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Biomedical subjects

Anna Falanga

Publications and source records attributed to Anna Falanga.

23 records · Page 2Linked to original sources

All-trans retinoic acid modulates microvascular endothelial cell hemostatic properties.

BACKGROUND AND OBJECTIVES: All-trans retinoic acid (ATRA) is an anti-tumor agent capable of controlling the hypercoagulable state associated with malignancy. Among hemostasis-regulating functions, ATRA modulates the procoagulant and fibrinolytic properties of endothelial cells (EC) from large vessels (HUVEC). In this study we investigated whether ATRA may affect the same activities of EC derived from microvessels (HMEC-1 cell line). DESIGN AND METHODS: We studied the effects of ATRA on procoagulant (i.e. tissue factor, TF), fibrinolytic (i.e. tissue plasminogen activator and inhibitor, t-PA and PAI-1) and anticoagulant (i.e. thrombomodulin, TM) properties of HMEC-1, compared to HUVEC. The type of retinoic acid receptor (RAR) possibly involved was identified by using synthetic retinoid selective agonists or antagonists for RAR alpha, beta or gamma. The study was conducted with or without tumor necrosis factor (TNF)alpha to induce the expression of some endothelial hemostatic properties. RESULTS: ATRA significantly inhibited TNFalpha-induced TF expression in HMEC-1 as well as HUVEC. ATRA increased t-PA antigen without significantly affecting PAI-1 expression, and counteracted the TNFalpha-induced t-PA decrease in both types of EC. Accordingly, t-PA activity was significantly increased by ATRA, even in the presence of TNFalpha. Finally, ATRA upregulated TM, and prevented TNFalpha-induced TM downregulation. The study with selective RARs agonists and antagonists indicated that RARalpha played a major role in t-PA and TM modulation, whereas all three receptors were involved in TF downregulation. INTERPRETATION AND CONCLUSIONS: This study provides the first evidence that ATRA increases antithrombotic potential also in microvascular EC, a very relevant compartment for tumor- and/or antitumor therapy-associated vascular complications.

Benzoates↗

Clotting mechanisms and cancer: implications in thrombus formation and tumor progression.

Development of cancer is associated with activation of blood coagulation. The results of laboratory tests clearly demonstrate that fibrin formation and dissolution is continuously ongoing at different rates in these patients, who are at increased risk of secondary thrombosis. Notably, fibrin formation is also involved in the process of tumor spread and metastasis. The pathogenesis of the hemostatic disorders in cancer is complex and reflects the interaction of different mechanisms involving the activation of various hemostatic components, such as the coagulation and fibrinolytic systems, the vascular endothelium, leukocytes, and platelets. Tumor cells possess the capacity to interact with all of these components. Indeed they directly activate the coagulation cascade by producing their own procoagulant factors, or they can stimulate the prothrombotic properties of other blood cell components. Additional mechanisms of blood clotting activation are started by the initiation of antitumor therapies. In the last 10 years research studies have greatly improved our knowledge of tumor-promoted prothrombotic functions. Understanding the molecular basis of the underlying mechanisms may help to identify better-targeted strategies to prevent thromboembolism in cancer patients. Further, pharmacological modulation of malignant cell hemostatic properties may not only affect the tumor-associated thrombotic risk but may also leave open the possibility to interfere with the progression of the disease.

Anticoagulants↗

Effect of all-trans-retinoic acid on the hypercoagulable state of patients with breast cancer.

To evaluate whether all-trans-retinoic acid (ATRA) is able to modulate the hemostatic system in patients with solid tumors, we studied patients with locally advanced breast cancer who were enrolled in a Phase Ib study of ATRA +/- Tamoxifen (Tam). In this study, two groups of 15 patients/each were treated for 21 days before operation with ATRA at three doses (15, 45, or 75 mg/m(2)/day on alternate days) given alone (group 1) or in combination with Tam (group 2). One additional group received Tam alone. Plasma samples were evaluated for hypercoagulation markers (FVIIa, F1+2, TAT, D-dimer), fibrinolysis proteins (t-PA, PAI-1), and coagulation inhibitors (protein C, AT). At baseline, cancer patients had FVIIa, F1+2, TAT, and PAI-1 significantly greater than control subjects. During treatment, in the patients given ATRA alone, hypercoagulation markers appeared unmodified. Instead, subjects given Tam alone had a significant elevation of FVIIa, F1+2, and TAT versus baseline. However, in the ATRA + Tam groups, hypercoagulation markers were decreased compared with Tam alone. These results suggest that in selected conditions, pre-operative ATRA may modulate the hypercoagulable state of breast cancer patients.

Aged↗

Biological and clinical aspects of anticancer effects of antithrombotics.

Hemostatic mechanisms play a role not only in cancer associated thrombotic diathesis, but also in tumor growth and dissemination. Hence, inhibition of fibrin formation has been considered a possible tool against the progression of malignant disease. An antineoplastic effect of antithrombotic agents in various experimental models (i.e. tumor cell in culture, experimental animals, and cancer patients) has often been suggested. Anticoagulant drugs such as heparins and vitamin K antagonists have been repeatedly tested in this context. However, heparins have been more extensively studied. Several reports in animal models demonstrate that heparin can reduce the primary tumor growth or its metastatic spread. Clinical studies of thrombosis in cancer patients show that, besides their role as antithrombotics, heparins may have beneficial effects on survival in these patients, with a major role for low molecular-weight heparin (LMWHs) compared to unfractionated heparin (UFH). More recently a number of prospective randomized clinical trials of LMWH for survival as a primary end-point in cancer patients have been conducted, showing favourable results.

Anticoagulants↗

45th annual meeting of the Italian Cancer Society. Bergamo, 9-12 November 2003.

The 45th Annual Meeting of the Italian Cancer Society (SIC), held at the Centro Congressi Giovanni XXIII in Bergamo, Italy on 9-12 November, 2003, attracted almost 400 participants. The Scientific Committee chaired by R Giavazzi (Mario Negri Institute, Bergamo) and the board of the Italian Cancer Society produced a packed and varied program. Plenary sessions with keynote speakers (24 lectures) were combined with oral proffered papers (20 selected presentations), providing a platform from laboratory science to clinical interventions. Two hundred and sixty-one abstracts were submitted to the conference and presented in poster and poster discussion sessions, providing a stimulating ground for discussion and a network of interactive collaboration among young investigators. The venue of Bergamo offered exceptional hospitality with social events in the beautiful old town and at the Modern Art Museum. We hope that the following report gives an idea of the event and will encourage the reader to attend the 46th meeting of the SIC, 24-26 October, 2004 in Pisa.

Anticarcinogenic Agents↗