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Venou TM, Vetsiou E, Varelas C, Daniilidis A, Psarras K, Koravou EE, Koutra M, Touloumenidou T, Tsolakidis V, Papalexandri A, Minti F, Mandala E, Dinas K, Vlachaki E, Gavriilaki E. Increased Complement Activation and Decreased ADAMTS13 Activity Are Associated with Genetic Susceptibility in Patients with Preeclampsia/HELLP Syndrome Compared to Healthy Pregnancies: An Observational Case-Controlled Study. J Pers Med 2024; 14:387. [PMID: 38673014 DOI: 10.3390/jpm14040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/13/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Preeclampsia is a progressive multi-systemic disorder characterized by proteinuria, critical organ damage, and new-onset hypertension. It can be further complicated by HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), resulting in critical liver or renal damage, disseminated coagulation, and grand mal seizures. This study aimed to examine the involvement of ADAMTS13, von Willebrand, and the complement system in the pathogenesis of preeclampsia/HELLP syndrome. We studied 30 Caucasian preeclamptic pregnant women and a control group of 15 healthy pregnancies. Genetic sequencing of ADAMTS13 and complement regulatory genes (MiniSeq System, Illumina) was performed. The modified Ham test was used to check for complement activation, ADAMTS13 activity, von Willebrand antigen (vWFAg) levels, and soluble C5b-9 levels were measured. Patients with preeclampsia had a decreased ADAMTS13 activity and increased C5b-9 levels. The vWFAg was significantly correlated with ADAMTS13 activity (r = 0.497, p = 0.003). Risk-factor variants were found in the genes of ADAMTS13, C3, thrombomodulin, CFB, CFH, MBL2, and, finally, MASP2. A portion of pregnant women with preeclampsia showed a decline in ADAMTS13 activity, correlated with vWFAg levels. These patients also exhibited an elevated complement activation and high-risk genetic variants in regulatory genes. Further research is needed to determine if these factors can serve as reliable biomarkers.
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Affiliation(s)
- Theodora-Maria Venou
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Evangelia Vetsiou
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Christos Varelas
- Hematology Department, Papanicolaou General Hospital, 57010 Thessaloniki, Greece
| | - Angelos Daniilidis
- 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56429 Thessaloniki, Greece
| | - Kyriakos Psarras
- 2nd Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | | | - Maria Koutra
- Hematology Department, Papanicolaou General Hospital, 57010 Thessaloniki, Greece
| | | | - Vasilis Tsolakidis
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | | | - Fani Minti
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evdokia Mandala
- 4th Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Efthymia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Eleni Gavriilaki
- 2nd Propedeutical Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
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Asteris PG, Gandomi AH, Armaghani DJ, Tsoukalas MZ, Gavriilaki E, Gerber G, Konstantakatos G, Skentou AD, Triantafyllidis L, Kotsiou N, Braunstein E, Chen H, Brodsky R, Touloumenidou T, Sakellari I, Alkayem NF, Bardhan A, Cao M, Cavaleri L, Formisano A, Guney D, Hasanipanah M, Khandelwal M, Mohammed AS, Samui P, Zhou J, Terpos E, Dimopoulos MA. Genetic justification of COVID-19 patient outcomes using DERGA, a novel data ensemble refinement greedy algorithm. J Cell Mol Med 2024; 28:e18105. [PMID: 38339761 PMCID: PMC10863978 DOI: 10.1111/jcmm.18105] [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: 06/12/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 02/12/2024] Open
Abstract
Complement inhibition has shown promise in various disorders, including COVID-19. A prediction tool including complement genetic variants is vital. This study aims to identify crucial complement-related variants and determine an optimal pattern for accurate disease outcome prediction. Genetic data from 204 COVID-19 patients hospitalized between April 2020 and April 2021 at three referral centres were analysed using an artificial intelligence-based algorithm to predict disease outcome (ICU vs. non-ICU admission). A recently introduced alpha-index identified the 30 most predictive genetic variants. DERGA algorithm, which employs multiple classification algorithms, determined the optimal pattern of these key variants, resulting in 97% accuracy for predicting disease outcome. Individual variations ranged from 40 to 161 variants per patient, with 977 total variants detected. This study demonstrates the utility of alpha-index in ranking a substantial number of genetic variants. This approach enables the implementation of well-established classification algorithms that effectively determine the relevance of genetic variants in predicting outcomes with high accuracy.
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Affiliation(s)
- Panagiotis G. Asteris
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Amir H. Gandomi
- Faculty of Engineering & ITUniversity of Technology SydneySydneyNew South WalesAustralia
- University Research and Innovation Center (EKIK), Óbuda UniversityBudapestHungary
| | - Danial J. Armaghani
- School of Civil and Environmental EngineeringUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Markos Z. Tsoukalas
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Gloria Gerber
- Hematology DivisionJohns Hopkins UniversityBaltimoreUSA
| | - Gerasimos Konstantakatos
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Athanasia D. Skentou
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Leonidas Triantafyllidis
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Nikolaos Kotsiou
- 2nd Propedeutic Department of Internal MedicineAristotle University of ThessalonikiThessalonikiGreece
| | | | - Hang Chen
- Hematology DivisionJohns Hopkins UniversityBaltimoreUSA
| | | | | | - Ioanna Sakellari
- Hematology Department – BMT UnitG Papanicolaou HospitalThessalonikiGreece
| | | | - Abidhan Bardhan
- Civil Engineering DepartmentNational Institute of Technology PatnaPatnaIndia
| | - Maosen Cao
- Department of Engineering MechanicsHohai UniversityNanjingChina
| | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials EngineeringUniversity of PalermoPalermoItaly
| | - Antonio Formisano
- Department of Structures for Engineering and ArchitectureUniversity of Naples “Federico II”NaplesItaly
| | - Deniz Guney
- Engineering FacultySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Mahdi Hasanipanah
- Department of Geotechnics and Transportation, Faculty of Civil EngineeringUniversiti Teknologi MalaysiaJohor BahruMalaysia
| | - Manoj Khandelwal
- Institute of Innovation, Science and SustainabilityFederation University AustraliaBallaratVictoriaAustralia
| | | | - Pijush Samui
- Civil Engineering DepartmentNational Institute of Technology PatnaPatnaIndia
| | - Jian Zhou
- School of Resources and Safety EngineeringCentral South UniversityChangshaChina
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Medical School, Faculty of MedicineNational Kapodistrian University of AthensAthensGreece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, Medical School, Faculty of MedicineNational Kapodistrian University of AthensAthensGreece
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3
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Gavriilaki E, Bousiou Z, Batsis I, Vardi A, Mallouri D, Koravou EE, Konstantinidou G, Spyridis N, Karavalakis G, Noli F, Patriarcheas V, Masmanidou M, Touloumenidou T, Papalexandri A, Poziopoulos C, Yannaki E, Sakellari I, Politou M, Papassotiriou I. Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) and Growth Differentiation Factor-15 (GDF-15) Levels Are Significantly Associated with Endothelial Injury Indices in Adult Allogeneic Hematopoietic Cell Transplantation Recipients. Int J Mol Sci 2023; 25:231. [PMID: 38203404 PMCID: PMC10778584 DOI: 10.3390/ijms25010231] [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: 11/21/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) and graft-versus-host disease (GvHD) represent life-threatening syndromes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In both conditions, endothelial dysfunction is a common denominator, and development of relevant biomarkers is of high importance for both diagnosis and prognosis. Despite the fact that soluble urokinase plasminogen activator receptor (suPAR) and growth differentiation factor-15 (GDF-15) have been determined as endothelial injury indices in various clinical settings, their role in HSCT-related complications remains unexplored. In this context, we used immunoenzymatic methods to measure suPAR and GDF-15 levels in HSCT-TMA, acute and/or chronic GVHD, control HSCT recipients, and apparently healthy individuals of similar age and gender. We found considerably greater SuPAR and GDF-15 levels in HSCT-TMA and GVHD patients compared to allo-HSCT and healthy patients. Both GDF-15 and suPAR concentrations were linked to EASIX at day 100 and last follow-up. SuPAR was associated with creatinine and platelets at day 100 and last follow-up, while GDF-15 was associated only with platelets, suggesting that laboratory values do not drive EASIX. SuPAR, but not GDF-15, was related to soluble C5b-9 levels, a sign of increased HSCT-TMA risk. Our study shows for the first time that suPAR and GDF-15 indicate endothelial damage in allo-HSCT recipients. Rigorous validation of these biomarkers in many cohorts may provide utility for their usefulness in identifying and stratifying allo-HSCT recipients with endothelial cell impairment.
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Affiliation(s)
- Eleni Gavriilaki
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Zoi Bousiou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Ioannis Batsis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Anna Vardi
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Despina Mallouri
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Evaggelia-Evdoxia Koravou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Georgia Konstantinidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Nikolaos Spyridis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Georgios Karavalakis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Foteini Noli
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Vasileios Patriarcheas
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Marianna Masmanidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Tasoula Touloumenidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Apostolia Papalexandri
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Christos Poziopoulos
- Department of Hematology, Metropolitan Hospital, Neo Faliro, 18547 Athens, Greece;
| | - Evangelia Yannaki
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Ioanna Sakellari
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Marianna Politou
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Papassotiriou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
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Papalexandri A, Gavriilaki E, Vardi A, Kotsiou N, Demosthenous C, Constantinou N, Touloumenidou T, Zerva P, Kika F, Iskas M, Batsis I, Mallouri D, Yannaki E, Anagnostopoulos A, Sakellari I. Pre-Emptive Use of Rituximab in Epstein-Barr Virus Reactivation: Incidence, Predictive Factors, Monitoring, and Outcomes. Int J Mol Sci 2023; 24:16029. [PMID: 38003218 PMCID: PMC10671524 DOI: 10.3390/ijms242216029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Post-transplant lymphoproliferative disease (PTLD) is a fatal complication of hematopoietic cell transplantation (HCT) associated with the Epstein-Barr virus (EBV). Multiple factors such as transplant type, graft-versus-host disease (GVHD), human leukocyte antigens (HLA) mismatch, patient age, and T-lymphocyte-depleting treatments increase the risk of PTLD. EBV reactivation in hematopoietic cell transplant recipients is monitored through periodic quantitative polymerase chain reaction (Q-PCR) tests. However, substantial uncertainty persists regarding the clinically significant EBV levels for these patients. Guidelines recommend initiating EBV monitoring no later than four weeks post-HCT and conducting it weekly. Pre-emptive therapies, such as the reduction of immunosuppressive therapy and the administration of rituximab to treat EBV viral loads are also suggested. In this study, we investigated the occurrence of EBV-PTLD in 546 HCT recipients, focusing on the clinical manifestations and risk factors associated with the disease. We managed to identify 67,150 viral genomic copies/mL as the cutoff point for predicting PTLD, with 80% sensitivity and specificity. Among our cohort, only 1% of the patients presented PTLD. Anti-thymocyte globulin (ATG) and GVHD were independently associated with lower survival rates and higher treatment-related mortality. According to our findings, prophylactic measures including regular monitoring, pre-emptive therapy, and supportive treatment against infections can be effective in preventing EBV-related complications. This study also recommends conducting EBV monitoring at regular intervals, initiating pre-emptive therapy when viral load increases, and identifying factors that increase the risk of PTLD. Our study stresses the importance of frequent and careful follow-ups of post-transplant complications and early intervention in order to improve survival rates and reduce mortality.
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Affiliation(s)
- Apostolia Papalexandri
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Anna Vardi
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Nikolaos Kotsiou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Christos Demosthenous
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Natassa Constantinou
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Tasoula Touloumenidou
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Panagiota Zerva
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Fotini Kika
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Michalis Iskas
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Ioannis Batsis
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Despina Mallouri
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Evangelia Yannaki
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Achilles Anagnostopoulos
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Ioanna Sakellari
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
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5
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Gavriilaki E, Nikolousis E, Koravou EE, Dimou-Besikli S, Kartsios C, Papakonstantinou A, Mpanti A, Pontikoglou C, Kalpadaki C, Bitsani A, Tassi I, Touloumenidou T, Chatziconstantinou T, Papathanasiou M, Syrigou A, Ztriva E, Kaiafa G, Mandala E, Mellios Z, Karakasis D, Kourakli A, Symeonidis A, Kapsali E, Papadaki HH, Lalayanni C, Sakellari I. Caplacizumab for immune thrombotic thrombocytopenic purpura: real-world multicenter data. Front Med (Lausanne) 2023; 10:1226114. [PMID: 37901415 PMCID: PMC10600458 DOI: 10.3389/fmed.2023.1226114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Given the limited real-world data of caplacizumab, our multicenter real-world study was designed to assess the safety and efficacy of caplacizumab in immune thrombotic thrombocytopenic pupura (iTTP), compared to historic controls. We have studied 70 patients: 23 in the caplacizumab and 47 in the historic control group. Plasma exchange was applied in all episodes except for two patients that denied plasma exchange. Rituximab as first-line treatment was more common in the caplacizumab group compared to historic control. Caplacizumab (10 mg daily) was given at a median on day 7 (1-43) from initial diagnosis for 32 (6-47) dosages. In the caplacizumab group, a median of 12 (8-23) patients required plasma exchange sessions versus 14 (6-32) in the control group. Caplacizumab administration did not produce any grade 3 complications or major hemorrhagic events. After a median of 19.0 (2.6-320) months since the iTTP diagnosis, 5 deaths occurred (4 in the control group and 1 in the caplacizumab group, p = 0.310). Caplacizumab patients achieved early platelet normalization and ADAMTS13 activity normalization at the end of treatment. Relapse was observed only in 2/23 (9%) caplacizumab patients, compared to 29/47 (62%) historic controls (p < 0.001). Overall, caplacizumab is safe and effective in treating iTTP, including cases refractory to plasma exchange, re-administration, and cases without previous plasma exchange treatment. No major hemorrhagic events were observed. Cessation of dosing guided by ADAMTS13 has ensured a low relapse rate.
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Affiliation(s)
- Eleni Gavriilaki
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | | | | | | | | | - Anastasia Mpanti
- Department of Hematology, Papageorgiou Hospital, Thessaloniki, Greece
| | | | - Christina Kalpadaki
- Department of Hematology, University of Crete School of Medicine, Crete, Greece
| | - Aikaterini Bitsani
- First Department of Internal Medicine, LAIKO General Hospital, Athens, Greece
| | - Ilianna Tassi
- Department of Hematology, University Hospital, Ioannina, Greece
| | | | | | - Maria Papathanasiou
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Antonia Syrigou
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Eleutheria Ztriva
- 1st Medical Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kaiafa
- 1st Medical Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Mandala
- 4th Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zois Mellios
- Department of Hematology, Evangelismos Hospital, Athens, Greece
| | | | - Alexandra Kourakli
- Division of Hematology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Argiris Symeonidis
- Division of Hematology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Eleni Kapsali
- Department of Hematology, University Hospital, Ioannina, Greece
| | | | - Chrysavgi Lalayanni
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioanna Sakellari
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
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6
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Tsiftsoglou SA, Gavriilaki E, Touloumenidou T, Koravou EE, Koutra M, Papayanni PG, Karali V, Papalexandri A, Varelas C, Chatzopoulou F, Chatzidimitriou M, Chatzidimitriou D, Veleni A, Rapti E, Kioumis I, Kaimakamis E, Bitzani M, Boumpas DT, Tsantes A, Sotiropoulos D, Papadopoulou A, Sakellari I, Kokoris S, Anagnostopoulos A. Targeted genotyping of COVID-19 patients reveals a signature of complement C3 and factor B coding SNPs associated with severe infection. Immunobiology 2023; 228:152351. [PMID: 36805858 PMCID: PMC9928680 DOI: 10.1016/j.imbio.2023.152351] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 01/19/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023]
Abstract
We have attempted to explore further the involvement of complement components in the host COVID-19 (Coronavirus disease-19) immune responses by targeted genotyping of COVID-19 adult patients and analysis for missense coding Single Nucleotide Polymorphisms (coding SNPs) of genes encoding Alternative pathway (AP) components. We have identified a small group of common coding SNPs in Survivors and Deceased individuals, present in either relatively similar frequencies (CFH and CFI SNPs) or with stark differences in their relative abundance (C3 and CFB SNPs). In addition, we have identified several sporadic, potentially protective, coding SNPs of C3, CFB, CFD, CFH, CFHR1 and CFI in Survivors. No coding SNPs were detected for CD46 and CD55. Our demographic analysis indicated that the C3 rs1047286 or rs2230199 coding SNPs were present in 60 % of all the Deceased patients (n = 25) (the rs2230199 in 67 % of all Deceased Males) and in 31 % of all the Survivors (n = 105, p = 0.012) (the rs2230199 in 25 % of all Survivor Males). When we analysed these two major study groups using the presence of the C3 rs1047286 or rs2230199 SNPs as potential biomarkers, we noticed the complete absence of the protective CFB rs12614 and rs641153 coding SNPs from Deceased Males compared to Females (p = 0.0023). We propose that in these individuals, C3 carrying the R102G and CFB lacking the R32W or the R32Q amino acid substitutions, may contribute to enhanced association dynamics of the C3bBb AP pre-convertase complex assembly, thus enabling the exploitation of the activation of the Complement Alternative pathway (AP) by SARS-CoV-2.
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Affiliation(s)
- Stefanos A Tsiftsoglou
- Laboratory of Pharmacology, Department of Pharmaceutical Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
| | - Eleni Gavriilaki
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece.
| | - Tasoula Touloumenidou
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | | | - Maria Koutra
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | | | - Vassiliki Karali
- Rheumatology and Clinical Immunology Unit, University General Hospital "Attikon", Αthens, Greece
| | - Apostolia Papalexandri
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Christos Varelas
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Fani Chatzopoulou
- Microbiology Department, Aristotle University of Thessaloniki, Greece
| | - Maria Chatzidimitriou
- Biomedical Sciences Alexander Campus International Hellenic University, Thessaloniki, Greece
| | | | - Anastasia Veleni
- Infectious Disease Committee, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Evdoxia Rapti
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
| | - Ioannis Kioumis
- Respiratory Failure Department, G Papanicolaou Hospital-Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Milly Bitzani
- 1st Intensive Care Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Dimitrios T Boumpas
- Rheumatology and Clinical Immunology Unit, University General Hospital "Attikon", Αthens, Greece
| | - Argyris Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
| | - Damianos Sotiropoulos
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Anastasia Papadopoulou
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
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7
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Gavriilaki E, Tsiftsoglou SA, Touloumenidou T, Farmaki E, Panagopoulou P, Michailidou E, Koravou EE, Mavrikou I, Iosifidis E, Tsiatsiou O, Papadimitriou E, Papadopoulou-Alataki E, Papayanni PG, Varelas C, Kokkoris S, Papalexandri A, Fotoulaki M, Galli-Tsinopoulou A, Zafeiriou D, Roilides E, Sakellari I, Anagnostopoulos A, Tragiannidis A. Targeted Genotyping of MIS-C Patients Reveals a Potential Alternative Pathway Mediated Complement Dysregulation during COVID-19 Infection. Curr Issues Mol Biol 2022; 44:2811-2824. [PMID: 35877417 PMCID: PMC9325260 DOI: 10.3390/cimb44070193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Complement dysregulation has been documented in adults with COVID-19 and implicated in relevant pediatric inflammatory responses against SARS-CoV-2. We propose that signatures of complement missense coding SNPs associated with dysregulation could also be identified in children with multisystem inflammatory syndrome (MIS-C). We investigated 71 pediatric patients with RT-PCR validated SARS-CoV-2 hospitalized in pediatric COVID-19 care units (November 2020–March 2021) in three major groups. Seven (7) patients suffered from MIS-C (MIS-C group), 32 suffered from COVID-19 and were hospitalized (admitted group), whereas 32 suffered from COVID-19, but were sent home. All patients survived and were genotyped for variations in the C3, C5, CFB, CFD, CFH, CFHR1, CFI, CD46, CD55, MASP1, MASP2, MBL2, COLEC11, FCN1, and FCN3 genes. Upon evaluation of the missense coding SNP distribution patterns along the three study groups, we noticed similarities, but also considerably increased frequencies of the alternative pathway (AP) associated with SNPs rs12614 CFB, rs1061170, and rs1065489 CFH in the MIS-C patients. Our analysis suggests that the corresponding substitutions potentially reduce the C3b-inactivation efficiency and promote slower and weaker AP C3bBb pre-convertase assembly on virions. Under these circumstances, the complement AP opsonization capacity may be impaired, leading to compromised immune clearance and systemic inflammation in the MIS-C syndrome.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
- Correspondence: (E.G.); (S.A.T.); Tel.: +30-697-3841-671 (E.G.); +30-697-9568-269 (S.A.T.)
| | - Stefanos A. Tsiftsoglou
- Laboratory of Pharmacology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (E.G.); (S.A.T.); Tel.: +30-697-3841-671 (E.G.); +30-697-9568-269 (S.A.T.)
| | - Tasoula Touloumenidou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Evangelia Farmaki
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Paraskevi Panagopoulou
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Elissavet Michailidou
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Evaggelia-Evdoxia Koravou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Ioulia Mavrikou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Elias Iosifidis
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Olga Tsiatsiou
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Eleni Papadimitriou
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Efimia Papadopoulou-Alataki
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Penelope Georgia Papayanni
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Christos Varelas
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Styliani Kokkoris
- Laboratory of Hematology and Hospital—Blood Transfusion Unit, Medical School, University General Hospital “Attikon”, NKUA, 12462 Athens, Greece;
| | - Apostolia Papalexandri
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Maria Fotoulaki
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Assimina Galli-Tsinopoulou
- 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, 54621 Thessaloniki, Greece; (A.G.-T.); (A.T.)
| | - Dimitrios Zafeiriou
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Emmanuel Roilides
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Ioanna Sakellari
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Achilles Anagnostopoulos
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Athanasios Tragiannidis
- 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, 54621 Thessaloniki, Greece; (A.G.-T.); (A.T.)
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8
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White HE, Salmon M, Albano F, Andersen CSA, Balabanov S, Balatzenko G, Barbany G, Cayuela JM, Cerveira N, Cochaux P, Colomer D, Coriu D, Diamond J, Dietz C, Dulucq S, Engvall M, Franke GN, Gineikiene-Valentine E, Gniot M, Gómez-Casares MT, Gottardi E, Hayden C, Hayette S, Hedblom A, Ilea A, Izzo B, Jiménez-Velasco A, Jurcek T, Kairisto V, Langabeer SE, Lion T, Meggyesi N, Mešanović S, Mihok L, Mitterbauer-Hohendanner G, Moeckel S, Naumann N, Nibourel O, Oppliger Leibundgut E, Panayiotidis P, Podgornik H, Pott C, Rapado I, Rose SJ, Schäfer V, Touloumenidou T, Veigaard C, Venniker-Punt B, Venturi C, Vigneri P, Vorkinn I, Wilkinson E, Zadro R, Zawada M, Zizkova H, Müller MC, Saussele S, Ernst T, Machova Polakova K, Hochhaus A, Cross NCP. Standardization of molecular monitoring of CML: results and recommendations from the European treatment and outcome study. Leukemia 2022; 36:1834-1842. [PMID: 35614319 PMCID: PMC9252906 DOI: 10.1038/s41375-022-01607-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022]
Abstract
Standardized monitoring of BCR::ABL1 mRNA levels is essential for the management of chronic myeloid leukemia (CML) patients. From 2016 to 2021 the European Treatment and Outcome Study for CML (EUTOS) explored the use of secondary, lyophilized cell-based BCR::ABL1 reference panels traceable to the World Health Organization primary reference material to standardize and validate local laboratory tests. Panels were used to assign and validate conversion factors (CFs) to the International Scale and assess the ability of laboratories to assess deep molecular response (DMR). The study also explored aspects of internal quality control. The percentage of EUTOS reference laboratories (n = 50) with CFs validated as optimal or satisfactory increased from 67.5% to 97.6% and 36.4% to 91.7% for ABL1 and GUSB, respectively, during the study period and 98% of laboratories were able to detect MR4.5 in most samples. Laboratories with unvalidated CFs had a higher coefficient of variation for BCR::ABL1IS and some laboratories had a limit of blank greater than zero which could affect the accurate reporting of DMR. Our study indicates that secondary reference panels can be used effectively to obtain and validate CFs in a manner equivalent to sample exchange and can also be used to monitor additional aspects of quality assurance.
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Affiliation(s)
- Helen E White
- Faculty of Medicine, University of Southampton, Southampton, UK.,Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Matthew Salmon
- Faculty of Medicine, University of Southampton, Southampton, UK.,Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Francesco Albano
- Department of Emergency and Organ Transplantation (D.E.T.O.)-Hematology and Stem Cell Transplantation Unit, University of Bari "Aldo Moro", Bari, Italy
| | | | - Stefan Balabanov
- Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gueorgui Balatzenko
- Laboratory of Medical Genetics National Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria
| | - Gisela Barbany
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Jean-Michel Cayuela
- Laboratory of Hematology, University Hospital Saint-Louis, Université de Paris, Paris, France
| | - Nuno Cerveira
- Department of Genetics and Research Centre, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Pascale Cochaux
- Department of Molecular Hemato-Oncology, LHUB-ULB, Brussels, Belgium
| | - Dolors Colomer
- Pathology Department, Hospital Clinic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Barcelona, Spain
| | - Daniel Coriu
- Fundeni Clinical Institute, Hematology Department, Bucharest, Romania.,Hematology Department, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | - Joana Diamond
- Laboratório de Hemato-Oncologia-LHO Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
| | - Christian Dietz
- Institute for Hematology and Oncology (IHO GmbH), Mannheim, Germany
| | - Stéphanie Dulucq
- University Hospital of Bordeaux, Laboratory of Hematology, Haut Lévêque Hospital, Pessac, France
| | - Marie Engvall
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Georg N Franke
- University of Leipzig Medical Center, Department for Hematology, Cellular Therapies and Hemostaseology, Leipzig, Germany
| | | | - Michal Gniot
- Poznan University of Medical Sciences, Department of Hematology and Bone Marrow Transplantation, Poznan, Poland
| | - María Teresa Gómez-Casares
- Hematology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Enrico Gottardi
- Laboratory of Chemical and Clinical Analysis "Area 3" A.O.U San Luigi Gonzaga-Orbassano, Turin, Italy
| | - Chloe Hayden
- SIHMDS Hosted by Imperial College Healthcare NHS Trust at Hammersmith Hospital, London, UK
| | - Sandrine Hayette
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service d'Hématologie Biologique, Pierre-Bénite, France
| | - Andreas Hedblom
- Section of Molecular Diagnostics, Clinical Genetics, Region Skåne, Lund, Sweden
| | - Anca Ilea
- Ritus Biotec Laboratory, Codlea-Brasov, Romania.,Transilvania University, Brasov, Romania
| | - Barbara Izzo
- Department of Molecular Medicine and Medical Biotechnology University 'Federico II' and CEINGE-Advanced Biotechnologies, Naples, Italy
| | | | - Tomas Jurcek
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Veli Kairisto
- Department of Genomics, Turku University Hospital Laboratories, Turku, Finland
| | | | - Thomas Lion
- Labdia Labordiagnostik/St. Anna Children´s Cancer Research Institute (CCRI), Vienna, Austria
| | - Nora Meggyesi
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Semir Mešanović
- Pathology Department, University Clinical Center Tuzla, Policlinic for Laboratory Diagnostics, Tuzla, Bosnia and Herzegovina
| | - Luboslav Mihok
- Department of Medical Genetics, National Cancer Institute, Bratislava, Slovakia
| | | | | | - Nicole Naumann
- III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany
| | | | | | - Panayiotis Panayiotidis
- Haematology Research Laboratory, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Helena Podgornik
- Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Christiane Pott
- Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Inmaculada Rapado
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041, Madrid, Spain.,Hematological Malignancies Clinical Research Unit, CNIO, 28029, Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029, Madrid, Spain
| | - Susan J Rose
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Vivien Schäfer
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Tasoula Touloumenidou
- Molecular Diagnostics Laboratory, Hematology Department and HCT Unit, George Papanicolaou General Hospital, Thessaloniki, Greece
| | - Christopher Veigaard
- HemoDiagnostic Laboratory, Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Claudia Venturi
- IRCSS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Paolo Vigneri
- Department of Clinical and Experimental Medicine, Center of Experimental Oncology and Hematology, University of Catania, Catania, Italy
| | - Ingvild Vorkinn
- Molecular Hemapathology, Oslo University Hospital, Oslo, Norway
| | - Elizabeth Wilkinson
- Haematological Malignancy Diagnostic Service, Leeds Teaching Hospitals, Leeds, UK
| | - Renata Zadro
- University Hospital Center Zagreb, Zagreb, Croatia
| | | | - Hana Zizkova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Martin C Müller
- Institute for Hematology and Oncology (IHO GmbH), Mannheim, Germany
| | - Susanne Saussele
- III. Medizinische Klinik, Universitätsmedizin Mannheim, Mannheim, Germany
| | - Thomas Ernst
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | | | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Nicholas C P Cross
- Faculty of Medicine, University of Southampton, Southampton, UK. .,Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.
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9
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Gavriilaki E, Papadopoulou A, Touloumenidou T, Stavridou F, Koravou EE, Giannaki M, Papalexandri A, Karavalakis G, Batsis I, Kourelis A, Chatzopoulou F, Chatzidimitriou D, Sotiropoulos D, Yannaki E, Sakellari I, Anagnostopoulos A. Neutralizing antibody and T cell responses to SARS-CoV-2 vaccination in hematopoietic cell transplant recipients. Bone Marrow Transplant 2022; 57:1183-1186. [PMID: 35449455 PMCID: PMC9022618 DOI: 10.1038/s41409-022-01675-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Anastasia Papadopoulou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Tasoula Touloumenidou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Fani Stavridou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Evaggelia-Evdoxia Koravou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Maria Giannaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Apostolia Papalexandri
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Georgios Karavalakis
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Andreas Kourelis
- Microbiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Chatzopoulou
- Microbiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Damianos Sotiropoulos
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Evangelia Yannaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece.
| | - Ioanna Sakellari
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
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10
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Asteris PG, Gavriilaki E, Touloumenidou T, Koravou E, Koutra M, Papayanni PG, Pouleres A, Karali V, Lemonis ME, Mamou A, Skentou AD, Papalexandri A, Varelas C, Chatzopoulou F, Chatzidimitriou M, Chatzidimitriou D, Veleni A, Rapti E, Kioumis I, Kaimakamis E, Bitzani M, Boumpas D, Tsantes A, Sotiropoulos D, Papadopoulou A, Kalantzis IG, Vallianatou LA, Armaghani DJ, Cavaleri L, Gandomi AH, Hajihassani M, Hasanipanah M, Koopialipoor M, Lourenço PB, Samui P, Zhou J, Sakellari I, Valsami S, Politou M, Kokoris S, Anagnostopoulos A. Genetic prediction of ICU hospitalization and mortality in COVID‐19 patients using artificial neural networks. J Cell Mol Med 2022; 26:1445-1455. [PMID: 35064759 PMCID: PMC8899198 DOI: 10.1111/jcmm.17098] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022] Open
Abstract
There is an unmet need of models for early prediction of morbidity and mortality of Coronavirus disease‐19 (COVID‐19). We aimed to a) identify complement‐related genetic variants associated with the clinical outcomes of ICU hospitalization and death, b) develop an artificial neural network (ANN) predicting these outcomes and c) validate whether complement‐related variants are associated with an impaired complement phenotype. We prospectively recruited consecutive adult patients of Caucasian origin, hospitalized due to COVID‐19. Through targeted next‐generation sequencing, we identified variants in complement factor H/CFH, CFB, CFH‐related, CFD, CD55, C3, C5, CFI, CD46, thrombomodulin/THBD, and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS13). Among 381 variants in 133 patients, we identified 5 critical variants associated with severe COVID‐19: rs2547438 (C3), rs2250656 (C3), rs1042580 (THBD), rs800292 (CFH) and rs414628 (CFHR1). Using age, gender and presence or absence of each variant, we developed an ANN predicting morbidity and mortality in 89.47% of the examined population. Furthermore, THBD and C3a levels were significantly increased in severe COVID‐19 patients and those harbouring relevant variants. Thus, we reveal for the first time an ANN accurately predicting ICU hospitalization and death in COVID‐19 patients, based on genetic variants in complement genes, age and gender. Importantly, we confirm that genetic dysregulation is associated with impaired complement phenotype.
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Affiliation(s)
- Panagiotis G. Asteris
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Eleni Gavriilaki
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | | | - Maria Koutra
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | | | - Vassiliki Karali
- Rheumatology and Clinical Immunology Unit University General Hospital ‘Attikon’ Athens Greece
| | - Minas E. Lemonis
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Anna Mamou
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Athanasia D. Skentou
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | | | - Christos Varelas
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | - Maria Chatzidimitriou
- Biomedical Sciences Alexander Campus International Hellenic University Thessaloniki Greece
| | | | - Anastasia Veleni
- Infectious Disease Committee G Papanicolaou Hospital Thessaloniki Greece
| | - Evdoxia Rapti
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
| | - Ioannis Kioumis
- Respiratory Failure Department G Papanicolaou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Milly Bitzani
- 1 Intensive Care Unit G Papanicolaou Hospital Thessaloniki Greece
| | - Dimitrios Boumpas
- Rheumatology and Clinical Immunology Unit University General Hospital ‘Attikon’ Athens Greece
| | - Argyris Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
| | | | | | | | - Lydia A. Vallianatou
- Cath and EP Laboratory/Covid Intensive Care Unit Hellenic Red Cross Hospital Athens Greece
| | - Danial J. Armaghani
- Department of Civil Engineering Faculty of Engineering University of Malaya Kuala Lumpur Malaysia
| | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials Engineering University of Palermo Palermo Italy
| | - Amir H. Gandomi
- Faculty of Engineering & Information Technology University of Technology Sydney Ultimo NSW Australia
| | - Mohsen Hajihassani
- Department of Mining Engineering Faculty of Engineering Urmia University Urmia Iran
| | - Mahdi Hasanipanah
- Institute of Research and Development Duy Tan University Da Nang Vietnam
| | | | - Paulo B. Lourenço
- Department of Civil Engineering ISISEUniversity of Minho Guimarães Portugal
| | - Pijush Samui
- Department of Civil Engineering National Institute of Technology Patna Patna Bihar India
| | - Jian Zhou
- School of Resources and Safety Engineering Central South University Changsha China
| | - Ioanna Sakellari
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | - Serena Valsami
- Hematology Laboratory ‐ Blood Bank Aretaieion HospitalSchool of MedicineNKUA Athens Greece
| | - Marianna Politou
- Hematology Laboratory ‐ Blood Bank Aretaieion HospitalSchool of MedicineNKUA Athens Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
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11
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Gavriilaki E, Asteris PG, Touloumenidou T, Koravou EE, Koutra M, Papayanni PG, Karali V, Papalexandri A, Varelas C, Chatzopoulou F, Chatzidimitriou M, Chatzidimitriou D, Veleni A, Grigoriadis S, Rapti E, Chloros D, Kioumis I, Kaimakamis E, Bitzani M, Boumpas D, Tsantes A, Sotiropoulos D, Sakellari I, Kalantzis IG, Parastatidis ST, Koopialipoor M, Cavaleri L, Armaghani DJ, Papadopoulou A, Brodsky RA, Kokoris S, Anagnostopoulos A. Genetic justification of severe COVID-19 using a rigorous algorithm. Clin Immunol 2021; 226:108726. [PMID: 33845193 PMCID: PMC8043057 DOI: 10.1016/j.clim.2021.108726] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 01/04/2023]
Abstract
Recent studies suggest excessive complement activation in severe coronavirus disease-19 (COVID-19). The latter shares common characteristics with complement-mediated thrombotic microangiopathy (TMA). We hypothesized that genetic susceptibility would be evident in patients with severe COVID-19 (similar to TMA) and associated with disease severity. We analyzed genetic and clinical data from 97 patients hospitalized for COVID-19. Through targeted next-generation-sequencing we found an ADAMTS13 variant in 49 patients, along with two risk factor variants (C3, 21 patients; CFH,34 patients). 31 (32%) patients had a combination of these, which was independently associated with ICU hospitalization (p = 0.022). Analysis of almost infinite variant combinations showed that patients with rs1042580 in thrombomodulin and without rs800292 in complement factor H did not require ICU hospitalization. We also observed gender differences in ADAMTS13 and complement-related variants. In light of encouraging results by complement inhibitors, our study highlights a patient population that might benefit from early initiation of specific treatment.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department – BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece,Corresponding author at: Hematology Department – BMT Unit, G. Papanicolaou Hospital, Exochi, 57010, Thessaloniki, Greece
| | - Panagiotis G. Asteris
- Computational Mechanics Laboratory, School of Pedagogical and Technological Education, Athens, Greece
| | | | | | - Maria Koutra
- Hematology Department – BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Vassiliki Karali
- Rheumatology and Clinical Immunology Unit, "Attikon" University Hospital, Athens, Greece
| | | | - Christos Varelas
- Hematology Department – BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Fani Chatzopoulou
- Microbiology Department, Aristotle University of Thessaloniki, Greece
| | - Maria Chatzidimitriou
- Biomedical Sciences, Alexander Campus International Hellenic University, Thessaloniki, Greece
| | | | - Anastasia Veleni
- Infectious Disease Committee, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Savvas Grigoriadis
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdoxia Rapti
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital “Attikon”, NKUA, Medical School, Greece
| | - Diamantis Chloros
- Pneumonology Department, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioannis Kioumis
- Respiratory Failure Department, G Papanicolaou Hospital-Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Milly Bitzani
- 1st Intensive Care Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Dimitrios Boumpas
- Rheumatology and Clinical Immunology Unit, "Attikon" University Hospital, Athens, Greece
| | - Argyris Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital “Attikon”, NKUA, Medical School, Greece
| | | | - Ioanna Sakellari
- Hematology Department – BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Stefanos T. Parastatidis
- Computational Mechanics Laboratory, School of Pedagogical and Technological Education, Athens, Greece
| | | | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials Engineering, University of Palermo, Palermo, Italy
| | - Danial J. Armaghani
- Department of Civil Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Robert Alan Brodsky
- Hematology Division, Department of Internal Medicine, Johns Hopkins University, Baltimore, USA
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital “Attikon”, NKUA, Medical School, Greece
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12
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Gavriilaki E, Koravou EE, Chatziconstantinou T, Kalpadaki C, Printza N, Ximeri M, Christoforidou A, Karavalakis G, Kaliou M, Kalaitzidou V, Tassi I, Tzellou M, Touloumenidou T, Papalexandri A, Papathanasiou M, Syrigou A, Kioumi A, Liga M, Kaiafa G, Spyridonidis A, Kapsali E, Kollios K, Mandala E, Vlachaki E, Tsirigotis P, Papadaki E, Lalayanni C, Sakellari I, Anagnostopoulos A. Real-world data of thrombotic microangiopathy management: The key role of ADAMTS13 activity and complement testing. Thrombosis Update 2021. [DOI: 10.1016/j.tru.2021.100043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Gavriilaki E, Sakellari I, Bousiou Z, Batsis I, Mallouri D, Masmanidou M, Vardi A, Chatzikonstantinou T, Koravou EE, Touloumenidou T, Papalexandri A, Yannaki E, Anagnostopoulos A. Complement Inhibition with Eculizumab in Adult Transplant-Associated Thrombotic Microangiopathy: Opening the Pandora’s Box. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00342-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Gavriilaki E, Sakellari I, Chatzikonstantinou T, Mallouri D, Batsis I, Vardi A, Bousiou Z, Koravou EE, Masmanidou M, Touloumenidou T, Papalexandri A, Athanasiadou A, Yannaki E, Anagnostopoulos A. Endothelial and Complement Activation As Predictors of Survival in Adult Allogeneic Hematopoietic Cell Transplantation. Hemasphere 2020; 5:e487. [PMID: 33324949 PMCID: PMC7732269 DOI: 10.1097/hs9.0000000000000487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioanna Sakellari
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Thomas Chatzikonstantinou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Despina Mallouri
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Anna Vardi
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Zoi Bousiou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Eudoxia-Evaggelia Koravou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Marianna Masmanidou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Tasoula Touloumenidou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Apostolia Papalexandri
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Anastasia Athanasiadou
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Evangelia Yannaki
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Hematology Department, Bone Marrow Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
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15
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Gavriilaki E, Touloumenidou T, Sakellari I, Batsis I, Mallouri D, Psomopoulos F, Tsagiopoulou M, Koutra M, Yannaki E, Papalexandri A, Taylor P, Nikolousis E, Stamouli M, Holbro A, Baltadakis I, Liga M, Spyridonidis A, Tsirigotis P, Charchalakis N, Tsakiris DA, Brodsky RA, Passweg J, Stamatopoulos K, Anagnostopoulos A. Pretransplant Genetic Susceptibility: Clinical Relevance in Transplant-Associated Thrombotic Microangiopathy. Thromb Haemost 2020; 120:638-646. [DOI: 10.1055/s-0040-1702225] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractTransplant-associated thrombotic microangiopathy (TA-TMA) is a life-threatening complication of allogeneic hematopoietic cell transplantation (HCT). We hypothesized that pretransplant genetic susceptibility is evident in adult TA-TMA and further investigated the association of TMA-associated variants with clinical outcomes. We studied 40 patients with TA-TMA, donors of 18 patients and 40 control non-TMA HCT recipients, without significant differences in transplant characteristics. Genomic DNA from pretransplant peripheral blood was sequenced for TMA-associated genes. Donors presented significantly lower frequency of rare variants and variants in exonic/splicing/untranslated region (UTR) regions, compared with TA-TMA patients. Controls also showed a significantly lower frequency of rare variants in ADAMTS13, CD46, CFH, and CFI. The majority of TA-TMA patients (31/40) presented with pathogenic or likely pathogenic variants. Patients refractory to conventional treatment (62%) and patients that succumbed to transplant-related mortality (65%) were significantly enriched for variants in exonic/splicing/UTR regions. In conclusion, increased incidence of pathogenic, rare and variants in exonic/splicing/UTR regions of TA-TMA patients suggests genetic susceptibility not evident in controls or donors. Notably, variants in exonic/splicing/UTR regions were associated with poor response and survival. Therefore, pretransplant genomic screening may be useful to intensify monitoring and early intervention in patients at high risk for TA-TMA.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Ioanna Sakellari
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Despina Mallouri
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Fotis Psomopoulos
- Department of Hematology, Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Maria Tsagiopoulou
- Department of Hematology, Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Maria Koutra
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Evangelia Yannaki
- Hematology Department–BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Pat Taylor
- Department of Haematology, University Hospitals Birmingham, Birmingham, United Kingdom
| | - Emmanuel Nikolousis
- Department of Haematology, University Hospitals Birmingham, Birmingham, United Kingdom
| | - Maria Stamouli
- Division of Hematology, Second Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Holbro
- Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Ioannis Baltadakis
- Department of Hematology, Bone Marrow Transplantation Unit, Evangelismos Hospital, Athens, Greece
| | - Maria Liga
- Department of Hematology, BMT Unit, University Hospital of Patras, Patras, Greece
| | | | - Panagiotis Tsirigotis
- Division of Hematology, Second Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Charchalakis
- Department of Hematology, Bone Marrow Transplantation Unit, Evangelismos Hospital, Athens, Greece
| | - Dimitrios A. Tsakiris
- Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Robert A. Brodsky
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Jacob Passweg
- Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - Kostas Stamatopoulos
- Department of Hematology, Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
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16
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Gavriilaki E, Chrysanthopoulou A, Sakellari I, Batsis I, Mallouri D, Touloumenidou T, Papalexandri A, Mitsios A, Arampatzioglou A, Ritis K, Brodsky RA, Mitroulis I, Anagnostopoulos A. Linking Complement Activation, Coagulation, and Neutrophils in Transplant-Associated Thrombotic Microangiopathy. Thromb Haemost 2019; 119:1433-1440. [PMID: 31266080 DOI: 10.1055/s-0039-1692721] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Transplant-associated thrombotic microangiopathy (TA-TMA) is a severe and life-threatening complication of hematopoietic cell transplantation (HCT) that often coincides with graft-versus-host-disease (GVHD). Although endothelial damage seems to be the common denominator for both disorders, the role of complement system, neutrophils, and coagulation has not been clarified. In an effort to distinguish the pathogenesis of TA-TMA from GVHD, we evaluated markers of complement activation, neutrophil extracellular trap (NET) release, endothelial damage, and activation of coagulation cascade in the circulation of patients with these two disorders, as well as control HCT recipients without TA-TMA or GVHD. We observed that the terminal complement product C5b-9 levels, the levels of markers of NET formation, and thrombin-antithrombin complex levels were significantly increased in the TA-TMA group compared with patients without complications, whereas there was no significant difference between the GVHD and the control group. On the other hand, the levels of circulating thrombomodulin, an endothelial damage marker, were significantly increased in both TA-TMA and GVHD patients. These findings propose a role for the interplay between complement system, neutrophil activation through NET release, and activation of the coagulation cascade in TA-TMA.
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Affiliation(s)
- Eleni Gavriilaki
- Department of Hematology, BMT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Akrivi Chrysanthopoulou
- Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioanna Sakellari
- Department of Hematology, BMT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Department of Hematology, BMT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Despina Mallouri
- Department of Hematology, BMT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
| | | | | | - Alexandros Mitsios
- Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Konstantinos Ritis
- Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Robert Alan Brodsky
- Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Ioannis Mitroulis
- Laboratory of Molecular Hematology, Democritus University of Thrace, Alexandroupolis, Greece.,Institute for Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases, Partner Site Dresden, of the German Cancer Research Center, Heidelberg and of the Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and of the Helmholtz Association/Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
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17
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Papalexandri A, Karypidou M, Stalika E, Kotta K, Touloumenidou T, Zerva P, Paleta A, Mallouri D, Batsis I, Sakellari I, Kotsianidis I, Anagnostopoulos A, Hadzidimitriou A, Margaritis D, Stamatopoulos K. Skewing of the T-cell receptor repertoire in patients receiving rituximab after allogeneic hematopoietic cell transplantation: what lies beneath? Leuk Lymphoma 2019; 60:1685-1692. [PMID: 30652530 DOI: 10.1080/10428194.2018.1543881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Rituximab is known to affect T cell immune responses. We and others have reported expansions of T large granular lymphocytes (T-LGLs) in lymphoma patients after Rituximab. We report here the immunogenetic profiling of the T cell receptor (TR) gene repertoire in 14 patients who received Rituximab post allo-HCT and explore clinicobiological correlations. All experienced antigenic triggers, CMV, EBV re-activation and chronic GvHD and had been treated with Rituximab. Skewing of TRBV genes was observed: 3 TRBV genes accounted for half of the repertoire. Oligoclonal pattern with expanded clonotypes was common. Patients with oligoclonality exhibited frequently cGvHD. Longitudinal samples in one revealed distinct clonotypes, suggesting clonal drift. T-LGL leukemia of donor origin with mixed chimerism eventually developed. In conclusion, we report development of oligoclonal T-LGLs after Rituximab post allo-HCT, alluding to antigen selection. Persistence of this phenomenon likely reflects strong antigenic stimulation by viruses and/or cGVHD aggravated by Rituximab.
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Affiliation(s)
- Apostolia Papalexandri
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece.,b Hematology Department, School of Health Sciences , Democritus University of Thrace , Alexandropouli , Greece
| | - Maria Karypidou
- c Institute of Applied Biosciences, Centre for Research and Technology Hellas , Thessaloniki , Greece
| | - Evangelia Stalika
- c Institute of Applied Biosciences, Centre for Research and Technology Hellas , Thessaloniki , Greece
| | - Konstantina Kotta
- c Institute of Applied Biosciences, Centre for Research and Technology Hellas , Thessaloniki , Greece
| | - Tasoula Touloumenidou
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Panagiota Zerva
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Angeliki Paleta
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Despina Mallouri
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Ioannis Batsis
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Ioanna Sakellari
- a Haematology Department and BMT Unit , G.Papanikolaou Hospital , Thessaloniki , Greece
| | - Ioannis Kotsianidis
- b Hematology Department, School of Health Sciences , Democritus University of Thrace , Alexandropouli , Greece
| | | | - Anastasia Hadzidimitriou
- c Institute of Applied Biosciences, Centre for Research and Technology Hellas , Thessaloniki , Greece
| | - Dimitris Margaritis
- b Hematology Department, School of Health Sciences , Democritus University of Thrace , Alexandropouli , Greece
| | - Kostas Stamatopoulos
- c Institute of Applied Biosciences, Centre for Research and Technology Hellas , Thessaloniki , Greece
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18
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Sakellari I, Papalexandri A, Mallouri D, Batsis I, Iskas M, Xochelli A, Marvaki A, Gavriilaki E, Vardi A, Zerva P, Touloumenidou T, Anagnostopoulos A. Donor EBV at the time of hematopoietic cell transplantation: Is it time to adopt molecular assays? J Clin Virol 2018; 102:32-33. [PMID: 29482045 DOI: 10.1016/j.jcv.2018.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Ioanna Sakellari
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece.
| | | | - Despina Mallouri
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Michail Iskas
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Aliki Xochelli
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Anastasia Marvaki
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Eleni Gavriilaki
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Anna Vardi
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Panagiota Zerva
- Hematology Department - BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
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19
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Gavriilaki E, Mainou M, Christodoulou I, Koravou EE, Paleta A, Touloumenidou T, Papalexandri A, Athanasiadou A, Apostolou C, Klonizakis P, Anagnostopoulos A, Vlachaki E. In vitro evidence of complement activation in patients with sickle cell disease. Haematologica 2017; 102:e481-e482. [PMID: 28912175 DOI: 10.3324/haematol.2017.174201] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Eleni Gavriilaki
- Haematology Department BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Maria Mainou
- Adults Thalassaemia Unit, 2 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece
| | - Ioanna Christodoulou
- Adults Thalassaemia Unit, 2 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece
| | | | - Aggeliki Paleta
- Haematology Department BMT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | | | | | - Chrysa Apostolou
- Adults Thalassaemia Unit, 2 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece
| | - Philippos Klonizakis
- Adults Thalassaemia Unit, 2 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece
| | | | - Efthymia Vlachaki
- Adults Thalassaemia Unit, 2 Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece
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20
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Pal K, Bystry V, Reigl T, Demko M, Krejci A, Touloumenidou T, Stalika E, Tichy B, Ghia P, Stamatopoulos K, Pospisilova S, Malcikova J, Darzentas N. GLASS: assisted and standardized assessment of gene variations from Sanger sequence trace data. Bioinformatics 2017; 33:3802-3804. [DOI: 10.1093/bioinformatics/btx423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 07/12/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Karol Pal
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Vojtech Bystry
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Tomas Reigl
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Martin Demko
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Adam Krejci
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Tasoula Touloumenidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Evangelia Stalika
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Boris Tichy
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Paolo Ghia
- Division of Molecular Oncology, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milan, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Sarka Pospisilova
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Internal Medicine--Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Jitka Malcikova
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Internal Medicine--Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Nikos Darzentas
- CEITEC—Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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21
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Gemenetzi K, Galigalidou C, Vlachonikola E, Stalika E, Xochelli A, Baliakas P, Karypidou M, Touloumenidou T, Minga E, Douka V, Iskas M, Athanasiadou A, Makris A, Stavroyianni N, Anagnostopoulos A, Hadzidimitriou A, Stamatopoulos K. Tp53 gene p72R polymorphism in chronic lymphocytic leukemia: incidence and clinical significance amongst cases with unmutated immunoglobulin receptors. Leuk Lymphoma 2016; 58:726-728. [PMID: 27686405 DOI: 10.1080/10428194.2016.1211276] [Citation(s) in RCA: 2] [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: 01/09/2023]
Affiliation(s)
- Katerina Gemenetzi
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece
| | - Chrysi Galigalidou
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece
| | - Elisavet Vlachonikola
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece
| | - Evangelia Stalika
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece.,b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | - Aliki Xochelli
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece.,b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | - Panagiotis Baliakas
- c Department of Immunology, Genetics and Pathology, Science for Life Laboratory , Uppsala University , Uppsala , Sweden
| | - Maria Karypidou
- b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | - Tasoula Touloumenidou
- b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | - Evangelia Minga
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece
| | - Vasiliki Douka
- b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | - Michalis Iskas
- b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | | | - Antonios Makris
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece
| | - Niki Stavroyianni
- b Hematology Department and HCT Unit , G. Papanicolaou Hospital , Thessaloniki , Greece
| | | | - Anastasia Hadzidimitriou
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece.,c Department of Immunology, Genetics and Pathology, Science for Life Laboratory , Uppsala University , Uppsala , Sweden
| | - Kostas Stamatopoulos
- a Institute of Applied Biosciences, Center of Research and Technology Hellas , Thessaloniki , Greece.,c Department of Immunology, Genetics and Pathology, Science for Life Laboratory , Uppsala University , Uppsala , Sweden
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22
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Navrkalova V, Young E, Baliakas P, Radova L, Sutton LA, Plevova K, Mansouri L, Ljungström V, Ntoufa S, Davis Z, Juliusson G, Smedby KE, Belessi C, Panagiotidis P, Touloumenidou T, Davi F, Langerak AW, Ghia P, Strefford JC, Oscier D, Mayer J, Stamatopoulos K, Pospisilova S, Rosenquist R, Trbusek M. ATM mutations in major stereotyped subsets of chronic lymphocytic leukemia: enrichment in subset #2 is associated with markedly short telomeres. Haematologica 2016; 101:e369-73. [PMID: 27479817 DOI: 10.3324/haematol.2016.142968] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Veronika Navrkalova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic Department of Molecular Medicine, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Emma Young
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Lenka Radova
- Department of Molecular Medicine, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Karla Plevova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic Department of Molecular Medicine, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Larry Mansouri
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Viktor Ljungström
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | | | - Zadie Davis
- Department of Molecular Pathology, Royal Bournemouth Hospital, UK
| | - Gunnar Juliusson
- Department of Laboratory Medicine, Stem Cell Center, Hematology and Transplantation, Lund University, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Tasoula Touloumenidou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Frederic Davi
- Laboratory of Hematology, Hospital Pitie-Salpetriere and University Pierre and Marie Curie, Paris, France
| | - Anton W Langerak
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - David Oscier
- Department of Molecular Pathology, Royal Bournemouth Hospital, UK
| | - Jiri Mayer
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Sarka Pospisilova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic Department of Molecular Medicine, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Martin Trbusek
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
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23
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Cross NCP, White HE, Ernst T, Welden L, Dietz C, Saglio G, Mahon FX, Wong CC, Zheng D, Wong S, Wang SS, Akiki S, Albano F, Andrikovics H, Anwar J, Balatzenko G, Bendit I, Beveridge J, Boeckx N, Cerveira N, Cheng SM, Colomer D, Czurda S, Daraio F, Dulucq S, Eggen L, El Housni H, Gerrard G, Gniot M, Izzo B, Jacquin D, Janssen JJWM, Jeromin S, Jurcek T, Kim DW, Machova-Polakova K, Martinez-Lopez J, McBean M, Mesanovic S, Mitterbauer-Hohendanner G, Mobtaker H, Mozziconacci MJ, Pajič T, Pallisgaard N, Panagiotidis P, Press RD, Qin YZ, Radich J, Sacha T, Touloumenidou T, Waits P, Wilkinson E, Zadro R, Müller MC, Hochhaus A, Branford S. Development and evaluation of a secondary reference panel for BCR-ABL1 quantification on the International Scale. Leukemia 2016; 30:1844-52. [PMID: 27109508 PMCID: PMC5240017 DOI: 10.1038/leu.2016.90] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/24/2022]
Abstract
Molecular monitoring of chronic myeloid leukemia patients using robust BCR-ABL1 tests standardized to the International Scale (IS) is key to proper disease management, especially when treatment cessation is considered. Most laboratories currently use a time-consuming sample exchange process with reference laboratories for IS calibration. A World Health Organization (WHO) BCR-ABL1 reference panel was developed (MR1–MR4), but access to the material is limited. In this study, we describe the development of the first cell-based secondary reference panel that is traceable to and faithfully replicates the WHO panel, with an additional MR4.5 level. The secondary panel was calibrated to IS using digital PCR with ABL1, BCR and GUSB as reference genes and evaluated by 44 laboratories worldwide. Interestingly, we found that >40% of BCR-ABL1 assays showed signs of inadequate optimization such as poor linearity and suboptimal PCR efficiency. Nonetheless, when optimized sample inputs were used, >60% demonstrated satisfactory IS accuracy, precision and/or MR4.5 sensitivity, and 58% obtained IS conversion factors from the secondary reference concordant with their current values. Correlation analysis indicated no significant alterations in %BCR-ABL1 results caused by different assay configurations. More assays achieved good precision and/or sensitivity than IS accuracy, indicating the need for better IS calibration mechanisms.
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Affiliation(s)
- N C P Cross
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - H E White
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Ernst
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - L Welden
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia
| | - C Dietz
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - G Saglio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - F-X Mahon
- Bergonie Institute Cancer Center Bordeaux, INSERM U1218, University of Bordeaux, Bordeaux, France
| | - C C Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - D Zheng
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S-S Wang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - F Albano
- Department of Hematology, University of Bari, Bari, Italy
| | - H Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.,Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - J Anwar
- King's College Hospital London, London, UK
| | - G Balatzenko
- National Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria
| | - I Bendit
- Laboratorio de Biologia Tumoral, Disciplina de Hematologia do HC-FMUSP, São Paulo, Brazil
| | - J Beveridge
- PathWest Laboratory Medicine WA, Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KUL, Leuven, Belgium
| | - N Cerveira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - S-M Cheng
- Department of Hematology and Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - S Czurda
- Division of Molecular Microbiology, Children's Cancer Research Institute, Vienna, Austria
| | - F Daraio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - S Dulucq
- Laboratoire Hematologie, Centre Hospitalier Universitaire de Bordeaux, Universite Bordeaux, Bordeaux, France
| | - L Eggen
- Laboratory of Molecular Pathology, Oslo University Hospital, Oslo, Norway
| | - H El Housni
- Clinique de Genetique Oncologique-Service de genetique, Hopital Erasme, Brussels, Belgium
| | - G Gerrard
- Imperial Molecular Pathology, Hammersmith Hospital, London, UK
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | | | - J J W M Janssen
- Department of Hematology and Molecular Diagnostics, VU University Medical Center, Amsterdam, The Netherlands
| | - S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Jurcek
- Center of Molecular Biology and Gene Therapy, Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - D-W Kim
- Seoul St Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea
| | - K Machova-Polakova
- Department of Molecular Genetics, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Martinez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO, Madrid, Spain
| | - M McBean
- Division of Cancer Medicine, Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - S Mesanovic
- Pathology Department, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - G Mitterbauer-Hohendanner
- Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | | | - M-J Mozziconacci
- Departement de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - T Pajič
- Specialized Haematology Laboratory, Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - N Pallisgaard
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - P Panagiotidis
- Hematology Unit, First Department of Internal Medicine, Laiko Hospital, University of Athens, Athens, Greece
| | - R D Press
- Department of Pathology and Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Y-Z Qin
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China
| | - J Radich
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - T Sacha
- Chair and Department of Hematology, Jagiellonian University, Kraków, Poland
| | - T Touloumenidou
- Laboratory of Molecular Biology, Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - P Waits
- Bristol Genetics Laboratory, Bristol, UK
| | | | - R Zadro
- Faculty of Pharmacy and Biochemistry and University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - S Branford
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA, Australia.,School of Medicine, University of Adelaide, SA, Adelaide, Australia.,School of Molecular and Biomedical Science, University of Adelaide, Adelaide, SA, Australia
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24
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Papalexandri A, Sakellari I, Apostolou C, Boussiou Z, Sotiropoulos D, Charalampidou S, Zerva P, Touloumenidou T, Konstantinou V, Mallouri D, Batsis I, Anagnostopoulos A. Immunogenetic Cross-Talk in Patients Transplanted for AML: CMV Reactivation Is Not a Strong Stimulus for Immune Response Against Leukemia. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.425] [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: 11/26/2022]
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25
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White H, Deprez L, Corbisier P, Hall V, Lin F, Mazoua S, Trapmann S, Aggerholm A, Andrikovics H, Akiki S, Barbany G, Boeckx N, Bench A, Catherwood M, Cayuela JM, Chudleigh S, Clench T, Colomer D, Daraio F, Dulucq S, Farrugia J, Fletcher L, Foroni L, Ganderton R, Gerrard G, Gineikienė E, Hayette S, El Housni H, Izzo B, Jansson M, Johnels P, Jurcek T, Kairisto V, Kizilors A, Kim DW, Lange T, Lion T, Polakova KM, Martinelli G, McCarron S, Merle PA, Milner B, Mitterbauer-Hohendanner G, Nagar M, Nickless G, Nomdedéu J, Nymoen DA, Leibundgut EO, Ozbek U, Pajič T, Pfeifer H, Preudhomme C, Raudsepp K, Romeo G, Sacha T, Talmaci R, Touloumenidou T, Van der Velden VHJ, Waits P, Wang L, Wilkinson E, Wilson G, Wren D, Zadro R, Ziermann J, Zoi K, Müller MC, Hochhaus A, Schimmel H, Cross NCP, Emons H. A certified plasmid reference material for the standardisation of BCR-ABL1 mRNA quantification by real-time quantitative PCR. Leukemia 2014; 29:369-76. [PMID: 25036192 PMCID: PMC4320294 DOI: 10.1038/leu.2014.217] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/21/2014] [Accepted: 06/25/2014] [Indexed: 11/14/2022]
Abstract
Serial quantification of BCR–ABL1 mRNA is an important therapeutic indicator in chronic myeloid leukaemia, but there is a substantial variation in results reported by different laboratories. To improve comparability, an internationally accepted plasmid certified reference material (CRM) was developed according to ISO Guide 34:2009. Fragments of BCR–ABL1 (e14a2 mRNA fusion), BCR and GUSB transcripts were amplified and cloned into pUC18 to yield plasmid pIRMM0099. Six different linearised plasmid solutions were produced with the following copy number concentrations, assigned by digital PCR, and expanded uncertainties: 1.08±0.13 × 106, 1.08±0.11 × 105, 1.03±0.10 × 104, 1.02±0.09 × 103, 1.04±0.10 × 102 and 10.0±1.5 copies/μl. The certification of the material for the number of specific DNA fragments per plasmid, copy number concentration of the plasmid solutions and the assessment of inter-unit heterogeneity and stability were performed according to ISO Guide 35:2006. Two suitability studies performed by 63 BCR–ABL1 testing laboratories demonstrated that this set of 6 plasmid CRMs can help to standardise a number of measured transcripts of e14a2 BCR–ABL1 and three control genes (ABL1, BCR and GUSB). The set of six plasmid CRMs is distributed worldwide by the Institute for Reference Materials and Measurements (Belgium) and its authorised distributors (https://ec.europa.eu/jrc/en/reference-materials/catalogue/; CRM code ERM-AD623a-f).
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Affiliation(s)
- H White
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - L Deprez
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - P Corbisier
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - V Hall
- National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK
| | - F Lin
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Mazoua
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - S Trapmann
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - A Aggerholm
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | - H Andrikovics
- Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - S Akiki
- Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - G Barbany
- Department of Molecular Medicine and Surgery, Clinical Genetics Karolinska Institutet, Stockholm, Sweden
| | - N Boeckx
- 1] Department of Laboratory Medicine, UZ Leuven, Belgium [2] Department of Oncology, KU Leuven, Belgium
| | - A Bench
- Molecular Malignancy Laboratory and Haemato-Oncology Diagnostic Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Catherwood
- Haematology Department, Belfast City Hospital, Belfast, UK
| | - J-M Cayuela
- Haematology Laboratory and EA3518, University Hospital Saint-Louis, AP-HP, University Paris Diderot, Paris, France
| | - S Chudleigh
- Department of Molecular Haematology, Yorkhill NHS Trust, Glasgow, UK
| | - T Clench
- Molecular Haematology, Bristol Royal Infirmary, Bristol, UK
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - F Daraio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - S Dulucq
- Laboratoire Hematologie, CHU Bordeaux, Hematopoiese Leucemique et Cibles Therapeutiques, INSERM U1035, Universite Bordeaux, Bordeaux, France
| | - J Farrugia
- Combined Laboratories, Derriford Hospital, Plymouth, UK
| | - L Fletcher
- Department of Genetics and Molecular Pathology, SA Pathology, Adelaide, SA, Australia
| | - L Foroni
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - R Ganderton
- Molecular Pathology, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - G Gerrard
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - E Gineikienė
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - S Hayette
- Laboratory of Molecular Biology and UMR5239, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - H El Housni
- Medical Genetics Department, Erasme Hospital, Brussels, Belgium
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy
| | - M Jansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - P Johnels
- Department of Clinical Genetics, University and Regional Laboratories, Lund, Sweden
| | - T Jurcek
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - V Kairisto
- Turku University Hospital, TYKSLAB, Laboratory of Molecular Genetics, Turku, Finland
| | - A Kizilors
- Laboratory for Molecular Haemato-Oncology, Kings College Hospital, London, UK
| | - D-W Kim
- Cancer Research Institute, The Catholic University of Korea, Seoul, South Korea
| | - T Lange
- Abteilung für Hämatologie und internistische Onkologie, Universität Leipzig, Leipzig, Germany
| | - T Lion
- Children's Cancer Research Institute/LabDia Labordiagnostik and Medical University, Vienna, Austria
| | - K M Polakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - G Martinelli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - S McCarron
- Cancer Molecular Diagnostics, St James's Hospital, Dublin, Ireland
| | - P A Merle
- VU Medical Centre, Department of Haematology, Amsterdam, The Netherlands
| | - B Milner
- Department of Medical Genetics, NHS-Grampian, Aberdeen, UK
| | | | - M Nagar
- Laboratory of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - G Nickless
- Molecular Oncology Diagnostics Unit, Guy's Hospital, London, UK
| | - J Nomdedéu
- Lab Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D A Nymoen
- Division of Pathology, Rikshospital, Oslo University Hospital, Oslo, Norway
| | - E O Leibundgut
- Molecular Diagnostics Laboratory, Department of Hematology, University Hospital Bern, Bern, Switzerland
| | - U Ozbek
- Genetics Department, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - T Pajič
- Specialized Haematology Laboratory, Division of Internal Medicine, Department of Haematology, University Medical Centre, Ljubljana, Slovenia
| | - H Pfeifer
- Department of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - C Preudhomme
- Laboratoire d'hématologie, CHU Lille, Lille, France
| | - K Raudsepp
- United Laboratories of Tartu University Hospitals, Tartu, Estonia
| | - G Romeo
- Molecular Haematology Laboratory, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA, Australia
| | - T Sacha
- Hematology Department, Jagiellonian University, Krakow, Poland
| | - R Talmaci
- Hematology Department, Fundeni Clinical Institute, University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania
| | - T Touloumenidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - P Waits
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - L Wang
- Department of Haematology, Royal Liverpool University Hospital, Liverpool, UK
| | - E Wilkinson
- HMDS, Leeds Institute of Oncology, St James's University Hospital, Leeds, UK
| | - G Wilson
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - D Wren
- Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Zadro
- Department of Laboratory Diagnostics, Clinical Hospital Center, Zagreb University School of Medicine, Zagreb, Croatia
| | - J Ziermann
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - K Zoi
- Haematology Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - H Schimmel
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - N C P Cross
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Emons
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
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Arvaniti E, Ntoufa S, Papakonstantinou N, Touloumenidou T, Laoutaris N, Anagnostopoulos A, Lamnissou K, Caligaris-Cappio F, Stamatopoulos K, Ghia P, Muzio M, Belessi C. Toll-like receptor signaling pathway in chronic lymphocytic leukemia: distinct gene expression profiles of potential pathogenic significance in specific subsets of patients. Haematologica 2011; 96:1644-52. [PMID: 21750087 DOI: 10.3324/haematol.2011.044792] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Signaling through the B-cell receptor appears to be a major contributor to the pathogenesis of chronic lymphocytic leukemia. Toll-like receptors bridge the innate and adaptive immune responses by acting as co-stimulatory signals for B cells. The available data on the expression of Toll-like receptors in chronic lymphocytic leukemia are limited and derive from small series of patients. DESIGN AND METHODS We profiled the expression of genes associated with Toll-like receptor signaling pathways in 192 cases of chronic lymphocytic leukemia and explored potential associations with molecular features of the clonotypic B-cell receptors. RESULTS Chronic lymphocytic leukemia cells express all Toll-like receptors expressed by normal activated B cells, with high expression of TLR7 and CD180, intermediate expression of TLR1, TLR6, TLR10 and low expression of TLR2 and TLR9. The vast majority of adaptors, effectors and members of the NFKB, JNK/p38, NF/IL6 and IRF pathways are intermediately-to-highly expressed, while inhibitors of Toll-like receptor activity are generally low-to-undetectable, indicating that the Toll-like receptor-signaling framework is competent in chronic lymphocytic leukemia. Significant differences were identified for selected genes between cases carrying mutated or unmutated IGHV genes or assigned to different subsets with stereotyped B-cell receptors. The differentially expressed molecules include receptors, NFκB/MAPK signaling molecules and final targets of the cascade. CONCLUSIONS The observed variations are suggestive of distinctive activation patterns of the Toll-like receptor signaling pathway in subgroups of cases of chronic lymphocytic leukemia defined by the molecular features of B-cell receptors. Additionally, they indicate that different or concomitant signals acting through receptors other than the B-cell receptor can affect the behavior of the malignant clone.
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Kostareli E, Hadzidimitriou A, Stavroyianni N, Darzentas N, Athanasiadou A, Gounari M, Bikos V, Agathagelidis A, Touloumenidou T, Zorbas I, Kouvatsi A, Laoutaris N, Fassas A, Anagnostopoulos A, Belessi C, Stamatopoulos K. Molecular evidence for EBV and CMV persistence in a subset of patients with chronic lymphocytic leukemia expressing stereotyped IGHV4-34 B-cell receptors. Leukemia 2009; 23:919-24. [PMID: 19148139 DOI: 10.1038/leu.2008.379] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The chronic lymphocytic leukemia (CLL) immunoglobulin repertoire is uniquely characterized by the presence of stereotyped B-cell receptors (BCRs). A major BCR stereotype in CLL is shared by immunoglobulin G-switched cases utilizing the immunoglobulin heavy-chain variable 4-34 (IGHV4-34) gene. Increased titers of IGHV4-34 antibodies are detected in selective clinical conditions, including infection by B-cell lymphotropic viruses, particularly Epstein-Barr virus (EBV) and cytomegalovirus (CMV). In this context, we sought evidence for persistent activation by EBV and CMV in CLL cases expressing the IGHV4-34 gene. The study group included 93 CLL cases with an intentional bias for the IGHV4-34 gene. On the basis of real-time PCR results for CMV/EBV DNA, cases were assigned to three groups: (1) double-negative (59/93); (2) single-positive (CMV- or EBV-positive; 25/93); (3) double-positive (9/93). The double-negative group was characterized by heterogeneous IGHV gene repertoire. In contrast, a bias for the IGHV4-34 gene was observed in the single-positive group (9/25 cases; 36%). Remarkably, all nine double-positive cases utilized the IGHV4-34 gene; seven of nine cases expressed the major BCR stereotype as described above. In conclusion, our findings indicate that the interactions of CLL progenitor cells expressing distinctive IGHV4-34 BCRs with viral antigens/superantigens might facilitate clonal expansion and, eventually, leukemic transformation. The exact type, timing and location of these interactions remain to be determined.
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Affiliation(s)
- E Kostareli
- School of Biology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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