 2015; 34:263-71. [PMID: 25564308 DOI: 10.1007/s10067-014-2839-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 01/21/2023]
Abstract
In contrast to randomised clinical trials, open-label studies have suggested that B cell depletion by a course of rituximab is associated with a significant clinical benefit. Our aim was to assess the safety and efficacy of rituximab in 15 refractory lupus patients, particularly those with more than one course of therapy. Disease activity was measured by the classic British Isles Lupus Assessment Group (BILAG) index, anti-DNA antibodies and complement levels. We assessed immunoglobulin levels, functional antibodies and serious adverse events. The mean patient age ± SD was 37.9 ± 7.2 years and mean disease duration was 8.5 ± 3.3 years; 46% were Afro-Caribbean, 27% South Asian, 20% Caucasian and 7% others. Twelve patients responded by 6 months; six avoided major flare for >1 year. Complete absence of disease activity (BILAG D/E) lasted for 5.5 (SD 3.8) months and 4.8 (SD 3.6) months after the first (n = 15) and second (n = 9) rituximab course, respectively. The mean 6-month reduction in daily prednisolone was 10.4 (SD 11.4) mg/day and 10.7 (SD 9.3) mg/day from baseline after the first and second course, respectively. Patients with low C3/C4 normalised their C3 by 6 months. Most patients with raised anti-dsDNA normalised after rituximab courses. Serious adverse events only occurred after more than four courses of rituximab. Rituximab was safe and efficacious for treating patients with refractory systemic lupus erythematosus (SLE) and was associated with significant steroid reduction, but more than four courses of rituximab was associated with an increased risk of serious infection in two patients.
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Affiliation(s)
- R A Hickman
- Rheumatology Research Group, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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Hickman RA, Hughes D, Cars T, Malmberg C, Cars O. Cell-wall-inhibiting antibiotic combinations with activity against multidrug-resistant Klebsiella pneumoniae and Escherichia coli. Clin Microbiol Infect 2013; 20:O267-73. [PMID: 24118201 DOI: 10.1111/1469-0691.12374] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 08/07/2013] [Accepted: 08/12/2013] [Indexed: 11/29/2022]
Abstract
The increasing prevalence of hospital and community-acquired infections caused by multidrug-resistant (MDR) bacterial pathogens is rapidly limiting the options for effective antibiotic therapy. Systematic studies on combinations of already available antibiotics that could provide an effective treatment against MDR bacteria are needed. We tested combinations of antibiotics that target one important physiological function (peptidoglycan synthesis) at several steps, and studied Enterobacteriaceae (Klebsiella pneumoniae and Escherichia coli) for which multidrug resistance associated with ESBL-producing plasmids has become a major problem. To measure the effectiveness of antibiotics alone and in combination, we used checkerboard assays, static antibiotic concentration time-kill assays, and an improved in-vitro kinetic model that simulates human pharmacokinetics of multiple simultaneously administered antibiotics. The target strains included an MDR K. pneumoniae isolate responsible for a recent major hospital outbreak. A double combination (fosfomycin and aztreonam) and a triple combination (fosfomycin, aztreonam and mecillinam) were both highly effective in reducing bacterial populations in all assays, including the in vitro kinetic model. These combinations were effective even though each of the MDR strains was resistant to aztreonam alone. Our results provide an initial validation of the potential usefulness of a combination of antibiotics targeting peptidoglycan synthesis in the treatment of MDR Gram-negative bacteria. We suggest that a combination of fosfomycin with aztreonam could become a useful treatment option for such infections and should be further studied.
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Affiliation(s)
- R A Hickman
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
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Abstract
Throughout my years so far of medical school, caffeine has supplied that extra energy needed to get me through the late nights before deadlines and exams. There is also another well-recognised group of students, well-recognised at least in the USA - those who illegitimately acquire drugs, such as Adderall, in the run up to, and even during, exams. A study published in the Journal of Attention Disorders identified that 56% of student patients with attention-deficit hyperactivity disorder (ADHD) had been approached by other students to acquire their ADHD medications; just under half of these ADHD patients complied. Of course, these stimulants can also be obtained with a simple internet search of symptoms to then present to the physician. Evidence demonstrates that these drugs can significantly bolster the score of an exam and so we ask, is it wrong for students to use these drugs for enhancing their grade?
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Hickman RA, Denniston AK, Yee CS, Toescu V, Murray PI, Gordon C. Bilateral retinal vasculitis in a patient with systemic lupus erythematosus and its remission with rituximab therapy. Lupus 2009; 19:327-9. [PMID: 19900982 DOI: 10.1177/0961203309347332] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Severe retinal vasculitis is a rare, but potentially blinding, complication of patients with systemic lupus erythematosus (SLE). We describe here the first reported case of treating severe bilateral SLE-associated retinal vasculitis with the anti-CD20 monoclonal antibody rituximab, a drug which has established its role in rheumatoid arthritis and has shown promise in case series for the treatment of severe SLE that is unresponsive to other therapies. This case suggests that rituximab-induced B-cell depletion may provide an important new therapeutic option for refractory cases of this devastating ocular complication.
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Affiliation(s)
- R A Hickman
- Rheumatology Research Group, University of Birmingham, Edgbaston, Birmingham, UK
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Hickman RA. Toward impeccable IV technique. When you have to reconstitute meds? RN 1981; 44:40-3. [PMID: 6908738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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