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Bedeschi MF, Mora S, Antoniazzi F, Boero S, Ravasio R, Scarano G, Selicorni A, Sessa M, Verdoni F, Zampino G, Maghnie M. The clinical management of children with achondroplasia in Italy: results of clinician and parent/caregiver surveys. J Endocrinol Invest 2024; 47:345-356. [PMID: 37466810 DOI: 10.1007/s40618-023-02151-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE This study aimed to assess the real-world management of achondroplasia in Italy. METHODS Two online surveys addressed to (1) parents/caregivers of individuals with achondroplasia and (2) Italian clinicians managing individuals with achondroplasia were conducted to assess real-world perspectives on achondroplasia management. Both surveys collected data on either patient or clinician demographics, details on diagnoses and referrals, disease complications, and views/experiences with limb lengthening surgery. RESULTS In total, 42 parents/caregivers and 19 clinicians (from 18 hospitals) completed the surveys. According to parents/caregivers, achondroplasia diagnosis was most commonly made in the third trimester of gestation (55% of respondents), with a genetic test performed to confirm the diagnosis in all but one case. In contrast, the clinicians indicated that, while achondroplasia was typically suspected during the prenatal period (78%), diagnosis was more frequently confirmed postnatally (72%). Parents/caregivers reported that the greatest impact of achondroplasia-related complications occurred in their children between the ages of 2-5 years. The most significant complications were otitis, sleep apnoea, stenosis of the foramen magnum or pressure on the spinal cord, and hearing difficulties. Lengthening surgery had been presented as a treatment option to 92% of responding parents/caregivers, with 76% of clinicians viewing surgery favourably. Typically, clinicians' reasons for suggesting limb lengthening surgery were to improve patient quality of life, increase patient autonomy and self-acceptance, improve trunk-limb disproportion, short stature and walking, and ensure that all possible treatment options had been presented to the parents/caregivers. CONCLUSION This survey provides insight into the real-world management of individuals with achondroplasia in Italy.
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Affiliation(s)
- M F Bedeschi
- Department of Woman-Child-Newborn, Medical Genetic Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Mora
- Laboratory of Paediatric Endocrinology, Department of Paediatrics, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - F Antoniazzi
- UO of Paediatrics, University of Verona, Verona, Italy
| | - S Boero
- Orthopaedics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - R Ravasio
- PharmaLex Italy S.p.A., Milan, Italy
| | - G Scarano
- Azienda Ospedaliera di Rilievo Nazionale "San Pio". P.O. "Gaetano Rummo", Benevento, Italy
| | - A Selicorni
- UOC Pediatria, Centro Fondazione Mariani per il bambino fragile, ASST Lariana, Como, Italy
| | - M Sessa
- Associazione per l'Informazione e lo Studio dell'Acondroplasia (AISAC), Milan, Italy
| | - F Verdoni
- IRCCS Istituto Galeazzi di Milano, Milan, Italy
| | - G Zampino
- UOC Pediatria, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Dipartimento di Scienza della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Maghnie
- Paediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
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Brizola E, Adami G, Baroncelli GI, Bedeschi MF, Berardi P, Boero S, Brandi ML, Casareto L, Castagnola E, Fraschini P, Gatti D, Giannini S, Gonfiantini MV, Landoni V, Magrelli A, Mantovani G, Michelis MB, Nasto LA, Panzeri L, Pianigiani E, Scopinaro A, Trespidi L, Vianello A, Zampino G, Sangiorgi L. Providing high-quality care remotely to patients with rare bone diseases during COVID-19 pandemic. Orphanet J Rare Dis 2020; 15:228. [PMID: 32867855 PMCID: PMC7456755 DOI: 10.1186/s13023-020-01513-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/27/2020] [Accepted: 08/19/2020] [Indexed: 01/08/2023] Open
Abstract
During the COVID-19 outbreak, the European Reference Network on Rare Bone Diseases (ERN BOND) coordination team and Italian rare bone diseases healthcare professionals created the "COVID-19 Helpline for Rare Bone Diseases" in an attempt to provide high-quality information and expertise on rare bone diseases remotely to patients and healthcare professionals. The present position statement describes the key characteristics of the Helpline initiative, along with the main aspects and topics that recurrently emerged as central for rare bone diseases patients and professionals. The main topics highlighted are general recommendations, pulmonary complications, drug treatment, trauma, pregnancy, children and elderly people, and patient associations role. The successful experience of the "COVID-19 Helpline for Rare Bone Diseases" launched in Italy could serve as a primer of gold-standard remote care for rare bone diseases for the other European countries and globally. Furthermore, similar COVID-19 helplines could be considered and applied for other rare diseases in order to implement remote patients' care.
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Affiliation(s)
- E Brizola
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - G Adami
- Rheumatology Unit, University of Verona, Verona, Italy
| | - G I Baroncelli
- Division of Pediatrics, Department of Obstetrics, Gynecology and Pediatrics, University Hospital, Pisa, Italy
| | - M F Bedeschi
- Medical Genetic Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - P Berardi
- Italian Osteogenesis Imperfecta Association (As.It.O.I), Olgiate Molgora (LC), Italy
| | - S Boero
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - M L Brandi
- Department of Experimental Biochemical and Clinical Sciences, University of Florence and Fondazione FIRMO, Florence, Italy
| | - L Casareto
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - E Castagnola
- Infectious Disease Department, Giannina Gaslini Institute, IRCCS, Genoa, Italy
| | - P Fraschini
- Scientific Institute, IRCCS E. Medea, Bosisio Parini (LC), Italy
| | - D Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - S Giannini
- Department of Medicine, Clinica Medica 1, University of Padova and Regional Centre for Osteoporosis, Padua, Italy
| | - M V Gonfiantini
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - V Landoni
- Valduce Hospital - Villa Beretta Rehabilitation Centre, Lecco, Italy
| | - A Magrelli
- National Center for Drug, Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - G Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M B Michelis
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - L A Nasto
- Department of Paediatric Orthopaedics, IRCCS Giannina Gaslini Institute, Children's Hospital, Genoa, Italy
| | - L Panzeri
- Italian Osteogenesis Imperfecta Association (As.It.O.I), Olgiate Molgora (LC), Italy
| | - E Pianigiani
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Scopinaro
- Italian Federation of Rare Diseases Patients Associations (UNIAMO FIMR), Rome, Italy
| | - L Trespidi
- Obstetrics and Gynecologic Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Vianello
- Respiratory Pathophysiology Division, University of Padua, Padua, Italy
| | - G Zampino
- Rare Diseases and Birth Defects Unit, Dipartimento di Scienza della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - L Sangiorgi
- Department of Rare Skeletal Disorders & CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
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Memeo A, Panuccio E, D'Amato RD, Colombo M, Boero S, Andreacchio A, Origo C, Pedretti L. Retrospective, multicenter evaluation of complications in the treatment of diaphyseal femur fractures in pediatric patients. Injury 2019; 50 Suppl 4:S60-S63. [PMID: 30777296 DOI: 10.1016/j.injury.2019.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/12/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Femoral shaft fractures are the commonest major pediatric fractures. For generations, traction and casting were the standard method of treatment for children. However, over the past two decades there has been growing recognition of the advantages of fixation and rapid mobilization. METHODS A prospective multicenter study was conducted at four Italian centers of reference for pediatric fractures (January 2005 to December 2014). The study involved 62 patients of both sexes, between 6 and 14 years of age, with closed femoral shaft fractures. The aim was to find out more about the short-term complications of titanium elastic nailing in diaphyseal femur fractures in children in order to reduce them. RESULTS The commonest complication observed in our study was pain at the nail entry point (24.19%) due to a local inflammatory reaction. After 1 year, 3.22% had limbs of different lengths. Proximal migration occurred in 1.61% of cases. DISCUSSION Over the last two decades, the treatment of femoral shaft fractures in pediatric patients has developed to include internal fixation using Titanium Elastic Nails (TEN). We only observed a few complications in our study, most of which were minor and associated with the surgical technique employed, particularly during the initial phase of the surgeon's learning curve. CONCLUSIONS TEN are an excellent internal fixation system if used by an expert surgeon and have a very low rate of complications. None of them produced permanent damage in the patients. In older children weighing more than 50 kg, alternative techniques such as subtrochanteric nailing, plates, or external fixation are advisable.
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Affiliation(s)
- A Memeo
- Pediatric Orthopaedics and Traumatology Department, G. Pini Institute, Milan, Italy
| | - E Panuccio
- Pediatric Orthopaedics and Traumatology Department, G. Pini Institute, Milan, Italy
| | - R D D'Amato
- Pediatric Orthopaedics and Traumatology Department, G. Pini Institute, Milan, Italy
| | - M Colombo
- 3 Orthopaedics and Traumatology Unit, G. Pini Institute, University of Milan, Italy.
| | - S Boero
- Orthopaedics and Traumatology Unit, Surgery Department Istituto Giannina Gaslini, Largo G. Gaslini 5-16100, Genova, Italy
| | - A Andreacchio
- Pediatric Orthopedic Department, Regina Margherita Children's Hospital, Torino, Italy
| | - C Origo
- Pediatric Orthopaedics Department, Ospedale Infantile C. Arrigo, Alessandria, Italy
| | - L Pedretti
- 2 Orthopaedics Clinic G. Pini Institute, University of Milan, Italy
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Damonte P, Sociali G, Parenti MD, Soncini D, Bauer I, Boero S, Grozio A, Holtey MV, Piacente F, Becherini P, Sanguineti R, Salis A, Damonte G, Cea M, Murone M, Poggi A, Nencioni A, Del Rio A, Bruzzone S. SIRT6 inhibitors with salicylate-like structure show immunosuppressive and chemosensitizing effects. Bioorg Med Chem 2017; 25:5849-5858. [PMID: 28958848 DOI: 10.1016/j.bmc.2017.09.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/15/2017] [Accepted: 09/17/2017] [Indexed: 12/19/2022]
Abstract
The NAD+-dependent deacetylase SIRT6 is an emerging cancer drug target, whose inhibition sensitizes cancer cells to chemo-radiotherapy and has pro-differentiating effects. Here we report on the identification of novel SIRT6 inhibitors with a salicylate-based structure. The new SIRT6 inhibitors show improved potency and specificity compared to the hit inhibitor identified in an in silico compound screen. As predicted based on SIRT6 biological roles, the new leads increase histone 3 lysine 9 acetylation and glucose uptake in cultured cells, while blocking TNF-α production and T lymphocyte proliferation. Notably, the new SIRT6 inhibitors effectively sensitize pancreatic cancer cells to gemcitabine. Finally, studies of compound fingerprinting and pharmacokinetics defined the drug-like properties of one of the new SIRT6 inhibitors, potentially allowing for subsequent in vivo proof-of-concept studies. In conclusion, new SIRT6 inhibitors with a salicylate-like structure were identified, which are active in cells and could potentially find applications in disease conditions, including cancer and immune-mediated disorders.
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Affiliation(s)
- Patrizia Damonte
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Giovanna Sociali
- Department of Experimental Medicine, Section of Biochemistry, University of Genoa, V.le Benedetto XV 1, 16132 Genoa, Italy
| | - Marco Daniele Parenti
- Institute of Organic Synthesis and Photoreactivity (ISOF), National Research Council (CNR), Via P. Gobetti 101, 40129 Bologna, Italy
| | - Debora Soncini
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Inga Bauer
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Silvia Boero
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy; IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Alessia Grozio
- Department of Experimental Medicine, Section of Biochemistry, University of Genoa, V.le Benedetto XV 1, 16132 Genoa, Italy
| | - Maria von Holtey
- Debiopharm International S.A., Chemin Messidor 5-7, 1002 Lausanne, Switzerland; Roche Diagnostics International AG, Forrenstrasse 2, 6343 Rotkreuz, Switzerland
| | - Francesco Piacente
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Pamela Becherini
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Roberta Sanguineti
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Annalisa Salis
- CEBR, University of Genova, V.le Benedetto XV, 7, 16132 Genoa, Italy
| | - Gianluca Damonte
- Department of Experimental Medicine, Section of Biochemistry, University of Genoa, V.le Benedetto XV 1, 16132 Genoa, Italy; CEBR, University of Genova, V.le Benedetto XV, 7, 16132 Genoa, Italy
| | - Michele Cea
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy
| | - Maximilien Murone
- Debiopharm International S.A., Chemin Messidor 5-7, 1002 Lausanne, Switzerland; Cellestia Biotech AG, Hochbergerstrasse 60C, 4057 Basel, Switzerland
| | - Alessandro Poggi
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Alessio Nencioni
- Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy; IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy.
| | - Alberto Del Rio
- Institute of Organic Synthesis and Photoreactivity (ISOF), National Research Council (CNR), Via P. Gobetti 101, 40129 Bologna, Italy; Innovamol Srls, Viale A. Corassori 24, 41124 Modena, Italy.
| | - Santina Bruzzone
- Department of Experimental Medicine, Section of Biochemistry, University of Genoa, V.le Benedetto XV 1, 16132 Genoa, Italy; CEBR, University of Genova, V.le Benedetto XV, 7, 16132 Genoa, Italy.
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Camodeca C, Nuti E, Tepshi L, Boero S, Tuccinardi T, Stura EA, Poggi A, Zocchi MR, Rossello A. Discovery of a new selective inhibitor of A Disintegrin And Metalloprotease 10 (ADAM-10) able to reduce the shedding of NKG2D ligands in Hodgkin's lymphoma cell models. Eur J Med Chem 2016; 111:193-201. [PMID: 26871660 DOI: 10.1016/j.ejmech.2016.01.053] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 11/29/2022]
Abstract
Hodgkin's lymphoma (HL) is the most common malignant lymphoma in young adults in the western world. This disease is characterized by an overexpression of ADAM-10 with increased release of NKG2D ligands, involved in an impaired immune response against tumor cells. We designed and synthesized two new ADAM-10 selective inhibitors, 2 and 3 based on previously published ADAM-17 selective inhibitor 1. The most promising compound was the thiazolidine derivative 3, with nanomolar activity for ADAM-10, high selectivity over ADAM-17 and MMPs and good efficacy in reducing the shedding of NKG2D ligands (MIC-B and ULBP3) in three different HL cell lines at non-toxic doses. Molecular modeling studies were used to drive the design and X-ray crystallography studies were carried out to explain the selectivity of 3 for ADAM-10 over MMPs.
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Affiliation(s)
- Caterina Camodeca
- Division of Immunology, Transplants and Infectious Diseases, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Elisa Nuti
- Dipartimento di Farmacia, Università di Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Livia Tepshi
- Dipartimento di Farmacia, Università di Pisa, Via Bonanno 6, 56126 Pisa, Italy; CEA, iBiTec-S, Service d'Ingenierie Moleculaire des Proteines, CE-Saclay, 91191 Gif sur Yvette Cedex, France
| | - Silvia Boero
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, 16132 Genoa, Italy
| | - Tiziano Tuccinardi
- Dipartimento di Farmacia, Università di Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Enrico A Stura
- CEA, iBiTec-S, Service d'Ingenierie Moleculaire des Proteines, CE-Saclay, 91191 Gif sur Yvette Cedex, France
| | - Alessandro Poggi
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, 16132 Genoa, Italy
| | - Maria Raffaella Zocchi
- Division of Immunology, Transplants and Infectious Diseases, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Armando Rossello
- Dipartimento di Farmacia, Università di Pisa, Via Bonanno 6, 56126 Pisa, Italy.
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Boero S, Morabito A, Banelli B, Cardinali B, Dozin B, Lunardi G, Piccioli P, Lastraioli S, Carosio R, Salvi S, Levaggi A, Poggio F, D'Alonzo A, Romani M, Del Mastro L, Poggi A, Pistillo MP. Erratum to: Analysis of in vitro ADCC and clinical response to trastuzumab: possible relevance of FcγRIIIA/FcγRIIA gene polymorphisms and HER-2 expression levels on breast cancer cell lines. J Transl Med 2016; 14:24. [PMID: 26801979 PMCID: PMC4724068 DOI: 10.1186/s12967-016-0779-y] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Silvia Boero
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Anna Morabito
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Barbara Banelli
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Barbara Cardinali
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Beatrice Dozin
- Clinical Epidemiology Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Gianluigi Lunardi
- Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
| | | | - Sonia Lastraioli
- Laboratory of Molecular Diagnostics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Roberta Carosio
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Sandra Salvi
- Unit of Pathology, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessia Levaggi
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Francesca Poggio
- Unit of Medical Oncology 2, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessia D'Alonzo
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Massimo Romani
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Lucia Del Mastro
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessandro Poggi
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, Genoa, Italy.
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Boero S, Morabito A, Banelli B, Cardinali B, Dozin B, Lunardi G, Piccioli P, Lastraioli S, Carosio R, Salvi S, Levaggi A, Poggio F, D'Alonzo A, Romani M, Del Mastro L, Poggi A, Pistillo MP. Analysis of in vitro ADCC and clinical response to trastuzumab: possible relevance of FcγRIIIA/FcγRIIA gene polymorphisms and HER-2 expression levels on breast cancer cell lines. J Transl Med 2015; 13:324. [PMID: 26450443 PMCID: PMC4598965 DOI: 10.1186/s12967-015-0680-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 09/24/2015] [Indexed: 11/10/2022] Open
Abstract
Background Trastuzumab is a humanized monoclonal antibody (mAb) currently used for the treatment of breast cancer (BC) patients with HER-2 overexpressing tumor subtype. Previous data reported the involvement of FcγRIIIA/IIA gene polymorphisms and/or antibody-dependent cellular cytotoxicity (ADCC) in the therapeutic efficacy of trastuzumab, although results on these issues are still controversial. This study was aimed to evaluate in vitro the functional relationships among FcγRIIIA/IIA polymorphisms, ADCC intensity and HER-2 expression on tumor target cells and to correlate them with response to trastuzumab. Patients and methods Twenty-five patients with HER-2 overexpressing BC, receiving trastuzumab in a neoadjuvant (NEO) or metastatic (MTS) setting, were genotyped for the FcγRIIIA 158V>F and FcγRIIA 131H>R polymorphisms by a newly developed pyrosequencing assay and by multiplex Tetra-primer-ARMS PCR, respectively. Trastuzumab-mediated ADCC of patients’ peripheral blood mononuclear cells (PBMCs) was evaluated prior to therapy and measured by 51Chromium release using as targets three human BC cell lines showing different levels of reactivity with trastuzumab. Results We found that the FcγRIIIA 158F and/or the FcγRIIA 131R variants, commonly reported as unfavorable in BC, may actually behave as ADCC favorable genotypes, in both the NEO (P ranging from 0.009 to 0.039 and from 0.007 to 0.047, respectively) and MTS (P ranging from 0.009 to 0.032 and P = 0.034, respectively) patients. The ADCC intensity was affected by different levels of trastuzumab reactivity with BC target cells. In this context, the MCF-7 cell line, showing the lowest reactivity with trastuzumab, resulted the most suitable cell line for evaluating ADCC and response to trastuzumab. Indeed, we found a statistically significant correlation between an increased frequency of patients showing ADCC of MCF-7 and complete response to trastuzumab in the NEO setting (P = 0.006). Conclusions Although this study was performed in a limited number of patients, it would indicate a correlation of FcγR gene polymorphisms to the ADCC extent in combination with the HER-2 expression levels on tumor target cells in BC patients. However, to confirm our findings further experimental evidences obtained from a larger cohort of BC patients are mandatory. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0680-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Silvia Boero
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Anna Morabito
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Barbara Banelli
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Barbara Cardinali
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Beatrice Dozin
- Clinical Epidemiology Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Gianluigi Lunardi
- Medical Oncology Unit, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
| | | | - Sonia Lastraioli
- Laboratory of Molecular Diagnostics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Roberta Carosio
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Sandra Salvi
- Unit of Pathology, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessia Levaggi
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Francesca Poggio
- Unit of Medical Oncology 2, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessia D'Alonzo
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Massimo Romani
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Lucia Del Mastro
- Development of Innovative Therapies Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
| | - Alessandro Poggi
- Unit of Molecular Oncology and Angiogenesis, IRCCS AOU San Martino-IST, Genoa, Italy.
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Sociali G, Galeno L, Parenti MD, Grozio A, Bauer I, Passalacqua M, Boero S, Donadini A, Millo E, Bellotti M, Sturla L, Damonte P, Puddu A, Ferroni C, Varchi G, Franceschi C, Ballestrero A, Poggi A, Bruzzone S, Nencioni A, Del Rio A. Quinazolinedione SIRT6 inhibitors sensitize cancer cells to chemotherapeutics. Eur J Med Chem 2015; 102:530-9. [DOI: 10.1016/j.ejmech.2015.08.024] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 01/09/2023]
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9
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Montecucco F, Lenglet S, Carbone F, Boero S, Pelli G, Burger F, Roth A, Bertolotto M, Nencioni A, Cea M, Dallegri F, Fraga-Silva RA, Fougère L, Elfakir C, Gassner AL, Rudaz S, Parissaux X, Wils D, Salomé M, Vuilleumier N, Poggi A, Mach F. Treatment with KLEPTOSE® CRYSMEB reduces mouse atherogenesis by impacting on lipid profile and Th1 lymphocyte response. Vascul Pharmacol 2015; 72:197-208. [PMID: 25921922 DOI: 10.1016/j.vph.2015.04.008] [Citation(s) in RCA: 12] [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: 12/29/2014] [Revised: 03/05/2015] [Accepted: 04/20/2015] [Indexed: 02/08/2023]
Abstract
The ability of pharmacological agents to target both "classical" risk factors and inflammation may be key for successful outcomes in the prevention and treatment of atherogenesis. Among the promising drugs interfering with cholesterol metabolism, we investigated whether methyl beta-cyclodextrin (KLEPTOSE® CRYSMEB) could positively impact on atherogenesis, lipid profile and atherosclerotic plaque inflammation in ApoE-/- mice. Eleven-week old ApoE-/- mice were fed either a normal diet (N.D.) or a high-cholesterol diet (H.D.), resulting in different levels of hypercholesterolemia. KLEPTOSE® CRYSMEB (40mg/kg) or vehicle was intraperitoneally administrated 3 times per week in the last 16weeks before euthanasia in mice under N.D. and in the last 11weeks under H.D. Treatment with KLEPTOSE® CRYSMEB reduced triglyceride serum levels in both atherogenesis mouse models. In H.D. mice, treatment with KLEPTOSE® CRYSMEB increased HDL-cholesterol levels and reduced free fatty acids and spleen weight. In both mouse models, treatment with KLEPTOSE® CRYSMEB reduced atherosclerotic plaque size in thoraco-abdominal aortas and intraplaque T lymphocyte content, but did not induce relevant improvements in other histological parameters of vulnerability (macrophage, neutrophil, MMP-9 and collagen content). Conversely and more markedly in H.D. mice, treatment with KLEPTOSE® CRYSMEB was associated with a reduction in genetic markers of Th1-mediated immune response. In vitro, KLEPTOSE® CRYSMEB dose-dependently abrogated Th1 proliferation and IFNγ release. In conclusion, treatment with KLEPTOSE® CRYSMEB reduced atherosclerotic plaque size by improving triglyceride serum levels and Th1-mediated response. These results indicate this drug as a potential tool for blocking atheroprogression associated with different severity degrees of hypercholesterolemia.
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Affiliation(s)
- Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy; Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland; Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland.
| | - Sébastien Lenglet
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy; Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Silvia Boero
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Graziano Pelli
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Fabienne Burger
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Aline Roth
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
| | - Maria Bertolotto
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Alessio Nencioni
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Michele Cea
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Rodrigo A Fraga-Silva
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Laëtitia Fougère
- Institut de Chimie Organique et Analytique CNRS-UMR 7311, University of Orleans, F-45067 Orléans cedex 02, France
| | - Claire Elfakir
- Institut de Chimie Organique et Analytique CNRS-UMR 7311, University of Orleans, F-45067 Orléans cedex 02, France
| | - Anne-Laure Gassner
- School of Pharmaceutical Sciences, University of Geneva, 30, quai Ernest-Ansermet, 1211 Geneva, Switzerland
| | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, 30, quai Ernest-Ansermet, 1211 Geneva, Switzerland
| | | | - Daniel Wils
- Roquette Frères, 62080 Lestrem cedex, France
| | - Marc Salomé
- Cabinet d'Etudes et Concepts, Ramonville, France
| | - Nicolas Vuilleumier
- Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland
| | - Alessandro Poggi
- Unit of Molecular Oncology and Angiogenesis, IRCCS Azienda Ospedaliera Universitaria San Martino-IST National Institute for Cancer Research, 16132 Genoa, Italy
| | - François Mach
- Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 64 avenue de la Roseraie, 1211 Geneva, Switzerland
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Soncini D, Caffa I, Zoppoli G, Cea M, Cagnetta A, Passalacqua M, Mastracci L, Boero S, Montecucco F, Sociali G, Lasigliè D, Damonte P, Grozio A, Mannino E, Poggi A, D'Agostino VG, Monacelli F, Provenzani A, Odetti P, Ballestrero A, Bruzzone S, Nencioni A. Nicotinamide phosphoribosyltransferase promotes epithelial-to-mesenchymal transition as a soluble factor independent of its enzymatic activity. J Biol Chem 2014; 289:34189-204. [PMID: 25331943 DOI: 10.1074/jbc.m114.594721] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Boosting NAD(+) biosynthesis with NAD(+) intermediates has been proposed as a strategy for preventing and treating age-associated diseases, including cancer. However, concerns in this area were raised by observations that nicotinamide phosphoribosyltransferase (NAMPT), a key enzyme in mammalian NAD(+) biosynthesis, is frequently up-regulated in human malignancies, including breast cancer, suggesting possible protumorigenic effects for this protein. We addressed this issue by studying NAMPT expression and function in human breast cancer in vivo and in vitro. Our data indicate that high NAMPT levels are associated with aggressive pathological and molecular features, such as estrogen receptor negativity as well as HER2-enriched and basal-like PAM50 phenotypes. Consistent with these findings, we found that NAMPT overexpression in mammary epithelial cells induced epithelial-to-mesenchymal transition, a morphological and functional switch that confers cancer cells an increased metastatic potential. However, importantly, NAMPT-induced epithelial-to-mesenchymal transition was found to be independent of NAMPT enzymatic activity and of the NAMPT product nicotinamide mononucleotide. Instead, it was mediated by secreted NAMPT through its ability to activate the TGFβ signaling pathway via increased TGFβ1 production. These findings have implications for the design of therapeutic strategies exploiting NAD(+) biosynthesis via NAMPT in aging and cancer and also suggest the potential of anticancer agents designed to specifically neutralize extracellular NAMPT. Notably, because high levels of circulating NAMPT are found in obese and diabetic patients, our data could also explain the increased predisposition to cancer of these subjects.
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Affiliation(s)
| | | | - Gabriele Zoppoli
- the Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium, the Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892
| | - Michele Cea
- From the Department of Internal Medicine, the Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston Novartis Institutes for BioMedical Research, Cambridge, Massachusetts 02139
| | - Antonia Cagnetta
- the Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston Novartis Institutes for BioMedical Research, Cambridge, Massachusetts 02139
| | - Mario Passalacqua
- Department of Experimental Medicine, Section of Biochemistry, and Italian Institute of Biostructures and Biosystems, University of Genoa, 16132 Genoa, Italy
| | - Luca Mastracci
- Department of Integrated Surgical and Diagnostic Sciences, Pathology Unit, University of Genoa, 16132 Genoa, Italy, the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Silvia Boero
- the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- From the Department of Internal Medicine, the Division of Cardiology, Foundation for Medical Researches, Department of Medical Specialties, University of Geneva, 1211 Geneva, Switzerland
| | - Giovanna Sociali
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research, and
| | | | | | - Alessia Grozio
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research, and
| | - Elena Mannino
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research, and
| | - Alessandro Poggi
- the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Vito G D'Agostino
- the Laboratory of Genomic Screening, Centre for Integrative Biology, University of Trento, 38123 Trento, Italy, and
| | | | - Alessandro Provenzani
- the Laboratory of Genomic Screening, Centre for Integrative Biology, University of Trento, 38123 Trento, Italy, and
| | - Patrizio Odetti
- From the Department of Internal Medicine, the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Alberto Ballestrero
- From the Department of Internal Medicine, the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Santina Bruzzone
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research, and
| | - Alessio Nencioni
- From the Department of Internal Medicine, the Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino-Istituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy,
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Musso A, Catellani S, Canevali P, Tavella S, Venè R, Boero S, Pierri I, Gobbi M, Kunkl A, Ravetti JL, Zocchi MR, Poggi A. Aminobisphosphonates prevent the inhibitory effects exerted by lymph node stromal cells on anti-tumor Vδ 2 T lymphocytes in non-Hodgkin lymphomas. Haematologica 2013; 99:131-9. [PMID: 24162786 DOI: 10.3324/haematol.2013.097311] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In this study, we analyzed the influence of mesenchymal stromal cells derived from lymph nodes of non-Hodgkin's lymphomas, on effector functions and differentiation of Vdelta (δ)2 T lymphocytes. We show that: i) lymph-node mesenchymal stromal cells of non-Hodgkin's lymphoma inhibit NKG2D-mediated lymphoid cell killing, but not rituximab-induced antibody-dependent cell-mediated cytotoxicity, exerted by Vδ2 T lymphocytes; ii) pre-treatment of mesenchymal stromal cells with the aminobisphosphonates pamidronate or zoledronate can rescue lymphoma cell killing via NKG2D; iii) this is due to inhibition of transforming growth factor-β and increase in interleukin-15 production by mesenchymal stromal cells; iv) aminobisphosphonate-treated mesenchymal stromal cells drive Vδ2 T-lymphocyte differentiation into effector memory T cells, expressing the Thelper1 cytokines tumor necrosis factor-α and interferon-γ. In non-Hodgkin's lymphoma lymph nodes, Vδ2 T cells were mostly naïve; upon co-culture with autologous lymph-node mesenchymal stromal cells exposed to zoledronate, the percentage of terminal differentiated effector memory Vδ2 T lymphocytes increased. In all non-Hodgkin's lymphomas, low or undetectable transcription of Thelper1 cytokines was found. In diffused large B-cell lymphomas and in a group of follicular lymphoma, transcription of transforming growth factor β and interleukin-10 was enhanced compared to non-neoplastic lymph nodes. Thus, in non-Hodgkin lymphomas mesenchymal stromal cells interfere with Vδ2 T-lymphocyte cytolytic function and differentiation to Thelper1 and/or effector memory cells, depending on the prominent in situ cytokine milieu. Aminobisphosphonates, acting on lymph-node mesenchymal stromal cells, can push the balance towards Thelper1/effector memory and rescue the recognition and killing of lymphoma cells through NKG2D, sparing rituximab-induced antibody-dependent cell-mediated cytotoxicity.
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12
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Alpigiani M, Salvati P, Rosina S, Callegari S, Tripodi G, Lorini R, Michelis M, Boero S. AB1171 Use of bone marrow cells (BMCS) added to platelet-rich plasma (PRP) for treatment of bone degenerative processes in jia patient: 18-month follow-up. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Poggi A, Boero S, Musso A, Zocchi MR. Selective role of mevalonate pathway in regulating perforin but not FasL and TNFalpha release in human Natural Killer cells. PLoS One 2013; 8:e62932. [PMID: 23667543 PMCID: PMC3646988 DOI: 10.1371/journal.pone.0062932] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/27/2013] [Indexed: 11/26/2022] Open
Abstract
We have analyzed the effects of fluvastatin, an inhibitor of the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase involved in mevalonate synthesis, on human NK cell-mediated anti-tumor cytolysis. Fluvastatin inhibited the activation of the small guanosin triphosphate binding protein (GTP) RhoA and the consequent actin redistribution induced by ligation of LFA1 involved in NK-tumor target cell adhesion. Also, fluvastatin reduced ganglioside M1 rafts formation triggered through the engagement of NK cell activating receptors as FcγRIIIA (CD16), NKG2D and DNAM1. Cytolysis of tumor targets was inhibited up to 90% when NK cells were cultured with fluvastatin by affecting i) receptor-mediated increase of the intracellular free calcium concentration, ii) activation of akt1/PKB and iii) perforin and granzyme release. Fluvastatin displayed a stronger inhibiting effect on NKG2D, DNAM1, 2B4, NKp30, NKp44 and NKp46 than on CD16-mediated NK cell triggering. This was in line with the impairment of surface expression of all these receptors but not of CD16. Remarkably, fluvastatin did not affect the expression of the inhibiting receptors CD94, KIR2D and LAIR1. FasL release elicited by either NK-tumor cell interaction or CD16 or NKG2D engagement, as well as FasL-mediated killing, were not sensitive to fluvastatin. Moreover, TNFα secretion triggered in NK cells upon incubation with tumor target cells or engagement of NKG2D receptor was not impaired in fluvastatin-treated NK cells. Likewise, antibody dependent cellular cytotoxicity (ADCC) triggered through FcγRIIIA engagement with the humanized monoclonal antibody rituximab or trastuzumab was only marginally affected in fluvastatin-treated NK cells. Altogether these findings suggest that interference with mevalonate synthesis impairs activation and assembly of cytoskeleton, degranulation and cytotoxic effect of perforins and granzyme but not FasL- and TNFα-mediated cytotoxicity.
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Affiliation(s)
- Alessandro Poggi
- Molecular Oncology and Angiogenesis Unit, IRCCS AOU San Martino - IST National Institute for Cancer Research, Genoa, Italy.
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14
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Laurent S, Queirolo P, Boero S, Salvi S, Piccioli P, Boccardo S, Minghelli S, Morabito A, Fontana V, Pietra G, Carrega P, Ferrari N, Tosetti F, Chang LJ, Mingari MC, Ferlazzo G, Poggi A, Pistillo MP. The engagement of CTLA-4 on primary melanoma cell lines induces antibody-dependent cellular cytotoxicity and TNF-α production. J Transl Med 2013; 11:108. [PMID: 23634660 PMCID: PMC3663700 DOI: 10.1186/1479-5876-11-108] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 04/23/2013] [Indexed: 01/01/2023] Open
Abstract
Background CTLA-4 (Cytotoxic T lymphocyte antigen-4) is traditionally known as a negative regulator of T cell activation. The blocking of CTLA-4 using human monoclonal antibodies, such as Ipilimumab, is currently used to relieve CTLA-4-mediated inhibition of anti-tumor immune response in metastatic melanoma. Herein, we have analyzed CTLA-4 expression and Ipilimumab reactivity on melanoma cell lines and tumor tissues from cutaneous melanoma patients. Then, we investigated whether Ipilimumab can trigger innate immunity in terms of antibody dependent cellular cytotoxicity (ADCC) or Tumor Necrosis Factor (TNF)-α release. Finally, a xenograft murine model was set up to determine in vivo the effects of Ipilimumab and NK cells on melanoma. Methods CTLA-4 expression and Ipilimumab reactivity were analyzed on 17 melanoma cell lines (14 primary and 3 long-term cell lines) by cytofluorimetry and on 33 melanoma tissues by immunohistochemistry. CTLA-4 transcripts were analyzed by quantitative RT-PCR. Soluble CTLA-4 and TNF-α were tested by ELISA. Peripheral blood mononuclear cells (PBMC), NK and γδT cells were tested in ADCC assay with Ipilimumab and melanoma cell lines. TNF-α release was analyzed in NK-melanoma cell co-cultures in the presence of ipilimumab. In vivo experiments of xenotransplantation were carried out in NOD/SCID mice. Results were analyzed using unpaired Student’s t-test. Results All melanoma cell lines expressed mRNA and cytoplasmic CTLA-4 but surface reactivity with Ipilimumab was quite heterogeneous. Accordingly, about 2/3 of melanoma specimens expressed CTLA-4 at different level of intensity. Ipilimumab triggered, via FcγReceptorIIIA (CD16), ex vivo NK cells as well as PBMC, IL-2 activated NK and γδT cells to ADCC of CTLA-4+ melanoma cells. No ADCC was detected upon interaction with CTLA-4- FO-1 melanoma cell line. TNF-α was released upon interaction of NK cells with CTLA-4+ melanoma cell lines. Remarkably, Ipilimumab neither affected proliferation and viability nor triggered ADCC of CTLA-4+ T lymphocytes. In a chimeric murine xenograft model, the co-engraftment of Ipilimumab-treated melanoma cells with human allogeneic NK cells delayed and significantly reduced tumor growth, as compared to mice receiving control xenografts. Conclusions Our studies demonstrate that Ipilimumab triggers effector lymphocytes to cytotoxicity and TNF-α release. These findings suggest that Ipilimumab, besides blocking CTLA-4, can directly activate the elimination of CTLA-4+ melanomas.
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Affiliation(s)
- Stefania Laurent
- Department of Internal Medicine, University of Genoa, Genoa, Italy
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15
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Alpigiani MG, Salvati P, Muraca M, Callegari S, Tripodi G, Lorini R, Michelis MB, Boero S. Use of bone marrow cells (BMCS) added to Platelet-Rich Plasma (PRP) for treatment of bone degenerative processes in JIA patients: a case report. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194544 DOI: 10.1186/1546-0096-9-s1-p188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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16
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Mantero E, Carbone M, Calevo MG, Boero S. Diagnosis and treatment of pediatric chronic osteomyelitis in developing countries: prospective study of 96 patients treated in Kenya. Musculoskelet Surg 2011; 95:13-8. [PMID: 21373913 DOI: 10.1007/s12306-011-0104-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 02/17/2011] [Indexed: 12/01/2022]
Abstract
The authors carried out a prospective study on 96 patients they treated in Kenya for chronic osteomyelitis from 2000 to 2009. All the patients received orthopedic surgery and antibiotic therapy, when possible based on the antibiotic sensitivity test. Among the 90 patients with at least 12 months' follow-up, 11 had osteomyelitis relapse (12.2%) and recovery rate was therefore 87.8% with no resulting disability. Risk factors for osteomyelitis relapse were investigated and previous treatment with beta-lactamines, predisposing to onset of methycillin-resistant Staphylococcus aureus (MRSA) infections (P = 0.03, OR = 5.74), and onset of osteomyelitis in the metaepiphyseal region (P < 0.0001) resulted statistically significant. Aim of the study was to evaluate the validity of our treatment of chronic osteomyelitis in Kenya on the basis of outcome.
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Affiliation(s)
- E Mantero
- U.O.C. Malattie Infettive Istituto Scientifico Giannina Gaslini, Genova L.go G. Gaslini, 5, 16147 Genoa, Italy
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Poggi A, Zancolli M, Boero S, Catellani S, Musso A, Zocchi MR. Differential survival of γδT cells, αβT cells and NK cells upon engagement of NKG2D by NKG2DL-expressing leukemic cells. Int J Cancer 2010; 129:387-96. [PMID: 20853320 DOI: 10.1002/ijc.25682] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 09/07/2010] [Indexed: 11/08/2022]
Abstract
Herein, we show that γδT, CD8(+) αβT lymphocytes and natural killer (NK) cells display a different sensitivity to survival signals delivered via NKG2D surface receptor. All the three effector cell populations activate Akt1/PKBalpha through the engagement of this molecule. Upon binding to leukemic cells expressing NKG2D ligands (NKG2DL), including chronic lymphocytic leukemias treated with transretinoic acid, most γδT (>60%) and half CD8(+) αβT cells (about 50%) received a survival signal, at variance with the majority of NK cells (>80%) that underwent apoptosis by day 5. Interestingly, oligomerization of NKG2D in γδT or CD8(+) αβT cells, led to a significant rise in nuclear/cytoplasmic ratio of both NF-kBp52 and RelB, the two NF-kB subunits mainly involved in the transcription of antiapoptotic proteins of the Bcl family. Indeed, the ratio between the antiapoptotic protein Bcl-2 or Bcl-x(L) and the proapoptotic protein Bax raised in γδT or CD8(+) αβT cells following NKG2D engagement by specific monoclonal antibodies or by NKG2DL expressing leukemic cells. Conversely, nuclear translocation of NF-kBp52 or RelB did not increase, nor the Bcl-2/Bax or the Bcl-x(L) /Bax ratios changed significantly, in NK cells upon oligomerizaton of NKG2D. Of note, transcripts for α5 importin, responsible for nuclear translocation of NF-kBp52/Rel B heterodimer, are significantly higher in γδT and CD8(+) αβT cells than in NK cells. These biochemical data may explain, at least in part, why γδT and CD8(+) αβT cells are cytolytic effector cells more resistant to target-induced apoptosis than NK cells.
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Affiliation(s)
- Alessandro Poggi
- Unit of Molecular Oncology and Angiogenesis, National Institute for Cancer Research, I-16132 Genoa.
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Sabatini F, Petecchia L, Boero S, Silvestri M, Klar J, Tenor H, Beume R, Hatzelmann A, Rossi G. A phosphodiesterase 4 inhibitor, roflumilast N-oxide, inhibits human lung fibroblast functions in vitro. Pulm Pharmacol Ther 2010; 23:283-91. [DOI: 10.1016/j.pupt.2010.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 01/27/2010] [Accepted: 02/28/2010] [Indexed: 12/31/2022]
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Boero S, Silvestri M, Ullmann N, Rossi GA. Modulation by flunisolide of tumor necrosis factor-alpha-induced stimulation of airway epithelial cell activities related to eosinophil inflammation. J Asthma 2010; 47:381-7. [PMID: 20528590 DOI: 10.3109/02770901003759410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tumor necrosis factor (TNF)-alpha, a proinflammatory cytokine involved in the pathogenesis of asthma, displays multiple functions on a variety of cells, including bronchial epithelial cells (BECs). OBJECTIVE To characterize in vitro changes induced by TNF-alpha on the function of BECs that may be related to eosinophilic inflammation and to evaluate their modulation by an inhaled corticosteroid, flunisolide. METHODS A normal human bronchial epithelial cell line (BEAS-2B) was incubated with TNF-alpha (10 ng/ml) to evaluate (a) intercellular adhesion molecule (ICAM)-1 expression and granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-5 release by BEAS-2B; (b) eosinophil adhesion to BEAS-2B; and (c) the modulation of these activities by flunisolide (0.1 to 10 microM). RESULTS Stimulation of BEAS-2 with TNF-alpha generated an increase in ICAM-1 expression (p = .0012), in GM-CSF and IL-5 release (p < .01), and in eosinophil adhesion to BEAS-2B, but this latter effect did not reach statistical significance. Flunisolide at all the tested concentrations effectively inhibited ICAM-1 expression and GM-CSF and IL-5 release (p < .05). The percent inhibition induced by the highest flunisolide concentration (10 muM) for the various BEAS-2B functions was 30%, 60%, and 70%, respectively. The effect of flunisolide appeared to be related to an inhibition of "TNF-alpha-induced" ICAM-1 expression and cytokine release with little or no involvement of the "constitutive" expression and release. CONCLUSION An increase in ICAM-1 expression in BECs was found to be induced by TNF-alpha and associated with enhancement of the constitutive secretion of GM-CSF and IL-5, cytokines related to eosinophilic inflammation. The ability of flunisolide to modulate these BECs activities appears to be mostly related to the inhibition of the "TNF-alpha-induced" responses.
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Affiliation(s)
- S Boero
- Pulmonary Diseases Unit, G. Gaslini Institute, Genoa, Italy
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20
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Ghio M, Contini P, Negrini S, Boero S, Musso A, Poggi A. Soluble HLA-I-mediated secretion of TGF-beta1 by human NK cells and consequent down-regulation of anti-tumor cytolytic activity. Eur J Immunol 2010; 39:3459-68. [PMID: 19830740 DOI: 10.1002/eji.200939728] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Soluble HLA class I (sHLA-I) molecules can regulate survival of NK cells and their anti-tumor killing activity. Herein, we have analysed whether interaction of sHLA-I with CD8 and/or different isoforms of killer Ig-like receptors (KIR) induced secretion of transforming growth factor (TGF)-beta1. CD8+KIR- NK cell clones secreted TGF-beta1 upon the interaction of sHLA-I with CD8 molecule. sHLA-Cw4 or sHLA-Cw3 alleles engaging inhibitory isoforms of KIR, namely KIR2DL1 or KIR2DL2, strongly downregulated TGF-beta1 production elicited through CD8. On the other hand, sHLA-Cw4 or sHLA-Cw3 alleles induced secretion of TGF-beta1 by ligation of stimulatory KIR2DS1 or KIR2DS2 isoforms. TGF-beta1 strongly reduced NK cell-mediated tumor cell lysis and production of pro-inflammatory cytokines such as TNF-alpha and IFN-gamma. Also, TGF-beta1 inhibited NK cell cytolysis induced by the engagement of stimulatory receptors including NKG2D, DNAM1, 2B4, CD69, NKp30, NKp44 and NKp46. The IL-2-dependent surface upregulation of some of these receptors was prevented by TGF-beta1. Furthermore, TGF-beta1 hampered IL-2-induced NK cell proliferation but not IL-2-mediated rescue from apoptosis of NK cells. Depletion of TGF-beta1 restored all the NK cell-mediated functional activities analysed. Taken together these findings suggest that sHLA-I antigens may downregulate the NK cell-mediated innate response by inducing TGF-beta1 release.
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MESH Headings
- Animals
- CD8 Antigens/metabolism
- Cell Line, Tumor
- Cell Proliferation
- Cell Survival
- Cytotoxicity, Immunologic
- Down-Regulation
- Flow Cytometry
- HLA Antigens/metabolism
- HLA-C Antigens/metabolism
- Humans
- Interferon-gamma/metabolism
- Killer Cells, Natural/cytology
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- NK Cell Lectin-Like Receptor Subfamily K/genetics
- NK Cell Lectin-Like Receptor Subfamily K/metabolism
- Protein Binding
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptors, KIR/metabolism
- Receptors, KIR2DL1/metabolism
- Receptors, KIR2DL2/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Solubility
- Transforming Growth Factor beta1/genetics
- Transforming Growth Factor beta1/metabolism
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- Massimo Ghio
- Department of Internal Medicine, University of Genoa and San Martino Hospital of Genoa, 16132-Italy
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21
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Marrè-Brunenghi G, Camoriano R, Valle M, Boero S. The psoas muscle as cause of low back pain in infantile cerebral palsy. J Orthop Traumatol 2008; 9:43-7. [PMID: 19384481 PMCID: PMC2656973 DOI: 10.1007/s10195-008-0104-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 01/14/2008] [Indexed: 11/30/2022] Open
Abstract
Psoas muscle spasticity is hypothesised as a rare cause of low back pain in patients with infantile cerebral palsy. The authors describe a new manoeuvre for the study of psoas tenderness and ultrasound (US)-guided transabdominal botulinum toxin injection technique. A possible causal relationship between psoas tension and low back pain was found incidentally in two examined cases. In subsequent patients, botulinum toxin was injected and, in cases of disappearance of symptoms, the psoas tendon was sectioned at the pelvic brim with definitive disappearance of pain. The relationship between psoas tension and low back pain in patients with infantile cerebral palsy seems likely, given the result in the four patients.
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Affiliation(s)
- G Marrè-Brunenghi
- Department of Orthopaedics, Giannina Gaslini Institute, Largo G. Gaslini 5, I-16147, Genoa, Italy,
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22
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Boero S, Sabatini F, Silvestri M, Petecchia L, Nachira A, Pezzolo A, Scarso L, Rossi GA. Modulation of human lung fibroblast functions by ciclesonide: evidence for its conversion into the active metabolite desisobutyryl-ciclesonide. Immunol Lett 2007; 112:39-46. [PMID: 17707916 DOI: 10.1016/j.imlet.2007.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 06/21/2007] [Accepted: 06/26/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Ciclesonide, an inhaled corticosteroid administered as inactive compound with almost no binding affinity for the glucocorticoid receptor, is clinically effective in asthma being converted by airway epithelial cells into its active metabolite desisobutyryl-(des)-ciclesonide. AIM To evaluate whether ciclesonide could directly modulate in vitro bronchial fibroblast functions being converted into des-ciclesonide by these pluripotent cells involved in the regulation of airway inflammation and remodelling. METHODS Ciclesonide (0.09-9.0 microM) was added to a human adult lung fibroblast cell line (CCL-202), seeded in medium in the presence of the following cytokines and growth factors: (a) basic fibroblast growth factor (bFGF) for cell proliferation, measured by tritiated thymidine ([3H]TdR) incorporation; (b) tumour necrosis factor (TNF)-alpha, to stimulate intercellular adhesion molecule (ICAM)-1 expression and monocyte chemoattractant protein-1 (MCP-1) and eotaxin release, evaluated by flow cytometry and ELISA, respectively; (c) transforming growth factor (TGF)-beta1, for induction of alpha smooth muscle actin (alpha-SMA) protein expression and modification of the organization of alpha-SMA stress fibres, evaluated by Western blot analysis and fluorescence microscopy. RESULTS The presence of ciclesonide in cell cultures induced a significant downregulation of: (a) bFGF-induced fibroblast proliferation and TNF-alpha-induced ICAM-1 expression, at the 0.3-9.0 microM concentrations (p<0.05); (b) TNF-alpha-induced MCP-1 release, at all the concentrations tested (p<0.05); (c) TNF-alpha-induced eotaxin release, at the three highest concentrations (0.9-9.0 microM) (p<0.05); (d) TGF-beta1-induced of alpha-SMA protein expression at the 0.3-3.0 microM concentrations, associated with a reduction in the organization of alpha-SMA stress fibres. CONCLUSIONS These data show at cellular level an effective anti-inflammatory activity of ciclesonide on human lung fibroblasts and support the hypothesis that also these cells, in addition to airway epithelial cells, may be involved in converting the parental compound into its active metabolite in the airways.
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Affiliation(s)
- Silvia Boero
- Pulmonary Disease Unit, G. Gaslini Institute, Largo G. Gaslini 5, 16147 Genoa, Italy
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Abstract
OBJECTIVE Our aim was to assess current demand for care of pelvic floor disorders and create projections for future demand for care. We also sought to better understand the characteristics of women seeking care. STUDY DESIGN Current demand for care was calculated by comparing those women seeking care through the female pelvic floor disorders clinic with those women of the same age range at risk within an integrated health care delivery program. Patients underwent complete urogynecologic evaluation including cystometry. Women seeking care were compared with regard to age, distribution of conditions (pelvic organ prolapse, stress conditions, urge conditions), and probability of undergoing surgery. Modeling the study population by use of data from the US Census Bureau, which projects population changes over the next 30 years, created predictions of future demand. RESULTS Data were available on 2070 consecutive patients with an age range of 30 to 89 years normally distributed around a median age of 61.5 years drawn from an at-risk population of 149,000 women aged 30 to 89 years. Older women generated more consults per 1000 woman years than did the younger cohorts (1.7 vs 18.6 consults per 1000 woman years for those 30-39 years old vs those 70-79 years old; P <.05). Estimates of growth in demand at 30 years indicate a 45% increase in demand while net growth of the same population segment should be 22%. Stress conditions were more common among younger women and urge conditions were more common among older women. Pelvic organ prolapse was equally distributed throughout the age ranges. CONCLUSIONS Over the next 30 years, growth in demand for services to care for female pelvic floor disorders will increase at twice the rate of growth of the same population. Demand for care for pelvic floor disorders comes from a wide age range of women, although mature age groups generate 10 times the number of consults per 1000 woman years as do their younger counterparts. Age plays a major role in the distribution of conditions with which patients present. These findings have broad implications for those responsible for administering programs to care for women, allocating research funds in women's health and geriatrics, and training physicians to meet this rapidly escalating demand.
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Affiliation(s)
- K M Luber
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Southern California Permanenete Medical Group, San Diego, USA.
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24
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Stella G, De Sanctis N, Boero S, Rondinella F. Benign tumors of the pediatric spine: statistical notes. Chir Organi Mov 1998; 83:15-21. [PMID: 9718811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A group of 50 pediatric patients affected with tumors or pseudotumors of the spine were studied with the purpose of determining the interval between the onset of symptoms and definitive diagnosis, the incidence of various symptoms, the statistical frequency based on age, sex, histologic type, localization, site. Also studied were diagnostic procedures adopted, therapy, recurrence, complications. The child affected with benign tumor pathology of the spine is rarely submitted early to appropriate diagnostic testing. Tumors are more frequently localized in the lumbar and thoracic spine and there is predilection for the vertebral arch. The most frequent histologic types are in decreasing order: histiocytosis X, osteoid osteoma, and aneurysmal cyst. Treatment is constituted by simple curettage in histiocytosis X, complete resection of the neoplasm in osteoid osteoma and osteoblastoma, partial resection associated with radiotherapy or selective embolization in aneurysmal bone cyst.
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MESH Headings
- Adolescent
- Adult
- Age Factors
- Bone Cysts, Aneurysmal/diagnosis
- Bone Cysts, Aneurysmal/surgery
- Bone Cysts, Aneurysmal/therapy
- Bone Diseases/diagnosis
- Child
- Child, Preschool
- Diagnosis, Differential
- Embolization, Therapeutic
- Female
- Histiocytosis, Langerhans-Cell/diagnosis
- Histiocytosis, Langerhans-Cell/surgery
- Humans
- Male
- Osteoblastoma/diagnosis
- Osteoblastoma/surgery
- Osteoma, Osteoid/diagnosis
- Osteoma, Osteoid/surgery
- Spinal Neoplasms/diagnosis
- Spinal Neoplasms/surgery
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Affiliation(s)
- G Stella
- II Divisione Ortopedia e Traumatologia, Istituto Scientifico Giannina Gaslini, Genova
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25
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Boero S, Catagni M, Donzelli O, Facchini R, Frediani PV. Congenital pseudarthrosis of the tibia associated with neurofibromatosis-1: treatment with Ilizarov's device. J Pediatr Orthop 1997; 17:675-84. [PMID: 9592010 DOI: 10.1097/00004694-199709000-00019] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We reexamined 21 patients with congenital pseudarthrosis of the leg (congenital pseudoarthrosis of the tibia; CPT) associated with neurofibromatosis-1 (NF-1), > or =2 years after the termination of treatment, for a statistical study of the results obtained by using Ilizarov's external fixator. Of the 21 tibias operated on, 17 consolidated after the first treatment, whereas four did not. Of the 17 consolidated tibias, four refractured and were retreated by using a variety of methods. Only one healed. At follow-up, which occurred > or =2 years after the removal of the fixator, the results were nine consolidations without deformities or with shortening <2 cm, five consolidations with axial deviation, and seven nonconsolidations. The statistically significant results were that (a) patients who were aged 5 years or older at operation had better results, and (b) the assembly II (resection of CPT stumps and their short-term compression possibly associated with corticotomy or epiphyseal distraction to correct limb discrepancy) gave better final results compared with the other device assemblies. We conclude that treatment with Ilizarov's fixator allows (a) a good percentage of healing over time (66.7%), especially in cases of normotrophic and cystic CPT; (b) further operations with or without the fixator to correct secondary or residual axial deviation; and (c) correction of limb discrepancy. This treatment avoids risking injury to the healthy contralateral leg. Additionally, for treatments that do not achieve satisfactory results, other treatment methods are not excluded. The CPT still remains a difficult problem for the orthopedic surgeon to solve.
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Affiliation(s)
- S Boero
- Istituto Scientifico Giannina Gaslini, Genova, Italy
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26
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Ceffa R, Bombelli M, Boero S, Marrè Brunenghi G, Mora R, Belluatti A, Piovani L, Iacobellis C, Susanna M, Guerreschi F, Perissinotto A. Extensimetric monitoring of healing in the treatment with the Ilizarov apparatus. A multicenter clinical trial. Bull Hosp Jt Dis 1997; 56:41-5. [PMID: 9063602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The results of a multicentric review are reported using the extensimetric instrumentation applied to the Ilizarov device. This clinical trial the follows same theoretical and experimental preliminary studies, outlines the advantages and current limits of the method, and sets the bases for further clinical and experimental research.
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Affiliation(s)
- R Ceffa
- Orthopaedic Department, Azienda Ospedaliera Maggiore della Carità, Novara, Italy
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27
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Dell'Acqua A, Boero S. [The echographic follow-up of patients treated with an external fixator in childhood and adolescence]. Radiol Med 1995; 89:409-15. [PMID: 7597221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In the last few years external fixation has started to be extensively used in pediatric orthopedics and traumatology and ultrasound (US) monitoring has been adopted. The role of US was investigated in a study on 64 patients aged 2 to 30 years treated from November, 1989, to December, 1993. Some patients underwent several interventions with different methods and therefore belong to more than one of the three considered groups. In case of surgical lengthening (group A), the role of US was investigated in a study on 54 patients aged 2 to 26 years. The following variables were studied with US: diastasis entity, stump axis and the evolution of regenerated tissue within 10 days of the beginning of lengthening (first follow-up), at 20 days (second follow-up) and at 30 days (third follow-up). Ilizarov and Wagner fixators and one external fixation reduction fixator were used on 54 patients in 83 segments (43 femurs, 39 tibias and 1 humerus). In all, 104 corticotomies were performed. In fractures treated with external fixators (group B), US allowed the study of the hematoma surrounding the lesion and of its progressive evolution from fibrous tissue to bone callus, within 30 days of external fixation (first follow-up), at 60 days (second follow-up) and at 90 days (third follow-up). Eight patients were treated. The segments treated were 9 femurs and 2 tibias, 11 fixators in all. Patients age ranged 9 to 19 years. Five patients underwent corrective osteotomies with external fixators (group C), in which group US follow-up exams were not standardized. For all 252 US examinations, performed in real time, an Acuson 128 unit with a 5-MHz linear probe was used and anterior, median and lateral longitudinal scans were acquired.
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Affiliation(s)
- A Dell'Acqua
- Servizio di Radiologia, Istituto Scientifico Giannina Gaslini, Genova
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Moscicki AB, Broering J, Powell K, Klein J, Clayton L, Smith G, Boero S, Darragh TM, Brescia RJ, Palefsky J. Comparison between colposcopic, cytologic, and histologic findings in women positive and negative for human papillomavirus DNA. J Adolesc Health 1993; 14:74-9. [PMID: 8386548 DOI: 10.1016/1054-139x(93)90088-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Little is known about the role of detection of human papillomavirus (HPV) DNA in exfoliated cells of the cervix in aiding the colposcopic diagnosis of cervical lesions. The purpose of our study was to compare the colposcopic findings of young women who were positive and negative for HPV DNA. Eighty-four women aged 13-22 years attending family planning clinics were examined colposcopically with the aide of acetic acid and Lugol's solution and without knowledge of HPV DNA status. Lesions identified were given scores based on the severity of observed colposcopic changes. Samples for cytology and HPV DNA testing, which included types 6, 11, 16, 18, 31, 33, and 35, were obtained at the time of the examination. Biopsies were performed on women with significant lesions identified on examination or with cytology suggestive of neoplasia. Students t-test and chi 2 analysis were performed to compare colposcopic variables and HPV DNA type. Of the 84 women examined, 17 were positive for HPV DNA; 9 had type 16/18. The average length of sexual activity was 2.7 years. Women with HPV 16/18 had a mean of 1.7 lesions visible at colposcopy compared to 0.7 lesions visible in those negative for HPV 16/18 (this included HPV DNA negative women and women positive for HPV types 6, 11, 31, 33, and 35) (p < 0.001). Women who were positive for HPV 16/18 also had higher lesional scores than the HPV 16/18-negative group (3.4 versus 1.0, respectively, p < 0.001). All four women who had dysplasia either on cytology or histology were positive for type 16/18.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A B Moscicki
- Department of Pediatrics, University of California, San Francisco
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29
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Canale G, Mastragostino S, Boero S. Surgical treatment of Legg-Calve-Perthes disease. Ital J Orthop Traumatol 1992; 18:443-52. [PMID: 1345635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Thirty-two patients (out of 52 undergoing surgery) with Legg-Calvé-Perthes disease (LCP) were examined retrospectively to assess the efficacy of surgical treatment on epiphyseal morphology at the primary healing. The analysis of the clinical results of the 33 hips considered indicated that it is necessary to operate above all on 3rd grade hips. For these the most frequent operation indicated is osteotomy of the pelvis. Femoral osteotomy must be limited to cases with only a slightly deformed femoral epiphysis in patients below the age of 7-8 years.
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Affiliation(s)
- G Canale
- II Divisione di Ortopedia e Traumatologia, Istituto Scientifico G. Gaslini, Genova
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30
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Mastragostino S, Bagliani GP, Boero S, Formica C, Origo C. The modified Wagner method for surgical lengthening of the limbs. Ital J Orthop Traumatol 1989; 15:133-44. [PMID: 2767959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The method proposed by Wagner in 1971 for surgical lengthening of the limbs was widely used by the authors for the treatment of dysmetria and (since 1976, for the first time in Italy) for disharmonic hypometria. The limitations of this method were revealed, however, by increasing knowledge in this field and the advent of new biological concepts of bone regeneration. The authors report 51 lengthenings carried out between 1982 and 1987 according to their own modification of the Wagner method. They conclude that the Wagner external fixator associated with corticotomy achieves excellent results, decreasing the number of surgical stages as well as the risk of infection and delay in consolidation.
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Affiliation(s)
- S Mastragostino
- Divisione di Ortopedia e Traumatologia, Istituto Scientifico Giannina Gaslini, Genova
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31
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Affiliation(s)
- S Mastragostino
- 2nd Orthopaedic and Traumatological Dept., Giannina Gaslini Scientific Institute, Genoa-Quarto, Italy
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32
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Affiliation(s)
- M Stura
- Ear, Nose and Throat Division, Giannina Gaslini Scientific Institute, Genoa-Quarto, Italy
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33
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Stura M, Boero S, Origo C, Tarantino V. [Audiologic problems in achondroplastics]. Minerva Pediatr 1987; 39:499-501. [PMID: 3627056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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