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Figueiredo JC, Levy J, Choi SY, Xu AM, Merin NM, Hamid O, Lemos T, Nguyen N, Nadri M, Gonzalez A, Mahov S, Darrah JM, Gong J, Paquette RL, Mita AC, Vescio RA, Salvy SJ, Mehmi I, Hendifar AE, Natale R, Tourtellotte WG, Ramanujan VK, Huynh CA, Sobhani K, Reckamp KL, Merchant AA. Low booster uptake in cancer patients despite health benefits. iScience 2024; 27:110596. [PMID: 39286512 PMCID: PMC11404159 DOI: 10.1016/j.isci.2024.110596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 06/06/2024] [Accepted: 07/24/2024] [Indexed: 09/19/2024] Open
Abstract
Patients with cancer are at increased risk of death from COVID-19 and have reduced immune responses to SARS-CoV2 vaccines, necessitating regular boosters. We performed comprehensive chart reviews, surveys of patients attitudes, serology for SARS-CoV-2 antibodies and T cell receptor (TCR) β sequencing for cellular responses on a cohort of 982 cancer patients receiving active cancer therapy accrued between November-3-2020 and Mar-31-2023. We found that 92 · 3% of patients received the primer vaccine, 70 · 8% received one monovalent booster, but only 30 · 1% received a bivalent booster. Booster uptake was lower under age 50, and among African American or Hispanic patients. Nearly all patients seroconverted after 2+ booster vaccinations (>99%) and improved cellular responses, demonstrating that repeated boosters could overcome poor response to vaccination. Receipt of booster vaccinations was associated with a lower risk of all-cause mortality (HR = 0 · 61, p = 0 · 024). Booster uptake in high-risk cancer patients remains low and strategies to encourage booster uptake are needed.
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Affiliation(s)
- Jane C Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julia Levy
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - So Yung Choi
- Biostatistics Shared Resource, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alexander M Xu
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Noah M Merin
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Omid Hamid
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, CA 90025, USA
| | - Tucker Lemos
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Nathalie Nguyen
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Maimoona Nadri
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alma Gonzalez
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Simeon Mahov
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Justin M Darrah
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jun Gong
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ronald L Paquette
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alain C Mita
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Robert A Vescio
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sarah J Salvy
- Research Center for Health Equity, Department of Biomedical Sciences, Los Angeles, CA 90048, USA
| | - Inderjit Mehmi
- The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, CA 90025, USA
| | - Andrew E Hendifar
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ronald Natale
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Warren G Tourtellotte
- Department of Neurology, Neurological Surgery and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - V Krishnan Ramanujan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Carissa A Huynh
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Karen L Reckamp
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Akil A Merchant
- Division of Hematology and Cellular Therapy, Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Zhao J, Jia L, Tao Y, Zhao X, Yang J, Lu Y, Yan Y, Mao L, Hu L, Lu J, Guo M, Chen C, Zhou Y, Wen Z, He Z, Xu L. TCR repertoire landscape reveals macrophage-mediated clone deletion in endotoxin tolerance. Inflamm Res 2023; 72:531-540. [PMID: 36633616 PMCID: PMC10023648 DOI: 10.1007/s00011-022-01685-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Endotoxin tolerance (ET) is a protective mechanism in the process of sepsis, septic shock, and their sequelae including uncontrolled inflammation. Accumulating evidence has shown that peripheral T cells contribute to the induction of ET. However, what and how T-cell development contributes to ET inductions remain unclear. METHODS Mice were intraperitoneally injected with LPS at a concentration of 5 mg/kg to establish an LPS tolerance model and were divided into two groups: a group examined 72 h after LPS injection (72-h group) and a group examined 8 days after LPS injection (8-day group). Injection of PBS was used as a control. We performed high-throughput sequencing to analyze the characteristics and changes of CD4+SP TCRβ CDR3 repertoires with respect to V direct to J rearrangement during the ET induction. Moreover, the proportion and proliferation, as well as surface molecules such as CD80 and CD86, of F4/80+ macrophages were analyzed using FCM. Furthermore, ACT assay was designed and administered by the tail vein into murine LPS-induced mouse model to evaluate the role of F4/80+ macrophages on the development of CD4+SP thymocytes in ET condition. RESULTS We found that the frequency and characteristics of the TCRβ chain CDR3 changed obviously under condition of ET, indicating the occurrence of TCR rearrangement and thymocyte diversification. Moreover, the absolute numbers of F4/80+ macrophages, but not other APCs, were increased in thymic medulla at 72-h group, accompanied by the elevated function-related molecules of F4/80+ macrophages. Furthermore, adoptively transferred OVA332-339 peptide-loaded macrophages into Rag-1-/- mice induced the clone deletion of OVA-specific CD4+SP, thereby ameliorating the pathology in lung tissue in LPS challenge. CONCLUSIONS These data reveal that the frequency and characteristics of the TCRβ chain CDR3 undergo dynamic programming under conditions of LPS tolerance. Furthermore, the peripheral macrophages may be a key factor which carry peripheral antigen to thymic medulla and affect the negative selection of T-cell population, thereby contributing to the formation of ET. These results suggest that the clone selection in thymus in ET may confer protection against microbial sepsis.
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Affiliation(s)
- Juanjuan Zhao
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Li Jia
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - YiJing Tao
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Xu Zhao
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Jing Yang
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Yanxin Lu
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Yaping Yan
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Ling Mao
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Lin Hu
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Jia Lu
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - MengMeng Guo
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Chao Chen
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China
| | - Ya Zhou
- Department of Medical Physics, Zunyi Medical University, Zunyi, China
| | - Zhenke Wen
- Jiangsu Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, 215123, Jiangsu, China.
| | - Zhixu He
- Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine, Zunyi Medical University, Zunyi, 563000, Guizhou, China.
| | - Lin Xu
- Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi, China.
- Department of Immunology, Zunyi Medical University, Zunyi, 563003, GuiZhou, China.
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