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Rodriguez R, Lee A, Mathis KW, Broome HJ, Thorwald M, Martinez B, Nakano D, Nishiyama A, Ryan MJ, Ortiz RM. Angiotensin receptor and tumor necrosis factor-α activation contributes to glucose intolerance independent of systolic blood pressure in obese rats. Am J Physiol Renal Physiol 2018; 315:F1081-F1090. [PMID: 29993275 DOI: 10.1152/ajprenal.00156.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Pathological activation of the renin-angiotensin system and inflammation are associated with hypertension and the development of metabolic syndrome (MetS). The contributions of angiotensin receptor type 1 (AT1) activation, independent of blood pressure, and inflammation to glucose intolerance and renal damage are not well defined. Using a rat model of MetS, we hypothesized that the onset of glucose intolerance is primarily mediated by AT1 activation and inflammation independent of elevated systolic blood pressure (SBP). To address this hypothesis, we measured changes in SBP, adiposity, plasma glucose and triglyceride levels, and glucose tolerance in six groups of rats: 1) lean, strain control Long-Evans Tokushima Otsuka (LETO; n = 5), 2) obese Otsuka Long-Evans Tokushima Fatty (OLETF; n = 8), 3) OLETF + angiotensin receptor blocker (ARB; 10 mg olmesartan/kg; n = 8), 4) OLETF + tumor necrosis factor-α (TNF-α) inhibitor (ETAN; 1.25 mg etanercept/kg; n = 6), 5) OLETF + TNF-α inhibitor + angiotensin receptor blocker (ETAN+ARB; 1.25 mg etanercept/kg + 10 mg olmesartan/kg; n = 6), and 6) OLETF + calcium channel blocker (CCB; 5 mg amlodipine/kg; n = 7). ARB and ETAN+ARB were most effective at decreasing SBP in OLETF, and ETAN did not offer any additional reduction. Glucose tolerance improved in ARB, ETAN, and ETAN+ARB compared with OLETF, whereas CCB had no detectable effect. Furthermore, all treatments reduced adiposity, whereas ETAN alone normalized urinary albumin excretion. These results suggest that AT1 activation and inflammation are primary factors in the development of glucose intolerance in a setting of MetS and that the associated increase in SBP is primarily mediated by AT1 activation.
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García AJM, Molina Méndez F, Lespron Robles M, Piedracruz Ramos L, Beltran Ochoa J, Martinez J, Rodriguez R, Lepe Mancilla J. Frailty assessment versus conventional risk scores for predicting 1 year outcome after TAVR. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rodriguez R, Moreno M, Lee AY, Godoy-Lugo JA, Nakano D, Nishiyama A, Parkes D, Awayda MS, Ortiz RM. Simultaneous GLP-1 receptor activation and angiotensin receptor blockade increase natriuresis independent of altered arterial pressure in obese OLETF rats. Hypertens Res 2018; 41:798-808. [PMID: 29985448 DOI: 10.1038/s41440-018-0070-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/11/2018] [Accepted: 01/14/2018] [Indexed: 01/08/2023]
Abstract
Obesity is associated with an inappropriately activated renin-angiotensin-aldosterone system, suppressed glucagon-like peptide-1 (GLP-1), increased renal Na+ reabsorption, and hypertension. To assess the link between GLP-1 and angiotensin receptor type 1 (AT1) signaling on obesity-associated impairment of urinary Na+ excretion (UNaV) and elevated arterial pressure, we measured mean arterial pressure (MAP) and heart rate by radiotelemetry and metabolic parameters for 40 days. We tested the hypothesis that stimulation of GLP-1 signaling provides added benefit to blockade of AT1 by increasing UNaV and further reducing arterial pressure in the following groups: (1) untreated Long-Evans Tokushima Otsuka (LETO) rats (n = 7); (2) untreated Otsuka Long-Evans Tokushima Fatty (OLETF) rats (n = 9); (3) OLETF + ARB (ARB; 10 mg olmesartan/kg/day; n = 9); (4) OLETF + GLP-1 receptor agonist (EXE; 10 µg exenatide/kg/day; n = 7); and (5) OLETF + ARB + EXE (Combo; n = 6). On day 2, UNaV was 60% and 62% reduced in the EXE and Combo groups, respectively, compared with that in the OLETF rats. On day 40, UNaV was increased 69% in the Combo group compared with that in the OLETF group. On day 40, urinary angiotensinogen was 4.5-fold greater in the OLETF than in the LETO group and was 56%, 62%, and 58% lower in the ARB, EXE, and Combo groups, respectively, than in the OLETF group. From day 2 to the end of the study, MAP was lower in the ARB and Combo groups than in the OLETF rats. These results suggest that GLP-1 receptor activation may reduce intrarenal angiotensin II activity, and that simultaneous blockade of AT1 increases UNaV in obesity; however, these beneficial effects do not translate to a further reduction in MAP.
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Menendez S, Martinez-Cruzado L, Rey-Vazquez V, Estupiñan O, Rodriguez R. PO-273 Evaluation of the role of SOX2 as cancer stem cell marker in sarcomas. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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jimenez MS, Enciso D, Rodriguez R, Ramirez J, Cabrera C, Reynoso J. New paradigms in nursing with the implementation of the enhanced recovery after surgery program ERAS at BenemÉrito Hospital Civil FAA Guadalajara, Jalisco, Mexico. Clin Nutr ESPEN 2018. [DOI: 10.1016/j.clnesp.2018.03.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Rodriguez R, Minas JN, Vazquez-Medina JP, Nakano D, Parkes DG, Nishiyama A, Ortiz RM. Chronic AT1 blockade improves glucose homeostasis in obese OLETF rats. J Endocrinol 2018; 237:271-284. [PMID: 29643115 PMCID: PMC5945211 DOI: 10.1530/joe-17-0678] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 12/17/2022]
Abstract
Obesity is associated with the inappropriate activation of the renin-angiotensin system (RAS), which increases arterial pressure, impairs insulin secretion and decreases peripheral tissue insulin sensitivity. RAS blockade reverses these detriments; however, it is not clear whether the disease state of the organism and treatment duration determine the beneficial effects of RAS inhibition on insulin secretion and insulin sensitivity. Therefore, the objective of this study was to compare the benefits of acute vs chronic angiotensin receptor type 1 (AT1) blockade started after the onset of obesity, hyperglycemia and hypertension on pancreatic function and peripheral insulin resistance. We assessed adipocyte morphology, glucose intolerance, pancreatic redox balance and insulin secretion after 2 and 11 weeks of AT1 blockade in the following groups of rats: (1) untreated Long-Evans Tokushima Otsuka (lean control; n = 10), (2) untreated Otsuka Long-Evans Tokushima Fatty (OLETF; n = 12) and (3) OLETF + ARB (ARB; 10 mg olmesartan/kg/day by oral gavage; n = 12). Regardless of treatment duration, AT1 blockade decreased systolic blood pressure and fasting plasma triglycerides, whereas chronic AT1 blockade decreased fasting plasma glucose, glucose intolerance and the relative abundance of large adipocytes by 22, 36 and 70%, respectively. AT1 blockade, however, did not improve pancreatic oxidative stress or reverse impaired insulin secretion. Collectively, these data show that AT1 blockade after the onset of obesity, hyperglycemia and hypertension improves peripheral tissue insulin sensitivity, but cannot completely reverse the metabolic derangement characterized by impaired insulin secretion once it has been compromised.
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Siso C, Esgueva A, Rodriguez R, Espinosa M, Córdoba O, Rubio I. Her2 positive and triple negative breast cancer patients with clinically negative nodes at diagnosis and breast pathologic complete response may spare axillary surgery after neoadjuvant treatment. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30288-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thorwald MA, Rodriguez R, Nakano D, Nishiyama A, Ortiz R. AT1 Receptor Blockade Improves Mitochondrial Activity in Insulin Resistant but not Type II Diabetic Hearts. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.719.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rubio IT, Rodriguez R, Esgueva-Colmenarejo A, Suarez M, Espinosa-Bravo M, Siso C, Cordoba O, Alvarado S, Volders J, Van Den Tol P. Abstract P5-22-10: Intraoperative ultrasound guided surgery after neoadjuvant treatment in breast cancer improves patient´s quality of life. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-22-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Intraoperative ultrasound guided surgery (IOUS) has shown not only to improve surgical outcomes by achieving higher rates of negative margins and reducing the need for re-excisions, but also showing better cosmetic results and patient's satisfaction in the adjuvant setting. After neoadjuvant treatments (NAT) we have shown that IOUS lowers the volume of resection in patients with pathologic complete response or minimal microscopic disease after NAT without compromising margins and local recurrences when compared to wire localization techniques (WL) The aim of this study was to determine if IOUS after NAT contributes to improve cosmetic outcomes and quality of life (QOL) when compared with WL.
Material and Methods. The pilot study enrolled patients treated with NAT who underwent breast-conserving surgery (BCS) between July 2008 and December 2012. On the follow up visit, cosmetic outcomes were assessed by the patient and surgeon on a 4 point Likert scale, by the Breast Cancer Conservative Treatment cosmetic results (BCCT.core) software, and by an independent panel. QOL was assessed using cancer-specific (EORTC QLQ-C30 and EORTC QLQ-B23) questionnaires.
Results. The study investigated 113 patients: 81 (71.6 %) in the IOUS group and 32 (28.3 %) in the WL group. The patient and tumor characteristics were comparable between the two groups. Mean follow up was 64 months (range, 12-90) in the WL group while 41 months (range, 18-107) in the IOUS group.
Cosmetic outcomes reported by the patient showed a tendency (p=0.07) for better results in the IOUS group. Patient reported cosmetic outcomes and the independent panel cosmetic evaluation significantly correlated with lumpectomy volume excised (p= 0.04, p = 0.02 respectively). The BCCT.core did not correlate with volume of tissue excised (p < 0.14). IOUS achieved better cosmetic outcomes compared to WL, with excellent outcomes of 30% and 19% respectively, although poor cosmetic outcomes were 3% and 0% respectively. Correlation between patients and surgeons evaluation regarding cosmetic outcomes and satisfaction was low (0.38 and 0.40 respectively). A comparison of the QOL scores of 113 patients showed a significantly better global health status (p = 0.03), better emotional and role function (p = 0.004), for patients with IOUS compared to WL patients.
Conclusions. This is the first study to show that breast volume excised significantly correlates with cosmetic outcomes in the neoadjuvant setting. These results suggest that IOUS after NAT contributes to a better quality of life and may influence cosmetic outcomes in breast cancer patients. Patient reported outcomes should be included in the quality assessment in breast surgery as the correlation with surgeons' evaluation is low.
Citation Format: Rubio IT, Rodriguez R, Esgueva-Colmenarejo A, Suarez M, Espinosa-Bravo M, Siso C, Cordoba O, Alvarado S, Volders J, Van Den Tol P. Intraoperative ultrasound guided surgery after neoadjuvant treatment in breast cancer improves patient´s quality of life [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-22-10.
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Higginson DP, Khiar B, Revet G, Béard J, Blecher M, Borghesi M, Burdonov K, Chen SN, Filippov E, Khaghani D, Naughton K, Pépin H, Pikuz S, Portugall O, Riconda C, Riquier R, Rodriguez R, Ryazantsev SN, Skobelev IY, Soloviev A, Starodubtsev M, Vinci T, Willi O, Ciardi A, Fuchs J. Enhancement of Quasistationary Shocks and Heating via Temporal Staging in a Magnetized Laser-Plasma Jet. PHYSICAL REVIEW LETTERS 2017; 119:255002. [PMID: 29303310 DOI: 10.1103/physrevlett.119.255002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Indexed: 06/07/2023]
Abstract
We investigate the formation of a laser-produced magnetized jet under conditions of a varying mass ejection rate and a varying divergence of the ejected plasma flow. This is done by irradiating a solid target placed in a 20 T magnetic field with, first, a collinear precursor laser pulse (10^{12} W/cm^{2}) and, then, a main pulse (10^{13} W/cm^{2}) arriving 9-19 ns later. Varying the time delay between the two pulses is found to control the divergence of the expanding plasma, which is shown to increase the strength of and heating in the conical shock that is responsible for jet collimation. These results show that plasma collimation due to shocks against a strong magnetic field can lead to stable, astrophysically relevant jets that are sustained over time scales 100 times the laser pulse duration (i.e., >70 ns), even in the case of strong variability at the source.
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Andrade F, Salazar A, Naguib M, Rodriguez R, Carugno J. Perioperative Morbidity Associated with Abdominal Myomectomy Compared with Abdominal Hysterectomy for Very Large Fibroid Uterus. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thorwald M, Rodriguez R, Lee A, Martinez B, Peti-Peterdi J, Nakano D, Nishiyama A, Ortiz RM. Angiotensin receptor blockade improves cardiac mitochondrial activity in response to an acute glucose load in obese insulin resistant rats. Redox Biol 2017; 14:371-378. [PMID: 29049981 PMCID: PMC5647524 DOI: 10.1016/j.redox.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 09/21/2017] [Accepted: 10/05/2017] [Indexed: 12/19/2022] Open
Abstract
Hyperglycemia increases the risk of oxidant overproduction in the heart through activation of a multitude of pathways. Oxidation of mitochondrial enzymes may impair their function resulting in accumulation of intermediates and reverse electron transfer, contributing to mitochondrial dysfunction. Furthermore, the renin-angiotensin system (RAS) becomes inappropriately activated during metabolic syndrome, increasing oxidant production. To combat excess oxidant production, the transcription factor, nuclear factor erythriod-2- related factor 2 (Nrf2), induces expression of many antioxidant genes. We hypothesized that angiotensin II receptor type 1 (AT1) blockade improves mitochondrial function in response to an acute glucose load via upregulation of Nrf2. To address this hypothesis, an oral glucose challenge was performed in three groups prior to dissection (n = 5–8 animals/group/time point) of adult male rats: 1) Long Evans Tokushima Otsuka (LETO; lean strain-control), 2) insulin resistant, obese Otsuka Long Evans Tokushima Fatty (OLETF), and 3) OLETF + angiotensin receptor blocker (ARB; 10 mg olmesartan/kg/d × 6 weeks). Hearts were collected at T0, T60, and T120 minutes post-glucose infusion. ARB increased Nrf2 binding 32% compared to OLETF at T60. Total superoxide dismutase (SOD) and catalase (CAT) activities were increased 45% and 66% respectively in ARB treated animals compared to OLETF. Mitochondrial enzyme activities of aconitase, complex I, and complex II increased by 135%, 33% and 66%, respectively in ARB compared to OLETF. These data demonstrate the protective effects of AT1 blockade on mitochondrial function during the manifestation of insulin resistance suggesting that the inappropriate activation of AT1 during insulin resistance may impair Nrf2 translocation and subsequent antioxidant activities and mitochondrial function. ARB increases cardiac mitochondrial enzyme activity in insulin resistant rats. Nrf2 binding activity increases when AT1 receptor activation is blocked. Glucose suppresses total cardiac GPx and CAT activities during insulin resistance.
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Probst M, Gupta M, Hendey G, Rodriguez R, Winkel G, Mower W. 371 Prevalence of Intracranial Injury in Blunt Head Trauma Patients With or Without Anticoagulant and Antiplatelet Use. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.341] [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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Penzhorn RD, Rodriguez R, Glugla M, Günther K, Yoshida H, Konishi S. A Catalytic Plasma Exhaust Purification System. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst88-a25173] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Suzuki-Vidal F, Clayson T, Stehlé C, Swadling GF, Foster JM, Skidmore J, Graham P, Burdiak GC, Lebedev SV, Chaulagain U, Singh RL, Gumbrell ET, Patankar S, Spindloe C, Larour J, Kozlova M, Rodriguez R, Gil JM, Espinosa G, Velarde P, Danson C. Counterpropagating Radiative Shock Experiments on the Orion Laser. PHYSICAL REVIEW LETTERS 2017; 119:055001. [PMID: 28949745 DOI: 10.1103/physrevlett.119.055001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Indexed: 06/07/2023]
Abstract
We present new experiments to study the formation of radiative shocks and the interaction between two counterpropagating radiative shocks. The experiments are performed at the Orion laser facility, which is used to drive shocks in xenon inside large aspect ratio gas cells. The collision between the two shocks and their respective radiative precursors, combined with the formation of inherently three-dimensional shocks, provides a novel platform particularly suited for the benchmarking of numerical codes. The dynamics of the shocks before and after the collision are investigated using point-projection x-ray backlighting while, simultaneously, the electron density in the radiative precursor was measured via optical laser interferometry. Modeling of the experiments using the 2D radiation hydrodynamic codes nym and petra shows very good agreement with the experimental results.
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Zegri Reiriz I, Dominguez F, De Alarcon A, Munoz P, Martinez-Selles M, Gonzalez-Ramallo V, Miro J, Falces C, Gonzalez-Rico C, Kortajarena -Urkola X, Lepe J, Rodriguez R, Reguera-Iglesias J, Navas E, Garcia-Pavia P. P4542Infective endocarditis antibiotic prophylaxis in mitral valve prolapse and bicuspid aortic valve: should it be considered? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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De la Calle M, Baquero F, Rodriguez R, González M, Fernández A, Omeñaca F, Bartha JL. Successful treatment of intrauterine cytomegalovirus infection with an intraventricular cyst in a dichorionic diamniotic twin gestation using cytomegalovirus immunoglobulin. J Matern Fetal Neonatal Med 2017; 31:2226-2229. [PMID: 28573940 DOI: 10.1080/14767058.2017.1338259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Congenital cytomegalovirus (CMV) infection is the leading cause of severe congenital abnormalities. CMV immunoglobulin (CMVIG) may lower risk for symptomatic disease in congenital CMV infection. In a twin pregnancy, only one fetus shows CMV infection, raising a dilemma about intervention since the uninfected fetus would be exposed to treatment unnecessarily. CMVIG (2 × 200 U/kg) was given due to high viral load and development of an intraventricular cyst. The cyst growth plateaued, no other brain damage developed, and at 8 months, the infant was symptom-free. CMVIG appears appropriate to treat intrauterine CMV infection in this setting.
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Adams GB, Feng J, Ghogha A, Mardiros A, Murakami J, Phung T, Rodriguez R, Sievers S, Spindler TJ, Wiltzius J, Yarka C, Yoder SC, Polverino T. Abstract 4979: Development of KITE-585: A fully human BCMA CAR T-cell therapy for the treatment of multiple myeloma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Multiple myeloma (MM) is a usually fatal malignancy of plasma cells, with no current therapy considered curative. About 15% of patients diagnosed with MM are stratified as high risk with poor treatment outcomes and short (2-3 years) survival from diagnosis. Standard risk patients tend to live longer but undergo chronic and/or high intensity therapy and likely experience a relapsing and remitting disease pattern. Therefore, there is still a considerable unmet need for innovative therapies that improve outcomes in MM. One such approach is to use adoptive transfer of engineered autologous T cells expressing a chimeric antigen receptor (CAR) directed against malignant cells. The efficacy of CAR T cells directed against hematological malignancies, particularly CD19-expressing B cell leukemia and lymphomas, has been demonstrated in multiple clinical studies. KITE-585 was developed as a CAR T cell immunotherapy product candidate directed against B cell maturation antigen (BCMA). BCMA is nearly ubiquitously expressed on MM cells, plasma cells and subsets of mature B cells, but with limited or absent expression on other tissues.
Methods: We generated >50 fully human IgGs directed against BCMA using the BCMA protein as antigen and selection criteria including affinity, cross-reactivity and poly-specificity. Following assessment of the binding of the IgGs to a MM cell line known to express BCMA, >10 IgGs were identified that met the criteria for affinity and selectivity and had a >50-fold binding over background. The 8 IgGs that demonstrated the highest specific binding were then sequence-converted to single-chain variable fragments (scFvs) and incorporated into CARs.
Results: In all but one case, human T cells engineered to express these CAR constructs exhibited specific cytolytic activity against MM cell lines (NCI-H929 and MM.1s). These CAR T cells demonstrated killing efficiencies of >95% at effector:target ratios of 1:1 over a 24-hour period. Similarly antigen-specific production of inflammatory cytokines was observed in response to target cell lines in vitro. Assessment of antigen-dependent proliferation over a 5 day period revealed >80% proliferation in the 7 constructs that showed cytolytic activity in vitro. Multiple different anti-BCMA CAR constructs representing distinct epitope binding bins of BCMA were then selected for in vivo evaluation. In two disseminated tumor models of luciferase labeled NCI-H929 or MM.1s cells injected intravenously (i.v.), a single i.v. injection of anti-BCMA CAR T-cells delayed the progression of disease and significantly increased survival when compared to control treatment.
Conclusions: The results of these studies highlight the potential of targeting BCMA with adoptive transfer of engineered T cells for the treatment of MM. Given these positive findings, progress towards Phase 1 clinical studies in MM patients with KITE-585 is continuing.
Citation Format: Gregor B. Adams, Jun Feng, Atefah Ghogha, Armen Mardiros, Jodi Murakami, Tammy Phung, Ruben Rodriguez, Stuart Sievers, Tassja J. Spindler, Jed Wiltzius, Clare Yarka, Sean C. Yoder, Tony Polverino. Development of KITE-585: A fully human BCMA CAR T-cell therapy for the treatment of multiple myeloma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4979. doi:10.1158/1538-7445.AM2017-4979
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Adams GB, Feng J, Ghogha A, Mardiros A, Rodriguez R, Spindler TJ, Wiltzius J, Polverino T. Abstract 2135: Selectivity and specificity of engineered T cells expressing KITE-585, a chimeric antigen receptor targeting B-cell maturation antigen (BCMA). Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Immunotherapy has provided treatment options for cancers that are otherwise refractory to standard approaches. One such technique is to use adoptive transfer of engineered autologous T cells expressing a chimeric antigen receptor (CAR) directed against a tumor antigen. The efficacy of CAR T cells directed against hematological malignancies, particularly CD19-expressing B cell leukemia and lymphomas, has been demonstrated in multiple clinical studies. The success of this approach has prompted development of CAR T cells directed to different tumor antigens for other tumor types. To ensure the selectivity and specificity of the CAR T cells against their intended target, screening methods need to be employed. Multiple myeloma is an incurable malignancy of plasma cells. B-cell maturation antigen (BCMA), also known as tumor necrosis factor superfamily member 17 (TNFRSF17) is nearly ubiquitously expressed on multiple myeloma cells, plasma cells and subsets of mature B cells.
Methods: In order to screen for the specificity of novel CAR T cells directed against BCMA, we utilized a cell microarray platform developed by Retrogenix. In this screen, approximately 4500 human plasma membrane proteins (representing up to 75% of the human plasma membrane proteome) are individually expressed in human HEK293 cells. Fluorescently labeled CAR T cells, which showed cytolytic activity against MM cell lines expressing BCMA, were applied to the cell microarray and specific binding of the CAR T cells to target cells was determined.
Results: Primary hits were sequenced to confirm identity and secondary specificity screens were performed on the identified hits. Specific binding of both mock transduced and BCMA CAR transduced T cells were confirmed for different plasma membrane proteins expressed from the HEK293 cells. These included known T cell interactors, such as ICOSLG, CD244 and CD86, where binding is proposed to be independent of CAR expression. Subtracting the hits of the mock transduced T cells from the BCMA CAR T cells demonstrated specific binding of the CAR T cells to BCMA. Utilizing the fully human IgGs directed against BCMA from which the single-chain variable fragments (scFvs) of the CARs were derived, we further confirmed specific binding to BCMA in additional secondary screens. Additionally, a lack of off-target binding of the fully human IgGs to normal tissue was demonstrated in a tissue cross reactivity screen.
Conclusions: These studies highlight the tractability of this cell microarray approach for determining the specificity of novel CAR constructs expressed in T cell. Demonstrating the selectivity and specificity of anti-BMCA CAR T cells further supports the progression of KITE-585 towards Phase 1 clinical studies in MM patients.
Citation Format: Gregor B. Adams, Jun Feng, Atefeh Ghogha, Armen Mardiros, Ruben Rodriguez, Tassja J. Spindler, Jed Wiltzius, Tony Polverino. Selectivity and specificity of engineered T cells expressing KITE-585, a chimeric antigen receptor targeting B-cell maturation antigen (BCMA) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2135. doi:10.1158/1538-7445.AM2017-2135
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Dang S, Thavalathil B, Ruiz D, Gomez-Orozco C, Caralis P, Gomez-Marin O, Levis S, Rodriguez R. ENHANCING COMMUNICATION AND SHARED DECISION MAKING VIA ELECTRONIC HEALTH RECORDS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mcinnis D, Hendrichs J, Shelly T, Barr N, Hoffman K, Rodriguez R, Lance D, Bloem K, Suckling D, Enkerlin W, Gomes P, Tan K. Can Polyphagous Invasive Tephritid Pest Populations Escape Detection for Years Under Favorable Climatic and Host Conditions? ACTA ACUST UNITED AC 2017. [DOI: 10.1093/ae/tmx038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Sanon VP, Patel S, Sanon S, Rodriguez R, Pham SV, Chilton R. Differential cardiovascular profiles of sodium-glucose cotransporter 2 inhibitors: critical evaluation of empagliflozin. Ther Clin Risk Manag 2017; 13:603-611. [PMID: 28496330 PMCID: PMC5422533 DOI: 10.2147/tcrm.s97619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
One of the most feared repercussions of type 2 diabetes mellitus is the risk of adverse cardiovascular outcomes. The current antidiabetic agents on the market have had difficulty in showing cardiovascular outcome improvement. The EMPA-REG OUTCOME trial studied the sodium-glucose cotransporter 2 inhibitor empagliflozin in type 2 diabetic patients at high risk of cardiovascular events. The trial results revealed a decrease in the composite primary end points of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke in those taking empagliflozin vs placebo. Those taking the medication also had a significant decrease in death from any cause, death from cardiovascular cause, and hospitalization for heart failure. The EMPA-REG trial is paradigm shifting because it demonstrates a clear mortality benefit to cardiovascular outcomes with a low side-effect profile, in contrast to prior outcome studies of hypoglycemic agents. Further studies are required to better clarify the long-term safety and efficacy of this promising class of diabetic drugs.
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Balogun A, Armijos R, Weigel M, Cevallos W, Sanchez X, Puebla E, Rodriguez R. Epidemiology of Cutaneous Leishmaniasis in an Endemic Pacific Coastal
Rainforest Area of Ecuador. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.133] [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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Wang Y, Armijos R, Weigel M, Balogun A, Sorocco T, Cevallos W, Sanchez X, Puebla E, Rodriguez R. Diagnosis of Cutaneous Leishmaniasis using Microscopic Detection and
Molecular-based PCR Assay Techniques. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.374] [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] Open
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Moore L, Marshall G, Seals S, Rodriguez R, Yates A, Dave N. P126 Assessment of pediatric asthma care by primary care providers in mississippi using an online questionnaire. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.136] [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]
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