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  1. Article ; Online: B-cell depletion with obinutuzumab for the treatment of IgG4-related disease.

    Lanzillotta, Marco / Mapelli, Paola / Dagna, Lorenzo / Della-Torre, Emanuel

    European journal of internal medicine

    2023  Volume 116, Page(s) 155–156

    MeSH term(s) Humans ; Immunoglobulin G4-Related Disease/drug therapy ; B-Lymphocytes ; Antibodies, Monoclonal, Humanized/therapeutic use
    Chemical Substances obinutuzumab (O43472U9X8) ; Antibodies, Monoclonal, Humanized
    Language English
    Publishing date 2023-07-21
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2023.07.019
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    Zs.A 2608: Show issues Location:
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  2. Article ; Online: B-Lymphocytes in the Pathophysiology of Pancreatic Adenocarcinoma.

    Minici, Claudia / Testoni, Sabrina / Della-Torre, Emanuel

    Frontiers in immunology

    2022  Volume 13, Page(s) 867902

    Abstract: Pancreatic adenocarcinoma is highly infiltrated by B lymphocytes but the relevance of these immune cells in tumor development has been surprisingly overlooked until recently. Based on available evidence from other solid tumors, interaction between B ... ...

    Abstract Pancreatic adenocarcinoma is highly infiltrated by B lymphocytes but the relevance of these immune cells in tumor development has been surprisingly overlooked until recently. Based on available evidence from other solid tumors, interaction between B lymphocytes and neoplastic cells is probably not uniformly stimulatory or inhibitory. Although presentation of tumor antigens to T cells and production of antitumor immunoglobulins might intuitively suggest a prominent tumor suppressive activity, specific subsets of B lymphocytes can secrete growth factors for neoplastic cells and immunosuppressive cytokines thus promoting escape from immunosurveillance and cancer progression. Because many of these mechanisms might also be implicated in the development of PDAC, and immune-modulation of B-cell activity is nowadays possible at different levels, determining the role of B-lymphocytes in this lethal cancer becomes of utmost importance to design novel therapeutic strategies. This review aims to discuss the emerging role of B cells in PDAC tumorigenesis, progression, and associated stromal reaction.
    MeSH term(s) Adenocarcinoma/pathology ; B-Lymphocytes ; Carcinoma, Pancreatic Ductal ; Humans ; Pancreatic Neoplasms ; Pancreatic Neoplasms
    Language English
    Publishing date 2022-03-14
    Publishing country Switzerland
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2022.867902
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  3. Article ; Online: B-Cell depletion therapy in IgG4-related disease: State of the art and future perspectives.

    Lanzillotta, Marco / Stone, John H / Della-Torre, Emanuel

    Modern rheumatology

    2022  Volume 33, Issue 2, Page(s) 258–265

    Abstract: IgG4-related disease (IgG4-RD) is an increasingly recognized immune-mediated fibroinflammatory disorder that promptly responds to glucocorticoids but commonly relapses during steroid tapering or after discontinuation. In the last few years, B-cell ... ...

    Abstract IgG4-related disease (IgG4-RD) is an increasingly recognized immune-mediated fibroinflammatory disorder that promptly responds to glucocorticoids but commonly relapses during steroid tapering or after discontinuation. In the last few years, B-cell depletion therapy with rituximab (RTX) proved to be effective in the induction of remission and maintenance treatment of IgG4-RD, providing a new powerful tool in the management of this emerging condition. In this review, we outline the pathogenetic rationale for using B-cell depleting agents in IgG4-RD, we summarize available clinical experience with RTX in this disease, and we describe future possible therapies targeting B-lymphocytes that are now in the pipeline.
    MeSH term(s) Humans ; Immunoglobulin G4-Related Disease/drug therapy ; Immunoglobulin G/therapeutic use ; Rituximab/therapeutic use ; Glucocorticoids/therapeutic use ; Glucocorticoids/pharmacology ; B-Lymphocytes
    Chemical Substances Immunoglobulin G ; Rituximab (4F4X42SYQ6) ; Glucocorticoids
    Language English
    Publishing date 2022-09-23
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2078157-X
    ISSN 1439-7609 ; 1439-7595
    ISSN (online) 1439-7609
    ISSN 1439-7595
    DOI 10.1093/mr/roac098
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  4. Article ; Online: Interleukin-6 inhibition for the treatment of IgG4 related vasculitis.

    Batani, Veronica / Minici, Claudia / Sanvito, Francesca / Venturini, Elena / Della-Torre, Emanuel

    European journal of internal medicine

    2023  Volume 118, Page(s) 149–151

    MeSH term(s) Humans ; Interleukin-6 ; Immunoglobulin G/therapeutic use ; Vasculitis/drug therapy
    Chemical Substances Interleukin-6 ; Immunoglobulin G
    Language English
    Publishing date 2023-09-16
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2023.09.015
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  5. Article ; Online: Fibrotic phenotype of IgG4-related disease.

    Lanzillotta, Marco / Culver, Emma / Sharma, Amita / Zen, Yoh / Zhang, Wen / Stone, John H / Della-Torre, Emanuel

    The Lancet. Rheumatology

    2024  

    Abstract: A prompt response to glucocorticoids is a clinical hallmark of IgG4-related disease. However, manifestations characterised by prominent tissue fibrosis on histological examination can be less responsive to glucocorticoid therapy than other types of IgG4- ... ...

    Abstract A prompt response to glucocorticoids is a clinical hallmark of IgG4-related disease. However, manifestations characterised by prominent tissue fibrosis on histological examination can be less responsive to glucocorticoid therapy than other types of IgG4-related disease. These manifestations include retroperitoneal fibrosis, fibrosing mediastinitis, Riedel thyroiditis, orbital pseudotumor, and hypertrophic pachymeningitis, among others. To explain this discrepancy, a preliminary distinction into proliferative and fibrotic phenotypes of IgG4-related disease has been proposed on the basis of clinical presentation, pathological features, and response to immunosuppressive therapy. Implications of this classification for patient management remain an important area of investigation. In this Series paper, we aim to dissect the pathophysiology of tissue fibrosis in IgG4-related disease and discuss how clinicians should approach the management of fibrotic manifestations of IgG4-related disease based on the most recent diagnostic and therapeutic developments.
    Language English
    Publishing date 2024-03-28
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2665-9913
    ISSN (online) 2665-9913
    DOI 10.1016/S2665-9913(23)00299-0
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  6. Article ; Online: Lymphadenopathy in the rheumatology practice: a pragmatic approach.

    Rodolfi, Stefano / Della-Torre, Emanuel / Bongiovanni, Lucia / Mehta, Puja / Fajgenbaum, David C / Selmi, Carlo

    Rheumatology (Oxford, England)

    2023  

    Abstract: Lymphadenopathy is a common clinical finding and diagnostic challenge within general medicine and rheumatology practice. It may represent a primary manifestation of an underlying immune-mediated disease or indicate an infectious or neoplastic ... ...

    Abstract Lymphadenopathy is a common clinical finding and diagnostic challenge within general medicine and rheumatology practice. It may represent a primary manifestation of an underlying immune-mediated disease or indicate an infectious or neoplastic complication requiring differing management. Evaluating lymphadenopathy is of particular relevance in rheumatology, given that lymph node enlargement is a common finding within the clinical spectrum of several well-known rheumatologic disorders including rheumatoid arthritis, systemic lupus erythematosus, and Sjögren syndrome. In addition, lymphadenopathy represents a hallmark manifestation of rare immunological diseases such as Castleman disease and IgG4-related disease that must be considered in the differential diagnosis because effective targeted treatments can now impact the prognosis of these conditions. In this review we present an overview of the clinical significance of lymphadenopathy in common and rare rheumatologic diseases and propose a practical approach to lymphadenopathy in the rheumatology practice. Differential diagnosis of Castleman disease and therapeutic options for this condition of increasing rheumatologic interest will be discussed in detail.
    Language English
    Publishing date 2023-12-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1464822-2
    ISSN 1462-0332 ; 1462-0324
    ISSN (online) 1462-0332
    ISSN 1462-0324
    DOI 10.1093/rheumatology/kead644
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  7. Article ; Online: The role of interleukin-17 in the pathogenesis of systemic sclerosis: Pro-fibrotic or anti-fibrotic?

    Bellando-Randone, Silvia / Della-Torre, Emanuel / Balanescu, Andra

    Journal of scleroderma and related disorders

    2021  Volume 6, Issue 3, Page(s) 227–235

    Abstract: Systemic sclerosis is characterized by widespread fibrosis of the skin and internal organs, vascular impairment, and dysregulation of innate and adaptive immune system. Growing evidence indicates that T-cell proliferation and cytokine secretion play a ... ...

    Abstract Systemic sclerosis is characterized by widespread fibrosis of the skin and internal organs, vascular impairment, and dysregulation of innate and adaptive immune system. Growing evidence indicates that T-cell proliferation and cytokine secretion play a major role in the initiation of systemic sclerosis, but the role of T helper 17 cells and of interleukin-17 cytokines in the development and progression of the disease remains controversial. In particular, an equally distributed body of literature supports both pro-fibrotic and anti-fibrotic effects of interleukin-17, suggesting a complex and nuanced role of this cytokine in systemic sclerosis pathogenesis that may vary depending on disease stage, target cells in affected organs, and inflammatory milieu. Although interleukin-17 already represents an established therapeutic target for several immune-mediated inflammatory diseases, more robust experimental evidence is required to clarify whether it may become an attractive therapeutic target for systemic sclerosis as well.
    Language English
    Publishing date 2021-08-14
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2397-1991
    ISSN (online) 2397-1991
    DOI 10.1177/23971983211039421
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  8. Article ; Online: Dupilumab as a

    Della-Torre, Emanuel / Lanzillotta, Marco / Yacoub, Mona-Rita

    Annals of the rheumatic diseases

    2020  Volume 81, Issue 2, Page(s) e24

    MeSH term(s) Antibodies, Monoclonal, Humanized ; Autoimmune Diseases/drug therapy ; Humans ; Immunoglobulin G4-Related Disease ; Steroids
    Chemical Substances Antibodies, Monoclonal, Humanized ; Steroids ; dupilumab (420K487FSG)
    Language English
    Publishing date 2020-01-14
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/annrheumdis-2020-216945
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  9. Article ; Online: Advances in the diagnosis and management of IgG4 related disease.

    Lanzillotta, Marco / Mancuso, Gaia / Della-Torre, Emanuel

    BMJ (Clinical research ed.)

    2020  Volume 369, Page(s) m1067

    Abstract: IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the ... ...

    Abstract IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and salivary glands are the most frequently observed disease phenotypes, differing in epidemiological features, serological findings, and prognostic outcomes. In view of this multifaceted presentation, IgG4 related disease represents a great mimicker of many neoplastic, inflammatory, and infectious conditions. Histopathology remains key to diagnosis because reliable biomarkers are lacking. Recently released classification criteria will be invaluable in improving early recognition of the disease. IgG4 related disease is highly treatable and responds promptly to glucocorticoids, but it can lead to end stage organ failure and even death if unrecognized. Prolonged courses of corticosteroids are often needed to maintain remission because the disease relapses in most patients. Rapid advancement in our understanding of the pathophysiology of IgG4 related disease is leading to the identification of novel therapeutic targets and possible personalized approaches to treatment.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Biomarkers/blood ; Glucocorticoids/therapeutic use ; Humans ; Immunity, Innate ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Immunoglobulin G4-Related Disease/diagnosis ; Immunoglobulin G4-Related Disease/physiopathology ; Magnetic Resonance Imaging ; Neck/diagnostic imaging ; Neck/pathology ; Phenotype ; Tomography, X-Ray Computed ; Treatment Outcome
    Chemical Substances Adrenal Cortex Hormones ; Biomarkers ; Glucocorticoids ; Immunoglobulin G
    Language English
    Publishing date 2020-06-16
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.m1067
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  10. Article ; Online: Incidence of endocrine and exocrine insufficiency in patients with autoimmune pancreatitis at diagnosis and after treatment: a systematic review and meta-analysis.

    Lanzillotta, Marco / Tacelli, Matteo / Falconi, Massimo / Arcidiacono, Paolo Giorgio / Capurso, Gabriele / Della-Torre, Emanuel

    European journal of internal medicine

    2022  Volume 100, Page(s) 83–93

    Abstract: Background: Autoimmune pancreatitis (AIP) is a rare form of pancreatitis that may lead to endocrine and exocrine insufficiency if left untreated. AIP clinically responds to glucocorticoids (GCs) therapy, but multiple GCs courses are often required to ... ...

    Abstract Background: Autoimmune pancreatitis (AIP) is a rare form of pancreatitis that may lead to endocrine and exocrine insufficiency if left untreated. AIP clinically responds to glucocorticoids (GCs) therapy, but multiple GCs courses are often required to maintain remission with detrimental effects on glycaemic control.
    Objective: In this systematic review and meta-analysis, we aimed to assess the rate of endocrine and of exocrine insufficiency at diagnosis and at follow up in patients with AIP as well as the impact of GC therapy on pancreatic function in the long-term.
    Methods: The MEDLINE, SCOPUS, and EMBASE databases were searched from inception to August 2021 to identify studies reporting data on endocrine and exocrine insufficiency in patients with AIP. Pooled events were calculated using a random-effect model and expressed in terms of pooled prevalence rates.
    Results: A total of 6522 AIP patients and sixty-two studies were included in the analysis. The pooled estimate rate for the overall prevalence of diabetes in AIP at baseline was 37% (95% CI 32-42, I
    Conclusion: A large proportion of patients with AIP displays concomitant exocrine and endocrine insufficiency at the time of diagnosis. The incidence of diabetes at the longest available follow up tends to increase in patients treated with GCs.
    MeSH term(s) Autoimmune Diseases/complications ; Autoimmune Diseases/drug therapy ; Autoimmune Diseases/epidemiology ; Autoimmune Pancreatitis ; Diabetes Mellitus/epidemiology ; Humans ; Incidence ; Pancreatitis/complications ; Prevalence
    Language English
    Publishing date 2022-03-30
    Publishing country Netherlands
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2022.03.014
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