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Taurino G, Dander E, Chiu M, Pozzi G, Maccari C, Starace R, Silvestri D, Griffini E, Bianchi MG, Carubbi C, Andreoli R, Mirandola P, Valsecchi MG, Rizzari C, D'Amico G, Bussolati O. Asparagine transport through SLC1A5/ASCT2 and SLC38A5/SNAT5 is essential for BCP-ALL cell survival and a potential therapeutic target. Br J Haematol 2024. [PMID: 38736325 DOI: 10.1111/bjh.19516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/25/2024] [Indexed: 05/14/2024]
Abstract
B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) blasts strictly depend on the transport of extra-cellular asparagine (Asn), yielding a rationale for L-asparaginase (ASNase) therapy. However, the carriers used by ALL blasts for Asn transport have not been identified yet. Exploiting RS4;11 cells as BCP-ALL model, we have found that cell Asn is lowered by either silencing or inhibition of the transporters ASCT2 or SNAT5. The inhibitors V-9302 (for ASCT2) and GluγHA (for SNAT5) markedly lower cell proliferation and, when used together, suppress mTOR activity, induce autophagy and cause a severe nutritional stress, leading to a proliferative arrest and a massive cell death in both the ASNase-sensitive RS4;11 cells and the relatively ASNase-insensitive NALM-6 cells. The cytotoxic effect is not prevented by coculturing leukaemic cells with primary mesenchymal stromal cells. Leukaemic blasts of paediatric ALL patients express ASCT2 and SNAT5 at diagnosis and undergo marked cytotoxicity when exposed to the inhibitors. ASCT2 expression is positively correlated with the minimal residual disease at the end of the induction therapy. In conclusion, ASCT2 and SNAT5 are the carriers exploited by ALL cells to transport Asn, and ASCT2 expression is associated with a lower therapeutic response. ASCT2 may thus represent a novel therapeutic target in BCP-ALL.
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Affiliation(s)
- Giuseppe Taurino
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Erica Dander
- Tettamanti Center, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Martina Chiu
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giulia Pozzi
- Laboratory of Human Anatomy, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Maccari
- Laboratory of Industrial Toxicology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rita Starace
- Tettamanti Center, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Daniela Silvestri
- Tettamanti Center, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Erika Griffini
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Massimiliano G Bianchi
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
- MRH-Microbiome Research Hub, Parco Area Delle Scienze 11/A, University of Parma, Parma, Italy
| | - Cecilia Carubbi
- Laboratory of Human Anatomy, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Andreoli
- Laboratory of Industrial Toxicology, Department of Medicine and Surgery, University of Parma, Parma, Italy
- CERT-Center of Excellence for Toxicological Research, University of Parma, Parma, Italy
| | - Prisco Mirandola
- Laboratory of Human Anatomy, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Maria Grazia Valsecchi
- Biostatistics and Clinical Epidemiology, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Carmelo Rizzari
- Department of Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Giovanna D'Amico
- Tettamanti Center, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Ovidio Bussolati
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
- MRH-Microbiome Research Hub, Parco Area Delle Scienze 11/A, University of Parma, Parma, Italy
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2
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Guglielmelli P, Szuber N, Gangat N, Capecchi G, Maccari C, Harnois M, Karrar O, Abdelmagid M, Balliu M, Nacca E, Atanasio A, Sestini I, Desilets A, Loscocco GG, Rotunno G, Busque L, Tefferi A, Vannucchi AM. CALR mutation burden in essential thrombocythemia and disease outcome. Blood 2024:blood.2023023428. [PMID: 38252902 DOI: 10.1182/blood.2023023428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/02/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Among 281 patients with essential thrombocythemia and calreticulin mutation, we found a variant allele frequency of >60% to be associated with significantly shortened myelofibrosis-free survival, mostly apparent with CALR type-1 and CALR type-indeterminate mutations.
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Affiliation(s)
| | | | | | | | | | - Michaël Harnois
- Groupe Québecois de Recherche sur la LMC et NMP (GQR LMC-NMP)/Chronic Myeloid Leukemia and Myeloproliferative Neoplasms Quebec Research Group, Montreal, Quebec, Canada
| | - Omer Karrar
- Mayo Clinic, Rochester, Minnesota, United States
| | | | | | | | | | | | | | | | - Giada Rotunno
- CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms. University of Florence and AOU Careggi, Florence, Italy
| | | | | | - Alessandro Maria Vannucchi
- CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms. University of Florence and AOU Careggi, Florence, Italy
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3
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Loscocco GG, Gesullo F, Capecchi G, Atanasio A, Maccari C, Mannelli F, Vannucchi AM, Guglielmelli P. One thousand patients with essential thrombocythemia: the Florence-CRIMM experience. Blood Cancer J 2024; 14:10. [PMID: 38238287 PMCID: PMC10796728 DOI: 10.1038/s41408-023-00968-7] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
We describe 1000 patients with essential thrombocythemia seen at the Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Florence, Italy, between 1980 and 2023: median age 59 years (18-95), females 65%, JAK2/CALR/MPL-mutated 66%/19%/4%, triple-negative (TN) 11%. Extreme thrombocytosis (ExT, platelets ≥1000 × 109/L) in 16%, leukocytosis (leukocytes >11 × 109/L) in 16%, and at least one cardiovascular risk factor in 52% of cases. JAK2-mutated patients were older (median 62 years) and CALR-mutated and TN (53 years for both) younger (p < 0.001). Female gender clustered with TN (76%) and JAK2 (67%) vs CALR (46%) mutations (p < 0.001). ExT clustered with CALR (type-2 more than type-1), TN and MPL, and leukocytosis with JAK2 mutation (p < 0.001). In multivariable analysis, risk factors for arterial thrombosis-free survival were age ≥60 years (HR 2.0; p < 0.001) and JAK2 mutation (HR 1.3; p = 0.02) with borderline significance for male gender (p = 0.08) and cardiovascular risk factors (p = 0.08); for venous thrombosis-free survival, JAK2 mutation (HR 1.9; p = 0.03) with borderline significance for venous thrombosis history (p = 0.07); for overall survival, older age (p < 0.001), male gender (HR 1.9; p < 0.001), absolute neutrophil count (ANC) ≥ 8 × 109/L (HR 1.8; p = 0.01), absolute lymphocyte count (ALC) < 1.7 × 109/L (HR 1.2; p = 0.03); for myelofibrosis-free survival, CALR mutation (HR 2.7; p < 0.001, particularly for CALR type 1/1-like, HR 3.3) and MPL mutation (HR 3.9; p = 0.001); for leukemia-free survival, older age (p = 0.03). Cytoreductive therapy appeared to mitigate both venous (HR 0.3; p = 0.01) and arterial thrombosis (HR 4; p = 0.04); there was a trend for aspirin in preventing arterial thrombosis recurrence. The current study provides real-world observations in essential thrombocythemia, representing a valid source document for interpreting current literature and planning future studies.
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Affiliation(s)
- Giuseppe G Loscocco
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
- Doctorate School GenOMec, University of Siena, Siena, Italy
| | - Francesca Gesullo
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giulio Capecchi
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Alessandro Atanasio
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Chiara Maccari
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesco Mannelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Alessandro M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
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4
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Giannelli G, Mattarozzi M, Gentili S, Fragni R, Maccari C, Andreoli R, Visioli G. A novel PGPR strain homologous to Beijerinckia fluminensis induces biochemical and molecular changes involved in Arabidopsis thaliana salt tolerance. Plant Physiol Biochem 2024; 206:108187. [PMID: 38100889 DOI: 10.1016/j.plaphy.2023.108187] [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] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
The use of PGPR is widely accepted as a promising tool for a more sustainable agricultural production and improved plant abiotic stress resistance. This study tested the ability of PVr_9, a novel bacterial strain, homologous to Beijerinckia fluminensis, to increase salt stress tolerance in A. thaliana. In vitro plantlets inoculated with PVr_9 and treated with 150 mM NaCl showed a reduction in primary root growth inhibition compared to uninoculated ones, and a leaf area significantly less affected by salt. Furthermore, salt-stressed PVr_9-inoculated plants had low ROS and 8-oxo-dG, osmolytes, and ABA content along with a modulation in antioxidant enzymatic activities. A significant decrease in Na+ in the leaves and a corresponding increase in the roots were also observed in salt-stressed inoculated plants. SOS1, NHX1 genes involved in plant salt tolerance, were up-regulated in PVr_9-inoculated plants, while different MYB genes involved in salt stress signal response were down-regulated in both roots and shoots. Thus, PVr_9 was able to increase salt tolerance in A. thaliana, thereby suggesting a role in ion homeostasis by reducing salt stress rather than inhibiting total Na+ uptake. These results showed a possible molecular mechanism of crosstalk between PVr_9 and plant roots to enhance salt tolerance, and highlighted this bacterium as a promising PGPR for field applications on agronomical crops.
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Affiliation(s)
- Gianluigi Giannelli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Monica Mattarozzi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Silvia Gentili
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Rosaria Fragni
- SSICA, Experimental Station for the Food Preserving Industry, Parma, Italy
| | - Chiara Maccari
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Andreoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Centre for Research in Toxicology (CERT), University of Parma, Parma, Italy
| | - Giovanna Visioli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy.
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5
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Mannelli F, Piccini M, Bencini S, Gianfaldoni G, Peruzzi B, Caporale R, Scappini B, Fasano L, Quinti E, Ciolli G, Pasquini A, Crupi F, Pilerci S, Pancani F, Signori L, Tarantino D, Maccari C, Paradiso V, Annunziato F, Guglielmelli P, Vannucchi AM. Effect of age and treatment on predictive value of measurable residual disease: implications for clinical management of adult patients with acute myeloid leukemia. Haematologica 2024; 109:60-71. [PMID: 37345475 PMCID: PMC10772533 DOI: 10.3324/haematol.2023.283196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/24/2023] [Accepted: 06/15/2023] [Indexed: 06/23/2023] Open
Abstract
Measurable residual disease (MRD) is a powerful predictor of outcome in acute myeloid leukemia. In the early phases of treatment, MRD refines initial disease risk stratification and is used for the allocation to allogeneic transplant. Despite its well-established role, a relatively high fraction of patients eventually relapses albeit achieving MRDneg status. The aim of this work was to assess specifically the influence of baseline features and treatment intensity on the predictive value of an MRDneg status, particularly focusing on MRD2, measured after two consecutive chemotherapy cycles. Among baseline features, younger MRD2neg patients (<55 years) had a significantly longer disease-free survival (median not reached) compared to their older counterparts (median 25.0 months, P=0.013, hazard ratio=2.08). Treatment intensity, specifically the delivery of a high dose of cytarabine in induction or first consolidation, apparently had a pejorative effect on the outcome of MRD2neg patients compared to standard dose (P=0.048, hazard ratio=1.80), a finding also confirmed by the analysis of data extracted from the literature. The combination of age and treatment intensity allowed us to identify categories of patients, among those who reached a MRD2neg status, characterized by significantly different disease-free survival rate. Our data showed that variables such as age and intensity of treatment administered can influence the predictive value of MRD in patients with acute myeloid leukemia. In addition to underscoring the need for further improvement of MRD analysis, these findings call for a reasoned application of MRD data, as currently available, to modulate consolidation therapy on adequately estimated relapse rates.
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Affiliation(s)
- Francesco Mannelli
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze.
| | - Matteo Piccini
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze
| | - Sara Bencini
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Firenze
| | | | - Benedetta Peruzzi
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Firenze
| | - Roberto Caporale
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Firenze
| | | | - Laura Fasano
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze
| | - Elisa Quinti
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze
| | - Gaia Ciolli
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze
| | | | | | - Sofia Pilerci
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze
| | - Fabiana Pancani
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
| | - Leonardo Signori
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
| | - Danilo Tarantino
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
| | - Chiara Maccari
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
| | | | | | - Paola Guglielmelli
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
| | - Alessandro M Vannucchi
- SOD Ematologia, Università di Firenze, AOU Careggi, Firenze, Italy; Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze
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Loscocco GG, Rotunno G, Mannelli F, Coltro G, Gesullo F, Pancani F, Signori L, Maccari C, Esposito M, Paoli C, Vannucchi AM, Guglielmelli P. The prognostic contribution of CBL, NRAS, KRAS, RUNX1, and TP53 mutations to mutation-enhanced international prognostic score systems (MIPSS70/plus/plus v2.0) for primary myelofibrosis. Am J Hematol 2024; 99:68-78. [PMID: 37846894 DOI: 10.1002/ajh.27136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
Contemporary risk models in primary myelofibrosis (PMF) include the mutation (MIPSS70) and mutation/karyotype enhanced (MIPSS70 plus/v2.0) international prognostic scoring systems. High molecular risk (HMR) mutations incorporated in one or both of these models include ASXL1, SRSF2, EZH2, IDH1/2, and U2AF1Q157; the current study examines additional prognostic contribution from more recently described HMR mutations, including CBL, NRAS, KRAS, RUNX1, and TP53. In a cohort of 363 informative cases (median age 58 years; 60% males), mutations included JAK2 61%, CALR 24%, MPL 6%, ASXL1 29%, SRSF2 10%, U2AF1Q157 5%, EZH2 10%, IDH1/2 4%, TP53 5%, CBL 5%, NRAS 7%, KRAS 4%, and RUNX1 4%. At a median follow-up of 4.6 years, 135 (37%) deaths and 42 (11.6%) leukemic transformations were recorded. Univariate analysis confirmed significant survival impact from the original MIPSS70/plus/v2.0 HMR mutations as well as CBL (HR 2.8; p < .001), NRAS (HR 2.4; p < .001), KRAS (HR 2.1; p = .01), and TP53 (HR 2.4; p = .004), but not RUNX1 mutations (HR 1.8; p = .08). Multivariate analysis (MVA) that included both the original and more recently described HMR mutations confirmed independent prognostic contribution from ASXL1 (HR 1.8; p = .007), SRSF2 (HR 4.3; p < .001), U2AF1Q157 (HR 2.9, p = .004), and EZH2 (HR 2.4; p < .001), but not from IDH1/2 (p = .3), TP53 (p = .2), CBL (p = .3), NRAS (p = .8) or KRAS (p = .2) mutations. The lack of additional prognostic value from CBL, NRAS, KRAS, RUNX1, and TP53 was further demonstrated in the setting of (i) MVA of mutations and karyotype, (ii) MVA of MIPSS70/plus/v2.0 composite scores and each one of the recently described HMR mutations, except TP53, and iii) modified MIPSS70/plus/plus v2.0 that included CBL, NRAS, KRAS, and TP53 as part of the HMR constituency, operationally referred to as "HMR+" category. Furthermore, "HMR+" enhancement of MIPSS70/plus/plus v2.0 did not result in improved model performance, as measured by C-statistics. We conclude that prognostic integrity of MIPSS70/plus/plus v2.0, as well as their genetic components, was sustained and their value not significantly upgraded by the inclusion of more recently described HMR mutations, including CBL, NRAS, KRAS, and RUNX1. Additional studies are needed to clarify the apparent additional prognostic value of TP53 mutation and its allelic state.
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Affiliation(s)
- Giuseppe G Loscocco
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
- Doctorate School GenOMec, University of Siena, Siena, Italy
| | - Giada Rotunno
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesco Mannelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giacomo Coltro
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesca Gesullo
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Fabiana Pancani
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Leonardo Signori
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Chiara Maccari
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Maria Esposito
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Chiara Paoli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Alessandro M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
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7
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Calabresi L, Carretta C, Romagnoli S, Rotunno G, Parenti S, Bertesi M, Bartalucci N, Rontauroli S, Chiereghin C, Castellano S, Gentili G, Maccari C, Vanderwert F, Mannelli F, Della Porta M, Manfredini R, Vannucchi AM, Guglielmelli P. Clonal dynamics and copy number variants by single-cell analysis in leukemic evolution of myeloproliferative neoplasms. Am J Hematol 2023; 98:1520-1531. [PMID: 37399248 DOI: 10.1002/ajh.27013] [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: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
Transformation from chronic (CP) to blast phase (BP) in myeloproliferative neoplasm (MPN) remains poorly characterized, and no specific mutation pattern has been highlighted. BP-MPN represents an unmet need, due to its refractoriness to treatment and dismal outcome. Taking advantage of the granularity provided by single-cell sequencing (SCS), we analyzed paired samples of CP and BP in 10 patients to map clonal trajectories and interrogate target copy number variants (CNVs). Already at diagnosis, MPN present as oligoclonal diseases with varying ratio of mutated and wild-type cells, including cases where normal hematopoiesis was entirely surmised by mutated clones. BP originated from increasing clonal complexity, either on top or independent of a driver mutation, through acquisition of novel mutations as well as accumulation of clones harboring multiple mutations, that were detected at CP by SCS but were missed by bulk sequencing. There were progressive copy-number imbalances from CP to BP, that configured distinct clonal profiles and identified recurrences in genes including NF1, TET2, and BCOR, suggesting an additional level of complexity and contribution to leukemic transformation. EZH2 emerged as the gene most frequently affected by single nucleotide and CNVs, that might result in EZH2/PRC2-mediated transcriptional deregulation, as supported by combined scATAC-seq and snRNA-seq analysis of the leukemic clone in a representative case. Overall, findings provided insights into the pathogenesis of MPN-BP, identified CNVs as a hitherto poorly characterized mechanism and point to EZH2 dysregulation as target. Serial assessment of clonal dynamics might potentially allow early detection of impending disease transformation, with therapeutic implications.
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Affiliation(s)
- Laura Calabresi
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara Carretta
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Simone Romagnoli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giada Rotunno
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sandra Parenti
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Matteo Bertesi
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Niccolò Bartalucci
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sebastiano Rontauroli
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Sara Castellano
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Gentili
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Chiara Maccari
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fiorenza Vanderwert
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Mannelli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Rossella Manfredini
- Centre for Regenerative Medicine "S. Ferrari", University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Maria Vannucchi
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Paola Guglielmelli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliera-Universitaria Careggi, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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8
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Galati S, DalCorso G, Furini A, Fragni R, Maccari C, Mozzoni P, Giannelli G, Buschini A, Visioli G. DNA methylation is enhanced during Cd hyperaccumulation in Noccaea caerulescens ecotype Ganges. Environ Sci Pollut Res Int 2023; 30:26178-26190. [PMID: 36352075 PMCID: PMC9995422 DOI: 10.1007/s11356-022-23983-w] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
In this study, we assess the DNA damage occurring in response to cadmium (Cd) in the Cd hyperaccumulator Noccaea caerulescens Ganges (GA) vs the non-accumulator and close-relative species Arabidopsis thaliana. At this purpose, the alkaline comet assay was utilized to evaluate the Cd-induced variations in nucleoids and the methy-sens comet assay, and semiquantitative real-time (qRT)-PCR were also performed to associate nucleus variations to possible DNA modifications. Cadmium induced high DNA damages in nuclei of A. thaliana while only a small increase in DNA migration was observed in N. caerulescens GA. In addition, in N. caerulescens GA, CpG DNA methylation increase upon Cd when compared to control condition, along with an increase in the expression of MET1 gene, coding for the DNA-methyltransferase. N. caerulescens GA does not show any oxidative stress under Cd treatment, while A. thaliana Cd-treated plants showed an upregulation of transcripts of the respiratory burst oxidase, accumulation of reactive oxygen species, and enhanced superoxide dismutase activity. These data suggest that epigenetic modifications occur in the N. caerulescens GA exposed to Cd to preserve genome integrity, contributing to Cd tolerance.
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Affiliation(s)
- Serena Galati
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | | | - Antonella Furini
- Department of Biotechnology, University of Verona, Verona, Italy
| | - Rosaria Fragni
- SSICA, Experimental Station for the Food Preserving Industry, Parma, Italy
| | - Chiara Maccari
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Paola Mozzoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Centre for Research in Toxicology (CERT), University of Parma, Parma, Italy
| | - Gianluigi Giannelli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Annamaria Buschini
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Giovanna Visioli
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy.
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9
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Guglielmelli P, Maccari C, Sordi B, Balliu M, Atanasio A, Mannarelli C, Capecchi G, Sestini I, Coltro G, Loscocco GG, Rotunno G, Angori E, Borri FC, Tefferi A, Vannucchi AM. Phenotypic correlations of CALR mutation variant allele frequency in patients with myelofibrosis. Blood Cancer J 2023; 13:21. [PMID: 36710362 PMCID: PMC9884661 DOI: 10.1038/s41408-023-00786-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/31/2023] Open
Affiliation(s)
- Paola Guglielmelli
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Chiara Maccari
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Benedetta Sordi
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Manjola Balliu
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Alessandro Atanasio
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Carmela Mannarelli
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Giulio Capecchi
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Ilaria Sestini
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Giacomo Coltro
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Giuseppe Gaetano Loscocco
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy ,grid.9024.f0000 0004 1757 4641Doctorate School GenOMec, University of Siena, Siena, Italy
| | - Giada Rotunno
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
| | - Eva Angori
- grid.8404.80000 0004 1757 2304University of Florence, Florence, Italy
| | - Filippo C. Borri
- grid.8404.80000 0004 1757 2304University of Florence, Florence, Italy
| | - Ayalew Tefferi
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Alessandro M. Vannucchi
- grid.24704.350000 0004 1759 9494CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, University of Florence, AOU Careggi, Florence, Italy
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10
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Magnani G, Denegri A, Bottioni F, Gurgoglione FL, Tuttolomondo D, Noni M, Barocelli F, Vrenozaj R, Catellani D, Indrigo E, Donelli D, Maccari C, Andreoli R, Corradi M, Ossola P, Marchesi C, Ardissino D, Niccoli G. 706 ETIOLOGICAL ROLE OF STRESS IN ACUTE CORONARY SYNDROME: THE STRESS-ACS-ACTION STUDY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.512] [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: 12/23/2022]
Abstract
Abstract
Background
Acute coronary syndrome (ACS) is the main cause of mortality worldwide and despite the adherence to guidelines it is still burdened by an unacceptable risk for cardiovascular (CV) events recurrence, highlighting the need to identify other than traditional cardiovascular risk factors (CVrF) implicated in atherosclerotic plaque instability. In this regard, psychosocial stress appears to be a crucial player in the development of CV disease. Nevertheless, stress is not easy to standardize and the mechanisms by which it promotes coronary artery disease (CAD) are poorly understood.
Materials and Methods
We therefore prospectively enrolled patients with ACS, stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) and subjects presenting traditional CVrF but without established CV disease. Multimodality cortisol assessment, expression of acute and chronic stress, through blood, urine and hair samples collection was ascertained at baseline. A regression analysis was performed to assess the relationships between significant variables at univariate analysis.
Results
Fifty patients were enrolled in the present study. Cortisol levels in blood and urine were numerically higher in patients with ACS compared to CAD patients and subjects with traditional CVrF only. Hair cortisol levels did not differ between the three groups. The regression analysis showed an inverse correlation (R= -,532, p<0.001 and R=-,615, p<0.001 respectively) between urinary cortisol (UC) and UC/creatinine ratio and left ventricular ejection fraction (LVEF).
Conclusion
The preliminary results of our study showed that patients with ACS did not have significantly higher levels of hair cortisol compared to stable patients. The finding of an inverse relationship between higher UC, UC/C ratio levels and lower LVEF values support a link between a hyperactivity of the hypothalamic-pituitary-adrenal axis and a worse ACS presentation. These preliminary data will be implemented with serial multimodality assessment of cortisol that allow potential implications in diagnosis and outcome.
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Affiliation(s)
- Giuia Magnani
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | - Andrea Denegri
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | | | | | | | - Manjola Noni
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | | | - Rosi Vrenozaj
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | - Davide Catellani
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | - Elia Indrigo
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | - Davide Donelli
- Department Of Cardiology, Parma University Hospital , Parma , Italy
| | - Chiara Maccari
- Laboratory Of Industrial Toxicology, Department Of Medicine And Surgery, University Of Parma , Parma , Italy
| | - Roberta Andreoli
- Laboratory Of Industrial Toxicology, Department Of Medicine And Surgery, University Of Parma , Parma , Italy
| | - Massimo Corradi
- Laboratory Of Industrial Toxicology, Department Of Medicine And Surgery, University Of Parma , Parma , Italy
| | - Paolo Ossola
- Department Of Neuroscience, Psychiatric Unit, Parma University Hospital , Parma , Italy
| | - Carlo Marchesi
- Department Of Mental Health, Parma University Hospital , Parma , Italy
| | - Diego Ardissino
- Department Of Cardiology, Parma University Hospital , Parma , Italy
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11
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Coltro G, Mannelli F, Loscocco GG, Mannarelli C, Rotunno G, Maccari C, Pancani F, Atanasio A, Vannucchi AM, Guglielmelli P. Differential prognostic impact of cytopenic phenotype in prefibrotic vs overt primary myelofibrosis. Blood Cancer J 2022; 12:116. [PMID: 35961958 PMCID: PMC9374751 DOI: 10.1038/s41408-022-00713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Giacomo Coltro
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Francesco Mannelli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giuseppe Gaetano Loscocco
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Carmela Mannarelli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giada Rotunno
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Chiara Maccari
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Fabiana Pancani
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alessandro Atanasio
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Alessandro Maria Vannucchi
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy. .,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | - Paola Guglielmelli
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,Center of Research and Innovation for Myeloproliferative Neoplasms (CRIMM), Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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12
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Loscocco GG, Guglielmelli P, Mannelli F, Mora B, Mannarelli C, Rotunno G, Pancani F, Maccari C, Bartalucci N, Romagnoli S, Coltro G, Passamonti F, Vannucchi AM. SF3B1 mutations in primary and secondary myelofibrosis: clinical, molecular and prognostic correlates. Am J Hematol 2022; 97:E347-E349. [PMID: 35796725 DOI: 10.1002/ajh.26648] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Giuseppe G Loscocco
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.,Doctorate School GenOMec, University of Siena, Siena, Italy
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesco Mannelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Barbara Mora
- Hematology Unit, Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi-Ospedale di Circolo, Italy
| | - Carmela Mannarelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giada Rotunno
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Fabiana Pancani
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Chiara Maccari
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Niccolò Bartalucci
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Simone Romagnoli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Giacomo Coltro
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesco Passamonti
- Hematology Unit, Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi-Ospedale di Circolo, Italy
| | - Alessandro M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
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13
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Mannelli F, Bencini S, Coltro G, Loscocco GG, Peruzzi B, Rotunno G, Maccari C, Gesullo F, Borella M, Paoli C, Caporale R, Mannarelli C, Annunziato F, Guglielmelli P, Vannucchi AM. Integration of multiparameter flow cytometry score improves prognostic stratification provided by standard models in primary myelofibrosis. Am J Hematol 2022; 97:846-855. [PMID: 35338671 DOI: 10.1002/ajh.26548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/22/2022]
Abstract
Prognostic modeling in myelofibrosis (MF) has classically pursued the integration of informative clinical and hematological parameters to separate patients' categories with different outcomes. Modern stratification includes also genetic data from karyotype and mutations. However, some poorly standardized variables, as peripheral blood (PB) blast count by morphology, are still included. In this study, we used multiparameter flow cytometry (MFC) with the aim of improving performance of existing scores. We studied 363 MF patients with available MFC files for PB CD34+ cells count determination at diagnosis. We adapted Ogata score to MF context including 2 parameters: absolute CD34+ cells count (/μL) and granulocytes to lymphocytes SSC ratio. A score of 1 was attributed to above-threshold values of each parameter. Accordingly, patients were categorized as MFClow (score = 0, 62.0%), MFCint (score = 1, 29.5%), and MFChigh (score = 2, 8.5%). MFClow had significantly longer median OS (not reached) compared to MFCint (55 months) and MFChigh (19 months). We integrated MFC into established models as a substitute of morphological PB blasts count. Patients were reclassified according to MFC-enhanced scores, and concordance (C-) indexes were compared. As regards IPSS, C-indexes were 0.67 and 0.74 for standard and MFC-enhanced model, respectively (Z score - 3.82; p = 0.0001). MFC-enhanced MIPSS70+ model in PMF patients yielded a C-index of 0.78, outperforming its standard counterpart (C-index 0.73; Z score - 2.88, p = 0.004). Our data suggest that the incorporation of MFC-derived parameters, easily attainable from standard assay used for CD34+ cells determination, might help to refine the current prognostic stratification models in myelofibrosis.
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Affiliation(s)
- Francesco Mannelli
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Sara Bencini
- Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Florence, Italy
| | - Giacomo Coltro
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Giuseppe G Loscocco
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
- Doctorate School GenOMec, University of Siena, Italy
| | - Benedetta Peruzzi
- Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Florence, Italy
| | - Giada Rotunno
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Chiara Maccari
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Francesca Gesullo
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Miriam Borella
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Chiara Paoli
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Roberto Caporale
- Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Florence, Italy
| | - Carmela Mannarelli
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Francesco Annunziato
- Centro Diagnostico di Citofluorimetria e Immunoterapia, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Florence, Italy
| | - Paola Guglielmelli
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
| | - Alessandro M Vannucchi
- CRIMM, Centro di Ricerca e Innovazione per le Malattie Mieloproliferative, Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina Sperimentale e Clinica, Denothe Excellence Center, Università degli Studi, Florence, Italy
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14
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Coltro G, Rotunno G, Mannelli F, Loscocco GG, Bartalucci N, Mannarelli C, Maccari C, Guglielmelli P, Vannucchi AM. P985: THE ALLELIC RATIO OF DRIVER AND ASXL1 MUTATIONS IS PROGNOSTICALLY RELEVANT IN PMF. Hemasphere 2022. [PMCID: PMC9430524 DOI: 10.1097/01.hs9.0000846808.30540.ef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Riscassi S, Corradi M, Andreoli R, Maccari C, Mercolini F, Pescollderungg L, Caffarelli C. Nitric oxide products and aldehydes in exhaled breath condensate in children with asthma. Clin Exp Allergy 2021; 52:561-564. [PMID: 34890073 DOI: 10.1111/cea.14066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 04/12/2021] [Accepted: 11/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Sara Riscassi
- Department of Pediatrics, Central Hospital of Bolzano, Bolzano, Italy
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Andreoli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Maccari
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | | | - Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, University of Parma, Parma, Italy
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16
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Loscocco GG, Guglielmelli P, Gangat N, Rossi E, Mannarelli C, Betti S, Maccari C, Ramundo F, Jadoon Y, Gesullo F, Ceglie S, Paoli C, Pardanani A, De Stefano V, Tefferi A, Vannucchi AM. Clinical and molecular predictors of fibrotic progression in essential thrombocythemia: A multicenter study involving 1607 patients. Am J Hematol 2021; 96:1472-1480. [PMID: 34424575 PMCID: PMC9293196 DOI: 10.1002/ajh.26332] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/14/2021] [Accepted: 08/17/2021] [Indexed: 12/31/2022]
Abstract
The current retrospective study involving a total of 1607 patients was designed to identify clinical and molecular variables that were predictive of inferior myelofibrosis‐free survival (MFS) in WHO‐defined essential thrombocythemia (ET), utilizing three independent patient cohorts: University of Florence, Italy (n = 718); Mayo Clinic, USA (n = 479) and Policlinico Gemelli, Catholic University, Rome, Italy (n = 410). The Florence patient cohort was first examined to identify independent risk factors for MFS, which included age > 60 years (HR 2.5, 95% CI 1.3–4.9), male sex (2.1, 1.2–3.9), palpable splenomegaly (2.1, 1.2–3.9), CALR 1/1‐like or MPL mutation (3.4, 1.9–6.1) and JAK2V617F variant allele frequency > 35% (4.2, 1.6–10.8). Subsequently, an operational molecular risk category was developed and validated in the other two cohorts from Mayo Clinic and Rome: “high molecular risk” category included patients with JAK2V617F VAF >35%, CALR type 1/1‐like or MPL mutations; all other driver mutation profiles were assigned to “low molecular risk” category. The former, compared to the latter molecular risk category, displayed significantly higher risk of fibrotic transformation: Florence cohort with respective fibrotic transformation risk rates of 8% vs. 1.2% at 10 years and 33% vs. 8% at 20 years (p < 0.001; HR 6.1; 95% CI 3.2–11.7); Mayo Cohort, 16% vs. 7% at 10 years and 44% vs. 25% at 20 years (p < 0.001; HR 2.5; 95% CI 1.6–4.1); and Rome cohort 7.8% vs. 4.6% at 10 years and 31.2% vs. 7.1% at 20 years (p = 0.007, HR 2.7; 95% CI 1.3–5.8). The present study provides practically useful risk signals for fibrotic transformation in ET and facilitates identification of patients who require close monitoring and appropriate counseling.
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Affiliation(s)
- Giuseppe G. Loscocco
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | - Naseema Gangat
- Divisions of Hematology Mayo Clinic Rochester Minnesota USA
| | - Elena Rossi
- Section of Hematology, Department of Radiological and Hematological Sciences Catholic University Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Carmela Mannarelli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | - Silvia Betti
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Chiara Maccari
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | - Francesco Ramundo
- Section of Hematology, Department of Radiological and Hematological Sciences Catholic University Rome Italy
| | - Yamna Jadoon
- Divisions of Hematology Mayo Clinic Rochester Minnesota USA
| | - Francesca Gesullo
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | - Sara Ceglie
- Section of Hematology, Department of Radiological and Hematological Sciences Catholic University Rome Italy
| | - Chiara Paoli
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
| | | | - Valerio De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences Catholic University Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - Ayalew Tefferi
- Divisions of Hematology Mayo Clinic Rochester Minnesota USA
| | - Alessandro M. Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center of Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliero‐Universitaria Careggi University of Florence Florence Italy
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Fantini S, Rontauroli S, Sartini S, Mirabile M, Bianchi E, Badii F, Maccaferri M, Guglielmelli P, Ottone T, Palmieri R, Genovese E, Carretta C, Parenti S, Mallia S, Tavernari L, Salvadori C, Gesullo F, Maccari C, Zizza M, Grande A, Salmoiraghi S, Mora B, Potenza L, Rosti V, Passamonti F, Rambaldi A, Voso MT, Mecucci C, Tagliafico E, Luppi M, Vannucchi AM, Manfredini R. Increased Plasma Levels of lncRNAs LINC01268, GAS5 and MALAT1 Correlate with Negative Prognostic Factors in Myelofibrosis. Cancers (Basel) 2021; 13:cancers13194744. [PMID: 34638230 PMCID: PMC8507546 DOI: 10.3390/cancers13194744] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/31/2023] Open
Abstract
Simple Summary Myelofibrosis (MF) displays the worst prognosis among Philadelphia-negative chronic myeloproliferative neoplasms. There is no curative therapy for MF, except for bone marrow transplantation, which however has a consistent percentage of failure. There is thus an urgent need of novel biomarkers to complement current stratification models and to enable better management of patients. To address this issue, we herein measured the plasma levels of several long noncoding RNAs (lncRNAs). Circulating lncRNAs has been already largely described as potential non-invasive biomarkers in cancers. In our study we unveiled that LINC01268, MALAT1 (both p < 0.0001) and GAS5 (p = 0.0003) plasma levels are significantly higher in MF patients if compared with healthy donors, and their increased plasma levels correlate with several detrimental features in MF. Among them, LINC01268 is an independent variable for both OS (p = 0.0297) and LFS (p = 0.0479), thus representing a putative new biomarker suitable for integrate contemporary prognostic models. Abstract Long non-coding RNAs (lncRNAs) have been recently described as key mediators in the development of hematological malignancies. In the last years, circulating lncRNAs have been proposed as a new class of non-invasive biomarkers for cancer diagnosis and prognosis and to predict treatment response. The present study is aimed to investigate the potential of circulating lncRNAs as non-invasive prognostic biomarkers in myelofibrosis (MF), the most severe among Philadelphia-negative myeloproliferative neoplasms. We detected increased levels of seven circulating lncRNAs in plasma samples of MF patients (n = 143), compared to healthy controls (n = 65). Among these, high levels of LINC01268, MALAT1 or GAS5 correlate with detrimental clinical variables, such as high count of leukocytes and CD34+ cells, severe grade of bone marrow fibrosis and presence of splenomegaly. Strikingly, high plasma levels of LINC01268 (p = 0.0018), GAS5 (p = 0.0008) or MALAT1 (p = 0.0348) are also associated with a poor overall-survival while high levels of LINC01268 correlate with a shorter leukemia-free-survival. Finally, multivariate analysis demonstrated that the plasma level of LINC01268 is an independent prognostic variable, suggesting that, if confirmed in future in an independent patients’ cohort, it could be used for further studies to design an updated classification model for MF patients.
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Affiliation(s)
- Sebastian Fantini
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Sebastiano Rontauroli
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Stefano Sartini
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Margherita Mirabile
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Elisa Bianchi
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Filippo Badii
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Monica Maccaferri
- Department of Laboratory Medicine and Pathology, Diagnostic Hematology and Clinical Genomics, AUSL/AOU Policlinico, 41124 Modena, Italy;
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy; (T.O.); (R.P.); (M.T.V.)
- Santa Lucia Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Neuro-Oncohematology, 00179 Rome, Italy
| | - Raffaele Palmieri
- Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy; (T.O.); (R.P.); (M.T.V.)
| | - Elena Genovese
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Chiara Carretta
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Sandra Parenti
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Selene Mallia
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Lara Tavernari
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
| | - Costanza Salvadori
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Francesca Gesullo
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Chiara Maccari
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Michela Zizza
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Alexis Grande
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Silvia Salmoiraghi
- Hematology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.S.); (A.R.)
| | - Barbara Mora
- Division of Hematology, Ospedale ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (B.M.); (F.P.)
| | - Leonardo Potenza
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Policlinico, 41124 Modena, Italy; (L.P.); (E.T.); (M.L.)
| | - Vittorio Rosti
- Center for the Study of Myelofibrosis, Foundation Policlinico San Matteo, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 27100 Pavia, Italy;
| | - Francesco Passamonti
- Division of Hematology, Ospedale ASST Sette Laghi, University of Insubria, 21100 Varese, Italy; (B.M.); (F.P.)
| | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy; (T.O.); (R.P.); (M.T.V.)
- Santa Lucia Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Neuro-Oncohematology, 00179 Rome, Italy
| | - Cristina Mecucci
- Department of Medicine and Surgery, Section of Hematology and Clinical Immunology, University of Perugia, 06129 Perugia, Italy;
| | - Enrico Tagliafico
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Policlinico, 41124 Modena, Italy; (L.P.); (E.T.); (M.L.)
- Center for Genome Research, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Mario Luppi
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Policlinico, 41124 Modena, Italy; (L.P.); (E.T.); (M.L.)
| | - Alessandro Maria Vannucchi
- Department of Experimental and Clinical Medicine, and Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), University of Florence, Careggi University Hospital, 50134 Florence, Italy; (P.G.); (C.S.); (F.G.); (C.M.); (M.Z.); (A.M.V.)
| | - Rossella Manfredini
- Centre for Regenerative Medicine, Life Sciences Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.F.); (S.R.); (S.S.); (M.M.); (E.B.); (F.B.); (E.G.); (C.C.); (S.P.); (S.M.); (L.T.)
- Correspondence:
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18
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Calò L, Anzillotti L, Maccari C, Cecchi R, Andreoli R. Validation of a Bioanalytical Method for the Determination of Synthetic and Natural Cannabinoids (New Psychoactive Substances) in Oral Fluid Samples by Means of HPLC-MS/MS. Front Chem 2020; 8:439. [PMID: 32656178 PMCID: PMC7325870 DOI: 10.3389/fchem.2020.00439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/27/2020] [Indexed: 11/13/2022] Open
Abstract
New psychoactive substances (NPS) represent an important focus nowadays and are continually produced with minimal structural modifications in order to circumvent the law and increase the difficulty of identifying them. Moreover, since there are a high number of different compounds, it is arduous to develop analytical screening and/or confirmation methods that allow the identification and quantification of these compounds. The aim of this work is to develop and validate a bioanalytical method for detecting new synthetic drugs in biological samples, specifically oral fluid, using high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS/MS) with minimal sample pretreatment. Oral fluid samples were simply centrifuged and denaturized with different rapid procedures before injection into the LC-MS/MS system. Calibration curves covered a linear concentration range from LOQ to 100 ng/mL. Validation parameters such as linearity, precision, accuracy, selectivity, matrix effect and thermal stability were evaluated and showed satisfactory results, in accordance with US Food & Drug Administration guidelines. The inter-day analytical bias and imprecision at two levels of quality control (QC) were within ±15% for most compounds. This method was able to identify and calculate the concentration of 10 NPS validated in this biological sample, even in the presence of matrix effect.
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Affiliation(s)
- Luca Calò
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luca Anzillotti
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Maccari
- Laboratory of Industrial Toxicology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rossana Cecchi
- Legal Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberta Andreoli
- Laboratory of Industrial Toxicology, Department of Medicine and Surgery, University of Parma, Parma, Italy.,Centre for Research in Toxicology (CERT), University of Parma, Parma, Italy
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Cremaschi E, Maggiore U, Maccari C, Cademartiri C, Andreoli R, Fiaccadori E. Linezolid levels in a patient with biliary tract sepsis, severe hepatic failure and acute kidney injury on sustained low-efficiency dialysis (SLED). Minerva Anestesiol 2010; 76:961-964. [PMID: 21102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report on a patient with biliary sepsis due to Vancomycin-resistant Enterococcus faecium (VRE) treated with linezolid (LNZ), who had both hepatic failure and acute kidney injury requiring daily sustained low-efficiency dialysis (SLED), a new intermittent, prolonged diffusive modality of renal replacement therapy for ICU patients. Following cholecystostomy and peritoneal drain insertion, serum, bile and peritoneal fluid serial samples were simultaneously collected for LNZ concentration measurement (chromatography/mass spectrometry). Unusually high serum antibiotic levels (20 mg/L or more) were achieved as early as 36 hours since the start of LNZ administration, owing to relatively low hepatic clearance. Serum LNZ leveled off after commencing SLED, apparently reaching steady state levels. The lowest values of Cmin in bile was 5.86 mg/L; the average serum and bile AUC0-12 over the observation period were 204 mg/L*h and 276 mg/L*h, with a AUC0-24/MIC ratio of 227 h and 307 h, respectively. The excellent biliary pharmacodynamic exposure suggests that standard-dose LNZ might represent a valuable choice in severe biliary infection, even in the presence of hepatic failure, when the patients receive highly efficient modalities of renal replacement therapy.
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Affiliation(s)
- E Cremaschi
- Department of Medical Clinic, Nephrology and Prevention, University of Parma, Parma, Italy
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Regolisti G, Cabassi A, Parenti E, Maccari C, Greco P, Borghetti A, Fiaccadori E. 6.17 Late Identification of a Tumour of the Juxta-Glomerular Apparatus (TJGA) in a Case of Longstanding Severe High-Renin Hypertension and Hypokalaemia. High Blood Press Cardiovasc Prev 2008. [DOI: 10.1007/bf03263664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Abstract
This teaching exercise demonstrates how principles of physiology might help in identifying the cause of a particularly severe case of metabolic acidosis and making appropriate decisions about therapy. The patient's plasma pH was 7.00 and their plasma bicarbonate concentration was 2 mmol/l. Because the time course of the patient's illness was believed to be <24 h, this suggested that a large quantity of acid had been added to the body in this short time period, but the medical team managing the case could not identify any acid that could have been produced rapidly by endogenous processes, or was ingested by the patient. Moreover, there was a question about how such a very low arterial PCO(2) (8 mmHg) could be sustained. Even once the diagnosis was made, there were issues to resolve concerning therapy. These included questions about how much sodium bicarbonate to administer, and what dangers might arise during this therapy. The missing links in this interesting story emerge during a discussion between the medical team and their imaginary mentor, Professor McCance.
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Affiliation(s)
- C Maccari
- Division of Nephrology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, M5B 1A6, Canada
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Maccari C, Ricci F, Valeri A. [Intensive care and resuscitation: visits to hospitalized patients]. Riv Inferm 1995; 14:125-130. [PMID: 7501950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The nurse's opinion and their feelings and attitudes toward the parents visits in coronary (CCU) and intensive care (ICU) units was evaluated. A questionnaire with closed questions was sent to 60 coronary care and intensive care units respectively. 50 questionnaires (41.6% were returned). Patients access to the wards is very dishomogeneous, with greater variability among ICUs. On average, patients are allowed to visit their relatives 1.35 hour/day, divided in two entry times. Only in 19% of wards (38 wards) there are exceptions to these rules. Nurses are not allowed to give any kind of information to relatives in 25% of wards, because this is considered a doctors' task. Probably the part of the limitations to the access of the relatives are due to organizative problems, but, according to the nurses, there are major opportunities for improvement.
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