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Rosangela Invernizzi,
Erica Travaglino,
Matteo G Della Porta,
Anna Gallì,
Luca Malcovati,
Vittorio Rosti, Gaetano Bergamaschi,
Benedetta G Erba,
Francesca Bellistri,
Raffaella Bastia,
Paolo Santambrogio,
Sonia Levi,
Mario Cazzola
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ABSTRACT: In myelodysplastic syndromes with ring sideroblasts (MDS-RS), the iron deposited in the mitochondria of RS is present in the form of mitochondrial ferritin (FTMT), but it is unknown whether FTMT overexpression is the cause or the result of mitochondrial iron deposition. Lentivirus FTMT-transduced CD34(+) bone marrow cells from seven healthy donors and CD34(+) cells from 24 patients with MDS-RS were cultured according to a procedure that allowed the expansion of high numbers of erythroid progenitors. These cells were used to investigate the possible influence of experimentally-induced FTMT overexpression on normal erythropoiesis and the functional effects of FTMT in sideroblastic erythropoiesis. In MDS-RS progenitors, FTMT overexpression was associated with reduced cytosolic ferritin levels, increased surface transferrin receptor expression and reduced cell proliferation; FTMT effects were independent of SF3B1 mutation status. Similarly, FTMT overexpressing normal erythroid progenitors were characterized by reduced cytosolic ferritin content and increased CD71 expression, and also by higher apoptotic rate in comparison with the FTMT- controls. Significantly lower levels of STAT5 phosphorylation following erythropoietin stimulation were found in both sideroblastic and normal FTMT(+) erythroid cells compared to the FTMT- cells. In conclusion, experimental overexpression of FTMT may modify mitochondrial iron availability and lead to ineffective erythropoiesis.
British Journal of Haematology 04/2013; · 4.94 Impact Factor
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Vittorio Rosti,
Laura Villani,
Roberta Riboni,
Valentina Poletto,
Elisa Bonetti,
Lorenzo Tozzi, Gaetano Bergamaschi,
Paolo Catarsi,
Elena Dallera,
Francesca Novara, [......],
Benedetta Peruzzi,
Marco Lucioni,
Paola Guglielmelli,
Alessandro Pancrazzi,
Giacomo Fiandrino,
Orsetta Zuffardi,
Umberto Magrini,
Marco Paulli,
Alessandro M Vannucchi,
Giovanni Barosi
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ABSTRACT: Increased microvessel density contributes to abnormal bone marrow and spleen microenvironment in myelofibrosis (MF). Taking advantage from the JAK2V617F mutation as a marker of malignancy, we investigated, in patients bearing the mutation in their granulocytes and undergoing splenectomy for therapeutical reasons, whether splenic ECs obtained either from capillaries by laser microdissection (LM), or from fresh spleen tissue by cell culture or by cell sorting, harbored such mutation. To extend the analysis to ECs of large vessels, endothelium from the splenic vein was also studied. We found JAK2V617F-positive ECs in 12 out of 18 patients also bearing the mutation in their granulocytes. In 3 patients the mutation was found in at least 2 different EC samples obtained either by LM or cell culture or cell sorting. In 1 out of 6 patients in whom it was searched, the mutation was detected in splenic vein ECs. In conclusion, we provide evidence that a proportion of ECs from the spleen and splenic vein of patients with MF bears the JAK2V617F mutation. We suggest that splenic ECs are involved in the process of malignant transformation in MF.
Blood 11/2012; · 9.90 Impact Factor
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Leukemia research 09/2011; 36(1):e7-9. · 2.36 Impact Factor
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ABSTRACT: TGFβ1 is secreted as latent protein that requires activation to become biologically active. It negatively regulates the progenitor cell growth, and favours the deposition of extra-cellular matrix in different tissues. We have studied TGFβ1 levels in Philadelphia-negative (Ph-) myeloproliferative diseases, evaluating patients with primary myelofibrosis (PMF) that is characterized by increased numbers of circulating progenitor cells and bone marrow (BM) fibrosis, and patients with polycythemia vera (PV) or essential thrombocythemia (ET) that do not present BM fibrosis. We found that patients with PMF, PV or ET have higher peripheral blood (PB) plasma levels of both bioactive and total TGFβ1 than healthy controls, with a balance bioactive/total TGFβ1 in favour of the latter. The balance between bioactive/total TGFβ1 in the BM plasma of patients mirrored that of PB, with most of TGFβ1 in the latent form; on the contrary, in the BM plasma of healthy controls most of the TGFβ1 was in the bioactive form. In conclusion, increased plasma levels of TGFβ1 and an altered ratio bioactive/total TGFβ1 in BM are not peculiar of patients with PMF suggesting that, whether altered levels of TGFβ1 have a role in myelofibrosis, this may not be related to the induction of BM fibrosis.
Cytokine 01/2011; 53(1):100-6. · 3.02 Impact Factor
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Vittorio Rosti,
Elisa Bonetti, Gaetano Bergamaschi,
Rita Campanelli,
Paola Guglielmelli,
Marcello Maestri,
Umberto Magrini,
Margherita Massa,
Carmine Tinelli,
Gianluca Viarengo,
Laura Villani,
Massimo Primignani,
Alessandro M Vannucchi,
Francesco Frassoni,
Giovanni Barosi
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ABSTRACT: Increased mobilization of circulating endothelial progenitor cells may represent a new biological hallmark of myeloproliferative neoplasms. We measured circulating endothelial colony forming cells (ECFCs) in 106 patients with primary myelofibrosis, fibrotic stage, 49 with prefibrotic myelofibrosis, 59 with essential thrombocythemia or polycythemia vera, and 43 normal controls. Levels of ECFC frequency for patient's characteristics were estimated by using logistic regression in univariate and multivariate setting. The sensitivity, specificity, likelihood ratios, and positive predictive value of increased ECFC frequency were calculated for the significantly associated characteristics. Increased frequency of ECFCs resulted independently associated with history of splanchnic vein thrombosis (adjusted odds ratio = 6.61, 95% CI = 2.54-17.16), and a summary measure of non-active disease, i.e. hemoglobin of 13.8 g/dL or lower, white blood cells count of 7.8×10(9)/L or lower, and platelet count of 400×10(9)/L or lower (adjusted odds ratio = 4.43, 95% CI = 1.45-13.49) Thirteen patients with splanchnic vein thrombosis non associated with myeloproliferative neoplasms were recruited as controls. We excluded a causal role of splanchnic vein thrombosis in ECFCs increase, since no control had elevated ECFCs. We concluded that increased frequency of ECFCs represents the biological hallmark of a non-active myeloproliferative neoplasm with high risk of splanchnic vein thrombosis. The recognition of this disease category copes with the phenotypic mimicry of myeloproliferative neoplasms. Due to inherent performance limitations of ECFCs assay, there is an urgent need to arrive to an acceptable standardization of ECFC assessment.
PLoS ONE 01/2010; 5(12):e15277. · 4.09 Impact Factor
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Haematologica 12/2009; 94(12):1631-3. · 6.42 Impact Factor
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Gaetano Bergamaschi,
Antonio Di Sabatino,
Riccardo Albertini,
Sandro Ardizzone,
Paolo Biancheri,
Elisa Bonetti,
Andrea Cassinotti,
Paolo Cazzola,
Konstantinos Markopoulos,
Alessandro Massari,
Vittorio Rosti,
Gabriele Bianchi Porro,
Gino R Corazza
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ABSTRACT: Anemia is a common complication of inflammatory bowel disease, but its epidemiology may be changing due to earlier diagnosis and improved treatments. We investigated the prevalence and pathogenesis of anemia in patients with inflammatory bowel disease.
In a cross-sectional study 263 out-patients with inflammatory bowel disease (165 with Crohn's disease, 98 with ulcerative colitis) were investigated. The influence of time from diagnosis, disease activity, inflammation and the status of iron and hematinic vitamins on the level of hemoglobin and prevalence of anemia were evaluated. In a second group of 27 patients with Crohn's disease, undergoing anti-tumor necrosis factor-alpha treatment with infliximab because of refractory or fistulizing disease, we determined the effects of infliximab on disease activity, hemoglobin, serum erythropoietin levels, iron status and inflammation.
In all, 104 of the 263 patients with inflammatory bowel disease were anemic. Age, gender and azathioprine treatment had no influence on anemia. The prevalence of anemia was highest at diagnosis (65%), decreased during the first 4 years after disease onset, and was stable thereafter. Active disease was associated with higher rates of anemia. At diagnosis most anemic patients had anemia of chronic disease; during follow-up iron deficiency and multifactorial forms of anemia became more prevalent. Eighteen of 27 patients undergoing treatment with infliximab were anemic; most of them had anemia of chronic disease. Infliximab reduced disease activity and improved anemia in 12 patients. This was mediated by an increased production of erythropoietin for the degree of anemia. In vitro infliximab increased the growth of erythroid progenitors from the peripheral blood of patients with active disease. Conclusions Anemia is a common problem in out-patients with inflammatory bowel disease; the prevalence and severity of anemia are related to the activity of the bowel disorder. The pathogenesis of anemia changes during the course of the disease, with anemia of chronic disease having a major role at diagnosis and iron deficiency and multifactorial forms of anemia during follow-up. In patients requiring anti-tumor necrosis factor-alpha treatment, response to therapy improves erythropoiesis.
Haematologica 10/2009; 95(2):199-205. · 6.42 Impact Factor
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Giovanna Piaggio,
Vittorio Rosti,
Mirko Corselli,
Francesca Bertolotti, Gaetano Bergamaschi,
Sarah Pozzi,
Davide Imperiale,
Barbara Chiavarina,
Elisa Bonetti,
Francesca Novara, [......],
Anna Garuti,
Margherita Massa,
Riccardo Ghio,
Rita Campanelli,
Andrea Bacigalupo,
Alessandro Pecci,
Gianluca Viarengo,
Orsetta Zuffardi,
Francesco Frassoni,
Giovanni Barosi
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ABSTRACT: Two putative types of circulating endothelial progenitor cells have been recently identified in vitro: (1) endothelial colony-forming cell (ECFC) and (2) colony-forming unit-endothelial cell (CFU-EC). Only the former is now recognized to belong to endothelial lineage. We have used the ECFC and CFU-EC assays to readdress the issue of the clonal relation between endothelial progenitor cells and hematopoietic stem cells in patients with Philadelphia-positive and Philadelphia-negative chronic myeloproliferative disorders. Both ECFCs and CFU-ECs were cultured from peripheral blood mononuclear cells, and either BCR-ABL rearrangement or JAK2-V617F mutation were assessed in both types of endothelial colonies. We found that ECFCs lack the disease-specific markers, which are otherwise present in CFU-ECs, thus reinforcing the concept that the latter belongs to the hematopoietic lineage, and showing that in chronic myeloproliferative disorders the cell that gives rise to circulating ECFC has a distinct origin from the cell of the hematopoietic malignant clone.
Blood 08/2009; 114(14):3127-30. · 9.90 Impact Factor
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ABSTRACT: Liver and spleen iron concentrations, serum ferritin level and binding of S-ferritin to concanavalin A (Con A) were measured in 12 patients with thalassaemia major or intermedia at the time of splenectomy. All these subjects had increased liver iron concentration, most of them had hepatic fibrosis but none of them had histological evidence of chronic hepatitis. No patient had ascorbic acid deficiency. Serum ferritin concentration was increased in all cases, ranging from 266 to 5 504 μg/l. In all but 2 subjects most of the protein did not bind to Con A, thus behaving as tissue ferritin. There were highly significant correlations between serum ferritin concentration, amount of blood transfused and liver iron concentration. On the average, iron concentration in the liver was about 3 times that in the spleen. The findings obtained suggest that in patients with thalassaemia major or intermedia most of the iron is deposited in parenchymal tissues and most of the S-ferritin derives by leakage from the cytosol of iron-loaded parenchymal cells. S-ferritin is a valid index of liver iron overload in thalassaemic patients without complications such as viral hepatitis and/or ascorbic acid deficiency.
European Journal Of Haematology 04/2009; 30(4):289 - 296. · 2.61 Impact Factor
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ABSTRACT: Anemia due to hematinic deficiencies is common in patients with untreated celiac disease. Although celiac disease is a chronic condition characterized by an intense inflammatory response of the intestinal mucosa, scant data are available about the prevalence of anemia of chronic disease in celiac disease.
One hundred and fifty-two patients with celiac disease at presentation were studied. Anemia was investigated by determining complete blood counts, body iron status, serum levels of the soluble transferrin receptor, erythropoietin, prohepcidin and interferon-gamma. Genotyping for HFE mutations associated with hereditary hemochromatosis was performed. Fifty-three anemic patients were re-evaluated for hematologic response after 1 year on a gluten-free diet.
At the time of diagnosis of celiac disease the prevalence of anemia was 34%. Fifty-three out of 65 anemic patients had either iron and/or vitamin deficiency (folate, vitamin B(12)). Hereditary hemochromatosis mutations did not affect the prevalence of anemia. In 11 cases iron status parameters were indicative of anemia of chronic disease, sometimes in association with iron deficiency (6 patients). Patients with anemia of chronic disease had low levels of erythropoietin for the degree of anemia and increased serum interferon-gamma. In most cases anemia improved following a gluten-free diet, response rates being similar in anemia of chronic disease and in anemia due to hematinic deficiencies.
Our study shows that, in addition to iron and vitamin deficiencies, anemia of chronic disease has a significant role in some patients with celiac disease. Suppression of intestinal inflammatory changes as a result of a gluten-free diet improves anemia by correcting iron and vitamin malabsorption as well as mechanisms contributing to anemia of chronic disease.
Haematologica 10/2008; 93(12):1785-91. · 6.42 Impact Factor
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ABSTRACT: Acquired mutations in the juxtamembrane region of MPL (W515K or W515L), the receptor for thrombopoietin, have been described in patients with primary myelofibrosis or essential thrombocythemia, which are chronic myeloproliferative disorders. We have developed a real-time polymerase chain reaction assay for the detection and quantification of MPL mutations that is based on locked nucleic acid fluorescent probes. Mutational analysis was performed using DNA from granulocytes. Reference curves were obtained using cloned fragments of MPL containing either the wild-type or mutated sequence; the predicted sensitivity level was at least 0.1% mutant allele in a wild-type background. None of the 60 control subjects presented with a MPLW515L/K mutation. Of 217 patients with myelofibrosis, 19 (8.7%) harbored the MPLW515 mutation, 10 (52.6%) with the W515L allele. In one case, both the W515L and W515K alleles were detected by real-time polymerase chain reaction. By comparing results obtained with conventional sequencing, no erroneous genotype attribution using real-time polymerase chain reaction was found, whereas one patient considered wild type according to sequence analysis actually harbored a low W515L allele burden. This is a simple, sensitive, and cost-effective procedure for large-scale screening of the MPLW515L/K mutation in patients suspected to have a myeloproliferative disorder. It can also provide a quantitative estimate of mutant allele burden that might be useful for both patient prognosis and monitoring response to therapy.
Journal of Molecular Diagnostics 10/2008; 10(5):435-41. · 3.58 Impact Factor
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British Journal of Haematology 03/2008; 84(4):755 - 756. · 4.94 Impact Factor
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ABSTRACT: Red cell ferritin was measured in normal subjects and patients with iron deficiency and iron overload by means of radioimmunoassays with antibodies to liver (basic) and heart (acidic) ferritins. In most of the subjects examined, red cells were found to contain greater amounts of heart-type than liver-type ferritin. The basic ferritin content reflected the abnormal body iron status both in iron deficiency and iron overload while the acidic ferritin content was less closely related to the iron status. The two immunologically different red-cell ferritins probably represent distinct ferritin molecules and may have different metabolic functions within haem-synthesizing erythroid cells.
British Journal of Haematology 03/2008; 53(4):659 - 665. · 4.94 Impact Factor
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Giovanni Barosi, Gaetano Bergamaschi,
Monia Marchetti,
Alessandro M Vannucchi,
Paola Guglielmelli,
Elisabetta Antonioli,
Margherita Massa,
Vittorio Rosti,
Rita Campanelli,
Laura Villani,
Gianluca Viarengo,
Elisabetta Gattoni,
Giancarla Gerli,
Giorgina Specchia,
Carmine Tinelli,
Alessandro Rambaldi,
Tiziano Barbui
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ABSTRACT: Few investigators have evaluated the usefulness of the JAK2 V617F mutation for explaining the phenotypic variations and for predicting the risk of major clinical events in primary myelofibrosis (PMF). In a transversal survey we assayed by allele-specific polymerase chain reaction (PCR) the JAK2 V617F mutational status in 304 patients with PMF. Multiple DNA samples were collected prospectively from 64 patients, and a highly sensitive quantitative PCR was used as a confirmatory test. In a longitudinal prospective study we determined the progression rate to clinically relevant outcomes in 174 patients who had JAK2 mutation determined at diagnosis. JAK2 V617F was identified in 63.4% of patients. None of the V617F-negative patients who were sequentially genotyped progressed to become V617F positive, whereas progression rate from heterozygous to homozygous mutation was 10 per 100 patient-years. JAK2 V617F mutation contributed to hemoglobin, aquagenic pruritus, and platelet count variability, whereas homozygous mutation was independently associated with higher white blood cell count, larger spleen size, and greater need for cytoreductive therapies. Adjusting for conventional risk factors, V617F mutation independently predicted the evolution toward large splenomegaly, need of splenectomy, and leukemic transformation. We conclude that JAK2 V617F genotype should be considered in any future risk stratification of patients with PMF.
Blood 01/2008; 110(12):4030-6. · 9.90 Impact Factor
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ABSTRACT: The clinical and haematological phenotype of patients with myelofibrosis harbouring MPL(W515L/K) mutation has not been thoroughly investigated. Of 217 myelofibrosis subjects, 18 (8.2%) had an MPL mutation, four of which (22%) co-existed with JAK2(V617F) mutation. When compared with MPL wild-type patients, irrespective of JAK2(V617F) status, those with MPL(W515L/K), were more frequently female, were older (61 years vs. 57 years; P = 0.02), presented with more severe anaemia (haemoglobin, 101 g/l vs. 121 g/l; P = 0.002) and were more likely to require regular transfusional support (P = 0.012). These data indicate that MPL mutation in myelofibrosis characterises patients with more severe anaemic phenotype.
British Journal of Haematology 06/2007; 137(3):244-7. · 4.94 Impact Factor
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ABSTRACT: The diagnosis of an underlying chronic myeloproliferative disorder (CMPD) is often problematic in patients with primary extrahepatic portal vein obstruction (EHPVO) or Budd-Chiari syndrome (BCS); indeed, conventional clinical and hematological parameters usually yield insufficient information. To assess the diagnostic contribution of the gain-of-function mutation V617F of the JAK2 gene, 93 patients with EHPVO or BCS were investigated. JAK2 V617F was identified in 35.6% of 73 patients with EHPVO and in 40% of 20 patients with BCS. Taking the JAK2 mutation as a test with the highest positive predictive value for the diagnosis of CMPD, conventional clinical-hematological parameters had a sensitivity for CMPD lower than 48%. Bone marrow (BM) histology provided a diagnosis of CMPD in 41/74 (55.4%) patients, with a sensitivity of 93.5%. Clonality of hematopoiesis as assessed by granulocyte X-chromosome inactivation was present in 65.1% of 43 informative female patients, with a sensitivity of 86.6%. By resolving the sensitivity bias of the JAK2 mutation with the results of BM histology and clonality assay, CMPD was diagnosed in 53% of patients with EHPVO or BCS. In conclusion, CMPD is the major cause of primary EHPVO or BCS. JAK2 V617F is a very reliable and noninvasive molecular marker for CMPD and should be used as a first test for diagnosis.
Hepatology 01/2007; 44(6):1528-34. · 11.66 Impact Factor
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Gaetano Bergamaschi
Haematologica 09/2005; 90(8):1011B. · 6.42 Impact Factor
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Gaetano Bergamaschi
Haematologica 04/2005; 90(3):289A. · 6.42 Impact Factor
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Gaetano Bergamaschi
Haematologica 03/2005; 90(2):146. · 6.42 Impact Factor
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Gaetano Bergamaschi
Haematologica 02/2005; 90(1):1. · 6.42 Impact Factor
