127 research outputs found
Role of high dose octreotide LAR for the treatment of GEP-NETs
Neuroendocrine Tumours (NETs) are a heterogeneous group of rare neoplasms that account for 0,5% of all malignancies. The increased incidence observed in the last few decades may be accounted for by increased awareness, improved diagnostic tools and a revision in the definition. The main primary sites are the gastro-entero-pancreatic (GEP) tract (62-67%), and the lung (22-27%). In patients with GEP-NETs, the strongest predictor of 5-years survival is the staging. An adequate clinical management of GEP-NETs should be multidisciplinary and should aim at assuring a good quality of life. Somatostatin (sst) analogues are widely used in these tumours, which often express sst receptors, since they are demonstrated to reduce clinical symptoms and tumour growth. Herein we explore the usefulness of doubling octreotide LAR dose in selected patients after escaping from symptoms control and/or tumour stabilization in course of treatment with standard dose
Geochemical Proxies and Mineralogical Fingerprints of Sedimentary Processes in a Closed Shallow Lake Basin Since 1850
AbstractLake systems are essential for the environment, the biosphere, and humans but are highly impacted by anthropogenic activities accentuated by climate change. Understanding how lake ecosystems change due to human impacts and natural forces is crucial to managing their current state and possible future restoration. The high sensitivity of shallow closed lakes to natural and anthropogenic forcing makes these lacustrine ecosystems highly prone to variations in precipitation and sedimentation processes. These variation processes, occurring in the water column, produce geochemical markers or proxies recorded in lake sedimentary archives. This study investigated specific proxies on high-resolution sedimentary archives (2â3 years resolution) of the Trasimeno lake (Central Italy). The Trasimeno lake underwent three different hydrological phases during the twentieth century due to several fluctuations induced mainly by human activities and climate change. The Trasimeno lake, a large and shallow basin located in the Mediterranean area, is a good case study to assess the effects of intense anthropogenic activity related to agriculture, tourism, industry, and climate changes during the Anthropocene. The aim is to identify the main characteristics of the main sedimentary events in the lake during the last 150 years, determining the concentrations of major and trace elements, the amount of organic matter, and the mineralogical composition of the sediments. This type of work demonstrates that studying sediment archives at high resolution is a viable method for reconstructing the lake's history through the evolution/trends of the geochemical proxies stored in the sediment records. This effort makes it possible to assess past anthropogenic impact and, under the objectives of the European Green Deal (zero-pollution ambition for a toxic-free environment), to monitor, prevent, and remedy pollution related to soil and water compartments.
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Epigenome-wide association study of peripheral immune cell populations in Parkinsonâs disease
Understanding the contribution of immune mechanisms to Parkinsonâs disease pathogenesis is an important challenge, potentially of major therapeutic implications. To further elucidate the involvement of peripheral immune cells, we studied epigenome-wide DNA methylation in isolated populations of CD14+ monocytes, CD19+ B cells, CD4+ T cells, and CD8+ T cells from Parkinsonâs disease patients and healthy control participants. We included 25 patients with a maximum five years of disease duration and 25 controls, and isolated four immune cell populations from each fresh blood sample. Epigenome-wide DNA methylation profiles were generated from 186 samples using the Illumina MethylationEpic array and association with disease status was tested using linear regression models. We identified six differentially methylated CpGs in CD14+ monocytes and one in CD8â+âT cells. Four differentially methylated regions were identified in monocytes, including a region upstream of RAB32, a gene that has been linked to LRRK2. Methylation upstream of RAB32 correlated negatively with mRNA expression, and RAB32 expression was upregulated in Parkinsonâs disease both in our samples and in summary statistics from a previous study. Our epigenome-wide association study of early Parkinsonâs disease provides evidence for methylation changes across different peripheral immune cell types, highlighting monocytes and the RAB32 locus. The findings were predominantly cell-type-specific, demonstrating the value of isolating purified cell populations for genomic studies
End-of-neoadjuvant treatment circulating microRNAs and HER2-positive breast cancer patient prognosis: An exploratory analysis from NeoALTTO
CĂĄncer de mama HER2 positivo; MicroARN circulante; Tratamiento neoadyuvanteCĂ ncer de mama HER2-positiu; MicroARN circulant; Tractament neoadjuvantHER2-positive breast cancer; Circulating microRNA; Neoadjuvant treatmentBackground: The absence of breast cancer cells in surgical specimens, i.e., pathological complete response (pCR), is widely recognized as a favorable prognostic factor after neoadjuvant therapy. In contrast, the presence of disease at surgery characterizes a prognostically heterogeneous group of patients. Here, we challenged circulating microRNAs (miRNAs) at the end of neoadjuvant therapy as potential prognostic biomarkers in the NeoALTTO study.
Methods: Patients treated within the trastuzumab arm (i.e., pre-operative weekly trastuzumab for 6 weeks followed by the addition of weekly paclitaxel for 12 weeks; post-operative FEC for 3 cycles followed by trastuzumab up to complete 1 year of treatment) were randomized into a training (n= 54) and testing (n= 72) set. RT-PCR-based high-throughput miRNA profile was performed on plasma samples collected at the end of neoadjuvant treatment of both sets. After normalization, circulating miRNAs associated with event free survival (EFS) were identified by univariate and multivariate Cox regression model.
Results: Starting from 23 circulating miRNAs associated with EFS in the training set, we generated a 3-circulating miRNA prognostic signature consisting of miR-185-5p, miR-146a-5p, miR-22-3p, which was confirmed in the testing set. The 3-circulating miRNA signature showed a C-statistic of 0.62 (95% confidence interval [95%CI] 0.53-0.71) in the entire study cohort. By resorting to a multivariate Cox regression model we found a statistical significant interaction between the expression values of miR-194-5p and pCR status (p.interaction =0.005) with an estimate Hazard Ratio (HR) of 1.83 (95%CI 1.14- 2.95) in patients with pCR, and 0.87 (95%CI 0.69-1.10) in those without pCR. Notably, the model including this interaction along with the abovementioned 3-circulating miRNA signature provided the highest discriminatory capability with a C-statistic of 0.67 (95%CI 0.58-0.76).
Conclusions: Circulating miRNAs are informative to identify patients with different prognosis among those with heterogeneous response after trastuzumab-based neoadjuvant treatment, and may be an exploitable tool to select candidates for salvage adjuvant therapy.The NeoALTTO study was sponsored by GlaxoSmithKline; Lapatinib is an asset of Novartis AG as of March 2, 2015. This sub-study was supported by the Italian Ministry of Health to SC. No grant number is applicable, funds were obtained through a law that allows tax-payers to allocate the 5 Ă 1000 share of their payments to research
Iron Speciation of Natural and Anthropogenic Dust by Spectroscopic and Chemical Methods
In this work, we have characterized the iron local structure in samples of two different types of atmospheric dust using X-ray absorption spectroscopy and selective leaching experiments. Specifically, we have investigated samples of long-range transported Saharan dust and freshly emitted steel plant fumes with the aim of individuating possible fingerprints of iron in the two cases. Findings include (1) prevalence of octahedral coordinated Fe 3 + for all samples; (2) presence of 6-fold coordinated Fe 3 + , aluminosilicates and iron oxy(hydr)oxides in Saharan dust and (3) of Fe-bearing spinel-like structures in the industrial fumes; (4) general predominance of the residual insoluble fraction with a notable difference: 69% for Saharan dust and 93% for steel production emissions, associated with aluminosilicates and non-reducible iron oxy(hydr)oxides, and Fe spinels, respectively. The remarkable differences between the X-ray absorption spectroscopy (XAS) spectra and leaching test results for the two sample types suggest the possibility to exploit the present approach in more complex cases. To this aim, two additional case studies of mixed aerosol samples are presented and discussed
Hydrophobicityâenhanced ferritin nanoparticles for efficient encapsulation and targeted delivery of hydrophobic drugs to tumor cells
Ferritin, a naturally occurring iron storage protein, has gained significant attention as a drug delivery platform due to its inherent biocompatibility and capacity to encapsulate therapeutic agents. In this study, we successfully genetically engineered human H ferritin by incorporating 4 or 6 tryptophan residues per subunit, strategically oriented towards the inner cavity of the nanoparticle. This modification aimed to enhance the encapsulation of hydrophobic drugs into the ferritin cage. Comprehensive characterization of the mutants revealed that only the variant carrying four tryptophan substitutions per subunit retained the ability to disassemble and reassemble properly. As a proof of concept, we evaluated the loading capacity of this mutant with ellipticine, a natural hydrophobic indole alkaloid with multimodal anticancer activity. Our data demonstrated that this specific mutant exhibited significantly higher efficiency in loading ellipticine compared to human H ferritin. Furthermore, to evaluate the versatility of this hydrophobicity-enhanced ferritin nanoparticle as a drug carrier, we conducted a comparative study by also encapsulating doxorubicin, a commonly used anticancer drug. Subsequently, we tested both ellipticine and doxorubicin-loaded nanoparticles on a promyelocytic leukemia cell line, demonstrating efficient uptake by these cells and resulting in the expected cytotoxic effect. This article is protected by copyright. All rights reserved
Predictive Value of MRI in Hypoxic-Ischemic Encephalopathy Treated with Therapeutic Hypothermia
Background: Hypoxic-ischemic encephalopathy (HIE) is a severe pathology, and no unique predictive biomarker has been identified. Our aims are to identify associations of perinatal and outcome parameters with morphological anomalies and ADC values from MRI. The secondary aims are to define a predictive ADC threshold value and detect ADC value fluctuations between MRIs acquired within 7 days (MR0) and at 1 year (MR1) of birth in relation to perinatal and outcome parameters. Methods: Fifty-one term children affected by moderate HIE treated with hypothermia and undergoing MRI0 and MRI1 were recruited. Brain MRIs were evaluated through the van Rooij score, while ADC maps were co-registered on a standardized cerebral surface, on which 29 ROIs were drawn. Statistical analysis was performed in Matlab, with the statistical significance value at 0.05. Results: ADC0 < ADC1 in the left and right thalami, left and right frontal white matter, right visual cortex, and the left dentate nucleus of children showing abnormal perinatal and neurodevelopmental parameters. At ROC analysis, the best prognostic ADC cut-off value was 1.535 mm2/s Ă 10-6 (sensitivity 80%, specificity 86%) in the right frontal white matter. ADC1 > ADC0 in the right visual cortex and left dentate nucleus, positively correlated with multiple abnormal perinatal and neurodevelopmental parameters. The van Rooij score was significantly higher in children presenting with sleep disorders. Conclusions: ADC values could be used as prognostic biomarkers to predict children's neurodevelopmental outcomes. Further studies are needed to address these crucial topics and validate our results. Early and multidisciplinary perinatal evaluation and the subsequent re-assessment of children are pivotal to identify physical and neuropsychological disorders to guarantee early and tailored therapy
Apatinib for the treatment of gastric cancer
Apatinib, a small-molecule inhibitor of vascular endothelial growth factor receptor 2, has demonstrated encouraging anti-cancer activity in gastric cancer within both in vitro and in vivo models.
AREAS COVERED:
Apatinib's efficacy, tolerability and safety have been evaluated in one Phase II and one Phase III study in metastatic/advanced gastric cancer. In this review, we focus on the mechanism of action of apatinib, its pharmacokinetic profile and its clinical activity in the treatment of advanced/metastatic gastric cancer. Expert commentary: Unfortunately, as yet, there is no definitive biomarker data for apatinib in gastric cance
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