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Journal ArticleDOI

CXCL13 plus interleukin 10 is highly specific for the diagnosis of CNS lymphoma

TL;DR: It is demonstrated for the first time that elevated CXCL13 concentration in cerebrospinal fluid (CSF) is prognostic and that CXC chemokine ligand and IL-10 mediate chemotaxis of lymphoma cells isolated from CNS lymphoma lesions.
About: This article is published in Blood.The article was published on 2013-06-06 and is currently open access. It has received 178 citations till now. The article focuses on the topics: Lymphoma & CXCL13.
Citations
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Journal ArticleDOI
TL;DR: There is evidence that patients with post-treatment Lyme disease syndrome do not have ongoing B. burgdorferi infection and, thus, do not benefit from additional antibiotic therapy, and most patients who receive this diagnosis have other illnesses.
Abstract: Lyme disease, caused by the Borrelia burgdorferi bacterium, is the most common vector-borne disease in the northern hemisphere. The clinical presentation varies with disease stage, and neurological manifestations (often referred to as Lyme neuroborreliosis) are reported in up to 12% of patients with Lyme disease. Most aspects of the epidemiology, clinical manifestation and treatment of Lyme neuroborreliosis are well known and accepted; only the management of so-called chronic Lyme disease is surrounded by considerable controversy. This term is used for disparate patient groups, including those who have untreated late-stage infection (for example, late neuroborreliosis), those with subjective symptoms that persist after treatment (termed 'post-treatment Lyme disease syndrome' [PTLDS]), and those with unexplained subjective complaints that may or may not be accompanied by positive test results for B. burgdorferi infection in serum (here called 'chronic Lyme disease'). The incidence of PTLDS is still a matter of debate, and its pathogenesis is unclear, but there is evidence that these patients do not have ongoing B. burgdorferi infection and, thus, do not benefit from additional antibiotic therapy. Chronic Lyme disease lacks an accepted clinical definition, and most patients who receive this diagnosis have other illnesses. Thus, a careful diagnostic work-up is needed to ensure proper treatment.

179 citations

Journal ArticleDOI
TL;DR: The complex networks of cellular interactions involving tumoral CXCL13 and CXCR5 integrate to promote cancer cell autonomous and non-autonomous responses, highlighting the relevance of autocrine and paracrine interactions in dictating the cancer phenotype.
Abstract: It is well-established that the chemokine C-X-C motif ligand 13 (CXCL13) and its receptor, the G-protein coupled receptor (GPCR) CXCR5, play fundamental roles in inflammatory, infectious and immune responses Originally identified as a B-cell chemoattractant, CXCL13 exerts important functions in lymphoid neogenesis, and has been widely implicated in the pathogenesis of a number of autoimmune diseases and inflammatory conditions, as well as in lymphoproliferative disorders Current evidence also indicates that the CXCL13:CXCR5 axis orchestrates cell-cell interactions that regulate lymphocyte infiltration within the tumor microenvironment, thereby determining responsiveness to cytotoxic and immune-targeted therapies In this review, we provide a comprehensive perspective of the involvement of CXCL13 and its receptor in cancer progression Studies in recent years postulated novel roles for this chemokine in controlling the cancer cell phenotype, and suggest important functions in the growth and metastatic dissemination of solid tumors Carcinogens have been found to induce CXCL13 production, and production of this chemokine within the tumor milieu has been shown to impact the proliferation, migration, and invasive properties of cancer cells Thus, the complex networks of cellular interactions involving tumoral CXCL13 and CXCR5 integrate to promote cancer cell autonomous and non-autonomous responses, highlighting the relevance of autocrine and paracrine interactions in dictating the cancer phenotype Dissecting the molecular and signaling events regulated by CXCL13 and how this chemokine dynamically controls the interaction between the cancer cell and the tumor microenvironment is key to identify novel effectors and therapeutic targets for cancer treatment

162 citations


Cites background from "CXCL13 plus interleukin 10 is highl..."

  • ...Just as CXCL13 has demonstrated potential clinical utility as a biomarker in infectious diseases involving the CNS, this chemokine has been also proposed as a marker of certain lymphomas....

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  • ...Of these, perhaps the best studied are the stages of Lyme disease and syphilis affecting the central nervous system (CNS) (Lyme neuroborreliosis and neurosyphilis)....

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  • ...Interestingly, whereas infection with B. burgdorferi appears to have no impact on plasma CXCL13 levels, once the bacteria establishes CNS infection, it leads to constitutively elevated CXCL13 levels in cerebrospinal fluid (CSF), which could be often more than several 100-fold greater than in the plasma (61)....

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  • ...CXCL13 appears to recruit B-cells within the CNS and facilitate their differentiation to plasma cells that produce a burgdorferi-targeted humoral response....

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  • ...Elevated CXCL13 levels in the CSF have been demonstrated for CNS lymphomas (72), and when elevated together with IL10 in the CSF, CXCL13 has a >99% specificity for primary and secondary lymphomas, leading to similar proposals that it serves as a biomarker for non-Hodgkin lymphoma involving the CNS (73)....

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Journal ArticleDOI
03 Oct 2013-Blood
TL;DR: The goal is to provide an overview of current knowledge regarding the pathogenesis of CNS lymphomas and to highlight promising strategies that the authors believe to be most effective in establishing diagnosis, staging, and therapeutic management.

148 citations


Cites background or methods from "CXCL13 plus interleukin 10 is highl..."

  • ...Our experience has been that repeated CSF cytological orflow-cytometric studies infrequently improves diagnostic yield in PCNSL, supporting development and implementation of other types of molecular diagnostic methods using CSF.38,40,49 Additional standard pretreatment staging tests for PCNSL include complete ophthalmologic examination including slit lamp; contrastenhanced computed tomography (CT) scan of the chest, abdomen, and pelvis; and bone marrow biopsy....

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  • ...Our experience has been that repeated CSF cytological orflow-cytometric studies infrequently improves diagnostic yield in PCNSL, supporting development and implementation of other types of molecular diagnostic methods using CSF.(38,40,49) Additional standard pretreatment staging tests for PCNSL include complete ophthalmologic examination including slit lamp; contrastenhanced computed tomography (CT) scan of the chest, abdomen, and pelvis; and bone marrow biopsy....

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  • ...The activity of intraventricular rituximab was additive or synergistic with methotrexate; this combination appeared to be useful in the setting of a high burden of leptomeningeal disease, eg, lymphoma cell counts.20 000 cells/mL in CSF. Finally, we demonstrated that intraventricular rituximab may overcome resistance mediated by the blood-brain barrier because several responses were noted in the CSF in patients with baseline serum rituximab concentrations.15 mg/mL. Notably, 2 patients achieved a first complete response of CNS lymphoma with intraventricular rituximab/ MTX, including one with CNS lymphoma refractory to high-dose systemic and intrathecal MTX plus 20 previous infusions of intravenous rituximab.108,109 In summary, given the data from a number of prospective trials as well as clinical series that document activity of rituximab in the setting of CNS lymphomas, as monotherapy and in combination with methotrexate-based induction regimens,110 as well as the overwhelming evidence that rituximab improves survival in systemic CD201 NHL, we recommend the incorporation of intravenous rituximab in CD201 CNS lymphoma–directed therapies....

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  • ...Measurement of CSF concentration of CXCL13 as well as interleukin (IL)-10 may also be useful in facilitating the diagnosis of CNS lymphoma, both at diagnosis and at relapse.(38) Transcriptional profile studies of PCNSLhave identified a number of potential mediators of disease pathogenesis including upregulated expression of MYC....

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Journal ArticleDOI
TL;DR: It is concluded that lenalidomide penetrates ventricular CSF and is active as monotherapy in relapsed CNS lymphomas and delays whole brain radiotherapy (WBRT) in patients with inadequate responses to lenalidumide.

128 citations

References
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Journal ArticleDOI
TL;DR: Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions.
Abstract: The clinical performance of a laboratory test can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy refers to the quality of the information provided by the classification device and should be distinguished from the usefulness, or actual practical value, of the information. Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions. Furthermore, ROC plots occupy a central or unifying position in the process of assessing and using diagnostic tools. Once the plot is generated, a user can readily go on to many other activities such as performing quantitative ROC analysis and comparisons of tests, using likelihood ratio to revise the probability of disease in individual subjects, selecting decision thresholds, using logistic-regression analysis, using discriminant-function analysis, or incorporating the tool into a clinical strategy by using decision analysis.

6,339 citations

Journal ArticleDOI
TL;DR: ROC analysis is shown to be related in a direct and natural way to cost/benefit analysis of diagnostic decision making and the concepts of "average diagnostic cost" and "average net benefit" are developed and used to identify the optimal compromise among various kinds of diagnostic error.

5,590 citations


"CXCL13 plus interleukin 10 is highl..." refers methods in this paper

  • ...The ability of CSF CXCL13 and IL-10 concentration to identify CNS lymphoma was evaluated by receiver-operating characteristic (ROC) curves.(19,20) Kaplan-Meier and log rank tests were used to assess differences in outcome according to expression of CXCL13 and IL-10....

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Journal ArticleDOI
TL;DR: New guidelines incorporating PET, IHC, and flow cytometry for definitions of response in non-Hodgkin's and Hodgkin's lymphoma are presented and it is hoped that they will be adopted widely by study groups, pharmaceutical and biotechnology companies, and regulatory agencies to facilitate the development of new and more effective therapies to improve the outcome of patients with lymphoma.
Abstract: Purpose Standardized response criteria are needed to interpret and compare clinical trials and for approval of new therapeutic agents by regulatory agencies. Methods The International Working Group response criteria (Cheson et al, J Clin Oncol 17:1244, 1999) were widely adopted, but required reassessment because of identified limitations and the increased use of [ 18 F]fluorodeoxyglucose-positron emission tomography (PET), immunohistochemistry (IHC), and flow cytometry. The International Harmonization Project was convened to provide updated recommendations. Results New guidelines are presented incorporating PET, IHC, and flow cytometry for definitions of response in non-Hodgkin’s and Hodgkin’s lymphoma. Standardized definitions of end points are provided. Conclusion We hope that these guidelines will be adopted widely by study groups, pharmaceutical and biotechnology companies, and regulatory agencies to facilitate the development of new and more effective therapies to improve the outcome of patients with lymphoma. J Clin Oncol 25:579-586. © 2007 by American Society of Clinical Oncology

4,080 citations

Journal ArticleDOI
TL;DR: Findings clearly suggest that marked overexpression of the miR-17-92 cluster with occasional gene amplification may play a role in the development of lung cancers, especially in their most aggressive form, small-cell lung cancer, and that the C13orf25 gene may well be serving as a vehicle in this regard.
Abstract: MicroRNAs (miRNAs) are small noncoding RNAs, thought to be involved in physiologic and developmental processes by negatively regulating expression of target genes. We have previously reported frequent down-regulation of the let-7 miRNA family in lung cancers and, in the present study, assessed alteration in a panel of 19 lung cancer cell lines. As a result, we found for the first time that the miR-17-92 cluster, which comprises seven miRNAs and resides in intron 3 of the C13orf25 gene at 13q31.3, is markedly overexpressed in lung cancers, especially with small-cell lung cancer histology. Southern blot analysis revealed the presence of increased gene copy numbers of the miRNA cluster in a fraction of lung cancer cell lines with overexpression. In addition, we were able to show predominant localization of C13orf25 transcripts within the nucleus and introduction of the expression construct of the miR-17-92 cluster, but not the putative open reading frame of C13orf25, enhancing lung cancer cell growth. These findings clearly suggest that marked overexpression of the miR-17-92 cluster with occasional gene amplification may play a role in the development of lung cancers, especially in their most aggressive form, small-cell lung cancer, and that the C13orf25 gene may well be serving as a vehicle in this regard.

1,607 citations

Journal ArticleDOI
TL;DR: An international group of experts meeting to review current standards of reporting and to formulate a consensus opinion regarding minimum baseline evaluation and common standards for assessing response to therapy hope that these guidelines will improve communication among investigators and comparability among clinical trials in a way that will allow to develop better therapies for patients.
Abstract: Standardized guidelines for the baseline evaluation and response assessment of primary CNS lymphoma (PCNSL) are critical to ensure comparability among clinical trials for newly diagnosed patients. The relative rarity of this tumor precludes rapid completion of large-scale phase III trials and, therefore, our reliance on the results of well-designed phase II trials is critical. To formulate this recommendation, an international group of experts representing hematologic oncology, medical oncology, neuro-oncology, neurology, radiation oncology, neurosurgery, and ophthalmology met to review current standards of reporting and to formulate a consensus opinion regarding minimum baseline evaluation and common standards for assessing response to therapy. The response guidelines were based on the results of neuroimaging, corticosteroid use, ophthalmologic examination, and CSF cytology. A critical issue that requires additional study is the optimal method to assess the neurocognitive impact of therapy and address the quality of life of PCNSL survivors. We hope that these guidelines will improve communication among investigators and comparability among clinical trials in a way that will allow us to develop better therapies for patients.

673 citations

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