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de Sousa LG, Liu S, Bhosale P, Altan M, Darbonne W, Schulze K, Dervin S, Yun C, Mahvash A, Verma A, Futreal A, Gite S, Cuentas EP, Cho WC, Wistuba I, Yao JC, Woodman SE, Halperin DM, Ferrarotto R. Atezolizumab plus bevacizumab in advanced Merkel cell carcinoma: A prospective study. Oral Oncol 2024; 151:106747. [PMID: 38460288 DOI: 10.1016/j.oraloncology.2024.106747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Affiliation(s)
- L Guimaraes de Sousa
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Bhosale
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Altan
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - W Darbonne
- Roche/Genentech, South San Francisco, CA, USA
| | - K Schulze
- Roche/Genentech, South San Francisco, CA, USA
| | - S Dervin
- Roche/Genentech, South San Francisco, CA, USA
| | - C Yun
- Roche/Genentech, South San Francisco, CA, USA
| | - A Mahvash
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Verma
- Department of Pathology, Yale-New Haven Hospital, New Haven, CT, USA
| | - A Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Gite
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Parra Cuentas
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - W C Cho
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J C Yao
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S E Woodman
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D M Halperin
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - R Ferrarotto
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Augusto DG, Murdolo LD, Chatzileontiadou DSM, Sabatino JJ, Yusufali T, Peyser ND, Butcher X, Kizer K, Guthrie K, Murray VW, Pae V, Sarvadhavabhatla S, Beltran F, Gill GS, Lynch KL, Yun C, Maguire CT, Peluso MJ, Hoh R, Henrich TJ, Deeks SG, Davidson M, Lu S, Goldberg SA, Kelly JD, Martin JN, Vierra-Green CA, Spellman SR, Langton DJ, Dewar-Oldis MJ, Smith C, Barnard PJ, Lee S, Marcus GM, Olgin JE, Pletcher MJ, Maiers M, Gras S, Hollenbach JA. A common allele of HLA is associated with asymptomatic SARS-CoV-2 infection. Nature 2023; 620:128-136. [PMID: 37468623 PMCID: PMC10396966 DOI: 10.1038/s41586-023-06331-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/15/2023] [Indexed: 07/21/2023]
Abstract
Studies have demonstrated that at least 20% of individuals infected with SARS-CoV-2 remain asymptomatic1-4. Although most global efforts have focused on severe illness in COVID-19, examining asymptomatic infection provides a unique opportunity to consider early immunological features that promote rapid viral clearance. Here, postulating that variation in the human leukocyte antigen (HLA) loci may underly processes mediating asymptomatic infection, we enrolled 29,947 individuals, for whom high-resolution HLA genotyping data were available, in a smartphone-based study designed to track COVID-19 symptoms and outcomes. Our discovery cohort (n = 1,428) comprised unvaccinated individuals who reported a positive test result for SARS-CoV-2. We tested for association of five HLA loci with disease course and identified a strong association between HLA-B*15:01 and asymptomatic infection, observed in two independent cohorts. Suggesting that this genetic association is due to pre-existing T cell immunity, we show that T cells from pre-pandemic samples from individuals carrying HLA-B*15:01 were reactive to the immunodominant SARS-CoV-2 S-derived peptide NQKLIANQF. The majority of the reactive T cells displayed a memory phenotype, were highly polyfunctional and were cross-reactive to a peptide derived from seasonal coronaviruses. The crystal structure of HLA-B*15:01-peptide complexes demonstrates that the peptides NQKLIANQF and NQKLIANAF (from OC43-CoV and HKU1-CoV) share a similar ability to be stabilized and presented by HLA-B*15:01. Finally, we show that the structural similarity of the peptides underpins T cell cross-reactivity of high-affinity public T cell receptors, providing the molecular basis for HLA-B*15:01-mediated pre-existing immunity.
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Affiliation(s)
- Danillo G Augusto
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
- Department of Biological Sciences, The University of North Carolina at Charlotte, Charlotte, NC, USA
- Programa de Pós-Graduação em Genética, Universidade Federal do Paraná, Curitiba, Brazil
| | - Lawton D Murdolo
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, Australia
| | - Demetra S M Chatzileontiadou
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, Australia
- Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Joseph J Sabatino
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Tasneem Yusufali
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Noah D Peyser
- Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Xochitl Butcher
- Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Kerry Kizer
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Karoline Guthrie
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Victoria W Murray
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Vivian Pae
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Sannidhi Sarvadhavabhatla
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Fiona Beltran
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Gurjot S Gill
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Colin T Maguire
- Clinical and Translational Science Institute, University of Utah, Salt Lake City, UT, USA
| | - Michael J Peluso
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Timothy J Henrich
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Steven G Deeks
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Michelle Davidson
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Sarah A Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- F.I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Cynthia A Vierra-Green
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Stephen R Spellman
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | | | - Michael J Dewar-Oldis
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, Australia
| | - Corey Smith
- QIMR Berghofer Centre for Immunotherapy and Vaccine Development Brisbane, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Peter J Barnard
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, Australia
| | - Sulggi Lee
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Gregory M Marcus
- Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Jeffrey E Olgin
- Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Martin Maiers
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Stephanie Gras
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria, Australia
- Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Jill A Hollenbach
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA.
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
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Jiang R, Hooshfar S, Rebecca Eno M, Yun C, Sonego Zimmermann E, Shinkyo R. Factors Influencing ADME Properties of Therapeutic Antisense Oligonucleotides: Physicochemical Characteristics and Beyond. Curr Drug Metab 2023; 24:536-552. [PMID: 37076460 DOI: 10.2174/1389200224666230418092626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 04/21/2023]
Abstract
Therapeutic antisense oligonucleotides (ASOs) represent a diverse array of chemically modified singlestranded deoxyribonucleotides that work complementarily to affect their mRNA targets. They vastly differ from conventional small molecules. These newly developed therapeutic ASOs possess unique absorption, distribution, metabolism, and excretion (ADME) processes that ultimately determine their pharmacokinetic, efficacy and safety profiles. The ADME properties of ASOs and associated key factors have not been fully investigated. Therefore, thorough characterization and in-depth study of their ADME properties are critical to support drug discovery and development processes for safe and effective therapeutic ASOs. In this review, we discussed the main factors affecting the ADME characteristics of these novels and evolving therapies. The major changes to ASO backbone and sugar chemistry, conjugation approaches, sites and routes of administration, etc., are the principal determinants of ADME and PK profiles that consequentially impact their efficacy and safety profiles. In addition, species difference and DDI considerations are important in understanding ADME profile and PK translatability but are less studied for ASOs. We, therefore, have summarized these aspects based on current knowledge and provided discussions in this review. We also give an overview of the current tools, technologies, and approaches available to investigate key factors that influence the ADME of ASO drugs and provide future perspectives and knowledge gap analysis.
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Affiliation(s)
- Rongrong Jiang
- Drug Metabolism and Pharmacokinetics, Eisai Inc., Massachusetts, USA
| | - Shirin Hooshfar
- Drug Metabolism and Pharmacokinetics, Eisai Inc., Massachusetts, USA
| | | | - Cassandra Yun
- Drug Metabolism and Pharmacokinetics, Eisai Inc., Massachusetts, USA
| | | | - Raku Shinkyo
- Drug Metabolism and Pharmacokinetics, Eisai Inc., Massachusetts, USA
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4
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Fleischmann CJ, Bulman CA, Yun C, Lynch KL, Wu AHB, Whitman JD. Detection of IgM, IgG, IgA and neutralizing antibody responses to SARS-CoV-2 infection and mRNA vaccination. J Med Microbiol 2023; 72. [PMID: 36748419 DOI: 10.1099/jmm.0.001632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introduction. One correlate of immunity for coronavirus disease 2019 (COVID-19) is the laboratory detection of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. These tests are widely implemented for clinical, public health, or research uses.Hypothesis/Gap Statement. Antibody responses by all classes of immunoglobulins may form from infection and vaccination, but few studies have performed direct head-to-head comparisons between these groups.Aim. The objective of this study was to evaluate the serological responses in natural SARS-CoV-2 infection and mRNA-based vaccination across multiple immunoglobulin classes and a surrogate neutralizing antibody (NAb) assay.Methodology. A suite of enzyme-linked immunosorbent assays (ELISAs) was used to qualitatively assess IgA, IgM and IgG positivity and neutralizing per cent signal inhibition of sera from RT-PCR-confirmed SARS-CoV-2-infected patients, COVID-19-immunized individuals ≥2 weeks after a second dose of mRNA vaccine and a set of pre-pandemic negative samples.Results. For confirmed SARS-CoV-2 infections, seroconversion of IgA, IgM, IgG and NAb increased by week after symptom onset, with positivity reaching 100 % after the third week for every immunoglobulin class. Vaccinated individuals demonstrated 100 % IgG positivity and high per cent signal inhibition by NAb, comparable to natural infection. High specificity, ranging from 96.7-98.9 %, was observed for each assay from a set of pre-pandemic COVID-19-negative samples.Conclusion. We make use of a comprehensive and readily adoptable suite of serological assays to provide data on the humoral immune response to SARS-CoV-2 infection and vaccination. We found that infection and vaccination both elicit robust IgG, IgM, IgA and neutralizing antibody responses.
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Affiliation(s)
| | - Christina A Bulman
- Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
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5
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Zhang Y, Halifax JC, Tangsombatvisit C, Yun C, Pang S, Hooshfar S, Wu AH, Lynch KL. Development and application of a High-Resolution mass spectrometry method for the detection of fentanyl analogs in urine and serum. J Mass Spectrom Adv Clin Lab 2022; 26:1-6. [PMID: 36065325 PMCID: PMC9440429 DOI: 10.1016/j.jmsacl.2022.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
Utilization of the fentanyl analog screening kit from the Centers for Disease ControlDevelopment of a fentanyl analog high resolution mass spectrometry library. Fentanyl analogs are rarely identified without the co-occurrence of fentanyl. Fentanyl analogs fragmentation occurs at two specific bonds generating two dominate ions.
Introduction The use of illicitly manufactured synthetic opioids, specifically fentanyl and its analogs, has escalated exponentially in the United States over the last decade. Due to the targeted nature of drug detection methods in clinical laboratories and the ever-evolving list of synthetic opioids of concern, alternative analytical approaches are needed. Methods Using the fentanyl analog screening (FAS) kit produced by the Centers for Disease Control and Prevention (CDC), we developed a liquid chromatography-high resolution mass spectrometry (LC-HRMS) synthetic opioid spectral library and data acquisition method using information dependent acquisition of product ion spectra. Chromatographic retention times, limits of detection and matrix effects, in urine and serum, for the synthetic opioids in the FAS kit (n = 150) were established. All urine and serum specimens sent to a clinical toxicology laboratory for comprehensive drug testing in 2019 (n = 856) and 2021 (n = 878) were analyzed with the FAS LC-HRMS library to determine the prevalence of fentanyl analogs and other synthetic opioids, retrospectively (2019) and prospectively (2021). Results The limit of detection (LOD) of each opioid ranged from 1 to 10 ng/mL (median, 2.5 ng/mL) in urine and 0.25–2.5 ng/mL (median, 0.5 ng/mL) in serum. Matrix effects ranged from −79 % to 86 % (median, −37 %) for urine, following dilution and direct analysis, and −80 % to 400 % (median, 0 %) for serum, following protein precipitation. The prevalence of fentanyl/fentanyl analogs in serum samples increased slightly from 2019 to 2021 while it remained the same in urine. There were only 2 samples identified that contained a fentanyl analog without the co-occurrence of fentanyl or fentanyl metabolites. Analysis of the established MS/MS spectral library revealed characteristic fragmentation patterns in most fentanyl analogs, which can be used for structure elucidation and drug identification of future analogs. Conclusions The LC-HRMS method was capable of detecting fentanyl analogs in routine samples sent for comprehensive drug testing. The method can be adapted to accommodate testing needs for the evolving opioid epidemic.
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Affiliation(s)
- Yu Zhang
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
| | - John C. Halifax
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
| | | | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
| | - Shaokun Pang
- SCIEX, 1201 Radio Rd, Redwood City, CA 94065, USA
| | - Shirin Hooshfar
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
| | - Alan H.B. Wu
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
| | - Kara L. Lynch
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave, ZSFG Bldg. 5, 2M16 San Francisco, CA 94110, USA
- Corresponding author.
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6
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Augusto DG, Yusufali T, Sabatino JJ, Peyser ND, Murdolo LD, Butcher X, Murray V, Pae V, Sarvadhavabhatla S, Beltran F, Gill G, Lynch K, Yun C, Maguire C, Peluso MJ, Hoh R, Henrich TJ, Deeks SG, Davidson M, Lu S, Goldberg SA, Kelly JD, Martin JN, Viera-Green CA, Spellman SR, Langton DJ, Lee S, Marcus GM, Olgin JE, Pletcher MJ, Gras S, Maiers M, Hollenbach JA. A common allele of HLA mediates asymptomatic SARS-CoV-2 infection. medRxiv 2022:2021.05.13.21257065. [PMID: 34031661 PMCID: PMC8142661 DOI: 10.1101/2021.05.13.21257065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Despite some inconsistent reporting of symptoms, studies have demonstrated that at least 20% of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will remain asymptomatic. Although most global efforts have focused on understanding factors underlying severe illness in COVID-19 (coronavirus disease of 2019), the examination of asymptomatic infection provides a unique opportunity to consider early disease and immunologic features promoting rapid viral clearance. Owing to its critical role in the immune response, we postulated that variation in the human leukocyte antigen (HLA) loci may underly processes mediating asymptomatic infection. We enrolled 29,947 individuals registered in the National Marrow Donor Program for whom high-resolution HLA genotyping data were available in the UCSF Citizen Science smartphone-based study designed to track COVID-19 symptoms and outcomes. Our discovery cohort (n=1428) was comprised of unvaccinated, self-identified subjects who reported a positive test result for SARS-CoV-2. We tested for association of five HLA loci (HLA-A, -B, -C, -DRB1, -DQB1) with disease course and identified a strong association of HLA-B*15:01 with asymptomatic infection, and reproduced this association in two independent cohorts. Suggesting that this genetic association is due to pre-existing T-cell immunity, we show that T cells from pre-pandemic individuals carrying HLA-B*15:01 were reactive to the immunodominant SARS-CoV-2 S-derived peptide NQKLIANQF, and 100% of the reactive cells displayed memory phenotype. Finally, we characterize the protein structure of HLA-B*15:01-peptide complexes, demonstrating that the NQKLIANQF peptide from SARS-CoV-2, and the highly homologous NQKLIANAF from seasonal coronaviruses OC43-CoV and HKU1-CoV, share similar ability to be stabilized and presented by HLA-B*15:01, providing the molecular basis for T-cell cross-reactivity and HLA-B*15:01-mediated pre-existing immunity.
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Affiliation(s)
- Danillo G. Augusto
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Programa de Pós-Graduação em Genética, Universidade Federal do Paraná, Curitiba, Brazil
- Department of Biological Sciences, The University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Tasneem Yusufali
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Joseph J. Sabatino
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Noah D. Peyser
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Lawton D. Murdolo
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Xochitl Butcher
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Victoria Murray
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Vivian Pae
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sannidhi Sarvadhavabhatla
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Fiona Beltran
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Gurjot Gill
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Kara Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Colin Maguire
- University of Utah, Clinical and Translational Science Institute, Salt Lake City, UT
| | - Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Timothy J. Henrich
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Michelle Davidson
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Cynthia A. Viera-Green
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Stephen R. Spellman
- CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - David J. Langton
- ExplantLab, The Biosphere, Newcastle Helix, Newcastle-upon-Tyne, UK
| | - Sulggi Lee
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Gregory M. Marcus
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey E. Olgin
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Mark J. Pletcher
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Stephanie Gras
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Bundoora, Victoria 3086, Australia
- Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria 3800, Australia
| | | | - Jill A. Hollenbach
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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Wolfson P, Cole R, Lynch K, Yun C, Wallach J, Andries J, Whippo M. The Pharmacokinetics of Ketamine in the Breast Milk of Lactating Women: Quantification of Ketamine and Metabolites. J Psychoactive Drugs 2022:1-5. [PMID: 35880962 DOI: 10.1080/02791072.2022.2101903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Ketamine is a general anesthetic with over 50 years of safe administration that is in increasing use for psychiatric indications. This is evidenced by the recent FDA approval of intranasal esketamine (the S-enantiomer) for the treatment of depression. With respect to ketamine and lactation, incredibly there are no available data on the secretion of ketamine or its metabolites in human breast milk. This information is essential to guide the use of ketamine in breastfeeding women who suffer with postpartum emotional disorders, ongoing depression, PTSD, and more. To address this unmet need, we conducted a pharmacokinetic analysis of the presence of ketamine and several of its major metabolites (norketamine, dehydronorketamine, and hydroxynorketamine isomers) in four women receiving two different intramuscular doses of ketamine - 0.5 mg/kg and 1.0 mg/kg. Our results demonstrate low and rapidly declining levels of ketamine and metabolites in breast milk during the 12-hour post-dosing period. The mean relative infant dose (RID) obtained from AUC estimates for the 0.5 and 1.0 mg/kg doses were 0.650% and 0.766%, respectively. This provides the foundation for studying the use of ketamine during the post-partum period.
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Affiliation(s)
| | - Rob Cole
- The Ketamine Research Foundation, CA, USA
| | - Kara Lynch
- The Ketamine Research Foundation, CA, USA
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8
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Wu AHB, Nguyen ED, Ong CM, Yun C, Lynch KL. Rate of Serum SARS-CoV-2 Antibody Decline for Two mRNA Vaccines. J Appl Lab Med 2022; 7:625-627. [PMID: 34648027 PMCID: PMC8524641 DOI: 10.1093/jalm/jfab137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/17/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Alan H B Wu
- University of California, San Francisco, San Francisco, CA, 94110
| | - Eric D Nguyen
- University of California, San Francisco, San Francisco, CA, 94110
| | - Chui Mei Ong
- University of California, San Francisco, San Francisco, CA, 94110
| | - Cassandra Yun
- University of California, San Francisco, San Francisco, CA, 94110
| | - Kara L Lynch
- University of California, San Francisco, San Francisco, CA, 94110
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9
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Hooshfar S, Tchu S, Yun C, Lynch KL. Development of a high-throughput differential mobility separation-tandem mass spectrometry (DMS-MS/MS) method for clinical urine drug testing. J Mass Spectrom Adv Clin Lab 2022; 23:50-57. [PMID: 35036987 PMCID: PMC8753179 DOI: 10.1016/j.jmsacl.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Differential mobility separation (DMS) is an analytical technique used for rapid separation of ions and isomers based on gas phase mobility prior to entering a mass spectrometer for analysis. The entire DMS process is accomplished in fewer than 20 ms and can be used as a rapid alternative to chromatographic separation. OBJECTIVE The primary objective was to evaluate the utility of DMS-tandem mass spectrometry (DMS-MS/MS) as a replacement for immunoassay-based clinical toxicology testing. METHODS A sensitive DMS-MS/MS method was developed and validated for simultaneous identification of 33 drugs and metabolites in human urine samples. After DMS optimization, the method was validated and used to screen 56 clinical urine samples. These results were compared to results obtained by immunoassay. RESULTS The DMS-MS/MS method achieved limits of detection ranging from 5 to 100 ng/mL. Moreover, the total analysis time was 2 min per sample. For the method performance evaluation, DMS-MS/MS results were compared with previously obtained urine toxicology immunoassay results. DMS-MS/MS showed higher sensitivity and identified 20% more drugs in urine, which were confirmed by LC-MS/MS. CONCLUSION The DMS-MS/MS as applied in our lab demonstrated the capability for rapid drug screening and provided better analytical performance than immunoassay.
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Key Words
- 6-MAM, 6-Monoacetylmorphine
- AMPH, amphetamines/ecstasy
- BENZ, benzodiazepines
- BUPR, buprenorphine
- CE, Collision energy
- COV, compensation voltage
- CXP, collision cell exit potential
- DAPPI, atmospheric pressure photo ionization
- DART, direct analysis in real time
- DC, direct current
- DESI, desorption electrospray ionization
- DMO, DMS offse
- DMS, differential mobility separation
- DP, declustering potential
- DR, DMS resolution enhancement
- DT, DMS cell temperature
- Differential mobility separation
- Drugs of abuse
- EDDP, 2-ethylidene1,5-dimethyl-3,3-diphenylpyrrolidine
- EP, entrance potential
- FAIMS, field asymmetric waveform ion mobility spectrometry
- FSI, fiber spray ionization
- GC-MS or LC-MS, gas chromatography- or liquid chromatography-mass spectrometry
- GS1, ion source gas 1
- GS2, ion source gas 2
- IMS, ion mobility spectrometry, IS, internal standards, LOD, limit of detection, MD, modifier, MDC, modifier composition, ME, matrix effects
- MRM, multiple reaction monitoring
- MS/MS, tandem mass spectrometry
- Mass spectrometry
- OPI, opiates
- OXY, oxycodone/oxmorphone
- QCs, quality controls
- SRM, selected reaction monitoring
- SV, separation voltage
- Urine drug screening
- WT-ESI, wooden-tip electrospray ionization
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Affiliation(s)
- Shirin Hooshfar
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
- Department of Drug Metabolism and Pharmacokinetics, Eisai Inc., Cambridge, MA, United States
| | - Simone Tchu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, United States
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10
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Zhang Y, Ong CM, Yun C, Mo W, Whitman JD, Lynch KL, Wu AHB. Diagnostic Value of Nucleocapsid Protein in Blood for SARS-CoV-2 Infection. Clin Chem 2021; 68:240-248. [PMID: 34358289 PMCID: PMC8436384 DOI: 10.1093/clinchem/hvab148] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Biomarkers have been widely explored for coronavirus disease 2019 diagnosis. Both viral RNA or antigens (Ag) in the respiratory system and antibodies (Ab) in blood are used to identify active infection, transmission risk, and immune response but have limitations. This study investigated the diagnostic utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein (N-Ag) in serum. METHODS We retrospectively studied 208 randomly selected cases with SARS-CoV-2 infection confirmed by viral RNA test in swabs. N-Ag concentrations were measured in remnant serum samples, compared to viral RNA or Ab results, and correlated to electronic health records for clinical value evaluation. RESULTS Serum N-Ag was detected during active infection as early as day 2 from symptom onset with a diagnostic sensitivity of 81.5%. Within 1 week of symptom onset, the diagnostic sensitivity and specificity reached 90.9% (95% CI, 85.1%-94.6%) and 98.3% (95% CI, 91.1%-99.9%), respectively. Moreover, serum N-Ag concentration closely correlated to disease severity, reflected by highest level of care, medical interventions, chest imaging, and the length of hospital stays. Longitudinal analysis revealed the simultaneous increase of Abs and decline of N-Ag. CONCLUSIONS Serum N-Ag is a biomarker for SARS-CoV-2 acute infection with high diagnostic sensitivity and specificity compared to viral RNA in the respiratory system. There is a correlation between serum N-Ag concentrations and disease severity and an inverse relationship of N-Ag and Abs. The diagnostic value of serum N-Ag, as well as technical and practical advantages it could offer, may meet unsatisfied diagnostic and prognostic needs during the pandemic.
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Affiliation(s)
- Yu Zhang
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Chui Mei Ong
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Weike Mo
- Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Jeffery D Whitman
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
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11
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Spinelli MA, Peluso MJ, Lynch KL, Yun C, Glidden DV, Henrich TJ, Deeks SG, Gandhi M. Differences in Post-mRNA Vaccination Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Immunoglobulin G (IgG) Concentrations and Surrogate Virus Neutralization Test Response by Human Immunodeficiency Virus (HIV) Status and Type of Vaccine: A Matched Case-Control Observational Study. Clin Infect Dis 2021; 75:e916-e919. [PMID: 34864962 PMCID: PMC8689738 DOI: 10.1093/cid/ciab1009] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Indexed: 01/19/2023] Open
Abstract
Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination, people living with human immunodeficiency virus (HIV, PLWH) had lower surrogate virus neutralization test response (P = .03) and a trend toward lower immunoglobulin G (IgG) response (P = .08), particularly among those with lower CD4+ T-cell counts and who received the BNT162b2 vaccine. Study of the impact of supplemental vaccine doses among PLWH is needed.
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Affiliation(s)
- Matthew A Spinelli
- Correspondence: M. A. Spinelli 995 Potrero Ave, Ward 84, San Francisco, CA 94110, USA. Email ()
| | - Michael J Peluso
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Timothy J Henrich
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Steven G Deeks
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Monica Gandhi
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, San Francisco, California, USA
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12
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Spinelli MA, Peluso MJ, Lynch K, Yun C, Glidden DV, Henrich TJ, Deeks S, Gandhi M. LB8. Lower SARS-CoV-2 IgG and Pseudovirus Neutralization Titers Post-mRNA Vaccination among People Living with HIV. Open Forum Infect Dis 2021. [PMCID: PMC8644162 DOI: 10.1093/ofid/ofab466.1639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Limited data are available on whether there are differences in the immune response to SARS-CoV-2 vaccination by HIV status or by mRNA vaccine type. Methods We saved residual outpatient laboratory samples of all previously mRNA-vaccinated individuals in the adult medicine clinics of a public hospital with a large outpatient HIV clinic during May 2021, and then excluded individuals with prior SARS-CoV-2 infection. We next 1:1 matched 100 PLWH to 100 outpatient HIV-negative adult medicine patients receiving care for chronic medical conditions on days since completion of second vaccination (minimum 10), sex, age +/-5 years, and the type of mRNA vaccine received. We defined a non-response as reciprocal pseudovirus neutralizing titer< 10 and anti-RBD IgG< 10 relative fluorescent units, and compared non-response by HIV status using mixed models. Results In each matched group there were 13 women; 25 received the mRNA-1273 vaccine and 75 received the BNT162b2 vaccine; the median age was 59. The median time from second vaccination was 35 days (IQR: 20–63). Among PLWH, the median CD4+ T-cell count was 511 (IQR: 351–796) and 5 individuals had HIV RNA > 200. We found 2.4-fold greater odds of pseudovirus neutralizing antibody non-response among PLWH compared to people without HIV (95% CI=1.1–5.4). Although few individuals in each group did not mount an IgG response (12 among PLWH vs. 5; p=0.08), continuous anti-RBD IgG concentrations were 43% lower among PLWH (95% CI=0.36–0.88). Among PLWH, when adjusting for age, sex, and days post-vaccination, each 100-cell increase in CD4+T-cell count was associated with 22% higher neutralizing antibody titers (GMR 1.22; 95% CI=1.09–1.37). Unsuppressed HIV RNA >200 was associated with 89% lower neutralizing antibody titers (GMR 0.11; 95% CI=0.01–0.84). Receipt of the BNT162b2 vs. mRNA-1273 vaccine was associated with 77% lower neutralizing titers (GMR 0.23; 95% CI=0.08–0.65) among PLWH. Post-mRNA Vaccination SARS-CoV-2 IgG Concentrations and Pseudovirus Neutralizing Titers by HIV Status and Vaccine Conclusion PLWH had lower than expected response to mRNA SARS-CoV-2 vaccines, with the highest non-response among those with low CD4+ counts, unsuppressed HIV RNA, and those who received the BNT162b2 vaccine. Immunization strategies to improve immune responses among PLWH should be studied, and may include booster vaccination or preference of the mRNA-1273 vaccine in this group. ![]()
Disclosures Matthew A. Spinelli, MD, MAS, Nothing to disclose Monica Gandhi, MD, MPH, Nothing to disclose
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Affiliation(s)
| | | | - Kara Lynch
- University of California San Francisco, San Francisco, California
| | | | | | | | | | - Monica Gandhi
- University of California, San Francisco, San Francisco, CA
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13
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Luo YR, Yun C, Wu AH, Lynch KL, Chakraborty I. Longitudinal Study of SARS-CoV-2 Antibody Characteristics Using Label-Free Immunoassays. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Since the start of the COVID-19 pandemic, much research has focused on the kinetics and magnitude of humoral immune response. With the advantages of monitoring real-time immunoreactions, label-free immunoassay (LFIA) is becoming a powerful tool in serology studies. We have developed LFIAs to measure SARS- CoV-2 antibody avidity and neutralization activity in a cohort of COVID-19 patients and determine if they correlate with antibody concentration. Serial serum samples collected from mild to severe COVID-19 patients were measured out to 8 months post-symptom onset to determine the durability of the neutralizing antibody response.
Methods/Case Report
Based on thin-film interferometry technology, we established a label-free IgG avidity assay and a label-free surrogate virus neutralization test (LF-sVNT). For measurement, sensing probes pre-coated with receptor-binding domain (RBD) of SARS-CoV-2 spike protein are applied to serum samples containing SARS-CoV-2 antibodies. The label-free IgG avidity assay measures the binding strength between RBD and IgG under urea dissociation. The LF-sVNT analyzes the binding ability of RBD to ACE2 after neutralizing RBD with antibodies.
Results (if a Case Study enter NA)
IgG avidity indices and neutralizing antibody titers (IC50) were determined from serum samples (n=246) from COVID-19 patients (n=113). IgG concentrations were measured using a fluorescent immunoassay. The neutralizing antibody titers showed a weak correlation with IgG concentrations and no correlation with IgG avidity indices. Over the time course up to 8 months post-symptom onset, IgG concentrations and neutralizing antibody titers presented similar trends: an initial rise, plateau and then in some cases a gradual decline after 40 days. The IgG avidity indices, in the same cases, plateaued after the initial rise.
Conclusion
The results demonstrated that LFIA could be used an excellent solution in the determination of SARS- CoV-2 antibody characteristics. The study found that IgG concentration and neutralizing antibody titer declined over time, while IgG avidity index remained constant after reaching a plateau. The decline of antibody neutralization activity can be attributed to the reduction in antibody quantity rather than the deterioration of antibody quality, as measured by antibody avidity.
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Affiliation(s)
- Y R Luo
- Pathology, Stanford University, Palo Alto, California, UNITED STATES
| | - C Yun
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
| | - A H Wu
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
| | - K L Lynch
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
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14
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van der Wijst MGP, Vazquez SE, Hartoularos GC, Bastard P, Grant T, Bueno R, Lee DS, Greenland JR, Sun Y, Perez R, Ogorodnikov A, Ward A, Mann SA, Lynch KL, Yun C, Havlir DV, Chamie G, Marquez C, Greenhouse B, Lionakis MS, Norris PJ, Dumont LJ, Kelly K, Zhang P, Zhang Q, Gervais A, Le Voyer T, Whatley A, Si Y, Byrne A, Combes AJ, Rao AA, Song YS, Fragiadakis GK, Kangelaris K, Calfee CS, Erle DJ, Hendrickson C, Krummel MF, Woodruff PG, Langelier CR, Casanova JL, Derisi JL, Anderson MS, Ye CJ. Type I interferon autoantibodies are associated with systemic immune alterations in patients with COVID-19. Sci Transl Med 2021; 13:eabh2624. [PMID: 34429372 PMCID: PMC8601717 DOI: 10.1126/scitranslmed.abh2624] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A subset of patients diagnosed with coronavirus disease 2019 (COVID-19) present with autoantibodies specific to type I interferons (IFNs). However, the systemic impacts of type I IFN–specific autoantibodies are not fully understood. Here, van der Wijst et al. longitudinally evaluated the relationship between type I IFN–specific autoantibody abundance and changes to the immune system of individuals with COVID-19. Using single-cell transcriptomics, the authors found that the presence of type I IFN autoantibodies correlated with reduced type I IFN–stimulated gene (ISG) expression in patients with critical COVID-19. Reduced ISG expression, in turn, correlated with increased expression of the inhibitory receptor, leukocyte-associated immunoglobulin-like receptor 1 (LAIR1), on monocytes. Together, these findings suggest that early evidence of type I IFN autoantibodies and increased LAIR1 expression may help distinguish severe cases of COVID-19. Neutralizing autoantibodies against type I interferons (IFNs) have been found in some patients with critical coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the prevalence of these antibodies, their longitudinal dynamics across the disease severity scale, and their functional effects on circulating leukocytes remain unknown. Here, in 284 patients with COVID-19, we found type I IFN–specific autoantibodies in peripheral blood samples from 19% of patients with critical disease and 6% of patients with severe disease. We found no type I IFN autoantibodies in individuals with moderate disease. Longitudinal profiling of over 600,000 peripheral blood mononuclear cells using multiplexed single-cell epitope and transcriptome sequencing from 54 patients with COVID-19 and 26 non–COVID-19 controls revealed a lack of type I IFN–stimulated gene (ISG-I) responses in myeloid cells from patients with critical disease. This was especially evident in dendritic cell populations isolated from patients with critical disease producing type I IFN–specific autoantibodies. Moreover, we found elevated expression of the inhibitory receptor leukocyte-associated immunoglobulin-like receptor 1 (LAIR1) on the surface of monocytes isolated from patients with critical disease early in the disease course. LAIR1 expression is inversely correlated with ISG-I expression response in patients with COVID-19 but is not expressed in healthy controls. The deficient ISG-I response observed in patients with critical COVID-19 with and without type I IFN–specific autoantibodies supports a unifying model for disease pathogenesis involving ISG-I suppression through convergent mechanisms.
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Affiliation(s)
- Monique G P van der Wijst
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9713AV Groningen, Netherlands.,Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sara E Vazquez
- Medical Scientist Training Program, University of California, San Francisco, San Francisco, CA 94143, USA.,Tetrad Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA.,Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA.,Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - George C Hartoularos
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, 75015 Paris, France.,University of Paris, Imagine Institute, 75015 Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Tianna Grant
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Raymund Bueno
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David S Lee
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA
| | - John R Greenland
- Department of Medicine, University of California, San Francisco, San Francisco Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
| | - Yang Sun
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Richard Perez
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,School of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Anton Ogorodnikov
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Alyssa Ward
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Sabrina A Mann
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA.,Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Kara L Lynch
- Zuckerberg San Francisco General, San Francisco, CA 94110, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Cassandra Yun
- Zuckerberg San Francisco General, San Francisco, CA 94110, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Diane V Havlir
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Carina Marquez
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Bryan Greenhouse
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Michail S Lionakis
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD 20814, USA
| | - Philip J Norris
- Zuckerberg San Francisco General, San Francisco, CA 94110, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,Vitalant Research Institute, San Francisco, CA 94118, USA
| | - Larry J Dumont
- Vitalant Research Institute, Denver, CO 80230, USA.,University of Colorado School of Medicine, Aurora, CO 80045, USA.,Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA
| | | | - Peng Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Adrian Gervais
- University of Paris, Imagine Institute, 75015 Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Tom Le Voyer
- University of Paris, Imagine Institute, 75015 Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA
| | - Alexander Whatley
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Yichen Si
- Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ashley Byrne
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Alexis J Combes
- ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA.,UCSF CoLabs, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Arjun Arkal Rao
- ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA.,UCSF CoLabs, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Yun S Song
- Chan Zuckerberg Biohub, San Francisco, CA 94158, USA.,Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720, USA.,Department of Statistics, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Gabriela K Fragiadakis
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,UCSF CoLabs, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Kirsten Kangelaris
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Carolyn S Calfee
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David J Erle
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Zuckerberg San Francisco General, San Francisco, CA 94110, USA
| | - Carolyn Hendrickson
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Matthew F Krummel
- ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Prescott G Woodruff
- ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Charles R Langelier
- Division of Infectious Disease, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, 75015 Paris, France.,University of Paris, Imagine Institute, 75015 Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY 10065, USA.,Howard Hughes Medical Institute, New York, NY 10065, USA
| | - Joseph L Derisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA.,Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| | - Mark S Anderson
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Chun Jimmie Ye
- Institute of Human Genetics, University of California, San Francisco, San Francisco, CA 94143, USA.,Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.,ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA.,Chan Zuckerberg Biohub, San Francisco, CA 94158, USA.,Departments of Epidemiology and Biostatistics and Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA 94143, USA.,Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA 94143, USA.,Parker Institute for Cancer Immunotherapy, San Francisco, CA 94129, USA
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15
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Ascierto P, Secrest M, Lambert P, Sarsour K, Tan A, Walls R, Reddy J, Seetasith A, Shenison D, Ngwa I, Yun C, Zhang Q. 1574P Mortality of 1,636 COVID-19 cancer patients (pts) and associated prognostic factors. Ann Oncol 2021. [PMCID: PMC8454377 DOI: 10.1016/j.annonc.2021.08.1567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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16
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Kim C, Liang D, Han Y, Ding S, Li K, Yun C, Yang W, Han J, Liu S, Du H, Wang C, Yang J. Micromagnetic simulation of microstructure effect for binary-main-phase Nd-Ce-Fe-B magnets. J Phys Condens Matter 2021; 33:445801. [PMID: 34348249 DOI: 10.1088/1361-648x/ac1aa1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
We investigate the magnetic properties of a chemically heterogeneous binary-main-phase (BMP) Nd-Ce-Fe-B magnet with a core-shell structure via micromagnetic simulation. It is found that the coercivity strongly depends on the shell thickness. The BMP magnet's coercivity initially increases and then decreases with increasing Nd-rich shell thickness, and so there is the optimal shell thickness which shows the maximum coercivity for any given Ce concentration. The simulation shows the significant difference in coercivity and maximum energy product between the BMP and single-main-phase magnets. Notably, the magnetization reversal mechanism of the BMP magnet is revealed in the simulation. Local reversals in the BMP magnet first occur in the Ce-rich shells, followed by the Nd-rich cores. Then, the magnetization in Ce-rich core/Nd-rich shell typed grains is switched after reversed magnetization of all the Nd-rich core/Ce-rich shell typed grains. The BMP magnet represents a further increased coercivity for a larger GB thickness, which can be well explained by a maximum stray field.
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Affiliation(s)
- C Kim
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - D Liang
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - Y Han
- School of New Energy, North China Electric Power University, Beijing 102206, People's Republic of China
| | - S Ding
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - K Li
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - C Yun
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - W Yang
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - J Han
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - S Liu
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - H Du
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - C Wang
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
| | - J Yang
- Institute of Condensed Matter and Materials Physics, School of Physics, Peking University, Beijing 100871, People's Republic of China
- State Key Laboratory for Mesoscopic Physics, School of Physics, Peking University, Beijing, 100871, People's Republic of China
- Beijing Key Laboratory for Magnetoelectric Materials and Devices, Beijing, 100871, People's Republic of China
- Collaborative Innovation Center of Quantum Matter, Beijing, 100871, People's Republic of China
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17
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Peluso MJ, Munter SE, Lynch KL, Yun C, Torres L, Iyer NS, Donatelli J, Ryan L, Deitchman AN, Deeks SG, Rutishauser RL, Henrich TJ. Discordant Virus-Specific Antibody Levels, Antibody Neutralization Capacity, and T-cell Responses Following 3 Doses of SARS-CoV-2 Vaccination in a Patient With Connective Tissue Disease. Open Forum Infect Dis 2021; 8:ofab393. [PMID: 34395717 PMCID: PMC8344490 DOI: 10.1093/ofid/ofab393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
We report a patient with connective tissue disease who developed modest severe acute respiratory syndrome coronavirus 2 receptor binding domain–specific antibody levels and a lack of neutralization capacity, despite having received 3 mRNA coronavirus disease 2019 vaccines and holding anti-B-cell therapy for >7 months before vaccination. The patient developed virus-specific T-cell responses.
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Affiliation(s)
- Michael J Peluso
- Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Sadie E Munter
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Leonel Torres
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
| | - Nikita S Iyer
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
| | - Joanna Donatelli
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
| | - Lindsay Ryan
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Amelia N Deitchman
- Department of Clinical Pharmacology, University of California San Francisco, San Francisco, California, USA
| | - Steven G Deeks
- Division of HIV, Infectious Disease and Global Medicine, University of California San Francisco, San Francisco, California, USA
| | - Rachel L Rutishauser
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
| | - Timothy J Henrich
- Division of Experimental Medicine, University of California San Francisco, San Francisco, California, USA
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18
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Neidleman J, Luo X, George AF, McGregor M, Yang J, Yun C, Murray V, Gill G, Greene WC, Vasquez J, Lee SA, Ghosn E, Lynch KL, Roan NR. Distinctive features of SARS-CoV-2-specific T cells predict recovery from severe COVID-19. Cell Rep 2021; 36:109414. [PMID: 34260965 PMCID: PMC8238659 DOI: 10.1016/j.celrep.2021.109414] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/14/2021] [Accepted: 06/24/2021] [Indexed: 02/08/2023] Open
Abstract
Although T cells are likely players in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity, little is known about the phenotypic features of SARS-CoV-2-specific T cells associated with recovery from severe coronavirus disease 2019 (COVID-19). We analyze T cells from 34 individuals with COVID-19 with severity ranging from mild (outpatient) to critical, culminating in death. Relative to individuals who succumbed, individuals who recovered from severe COVID-19 harbor elevated and increasing numbers of SARS-CoV-2-specific T cells capable of homeostatic proliferation. In contrast, fatal COVID-19 cases display elevated numbers of SARS-CoV-2-specific regulatory T cells and a time-dependent escalation in activated bystander CXCR4+ T cells, as assessed by longitudinal sampling. Together with the demonstration of increased proportions of inflammatory CXCR4+ T cells in the lungs of individuals with severe COVID-19, these results support a model where lung-homing T cells activated through bystander effects contribute to immunopathology, whereas a robust, non-suppressive SARS-CoV-2-specific T cell response limits pathogenesis and promotes recovery from severe COVID-19.
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Affiliation(s)
- Jason Neidleman
- Gladstone Institutes, San Francisco, CA 94158, USA; Department of Urology, University of California, San Francisco, CA 94158, USA
| | - Xiaoyu Luo
- Gladstone Institutes, San Francisco, CA 94158, USA
| | - Ashley F George
- Gladstone Institutes, San Francisco, CA 94158, USA; Department of Urology, University of California, San Francisco, CA 94158, USA
| | - Matthew McGregor
- Gladstone Institutes, San Francisco, CA 94158, USA; Department of Urology, University of California, San Francisco, CA 94158, USA
| | - Junkai Yang
- Deptartments of Medicine and Pediatrics, Lowance Center for Human Immunology, Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, CA 94110, USA
| | - Victoria Murray
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA 94110, USA
| | - Gurjot Gill
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA 94110, USA
| | - Warner C Greene
- Gladstone Institutes, San Francisco, CA 94158, USA; Department of Medicine, University of California, San Francisco, CA 94110, USA
| | - Joshua Vasquez
- Department of Medicine, University of California, San Francisco, CA 94110, USA
| | - Sulggi A Lee
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA 94110, USA
| | - Eliver Ghosn
- Deptartments of Medicine and Pediatrics, Lowance Center for Human Immunology, Emory Vaccine Center, Emory University, Atlanta, GA 30322, USA.
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, CA 94110, USA.
| | - Nadia R Roan
- Gladstone Institutes, San Francisco, CA 94158, USA; Department of Urology, University of California, San Francisco, CA 94158, USA.
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19
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Luo YR, Yun C, Chakraborty I, Wu AHB, Lynch KL. A SARS-CoV-2 Label-Free Surrogate Virus Neutralization Test and a Longitudinal Study of Antibody Characteristics in COVID-19 Patients. J Clin Microbiol 2021; 59:e0019321. [PMID: 33827900 PMCID: PMC8218741 DOI: 10.1128/jcm.00193-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/05/2021] [Indexed: 12/21/2022] Open
Abstract
Methods designed to measure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) humoral response include virus neutralization tests to determine antibody neutralization activity. For ease of use and universal applicability, surrogate virus neutralization tests (sVNTs) based on antibody-mediated blockage of molecular interactions have been proposed. A surrogate virus neutralization test was established on a label-free immunoassay platform (LF-sVNT). The LF-sVNT analyzes the binding ability of SARS-CoV-2 spike protein receptor-binding domain (RBD) to angiotensin-converting enzyme 2 (ACE2) after neutralizing RBD with antibodies in serum. The LF-sVNT neutralizing antibody titers (50% inhibitory concentration [IC50]) were determined from serum samples (n = 246) from coronavirus disease 2019 (COVID-19) patients (n = 113), as well as the IgG concentrations and the IgG avidity indices. Although there was variability in the kinetics of the IgG concentrations and neutralizing antibody titers between individuals, there was an initial rise, plateau, and then in some cases a gradual decline at later time points after 40 days after symptom onset. The IgG avidity indices, in the same cases, plateaued after an initial rise and did not show a decline. The LF-sVNT can be a valuable tool in research and clinical laboratories for the assessment of the presence of neutralizing antibodies to COVID-19. This study is the first to provide longitudinal neutralizing antibody titers beyond 200 days post-symptom onset. Despite the decline of IgG concentration and neutralizing antibody titer, IgG avidity index increases, reaches a plateau, and then remains constant up to 8 months postinfection. The decline of antibody neutralization activity can be attributed to the reduction in antibody quantity rather than the deterioration of antibody quality, as measured by antibody avidity.
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Affiliation(s)
- Yiqi Ruben Luo
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | | | - Alan H. B. Wu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Kara L. Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital, San Francisco, California, USA
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20
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van Wijk XMR, Yun C, Lynch KL. Evaluation of Biomarkers in Sepsis: High Dimethylarginine (ADMA and SDMA) Concentrations Are Associated with Mortality. J Appl Lab Med 2021; 6:592-605. [PMID: 33382901 DOI: 10.1093/jalm/jfaa156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND As modulators of nitric oxide generation, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) may play important roles in sepsis. Current data on dimethylarginines are conflicting, and direct comparison data with other biomarkers are limited. METHODS Fifty-five patients were included in the final analysis and were divided into 4 groups: infection without sepsis, sepsis, severe sepsis, and septic shock. The first available samples on hospital admission were analyzed for ADMA, SDMA, procalcitonin (PCT), C-reactive protein, heparin binding protein (HBP), zonulin, soluble CD25 (sCD25), and soluble CD163 (sCD163). White blood cell (WBC) counts and lactate results were obtained from the medical record. RESULTS There were no statistically significant differences in ADMA and SDMA concentrations among the 4 groups; however, PCT, WBC, HBP, and sCD25 showed statistically significant differences. Lactate only trended toward statistical significance, likely because of limited availability in the medical record. Differences between survivors of sepsis and nonsurvivors at 30 days were highly statistically significant for ADMA and SDMA. Areas under the curve (AUCs) for ROC analysis were 0.88 and 0.95, respectively. There was also a statistically significant difference between survivors of sepsis and nonsurvivors for HBP, lactate, sCD25, and sCD163; however, AUCs for ROC curves were not statistically significantly different from 0.5. CONCLUSIONS Analysis of biomarkers other than dimethylarginines were in general agreement with expectations from the literature. ADMA and SDMA may not be specific markers for diagnosis of sepsis; however, they may be useful in short-term mortality risk assessment.
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Affiliation(s)
- Xander M R van Wijk
- Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, Chicago, IL
| | - Cassandra Yun
- Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, Chicago, IL
| | - Kara L Lynch
- Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, Chicago, IL
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21
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Spinelli MA, Lynch KL, Yun C, Glidden DV, Peluso MJ, Henrich TJ, Gandhi M, Brown LB. SARS-CoV-2 seroprevalence, and IgG concentration and pseudovirus neutralising antibody titres after infection, compared by HIV status: a matched case-control observational study. Lancet HIV 2021; 8:e334-e341. [PMID: 33933189 PMCID: PMC8084354 DOI: 10.1016/s2352-3018(21)00072-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 02/07/2023]
Abstract
Background Most cohorts show similar or lower COVID-19 incidence among people living with HIV compared with the general population. However, incidence might be affected by lower testing rates among vulnerable populations. We aimed to compare SARS-CoV-2 IgG seroprevalence, disease severity, and neutralising antibody activity after infection among people with and without HIV receiving care in a county hospital system over a 3-month period. Methods In this matched case-control observational study, remnant serum samples were collected between Aug 1 and Oct 31, 2020, from all people living with HIV who underwent routine outpatient laboratory testing in a municipal health-care system (San Francisco General Hospital, CA, USA). Samples from people living with HIV were date of collection-matched (same day) and age-matched (±5 years) to samples from randomly selected adults (aged 18 years or older) without HIV receiving care for chronic conditions at the same hospital. We compared seroprevalence by HIV status via mixed-effects logistic regression models, accounting for the matched structure of the data (random effects for the matched group), adjusting for age, sex, race or ethnicity, and clinical factors (ie, history of cardiovascular or pulmonary disease, and type 2 diabetes). Severe COVID-19 was assessed in participants with past SARS-CoV-2 (IgG or PCR) infection by chart review and compared with multivariable mixed-effects logistic regression, adjusting for age and sex. SARS-CoV-2 IgG, neutralising antibody titres, and antibody avidity were measured in serum of participants with previous positive PCR tests and compared with multivariable mixed-effects models, adjusting for age, sex, and time since PCR-confirmed SARS-CoV-2 infection. Findings 1138 samples from 955 people living with HIV and 1118 samples from 1062 people without HIV were tested. SARS-CoV-2 IgG seroprevalence was 3·7% (95% CI 2·4 to 5·0) among people with HIV compared with 7·4% (5·7 to 9·2) among people without HIV (adjusted odds ratio 0·50, 95% CI 0·30 to 0·83). Among 31 people with HIV and 70 people without HIV who had evidence of past infection, the odds of severe COVID-19 were 5·52 (95% CI 1·01 to 64·48) times higher among people living with HIV. Adjusting for time since PCR-confirmed infection, SARS-CoV-2 IgG concentrations were lower (percentage change −53%, 95% CI −4 to −76), pseudovirus neutralising antibody titres were lower (−67%, −25 to −86), and avidity was similar (7%, −73 to 87) among people living with HIV compared with those without HIV. Interpretation Although fewer infections were detected by SARS-CoV-2 IgG testing among people living with HIV than among those without HIV, people with HIV had more cases of severe COVID-19. Among people living with HIV with past SARS-CoV-2 infection, lower IgG concentrations and pseudovirus neutralising antibody titres might reflect a diminished serological response to infection, and the similar avidity could be driven by similar time since infection. Funding US National Institute of Allergy and Infectious Diseases, US National Institutes of Health.
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Affiliation(s)
- Matthew A Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Michael J Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Timothy J Henrich
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Lillian B Brown
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
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22
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van der Wijst MGP, Vazquez SE, Hartoularos GC, Bastard P, Grant T, Bueno R, Lee DS, Greenland JR, Sun Y, Perez R, Ogorodnikov A, Ward A, Mann SA, Lynch KL, Yun C, Havlir DV, Chamie G, Marquez C, Greenhouse B, Lionakis MS, Norris PJ, Dumont LJ, Kelly K, Zhang P, Zhang Q, Gervais A, Le Voyer T, Whatley A, Si Y, Byrne A, Combes AJ, Rao AA, Song YS, Fragiadakis GK, Kangelaris K, Calfee CS, Erle DJ, Hendrickson C, Krummel MF, Woodruff PG, Langelier CR, Casanova JL, Derisi JL, Anderson MS, Ye CJ. Longitudinal single-cell epitope and RNA-sequencing reveals the immunological impact of type 1 interferon autoantibodies in critical COVID-19: Anti-IFN antibodies in critical COVID-19 correlate with poor ISG response and upregulation of LAIR1 surface protein in PBMCs. bioRxiv 2021:2021.03.09.434529. [PMID: 33758859 PMCID: PMC7987018 DOI: 10.1101/2021.03.09.434529] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Type I interferon (IFN-I) neutralizing autoantibodies have been found in some critical COVID-19 patients; however, their prevalence and longitudinal dynamics across the disease severity scale, and functional effects on circulating leukocytes remain unknown. Here, in 284 COVID-19 patients, we found IFN-I autoantibodies in 19% of critical, 6% of severe and none of the moderate cases. Longitudinal profiling of over 600,000 peripheral blood mononuclear cells using multiplexed single-cell epitope and transcriptome sequencing from 54 COVID-19 patients, 15 non-COVID-19 patients and 11 non-hospitalized healthy controls, revealed a lack of IFN-I stimulated gene (ISG-I) response in myeloid cells from critical cases, including those producing anti-IFN-I autoantibodies. Moreover, surface protein analysis showed an inverse correlation of the inhibitory receptor LAIR-1 with ISG-I expression response early in the disease course. This aberrant ISG-I response in critical patients with and without IFN-I autoantibodies, supports a unifying model for disease pathogenesis involving ISG-I suppression via convergent mechanisms.
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Affiliation(s)
- Monique G P van der Wijst
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - Sara E Vazquez
- Medical Scientist Training Program, University of California. San Francisco, CA, USA
- Tetrad Graduate Program, University of California, San Francisco, CA, USA
- Diabetes Center, University of California, San Francisco, CA, USA
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - George C Hartoularos
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Tianna Grant
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - Raymund Bueno
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - David S Lee
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
- ImmunoX Initiative, University of California, San Francisco, CA, USA
| | - John R Greenland
- Department of Medicine, San Francisco VA Health Care System, University of California, San Francisco, CA, USA
| | - Yang Sun
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
- ImmunoX Initiative, University of California, San Francisco, CA, USA
| | - Richard Perez
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Anton Ogorodnikov
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - Alyssa Ward
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
| | - Sabrina A Mann
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Kara L Lynch
- Zuckerberg San Francisco General, San Francisco, CA, USA
| | - Cassandra Yun
- Zuckerberg San Francisco General, San Francisco, CA, USA
| | - Diane V Havlir
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Gabriel Chamie
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Carina Marquez
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Bryan Greenhouse
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Michail S Lionakis
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Philip J Norris
- Zuckerberg San Francisco General, San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, CA, USA
| | - Larry J Dumont
- Vitalant Research Institute, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
- Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | | | - Peng Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Adrian Gervais
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Tom Le Voyer
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Alexander Whatley
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Yichen Si
- Department of Biostaticstics, University of Michigan
| | | | - Alexis J Combes
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, CA, USA
- UCSF CoLabs, University of California, San Francisco, CA, USA
| | - Arjun Arkal Rao
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, CA, USA
- UCSF CoLabs, University of California, San Francisco, CA, USA
| | - Yun S Song
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
- Department of Statistics, University of California, Berkeley, CA, USA
| | - Gabriela K Fragiadakis
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- UCSF CoLabs, University of California, San Francisco, CA, USA
| | - Kirsten Kangelaris
- Division of Infectious Disease, Department of Medicine, University of California, San Francisco, CA, USA
| | - Carolyn S Calfee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - David J Erle
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Zuckerberg San Francisco General, San Francisco, CA, USA
| | - Carolyn Hendrickson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Matthew F Krummel
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Prescott G Woodruff
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, CA, USA
| | - Charles R Langelier
- Division of Infectious Disease, Department of Medicine, University of California, San Francisco, CA, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, New York, NY, USA
| | - Joseph L Derisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Mark S Anderson
- Diabetes Center, University of California, San Francisco, CA, USA
- Endocrine Division, Department of Medicine, University of California, San Francisco, CA, USA
| | - Chun Jimmie Ye
- Institute of Human Genetics, University of California, San Francisco, CA, USA
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, California, USA
- ImmunoX Initiative, University of California, San Francisco, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Departments of Epidemiology and Biostatistics, Bioengineering and Therapeutic Sciences
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
- Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA
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23
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Feagan BG, Loftus EV, Danese S, Vermeire S, Sandborn WJ, Ritter T, Mehta R, Seidler U, Seibold F, Beales I, Kim H, McNally J, Yun C, Zhao S, Liu X, Tasset C, Besuyen R, Watanabe M, Schreiber S, Rogler G, Hibi T, Peyrin-Biroulet L. A15 EFFICACY AND SAFETY OF FILGOTINIB AS INDUCTION THERAPY FOR PATIENTS WITH MODERATELY TO SEVERELY ACTIVE ULCERATIVE COLITIS: RESULTS FROM THE PHASE 2B/3 SELECTION STUDY. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aims
The SELECTION (NCT02914522) Induction Studies evaluated the efficacy/safety of filgotinib (FIL), a preferential JAK1 inhibitor, as induction therapy for patients (pts) with moderately to severely active ulcerative colitis (UC) who were biologic-naïve but failed conventional therapy (Induction Study A) or failed prior biologics (Induction Study B).
Methods
Pts were randomized 2:2:1 to once–daily FIL 200mg, FIL 100mg or placebo (PBO). The primary (clinical remission), key secondary (Mayo Clinic Score [MCS] remission, endoscopic remission, and histologic remission), and exploratory endpoints (MCS response and endoscopic improvement) were assessed at Week 10.
Results
In both studies, baseline demographics and disease characteristics were similar across treatment groups. In Study A, 659 pts were randomized and treated. Baseline mean MCS was 8.6 and 56% had a Mayo endoscopic subscore (ES)=3. A significantly higher proportion of biologic-naïve pts on FIL 200mg achieved clinical remission vs PBO and all key secondary endpoints (Table). In Study B, 689 pts were randomized and treated. Baseline mean MCS was 9.3 and 78% had ES=3. Prior treatment failures were: anti-TNF (86%), vedolizumab (52%) and both (dual-refractory; 43%). A significantly higher proportion of biologic-experienced pts on FIL 200mg achieved clinical remission vs PBO. In Studies A and B, a greater proportion of pts on FIL 200 mg achieved an MCS response and endoscopic improvement vs PBO.
The rates of AEs, serious AEs and discontinuations due to AEs were similar across FIL and PBO groups during induction. In the PBO, FIL 100mg and FIL 200mg groups, serious infections occurred in 0.7%, 0.7% and 0.4% pts in Study A and 1.4%, 1.4% and 0.8% pts in Study B; H Zoster occurred in <1% in both groups for both cohorts.
Conclusions
SELECTION included a high proportion of dual-refractory pts, and pts with severe endoscopic disease. Both doses of FIL were well tolerated. Filgotinib 200mg was effective induction therapy for both biologic-naïve/-experienced pts with moderately to severely active UC.
Funding Agencies
None
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Affiliation(s)
| | - E V Loftus
- Mayo Clinic College of Medicine, Rochester, MN
| | - S Danese
- Humanitas University, Milan, Italy
| | - S Vermeire
- University Hospitals Leuven, Leuven, Belgium
| | - W J Sandborn
- University of California San Diego, La Jolla, CA
| | | | - R Mehta
- Surat Institute of Digestive Science (SIDS), Surat, India
| | - U Seidler
- Hannover Medical School, Hannover, Germany
| | - F Seibold
- Seibold & Partner Crohn’s Colitis Center, Gastroenterological Practice Balsiger, Bern, Switzerland
| | - I Beales
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - H Kim
- Kyung Hee University Hospital, Center for Crohn’s and Colitis, Seoul, Korea (the Republic of)
| | - J McNally
- Gilead Sciences, Inc., Foster City, CA
| | - C Yun
- Gilead Sciences, Inc., Foster City, CA
| | - S Zhao
- Gilead Sciences, Inc., Foster City, CA
| | - X Liu
- Gilead Sciences, Inc., Foster City, CA
| | | | | | - M Watanabe
- Tokyo Medical and Dental University, Tokyo, Japan
| | - S Schreiber
- University Hospital Schleswig-Holstein, Department of Medicine I and Institute for Clinical Molecular Biology, Kiel, Germany
| | - G Rogler
- University Hospital of Zurich, Zurich, Switzerland
| | - T Hibi
- Kitasato University Kitasato Institute Hospital, Center for Advanced IBD Research and Treatment, Tokyo, Japan
| | - L Peyrin-Biroulet
- Lorraine University, Nancy University Hospital and Inserm U1256 NGERE, Vandoeuvre-les-Nancy, France
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24
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Neidleman J, Luo X, George AF, McGregor M, Yang J, Yun C, Murray V, Gill G, Greene WC, Vasquez J, Lee S, Ghosn E, Lynch K, Roan NR. Distinctive features of SARS-CoV-2-specific T cells predict recovery from severe COVID-19. medRxiv 2021:2021.01.22.21250054. [PMID: 33532792 PMCID: PMC7852243 DOI: 10.1101/2021.01.22.21250054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Although T cells are likely players in SARS-CoV-2 immunity, little is known about the phenotypic features of SARS-CoV-2-specific T cells associated with recovery from severe COVID-19. We analyzed T cells from longitudinal specimens of 34 COVID-19 patients with severities ranging from mild (outpatient) to critical culminating in death. Relative to patients that succumbed, individuals that recovered from severe COVID-19 harbored elevated and increasing numbers of SARS-CoV-2-specific T cells capable of homeostatic proliferation. In contrast, fatal COVID-19 displayed elevated numbers of SARS-CoV-2-specific regulatory T cells and a time-dependent escalation in activated bystander CXCR4+ T cells. Together with the demonstration of increased proportions of inflammatory CXCR4+ T cells in the lungs of severe COVID-19 patients, these results support a model whereby lung-homing T cells activated through bystander effects contribute to immunopathology, while a robust, non-suppressive SARS-CoV-2-specific T cell response limits pathogenesis and promotes recovery from severe COVID-19.
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Affiliation(s)
- Jason Neidleman
- Gladstone Institutes, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, CA, USA
| | - Xiaoyu Luo
- Gladstone Institutes, San Francisco, CA, USA
| | - Ashley F. George
- Gladstone Institutes, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, CA, USA
| | - Matthew McGregor
- Gladstone Institutes, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, CA, USA
| | - Junkai Yang
- Department of Medicine, Lowance Center for Human Immunology, Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, CA USA
| | - Victoria Murray
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA, USA
| | - Gurjot Gill
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA, USA
| | - Warner C. Greene
- Gladstone Institutes, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Joshua Vasquez
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Sulggi Lee
- Zuckerberg San Francisco General Hospital and the University of California, San Francisco, CA, USA
| | - Eliver Ghosn
- Department of Medicine, Lowance Center for Human Immunology, Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Department of Pediatrics, Lowance Center for Human Immunology, Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Kara Lynch
- Department of Laboratory Medicine, University of California, San Francisco, CA USA
| | - Nadia R. Roan
- Gladstone Institutes, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, CA, USA
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25
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Routledge I, Epstein A, Takahashi S, Janson O, Hakim J, Duarte E, Turcios K, Vinden J, Sujishi K, Rangel J, Coh M, Besana L, Ho WK, Oon CY, Ong CM, Yun C, Lynch K, Wu AHB, Wu W, Karlon W, Thornborrow E, Peluso MJ, Henrich TJ, Pak JE, Briggs J, Greenhouse B, Rodriguez-Barraquer I. Citywide serosurveillance of the initial SARS-CoV-2 outbreak in San Francisco. Res Sq 2021:rs.3.rs-180966. [PMID: 33564754 PMCID: PMC7872360 DOI: 10.21203/rs.3.rs-180966/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Serosurveillance provides a unique opportunity to quantify the proportion of the population that has been exposed to pathogens. Here, we developed and piloted Serosurveillance for Continuous, ActionabLe Epidemiologic Intelligence of Transmission (SCALE-IT), a platform through which we systematically tested remnant samples from routine blood draws in two major hospital networks in San Francisco for SARS-CoV-2 antibodies during the early months of the pandemic. Importantly, SCALE-IT allows for algorithmic sample selection and rich data on covariates by leveraging electronic medical record data. We estimated overall seroprevalence at 4.2%, corresponding to a case ascertainment rate of only 4.9%, and identified important heterogeneities by neighborhood, homelessness status, and race/ethnicity. Neighborhood seroprevalence estimates from SCALE-IT were comparable to local community-based surveys, while providing results encompassing the entire city that have been previously unavailable. Leveraging this hybrid serosurveillance approach has strong potential for application beyond this local context and for diseases other than SARS-CoV-2.
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26
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Luo YR, Goodnough R, Yun C, Wu AHB, Lynch KL. Establishment of a High-Resolution Liquid Chromatography-Mass Spectrometry Spectral Library for Screening Toxic Natural Products. J Anal Toxicol 2021; 46:303-321. [PMID: 33506876 DOI: 10.1093/jat/bkab015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 11/14/2022] Open
Abstract
Many natural products have biological effects on humans and animals. Poisoning caused by natural products is common in clinical toxicology cases. Liquid chromatography-high-resolution-mass spectrometry (LC-HRMS) has recently emerged as a powerful analytical tool for large-scale target screening, and the application of LC-HRMS can be expanded to evaluate potential natural product poisoning in clinical cases. We report the construction of an LC-HRMS spectral library of 95 natural products commonly implicated in poisoning, and an LC-HRMS assay was validated for definitive detection of natural products in urine and serum samples. For each compound, the limit of detection (LOD) was determined in the analytical range of 1.0 - 1000 ng/mL for urine samples and 0.50 - 500 ng/mL for serum samples. The mean (SD) of matrix effects for urine samples and that for serum samples were both -21% (22%), and the mean (SD) of recovery for serum samples was 89% (26%). The LC-HRMS assay was successfully applied to identify natural products in clinical cases. The spectral library parameters of each compound are provided in the supplementary material to aid other laboratories in identification of unknown natural toxins and development of similar methods on different mass spectrometry platforms.
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Affiliation(s)
- Yiqi Ruben Luo
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Robert Goodnough
- Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
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27
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Zhao K, Zhu H, Campo ERD, Yun C, Ye J, Zhu Z, Zhao W, Zhou J, Wu C, Tang H, Min F, Li L, Lin Q, Xia Y, Li J. OC-0693: Involved-Field Irradiation in Definitive Chemoradiotherapy for Loco-Regional Esophageal Cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00715-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Luo YR, Yun C, Lynch KL, Comstock K. A High-Resolution Liquid Chromatography-Mass Spectrometry Method for Identification of Toxic Natural Products in Clinical Cases. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Many natural products have biological effects on humans and animals. Poisoning caused by natural products is often found in clinical toxicology cases. Liquid chromatography-high-resolution-mass spectrometry (LC-HRMS) has recently emerged as a powerful analytical tool for large-scale target screening, and the application of LC-HRMS can be expanded to solve the clinical cases of natural product poisoning.
Methods
The LC-HRMS method is based on a spectral library of 121 natural products. The spectral library was constructed by analyzing standards either in a Q-TOF mass spectrometer (only MS2 spectra acquired) or in an Orbitrap Tribrid mass spectrometer (MS2 and MS3 spectra acquired).
Results
The LC-HRMS method was verified for the limit of detection (LOD) and matrix effects in both serum and urine matrices. For each compound, the LOD was evaluated from 1.0 ng/ml to 1000 ng/ml for urine samples and from 0.50 ng/ml to 500 ng/ml for serum samples. The matrix effects were determined at three concentration levels andranged from 30.4% to 123.5% for urine samples and from 23.4% to 132.9% for serum samples. The LC-HRMS method was successfully applied to identify the culprits in three clinical cases. In addition, the combined use of MS2 and MS3 spectra enhanced the accuracy of compound identification, in library search reducing the importance of retention time that varies among instruments and consumable lots. In Case 1, the patient presented with paresthesias, arrhythmias, and stiffened arms and legs. The toxic alkaloid aconitine was identified in the serum sample and the extract of herbs that the patient ingested. In Case 2, the patients presented with weakness, dizziness, and vomiting.
The symptoms were caused by mistakenly taking Nicotiana glauca leaves and the alkaloid anabasine was identified as the culprit. In Case 3, the patients were suspected of intoxicated by taking too much extract of lupini beans. The culprit alkaloids from lupini beans lupanine and sparteine were found in the serum samples.
Conclusion
The involvement of a toxicology laboratory with the capability to perform the LC-HRMS method and with experience in the investigation of undifferentiated cases provides a unique diagnostic advantage in cases where exposure to toxic substances is possible.
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Affiliation(s)
- Y R Luo
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
| | - C Yun
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
| | - K L Lynch
- Laboratory Medicine, University of California San Francisco, San Francisco, California, UNITED STATES
| | - K Comstock
- Thermo Fisher Scientific, San Jose, California, UNITED STATES
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29
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Luo YR, Chakraborty I, Yun C, Wu AHB, Lynch KL. Kinetics of SARS-CoV-2 Antibody Avidity Maturation and Association with Disease Severity. Clin Infect Dis 2020; 73:e3095-e3097. [PMID: 32927483 PMCID: PMC7543300 DOI: 10.1093/cid/ciaa1389] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/11/2020] [Indexed: 12/23/2022] Open
Abstract
The kinetics of IgG avidity maturation during SARS-CoV-2 infection was studied. The IgG avidity assay used a novel label-free immunoassay technology. It was found that there was a strong correlation between IgG avidity and days since symptom onset, and peak readings were significantly higher in severe than mild disease cases.
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Affiliation(s)
- Yiqi Ruben Luo
- Department of Laboratory Medicine, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | | | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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30
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van Wijk XMR, Yun C, Hooshfar S, Arens AM, Lung D, Wu AHB, Lynch KL. A Liquid-Chromatography High-Resolution Mass Spectrometry Method for Non-FDA Approved Benzodiazepines. J Anal Toxicol 2019; 43:316-320. [PMID: 30462225 DOI: 10.1093/jat/bky092] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022] Open
Abstract
Benzodiazepines (BZDs) are widely used for treatment of anxiety and insomnia, however, this class of drugs is also commonly abused. Many different BZDs and analogs have been produced that are not FDA-approved. We tested 15 of these with the ThermoFisher CEDIA® BZD-immunoassay. With the exception of ketazolam, all compounds showed significant reactivity, highlighting the need for mass spectrometry confirmation assays. We developed a liquid-chromatography high-resolution mass spectrometry method for the detection of these 15 non-FDA approved BZDs. The limit of detection for most compounds ranged from 1 to 50 ng/mL, with mostly positive matrix effects observed in urine and negative matrix effects in serum. In a clinical research case, clonazolam and etizolam were detected in serum at 10.2 and 281 ng/mL, with an apparent elimination half-life of 3.6 and 4.8 hours, respectively. Although we did not detect non-FDA approved BZDs in 211 urine samples that were previously determined to be BZD-positive by immunoassay, abuse of these drugs is on the rise and clinical and forensic toxicology laboratories should consider developing methods to detect them.
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Affiliation(s)
- Xander M R van Wijk
- Department of Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, 1001 Potrero Ave, ZSFG Bldg 5, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, 1001 Potrero Ave, ZSFG Bldg 5, San Francisco, CA, USA
| | - Shirin Hooshfar
- Department of Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, 1001 Potrero Ave, ZSFG Bldg 5, San Francisco, CA, USA
| | - Ann M Arens
- Department of Emergency Medicine, Hennepin Healthcare, Minneapolis, MN, USA
| | - Derrick Lung
- California Poison Control System, San Francisco Division, CA, USA.,Emergency Medicine, San Mateo Medical Center, San Mateo, CA, USA
| | - Alan H B Wu
- Department of Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, 1001 Potrero Ave, ZSFG Bldg 5, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco and Zuckerberg San Francisco General, 1001 Potrero Ave, ZSFG Bldg 5, San Francisco, CA, USA
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31
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Socinski M, Velcheti V, Mekhail T, Chae Y, Leal T, Dowell J, Tsai M, Dakhil C, Stella P, Shen V, Hu S, Paul S, Shames D, Schleifman E, Fabrizio D, Nowicki M, Yun C, Phan S, Kim E. Final efficacy results from B-F1RST, a prospective phase II trial evaluating blood-based tumour mutational burden (bTMB) as a predictive biomarker for atezolizumab (atezo) in 1L non-small cell lung cancer (NSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.081] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Lynch KL, Luo YR, Hooshfar S, Yun C. Correlation of Breath and Blood Δ9-Tetrahydrocannabinol Concentrations and Release Kinetics Following Controlled Administration of Smoked Cannabis. Clin Chem 2019; 65:1171-1179. [DOI: 10.1373/clinchem.2019.304501] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/18/2019] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
Cannabis use results in impaired driving and an increased risk of motor vehicle crashes. Cannabinoid concentrations in blood and other matrices can remain high long after use, prohibiting the differentiation between acute and chronic exposure. Exhaled breath has been proposed as an alternative matrix in which concentrations may more closely correspond to the window of impairment; however, efficient capture and analytically sensitive detection methods are required for measurement.
METHODS
Timed blood and breath samples were collected from 20 volunteers before and after controlled administration of smoked cannabis. Cannabinoid concentrations were measured using LC-MS/MS to determine release kinetics and correlation between the 2 matrices.
RESULTS
Δ9-Tetrahydrocannabinol (THC) was detected in exhaled breath for all individuals at baseline through 3 h after cannabis use. THC concentrations in breath were highest at the 15-min timepoint (median = 17.8 pg/L) and declined to <5% of this concentration in all participants 3 h after smoking. The decay curve kinetics observed for blood and breath were highly correlated within individuals and across the population.
CONCLUSIONS
THC can be reliably detected throughout the presumed 3-h impairment window following controlled administration of smoked cannabis. The findings support breath THC concentrations as representing a physiological process and are correlated to blood concentrations, albeit with a shorter window of detection.
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Affiliation(s)
- Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
| | - Y Ruben Luo
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
| | - Shirin Hooshfar
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
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33
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Luo YR, Han J, Yun C, Lynch KL. Azo coupling-based derivatization method for high-sensitivity liquid chromatography-tandem mass spectrometry analysis of tetrahydrocannabinol and other aromatic compounds. J Chromatogr A 2019; 1597:109-118. [PMID: 30910385 DOI: 10.1016/j.chroma.2019.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/01/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
An azo coupling-based derivatization method is reported for high-sensitivity liquid chromatography-tandem mass spectrometry (LC-MS/MS) quantitation of tetrahydrocannabinol (THC) and other aromatic compounds, i.e. phenols and amines. Through the azo coupling of a diazonium to an analyte, it produces a derivatized analyte which has enhanced ionization efficiency and results in high-response fragments in tandem mass spectrometry. The derivatization method was applied to six typical aromatic compounds using three different diazonium salts as derivatization reagents, demonstrating its applicability to a variety of analytes and reagents. The derivatization reaction can be directly carried out in neat samples, and after derivatization the samples can be immediately sent to the LC-MS/MS instrument for analysis. These advantages facilitate a one-step sample preparation procedure that can be completed in less than one hour, allowing for a "derivatize & shoot" lab workflow. The derivatization method was applied to establish an LC-MS/MS assay for the quantitation of THC in human breath samples. The derivatization conditions were studied in this application, including the effects of acidity, organic solvent, and diazonium concentration in the reaction. The THC derivatization assay was validated and achieved a limit of quantitation (LOQ) of 0.50 pg/ml using either of the two regio-isomers of the azo-derivative of THC (THC-DRV). To prove that the derivatization method has compatibility with complex-matrix samples, a THC derivatization assay for serum samples was established, in which the azo coupling reaction was directly carried out in crude protein-precipitated supernatants. An LOQ of 5.0 pg/ml was achieved. In addition, excellent correlation between THC derivatization and non-derivatization assays was found in the analysis of whole blood samples.
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Affiliation(s)
- Yiqi Ruben Luo
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
| | - Jichun Han
- Applin Biotech Inc., Hangzhou, Zhejiang, China
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California, San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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Luo YR, Yun C, Lynch KL. Quantitation of Cannabinoids in Breath Samples Using a Novel Derivatization LC–MS/MS Assay with Ultra-High Sensitivity. J Anal Toxicol 2019; 43:331-339. [DOI: 10.1093/jat/bkz023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/10/2019] [Accepted: 02/27/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
As the legalization of medical and recreational marijuana use expands, measurement of tetrahydrocannabinol (THC) in human breath has become an area of interest. The presence and concentration of cannabinoids in breath have been shown to correlate with recent marijuana use and may be correlated with impairment. Given the low concentration of THC in human breath, sensitive analytical methods are required to further evaluate its utility and window of detection. This paper describes a novel derivatization method based on an azo coupling reaction that significantly increases the ionization efficiency of cannabinoids for LC–MS/MS analysis. This derivatization reaction allows for a direct derivatization reaction with neat samples and does not require further sample clean-up after derivatization, thus facilitating an easy and rapid “derivatize & shoot” sample preparation. The derivatization assay allowed for limits of quantitation (LOQ’s) in the sub-pg/mL to pg/mL range for the five cannabinoids in breath samples, i.e., only 5~50 femtograms of an analyte was required for quantitation in a single analysis. This ultrahigh sensitivity allowed for the quantitation of cannabinoids in all breath samples collected within 3 hours of smoking cannabis (n = 180). A linear correlation between THC and cannabinol (CBN) in human breath was observed, supporting the hypothesis that CBN is converted from THC during the combustion of cannabis. The derivatization method was also applied to the analysis of cannabinoids in whole blood samples, achieving LOQ’s at ten-pg/mL to sub-ng/mL level. This azo coupling-based derivatization approach provided the needed analytical sensitivity for the analysis of THC in human breath samples using LC–MS/MS and could be a valuable tool for the analysis of other aromatic compounds in the future.
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Affiliation(s)
- Yiqi Ruben Luo
- Department of Laboratory Medicine, University of California San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Cassandra Yun
- Department of Laboratory Medicine, University of California San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Kara L Lynch
- Department of Laboratory Medicine, University of California San Francisco, and Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
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Yoo J, Yun C, Bui N, Oh J, Nam S. Photoacoustic Monitoring of the Viability of Mesenchymal Stem Cells Labeled with Indocyanine Green. Ing Rech Biomed 2019. [DOI: 10.1016/j.irbm.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Affiliation(s)
- C Yun
- Colleage of Agriculture and Life Sciences, Seoul National University,Seoul, Republic of Korea
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Kim E, Velcheti V, Mekhail T, Leal T, Dowell J, Tsai M, Dakhil C, Stella P, Shen V, Hu S, Paul S, Shames D, Schleifman E, Fabrizio D, Yun C, Phan S, Socinski M. Primary efficacy results from B-F1RST, a prospective phase II trial evaluating blood-based tumour mutational burden (bTMB) as a predictive biomarker for atezolizumab (atezo) in 1L non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.067] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yoon J, Lee E, Lee S, Jung K, Park S, Shin C, Thomas R, Yun C. 0710 Sleep EEG Spectral Power Characteristics According to Age and Gender in Middle-to-Late Adulthood. Sleep 2018. [DOI: 10.1093/sleep/zsy061.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Yoon
- Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
| | - E Lee
- Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
| | - S Lee
- Korea University Ansan Hospital, Ansan, KOREA, REPUBLIC OF
| | - K Jung
- Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
| | - S Park
- Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
| | - C Shin
- Korea University Ansan Hospital, Ansan, KOREA, REPUBLIC OF
| | - R Thomas
- Beth Israel Deaconess Medical Center, Boston, MA
| | - C Yun
- Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
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Yang K, Sunwoo J, Hwangbo Y, Kim W, Chu M, Yun C. 0507 Prevalence, Sleep Characteristics, And Comorbidity Of High Risk For Obstructive Sleep Apnea: A Nationwide Questionnaire Study In South Korea. Sleep 2018. [DOI: 10.1093/sleep/zsy061.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, KOREA, REPUBLIC OF
| | - J Sunwoo
- Department of Neurology, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, KOREA, REPUBLIC OF
| | - Y Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, KOREA, REPUBLIC OF
| | - W Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, KOREA, REPUBLIC OF
| | - M Chu
- Department of Neurology, Hallym University College of Medicine, Seoul, KOREA, REPUBLIC OF
| | - C Yun
- Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
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Im H, Yun C. 0656 Association With Corrected Social Jetlag And Hyperlipidemia Among Korean Population. Sleep 2018. [DOI: 10.1093/sleep/zsy061.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Im
- Hangang Sacred Heart Hospital, Hallym University, Seoul, KOREA, REPUBLIC OF
| | - C Yun
- Seoul National University Bundang Hospital, Seongnam, KOREA, REPUBLIC OF
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Park J, Choi H, Yoon J, Yoon S, Yun C. 0318 Comparison on Feature Extraction Methodologies for Sleepiness Detection Using Electroencephalography. Sleep 2018. [DOI: 10.1093/sleep/zsy061.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Park
- Seoul National University Bundang Hospital, Seong Nam, KOREA, REPUBLIC OF
| | - H Choi
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, KOREA, REPUBLIC OF
| | - J Yoon
- Seoul National University Bundang Hospital, Seong Nam, KOREA, REPUBLIC OF
| | - S Yoon
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, KOREA, REPUBLIC OF
| | - C Yun
- Seoul National University Bundang Hospital, Seong Nam, KOREA, REPUBLIC OF
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Thomas RJ, Kim H, Yun C, Kim S, Kim E, Lee S, Shin C. 0966 Dipping Pattern of Nocturnal Blood Pressure and Depressive Symptoms. Sleep 2018. [DOI: 10.1093/sleep/zsy061.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R J Thomas
- Beth Israel Deaconess Medical Center, Boston, MA
| | - H Kim
- Boston University, Boston, MA
| | - C Yun
- Seoul National University Bundang Hospital, Seoul, KOREA, REPUBLIC OF
| | - S Kim
- Institute of Human Genomic Study, Ansan, KOREA, REPUBLIC OF
| | - E Kim
- Institute of Human Genomic Study, Ansan, KOREA, REPUBLIC OF
| | - S Lee
- Institute of Human Genomic Study, Ansan, KOREA, REPUBLIC OF
| | - C Shin
- Institute of Human Genomic Study, Ansan, KOREA, REPUBLIC OF
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He P, Chen G, Wang Z, Guo C, Li N, Yun C, Zheng X. Adults with intellectual disabilities in China: comorbid psychiatric disorder and its association with health service utilisation. J Intellect Disabil Res 2018; 62:106-114. [PMID: 29178565 DOI: 10.1111/jir.12451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 10/09/2017] [Accepted: 10/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adults with intellectual disabilities (ID) often have multiple comorbidities. Psychiatric disorders in this population have been poorly studied in developing countries. We aimed to investigate the prevalence of psychiatric disorders in adults with ID and whether comorbid psychiatric disorders were associated with health service utilisation. METHODS We obtained data from the Second National Sample Survey on Disability, conducted in 31 provinces of China and selected a subsample of 13 631 adults aged 18 years and above with ID. ID were defined by intelligence quotient score under 70, deficits in two or more adaptive behaviours and age of onset under 18 years. Psychiatric disorders were identified according to the International Statistical Classification of Diseases, Tenth Revision. Logistic regressions were used for data analyses. RESULTS The prevalence of psychiatric disorders in adults with ID was 16.7%. The most prevalent type of psychiatric disorder was dementia. Older adults, females, being minorities, urban residents, being literate, low-income groups and having severe ID, were associated with elevated risk of psychiatric disorder among adults with ID. Compared with individuals without psychiatric disorders, those with comorbid psychiatric disorders were more likely to use medical service and less likely to use rehabilitation service. CONCLUSIONS The prevalence of psychiatric disorder in adults with ID was strikingly higher than that in the general population. Health service utilisation among Chinese adults with ID remained a big challenge. There is a possibility of diagnostic overshadowing by local clinicians, which may have resulted in overdiagnosis of dementia and underdiagnosis of common mental disorders. This study informs further investigations regarding common mental disorders among people with ID and has implications for public health strategies and health policies to meet health service need for this population.
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Affiliation(s)
- P He
- Institute of Population Research, Peking University, Beijing, China
| | - G Chen
- Institute of Population Research, Peking University, Beijing, China
| | - Z Wang
- Institute of Population Research, Peking University, Beijing, China
| | - C Guo
- Institute of Population Research, Peking University, Beijing, China
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - N Li
- Institute of Population Research, Peking University, Beijing, China
| | - C Yun
- Institute of Population Research, Peking University, Beijing, China
| | - X Zheng
- Institute of Population Research, Peking University, Beijing, China
- APEC Health Science Academy (HeSAY), Peking University, Beijing, China
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de Marinis F, Barlesi F, Rittmeyer A, von Pawel J, Han JY, Kozloff M, Spira A, Fehrenbacher L, Gandara D, Yu W, He P, Yun C, Ballinger M, Gandhi M, Gadgeel S. Survival and safety of atezolizumab by best overall response (BOR) in the phase III NSCLC OAK study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Mok T, Gadgeel S, Kim E, Velcheti V, Hu S, Riehl T, Schleifman E, Paul S, Mocci S, Shames D, Phan S, Yun C, Mathisen M, Kowanetz M, Sweere U, Socinski M. Blood first line ready screening trial (B-F1RST) and blood first assay screening trial (BFAST) enable clinical development of novel blood-based biomarker assays for tumor mutational burden (TMB) and somatic mutations in 1L advanced or metastatic NSCLC. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kim H, Thomas RJ, Kim S, Yun C, Au R, Lee S, Shin C. 0287 HABITUAL SLEEP DURATION, DEPRESSION SYMPTOMS, AND NEUROPSYCHOLOGICAL PERFORMANCE IN MIDDLE-AGED AND OLDER ADULTS: FINDINGS FROM A KOREAN COMMUNITY SAMPLE. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Yoon J, Kim T, Lee S, Chu M, Yang K, Kim W, Park S, Shin C, Yun C. 0741 PREVALENCE AND CHARACTERISTICS OF RESTLESS LEGS SYNDROME IN KOREAN ADULTS: THE STUDY ON TWO-INDEPENDENT POPULATIONS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chern J, Frey M, Musa F, Alard A, Yun C, Kahler D, Curtin J, Blank S, Schneider R. The efficacy of mTORC1/2 inhibition on ovarian cancer stem cells. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Im H, Baek S, Yun C, Park S. The causal link between epilepsy and sleep disturbance. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Baik I, Yun C, Yoon D, Shin C. Associations of subjective and objective assessments of snoring, telomere shortening, and a missense mutation in the SCN2B gene in a population-based study. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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