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Damiani A, Orlandi M, Bruni C, Bandini G, Lepri G, Scaletti C, Ravaglia C, Frassanito F, Guiducci S, Moggi-Pignone A, Matucci-Cerinic M, Poletti V, Tofani L, Colby TV, Randone SB, Tomassetti S. The role of lung biopsy for diagnosis and prognosis of interstitial lung disease in systemic sclerosis: a systematic literature review. Respir Res 2024; 25:138. [PMID: 38521926 PMCID: PMC10960984 DOI: 10.1186/s12931-024-02725-1] [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: 09/28/2023] [Accepted: 02/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The prognostic and theragnostic role of histopathological subsets in systemic sclerosis interstitial lung disease (SSc-ILD) have been largely neglected due to the paucity of treatment options and the risks associated with surgical lung biopsy. The novel drugs for the treatment of ILDs and the availability of transbronchial cryobiopsy provide a new clinical scenario making lung biopsy more feasible and a pivotal guide for treatment. The aim of our study was to investigate the usefulness of lung biopsy in SSc ILD with a systematic literature review (SLR). METHODS PubMed, Embase and Cochrane databases were searched up to June 30, 2023. Search terms included both database-specific controlled vocabulary terms and free-text terms relating to lung biopsy and SSc-ILD diagnostic and prognosis. The SLR was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Studies were selected according to the PEO (population, exposure, and outcomes) framework and Quality assessment of diagnostic accuracy studies (QUADAS) were reported. RESULTS We selected 14 articles (comprising 364 SSc-ILD patients). The paucity and heterogeneity of the studies prevented a systematic analysis. Diffuse cutaneous SSc was present in 30-100% of cases. Female predominance was observed in all studies (ranging from 64 to 100%). Mean age ranged from 42 to 64 years. Mean FVC was 73.98 (+/-17.3), mean DLCO was 59.49 (+/-16.1). Anti-Scl70 antibodies positivity was detected in 33% of cases (range: 0-69.6). All patients underwent surgical lung biopsies, and multiple lobes were biopsied in a minority of studies (4/14). Poor HRCT-pathologic correlation was reported with HRCT-NSIP showing histopathologic UIP in up to 1/3 of cases. Limited data suggest that SSc-UIP patients may have a worse prognosis and response to immunosuppressive treatment compared to other histopathologic patterns. CONCLUSIONS The data from this SLR clearly show the paucity and heterogeneity of the studies reporting lung biopsy in SSc ILD. Moreover, they highlight the need for further research to address whether the lung biopsy can be helpful to refine prognostic prediction and guide therapeutic choices.
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Affiliation(s)
- A Damiani
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - M Orlandi
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
- Department of Medical and Surgical for Children and Adults, Modena, Italy
| | - C Bruni
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - G Bandini
- Department of Experimental and Clinical Medicine, Division of Internal Medicine, University of Florence, Careggi University Hospital, Florence, Italy
| | - G Lepri
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - C Scaletti
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - C Ravaglia
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Bologna University, Forlì, Italy
| | - F Frassanito
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - S Guiducci
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - A Moggi-Pignone
- Department of Experimental and Clinical Medicine, Division of Internal Medicine, University of Florence, Careggi University Hospital, Florence, Italy
| | - M Matucci-Cerinic
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
- Unit of Immunology, Rheumatology, Allergy and Rare diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy
| | - V Poletti
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Bologna University, Forlì, Italy
| | - L Tofani
- Department of Statistics, Informatics and Applications, University of Florence, Florence, Italy
| | - T V Colby
- Department of Pathology and Laboratory Medicine (Emeritus), Mayo Clinic, Scottsdale, AZ, 13400, USA
| | - S Bellando Randone
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Florence, Careggi University Hospital, Florence, Italy
| | - Sara Tomassetti
- Department of Clinical and Experimental Medicine, University of Florence and Interventional Pulmonology Unit, Careggi University Hospital, Largo Brambilla 3, Florence, 50134, Italy.
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Das S, Rruga F, Montepeloso A, Dimartino A, Spadini S, Corre G, Patel J, Cavalca E, Ferro F, Gatti A, Milazzo R, Galy A, Politi LS, Rizzardi GP, Vallanti G, Poletti V, Biffi A. An empowered, clinically viable hematopoietic stem cell gene therapy for the treatment of multisystemic mucopolysaccharidosis type II. Mol Ther 2024; 32:619-636. [PMID: 38310355 PMCID: PMC10928283 DOI: 10.1016/j.ymthe.2024.01.034] [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: 07/31/2023] [Revised: 10/14/2023] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
Mucopolysaccharidosis type II (MPS II), or Hunter syndrome, is a rare X-linked recessive lysosomal storage disorder due to a mutation in the lysosomal enzyme iduronate-2-sulfatase (IDS) gene. IDS deficiency leads to a progressive, multisystem accumulation of glycosaminoglycans (GAGs) and results in central nervous system (CNS) manifestations in the severe form. We developed up to clinical readiness a new hematopoietic stem cell (HSC) gene therapy approach for MPS II that benefits from a novel highly effective transduction protocol. We first provided proof of concept of efficacy of our approach aimed at enhanced IDS enzyme delivery to the CNS in a murine study of immediate translational value, employing a lentiviral vector (LV) encoding a codon-optimized human IDS cDNA. Then the therapeutic LV was tested for its ability to efficiently and safely transduce bona fide human HSCs in clinically relevant conditions according to a standard vs. a novel protocol that demonstrated superior ability to transduce bona fide long-term repopulating HSCs. Overall, these results provide strong proof of concept for the clinical translation of this approach for the treatment of Hunter syndrome.
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Affiliation(s)
- Sabyasachi Das
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA
| | - Fatlum Rruga
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Women and Child's Health, University of Padua, 35128 Padua, Italy
| | - Annita Montepeloso
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA
| | - Agnese Dimartino
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Women and Child's Health, University of Padua, 35128 Padua, Italy
| | - Silvia Spadini
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Women and Child's Health, University of Padua, 35128 Padua, Italy
| | | | - Janki Patel
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA
| | - Eleonora Cavalca
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA
| | - Francesca Ferro
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA 02115, USA
| | | | | | | | - Letterio S Politi
- Humanitas University and IRCCS Humanitas Research Hospital, 20090 Pieve Emanuele (MI), Italy
| | | | | | - Valentina Poletti
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Women and Child's Health, University of Padua, 35128 Padua, Italy
| | - Alessandra Biffi
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of Women and Child's Health, University of Padua, 35128 Padua, Italy.
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Volpato E, Banfi P, Poletti V, Pagnini F. Living beyond loss: a qualitative investigation of caregivers' experiences after the death of their relatives with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:75-87. [PMID: 37674380 DOI: 10.1080/21678421.2023.2255628] [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: 05/05/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Caregivers of Amyotrophic Lateral Sclerosis (ALS) patients experience varying psychological responses following the patient's death, including sadness, loneliness, guilt, and a loss of purpose. OBJECTIVES This research aims to investigate the caregiver journey experienced from the time of diagnosis to the loss of a care recipient, with a specific focus on understanding the factors that contribute to improved coping with bereavement. METHODS The present study used the Interpretative Phenomenological Approach (IPA) to qualitatively explore the accounts of 41 Italian bereaved caregivers of people affected by ALS (Mean Age = 59.78; Female: 60.98%; Male: 39.02%). RESULTS Results revealed 5 overarching themes representing 5 macro areas that emerged from the analysis of the interviews ("Caregiver's perception of his/her life", "Caregiver's feelings", "Caregiver's life after patient's death", "Caregiver's disease description", "Caregiver's help resources"), these were further defined based on 12 main themes, which were, in turn, articulated into 30 subthemes. The transition from life before ALS ("a peaceful landscape") to caregiver life (compared to the color "black") was a "shock", during which caregivers had to change their needs. However, life after the person living with ALS' death was both characterized by a sense of "re-birth" and "emptiness", and a general need for "psychological assistance" and "social support". CONCLUSIONS Results emphasize the need to improve the psychological support offered to caregivers of person living with ALS after the patient's death, tailoring it to the specificity of the condition, to meet their emotional needs, reduce isolation and help them cope with practical challenges and plans.
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Affiliation(s)
- Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy and
- Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Paolo Banfi
- Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Valentina Poletti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy and
- Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy and
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Poletti V, Petrarulo S, Piciucchi S, Dubini A, De Grauw AJ, Sultani F, Martinello S, Gonunguntla HK, Ravaglia C. EBUS-guided cryobiopsy in the diagnosis of thoracic disorders. Pulmonology 2024:S2531-0437(23)00223-4. [PMID: 38182468 DOI: 10.1016/j.pulmoe.2023.11.008] [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: 10/18/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Endobronchial Ultrasound (EBUS) has emerged as a crucial tool for diagnosing intrathoracic disorders, particularly in the staging of lung cancer. However, its diagnostic capabilities in the context of benign and rare diseases remain a subject of debate. AIM to investigate the diagnostic yield and safety of EBUS-transbronchial mediastinal cryobiopsy (EBUS-TMC) in comparison to EBUS-transbronchial needle aspiration (TBNA) for a broad spectrum of intrathoracic diseases. METHODS a single-centre retrospective observational study conducted on 48 patients who underwent both EBUS-TBNA and endobronchial ultrasound-transbronchial mediastinal cryobiopsy (EBUS-TMC) in the same procedure between August 2021 and October 2023. RESULTS The overall diagnostic yield of EBUS-TMC surpassed that of EBUS-TBNA (95.8% vs 54.1 %), notably excelling in the diagnosis of sarcoidosis (92.8% vs 78.5 %), rare mediastinal disorders (100% vs 0 %), hyperplastic lymphadenopathy (100% vs 0 %), and lymphoproliferative disease (100% vs 0 %). No significant differences were observed in the diagnosis of NSCLC and SCLC. Samples obtained through EBUS-TMC facilitated the acquisition of NGS and immunohistochemical analyses more readily. CONCLUSION EBUS-TMC may contribute to the precise diagnosis and subtyping of mediastinal diseases, especially lymphomas and rare mediastinal tumors, thereby reducing the number of non-diagnostic procedures.
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Affiliation(s)
- V Poletti
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy; Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy; Department of Respiratory Diseases & Allergy, Aarhus University, Aarhus, Denmark.
| | - S Petrarulo
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy
| | - S Piciucchi
- Department of Radiology, GB Morgagni Hospital, Forlì, Italy
| | - A Dubini
- Department of Pathology, GB Morgagni - L.Pierantoni Hospital Forlì Italy
| | - A J De Grauw
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy
| | - F Sultani
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy
| | - S Martinello
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy
| | - H K Gonunguntla
- Division of Interventional Pulmonology, Yashoda Hospitals, Hyderabad, India
| | - C Ravaglia
- Department of Medical Specialities-Pulmonology, GB Morgagni Hospital, Bologna University-Forlì-Ravenna Campus, Forlì, Italy; Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy
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Poletti V, Montepeloso A, Pellin D, Biffi A. Prostaglandin E2 as transduction enhancer affects competitive engraftment of human hematopoietic stem and progenitor cells. Mol Ther Methods Clin Dev 2023; 31:101131. [PMID: 37920236 PMCID: PMC10618226 DOI: 10.1016/j.omtm.2023.101131] [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: 04/18/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
Ex vivo gene therapy (GT) is a promising treatment for inherited genetic diseases. An ideal transduction protocol should determine high gene marking in long-term self-renewing hematopoietic stem cells (HSCs), preserving their repopulation potential during in vitro manipulation. In the context of the improvement of a clinically applicable transduction protocol, we tested prostaglandin E2 (PGE2) as a transduction enhancer (TE). The addition of PGE2 shortly before transduction of human CD34+ cells determined a significant transduction increase in the in vitro cell progeny paralleled by a significant reduction of their clonogenic potential. This effect increased with the duration of PGE2 exposure and correlated with an increase of CXCR4 expression. Blockage of CXCR4 with AMD3100 (plerixafor, Mozobil) did not affect transduction efficiency but partially rescued CD34+ clonogenic impairment in vitro. Once transplanted in vivo in a competitive repopulation assay, human CD34+ cells transduced with PGE2 contributed significantly less than cells transduced with a standard protocol to the repopulation of recipient mice, indicating a relative repopulation disadvantage of the PGE2-treated CD34+ cells and a counter-selection for the PGE2-treated cell progeny in vivo. In conclusion, our data indicate the need for risk/benefit evaluations in the use of PGE2 as a TE for clinical protocols of GT.
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Affiliation(s)
- Valentina Poletti
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Woman’s and Child Health Department, University of Padova, 35128 Padova, Italy
- Gene Therapy Program, Boston Children’s Dana-Farber Cancer and Blood Disorder Center, Boston, MA 02115, USA
- Pediatric Research Institute Città Della Speranza, 35127 Padova, Italy
| | - Annita Montepeloso
- Gene Therapy Program, Boston Children’s Dana-Farber Cancer and Blood Disorder Center, Boston, MA 02115, USA
| | - Danilo Pellin
- Gene Therapy Program, Boston Children’s Dana-Farber Cancer and Blood Disorder Center, Boston, MA 02115, USA
| | - Alessandra Biffi
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Woman’s and Child Health Department, University of Padova, 35128 Padova, Italy
- Gene Therapy Program, Boston Children’s Dana-Farber Cancer and Blood Disorder Center, Boston, MA 02115, USA
- Pediatric Research Institute Città Della Speranza, 35127 Padova, Italy
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Poletti V, Pagnini F, Banfi P, Volpato E. Illness Perceptions, Cognitions, and Beliefs on COPD Patients' Adherence to Treatment - A Systematic Review. Patient Prefer Adherence 2023; 17:1845-1866. [PMID: 37533752 PMCID: PMC10392903 DOI: 10.2147/ppa.s412136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/07/2023] [Indexed: 08/04/2023] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease characterized by persistent respiratory symptoms and airflow limitation. Besides its irreversibility, COPD is a treatable condition, and patients would strongly benefit from being adherent to their treatments. However, almost half of them are non-adherent, and, according to several recent studies, the way the patient perceives the disease might influence this variable. Aim This systematic review provided a synthesis of studies about the relationships between illness perceptions (IP), cognitions, beliefs, and adherence in COPD. Methods English language publications were searched in PubMed, Medline, Scopus, ResearchGate, PsycINFO, and Cochrane Library databases from November 2022 to February 2023, following PRISMA guidelines. The reference lists of eligible studies were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. Results A total of 14 studies were included. Adherence to treatment in COPD is confirmed to be low, using both self-report questionnaires and objective assessment systems. Most studies concluded that COPD is perceived as a moderate threat destined to last forever, even if many participants referred to little disease knowledge. This perception did not change between adherent and non-adherent groups. Those who considered more necessary to take their medicines and had a caregiver were more adherent and less concerned about their future. On the other side, forgetfulness, lack of trust in medications, and difficulties in understanding how to take them were perceived as the main causes of non-adherence. Other predictors of non-adherence, like depression, low self-efficacy, and severity of disease were confirmed. Conclusion The systematic review highlights the variability of the relationship between IP, cognitions and beliefs, and COPD treatment adherence. A new level of awareness of the relationship between patients' subjective point of view and treatment adherence may inform future treatment options and promote a more personalized intervention.
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Affiliation(s)
- Valentina Poletti
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
| | | | - Eleonora Volpato
- Department of Psychology, Università Cattolica Del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
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Ravaglia C, Sultani F, Piciucchi S, Dubini A, De Grauw AJ, Martinello S, Oldani S, Maitan S, Stella F, Poletti V. Diagnostic yield and safety of transbronchial lung cryobiopsy for diffuse parenchymal lung diseases diagnosis: Comparison between 1.7-mm and 1.9-mm probes. Pulmonology 2023:S2531-0437(23)00081-8. [PMID: 37210342 DOI: 10.1016/j.pulmoe.2023.04.003] [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: 01/12/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/22/2023] Open
Abstract
PURPOSE OF THE RESEARCH transbronchial lung cryobiopsy has been recently accepted as a valid and less invasive alternative to surgical lung biopsy. The purpose of this randomized controlled study was to evaluate, for the first time, the quality and safety of biopsy specimens obtained by using the new disposable 1.7-mm cryoprobe compared with the standard re-usable 1.9 mm cryoprobe in the diagnosis of diffuse parenchymal lung diseases. METHODS 60 consecutive patients were prospectively enrolled and randomly assigned to two different groups: 1.9 mm (group A) and 1.7 mm (group B); primary endpoints were pathological and multidisciplinary diagnostic yield, sample size and complication rate. PRINCIPAL RESULTS the pathological diagnostic yield of cryobiopsy was 100% in group A and 93.3% in group B (p = 0.718); cryobiopsy median diameter was 6.8 mm in group A and 6.7 mm in group B (p = 0,5241). Pneumothorax occurred in 9 patients in group A and 10 in group B (p = 0.951); mild-to-moderate bleeding in 7 cases and 9 cases in group A and B respectively (p = 0.559). No death or severe adverse events were observed. CONCLUSIONS there was no statistically significant difference between the two groups, regarding diagnostic yield, adverse events and sampling adequacy.
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Affiliation(s)
- C Ravaglia
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy.
| | - F Sultani
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - S Piciucchi
- Radiology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - A Dubini
- Pathology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - A J De Grauw
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - S Martinello
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - S Oldani
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - S Maitan
- Anesthesiology and Intensive Care Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - F Stella
- Alma Mater Studiorum University of Bologna, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Bologna, Italy; Thoracic Surgery Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - V Poletti
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy; Alma Mater Studiorum University of Bologna, Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Bologna, Italy
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Peviani M, Das S, Patel J, Jno‐Charles O, Kumar R, Zguro A, Mathews TD, Cabras P, Milazzo R, Cavalca E, Poletti V, Biffi A. An innovative hematopoietic stem cell gene therapy approach benefits CLN1 disease in the mouse model. EMBO Mol Med 2023; 15:e15968. [PMID: 36876653 PMCID: PMC10086581 DOI: 10.15252/emmm.202215968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 03/07/2023] Open
Abstract
Hematopoietic stem and progenitor cells (HSPCs) can establish a long-lasting microglia-like progeny in the central nervous system of properly myeloablated hosts. We exploited this approach to treat the severe CLN1 neurodegenerative disorder, which is the most aggressive form of neuronal ceroid lipofuscinoses due to palmitoyl-protein thioesterase-1 (PPT1) deficiency. We here provide the first evidence that (i) transplantation of wild-type HSPCs exerts partial but long-lasting mitigation of CLN1 symptoms; (ii) transplantation of HSPCs over-expressing hPPT1 by lentiviral gene transfer enhances the therapeutic benefit of HSPCs transplant, with first demonstration of such a dose-effect benefit for a purely neurodegenerative condition like CLN1 disease; (iii) transplantation of hPPT1 over-expressing HSPCs by a novel intracerebroventricular (ICV) approach is sufficient to transiently ameliorate CLN1-symptoms in the absence of hematopoietic tissue engraftment of the transduced cells; and (iv) combinatorial transplantation of transduced HSPCs intravenously and ICV results in a robust therapeutic benefit, particularly on symptomatic animals. Overall, these findings provide first evidence of efficacy and feasibility of this novel approach to treat CLN1 disease and possibly other neurodegenerative conditions, paving the way for its future clinical application.
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Affiliation(s)
- Marco Peviani
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
- San Raffaele Telethon Institute for Gene Therapy (SR‐TIGET), San Raffaele Scientific InstituteMilanItaly
- Department of Biology and Biotechnology “L. Spallanzani”University of PaviaPaviaItaly
| | - Sabyasachi Das
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Janki Patel
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Odella Jno‐Charles
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Rajesh Kumar
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Ana Zguro
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Tyler D Mathews
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
| | - Paolo Cabras
- Department of Biology and Biotechnology “L. Spallanzani”University of PaviaPaviaItaly
| | - Rita Milazzo
- San Raffaele Telethon Institute for Gene Therapy (SR‐TIGET), San Raffaele Scientific InstituteMilanItaly
| | - Eleonora Cavalca
- San Raffaele Telethon Institute for Gene Therapy (SR‐TIGET), San Raffaele Scientific InstituteMilanItaly
| | - Valentina Poletti
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
| | - Alessandra Biffi
- Gene Therapy ProgramDana‐Farber/Boston Children's Cancer and Blood Disorders CenterBostonMAUSA
- Harvard Medical SchoolBostonMAUSA
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Woman's and Child Health DepartmentUniversity of PadovaPadovaItaly
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Kronborg-White S, Bendstrup E, Gori L, Luzzi V, Madsen LB, Poletti V, Rasmussen TR, Trigiani M, Vezzosi S, Tomassetti S. A pilot study on the use of the super dimension navigation system for optimal cryobiopsy location in interstitial lung disease diagnostics. Pulmonology 2023; 29:119-123. [PMID: 34526242 DOI: 10.1016/j.pulmoe.2021.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/06/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Transbronchial cryobiopsies has become increasingly important in the diagnostic workup for interstitial lung diseases. The rate of complications and mortality are low compared to surgical lung biopsies, but the diagnostic yield is not as high. The reason for the lower diagnostic yield could in some cases be explained by biopsies taken too centrally or in less affected areas. In this pilot study we examined the feasibility of using the electromagnetic navigation system, superDimension (SD), when performing cryobiopsies to increase the diagnostic yield. METHODS Electromagnetic navigation bronchoscopy and cryobiopsies were performed using SD. An electromagnetic board placed on the back of the patient and a position sensor at the tip of the navigational probe created a real-time 3D reconstruction of previously acquired computer tomography images. The procedure was performed with the patients in general anesthesia using a rigid bronchoscope when performed in Florence and with a flexible bronchoscope through an orotracheal tube when performed in Aarhus. RESULTS In total, 18 patients were included. Five patients were excluded, partly due to technical difficulties. Disposable 1.7 mm cryoprobes were used in Aarhus, and reusable 1.9 mm probes in Florence. Pneumothorax was detected in three (23%), mild hemorrhage was seen in one (8%) and moderate hemorrhage in six (46%). The biopsies contributed to the diagnosis in 11 of the patients (85%). CONCLUSION Using superDimension electromagnetic navigation system when performing cryobiopsies is feasible. A larger prospective trial is necessary to homogenize the technique between centres and to evaluate diagnostic advantage and complications.
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Affiliation(s)
- S Kronborg-White
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of Internal Medicine, Viborg Regional Hospital, Viborg, Denmark.
| | - E Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - L Gori
- Department of Experimental and Clinical Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Florence, Italy
| | - V Luzzi
- Department of Experimental and Clinical Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Florence, Italy
| | - L B Madsen
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - V Poletti
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of the Diseases of the Thorax, Ospedale Morgagni, Forli, Italy
| | - T R Rasmussen
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - M Trigiani
- Department of Experimental and Clinical Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Florence, Italy
| | - S Vezzosi
- Department of Quality, control and Technology, Careggi University Hospital, Florence, Italy
| | - S Tomassetti
- Department of Experimental and Clinical Medicine, Interventional Pulmonology Unit, Careggi University Hospital, Florence, Italy
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10
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Brusson M, Chalumeau A, Martinucci P, Romano O, Felix T, Poletti V, Scaramuzza S, Ramadier S, Masson C, Ferrari G, Mavilio F, Cavazzana M, Amendola M, Miccio A. Novel lentiviral vectors for gene therapy of sickle cell disease combining gene addition and gene silencing strategies. Molecular Therapy - Nucleic Acids 2023; 32:229-246. [PMID: 37090420 PMCID: PMC10113710 DOI: 10.1016/j.omtn.2023.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
Sickle cell disease (SCD) is due to a mutation in the β-globin gene causing production of the toxic sickle hemoglobin (HbS; α2βS 2). Transplantation of autologous hematopoietic stem and progenitor cells (HSPCs) transduced with lentiviral vectors (LVs) expressing an anti-sickling β-globin (βAS) is a promising treatment; however, it is only partially effective, and patients still present elevated HbS levels. Here, we developed a bifunctional LV expressing βAS3-globin and an artificial microRNA (amiRNA) specifically downregulating βS-globin expression with the aim of reducing HbS levels and favoring βAS3 incorporation into Hb tetramers. Efficient transduction of SCD HSPCs by the bifunctional LV led to a substantial decrease of βS-globin transcripts in HSPC-derived erythroid cells, a significant reduction of HbS+ red cells, and effective correction of the sickling phenotype, outperforming βAS gene addition and BCL11A gene silencing strategies. The bifunctional LV showed a standard integration profile, and neither HSPC viability, engraftment, and multilineage differentiation nor the erythroid transcriptome and miRNAome were affected by the treatment, confirming the safety of this therapeutic strategy. In conclusion, the combination of gene addition and gene silencing strategies can improve the efficacy of current LV-based therapeutic approaches without increasing the mutagenic vector load, thus representing a novel treatment for SCD.
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11
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Piciucchi S, Garo ML, Tomassetti S, Ravaglia C, Poletti V. Supine vs prone position in mild to moderate COVID-19 pneumonia: The impact of proning on computed tomography findings. Eur J Intern Med 2022; 104:118-119. [PMID: 35738975 PMCID: PMC9212665 DOI: 10.1016/j.ejim.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/18/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- S Piciucchi
- Department of Radiology, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy.
| | - M L Garo
- Independent Research, Mathsly, Italy
| | - S Tomassetti
- Department of Experimental and Clinical Medicine Careggi University Hospital Florence, Italy
| | - C Ravaglia
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì
| | - V Poletti
- Pulmonology Unit, G.B. Morgagni Hospital/University of Bologna, Forlì; Dipartimento di Medicina Specialistica e Sperimentale (DIMES), University of Bologna, Forlì Campus, Italy; Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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12
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Poletti E, Galvani M, Dubini A, Poletti V, Piciucchi S. Correlations between radiological and histological findings in patients with pulmonary vein stenosis after radiofrequency ablation: A case series. Pulmonology 2022; 28:396-398. [PMID: 35896431 DOI: 10.1016/j.pulmoe.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/02/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- E Poletti
- IRCCS Policlinico San Donato, Milan/University of Milano Statale, Milan, Italy.
| | - M Galvani
- Department of Cardiology, GB Morgagni Hospital, Forlì/University of Bologna, Italy
| | - A Dubini
- Department of Pathology, GB Morgagni Hospital, Forlì/University of Bologna, Italy
| | - V Poletti
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì/University of Bologna, Italy; Department of Respiratory Disease & Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - S Piciucchi
- Department of Radiology, GB Morgagni Hospital, Forlì/University of Bologna, Italy
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13
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Piciucchi S, Poletti V. Diffuse pulmonary ill-defined centrilobular opacities: Not only bronchiolitis. Eur J Intern Med 2022; 100:125-126. [PMID: 35346567 DOI: 10.1016/j.ejim.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/16/2022] [Indexed: 11/20/2022]
Affiliation(s)
- S Piciucchi
- Department of Radiology, Ospedale GB Morgagni/University of Bologna, Forlì, Italy.
| | - V Poletti
- Department of Diseases of the Thorax, Ospedale GB Morgagni, DIMES University of Bologna, Forlì; Department of Respiratory Diseases and Allergy, Aarhus University, Aarhus, Denmark
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14
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Poletti V, Pagnini F, Banfi P, Volpato E. The Role of Depression on Treatment Adherence in Patients with Heart Failure-a Systematic Review of the Literature. Curr Cardiol Rep 2022; 24:1995-2008. [PMID: 36327056 PMCID: PMC9747824 DOI: 10.1007/s11886-022-01815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Although poor medication adherence is considered an impacting risk factor for worsening heart failure (HF) outcomes, adherence rates in HF patients continue to be considerably low. To improve this condition, several studies investigated the impact of many determinants on medication adherence; however, few authors explored the role of depression on it. PURPOSE OF REVIEW The purpose of this systematic review was to explore the association between depressive symptoms and medication adherence in HF patients. In particular, the research question was is depression a barrier to medication adherence in HF patients? METHODS A systematic review of quantitative analysis studies was undertaken. Six electronic databases were searched between the end of October and March 2022. Thirty-one trials were included, all of them assessed depression, adherence to medication, and their possible relationship. RESULTS As was intended, findings showed that the impact of a mild to moderate level of depression was significant on adherence to treatment in HF patients. However, many other risk factors emerged, like family support and health practices (es. low sodium diet). CONCLUSION The detection of depression in the setting of HF should be crucial to HF patients' physical health and quality of life. Future research should take depression into account, exploring this area through self-report and qualitative interview as well.
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Affiliation(s)
- Valentina Poletti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA USA
| | | | - Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
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15
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Tzilas V, Poletti V, Bouros D. Reversed halo sign in radiation induced organizing pneumonia: natural course of the underlying pathophysiology. Pulmonology 2021; 27:460-464. [PMID: 33853753 DOI: 10.1016/j.pulmoe.2020.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- V Tzilas
- Interstital Lung Disease Unit, Athens Medical Center, Athens, Greece
| | - V Poletti
- Department of Diseases of the Thorax, Azienda USL Romagna, GB Morgagni Hospital, Forlì, Italy; Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - D Bouros
- Interstital Lung Disease Unit, Athens Medical Center, Athens, Greece; First Academic Department of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Medical School, National and Kapodistrian University of Athens, Greece.
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16
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Oldani S, Ravaglia C, Bensai S, Bertolovic L, Ghirotti C, Puglisi S, Martinello S, Sultani F, Colinelli C, Piciucchi S, Simoncelli S, Poletti V. Pathophysiology of light phenotype SARS-CoV-2 interstitial pneumonia: from histopathological features to clinical presentations. Pulmonology 2021; 28:333-344. [PMID: 33832850 PMCID: PMC7997696 DOI: 10.1016/j.pulmoe.2021.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 12/16/2022] Open
Abstract
Little is known about the light phenotype of SARS-CoV-2 pneumonia, which behaves in an unusual way, unlike other known respiratory diseases. We believe that the histopathological features of early COVID-19 could be considered the pathophysiological hallmark of this disease. Lung cryobiopsies show almost pristine alveoli, enlarged/hyperplasic alveolar capillaries along with dilatation of the post capillary pulmonary venules. Hypoxemia could therefore be explained by a reduction of the normal V/Q ratio, due to blood overflow around well ventilated alveoli. This could clarify typical manifestations of type L COVID-19, such as happy hypoxemia, response to awake prone positioning, response to PEEP/CPAP and platypnea orthodeoxia.
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Affiliation(s)
- S Oldani
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy.
| | - C Ravaglia
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - S Bensai
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - L Bertolovic
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - C Ghirotti
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - S Puglisi
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - S Martinello
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - F Sultani
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - C Colinelli
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - S Piciucchi
- Radiology Unit, GB Morgagni Hospital, Forlì, FC, Italy
| | - S Simoncelli
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy
| | - V Poletti
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy; Department of Respiratory Diseases & Allergy. Aarhus University Hospital, Aarhus, Denmark
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17
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Poletti V, Vancheri C, Albera C, Harari S, Pesci A, Metella RR, Campolo B, Crespi G, Rizzoli S. Clinical course of IPF in Italian patients during 12 months of observation: results from the FIBRONET observational study. Respir Res 2021; 22:66. [PMID: 33627105 PMCID: PMC7903602 DOI: 10.1186/s12931-021-01643-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/29/2021] [Indexed: 01/20/2023] Open
Abstract
Background FIBRONET was an observational, multicentre, prospective cohort study investigating the baseline characteristics, clinical course of disease and use of antifibrotic treatment in Italian patients with idiopathic pulmonary fibrosis (IPF).
Methods Patients aged ≥ 40 years diagnosed with IPF within the previous 3 months at 20 Italian centres were consecutively enrolled and followed up for 12 months, with evaluations at 3, 6, 9 and 12 months. The primary objective was to describe the clinical course of IPF over 12 months of follow-up, including changes in lung function measured by % predicted forced vital capacity (FVC% predicted). Results 209 patients (82.3% male, mean age 69.54 ± 7.43 years) were enrolled. Mean FVC% predicted was relatively preserved at baseline (80.01%). The mean time between IPF diagnosis and initiation of antifibrotic therapy was 6.38 weeks; 72.3% of patients received antifibrotic therapy within the first 3 months of follow-up, and 83.9% within 12 months of follow-up. Mean FVC% predicted was 80.0% at baseline and 82.2% at 12 months, and 47.4% of patients remained stable (i.e. had no disease progression) in terms of FVC% predicted during the study. Conclusions FIBRONET is the first prospective, real-life, observational study of patients with IPF in Italy. The short time between diagnosis and initiation of antifibrotic therapy, and the stable lung function between baseline and 12 months, suggest that early diagnosis and prompt initiation of antifibrotic therapy may preserve lung function in patients with IPF. Trial registration: NCT02803580
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Affiliation(s)
- V Poletti
- Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy.,Department of Respiratory Diseases & Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - C Vancheri
- Regional Referral Centre for Rare Lung Diseases-University Hospital "Policlinico G. Rodolico", Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
| | - C Albera
- S.C. Pneumologia U., A.O.U. Città Della Scienza E Della Salute (Molinette), University of Torino, Torino, Italy
| | - S Harari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Medicine, Ospedale San Giuseppe MultiMedica IRCCS, Milan, Italy
| | - A Pesci
- Ospedale San Gerardo, ASST Monza, Monza, Italy
| | - R R Metella
- Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, Università degli Studi di Siena, Siena, Italy
| | | | - G Crespi
- Boehringer Ingelheim, Milan, Italy
| | - S Rizzoli
- MediNeos Observational Research, Modena, Italy
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18
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Piciucchi S, Ravaglia C, Vizzuso A, Bertocco M, Poletti V. Reversibility of venous dilatation and parenchymal changes density in Sars-Cov-2 pneumonia: toward the definition of a peculiar pattern. Pulmonology 2020; 27:353-357. [PMID: 33272912 PMCID: PMC7667388 DOI: 10.1016/j.pulmoe.2020.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/21/2020] [Accepted: 10/16/2020] [Indexed: 10/25/2022] Open
Affiliation(s)
- S Piciucchi
- Department of Radiology, Ospedale GB Morgagni, Forlì, Italy.
| | - C Ravaglia
- Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy
| | - A Vizzuso
- Department of Radiology, Ospedale GB Morgagni, Forlì, Italy
| | - M Bertocco
- Department of Radiology, Ospedale GB Morgagni, Forlì, Italy
| | - V Poletti
- Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì, Italy; Department of Respiratory Diseases & Allergy, Aarhus University Hospital, Aarhus, Denmark
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19
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China N, Gurioli C, Maitan S, Poletti V. rs1573858 GATA-2 homozygote variant associated with pulmonary alveolar proteinosis, cytopenia and neurologic dysfunction. Pulmonology 2020; 26:178-180. [DOI: 10.1016/j.pulmoe.2019.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/05/2019] [Accepted: 09/12/2019] [Indexed: 11/29/2022] Open
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20
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Charrier S, Lagresle-Peyrou C, Poletti V, Rothe M, Cédrone G, Gjata B, Mavilio F, Fischer A, Schambach A, de Villartay JP, Cavazzana M, Hacein-Bey-Abina S, Galy A. Biosafety Studies of a Clinically Applicable Lentiviral Vector for the Gene Therapy of Artemis-SCID. Mol Ther Methods Clin Dev 2019; 15:232-245. [PMID: 31720302 PMCID: PMC6838972 DOI: 10.1016/j.omtm.2019.08.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022]
Abstract
Genetic deficiency of the nuclease DCLRE1C/Artemis causes radiosensitive severe combined immunodeficiency (RS-SCID) with lack of peripheral T and B cells and increased sensitivity to ionizing radiations. Gene therapy based on transplanting autologous gene-modified hematopoietic stem cells could significantly improve the health of patients with RS-SCID by correcting their immune system. A lentiviral vector expressing physiological levels of human ARTEMIS mRNA from an EF1a promoter without post-transcriptional regulation was developed as a safe clinically applicable candidate for RS-SCID gene therapy. The vector was purified in GMP-comparable conditions and was not toxic in vitro or in vivo. Long-term engraftment of vector-transduced hematopoietic cells was achieved in irradiated Artemis-deficient mice following primary and secondary transplantation (6 months each). Vector-treated mice displayed T and B lymphopoiesis and polyclonal T cells, had structured lymphoid tissues, and produced immunoglobulins. Benign signs of inflammation were noted following secondary transplants, likely a feature of the model. There was no evidence of transgene toxicity and no induction of hematopoietic malignancy. In vitro, the vector had low genotoxic potential on murine hematopoietic progenitor cells using an immortalization assay. Altogether, these preclinical data show safety and efficacy, and support further development of the vector for the gene therapy of RS-SCID.
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Affiliation(s)
- Sabine Charrier
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
| | - Chantal Lagresle-Peyrou
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France.,Laboratory of Human Lymphohematopoiesis, UMR 1163, INSERM, Université Paris Descartes Sorbonne Paris Cité, Imagine Institute, Paris, France
| | - Valentina Poletti
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
| | - Michael Rothe
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Grégory Cédrone
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
| | - Bernard Gjata
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
| | - Fulvio Mavilio
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
| | - Alain Fischer
- INSERM, UMR 1163, Paris Descartes University-Sorbonne Paris Cité, Paris, France.,Imagine Institute, Paris, France.,Immunology Pediatric Department, Hopital Necker-Enfants Malades, AP-HP, Paris, France.,Collège de France, Paris, France
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Jean-Pierre de Villartay
- Laboratory of Genome Dynamics in the Immune System, UMR1163, INSERM, Université Paris Descartes Sorbonne Paris Cité, Imagine Institute, Paris, France
| | - Marina Cavazzana
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France.,Laboratory of Human Lymphohematopoiesis, UMR 1163, INSERM, Université Paris Descartes Sorbonne Paris Cité, Imagine Institute, Paris, France.,Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Salima Hacein-Bey-Abina
- Biotherapy Clinical Investigation Center, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpitaux de Paris, INSERM, Paris, France
| | - Anne Galy
- Genethon and UMR_S951, INSERM, Université Evry, Université Paris Saclay, Evry, 91002 Evry, France
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Abstract
In the last decade, the gene therapy (GT) field experienced a renaissance, thanks to crucial understandings and innovations in vector design, stem cell manipulation, conditioning protocols, and cell/vector delivery. These efforts were successfully coupled with unprecedented clinical results of the trials employing the newly developed technology and with the novel establishment of academic-industrial partnerships. A renewed and strengthened interest is rising in the development of gene-based approaches for inherited neurometabolic disorders with severe neurological involvement. Inherited metabolic disorders are monogenetic diseases caused by enzymatic or structural deficiencies affecting the lysosomal or peroxisomal metabolic activity. The metabolic defect can primarily affect the central nervous system, leading to neuronal death, microglial activation, inflammatory demyelination, and axonal degeneration. This review provides an overview of the GT strategies currently under clinical investigation for neurometabolic lysosomal and peroxisomal storage diseases, such as adrenoleukodystrophy and metachromatic leukodystrophy, as well as novel emerging indications such as mucopolysaccharidoses, gangliosidoses, and neuronal ceroid lipofuscinoses, with a comprehensive elucidation of the main features and mechanisms at the basis of a successful GT approach for these devastating diseases.
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Affiliation(s)
- Valentina Poletti
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Alessandra Biffi
- Gene Therapy Program, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.,Pediatric Hematology, Oncology and Stem Cell Transplant, Woman's and Child Health Department, University of Padova, Padova, Italy
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22
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Urbinati F, Campo Fernandez B, Masiuk KE, Poletti V, Hollis RP, Koziol C, Kaufman ML, Brown D, Mavilio F, Kohn DB. Gene Therapy for Sickle Cell Disease: A Lentiviral Vector Comparison Study. Hum Gene Ther 2019; 29:1153-1166. [PMID: 30198339 DOI: 10.1089/hum.2018.061] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Sickle cell disease (SCD) is an inherited blood disorder caused by a single amino acid substitution in the β-globin chain of hemoglobin. Gene therapy is a promising therapeutic alternative, particularly in patients lacking an allogeneic bone marrow (BM) donor. One of the major challenges for an effective gene therapy approach is the design of an efficient vector that combines high-level and long-term β-globin expression with high infectivity in primary CD34+ cells. Two lentiviral vectors carrying an anti-sickling β-globin transgene (AS3) were directly compared: the Lenti/βAS3-FB, and Globe-AS3 with and without the FB insulator. The comparison was performed initially in human BM CD34+ cells derived from SCD patients in an in vitro model of erythroid differentiation. Additionally, the comparison was carried out in two in vivo models: First, an NOD SCID gamma mouse model was used to compare transduction efficiency and β-globin expression in human BM CD34+ cells after transplant. Second, a sickle mouse model was used to analyze β-globin expression produced from the vectors tested, as well as hematologic correction of the sickle phenotype. While minor differences were found in the vectors in the in vitro study (2.4-fold higher vector copy number in CD34+ cells when using Globe-AS3), no differences were noted in the overall correction of the SCD phenotype in the in vivo mouse model. This study provides a comprehensive in vitro and in vivo analysis of two globin lentiviral vectors, which is useful for determining the optimal candidate for SCD gene therapy.
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Affiliation(s)
- Fabrizia Urbinati
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Beatriz Campo Fernandez
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Katelyn E Masiuk
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Valentina Poletti
- 2 Genethon , Evry, France; and University of Modena and Reggio Emilia , Italy
| | - Roger P Hollis
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Colin Koziol
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Michael L Kaufman
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Devin Brown
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
| | - Fulvio Mavilio
- 3 Dipartimento di Scienza Della Vita, University of Modena and Reggio Emilia , Italy
| | - Donald B Kohn
- 1 Department of Microbiology, Immunology, and Molecular Genetics, University of California , Los Angeles, California; University of Modena and Reggio Emilia , Italy
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23
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Moussy A, Papili Gao N, Corre G, Poletti V, Majdoul S, Fenard D, Gunawan R, Stockholm D, Páldi A. Constraints on Human CD34+ Cell Fate due to Lentiviral Vectors Can Be Relieved by Valproic Acid. Hum Gene Ther 2019; 30:1023-1034. [PMID: 30977420 DOI: 10.1089/hum.2019.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The initial stages following the in vitro cytokine stimulation of human cord blood CD34+ cells overlap with the period when lentiviral gene transfer is typically performed. Single-cell transcriptional profiling and time-lapse microscopy were used to investigate how the vector-cell crosstalk impacts on the fate decision process. The single-cell transcription profiles were analyzed using a new algorithm, and it is shown that lentiviral transduction during the early stages of stimulation modifies the dynamics of the fate choice process of the CD34+ cells. The cells transduced with a lentiviral vector are biased toward the common myeloid progenitor lineage. Valproic acid, a histone deacetylase inhibitor known to increase the grafting potential of the CD34+ cells, improves the transduction efficiency to almost 100%. The cells transduced in the presence of valproic acid can subsequently undergo normal fate commitment. The higher gene transfer efficiency did not alter the genomic integration profile of the vector. These observations open the way to substantially improving lentiviral gene transfer protocols.
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Affiliation(s)
- Alice Moussy
- 1Ecole Pratique des Hautes Etudes, PSL Research University, UMRS951, INSERM, Univ-Evry, Paris, France; University at Buffalo, The State University of New York, Buffalo, New York
| | - Nan Papili Gao
- 2Institute for Chemical Bioengineering, ETH Zurich, Zurich, Switzerland; University at Buffalo, The State University of New York, Buffalo, New York.,3Swiss Institute of Bioinformatics, Lausanne, Switzerland; University at Buffalo, The State University of New York, Buffalo, New York
| | - Guillaume Corre
- 4Genethon, Evry, France; and University at Buffalo, The State University of New York, Buffalo, New York
| | - Valentina Poletti
- 4Genethon, Evry, France; and University at Buffalo, The State University of New York, Buffalo, New York
| | - Saliha Majdoul
- 4Genethon, Evry, France; and University at Buffalo, The State University of New York, Buffalo, New York
| | - David Fenard
- 4Genethon, Evry, France; and University at Buffalo, The State University of New York, Buffalo, New York
| | - Rudiyanto Gunawan
- 2Institute for Chemical Bioengineering, ETH Zurich, Zurich, Switzerland; University at Buffalo, The State University of New York, Buffalo, New York.,3Swiss Institute of Bioinformatics, Lausanne, Switzerland; University at Buffalo, The State University of New York, Buffalo, New York.,5Department of Chemical and Biological Engineering, University at Buffalo, The State University of New York, Buffalo, New York
| | - Daniel Stockholm
- 1Ecole Pratique des Hautes Etudes, PSL Research University, UMRS951, INSERM, Univ-Evry, Paris, France; University at Buffalo, The State University of New York, Buffalo, New York
| | - András Páldi
- 1Ecole Pratique des Hautes Etudes, PSL Research University, UMRS951, INSERM, Univ-Evry, Paris, France; University at Buffalo, The State University of New York, Buffalo, New York
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24
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Poletti V, Urbinati F, Charrier S, Corre G, Hollis RP, Campo Fernandez B, Martin S, Rothe M, Schambach A, Kohn DB, Mavilio F. Pre-clinical Development of a Lentiviral Vector Expressing the Anti-sickling βAS3 Globin for Gene Therapy for Sickle Cell Disease. Mol Ther Methods Clin Dev 2018; 11:167-179. [PMID: 30533448 PMCID: PMC6276308 DOI: 10.1016/j.omtm.2018.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/29/2018] [Indexed: 01/10/2023]
Abstract
Sickle cell disease (SCD) is caused by a mutation (E6V) in the hemoglobin (Hb) β-chain that induces polymerization of Hb tetramers, red blood cell deformation, ischemia, anemia, and multiple organ damage. Gene therapy is a potential alternative to human leukocyte antigen (HLA)-matched allogeneic hematopoietic stem cell transplantation, available to a minority of patients. We developed a lentiviral vector expressing a β-globin carrying three anti-sickling mutations (T87Q, G16D, and E22A) inhibiting axial and lateral contacts in the HbS polymer, under the control of the β-globin promoter and a reduced version of the β-globin locus-control region. The vector (GLOBE-AS3) transduced 60%–80% of mobilized CD34+ hematopoietic stem-progenitor cells (HSPCs) and drove βAS3-globin expression at potentially therapeutic levels in erythrocytes differentiated from transduced HSPCs from SCD patients. Transduced HSPCs were transplanted in NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ (NSG)-immunodeficient mice to analyze biodistribution, chimerism, and transduction efficiency in bone marrow (BM), spleen, thymus, and peripheral blood 12–14 weeks after transplantation. Vector integration site analysis, performed in pre-transplant HSPCs and post-transplant BM cells from individual mice, showed a normal lentiviral integration pattern and no evidence of clonal dominance. An in vitro immortalization (IVIM) assay showed the low genotoxic potential of GLOBE-AS3. This study enables a phase I/II clinical trial aimed at correcting the SCD phenotype in juvenile patients by transplantation of autologous hematopoietic stem cells (HSC) transduced by GLOBE-AS3.
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Affiliation(s)
| | - Fabrizia Urbinati
- Department of Microbiology, Immunology and Molecular Genetics, UCLA, Los Angeles, CA, USA
| | | | | | - Roger P. Hollis
- Department of Microbiology, Immunology and Molecular Genetics, UCLA, Los Angeles, CA, USA
| | | | | | - Michael Rothe
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
- Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Donald B. Kohn
- Department of Microbiology, Immunology and Molecular Genetics, UCLA, Los Angeles, CA, USA
| | - Fulvio Mavilio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Paris Descartes University, Imagine Institute, Paris, France
- Corresponding author: Fulvio Mavilio, PhD, Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
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25
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Bruni A, Grossi F, Katia F, Capelletto E, Buffoni L, Badellino S, Poletti V, Chiari R, Giaj Levra N, Banna G, Vagge S, Borghetti P, Baldini E, Bria E, Tiseo M, Paci M, Ciammella P, Taraborrelli M, Ricardi U, Scotti V. The standard of care for stage III NSCLC in the era of immunotherapy: An Italian national survey on the current pattern of care among Italian thoracic oncologists. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy291.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Lidonnici MR, Paleari Y, Tiboni F, Mandelli G, Rossi C, Vezzoli M, Aprile A, Lederer CW, Ambrosi A, Chanut F, Sanvito F, Calabria A, Poletti V, Mavilio F, Montini E, Naldini L, Cristofori P, Ferrari G. Multiple Integrated Non-clinical Studies Predict the Safety of Lentivirus-Mediated Gene Therapy for β-Thalassemia. Mol Ther Methods Clin Dev 2018; 11:9-28. [PMID: 30320151 PMCID: PMC6178212 DOI: 10.1016/j.omtm.2018.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/07/2018] [Indexed: 01/07/2023]
Abstract
Gene therapy clinical trials require rigorous non-clinical studies in the most relevant models to assess the benefit-to-risk ratio. To support the clinical development of gene therapy for β-thalassemia, we performed in vitro and in vivo studies for prediction of safety. First we developed newly GLOBE-derived vectors that were tested for their transcriptional activity and potential interference with the expression of surrounding genes. Because these vectors did not show significant advantages, GLOBE lentiviral vector (LV) was elected for further safety characterization. To support the use of hematopoietic stem cells (HSCs) transduced by GLOBE LV for the treatment of β-thalassemia, we conducted toxicology, tumorigenicity, and biodistribution studies in compliance with the OECD Principles of Good Laboratory Practice. We demonstrated a lack of toxicity and tumorigenic potential associated with GLOBE LV-transduced cells. Vector integration site (IS) studies demonstrated that both murine and human transduced HSCs retain self-renewal capacity and generate new blood cell progeny in the absence of clonal dominance. Moreover, IS analysis showed an absence of enrichment in cancer-related genes, and the genes targeted by GLOBE LV in human HSCs are well known sites of integration, as seen in other lentiviral gene therapy trials, and have not been associated with clonal expansion. Taken together, these integrated studies provide safety data supporting the clinical application of GLOBE-mediated gene therapy for β-thalassemia.
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Affiliation(s)
- Maria Rosa Lidonnici
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ylenia Paleari
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Tiboni
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Mandelli
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Claudia Rossi
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Michela Vezzoli
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Annamaria Aprile
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carsten Werner Lederer
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Department of Molecular Genetics Thalassaemia, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | | | | | - Francesca Sanvito
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Calabria
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Fulvio Mavilio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modeno, Italy
| | - Eugenio Montini
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Naldini
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Patrizia Cristofori
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,GlaxoSmithKline Ware, Hertfordshire, UK
| | - Giuliana Ferrari
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
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27
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Weber L, Poletti V, Magrin E, Antoniani C, Martin S, Bayard C, Sadek H, Felix T, Meneghini V, Antoniou MN, El-Nemer W, Mavilio F, Cavazzana M, Andre-Schmutz I, Miccio A. An Optimized Lentiviral Vector Efficiently Corrects the Human Sickle Cell Disease Phenotype. Mol Ther Methods Clin Dev 2018; 10:268-280. [PMID: 30140714 PMCID: PMC6105766 DOI: 10.1016/j.omtm.2018.07.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/29/2018] [Indexed: 12/17/2022]
Abstract
Autologous transplantation of hematopoietic stem cells transduced with a lentiviral vector (LV) expressing an anti-sickling HBB variant is a potential treatment for sickle cell disease (SCD). With a clinical trial as our ultimate goal, we generated LV constructs containing an anti-sickling HBB transgene (HBBAS3), a minimal HBB promoter, and different combinations of DNase I hypersensitive sites (HSs) from the locus control region (LCR). Hematopoietic stem progenitor cells (HSPCs) from SCD patients were transduced with LVs containing either HS2 and HS3 (β-AS3) or HS2, HS3, and HS4 (β-AS3 HS4). The inclusion of the HS4 element drastically reduced vector titer and infectivity in HSPCs, with negligible improvement of transgene expression. Conversely, the LV containing only HS2 and HS3 was able to efficiently transduce SCD bone marrow and Plerixafor-mobilized HSPCs, with anti-sickling HBB representing up to ∼60% of the total HBB-like chains. The expression of the anti-sickling HBB and the reduced incorporation of the βS-chain in hemoglobin tetramers allowed up to 50% reduction in the frequency of RBC sickling under hypoxic conditions. Together, these results demonstrate the ability of a high-titer LV to express elevated levels of a potent anti-sickling HBB transgene ameliorating the SCD cell phenotype.
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Affiliation(s)
- Leslie Weber
- Laboratory of Human Lymphohematopoiesis, INSERM UMR_S1163, 75015 Paris, France.,Paris Diderot University - Sorbonne Paris Cité, 75015 Paris, France
| | | | - Elisa Magrin
- Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Chiara Antoniani
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.,Laboratory of chromatin and gene regulation during development, INSERM UMR_S1163, 75015 Paris, France
| | | | - Charles Bayard
- Laboratory of Human Lymphohematopoiesis, INSERM UMR_S1163, 75015 Paris, France
| | - Hanem Sadek
- Laboratory of Human Lymphohematopoiesis, INSERM UMR_S1163, 75015 Paris, France
| | - Tristan Felix
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.,Laboratory of chromatin and gene regulation during development, INSERM UMR_S1163, 75015 Paris, France
| | - Vasco Meneghini
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.,Laboratory of chromatin and gene regulation during development, INSERM UMR_S1163, 75015 Paris, France
| | | | - Wassim El-Nemer
- Biologie Intégrée du Globule Rouge, INSERM UMR_S1134, Paris Diderot University, Sorbonne Paris Cité, Université de la Réunion, Université des Antilles, 75015 Paris, France.,Institut National de la Transfusion Sanguine, 75015 Paris, France.,Laboratoire d'Excellence GR-Ex, 75015 Paris, France
| | - Fulvio Mavilio
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.,Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Marina Cavazzana
- Laboratory of Human Lymphohematopoiesis, INSERM UMR_S1163, 75015 Paris, France.,Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France
| | - Isabelle Andre-Schmutz
- Laboratory of Human Lymphohematopoiesis, INSERM UMR_S1163, 75015 Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France
| | - Annarita Miccio
- Genethon, INSERM UMR951, 91000 Evry, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.,Laboratory of chromatin and gene regulation during development, INSERM UMR_S1163, 75015 Paris, France
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28
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Abstract
A case is presented of a 30-year-old woman with a malignant ependymoma with extracranial metastases involving the cervical lymph nodes. The positive reaction to antibody against glial fibrillary acidic protein confirmed the ependymoma origin of the lymph node metastases.
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29
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Abstract
Replication-defective retroviral vectors have been used for more than 25 years as a tool for efficient and stable insertion of therapeutic transgenes in human cells. Patients suffering from severe genetic diseases have been successfully treated by transplantation of autologous hematopoietic stem-progenitor cells (HSPCs) transduced with retroviral vectors, and the first of this class of therapies, Strimvelis, has recently received market authorization in Europe. Some clinical trials, however, resulted in severe adverse events caused by vector-induced proto-oncogene activation, which showed that retroviral vectors may retain a genotoxic potential associated to proviral integration in the human genome. The adverse events sparked a renewed interest in the biology of retroviruses, which led in a few years to a remarkable understanding of the molecular mechanisms underlying retroviral integration site selection within mammalian genomes. This review summarizes the current knowledge on retrovirus-host interactions at the genomic level, and the peculiar mechanisms by which different retroviruses, and their related gene transfer vectors, integrate in, and interact with, the human genome. This knowledge provides the basis for the development of safer and more efficacious retroviral vectors for human gene therapy.
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Affiliation(s)
| | - Fulvio Mavilio
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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30
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Holstein M, Mesa-Nuñez C, Miskey C, Almarza E, Poletti V, Schmeer M, Grueso E, Ordóñez Flores JC, Kobelt D, Walther W, Aneja MK, Geiger J, Bonig HB, Izsvák Z, Schleef M, Rudolph C, Mavilio F, Bueren JA, Guenechea G, Ivics Z. Efficient Non-viral Gene Delivery into Human Hematopoietic Stem Cells by Minicircle Sleeping Beauty Transposon Vectors. Mol Ther 2018; 26:1137-1153. [PMID: 29503198 PMCID: PMC6079369 DOI: 10.1016/j.ymthe.2018.01.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 02/28/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 12/26/2022] Open
Abstract
The Sleeping Beauty (SB) transposon system is a non-viral gene delivery platform that combines simplicity, inexpensive manufacture, and favorable safety features in the context of human applications. However, efficient correction of hematopoietic stem and progenitor cells (HSPCs) with non-viral vector systems, including SB, demands further refinement of gene delivery techniques. We set out to improve SB gene transfer into hard-to-transfect human CD34+ cells by vectorizing the SB system components in the form of minicircles that are devoid of plasmid backbone sequences and are, therefore, significantly reduced in size. As compared to conventional plasmids, delivery of the SB transposon system as minicircle DNA is ∼20 times more efficient, and it is associated with up to a 50% reduction in cellular toxicity in human CD34+ cells. Moreover, providing the SB transposase in the form of synthetic mRNA enabled us to further increase the efficacy and biosafety of stable gene delivery into hematopoietic progenitors ex vivo. Genome-wide insertion site profiling revealed a close-to-random distribution of SB transposon integrants, which is characteristically different from gammaretroviral and lentiviral integrations in HSPCs. Transplantation of gene-marked CD34+ cells in immunodeficient mice resulted in long-term engraftment and hematopoietic reconstitution, which was most efficient when the SB transposase was supplied as mRNA and nucleofected cells were maintained for 4–8 days in culture before transplantation. Collectively, implementation of minicircle and mRNA technologies allowed us to further refine the SB transposon system in the context of HSPC gene delivery to ultimately meet clinical demands of an efficient and safe non-viral gene therapy protocol.
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Affiliation(s)
- Marta Holstein
- Transposition and Genome Engineering, Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
| | - Cristina Mesa-Nuñez
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIEMAT/CIBERER), Madrid, Spain; Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM) Madrid, Spain
| | - Csaba Miskey
- Transposition and Genome Engineering, Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
| | - Elena Almarza
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIEMAT/CIBERER), Madrid, Spain; Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM) Madrid, Spain
| | | | | | - Esther Grueso
- Transposition and Genome Engineering, Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
| | - Juan Carlos Ordóñez Flores
- Transposition and Genome Engineering, Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
| | - Dennis Kobelt
- Translational Oncology, Experimental and Clinical Research Center, Charité University Medicine, Berlin, Germany
| | - Wolfgang Walther
- Translational Oncology, Experimental and Clinical Research Center, Charité University Medicine, Berlin, Germany
| | | | | | - Halvard B Bonig
- Department of Transfusion Medicine and Immunohematology, Johann-Wolfgang-Goethe Universität, Frankfurt, Germany
| | - Zsuzsanna Izsvák
- Mobile DNA, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | | | - Carsten Rudolph
- ethris GmbH, Planegg, Germany; Department of Pediatrics, Ludwig Maximilian University, Munich, Germany
| | - Fulvio Mavilio
- Genethon, Evry, France; Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Juan A Bueren
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIEMAT/CIBERER), Madrid, Spain; Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM) Madrid, Spain
| | - Guillermo Guenechea
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIEMAT/CIBERER), Madrid, Spain; Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM) Madrid, Spain
| | - Zoltán Ivics
- Transposition and Genome Engineering, Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany.
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31
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Romano O, Cifola I, Poletti V, Severgnini M, Peano C, De Bellis G, Mavilio F, Miccio A. Retroviral Scanning: Mapping MLV Integration Sites to Define Cell-specific Regulatory Regions. J Vis Exp 2017. [PMID: 28605390 DOI: 10.3791/55919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Moloney murine leukemia (MLV) virus-based retroviral vectors integrate predominantly in acetylated enhancers and promoters. For this reason, mLV integration sites can be used as functional markers of active regulatory elements. Here, we present a retroviral scanning tool, which allows the genome-wide identification of cell-specific enhancers and promoters. Briefly, the target cell population is transduced with an mLV-derived vector and genomic DNA is digested with a frequently cutting restriction enzyme. After ligation of genomic fragments with a compatible DNA linker, linker-mediated polymerase chain reaction (LM-PCR) allows the amplification of the virus-host genome junctions. Massive sequencing of the amplicons is used to define the mLV integration profile genome-wide. Finally, clusters of recurrent integrations are defined to identify cell-specific regulatory regions, responsible for the activation of cell-type specific transcriptional programs. The retroviral scanning tool allows the genome-wide identification of cell-specific promoters and enhancers in prospectively isolated target cell populations. Notably, retroviral scanning represents an instrumental technique for the retrospective identification of rare populations (e.g. somatic stem cells) that lack robust markers for prospective isolation.
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Affiliation(s)
- Oriana Romano
- Center for Genome Research, Department of Life Sciences, University of Modena and Reggio Emilia; Laboratory of Chromatin and Gene Regulation During Development, Imagine Institute
| | | | | | | | | | | | - Fulvio Mavilio
- Center for Genome Research, Department of Life Sciences, University of Modena and Reggio Emilia; Généthon
| | - Annarita Miccio
- Center for Genome Research, Department of Life Sciences, University of Modena and Reggio Emilia; Laboratory of Chromatin and Gene Regulation During Development, Imagine Institute; Généthon; Sorbonne Paris Cité - Université Paris Descartes;
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Massaccesi C, Colella S, Fioretti F, D'Emilio V, Panella G, Primomo G, Barbisan F, Pela R, Poletti V. An unusual thoracic localizations of Erdheim- Chester disease: A case report. Respir Med Case Rep 2017; 20:116-119. [PMID: 28149747 PMCID: PMC5271674 DOI: 10.1016/j.rmcr.2017.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 02/08/2023] Open
Abstract
Erdheim- Chester disease is a rare non- Langerhans cell histiocytosis that usually involves the bones, heart, central nervous system, retroperitoneum, eyes, kidneys, skin and adrenals. Lungs are affected in up to one-half cases; at CT scan various patterns are described: interstitial disease, consolidations, micronodules and microcysts, with or without pleural involvement. We presented a case of a 59 year-old man with unusual intrathoracic manifestation of Erdheim- Chester disease. Singularities of our report are the lonely thoracic involvement at the onset of the disease and a histiocytic lesion in the posterior mediastinum.
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Affiliation(s)
- C Massaccesi
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - S Colella
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - F Fioretti
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - V D'Emilio
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - G Panella
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - G Primomo
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - F Barbisan
- Department of Pathology, "Ospedali Riuniti", Ancona, Italy
| | - R Pela
- Pulmonary Unit, "C. e G. Mazzoni" Hospital, Ascoli Piceno, Italy
| | - V Poletti
- Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy; Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Colella S, Clementsen PF, Gurioli C, Gurioli CH, Ravaglia C, Tomassetti S, Rossi A, Piciucchi S, Dubini A, Poletti V. Endobronchial-ultrasound needle aspiration and endoscopic ultrasound-fine-needle aspiration in thoracic diseases. Pathologica 2016; 108:59-79. [PMID: 28195251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
EBUS-TBNA and EUS-FNA are minimally invasive techniques rapidly gaining ground in the non-surgical invasive diagnostic approach to thoracic diseases due to their high accuracy and low morbidity and mortality compared to surgical techniques. Moreover, in the diagnosis and staging of lung cancer the combination of the two techniques is superior to either test alone. In this review we focus on the role of EBUS-TBNA and EUS-FNA in both malignant and non-malignant thoracic diseases.
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Affiliation(s)
- S Colella
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
| | - P F Clementsen
- Copenhagen Academy for Medical Education and Simulation, Rigshospitalet, Denmark
- Department of Pulmonary Medicine, Gentofte Hospital, Denmark
| | - C Gurioli
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
| | - C H Gurioli
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
| | - C Ravaglia
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
| | - S Tomassetti
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
| | - A Rossi
- Pulmonary Unit, University of Verona, Italy
| | - S Piciucchi
- Departments of Radiology, GB Morgagni-L Pierantoni Hospital, Forlì, Italy
| | - A Dubini
- Department of Pathology, GB Morgagni-L Pierantoni Hospital, Forlì, Italy
| | - V Poletti
- Pulmonary Unit, Department of Thoracic Diseases, Azienda USL Romagna, GB Morgagni-L-Pierantoni Hospital, Forlì, Italy
- Department of Respiratory Diseases & Allergology, Aarhus University Hospital, Denmark
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Charrier S, Poletti V, Martin S, Gjata B, Hebben M, Vignaud A, Zhang F, Buckland K, Rothe M, Schambach A, Gaspar B, Thrasher A, Mavilio F. 690. Development of a Clinical Lentiviral Vector for Gene Therapy of SCID-X1. Mol Ther 2016. [DOI: 10.1016/s1525-0016(16)33498-0] [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: 10/20/2022] Open
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35
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Romano O, Peano C, Tagliazucchi GM, Petiti L, Poletti V, Cocchiarella F, Rizzi E, Severgnini M, Cavazza A, Rossi C, Pagliaro P, Ambrosi A, Ferrari G, Bicciato S, De Bellis G, Mavilio F, Miccio A. Transcriptional, epigenetic and retroviral signatures identify regulatory regions involved in hematopoietic lineage commitment. Sci Rep 2016; 6:24724. [PMID: 27095295 PMCID: PMC4837375 DOI: 10.1038/srep24724] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/11/2015] [Accepted: 04/04/2016] [Indexed: 12/21/2022] Open
Abstract
Genome-wide approaches allow investigating the molecular circuitry wiring the genetic and epigenetic programs of human somatic stem cells. Hematopoietic stem/progenitor cells (HSPC) give rise to the different blood cell types; however, the molecular basis of human hematopoietic lineage commitment is poorly characterized. Here, we define the transcriptional and epigenetic profile of human HSPC and early myeloid and erythroid progenitors by a combination of Cap Analysis of Gene Expression (CAGE), ChIP-seq and Moloney leukemia virus (MLV) integration site mapping. Most promoters and transcripts were shared by HSPC and committed progenitors, while enhancers and super-enhancers consistently changed upon differentiation, indicating that lineage commitment is essentially regulated by enhancer elements. A significant fraction of CAGE promoters differentially expressed upon commitment were novel, harbored a chromatin enhancer signature, and may identify promoters and transcribed enhancers driving cell commitment. MLV-targeted genomic regions co-mapped with cell-specific active enhancers and super-enhancers. Expression analyses, together with an enhancer functional assay, indicate that MLV integration can be used to identify bona fide developmentally regulated enhancers. Overall, this study provides an overview of transcriptional and epigenetic changes associated to HSPC lineage commitment, and a novel signature for regulatory elements involved in cell identity.
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Affiliation(s)
- Oriana Romano
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy.,INSERM UMR 1163, Laboratory of chromatin and gene regulation during development, Paris, France
| | - Clelia Peano
- Institute of Biomedical Technologies, CNR, Milan, Italy
| | | | - Luca Petiti
- Institute of Biomedical Technologies, CNR, Milan, Italy
| | | | | | - Ermanno Rizzi
- Institute of Biomedical Technologies, CNR, Milan, Italy.,Telethon Foundation, Milan, Italy
| | | | - Alessia Cavazza
- Dana Farber Cancer Institute, Harvard Medical School, Boston, US
| | - Claudia Rossi
- San Raffaele-Telethon Institute for Gene Therapy (TIGET), San Raffaele Scientific Institute, Milan, Italy
| | - Pasqualepaolo Pagliaro
- Az. Osp. Policlinico Universitario di Bologna, Policlinico S. Orsola-Malpighi, Unità Operativa di Immunoematologia e Trasfusionale, Bologna, Italy
| | | | - Giuliana Ferrari
- San Raffaele-Telethon Institute for Gene Therapy (TIGET), San Raffaele Scientific Institute, Milan, Italy.,Vita Salute San Raffaele University, Milan, Italy
| | - Silvio Bicciato
- Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Fulvio Mavilio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Genethon, Evry, France
| | - Annarita Miccio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,INSERM UMR 1163, Laboratory of chromatin and gene regulation during development, Paris, France.,Paris Descartes, Sorbonne Paris Cité University, Imagine Institute, Paris, France
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36
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Milioli G, Bosi M, Riccardi S, Puligheddu M, Poletti V, Cortelli P, Terzano M, Parrino L. The additional value of CAP measures in the detection of flow limitation events in OSAS patients: A comparison with AASM arousals. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1466] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pietrangeli V, Piciucchi S, Tomassetti S, Ravaglia C, Gurioli C, Gurioli C, Cavazza A, Dubini A, Poletti V. Diffuse Neuroendocrine Hyperplasia with Obliterative Bronchiolitis and Usual Interstitial Pneumonia: An Unusual “Headcheese Pattern” with Nodules. Lung 2015; 193:1051-4. [DOI: 10.1007/s00408-015-9817-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 09/27/2015] [Indexed: 11/30/2022]
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38
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Cottin V, Crestani B, Danel C, Debray MP, Nunes H, Poletti V, Prévost G, Vergnon JM, Wallaert B, Cordier JF. [3rd French day of idiopathic pulmonary fibrosis. September 19, 2014]. Rev Pneumol Clin 2015; 71:189-206. [PMID: 26232107 DOI: 10.1016/j.pneumo.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 05/25/2015] [Accepted: 06/02/2015] [Indexed: 06/04/2023]
Affiliation(s)
- V Cottin
- Service de pneumologie, CHU Bichat, 46, rue Henri-Huchard, 75877 Paris, France.
| | - B Crestani
- Département d'anatomie pathologique, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France
| | - C Danel
- Service de radiologie - imagerie médicale, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France
| | - M-P Debray
- Service de pneumologie, hôpital Avicenne, 125, route de Stalingrad, 93000 Bobigny, France
| | - H Nunes
- Dipartimento Toracico, Ospedale GB Morgagni, U.O. di Pneumologia, Via Carlo Forlanini 34, 47121 Forlì (FC), Italie
| | - V Poletti
- Service de pneumologie, CHU Larrey, 24, chemin de Pouvourville, 31059 Toulouse, France
| | - G Prévost
- Service de pneumologie, hôpital Nord, CHU de Saint-Étienne, bâtiment C, 42055 Saint-Étienne cedex 2, France
| | - J-M Vergnon
- Service de pneumologie, CHRU Calmette, boulevard du Professeur-J.-Leclercq, 59037 Lille, France
| | - B Wallaert
- Service de pneumologie, hôpital Louis-Pradel, université Claude-Bernard, BP Lyon Montchat, 69394 Lyon cedex 03, France
| | - J-F Cordier
- Service de pneumologie, CHU Louis-Pradel, 28, avenue du Doyen-Lépine, 69677 Lyon cedex, France
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Franco I, Dubini A, Piciucchi S, Casoni G, Poletti V. Interstitial lung disease preceding primary biliary cirrhosis in a male patient. Rev Port Pneumol (2006) 2015; 21:214-7. [PMID: 25998779 DOI: 10.1016/j.rppnen.2015.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 02/18/2015] [Accepted: 02/20/2015] [Indexed: 12/15/2022] Open
Abstract
A 47-year-old male was admitted with subacute onset of dry cough and fever. Chest tomography demonstrated multifocal areas of consolidation and ground glass attenuation. Cytological analysis of bronchoalveolar lavage revealed lymphocytosis and eosinophilia and anatomopathological exam of transbronchial cryobiopsy showed poorly formed non-caseous granulomas associated to interstitial lympho-plasmocitary infiltrate. The diagnosis of idiopathic granulomatous lung disease (GLD) was assumed and the patient started oral prednisolone, presenting clinical, functional and radiological improvement. Two years later, the patient was diagnosed with primary biliary cirrhosis (PBC). At this time, it was possible to associate GLD with the autoimmune hepatobiliary disease. Clinical, epidemiological and pathological aspects of this uncommon case of interstitial lung disease as first presentation of PBC in a male patient are discussed.
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Affiliation(s)
- I Franco
- Department of Pulmonary Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - A Dubini
- Department of Anatomic Pathology, G.B. Morgagni L. Pierantoni General Hospital, Forlí, Italy
| | - S Piciucchi
- Department of Radiology, G.B. Morgagni L. Pierantoni General Hospital, Forlí, Italy
| | - G Casoni
- Department of Diseases of the Thorax, G.B. Morgagni L. Pierantoni General Hospital, Forlí, Italy
| | - V Poletti
- Department of Diseases of the Thorax, G.B. Morgagni L. Pierantoni General Hospital, Forlí, Italy
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Poletti V, Delli Carri A, Malagoli Tagliazucchi G, Faedo A, Petiti L, Mazza EMC, Peano C, De Bellis G, Bicciato S, Miccio A, Cattaneo E, Mavilio F. Genome-Wide Definition of Promoter and Enhancer Usage during Neural Induction of Human Embryonic Stem Cells. PLoS One 2015; 10:e0126590. [PMID: 25978676 PMCID: PMC4433211 DOI: 10.1371/journal.pone.0126590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/06/2015] [Indexed: 11/21/2022] Open
Abstract
Genome-wide mapping of transcriptional regulatory elements is an essential tool for understanding the molecular events orchestrating self-renewal, commitment and differentiation of stem cells. We combined high-throughput identification of transcription start sites with genome-wide profiling of histones modifications to map active promoters and enhancers in embryonic stem cells (ESCs) induced to neuroepithelial-like stem cells (NESCs). Our analysis showed that most promoters are active in both cell types while approximately half of the enhancers are cell-specific and account for most of the epigenetic changes occurring during neural induction, and most likely for the modulation of the promoters to generate cell-specific gene expression programs. Interestingly, the majority of the promoters activated or up-regulated during neural induction have a “bivalent” histone modification signature in ESCs, suggesting that developmentally-regulated promoters are already poised for transcription in ESCs, which are apparently pre-committed to neuroectodermal differentiation. Overall, our study provides a collection of differentially used enhancers, promoters, transcription starts sites, protein-coding and non-coding RNAs in human ESCs and ESC-derived NESCs, and a broad, genome-wide description of promoter and enhancer usage and of gene expression programs characterizing the transition from a pluripotent to a neural-restricted cell fate.
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Affiliation(s)
- Valentina Poletti
- Division of Genetics and Cell Biology, Scientific Institute H. San Raffaele, Milan, Italy
- Genethon, Evry, France
| | | | | | - Andrea Faedo
- Department of Biosciences, University of Milano, Milan, Italy
| | - Luca Petiti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Clelia Peano
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Gianluca De Bellis
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Silvio Bicciato
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Annarita Miccio
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Imagine Institute, Paris, France
| | - Elena Cattaneo
- Department of Biosciences, University of Milano, Milan, Italy
| | - Fulvio Mavilio
- Genethon, Evry, France
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
- * E-mail:
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Conti V, Grazia M, Romagnoli M, Poletti G, Cristino S, Ciliberti G, Piciucchi S, Mosconi G, Poletti V. Lung injury associated with mTOR inhibitors (sirolimus and everolimus). MINERVA UROL NEFROL 2014; 66:283-285. [PMID: 25531195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- V Conti
- Department of Medical Sciences, Research Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy -
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Poletti V, Egan J. Classification, natural history and staging of idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30 Suppl 1:13-20. [PMID: 24081239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Indexed: 06/02/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) is defined as a fibrosing disease limited to the lungs of unknown aetiology characterised radiologically and/or morphologically by the usual interstitial pneumonitis pattern. It is a disease with an ominous prognosis. There is currently no consensus regarding the staging and classification of IPF. As highlighted in the revised ATS/ERS guidelines, proposed stages may be based on resting pulmonary function test measurements and/or the extent of radiologic abnormalities, but it is unknown if these staging approaches are relevant to clinical decision-making. Thus, the unmet needs in IPF include a complete knowledge of the pathogenetic mechanisms leading to lung destruction, an improved understanding of different clinico-radiological subtypes of this disorder and finally, the identification of staging systems of clinical value.
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Affiliation(s)
- V Poletti
- Department of Thoracic Diseases, Ospedale Morgagni Forlì, Italy.
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Tomassetti S, Ruy JH, Gurioli C, Ravaglia C, Buccioli M, Tantalocco P, Decker PA, Cavazza A, Dubini A, Agnoletti V, Gurioli C, Casoni GL, Romagnoli M, Poletti V. The effect of anticoagulant therapy for idiopathic pulmonary fibrosis in real life practice. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30:121-127. [PMID: 24071883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND IPF is a common form of interstitial lung disease for which there is no effective therapy and usually results in death. Two previous contradictory studies showed anticoagulant therapy to be associated with both improved and worsened survival, respectively. OBJECTIVE The objective of this retrospective cohort study was to evaluate the effect of anticoagulant therapy on the survival and disease progression of patients with idiopathic pulmonary fibrosis (IPF) in real clinical practice. METHODS We compared the clinical characteristics, time to disease progression, incidence of acute exacerbation, and survival of 25 (20%) IPF patients receiving anticoagulant therapy to the remaining 97 IPF patients not receiving anticoagulant therapy. In addition we conducted a sensitivity analysis using as comparator a group of 25 patients matched by age, sex, functional impairment, cardiac comorbidities and pulmonary hypertension. RESULTS Patients on anticoagulant therapy had a worse 1- and 3-year survival (84% and 53% versus 89% and 64% in the non-anticoagulant group, respectively), a difference that persisted after adjusting for age and comorbidities (hazard ratio 3.1 - 95% confidence interval, 1.4 to 7.0; p=0.006) and after comparison with the matched group (adjusted HR=4.8, 95% CI: 1.8-12.8; p=0.002). IPF patients on anticoagulant therapy had a shorter interval to disease progression ( 0.7 years versus 1.6 years, adjusted HR 2.2 -95% CI, 0.96 to 5.1; p=0.063) confirmed also in the analysis with matched subgroups (HR=2.7 (95% CI: 1.2-6.5); p=0.023). The incidence of acute exacerbations did not differ in the two groups (22% versus 23%). Two patients (8%) experienced anticoagulant treatment related complications and included an episode of hemorrhagic shock. CONCLUSION In this retrospective study patients treated with anticoagulants had a worse survival and a shorter interval to disease progression. This support the recent finding that warfarin worsen the respiratory status and survival of IPF patients.
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Ravaglia C, Gurioli C, Romagnoli M, Casoni G, Tomassetti S, Gurioli C, Poletti V. Sarcoidosis and autoimmune thyroid disease. Pneumologie 2012. [DOI: 10.1055/s-0032-1329835] [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: 10/27/2022]
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45
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Ravaglia C, Gurioli C, Romagnoli M, Casoni G, Tomassetti S, Gurioli C, Poletti V. Sarcoidosis is a frequent benign cause of lymphadenopathy in neoplastic patients. Pneumologie 2012. [DOI: 10.1055/s-0032-1329836] [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: 10/27/2022]
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46
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Wells AU, Behr J, Costabel U, Cottin V, Poletti V. Triple therapy in idiopathic pulmonary fibrosis: an alarming press release. Eur Respir J 2012; 39:805-6. [PMID: 22467722 DOI: 10.1183/09031936.00009112] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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47
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Ravaglia C, Gurioli C, Casoni G, Romagnoli M, Tomassetti S, Gurioli C, Corso RM, Poletti G, Dubini A, Marinou A, Poletti V. Diagnostic role of rapid on-site cytologic examination (ROSE) of broncho-alveolar lavage in ALI/ARDS. Pathologica 2012; 104:65-69. [PMID: 22953502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND While bronchoscopy should be considered in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in which the cause cannot be determined from history or clinical and laboratory data, there are no studies about the utility of rapid on-site examination (ROSE) of broncho-alveolar lavage for identification, as early as possible, of the pathological condition underlying the onset of this condition. The aim of this prospective, observational study was to evaluate the diagnostic role of ROSE of BAL in ALI/ARDS. METHODS 71 patients with ALI/ARDS underwent bronchoalveolar lavage, and one part of the sample was examined with ROSE. The on-site report was categorized as diagnostic (specific diagnosis), presence of atypical reactive type II pneumocytes with no further comments or not diagnostic. RESULTS ROSE of bronco-alveolar lavage yielded 29 (41%) specific diagnoses, revealed typical features of diffuse alveolar damage without a specific diagnosis in 28 patients (39%) and did not reveal a specific diagnosis in the remaining 14 cases (20%). CONCLUSIONS The results of this study show that, in patients with ALI/ARDS, bronchoalveolar lavage with ROSE is diagnostic in 40% of cases: ROSE may therefore spare lung biopsies and improve the prognosis of patients with ARDS (immunocompetent or not) as therapy could be started or modified at a very early phase.
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Affiliation(s)
- C Ravaglia
- Department of Diseases of the Thorax, Pulmonology Unit, Morgagni-Pierantoni Hospital, Forli, Italy
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48
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Margaritopoulos GA, Romagnoli M, Poletti V, Siafakas NM, Wells AU, Antoniou KM. Recent advances in the pathogenesis and clinical evaluation of pulmonary fibrosis. Eur Respir Rev 2012; 21:48-56. [DOI: 10.1183/09059180.00007611] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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49
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Miccio A, Poletti V, Tiboni F, Rossi C, Antonelli A, Mavilio F, Ferrari G. The GATA1-HS2 enhancer allows persistent and position-independent expression of a β-globin transgene. PLoS One 2011; 6:e27955. [PMID: 22164220 PMCID: PMC3229501 DOI: 10.1371/journal.pone.0027955] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 10/28/2011] [Indexed: 11/19/2022] Open
Abstract
Gene therapy of genetic diseases requires persistent and position-independent expression of a therapeutic transgene. Transcriptional enhancers binding chromatin-remodeling and modifying complexes may play a role in shielding transgenes from repressive chromatin effects. We tested the activity of the HS2 enhancer of the GATA1 gene in protecting the expression of a β-globin minigene delivered by a lentiviral vector in hematopoietic stem/progenitor cells. Gene expression from proviruses carrying GATA1-HS2 in both LTRs was persistent and resistant to silencing at most integration sites in the in vivo progeny of human hematopoietic progenitors and murine long-term repopulating stem cells. The GATA1-HS2-modified vector allowed correction of murine β-thalassemia at low copy number without inducing clonal selection of erythroblastic progenitors. Chromatin immunoprecipitation studies showed that GATA1 and the CBP acetyltransferase bind to GATA1-HS2, significantly increasing CBP-specific histone acetylations at the LTRs and β-globin promoter. Recruitment of CBP by the LTRs thus establishes an open chromatin domain encompassing the entire provirus, and increases the therapeutic efficacy of β-globin gene transfer by reducing expression variegation and epigenetic silencing.
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Affiliation(s)
- Annarita Miccio
- H. San Raffaele-Telethon Institute for Gene Therapy (HSR-TIGET), Istituto Scientifico H. San Raffaele, Milan, Italy
- Department of Biomedical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valentina Poletti
- Laboratory of Gene Expression, Istituto Scientifico H. San Raffaele, Milan, Italy
| | - Francesca Tiboni
- H. San Raffaele-Telethon Institute for Gene Therapy (HSR-TIGET), Istituto Scientifico H. San Raffaele, Milan, Italy
| | - Claudia Rossi
- H. San Raffaele-Telethon Institute for Gene Therapy (HSR-TIGET), Istituto Scientifico H. San Raffaele, Milan, Italy
| | - Antonella Antonelli
- H. San Raffaele-Telethon Institute for Gene Therapy (HSR-TIGET), Istituto Scientifico H. San Raffaele, Milan, Italy
| | - Fulvio Mavilio
- Department of Biomedical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Laboratory of Gene Expression, Istituto Scientifico H. San Raffaele, Milan, Italy
| | - Giuliana Ferrari
- H. San Raffaele-Telethon Institute for Gene Therapy (HSR-TIGET), Istituto Scientifico H. San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
- * E-mail:
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Agnoletti V, Gurioli C, Piraccini E, Maitan S, Corso MR, Buccioli M, Poletti V, Gambale G. Efficacy and safety of thoracic paravertebral block for medical thoracoscopy. Br J Anaesth 2011; 106:916-7. [PMID: 21576109 DOI: 10.1093/bja/aer143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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