Mild SARS-CoV-2 infection in rhesus macaques is associated with viral control prior to antigen-specific T cell responses in tissues

SARS-CoV-2 primarily replicates in mucosal sites, and more information is needed about immune responses in infected tissues. Here, we used rhesus macaques to model protective primary immune responses in tissues during mild COVID-19. Viral RNA levels were highest on days 1-2 post-infection and fell precipitously thereafter. 18F-fluorodeoxyglucose (FDG)-avid lung abnormalities and interferon (IFN)-activated monocytes and macrophages in the bronchoalveolar lavage (BAL) were found on days 3-4 post-infection. Virus-specific effector CD8+ and CD4+ T cells became detectable in the BAL and lung tissue on days 7-10, after viral RNA, radiologic evidence of lung inflammation, and IFN-activated myeloid cells had substantially declined. Notably, SARS-CoV-2-specific T cells were not detectable in the nasal turbinates, salivary glands, and tonsils on day 10 post-infection. Thus, SARS-CoV-2 replication wanes in the lungs of rhesus macaques prior to T cell responses, and in the nasal and oral mucosa despite the apparent lack of antigen-specific T cells, suggesting that innate immunity efficiently restricts viral replication during mild COVID-19.

Tissue Trafficking Kinetics of Rhesus Macaque Natural Killer Cells Measured by Serial Intravascular Staining

The in vivo tissue distribution and trafficking patterns of natural killer (NK) cells remain understudied. Animal models can help bridge the gap, and rhesus macaque (RM) primates faithfully recapitulate key elements of human NK cell biology. Here, we profiled the tissue distribution and localization patterns of three NK cell subsets across various RM tissues. We utilized serial intravascular staining (SIVS) to investigate the tissue trafficking kinetics at steady state and during recovery from CD16 depletion. We found that at steady state, CD16+ NK cells were selectively retained in the vasculature while CD56+ NK cells had a shorter residence time in peripheral blood. We also found that different subsets of NK cells had distinct trafficking kinetics to and from the lymph node as well as other lymphoid and non-lymphoid tissues. Lastly, we found that following administration of CD16-depleting antibody, CD16+ NK cells and their putative precursors retained a high proportion of continuously circulating cells, suggesting that regeneration of the CD16 NK compartment may take place in peripheral blood or the perivascular compartments of tissues.

Phase I study of single agent NIZ985, a recombinant heterodimeric IL-15 agonist, in adult patients with metastatic or unresectable solid tumors

Background

NIZ985 is a recombinant heterodimer of physiologically active interleukin (IL-)15 and IL-15 receptor alpha. In preclinical models, NIZ985 promotes cytotoxic lymphocyte proliferation, killing function, and organ/tumor infiltration, with resultant anticancer effects. In this first-in-human study, we assessed the safety, pharmacokinetics, and immune effects of NIZ985 in patients with metastatic or unresectable solid tumors.

Methods

Single agent NIZ985 dose escalation data are reported from a phase I dose escalation/expansion study of NIZ985 as monotherapy. Adult patients (N=14) received 0.25, 0.5, 1, 2 or 4 µg/kg subcutaneous NIZ985 three times weekly (TIW) for the first 2 weeks of each 28-day cycle, in an accelerated 3+3 dose escalation trial design. IL-15 and endogenous cytokines were monitored by ELISA and multiplexed electrochemiluminescent assays. Multiparameter flow cytometry assessed the frequency, phenotype and proliferation of peripheral blood mononuclear cells. Preliminary antitumor activity was assessed by overall response rate (Response Evaluation Criteria in Solid Tumors V.1.1).

Results

As of March 2, 2020, median treatment duration was 7.5 weeks (range 1.1–77.1). Thirteen patients had discontinued and one (uveal melanoma) remains on treatment with stable disease. Best clinical response was stable disease (3 of 14 patients; 21%). The most frequent adverse events (AEs) were circular erythematous injection site reactions (100%), chills (71%), fatigue (57%), and fever (50%). Treatment-related grade 3/4 AEs occurred in six participants (43%); treatment-related serious AEs (SAEs) in three (21%). The per-protocol maximum tolerated dose was not reached. Pharmacokinetic accumulation of serum IL-15 in the first week was followed by significantly lower levels in week 2, likely due to more rapid cytokine consumption by an expanding lymphocyte pool. NIZ985 treatment was associated with increases in several cytokines, including interferon (IFN)-γ, IL-18, C-X-C motif chemokine ligand 10, and tumor necrosis factor-β, plus significant induction of cytotoxic lymphocyte proliferation (including natural killer and CD8⁺ T cells), increased CD16⁺ monocytes, and increased CD163⁺ macrophages at injection sites.

Conclusions

Subcutaneous NIZ985 TIW was generally well tolerated in patients with advanced cancer and produced immune activation paralleling preclinical observations, with induction of IFN-γ and proliferation of cytotoxic lymphocytes. Due to delayed SAEs at the two highest dose levels, administration is being changed to once-weekly in a revised protocol, as monotherapy and combined with checkpoint inhibitor spartalizumab. These alterations are expected to maximize the potential of NIZ985 as a novel immunotherapy.

Trial registration number

NCT02452268.

Spatiotemporal single-cell profiling reveals that invasive and tissue-resident memory donor CD8+ T cells drive gastrointestinal acute graft-versus-host disease

Organ infiltration by donor T cells is critical to the development of acute graft-versus-host disease (aGVHD) in recipients after allogeneic hematopoietic stem cell transplant (allo-HCT). However, deconvoluting the transcriptional programs of newly recruited donor T cells from those of tissue-resident T cells in aGVHD target organs remains a challenge. Here, we combined the serial intravascular staining technique with single-cell RNA sequencing to dissect the tightly connected processes by which donor T cells initially infiltrate tissues and then establish a pathogenic tissue residency program in a rhesus macaque allo-HCT model that develops aGVHD. Our results enabled creation of a spatiotemporal map of the transcriptional programs controlling donor CD8⁺ T cell infiltration into the primary aGVHD target organ, the gastrointestinal (GI) tract. We identified the large and small intestines as the only two sites demonstrating allo-specific, rather than lymphodepletion-driven, T cell infiltration. GI-infiltrating donor CD8⁺ T cells demonstrated a highly activated, cytotoxic phenotype while simultaneously developing a canonical tissue-resident memory T cell (T_RM) transcriptional signature driven by interleukin-15 (IL-15)/IL-21 signaling. We found expression of a cluster of genes directly associated with tissue invasiveness, including those encoding adhesion molecules (ITGB2), specific chemokines (CCL3 and CCL4L1) and chemokine receptors (CD74), as well as multiple cytoskeletal proteins. This tissue invasion transcriptional signature was validated by its ability to discriminate the CD8⁺ T cell transcriptome of patients with GI aGVHD from those of GVHD-free patients. These results provide insights into the mechanisms controlling tissue occupancy of target organs by pathogenic donor CD8⁺ T_RM cells during aGVHD in primate transplant recipients.

Measurement of leukocyte trafficking kinetics in macaques by serial intravascular staining

Leukocyte trafficking enables detection of pathogens, immune responses, and immune memory. Dysregulation of leukocyte trafficking is often found in disease, highlighting its important role in homeostasis and the immune response. Whereas some of the molecular mechanisms mediating leukocyte trafficking are understood, little is known about the regulation of trafficking, including trafficking kinetics and its impact on immune homeostasis. We developed a method of serial intravascular staining (SIVS) to measure trafficking kinetics in nonhuman primates using infusions of fluorescently labeled antibodies to label circulating leukocytes. Because antibody infusions labeled only leukocytes in the blood, cells were "barcoded" according to their location at the time of each infusion, providing positional histories that could be used to infer trafficking kinetics. We used SIVS and multiparameter flow cytometry to quantitate cellular trafficking into lymphoid tissues of healthy animals at homeostasis and to identify perivascular cells that could be unique to nonlymphoid organs. To investigate how these parameters could be influenced during disease, SIVS was used to quantify lymphocyte trafficking in macaques infected with the bacterial pathogen Mycobacterium tuberculosis and to enumerate intravascular leukocytes in lung granulomas. We showed that whereas most cells in lung granulomas were localized there for more than 24 hours, granulomas were dynamic with a slow continual cellular influx, the rate of which predicted clearance of M. tuberculosis from the granulomas. SIVS, in combination with intracellular staining and multiparametric flow cytometry, is a powerful method to quantify the kinetics of leukocyte trafficking in nonhuman primates in vivo.

IL15 by Continuous Intravenous Infusion to Adult Patients with Solid Tumors in a Phase I Trial Induced Dramatic NK-Cell Subset Expansion

PURPOSE

The first-in-human clinical trial with human bolus intravenous infusion IL15 (rhIL15) was limited by treatment-associated toxicity. Here, we report toxicity, immunomodulation, and clinical activity of rhIL15 administered as a 10-day continuous intravenous infusion (CIV) to patients with cancers in a phase I trial.

PATIENTS AND METHODS

Patients received treatment for 10 days with CIV rhIL15 in doses of 0.125, 0.25, 0.5, 1, 2, or 4 μg/kg/day. Correlative laboratory tests included IL15 pharmacokinetic (PK) analyses, and assessment of changes in lymphocyte subset numbers.

RESULTS

Twenty-seven patients were treated with rhIL15; 2 μg/kg/day was identified as the MTD. There were eight serious adverse events including two bleeding events, papilledema, uveitis, pneumonitis, duodenal erosions, and two deaths (one due to likely drug-related gastrointestinal ischemia). Evidence of antitumor effects was observed in several patients, but stable disease was the best response noted. Patients in the 2 μg/kg/day group had a 5.8-fold increase in number of circulating CD8⁺ T cells, 38-fold increase in total NK cells, and 358-fold increase in CD56^bright NK cells. Serum IL15 concentrations were markedly lower during the last 3 days of infusion.

CONCLUSIONS

This phase I trial identified the MTD for CIV rhIL15 and defined a treatment regimen that produced significant expansions of CD8⁺ T and NK effector cells in circulation and tumor deposits. This regimen has identified several biological features, including dramatic increases in numbers of NK cells, supporting trials of IL15 with anticancer mAbs to increase antibody-dependent cell-mediated cytotoxicity and anticancer efficacy.

Rationally designed carbohydrate-occluded epitopes elicit HIV-1 Env-specific antibodies

An array of carbohydrates masks the HIV-1 surface protein Env, contributing to the evasion of humoral immunity. In most HIV-1 isolates ‘glycan holes’ occur due to natural sequence variation, potentially revealing the underlying protein surface to the immune system. Here we computationally design epitopes that mimic such surface features (carbohydrate-occluded neutralization epitopes or CONE) of Env through ‘epitope transplantation’, in which the target region is presented on a carrier protein scaffold with preserved structural properties. Scaffolds displaying the four CONEs are examined for structure and immunogenicity. Crystal structures of two designed proteins reflect the computational models and accurately mimic the native conformations of CONEs. The sera from rabbits immunized with several CONE immunogens display Env binding activity. Our method determines essential structural elements for targets of protective antibodies. The ability to design immunogens with high mimicry to viral proteins also makes possible the exploration of new templates for vaccine development.

Areas of HIV envelope (Env) that aren’t covered by glycans are potential targets for antibodies. Here, the authors computationally design small protein mimics of four such epitopes and show that they can induce Env binding antibodies in rabbits.

Delineating tissue-specific alloimmunity during acute GVHD

After allogeneic hematopoietic cell transplantation (allo-HCT), donor T cells undergo priming in secondary lymphoid tissues followed by migration to different target organs, where they mediate inflammation and cause acute Graft-versus-Host Disease (aGVHD). Here, we characterized T cells infiltrating GVHD-target organs using a model of aGVHD in non-human primates in order to delineate tissue-specific patterns of the alloimmune response. We found that aGVHD profoundly shifted the T cell phenotype from the naïve state toward an effector-memory state in both the blood and secondary lymphoid organs, with an attenuated shift in non-lymphoid organs. However, in all compartments, tissue-infiltrating T cells demonstrated an aGVHD-specific activated phenotype characterized by a high rate of proliferation and elevated effector functions. In addition, transcriptomic profiles of aGVHD- and tissue-residency developed in T cells residing the colon, liver and lungs as well as in the blood. To further delineate the patterns of T cell trafficking and activation during aGVHD, we directly labeled leukocytes in vivo using fluorescent anti-CD45 antibodies. Using this approach, we detected notable changes in T cell trafficking patterns which included increased T cell trafficking to lymph nodes, lungs and kidneys after allo-HCT, with rates of T cell migration to the GI tract unchanged even during aGVHD. These data provides novel insights into the spatial organization of systemic alloimmunity during aGVHD and the organ-specific impact of this disease on T cell trafficking, activation and functional maturation.

Geographic clonal tracking in macaques provides insights into HSPC migration and differentiation

Wu et al. use barcode tracking to uncover prolonged geographic bone marrow segregation of regenerating hematopoietic stem and progenitor cell clones after transplantation and provide evidence for local bone marrow production of T cells.

The geographic distribution of hematopoiesis at a clonal level is of interest in understanding how hematopoietic stem and progenitor cells (HSPCs) and their progeny interact with bone marrow (BM) niches during regeneration. We tagged rhesus macaque autologous HSPCs with genetic barcodes, allowing clonal tracking over time and space after transplantation. We found marked geographic segregation of CD34⁺ HSPCs for at least 6 mo posttransplantation, followed by very gradual clonal mixing at different BM sites over subsequent months to years. Clonal mapping was used to document local production of granulocytes, monocytes, B cells, and CD56⁺ natural killer (NK) cells. In contrast, CD16⁺CD56⁻ NK cells were not produced in the BM, and in fact were clonally distinct from multipotent progenitors producing all other lineages. Most surprisingly, we documented local BM production of CD3⁺ T cells early after transplantation, using both clonal mapping and intravascular versus tissue-resident T cell staining, suggesting a thymus-independent T cell developmental pathway operating during BM regeneration, perhaps before thymic recovery.

Comparison of viral Env proteins from acute and chronic infections with subtype C human immunodeficiency virus type 1 identifies differences in glycosylation and CCR5 utilization and suggests a new strategy for immunogen design

Understanding human immunodeficiency virus type 1 (HIV-1) transmission is central to developing effective prevention strategies, including a vaccine. We compared phenotypic and genetic variation in HIV-1 env genes from subjects in acute/early infection and subjects with chronic infections in the context of subtype C heterosexual transmission. We found that the transmitted viruses all used CCR5 and required high levels of CD4 to infect target cells, suggesting selection for replication in T cells and not macrophages after transmission. In addition, the transmitted viruses were more likely to use a maraviroc-sensitive conformation of CCR5, perhaps identifying a feature of the target T cell. We confirmed an earlier observation that the transmitted viruses were, on average, modestly underglycosylated relative to the viruses from chronically infected subjects. This difference was most pronounced in comparing the viruses in acutely infected men to those in chronically infected women. These features of the transmitted virus point to selective pressures during the transmission event. We did not observe a consistent difference either in heterologous neutralization sensitivity or in sensitivity to soluble CD4 between the two groups, suggesting similar conformations between viruses from acute and chronic infection. However, the presence or absence of glycosylation sites had differential effects on neutralization sensitivity for different antibodies. We suggest that the occasional absence of glycosylation sites encoded in the conserved regions of env, further reduced in transmitted viruses, could expose specific surface structures on the protein as antibody targets.

HEREDITY OF THE Rh BLOOD TYPES : II. OBSERVATIONS ON THE RELATION OF FACTOR HR TO THE RH BLOOD TYPES

1. The theory of six allelic genes is reviewed, using the new improved nomenclature, and data are summarized regarding the distributions of the eight Rh types among white and negro individuals in New York City. 2. Results are presented of tests for property Hr in a series of 239 white individuals and 49 negroes. Statistical analysis of these data yields results supporting Race and Taylor's hypothesis that anti-Hr sera react with the blood properties determined by the genes Rh₂, Rh'' Rh_o, and rh, but not with the factors determined by genes Rh₁ and Rh'. 3. The practical importance of the Hr factor is discussed.

Effect of monensin on the performance of cattle on pasture or fed harvested forages in confinement

Three series of trials were conducted to evaluate the effect of monensin on the growth performance of cattle. Twenty-four trials were conducted to evaluate the addition of monensin at 200 mg/d to limited quantities of supplemental concentrate for growing cattle grazing pastures. The pastures ranged from dormant end-of-the-season grasses and crop residues to lush green pastures, and were located in several different states. Pasture plus supplement supported gains of control cattle (without monensin) of .24 to .96 kg, with an average of .56 kg/d. The addition of 200 mg monensin to the supplement increased daily gain in all 24 trials by an average of .09 kg daily (+16.3%). Eleven trials were conducted with monensin and energy supplements fed at .907 kg.- head-1 X d-1 to growing cattle grazing growing, nondormant pastures for an average period of 117 d. Each trial was designed to compare the performance of unsupplemented cattle, cattle fed a supplement and cattle fed a supplement with monensin. Cattle on pasture gained .50 kg daily. Supplement feeding increased average daily gain by .09 kg and the addition of monensin to the supplement further increased gain by .09 kg, for a total increase of .18 kg (34.2%). The efficiencies with which supplemental feed was converted to extra gain (kg supplement/kg gain) for the supplement-only and the monensin treatment groups were 10.1:1 and 5.0:1, respectively. In a series of 12 trials, monensin was added at a level of 33 mg/kg air-dry diet to limited quantities of supplemental feed for cattle fed harvested forages in confinement. All trials compared monensin feeding with a nonmedicated control treatment. Hay was fed in 8 of the 12 trials, fresh-cut green-chop in two trials and ensiled corn stover and ensiled milo stover in one trial each. Monensin reduced feed intake by -3.1%, improved average daily gain by .09 kg (+14.4%) and improved feed efficiency by 15.3%.

Administration of monensin in self-fed (salt limiting) dry supplements or on an alternate-day feeding schedule

Two series of trials were conducted to evaluate alternative methods of administering monensin to pasture cattle. In a series of five trials, monensin was incorporated into supplements at 440 mg/kg to provide an average intake of 200 mg X head-1 X d-1 for growing cattle on pasture. Comparisons were made between daily and alternate-day feeding of the supplements. A control treatment consisting of unmedicated supplement fed daily also was included. Monensin at 200 mg/d and 400 mg on alternate days increased gain by .077 (P less than .01) and .082 (P less than .01) kg/d above control-cattle gains (.54 kg daily). Nine pasture trials were conducted to compare the effectiveness of monensin in increasing the daily gain of growing cattle when hand-fed daily in a supplement or self-fed in supplements that contained salt to regulate supplement intake. Desired supplement intakes were approximately .454 kg X head-1 X d-1 in six trials, .68 kg/d in one trial and 1.81 kg/d in two trials. Monensin produced gain increases of .09 kg daily (P less than .01) with both feeding systems. The daily gains of cattle that were hand-fed and self-fed were equal (P greater than .10). Self-fed treatments containing monensin required fewer changes in salt level than self-fed treatments not containing monensin, and the salt levels required to limit intake were generally 25 to 50% lower when monensin was in the supplement.

Effect of monensin and tylosin on average daily gain, feed efficiency and liver abscess incidence in feedlot cattle

Fourteen trials were conducted to evaluate the effects of feeding monensin at 33 ppm alone, tylosin at 11 ppm alone and the two feed additives in combination on the average daily gain, average daily feed intake, feed:gain ratio and the incidence of liver abscesses in feedlot cattle. Monensin reduced feed intake and improved feed efficiency (P less than .05), and had no effect on average daily gain. Tylosin improved average daily gain (P less than .05) and had no effect on daily feed intake. The effect of tylosin on feed efficiency approached significance. The interaction of monensin and tylosin was nonsignificant for daily gain, daily feed intake and feed:gain ratio. Monensin had no effect on liver abscess incidence, while tylosin reduced abscess incidence from 27 to 9%.

Monensin toxicity in cattle

Monensin has been tested to determine its toxicity and safety in cattle. Single dose acute toxicity and signs associated with toxicity were determined by oral gavage, 7-d oral gavage and feeding experiments with high concentrations of monensin in feed. Oral feeding studies indicated a near complete anorexia resulting from intake of sublethal amounts of monensin. In these cases, cattle recovered from the insulting dose and resumed growth and feed intake. In long-term chronic feedlot, pasture supplement, and reproduction safety studies conducted with monensin administered in the feed, the high concentrations caused cattle to show signs of mild monensin intoxication. Mortality resulted from feeding groups of cattle large quantities of monensin in small quantities of feed. Furthermore, these studies have demonstrated no detrimental effects upon reproduction. Collectively, these studies indicate that the greatest risk of intoxication occurs when cattle first receive a feed containing monensin. Mixing errors and misuse situations under actual use conditions have resulted in cases of cattle mortality. In most cases the mortality was predictable based upon the exposure in controlled studies.

Effects of monensin fed to replacement dairy heifers during the growing and gestation period upon growth, reproduction, and subsequent lactation

Sixty Holstein heifers initially weighing 196 kg were assigned by weight to treatments of 0, 200, and 600 mg of monensin. These treatments were fed daily until calving to determine effects of monensin on growth rate, feed consumption, feed efficiency, reproductive performance, and subsequent lactation. Throughout the feeding period the control (0 mg) heifers received sufficient feed to allow a calculated growth rate of .68 kg/day. Monensin treatment groups were fed the same amount of the identical ration over the 448-day experiment. Daily gain, feed intake, and feed efficiency for the 0, 200, and 600 mg treatments were .60, .69, .69 kg, 7.47, 7.46, 7.43 kg, and 12.41, 10.81, 10.81. Although days on trial to first estrus were not different among treatment groups, heifers fed monensin at 200 and 600 mg/day conceived 38 and 34 days sooner than 0 mg heifers. Percent conception, number of calves born, calf birth weight, and calving difficulty were not affected by treatment. Milk production was measured for 120 days subsequent to the experimental feeding of monensin. During this period heifers were fed a common ration ad libitum. Milk production of 17.1, 16.9, and 17.0 kg/day for 0, 200, and 600 mg was not affected by prior treatment.

Effects of changes in feed level, starvation, and level of feed after starvation upon the concentration of rumen protozoa in the ovine

Four rumen fistulated sheep were used in five experiments to investigate the effect of feed level upon the concentration of rumen ciliate protozoa. The sheep were fed once daily 650 g of a pelleted diet composed of corn cobs, 45%; alfalfa meal, 35%; oats, 12.5%; cane molasses, 5%; urea, 0.4%; and vitamins and minerals, 2%. The concentration of protozoa reached minimum and maximum values at 5 and 22.5 h after feeding, respectively. Thus, to estimate apparent generation rates, concentrations of protozoa were determined at 5 and 20 h postfeeding. Apparent generation rate/h = natural log of ([concentration of protozoa at 20 h divided by concentration at 5 h] divided by the time interval, [T20 to T5]). Alteration of the feed to protozoa ratio by starvation and by changing the level of feed (200 to 900 g/day) showed that as the ratio of feed to protozoa increased, generation rate increased. Measurements of liquid turnover rates in the rumen showed that turnover rate decreased as feed level decreased. Turnover rate was near zero when the sheep were starved. Small quantities of soluble substrates, added directly to the rumen of starved sheep, maintained the protozoal population when rumen turnover was minimal. Furthermore, as rumen turnover rate increased with increased levels of feed, the effect of substrate on maintaining the protozoal population was negated. Thus, at high feed levels, turnover rate may be the dominant factor controlling the establishment and concentration of protozoa in the rumen.

Neuroblastoma, Ganglioneuroma and Fibroneuroma in a Stillborn Fetus

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