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De Muynck K, Heyerick L, De Ponti FF, Vanderborght B, Meese T, Van Campenhout S, Baudonck L, Gijbels E, Rodrigues PM, Banales JM, Vesterhuus M, Folseraas T, Scott CL, Vinken M, Van der Linden M, Hoorens A, Van Dorpe J, Lefere S, Geerts A, Van Nieuwerburgh F, Verhelst X, Van Vlierberghe H, Devisscher L. Osteopontin characterizes bile duct-associated macrophages and correlates with liver fibrosis severity in primary sclerosing cholangitis. Hepatology 2024; 79:269-288. [PMID: 37535809 PMCID: PMC10789378 DOI: 10.1097/hep.0000000000000557] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND AIMS Primary sclerosing cholangitis (PSC) is an immune-mediated cholestatic liver disease for which pharmacological treatment options are currently unavailable. PSC is strongly associated with colitis and a disruption of the gut-liver axis, and macrophages are involved in the pathogenesis of PSC. However, how gut-liver interactions and specific macrophage populations contribute to PSC is incompletely understood. APPROACH AND RESULTS We investigated the impact of cholestasis and colitis on the hepatic and colonic microenvironment, and performed an in-depth characterization of hepatic macrophage dynamics and function in models of concomitant cholangitis and colitis. Cholestasis-induced fibrosis was characterized by depletion of resident KCs, and enrichment of monocytes and monocyte-derived macrophages (MoMFs) in the liver. These MoMFs highly express triggering-receptor-expressed-on-myeloid-cells-2 ( Trem2 ) and osteopontin ( Spp1 ), markers assigned to hepatic bile duct-associated macrophages, and were enriched around the portal triad, which was confirmed in human PSC. Colitis induced monocyte/macrophage infiltration in the gut and liver, and enhanced cholestasis-induced MoMF- Trem2 and Spp1 upregulation, yet did not exacerbate liver fibrosis. Bone marrow chimeras showed that knockout of Spp1 in infiltrated MoMFs exacerbates inflammation in vivo and in vitro , while monoclonal antibody-mediated neutralization of SPP1 conferred protection in experimental PSC. In human PSC patients, serum osteopontin levels are elevated compared to control, and significantly increased in advanced stage PSC and might serve as a prognostic biomarker for liver transplant-free survival. CONCLUSIONS Our data shed light on gut-liver axis perturbations and macrophage dynamics and function in PSC and highlight SPP1/OPN as a prognostic marker and future therapeutic target in PSC.
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Affiliation(s)
- Kevin De Muynck
- Department of Basic & Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Lander Heyerick
- Department of Basic & Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Federico F. De Ponti
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Bart Vanderborght
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Tim Meese
- Department of Pharmaceutics, Laboratory of Pharmaceutical Biotechnology, Ghent University, Ghent, Belgium
- NXTGNT, Ghent University, Ghent, Belgium
| | - Sanne Van Campenhout
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Leen Baudonck
- Department of Basic & Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
| | - Eva Gijbels
- Department of Basic & Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Pedro M. Rodrigues
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute, Donostia University Hospital, University of the Basque Country (UPV-EHU), Donostia-San Sebastian, Spain
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Jesus M. Banales
- Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute, Donostia University Hospital, University of the Basque Country (UPV-EHU), Donostia-San Sebastian, Spain
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
- Department of Biochemistry and Genetics, School of Sciences, University of Navarra, Pamplona, Spain
| | - Mette Vesterhuus
- Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Norwegian PSC Research Center, Oslo, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Trine Folseraas
- Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Norwegian PSC Research Center, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
- Research Institute of Internal Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Charlotte L. Scott
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Mathieu Vinken
- Department of Pharmaceutical and Pharmacological Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Sander Lefere
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
| | - Anja Geerts
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Filip Van Nieuwerburgh
- Department of Pharmaceutics, Laboratory of Pharmaceutical Biotechnology, Ghent University, Ghent, Belgium
- NXTGNT, Ghent University, Ghent, Belgium
| | - Xavier Verhelst
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Hans Van Vlierberghe
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine and Paediatrics, Hepatology Research Unit, Ghent University, Ghent, Belgium
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Lindsey Devisscher
- Department of Basic & Applied Medical Sciences, Gut-Liver Immunopharmacology Unit, Ghent University, Ghent, Belgium
- Liver Research Center Ghent, Ghent University, Ghent University Hospital, Ghent, Belgium
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Demuytere J, Carlier C, Van de Sande L, Hoorens A, De Clercq K, Giordano S, Morosi L, Matteo C, Zucchetti M, Davoli E, Van Dorpe J, Vervaet C, Ceelen W. Preclinical Activity of Two Paclitaxel Nanoparticle Formulations After Intraperitoneal Administration in Ovarian Cancer Murine Xenografts. Int J Nanomedicine 2024; 19:429-440. [PMID: 38260242 PMCID: PMC10800285 DOI: 10.2147/ijn.s424045] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/30/2023] [Indexed: 01/24/2024] Open
Abstract
Background Epithelial ovarian cancer is associated with high mortality due to diagnosis at later stages associated with peritoneal involvement. Several trials have evaluated the effect of intraperitoneal treatment. In this preclinical study, we report the efficacy, pharmacokinetics and pharmacodynamics of intraperitoneal treatment with two approved nanomolecular formulations of paclitaxel (nab-PTX and mic-PTX) in a murine ovarian cancer xenograft model. Methods IC50 was determined in vitro on three ovarian cancer cell lines (OVCAR-3, SK-OV-3 and SK-OV-3-Luc IP1). EOC xenografts were achieved using a modified subperitoneal implantation technique. Drug treatment was initiated 2 weeks after engraftment, and tumor volume and survival were assessed. Pharmacokinetics and drug distribution effects were assessed using UHPLC-MS/MS and MALDI imaging mass spectrometry, respectively. Pharmacodynamic effects were analyzed using immunohistochemistry and transmission electron microscopy using standard protocols. Results We demonstrated sub-micromolar IC50 concentrations for both formulations on three EOC cancer cell lines in vitro. Furthermore, IP administration of nab-PTX or mic-PTX lead to more than 2-fold longer survival compared to a control treatment of IP saline administration (30 days in controls, 66 days in nab-PTX treated animals, and 76 days in mic-PTX animals, respectively). We observed higher tissue uptake of drug following nab-PTX administration when compared to mic-PTX, with highest uptake after 4 hours post-treatment, and confirmed this lower uptake of mic-PTX using HPLC on digested tumor samples. Furthermore, apoptosis was not increased in tumor implants up to 24h post-treatment. Conclusion Intraperitoneal administration of both nab-PTX and mic-PTX results in a significant anticancer efficacy and survival benefit in a mouse OC xenograft model.
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Affiliation(s)
- Jesse Demuytere
- Department of GI Surgery, Ghent University Hospital, and Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Charlotte Carlier
- Department of GI Surgery, Ghent University Hospital, and Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Leen Van de Sande
- Department of GI Surgery, Ghent University Hospital, and Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Kaat De Clercq
- Laboratory of Pharmaceutical Technology, Ghent University, Ghent, Belgium
| | - Silvia Giordano
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milano, Italy
| | - Lavinia Morosi
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milano, Italy
| | - Cristina Matteo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milano, Italy
| | - Massimo Zucchetti
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milano, Italy
| | - Enrico Davoli
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri - IRCCS, Milano, Italy
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Chris Vervaet
- Laboratory of Pharmaceutical Technology, Ghent University, Ghent, Belgium
| | - Wim Ceelen
- Department of GI Surgery, Ghent University Hospital, and Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Hermie L, Biervliet SV, Hoorens A, Cauwenberghe LV, Robberecht E, Defreyne L. Pre-emptive transjugular intrahepatic portosystemic shunt in pediatric cystic fibrosis-related liver disease and portal hypertension: prospective long-term results. Diagn Interv Radiol 2024; 30:55-64. [PMID: 36994654 PMCID: PMC10773179 DOI: 10.4274/dir.2022.221818] [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: 08/22/2022] [Accepted: 12/23/2022] [Indexed: 03/31/2023]
Abstract
PURPOSE Portal hypertension (PHT) and its sequelae are the most clinically important manifestations in cystic fibrosis-related liver disease (CFLD). This paper aimed to evaluate the safety and efficacy of a pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) to prevent PHT-related complications in pediatric patients with CFLD. METHODS This was a prospective single-arm study on pediatric patients with CFLD, signs of PHT, and preserved liver function who underwent a pre-emptive TIPS in a single tertiary CF center between 2007 and 2012. The long-term safety and clinical efficacy were assessed. RESULTS A pre-emptive TIPS was performed on seven patients with a mean age of 9.2 years (± standard deviation: 2.2). The procedure was technically successful in all patients, with an estimated median primary patency of 10.7 years [interquartile range (IQR) 0.5-10.7)]. No variceal bleeding was observed during the median follow-up of 9 years (IQR 8.1-12.9). In two patients with advanced PHT and rapidly progressive liver disease, severe thrombocytopenia could not be stopped. Subsequent liver transplantation revealed biliary cirrhosis in both patients. In the remaining patients with early PHT and milder porto-sinusoidal vascular disease, symptomatic hypersplenism did not occur, and liver function remained stable until the end of the follow-up. Inclusion for pre-emptive TIPS was discontinued in 2013 following an episode of severe hepatic encephalopathy. CONCLUSION TIPS is a feasible treatment with encouraging long-term primary patency to avoid variceal bleeding in selected patients with CF and PHT. However, as the progression of liver fibrosis, thrombocytopenia, and splenomegaly is inevitable, the clinical benefits due to pre-emptive placement appear to be minor.
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Affiliation(s)
- Laurens Hermie
- Ghent University Hospital, Department of Vascular and Interventional Radiology, Gent, Belgium
| | | | - Anne Hoorens
- Ghent University Hospital, Department of Pathology, Gent, Belgium
| | - Lien Van Cauwenberghe
- Ghent University Hospital, Department of Vascular and Interventional Radiology, Gent, Belgium
| | - Eddy Robberecht
- Ghent University Hospital, Department of Pediatrics, Gent, Belgium
| | - Luc Defreyne
- Ghent University Hospital, Department of Vascular and Interventional Radiology, Gent, Belgium
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Van Roey G, Goos W, Claessens C, Hoorens A, Verlinden W, Schouten J. Acute grade IV toxic hepatitis due to the e-cigarette. Acta Gastroenterol Belg 2024; 87:44-47. [PMID: 38431791 DOI: 10.51821/87.1.11378] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
A 46-year-old woman presented at the emergency department because of acute hepatitis with jaundice. After hepatological work-up including liver biopsy, drug induced liver disease (DILI) was suspected. Patient recovered completely within a few months. One year later she presented again with jaundice due to acute hepatitis. Vaping was the only agent that could be identified as causative agent for DILI. After VAPING cessation, the hepatitis resolved completely. Calculated RUCAM score was 10, making the diagnosis of toxic hepatitis very likely. During follow-up liver tests remained normal. This is the first report of severe DILI secondary to the use of e-cigarettes. In future vaping can be included in the differential diagnosis of DILI.
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Affiliation(s)
- G Van Roey
- Department of Gastroenterology, AZ Turnhout, Turnhout, Belgium
| | - W Goos
- Department of Gastroenterology, AZ Turnhout, Turnhout, Belgium
| | - C Claessens
- Department of Gastroenterology, AZ Turnhout, Turnhout, Belgium
| | - A Hoorens
- Department of Pathology, University Hospital Ghent, Ghent, Belgium
| | - W Verlinden
- Department of Gastroenterology, VITAZ, St Niklaas, Belgium
| | - J Schouten
- Department of Gastroenterology, VITAZ, St Niklaas, Belgium
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Cordier F, Ferdinande L, Hoorens A, Van de Vijver K, Van Dorpe J, Creytens D. Soft Tissue and Bone Tumor Diagnostics: Harnessing the Power of Molecular Techniques. Genes (Basel) 2023; 14:2229. [PMID: 38137051 PMCID: PMC10742688 DOI: 10.3390/genes14122229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Since the introduction of new molecular techniques, the diagnostic landscape of soft tissue and bone tumors has expanded greatly over the past few years. The use of new molecular techniques has led to the identification of new genetic alterations and, therefore, to a better understanding of tumorigenesis, tumor detection and classification. Furthermore, methylation profiling has emerged as a classification tool for soft tissue and bone tumors. Molecular pathology also plays an important role in the determination of patient prognosis and in the identification of targets that can be used for targeted therapy. As a result, molecular pathology has gained a more prominent role in the daily practice of the surgical pathologist. This review delves into various molecular techniques applied in the surgical pathology of soft tissue and bone tumors. It highlights their applications through the analysis of five specific cases.
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Affiliation(s)
- Fleur Cordier
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Liesbeth Ferdinande
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
| | - Koen Van de Vijver
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
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Mortier C, Quintelier K, De Craemer AS, Renson T, Deroo L, Dumas E, Verheugen E, Coudenys J, Decruy T, Lukasik Z, Van Gassen S, Saeys Y, Hoorens A, Lobatón T, Van den Bosch F, Van de Wiele T, Venken K, Elewaut D. Gut Inflammation in Axial Spondyloarthritis Patients is Characterized by a Marked Type 17 Skewed Mucosal Innate-like T Cell Signature. Arthritis Rheumatol 2023; 75:1969-1982. [PMID: 37293832 DOI: 10.1002/art.42627] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/29/2023] [Accepted: 06/06/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Patients with spondyloarthritis (SpA) often present with microscopic signs of gut inflammation, a risk factor for progressive disease. We investigated whether mucosal innate-like T cells are involved in dysregulated interleukin-23 (IL-23)/IL-17 responses in the gut-joint axis in SpA. METHODS Ileal and colonic intraepithelial lymphocytes (IELs), lamina propria lymphocytes (LPLs), and paired peripheral blood mononuclear cells (PBMCs) were isolated from treatment-naive patients with nonradiographic axial SpA with (n = 11) and without (n = 14) microscopic gut inflammation and healthy controls (n = 15) undergoing ileocolonoscopy. The presence of gut inflammation was assessed histopathologically. Immunophenotyping of innate-like T cells and conventional T cells was performed using intracellular flow cytometry. Unsupervised clustering analysis was done by FlowSOM technology. Serum IL-17A levels were measured via Luminex. RESULTS Microscopic gut inflammation in nonradiographic axial SpA was characterized by increased ileal intraepithelial γδ-hi T cells, a γδ-T cell subset with elevated γδ-T cell receptor expression. γδ-hi T cells were also increased in PBMCs of patients with nonradiographic axial SpA versus healthy controls and were strongly associated with Ankylosing Spondylitis Disease Activity Score. The abundance of mucosal-associated invariant T cells and invariant natural killer T cells was unaltered. Innate-like T cells in the inflamed gut showed increased RORγt, IL-17A, and IL-22 levels with loss of T-bet, a signature that was less pronounced in conventional T cells. Presence of gut inflammation was associated with higher serum IL-17A levels. In patients treated with tumor necrosis factor blockade, the proportion of γδ-hi cells and RORγt expression in blood was completely restored. CONCLUSION Intestinal innate-like T cells display marked type 17 skewing in the inflamed gut mucosa of patients with nonradiographic axial SpA. γδ-hi T cells are linked to intestinal inflammation and disease activity in SpA.
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Affiliation(s)
- Céline Mortier
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Katrien Quintelier
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium, Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium, and Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ann-Sophie De Craemer
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Thomas Renson
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Liselotte Deroo
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Emilie Dumas
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Eveline Verheugen
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Julie Coudenys
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Tine Decruy
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Zuzanna Lukasik
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Sofie Van Gassen
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University and Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Yvan Saeys
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University and Data Mining and Modeling for Biomedicine group, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Triana Lobatón
- Department of Internal Medicine and Pediatrics, Ghent University and Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Filip Van den Bosch
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Tom Van de Wiele
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Koen Venken
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
| | - Dirk Elewaut
- Department of Rheumatology, Faculty of Medicine and Health Sciences, Ghent University and Unit for Molecular Immunology and Inflammation, VIB-UGent Center for Inflammation Research, Ghent, Belgium
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Braet H, Fransen PP, Chen Y, Van Herck S, Mariën R, Vanhoorne V, Ceelen W, Madder A, Ballet S, Hoogenboom R, De Geest B, Hoorens A, Dankers PYW, De Smedt SC, Remaut K. Smart hydrogels delivered by high pressure aerosolization can prevent peritoneal adhesions. J Control Release 2023; 362:138-150. [PMID: 37619864 DOI: 10.1016/j.jconrel.2023.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
Postoperative peritoneal adhesions occur in the majority of patients undergoing intra-abdominal surgery and are one of the leading causes of hospital re-admission. There is an unmet clinical need for effective anti-adhesive biomaterials, which can be applied evenly across the damaged tissues. We examined three different responsive hydrogel types, i.e. a thermosensitive PLGA-PEG-PLGA, a pH responsive UPy-PEG and a shear-thinning hexapeptide for this purpose. More specifically, their potential to be homogeneously distributed in the peritoneal cavity by high pressure nebulization and prevent peritoneal adhesions was evaluated. Solutions of each polymer type could be successfully nebulized while retaining their responsive gelation behavior in vitro and in vivo. Furthermore, none of the polymers caused in vitro toxicity on SKOV3-IP2 cells. Following intraperitoneal administration, both the PLGA-PEG-PLGA and the hexapeptide hydrogels resulted in local inflammation and fibrosis and failed in preventing peritoneal adhesions 7 days after adhesion induction. In contrast, the pH sensitive UPy-PEG formulation was well tolerated and could significantly reduce the formation of peritoneal adhesions, even outperforming the commercially available Hyalobarrier® as positive control. To conclude, local nebulization of the bioresponsive UPy-PEG hydrogel can be considered as a promising approach to prevent postsurgical peritoneal adhesions.
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Affiliation(s)
- Helena Braet
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | | | - Yong Chen
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Simon Van Herck
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Remco Mariën
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | | | - Wim Ceelen
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Annemieke Madder
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Steven Ballet
- Departments of Chemistry and Bioengineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Richard Hoogenboom
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Bruno De Geest
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Anne Hoorens
- CRIG - Cancer Research Institute Ghent, Ghent, Belgium; Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Patricia Y W Dankers
- Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Stefaan C De Smedt
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium
| | - Katrien Remaut
- Department of Pharmaceutics, Ghent University, Ghent, Belgium; CRIG - Cancer Research Institute Ghent, Ghent, Belgium.
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Truyens M, Hoste L, Geldof J, Hoorens A, Haerynck F, Huis In 't Veld D, Lobatón T. Successful treatment of ulcerative colitis with anakinra: a case report. Acta Gastroenterol Belg 2023; 86:573-576. [PMID: 38240554 DOI: 10.51821/86.4.11246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Currently the effect of IL-1 blockade on ulcerative colitis (UC) is still ambiguous. This case report describes a patient with UC who developed severe complications after an episode of azathioprineinduced pancytopenia including cytomegalovirus pneumonitis, hemophagocytic lymphohistiocytosis, and probable pulmonary aspergillosis. Imaging after the hospitalization revealed a severe disseminated chronic candidiasis and persisting inflammation was seen. Genetic testing revealed heterozygous variants in NOD2 and NLRP12, and cytokine testing showed an increase in IL-1Ra, IL-18, CXCL9, and CXCL10. Consequently an IL-1 mediated autoinflammatory syndrome was suspected. Simultaneously, the patient developed a corticosteroid dependent UC flare-up. Treatment with anakinra was initiated for the IL-1 mediated disease which quickly induced remission of both the inflammatory syndrome and the UC.
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Affiliation(s)
- M Truyens
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- VIB Center for Inflammation Research, Ghent, Belgium
- Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
| | - L Hoste
- Department of Pediatric Pulmonology, Infectious Diseases and Immunology, Ghent University Hospital, Ghent, Belgium
- Primary Immunodeficiency Research Lab, Center for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Center, Ghent University, Ghent, Belgium
| | - J Geldof
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
| | - A Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - F Haerynck
- Department of Pediatric Pulmonology, Infectious Diseases and Immunology, Ghent University Hospital, Ghent, Belgium
- Primary Immunodeficiency Research Lab, Center for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Center, Ghent University, Ghent, Belgium
| | - D Huis In 't Veld
- Department of Internal Medicine and Infectious Diseases, University Hospital, Ghent, Belgium
| | - T Lobatón
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
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de Carvalho LFA, Gryspeerdt F, Rashidian N, Van Hove K, Maertens L, Ribeiro S, Hoorens A, Berrevoet F. Predictive factors for survival in borderline resectable and locally advanced pancreatic cancer: are these really two different entities? BMC Surg 2023; 23:296. [PMID: 37775737 PMCID: PMC10541717 DOI: 10.1186/s12893-023-02200-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND The treatment of borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) has evolved with a wider application of neoadjuvant chemotherapy (NACHT). The aim of this study was to identify predictive factors for survival in BR and LA PDAC. METHODS Clinicopathologic data of patients with BR and LA PDAC who underwent surgical exploration between January 2011 and June 2021 were retrospectively collected. Survival from the date of surgery was estimated using the Kaplan-Meier method. Simple and multiple Cox proportional hazards models were fitted to identify factors associated with survival. Surgical resection was analyzed in combination with the involvement of lymph nodes as this last was only known after a formal resection. RESULTS Ninety patients were surgically explored (BR: 45, LA: 45), of which 51 (57%) were resected (BR: 31, LA: 20). NACHT was administered to 43 patients with FOLFIRINOX being the most frequent regimen applied (33/43, 77%). Major complications (Clavien-Dindo grade III and IV) occurred in 7.8% of patients and 90-day mortality rate was 3.3%. The median overall survival since surgery was 16 months (95% CI 12-20) in the group which underwent surgical resection and 10 months (95% CI 7-13) in the group with an unresectable tumor (p=0.001). Cox proportional hazards models showed significantly lower mortality hazard for surgical resection compared to no surgical resection, even after adjusting for National Comprehensive Cancer Network (NCCN) classification and administration of NACHT [surgical resection with involved lymph nodes vs no surgical resection (cHR 0.49; 95% CI 0.29-0.82; p=0.007)]. There was no significant difference in survival between patients with BR and LA disease (cHR= 1.01; 95% CI 0.63-1.62; p=0.98). CONCLUSIONS Surgical resection is the only predictor of survival in patients with BR and LA PDAC, regardless of their initial classification as BR or LA. Our results suggest that surgery should not be denied to patients with LA PDAC a priori. Prospective studies including patients from the moment of diagnosis are required to identify biologic and molecular markers which may allow a better selection of patients who will benefit from surgery.
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Affiliation(s)
- Luís Filipe Abreu de Carvalho
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Filip Gryspeerdt
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Niki Rashidian
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Kobe Van Hove
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Lambertine Maertens
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Suzane Ribeiro
- Department of Gastroenterology, Division of Digestive Oncology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Frederik Berrevoet
- Department of HPB surgery and liver transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Boerrigter MM, te Morsche RHM, Venselaar H, Pastoors N, Geerts AM, Hoorens A, Drenth JPH. Novel α-1,3-Glucosyltransferase Variants and Their Broad Clinical Polycystic Liver Disease Spectrum. Genes (Basel) 2023; 14:1652. [PMID: 37628703 PMCID: PMC10454741 DOI: 10.3390/genes14081652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Protein-truncating variants in α-1,3-glucosyltransferase (ALG8) are a risk factor for a mild cystic kidney disease phenotype. The association between these variants and liver cysts is limited. We aim to identify pathogenic ALG8 variants in our cohort of autosomal dominant polycystic liver disease (ADPLD) individuals. In order to fine-map the phenotypical spectrum of pathogenic ALG8 variant carriers, we performed targeted ALG8 screening in 478 ADPLD singletons, and exome sequencing in 48 singletons and 4 patients from two large ADPLD families. Eight novel and one previously reported pathogenic variant in ALG8 were discovered in sixteen patients. The ALG8 clinical phenotype ranges from mild to severe polycystic liver disease, and from innumerable small to multiple large hepatic cysts. The presence of <5 renal cysts that do not affect renal function is common in this population. Three-dimensional homology modeling demonstrated that six variants cause a truncated ALG8 protein with abnormal functioning, and one variant is predicted to destabilize ALG8. For the seventh variant, immunostaining of the liver tissue showed a complete loss of ALG8 in the cystic cells. ALG8-associated ADPLD has a broad clinical spectrum, including the possibility of developing a small number of renal cysts. This broadens the ADPLD genotype-phenotype spectrum and narrows the gap between liver-specific ADPLD and kidney-specific ADPKD.
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Affiliation(s)
- Melissa M. Boerrigter
- Department of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - René H. M. te Morsche
- Department of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Hanka Venselaar
- Center for Molecular and Biomolecular Informatics, Research Institute for Medical Innovation, 6500 HB Nijmegen, The Netherlands
| | - Nikki Pastoors
- Department of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Anja M. Geerts
- Department of Gastroenterology and Hepatology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Joost P. H. Drenth
- Department of Gastroenterology and Hepatology, Research Institute for Medical Innovation, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Venken K, Jarlborg M, Decruy T, Mortier C, Vlieghe C, Gilis E, De Craemer AS, Coudenys J, Cambré I, Fleury D, Klimowicz A, Van den Bosch F, Hoorens A, Lobaton T, de Roock S, Sparwasser T, Nabozny G, Jacques P, Elewaut D. Distinct immune modulatory roles of regulatory T cells in gut versus joint inflammation in TNF-driven spondyloarthritis. Ann Rheum Dis 2023; 82:1076-1090. [PMID: 37197892 DOI: 10.1136/ard-2022-223757] [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: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVES Gut and joint inflammation commonly co-occur in spondyloarthritis (SpA) which strongly restricts therapeutic modalities. The immunobiology underlying differences between gut and joint immune regulation, however, is poorly understood. We therefore assessed the immunoregulatory role of CD4+FOXP3+ regulatory T (Treg) cells in a model of Crohn's-like ileitis and concomitant arthritis. METHODS RNA-sequencing and flow cytometry was performed on inflamed gut and joint samples and tissue-derived Tregs from tumour necrosis factor (TNF)∆ARE mice. In situ hybridisation of TNF and its receptors (TNFR) was applied to human SpA gut biopsies. Soluble TNFR (sTNFR) levels were measured in serum of mice and patients with SpA and controls. Treg function was explored by in vitro cocultures and in vivo by conditional Treg depletion. RESULTS Chronic TNF exposure induced several TNF superfamily (TNFSF) members (4-1BBL, TWEAK and TRAIL) in synovium and ileum in a site-specific manner. Elevated TNFR2 messenger RNA levels were noted in TNF∆ARE/+ mice leading to increased sTNFR2 release. Likewise, sTNFR2 levels were higher in patients with SpA with gut inflammation and distinct from inflammatory and healthy controls. Tregs accumulated at both gut and joints of TNF∆ARE mice, yet their TNFR2 expression and suppressive function was significantly lower in synovium versus ileum. In line herewith, synovial and intestinal Tregs displayed a distinct transcriptional profile with tissue-restricted TNFSF receptor and p38MAPK gene expression. CONCLUSIONS These data point to profound differences in immune-regulation between Crohn's ileitis and peripheral arthritis. Whereas Tregs control ileitis they fail to dampen joint inflammation. Synovial resident Tregs are particularly maladapted to chronic TNF exposure.
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Affiliation(s)
- Koen Venken
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Matthias Jarlborg
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Tine Decruy
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Céline Mortier
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Carolien Vlieghe
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Elisabeth Gilis
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Ann-Sophie De Craemer
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Julie Coudenys
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Isabelle Cambré
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Devan Fleury
- Immunology and Respiratory Department, Boehringer Ingelheim Corp Pharmaceutical Research and Development Centre Ridgefield, Ridgefield, Connecticut, USA
| | - Alexander Klimowicz
- Immunology and Respiratory Department, Boehringer Ingelheim Corp Pharmaceutical Research and Development Centre Ridgefield, Ridgefield, Connecticut, USA
| | - Filip Van den Bosch
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, University Hospital Ghent, Gent, Belgium
| | - Triana Lobaton
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Gastroenterology unit), Ghent University, Ghent, Belgium
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Sytze de Roock
- Department of Pediatric Immunology, Center for Molecular and Cellular Intervention CMCI, Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tim Sparwasser
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gerald Nabozny
- Immunology and Respiratory Department, Boehringer Ingelheim Corp Pharmaceutical Research and Development Centre Ridgefield, Ridgefield, Connecticut, USA
| | - Peggy Jacques
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
| | - Dirk Elewaut
- Molecular Immunology and Inflammation Unit, VIB Center for Inflammation Research, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics (Rheumatology unit), Ghent University, Ghent, Belgium
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12
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Arjona-Sanchez A, Martinez-López A, Moreno-Montilla MT, Mulsow J, Lozano-Lominchar P, Martínez-Torres B, Rau B, Canbay E, Sommariva A, Milione M, Deraco M, Sgarbura O, Torgunrud A, Kepenekian V, Carr NJ, Hoorens A, Delhorme JB, Wernert R, Goere D, Martin-Roman L, Cosyns S, Flatmark K, Davidson B, Khellaf L, Pereira-Perez F, Rodriguez-Ortiz L, Ibáñez-Costa A, Romero-Ruiz A. External multicentre validation of pseudomyxoma peritonei PSOGI-Ki67 classification. Eur J Surg Oncol 2023; 49:1481-1488. [PMID: 36935222 DOI: 10.1016/j.ejso.2023.03.206] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare malignant disease. Adding of the Ki67 proliferation index to the PSOGI PMP classification provided two different subcategories of the extensive HG-PMP group (HG-PMP ≤15% and HG-PMP >15%) with different survival in a previous unicentric study. This study aims to carry out an external and multicentre validation of this new proposed classification. METHOD It was a prospective analysis of samples from a historical and international cohort of patients. A representative area with higher cellular density was used to determine the Ki67%. The Ki67 proliferation index (%) was determined in all the HG-PMP patients. A Cox proportional hazard models and multivariable COX models were used. The Kaplan-Meier method and the two-tailed log-rank test were used to analyse the effect of different PSOGI-Ki67 categories on OS and DFS. Its predictive accuracy was analysed using Harrel's C-index and the ROC curve. The calibration was performed using the calibration plots matching. RESULTS After exclusions, 349 patients were available for analysis. The 5-years OS were 86% for LG-PMP, 59% for HG-PMP≤15, 38% for HG-PMP>15 and 42% for SRC-PMP (p = 0.0001). The 5-years DFS were 49% for LG-PMP, 35% for HG-PMP≤15, 16% for HG-PMP>15 and 18% SRC-PMP (p = 0.0001). The discrimination capability of PSOGI-Ki67 was validated. CONCLUSION the PSOGI-Ki67 classification discriminates and predicts the OS and DFS in patients with PMP dividing the HG-PMP category into two well-defined sub-categories. The Ki67 proliferation index should be incorporated routinely in the pathology report for these patients.
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Affiliation(s)
- A Arjona-Sanchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Spain; Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. https://twitter.com/alarjosan
| | - A Martinez-López
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Spain; Pathology Unit, Reina Sofia University Hospital, Spain
| | - M T Moreno-Montilla
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - J Mulsow
- National Centre for Peritoneal Malignancy, Mater Hospital, Dublin, Ireland
| | - P Lozano-Lominchar
- Department of General Surgery, Peritoneal Carcinomatosis, Sarcoma and Complex Pelvis Cases, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | - B Martínez-Torres
- Department of General Surgery, Hospital University Fuenlabrada, Madrid, Spain
| | - B Rau
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität, Department of Special Surgical Oncology, Berlin, Germany
| | - E Canbay
- NPO HIPEC Istanbul centre for Peritoneal Surface Malignancies, Istambul, Turkey
| | - A Sommariva
- Advanced Surgical Oncology Unit Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS Padova, Italy
| | - M Milione
- Pathology Division, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Deraco
- Peritoneal Surfaces Malignance Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - O Sgarbura
- Department of Surgical Oncology, Cancer Institute of Montpellier, University of Montpellier, IRCM, Institut de Recherche en Cancérologie de Montpellier, Université de Montpellier, Institut régional du Cancer de Montpellier, Montpellier, France
| | - A Torgunrud
- Department of Tumor Biology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | - N J Carr
- Pathology Department, Peritoneal Malignancy Institute Basingstoke, UK
| | - A Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - J B Delhorme
- Department of general and digestive surgery, Hautepierre Hospital, Hôpitaux universitaires de Strasbourg, France
| | - R Wernert
- Surgical Oncology, ICO Paul Papin, Angers, France
| | - D Goere
- Digestive Surgery, APHP Hopital Saint Louis, France
| | - L Martin-Roman
- National Centre for Peritoneal Malignancy, Mater Hospital, Dublin, Ireland
| | - S Cosyns
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - K Flatmark
- Department of Gastorenterological Surgery, The Norwegian Radium Hospital, Oslo university Hospital, Oslo, Norway
| | - B Davidson
- Department of Pathology, The Norwegian Radium Hospital, Oslo university Hospital, Oslo Norway. University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, N-0316, Oslo, Norway
| | - L Khellaf
- Department of Pathology, Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - F Pereira-Perez
- Department of General Surgery, Hospital University Fuenlabrada, Madrid, Spain
| | - L Rodriguez-Ortiz
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain; Digestive Surgery, APHP Hopital Saint Louis, France
| | - A Ibáñez-Costa
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - A Romero-Ruiz
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
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Cordier F, Hoorens A, Ferdinande L, Van Dorpe J, Creytens D. Inflammatory myofibroblastic tumor of the distal common bile duct: Literature review with focus on pathological examination. World J Clin Cases 2023; 11:4734-4739. [PMID: 37584005 PMCID: PMC10424039 DOI: 10.12998/wjcc.v11.i20.4734] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 07/06/2023] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) of the biliary tract is rare, and often difficult to diagnose or to distinguish from other tumors due to its atypical clinical presentation and nonspecific radiological features. Histologically, IMTs are (myo)fibroblastic neoplasms with a prominent inflammatory infiltrate. They are characterized by receptor tyrosine kinase gene rearrangements, most often involving an anaplastic lymphoma kinase (ALK) translocation. The final diagnosis of IMT depends on histopathology and immunohistochemical examination. In this manuscript, we provide a clinical and morphomolecular overview of IMT and the difficulties that may arise in using immunohistochemical and molecular techniques in diagnosing IMT.
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Affiliation(s)
- Fleur Cordier
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
| | | | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
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14
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Desmedt V, Jauregui-Amezaga A, Fierens L, Aspeslagh S, Dekervel J, Wauters E, Peeters M, Sabino J, Crapé L, Somers M, Hoorens A, Dutré J, Lobatón T. Position statement on the management of the immune checkpoint inhibitor-induced colitis via multidisciplinary modified Delphi consensus. Eur J Cancer 2023; 187:36-57. [PMID: 37116287 DOI: 10.1016/j.ejca.2023.03.025] [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: 07/20/2022] [Revised: 02/10/2023] [Accepted: 03/23/2023] [Indexed: 04/30/2023]
Abstract
INTRODUCTION The use of immune checkpoint inhibitors (ICIs) in cancer immunotherapy has shown increased overall survival in a wide range of cancer types with the associated risk of developing severe immune-mediated adverse events, commonly involving the gastrointestinal tract. AIM The aim of this position statement is to provide an updated practice advice to the gastroenterologists and oncologists on the diagnosis and management of ICI-induced gastrointestinal toxicity. METHODOLOGY The evidence reviewed in this paper includes a comprehensive search strategy of English language publications. Consensus was reached using a three-round modified Delphi methodology and approved by the members of the Belgian Inflammatory Bowel Disease Research and Development Group (BIRD), Belgian Society of Medical Oncology (BSMO), Belgian group of Digestive Oncology (BGDO), and Belgian Respiratory Society (BeRS). CONCLUSIONS The management of ICI-induced colitis requires an early multidisciplinary approach. A broad initial assessment is necessary (clinical presentation, laboratory markers, endoscopic and histologic examination) to confirm the diagnosis. Criteria for hospitalisation, management of ICIs, and initial endoscopic assessment are proposed. Even if corticosteroids are still considered the first-line therapy, biologics are recommended as an escalation therapy and as early treatment in patients with high-risk endoscopic findings.
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Affiliation(s)
- Valérie Desmedt
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Belgium
| | - Aranzazu Jauregui-Amezaga
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Belgium; Laboratory of Experimental Medicine and Pediatrics (LEMP), Division of Gastroenterology-Hepatology, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.
| | - Liselotte Fierens
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), Catholic University of Leuven, Belgium
| | | | - Jeroen Dekervel
- Department of Gastroenterology and Hepatology, University Hospital Leuven, Belgium
| | - Els Wauters
- Respiratory Oncology Unit (Pulmonology), University Hospitals KU Leuven, Leuven, Belgium; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Marc Peeters
- Department of Digestive Oncology, University Hospital Antwerp, Belgium
| | - Joao Sabino
- Department of Gastroenterology and Hepatology, University Hospital Leuven, Belgium
| | - Lara Crapé
- Department of Gastroenterology, Algemeen Stedelijk Ziekenhuis Aalst, Belgium
| | - Michael Somers
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Belgium
| | - Anne Hoorens
- Department of Pathology, University Hospital Ghent, Belgium
| | - Joris Dutré
- Department of Gastroenterology, Ziekenhuis Netwerk Antwerpen Jan Palfijn, Belgium
| | - Triana Lobatón
- Department of Gastroenterology and Hepatology, University Hospital Ghent, Belgium; Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
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15
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Ferdinande K, Lamiroy T, Hoorens A, Verhelst X, Degroote H, Raevens S, Van Vlierberghe H, Geerts A. An unusual cause of portal hypertension. Acta Gastroenterol Belg 2023; 86:509-510. [PMID: 37814574 DOI: 10.51821/86.3.11925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
A 66-year-old male with a medical history of coronary artery disease presented with nonspecific symptoms of anorexia, lethargy and an increase in abdominal girth. He was diagnosed 3 months ago with chronic liver disease of undetermined aetiology. He did not smoke and was a social drinker till 4 months ago. He was taking tests showed progressive cholestatic liver enzymes (total bilirubin 1,09 mg/dL, AST 130 U/L, ALT 129 U/L, GGT 517 U/L and ALP 641 U/L) and a severe hypoalbuminemia. Laboratory workup made a metabolic, autoimmune, and viral aetiology of the suspected cirrhosis less probable. Urinalysis showed a rapidly progressive proteinuria in the nephrotic range accompanied by the presence of serum spike of monoclonal lambda light Furosemide, Aldactone, Pantoprazole, Acetylcysteine and Atorvastatin. He had no personal or familial history of liver diseases. Physical examination revealed a tender but distended abdomen and large ascites was present. The laboratory chain protein on electrophoresis with immunofixation. Doppler echocardiography revealed a hypertrophic cardiomyopathy based on diffuse left and right ventricular hypertrophy with relative apical sparing. A diagnostic paracentesis was undertaken and the results were consistent with portal hypertension (SAAG 1,6 g/ dL). Considering the concomitant presence of hypertrophic cardiomyopathy, nephrotic syndrome and a presentation of portal hypertension of undetermined aetiology in presence of a monoclonal IgG lambda light chain spike, a transjugular liver biopsy (figure 1 and 2) was performed with HVPG measurement consistent with significant portal hypertension (15 mmHg).
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Affiliation(s)
- K Ferdinande
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - T Lamiroy
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - A Hoorens
- Department of Pathology, Ghent University Hospital, Belgium
| | - X Verhelst
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - H Degroote
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - S Raevens
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - H Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
| | - A Geerts
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Belgium
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16
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Nuzhat N, Van Schil K, Liakopoulos S, Bauwens M, Rey AD, Käseberg S, Jäger M, Willer JR, Winter J, Truong HM, Gruartmoner N, Van Heetvelde M, Wolf J, Merget R, Grasshoff-Derr S, Van Dorpe J, Hoorens A, Stöhr H, Mansard L, Roux AF, Langmann T, Dannhausen K, Rosenkranz D, Wissing KM, Van Lint M, Rossmann H, Häuser F, Nürnberg P, Thiele H, Zechner U, Pearring JN, De Baere E, Bolz HJ. CEP162 deficiency causes human retinal degeneration and reveals a dual role in ciliogenesis and neurogenesis. J Clin Invest 2023; 133:e161156. [PMID: 36862503 PMCID: PMC10104899 DOI: 10.1172/jci161156] [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: 04/18/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Defects in primary or motile cilia result in a variety of human pathologies, and retinal degeneration is frequently associated with these so-called ciliopathies. We found that homozygosity for a truncating variant in CEP162, a centrosome and microtubule-associated protein required for transition zone assembly during ciliogenesis and neuronal differentiation in the retina, caused late-onset retinitis pigmentosa in 2 unrelated families. The mutant CEP162-E646R*5 protein was expressed and properly localized to the mitotic spindle, but it was missing from the basal body in primary and photoreceptor cilia. This impaired recruitment of transition zone components to the basal body and corresponded to complete loss of CEP162 function at the ciliary compartment, reflected by delayed formation of dysmorphic cilia. In contrast, shRNA knockdown of Cep162 in the developing mouse retina increased cell death, which was rescued by expression of CEP162-E646R*5, indicating that the mutant retains its role for retinal neurogenesis. Human retinal degeneration thus resulted from specific loss of the ciliary function of CEP162.
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Affiliation(s)
- Nafisa Nuzhat
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristof Van Schil
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Sandra Liakopoulos
- Cologne Image Reading Center, Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
| | - Miriam Bauwens
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Alfredo Dueñas Rey
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Stephan Käseberg
- Institute of Human Genetics, University Medical Center Mainz, Mainz, Germany
| | - Melanie Jäger
- Department of Ophthalmology, Justus-Liebig-University Giessen, Giessen, Germany
- Augenarztpraxis Bad Brückenau, Bad Brückenau, Germany
| | | | - Jennifer Winter
- Institute of Human Genetics, University Medical Center Mainz, Mainz, Germany
| | - Hanh M. Truong
- Cell and Molecular Biology Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Nuria Gruartmoner
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Mattias Van Heetvelde
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | | | | | | | - Jo Van Dorpe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Heidi Stöhr
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Luke Mansard
- Laboratoire de Génétique Moléculaire, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Anne-Françoise Roux
- Laboratoire de Génétique Moléculaire, CHU de Montpellier, Université de Montpellier, Montpellier, France
| | - Thomas Langmann
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Katharina Dannhausen
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - David Rosenkranz
- Senckenberg Centre for Human Genetics, Frankfurt am Main, Germany
| | | | - Michel Van Lint
- Department of Ophthalmology, Brussels University Hospital, Jette, Belgium
| | - Heidi Rossmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Friederike Häuser
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Holger Thiele
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ulrich Zechner
- Institute of Human Genetics, University Medical Center Mainz, Mainz, Germany
- Senckenberg Centre for Human Genetics, Frankfurt am Main, Germany
| | - Jillian N. Pearring
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Ophthalmology and
- Cell and Molecular Biology Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Elfride De Baere
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Hanno J. Bolz
- Senckenberg Centre for Human Genetics, Frankfurt am Main, Germany
- Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany
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17
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Hoorens A, Borbath I, Vandamme T, Verslype C, Demetter P, Cuyle PJ, Ribeiro S, Van Damme N, Geboes KP. Belgian guidelines for pathology reporting of neuroendocrine neoplasms of the pancreaticobiliary and gastrointestinal tract. Acta Gastroenterol Belg 2023; 86:345-351. [PMID: 37428168 DOI: 10.51821/86.2.11309] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Since neuroendocrine neoplasms are rare tumors, registration of patient data in national and multinational registries is recommended. Indeed, this will facilitate multicenter studies on the epidemiology, efficacy and safety of diagnostic and therapeutic strategies for well-differentiated neuroendocrine tumors as well as for neuroendocrine carcinomas. In Belgium, data on patient and tumor characteristics of all newly diagnosed malignancies have been collected in the Belgian Cancer Registry since 2004 including anonymized full pathological reports. The Digestive Neuroendocrine Tumor (DNET) registry collects information on classification, staging, diagnostic tools and treatment in a prospective national online database. However, the terminology, classification and staging systems of neuroendocrine neoplasms have changed repeatedly over the past 20 years as a result of a better understanding of these rare tumors, by joining forces internationally. These frequent changes make it very difficult to exchange data or perform retrospective analyses. For optimal decision making, for a clear understanding and to allow reclassification according to the latest staging system, several items need to be described in the pathology report. This paper provides an overview of the essential items in reporting neuroendocrine neoplasms of the pancreaticobiliary and gastrointestinal tract.
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Affiliation(s)
- A Hoorens
- Department of Pathology, UZ Gent, C Heymanslaan 10, 9000 Gent, Belgium
| | - I Borbath
- Department of Gastroenterology, Cliniques Universitaires Saint Luc, Brussels,Belgium
| | - T Vandamme
- Department of Oncology, UZ Antwerpen, Antwerpen, Belgium
| | - C Verslype
- Department of Gastroenterology, UZ Leuven, Leuven, Belgium
| | - P Demetter
- Department of Pathology, Jules Bordet Institute, Anderlecht, Belgium
| | - P J Cuyle
- Department of Gastroenterology, Imelda Bonheiden, Bonheiden, Belgium
| | - S Ribeiro
- Department of Gastroenterology, UZ Gent, Gent, Belgium
| | - N Van Damme
- Belgian Cancer Registry, Sint-Joost-ten-Node, Belgium
| | - K P Geboes
- Department of Gastroenterology, UZ Gent, Gent, Belgium
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18
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Maris L, De Man K, Gryspeerdt F, Hoorens A, Keereman V, Kiekens A, Van den Broeck B, Van de Sande L, Vanhove C, Berrevoet F. 18F-FDG-PET-CT specimen imaging for perioperative visualization of pancreatic adenocarcinoma: a proof-of-concept study. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.445] [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: 02/25/2023]
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19
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De Craemer AS, Witte T, Lobaton Ortega T, Hoorens A, De Vos M, Cuvelier C, Vastert SJ, Baraliakos X, Van den Bosch F, Elewaut D. Anti-CD74 IgA antibodies show diagnostic potential for axial spondyloarthritis but are not associated with microscopic gut inflammation. Rheumatology (Oxford) 2023; 62:984-990. [PMID: 35781486 DOI: 10.1093/rheumatology/keac384] [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: 02/10/2022] [Revised: 06/25/2022] [Accepted: 06/25/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Gut inflammation commonly occurs in axial SpA (axSpA), and is linked to disease activity and outcome. Given the role of IgA in mucosal immunity, we explored the association between anti-CD74 IgA antibodies, gut inflammation and axSpA. METHODS Anti-CD74 IgA was measured by ELISA in serum samples of axSpA patients, fulfilling the 2009 Assessment of SpondyloArthritis international Society classification criteria. A group of fibromyalgia (FM) and RA patients served as non-inflammatory and inflammatory controls. Newly diagnosed axSpA patients underwent ileocolonoscopy; mucosal biopsies were histopathologically assessed as normal, acute or chronically inflamed. Optimal anti-CD74 IgA cut-off values were determined with a receiver operating characteristics curve. RESULTS axSpA patients (n = 281) showed higher anti-CD74 IgA levels [mean (s.d.) 18.8 (12.4) U/ml] compared with 100 FM patients [10.9 (5.0) U/ml, P < 0.001] and 34 RA patients [13.7 (9.6) U/ml, P = 0.02]. The area under the receiver operating characteristics curve for diagnosis (axSpA vs FM) was 0.70, providing a sensitivity of 60% and specificity of 87% (cut-off 15 U/ml). Antibody concentrations were not significantly different between axSpA patients with (n = 40) and without (n = 69) gut inflammation (P = 0.83), yielding an area under the receiver operating characteristics curve of 0.51. Anti-CD74 IgA levels were not associated with degree of bone marrow oedema on MRI of the sacroiliac joints, CRP or any other disease-specific feature such as the use of NSAIDs or biological treatment. CONCLUSION Serum anti-CD74 IgA is a potentially useful diagnostic biomarker for axSpA. However, antibody levels do not correlate with any phenotypical feature, including microscopic gut inflammation, suggesting this to be a disease-specific rather than an inflammatory marker.
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Affiliation(s)
- Ann-Sophie De Craemer
- Department of Internal Medicine and Pediatrics, Ghent University
- Department of Rheumatology, Ghent University Hospital, Ghent
- Center for Inflammation Research, Molecular Immunology and Inflammation Unit, VIB-UGent, Zwijnaarde, Belgium
| | - Torsten Witte
- Department of Rheumatology and Clinical Immunology, Medical School Hannover, Hannover, Germany
| | - Triana Lobaton Ortega
- Department of Internal Medicine and Pediatrics, Ghent University
- Department of Gastroenterology
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Martine De Vos
- Department of Internal Medicine and Pediatrics, Ghent University
- Department of Gastroenterology
| | - Claude Cuvelier
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Sebastiaan J Vastert
- Department of Pediatric Rheumatology and Immunology, Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | | | - Filip Van den Bosch
- Department of Internal Medicine and Pediatrics, Ghent University
- Department of Rheumatology, Ghent University Hospital, Ghent
- Center for Inflammation Research, Molecular Immunology and Inflammation Unit, VIB-UGent, Zwijnaarde, Belgium
| | - Dirk Elewaut
- Department of Internal Medicine and Pediatrics, Ghent University
- Department of Rheumatology, Ghent University Hospital, Ghent
- Center for Inflammation Research, Molecular Immunology and Inflammation Unit, VIB-UGent, Zwijnaarde, Belgium
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20
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Mosquera-Romero S, Anaya-Garzon J, Garcia-Timermans C, Van Dorpe J, Hoorens A, Commenges-Bernole N, Verbeken K, Rabaey K, Varia J. Combined Gold Recovery and Nanoparticle Synthesis in Microbial Systems Using Fractional Factorial Design. Nanomaterials (Basel) 2022; 13:83. [PMID: 36615993 PMCID: PMC9824045 DOI: 10.3390/nano13010083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Green synthesis of gold nanoparticles (AuNPs) using microorganisms has been generally studied aiming for high-yield production and morphologies appropriated for various applications, such as bioremediation, (bio)sensors, and (bio)catalysis. Numerous approaches showed the individual effect of factors influencing the synthesis of AuNPs with limited analysis of the governing factors enhancing the production and desired quality of the precipitates. This study proposes a fractional-factorial design to investigate the simultaneous influence of seven environmental factors (cell concentration, temperature, anoxic/oxic conditions, pH, gold concentration, electron donor type, and bacterial species) on the recovery yield and synthesis of targeted AuNPs. Various sizes and morphologies of the AuNPs were obtained by varying the environmental factors studied. The factors with significant effects (i.e., 0.2 mM Au and pH 5) were selected according to statistical analysis for optimal removal of 88.2 ± 3.5% of gold and with the production of valuable 50 nm AuNPs, which are known for their enhanced sensitivity. Implications of the cytochrome-C on the bacterial mechanisms and the provision of electron donors via an electrochemical system are further discussed. This study helps develop gold recovery and nanoparticle synthesis methods, focusing on the determining factor(s) for efficient, low-cost, green synthesis of valuable materials.
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Affiliation(s)
- Suanny Mosquera-Romero
- Center for Microbial Ecology & Technology (CMET), Ghent University, Coupure Links 653, B-9000 Gent, Belgium
- ESPOL Polytechnic University, Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias Naturales y Matemáticas, Campus Gustavo Galindo km. 30.5 Vía Perimetral, Guayaquil P.O. Box 09-01-5863, Ecuador
| | - Juan Anaya-Garzon
- Center for Microbial Ecology & Technology (CMET), Ghent University, Coupure Links 653, B-9000 Gent, Belgium
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, Grenoble INP (Institute of Engineering and Management University Grenoble Alpes), LEPMI, 38000 Grenoble, France
| | - Cristina Garcia-Timermans
- Center for Microbial Ecology & Technology (CMET), Ghent University, Coupure Links 653, B-9000 Gent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Entrance 23, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Entrance 23, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Nadine Commenges-Bernole
- University Grenoble Alpes, University Savoie Mont Blanc, CNRS, Grenoble INP (Institute of Engineering and Management University Grenoble Alpes), LEPMI, 38000 Grenoble, France
| | - Kim Verbeken
- Department of Materials, Textiles and Chemical Engineering, Ghent University, Technologiepark-Zwijnaarde 46, B-9052 Gent, Belgium
| | - Korneel Rabaey
- Center for Microbial Ecology & Technology (CMET), Ghent University, Coupure Links 653, B-9000 Gent, Belgium
- Centre for Advanced Process Technology for Urban Resource Recovery (CAPTURE), Frieda Saeysstraat 1, B-9000 Ghent, Belgium
| | - Jeet Varia
- Center for Microbial Ecology & Technology (CMET), Ghent University, Coupure Links 653, B-9000 Gent, Belgium
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21
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Deroo L, Hoorens A, Verhelst X, Degroote H, Van Vlierberghe H, Geerts A. Rare case of ascites several years after liver transplantation. Gastroenterol Rep (Oxf) 2022; 10:goac076. [PMID: 36479156 PMCID: PMC9722221 DOI: 10.1093/gastro/goac076] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Liesbeth Deroo
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Xavier Verhelst
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Helena Degroote
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Hans Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Anja Geerts
- Corresponding author. Department of Gastroenterology and Hepatology, Ghent University Hospital, De Pintelaan 185, 1K12IE, B-9000 Ghent, Belgium. Tel: +32-9-332-2371;
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22
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Anné F, Snauwaert C, Vandeputte L, Berrevoet F, Van Huysse J, Van Dorpe J, Hoorens A. The added value of peroral cholangioscopy to diagnose intraductal papillary neoplasm of the bile duct. Endoscopy 2022; 54:E759-E760. [PMID: 35477119 DOI: 10.1055/a-1792-2395] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Florence Anné
- Ghent University Faculty of Medicine and Health Sciences, Department of Hepatology and Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Christophe Snauwaert
- Department of Hepatology and Gastroenterology, AZ Sint-Jan Bruges-Ostend AV, Bruges, Belgium
| | - Lieven Vandeputte
- Department of Hepatology and Gastroenterology, AZ Sint-Jan Bruges-Ostend AV, Bruges, Belgium
| | - Frederik Berrevoet
- Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium
| | | | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
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23
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Deleersnijder D, Laurens W, De Meester J, Cleenders E, Dendooven A, Lerut E, De Vriese AS, Dejagere T, Helbert M, Hellemans R, Koshy P, Maes B, Pipeleers L, Van Craenenbroeck AH, Van Laecke S, Vande Walle J, Couttenye MM, Meeus G, Sprangers B, De Rycke A, Bogaert AM, Woestenburg A, Denys B, Maes B, Peeters D, Vanbelleghem H, Donck J, Scharpé J, De Clippeleir N, Colson A, Meyvis K, Vandepitte K, Reyns LM, Peeters J, Decupere M, Helbert M, Zeegers M, Neirynck N, Bernaert P, Dejagere T, Lemahieu W, Sprangers B, Pipeleers L, Hellemans R, Van Laecke S, Knops N, Levtchenko E, Walle JV, Karamaria S, Van Hoeck K, Trouet D, Mauel R, Dendooven A, Hoorens A, Van Dorpe J, Praet M, Geers C, Lerut E, Koshy P, Roskams T, Aydin S, Siozopoulou V, Schelfhout AM, De Raeve H, Steenkiste E, Dedeurwaerdere F, Dalle I, Cokelaere K, Deloose S, De Paepe P, Van Eyken P. Clinicopathological characteristics and disease chronicity in native kidney biopsies in Flanders. Clin Kidney J 2022; 16:125-137. [PMID: 36726429 PMCID: PMC9871845 DOI: 10.1093/ckj/sfac208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Background The Flemish Collaborative Glomerulonephritis Group (FCGG) registry provides complete population data on kidney disease epidemiology in the region of Flanders (Belgium), as it captures all native kidney biopsies performed in its population of 6.5 million inhabitants. Methods From 2017 until 2019, 2054 adult kidney biopsies were included from 26 nephrology centers (one biopsy per patient). Data on nephrotic and nephritic syndrome were available in 1992 and 2026 biopsies, respectively. In a subgroup of 898 biopsies containing ≥10 glomeruli from 2018 to 2019, disease chronicity was graded using the Mayo Clinic Chronicity Score (MCCS). The association between clinical variables and MCCS was determined using simple and multiple linear regression models. Results Nephrotic syndrome (present in 378 patients, 19.0%) was most frequently caused by minimal change disease in younger patients (18-44 years), membranous nephropathy in older patients (45-74 years) and amyloidosis in the elderly (>75 years). Nephritic syndrome (present in 421 patients, 20.8%) was most frequently caused by immunoglobulin A nephropathy (IgAN) in younger patients (18-64 years) and ANCA-associated vasculitis (AAV) in older patients (>64 years). AAV and IgAN were the most frequent underlying diagnoses in biopsies in which crescents were identified. In multivariable analysis, acute and chronic kidney disease and diagnoses of diabetic kidney disease, nephrosclerosis and hyperoxaluria/hypercalcemic nephropathy were associated with the highest MCCS increases. Conclusions The FCGG registry validates data from previous Western European registries and provides a snapshot of disease chronicity in the whole biopsied Flemish population.
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Affiliation(s)
| | | | - Johan De Meester
- Department of Nephrology and Dialysis, VITAZ Hospital, Sint-Niklaas, Belgium
| | - Evert Cleenders
- Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
| | - Amélie Dendooven
- Division of Pathology, University Hospital Ghent, Ghent, Belgium,Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
| | - Evelyne Lerut
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium,Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - An S De Vriese
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium,Department of Nephrology and Infectious Diseases, AZ Sint-Jan, Brugge, Belgium
| | - Tom Dejagere
- Department of Nephrology, Jessa Hospital, Hasselt, Belgium
| | - Mark Helbert
- Department of Nephrology, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Rachel Hellemans
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium,Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Priyanka Koshy
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Maes
- Department of Nephrology, AZ Delta, Roeselare, Belgium
| | - Lissa Pipeleers
- Department of Nephrology, University Hospital Brussels, Brussels, Belgium
| | - Amaryllis H Van Craenenbroeck
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium,Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
| | - Steven Van Laecke
- Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium,Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Marie M Couttenye
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium,Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Gert Meeus
- Department of Nephrology, AZ Groeninge Hospital, Kortrijk, Belgium
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24
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Deolet E, Callewaert B, Geldof J, Van Biervliet S, Vande Velde S, Van Dorpe J, Van Winckel M, Hoorens A. Apoptotic enteropathy, gluten intolerance, and IBD-like inflammation associated with lipotoxicity in DGAT1 deficiency-related diarrhea: a case report of a 17-year-old patient and literature review. Virchows Arch 2022; 481:785-791. [PMID: 35763111 DOI: 10.1007/s00428-022-03365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
We present a long-term follow-up in a 17-year-old girl with DGAT1-related diarrhea, an autosomal recessive disorder characterized by impaired triglyceride absorption. Neonatal presentation included severe congenital diarrhea, protein-losing enteropathy, and failure to thrive requiring total parenteral nutrition. Duodenal biopsies revealed apoptotic enteropathy and acute inflammation with the presence of macrophages and Touton giant cells, related to the intake of fat. She was able to switch to enteral nutrition on a fat-free diet. However, at age 10, she developed gluten-induced enteropathy and then IBD-like inflammation 5 years later. Immunohistochemistry was able to confirm the diagnosis, while DGAT1 sequencing remained inconclusive. This highlights the role of histopathology and immunohistochemistry, despite the increasing importance of genetic analysis in the diagnostic work-up. This report also illustrates that parenteral nutrition weaning is possible in DGAT1-related diarrhea, but gut barrier dysfunction might increase the risk of autoimmune intestinal disease.
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Affiliation(s)
- Ellen Deolet
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Bert Callewaert
- Center for Medical Genetics, Ghent University Hospital, 9000, Ghent, Belgium.,Department of Biomolecular Medicine, Ghent University, 9000, Ghent, Belgium
| | - Jeroen Geldof
- Department of Gastroenterology and Hepatology, Ghent University Hospital, 9000, Ghent, Belgium
| | | | - Saskia Vande Velde
- Department of Paediatric Gastroenterology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Myriam Van Winckel
- Department of Paediatric Gastroenterology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
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25
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Puengel T, Lefere S, Hundertmark J, Kohlhepp M, Penners C, Van de Velde F, Lapauw B, Hoorens A, Devisscher L, Geerts A, Boehm S, Zhao Q, Krupinski J, Charles ED, Zinker B, Tacke F. Combined Therapy with a CCR2/CCR5 Antagonist and FGF21 Analogue Synergizes in Ameliorating Steatohepatitis and Fibrosis. Int J Mol Sci 2022; 23:ijms23126696. [PMID: 35743140 PMCID: PMC9224277 DOI: 10.3390/ijms23126696] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: With new potential drug targets emerging, combination therapies appear attractive to treat non-alcoholic steatohepatitis (NASH) and fibrosis. Chemokine receptor CCR2/5 antagonists can improve fibrosis by reducing monocyte infiltration and altering hepatic macrophage subsets. Fibroblast growth factor 21 (FGF21) may improve NASH by modulating lipid and glucose metabolism. We compared effects of single drug to combination treatment as therapeutic strategies against NASH. (2) Methods: We analyzed serum samples and liver biopsies from 85 nonalcoholic fatty liver disease (NAFLD) patients. A CCR2/5 inhibitor (BMS-687681-02-020) and a pegylated FGF21 agonist (BMS-986171) were tested in male C57BL/6J mice subjected to dietary models of NASH and fibrosis (choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD) up to 12 weeks; short- (2w) or long-term (6w) treatment). (3) Results: In NAFLD patients, chemokine CCL2 and FGF21 serum levels correlated with inflammatory serum markers, only CCL2 was significantly associated with advanced liver fibrosis. In rodent NASH, CCR2/5 inhibition significantly reduced circulating Ly6C+ monocytes and hepatic monocyte-derived macrophages, alongside reduced hepatic inflammation and fibrosis. FGF21 agonism decreased body weight, liver triglycerides and histological NASH activity. Combination treatment reflected aspects of both compounds upon short- and long-term application, thereby amplifying beneficial effects on all aspects of steatohepatitis and fibrosis. (4) Conclusions: CCR2/5 inhibition blocks hepatic infiltration of inflammatory monocytes, FGF21 agonism improves obesity-related metabolic disorders. Combined therapy ameliorates steatohepatitis and fibrosis more potently than single drug treatment in rodent NASH, corroborating the therapeutic potential of combining these two approaches in NASH patients.
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Affiliation(s)
- Tobias Puengel
- Department of Hepatology & Gastroenterology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353 Berlin, Germany; (J.H.); (M.K.); (F.T.)
- Berlin Institute of Health (BIH), 10178 Berlin, Germany
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany;
- Correspondence: (T.P.); (S.L.); Tel.: +49-30-450-630-057 (T.P.); +49-30-450-553-022 (S.L.)
| | - Sander Lefere
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany;
- Hepatology Research Unit, Department of Internal Medicine and Pediatrics, Liver Research Center Ghent, Ghent University, B-9000 Ghent, Belgium;
- Correspondence: (T.P.); (S.L.); Tel.: +49-30-450-630-057 (T.P.); +49-30-450-553-022 (S.L.)
| | - Jana Hundertmark
- Department of Hepatology & Gastroenterology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353 Berlin, Germany; (J.H.); (M.K.); (F.T.)
| | - Marlene Kohlhepp
- Department of Hepatology & Gastroenterology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353 Berlin, Germany; (J.H.); (M.K.); (F.T.)
| | - Christian Penners
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany;
| | | | - Bruno Lapauw
- Department of Endocrinology, Ghent University, B-9000 Ghent, Belgium; (F.V.d.V.); (B.L.)
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, B-9000 Ghent, Belgium;
| | - Lindsey Devisscher
- Gut-Liver Immunopharmacology Unit, Department of Basic and Applied Medical Sciences, Liver Research Center Ghent, Ghent University, B-9000 Ghent, Belgium;
| | - Anja Geerts
- Hepatology Research Unit, Department of Internal Medicine and Pediatrics, Liver Research Center Ghent, Ghent University, B-9000 Ghent, Belgium;
| | - Stephanie Boehm
- Bristol-Myers Squibb, Princeton, NJ 08540, USA; (S.B.); (Q.Z.); (J.K.); (E.D.C.); (B.Z.)
| | - Qihong Zhao
- Bristol-Myers Squibb, Princeton, NJ 08540, USA; (S.B.); (Q.Z.); (J.K.); (E.D.C.); (B.Z.)
| | - John Krupinski
- Bristol-Myers Squibb, Princeton, NJ 08540, USA; (S.B.); (Q.Z.); (J.K.); (E.D.C.); (B.Z.)
| | - Edgar D. Charles
- Bristol-Myers Squibb, Princeton, NJ 08540, USA; (S.B.); (Q.Z.); (J.K.); (E.D.C.); (B.Z.)
| | - Bradley Zinker
- Bristol-Myers Squibb, Princeton, NJ 08540, USA; (S.B.); (Q.Z.); (J.K.); (E.D.C.); (B.Z.)
| | - Frank Tacke
- Department of Hepatology & Gastroenterology, Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), 13353 Berlin, Germany; (J.H.); (M.K.); (F.T.)
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26
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Kestens L, Van Acker L, Hoorens A, Kreps EO, Haerynck F, Debrock A, Catry V, Weyers S, Roelens K, Van Braeckel E. A case of disseminated tuberculosis during a twin pregnancy following in vitro fertilization. Int J Infect Dis 2022; 120:41-43. [DOI: 10.1016/j.ijid.2022.04.014] [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] [Received: 02/09/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022] Open
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27
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Gijbels E, De Muynck K, Vanderborght B, Meese T, Van Nieuwerburgh F, Vanlander A, Berrevoet F, Hendrikx B, Hoorens A, Van Vlierberghe H, Vinken M, Devisscher L. Systematic comparison of experimental and human obstructive cholestasis reveals conservation of canonical pathway activation and biomarkers relevant for cholestatic liver disease. Genes Dis 2022; 10:18-21. [PMID: 37013051 PMCID: PMC10066269 DOI: 10.1016/j.gendis.2022.02.003] [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] [Received: 10/01/2021] [Revised: 01/31/2022] [Accepted: 02/21/2022] [Indexed: 10/18/2022] Open
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28
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Laurens W, Deleersnijder D, Dendooven A, Lerut E, De Vriese AS, Dejagere T, Helbert M, Hellemans R, Koshy P, Maes B, Pipeleers L, Van Craenenbroeck AH, Van Laecke S, Walle JV, Coutteneye MM, De Meester J, Sprangers B, De Vriese A, De Rycke A, Bogaert AM, Woestenburg A, Denys B, Maes B, Peeters D, Vanbelleghem H, Donck J, Scharpé J, De Clippeleir N, Vanparys J, Meyvis K, Vandepitte K, Reyns LM, Verresen L, Decupere M, Helbert M, Zeegers M, Neirynck N, Bernaert P, Dejagere T, Lemahieu W, Sprangers B, Pipeleers L, Hellemans R, Van Laecke S, Levtchenko E, Karamaria S, Van Hoeck K, Trouet D, Mauel R, Dendooven A, Hoorens A, Van Dorpe J, Praet M, Geers C, Lerut E, Koshy P, Roskams T, Aydin S, Siozopoulou V, Schelfhout AM, De Raeve H, Steenkiste E, Dedeurwaerdere F, Dalle I, Cokelaere K, Deloose S, De Paepe P, Van Eyken P. Epidemiology of native kidney disease in Flanders: results from the FCGG kidney biopsy registry. Clin Kidney J 2022; 15:1361-1372. [PMID: 35756729 PMCID: PMC9217646 DOI: 10.1093/ckj/sfac033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background The Flemish Collaborative Glomerulonephritis Group (FCGG) registry is the first population-based native kidney biopsy registry in Flanders, Belgium. In this first analysis, we report on patient demographics, frequency distribution and incidence rate of biopsied kidney disease in adults in Flanders. Methods From January 2017 to December 2019, a total of 2054 adult first native kidney biopsies were included. A ‘double diagnostic coding’ strategy was used, in which every biopsy sample received a histopathological and final clinical diagnosis. Frequency distribution and incidence rate of both diagnoses were reported and compared with other European registries. Results The median age at biopsy was 61.1 years (interquartile range, 46.1–71.7); male patients were more prevalent (62.1%) and biopsy incidence rate was 129.3 per million persons per year. Immunoglobulin A nephropathy was the most frequently diagnosed kidney disease (355 biopsies, 17.3% of total) with a similar frequency as in previously published European registries. The frequency of tubulointerstitial nephritis (220 biopsies, 10.7%) and diabetic kidney disease (154 biopsies, 7.5%) was remarkably higher, which may be attributed to changes in disease incidence as well as biopsy practices. Discordances between histopathological and final clinical diagnoses were noted and indicate areas for improvement in diagnostic coding systems. Conclusions The FCGG registry, with its ‘double diagnostic coding’ strategy, provides useful population-based epidemiological data on a large Western European population and allows subgroup selection for future research.
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Affiliation(s)
- Wim Laurens
- Department of Nephrology and Dialysis, AZ Nikolaas Hospital, Sint-Niklaas, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Belgium
| | - Dries Deleersnijder
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Division of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Amélie Dendooven
- Division of Pathology, University Hospital Ghent, Ghent, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
| | - Evelyne Lerut
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - An S De Vriese
- Department of Internal Medicine and Pediatrics, Ghent University, Belgium
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan, Brugge, Belgium
| | - Tom Dejagere
- Department of Nephrology, Jessa Hospital, Hasselt, Belgium
| | - Mark Helbert
- Department of Nephrology, ZNA Middelheim Hospital, Antwerp, Belgium
| | - Rachel Hellemans
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Priyanka Koshy
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bart Maes
- Department of Nephrology, AZ Delta, Roeselare, Belgium
| | - Lissa Pipeleers
- Department of Nephrology, University Hospital Brussels, Brussels, Belgium
| | - Amaryllis H Van Craenenbroeck
- Division of Nephrology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
| | - Steven Van Laecke
- Renal Division, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Johan Vande Walle
- Department of Internal Medicine and Pediatrics, Ghent University, Belgium
- Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium
| | - Marie M Coutteneye
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Johan De Meester
- Department of Nephrology and Dialysis, AZ Nikolaas Hospital, Sint-Niklaas, Belgium
| | - Ben Sprangers
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Division of Nephrology, University Hospitals Leuven, Leuven, Belgium
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29
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Guilliams M, Bonnardel J, Haest B, Vanderborght B, Wagner C, Remmerie A, Bujko A, Martens L, Thoné T, Browaeys R, De Ponti FF, Vanneste B, Zwicker C, Svedberg FR, Vanhalewyn T, Gonçalves A, Lippens S, Devriendt B, Cox E, Ferrero G, Wittamer V, Willaert A, Kaptein SJF, Neyts J, Dallmeier K, Geldhof P, Casaert S, Deplancke B, Ten Dijke P, Hoorens A, Vanlander A, Berrevoet F, Van Nieuwenhove Y, Saeys Y, Saelens W, Van Vlierberghe H, Devisscher L, Scott CL. Spatial proteogenomics reveals distinct and evolutionarily conserved hepatic macrophage niches. Cell 2022; 185:379-396.e38. [PMID: 35021063 PMCID: PMC8809252 DOI: 10.1016/j.cell.2021.12.018] [Citation(s) in RCA: 282] [Impact Index Per Article: 141.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/12/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022]
Abstract
The liver is the largest solid organ in the body, yet it remains incompletely characterized. Here we present a spatial proteogenomic atlas of the healthy and obese human and murine liver combining single-cell CITE-seq, single-nuclei sequencing, spatial transcriptomics, and spatial proteomics. By integrating these multi-omic datasets, we provide validated strategies to reliably discriminate and localize all hepatic cells, including a population of lipid-associated macrophages (LAMs) at the bile ducts. We then align this atlas across seven species, revealing the conserved program of bona fide Kupffer cells and LAMs. We also uncover the respective spatially resolved cellular niches of these macrophages and the microenvironmental circuits driving their unique transcriptomic identities. We demonstrate that LAMs are induced by local lipid exposure, leading to their induction in steatotic regions of the murine and human liver, while Kupffer cell development crucially depends on their cross-talk with hepatic stellate cells via the evolutionarily conserved ALK1-BMP9/10 axis.
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Affiliation(s)
- Martin Guilliams
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium.
| | - Johnny Bonnardel
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium
| | - Birthe Haest
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium
| | - Bart Vanderborght
- Hepatology Research Unit, Department Internal Medicine and Pediatrics, Liver Research Center, Ghent University, Belgium; Gut-Liver Immunopharmacology Unit, Department of Basic and Applied Medical Sciences, Liver Research Center, Ghent University, Belgium
| | - Camille Wagner
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium
| | - Anneleen Remmerie
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Anna Bujko
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Liesbet Martens
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Tinne Thoné
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Robin Browaeys
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Federico F De Ponti
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Bavo Vanneste
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Christian Zwicker
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Freya R Svedberg
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium
| | - Tineke Vanhalewyn
- Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Amanda Gonçalves
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Saskia Lippens
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Bert Devriendt
- Laboratory of Immunology, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Eric Cox
- Laboratory of Immunology, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Giuliano Ferrero
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Valerie Wittamer
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), Université Libre de Bruxelles (ULB), Brussels, Belgium; ULB Institute of Neuroscience (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium; WELBIO, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Andy Willaert
- Center for Medical Genetics Ghent, Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Suzanne J F Kaptein
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery, Leuven, Belgium
| | - Johan Neyts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery, Leuven, Belgium
| | - Kai Dallmeier
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery, Leuven, Belgium
| | - Peter Geldhof
- Laboratory of Parasitology, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Stijn Casaert
- Laboratory of Parasitology, Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Bart Deplancke
- Laboratory of Systems Biology and Genetics, Institute of Bioengineering, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Peter Ten Dijke
- Oncode Institute, Department of Cell and Chemical Biology, Leiden Medical Center, Leiden, Netherlands
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
| | - Aude Vanlander
- Department of General and Hepatopancreatobiliary Surgery and Liver Transplantation, Ghent University Hospital, Ghent 9000, Belgium
| | - Frederik Berrevoet
- Department of General and Hepatopancreatobiliary Surgery and Liver Transplantation, Ghent University Hospital, Ghent 9000, Belgium
| | - Yves Van Nieuwenhove
- Department of Human Structure and Repair, Ghent University Hospital, Ghent 9000, Belgium
| | - Yvan Saeys
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Wouter Saelens
- Laboratory of Systems Biology and Genetics, Institute of Bioengineering, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Hans Van Vlierberghe
- Hepatology Research Unit, Department Internal Medicine and Pediatrics, Liver Research Center, Ghent University, Belgium; Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent 9000, Belgium
| | - Lindsey Devisscher
- Gut-Liver Immunopharmacology Unit, Department of Basic and Applied Medical Sciences, Liver Research Center, Ghent University, Belgium
| | - Charlotte L Scott
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Belgium; Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium.
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Vandekerckhove E, Ameloot E, Hoorens A, De Man K, Berrevoet F, Geboes K. Intrapancreatic accessory spleen mimicking pancreatic NET: can unnecessary surgery be avoided? Acta Clin Belg 2021; 76:492-495. [PMID: 32394810 DOI: 10.1080/17843286.2020.1762351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/24/2022]
Abstract
Pancreatic nodules are frequently found incidentally and often pose a diagnostic and therapeutic challenge when surgery is considered. We present the case of a 66-year-old cirrhotic patient with a pancreatic nodule with signal intensity and contrast enhancement pattern suggestive for a non-functional neuroendocrine lesion. A 68Gallium-DOTATOC PET-CT scan revealed a correspondent focal tracer uptake in the pancreatic tail. After distal pancreatectomy, the specimen surprisingly revealed intrapancreatic splenic tissue. Nuclear imaging has previously been reported to produce a false-positive result for the presence of a neuroendocrine tumor when an intrapancreatic accessory spleen is present. This case reminds us of the diagnostic pitfalls in pancreatic nodules, to consider a broad differential diagnosis and to remain critical before referring the patient for surgery.
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Affiliation(s)
| | - Eline Ameloot
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Kathia De Man
- Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Frederik Berrevoet
- Department of Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium
| | - Karen Geboes
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
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31
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Cordier F, Hoorens A, Van Dorpe J, Creytens D. Pediatric vascular tumors of the liver: Review from the pathologist’s point of view. World J Hepatol 2021; 13:1316-1327. [PMID: 34786168 PMCID: PMC8568580 DOI: 10.4254/wjh.v13.i10.1316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/10/2021] [Accepted: 08/27/2021] [Indexed: 02/06/2023] Open
Abstract
Differential diagnosis of pediatric vascular liver tumors can be challenging due to inconsistent nomenclature, histologic overlap and the rarity of some entities. Here we give an up-to-date overview of the most important entities. We discuss the clinic, histology and pathophysiology of hepatic congenital and infantile heman gioma, hepatic epithelioid hemangioendothelioma and hepatic angiosarcoma.
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Affiliation(s)
- Fleur Cordier
- Department of Pathology, Ghent University Hospital, Ghent University, Ghent 9000, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent University, Ghent 9000, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent University, Ghent 9000, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent University, Ghent 9000, Belgium
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Waked B, De Maeyer F, Carton S, Pieter-Jan CUYLE, Vandamme T, Verslype C, Demetter P, Borbath I, Van Eycken L, Hoorens A, Geboes K, Van Damme N, Ribeiro S. Quality of pathology reporting and adherence to guidelines in rectal neuroendocrine neoplasms: a Belgian national study. Acta Clin Belg 2021; 77:823-831. [PMID: 34607538 DOI: 10.1080/17843286.2021.1985806] [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] [Indexed: 10/20/2022]
Abstract
The incidence of neuroendocrine neoplasms (NEN) in the rectum is rising since the introduction of colonoscopy screening programs. Guidelines, such as the European NeuroEndocrine Tumor Society (ENETS) algorithm, are mainly based on expert opinion. The goal of this nationwide study is to gain a better insight into the evolution in pathology reporting and adherence to the ENETS guidelines in Belgium. In Belgium, all NENs have to be reported to the Belgian Cancer Registry. We thoroughly reviewed all available pathology reports, coded as rectal NEN between 2004 and 2015, and reclassified according to World Health Organisation (WHO) classification 2019. To evaluate the adherence to the ENETS guidelines, population-based cancer registry data were linked with the medical procedures of the Belgian Health Insurance database. A total of 670 rectal NEN were retained and 16% of the cases needed reclassification. Annual incidence between 2004 and 2015 tripled from 0,20 to 0,61 per 100.000 inhabitants. Reporting of Ki67 proliferation index ameliorated most, while reporting of tumor size, lymphovascular and perineural invasion remained disappointing. Endoscopic ultrasound was performed in only 36.6% of the cases, while the mostly recommended mode of treatment (endoscopic/surgical/no resection) was followed in the majority of the cases. Incidence of rectal NEN in Belgium increased throughout the years and quality of pathology reporting improved especially after the WHO classification update in 2010. The growing awareness and knowledge among clinicians and pathologists in the community counters the need for centralization.
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Affiliation(s)
- Bruno Waked
- Ghent University Hospital, Department of Gastroenterology. Ghent, Belgium
| | - Filip De Maeyer
- Az Sint-Elisabeth Zottegem, Department of Gastroenterology. Godveerdegemstraat 69, Zottegem, Belgium
| | - Saskia Carton
- Imeldaziekenhuis, Bonheiden, Department of Gastroenterology. Bonheiden, Belgium
| | - CUYLE Pieter-Jan
- Imeldaziekenhuis, Bonheiden, Department of Gastroenterology. Bonheiden, Belgium
| | - Timon Vandamme
- Ziekenhuis Netwerk Antwerpen, Department of Gastroenterology. Antwerp, Belgium
| | - Chris Verslype
- University Hospital Gasthuisberg Leuven, Department of Gastroenterology. Leuven, Belgium
| | - Pieter Demetter
- Institute Jules Bordet, Department of Gastroenterology. Brussels, Belgium
| | - Ivan Borbath
- Cliniques Universitaires Saint-Luc, Department of Gastro-enterology. Brussels, Belgium
| | | | - Anne Hoorens
- Ghent University Hospital, Department of Pathology. Ghent, Belgium
| | - Karen Geboes
- Ghent University Hospital, Department of Gastroenterology. Ghent, Belgium
| | | | - Suzane Ribeiro
- Ghent University Hospital, Department of Gastroenterology. Ghent, Belgium
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33
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Keyzer M, Hoorens A, Van Dorpe J, Bogaert AM. Symmetric polyneuropathy after viral symptomatology - not always Guillain-Barré Syndrome. Acta Clin Belg 2021; 76:384-391. [PMID: 32167414 DOI: 10.1080/17843286.2020.1740858] [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] [Indexed: 10/24/2022]
Abstract
Introduction: Guillain-Barré Syndrome usually presents with ascending symmetric polyneuropathy, typically preceded by a viral infection. Despite the low incidence, physicians will often include Guillain-Barré Syndrome in their differential diagnosis. However, another underlying cause of polyneuropathy known as ANCA-associated vasculitis (AAV) is even more rare than Guillain-Barré Syndrome and therefore is usually overlooked. AAV has a broad spectrum of symptomatology and sometimes presents only with neurological complaints. If treated inappropriately, AAV can be lethal.Case report: In this case report, we describe a 72-year-old man presenting with complaints of symmetric polyneuropathy and paresis of both legs, initially diagnosed as Guillain-Barré Syndrome. During his treatment with intravenous immunoglobulins, he developed acute renal failure. Further investigations showed ANCA positive pauci-immune acute glomerulonephritis. This, in combination with eosinophilia and sinusitis, led to a final diagnosis of Eosinophilic Granulomatosis with Polyangiitis EGPA (Churg-Strauss disease). Induction therapy was initiated using glucocorticoids, cyclophosphamide and temporary plasmapheresis, followed by maintenance therapy with azathioprine complicated by bone marrow suppression. Azathioprine was discontinued and monotherapy with low-dose glucocorticoids was continued with the recovery of bone marrow function, good clinical condition and no relapse of vasculitis at 14 months follow-up.Conclusion: Physicians should be aware of the possible presentations of AAV. When suspected, indirect immunofluorescence assay for ANCA should be performed. When AAV is diagnosed, induction therapy should be administered as soon as possible, followed by maintenance therapy and careful follow-up, as patients are at risk for opportunistic infections, bone marrow toxicity or relapse.
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Affiliation(s)
- Michiel Keyzer
- Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathological Anatomy, Ghent University Hospital, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathological Anatomy, Ghent University Hospital, Ghent, Belgium
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Van de Bruaene C, Hoorens A, de Coninck S. Heavy on the Stomach. Gastroenterology 2021; 161:e7-e8. [PMID: 33610528 DOI: 10.1053/j.gastro.2021.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/09/2021] [Indexed: 12/02/2022]
Affiliation(s)
| | - Anne Hoorens
- Department of Pathology Ghent University Hospital, Ghent, Belgium
| | - Steven de Coninck
- Department of Gastroenterology, Sint Andries ziekenhuis Tielt, Tielt, Belgium
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35
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Affiliation(s)
- Karen Geboes
- Department of Gastroenterology, Universitair Ziekenhuis Gent, Gent, Belgium.
| | - Anne Hoorens
- Department of Pathology, Universitair Ziekenhuis Gent, Gent, Belgium
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36
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Ceelen W, De Man M, Willaert W, van Ramshorst GH, Geboes K, Hoorens A. Incidentally found mucinous epithelial tumors of the appendix with or without pseudomyxoma peritonei: diagnostic and therapeutic algorithms based on current evidence. Acta Chir Belg 2021; 121:225-234. [PMID: 33904809 DOI: 10.1080/00015458.2021.1894734] [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] [Indexed: 10/21/2022]
Abstract
Mucinous appendiceal tumors with or without the pseudomyxoma peritonei (PMP) syndrome are rare, but often present as an incidental finding. The confusing histology and lack of large prospective trials result in a considerable diagnostic and therapeutic challenge in these patients. We propose treatment algorithms in patients with incidentally found mucinous epithelial appendiceal tumors, with or without PMP, based on the currently available evidence. The therapeutic approach should take into account the histology and grade of the primary appendix tumor, as well as those of the associated peritoneal disease.
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Affiliation(s)
- Wim Ceelen
- Department ofGI Surgery, Ghent University Hospital, Ghent, Belgium
| | - Marc De Man
- Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium
| | - Wouter Willaert
- Department ofGI Surgery, Ghent University Hospital, Ghent, Belgium
| | | | - Karen Geboes
- Department of Digestive Oncology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
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Syryn H, Hoorens A, Grammatikopoulos T, Deheragoda M, Symoens S, Vande Velde S, Van Biervliet S, Van Winckel M, Verloo P, Callewaert B, De Bruyne R. Two cases of DCDC2-related neonatal sclerosing cholangitis with developmental delay and literature review. Clin Genet 2021; 100:447-452. [PMID: 34155636 DOI: 10.1111/cge.14012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022]
Abstract
Ciliopathies are a group of clinical and molecular heterogeneous conditions with pleiotropic manifestations affecting the central nervous system, renal, liver, skeletal, and ocular systems. Biallelic pathogenic variants in DCDC2 cause a ciliopathy primarily presenting with neonatal sclerosing cholangitis (NSC). Pathogenic variants in DCDC2 have further been reported in the context of nephronophthisis and non-syndromic recessive deafness. Polymorphisms in DCDC2 have also been associated with dyslexia and DCDC2 has a role in neuronal development. We report on two unrelated patients with DCDC2-related NSC with additional central nervous system impairment manifesting as microcephaly, global developmental delay, and axial hypotonia. Histological findings of our patients can mimic biliary atresia or congenital hepatic fibrosis. We further show that transmission electron microscopy in patients with NSC does not always show absence of primary cilia. Hence patients with DCDC2 pathogenic variants should also undergo an evaluation of neuromotor development. Review of all reported patients further reveals a risk for supra-aortic arterial aneurysms.
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Affiliation(s)
- Hannes Syryn
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Tassos Grammatikopoulos
- Paediatric Liver, Gastroenterology & Nutrition Centre and MowatLabs, King's College Hospital NHS Foundation Trust, London, UK
| | - Maesha Deheragoda
- Institute of Liver Studies, King's College Hospital NHS Trust, London, UK
| | - Sofie Symoens
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Saskia Vande Velde
- Department of Paediatric Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Stephanie Van Biervliet
- Department of Paediatric Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Myriam Van Winckel
- Department of Paediatric Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
| | - Patrick Verloo
- Department of Paediatric Neurology, Ghent University Hospital, Ghent, Belgium
| | - Bert Callewaert
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Ruth De Bruyne
- Department of Paediatric Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
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38
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Van de Velde F, Bekaert M, Hoorens A, Geerts A, T'Sjoen G, Fiers T, Kaufman JM, Van Nieuwenhove Y, Lapauw B. Histologically proven hepatic steatosis associates with lower testosterone levels in men with obesity. Asian J Androl 2021; 22:252-257. [PMID: 31274482 PMCID: PMC7275796 DOI: 10.4103/aja.aja_68_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Men with obesity often present with low testosterone (T) and sex hormone-binding globulin (SHBG) levels. Several mechanisms for this have been proposed, but as SHBG is secreted by hepatocytes and sex steroids undergo hepatic metabolization, this study investigates whether severity and histological components of nonalcoholic fatty liver disease (NAFLD) are associated with sex steroid levels in obese men. This cross-sectional study included 80 obese men (age: 46 ± 11 years; body mass index: 42.2 ± 5.5 kg m−2). Serum levels of total T and estradiol (E2) were measured using liquid chromatography coupled with tandem mass spectroscopy (LC/MS-MS) and SHBG and gonadotropins by immunoassay. Liver biopsies were evaluated using Steatosis, Activity, and Fibrosis scoring. Participants with steatohepatitis had similar median (1st quartile–3rd quartile) total T levels (7.6 [5.0–11.0] nmol l−1 vs 8.2 [7.2–10.9] nmol l−1; P = 0.147), lower calculated free T (cFT) levels (148.9 [122.9–188.8] pmol l−1 vs 199.5 [157.3–237.6] pmol l−1; P = 0.006), and higher free E2/T ratios (10.0 [6.4–13.9] x10-3 vs 7.1 [5.7–10.7] x10-3; P = 0.026) compared to men with only nonalcoholic fatty liver. Among the histological components of NAFLD, only steatosis was independently associated with total T (rs = −0.331, P = 0.003) and cFT levels (rs = −0.255, P = 0.025). Obese men with steatohepatitis have even lower cFT levels compared to those without, an association mainly driven by grade of steatosis. Whether this reflects a subgroup of men with a more severe obesity-related phenotype or results from direct relations between hepatic steatosis and sex steroid metabolism needs further investigation.
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Affiliation(s)
| | - Marlies Bekaert
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anja Geerts
- Department of Hepathology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Tom Fiers
- Department of Clinical Biology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Yves Van Nieuwenhove
- Department of Gastro-Intestinal Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
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Vlaemynck K, De Man M, De Man K, Hoorens A, Geboes K. Neuroendocrine tumor with diarrhea: not always the usual suspects - a case report of metastatic calcitoninoma with literature review. Acta Clin Belg 2021; 76:239-243. [PMID: 31900071 DOI: 10.1080/17843286.2020.1711668] [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] [Indexed: 10/25/2022]
Abstract
We describe a case of a 59-year-old man without relevant past medical history, presenting with chronic diarrhea and weight loss. Extensive laboratory analysis, stool cultures and gastro- and ileocolonoscopy could not identify a diagnosis. Abdominal imaging revealed a mass in the uncinate process of the pancreas with mesenteric adenopathies and liver metastases. Fine needle aspiration was compatible with a pancreatic neuroendocrine tumor with low proliferative capacity (Ki-67 <1%). Immunohistochemical staining was positive for calcitonin and serum calcitonin levels were clearly elevated. Surprisingly, 18FDG PET-CT scan was positive, but no tracer uptake was seen on 68Gallium-DOTATOC PET-CT scan. Treatment with somatostatin analogues was not successful, but long-term tumor control could be obtained with Everolimus. However, no significant effect was seen on stool frequency despite additional treatment with multiple symptomatic therapies, liver-directed therapy with radio- and chemoembolization and additional external radiotherapy to the primary pancreatic tumor. Ondansetron, eventually, seems to be the only therapy, until now, causing a decrease in stool frequency.Functioning pancreatic calcitoninomas are considered to be a rare disease entity with few literature on optimal (nuclear) imaging and treatment. We discuss molecular insights regarding these aspects that can be of great interest to nuclear medicine physicians, pathologists, endocrinologists and gastroenterologists.
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Affiliation(s)
- Kenny Vlaemynck
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Marc De Man
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Kathia De Man
- Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Karen Geboes
- Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
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40
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Ceelen W, Sandra L, Van de Sande L, Graversen M, Vermeulen A, Reynders D, Cosyns S, Hoorens A, Willaert W. Intraperitoneal aerosolized nanoparticle albumin based paclitaxel (NAB-PTX) for irresectable peritoneal metastases: A first in human phase I study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4065 Background: Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) was recently introduced in the palliative treatment of peritoneal metastases (PM). Results from preclinical experiments suggest that intraperitoneal (IP) Nab-PTX may result in superior efficacy compared to solvent based paclitaxel (PTX). We performed a phase I first-in-human trial of PIPAC using Nab-PTX in patients with PM from upper gastrointestinal, breast, or ovarian cancer. Methods: Eligible patients with biopsy-proven PM underwent up to three PIPAC treatments using Nab-PTX with a four-week interval at two university hospitals. Patients underwent laparoscopy with IP nebulization of Nab-PTX over 5 min; the procedure was completed after 30 min. The dose of Nab-PTX was escalated from 35 to 140 mg/m2 using a Bayesian approach until the maximally tolerated dose (MTD) was reached. Secondary endpoints included surgical morbidity, pharmacokinetics (PK), histological treatment response, and overall survival. Blood and tissue samples were taken after each PIPAC procedure. Population PK analysis was performed using Monolix version 2020R1. Quality of life was measured using the EORTC QLQ-C30 questionnaire and visual analogue pain scales (VAS). Results: Twenty-three patients were included. The primary tumor was gastric cancer (55%), ovarian cancer (20%), hepatobiliary or pancreatic cancer (15%), breast cancer (5%), and miscellaneous (5%). No dose limiting toxicity was observed. Grade 3 thrombopenia was observed in one patient allocated to a dose of 90 mg/m2. One patient allocated to the highest dose experienced grade 3 neutropenia one week after each PIPAC. The most frequent treatment-related toxicities were liver toxicity (grade 1 to 3, 75%) and anemia (grade 1 to 3, 70%). Eight patients (40%) showed surgical site infections including wound infection and wound dehiscence (grade 1 to 3), four of whom required treatment with antibiotics. Treatment was associated with histological response in 35% of patients, while stable disease and progressive disease were found in 35% and 30%, respectively. The absorption of PTX continued long after the end of the procedure (30 min), with the Tmax reached between 2 and 6 h after initiation of the procedure. Median tumor PTX concentrations suggested accumulation: 9.37 ng/mg, 14.78 ng/mg and 25.75 ng/mg after the first, second and third PIPAC, respectively. EORTC global health, functional, and symptom scores as well as VAS scores remained stable throughout the treatment period. Overall survival after one year was 57%. Conclusions: PIPAC with Nab-PTX may be applied safely up to a dose of 140 mg/m2 and results in a favorable PK profile and promising anticancer activity. At the MTD of 140 mg/m2, considerable surgical site infections and liver toxicity were observed. Therefore, the recommended dose for future phase II trials is 112.5 mg/m2. Clinical trial information: NCT03304210.
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Affiliation(s)
- Wim Ceelen
- Ghent University Hospital, Department of GI Surgery, Ghent, Belgium
| | - Louis Sandra
- Ghent University, Laboratory of Medical Biochemistry and Clinical Analysis, Gent, Belgium
| | | | | | - An Vermeulen
- Ghent University, Laboratory of Medical Biochemistry and Clinical Analysis, Gent, Belgium
| | - Dries Reynders
- Ghent University, Department of Applied Mathematics, Computer Science and Statistics, Ghent, Belgium
| | - Sarah Cosyns
- Ghent University, Laboratory of Experimental Surgery, Ghent, Belgium
| | - Anne Hoorens
- Ghent University Hospital, Department of Pathology, Ghent, Belgium
| | - Wouter Willaert
- Ghent University Hospital, Department of GI Surgery, Ghent, Belgium
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41
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De Vos N, Van der Meulen J, Van Der Linden M, Claes K, Candaele AS, Vanlander A, Troisi RI, Van Vlierberghe H, Smeets P, Van Dorpe J, Hoorens A. Myxoid hepatocellular adenoma, a rare variant of hepatocellular adenoma with distinct imaging features: A case report with immunohistochemical and molecular analysis and literature review. Clin Res Hepatol Gastroenterol 2021; 45:101478. [PMID: 32620388 DOI: 10.1016/j.clinre.2020.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 02/04/2023]
Abstract
Preoperative imaging and histopathology, immunohistochemistry and molecular analysis after resection of 2 hepatocellular adenomas (HCAs) (20 and 2cm) in a 53-year-old female patient were performed. On imaging, the large lesion resembled a myxoid HCA, while the small lesion resembled a more conventional HCA with a small myxoid/fluid area. On microscopy, the large lesion showed cords and nests of hepatocytes embedded in abundant myxoid matrix, while the small lesion resembled a conventional HCA with small foci of myxoid change and serosities; both consistent with a myxoid HCA. Immunophenotyping and molecular subtyping excluded inflammatory HCA, CTNNB1 mutated HCA and sonic hedgehog HCA, and was consistent with HNF1A mutated HCA. The myxoid change as well as the serosities may allow imaging diagnosis of myxoid HCA. As fluid vacuoles can also be present in ASS1+HCA, sonic hedgehog HCA has to be considered in the differential diagnosis.
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Affiliation(s)
- Nicolas De Vos
- Department of Radiology, Ghent University Hospital, Ghent 9000, Belgium.
| | - Joni Van der Meulen
- Centre for Medical Genetics, Ghent University Hospital, Ghent 9000, Belgium.
| | | | - Kathleen Claes
- Centre for Medical Genetics, Ghent University Hospital, Ghent 9000, Belgium.
| | | | - Aude Vanlander
- Department of General Hepatobiliary and Liver Transplantation Surgery, Ghent University Hospital, Ghent 9000, Belgium.
| | - Roberto Ivan Troisi
- Department of Human Structure and Repair, University of Ghent Faculty of Medicine, Ghent 9000, Belgium.
| | - Hans Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent 9000, Belgium.
| | - Peter Smeets
- Department of Radiology, Ghent University Hospital, Ghent 9000, Belgium.
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium.
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium.
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42
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Devisscher L, Van Campenhout S, Lefere S, Raevens S, Tilleman L, Van Nieuwerburgh F, Van Eeckhoutte HP, Hoorens A, Lynes MA, Geerts A, Laukens D, Van Vlierberghe H. Metallothioneins alter macrophage phenotype and represent novel therapeutic targets for acetaminophen-induced liver injury. J Leukoc Biol 2021; 111:123-133. [PMID: 33724533 DOI: 10.1002/jlb.3a0820-527r] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Acetaminophen (APAP) intoxication is the foremost cause of drug-induced liver failure in developed countries. The only pharmacologic treatment option, N-acetylcysteine (NAC), is not effective for patients who are admitted too late and/or who have excessive liver damage, emphasizing the need for alternative treatment options. APAP intoxication results in hepatocyte death and release of danger signals, which further contribute to liver injury, in part by hepatic monocyte/macrophage infiltration and activation. Metallothionein (MT) 1 and 2 have important danger signaling functions and might represent novel therapeutic targets in APAP overdose. Therefore, we evaluated hepatic MT expression and the effect of anti-MT antibodies on the transcriptional profile of the hepatic macrophage population and liver injury following APAP overdose in mice. Hepatic MT expression was significantly induced in APAP-intoxicated mice and abundantly present in human livers. APAP intoxication in mice resulted in increased serum transaminase levels, extended necrotic regions on liver histology and induced expression of proinflammatory markers, which was significantly less pronounced in mice treated with anti-MT antibodies. Anti-MT antibody therapy attenuated proinflammatory macrophage polarization, as demonstrated by RNA sequencing analyses of isolated liver macrophages and in LPS-stimulated bone marrow-derived macrophages. Importantly, NAC and anti-MT antibodies were equally effective whereas administration of anti-MT antibody in combination with NAC exceeded the efficiency of both monotherapies in APAP-induced liver injury (AILI). We conclude that the neutralization of secreted MTs using a monoclonal antibody is a novel therapeutic strategy as mono- or add-on therapy for AILI. In addition, we provide evidence suggesting that MTs in the extracellular environment are involved in macrophage polarization.
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Affiliation(s)
- Lindsey Devisscher
- Gut-Liver ImmunoPharmacology Unit, Department Basic and Applied Medical Sciences, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sanne Van Campenhout
- Gut-Liver ImmunoPharmacology Unit, Department Basic and Applied Medical Sciences, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sander Lefere
- Gut-Liver ImmunoPharmacology Unit, Department Basic and Applied Medical Sciences, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sarah Raevens
- Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Laurentijn Tilleman
- Laboratory of Pharmaceutical Biotechnology, Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Filip Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Hannelore P Van Eeckhoutte
- Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Michael A Lynes
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, USA
| | - Anja Geerts
- Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Debby Laukens
- Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hans Van Vlierberghe
- Hepatology Research Unit, Department of Gastroenterology and Hepatology, Liver Research Center Ghent, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Merola E, Zandee W, de Mestier L, Klümpen HJ, Makulik K, Geboes K, van Velthuysen ML, Couvelard A, Cros J, van Eeden S, Hoorens A, Stephenson T, Zajęcki W, de Herder W, Munir A. Histopathological Revision for Gastroenteropancreatic Neuroendocrine Neoplasms in Expert Centers: Does It Make the Difference? Neuroendocrinology 2021; 111:170-177. [PMID: 32155627 DOI: 10.1159/000507082] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The correct histopathological diagnosis of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) is crucial for treatment selection and prognostication. It is also very challenging due to limited experience in nonexpert centers. Revision of pathology is standard of care for most patients who are referred to NEN expert centers. OBJECTIVES To describe the clinical impact of histopathological revision for GEP-NEN patients referred to an expert center. METHODS Retrospective multicenter analysis of all GEP-NENs receiving a histopathological revision in 6 European NEN expert centers (January 2016 to December 2016) to evaluate the impact on patient management. RESULTS 175 patients were included and 14.7% referred for a second opinion. Histological samples were 69.1% biopsies, 23.4% surgical specimens, and 7.5% endoscopic resections. Histopathological changes due to revision included first assessment of Ki67 in 8.6% of cases, change in grading in 11.4% (3.4% G1 to G2; 5.7% G2 to G1; 0.6% G2 to G3; 1.7% G3 to G2), definition of tumor invasion in 10.8%, additional immunohistochemical staining in 2.3%, diagnosis of mixed adenoneuroendocrine carcinoma in 3.4%, exclusion of NEN in 3.4%, first diagnosis of NEN in 2.3%, and tumor differentiation for G3 in 1.7%. The revision had a clinical impact in 36.0% of patients, leading to a new therapeutic indication in 26.3%. The indication to then perform a new imaging test occurred in 21.1% and recommendation to follow-up with no further treatment in 6.3%. CONCLUSIONS Histopathological revision in expert centers for NENs can change the diagnosis, with a significant clinical impact in about one third of patients.
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Affiliation(s)
- Elettra Merola
- Department of Gastroenterology, Azienda Provinciale Servizi Sanitari (APSS), Trento, Italy,
| | - Wouter Zandee
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Louis de Mestier
- Department of Gastroenterology and Pancreatology, Beaujon Hospital (APHP) and Paris 7 University, Clichy, France
| | - Heinz Josef Klümpen
- Department of Medical Oncology, Academic Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Karolina Makulik
- Department of Endocrinology and Neuroendocrine Tumors, Medical University of Silesia, Katowice, Poland
| | - Karen Geboes
- Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
| | | | - Anne Couvelard
- Department of Pathology, Beaujon/Bichat Hospital (APHP) and Université de Paris, Clichy, France
| | - Jérôme Cros
- Department of Pathology, Beaujon/Bichat Hospital (APHP) and Université de Paris, Clichy, France
| | - Susanne van Eeden
- Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands
| | - Anne Hoorens
- Department of Pathology, University Hospital Ghent, Ghent, Belgium
| | - Timothy Stephenson
- Department of Pathology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - W Zajęcki
- Department of Endocrinology and Neuroendocrine Tumors, Medical University of Silesia, Katowice, Poland
| | - Wouter de Herder
- Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - Alia Munir
- Department of Endocrinology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Cuyle PJ, Geboes K, Carton S, Casneuf V, Decaestecker J, De Man M, Demolin G, Deroose CM, De Vleeschouwer C, Flamen P, Hendlisz A, Hoorens A, Janssens J, Karfis I, Lybaert W, Machiels G, Monsaert E, Sinapi I, Van Cutsem E, Vandamme T, Borbath I, Verslype C. Current practice in approaching controversial diagnostic and therapeutic topics in gastroenteropancreatic neuroendocrine neoplasm management. Belgian multidisciplinary expert discussion based on a modified Delphi method. Acta Gastroenterol Belg 2020; 83:643-653. [PMID: 33321023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND STUDY AIMS Neuroendocrine neoplasms (NENs) are relatively rare, with marked clinical and biological heterogeneity. Consequently, many controversial areas remain in diagnosis and optimal treatment stratification for NEN patients. We wanted to describe current clinical practice regarding controversial NEN topics and stimulate critical thinking and mutual learning among a Belgian multidisciplinary expert panel. PATIENTS AND METHODS A 3-round, Delphi method based project, coordinated by a steering committee (SC), was applied to a predefined multidisciplinary NEN expert panel studying the following controversial topics : factors guiding therapeutic decision making, the use of somatostatin analogues (SSA) in adjuvant setting, the interference between non-radioactive and radioactive SSAs, challenging small intestine neuroendocrine tumor (NET) cases, the approach of the carcinoid syndrome, the role of chemotherapy in well differentiated NET, the relevance of NET G3 and neuroendocrine carcinoma subclassification and the role of imaging techniques in NEN management. RESULTS A high level of consensus exists regarding the necessary diagnostic work-up, use of imaging techniques and interference between non-radioactive and radioactive SSAs. However, the prognostic impact of tumor functionality might be overrated and adequate diarrhea differential diagnostic work-up in these patients is underused. Significant differences are seen between individual experts and centers regarding treatment preferences both on the treatment modality level, as well as the choice of specific drugs (e.g. chemotherapy regimen). CONCLUSIONS A Delphi-like multi-round expert discussion proves useful to boost critical thinking and discussion among experts of different background, as well as to describe current clinical practice and stimulate mutual learning in the absence of high-level scientific guidance.
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Affiliation(s)
- P-J Cuyle
- Gastroenterology/Digestive Oncology, Imelda General Hospital, Bonheiden, Belgium
| | - K Geboes
- Gastroenterology, Digestive Oncology, Ghent University Hospital, Ghent, Belgium
| | - S Carton
- Gastroenterology/Digestive Oncology, Imelda General Hospital, Bonheiden, Belgium
| | - V Casneuf
- Gastroenterology/Digestive Oncology, OLV Hospital, Aalst, Belgium
| | - J Decaestecker
- Gastroenterology/Digestive Oncology, AZ Delta Hospital, Roeselare, Belgium
| | - M De Man
- Gastroenterology, Digestive Oncology, Ghent University Hospital, Ghent, Belgium
| | - G Demolin
- Gastroenterology/Digestive Oncology, Centre Hospitalier Chrétien St-Joseph, Liège, Belgium
| | - C M Deroose
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | - C De Vleeschouwer
- Gastroenterology/Digestive Oncology, Mariaziekenhuis Noord-Limburg, Pelt, Belgium
| | - P Flamen
- Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Hendlisz
- Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - A Hoorens
- Pathology, Ghent University Hospital, Ghent, Belgium
| | - J Janssens
- Gastroenterology/Digestive Oncology, AZ Turnhout, Turnhout, Belgium
| | - I Karfis
- Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - W Lybaert
- Medical Oncology, AZ Nikolaas, Sint-Niklaas, Belgium
| | - G Machiels
- Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - E Monsaert
- Gastroenterology/Digestive Oncology, AZ Maria Middelares, Ghent, Belgium
| | - I Sinapi
- Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - E Van Cutsem
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - T Vandamme
- NETwerk, Antwerp University Hospital, Edegem, Belgium
| | - I Borbath
- Gastroenterology/Digestive Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - C Verslype
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
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45
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Remmerie A, Martens L, Thoné T, Castoldi A, Seurinck R, Pavie B, Roels J, Vanneste B, De Prijck S, Vanhockerhout M, Binte Abdul Latib M, Devisscher L, Hoorens A, Bonnardel J, Vandamme N, Kremer A, Borghgraef P, Van Vlierberghe H, Lippens S, Pearce E, Saeys Y, Scott CL. Osteopontin Expression Identifies a Subset of Recruited Macrophages Distinct from Kupffer Cells in the Fatty Liver. Immunity 2020; 53:641-657.e14. [PMID: 32888418 PMCID: PMC7501731 DOI: 10.1016/j.immuni.2020.08.004] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/14/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
Metabolic-associated fatty liver disease (MAFLD) represents a spectrum of disease states ranging from simple steatosis to non-alcoholic steatohepatitis (NASH). Hepatic macrophages, specifically Kupffer cells (KCs), are suggested to play important roles in the pathogenesis of MAFLD through their activation, although the exact roles played by these cells remain unclear. Here, we demonstrated that KCs were reduced in MAFLD being replaced by macrophages originating from the bone marrow. Recruited macrophages existed in two subsets with distinct activation states, either closely resembling homeostatic KCs or lipid-associated macrophages (LAMs) from obese adipose tissue. Hepatic LAMs expressed Osteopontin, a biomarker for patients with NASH, linked with the development of fibrosis. Fitting with this, LAMs were found in regions of the liver with reduced numbers of KCs, characterized by increased Desmin expression. Together, our data highlight considerable heterogeneity within the macrophage pool and suggest a need for more specific macrophage targeting strategies in MAFLD. Resident KCs are lost with time in MAFLD Resident KCs are replaced by distinct subsets of bone marrow derived macrophages One subset of recruited macrophages termed hepatic LAMs, express Osteopontin Hepatic LAMs are found in zones characterized by increased Desmin expression
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Affiliation(s)
- Anneleen Remmerie
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium
| | - Liesbet Martens
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Tinne Thoné
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Angela Castoldi
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
| | - Ruth Seurinck
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Benjamin Pavie
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Joris Roels
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Bavo Vanneste
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Sofie De Prijck
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Mathias Vanhockerhout
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Mushida Binte Abdul Latib
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Lindsey Devisscher
- Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent 9000, Belgium
| | - Johnny Bonnardel
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; Laboratory of Myeloid Cell Biology in Tissue Homeostasis and Regeneration, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Niels Vandamme
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Anna Kremer
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Peter Borghgraef
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Hans Van Vlierberghe
- Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent 9000, Belgium
| | - Saskia Lippens
- Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium; VIB BioImaging Core, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium
| | - Edward Pearce
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany; University of Freiburg, Freiburg, Germany
| | - Yvan Saeys
- Data Mining and Modelling for Biomedicine, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Applied Mathematics, Computer Science and Statistics, Faculty of Science, Ghent University, Ghent, Belgium
| | - Charlotte L Scott
- Laboratory of Myeloid Cell Biology in Tissue Damage and Inflammation, VIB-UGent Center for Inflammation Research, Technologiepark-Zwijnaarde 71, Ghent 9052, Belgium; Department of Biomedical Molecular Biology, Faculty of Science, Ghent University, Ghent, Belgium.
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46
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Noë M, Niknafs N, Fischer CG, Hackeng WM, Beleva Guthrie V, Hosoda W, Debeljak M, Papp E, Adleff V, White JR, Luchini C, Pea A, Scarpa A, Butturini G, Zamboni G, Castelli P, Hong SM, Yachida S, Hiraoka N, Gill AJ, Samra JS, Offerhaus GJA, Hoorens A, Verheij J, Jansen C, Adsay NV, Jiang W, Winter J, Albores-Saavedra J, Terris B, Thompson ED, Roberts NJ, Hruban RH, Karchin R, Scharpf RB, Brosens LAA, Velculescu VE, Wood LD. Genomic characterization of malignant progression in neoplastic pancreatic cysts. Nat Commun 2020; 11:4085. [PMID: 32796935 PMCID: PMC7428044 DOI: 10.1038/s41467-020-17917-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 07/23/2020] [Indexed: 01/04/2023] Open
Abstract
Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are non-invasive neoplasms that are often observed in association with invasive pancreatic cancers, but their origins and evolutionary relationships are poorly understood. In this study, we analyze 148 samples from IPMNs, MCNs, and small associated invasive carcinomas from 18 patients using whole exome or targeted sequencing. Using evolutionary analyses, we establish that both IPMNs and MCNs are direct precursors to pancreatic cancer. Mutations in SMAD4 and TGFBR2 are frequently restricted to invasive carcinoma, while RNF43 alterations are largely in non-invasive lesions. Genomic analyses suggest an average window of over three years between the development of high-grade dysplasia and pancreatic cancer. Taken together, these data establish non-invasive IPMNs and MCNs as origins of invasive pancreatic cancer, identifying potential drivers of invasion, highlighting the complex clonal dynamics prior to malignant transformation, and providing opportunities for early detection and intervention.
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Affiliation(s)
- Michaël Noë
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Noushin Niknafs
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Catherine G Fischer
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wenzel M Hackeng
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands
| | - Violeta Beleva Guthrie
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Waki Hosoda
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan
| | - Marija Debeljak
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eniko Papp
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vilmos Adleff
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James R White
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Antonio Pea
- Department of Surgery - The Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
- ARC-Net Centre for Applied Research on Cancer, University and Hospital Trust of Verona, Verona, Italy
| | | | - Giuseppe Zamboni
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy
- Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Paola Castelli
- Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Seung-Mo Hong
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Shinichi Yachida
- Department of Cancer Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Anthony J Gill
- University of Sydney, Sydney, NSW, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia
- Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jaswinder S Samra
- University of Sydney, Sydney, NSW, Australia
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, NSW, Australia
- Faculty of Medical and Health Sciences, Macquarie University, Sydney, Australia
| | - G Johan A Offerhaus
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Joanne Verheij
- Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands
| | - Casper Jansen
- LABPON, Laboratory for Pathology Eastern Netherlands, Hengelo, The Netherlands
| | | | - Wei Jiang
- Department of Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jordan Winter
- University Hospitals Cleveland Medical Center and Seidman Cancer Center, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
| | | | - Benoit Terris
- Service de Pathologie, AP-HP, Hôpital Cochin, Université Paris Descartes, Paris, France
| | - Elizabeth D Thompson
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas J Roberts
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ralph H Hruban
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rachel Karchin
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Robert B Scharpf
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lodewijk A A Brosens
- Department of Pathology, The University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Victor E Velculescu
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Laura D Wood
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Wieme G, Berrevoet F, Vanlander A, Van Dorpe J, Hoorens A, Parton B, Van Limmen J, De Bruyne A, De Man M, Geboes K, Claes K. Abstract A15: Detection of genome-wide copy number alterations in tumor tissue and cell-free DNA of pancreatic cancer patients. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.liqbiop20-a15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Pancreatic cancer is considered one of the deadliest malignancies, with only an 8% 5-year survival. The diagnosis of pancreatic cancer is very challenging since early-stage pancreatic cancer is associated with nonspecific and rarely noticeable symptoms. Additionally, the current diagnostic tools (such as imaging and the measurement of serum tumor marker CA19-9 levels) have limitations. Liquid biopsies make it possible to detect tumor-specific molecular alterations by analysis of cell-free DNA (cfDNA) isolated from plasma, which contains circulating tumor DNA (ctDNA). Large genomic rearrangements have become evident as key mutagenic events in the progression of solid tumors. In this study we evaluated the prevalence of large-scale genomic rearrangements in pancreatic resections and cell-free DNA (cfDNA) of pancreatic cancer patients. Genome-wide copy number profiles were derived from shallow whole-genome sequencing (sWGS). We applied sWGS to cfDNA samples from all patients at different time points. Concordance of the profiles was evaluated between cfDNA and matched FFPE tumor tissue in samples of operable pancreatic cancer patients. Clear copy number variations (CNVs) were observed in 13 FFPE tumor samples of 16 resectable patients (81%). This indicates that chromosomal instability is a frequent mechanism in pancreatic cancer. We then evaluated if CNVs could be detected in cfDNA of operable patients. Unfortunately, in none of the 50 operable patients were CNVs established. In contrast, cfDNA analysis in metastatic patients revealed clear CNVs in 66.7% (10/15) of the patients at the time of diagnosis. Although cfDNA concentrations were not statistically significantly increased compared to operable patients, remarkably higher CA19-9 values were determined in nonoperable patients. Preliminary data indicate that this approach can predict recurrence. For instance, a copy number change in a follow-up sample (1-year post-surgery; 6-months post-chemotherapy) was observed in a borderline-operative patient diagnosed with a liver metastasis. The CNV profiles obtained in both FFPE resections as well as in cfDNA were patient unique, but some recurrent alterations on chromosome 9 (region with CDKN2A and CDKN2B) and on chromosome 12 (region with KRAS) were ascertained. These results demonstrate detection of tumor-derived CNVs in cfDNA of advanced pancreatic cancer cases. We also show that there is potential to use cfDNA-derived profiles to monitor treatment response. Based on the results of this proof-of-concept study, additional patients are currently being analyzed.
Citation Format: Greet Wieme, Frederik Berrevoet, Aude Vanlander, Jo Van Dorpe, Anne Hoorens, Bram Parton, Jurgen Van Limmen, Ann De Bruyne, Marc De Man, Karen Geboes, Kathleen Claes. Detection of genome-wide copy number alterations in tumor tissue and cell-free DNA of pancreatic cancer patients [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr A15.
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Affiliation(s)
- Greet Wieme
- 1Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium,
| | - Frederik Berrevoet
- 2Department of General and Hepatobiliary surgery, Ghent University Hospital, Ghent, Belgium,
| | - Aude Vanlander
- 2Department of General and Hepatobiliary surgery, Ghent University Hospital, Ghent, Belgium,
| | - Jo Van Dorpe
- 3Department of Pathology, Ghent University Hospital, Ghent, Belgium,
| | - Anne Hoorens
- 3Department of Pathology, Ghent University Hospital, Ghent, Belgium,
| | - Bram Parton
- 1Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium,
| | - Jurgen Van Limmen
- 4Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium,
| | - Ann De Bruyne
- 4Department of Anesthesiology, Ghent University Hospital, Ghent, Belgium,
| | - Marc De Man
- 5Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Karen Geboes
- 5Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
| | - Kathleen Claes
- 1Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium,
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Demuytere J, Ceelen W, Van Dorpe J, Hoorens A. The role of the peritoneal microenvironment in the pathogenesis of colorectal peritoneal carcinomatosis. Exp Mol Pathol 2020; 115:104442. [PMID: 32305340 DOI: 10.1016/j.yexmp.2020.104442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/01/2020] [Accepted: 04/15/2020] [Indexed: 01/06/2023]
Abstract
Recent insights have implicated mesothelial-to-mesenchymal transition (MMT) as a mechanism by which mesothelial cells can transdifferentiate into cancer-associated fibroblasts (CAFs) in several cancers metastasizing to the peritoneum. However, this was not evaluated extensively in colorectal cancer. We examined the presumed mesothelial origin of CAFs in three types of colorectal carcinoma: conventional type adenocarcinoma, mucinous carcinoma and signet ring cell carcinoma. We evaluated the expression of mesothelial, mesenchymal, angiogenesis and colorectal cancer-related markers in peritoneal samples of twelve colorectal cancer patients with peritoneal carcinomatosis and four control patients by immunohistochemistry. We observed morphological and immunohistochemical changes in the vicinity of tumor implants in all studied colorectal cancer types. Mesothelial cells acquired a spindle-shaped myofibroblast-like morphology, lost expression of mesothelial markers, and gained expression of mesenchymal markers. Analysis of consecutive tissue sections and double staining for mesothelial and mesenchymal markers revealed overlap in expression of mesothelial and CAF markers. These findings are highly suggestive of a mesothelial origin of CAFs in peritoneal carcinomatosis in colorectal cancer. Interfering with the process of MMT might be a valuable approach in treating and preventing peritoneal carcinomatosis. Differences observed between colorectal cancer types suggest that one single strategy might not be applicable.
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Affiliation(s)
- Jesse Demuytere
- Laboratory of Experimental Surgery, Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Wim Ceelen
- Laboratory of Experimental Surgery, Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium..
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Dano H, Baldin P, Demetter P, Driessen A, Hoorens A, Sagaert X, Van Huysse J, Verset L, Jouret-Mourin A. Guidelines for an optimal management of a malignant colorectal polyp. What is essential in a pathology report ? Acta Gastroenterol Belg 2020; 83:53-59. [PMID: 32233272] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Colorectal cancer (CRC) has become the most common malignancy in our country. Routine screening colonoscopy is on the rise. With the recent advances in endoscopic treatment, many T1 colorectal carcinomas are now found and their percentage amenable to endoscopic resection has increased. Endoscopists and pathologists dealing with the steadily increasing number of excised colorectal polyps have to collaborate closely to optimize patient care. Therapeutic management of patients after endoscopic resection is based on precise histological criteria that determine the risk of metastasis and the need for complementary surgery. This paper summarizes the procedures for the macroscopic management of endoscopic excisions and presents the identified risk factors which should be included in a standardized pathology report.
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Affiliation(s)
- H Dano
- Department of Pathology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium
| | - P Baldin
- Department of Pathology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium
| | - P Demetter
- Department of Pathology, Institut Jules Bordet, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - A Driessen
- Department of Pathology University Hospital Antwerp, University Antwerp, Edegem, Belgium
| | - A Hoorens
- Department of Pathology, University Hospital Ghent, Ghent, Belgium
| | - X Sagaert
- Department of Pathology, KUL, Leuven
| | - J Van Huysse
- Department of Pathology, AZ Sint Jan, Brugge, Belgium
| | - L Verset
- Department of Pathology, Institut Jules Bordet, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - A Jouret-Mourin
- Department of Pathology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium
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50
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Bogaert AM, Hoorens A, Praet M, Van Dorpe J, Poppe B, De Scheerder MA. Tissue is the issue: when a second biopsy reveals the true diagnosis. Clin Kidney J 2019; 14:429-431. [PMID: 33564449 PMCID: PMC7857801 DOI: 10.1093/ckj/sfz165] [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: 07/30/2019] [Accepted: 10/22/2019] [Indexed: 11/27/2022] Open
Abstract
We describe the case of a woman with minimal glomerular changes on initial kidney biopsy. On long-term follow-up, the patient developed nephrotic proteinuria and a second kidney biopsy was performed, which revealed focal segmental glomerulosclerosis (FSGS). Findings from electron microscopy (EM) examination suggested a genetic form of FSGS. Next-generation sequencing showed heterozygosity for a mutation in COL4A3. Collagen IV nephropathies can be linked to late-onset FSGS. By establishing a genetic cause of FSGS, immunosuppressive treatment can be avoided. This case emphasizes the importance of re-biopsy in cases of a non-explained rise in proteinuria. EM can be helpful in differentiating between primary and secondary FSGS and informing treatment strategies. In cases of adult-onset FSGS that cannot be categorized by clinical–pathological assessment, genetic testing should be considered.
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Affiliation(s)
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Marleen Praet
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - Bruce Poppe
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
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