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O'Gorman C, Khoury R, Anderson A, Carter M, DiCesare F, Dubé S, Ereshefsky L, Grossberg G, Hefting N, Khan S, Lind S, Moebius H, Shiovitz T, Rosenberg P. A Framework for Developing Pharmacotherapy for Agitation in Alzheimer's Disease: Recommendations of the ISCTM* Working Group. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 7:274-282. [PMID: 32920630 DOI: 10.14283/jpad.2020.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dementia is characterized by a significant decline in one of several cognitive domains such as memory, language and executive function, affecting independence and representing a significant deterioration from a previous level of functioning (1). Alzheimer’s Disease (AD) represents the most common form of dementia and contributes up to 70% of the almost 50 million dementia cases worldwide, a number that is projected to double in 20 years (2).
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Keegan N, Schonhoft J, Barnett E, Cohn E, Zhao J, Carbone E, Zanone M, Anderson A, Wenstrup R, Scher H. 613P Chromosomal instability (CIN) biomarker in circulating tumor cells (CTC) may predict for therapy resistance in metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gomes VCL, Del Piero F, Langohr IM, Aguiar LH, Anderson A, Sones JL, Pinto CR. Equine focal mucopurulent placentitis associated with
Stenotrophomonas maltophilia. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhao J, Antonarakis E, Cheng H, George D, Aggarwal R, Abida W, Decker B, Smart-Curley T, Schonhoft J, Anderson A, Haywood S, Riedel E, Carver B, Wyatt A, Feng F, Knudsen K, Rathkopf D. 598P A phase Ib study of enzalutamide (Enza) plus CC-115 in men with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Senthilkumar A, Anderson A, Sekar M. Performance analysis of R600a vapour compression refrigeration system using CuO/Al2O3 hybrid nanolubricants. APPLIED NANOSCIENCE 2021. [DOI: 10.1007/s13204-021-01936-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brown P, Anderson A, Hargreaves B, Morgan A, Isaacs JD, Pratt A. OP0033 REGULATORY T CELL CD39 EXPRESSION AS A PREDICTOR OF EARLY REMISSION-INDUCTION WITH METHOTREXATE IN NEW-ONSET RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The long term outcomes for patients with rheumatoid arthritis (RA) depend on early and effective disease control. Methotrexate remains the key first line disease modifying therapy for the majority of patients, with 40% achieving an ACR50 on monotherapy(1). There are at present no effective biomarkers to predict treatment response, preventing effective personalisation of therapy. A putative mechanism of action of methotrexate, the potentiation of anti-inflammatory adenosine signalling, may inform biomarker discovery. By antagonism of the ATIC enzyme in the purine synthesis pathway, methotrexate has been proposed to increase the release of adenosine moieties from cells, which exert an anti-inflammatory effect through interaction with ADORA2 receptors(2). Lower expression of CD39 (a cell surface 5-’ectonucleotidase required for the first step in the conversion of ATP to adenosine) on circulating regulatory T-Lymphocytes (Tregs) was previously identified in patients already established on methotrexate who were not responding (DAS28 >4.0 vs <3.0)(3). We therefore hypothesised that pre-treatment CD39 expression on these cells may have clinical utility as a predictor of early methotrexate efficacy.Objectives:To characterise CD39 expression in peripheral blood mononuclear cells in RA patients naïve to disease modifying therapy commencing methotrexate, and relate this expression to 4 variable DAS28CRP remission (<2.6) at 6 months.Methods:68 treatment naïve early RA patients starting methotrexate were recruited from the Newcastle Early Arthritis Clinic and followed up for 6 months. Serial blood samples were taken before and during methotrexate therapy with peripheral blood mononuclear cells isolated by density centrifugation. Expression of CD39 by major immune subsets (CD4+ and CD8+ T-cells, B-lymphocytes, natural killer cells and monocytes) was determined by flow cytometry. The statistical analysis used was binomial logistic regression with baseline DAS28CRP used as a covariate due to the significant association of baseline disease activity with treatment response.Results:Higher pre-treatment CD39 expression was observed in circulating CD4+ T-cells of patients who subsequently achieved clinical remission at 6 months versus those who did not (median fluorescence 4854.0 vs 3324.2; p = 0.0108; Figure 1-A). This CD39 expression pattern was primarily accounted for by the CD4+CD25 high sub-population (median fluorescence 9804.7 vs 6455.5; p = 0.0065; Figure 1-B). These CD25 high cells were observed to have higher FoxP3 and lower CD127 expression than their CD39 negative counterparts, indicating a Treg phenotype. No significant associations were observed with any other circulating subset. A ROC curve demonstrates the discriminative utility of differential CD39 expression in the CD4+CD25 high population for the prediction of DAS28CRP remission in this cohort, showing greater specificity than sensitivity for remission prediction(AUC: 0.725; 95% CI: 0.53 - 0.92; Figure 1-C). Longitudinally, no significant induction or suppression of the CD39 marker was observed amongst patients who did or did not achieve remission over the 6 months follow-up period.Figure 1.Six month DAS28CRP remission versus pre-treatment median fluorescence of CD39 expression on CD4+ T-cells (A); CD25 High expressing CD4+ T-cells (B); and ROC curve of predictive utility of pre-treatment CD39 expression on CD25 High CD4+ T-cells (C).Conclusion:These findings support the potential role of CD39 in the mechanism of methotrexate response. Expression of CD39 on circulating Tregs in treatment-naïve RA patients may have particular value in identifying early RA patients likely to respond to methotrexate, and hence add value to evolving multi-parameter discriminatory algorithms.References:[1]Hazlewood GS, et al. BMJ. 2016 21;353:i1777[2]Brown PM, et al. Nat Rev Rheumatol. 2016;12(12):731-742[3]Peres RS, et al. Proc Natl Acad Sci U S A. 2015;112(8):2509-2514Disclosure of Interests:None declared
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Swift J, Stanway J, Nicorescu I, Hilkens C, Stevenaert F, Anderson A, Pratt A, Isaacs JD. AB0025 CITRULLINATED-PEPTIDE SPECIFIC CD4+ T CELL RESPONSES IN RHEUMATOID ARHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:CD4+ T cells reacting to post-translationally modified, citrullinated self-antigens are thought to play a central role in the pathogenesis of rheumatoid arthritis (RA)1. This is evidenced by a strong HLA class II association, the success of therapeutic co-stimulation blockade and the detection of autoantigen specific T-cells using HLA class II multimers2. These cells may represent a target for antigen-specific, tolerogenic therapies and their in-depth phenotyping may provide the means by which to monitor such treatment.Objectives:To identify the citrullinated-peptide (cit-peptide) induced cytokine repertoire of antigen-specific memory CD4+ T cells in both healthy controls (HCs) and ACPA positive RA patients using intracellular cytokine staining and flow cytometry. Of note, the HLA-types of both HCs and RA patients were not known.Methods:Cryopreserved peripheral blood mononuclear cells (PBMC) from both HCs (n = 8) and RA patients (n = 13) with both early (untreated) and established disease were thawed and labelled with a proliferation tracking dye (PTD). Labelled PBMC were then either incubated alone or with a pool of cit-peptides for 9-days, followed by a 5-hour restimulation with PMA and ionomycin, where cytokine secretion was blocked for the final 4-hours using brefeldin-A. Cells were then harvested, permeabilised and stained for T cell surface markers and intracellular cytokines including IFN-γ, IL-4, IL-21 and IL-17. Stained cells were immediately acquired using a BD Fortessa X20, where antigen-specific CD4+ T cells were identified as the viable CD45RO+ (memory) CD4+ T cell population that had proliferated (PTDlow) in response to the cit-peptides. Stimulation indices (SI) were calculated as the percentage of proliferated memory CD4+ T cells in the stimulated wells divided by the percentage in the unstimulated conditions, and cit-peptide responders were defined as those with an SI > 2.0. Net cytokine production was measured by subtracting the percentage cytokine production from unstimulated CD4+ CD45RO+ PTDlow cells, from those stimulated with the cit-peptides.Results:Comparable proliferative responses were observed in both donor groups in response to stimulation with the cit-peptide pool, where 37 % of HCs and 31 % of RA patients responded with an SI > 2.0 (Fig. 1A). While little cytokine production was observed in the cit-peptide responding HC T cells, for responding RA donors, cit-peptide responsive CD4+ memory T cells were predominantly IFN-γ and IL-21 producing (Fig. 1B and 1C). In contrast, these donors did not produce significant levels of either IL-17 or IL-4 (Fig. 1D and 1E).Conclusion:Cit-peptides were able to induce proliferation in both HCs and RA memory CD4+ T cells which, amongst the RA donors only, were of a Th1/Tfh subtype. In contrast, and while based only on a small sample, cit-peptides did not induce either IL-17 or IL-4 production in either donor group, suggesting a lack of Th17/Th2 responses. Not all donors responded to the peptide pool, possibly reflecting the limited number of pooled cit-peptides or to a lack of confirmed HLA-DRB1*04:01 positive donors, as peptides were selected for their specificity on this basis. Future work will therefore include HLA-typing, as well as the inclusion of additional citrullinated-epitopes to demonstrate autoreactivity in a wider cross-section of patients. Further phenotyping of the cit-peptide specific T cells will be performed, and future plans will be to study the assay data alongside clinical outcomes to assess its value for immune monitoring.References:[1]Malmström, V et al Nat Rev Immunol. 2017; 17(1):60-75.[2]Gerstner, C et al BMC Immunol. 2020; 21(27):1-14.Disclosure of Interests:Jessica Swift: None declared, James Stanway: None declared, Ioana Nicorescu: None declared, Catharien Hilkens: None declared, Frederik Stevenaert Employee of: Janssen, Amy Anderson Grant/research support from: Pfizer, GSK and Janssen, Arthur Pratt Grant/research support from: Pfizer, GSK and Janssen, John D Isaacs Speakers bureau: Abbvie, Gilead, Roche, UC, Consultant of: Abbvie, Gilead, Roche, UC, Grant/research support from: Pfizer, GSK and JanssenFigure 1.Citrullinated-peptide specific memory CD4+ T cell proliferation (A) and net % cytokine production of IFN-γ (B), IL-21 (C), IL-17 (D) and IL-4 (E) positive cells.
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Maldonado López A, Aubert Y, Anderson A, Ko E, Liu F, Capell B. 165 Elucidating the METTL3-m6A epitranscriptome in epidermal development and carcinogenesis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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York JD, Colsky J, Croft K, Segalewitz T, DiBiase L, Anderson A, Palaez A, Shahmohammadi A, Pipkin M, Machuca T, Plowman E. Dysphagia in Lung Transplant Recipients: Prevalence, Risk Factors and Health-Related Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Segalewitz T, Colsky J, York JD, Croft K, DiBiase L, Anderson A, Pelaez A, Shahmohammadi A, Pipkin M, Machuca T, Plowman E. Is Dysphagia a Pre-Existing Condition in Individuals Undergoing Lung Transplantation? Radiographic Swallowing Safety Profiles before and after Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Dawson S, Carolan C, Daniels T, Lee K, Anderson A, Choyce J, Gledhill H, Warnock L, Moran P, Wildman M. P235 Using a 1,500-patient learning health system (LHS) to support virtual clinics and medicines optimisation: a UK seven-centre Patient and Public Involvement (PPI) project to understand user experience. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01260-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hong D, Bang YJ, Barlesi F, Durm G, Falchook G, Govindan R, Dy G, Park K, Strickler J, Burns T, Kim J, Ang A, Lipford J, Ngarmchamnanrith G, Anderson A, Li B. MO01.31 Durability of Clinical Benefit and Biomarkers in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC) Treated with Sotorasib, a KRAS(G12C) Inhibitor. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carolan C, Dawson S, Cunningham J, Choyce J, Tugwell A, Faulkner J, Barnett T, Thomas M, Gledhill H, Anderson A, Tature D, Szczepanski R, Lowther M, Pickering N, Daniels T, Galey P, Wildman M. P217 Delivering quality improvement coaching in a virtual world: the use of digital technology to empower and engage CFDigiCare clinicians to undertake quality improvement activities nationally. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Anderson A, Lazar A, Zhang M, Braunstein S. Predictors Of Survival For Patients With Leptomeningeal Metastases From Breast Cancer: A Single-Center Experience. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hong D, Bang YJ, Barlesi F, Durm G, Falchook G, Govindan R, Dy G, Park K, Strickler J, Burns T, Kim J, Ang A, Lipford J, Ngarmchamnanrith G, Anderson A, Li B. 1257O Durability of clinical benefit and biomarkers in patients (pts) with advanced non-small cell lung cancer (NSCLC) treated with AMG 510 (sotorasib). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Akaike T, Qazi J, Anderson A, Behnia FS, Shinohara MM, Akaike G, Hippe DS, Thomas H, Takagishi SR, Lachance K, Park SY, Tarabadkar ES, Iyer JG, Blom A, Parvathaneni U, Vesselle H, Nghiem P, Bhatia S. High somatostatin receptor expression and efficacy of somatostatin analogues in patients with metastatic Merkel cell carcinoma. Br J Dermatol 2020; 184:319-327. [PMID: 32320473 DOI: 10.1111/bjd.19150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is an aggressive, high-grade, cutaneous neuroendocrine tumour (NET). Agents blocking programmed death 1/programmed death ligand 1 have efficacy in metastatic MCC (mMCC), but half of patients do not derive durable benefit. Somatostatin analogues (SSAs) are commonly used to treat low- and moderate-grade NETs that express somatostatin receptors (SSTRs). OBJECTIVES To assess SSTR expression and the efficacy of SSAs in mMCC, a high-grade NET. Methods In this retrospective study of 40 patients with mMCC, SSTR expression was assessed radiologically by somatostatin receptor scintigraphy (SRS; n = 39) and/or immunohistochemically when feasible (n = 9). Nineteen patients (18 had SRS uptake in MCC tumours) were treated with SSA. Disease control was defined as progression-free survival (PFS) of ≥ 120 days after initiation of SSA. RESULTS Thirty-three of 39 patients (85%) had some degree (low 52%, moderate 23%, high 10%) of SRS uptake. Of 19 patients treated with SSA, seven had a response-evaluable target lesion; three of these seven patients (43%) experienced disease control, with a median PFS of 237 days (range 152-358). Twelve of 19 patients did not have a response-evaluable lesion due to antecedent radiation; five of these 12 (42%) experienced disease control (median PFS of 429 days, range 143-1757). The degree of SSTR expression (determined by SRS and/or immunohistochemistry) did not correlate significantly with the efficacy endpoints. CONCLUSIONS In contrast to other high-grade NETs, mMCC tumours appear frequently to express SSTRs. SSAs can lead to clinically meaningful disease control with minimal side-effects. Targeting of SSTRs using SSA or other novel approaches should be explored further for mMCC.
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Tariq F, Alobaidi B, Xavier M, Mccorkindale M, Veltman J, Isaacs J, Pratt A, Anderson A, Collin M. THU0026 CLONAL HAEMATOPOIESIS ASSOCIATED SOMATIC MUTATIONS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Clonal haematopoiesis of indeterminate potential (CHIP) occurs when somatic mutations arise in myeloid neoplasia driver genes of haematopoietic progenitor cells, in the absence of overt cytopenia or dysplasia. The prevalence of CHIP increases with age. The most common genes affected by CHIP mutations in unselected populations are DNMT3A, ASXL1, and TET2. The presence of CHIP is linked to increased basal level of inflammation and a high risk of cardiovascular disease and all-cause mortality. Rheumatoid arthritis (RA) is one of the most common and debilitating multi-system autoimmune disorders, affecting up to 1% of adults in developed countries. The role of somatic mutations in the pathogenesis of autoimmune diseases is an unexplored area; therefore, we aimed to test the hypothesis that clonal haematopoiesis (CH) is associated with the incidence and severity of RA.Objectives:To evaluate the association of CH somatic mutation with severity of RA.Methods:163 RA patients were recruited from the following cohorts: (i)Early RA/treatment naive (n=31), (ii)Refractory RA - non-responders to Disease-Modifying Anti-Rheumatic Drugs (DMARDs) and biologics (n=48), (ii)Flare (n=41) vsRemission patients (n=43) –patients treated with DMARDs and withdrawn from treatment on achieving remission. Six months later, 50% relapse and 50% sustain remission. Single molecule molecular inversion probes (smMIPs) were used to screen for somatic mutations in 40 loci known to carry clonal haematopoiesis driver mutations (CHDMs). Whole exome sequencing was also performed on Flare/Remission patients (n = 84) to screen for CHDMs and other somatic mutations. In-house bioinformatics pipelines were used to call mutations from both the datasets.Results:We identified CH in RA with an overall prevalence of 14%. Twenty-four unique variants with a variant allele frequency (VAF) of 2-35% were found in ten genes including ASXL1, CBL, DNMT3A, GNAS, GNB1, PTPN11, PTPN12, SF3B1, TET2, and TP53. The number of unique patients carrying mutations in these genes are follows:refractory: n=12/48, flare: n=6/41,remission: n=4/43 andearly RA: n=2/31. The majority of the mutations occurred in DNMT3A (n=6) followed by TP53 (N=4) and TET2 (n=3). Two variants with VAF of 15% were identified in two patients under the age of 30, both with clinically severe disease. In patients between the ages of 50-59 yrs., 60-69 yrs., and 70-79 yrs., CH was observed at 11% (4/35), 23% (11/46) and 17%(7/41), respectively.Conclusion:We here report the prevalence of CH in RA, affecting more patients with clinically advanced/refractory disease compared to those with early/less severe disease.Further study will be conducted to confirm the results.References:[1]Acuna-Hidalgo, R., Sengul, H., Steehouwer, M., van de Vorst, M., Vermeulen, S., & Kiemeney, L. et al. (2017). Ultra-sensitive Sequencing Identifies High Prevalence of Clonal Hematopoiesis-Associated Mutations throughout Adult Life.The American Journal Of Human Genetics,101(1), 50-64. doi: 10.1016/j.ajhg.2017.05.013[2]NRAS - National Rheumatoid Arthritis Society. (2020). Retrieved 30 January 2020, fromhttps://www.nras.org.uk/what-is-ra-article[3]Steensma, D., Bejar, R., Jaiswal, S., Lindsley, R., Sekeres, M., Hasserjian, R., & Ebert, B. (2015). Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes.Blood,126(1), 9-16. doi: 10.1182/blood-2015-03-631747Acknowledgments:National Institute for Health Research, United KingdomDisclosure of Interests:Fareeha Tariq: None declared, Bilal Alobaidi: None declared, Miguel Xavier: None declared, Michael McCorkindale: None declared, Joris Veltman: None declared, John Isaacs Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck, Pfizer, Roche, Arthur Pratt Grant/research support from: Pfizer, GSK, Amy Anderson: None declared, Matthew Collin: None declared
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Maney N, De Paula-Lemos H, Barron-Millar B, Mellor A, Isaacs JD, Anderson A, Pratt A. SAT0013 PIM-1 KINASE IS A MEASURABLE MEDIATOR OF CD4+ T CELL DYSREGULATION AND THERAPEUTIC TARGET IN EARLY RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:As well as being an established oncoprotein and a therapeutic target in cancer,Proviral Integration site for murine Moloney leukemia virus-1(pim-1) has been implicated in human autoimmunity. We previously confirmed this serine-threonine protein kinase to be strikingly upregulated in circulating CD4+ T cells of untreated rheumatoid arthritis (RA) patients as a consequence of IL-6 signalling1-2. Evidence for the relevance of pim-1 signalling in the disruption of RA synovial fibroblast (RASF) homeostasis3further supports its candidacy as a therapeutic target.Objectives:To investigate PIM1 and its family members (PIM2 and PIM3) as potential candidates for drug repurposing in RA.Methods:A flow cytometric assay for PIM1 transcript measurement in circulating CD4+ T cells of early arthritis patients was validated against real-time PCR in paired cells isolated by bead selection. Synovial protein expression in tissue from the same cohort of untreated RA patients and disease controls was determined by quantitative multiplex immunofluorescence. The functional consequences of manipulating pim kinase family expression in freshly purified T cell receptor (TCR)-stimulated CD4+ T cells from early RA patients was explored. The impact of pim-1 specific and pim-1-3 (pan-pim) kinase inhibition on progression of the IL-6 dependent collagen-induced arthritis (CIA) model was assessed.Results:The percentage of circulating CD4+ T cells positive forPIM1transcript by flow cytometry proved a faithful surrogate for gene expression in early arthritis (Figure 1A), distinguishing RA from other pathologies (Figure 1B). Pim-1 protein expression was increased in the synovium of untreated RA compared with disease controls, including amongst infiltrating CD4+ T cells (Figure 1C-D).In vitro, exposure of TCR-stimulated early RA CD4+ T cells to pim kinase inhibitors restrained their activation and proliferative capacity; diminished pro-inflammatory cytokine production (IFN-g and IL-17) and an expanded CD25hiFoxP3+ regulatory T cell (Treg) fraction were also observed in treatedversusun-treated cells. Finally, administration of pim inhibitors robustly attenuated clinical scores of arthritis in the CIA model, with reduced cartilage loss observed in animals treated with a pan-PIM inhibitor compared with vehicle control (Figure 2).Conclusion:Our data highlight pim kinases as plausible therapeutic targets for a subgroup of early RA patients that may be identifiable using tractable in vitro assays. Pim kinase inhibitors could simultaneously target immune inflammation and RASF dysregulation; consideration should now be given to their repurposing for this condition.References:[1] Anderson AE et al Annals of the Rheumatic Diseases 2016; 75:466-73.[2] Anderson AE et al Rheumatology 2019; 58:1250-1258[3] Ha YJ et al Rheumatology 2019; 58:154-64Disclosure of Interests:Nicola Maney Consultant of: Current employee of Eli Lilly, Henrique De Paula-Lemos: None declared, Ben Barron-Millar: None declared, Andrew Mellor Shareholder of: NewLink Genetics PLC, and has received patent licensing income from this source., John D Isaacs Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck, Pfizer, Roche, Amy Anderson: None declared, Arthur Pratt Grant/research support from: Pfizer, GlaxoSmithKlein
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Swift J, Stanway J, Hilkens C, Anderson A, Pratt A, Isaacs J. OP0129 AUTOREACTIVE, CITRULLINATED PEPTIDE-SPECIFIC T CELLS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Self-reactive CD4+ T cells are thought to play a key role in the pathogenesis of rheumatoid arthritis (RA) and represent a target for antigen-specific, tolerogenic therapies1. Phenotyping such cells could provide the means with which to monitor these treatments. Here, we aimed to demonstrate antigen-induced T cell responses to RA relevant epitopes using peptide stimulation of peripheral blood mononuclear cells (PBMC). Several autoantigens have been described in RA, including various citrullinated peptide (cit-peptide) epitopes2; here we have used a combination of cit-peptides that will be used to load tolerogenic dendritic cells in a forthcoming experimental medicine study (AuToDeCRA II).Objectives:To detect peripheral blood T cell proliferation in response to candidate autoantigens in RA patients and healthy controls (HCs) using flow cytometry.Methods:PBMC from RA patients and HCs were obtained following informed consent and were cryopreserved. Prior to use, cells were thawed in medium supplemented with human serum and were labelled with a proliferation tracking dye (PTD). 2x105labelled cells were plated into 96 well plates with a minimum of 7 replicates per condition and were either cultured alone or stimulated with individual peptides at varying concentrations or a peptide pool. On day 9, cells from replicate wells were harvested, pooled and stained for surface markers and viability. Samples were acquired on a BD Fortessa X20 and analysis was performed in FlowJo version 10. A manual gating strategy was used to identify CD45RO+ (memory) CD4+ T cells and amongst this population, activated/proliferated cells were defined as CD25+ PTD low. Stimulation indices (SI) were calculated as the percentage of activated/proliferated cells from stimulated wells divided by the percentage from unstimulated wells.Results:Ten RA patients (including early and established disease) were recruited alongside seven HCs. Cit-peptides were initially titrated on an individual basis to determine the optimum concentration for use (n = 2). We then compared stimulation with either single peptides or a pool (n = 2), and found that PBMC stimulated with the pooled cit-peptides had a higher proliferative response. Both single and pooled cit-peptide induced T cell proliferation was observed in both RA and HC samples (Figure 1); the largest responses were seen amongst RA patients, with a maximum stimulation index of 52.4 compared to a maximum of 6.75 in the HC group. Only 1 HC sample responded with an SI greater than 3.0, whereas 50 % of RA patients elicited responses above this. Two of the RA patients failed to respond to the peptide pool (SI < 1.0). Of note, RA patients were not selected on the basis of tissue type whereas selected peptides bind preferentially to class II HLA containing the shared epitope (SE).Figure 1Antigen-specific CD4+ CD45RO+ responses of citrullinated peptide stimulated PBMC from HCs and RA patients.Conclusion:In non-HLA typed individuals, cit-peptide induced proliferative T cell responses were detectable in both RA patients and HCs, and although SIs overall were higher amongst RA patients this did not reach statistical significance in this small sample. Not all RA patients responded to the peptide pool which may be due to the limited number of citrullinated epitopes used, or to RA patients with a non-SE HLA type. Additional work should establish the need for HLA typing in this assay; around half of seropositive RA patients would be expected to be SE positive3. Furthermore, a wider array of cit-peptides may be needed to demonstrate autoreactivity in a broader cross-section of RA patients. Our future plans are to further phenotype the cellular subsets responding to the peptide pool and to study assay data in the context of clinical outcomes, to assess its utility for immune monitoring.References:[1]McInnes, I. B. & Schett, G. N Engl J Med. 2011; 365(23):2205-2219[2]James, E. Aet al. Arthritis Rheum. 2014; 66(7):1712-1722[3]Thomson, Wet al. Arthritis Rheum. 1999; 42(4):757-762Disclosure of Interests:Jessica Swift: None declared, James Stanway: None declared, Catharien Hilkens: None declared, Amy Anderson: None declared, Arthur Pratt Grant/research support from: Pfizer, GlaxoSmithKlein, John Isaacs Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck, Pfizer, Roche
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Clark A, Naamane N, Nair N, Anderson A, Thalayasingam N, Diboll J, Barton A, Eyre S, Isaacs JD, Reynard L, Pratt A. THU0005 VARIABILITY OF DNA METHYLATION IS A DRIVER OF LYMPHOCYTE DYSREGULATION IN EARLY RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:DNA methylation patterns differ between leukocyte subsets and mediate the impact of environmental exposures on the molecular and functional phenotype of immune cells. Besides differences in mean methylation of CpG positions amongst patients with immune mediated diseases, recent evidence indicates variability of site-specific DNA methylation also contributes to pathogenesis1,2.Objectives:To seek evidence of altered DNA methylation patterns in RA, controlling for systemic inflammation and immunotherapy use.Methods:Patients with confirmed clinical diagnoses were enrolled from the Northeast Early Arthritis Cohort (NEAC). CD4+and CD19+lymphocytes were isolated from fresh blood by positive selection prior to therapeutic immune modulation. Methylation was quantified in cell subset-specific DNA (Infinium MethylationEPIC BeadChip, Illumina)3. Differentially methylated positions and regions (DMPs, DMRs) between RA and non-RA patients were identified (linear modelling, filtering on 5% pairwise difference in mean DNA methylation, and DMRcate package). Next, to identify instances where methylation variance differed between comparator groups, Bartlett’s test was performed using the iEVORA package, which accounts for outlier values4. Findings were controlled for technical confounders and subject to multiple test correction (FDR). A validated hypergeometric test was used to annotate enriched pathways.Results:After sample- and probe-level quality control, CD4+ and B lymphocyte specific data were respectively available for 45 and 49 RA patients, and 64 and 81 disease controls matched for systemic inflammation (CRP, ESR). No DMPs were identified in either cell type at FDR < 0.05 and Δβ ≥0.05. Only following relaxation of multiple test correction was it possible to identify DMRs in either cell type, most notably encapsulating 10 CpGs relatively hypomethylated at the promoter of the endosome protein-encodingRUFY1gene in CD4+ lymphocytes of RA patients (Δβ = 0.076). By contrast, striking evidence for differential variation in DNA methylation was observed at 291 and 601 CpGs of CD4+ and B lymphocytes, respectively (exemplars depicted in Figure 1). Only 15 of these differentially variable positions (DVPs) were common to both cell types. Pathway analysis highlighted potential functional consequences of DVP associations; for example, RA-specific hypervariability implicates prostaglandinsignalling in CD4+ lymphocytes.Conclusion:We highlight a role for altered variability in DNA methylation during the molecular pathogenesis of RA, and emphasise the importance of its study in relevant cell subsets.References:[1]Paul DSet al. Nature Communications 7, 13555 doi: 10.1038/ncomms13555 (2016).[2]Webster AP et al. Genome Medicine 10, 64 (2018)doi:10.1186/s13073-018-0575-9.[3]Clark AD et al. Journal of Allergy and Clinical Immunology 2019; doi: 10.1016/j.jaci.2019.12.910[4]Teschendorff AE et al. Nature Communications 2016; 7:12.Disclosure of Interests:Alexander Clark: None declared, Najib Naamane: None declared, Nisha Nair: None declared, Amy Anderson: None declared, Nishanthi Thalayasingam: None declared, Julie Diboll: None declared, Anne Barton Consultant of: AbbVie, Stephen Eyre: None declared, John D Isaacs Consultant of: AbbVie, Bristol-Myers Squibb, Eli Lilly, Gilead, Janssen, Merck, Pfizer, Roche, Louise Reynard: None declared, Arthur Pratt Grant/research support from: Pfizer, GlaxoSmithKlein
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Anderson A, Fawdon M, Booth Z, Hodgson R, Parker S, Goodfellow N, Quibell R, Bourke S. P350 Bereavement: a ‘time to remember’ event for families bereaved by cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Okwuosa I, Xu Y, Andrei A, Warzecha A, Kao A, Hsich E, Dew M, Kormos R, Anderson A, Pham D, Yancy C, LaRue S, Petty M, Cotts W, Pamboukian S, Pagani F, Lampert B, Murray M, Tekeda K, Yuzefpolskaya M, Silvestry S, Kirklin J, Collum S, Grady K. Sustaining Quality of Life of the Aged: Transplant or Mechanical Support (Sustain-It): Caregiver Perceived Burden. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ariyaratne H, Scott E, Anderson A, Cooper E, Pasciuti K. Linac-based stereotactic ablative radiotherapy for lung cancer: single-institution outcomes. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Riley EA, Owora A, McCleary J, Anderson A. Sleepiness, Exertion Fatigue, Arousal, and Vigilant Attention in Persons With Chronic Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1491-1508. [PMID: 31437012 DOI: 10.1044/2019_ajslp-18-0301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Individuals in the acute and chronic stages of stroke recovery often report more daytime sleepiness (Sterr, Herron, Dijk, & Ellis, 2008) and fatigue that qualitatively differs from "normal" feelings of fatigue they experienced prestroke (De Doncker, Dantzer, Ormstad, & Kuppuswamy, 2018). Speech-language pathologists frequently observe signs of fatigue in their clients with aphasia and perceive that client fatigue impedes therapeutic interventions (Riley, 2017). The current study aimed to quantify daytime sleepiness, exertion fatigue, and physiologically measured arousal and vigilant attention in persons with aphasia. Method We measured sleepiness, exertion fatigue, arousal, and vigilant attention in 10 participants with aphasia and 10 neurologically healthy adults. Daytime sleepiness was measured using the Epworth Sleepiness Scale (Johns, 1991). Exertion fatigue was measured using the Visual Analog Fatigue Scale (B. Y. Tseng, Gajewski, & Kluding, 2010) before and after a 72-min computer-administered language task. Arousal was measured using heart rate and variability (Shaffer & Ginsberg, 2017). Vigilant attention was measured using electroencephalography and subsequently classified into 1 of 4 levels of vigilant attention using a classification algorithm (Berka et al., 2004). Results Persons with aphasia did not show significant differences from controls in reported amount of daytime sleepiness, exertion fatigue, or overall physiological arousal but demonstrated different patterns of electroencephalography-measured vigilant attention and error production as compared to controls. Conclusions Although overall sleepiness, exertion fatigue, and overall arousal did not differ between groups, physiological measures of vigilant attention may be more sensitive to differences and may explain feelings of fatigue that persons with chronic aphasia experience.
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Hughes D, Dailianis AE, Hill L, McIntyre DA, Anderson A, Anderson A, Barrat C, Battista K, Beatty S, Blanch T, Briones D, Brooks R, Brown J, Burnie A, Clark T, Dailianis A, Destro C, Dijs B, Dombroski P, Fyfe R, Gebler J, Gerry A, Graham T, Hadjimichael D, Heaton S, Hetrick S, High E, Hill L, Hirt B, Hulett B, Hussain Z, Kalinowski R, Kerr D, Matouchi N, Maycock L, Munyard S, Murphy M, Remes A, Ristov K, Robbins R, Rodriquez R, Shebuski J, Simes V, Smith K, Vanderpoel S, Wang D. TECRA® Unique™ Test for Rapid Detection of Salmonella in Food: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.2.416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
The TECRA® Unique™ Salmonella test uses the principle of immunoenrichment to allow rapid detection of Salmonellae in food. A collaborative study was conducted to compare the TECRA Salmonella Unique test with the reference culture method given in the U.S. Food and Drug Administration's Bacteriological Analytical Manual. Three food types (milk powder, pepper, and soy flour) were analyzed in Australia and 2 food types (milk chocolate and dried egg) were analyzed in the United States. Forty-one collaborators participated in the study. For each of the 5 foods at each of the 3 levels, a comparison showed no significant differences (p ≥ 0.05) in the proportion of positive test samples for Unique and that for the reference method using the Chi-square test for independence with continuity correction.
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