Gut microbiome modulates response to anti-PD-1 immunotherapy in melanoma patients

Preclinical mouse models suggest that the gut microbiome modulates tumor response to checkpoint blockade immunotherapy; however, this has not been well-characterized in human cancer patients. Here we examined the oral and gut microbiome of melanoma patients undergoing anti-programmed cell death 1 protein (PD-1) immunotherapy (n = 112). Significant differences were observed in the diversity and composition of the patient gut microbiome of responders versus nonresponders. Analysis of patient fecal microbiome samples (n = 43, 30 responders, 13 nonresponders) showed significantly higher alpha diversity (P < 0.01) and relative abundance of bacteria of the Ruminococcaceae family (P < 0.01) in responding patients. Metagenomic studies revealed functional differences in gut bacteria in responders, including enrichment of anabolic pathways. Immune profiling suggested enhanced systemic and antitumor immunity in responding patients with a favorable gut microbiome as well as in germ-free mice receiving fecal transplants from responding patients. Together, these data have important implications for the treatment of melanoma patients with immune checkpoint inhibitors.

Assessment of pathogenicity and antigenicity of American lineage influenza H5N2 viruses in Taiwan

During December 2003 and March 2004, large scale epidemics of low-pathogenic avian influenza (LPAI) H5N2 occurred in poultry farms in central and southern Taiwan. Based on genomic analysis, these H5N2 viruses contain HA and NA genes of American-lineage H5N2 viruses and six internal genes from avian influenza A/H6N1 viruses endemic in poultry in Taiwan. After disappearing for several years, these novel influenza H5N2 viruses caused outbreaks in poultry farms again in 2008, 2010 and 2012, and have evolved into high pathogenic AI (HPAI) since 2010. Moreover, asymptomatic infections of influenza H5N2 were detected serologically in poultry workers in 2012. Therefore, we evaluated antigenicity and pathogenicity of the novel H5N2 viruses in ferrets. We found that no significant antigenic difference was detected among the novel H5N2 viruses isolated from 2003 to 2014 and the novel H5N2 viruses could cause mild infections in ferrets. Monitoring zoonotic transmission of the novel H5N2 viruses is necessary.

A Novel Hybrid Viabahn-assisted Bypass Technique: Extra-arterial Flossing Wiring for Chronic Total Occlusion in Superficial Femoral Artery

Introduction

A hybrid Viabahn-assisted bypass (VAB) technique is introduced for revascularizing chronic total occlusion (CTO) in superficial femoral artery (SFA) when bypass surgery is difficult or endovascular intervention fails.

Report

This technique combines extra-arterial flossing wiring with antegrade-retrograde intervention via traditional open exposure of middle SFA and deploying a Viabahn from the proximal true lumen through the subintimal lumen and extra-arterial space, and back into distal true lumen to restore flow. It only needs a 3–5 cm incision to expose the mid-SFA without clamping or endarterectomy of the SFA.

Discussion

This hybrid procedure is an alternative technique to improve SFA revascularization in some difficult CTOs.

Association between MTHFR gene polymorphisms (C677T, A1298C) and genetic susceptibility to prostate cancer: a meta-analysis

Genetic polymorphisms (C677T and A1298C) in methylenetetrahydrofolate reductase (MTHFR) were shown to be related to prostate cancer risk in previous studies; however, the results are controversial. We performed a meta-analysis of previous studies and quantitatively estimated these associations. Pubmed, Embase, and Cochrane Library Database were searched for published case-control studies evaluating the association between C677T (or A1298C) and prostate cancer risk. Pooled associations were presented as odds ratios (ORs) along with their 95% confidence intervals. Twenty-one case control studies were identified for meta-analysis that included 21,581 participants. No significant associations were found between the MTHFR polymorphisms C677T or A1298C and prostate cancer risk in our meta-analysis. However, in subgroup analyses, the C677T CT polymorphism was associated with increased prostate cancer risk in East Asians (CT vs CC+TT: OR = 1.324, P = 0.03). The A1298C CC polymorphism in MTHFR was also linked to slightly reduced prostate cancer risk in European residents (CC vs AC+AA: OR = 0.751, P = 0.004; CC vs AA: OR = 0.768, P = 0.011), whereas it was associated with a significantly increased prostate cancer risk in Asian residents (CC vs AA: OR = 1.862, P = 0.006). The C677T CT polymorphism of MTHFR may be a risk factor for prostate cancer in East Asians. The association between the MTHFR A1298C CC genotype and prostate cancer risk may vary within different populations. Large-scale well-designed studies are required to confirm these associations.

Evaluation of MDCK cell-derived influenza H7N9 vaccine candidates in ferrets

Avian-origin influenza A (H7N9) viruses emerged as human pathogens in China in early 2013 and have killed >100 persons. Influenza vaccines are mainly manufactured using egg-based technology which could not meet the surging demand during influenza pandemics. In this study, we evaluated cell-based influenza H7N9 vaccines in ferrets. An egg-derived influenza H7N9 reassortant vaccine virus was adapted in MDCK cells. Influenza H7N9 whole virus vaccine antigen was manufactured using a microcarrier-based culture system. Immunogenicity and protection of the vaccine candidates with three different formulations (300μg aluminum hydroxide, 1.5μg HA, and 1.5μg HA plus 300μg aluminum hydroxide) were evaluated in ferrets. In ferrets receiving two doses of vaccination, geometric mean titers of hemagglutination (HA) inhibition and neutralizing antibodies were <10 and <40 for the control group (adjuvant only), 17 and 80 for the unadjuvanted (HA only) group, and 190 and 640 for the adjuvanted group (HA plus adjuvant), respectively. After challenge with wild-type influenza H7N9 viruses, virus titers in respiratory tracts of the adjuvanted group were significantly lower than that in the control, and unadjuvanted groups. MDCK cell-derived influenza H7N9 whole virus vaccine candidate is immunogenic and protective in ferrets and clinical development is highly warranted.

Detection of human JCPyV and BKPyV in diffuse large B-cell lymphoma of the GI tract

Previous studies have demonstrated that infection with human polyomavirus, such as JCPyV and BKPyV, might be associated with various human tumors. However, an association between human JCPyV and BKPyV infection and diffuse large B-cell lymphoma (DLBCL) has not been reported. The purpose of this study was to examine DLBCLs of the gastrointestinal tract for evidence of human polyomavirus infection. Nested PCR and DNA sequencing were employed for viral DNA detection and viral genotype identification. In addition, two viral proteins, the large tumor antigen (LT) and the major structural protein (VP1), were detected by immunohistochemistry (IHC). Human JCPyV and BKPyV DNA was detected in 14 out of 16 tissue samples (87.5%), whereby nine cases were infected with JCPyV and five cases were infected with BKPyV. Both archetypal and rearranged genotypes of JCPyV and BKPyV were detected in the tissues. LT was detected in 11 tissue samples (68.75%). However, VP1 was not detected in any of the tissue samples. The presence of human JCPyV and BKPyV DNA and protein in DLBCL tissues of gastrointestinal tract were first reported in this study. The current results provide evidence of a possible association between human JCPyV and BKPyV infection and DLBCL.

Detection of human JCPyV and BKPyV in diffuse large B-cell lymphoma of the GI tract

Previous studies have demonstrated that infection with human polyomavirus, such as JCPyV and BKPyV, might be associated with various human tumors. However, an association between human JCPyV and BKPyV infection and diffuse large B-cell lymphoma (DLBCL) has not been reported. The purpose of this study was to examine DLBCLs of the gastrointestinal tract for evidence of human polyomavirus infection. Nested PCR and DNA sequencing were employed for viral DNA detection and viral genotype identification. In addition, two viral proteins, the large tumor antigen (LT) and the major structural protein (VP1), were detected by immunohistochemistry (IHC). Human JCPyV and BKPyV DNA was detected in 14 out of 16 tissue samples (87.5%), whereby nine cases were infected with JCPyV and five cases were infected with BKPyV. Both archetypal and rearranged genotypes of JCPyV and BKPyV were detected in the tissues. LT was detected in 11 tissue samples (68.75%). However, VP1 was not detected in any of the tissue samples. The presence of human JCPyV and BKPyV DNA and protein in DLBCL tissues of gastrointestinal tract were first reported in this study. The current results provide evidence of a possible association between human JCPyV and BKPyV infection and DLBCL.

Enzymatic stability and immunoregulatory efficacy of a synthetic indolicidin analogue with regular enantiomeric sequence

Cell-mediated immunity plays a major role in protecting the host from viral infections and tumor challenge. Here, we report the enzymatic stability and adjuvanticity of a peptiomimetic stereoisomer of the bovine neutrophil peptide indolicidin. The analogue, dubbed ld-indolicidin, contains the regular enantiomeric sequence of indolicidin and is synthesized by general stepwise solid-phase strategy. ld-Indolicidin possesses high resistance to enzymatic degradation and shows tolerance in mice. As vaccine adjuvant, ld-indolicidin is better able than the native form of indolicidin to enhance cell-mediated immune responses, using inactivated H5N1 virus as a model antigen. Taken together, these results open up a new approach to the development of vaccine adjuvants and immunotherapy technologies.

Transgenic expression of haem oxygenase-1 in pancreatic beta cells protects non-obese mice used as a model of diabetes from autoimmune destruction and prolongs graft survival following islet transplantation

AIMS/HYPOTHESIS

Haem oxygenase 1 (HO-1) has strong anti-apoptotic, anti-inflammatory and antioxidative effects that help protect cells against various forms of immune attack. We investigated whether transgenic expression of Ho-1 (also known as Hmox1) in pancreatic beta cells would protect NOD mice from autoimmune damage and prolong graft survival following islet transplantation.

METHODS

To evaluate the protective effect of beta cell-specific HO-1 in autoimmune diabetes, we used an insulin promoter-driven murine Ho-1 construct (pIns-mHo-1) to generate a transgenic NOD mouse. Transgene expression, insulitis and the incidence of diabetes in mice were characterised. Lymphocyte composition, the development of T helper (Th)1, Th2 and T regulatory (Treg) cells, T cell proliferation and lymphocyte-mediated disease transfer were analysed. The potential effects of transgenic islets and islet transplantation on apoptosis, inflammation and the generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS) were evaluated.

RESULTS

Transgenic mice showed less severe insulitis and a lower incidence of diabetes than non-transgenic control littermates. Lymphocyte composition and functions were not affected. Islets from transgenic mice expressed lower levels of proinflammatory cytokines/chemokines, proapoptotic gene expression and amounts of ROS/RNS, and were more resistant to TNF-α- and IFN-γ-induced apoptosis. Islet grafts from transgenic mice also survived longer in diabetic recipients than control islets.

CONCLUSIONS/INTERPRETATION

Transgenic overexpression of Ho-1 in beta cells protected NOD mice from diabetes and delayed the autoimmune destruction of islet grafts, providing valuable insight into the development of better strategies for clinical islet transplantation in patients with type 1 diabetes.

Risk factors of multidrug resistance in nosocomial bacteremia due to Acinetobacter baumannii: a case-control study

BACKGROUND AND PURPOSE

Acinetobacter baumannii is an important nosocomial pathogen. Bacteremia caused by multidrug-resistant A. baumannii (MDRAB) leads to higher mortality and medical cost compared with non-MDRAB bacteremia. We aimed to identify risk factors of multidrug resistance in A. baumannii bacteremia.

METHODS

A matched case-control study was conducted to compare the differences in risk factors of patients with MDRAB and non-MDRAB bacteremia.

RESULTS

Sixty three patients with MDRAB bacteremia and 63 matched patients with non-MDRAB bacteremia were identified from hospital and laboratory records of the period 1996 to 2002. Multivariate logistic regression analysis identified four independent risk factors associated with multidrug resistance in A. baumannii bacteremic patients: previous colonization with A. baumannii (odds ratio [OR], 7.99; 95% confidence interval [CI], 2.1-30.6; p=0.002), antecedent antimicrobial therapy (OR, 6.10; 95% CI, 1.2-29.9; p=0.026) the number of recently prescribed antibiotics (OR 1.35; 95% CI, 1.0-1.8; p=0.026), and recent invasive procedures (OR, 4.17; 95% CI, 1.6-11.1; p=0.004).

CONCLUSIONS

Overall, patients with MDRAB bacteremia had earlier A. baumannii colonization, greater previous exposure to antimicrobial agents and recent invasive procedures. The results of this study demonstrate a rationale for the development of effective interventions to minimize the impact of MDRAB.

Changes of brachial flow-mediated vasodilation in different ischemic stroke subtypes

The relationship between endothelial dysfunction and stroke subtypes is unclear. We prospectively measured brachial flow-mediated vasodilation (FMD) in 143 patients with acute ischemic stroke and 40 controls. The overall stroke patients had impaired FMD, but only lacunar infarction had significantly impaired FMD vs the controls. Impaired FMD was an independent predictor for lacunar infarction. Ischemic stroke is associated with endothelial dysfunction, which is more conspicuous in lacunar infarction.

An atomic force microscope study of thermal behavior of phospholipid monolayers on mica

We observed by using atomic force microscope (AFM) phospholipid (1,2-dipalmitoyl-sn-glycero-3-phosphocholine) monolayers on mica being annealed and cooled to a selection of temperatures through steps of 2-4 degrees C/min. The annealed phospholipid monolayers started to disappear at 45-50 degrees C and disappeared completely above 60-63 degrees C under AFM observation. The phospholipid monolayers reformed when the samples were cooled below 60 degrees C and developed from fractal into compact monolayer films with decreasing temperatures. Simultaneously the height of the reformed phospholipid films also increased with decreasing temperatures from 0.4 nm to the value before annealing. The observed thermal features are attributed to a phase-transition process that upon heating to above 45-50 degrees C, the lipids condensed in the monolayers transform into a low-density expanded phase in which the lipids are invisible to AFM, and the transformation continues and completes at 60-63 degrees C. The lipid densities of the expanded phase inferred from the dissociated area of the condensed phase are observed to be a function of the temperature. The behavior contrasts with a conventional first-order phase transition commonly seen in the Langmuir films. The temperature-dependent height and shape of the reformed phospholipid films during cooling are argued to arise from the adjustment of the packing and molecular tilting (with respect to the mica surface) of the phospholipids in order to accommodate more condensed phospholipids.

Growth of Co clusters on thin films Al2O3∕NiAl(100)

We present a scanning tunnel microscopy study of Co clusters grown through vapor deposition on Al(2)O(3) thin films over NiAl(100) at different coverages and temperatures. Formation of Co clusters was observed at 90, 300, 450, and 570 K. At the three lower temperatures, we find narrow cluster size distributions and the mean sizes (with a diameter of 2.6 nm and a height of 0.7 nm) do not change significantly with the coverage and temperature, until the clusters start to coalesce. Even on 3-4-nm-wide crystalline Al(2)O(3) strips where the deposited Co atoms are confined, the same features sustain. Only at 570 K the normal growth mode where the cluster size increases with the deposition coverage is observed, although the data are less conclusive. A simple modeling of kinetic surface processes on a strip confirms the normal growth mode, but fails to show a favored size unless additional energetic constraints are applied on the cluster sizes. Increasing Co coverages to cluster coalescence, a larger preferable size (mean diameter of 3.5 nm and height of 1.4 nm) appears for growth at 450 K. These two sizes are corroborated by morphology evolution of high Co coverages deposited at 300 K and annealed to 750 K, in which the coalescence is eliminated and the two preferable geometries appear and coexist.

Non-clostridial gas gangrene caused by Klebsiella pneumoniae: a case report

A 45-y-old man was hospitalized due to pain and swelling of the right leg for 3 d. Bullae developed with gas formation involving multiple compartments of the entire limb 46 h later. Klebsiella pneumoniae was recovered from blood and surgical specimens. The patient died on Day 8 despite amputation and antibiotic therapy.

Quality-adjusted survival estimation with periodic observations

Quality-adjusted survival is a measure that integrates both longevity and quality-of-life information. The analysis of quality-adjusted survival in a clinical study with data collected at periodic intervals encounters difficulties due to incomplete information. Based on observed time points, the time axis is partitioned into a set of disjoint time intervals, and under a Markovian assumption on patient's health status, the expected quality-adjusted survival is estimated as the summed product of the quality of life and its mean sojourn time of each health state within partitioned intervals. It is shown that the estimator is asymptotically normal with a simple variance calculation. A simulation study is conducted to investigate the behavior of the estimator, and a stroke study illustrates the use of the estimator.

Disulfide bonds stabilize JC virus capsid-like structure by protecting calcium ions from chelation

To investigate the role of disulfide bonds in the capsid structure, a recombinant JC virus-like particle (VLP) was used. The major capsid protein, VP1, of the JC virus was expressed in yeast cells. The yeast-expressed VP1 was self-assembled into a VLP. Disulfide bonds were found in the VLP which caused dimeric and trimeric VP1 linkages as demonstrated by non-reducing SDS-PAGE. The VLP remained intact when disulfide bonds were reduced by dithiothreitol. The VLP without disulfide bonds could be disassembled into capsomeres by EGTA alone, but those with disulfide bonds could not be disassembled by EGTA. Capsomeres were reassembled into VLPs in the presence of calcium ions. Capsomeres formed irregular aggregations instead of VLPs when treated with diamide to reconstitute the disulfide bonds. These results indicate that disulfide bonds play an important role in maintaining the integrity of the JC VLP by protecting calcium ions from chelation.

Genome mining for human cancer genes: wherefore art thou?

In an initial data-mining effort, the draft human genome was searched to find paralogs of known tumor suppressor genes, and for gene arrangements, which are typical of oncogenes, in cancer cells. The results were disappointing, indicating that although knowledge of the human genome will undoubtedly be of great help, other approaches to identify new oncogenes are needed.

RINT-1, a novel Rad50-interacting protein, participates in radiation-induced G(2)/M checkpoint control

Rad50, an structural maintenance of chromosomes (SMC) protein family member, participates in a variety of cellular processes, including DNA double-strand break repair, cell cycle checkpoint activation, telomere maintenance, and meiosis. Disruption of Rad50 in mice leads to lethality during early embryogenesis, indicating its essential function in normal proliferating cells. In addition to its ability to form a complex with the DNA double-strand break repair proteins Mre11 and NBS1, Rad50 may interact with other cellular proteins to execute its full range of biological activities. A novel 87-kDa protein named RINT-1 was identified using the C-terminal region of human Rad50 as the bait in a yeast two-hybrid screen. Human RINT-1 shares sequence homology with a novel protein identified in Drosophila melanogaster, including a coiled-coil domain within its N-terminal 150 amino acids, a conserved central domain of about 350 amino acids, and a C-terminal region of 90 amino acids exhibiting 35--38% identity. The conserved central and C-terminal regions of RINT-1 are required for its interaction with Rad50. While Rad50 and RINT-1 are both expressed throughout the cell cycle, RINT-1 specifically binds to Rad50 only during late S and G(2)/M phases, suggesting that RINT-1 may be involved in cell cycle regulation. Consistent with this possibility, MCF-7 cells expressing an N-terminally truncated RINT-1 protein displayed a defective radiation-induced G(2)/M checkpoint. These results suggest that RINT-1 may play a role in the regulation of cell cycle control after DNA damage.

Sequence-specific transcriptional corepressor function for BRCA1 through a novel zinc finger protein, ZBRK1

BRCA1 has been implicated in the transcriptional regulation of DNA damage-inducible genes that function in cell cycle arrest. To explore the mechanistic basis for this regulation, a novel human gene, ZBRK1, which encodes a 60 kDa protein with an N-terminal KRAB domain and eight central zinc fingers, was identified by virtue of its interaction with BRCA1 in vitro and in vivo. ZBRK1 binds to a specific sequence, GGGxxx CAGxxxTTT, within GADD45 intron 3 that supports the assembly of a nuclear complex minimally containing both ZBRK1 and BRCA1. ZBRK1 represses transcription through this recognition sequence in a BRCA1-dependent manner. These results thus reveal a novel corepressor function for BRCA1 and provide a mechanistic basis for the biological activity of BRCA1 through sequence-specific transcriptional regulation.

NBS1 and TRF1 colocalize at promyelocytic leukemia bodies during late S/G2 phases in immortalized telomerase-negative cells. Implication of NBS1 in alternative lengthening of telomeres

Nijmegen breakage syndrome, a chromosomal instability disorder, is characterized in part by cellular hypersensitivity to ionizing radiation. The NBS1 gene product, p95 (NBS1 or nibrin) forms a complex with Rad50 and Mre11. Cells deficient in the formation of this complex are defective in DNA double-strand break repair, cell cycle checkpoint control, and telomere length maintenance. How the NBS1 complex is involved in telomere length maintenance remains unclear. Here we show that the C-terminal region of NBS1 interacts directly with a telomere repeat binding factor, TRF1, by both yeast two-hybrid and in vivo DNA-coimmunoprecipitation assays. NBS1 and Mre11 colocalize with TRF1 at promyelocytic leukemia (PML) nuclear bodies in immortalized telomerase-negative cell lines, but rarely in telomerase-positive cell lines. The translocation of NBS1 to PML bodies occurs specifically during late S to G(2) phases of the cell cycle and coincides with active DNA synthesis in these NBS1-containing PML bodies. These results suggest that NBS1 may be involved in alternative lengthening of telomeres in telomerase-negative immortalized cells.

Functional link of BRCA1 and ataxia telangiectasia gene product in DNA damage response

BRCA1 encodes a familial breast cancer suppressor that has a critical role in cellular responses to DNA damage. Mouse cells deficient for Brca1 show genetic instability, defective G2-M checkpoint control and reduced homologous recombination. BRCA1 also directly interacts with proteins of the DNA repair machinery and regulates expression of both the p21 and GADD45 genes. However, it remains unclear how DNA damage signals are transmitted to modulate the repair function of BRCA1. Here we show that the BRCA1-associated protein CtIP becomes hyperphosphorylated and dissociated from BRCA1 upon ionizing radiation. This phosphorylation event requires the protein kinase (ATM) that is mutated in the disease ataxia telangiectasia. ATM phosphorylates CtIP at serine residues 664 and 745, and mutation of these sites to alanine abrogates the dissociation of BRCA1 from CtIP, resulting in persistent repression of BRCA1-dependent induction of GADD45 upon ionizing radiation. We conclude that ATM, by phosphorylating CtIP upon ionizing radiation, may modulate BRCA1-mediated regulation of the DNA damage-response GADD45 gene, thus providing a potential link between ATM deficiency and breast cancer.