RESUMEN
DLBCL is the most common lymphoma subtype occurring in older populations as well as in younger HIV infected patients. The current treatment options for DLBCL are effective for most patients yet the relapse rate is high. While many biomarkers for DLBCL exist, they are not in clinical use due to low sensitivity and specificity. In addition, these biomarkers have not been studied in the HIV context. Therefore, the identification of new biomarkers for HIV negative and HIV positive DLBCL, may lead to a better understanding of the disease pathology and better therapeutic design. Protein biomarkers for DLBCL were determined using MALDI imaging mass spectrometry (IMS) and characterised using LC-MS. The expression of one of the biomarkers, heat shock protein (Hsp) 70, was confirmed on a separate cohort of samples using immunohistochemistry. The biomarkers identified in the study consisted of four protein clusters including glycolytic enzymes, ribosomal proteins, histones and collagen. These proteins could differentiate between control and tumour tissue, and the DLBCL immunohistochemical subtypes in both cohorts. The majority (41/52) of samples in the confirmation cohort were negative for Hsp70 expression. The HIV positive DLBCL cases had a higher percentage of cases expressing Hsp70 than their HIV negative counterparts. The non-GC subtype also frequently overexpressed Hsp70, confirming MALDI IMS data. The expression of Hsp70 did not correlate with survival in both the HIV negative and HIV positive cohort. This study identified potential biomarkers for HIV negative and HIV positive DLBCL from FFPE tissue sections. These may be used as diagnostic and prognostic markers complementary to current clinical management programmes for DLBCL.
Asunto(s)
Biomarcadores , Infecciones por VIH/complicaciones , Linfoma de Células B Grandes Difuso/complicaciones , Linfoma de Células B Grandes Difuso/metabolismo , Proteoma , Proteómica , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Ganglios Linfáticos/metabolismo , Ganglios Linfáticos/patología , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/mortalidad , Péptidos/metabolismo , Pronóstico , Proteómica/métodos , Seudolinfoma/complicaciones , Seudolinfoma/diagnóstico , Seudolinfoma/metabolismo , Transducción de SeñalRESUMEN
A 30-year-old pregnant HIV-seropositive woman presented with symptoms and signs suggestive of severe pulmonary arterial hypertension, with a fatal outcome. Histological features of pulmonary arterial hypertension were present at post mortem. This is the first report of histologically confirmed HIV-associated pulmonary arterial hypertension associated with pregnancy in Africa.