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Relationships between lymphomas linked to hepatitis C virus infection and their microenvironment

World Journal of Gastroenterology 2013年第44期19卷 7874-7879页

作者： Antonino Carbone Annunziata Gloghini Department of Pathology Centro di Riferimento Oncologico Aviano Istituto Nazionale Tumori IRCCSAviano and Pordenone Hospital 33081 Aviano Italy Member of WHO IARC Monograph Working Group on Biological Agents 2009 Lyon France Department of Diagnostic Pathology and Laboratory Medicine Fondazione IRCCS Istituto Nazionale dei Tumori 20133 Milano Italy

The relationships between lymphomas and their microenvironment appear to follow 3 major patterns:(1)an independent pattern;(2)a dependent pattern on deregulated interactions;and(3)a dependent pattern on regulated coexistence.Typical examples of the third pattern are hepatitis C virus(HCV)-associated marginal zone lymphomas(MZLs)and mucosa-associated lymphoid tissue lymphomas.In these lymphomas,a regulated coexistence of the malignant cells and the microenvironmental factors usually occurs.At least initially,however,tumor development and cell growth largely depend on external signals from the microenvironment,such as viral antigens,cytokines,and cell-cell interactions.The association between HCV infection and B-cell lymphomas is not completely defined,although this association has been demonstrated by epidemiological studies.MZL and diffuse large B-cell lymphoma are the histotypes most frequently associated with HCV infection.Many mechanisms have been proposed for explaining HCV-induced lymphomagenesis;antigenic stimulation by HCV seems to be fundamental in establishing B-cell expansion as observed in mixed cryoglobulinemia and in B-cell lymphomas.Recently,antiviral treatment has been proved to be effective in the treatment of HCV-associated indolent lymphomas.Importantly,clinically responses were linked to the eradication of the HCV-RNA,providing a strong argument in favor of a causative link between HCV and lymphoproliferation.

关键词： Hepatitis C virus-infection B-cell lymphomas Marginal zone lymphoma Mucosa-associated lymphoid tissue lymphomas Diffuse large B-cell lymphomas Microenvironment

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Proteinuria in paediatric patients with human immunodefi ciency virus infection

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World Journal of Clinical Cases 2013年第1期1卷 13-18页

作者： Vania Giacomet Paola Erba Francesca Di Nello Sonia Coletto Alessandra Viganò Gian Vincenzo Zuccotti Department of Paediatrics L Sacco Hospital University of Milan 20157 Milan Italy

In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.

关键词： Human immunodeficiency virus-infection Nephropathy Proteinuria Antiretroviral therapy Children

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