Paraproteinemic Maculopathy

Mansour, Ahmad M.; Arévalo, J. Fernando; Badal, Josep; Moorthy, Ramana S.; Shah, Gaurav K.; Zegarra, Hernando; Pulido, José S.; Charbaji, Abdulrazzak; Amselem, Luis; Lavaque, Alejandro Jose; Casella, Antônio Marcelo Barbante; Ahmad, Baseer; Paschall, Joshua G.; Caimi, Antonio; Staurenghi, Giovanni

doi:10.1016/j.ophtha.2014.04.007

Cited by 38 publications

(66 citation statements)

References 36 publications

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“…Moreover, in the skin it has been shown to control the expression of a network of genes involved in cell proliferation, differentiation and inflammatory responses (2,5). Thus, PPARc represents a new target for the treatment of various diseases including metabolic, autoimmune and inflammatory disorders (6)(7)(8)(9)(10)(11)(12).…”

mentioning

confidence: 99%

The role of PPARγ‐mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology

Ramot

Mastrofrancesco

Camera

et al. 2015

Experimental Dermatology

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Yuval Ramot and Arianna Mastrofrancesco contributed equally to this work.Abstract: Peroxisome proliferator-activated receptors (PPARs) are ligand-activated transcription factors that modulate the expression of multiple different genes involved in the regulation of lipid, glucose and amino acid metabolism. PPARs and cognate ligands also regulate important cellular functions, including cell proliferation and differentiation, as well as inflammatory responses. This includes a role in mediating skin and pilosebaceous unit homoeostasis: PPARs appear to be essential for maintaining skin barrier permeability, inhibit keratinocyte cell growth, promote keratinocyte terminal differentiation and regulate skin inflammation. They also may have protective effects on human hair follicle (HFs) epithelial stem cells, while defects in PPARc-mediated signalling may promote the death of these stem cells and thus facilitate the development of cicatricial alopecia (lichen planopilaris). Overall, however, selected PPARc modulators appear to act as hair growth inhibitors that reduce the proliferation and promote apoptosis of hair matrix keratinocytes. The fact that commonly prescribed PPARc-modulatory drugs of the thiazolidine-2,4-dione class can exhibit a battery of adverse cutaneous effects underscores the importance of distinguishing beneficial from clinically undesired cutaneous activities of PPARc ligands and to better understand on the molecular level how PPARc-regulated cutaneous lipid metabolism and PPARcmediated signalling impact on human skin physiology and pathology. Surely, the therapeutic potential that endogenous and exogenous PPARc modulators may possess in selected skin diseases, ranging from chronic inflammatory hyperproliferative dermatoses like psoriasis and atopic dermatitis, via scarring alopecia and acne can only be harnessed if the complexities of PPARc signalling in human skin and its appendages are systematically dissected.

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confidence: 99%

The role of PPARγ‐mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology

Ramot

Mastrofrancesco

Camera

et al. 2015

Experimental Dermatology

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“…4,5 Among the ocular complications, corneal involvement is less well recognized than others. 7 Precise epidemiologic studies on the prevalence of corneal involvement in monoclonal gammopathies are not available; data from Bourne et al 37 showed a prevalence of one case out of 100 gammopathic patients, while in a prospective study, Aronson and Shaw 38 detected no corneal deposits in 13 patients with MM.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, MM is a malignant plasma cell disorder characterized by excess BM plasma cells, monoclonal protein, osteolytic bone lesions, renal disease, anemia, and hypercalcemia. 1,2 The eye can be involved in monoclonal gammopathies as a consequence of the ophthalmic localization, 3 blood hyperviscosity, 4,5 or deposition of light chains in the ocular tissues. 6 Among the ocular localizations, corneal involvement is the less well recognized than others.…”

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confidence: 99%

Corneal Structural Changes in Nonneoplastic and Neoplastic Monoclonal Gammopathies

Aragona

Allegra

Postorino

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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METHODS. Three groups of subjects were considered: group 1, twenty normal subjects; group 2, fifteen patients with monoclonal gammopathy of undetermined significance (MGUS); group 3, eight patients with smoldering multiple myeloma and eight patients with untreated multiple myeloma. After hematologic diagnosis, patients underwent ophthalmologic exam and in vivo confocal microscopic study. The statistical analysis was performed using ANOVA and Student-Newman-Keuls tests and receiver operating characteristic (ROC) curve analysis.RESULTS. Epithelial cells of gammopathic patients showed significantly higher reflectivity than controls, demonstrated by optical density (P < 0.001). Subbasal nerve density, branching, and beading were significantly altered in gammopathic patients (P ¼ 0.01, P ¼ 0.02, P ¼ 0.02, respectively). The number of keratocytes was significantly reduced in neoplastic patients (P < 0.001 versus both normal and MGUS) in the anterior, medium, and posterior stroma. The ROC curve analysis showed good sensitivity and specificity for this parameter. Group 2 and 3 keratocytes showed higher nuclear and cytoplasmatic reflectivity in the medium and posterior stroma. Endothelial cells were not affected. CONCLUSIONS.Patients with neoplastic gammopathies showed peculiar alterations of the keratocyte number, which appeared significantly reduced. A follow-up with corneal confocal microscopy of patients with MGUS is suggested as a useful tool to identify peripheral tissue alterations linked to possible neoplastic disease development.

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“…This is accompanied by microcirculation disorders in combination with hypercholesterolemia and hyperfibrinogenemia. They particularly distinguish paraproteinemia maculopathy, associated with pathological accumulation of monoclonal antibodies [140]. Microcirculation disorders disrupt nutrition and oxygen delivery to the retinal pigment epithelial cells.…”

Section: Age-related Macular Degeneration (Amd): Amdmentioning

confidence: 99%

“…The positive effect persisted after 3 and 12 months and it was considered that there are no other therapeutic alternatives in this pathology except cascade plasmapheresis [28, [147][148][149]. According to the recommendations of ASFA, rheopheresis is the method of choice in the treatment of this pathology [150].…”

Section: Age-related Macular Degeneration (Amd): Amdmentioning

confidence: 99%

Plasmapheresis in Ophthalmology

Voinov

Karchevscy

2019

CTOY

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Loss of sight is one of the most severe disabling factors in human. The total number of such people is known to account for millions worldwide. In North America alone more than 1 million are completely blind and about 14 million have some degree of sight loss. There are many different diseases that lead to sight loss such as diabetic retinopathy, senile macular degeneration, various types of autoimmune retinopathy, optic nerves damage and many others. As a rule, they cannot be corrected with glasses, and not always amenable to drug therapy. Often the cause of these diseases is accumulation of various autoantibodies and other metabolites, the molecules large size of which does not allow them to be excreted by the kidneys and the fact of their accumulation indicates impossibility of their removal with help of drug therapy. It makes us resort to such method of their direct removal from the body as plasmapheresis and the aim of this study is to justify its use in ophthalmology.

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Paraproteinemic Maculopathy

Cited by 38 publications

References 36 publications

The role of PPARγ‐mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology

The role of PPARγ‐mediated signalling in skin biology and pathology: new targets and opportunities for clinical dermatology

Corneal Structural Changes in Nonneoplastic and Neoplastic Monoclonal Gammopathies

Plasmapheresis in Ophthalmology

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