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Curran CS, Cui X, Li Y, Jeakle M, Sun J, Demirkale CY, Minkove S, Hoffmann V, Dhamapurkar R, Chumbris S, Bolyard C, Iheanacho A, Eichacker PQ, Torabi-Parizi P. Anti-PD-L1 therapy altered inflammation but not survival in a lethal murine hepatitis virus-1 pneumonia model. Front Immunol 2024; 14:1308358. [PMID: 38259435 PMCID: PMC10801642 DOI: 10.3389/fimmu.2023.1308358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Because prior immune checkpoint inhibitor (ICI) therapy in cancer patients presenting with COVID-19 may affect outcomes, we investigated the beta-coronavirus, murine hepatitis virus (MHV)-1, in a lethal pneumonia model in the absence (Study 1) or presence of prior programmed cell death ligand-1 (PD-L1) antibody (PD-L1mAb) treatment (Study 2). Methods In Study 1, animals were inoculated intratracheally with MHV-1 or vehicle and evaluated at day 2, 5, and 10 after infection. In Study 2, uninfected or MHV-1-infected animals were pretreated intraperitoneally with control or PD-L1-blocking antibodies (PD-L1mAb) and evaluated at day 2 and 5 after infection. Each study examined survival, physiologic and histologic parameters, viral titers, lung immunophenotypes, and mediator production. Results Study 1 results recapitulated the pathogenesis of COVID-19 and revealed increased cell surface expression of checkpoint molecules (PD-L1, PD-1), higher expression of the immune activation marker angiotensin converting enzyme (ACE), but reduced detection of the MHV-1 receptor CD66a on immune cells in the lung, liver, and spleen. In addition to reduced detection of PD-L1 on all immune cells assayed, PD-L1 blockade was associated with increased cell surface expression of PD-1 and ACE, decreased cell surface detection of CD66a, and improved oxygen saturation despite reduced blood glucose levels and increased signs of tissue hypoxia. In the lung, PD-L1mAb promoted S100A9 but inhibited ACE2 production concomitantly with pAKT activation and reduced FOXO1 levels. PD-L1mAb promoted interferon-γ but inhibited IL-5 and granulocyte-macrophage colony-stimulating factor (GM-CSF) production, contributing to reduced bronchoalveolar lavage levels of eosinophils and neutrophils. In the liver, PD-L1mAb increased viral clearance in association with increased macrophage and lymphocyte recruitment and liver injury. PD-L1mAb increased the production of virally induced mediators of injury, angiogenesis, and neuronal activity that may play role in COVID-19 and ICI-related neurotoxicity. PD-L1mAb did not affect survival in this murine model. Discussion In Study 1 and Study 2, ACE was upregulated and CD66a and ACE2 were downregulated by either MHV-1 or PD-L1mAb. CD66a is not only the MHV-1 receptor but also an identified immune checkpoint and a negative regulator of ACE. Crosstalk between CD66a and PD-L1 or ACE/ACE2 may provide insight into ICI therapies. These networks may also play role in the increased production of S100A9 and neurological mediators in response to MHV-1 and/or PD-L1mAb, which warrant further study. Overall, these findings support observational data suggesting that prior ICI treatment does not alter survival in patients presenting with COVID-19.
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Affiliation(s)
- Colleen S. Curran
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Xizhong Cui
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Yan Li
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Mark Jeakle
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Junfeng Sun
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Cumhur Y. Demirkale
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Samuel Minkove
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Victoria Hoffmann
- Division of Veterinary Resources, National Institutes of Health, Bethesda, MD, United States
| | - Rhea Dhamapurkar
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Symya Chumbris
- Texcell North-America, Inc., Frederick, MD, United States
| | | | | | - Peter Q. Eichacker
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Parizad Torabi-Parizi
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
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Wang C, Liu G, Ding Y, Li Z, Zhen Y, Cui J, Yao W, Di A, Huang K, Feng P, Wu R. Application of peripherally inserted central catheter in immune tolerance induction treatment of children with hemophilia A and accompanying inhibitors in China. Hematology 2023; 28:2250601. [PMID: 37675982 DOI: 10.1080/16078454.2023.2250601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/04/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE To explore the feasibility, safety and cost effectiveness of the use of peripherally inserted central catheter (PICC) in children with hemophilia A and inhibitors who underwent ITI treatment. METHOD This retrospective cohort study evaluated the effect of PICC placement and ITI on bleeding rates, costs, and parents' satisfaction before and within 6 months after PICC placement in children with hemophilia A and inhibitors. RESULTS A total of 20 children with hemophilia A and high-titer inhibitors were included, with a success rate for PICC placement of 100%, at a cost of ¥6730.50. Parents' satisfaction with PICC was 100%, and the total length of catheter indwelling was 6055 days. In terms of curative effect, the success rate of ITI treatment was 75%, and the annualized bleeding rate was decreased from 10.90 ± 12.16 times before placement to 2.10 ± 3.32 times (p < 0.05). The transportation expense for children and their parents to the clinic decreased from ¥20,920 ± 32,274.57 before catheter placement to ¥2915 ± 2195.99 (p < 0.05). Time of children missed school and their parents missed work decreased from 10.85 ± 22.36 days to 1.90 ± 3.58 (p < 0.05) days and 40.33 ± 46.11 days to 3.83 ± 7.11 days (p < 0.05), respectively. CONCLUSION The use of PICC for ITI treatment in children with hemophilia A and accompanying inhibitors in developing countries (e.g. China) can ensure the effect of ITI, reducing expense and improving the quality of life without obvious side effects.
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Affiliation(s)
- Chunli Wang
- Nursing Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
- National Center for Children's Health, Beijing, People's Republic of China
| | - Guoqing Liu
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
| | - Yaguang Ding
- Nursing Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
- National Center for Children's Health, Beijing, People's Republic of China
| | - Zekun Li
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
| | - Yingzi Zhen
- Nursing Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
- National Center for Children's Health, Beijing, People's Republic of China
| | - Jie Cui
- Nursing Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
- National Center for Children's Health, Beijing, People's Republic of China
| | - Wanru Yao
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
| | - Ai Di
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
| | - Kun Huang
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
| | - Ping Feng
- Nursing Department, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
- National Center for Children's Health, Beijing, People's Republic of China
| | - Runhui Wu
- National Center for Children's Health, Beijing, People's Republic of China
- Beijing Key Laboratory of Pediatric Hematology Oncology, Hematology Center, Beijing, People's Republic of China
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, People's Republic of China
- Ministry of Education, Key Laboratory of Major Diseases in Children, Beijing, People's Republic of China
- Department II of Hematology Center, Haemophilia Comprehensive Care Center, Beijing Children's HospitalCapital Medical University, Beijing, People's Republic of China
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