POS1153 CHARACTERISTICS OF GUT MICROBIOME AND THEIR ASSOCIATIONS WITH PERIPHERAL LYMPHOCYTE SUBPOPULATIONS AND CYTOKINES IN RHEUMATOID ARTHRITIS PATIENTS COMPLICATED WITH OSTEOPOROSIS

Background

Osteoporosis(OP) is one of the major comorbidities of rheumatoid arthritis(RA) which is associated with immune disorders[1]. The gut microbiota has been highlighted to be an important environmental factor to influence immune system in maintaining bone health and regulating bone remodeling[2]. However, the alterations of intestinal flora and its relationship with immune system in RA patients with OP are unclear.

Objectives

To investigate the characteristics of gut microbiome as well as the associations between flora and peripheral lymphocyte subpopulations and cytokines in rheumatoid arthritis patients complicated with osteoporosis.

Methods

Total 28 RA patients were divided into 14 RA-non-OP and 14 gender- and age-matched RA-OP groups according to their bone mineral density (BMD) and the history of fragility fracture. Gut microbiota of participants were investigated by 16s rRNA and peripheral lymphocyte subsets and cytokines were assessed via flow cytometry. Indicators like erythrocyte sedimentation rate (ESR), C-reaction protein (CRP), anti-cyclic citrullinated peptide antibody (ACPA) and anti-mutated citrullinated vimentin (MCV) antibody were recorded meanwhile. Alpha diversity (ACE, Chao1, Simpson, Shannon) and beta diversity indices were analyzed using QIIME2. Biomarker species were recognized based on STEMP. Spearman analysis was adopted for correlation of two variables. All P-values reported herein were two-tailed and P-value<0.05 was taken as statistically significant.

Results

The alpha-diversity have no significant difference between RA-non-OP and RA-OP groups (P >0.05, Figure 1A). The community structure of microflora differed between two groups (P <0.05, Figure 1B). As for the composition of intestinal flora at genus level, Faecalibacterium, Proteus, Catenibacterium, Enterobacter and Erysipelatoclostridium in RA-OP group as well as Lachnospiraceae_ND3007_group, Parasutterella, Megasphaera, Tyzzerella, UCG-005, Clostridium_sensu_stricto_1, UCG-002, Lachnospiraceae_NK4A136_group, Christensenellaceae_R-7_group, Prevotella, Parabacteroides in RA-non-OP group were significantly increased (Figure 1C). There were positive correlations between Lachnospiraceae_NK4A136_group and the level of T, Th1 and Th17 cells, but negative relevance with ESR, CRP and IL-10 (P <0.05). The relative abundance of Faecalibacterium was negatively correlated with IL-2, IL-4, TNF-α and positively with MCV (P <0.05). Clostridium_sensu_stricto_1 and Lachnospiraceae_ND3007_group were negatively correlated with ACPA and MCV respectively as well as IL-2 (P <0.05, Figure 1D-E).

Conclusion

Abnormality of immune system may contribute directly or indirectly to OP in RA, which may be related to the disturbance of gut microbiota.

References

[1]Horta-Baas G, Romero-Figueroa MDS, Montiel-Jarquín AJ, et al. Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis. J Immunol Res. 2017;2017:4835189.

[2]Raterman HG, Bultink IE, Lems WF. Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother. 2020 Oct;21(14):1725-1737.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

AB0844 Characterizing Gut Microbial Enterotypes in undifferentiated spondyloarthritis

Background

The presence of dysbiosis in the gut microbiome is responsible for the initiation of autoinflammatory and autoimmune diseases. However, such dysbiosis is difficult to characterize in sweeping generalization owing to the high dimensional complexity of the gut microbiota.

Objectives

This study designed to characterize the gut microbial enterotype in patients with undifferentiated spondyloarthritis (USpA) from lower dimensionality and describe the dysbiosis.

Methods

The Fecal samples of 105 patients were diagnosed with USpA and gender- and age- matched 105 healthy controls (HC) were included in the intestinal microbiota composition analyses via Illumina sequencing of bacterial 16S rRNA genes. Microbiota-derived clustering was performed using Dirichlet multinomial mixtures (DMM) modeling. To identify discriminative features in abundance between enterotypes, the Linear Discriminant Analysis Effect Size (LEfSe) algorithm was used with the online interface Galaxy (Log10 LDA score > 4.0). The phyloseq R package to compute alpha diversity (ACE, Chao1, Shannon and Simpson indices), beta diversity (Bray-Curtis dissimilarity) and the microbial composition (at the genus level) to describe the richness and diversity of the microbiota between two enterotypes.

Results

As showed in Figure 1A and C, by evaluating the Laplace approximation to the negative log mode, 2 distinctly enterotypes were identified in the USpA and HC microbiota dataset. LEfSe Analysis indicated the distinctive abundant microbial clades between the 2 enterotypes (LDA score >4) in both the USpA and HC group respectively. At the genus level, Faecalibacterium and Prevotella was the driving genus of enterotype 1 and Bacteroides contributed to enterotype 2 (Figure 1B, D). The alpha-diversity and beta diversity between the distinctive enterotypes was highly significantly different (P < 0.01, Figure 1E, F). Distinct bacterial profiles were also observed in enterotype 1 and 2 (Figure 1G). Interestingly, no significant differences were found between USpA patients and HC for the corresponding same intestinal type. This may be because USpA was at a comparatively early stage of spondyloarthritis (SpA).

Conclusion

Two significantly distinct bacterial microbiota structures existed in the USpA patients which was consistent with the general healthy population.

References

[1]Belkaid Y, Hand TW: Role of the microbiota in immunity and inflammation. Cell 2014, 157(1):121-141.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared

OP0087 INTEGRATED SYSTEMS ANALYSIS OF THE GUT MICROBIOTA PHENOTYPES IN THE RHEUMATOID ARTHRITIS

Background

Patients with rheumatoid arthritis (RA) displays extreme dysbiosis in microbiota. However, such dysbiosis is difficult to characterize owing to the high dimensional complexity of the gut microbiota1,2.

Objectives

The aim of this study was to discover the enterotype characters of intestinal flora in RA.

Methods

Fecal samples from 145 RA patients were collected for bacterial 16S rRNA genes sequencing. Mathematical modeling using Dirichlet multinomial mixtures (DMM) was applied to describe the variability in the microbiome data and cluster samples into enterotypes. The alpha-diversity, beta-diversity and the microbial composition analysis of the gut microbiome were used to define the difference of gut microbiota profiles between different enterotypes. The nonredundant taxonomic biomarkers for each enterotype were selected by using LEfSe. Inflammatory biomarkers (ESR, CRP), auto-antibodies(ACPA, MCV), peripheral lymphocytes subsets and cytokines were analyzed in our cohort using the Kruskal-Wallis test.

Results

Laplace approximation of DMM indicated two significantly distinct bacterial microbiota structures (RAE1 and RA E2) existed in the dataset (Figure 1a). Principal co-ordinates analyses confirmed that these two microbiota states explained a reasonable proportion of observed variance in microbiota composition(ANOSIM R2 = 0.267, p = 0.001; Figure 1b), with distinct bacterial genus distribution of in each enterotype (Figure 1c). RA E1 were primarily dominated by Prevotella while RA E2 by Bacteroides. Interestingly, Chao1, ACE, Shannon and Simpson revealed a higher alpha diversity in Prevotella-enriched enterotype (p< 0.001, Figure 1d). Fourteen selected taxonomic biomarkers at different phylogenetic levels showed great discriminant ability, with Log10 LDA score > 4.0 (Figure 1e-g). Further, inflammatory biomarkers (ESR, CRP) and auto-antibodies(ACPA, MCV) as well as the number of T, B and CD4+T, Th1, Th2, Th17, and Treg were consistent in RA E1 and RA E2 (p > 0.05, Figure 2h). But CD8+T were significantly higher in RA E2 than in RA E2 (p < 0.05).

Conclusion

Despite RA gut microbiota being of different dysbiosis, two patterns of dysbiosis, designated as RA-enterotypes, were predominant among the RA patient cohort. RA E2 exhibited a loss of Prevotella but a growth of Bacteroides, while RA E1 presented the opposite results.

References

[1]Arumugam M, Raes J, Pelletier E, et al. Enterotypes of the human gut microbiome. Nature 2011;473(7346):174-80. doi: 10.1038/nature09944

[2]Costea PI, Hildebrand F, Arumugam M, et al. Enterotypes in the landscape of gut microbial community composition. Nat Microbiol 2018;3(1):8-16. doi: 10.1038/s41564-017-0072-8

Acknowledgements

This work was supported by the National Natural Science Foundation of China (No. 82001740).

Disclosure of Interests

None declared.

Artificial Intelligence-Powered Hematoxylin and Eosin Analyzer Reveals Distinct Immunologic and Mutational Profiles among Immune Phenotypes in Non-Small-Cell Lung Cancer

The tumor microenvironment can be classified into three immune phenotypes: inflamed, immune excluded, and immune-desert. Immunotherapy efficacy has been shown to vary by phenotype; yet, the mechanisms are poorly understood and demand further investigation. This study unveils the mechanisms using an artificial intelligence-powered software called Lunit SCOPE. Artificial intelligence was used to classify 965 samples of non-small-cell lung carcinoma from The Cancer Genome Atlas into the three immune phenotypes. The immune and mutational profiles that shape each phenotype using xCell, gene set enrichment analysis with RNA-sequencing data, and cBioportal were described. In the inflamed subtype, which showed higher cytolytic score, the enriched pathways were generally associated with immune response and immune-related cell types were highly expressed. In the immune excluded subtype, enriched glycolysis, fatty acid, and cholesterol metabolism pathways were observed. The KRAS mutation, BRAF mutation, and MET splicing variant were mostly observed in the inflamed subtype. The two prominent mutations found in the immune excluded subtype were EGFR and PIK3CA mutations. This study is the first to report the distinct immunologic and mutational landscapes of immune phenotypes, and demonstrates the biological relevance of the classification. In light of these findings, the study offers insights into potential treatment options tailored to each immune phenotype.

Cause of postoperative mortality in patients with end-stage renal disease

Background: The number of patients with end-stage renal disease (ESRD) who are dependent on hemodialysis is increasing rapidly. As a result, more patients with ESRD need surgery. These patients have a significantly higher risk of postoperative death than those with normal kidney function. Therefore, this study analyzed the causes of postoperative mortality in ESRD patients undergoing surgery under general anesthesia and the risk factors for postoperative mortality.Methods: This retrospective analysis examined the mortality of ESRD patients, 20 to 80 years old, undergoing surgery under general anesthesia. We excluded patients who underwent cardiac, cancer, or emergency surgery or organ transplantation from the analysis. The primary outcome was the cause of postoperative 30-day mortality in ESRD patients. We also assessed the mortality rate and risk factors.Results: There were 2,459 eligible ESRD patients. When patients underwent multiple surgeries during the study period, only the last surgery was considered. In total, 167 patients died during the study period, including 65 within 30 days postoperatively. The cause of death was sepsis in 22 cases (33.8%) and a major cardiac event in 16 (24.6%). Atrial fibrillation, current angina, previous myocardial infarction, asthma, lower hemoglobin and albumin levels, and a larger intraoperative colloid volume were likely to increase mortality. Conclusions: Our study suggests that immunological issues have a significant role in the death of ESRD patients after general anesthesia.

Abstract P4-05-07: Assistance with an artificial intelligence-powered tumor infiltrating lymphocytes (TIL) analyzer reduces interobserver variation in pathologic scoring of TIL in breast cancer

Background Tumor infiltrating lymphocytes (TIL) is a promising prognostic marker in breast cancer. However, TIL is manually scored by pathologists, thus laborious work is required and interobserver heterogeneity exists in the results. In this study, we aimed to evaluate the clinical utility of an artificial intelligence (AI)-powered TIL analyzer in terms of reducing the interobserver variation. Methods Lunit SCOPE IO, AI-powered TIL analyzer was trained and validated with a 2.8 x 109 micrometer2 area and 5.9 x 106 TIL from 3,166 H&E Whole-Slide Images (WSI) of multiple cancer types including breast cancer, annotated by 52 board-certified pathologists. Three independent board-certified pathologists scored TIL% of H&E slides of breast cancer from an external cohort (N = 199). TIL% was calculated referenced on the guideline of Immuno-Oncology Biomarker Working Group on Breast Cancer. For the cases of TIL score difference between each pathologist and AI model more than 15%, the pathologists were asked to revise TIL% in assistance with AI model which displays both stromal area and TIL. Finally, we compared the interobserver variation based on intraclass correlation coefficients (ICC) before and after AI assistance. Results The distribution of TIL score by 3 pathologists was 7% (5-20%), 15% (5-50%), and 20% (10-40%), respectively [median (25%-75% quantile)]. The ICC value of the initial TIL score evaluation was 0.716 (95% confidence interval, 0.560-0.811). Afterward, pathologists revised their initial scoring with assistance of AI model for the cases of difference more than 15% (n = 19, 72, and 73, respectively for each pathologist). After rescoring, number of slides with 15% or more difference of TIL% between raters significantly decreased from 109 slides (54.8%) to 75 slides (37.7%, p &lt; 0.001). The ICC value after re-scoring TIL% was 0.831 (95% confidence interval, 0.725-0.890). Conclusions There was a notable interobserver variation to score TIL% in breast cancer. Assistance with AI-powered TIL analyzer substantially improved the pathologist’s consensus and could be regarded as one of references for the final labeling of TIL%.

Citation Format: Soo Ick Cho, Wonkyung Jung, Sangjoon Choi, Seokhwi Kim, Sanghoon Song, Gahee Park, Minuk Ma, Seonwook Park, Sergio Pereira, Sangheon Ahn, Brian Jaehong Aum, Seunghwan Shin, Kyunghyun Paeng, Donggeun Yoo, Chan-Young Ock. Assistance with an artificial intelligence-powered tumor infiltrating lymphocytes (TIL) analyzer reduces interobserver variation in pathologic scoring of TIL in breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-05-07.

Characterization of photoinduced normal state through charge density wave in superconducting YBa2Cu3O6.67

The normal state of high-T_c cuprates has been considered one of the essential topics in high-temperature superconductivity research. However, compared to the high magnetic field study of it, understanding a photoinduced normal state remains elusive. Here, we explore a photoinduced normal state of YBa₂Cu₃O_6.67 through a charge density wave (CDW) with time-resolved resonant soft x-ray scattering, as well as a high magnetic field x-ray scattering. In the nonequilibrium state where people predict a quenched superconducting state based on the previous optical spectroscopies, we experimentally observed a similar analogy to the competition between superconductivity and CDW shown in the equilibrium state. We further observe that the broken pairing states in the superconducting CuO₂ plane via the optical pump lead to nucleation of three-dimensional CDW precursor correlation. Ultimately, these findings provide a critical clue that the characteristics of the photoinduced normal state show a solid resemblance to those under magnetic fields in equilibrium conditions.

High strength, epoxy cross-linked high sulfur content polymers from one-step reactive compatibilization inverse vulcanization

Inverse vulcanization provides a simple, solvent-free method for the preparation of high sulfur content polymers using elemental sulfur, a byproduct of refining processes, as feedstock. Despite the successful demonstration of sulfur polymers from inverse vulcanization in optical, electrochemical, and self-healing applications, the mechanical properties of these materials have remained limited. We herein report a one-step inverse vulcanization using allyl glycidyl ether, a heterobifunctional comonomer. The copolymerization, which proceeds via reactive compatibilization, gives an epoxy cross-linked sulfur polymer in a single step, as demonstrated through isothermal kinetic experiments and solid-state 13C NMR spectroscopy. The resulting high sulfur content (≥50 wt%) polymers exhibited tensile strength at break in the range of 10-60 MPa (70-50 wt% sulfur), which represents an unprecedentedly high strength for high sulfur content polymers from vulcanization. The resulting high sulfur content copolymer also exhibited extraordinary shape memory behavior along with shape reprogrammability attributed to facile polysulfide bond rearrangement.

Updating species diversity of Colletotrichum, with a phylogenomic overview

The genus Colletotrichum includes important plant pathogens, endophytes, saprobes and human pathogens. Even though the polyphasic approach has facilitated Colletotrichum species identification, knowledge of the overall species diversity and host distribution is largely incomplete. To address this, we examined 952 Colletotrichum strains isolated from plants representing 322 species from 248 genera, or air and soil samples, from 87 locations in China, as well as 56 strains from Saudi Arabia, Thailand, Turkey, and the UK. Based on morphological characteristics and multi-locus phylogenetic analyses, the strains were assigned to 107 species, including 30 new species described in this paper and 18 new records for China. The currently most comprehensive backbone tree of Colletotrichum, comprising 16 species complexes (including a newly introduced C. bambusicola species complex) and 15 singleton species, is provided. Based on these analyses, 280 species with available molecular data are accepted in this genus, of which 139 have been reported in China, accounting for 49.6 % of the species. Colletotrichum siamense, C. karsti, C. fructicola, C. truncatum, C. fioriniae, and C. gloeosporioides were the most commonly detected species in China, as well as the species with the broadest host range. By contrast, 76 species were currently found to be associated with a single plant species or genus in China. To date, 33 Colletotrichum species have been exclusively reported as endophytes. Furthermore, we generated and assembled whole-genome sequences of the 30 new and a further 18 known species. The most comprehensive genome tree comprising 94 Colletotrichum species based on 1 893 single-copy orthologous genes was hence generated, with all nodes, except four, supported by 100 % bootstrap values. Collectively, this study represents the most comprehensive investigation of Colletotrichum diversity and host occurrence to date, and greatly enhances our understanding of the diversity and phylogenetic relationships in this genus.

Out-of-equilibrium dynamics driven by photoinduced charge transfer in CsCoFe Prussian Blue Analogue nanocrystals

In this paper we study the out-of-equilibrium dynamics associated with photoinduced charge-transfer (CT) in cyanide-bridged Co-Fe Prussian blue analogue nanocrystals. In these coordination networks, the structural trapping of the photoinduced...

[Influence of guided bone regeneration on marginal bone loss of implants in the mandible posterior region: a 10-year retrospective cohort study]

Objective: To investigate the effect of guided bone regeneration (GBR) on marginal bone loss (MBL) in the region of the mandibular posterior tooth by using a retrospective cohort study, in order to provide reference for clinical practice. Methods: The research subjects were patients who received dental implants from October 2008 to June 2011 in the region of the mandibular posterior tooth at the Department of Oral Implantology, School of Stomatology, The Fourth Military Medical University. According to whether GBR was performed or not and the time of implant insertion, the patients were divided into the controls group (patients without bone grafting), simultaneous GBR implantation group, and delayed GBR implantation group. On this basis, the MBL was measured according to radiographs by comparing the marginal bone level from that of immediate postoperation 10 years ago. General data was collected and compared among groups, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and gingival papilla height. Results: The controls group (patients without bone grafting), implantation group, and delayed GBR implantation group followed 58, 76, 26 implants in 26, 32, 13 patients aging at (46.5±9.9), (45.5±10.7), (58.3±6.4) respectively. The duration of the follow-up was (11.2±0.7), (11.1±0.8), (11.1±0.9) years respectively. The 10-year implant survival rate was 100% (58/58), 100% (76/76), 100% (26/26). The MBL was (0.91±0.28), (0.84±0.27), (1.01±0.27) mm respectively. The MBL difference of patients with simultaneous GBR implantation and delayed GBR implantation showed statistical significance (P<0.05), but these two groups showed no statistical significance compared with the controls group (P>0.05). The mPI, mSBI, PD, and gingival papilla height of the three groups all had no significance on statistics (P>0.05). Conclusions: It can be concluded that there is no difference in long-term marginal bone resorption between simultaneous and delayed implantation with or without GBR (using autologous blood mixed with granular bone meal) in the posterior mandibular area.

Reduced miR-363-3p expression in non-small cell lung cancer is associated with gemcitabine resistance via targeting of CUL4A

The article "Reduced miR-363-3p expression in non-small cell lung cancer is associated with gemcitabine resistance via targeting of CUL4A", W.-G. Bian, X.-N. Zhou, S. Song, H.-T. Chen, Y. Shen, P. Chen, published in Eur Rev Med Pharmacol Sci 2019; 23 (2): 649-659-DOI: 10.26355/eurrev_201901_16879-PMID: 30720173, has been retracted by the authors due to several inaccuracies in the research design. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/16879.

921 Comparison of PI3K/AKT/mTOR pathway profiles amongst three immune phenotypes classified by artificial intelligence-powered H&E analyzer in non-small cell lung cancer

Background

The phosphatidylinositol 3-kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) pathway plays a significant role in both tumorigenesis and progression of disease in non-small cell lung cancer (NSCLC).1 Increased activation of the pathway, whether in tumor or immune cells, results in an immunosuppressive tumor microenvironment.2 Therefore, we looked into how this pathway differs in three distinct NSCLC immune phenotypes.

Methods

Lunit SCOPE IO (Lunit, Seoul, Republic of Korea), a deep learning-based hematoxylin and eosin (H&E) image analytics tool, identifies lymphocytes and quantifies lymphocyte density within the cancer epithelium (CE-Lym), stroma (CS-Lym), and combined area (C-Lym). We applied Lunit-SCOPE IO to H&E-stained tissue images of 965 NSCLC samples from The Cancer Genome Atlas (TCGA). Tumors in the lowest tertile of C-Lym were labeled as immune-desert, and the remaining tumors were classified as inflamed and immune-excluded according to the median of the ratio of CE-Lym to CS-Lym.Utilizing RNA-sequencing data from TCGA, gene set enrichment analysis (GSEA) was conducted to analyze the differences in mTORC1 and PI3K/Akt/mTOR signaling between the subtypes.3 We obtained mutational data related to the PI3K/Akt/mTOR pathway from cBioPortal to compare the ratio of functional mutations between the immune phenotypes.4

Results

The mTORC1 signaling gene set was consistently enriched in immune-excluded, whether compared to inflamed (padj < 0.01, normalized enrichment score [NES]: 2.3) or immune-desert (padj < 0.01, NES: 1.6). However, PI3K/Akt/mTOR signaling gene set enrichment did not show statistically significant differences between the immune phenotypes.Within the three immune phenotypes, we analyzed three functional mutations: PIK3CA, PTEN, and Akt1 (figure 1). Of the total 112 samples showing the functional mutations of the PI3K/Akt/mTOR pathway, 53 were immune-excluded, 31 inflamed, and 28 immune-desert. The relation between mutation frequency and the immune subtypes was significant (X2 (2) = 11.1979, p < .01). The immune-excluded was more likely than the other subtypes to have functional PI3K/Akt/mTOR mutations.

Abstract 921 Figure 1

The landscape of functional mutation and immune phenotypes regarding PI3K/Akt/mTOR pathway

Conclusions

The three tissue phenomic subtypes showed different PI3K/Akt/mTOR pathway profiles, with immune-excluded having the most mutation samples and the greatest enhancement of mTORC1 signaling gene set. Likewise, tissue H&E based tumor microenvironment classification by Lunit SCOPE IO can be applied to other hallmark pathways and tumor types, and such further investigation of the tumor microenvironment can provide insights into novel therapeutic avenues.

References

Tan AC. Targeting the PI3K/Akt/mTOR pathway in non-small cell lung cancer (NSCLC). Thorac Cancer 2020;11(3):511–8.

O’Donnell JS, Massi D, Teng MWL, Mandala M. PI3K-AKT-mTOR inhibition in cancer immunotherapy, redux. Semin Cancer Biol 2018;48:91–103.

Liberzon A, Birger C, Thorvaldsdóttir H, Ghandi M, Mesirov JP, Tamayo P. The molecular signatures database hallmark gene set collection. Cell Systems 2015;1(6):417–25.

Cerami E, Gao J, Dogrusoz U, Gross BE, Sumer SO, Aksoy BA, et al. The cBio cancer genomics portal: an open platform for exploring multidimensional cancer genomics data. Cancer Discov 2012;2(5):401–4.

830 Artificial intelligence-powered spatial analysis of tumor-infiltrating lymphocytes reveals immune-excluded phenotype related to APOBEC signature and clonal evolution of cancer

Background

Little is known about bridging clonal heterogeneity into the resistance of immune checkpoint inhibitors (ICI). Recent reports showed that excluded tumor-infiltrating lymphocytes (TIL) into stroma assessed by an artificial intelligence (AI)-powered spatial TIL analyzer, Lunit SCOPE IO, was related to loss-of-heterozygosity of HLA genes which would be one of crucial resistance pathways of ICI.1 In the current study, we hypothesized that Immune-excluded phenotype called by Lunit SCOPE IO would be related to clonal heterogeneity resulted from genome-wide accidents during early carcinogenesis which may cause an improper targeting of TIL for diverse clones with multiple genomic aberrations.

Methods

For spatial TIL analysis, we applied Lunit SCOPE IO1 which automatically detects TIL and segmentizes cancer area and stroma, then it classified Immune phenotype of 1 mm2-sized grid in H&E image. Inflamed score or Immune-excluded score were defined as the proportion of Inflamed phenotype, which is high intra-tumoral TIL density, or Immune-excluded phenotype, which is exclusively high TIL density only in stroma, within a whole-slide image, respectively. We evaluated the correlation of Immune phenotype with APOBEC mutational signature by single-base substitution (SBS) signature 2 and/or SBS13,2 whole-genome doubling, and subclonal genome fraction which reflects intra-tumoral heterogeneity,3 and clusters of T cell receptor (TCR) repertoire 4 derived from previous reports of The Cancer Genome Atlas (TCGA), consists of 7,467 tumor samples from 22 cancer types.

Abstract 830 Table 1

Correlation between immune phenotype and clonal evolution of cancer [* Median (95% confidence interval)]

Results

In the TCGA pan-carcinoma database, APOBEC mutational signature was significantly correlated with increased ratio of cancer stroma to cancer epithelium (median 0.866 vs 1.19, fold change +37.4%), and increased TIL density in cancer stroma (median 558 vs 764 / mm2, fold change +36.9%), but it was not correlated with intra-tumoral TIL density (median 63 vs 59 / mm2, fold change -6.3%). Interestingly, Immune-excluded score (IES) called by Lunit SCOPE IO was positively correlated with APOBEC mutational signature as well as expression levels of APOBEC1, APOBEC3A, and APOBEC3B, whole-genome doubling, and subclonal genome fraction, respectively, while Inflamed score (IS) or immune cytolytic activity (GZMA and PRF1 expressions) was negatively or not significantly correlated to those variables (table 1). TCR repertoire was expanded in the tumor samples with high IS (spearman rho = 0.279), but it was not increased in those with high IES (spearman rho = -0.0595).

Conclusions

There is a significant correlation between distinct TIL deposition in stroma, or Immune-excluded phenotype, with APOBEC-attributed clonal expansion of cancer, without proper expansion of TCR repertoire.

References

Ock CY, Park C, Paeng K, Yoo D, Kim S, Park S, Lee SH, Mok T, Bang YJ. Artificial intelligence-powered spatial analysis of tumor-infiltrating lymphocytes reveals distinct genomic profile of immune excluded phenotype in pan-carcinoma. Cancer Res 2021;81(Supp 13):1908.

Alexandrov LB, Kim J, Haradhvala NJ, Huang MN, Tian Ng AW, Wu Y, Boot A, Covington KR, Gordenin DA, Bergstrom EN, Islam SMA, Lopez-Bigas N, Klimczak LJ, McPherson JR, Morganella S, Sabarinathan R, Wheeler DA, Mustonen V, PCAWG Mutational Signatures Working Group, Getz G, Rozen SG, Stratton MR, PCAWG Consortium. The repertoire of mutational signatures in human cancer. Nature 2020;578(7793):94–101.

Taylor AM, Shih J, Ha G, Gao GF, Zhang X, Berger AC, Schumacher SE, Wang C, Hu H, Liu J, Lazar AJ, Cancer Genome Atlas Research Network, Cherniack AD, Beroukhim R, Meyerson M. Genomic and functional approaches to understanding cancer aneuploidy. Cancer Cell 2018;33(4):676–689.e3.

Zhang H, Liu L, Zhang J, Chen J, Ye J, Shukla S, Qiao J, Zhan X, Chen H, Wu CJ, Fu YX, Li B. Investigation of antigen-specific T-Cell receptor clusters in human cancers. Clin Cancer Res 2020;26(6):1359–1371.

Effects of x-ray free-electron laser pulse intensity on the Mn K 1,3 x-ray emission spectrum in photosystem II-A case study for metalloprotein crystals and solutions

In the last ten years, x-ray free-electron lasers (XFELs) have been successfully employed to characterize metalloproteins at room temperature using various techniques including x-ray diffraction, scattering, and spectroscopy. The approach has been to outrun the radiation damage by using femtosecond (fs) x-ray pulses. An example of an important and damage sensitive active metal center is the Mn4CaO5 cluster in photosystem II (PS II), the catalytic site of photosynthetic water oxidation. The combination of serial femtosecond x-ray crystallography and Kβ x-ray emission spectroscopy (XES) has proven to be a powerful multimodal approach for simultaneously probing the overall protein structure and the electronic state of the Mn4CaO5 cluster throughout the catalytic (Kok) cycle. As the observed spectral changes in the Mn4CaO5 cluster are very subtle, it is critical to consider the potential effects of the intense XFEL pulses on the Kβ XES signal. We report here a systematic study of the effects of XFEL peak power, beam focus, and dose on the Mn Kβ1,3 XES spectra in PS II over a wide range of pulse parameters collected over seven different experimental runs using both microcrystal and solution PS II samples. Our findings show that for beam intensities ranging from ∼5 × 1015 to 5 × 1017 W/cm2 at a pulse length of ∼35 fs, the spectral effects are small compared to those observed between S-states in the Kok cycle. Our results provide a benchmark for other XFEL-based XES studies on metalloproteins, confirming the viability of this approach.

Determination of Material Requirements for 3D Gel Food Printing Using a Fused Deposition Modeling 3D Printer

The material requirements for printing gel food with a fused deposition modeling 3D printer were determined based on fidelity, shape retention, and extrudability, as described by the rheological parameters of storage modulus (G’), yield stress (τ₀), and phase angle (δ). The material requirements were determined for printing gel food using three formulations containing gelatin, gelatin and pectin, and gum mixture as the gelling agents. As compared with formulations based on gelatin alone, pectin-containing gelatin-based formulations yielded higher δ and lower G’ and τ₀ values, while gum mixture-based formulations formed a gel with higher G’ and δ values and a wider range of τ₀. Overall, this study presents quantitative material requirements for printing gel products containing gelatin, gelatin–pectin, and gum mixtures.

Analgesic effects of erector spinae plane block can differ according to needle size: A case report

RATIONALE

Unlike brachial plexus block, erector spinae plane block (ESPB) does not target specific nerves, so the analgesic effect may differ depending on the extent of diffusion of local anesthetic. Therefore, needle size, which can affect the diffusion of local anesthetic, may be an important factor in the analgesic effect.

PATIENT CONCERNS

Four patients with end-stage renal disease on hemodialysis received vascular surgery due to arteriovenous fistula occlusion. Vascular bypass surgery was performed on the axillary vein.

DIAGNOSES

Four patients with end-stage renal disease on hemodialysis were diagnosed with arteriovenous fistula occlusion. One in 4 patients was diagnosed with diaphragm paralysis after ESPB, and the other 3 did not develop diaphragm paralysis.

INTERVENTIONS

ESPB was conducted by ultrasound using a 25- or 22-gauge needle at the C7 level. The extent of nerve blockade was determined based on cold sensation, and diaphragm excursion and thickness were measured via ultrasound.

OUTCOMES

The analgesic effect was excellent in 2 patients treated using a 22-gauge needle, but was poor in 2 other patients treated with a 25-gauge needle.

LESSONS

ESPB at the C7 level can cause diaphragm paralysis, and needle size may affect the extent of diffusion of local anesthetic.

Potency of propofol for inducing loss of consciousness in end-stage kidney disease patients

It can be difficult for anesthesiologists to determine the optimal dose of propofol for end-stage kidney disease (ESKD) patients due to changes in drug disposition. The purpose of this study was to evaluate the potency of propofol for inducing loss of consciousness in ESKD patients. Patients with normal kidney function (Control group, n = 15), those with ESKD (ESKD group, n = 15), and those with ESKD undergoing cervical epidural anesthesia (ESKD-CEB group, n = 15) were administered propofol by target-controlled infusion (TCI) using the Schneider model. The effect-site concentration (Ce) of propofol started at 0.5 μg/ml and increased in increments of 0.5 μg/ml until the patient did not respond to verbal commands. The relationship between the probability (P) of loss of consciousness and the Ce of propofol was analyzed in each group using logistic regression. The Ce values of propofol at the time of loss of consciousness were 4.3 ± 0.9, 3.7 ± 0.9, and 3.3 ± 1.0 μg/ml for the Control, ESKD, and ESKD-CEB* groups, respectively (*significant difference vs. control, P < 0.05). The estimated Ce50 values for lost ability to respond to verbal command were 4.56, 3.75, and 3.21 μg/ml for the Control, ESKD, and ESKD-CEB groups, respectively. In conclusion, when inducing anesthesia in ESKD patients, we recommend using an initial dose similar to that of patients with normal kidney function, or rather starting with a lower dose.

Nonuniform Flow Dynamics Probed by Nanosecond X-Ray Speckle Visibility Spectroscopy

We report observations of nanosecond nonuniform colloidal dynamics in a free flowing liquid jet using ultrafast x-ray speckle visibility spectroscopy. Utilizing a nanosecond double-bunch mode, the Linac Coherent Light Source free electron laser produced pairs of femtosecond coherent hard x-ray pulses. By exploring anisotropy in the visibility of summed speckle patterns which relates to the correlation functions, we evaluate not only the average particle flow rate in a colloidal nanoparticle jet, but also the nonuniform flow field within. The methodology presented here establishes the foundation for the study of nano- and atomic-scale inhomogeneous fluctuations in complex matter using x-ray free electron laser sources.

The influence of propofol-based total intravenous anesthesia on postoperative outcomes in end-stage renal disease patients: A retrospective observation study

Background

To determine whether the anesthetic method of propofol total intravenous anesthesia (TIVA) is associated with postoperative outcome in ESRD patients, we evaluated the incidence of postoperative major adverse cardiac events (MACE), comparing propofol TIVA versus anesthesia with volatile anesthesia in ESRD patients.

Methods

Retrospectively, we identified cases with ESRD patients who underwent surgery under general anesthesia. Patients were divided into those who received only volatile anesthesia (volatile group) and those who received only propofol TIVA (TIVA group). The incidence of MACE and potential confounding variables were compared separately in a univariate logistic model and subsequently by multivariate logistic regression.

Results

Among the 2576 cases in ESRD patients, 1374 were in the TIVA group and 1202 were in the volatile group. The multivariate analysis included 12 factors, including the anesthesia method, of which five factors were significant. Factors that were associated with a significantly lower MACE risk included preoperative chloride concentration (OR: 0.96; 95% CI, 0.92–0.99), baseline SBP (OR: 0.98; 95% CI, 0.98–0.99), and propofol TIVA (OR: 0.37; 95% CI, 0.22–0.60).

Conclusions

We inferred that the anesthetic method associated with the postoperative outcome in patients with ESRD.

EFFECT OF EMULSION SBR PREPARED BY ASYMMETRIC REVERSIBLE ADDITION-FRAGMENTATION TRANSFER AGENT ON PROPERTIES OF SILICA-FILLED COMPOUNDS

The development of ultra-high-performance tires that satisfy fuel efficiency, traction, handling performance, and abrasion resistance has gained significant importance in the tire industry. Solution SBR has been used as a raw material, owing to its useful characteristics (e.g., narrow dispersity controllable microstructure and chain-end functionalization). In a recent improvement, emulsion SBR (ESBR), a high-molecular-weight compound with narrow dispersity, has been reported for application in the tire tread compounds. In particular, S,S-dibenzyl trithiocarbonate (DBTC) reversible addition-fragmentation transfer (RAFT) ESBR has exhibited excellent abrasion resistance and fuel efficiency in unfilled and carbon black–filled vulcanizates. However, owing to the symmetrical structure of DBTC RAFT ESBR, the polymer chain was shortened by the reaction of a silane coupling agent with trithiocarbonate, leading to poor abrasion resistance and fuel efficiency in the case of silica-filled vulcanizates. In this study, benzyl (4-methoxyphenyl) trithiocarbonate (BMPTC), an asymmetric RAFT agent that promotes unilateral polymer growth, was synthesized and used in the polymerization of BMPTC RAFT ESBR. Chain cleavage was not observed. Upon application to silica-filled vulcanizates, BMPTC RAFT ESBR exhibited improved abrasion resistance (by 9%), improved fuel efficiency (by 20%), and improved wet traction performance (by 10%) compared with the DBTC RAFT ESBR.