Alpelisib administration reduced lymphatic malformations in a mouse model and in patients.

Lymphatic cystic malformations are rare genetic disorders mainly due to somatic gain-of-function mutations in the PIK3CA gene. These anomalies are frequently associated with pain, inflammatory flares, esthetic deformities, and, in severe forms, life-threatening conditions. There is no approved medical therapy for patients with lymphatic malformations. In this proof-of-concept study, we developed a genetic mouse model of PIK3CA-related lymphatic malformations that recapitulates human disease. Using this model, we demonstrated the efficacy of alpelisib, an approved pharmacological inhibitor of PIK3CA in oncology, in preventing lymphatic malformation occurrence, improving lymphatic anomalies, and extending survival. On the basis of these results, we treated six patients with alpelisib, including three children, displaying severe PIK3CA-related lymphatic malformations. Patients were already unsuccessfully treated with rapamycin, percutaneous sclerotherapies, and debulking surgical procedures. We assessed the volume of lymphatic malformations using magnetic resonance imaging (MRI) for each patient. Alpelisib administration was associated with improvements in the six patients. Previously intractable vascular malformations shrank, and pain and inflammatory flares were attenuated. MRI showed a decrease of 48% in the median volume of lymphatic malformations over 6 months on alpelisib. During the study, two patients developed adverse events potentially related to alpelisib, including grade 1 mucositis and diarrhea. In conclusion, this study supports PIK3CA inhibition as a promising therapeutic strategy in patients with PIK3CA-related lymphatic anomalies.

A fast and environment-friendly MEPSPEP/UHPLC-PDA methodology to assess 3-hydroxy-4,5-dimethyl-2(5H)-furanone in fortified wines.

Sotolon is widely associated with the quality of fortified aged wines, and has also been linked to premature oxidative aging (premox). Here we developed a single, fast and environmental-friendly microextraction by packed sorbent ultra-high pressure liquid chromatography analysis (MEPS/UHPLC-PDA) for sotolon quantification in different wines. The best extraction conditions (loading three times 250µL samples through the MEPSPEP sorbent and elution with 100µL of 50% MeOH) were combined with a fast UHPLC separation (5min separation using acidified 10% MeOH isocratic flow in a CORTECS C18 column) to allow unparalleled minimum sample and solvents volumes usage. The validated methodology showed good linearity (r(2)>0.993) and precision (<5.6%); high recovery (>81%) and detection limits (0.45-2.51µg/L) far below sotolon odor threshold for any type of wine. The methodology was successfully applied to selected white table and Madeira wines, encompassing therefore a wide range of alcohol and sugar contents. Furthermore, as far we may know, this is the first time a single methodology can be used to assess both wine aging or premox according to the type of wine.