Optimization of IL13Rα2-Targeted Chimeric Antigen Receptor T Cells for Improved Anti-tumor Efficacy against Glioblastoma

T cell immunotherapy is emerging as a powerful strategy to treat cancer and may improve outcomes for patients with glioblastoma (GBM). We have developed a chimeric antigen receptor (CAR) T cell immunotherapy targeting IL-13 receptor α2 (IL13Rα2) for the treatment of GBM. Here, we describe the optimization of IL13Rα2-targeted CAR T cells, including the design of a 4-1BB (CD137) co-stimulatory CAR (IL13BBζ) and a manufacturing platform using enriched central memory T cells. Utilizing orthotopic human GBM models with patient-derived tumor sphere lines in NSG mice, we found that IL13BBζ-CAR T cells improved anti-tumor activity and T cell persistence as compared to first-generation IL13ζ-CAR CD8⁺ T cells that had shown evidence for bioactivity in patients. Investigating the impact of corticosteroids, given their frequent use in the clinical management of GBM, we demonstrate that low-dose dexamethasone does not diminish CAR T cell anti-tumor activity in vivo. Furthermore, we found that local intracranial delivery of CAR T cells elicits superior anti-tumor efficacy as compared to intravenous administration, with intraventricular infusions exhibiting possible benefit over intracranial tumor infusions in a multifocal disease model. Overall, these findings help define parameters for the clinical translation of CAR T cell therapy for the treatment of brain tumors.

A Model To Identify Individuals at High Risk for Esophageal Squamous Cell Carcinoma and Precancerous Lesions in Regions of High Prevalence in China

BACKGROUND & AIMS

We aimed to develop a population-based model to identify individuals at high risk for esophageal squamous cell carcinoma (ESCC) in regions of China with a high prevalence of this cancer.

METHODS

We collected findings from 15,073 permanent residents (45-69 years old) of 334 randomly selected villages in Hua County, Henan Province, China who underwent endoscopic screening (with iodine staining) for ESCC from January 2012 through September 2015. The entire esophagus and stomach were examined; biopsies were collected from all focal lesions (or from standard sites in the esophagus if no abnormalities were found) and analyzed histologically. Squamous dysplasia, carcinoma in situ, and ESCC were independently confirmed by 2 pathologists. Before endoscopy, subjects completed a questionnaire on ESCC risk factors. Variables were evaluated with unconditional univariate logistic regression analysis; variables found to be significantly associated with ESCC were then analyzed by multivariate logistic regression modeling. We used the Akaike information criterion to develop our final model structure and the coding form of variables with multiple measures. We developed 2 groups of models, separately defining severe dysplasia and above (SDA) (lesions including severe dysplasia and higher-grade lesions) and moderate dysplasia and above (lesions including moderate dysplasia and higher-grade lesions) as outcome events. Age-stratified and whole-age models were developed; their discriminative ability in the full multivariate model and the simple age model was compared. We performed area under the receiver operating characteristic curve (AUC) and the DeLong test to evaluate model performance.

RESULTS

Our age-stratified prediction models identified individuals 60 years of age or younger with SDA with an AUC value of 0.795 (95% confidence interval, 0.736-0.854) and individuals older than 60 years with SDA with an AUC value of 0.681 (95% confidence interval, 0.618-0.743). Factors associated with SDA in individuals 60 years or younger included age closer to 60 years, use of coal or wood as a main source of cooking fuel, body mass index of 22 kg/m² or less, unexplained epigastric pain, and rapid ingestion of meals. In subjects older than 60 years, SDA associated with age, family history of ESCC, cigarette smoking, body mass index of 22 kg/m² or less, pesticide exposure, irregular eating habits, intake of high temperature foods, rapid ingestion of meals, and ingestion of leftover food in summer months. Use of our model in screening could have allowed 27% of subjects 60 years or younger and 9% of subjects older than 60 years to avoid endoscopy without missing SDAs. This means that approximately 2500 of endoscopies in total (16.6%) could have been avoided.

CONCLUSIONS

We developed a low-cost, easy-to-use model to identify individuals at risk for severe dysplasia or cancer of the esophagus living in a region of China with a high risk of ESCC. This model might be used to select individuals and groups of persons who should undergo endoscopy analysis for esophageal cancer.

HLA-A*24:388N: a novel HLA-A*24 allele identified by sequence-based typing

The novel allele, A*24:388N, was identified by sequence-based typing in a Chinese individual.

A novel anterior approach for the fixation of ulnar coronoid process fractures

BACKGROUND

There is no universally accepted approach to the elbow for the fixation of coronoid process fractures. This study aims to introduce a novel anterior surgical approach for the fixation of the ulnar coronoid fracture, with minimal surgical dissection damage and excellent visualization for reduction and internal fixation.

HYPOTHESIS

The anterior approach can facilitate satisfactory outcomes for coronoid process fractures.

MATERIAL AND METHODS

From February 2010 to July 2014, 12 patients (8 males and 4 females; range 14-62years; mean age 31years) with a closed fracture of the coronoid process of the ulna were included in this study. According to Adams classification, we included 5 type II, 3 type III, 3 type IV AM, and 1 type IV AL. The fractures were treated operatively via an anterior approach between nerves and blood vessels. The anatomical reduction and fixation with cannulated screws or a mini plate was easily performed. One elbow showed significant joint instability, necessitating, another incision to repair the lateral collateral ligament, and a subsequent operation with a hinged external fixator was required. The remaining patients received a splint for 2 weeks followed by functional exercises.

RESULTS

Mean follow-up was 21 months (13-36). Fracture union was achieved in each patient. The arc of elbow flexion and extension were (135±15)°, and forearm pronation/supination were restored to (165±15)°. When compared with the normal side, there was no significant difference in the functional outcome (P>0.05). According to Morrey' scale, the functional recovery of the injured arms was assessed as excellent in eleven patients and good in one. Mild heterotopic ossification was found in one case, which had not impaired the elbow function. No other complications were noted.

CONCLUSIONS

The anterior approach has the benefits of simplicity, safety, minimal invasion, excellent exposure, and satisfactory prognosis for coronoid process fractures.

LEVEL OF EVIDENCE

Prospective study, Level IV.

Emergence of Salmonella enterica serovar Indiana and California isolates with concurrent resistance to cefotaxime, amikacin and ciprofloxacin from chickens in China

The aim of this study was to investigate the prevalence and characterization of Salmonella concerning the poultry industry in China. A total of 170 non-duplicate Salmonella isolates were recovered from the 1540 chicken samples. Among the Salmonella isolates from chickens, the predominant serovars were S. enterica serovar Enteritidis (S. Enteritidis) (49/170, 28.8%), S. enterica serovar Indiana (S. Indiana) (37/170, 21.8%) and S. enterica serovar California (S. California) (34/170, 20.0%). High antimicrobial resistance was observed for ciprofloxacin (68.2%), amikacin (48.2%) and cefotaxime (44.7%). Of particular concerns were the 18 S. Indiana and 17 S. California isolates, which were concurrently resistant to cefotaxime, amikacin and ciprofloxacin. The bla_CTX-M genes, 16S rRNA methylase genes (armA, rmtD or rmtC) and five plasmid-mediated quinolone resistance (PMQR) determinants (aac(6')-Ib-cr, oqxAB, qnrB, qepA and qnrD) were identified in 18 S. Indiana and 17 S. California isolates. To clarify their genetic correlation, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were further conducted. PFGE profiles showed that the majority of S. Indiana and S. California isolates were clonally unrelated with a standard cut-off of 85%. The results of MLST demonstrated that ST17 and ST40 were the most common ST types in S. Indiana and S. California isolates, respectively. Our findings indicated that the multiple antibiotic resistant S. Indiana and S. California isolates were widespread in chicken in China and might pose a potential threat to public health.

Radical Chemistry and Structural Relationships of PPCP Degradation by UV/Chlorine Treatment in Simulated Drinking Water

The UV/chlorine process is an emerging advanced oxidation process (AOP) used for the degradation of micropollutants. However, the radical chemistry of this AOP is largely unknown for the degradation of numerous structurally diverse micropollutants in water matrices of varying quality. These issues were addressed by grouping 34 pharmaceuticals and personal care products (PPCPs) according to the radical chemistry of their degradation in the UV/chlorine process at practical PPCP concentrations (1 μg L^-1) and in different water matrices. The contributions of HO^• and reactive chlorine species (RCS), including Cl^•, Cl₂^•-, and ClO^•, to the degradation of different PPCPs were compound specific. RCS showed considerable reactivity with olefins and benzene derivatives, such as phenols, anilines, and alkyl-/alkoxybenzenes. A good linear relationship was found between the RCS reactivity and negative values of the Hammett ∑σ_p⁺ constant for aromatic PPCPs, indicating that electron-donating groups promote the attack of benzene derivatives by RCS. The contribution of HO^•, but not necessarily RCS, to PPCP removal decreased with increasing pH. ClO^• showed high reactivity with some PPCPs, such as carbamazepine, caffeine, and gemfibrozil, with second-order rate constants of 9.2 × 10⁷, 1.03 × 10⁸, and 4.16 × 10⁸ M^-1 s^-1, respectively, which contributed to their degradation. Natural organic matter (NOM) induced significant scavenging of ClO^• and greatly decreased the degradation of PPCPs that was attributable to ClO^•, with a second-order rate constant of 4.5 × 10⁴ (mg L^-1)^-1 s^-1. Alkalinity inhibited the degradation of PPCPs that was primarily attacked by HO^• and Cl^• but had negligible effects on the degradation of PPCPs by ClO^•. This is the first study on the reactivity of RCS, particularly ClO^•, with structurally diverse PPCPs under simulated drinking water condition.

Radical Chemistry and Structural Relationships of PPCP Degradation by UV/Chlorine Treatment in Simulated Drinking Water

The UV/chlorine process is an emerging advanced oxidation process (AOP) used for the degradation of micropollutants. However, the radical chemistry of this AOP is largely unknown for the degradation of numerous structurally diverse micropollutants in water matrices of varying quality. These issues were addressed by grouping 34 pharmaceuticals and personal care products (PPCPs) according to the radical chemistry of their degradation in the UV/chlorine process at practical PPCP concentrations (1 μg L^-1) and in different water matrices. The contributions of HO^• and reactive chlorine species (RCS), including Cl^•, Cl₂^•-, and ClO^•, to the degradation of different PPCPs were compound specific. RCS showed considerable reactivity with olefins and benzene derivatives, such as phenols, anilines, and alkyl-/alkoxybenzenes. A good linear relationship was found between the RCS reactivity and negative values of the Hammett ∑σ_p⁺ constant for aromatic PPCPs, indicating that electron-donating groups promote the attack of benzene derivatives by RCS. The contribution of HO^•, but not necessarily RCS, to PPCP removal decreased with increasing pH. ClO^• showed high reactivity with some PPCPs, such as carbamazepine, caffeine, and gemfibrozil, with second-order rate constants of 9.2 × 10⁷, 1.03 × 10⁸, and 4.16 × 10⁸ M^-1 s^-1, respectively, which contributed to their degradation. Natural organic matter (NOM) induced significant scavenging of ClO^• and greatly decreased the degradation of PPCPs that was attributable to ClO^•, with a second-order rate constant of 4.5 × 10⁴ (mg L^-1)^-1 s^-1. Alkalinity inhibited the degradation of PPCPs that was primarily attacked by HO^• and Cl^• but had negligible effects on the degradation of PPCPs by ClO^•. This is the first study on the reactivity of RCS, particularly ClO^•, with structurally diverse PPCPs under simulated drinking water condition.

Tannerella forsythia and coating color on the tongue dorsum, and fatty food liking associate with fat accumulation and insulin resistance in adult catch-up fat

BACKGROUND/OBJECTIVES

We aimed to determine the alteration of Tannerella forsythia and coating color on the dorsal tongue, and fatty food liking in catch-up fat in adult (CUFA), as well as the probable associations between fat accumulation, insulin resistance (IR) and these changes.

SUBJECTS/METHODS

T. forsythia on the tongue dorsum, fatty food liking, fat accumulation and insulin sensitivity were investigated in CUFA humans and rats, and tongue-coating color was observed in CUFA individuals. We further determined the changes of fatty food liking, fat accumulation and IR in T. forsythia-infected rodents by oral lavage.

RESULTS

Increases in fat accumulation, IR, percentage of subjects with yellow tongue coating and that with T. forsythia detected were observed in CUFA individuals. Additionally, the fat ranking scores were significantly lower and the hedonic ratings of low-fat options of sampled food were lower, while the ratings of high-fat options were remarkably higher in CUFA subjects. Additionally, T. forsythia level elevated in CUFA rats, and fatty food liking, fat accumulation and IR increased in CUFA and T. forsythia-infected animals, with the increases in T. forsythia infection and fatty food liking preceding the occurrence of fat accumulation and IR.

CONCLUSIONS

T. forsythia and yellow coating on the dorsal tongue and fatty food liking associate fat accumulation and IR in CUFA. Moreover, we tentatively put forward that T. forsythia, which is very important in yellow tongue-coating microbiota, and its consequent increases in fatty food liking, might be crucial in the development of fat accumulation and IR in CUFA.

Targeting Leptin as a Therapeutic Strategy against Ovarian Cancer Peritoneal Metastasis

BACKGROUND/AIMS

Epithelial ovarian cancer (OC) is the leading cause of death in patients with gynecologic malignancy. Malignant ascites, a shared symptom of advanced OC patients, plays an important role in the peritoneal metastasis cascade of OC. Since leptin existed in great amount in malignant ascites, we speculated that it might be involved in the modulation of tumor cells malignant behavior.

METHOD

Here, we demonstrated that blocking of leptin could significantly suppress ovarian malignant ascitesinduced metastatic aggravation of OC cells. Furthermore, our results suggested that leptin was highly expressed in OC and correlated with poor outcome of OC patients. Recombinant leptin notably promoted the migration, invasion and proliferation of OC cells.

RESULT

Mechanistically, we found that leptin induced epithelial-mesenchymal transition (EMT) program in OC cells through the activation of the PI3K/Akt/mTOR pathway. Pharmacological inhibition of the PI3K/Akt/mTOR pathway partly impaired leptin-induced malignant transformation of OC cells. More importantly, our in vivo xenograft experiment showed that blocking of leptin could dramatically inhibit OC cells peritoneal dissemination.

CONCLUSION

Collectively, this study emphasized the importance of leptin in OC progression and illustrated a novel mechanism that the PI3K/Akt/mTOR pathway was involved in leptin-induced EMT. Our findings provide new insights into leptin exertion on OC metastasis and identify the potential of leptin neutralizing as a novel strategy against OC peritoneal dissemination.

Second harmonic generation enhancement from a nonlinear nanocrystal integrated hyperbolic metamaterial cavity

We theoretically investigate the dipolar whispering-gallery modes (WGMs) with different mode orders supported by spherical hyperbolic metamaterial (HMM) cavities consisting of alternating metal and dielectric layers. Associated with the excitations of the WGMs with the highest and the second highest mode orders, the HMM cavities are capable of creating highly enhanced and uniformly distributed local fields in the entire dielectric core region. Variation on the metal filling ratio allows for easily tuning the resonant wavelengths of WGMs over a wide spectral range. By integrating a nonlinear nanocrystal into the HMM cavities, we show enhancements of intensity of second harmonic generation up to a factor of 3.9 × 10¹⁰, which is two orders of magnitude higher than the largest enhancement achieved in the single-layer plasmonic core-shell cavities.