HRAS1 proto-oncogene polymorphisms in human malignant melanoma: TaqI defined alleles significantly associated with the disease.

We have analysed the DNA of peripheral blood leukocytes (PBL) from 55 melanoma patients and 53 healthy individuals and failed to find any significant association between melanoma and rare HRAS1 alleles defined by MspI/HpaII digestion. However, the analysis of the same DNAs for a different polymorphism based on the presence of additional TaqI sites in the variable tandem repeat region of HRAS1 showed that the total frequency of a group of allelic variants, named Tp, was significantly higher in melanoma patients than in normal donors.

Screening for mutations in exon 11 of the BRCA1 gene in 70 Italian breast and ovarian cancer patients by protein truncation test.

The most common mutations in the familial breast and ovarian cancer susceptibility gene BRCA1 are frameshift and nonsense mutations, which lead to the synthesis of truncated proteins. On this ground, we have analysed BRCA1 exon 11, which includes about 61% of coding region, in germline DNA from 70 Italian breast and/or ovarian cancer patients, using the protein truncation test (PTT). BRCA1 mutations were identified in nine of 29 (approximately 31%) patients with a family history of cancer and in three of 41 (approximately 7%) women with early-onset breast carcinomas, and were subsequently characterized by sequence analysis. In addition, BRCA1 mutations were also detected in six affected relatives of two positive index cases. The observed frequencies of mutations were not significantly different from those expected on the basis of the phenotypic characteristics of patients and their families, indicating that PTT is a rapid and sensitive method that can be used for a first BRCA1 mutational screening. The histological findings in BRCA1 mutated cases showed that eight of nine (approximately 89%) breast carcinomas were of grade III and nine of 9 (100%) ovarian carcinomas were of the endometrioid type (eight of grade III and one of grade II). This suggests that specific histological characteristics may represent additional criteria for selection of cases eligible to BRCA1 mutational analysis.

Interleukin-2 gene-transduced human melanoma cells efficiently stimulate MHC-unrestricted and MHC-restricted autologous lymphocytes.

Two human melanoma lines were transduced by a retroviral vector with the gene of the human interleukin-2 (IL-2) and characterized for their immunological properties in comparison with the parental lines. Transduction resulted in the production of biologically active IL-2 in the average amounts of 2,282 and 2,336 pg/ml per 10(5) cells per 24 hr over 3 and 2 months by the Me14932/IL-2 and the Me1B6/IL-2 lines, respectively. Melanoma-transduced cells lost their tumorigenicity in nude mice. No major changes in the phenotype were observed in IL-2 gene-transduced lines. In fact, more than 90% of cells expressed class I and II(DR) HLA, adhesion molecules, integrins, and melanoma-associated antigens. Irradiation with 100-400 Gy, while inhibiting tumor cell growth in vitro, allowed the release of IL-2 by the transduced cells for at least 5 weeks. The two melanoma lines also maintained susceptibility to lysis by lymphokine-activated killer (LAK) cells and by a HLA-A2-restricted melanoma-specific cytotoxic T lymphocyte (CTL) clone recognizing the melanoma antigen (Melan-A). In a limiting dilution assay, transduced, but not parental melanoma lines unless added with an amount of IL-2 comparable to that released by the transduced cells, were able to expand both nonspecific and melanoma-specific CTL precursors from autologous peripheral blood lymphocytes (PBL). In mixed lymphocytes-tumor cultures, IL-2 gene-transduced melanoma cells stimulated the expansion of major histocompatibility complex (MHC)-unrestricted effectors from autologous PBL, and of CD3+ CD8+ MHC-restricted CTL from tumor-invaded lymph nodes. These results indicate that IL-2 gene transduction does not alter significantly the expression of the immunologically relevant molecules of human melanoma lines while increasing their ability to stimulate both specific and nonspecific lymphocyte responses. These lines will be of value in the vaccination of melanoma patients.

Inconsistent expression of HLA-B antigens on peripheral blood lymphocytes of stage I melanoma patients: an indicator of poor prognosis.

The survival of stage I melanoma patients was evaluated and compared with the detectable expression of HLA antigens. Of 904 patients who were surgically treated, 219 were HLA typed on peripheral blood lymphocytes. Four consecutive HLA typings were considered necessary. Median follow-up was 8 years. Two main groups of patients were considered: (a) patients with consistent detectable expression of antigens; and (b) patients with inconsistent detectable expression of antigens. Patients with consistent HLA antigens detection had an 8-year survival rate of 87.7% compared with 49.2% of patients with an inconsistent rate (P10(-7). Multivariate analysis of survival of the 182 HLA-typed patients who survived at least 24 months from surgery showed that two of the criteria had an independent impact on survival: tumour thickness (P 0.02) and HLA typing (P 2 x 10(-5). Inconsistent detection of HLA antigens on peripheral blood lymphocytes during the first 24 months after surgery is an indicator of poor prognosis in stage I melanoma patients.

HLA-A, B, C, DR and DQ expression and hepatocellular carcinoma: study of 205 Italian subjects.

We have evaluated the frequency of HLA class I and II antigens in 205 Italian patients with hepatocellular carcinoma (HCC) and 749 blood donors (controls). Moreover, we have looked for correlations between HLA antigen frequencies and HBV and/or HCV infections in HCC patients. We found great differences in HLA antigen frequencies considering only two groups: HCC patients and controls. The polymorphism is smaller when we consider the different groups of HCC patients in regard to the previous viral infections (HBV and/or HCV). The most interesting finding is the higher frequency of Cw7, B8 and DR3 in almost all groups of HCC patients. It is well known, that the HLA A1, Cw7, B8, DR3 antigen haplotype is associated with a rapid decline of CD4 cells, and HLA B8, DR3 positive subjects may display some changes in immune parameters and are prone to develop several immunological diseases. Thus HCC might be the result of a lower sensitivity (genetically given) to mitogenic stimuli of HBV and HCV.

Malignant melanoma: sister chromatid exchange analysis in three families.

Sister chromatid exchange (SCE) was analyzed in stimulated lymphocytes and skin fibroblasts in members of three families with cutaneous malignant melanoma (CMM). Two of these families were characterized by familial CMM; the other family had one patient affected by CMM and two others with other cutaneous melanocytic lesions. All the patients had undergone surgery but no chemotherapy. Higher and differing SCE rates were found in lymphocytes and in fibroblasts of all patients. A wide range of SCE distribution was found in patients with high SCE rate. A few healthy close relatives also showed relatively high SCE rates and wide range distributions. These subjects may be regarded as a subset of family members at high risk for developing cancer. The variability of SCE rates and distribution may reflect genetic heterogeneity of CMM.

Sister chromatid exchange and proliferation pattern in stimulated lymphocytes of cutaneous malignant melanoma patients.

Sister chromatid exchange (SCE) and the proliferative pattern of phytohemagglutinin-stimulated lymphocytes were examined in 36 nonfamilial cutaneous malignant melanoma (CMM) patients. One close relative of each of 27 CMM patients was also examined. All the patients had undergone surgical treatment for the neoplasm, but had received no chemotherapy or radiotherapy. The SCE rates were found to be higher and more variable in a significant fraction of CMM patients, and in relatively fewer unaffected relatives, which is in contrast to findings in unrelated subjects taken as controls. Also, variable and higher proportions of cells in metaphase of the first cell cycle (M1), after 72-hr culture in the presence of bromodeoxyuridine, were more often found among the CMM patients than in the controls; however, no effect of clinical progression of the neoplastic disease on SCE rates or on the lymphoproliferative pattern was observed. The present study indicates heterogeneity among subjects who develop CMM and suggests that the peculiarities of SCE rates and of the lymphoproliferative patterns observed in some of the CMM patients and in a few of their close relatives may be connected with the mechanism of onset of the neoplasm.

Sister chromatid exchange analysis in familial groups of malignant melanoma patients.

Sister chromatid exchange (SCE) analysis was carried out on peripheral blood lymphocytes of 20 familial malignant melanoma (FMM) and 39 sporadic malignant melanoma (SMM) untreated patients, belonging to 10 and 39 families, respectively. The study was extended to 39 unaffected close relatives of FMM patients, to 187 unaffected close relatives of SMM patients, and to 20 unaffected unrelated individuals (control group), all examined under the same conditions. The mean SCE rates/cell were significantly higher in MM families than in the control group, and in melanoma patients than in their close relatives. The mean SCE levels of FMM and SMM patients, (8.4 +/- 0.8 and 8.0 +/- 0.3, respectively) were similar, and so were the distributions of individuals in classes of increasing SCE values (with a modal value at 7-8 SCEs/cell). The mean SCE levels of close relatives of FMM and SMM patients were also similar (5.4 +/- 0.2 and 5.4 +/- 0.1, respectively, with a modal value at 4-5 SCEs/cell), and slightly higher than in the control group (4.7 +/- 0.2 SCEs/cell). More than 7 SCEs/cell were observed in the majority (41 of 59) of FMM or SMM patients, in a smaller fraction (25 of 227) unaffected relatives, and in none of 20 unrelated unaffected individuals. These observations favor the hypothesis that higher SCE levels may be an expression of constitutional lesions predisposing to this neoplastic disease.

HLA and multiple sclerosis in Italy: a review of the literature.

HLA antigens of locus A, C, B, DR and DQ were typed in 104 Italian multiple sclerosis patients and in 905 healthy controls; the results have been compared with those published in the Italian literature. The Italian studies have been reviewed regarding the ethnic origin of the typed population and the corresponding prevalence of the disease. The data suggest a lack of association between A3 and B7 antigens and Italian multiple sclerosis and a relevance of other DR locus antigens (mainly DR4 and DR5), in addition to DR2, in the susceptibility to the disease.

S100 protein serum levels in cutaneous malignant melanoma.

We investigated the utility of serum S100 determined by means of immunoradiometric assay in a cohort of 438 patients affected by cutaneous melanoma (126 untreated and 312 previously treated). Using 0.2 microg/l cut-off value, determined in 134 healthy blood donors, the sensitivity was 4.2% in stage I patients (4/94), 5.3% in stage II patients (1/19), and 38.5% in stage III patients (5/13). Even though the sensitivity increased progressively from stage I to stage II and III, these differences were not statistically significant. The prognostic significance of S100 evaluation at diagnosis was investigated in terms of survival but no statistical correlation between S100 basal levels and survival was found. In the 312 previously treated patients serum S100 levels were correlated to disease extent, high levels of the marker were observed in 42.8% (9/21) of patients with local recurrence, in 32% (16/50) of patients with lymph node and/or in-transit metastases, in 77.3% (17/22) of patients with distant metastases, and in patients with NED, the specificity of the marker was 96.8% (212/219). The difference between these groups were statistically significant. In conclusion, S100 protein was abnormally high in patients with metastatic malignant melanoma. Serial S100 measurements in a follow-up study are necessary to test the importance of the protein in the management of patients with metastatic malignant melanoma.

Human leukocyte antigens (HLA) and haplotypes in familial polyposis coli (FPC).

Close correlation between HLA antigens and haplotypes and familial polyposis coli, an infrequent inherited condition which results in an early onset of colonic adenomas and carcinoma is reported. Similarity between the patients' group and their healthy relatives is recorded, both groups differing from a healthy control group (HLA B35, DR5). This haplotype cannot be considered as a marker of the disease but provides a statistical indication of a high risk of adenomas in each family affected by FPC.

Association between longevity and allelic forms of human leukocyte antigens (HLA): population study of aged Italian human subjects.

Several arguments support the idea of a link between longevity and heredity, both in humans and in experimental animals. We have therefore investigated the possibility of an association between the human leukocyte antigens (HLA) and longevity in two groups of Italian subjects: 108 healthy subjects over 85 years old, and 749 healthy blood donors (controls). Only four antigens showed a higher frequency in the elder group: HLA-A31(19), B7, Cw7 and DQ1. These findings suggest an involvement of HLA antigens in human longevity, but the real biological meaning of these results is still unclear.

Lower frequency of sister chromatid exchanges and altered frequency of HLA B-region alleles among individuals with sporadic dysplastic nevi.

Sister chromatid exchanges (SCE) were analyzed in peripheral blood lymphocytes of 24 individuals, following diagnosis, and prior to surgical removal, of a sporadic dysplastic nevus (DN). Lower SCE values and variability were found in 23 sporadic DN individuals compared with controls (2.52 +/- 0.12 and 3.76 +/- 0.22 SCE/cell, respectively). These DN individuals, contrarily to healthy controls and some types of tumor patients whose cells are hypersensitive to mutagenic agents, did not show increased SCE rates as a consequence of cigarette smoking, alcohol consumption and diagnostic radiation treatments. These observations are in contrast with clinical evidence that similar lesions are both markers or risk and precursors of malignancy in individuals with multiple nevi, affected by the dysplastic nevus syndrome (DNS) or belonging to FMM (familial malignant melanoma) families. Three HLA class I alleles out of 72 tested were found more frequently in sporadic DN individuals compared with controls: B37 (p < 0.05), B52 (p < 0.01) and B70 (p < 0.01). Whether the greater chromosomal stability (as shown by the SCE analysis), and/or the altered frequency of some HLA alleles could influence the chance of developing cutaneous malignancy in DN individuals is yet to be evaluated.

HLA-antigens in Italian type 1 diabetic patients: role of DR3/DR4 antigens and breast feeding in the onset of the disease.

HLA-A, B, C, DR and DQ typing was performed in 381 Italian insulin-dependent diabetic patients and in 905 normal Italian subjects. The diabetic patients had significantly higher frequencies of HLA-Cw7, B8, B18, DR3, DR4, DQw2 and DQw3 and significantly lower frequencies of HLA-B17, Bw51, DR2, DR7 and DRw11. The frequency of heterozygosity for HLA-DR3/DR4 was significantly higher in patients who developed the disease in the first 2 years of life and DR3+/DR4-, DQw2 and DQw3 alleles were higher in those aged less than 14 years at onset. The HLA-DR4 allele was associated with onset of diabetes in autumn and HLA-B18 with onset in Autumn-winter. Diabetic children who were breast fed had a later onset of insulin-dependent diabetes mellitus than those who were bottle fed but these differences were independent of HLA typing (11.8 +/- 0.72 years vs 9.23 +/- 0.42 years; mean +/- SEM). We conclude that: (1) in general, HLA distribution in Italian insulin-dependent diabetic patients reflects previous data reported in other European and North American populations; (2) HLA-DR3 and DR4 are strongly associated with insulin-dependent diabetes in Italy as well, and these alleles seem to predispose to an earlier onset of the disease; and (3) breast feeding may delay the onset of the disease.

HLA antigen frequencies in malignant melanoma patients. A second study.

Two groups of malignant melanoma (MM) patients were considered: the group of 140 patients previously published and a new one of 58, both typed for HLA-A, -B and -C antigens at the Istituto Nazionale Tumori of Milan. The control group consisted of healthy blood donors not related to the patients. Only the HLA-Bw35 antigen frequency was significantly decreased in both groups of patients. To investigate the HLA-A and -B blanks, 62 MM patients and 90 healthy controls, who showed non-homozygotic blanks when they were firstly HLA typed, volunteered to repeat the HLA typing three or more times in a 2-year period. A significant increase in both HLA-A and -B blanks in the patients as compared to controls was noticed (p = 3 X 10(-4) and 3 X 10(-5), respectively). In the future, attempts should be made to correlate the HLA antigen and blank frequencies with the evolution of the disease and, also, to verify the hypothesis that the HLA-Bw35 antigen may be an associated resistance factor against the tumor.

HLA antigens in malignant melanoma patients.

One hundred and forty melanoma patients, divided in 2 groups, i.e., patients with clinical evidence of melanoma and patients with no clinical evidence of melanoma, were typed for HLA-A, -B and -C antigens and compared with 340 to 905 (according to each HLA antigen examined) healthy adult blood donors. Overall, a highly significant increase in HLA-B40 antigen (p = 5.6 x 10(-7)) and a decrease in HLA-BW35 (p = 1.6 x 10(-4)) was observed. No relevant difference was found between the 2 groups. Moreover, an unexpected excess of HLA blanks was observed at both A and B loci in the first group (p = 1.3 x 10(-2) and p = 3.3 x 10(-6), respectively) and only at the B locus in the second (p = 1.2 x 10(-2)), when the patients were compared to 288 healthy individuals HLA typed at the same time and with the same HLA antisera as the patients. The increase in HLA blanks in melanoma patients deserves further investigation to ascertain whether it may be due to the tumor not yet surgically removed or may be referred to technical pitfalls.

Immunoglobulin allotypes in familial malignant melanoma.

There is some evidence that genes at loci on the lower end of chromosome 14, encoding for the immunoglobulin heavy chains allotypes (Gm), may influence susceptibility to human tumors. We examined the Gm and Km (IgK light chain) allotype distribution in a sample of 41 patients with familial malignant melanoma and in 79 healthy relatives. An increased frequency of the haplotype carrying the Gm (2) allotype, namely Gm (1, 2, 17;..;21), seemed to be peculiar to patients, since it was almost twice as frequent in them than in the healthy population and four times as frequent with respect to the healthy relatives. Our findings are in keeping with previous suggestions that in Caucasian melanoma patients genes of the immunoglobulin heavy chain constant region, or Gm-linked genes, may enhance susceptibility to malignant melanoma.

HLA antigens in familial and sporadic cutaneous melanoma.

One hundred and twenty-four subjects belonging to 25 families, 51 with familial malignant melanoma (FMM), and 186 subjects belonging to 41 families, 41 with sporadic malignant melanoma, were typed for the HLA A, B, C and DR loci of the HLA system. There was the same statistically significant difference in the frequency of the haplotype A9, B35, Cw4 between each group of patients and the respective healthy relatives (p = 0.01, p = 0.01 and p = 4 x 10(-3), respectively). Moreover, the higher frequency of the haplotype A9, B35, Cw4 in the healthy members of the FMM families (42.46%) compared with the healthy members of the SMM families (23.44%) indicates that in the latter group other individuals are at risk for the disease. Furthermore, the different frequency of haplotypes B5, DR5 and B5, Cw1 suggest that differences exist between the two groups of healthy relatives. These observations confirm that the HLA region is involved in the etiology of malignant melanoma.

HLA antigens in ovarian adenocarcinoma patients.

Sixty five patients affected by ovarian carcinoma, 40 controls with benign ovarian disease were typed for HLA A, B and C antigens and compared with 132 adult female blood donors. A highly significant increase in HLA B7 antigen (p = 0,0083) and a decrease in HLA A11, A28, B12 (p = 0,04; p = 0.03 respectively) in patients vs controls has been noticed. The comparison among the ovarian benign disease patients, and those with ovarian carcinoma and the healthy controls showed a decrease in the HLA A1 antigen frequency. Besides, the patients presented an increased and a decreased frequency of the A and O blood phenotypes respectively. These data confirm those of other Authors, and we can conclude that the neoplastic disease does not show a strong association with histocompatibility antigens.

HLA-A, B, C and DR in hepatitis B virus (HBV)-related liver cirrhosis: a study of 851 elderly subjects.

The possible correlation between HLA system and liver cirrhosis secondary to HBV infection has been studied in 102 hospitalized elderly patients affected by liver cirrhosis (histologically proven) and 749 elderly health controls. Increased frequencies of HLA-A2, Cw4, Cw5, DR4, DR5 and DR7 have been observed in patients with liver cirrhosis and previous HBV infection, while a lower frequency of HLA-A2 and higher frequencies of HLA-A3, B35, Cw4, DR3 have been observed in patients without previous HBV infection when compared with controls.